Confused and not knowing exactly what to do, Lynn wandered over to the counter facing the central desk. She assumed she would soon be challenged, but felt it no longer made a difference. If Carl was not in the PACU or on the fifth floor, then where the hell was he? And why was he not on the orthopedic floor? There were beds available, according to Hank. Of course maybe Carl had been finished so soon that it was before the beds on five were ready. Hank had said that they had been vacated just that morning. Lynn felt that had to be the explanation. Yet the ongoing mystery was starting to upset her, fanning the subliminal tension she had felt upon awakening that morning, the same tension that had made her laugh so hard at Ronald’s off-color joke about the angel.
“Can I help you?” a voice questioned.
Lynn turned to face a PACU nurse almost as tall as she. The nurse was gowned over her scrubs. She regarded Lynn with a questioning, steady gaze.
“I hope so,” Lynn said. “I’m looking for Dr. Weaver’s first case. A man named Carl Vandermeer.”
“And who are you?” The woman’s voice wasn’t challenging or truculent, just authoritative.
“I’m Lynn Peirce, a medical student. I did a rotation in orthopedics and scrubbed with Dr. Weaver.” It was the first thought that came to her mind. It wasn’t a real explanation, but it sounded good.
The nurse eyed Lynn for a moment, then went behind the desk. “The name is not familiar to me,” she said. She took a quick look at the PACU log and found it. “He was Gloria’s case,” she said to Lynn, and then called loudly across the room. “Gloria! What was the dispensation of the Vandermeer case?”
“The neuro consult guys took him to the neuro ICU,” Gloria called back.
Lynn reached out and grabbed onto the edge of the desk to help support herself. The neuro ICU! What the hell did that mean? As she turned and fled from the PACU, she tried not to think. The problem was that she had a pretty good idea of what it meant for Carl to be in the neuro ICU.
4
Monday, April 6, 11:05 A.M.
Lynn was in a hurry. It was a way to avoid thinking. Without bothering to change back to her street clothes, she went directly to the main elevators, where a number of people were waiting. To avoid the possibility of getting into a conversation, she avoided any eye contact, keeping her attention glued to the floor indicators above the elevator doors. Nervously she continuously pressed the up button. None of the cars appeared to be moving up or down.
“That’s not going to get the elevator here any faster,” a woman said. Lynn closed her eyes, hoping that by not responding she would be spared having to try to be pleasant while her mind was in turmoil. There was nothing about Carl being in the neuro ICU that could be good news, and it was difficult not to imagine the worst.
“You are a fourth-year med student, if I’m not mistaken,” the voice said, undeterred by Lynn’s silence.
Reluctantly Lynn turned to face the woman. As soon as she did, she recognized her as one of the surgical attendings. She was wearing a long white lab coat over scrubs. Lynn assumed she was between cases and heading up to the surgery floor to check on a patient.
Lynn tried to smile in an attempt to be sociable. Her pulse was throbbing in her temples. She wondered if her face was red or pale. It had to be one extreme or the other, as she was experiencing an adrenaline rush. She was aware she was hyperventilating. She nodded. “I am,” she said distractedly. What the hell could be holding up the elevators? Still none had moved from the various floors where they had been when she first hit the button.
“Lynn Peirce,” the surgeon said, bending forward and reading Lynn’s ID hanging from a lanyard around her neck. “Actually, I remember you from your third-year surgery rotation. I’m Dr. Patricia Scott.”
“I remember you for sure,” Lynn managed. “Your lectures were terrific, especially your slides.” Lynn forced another half smile at the tall, elegant woman before returning her attention to the elevator floor indicator. She hoped her anxiousness wasn’t too apparent. She didn’t want to explain herself.
“Thank you. You must have been paying attention. I remember you did extremely well. I understand you got your residency notification a couple of weeks ago. Considering how well you did in your surgery rotation, I hope you gave surgery some consideration.”
“Orthopedics, actually,” Lynn said.
“Indeed! That’s terrific. We need more women in all the surgical fields, particularly orthopedics, where we are not very well represented. Where will you be going for your training?”
“I’m staying here,” Lynn said.
“Wonderful,” Dr. Scott said sincerely. “That’s super. I’ll look forward to having you scrub with me during your first year of general surgery.”
“I’m sure I will enjoy that, Dr. Scott,” Lynn said, hoping she didn’t appear as preoccupied and stressed as she felt. Finally one of the elevators that had seemingly been parked on the first floor began to ascend.
“You can call me Patricia now that you will be part of the house staff. And, for the record, my office is always open if you need any advice. It wasn’t that long ago I went through the training gauntlet, and unfortunately surgery is still anachronistically considered by some to be a men’s club.”
“I appreciate your thoughtfulness,” Lynn said.
The elevator’s doors opened. The car was jam-packed. Dr. Scott gestured for Lynn to precede her, and both had to literally squeeze in to allow the doors to close. Lynn was briefly tempted to ask Dr. Scott what it meant for a patient to go to the neuro ICU directly from the PACU, but she didn’t. The trouble was, she could guess. It had to have been some kind of anesthesia problem or disaster. Yet she still maintained a certain amount of hope it could have been something less worrisome. Could a nerve in Carl’s leg have been damaged with the bone drill? As bad as that might be, it was better than other possibilities she was trying to avoid imagining.
By the time they got up to the sixth floor, where neurology and neurosurgery were located, the elevator had emptied considerably. Lynn thanked Patricia Scott before getting off. She walked quickly. She knew where the neuro ICU was located. She’d been there on a few occasions during her neurology rotation and again during her stint on neurosurgery.
Most visitors to the floor were expected to check in at the main nurses’ station. But Lynn decided on the spur of the moment to act the same way she had down in the PACU: as if she belonged. Without hesitation she pushed into the ICU directly.
The neuro ICU appeared superficially similar to the PACU in terms of its prominent high-tech equipment, but here patients stayed much longer, sometimes weeks, even months on occasion. There were separate cubicles defined by glass walls, and not all the patients were sporting bandages. There was also less frantic activity from constant arrival and departure. Instead, a kind of heavy silence reigned, broken only by the distant beeping of monitors and the rhythms of the ventilators. A central circular desk was positioned to afford a view into each of the sixteen individual bays. All were occupied. At least half had nurses in direct attendance.
As Lynn glanced around the room she saw that each cubicle had an ID slot with the patient’s name printed in bold letters. Almost at once she zeroed in on VANDERMEER, cubicle 8. Slowly she advanced. Carl was supine. She could not see his face. As she had expected, there was a CPM apparatus constantly flexing and extending his operated leg. Seeing it gave her a modicum of premature hope that everything was as it should be, but it didn’t last long.