Kitabı oku: «Sacred Trust», sayfa 2

The X-ray tech finished her work in the room, and Lauren took Mrs. Conn’s vitals once more. “Down again. BP is 95 over 55 with a 90 pulse.”

“Thanks, Lauren. I’ll go have a talk with her daughter as soon as I check the test results.”

“Okay, I’ll go see Frankie again.” Lauren gave Mrs. Conn another sad look and walked out of the room.

Had there been time, Lukas would have sat with the patient, but he had to return to reassure the mother with the sick baby, talk to the girl with the sprain, and check on Frankie. Where was Mrs. Conn’s daughter, Mrs. Richmond? Why wasn’t she in here? More than likely she was exhausted and had found a sofa or chair on which to sleep.

When Lukas finished his round of the patients, he returned to Mrs. Conn and read the test results. As expected, they looked normal for an elderly woman with late-stage cancer. She continued to rest peacefully, but her blood pressure and respiration were falling.

He found the E.R. secretary at the central desk. “Carol, would you please call Dr. Richmond’s office and advise her of her grandmother’s condition? I’m going—”

Carol raised a hand. “Wait a minute, Dr. Bower. We received permission to treat Cindy Hawkins with the injured wrist. Also, I have Dr. Simeon on the line. You wanted to talk with him about his patient, Mr. Verris?”

After a quick consultation with Dr. Simeon, Lukas made arrangements to have Franklin Verris, the possible suicide attempt, admitted to ICU, then went back to check on the seventy-three-year-old gentleman one more time.

Shelly kept her vigil at her neighbor’s bedside. Lauren stood at the other side of the bed, adjusting an IV line.

“Any change, Lauren?” Lukas asked.

“I’m not sure. There’s no difference in his vitals, but his breathing seemed to change a moment ago. It’s been twenty minutes, and I’m getting ready to give him the next dose. Do you want me to go ahead with it?”

Lukas bent over Mr. Verris and gently raised his right eyelid. He took out a penlight and shone a beam directly at the pupil. There was a faint reaction. The man didn’t look as pale as he had looked before. But according to Dr. Simeon an overdose was highly unlikely. He had disagreed with Lukas’s request for Romazicon. However, Lauren was prepared for another dose, and since Lukas had already given the order, he decided to carry it out.

“Go for it, Lauren. I need to stay and watch him, but I also need to talk to Mrs. Richmond. I’ll be back.”

Chapter Two

L ukas opened the door to the private waiting room and saw a tall, slender woman pacing the floor. Her casual attire of jeans, jogging shoes and a “Hiking is Life” T-shirt skewed the impression he’d formed in his mind of a wealthy, polished benefactress of the hospital.

Mrs. Richmond’s long, dark brown hair was pulled back into a ponytail at the nape of her neck. She turned to face him, and he saw that the hair was liberally streaked with gray around the temples. Her large, dark eyes met his with deep gravity. She was at least sixty, and the gaunt face told him of recent weight loss. The prominent dark circles under her eyes told him she probably hadn’t slept well for weeks.

“Mrs. Richmond?”

“Yes.” Her voice held fear.

“I’m Dr. Bower, the emergency room physician on duty today. I need to speak with you about your mother.”

Mrs. Richmond nodded. “I should be in there with her, I know, but the moaning…I just couldn’t handle it, had to get away from it for a while.” She resumed her pacing. “She moaned all night. I gave her morphine suppositories twice as often as…” She turned back. “I’m sorry. I’m rambling. It’s just so hard to think straight these days.”

“I understand. Have you had an aide helping you with your mother at home?”

“No. I didn’t want my mother thinking I’d abandoned her to a stranger.”

“So you’ve been taking care of her yourself?”

“My daughter helps when she can.”

“I’m sure that’s very hard on you, Mrs. Richmond.”

“Call me Ivy. Is she still moaning?”

“She was peaceful when I left her a few minutes ago. We gave her an injection. We ran some tests to see if there might be a pneumonia or something else causing her deterioration.” He paused. “I’m sorry, Ivy, but none of the tests show a secondary problem. I’m afraid the cancer is taking her.”

Ivy nodded slowly. “Hard to believe a little mole on her cheek could do such damage. Melanoma, you know.”

“Yes. I’m sorry. Her oncologist is in Springfield?”

“Yes, but it’s no use calling him. He’ll just increase the morphine.” Fatigue sharpened her voice. “She’s not worth his time. She’s just an old woman.”

“We want to make her as comfortable as possible. I understand you have the DNR request she signed?”

Ivy grew still as her eyes flashed back to his face. Her chin lifted a fraction. “Why?”

“Would you like to sit down?”

“I’ll stand.”

“I know you must be tired. I want to honor your mother’s advance directive, and to do so, I need the DNR sheet. This is all just legalities, and I apologize for having to ask you for it at a time like this.”

“You mean to just let her die?”

Lukas flinched at the harsh tone of her voice and the sudden, angry-suspicious expression in her eyes.

“If her heart should stop,” he said gently, “we wish to honor her request not to restart it.”

“What’s this ‘we’ business? You’re the doctor. You call the shots. I don’t want my mother’s heart to stop, and if it does, I want you to start it again.”

He held her suddenly angry gaze for a moment. She couldn’t know what she was saying.

“Mrs. Richmond, I thought you understood about your mother’s request.”

“My mother is not capable of making that decision now. I have power of attorney, and I don’t want you to just let her die like some worthless old woman. She’s a living human being with a soul.”

“Of course she is.” He hadn’t foreseen this. How could he get through to her? “I’m not talking about euthanasia. I’m talking about allowing nature to take its course, allowing your mother to retain her dignity and keep her from unnecessary pain. I’ve asked a nurse to call your daughter, Dr. Richmond, and she should be here—”

“You did what?” Her dark eyes flashed, and fatigue tightened the tension in her voice.

Lukas blinked at her helplessly. This was not going well. She was clearly, and understandably, irrational from lack of sleep. There had to be some way to make her see, without becoming too graphic.

“I specifically delayed calling my daughter because I wanted to put her through as little heartache as possible,” Ivy said. “She’s been through enough. You had no right to call her.”

“I’m sorry you feel that way, but Mrs. Conn’s condition is getting worse. I felt family needed to be here.”

“Not yet!” She paused with a gasp, placing a hand on her chest.

He stepped toward her. “Are you okay?”

“I’m fine.” Lowering her hand, she took a deep breath and held his gaze. “I don’t care what the DNR form says. I have durable power of attorney, and I want you to do everything for my mother. She’s not ready to die. She’s not…”

“I didn’t mean for this to be so difficult.” Lukas kept his voice gentle, resisting the urge to ask if he could examine her. He’d seen this kind of family reaction before, during his oncology rotation, when a caregiver was so exhausted that they became confused and combative. They often blamed the physician for the pain of their dying loved one. “I will contact Mrs. Conn’s family physician and clarify the matter.” He turned to leave.

“You don’t believe I have power of attorney?” she challenged, her voice rising a decibel.

He paused with his hand on the door. Lord, give me compassion.

But what about Mrs. Conn? She would suffer even more pain if they managed to resuscitate her.

He turned back to face Ivy, and he tried to keep his voice gentle. He knew his words were not. “What I believe is immaterial, Mrs. Richmond. For instance, I believe that to impose heroic measures onto a patient suffering the last stages of advanced carcinomatosis is not only transferring much-needed care from the living to the dying, it is inhumane to the dying.”

“Only if you don’t believe in hell.”

“Mrs. Richmond—”

“Ivy! My name’s Ivy!”

“I’m sorry, Ivy. I do believe in hell. I also believe that your mother is at peace about this. She told me she was ready to go.”

“What do you mean, she told you?” Ivy snapped. “Mother hasn’t spoken in days. What are you trying to pull here?”

Be gentle. Be patient. But what about Mrs. Conn? “Ivy, to try to resuscitate your mother at this stage would only cause greater, unnecessary suffering. And for what? A few more minutes or hours for the family to say goodbye? What about your mother’s feelings? She’s made her decision already.”

There. He’d done it again, him and his bad habit of stating his opinion to the wrong people at the wrong time. But if there was the slightest chance Ivy would listen…

She bent her head, her eyes closed for a moment. He watched her hopefully.

She reached into the right back pocket of her jeans and drew out a folded three-page form. “I had hoped it would never come to this.” The strength had left her voice. She unfolded the papers and held them out with shaking hands. “I have the power of attorney. Are you satisfied?”

Beverly caught up with Lukas as he reentered the E.R. proper. “That Mustang’s mine!”

Lukas struggled to work up some enthusiasm. “Don’t tell me you cajoled Dr. Wong—”

“Nope.” She jingled Cowboy’s keys. “Sweet-talked one of the new EMTs to help me. Buck likes animals.”

“Yes, but did you tell him this wasn’t a gerbil?”

She grimaced. “He knows it’s a big animal.”

“Horses are big animals. How will you feel if your helper comes back in here on a stretcher?”

“Awful.” She shrugged. “Dr. Wong’s finished with Cowboy. Got any patients for me?”

“Have I ever.” He gestured toward the charts at the desk. “Enjoy.”

He left her staring at the sudden overload and stepped back into exam room one to check on Mr. Verris. Shelly still sat there beside his bed, and Lauren entered behind Lukas, as if geared to his location by radar.

“Any change?” Lukas asked Lauren.

“Test results are in.”

Lukas checked the printouts. Nothing. Everything was normal. Even the drug screen was not helpful, because all it showed were benzodiazepines, and that was to be expected for someone who occasionally took them to sleep. Lukas could have done a quantitative drug screen, but that would have taken too long.

“BP’s gone up just a little, but not much,” Lauren continued. “Pulse and respiration are the same. They’ve called from upstairs to let us know they’re coming to take him to ICU.”

“Let’s make sure they know he still needs a CT scan.” Lukas did his own assessment. Was it his imagination, or was the man breathing more deeply? As he watched, Frankie’s head moved a fraction of an inch.

Lukas looked up to see if Lauren had noticed. “Has he moved like that before?”

“I don’t think so.”

He watched a moment longer. It was probably just a stimulation of the limbic system, a common event in a coma patient.

Lukas did an auscultation of Frankie’s chest one more time, then shook his head. With a nod at Shelly, he left the room. He was feeling more and more frustrated as the day progressed.

Lauren stepped out of the room behind him. “Dr. Bower? Some of the staff are getting together after this shift over at the cantina across the street. Want to join us?”

“Uh…sure. Yes, I’ll be there. Thank you for asking.” Lukas nodded and continued down the hall, knowing he would be kicking himself tonight when it came time to show up at the cantina. He would be starving when he got off, as usual, and since he always ate out anyway, this would be a good way to get better acquainted with the people who worked here. Unfortunately, he knew that by the time he arrived at the restaurant, he would be feeling so awkward about meeting with a group of near strangers, he would have lost his appetite. Almost.

Moving to a new place was lonely business, especially for him. Funny, he could face patients and coworkers all day long with no problem, but when his time was not regimented, he had trouble forcing himself to reach out to others. It wasn’t that he didn’t like people, because he did. The youngest of three boys in a loving Christian family, Lukas was the only shy one in the bunch, and he had often been teased about it. The teasing had only made him more self-conscious, turning him inward, and now his family despaired of ever seeing him married. But this was a new place, and no one here knew about his shyness. It was time to dig himself out of the rut—or pray that God would move him out.

He took Mrs. Richmond’s papers to the secretary. “We’ll need copies of these, Carol. Please call Dr. Richmond back and tell her that she needs to be on standby. Her grandmother is holding her own at the moment, but she could deteriorate fast, and she’s now a full code.”

“Yes, sir.” Carol grabbed the papers from him, dark eyes glowering as she spun around to the copier. She muttered something under her breath.

Lukas watched the characteristically cheerful secretary in surprise. “Carol, are you okay?”

She put the first sheet into the copier and pressed the button. “Fine, just fine,” she mumbled. “We’re swamped, we’ve got patients dying back there, and all I hear are complaints that we’re not seeing people fast enough.” She indicated the waiting room. “Griping because you haven’t looked at their scalps yet. They’d be in here right now, except one of them had to step outside for a smoke. I get so tired—”

“Have they been signed in?”

“No, I’ve been too busy with these other—”

“I’ll take care of them.” Lukas glanced out the door, where one of the women he’d seen earlier stood smoking, talking to the other. He strolled out to join them.

“Hello, ladies, I’m Dr. Bower. I hear you’re unhappy about our service. What’s the emergency?”

The smoker quickly shoved her half-smoked cigarette into the receptacle like a school kid caught by the teacher.

“We need to be treated for head lice,” the nonsmoker said.

The patio was deserted, Lukas noticed. He took another step forward, carefully looked at first one over-permed head of hair, then at the smoker’s long, stringy brown hair.

He took out a notepad and a pen and wrote the name of a shampoo. He held it out toward the smoker. “Wash with it once, then wait a week and wash again. You can buy this at your local pharmacy.”

She stared at the note in his hand. “No prescription?”

“You don’t need a prescription for this. The two of you can share a bottle.”

“But we’ll have to pay for it.”

Lukas felt his skin tingle with growing irritation. He inhaled slowly, counting to ten as he placed the note on the top of a trash can nearby. It had suddenly become a stressful day, the worst he’d had in a long time. He couldn’t blame it all on these two misguided souls.

He turned and opened the heavy glass door. “Ladies, the shampoo costs less than a pack or two of your favorite brand of cigarettes.”

“But we have Medicaid cards,” the smoker called after him. “We can report you for refusing to treat us!”

He stopped midstride and slowly turned back toward them. “Feel free,” he said, keeping his voice calm. “I feel I should warn you, however, that when a card carrier tries to use the card in the E.R. for nonemergency care, she can lose her card. It’s called Medicaid abuse. I think you’ll find that shampoo works very well as long as you follow the directions.” He stepped inside and let the door close silently behind him.

There were other Medicaid cardholders—for instance, the little baby in exam room three—who needed treatment today, not next week, and Lukas saw to it that they received good care. Lots of Medicaids used the emergency room here because many family practitioners refused to take assignment. Those who did still limited their patients. Medicaid paid so little that a physician who took too many could go broke. The system didn’t work. Many times the people who behaved with integrity got left out entirely—both the honest Medicaid recipients and the honestly compassionate physicians. Greed was the culprit on all sides. Lawmakers spent their time writing more laws because people kept figuring out ways to take advantage of the system. It was frustrating. Lukas had to keep reminding himself not to blame the patients who sometimes misunderstood the constantly changing rules.

Lukas glanced around at the emergency department. He liked this little ten-bed setup. The exam rooms surrounded a large central station. Each room was well equipped. Five of the ten rooms had excellent cardiac equipment. There was a separate ambulance entrance and two physician call rooms.

Mrs. Estelle Pinkley, the hospital administrator, had done a remarkable job when she’d convinced the county to pay for this upgrade. Lukas had jumped at the chance to receive a dependable salary with benefits so far away from the congestion and stress and corruption of the city. Yes, he knew corruption was everywhere, but right now, with specific, damaging events so fresh in his memory, Kansas City represented everything painful.

Carol met Lukas as he entered the E.R. proper. “Dr. Bower, Mrs. Conn is getting worse. Lauren said to notify you.”

“Thanks, Carol. Please call Dr. Richmond back.”

“Lauren already did so.”

“Get ready to call a code if necessary.”

“Dr. Richmond will have a fit about that, you know.”

“Maybe she can do more about it than I was able to.”

Chapter Three

M ercy Richmond ran the block from her medical office to the hospital, not bothering to remove her lab coat. Mom had promised to call when the time came, but she hadn’t done so. Instead, Lauren had been the one to break the news.

Shoving open the glass doors into the emergency room reception area, Mercy barely slowed her stride. “Carol, where’s Grandma?”

“She was in exam room eight, but they called a code and moved her to trauma room one.”

Mercy stopped and wheeled back. “What? There’s not supposed to be a code!”

Carol shook her head in sympathy. “I’m sorry. Dr. Bower called it. He had to.”

“We’ll see about that.” Mercy swung back on course. First, administration had arbitrarily decided to bring in a full-time E.R. doc from Kansas City, and now this hotshot doc had decided to ignore a perfectly legal DNR request. Perhaps he’d never learned to read.

She pushed through the swinging double doors that pretended to lend privacy to the open emergency room. A secretary manned the central station. All other hands were gathered in the trauma room, six people altogether, including Grandma’s frail, still body on the bed. Others worked with quick efficiency, responding without question to the soft-spoken commands of a slender, brown-haired man in green scrubs. He knew the drill well.

“Get me a blood gas…. Push the epi now, Lauren…. Any pulse…? Continue CPR.”

Mercy stopped just inside the doorway as a nurse from upstairs pushed methodically against Grandma’s chest and another bagged her.

“What’s going on here?” Mercy demanded. “Doctor, what are you doing to my grandmother?”

He looked up, his blue eyes behind gray-framed spectacles holding her with gentle concern. “You must be Dr. Richmond. I’m sorry, but as per your mother’s request, we are attempting resuscitation.” He turned back to the table.

“Stand clear,” he called as he prepared the paddles to send a jolt of electricity through Grandma’s chest. He placed one paddle above her right breast, and the other paddle he placed to the side below her left breast.

Mercy stood in stunned horror as the frail body jerked, arms flying out, legs up. Mercy had done the same procedure herself many times during her shifts in E.R. but not on someone she loved like Grandma.

“Check pulse,” Dr. Bower said.

Lauren gently felt the carotid artery for a moment, then shook her head. “Nothing, Doctor.”

“Continue CPR. Prepare more epi, and I need lidocaine, 1.5 milligrams per kilogram. What’s that blood gas?”

“Not back yet, Doctor.”

Mercy stepped toward him. “Dr. Bower, I’m her granddaughter. Stop this code.”

He was barely taller than her five feet eight inches, but his expression held calm authority. “As I said, Dr. Richmond, your mother—”

“I heard what you said, but my grandmother signed a DNR form weeks ago. Surely that has some bearing on this case.”

“You know that form does me no good. Believe me, I wish it did.” Dr. Bower’s voice betrayed frustration. He lowered his voice. “Your mother showed me her papers for legal power of attorney. Her order is to resuscitate.”

“Forget that order. As a fellow physician—”

“I can’t break the law, Dr. Richmond.”

“Don’t abuse this patient any more than she has already been abused!”

Dr. Bower grimaced at her words, sighed and shook his head. “I’d love to comply, but I can’t. If you want to sway the decision, please talk to your mother. I tried.” He turned back to the table. “Stop CPR.”

The monitor showed an irregular, sawtooth pattern. Grandma’s heart was in ventricular fibrillation. Mercy hoped it would not change back.

“Where is my mother?” she asked, her voice heavy with frustration.

“She was in the private waiting room when I left her.” Dr. Bower shook his head at the monitor. “No change. We need to shock again.”

He charged the defibrillator to 360 joules. “Clear.”

Mercy stepped back and almost turned to leave, but she couldn’t. A sort of morbid amazement held her there, watching the scene of horror play out before her. She gripped the door frame. A loud pop and flash preceded the stench of burned flesh. An electrode had blown. Lauren and Dr. Bower checked for signs of life while another nurse replaced the electrode.

“No change,” Dr. Bower said.

Mercy felt sick. Mom should be here to see what her crazy order was doing to Grandma. But then, Mom, too, had suffered enough.

Again they shocked, and Mercy could not bring herself to leave. CPR resumed. The longer they worked, the more convinced she became that Grandma was already far past their so-called help. And that meant she was also past any more pain.

Dr. Bower called a halt a seeming eternity later. Mercy did not move until he pronounced the time of death.

She stepped from the doorway as the code team cleaned up the mess of scattered monitor strips and plastic wrapping that had been tossed on the floor during the code. One by one, they filed out past her, some avoiding her eyes as if ashamed of the work they had just done.

Lauren stopped and laid a tanned, slender hand on Mercy’s shoulder. “I’m sorry, Dr. Mercy.” Tears filled her pretty green eyes.

“So am I, Lauren. Thanks for calling me over.”

“It was Dr. Bower’s request. Your mom told us not to.”

“Figures.” Mercy was thirty-nine, and Mom had still not overcome the need to hem her in with maternal over-protectiveness. Often it rankled. It showed lack of respect for Mercy’s ability to cope. For goodness’ sake, she was a doctor.

Dr. Bower paused for a moment at the bedside, his hand resting gently on Grandma’s arm, his head bent and eyes closed. When the last team member had left the room, Mercy walked over to stand beside the man and gaze into Grandma’s silent, scarred face.

Dr. Bower raised his head and looked at her. “I’m sorry, Dr. Richmond, I’ve been told she was a much loved lady.” He had a kind voice, deep and masculine, but with a gentle quality.

Mercy nodded, dry eyed. “She was.”

“I apologize for my abruptness. I could have handled the situation better.”

The sincerity in his voice disarmed her. She’d been prepared for battle when she came in here. Now she felt spent. Empty. “I wouldn’t let you.” She shook her head. “I had always sworn that I would never do to another doc what patients and families have done to me, and here I led the pack—aided by my mother, of course. I know the law, Dr. Bower. It’s just that she’s my grandma.” Her voice caught, and her professional demeanor abandoned her for a moment. Her throat ached with tears she refused to shed. She was grateful for the man’s thoughtful silence.

“My mother died of metastatic breast cancer three years ago,” he said after a few moments. “I remember the feelings of helplessness and anger. I wanted to do so much more for her, and there was nothing more to do except keep her comfortable. Had we revived your grandmother…”

“I know.”

There was another pause, then Dr. Bower asked, “Would you like me to go with you to tell your mother?”

Mercy took a final look at Grandma and turned away. “No, thank you. It’ll be best coming from me.”

He hesitated. “Did you not have a chance to discuss the DNR form with your mother?”

“I tried. Mom wouldn’t talk about it.”

“It’s a difficult subject to discuss. I gathered that your mother was the main caregiver.”

“Yes. I tried to help more, just to keep her from exhausting herself.” Mercy shook her head. “Mom can be stubborn and self-sufficient. She’s lost so much sleep lately…she hasn’t been her usual, rational self—not that she’s ever been a perfect example of rationality.” Why was she talking to this stranger like this? And a man, to boot.

“I know what you mean,” he said. “My father was the same way after Mom’s death. Be patient with your mother. This kind of grief and exhaustion can do strange things to the mind. And it can last a lot longer than anyone expects.”

“Let me talk to Mom.” She forced a smile and looked again into those blue eyes. “It’ll be easier for all of us.”

A few moments later, after taking a drink of water from the fountain and a few deep breaths to compose herself, Mercy opened the door to the private waiting room. The first thing she saw was Mom standing there in the middle of the floor, glaring in her direction.

“Where is that blasted doctor? I told them not to call you yet.” Ivy Richmond turned to pace across the room toward the thickly cushioned sofa on the far side, then back again. “It’s been over an hour, and no one has seen fit to tell me anything. Do you know that man came in here and asked for permission to just let Mother die?”

“Grandma had an advance directive, Mom.”

“How can he just take it upon himself to decide who is and who isn’t worthy to live? Mother couldn’t have known what she was doing when she signed that form.” Tears filled Ivy’s eyes. “Oh, Mother.”

Mercy’s eyes grew moist, too. She’d thought they would have been drained of emotion months ago, but the stages of grief had continued to batter them. Right now confusion ran high, and Mercy knew Mom was exhausted and weak from too many nights of sleeplessness.

Ivy jerked another tissue from the box on an end table and blew her reddened nose. “I wish they hadn’t called you against my wishes.”

“It’s a good thing they did.”

Ivy stiffened at those words.

“She’s gone, Mom.”

Ivy’s face twisted into a mask of pain. “Mother wasn’t ready to die.”

Mercy closed the door behind her and took a seat on the nearby recliner, perching on the edge with her hands in her pockets. “We’re the ones who weren’t ready.”

Ivy turned away. “I can’t believe my own daughter, the learned doctor, cannot grasp the reality of an afterlife.”

Mercy suppressed a sigh. Now was not the time to bring up that old argument again, but if Mom had found peace in her so-called God these past few years, where was that peace now?

Ivy reached up toward her chest with both hands and bent forward, as if on a sob.

“Mom…?”

Ivy shook her head.

Mercy stepped up and laid a hand on her mother’s shoulder. “Mom? Are you okay?”

Slowly Ivy straightened and turned around. Her face was as gray as the clouds gathering outside, but she nodded and patted Mercy’s hand.

“I’ll be fine. This just brings back so many memories.”

“I know.” Mercy’s father had also died a lingering, painful death five years ago. That was when Mom had suddenly started babbling about “finding Jesus.” At the time, Mercy was sure she would get over it, but she hadn’t. Where was her Jesus now?

Ivy took a deep breath and squared her shoulders. “That doctor is dangerous. He doesn’t hold human life sacred. He tried to manipulate me into allowing Mother to die. He was going to go over my head to keep from doing anything for her. Did he even try to save her?”

“He called a code. I saw it.”

“How hard did he try?”

“He did everything to resuscitate her. He had already begun when I arrived.”

“And he didn’t revive her at all?”

“No.”

“Is that normal for someone whose heart has just stopped?”

“It would be hard for me to say, Mom. Everyone is different. Most of the codes I get have been out for at least fifteen minutes.”

“I think he could have bought us more time. Do you know that he as much as told me he had other patients who needed him more than she did and that doing more for her would be inhumane?” Ivy put a hand to her chest again, then quickly dropped it.

Mercy held her mother’s dark gaze and said nothing.

“Jarvis didn’t want this new doctor here in the first place, did he?” Ivy asked. They both knew that Dr. Jarvis George, E.R. director, had been bitterly opposed to bring in a full-time physician for the E.R.

“No, and neither did I. But to be fair, I disagreed with the code, too. I even tried to stop him. He did what he felt he had to, and I can’t blame him for that. Granted, he could have been a little more tactful with you, but…”

“I’ll have a talk with Jarvis. Maybe he can put my mind at ease about this guy, but if he can’t, I may have to have a talk with administration.”