Robin Cook - Terminal

All in all Janet felt profoundly distraught, and to make matters worse she was facing a day in which she was expected to obtain deceitfully a sample of medicine that was highly controlled. If she failed, she faced the possibility of Sean packing his things and leaving Miami. As she neared the hospital Janet found herself thinking longingly about Sunday, the first day she was scheduled to have off. The fact that she was already thinking about vacation time at the start of her second day on the job gave an indication of her level of stress.

The bustling atmosphere of the floor turned out to be a godsend for Janet’s troubled mind. Within minutes of her arrival, she was swept up in the tumult of the hospital. Nursing report gave the oncoming day shift a hint of the work ahead of them. Between diagnostic tests, treatments, and complicated medication protocols, all the nurses knew they would have little free time. The most disturbing news was that Helen Cabot had not improved overnight as the doctors had hoped. In fact, the night nurse taking care of her felt she’d actually lost ground, having had a small seizure around four A.M. Janet listened carefully to this part of the briefing since she’d arranged to be assigned to Helen Cabot for the day.

Regarding the controlled medicines, Janet had concocted a plan. Having seen the type of vials they came in, she’d made it a point to obtain similar vials that were empty. Now all she needed was some time alone with the medicine.

After report had concluded, Janet launched into work. The first order of business was to start an IV line for Gloria D’Amataglio. It was Gloria’s last day of IV medication on her current chemotherapy cycle. Having shown an early facility with venipuncture, Janet was in demand for the procedure. During report she’d offered to start Gloria’s IV since there had been some problems doing so in the past. The nurse scheduled to care for Gloria for the day had readily agreed.

Armed with all the necessary paraphernalia, Janet went into Gloria’s room. Gloria was sitting on the bed, leaning against a bank of pillows, obviously feeling better than she had the day before. While they chatted nostalgically about the beauty of the pond on the Wellesley campus and how romantic it had been on party weekends, Janet got the IV going.

“I hardly felt that,” Gloria said in admiration.

“Glad to help,” Janet said.

Leaving Gloria’s room, Janet felt her stomach tighten as she prepared herself for her next task: getting to the controlled medication. She had to dodge several gurneys, then did a kind of sidestep dance to get around the housekeeper and his bucket.

Reaching the nurses’ station, Janet got out Helen Cabot’s chart and turned to the order sheet. It indicated that Helen was to get her MB30 °C and MB303C starting at eight A.M. First Janet got the IV bottle and syringes; she then got the empty containers which she’d put aside. Finally she went to Marjorie and asked for Helen’s medication.

“Just a sec,” Marjorie said. She ran down the corridor to the elevators to give a completed X-ray form to an orderly taking a patient down to X-ray.

“That guy never remembers the requisition,” Tim commented with a shake of his head.

Marjorie returned to the nurses’ station at a jog. As she rounded the counter, she was already removing the key from around her neck for the special medication locker.

“What a day!” she said to Janet. “And to think it’s just starting!” She was obviously preoccupied with the welter of activity hospital wards faced at the beginning of each workday. Opening the small but stoutly built refrigerator, she reached in and brought out the two vials of Helen Cabot’s medicine. Consulting a ledger that was also stored in the refrigerator, she told Janet she should take 2 ccs of the larger vial and a half cc of the smaller. She showed Janet where to initial after she administered the medication and where Marjorie would initial when Janet was finished.

“Marjorie, I have Dr. Larsen on the line,” Tim said, interrupting them.

With the vials of clear fluid safely in hand, Janet retreated to the pharmacy closet. First she turned on the hot water in the small sink. After making sure no one was watching, she held the two MB vials under the hot water. When the gummed labels came loose, Janet pulled them off and placed them on the empty vials. She tucked the now unlabeled vials into the utility drawer back behind an assortment of plastic dosage cups, pencils, pads, and rubber bands.

After another precautionary glance into the busy nurses’ station, Janet held the two empty vials over her head and let them fall to the tile floor. Both smashed into tiny shards. After pouring a small amount of water onto the glass pieces, Janet turned and left the pharmacy closet.

Marjorie was still on the phone, and Janet had to wait for her to disconnect. As soon as she did, Janet put a hand on her arm.

“There’s been an accident,” Janet said. She tried to sound upset, which wasn’t difficult considering her nervousness.

“What happened?” Marjorie asked. Her eyes widened.

“I dropped the two vials,” Janet said. “They slipped out of my hand and broke on the floor.”

“Okay, okay!” Marjorie said, reassuring herself as well as Janet. “Let’s not get too excited. Accidents happen, especially when we’re busy and rushing about. Just show me.”

Janet led her back to the pharmacy closet and pointed at the remains of the two vials. Marjorie squatted down and, using her thumb and forefinger, gingerly pulled out the shards attached to the labels.

“I’m terribly sorry,” Janet said.

“It’s okay,” Marjorie said. She stood up and shrugged. “As I said, accidents happen. Let’s call Ms. Richmond.”

Janet followed Marjorie back to the nurses’ station where Marjorie placed a call to the director of nursing. After she explained what had happened, she had to get out the ledger from the medicine refrigerator. Janet could see the vials for the other two patients as she did so.

“There was 6cc in the larger and 4cc in the smaller,” Marjorie said into the phone. She listened, agreed several times, then hung up.

“No problem,” Marjorie said. She made an entry into the ledger, then handed the pen to Janet. “Just initial where I indicated what was lost,” she said.

Janet wrote her initials.

“Now head over to Ms. Richmond’s office in the research building, seventh floor,” Marjorie said. “Bring these labels with you.” She put the broken glass fragments with their attached labels in an envelope and handed them to Janet. “She’ll give you several new vials, okay?”

Janet nodded and apologized again.

“It’s all right,” Marjorie assured her. “It could have happened to anyone.” Then she asked Tim to page Tom Widdicomb to get him to mop up the pharmacy closet.

With her heart pounding and knowing her face was flushed, Janet walked toward the elevators as calmly as she could. Her ruse had worked, but she didn’t feel good about it. She felt like she was taking advantage of Marjorie’s trust and good nature. She was also concerned that someone might stumble across the unlabeled vials in the utility drawer. Janet would have liked to have removed them, but she felt she couldn’t risk it until later when she could give them directly to Sean.

Despite her preoccupation with Helen’s drugs, as Janet came abreast of Gloria’s door she noticed it was closed. Having just started her IV, this disturbed her. Except for the one incident when Marjorie had introduced Janet to Gloria, Gloria’s door was always ajar. Gloria had even commented that she liked to have it open so she could stay in touch with life on the ward.

Perplexed, Janet stopped and stared at the door, debating with herself what she should do. She was already behind with her work so she should get over to Ms. Richmond’s office. Yet Gloria’s door bothered her. Fearing Gloria might be feeling poorly, Janet stepped over to the door and knocked. When there was no response, she knocked again louder. When there was still no answer, Janet pushed the door open and peered inside. Gloria was flat on the bed. One of her legs was dangling over the side of the mattress. It seemed an unnatural position for a nap.