Richard Mabry: Diagnosis Death

Elena took a deep breath and made a conscious effort to loosen her death grip on the phone. "Not that it makes any difference to you, but it's Dr. Gardner. I'm well aware of the situation, and I have no intention of letting this debt slide. But right now I'm in residency training, working eighty hours a week. The pay's not much, certainly not what you'd expect a doctor to make. Then there are deductions for taxes and Social Security. Some of what's left goes for utilities, groceries, rent, car payment. You know, living expenses, although I don't know if you could call what I'm doing living. I've tried to pay something on my debts every month since Mark…" The words trailed off. What was the use? Elena leaned forward onto her desk and watched her tears drip onto the blotter.

"Mrs. Gardner?" The woman might have been a robot for all her response to the emotion in Elena's voice. Maybe she was. Maybe they used robots for this. Certainly, it seemed to Elena that the people she'd talked with so far had no living, beating hearts.

"I'll keep paying you as much as I can," Elena said. "My employment situation is sort of up in the air right now, but you can rest assured that this debt and my medical school loans will be the first things I repay." Elena took a deep breath. "Now please stop calling me. I know how much I owe. I know where to send the payments. I know all of it. Actually, I can't seem to get it out of my head."

The emotionless voice was saying something when Elena hung up. It was just too much. She put her head on the desk and let the tears flow unchecked.

"Good dinner."

"Will, the worst meal you ever ate was wonderful." Dr. Cathy Sewell grinned. The way to her husband's heart might not be through his stomach, but it certainly represented an easy shortcut. "Coffee?"

She poured coffee for Will, herbal tea for herself, and followed him into the living room. "Good news," Cathy said. "I got a call from Amy Gross today."

Will put down the paper. "Did she find someone?"

"Dr. Elena Gardner, one of the residents who's finishing in less than a month, had her practice offer fall through. Amy thinks she might be a good fit here. She'll drive up this weekend to talk with me."

"Do you know her?"

Cathy sipped her tea. "Vaguely, although I didn't recognize her name at first. Apparently she took her husband's name when they married." Cathy smiled. "Personally, I'm glad you were okay with my continuing to practice as Cathy Sewell. Can you imagine the hassle of changing the name on all those documents?"

Will grinned. "Yeah, and I'm glad you didn't make me take yours. 'Law offices of Will Kennedy-Sewell, how may I help you?' "

"Amy said Dr. Gardner has had some problems recently."

"Professional problems?"

"No, Amy says she's the sharpest resident they've had since I graduated. I waved that off as flattery, but if she practices the way I do that'll be good."

Will got up from his chair and moved toward the small kitchen adjacent to the living room. "I want a couple of cookies to go with my coffee. Want anything?"

"No, I'm good," Cathy called. She waited for him to return and settle into his chair. "You mentioned professional ability, and I guess it does affect that, although indirectly. Her husband had a ruptured berry aneurysm-" She caught herself and corrected her doctor-speak explanation.

"A little over six months ago, a blood vessel in her husband's brain burst, and by the time they got him into surgery, the damage was too great for him to recover. He was left in the deepest level of coma. He could be kept alive, but he was never going to recover. Elena struggled with the decision to take him off life support. Apparently she finally agreed, but I get the impression there was some irregularity about the way it was done. Amy says Elena has had problems since then."

"Such as…?"

"I tried to get details from her, but she said I'd have to ask Elena about them."

Will took a sip of coffee, winced, and blew across the surface of the cup. "I'll be glad to sit in on the interview if you'd like my opinion, but I'm pretty sure you can trust your own judgment."

Cathy began to run through the things she wanted to discuss with this new doctor. She took a deep breath and blew it out slowly through pursed lips. She smiled. Could it be that she was unconsciously practicing cleansing breaths to help her through labor?

"Earth to Cathy? Where'd you go?"

"Sorry. I was wondering how my patients might relate to Dr. Gardner. It won't be a problem for me, but I'm afraid it might be for a few of them."

"Sorry," Will said. "I'm not following."

Cathy pushed aside her cup and saucer. "I didn't recognize her from her married name, but when I heard her maiden name I remembered her."

"Okay, I'll bite. What was Elena's maiden name?"

"Perez."

"And you think this might present a problem?"

"As I said, not for me, but the potential is there. Since Doc Gladstone retired, I trade call with Dr. Brown. You and I know that Emmett Brown is a competent doctor, but there are still a few of my patients who refuse to see him because they're uncomfortable being treated by an African American."

Will pushed his cup and saucer aside. "And you think they might feel the same way about this Dr. Gardner?"

"I don't recall a lot about Elena, but I do remember what she looks like. And I remember you could take one look at her and know she was Latina-a very beautiful one, by the way. Whether she uses the name Gardner or Perez, people are going to know her heritage."

Will watched as Cathy clenched her jaw. He knew that look and felt sorry for anyone who stood in her way when she displayed it. "But it's not going to sway your decision, is it?"

"Not in the least."

"Come in." The response to Elena's light tap hardly carried through the closed door of the ICU room.

Elena had dreaded this visit all morning. After talking with the neurosurgeon, she was more certain than ever what was ahead for the patient and his wife. Now she owed it to Erma Pulliam to share her knowledge. Elena steeled herself and pushed through the door.

"Mrs. Pulliam, I'm Doctor Gardner. I took care of your husband in the emergency room."

The lines in the woman's face were etched more deeply than Elena remembered. Her eyes carried a sadness that seemed beyond utterance. She sat at her husband's bedside, one hand covering his. "I remember you." Mrs. Pulliam's voice cracked. She cleared her throat. "You came out to the waiting room and told me what was happening. I appreciate that so much. I guess… I guess Dr. Clark's a busy man, but I keep missing him. I spend most of my time here. Just go home to change clothes and catch a nap. The nurses have trays sent to me, so I don't have to leave the room to eat. But still, I've only seen Dr. Clark once in the past two days. And when I ask him how Chester's doing, he just says, 'All we can do is wait.' "

Chester Pulliam lay pale and still. A large bandage covered his head. A ventilator puffed oxygenated air into his lungs via a tube into his windpipe. The monitor at the head of Chester's bed displayed blood pressure and pulse readings in the high normal range. IV fluids dripped slowly through a tube into a needle in the back of the man's right hand. The plastic bag hanging off the bed rail told Elena a urinary catheter was in place.

Elena lifted Chester's eyelids. His eyes were fixed straight ahead, the pupils midsize. She grabbed his Achilles tendon and squeezed. No reaction. She ran her thumbnail along the sole of his foot. The toes splayed and flexed upward. She frowned.

"Mrs. Pulliam, your husband had a very serious episode of bleeding inside his skull. That put a lot of pressure on his brain. Dr. Clark relieved that pressure and sealed off the blood vessel that burst, but the damage that was done has left Chester in a very deep coma."