Jodi Picoult - Small Great Things

“No.”

“Did Ruth provide substandard care?”

“No.”

“When you wrote that note in the infant’s chart, you knew there would only be two nurses working at any given time, and that there might be a possibility the patient might be left without supervision at some point during his hospital stay?”

“That’s not true. The other nurse on duty would have covered.”

“And what if that nurse was busy? What if,” Kennedy says, “she got called away on an emergency C-section, for example, and the only nurse remaining on the floor was in fact African American?”

Marie’s mouth opens and closes, but no sound emerges.

“I’m sorry, Ms. Malone-I didn’t quite get that.”

“Davis Bauer was not left unsupervised at any point,” she insists. “Ruth was there.”

“But you-her supervisor-you had prohibited her from ministering to this particular patient, isn’t that right?”

“No, I-”

“Your note barred her from actively treating this particular patient-”

“In general, ” Marie explains. “Obviously not in the case of emergency .”

Kennedy’s eyes flash. “Was that written in the patient’s chart?”

“No, but-”

“Was that written on your Post-it note?”

“No.”

“Did you advise Ruth that in certain circumstances her Nightingale pledge as a nurse should supersede what you’d ordered?”

“No,” Marie murmurs.

Kennedy folds her arms. “Then how,” she asks, “was Ruth supposed to know?”

–

WHEN COURT BREAKS for lunch, Kennedy offers to get us a bite to eat, so that Edison and I don’t have to run a gauntlet of press. I tell her I’m not hungry. “I know it doesn’t feel like it,” she tells me. “But this was a good start.”

I give her a look that tells her exactly what I’m thinking: there is no way that jury isn’t going to be thinking of Turk Bauer trying to resuscitate his own son.

After Kennedy leaves us, Edison sits down beside me. He loosens his tie. “You all right?” I ask him, squeezing his hand.

“I can’t believe you’re the one asking me that.”

A lady walks by us and sits beside Edison on the bench outside the courtroom. She is deeply involved in a text conversation on her phone. She laughs and frowns and tsks, a human opera of one. Then finally she looks up as if she’s just realized where she is.

She sees Edison beside her, and shifts just the tiniest bit, to put a hair of space between them. Then she smiles, as if this will make everything all right.

“You know,” I say, “I’m sort of hungry.”

Edison grins. “I’m always hungry.”

We rise in tandem and sneak out the back of the courthouse. I don’t even care at this point if I run into the entirety of the media, or Wallace Mercy himself. I wander down the street with my arm tucked into Edison’s until we find a pizza place.

We order slices and sit down, waiting to be called. In the booth, Edison hunches over his Coca-Cola, sucking hard on the straw until he reaches the bottom of the glass and slurps. I, too, am lost in my thoughts and my memories.

I guess I didn’t realize that a trial is not just a sanctioned character assassination. It is a mind game, so that the defendant’s armor is chipped away one scale at a time, until you can’t help but wonder if maybe what the prosecution is saying is true.

What if I had done it on purpose?

What if I’d hesitated not because of Marie’s Post-it note but because, deep down, I wanted to?

I am distracted by Edison’s voice. Blinking, I come back to center. “Did they call our name?”

He shakes his head. “Not yet. Mama, can I…can I ask you something?”

“Always.”

He mulls for a moment, as if he is sifting through words. “Was it…was it really like that?”

There is a bell at the front counter. Our food is ready.

I make no move to retrieve it. Instead I meet my son’s gaze. “It was worse,” I say.

–

THE ANESTHESIOLOGIST WHO is called that afternoon as a witness for the State is someone I do not know very well. Isaac Hager doesn’t work on my floor unless a code is called. Then, he arrives with the rest of the team. When he came to minister to Davis Bauer I did not even know his name.

“Prior to responding to the code,” Odette asks, “had you ever met this patient?”

“No,” Dr. Hager says.

“Had you ever met his parents?”

“No.”

“Can you tell us what you did when you reached the nursery?”

“I intubated the patient,” Dr. Hager replies. “And when my colleagues couldn’t get an IV in, I tried to help.”

“Did you make any comments to Ruth during this process?” Odette asks.

“Yes. She was doing compressions, and I instructed her at several times to stop so that we could see if the patient was responding. At one point, when I felt she was a little aggressive with her chest compressions, I told her so.”

“Can you describe what she was doing?”

“Chest compressions on an infant involve pressing the sternum down a half inch, about two hundred times a minute. The complexes on the monitor were too high; I thought Ruth was pushing down too hard.”

“Can you explain what that means to a layperson?”

Dr. Hager looks at the jury. “Chest compressions are the way we manually make a heart beat, if it’s not doing it by itself. The point is to physically push the cardiac output…but then let up on your thrust long enough to let blood fill the heart. It’s not unlike plunging a toilet. You have to push down, but if you keep doing that and don’t pull up, creating suction, the bowl won’t fill with water. Likewise, if you do compressions too fast or too hard, you’re pumping, pumping, pumping, but there’s no blood circulating in the body.”

“Do you remember what you said to Ruth, exactly?”

He clears his throat. “I told her to lighten up.”

“Is it unusual for an anesthesiologist to suggest a modification to the person who is doing compressions?”

“Not at all,” Dr. Hager says. “It’s a system of checks and balances. We’re all watching each other during a code. I might just as well have been watching to see if both sides of the chest were rising, and if they weren’t, I would have told Marie Malone to bag harder.”

“How long was Ruth overly aggressive?”

“Objection!” Kennedy says. “She’s putting words in the witness’s mouth.”

“I’ll rephrase. How long was the defendant aggressive with her chest compressions?”

“It was only slightly aggressive, and for less than a minute.”

“In your expert medical opinion, Doctor,” Odette asks, “could the defendant’s actions have caused harm to the patient?”

“The act of saving a life can look pretty violent, Ms. Lawton. We slice open skin, we crack ribs, we shock with extreme voltage.” Then he turns to me. “We do what we have to do, and when we are lucky, it works.”

“Nothing further,” the prosecutor says.

Kennedy approaches Dr. Hager. “Emotions were running very high in that nursery, weren’t they?”

“Yes.”

“Those compressions that Ruth was doing-were they adversely affecting the infant’s life?”

“On the contrary. They were keeping him alive while we attempted medical intervention.”

“Were they contributory to the infant’s death?”

“No.”

Kennedy leans on the railing of the jury box. “Is it fair to say that in that nursery, everyone was trying to save that baby’s life?”

“Absolutely.”

“Even Ruth?”

Dr. Hager looks right at me. “Yes,” he says.

–

THERE IS A recess after the anesthesiologist’s testimony. The judge leaves, and the jury is removed from their box. Kennedy spirits me away to a conference room, where I am supposed to stay, so that I remain safely sequestered from the media.