Richard Mabry - Diagnosis Death

Even though there was no one within earshot, Cathy leaned a bit closer to Elena. "This is a two-part deal. What I need now is a locum tenens to cover my practice while I'm on maternity leave. I've told you about the salary and benefits. Do you have any questions there?"

Elena shook her head.

"But I'd like the contract to include an option for a permanent association." Cathy said.

Elena was afraid her dry throat could only emit a croak. She sipped from her cup. "The option would rest with you?"

"No, with both of us."

"Is the practice big enough to support two doctors?"

"I think there's room for another primary care doctor here in town, but I'll have a better idea about that later. First I have to fill the locum tenens position."

Elena had to concentrate hard on the words as they came through the high-pitched hum in her ears. It was happening. She had a place to practice.

"So far as your capabilities, there's no question there," Cathy said. "And I think you and I would be a good fit. There's only one thing."

Elena felt the muscles in her shoulders tighten like a violin string. She thought it was all behind her, but here it came again. "What's that?"

"Amy hinted that your husband's death is still affecting your professional behavior. Let's clear the air about that."

The sound of breaking glassware from the kitchen split the air. The noise might as well have been the sound of Elena's composure shattering. She squeezed her eyes closed in an unsuccessful attempt to stop the tears she already felt forming there.

Cathy was sorry to trigger the emotional display, but Amy had made it clear that Elena still carried some baggage after the death of her husband. Cathy had to know the extent of that baggage.

Will, bless him, was unflustered. Most men didn't know how to react to a woman's tears, but his reaction was immediate and unembarrassed. "Elena, let's go over to my office for this conversation. We can all ride together, and I'll bring you and Cathy back here to pick up her car afterward."

He didn't wait for a response. He shepherded the two women out of the restaurant and helped them into his pickup truck. Once inside the building, Cathy showed Elena to the restroom and suggested she splash some water on her face and repair her makeup. "We'll be here in Will's office."

As Elena disappeared down the hall, Cathy said, "So there's something there."

"I sort of figured there was. Why don't you let me see if I can get it out of her? In this situation, I think it would be better if you just provided a comforting female presence."

Cathy recalled a time when she'd sat in this office and poured out some significant secrets to Will. She hadn't intended to, but at the time it had seemed so easy, so natural to confide in him. She wasn't sure whether the knack came from his training as a lawyer or his growing up with a pastor for a father. In any event, she decided to go along with him.

"I'm so sorry I broke down like that." Elena eased through the door and took a seat on the sofa that occupied one wall of Will's office. She appeared to be holding herself together by a supreme effort.

"No problem," Will said. "Would you like some water, a Coke?"

Elena shook her head. "No. Really, I'm okay." She rummaged in her purse, pulled out a tissue, and dabbed at her eyes.

Will rested one hip on the edge of his desk and said, "We know you've had problems since Mark's death, and we need to understand what they are."

"It's sort of complicated," Elena said.

"It usually is," Will said. "Start at the beginning."

Cathy took a seat on the sofa beside Elena and turned halfway so she was facing the woman. She tried to make her expression and her body language nonjudgmental and encouraging.

Elena took a deep breath. "Mark and I met right after I graduated from med school. One of my classmates was dating his roommate, and she fixed me up on a blind date with Mark. I know it sounds hokey, but it really was love at first sight. We were married six months later, halfway through my first year of residency."

"What did Mark do for a living?" Will asked.

"He started out as a computer programmer. Then, after we were married, his company made him sort of a troubleshooter. You know, if a company was having IT problems their in-house staff couldn't solve, Mark was the guy they called."

"Did he travel a lot?"

"Not really. I was the one who was always gone." She looked at Cathy. "Not travel, of course, but you know how it is. Nights on call at the hospital. And when I was home, I barely had time to keep things going. Mark did his share-more than his share, I guess-of the housework. We… we had a great marriage."

Cathy noted the hesitation and filed it away. Most marriages weren't great a hundred percent of the time, and she was willing to bet Elena's hadn't been, either. But she guessed it was normal to remember things as perfect once they were out of reach.

Will's voice was so soft Elena had to lean forward to hear him. "Then what happened?"

"It was almost seven months ago. He woke me sometime after midnight. He had a terrible headache. His speech was sort of fuzzy. I turned on the light and saw his eye was drooping." She swallowed hard. "I called 911. He was unconscious by the time the paramedics got there. I rode with him to the hospital. He stopped breathing halfway there, so I intubated him and kept him going with an Ambu bag. At the hospital, I pulled every string I could think of to get a neurosurgeon there stat."

Cathy felt herself drawn into the story, first as the clinical picture unfolded, then as Elena told about her relationship with her mother-in-law. Her heart was touched by the enormous responsibility thrust on Elena when Mark's prognosis became obvious.

"And how did Mark's mother react to all this?" Will asked.

"She thought I should have noticed symptoms earlier and gotten Mark to the doctor."

Cathy couldn't help herself. "But he had a berry aneurysm." She looked at Will. "A weak spot in the wall of an artery in the brain. Most often there aren't any symptoms. The first you know of it is when it ruptures, like this one did."

Elena nodded. "Makes no difference. She was convinced I'd missed the diagnosis, that I should have somehow gotten him better treatment. But the thing that put the final barrier between us was that she kept holding on to the idea that, if Mark were kept on life support long enough, he'd eventually recover. I think she had visions of his being moved into her home where she could nurse him back to health-and get him away from me."

Cathy spoke softly, but still her voice seemed too loud for the circumstances. "How did it finally play out?"

"The neurologic damage Mark sustained was extensive. There might have been a chance-a very slim chance-that he could be weaned off the respirator, but he'd remain in a coma. He'd never function as a sentient human again."

"So it was up to you to withdraw life support," Will said.

"That's right. But Lillian kept arguing." Elena paused and chose her words carefully. "After two weeks, Mark came off life support and-" The words seemed to hang in her throat.

"I understand how you must feel." Will's voice was calm. "I know a little about survivor guilt, not from firsthand experience, thank goodness, but from counseling with lots of widows and widowers when we prepare to probate wills."

"Oh, there's that," Elena said. "I live with survivor guilt every day. But I know that I'll get over it eventually. What I can't get away from are the phone calls that come at midnight every Tuesday."

Elena told them about the phone calls and the card, and explained why she thought Mark's mother was behind them. She told them about the financial morass in which she was trapped because of Mark's final expenses. More and more came rushing out. She appeared not so much to finish as to simply run out of steam.