Jimmy nodded. "Sometimes." His eyes focused on something Earl couldn't see.
Judging from the pain reflected in the priest's gaze, Earl didn't want to see it. "You still could have come to me, Jimmy," he said softly. "Brought me patients' names and chart numbers. That's the kind of documentation that would have nailed Wyatt and others like him."
"Yeah, right. Case by case, committee by committee- it takes forever that way."
Earl exhaled long and hard. "But keep at it enough, and even the thickest-skulled dinosaurs change their ways in the end."
"Then why didn't you do it?"
"Me?"
"Yeah. You're a physician. Nothing stopped you from stepping up with charts and patient names these last twenty-five years."
Earl bristled. "Nobody dies like that in my department. Certainly not since I've been chief."
Jimmy's eyes narrowed into a hard, unjoking glare. "And that's the trouble with you, Earl. You hide in ER."
"Hide?"
"Yes, hide. It's a domain as black and white as any in the hospital. The sicker the patients, the easier your job. Stabilize 'em, medicate 'em, and ship 'em upstairs. Don't get me wrong, you're great at it- decisive, skilled, and courageous. But one of the reasons the job suits you isn't so noble. The patients don't hang around, and you like it that way. The ones who don't make it, you can honestly tell yourself they died while you were trying everything possible. The ones who do, their pain, fear, and despair are muted by shock or postponed by drugs. The long and short of it all is that you get to keep your losses more cut-and-dried. No having to deal with the long, messy aftermath that survival involves."
"Whoa. Now wait a minute, Jimmy. I find out how people did after they left ER. Their doctors tell me-"
"I'm not talking about the clinical results or satisfying your medical curiosity."
"Jesus, Jimmy, what the hell's the matter with you?"
"What's the matter is, you can't be VP, medical and bury yourself in a mentality that has a fix for everything."
Earl leapt to his feet. "That's not fair!"
"What's fair got to do with it? You want to face a patient's lingering, share in his or her long-term agony, witness their slow settling for a fraction of a former life, then watch your successes as they piece together what they lost from the heart attack or stroke or car accident that derailed them."
"Damn it, Jimmy, how dare you-"
"Why, in all the years I've been here, I never once saw you up on the floors visiting with any of the people you saved."
Earl felt he'd been gut-punched.
He stood behind his desk as a tiny prickle of sweat dampened the back of his shirt despite the chill of cold air pouring over his head from a ventilation duct in the ceiling.
The black of Jimmy's eyes increased its hold on him. "If you'd had any inkling at all for that part of the game, Earl, now and then I would have found you on the wards where it plays itself out. And maybe, just maybe, when you came across wretched souls with barely days left to live, bellowing like wounded beasts, you might have acquired the same compassion for them that you found for the likes of Artie Baxter when you made sure he didn't suffer in ER."
With that, the priest released him from the tractor-beam grip of his stare, quietly opened the door, and disappeared into the darkened corridor.
The head nurse slid her glasses to the tip of her nose, peered at him, then let them drop on their silver chain. "Dr. Garnet! We don't usually see you up here."
"Here" referred to the Palliative Care Unit, or "terminus," as some of the more callous residents called it.
"Then it's about time," he answered, straining to read the woman's name tag. "Mrs. Yablonsky, would you be so kind as to grab the chart cart and accompany me as I see the patients?"
Crinkles at the corners of her eyes lessened. "See the patients?"
"Yes."
"All of them?"
"Yep."
"Now?"
He nodded.
"But why?"
"I want to check their pain medication."
The visible portion of her face corrugated itself into a frown. "You mean without their doctors knowing?"
Jesus, he'd be here all night answering her questions. "We're going to be doing an audit on pain management throughout the whole hospital. Dr. Wyatt himself will be chairing it. I thought I'd get a head start."
The far smoother foreheads of two younger nurses who had approached from behind her scrunched up in amazement.
"Dr. Wyatt knows about this?" the supervisor asked.
Earl smiled in response.
"Well, it's most peculiar…" She pushed herself out of a swivel seat, surprising him with her height. With eyes nearly at the same level as his, she also possessed the big shoulders and sculpted build of someone who swam laps across Lake Erie.
While he waited for her to prepare the charts his gaze drifted along the polished, barren corridor, and he shuddered at the thought of being stuck here to die. Just park him under a tree with a nice view and a bottle of whisky when his time came.
He'd never admitted it to anyone, but deep down he hated hospitals, felt claustrophobic in them. As a patient, he'd loathe every part of surrendering to any regime that a place like St. Paul's would impose on him, especially with his butt hanging out the back of a tie-up gown.
Through windows at the far end of the unit he watched the sun as it slipped behind a column of thunderheads that had been piling up over the lake. Immediately the passageway darkened, and everything became cast in a thin yellow light. Low rumbles sounded outside, and a crackle of static interrupted the quiet music from a radio on the work counter.
"Storm's coming," said one of the younger nurses, reaching up and snapping the off button.
Only then did he hear the weak moans and wailing. Mere wisps of sound that floated out from the semidarkness of the hallway, they were the kind of noises that, once gotten used to, could easily be ignored- with the help of a radio. "Are they always crying like that?"
"Oh, this is nothing," Yablonsky said. "Sometimes they get to screaming so loud you can't hear yourself think." Oblivious to her own callousness, she never paused in pulling out charts and placing them on a pushcart.
A twist of anger turned his stomach.
In the first room they stopped in, he found an old man curled in bed, as withered and emaciated as a mummy. His skin had yellowed with jaundice, and, either comatose or sleeping soundly, he didn't respond when Yablonsky called his name or slipped the mask that had fallen off his face back into place. Earl let him be.
Next door to him lay an elderly lady in similar shape.
In the third room, a gaunt, gray-faced woman with the wisps of her remaining hair combed neatly into place sat in a chair and stared out at the approaching rain clouds. Her upper face brightened as soon as she saw him. "How nice, a new doctor."
A glance at her chart before coming in revealed her name to be Sadie Locke and that she had metastatic cancer of the breast that neither chemotherapy nor radiation could halt. As he stepped up to shake her hand and introduce himself, the sleeve of her housecoat slipped up her arm to reveal a swarm of florid red blotches where the tumor had seeded itself to her skin, and a sniff of decay floated down the back of his nose.
"I love a thunderstorm at the end of a hot summer day, don't you?" she said after assuring him she felt comfortable most days on her current drug regime. "It's so refreshing, and the air smells wonderfully clean afterward."
"Yes, I know exactly what you mean," he said. Her pleasant manner put him at ease. Normally having nothing to offer a patient but small talk made him feel awkward. "Do you have family?" he asked after a few seconds, mostly to reassure himself she knew someone who cared enough to keep her company. He couldn't imagine anything worse than being confined to a room, with no prospects of a visitor.