Richard Mabry: Diagnosis Death

"Will he be all right, Doctor?"

In Elena's mind a scene played out, one she knew as certainly as if she'd written the script. Chester would never recover from his coma. He'd go to a rehab facility. Despite decent care, he'd get contractures and bedsores. Eventually he'd get pneumonia or an overwhelming urinary tract infection with sepsis, and that would be his terminal event.

Tell her what's coming, Elena. She took a deep breath. "Every day he remains in a coma makes it less likely that he'll regain consciousness. And if he does begin to react, we can't know how much permanent damage there is, how much function he'll have." Elena surprised herself with her next words. "But there's still hope."

Mrs. Pulliam dabbed at her eyes. "Thank you, Dr. Gardner. That's all I want-to know that there's hope." She eased out of the chair with obvious effort. With one hand still grasping that of her husband, she reached with the other and took Elena's arm. "Thank you for giving me that."

Why did you lie? You know what's ahead. Elena swallowed hard. "There's always hope."

David wasn't sure why he felt the need to call Elena. Call it a premonition. Call it a divine prompting. Call it a surfacing of his suppressed desire to spend more time with Elena. For whatever reason, as soon as he reached his car to start the drive home, he pulled out his cell phone and punched her speed-dial number.

"Dr. Gardner." The tone of those two words painted a clear picture, and David was glad he'd called. Elena was really down. Time to step in.

"Elena, it's David. Can you talk right now?"

"Oh, right. Yeah, I guess so. I'm on my way to pick up my dry cleaning and buy a few groceries."

Run with the hunch. "Why don't you meet me at the El Fenix on Lemmon Avenue? I'll buy you some good Tex-Mex and we can talk."

"Oh, I couldn't-I mean, that's not…" He could hear a car honking in the background. Elena was probably working her way through the same type of traffic he was. "David, do you really want to do this?"

"Why not? We both need to eat. I'll bet you're too tired to cook, and I'm really not in the mood for a bologna sandwich tonight." He grinned, thinking there was no need to let Elena know about the pot roast simmering in the Crock-Pot at home. No need to puncture that "men can't cook" myth. "So, what do you say?"

"Why not? I'm probably about half an hour away. Will that work?"

"Whoever gets there first gets a table," David said.

Twenty-five minutes later, he was munching on tortilla chips when Elena walked in. He rose and gave her a brotherly hug. "Bad day?" he asked.

"Not great, but not as bad as it could be. At least it's not Tuesday."

The waiter approached, but before he could speak Elena said, "Diet Coke with lime. Chicken taco salad."

David added his own order. When they were alone, he said, "So you expect another phone call next week?"

"I'm not sure. It's possible that she's escalated the action."

He listened as she related her story of the note and its cryptic message. "And you think it's from the same person?"

"It all fits together. Mark's birthday was four weeks ago-on a Tuesday. That's when the calls began. The message reached me Wednesday, but it was mailed on Tuesday."

David dipped a chip in salsa and crunched it, then took a sip of iced tea. "I'm hearing you say this is all related to Mark's death-the calls, the note, everything. Is that right?"

"I think so. Mark's mother…" She shook her head.

"You don't have to talk about it if you don't want to."

"No, I need to. You see, Mark's mother didn't like me from the get-go."

"What about Mark's father?"

"He died when Mark was in his teens. Left the family comfortably fixed, and Lillian never let anyone forget that. She's spent most of her life parading her social status."

David nodded. "So Mark's mother opposed the marriage."

"Actually, 'marrying beneath him' was the way she put it, because, to her at least, I was a Mexican, born in Monterrey. Never mind that Mama was a U.S. citizen, the daughter of an American diplomat, that she was cultured and sophisticated, spoke flawless English, came from an upper-class background. Forget the fact that she married a wealthy Monterrey businessman."

A waiter deposited more salsa and a fresh basket of chips on the table. Elena murmured, " Gracias," and he padded away. She pushed the chips toward David. If she was hungry for anything, it was conversation, not food.

"If you were born in Mexico-?" He left the question hanging.

Elena took a deep breath. She was tired of explaining this, but she'd brought it up and David deserved to know all the details. "My parents wanted their only daughter to be raised in the U.S., so they moved to Texas when I was an infant. I don't know how it happened-some law or other-but anyway, I was a U.S. citizen because of my mother. My father got his citizenship later." She lowered her head. "After my parents were killed in an auto accident when I was eight, my mother's sister and her husband raised me. There was no Spanish spoken in that home. I grew up like an Anglo. But none of that mattered to Lillian. All she cared about was my name, the color of my skin, the appearance of my features."

David paused with a chip halfway to the salsa. "So there was an uncomfortable relationship there."

"There was no relationship. We saw Mark's mother when we had to, but it was obvious she disapproved of our marriage."

"And this continued?"

Elena shook her head. "It got worse. You see, when Mark had his cerebral aneurysm, Lillian figured the dumb Mexican should have been smarter. I was a doctor. I should have seen it coming. I should have gotten him to the hospital more quickly. I should have pulled strings to get him a better surgeon." She bit her lip. "I should have saved his life-instead of ending it the way I did."

"What do you mean?"

Elena shoved her plate away. Score another one for the widow's diet. "To Lillian, so long as Mark's heart was beating and that monitor hadn't flat-lined, even though it took a respirator and a bunch of IV medications to keep him going, he was alive."

"And when you stopped all that?"

"Lillian is of the opinion that when I discontinued life support, I murdered her son."

Dr. Milton Gaines laid his half-specs on the desk and looked across at his colleague and patient. "You're doing fine, Cathy. In another few weeks you'll give birth to a healthy baby. Sure you and Will don't want to know whether it's a girl or boy?"

"No. We've decided to wait and be surprised." Cathy shifted in her chair, seeking a more comfortable position and finding none. "I appreciate your seeing me this late in the day, Milton. It's tough for me to get out of the office."

"Glad to do it. And I know how it feels to be swamped with patients."

Cathy felt a foot bury itself in her side. "Are you about ready to take on an associate?"

"I hadn't planned to quite yet, but some things have changed. This is going to come out at the hospital staff meeting next week, and I suppose you can keep it to yourself until then. Arthur Harshman's retiring. He and his wife are moving to Florida."

That surprised Cathy. Somehow, she'd pictured Arthur Harshman as sort of an ageless icon in the medical community, always here, always the same, holding sway in hospital staff meetings because most doctors didn't dare disagree with him. He had the bedside manner of Attila the Hun, but there was no question about his competence in obstetrics and gynecology. She was surprised to realize she'd miss him. "So, what about-"

"About someone to fill in when I can't be here? For now, Tom Denson in Bridgeport has agreed to drive over to cover if I have to be away, which won't be often. And I have an associate who'll be starting soon. He's finishing his residency June 30."