Richard Mabry - Diagnosis Death

How many times had she heard that excuse? She hoped the man was right, but her intuition told her different.

"Let me get a bit of history. Then I'll have a look at you." She eased onto the rolling stool and propped the chart on her knee. "What's the main thing that's bothering you?"

"It's really nothing. I just get out of breath real easy."

"How far can you walk without getting tired?" Elena asked.

"Maybe from here to the front of the waiting room out there."

The distance he indicated was less than a hundred feet. "Do you ever wake up short of breath?"

"Sometimes. But it helps if I prop up on two or three pillows."

Thirty minutes later, Elena sat in the exam room with the patient and his wife. "Mr. Emerson, you have what we call congestive heart failure." She saw the look of shock that the words "heart failure" always produced, so she hurried on. "There's no need to panic. This is fairly common, and we can treat it. I need to start you on a medicine to improve the efficiency of your heart. It's called digitalis, and doctors have been using it in one form or another for over two hundred years, so you know it must work."

"I've heard of digitalis," Mrs. Emerson said. "Is that all that's needed?"

"No. In this condition, the body accumulates fluid." Elena looked at Mr. Emerson. "This is why your feet and ankles are swollen. We treat that with medicines called diuretics. You've probably heard them called 'water pills.' "

"Anything else?" To Mrs. Emerson's credit, she hadn't berated her husband for putting off this visit so long. But Elena got the distinct impression that Emerson's wife would definitely make sure he followed orders from now on.

"There's salt restriction," Elena said. "That means you cook without added salt. And hide the salt shaker so your husband doesn't use it."

While Mary phoned to set up an appointment with a cardiologist, Elena answered a few more questions. She rose and handed Emerson the appointment slip. "If you have problems before then, call us. We're here to help."

On his way out the door, Emerson offered Elena his hand. "Thanks, doctor. I'm glad she bullied me into coming." The loving look he gave his wife took any sting out of the words.

Elena decided that Emerson was lucky on two counts. He'd sought medical help before his disease became irreversible. And he had a partner, someone who'd help him through the days ahead. She wished she could say the same for herself.

Elena must have eaten something that evening, but she couldn't remember what it was. Anyway, she wasn't hungry. She'd flipped on the TV when she got home, just as she did every night, but there was no comfort in the noise, and the flickering images made no sense.

She slumped in a chair in her living room and tried to sort out the tangled mess that was her life. Mark was gone. She'd almost come to grips with that, although there were still times when she couldn't quite believe she'd never see him again. The thought brought a few tears to her eyes, but she counted that an improvement over the floods that came without warning right after his death.

The harassment from her mother-in-law apparently wasn't going to stop, but maybe she could outrun it when she moved. In the meantime, she still had those Tuesday night calls and threatening letters to contend with.

Her finances were in ruins. Mark's insurance-he'd been so stubborn about having his own coverage through work instead of being included with hers-had only paid a part of the expenses of his illness. There were still unpaid obligations for ambulance services, lab and X-rays, even the cost of his funeral. She'd been able to stave off her creditors, but eventually she had to pay those debts. And that meant hanging on to the position Cathy Sewell offered.

Which brought her to her next quandary. The tribunal-she'd come to think of Matney, Gross, and Clark in that fashion-had promised they'd conduct their investigation discreetly, but would Amy Gross think it best to warn Cathy of this latest hiccup in Elena's professional career? Had they talked already? Would the practice offer, the lifeline to which she clung so desperately, be yanked out of her reach?

No, it was better to face it head-on. She'd call Cathy and tell her the truth. At least, as much of the truth as Elena was prepared to offer. Maybe that would be enough.

The first time Elena dialed Cathy's home number, the line was busy. Was Amy talking with Cathy even now? Elena cradled the phone, looked at her watch, and decided to give it fifteen minutes before she called again. She made a cup of tea. It sat untouched on the table beside her chair when she roused herself from thoughts that went round and round like horses on a carousel, ending where they started with no progress.

She dialed again. One ring. Two. Three. Oh, please answer.

"Dr. Sewell."

"Cathy, this is Elena. Do you have a minute to talk?"

"Sure. What's up?"

How do I say this? "Listen, there's a problem here. I hope it won't affect your decision to offer me the contract, but you need to know about it."

Elena told the story as unemotionally as possible. She started with Pulliam's presentation in the emergency room. She freely admitted that, because of the similarity to Mark's situation, she'd been drawn to Erma Pulliam and felt a need to counsel her. Elena told how she stood alone in Chester Pulliam's room and wrestled with the concept of putting an end to an existence that was hardly a life. "But I didn't do it."

"Elena, that's all understandable," Cathy said. "I'm glad you felt free to unburden yourself to me, but this isn't going to affect our relationship. Matter of fact, this was probably a breakthrough for you. Maybe it will help you get past Mark's death."

"Unfortunately, the story doesn't stop there. Yesterday afternoon, I met at their request with Pulliam's neurosurgeon, the chair of the neurosurgery department, and Amy Gross."

As she spilled out the rest of the story, Elena envisioned Cathy's face darkening, her thoughts already centered on how she could break the employment contract they'd signed. "So that's where I stand," Elena concluded. "They say I'm okay so long as I stay out of trouble, but it seems to me that trouble is actively seeking me out. If you don't want an associate who's tainted with a reputation for mercy killing, I'd understand. But I swear to you that I didn't discontinue Chester Pulliam's respirator."

The silence on the other end of the line spoke volumes to Elena. Cathy was about to cut her loose. And then what would she do?

"Elena, I accept what you tell me as truth. But let's look at it this way. Was there any hope for Chester Pulliam to live?"

"Maybe one chance in a thousand he could come off the vent, but even then he'd never be a sentient human being again."

"And his wife was leaning toward pulling the- Sorry. I've got to stop using that expression. She was about ready to discontinue life support?"

"Yes."

"So this isn't a case of murder, or manslaughter, or any other crime. What it represents is someone who wanted to get you in trouble professionally, for going outside protocol, for ignoring policy. Right?"

Elena found herself nodding. "Yes, I guess so."

"So the question we have to answer-"

"Right, it's the same one Amy asked. Why did someone want to blame me?" Elena reached for the cold cup of tea and drained it, but her throat was still dry. "Does this mean you still want me there?"

"More than ever. I think the sooner you leave Dallas and the medical school complex behind, the safer you'll be."

Hours later, as Elena lay in her bed, Cathy's words made her shiver. Was this more than harassment? Was she actually in danger? And wasn't it ironic that her escape from danger hinged on a move to Dainger?

She determined to keep a low profile for the next couple of weeks. If a patient with an intracranial hemorrhage presented to the emergency room, she'd get them into the hands of a neurosurgeon as quickly as possible, but there was no way she'd participate in their care. And afterward, she'd avoid their room like the plague. Matter of fact, she wouldn't even visit the ICU unless she was called there to help with a procedure. For the next two weeks and two days, she'd walk the straight and narrow.