David Bajo - Mercy 6

She returned to her ER cubicle to do charts. Mullich was no longer following her, no doubt more intrigued by Claiborne’s Hell. Doctors hated charts because charts were menial, below a physician’s station. Mere data entry, what her mentor had called paperwork. But the most profound cause of that hatred was the fact that charts acknowledged an overseer, reminded a physician that all her decisions and acts were up for assessment, even though 99 percent of those decisions and acts were repetitions, determined by precedent. And that last fact was the most difficult part of the acknowledgment, that what they were all doing was mimicking, robotics, child’s play.

But these four new charts tagged on to the end of Mendenhall’s long day were different; she saw them as an act of organization and self-checking, probably what charts were originally meant to be, way back when Mercy General had been built, when the telescope on the roof had been whole and aimed toward the Milky Way.

Enry Dozier was a fifty-three-year-old janitor with a clean work record during seven years of employment at Mercy. His medical history was in the system and showed nothing unusual, nothing more than a slightly elevated BP, almost average for a black male. He never missed the hospital’s required checkup. He had been found slumped over his ladder in the seventh floor hall, one fluorescent tube leaning against a rung, the other shattered along the floor, presumably dropped. He was at the far end of the hall, past the patient rooms, so it was unknown how long he had been like that before being discovered by a patient taking a prescribed hall walk.

He had been unresponsive during transport to the ER.

Lana Fleming, a sixty-three-year-old retired middle school teacher, had been admitted for surgery to scrape bone chips from her talocrural joint. The procedure had been successful. Her medical history was in the system and showed nothing unusual, nothing more than being overweight, average for a white female over sixty.

The bone chips indicated that she had been athletic until her fifties. On the fourth floor, she had slumped over her roommate’s bed while sharing tea and dessert. She had been standing over the woman’s bed, making plans to get together after recuperation.

Fleming had been checked out but hadn’t changed out of her gown.

The roommate had buzzed for the nurses immediately. Fleming had been unresponsive during transport to the ER.

Marley Peterson, a forty-one-year-old surgical nurse had been at Mercy for ten years. Her work record was stellar; her medical history, which was in the system, was marred by a smoking habit that had yet to exhibit any health repercussions. She had never missed the hospital’s required checkup. The only prescription after every six-month checkup was to stop smoking. She had been treated for staph infections twice during her Mercy career: one MRSA, one VRSA. She had been discovered in a second-floor ventilation room that was also used for water storage. A worker from the physical plant, retrieving a jug for a water cooler, had found her slumped on the floor and alerted nurses. She had shallow breathing and pulse during transport to the ER.

Richard Verdasco, in his early thirties, had been visiting his mother in ICU. His medical records were not in the system. The mother, Lupita Verdasco, was in post-op ICU, not conscious after surgery to remove a brain tumor. Richard Verdasco had been found slouched in an armchair in the visiting area, a magazine across his lap. Another visitor sitting in the same area at first had thought he was sleeping but had alerted nurses after noticing that his eyes were open and unblinking. Verdasco had been unresponsive during transport to the ER.

It was infection, Thorpe’s domain. She should take advantage.

The ER would go still without incoming. She could run on the treadmill in PT, have a yogurt, granola, and apple at the cafeteria, take a whirlpool in fourth floor recovery, nap in the surgeons’ lounge on Two. Claiborne would be furious about having started things with the Dozier case, but she never needed Claiborne because by the time stuff got to him, the patient was no longer hers, was either dead or parsed out to a real specialty. Claiborne needed her. He needed her for any decent consultation on trauma.

She petted her screen, scrolling down the four charts. Did they make it feel like skin on purpose? All first-year med students are assigned virtual patients. Some create avatars, whether allowed or not. That was one of the biggest changes in medicine, her mentor claimed. They often argued over whether this was good or bad, changing sides depending on what they’d seen that day in the ER.

She looked at Dozier’s chart. Then she gazed unfocused over the bay. This was what she did instead of closing her eyes. She pictured Dozier three ways, recalling him in the ER and Pathology, then imagining him slumped over his ladder. She hadn’t really seen any posturing, any signs whatsoever indicating disconnection.

We see what we are, her mentor had told her. Take one patient complaining of headache and fatigue and send him to four different specialists. You will receive four different diagnoses, four different prescriptions. Throw in one meddling aunt and receive another diagnosis and another prescription. Pathologists are different—different but not exempt. They see pathology. But is there always a pathology? Believe in life, Dr. Mendenhall, he told her. That there is something beyond diagnosis and pathology.

Pathology buzzed her, one word from Claiborne: Come.

Pathology seemed darker. Maybe it was the increased coolness and the change in music, an even more spare solo violin piece.

Maybe it was the bodies, now naked, with a fourth steel bed empty and waiting. Maybe it was the way Claiborne, Mullich, and the tech were standing. Claiborne now had Mullich in gloves and mask. At first she thought the architect was a cutter. The three stood in waiting formation, turned toward her entrance.

The mix confused her. The coolness meant Thorpe was setting things up for a long haul. The garb for Mullich indicated this also.

The presentation of the bodies appeared Thorpe-ready, propped with limb angles measured and even. The empty bed—“Don’t call them tables,” Claiborne had insisted the first time she had made the mistake—held intrigue. Thorpe would keep Peterson alive on paper for as long as possible to get the best cultures, even if she had a DNR. Peterson was too young for a DNR. But she was a nurse, no doubt a human petri dish, perfect collateral for Thorpe.

Mendenhall put on fresh gloves when she entered but ignored the crisply folded mask. She eyed the empty bed, then checked Claiborne.

“That one’s for you,” Claiborne told her.

She’d been awake for twenty hours straight. This was a dream.

Claiborne motioned his mask and gloves toward Mullich. “His idea. A fourth bed just to give you the best perspective.”

Claiborne went to Dozier, who was first in line. That was strange, too, the way the beds were ordered: Dozier, Fleming, Verdasco, then the empty steel for Peterson, the four aligned in a neat slant rather than squared.

“Him again,” said Claiborne, nodding toward Mullich. “They’re arranged according to the floors they were found on.”

The others followed him to Dozier.

“Look at him first,” he told Mendenhall. “Head and neck. Then go to the scans.”

“Scans? You took scans?”

“You’ll see.”

She crouched to get a level profile of Dozier. The skull was balanced on the occipital, cleanly presenting throat and nape. His beard had been combed into a point. His lips were in repose, not yet slipping into grimace. With two fingers, she palpitated what could have been slight swelling beneath his Adam’s apple. “Maybe something there.” She shrugged. “Not worth a scan. I thought you would just run an X-ray.”