Sure, PFG had some trouble eleven months ago with an outbreak of C. difficile. Four elderly patients contracted the bacterial infection, and one of them had died. (Too bad the Promise Falls Standard was still printing at the time; it was front-page material for the better part of two weeks.) But that was the sort of thing that could happen to any hospital, and almost invariably did. Agnes Pickens had instituted even more rigorous hand-washing and cleaning procedures, and had gotten the outbreak under control. And where was the Standard’s front-page story on that?
Ask anyone in town if they’d be happy to be treated at Promise Falls General, and invariably they’d say, “Uh, if you think there’s even a chance of one in a hundred you can get me to Syracuse or Albany before I die, I’ll take a pass on PFG.” Changing that perception was proving to be a challenge for Agnes.
A woman in a pale green uniform and a hairnet walked into the room with a plate of bran muffins.
“Here you go, Ms. Pickens,” she said.
“Frieda, take them off that plate and arrange them with the others,” Agnes said. “And I hope to God you washed your hands before you touched the food.”
“Of course, ma’am.” She added the new muffins to the platter and slipped out of the room as Carol entered.
“They’re here,” she said.
“Send them in,” Agnes said.
Ten people filed in, nodding greetings, making small talk. Local businesspeople, two doctors, the hospital’s chief fund-raiser.
“Morning, Agnes,” said a silver-haired man in his early sixties.
“Dr. Sturgess,” she said, shaking his hand. Then added, “Jack.”
Jack Sturgess, as if anticipating a rebuke, smiled and said, “I’ve started entering my notes into the system this week. Honest. No more paper.”
A few others heard the comment and chuckled as they helped themselves to coffee and tea and settled into the cushioned high-backed chairs around the table’s perimeter. Several helped themselves to muffins, and Agnes noticed at least three of them reaching for a bran.
She liked vindications, no matter how small.
She also liked being in charge. Liked it very much. Here she was, someone who’d never been a doctor, in charge of all this. After graduating nursing school, she’d tried her hand at being a midwife in Rochester for a couple of years, then returned to school for business. Applied, and got, a job in this hospital’s administrative department and, over the years, worked her way right to the top.
Agnes Pickens took her seat at the head of the table and kept her welcome short. “I want to get straight to business,” she said, setting her cell phone, screen up, on the table next to her copy of the hospital report. “You’ll notice on the first page of the document before you that the rankings are in and they are not satisfactory. They are a disgrace. They do not reflect the quality of the work that we are doing here at Promise Falls General.”
A woman at the far end of the table said, “You have to take those things with a grain of—”
“Dr. Ford, I’m speaking. While this ranking is grossly unfair, the only way we’re going to deal with it is to work even harder in every department. We need to look at every single thing we do here and find a way to do it even better. For example, we’re still not where we need to be on computerization of records. It’s vitally important that all relevant patient information be entered into the system to avoid any potential allergy and medication mix-ups. But some staff are still recording information on paper, and leaving it to others to input this data.”
“Not guilty,” Jack Sturgess said. “I’ve gone totally computer.”
“You’re an inspiration to us all,” Agnes said.
Her phone buzzed. She glanced down, saw that it was her sister, Arlene Harwood, calling. She also noticed, for the first time, that she had a couple of voice-mail messages. Agnes felt that whatever they were could wait. The phone buzzed six times, the vibrations traveling the length of the table like a minor earth tremor.
“I’m getting pushback from some staff on this computer filing issue, and I want to get the message out that no one is so special as to be exempt from this. No one. And it’s not the regular rank and file who are resisting. It’s the doctors and surgeons and specialists who seem to think that somehow this duty is beneath them. In part, it’s a generational issue. Younger physicians who’ve grown up with technology are not—”
The phone buzzed again. Arlene trying a second time.
Agnes Pickens hated to be thrown off her game when she was in the middle of something. She picked up the phone, pressed a button to immediately decline the call.
“As I was saying, just because some people who work here, or have privileges here, may not be as computer-savvy as some of their younger colleagues is not an excuse. They are going to have to—”
A text appeared on her phone. From Arlene:
CALL ME!!! IT’S ABOUT MARLA.
Agnes studied the screen for several seconds. “Excuse me,” she said finally, pushing back her chair. “I want five ideas on how to get this ranking up by the time I come back.” She grabbed her phone, exited the boardroom, and closed the door behind her. She entered her sister’s home number and put the phone to her ear.
“Agnes?”
“I’m in the middle of a board meeting,” she said. “What’s this about Marla?”
“My God, I’ve been calling and calling.”
“What is it?”
“She’s done it again,” Arlene said. “David just called. I sent him by to see her with some chili and—”
“Done what, Arlene?”
“David found her looking after a baby.”
Agnes closed her eyes and touched her free hand to her temple, as if she could magically ward off the headache she knew was coming.
“There’s been no incident here,” Agnes said. “If someone had taken a baby from the hospital I would have been notified instantly. David must be mistaken.”
“I don’t know where she got it,” Arlene said. “But I trust David on this. If he says there’s a baby, there’s a baby.”
“Dear God,” Agnes said. “That child, I swear.”
“She’s not a child. She’s a grown woman, and she’s been traumatized. It’s not her fault.”
“Don’t lecture me, Arlene.” It never ended, Agnes thought. Once an older sister, always an older sister.
Agnes wasn’t just younger than Arlene. She was her much younger sister. Their mother had Arlene at the age of twenty, and didn’t get pregnant with Agnes until she was thirty-five. There was one other child, a boy named Henry, a couple of years after Arlene, and then a gulf of thirteen years. Everyone figured Agnes must have been an accident. Surely their parents hadn’t planned to have her. But once they knew she was on the way, they went ahead and had her. The thought of terminating the pregnancy never even occurred to their parents, and not because they were at all religious or were staunchly prolife.
They just figured, What the hell. Let’s have another kid.
Despite having an older brother and sister, Agnes felt as though she were an only child. The age difference meant her siblings had very little to do with her. They were either in or just starting high school when she came along. So they were never playmates, never went to school together. Arlene and Henry, being two years apart, had a bond Agnes could only dream of. She resented it for years, until Henry was killed in a car accident nearly two decades earlier. Only then, it struck Agnes, did Arlene begin to take a greater interest in her.