Thomas’s patients were inconveniently sprinkled on all three surgical floors. After Grand Rounds he’d taken the elevator to the eighteenth to work his way down. Normally on Saturdays, he liked to make rounds before the conference and before visiting hours. But today he’d arrived at the hospital late and consequently lost a lot of time reassuring nervous families. They would follow him out of the room and stand asking questions in the hall until in desperation he cut them off to examine his next patient only to be further delayed by that person’s relatives.
It was a relief to reach the ICU where visitors were rarely allowed. As he pushed through the door he allowed himself to think about the regrettable episode with George Sherman. As understandable as his reaction was, Thomas was surprised and disappointed in himself.
In the ICU, Thomas checked on the three patients he’d operated on the day before. All were fine. They’d been extubated and had taken something by mouth. EKGs, blood pressures, and all other vital signs were stable and normal. Mr. Campbell had had a few brief episodes of an irregular cardiac rhythm but that had been controlled when an astute resident found some unrelieved gastric dilation. Thomas got the fellow’s name. He wanted to compliment him next time he had the opportunity. Thomas walked over to Mr. Campbell’s bed. The man smiled weakly. Then he started to speak.
Thomas bent over. “What did you say, Mr. Campbell?”
“I have to urinate,” said Mr. Campbell softly.
“You have a catheter in your bladder,” said Thomas.
“I still have to urinate,” said Mr. Campbell.
Thomas gave up. He’d let the nursing staff argue with Mr. Campbell.
As he turned to leave, he glanced at the sorry case in the bed next to Mr. Campbell. It was one of Ballantine’s disasters. The patient had embolized air to the brain during the operation and now was no more than a living vegetable totally dependent on a breathing machine, but with the quality of the nursing care at the Memorial, he could be expected to live indefinitely.
Thomas felt an arm on his shoulder. He turned and was surprised to find George Sherman.
“Thomas,” began George. “I think it is healthy that we have disagreements if only because it might force us to examine our own positions. But it upsets me to think there has to be animosity.”
“I was embarrassed at my own behavior,” said Thomas. That was as close as he could come to an apology.
“I got a bit hot under the collar myself,” admitted George. He let his eyes leave Thomas’s face, noticing which bed Thomas had stopped at. “Poor Mr. Harwick. Talk about a shortage of beds. Here’s another one we could use.”
Thomas smiled in spite of himself.
“Trouble is,” added George, “Mr. Harwick is going to be here for a long time unless .
“Unless what?” asked Thomas.
“Unless we pull the plug, as they say,” George smiled.
Thomas tried to leave, but George gently restrained him. Thomas wondered why the man felt obligated to touch him all the time.
“Tell me,” asked George. “Would you have the courage to pull the plug?”
“Not unless I talked with Rodney Stoddard first,” said Thomas sarcastically. “What about you, George? You seem willing to do most anything to get more beds.”
George laughed and withdrew his arm. “We all have our secrets, don’t we? I never expected you to say that you’d talk to Rodney. That’s a good one.” George gave Thomas another of his little taps and walked away, waving good-bye to the ICU nurses.
Thomas watched him, then glanced back at the patient, thinking over George’s comments. From time to time a brain-dead patient was taken off his life support system, but neither doctors nor nurses acknowledged the fact.
“Dr. Kingsley?”
Thomas turned to face one of the ICU clerks.
“Your service is on the line.”
Giving Ballantine’s patient one last glance, Thomas walked over to the central desk wondering how he could get Ballantine to refer his difficult cases. Thomas was confident these “unanticipated” and “unavoidable” tragedies would not happen if he did the surgery.
Thomas answered the phone with undisguised irritation. Invariably when the answering service looked for him it meant bad news. This time, however, the operator just said that he should call his mother as soon as he could.