Love changes everything, p.27
Love Changes Everything, page 27
“Don’t tell me,” Sam said. Even though she’d seen the images years earlier, and knew what she was looking for, she couldn’t find the abscess.
“Uncle,” Sam said, and Kirby pointed it out to her.
“That is small,” she said, feeling humbled. So easy to miss. So fine a line between the right and wrong diagnosis, between life and death.
“Well, it wasn’t small when he reached Philadelphia. You got him there just in time.”
Sam absentmindedly fingered the angel dangling from her earlobe and said a prayer of thanks.
“So I have three problems with the chart,” Kirby admitted as they returned to the conference table and sat, this time side by side.
“What?” Sam asked, alarmed.
“First, there’s no electronic record of you looking at this CT scan when the patient was in the ER.”
Sam bit her lip. After a moment, she shook her head. “I remember this case well, because the circumstances were so unusual. But I can’t say if I saw the CT then or not. I do remember looking at it later and thinking it was amazing that the radiologist picked it up at all.”
“Well, since there’s no proof you ever saw it, on the first visit or the second, how should you answer the question?”
Sam thought about that for a moment, too. “What was the question?”
Kirby replied instantly. “Did you review the CT scan and relay those findings to the patient’s parents?”
“I’m not qualified to read CT scans. I rely on the radiologist’s interpretation to develop my diagnosis and treatment plan. And then I share them with the patient and family.”
A big smile spread across Kirby’s face. “Excellent, Sam. Or you can just say, ‘I don’t recall.’”
Sam beamed, relieved she was handling the interrogation so well and happy for Kirby’s praise.
“So can you explain to me why your electronic fingerprint is on the CT scan images two weeks later?”
“What?” Sam asked. “I looked at it. I told you that. I think it was when I talked to his pediatrician after his surgery.”
“The X-ray log shows that you looked at this film fifteen days after it was taken. What possible reason could you have for going into the chart to look at the images then?” Kirby’s tone was just a little brisk, just enough to irritate Sam.
“I…” Sam paused as she scrambled for an answer. “I don’t recall why I did that.”
Kirby nodded. “Perfect. Because it doesn’t really matter, but someone’s going to ask you about it.”
“I think that’s why.”
“But you’re not sure. So your answer is…”
“I don’t recall,” Sam said calmly.
“Exactly,” Kirby exclaimed.
“Got it.”
“Okay, that’s two problems addressed. The third is bigger.”
“Okay,” Sam said and turned, bracing herself for something catastrophic.
“The hospital keeps records of all outgoing phone calls. You have great documentation of everything in the record, including your conversation with the pediatrician. But there’s no phone record that you ever called her. No call was placed to her office, her home, or her cell phone during the time frame this patient was in the ER.”
“Oh, this is easy,” Sam said as she breathed a sigh of relief and explained about Tyler’s mother calling the pediatrician on her personal cell phone.
“You’re kidding me. They’re friends?”
“Apparently not any longer.” Sam didn’t even try to hide the sarcasm.
“I guess not.”
“It is possible the plaintiff’s attorney will challenge you on this, but very unlikely. There is no way to prove anything, either way, and as I see it, you had no reason to lie when you saw this boy the first time. He was really rather stable then. Fortunately, you finished his note within minutes of his leaving the ER, so it seems logical that you didn’t fabricate a phone call to the pediatrician.”
“Fabricate? You’ve got to be kidding.”
“Oh, Sam, I wish I were. People do all kinds of crazy things to cover their asses when things go wrong, including falsifying medical records.”
“But you don’t think it’ll be a problem for me?”
“This one question—this is one of the few times where you should elaborate. Discuss how unusual this was, and how you remember it precisely because it was out of the ordinary for the patient’s mother to call their pediatrician on the cell phone. Does that make sense?”
“Perfect.”
“Ready to go before the camera?”
“Yes,” Sam said, but she actually wanted to leave that office. This process was exhausting. “Can we take a break? Maybe five minutes for some fresh air?”
Kirby nodded. “That sounds like a great idea. Mind if I join you?”
“Not at all.”
They walked toward the exit, the same way she’d come in, chatting about the weather. Both had jobs that kept them inside, but with Sam having to work her share of evenings and overnight shifts, she had some days off. Kirby told Sam she worked during the day, so she liked to take her lunch on the bench outside her Harrisburg office building, just to get some vitamin D.
“This is nerve-racking, Kirby,” Sam said after a moment. She’d practiced yoga and meditation for years, and had the ability to focus her mind and to push negative energy aside, but she was struggling with this deposition. She felt powerless.
“I can imagine. And there’s nothing I can say to help, except that you need to hang in there. It’ll be over soon.”
“You really think this will be it? They won’t sue me?”
“You won’t know for sure until he turns twenty. He can still file a lawsuit until then. But it doesn’t make sense that they’d sue you separately, at a later date. If they don’t name you after your deposition, they’re not going to name you at all. That’s why this is so important. We have one chance to get it right.”
Sam sighed. She’d have to worry about this for another year and a half.
Kirby stopped and looked at Sam. “I know you’re worrying. But just remember how much you did for this boy. You saved his life. If you get sued, even if you lose, you know that. There is a young man—the same age as our sons—who most definitely wouldn’t be alive today if you hadn’t done exactly what you did thirteen years ago.”
Sam wished Kirby’s reassurance made her feel better, but it didn’t. Yes, she knew she’d done everything right, but it was still nerve-racking to be in this position. “C’mon. Let’s find that sunshine.”
When they reached the sidewalk, Sam kept walking. “I want to show you something.”
As soon as they’d passed the bulk of cars in the lot, Kirby stopped.
“Wow, Sam. You still have it!”
“I do. I’ve been driving this car for more than thirty years.”
Kirby walked around it, and Sam used the remote to open the doors.
“Classic-car plate, huh? Kirby said as she sat in the passenger seat and stroked the wooden dash. “This is real wood, isn’t it, Sam?”
“I think it is. I haven’t had to replace it. Yet. So I’m not sure.”
“Good cars run forever, if you take care of them.” She looked at Sam. “I’m not surprised you kept it.”
“Since college, it’s never really been my go-to car. I just bring her out on sunny days. But yeah…how could I get rid of her? My only dilemma is which son gets it when I die. They share a car now, so maybe I’ll leave it to both of them.”
“Remember I told you about my grandfather’s Corvette? He still has it! But anyway, he told me about a guy who was buried in his ’Vette. You could be buried in your Benz.”
Sam shook her head. “Wait a minute. Your grandfather’s still alive?”
“Yeah. He’s ninety,” Kirby said as she sat back into the seat and turned to face Sam with a big grin.
“Tell me he doesn’t actually drive the ’Vette.”
“No, but he sits in it.”
“You have great genes, Kirby.”
“I do.”
“I want to be cremated,” Sam confessed.
“Makes things easier, doesn’t it?”
Sam leaned back, too, and they both closed their eyes. The day was warm, and even with the car doors open, Sam quickly grew hot. Still, she was hesitant to move. It was peaceful in the car, and more bullshit awaited her back in Kirby’s office. She’d sit in the car and sweat all afternoon if she could, rather than go inside.
“I’m glad we found each other again, Sam,” Kirby said.
“We were good friends,” Sam said, overwhelmed with relief that Kirby felt the same way.
“We were. And I’m sweating in my nicest suit. Let’s go back in.” Her tone was dry, and Sam sensed Kirby was deliberately trying to keep things light.
Sam locked the car, and they began walking, but she stopped to check out Kirby’s suit. “It is a nice suit. Do you still hate dressing up, or have you gotten used to it?”
“I hate it with all my heart.”
“Maybe we should wear sweats next time.”
“Next time, a dozen lawyers will be in the room, and we’ll be videotaping it. You should definitely not wear sweats.”
“I love that I wear scrubs to work. It makes life so easy. I get up, pull on jeans and a shirt, slip into my flip-flops, and off I go.”
“I hate you.”
“Do you work full-time?”
“What? Full-time? Yes, of course. Remember—I get no sun.” Kirby paused and turned to look at her. “What, wait. You work part-time?”
Sam nodded. “I decided long ago that I was going to live modestly and spend time with my kids. Now that they don’t choose to spend any time with me, I have some extra to do the things I enjoy.”
“Oh, yeah? Like what?”
“I work in my garden, and as you can probably tell, that takes a fair amount of my time. I still hike. Sometimes I kayak, but not as much as I used to. The ER doctor in me is always looking out for danger, and the river can be dangerous. I love to golf, but I’m not very good at it. They tell me I still have a softball swing.”
“Once I started playing golf, I got hooked. I stopped playing softball.”
“Me, too.” Sam didn’t mention that after she’d started medical school, she’d stopped playing softball because the sport reminded her too much of Kirby. “I guess you crush the ball, huh? You won the longest-drive prize.”
“I do have power. I just wish I could putt a little better.”
When they arrived back at Kirby’s office, Sam used the restroom, and Kirby poured her a cold glass of water.
“Ready?” Kirby asked as she handed Sam the glass, suddenly all business again.
“Yeah.”
“Okay. A few things. I know you’re angry about being deposed. I mean, how can you not be? You did your job, took care of your patient, and now you’re here. But think about this—who’s in a worse position? You, who’s having a bad day, or this boy, who has chronic headaches and seizures? Even if that’s no one’s fault, there’s still an eighteen-year-old boy—the same age as our sons—who has these terrible problems. Invoke your internal Mama Bear and have empathy. That will show you care, which is huge. Huge. Control your anger, and keep your calm. Look professional, because if you do, that lawyer is not going to want to tangle with you.”
Sam looked at Kirby with admiration, saw the professional she’d become, and was proud of her. Happy, too, that she’d done so well for herself in the world. And apparently, she was really a better person than Sam gave her credit for, because she showed absolutely no animosity toward Sam. Sam, with her perfect Catholic upbringing, who had to try so hard to forgive and forget when she was slighted, was shamed.
“You are such a good person, K.”
Kirby blushed and cleared her throat. “Okay, so ditch the anger. Speak slowly and clearly. Look at the questioner, not the camera. If you need a sip of water, take it. We’re going to do this for a few minutes, just until you get comfortable, and then we’ll wrap it up. Okay? You ready?”
Sam nodded, and Kirby called in the camera crew and every other lawyer from the office, as well as a few secretaries and janitors. Hoping to prepare Sam for what the actual deposition would be like, Kirby filled every seat at the long conference table and had extras standing in the corners for added intimidation.
They began, with a large, bearded attorney questioning her. Sam remembered the rules and followed them, surprised when after only a few questions and answers, Kirby thanked everyone for their help and told Sam they were finished for the day.
“That was easy,” Sam said.
“You’re very good, Sam. First of all, I sense that you’re confident. You did a good job with this patient, and you know that, and it helps. Second of all, you have a natural poise that helps tremendously. You’re authentic. The opposing lawyer will see you and just say ‘no way.’ They’re not going to pursue this.”
“I hope not.”
Kirby patted her on the back. “I’ll see you in two weeks.”
Chapter Twenty-three
On the day of the deposition, Sam felt unbelievably calm. The ER schedule was already set, so she had to work, but the evening-shift doctor came in early so Sam could get to the Saxton Pavilion by three o’clock. After signing out her cases, she changed into her most serious suit, a chic blue Brooks Brothers pinstriped jacket and skirt, coupled with a vivid teal-colored shell.
The only jitters she felt had to do with seeing Kirby again. Without the excuse of vacation photos, Sam hadn’t had a reason to reach out to her, and the line of communication between them seemed to be broken. Sam didn’t know what it meant, and that worried her more than the damn deposition.
Kirby met her in the lobby of the same office where they’d met twice before and patted her shoulder. “You’ve got this,” she said as they walked down the hallway together.
Suddenly Sam wanted to hug her, to pull her into the nearest closet and wrap her arms around Kirby, suck some of her strength and energy to help her through this. And maybe just to feel her, to feel that connection she was missing.
In spite of the preparation, Sam was still shocked as they entered the conference room. Just about every seat was occupied, with men and women in suits sitting behind laptops and briefcases and files stuffed with paper. None of them seemed to notice her arrival. A camera was set up on a tripod, and a woman wearing a headset stood behind it, preoccupied by her cell phone. The CT scan hung on the darkened X-ray light box, and a cart with pitchers of ice water and disposable cups stood off to the side.
Wanting to look like she had some control, Sam walked to the cart and casually poured herself a glass of ice water, then poured another for Kirby. Then she had a seat, beside Kirby, and squeezed the tissue in her hand, drying her palms.
Kirby leaned in to whisper in her ear and the intimacy caused Sam to shiver. “Remember. I don’t recall for anything you don’t remember or think you shouldn’t answer. Ask to talk to me if you have a question. Refer to the medical record if you need to. Now I’m going to let him sit for a minute, and you just think about Yosemite, and then we’ll get started.”
After the minute, Kirby, addressing no one in particular, cleared her throat. “It’s after three. I’d like to get started.”
Instantly, the laptops fell quiet, and the phones shut down as every eye in the room turned to her. A man, petite and clean shaven and probably not more than thirty years old, stood from the seat across from her and offered his hand. After introducing himself as the plaintiff’s lead attorney, they began.
Sam raised her right hand and pledged to be truthful, and then he started with his questions. After he finished dissecting her resume, he progressed to the chart, and Sam had a better appreciation for just how well Kirby had prepared her. They were at it for an hour before there was a curve ball, a question about the boy’s medical record. “Were you aware that the child was already taking an antibiotic when he came to the ER?”
After referring to the chart, where Sam noted the antibiotic, she told him she was. “So you were aware that the child had seen the pediatrician the day before?”
Again Sam looked at the chart and saw that reference. “Yes.”
“Did you look into the electronic record, which was available to you, to review the pediatrician’s exam findings from the day before?”
Sam could find no documentation in the chart that she’d reviewed the pediatrician’s note. “I don’t recall.”
“Well, luckily, the computer log has a better memory,” he said with a broad smile. “No one, including you, entered that note, on either of his trips to the ER. Now, Doctor, with a child who you thought was so sick, shouldn’t you have read his chart a little more carefully?”
Sam might have been put off by his demeanor, or the surprise question, but she wasn’t. Confident that she’d followed protocol, provided good care, and done her very best, she answered quite calmly. “I review old records when I need to. In this case, I didn’t need to. What I needed was a spinal tap, which the parents refused. I needed to admit him, which the parents also refused.”
“So, you felt the patient needed testing, and the parents didn’t understand the importance of that testing and made an error in judgment. Isn’t there a protocol in place for such situations? Couldn’t you have taken that child into protective custody and contacted Children and Youth Services?”
Sam took a deep breath, and in spite of her nerves, her answer was clear. Just as she and Kirby had rehearsed. “To my knowledge, there is no such protocol. In my twenty years of experience, I’ve never seen that happen. I think I would have needed another physician to agree with my plan. And since the pediatrician, who knew the child well, was against admission, I don’t feel I had grounds to do that.”
He didn’t look surprised by her answer, or disappointed. He was as good, or as well prepared, as Kirby. He moved on. The questions became easier, because they’d rehearsed, and it seemed to her that he almost gave up. He’d gone at her with fastballs, and when he realized Sam wasn’t going to strike out, that she wasn’t intimidated, and that she’d been well prepared, he realized he wasn’t going to win this fight. It became a formality at that point, and a little after five o’clock, he suddenly looked up and announced that he had no further questions.
