Tony Scott - Along Came COVID - Love and Loss in the 2020 Pandemic

Peggy jumped when the frosted window rattled.

“Now they are threatening to terminate me,” Brian said, sitting backwards in the aging, squeaky, rolling chair, arms crossed on top of the chair back, and resting his chin on his arms.

“Based on what you said last time you were here, I would say they have a point. They can’t have somebody in the operating room high on fentanyl,” Peggy said. “Who is ‘they?’”

“JD Thompson and Emily.”

“Who is JD Thompson, again?”

“The Dean of Faculty.”

“Sorry, I forgot. What are they expecting of you?”

“They want me to go to rehab, move on to a surveilled probation, and then a structured work schedule.”

“OK.”

“But I don’t need rehab. I use Percocet for knee pain. I had an old injury, had arthroscopic knee surgery two years ago, but recently I am having trouble again.”

“Since the surgery, did you have a period of time when you didn’t take any pain medicines?”

“No.”

“So, who’s been giving you Percocet for two years?”

“Dr John Ballinger, one of our orthopedic surgeons,” Brian said. Peggy knew this not to be true. Brian hadn’t been here a year yet. Who did he get it from in Lubbock?

“So, what about the marijuana?”

“What about marijuana? What I do in my off time is not any of anybody’s business. I use it for my knee.”

“Where do you get it?”

“Around.”

“Well, it looks to me like you have a decision to make. Either you address the problem head on, tackle it with all your heart and soul, or you let the actions take their course and wind up without a career, facing felony charges, and without a paycheck. You know this accounts for a significant part of our nation’s homeless.”

“I don’t see why everybody thinks I have such a problem. I haven’t missed work, I haven’t made any errors, and I’ve done everything everybody expected of me.”

“No, Brian, that’s not even what you have told me. Emily wants you to start a research project or join one in progress, do some medical school administration, or get active in teaching rounds. We have noticed you late or absent for rounds, irritable with students, nurses, residents, and fellows, and not very instructive. Then there are the board exams and a divorce. How much do you need? Perhaps a two by four upside your head would help, as my dad would say.”

“Those aren’t connected.”

“You don’t think so?”

“No. Why would they be?”

“Most opiate addicts can’t function at work, their interpersonal relationships deteriorate, and their concentration and mental acuity suffers.”

“Do you think my mental acuity is suffering?”

“From what you have told me about good performance on in-service training examinations which has now deteriorated to failure on boards, I would say the answer is a resounding yes .”

“So, you think my board exams are because of my opiates?”

“Yes. What does Dean Thompson say?

“The same.”

“What is he suggesting you do?”

“Get off my opiates and marijuana, go to rehab, for which they recommended the Pain Management Clinic here at the University, and reset my life and career goals.”

“The sooner you do, the better.”

“I don’t see how you have helped me.”

“Maybe not yet.”

“What do you mean?”

“Brian, you have to recognize the problem, then you have to let people around you who are skilled at dealing with this help you get a grip on it. From what little I know it’s recognizing the problem that is the biggest obstacle.”

“I don’t see it.”

“This is a medical problem like all others. What if you had lymphoma or cancer of the pancreas?”

“I would go to a doctor and get surgery or chemotherapy.”

“So, what’s the difference? You’re at risk of dying of this just like you would be of lymphoma or cancer of the pancreas. You will not get well if you don’t meet it head on.”

“This has nothing to do with lymphoma or cancer. This is not like that at all. This is me coping with a problem with my knee and coping well. Staying at work, continuing to function.”

“You mean like your wife, your tardiness, your pinpoint pupils, and your board exams?”

“I knew you wouldn’t help. I’m out of here.” Brian got up and left the room, mumbling unintelligible syllables. He closed the door gently, but the window rattled in protest.

Peggy wondered if he would turn the corner or wind up in a tent in a park. Knowing that people dedicated to his problem were working on him was reassuring, and she didn’t think there was anything she could contribute. Maybe being a sounding board was helping. But even cancer of the pancreas and lymphoma when doggedly treated don’t always end well.

The phone rang. “Dr Valdez, this is Ricky.” Peggy brushed shards of deep sleep away. She had to orient herself. She was at home, in her own bed. Ricky. Ricky. Blue lights from the nightstand said 4:30 am.

“Ricky. What’s up?”

“We thought we should tell you that our patient had a cardiac arrest. She died about two hours ago.”

“What? She died?” Peggy tried to push through a thick shroud of dream fragments. “Ricky.” She wondered why Ricky was calling her at home, but didn’t pursue the issue.

“Yes, Dr Valdez, Ricky.”

“Where are you?”

“At the charting station in ICU. I was trying to finish up the death certificate, which I’ve never done before. I’m making slow progress. When I think I’ve finished it, the computer rejects it.”

They discussed the diagnosis until they came to an agreement on how to describe the asthma and COVID which the computer finally accepted. “Yes ma’am, it worked. Sorry to have awakened you.”

A few hours later, Haley opened rounds. “Good morning everybody,” she said to grim faces. “Our coronavirus patient died in the night. This is bad.”

Faith, not having been in the hospital overnight, wrestled to get words out, “Why did she die? What killed her?”

“They couldn’t oxygenate her, and then she arrested. In other words, lung failure.” Ann answered.

“I talked to her the day before yesterday, and I sat and held her hand. I did her admission chart work and told her we would take care of her!” Faith’s voice trembled and cracked. “Then I saw her yesterday, when she looked terrible. I guess I shouldn’t be shocked, but I am.”

“We did take care of her,” Peggy said. “But her disease was bad and progressed rapidly. OK, what do we have here?”

“That sounded crass, Peggy,” Ann said. “But I know what you mean.”

Josh said, “Well, as you can imagine, we’ve got a lot of patients with minor issues we need to clear out of here. There are non-COVID colds, there’s a patient with contractions that isn’t in preterm labor, and a urinary tract infection that needs to be sent home. We don’t have anyone with anything serious.”

“This is a little annoying,” Haley said.

Peggy missed the point. “What’s annoying, Haley?”

“That we’ve got so many patients with minor issues that were not taken care of during the night. They should all be out of here already. It’s always like this, considering.”

Peggy still didn’t get it. “Considering what?”

“Our nighttime attending.”

“Who was it?”

“Yankton.”

“OK, what did he say about our death?”

“They couldn’t find him,” Haley said. “We aren’t sure he knows. Ann finally called Dr Beacham, and Ricky called you. Can’t you get fired for that?”

“You don’t talk to me about each patient,” Peggy said. “Why couldn’t you send them home? And if you couldn’t find him, why didn’t you send them home anyway?”