Richard Mabry: Medical Error

The intern might have been young, but she knew she was in charge, and she refused to back down. "Mr. Donovan, the citizen who called the ambulance said a man was beating you with a club. That's assault, and it's a crime. I've notified the police, and they're sending someone to take your statement. You can't go until they're through with you."

This wasn't medicine, this was law, and now Ross was in his element. Talking to the police wouldn't help, and he knew his rights. "Doctor, I have no obligation, legal or otherwise, to talk with the police. This was a mugging, interrupted by a passerby. I have no idea who my attacker was, I'm not going to press charges, and it would take the police about five minutes to put any paperwork generated by my report into a drawer and forget it."

"But-"

Ross gathered his dignity, reaching behind him to hold his gown closed. "Do you have any medical reason to hold me? Are you going to force me to sign out AMA?" He figured that having a patient leave the hospital against medical advice would make the young doctor fill out a ream of paperwork, and he hoped this would be the leverage he needed.

She chewed on her lip for a moment before opening his chart and starting to write. "If you have a headache that Tylenol or Advil doesn't relieve, if you start seeing double, if you begin vomiting, if you find yourself stumbling or falling…"

Ross half-listened to the rest of the instructions. They had taken his watch along with his clothing and other valuables, but the clock on the exam room wall told him that if he hurried he would only be a few minutes late for his appointment with Anna. And after the events of last night, that seemed more important than ever.

Anna looked at her watch again. Nine-thirty. She tapped once more on the door of Ross's office, knowing there wouldn't be any response. The lights were off, and when she pressed her ear against the glass of the upper part of the door she heard only silence.

All sorts of scenarios ran through her head. Ross had hinted of danger last night. Had something happened to him? Was he lying behind the locked door, maybe in a pool of blood? She pulled out her cell phone and hit the "redial" button. She counted the rings as she heard them, slightly out of phase, first the buzz of her phone and then the electronic ring inside the office. She hung up when Ross's answering machine kicked in.

Try his cell phone again? There'd been no answer when she arrived here early for her appointment and anxious to hear Ross's news. She was punching in the numbers when she heard a "ding" from the elevator nearby. A few seconds later, Ross rounded the corner.

She almost didn't recognize her attorney. His clothes were rumpled and dirty, his hair mussed. He was unshaven. Her first thought was that he'd been drinking again, and her stomach clenched. What would this do to her case? She was already formulating alternate strategies when a sense of shame hit her. She'd completely ignored the possible consequences to Ross if he had slipped back into his old pattern of alcoholism. How could she be so self-centered? This was a man who had gone out on a limb for her, apparently put himself in danger last night. No, whatever he'd done, she'd help him through it. They'd deal with it together.

"Anna, I'm so sorry to be late. Let's go inside."

He pulled a small ring of keys from his pocket and opened the door. The smell of liquor made Anna's nostrils quiver. The office smelled like a distillery-or, at least, what she imagined a distillery would smell like. She'd been around lots of alcohol in her life, sometimes at parties, more often in the emergency room as she dealt with drunks and accident victims. There was no mistaking the aroma. She felt a tear form in her eye, but not just from the fumes. No question, Ross had been drinking.

The lawyer moved quickly to the window and fumbled for a minute. "Oh, man. I forgot. These windows don't open. Let me get rid of this." He picked up the wastebasket and carried it out the door. He was back in a few moments, drying his hands on a paper towel. "I'd like to leave the door into the hall open to let this place air out, but we need some privacy. Can we go to the coffee shop downstairs? I could use some coffee anyway."

"Yes, I bet you could," Anna said. "And maybe we can stop at the drugstore and get you some vitamins. I don't drink, but my colleagues who do tell me that large doses of B vitamins help them get over their hangovers."

Anna could see Ross's expression change from confusion to understanding to indignation. "Anna," he said, "I haven't been drinking. Actually, I was tempted to drink yesterday, but I dropped the liquor, glass and all, into the wastebasket. Apparently, the cleaning lady decided to skip this office last night."

"But what about your appearance? You have to admit, you look like somebody who's been on an all-night bender."

"Let's get that coffee," Ross said. "I have quite a story to tell you."

"Good morning. Coffee?"

"Yes, please." Ross turned over the empty cups on the table and inhaled the rich aroma of strong coffee as the waitress poured.

"Do you need a few minutes?" the waitress asked.

"Orange juice and an English muffin," Anna said without opening her menu.

"Two eggs over easy, wheat toast, crisp bacon." Ross drank deeply from his cup of coffee, then lifted it and held it out to be topped off. "And please keep the coffee coming."

After the squeak of the waitress's shoes faded, Ross leaned forward and fixed Anna with a steady gaze. "First, do you believe I haven't been drinking? I'd ask you to smell my breath, but since I haven't brushed my teeth since yesterday I think that might be unwise."

A hint of a smile flickered across Anna's face. "Okay, the alcohol smell was in your office but not on you, so I guess you're clean. But look at you. Why were you late?" Her eyes traveled over him, and Ross became acutely aware of his wrinkled suit and a day's growth of beard.

He looked around, confirming there was no one within earshot."Right after I talked with you last night, someone hit me over the head and knocked me out. I might have ended up in the morgue, but apparently a passerby saw the attack. Their shouts scared offmy assailant. I ended up in the emergency room at Parkland, where I practically had to fight the intern to retrieve my pants and leave."

"Who was the intern?" Anna shook her head. "No, never mind. Doesn't matter. Are you sure you're all right now? No double vision? No throwing up. No-"

Ross held up both hands, palms out. "I'm fine. I had a mild concussion, that's all. I've been given all the warnings. The important thing is what I found out before I was attacked with a club."

"And that would be…?"

"When Green showed us that pill bottle with your name and Eric Hatley's on it, I noticed the pharmacy it came from. Yesterday, it dawned on me that I knew one of the pharmacists working there. I'd defended him on a DWI charge that almost cost him his license to practice. He still owes me big-time, so I called in the favor and got some information."

The waitress returned with their food. After she set down the plates and refilled their coffee cups, Ross continued. "The pharmacist-his name is Glenn-had an AA meeting last night, and I arranged to meet him in the neighborhood. If anyone saw us together, it would just be two alcoholics headed for a meeting. He sweated bullets the whole time we talked, and he couldn't get away fast enough after we were through, but I hit pay dirt with him."

Anna paused with her muffin halfway to her mouth. "What did you find out?"

"Glenn said a man approached him, one he'd seen a couple of times at AA. The man wanted a prescription inserted into the files at the pharmacy and a vial made up with matching data. No need to dispense the medication. When Glenn unfolded the prescription the man handed him, there were five one-hundred dollar bills inside."