Richard Mabry - Medical Error

Nick shifted the wicker basket from his left hand to his right. The woman at the deli had sold him the picnic hamper for what she'd termed a bargain price, probably because he'd spent so much on the food in it. He wasn't sure what made him think he could make this crazy idea work. After all, he'd told Anna only yesterday that he'd be tied up today. She probably had her day all planned out-a day without him. But after doing the frozen section, after hammering out the stack of stuffon his desk that he'd put offfor a week, he found that he missed her. He wanted to talk to her, be with her, even smell the floral scent of her shampoo. The way he felt about her… it was different than anything he'd ever felt about a woman. And he liked it.

The front door swung open and Anna stood there smiling at him. She was dressed casually: simple skirt and blouse, sandals. Her red hair was pulled back with a band that matched her green eyes. "You're just full of surprises, aren't you?"

"I like to keep you guessing," Nick said. He hefted the basket."Can I put this down somewhere? I think the lady at the deli threw in some lead weights when my back was turned."

Anna beckoned him in. "Sure. Bring it into the living room. We'll set up a picnic on the coffee table."

Nick pulled a red checked cloth offthe top of the basket and handed it to Anna. "When Nick Valentine brings a picnic, he brings everything except the ants."

"Where did you get all this?" Anna asked. "Red checked tablecloth, picnic hamper, goodies. This is like something out of a movie."

Nick shrugged an "it was nothing" gesture. "I'd heard about this little deli in Highland Park. Family owned, been there for years. I decided to pick up a couple of sandwiches and call you to see if you wanted to share them with me." He shrugged. "I ended up buying all this."

"It's wonderful. But there's so much food."

"As I told you, any leftover food won't be wasted. As for the basket and tablecloth, maybe you can keep them for our next picnic."

Nick wondered why he'd said that. It sounded brash, assuming that there'd be more picnics, more time together. Don't rush her. Take it easy. Be cool.

Anna scooped a pile of mail offthe coffee table. "Let me clear this offso I can spread the cloth." Two letters on the bottom of the pile slipped from her grasp and fell to the floor.

Nick set the basket on the floor and stooped to retrieve the mail. "Let me get those." One letter had landed address side up, and his eyes brushed across the return address: Metro Clinical Laboratories. "This looks like a lab report."

Anna smoothed the wrinkles from the cloth and began to pull items from the hamper. "Oh, that's probably mine. I had my annual physical a couple of weeks ago. I suppose my doctor ordered some kind of new test that the lab at the med center wasn't set up to do yet, so he sent it to an outside lab."

Nick frowned, but hurried to erase it before Anna looked up. "You know, I'm in the pathology department. If there's a test out there that we can't run, I haven't heard about it."

"Well, Dr. Pathologist, in that case, why don't you open it and see what it is? And if I have trouble interpreting the results, I've got an expert on hand."

Nick fumbled with the envelope. "Are you sure, Anna?" There was no levity in his voice now. "This is confidential stuff. Look." He held out the envelope and pointed to the large red letters in the lower-right-hand corner: CONFIDENTIAL.

"I don't mind if you know my cholesterol or my triglyceride or whatever. Go ahead. I almost have our picnic set up, and I don't want to stop."

Nick ran his finger under the flap and pulled out a single sheet of paper. He scanned the results with a practiced eye. Then he looked at the top of the page and double-checked the name and address of the patient. Finally, he asked, "What's your date of birth?"

"Why do you ask?"

"Just making sure this is really your report."

For the first time, Anna looked up. "July seventh."

"That matches." Nick said. "Did your doctor talk with you about ordering any unusual tests?"

"Nick, you're scaring me," Anna said. "What is it?"

He handed the report to her. "You'd better see this yourself."

Anna put down the loaf of sliced sourdough bread she was holding and looked down at the report in her hand. "Why did Dr. Reed order these? And why were they sent to a lab outside the medical center? The names of the tests are vaguely familiar, but I can't quite place them."

Nick eased onto the sofa and patted the cushion beside him."Anna, sit down."

She sank into the seat, the picnic forgotten. "I don't understand," she said.

"Let me take your questions in order." Nick's voice was quiet, his tone sober. This wasn't the Nick who'd walked in her front door a few moments ago, the one who made her perk up. He'd changed. And it wasn't good. "First, Dr. Reed must have ordered these tests because he had reason to suspect a serious illness."

"What kind of-"

"I'll get to that. Second, he probably sent them to an outside lab because he was being considerate. By and large, our lab personnel at the medical center are professionals. They respect patient confidentiality. But sometimes they let things slip. He didn't want this information to get out."

Anna took a deep breath. She couldn't recall feeling this way since she waited for the dean's office to post the list of those who'd passed their courses and would receive their MD degree. When the list went up, she almost turned away without reading it. She ached to know the verdict but was afraid of what she'd see.

"Anna, are you okay?" There was concern in Nick's voice."Can I get you something to drink?"

"No, I'll be fine. Go on." Anna tried to swallow, to move her heart out of her throat as she waited for the other shoe to drop.

"You're right about the tests. You don't deal with them every day, but I do." Nick held up the paper. "If this first one is positive, it's followed up by another. If that one is positive, they do a third. If they're all three positive, then we do a confirmatory test. Even then, some clinicians insist on a fourth assay as sort of a fail-safe. If that's positive, there's no doubt."

"What are you saying?"

It seemed to Anna that Nick shrank back a bit. "You're HIV positive."

She felt as though someone had slammed a fist into her gut."That can't be true."

"They ran all the tests," Nick said. "To be sure. After all, this is an area where false positives and false negatives can be disastrous."

Anna shook her head, as though trying to dislodge what she'd just heard. "No, no. I mean, there's no way I could be HIV-positive." She stopped, trying to figure out how to couch her reply. "I haven't had any exposure."

"Sure you have." Nick's tone was neutral, nonjudgmental."You've been in patient contact for what? At least the last three years of med school, three or four more in residency, then in practice. Didn't you ever notice a hole in your glove during surgery? Maybe you had a little cut on your hand at the time but paid no attention to it. Did you accidentally stick yourself with a needle? Sure you've had exposure. It doesn't take sexual contact to contract AIDS. Blood exposure to non-intact skin will do it."

Anna felt the initial adrenaline rush of fear fading. Think logically, she told herself. Think about it. Once more she looked at the report, this time a lot more carefully. Studied it as though her life depended on it, which in a way, it did. She moved past the lab values themselves, and concentrated on the heading of the report.

That was her name, her date of birth. She didn't know her insurance number offhand, but she was willing to bet the designation at the top of the page was correct. Her home address was right, down to the added four digits after the ZIP code, numbers that Anna never could remember. And she could see why her doctor might have had the report sent to her at home, to protect her privacy. But why would Gary