Chapter Thirteen
All hospitals have problems with drug theft. By law, each narcotic that is taken from the dispensary must be signed for, but no matter how controlled the security is, drug addicts almost invariably find a way to circumvent it.
Embarcadero County Hospital was having a major problem. Margaret Spencer went to see Ben Wallace. "I don't know what to do, doctor. Our fentanyl keeps disappearing. "
Fentanyl is a highly addictive narcotic and anesthetic drug.
"How much is missing?"
"A great deal. If it were just a few bottles, there could be an innocent explanation for it, but it's happening now on a regular basis. More than a dozen bottles a week are disappearing. "
"Do you have any idea who might be taking it?"
"No, sir. I've talked to security. They're at a loss. "
"Who has access to the dispensary?"
"That's the problem. Most of the anesthetists have pretty free access to it, and most of the nurses and surgeons. "
Wallace was thoughtful. "Thank you for coming to me. I'll take care of it. "
"Thank you, doctor. " Nurse Spencer left.
I don't need this right now, Wallace thought angrily. A hospital board meeting was coming up, and there were already enough problems to be dealt with. Ben Wallace was well aware of the statistics. More than 10 percent of the doctors in the United States became addicted, at one time or another, to either drugs or alcohol. The easy accessibility of the drugs made them a temptation. It was simple for a doctor to open a cabinet, take out the drug he wanted, and use a tourniquet and syringe to inject it. An addict could need a fix as often as every two hours.
Now it was happening at his hospital. Something had to be done about it before the board meeting. It would look bad on my record.
Ben Wallace was not sure whom he could trust to help him find the culprit. He had to be careful. He was certain that neither Dr. Taylor nor Dr. Hunter was involved, and after a great deal of thought, he decided to use them.
He sent for the two of them. "I have a favor to ask of you," he told them. He explained about the missing fentanyl. "I want you to keep your eyes open. If any of the doctors you work with have to step out of the OR for a moment, in the middle of an operation, or show any other signs of addiction, I want you to let me know. Look for any changes in personality - depression or mood swings - or tardiness, or missed appointments. I would appreciate it if you would keep this strictly confidential. "
When they left the office, Kat said, "This is a big hospital. We're going to need Sherlock Holmes. "
"No, we won't," Paige said unhappily. "I know who it is. "
Mitch Campbell was one of Paige's favorite doctors. Dr. Campbell was a likable gray-haired man in his fifties, always good-humored, and one of the hospital's best surgeons. Paige had noticed lately that he was always a few minutes late for an operation, and that he had developed a noticeable tremor. He used Paige to assist him as often as possible, and he usually let her do a major part of the surgery. In the middle of an operation, his hands would begin to shake and he would hand the scalpel to Paige.
"I'm not feeling well," he would mumble. "Would you take over?"
And he would leave the operating room.
Paige had been concerned about what could be wrong with him. Now she knew. She debated what to do. She was aware that if she brought her information to Wallace, Dr. Campbell would be fired, or worse, his career would be destroyed. On the other hand, if she did nothing, she would be putting patients' lives in danger. Perhaps I could talk to him, Paige thought. Tell him what I know, and insist that he get treatment. She discussed it with Kat.
"It's a problem," Kat agreed. "He's a nice guy, and a good doctor. If you blow the whistle, he's finished, but if you don't, you have to think about the harm he might do. What do you think will happen if you confront him?"
"He'll probably deny it, Kat. That's the usual pattern. "
"Yeah. It's a tough call. "
The following day, Paige had an operation scheduled with Dr. Campbell. I hope I'm wrong, Paige prayed. Don't let him be late, and don't let him leave during the operation.
Campbell was fifteen minutes late, and in the middle of the operation, he said, "Take over, will you, Paige? I'll be right back. "
I must talk to him, Paige decided. I can't destroy his career.
The following morning, as Paige and Honey drove into the doctors' parking lot, Harry Bowman pulled up next to them in the red Ferrari.
"That's a beautiful car," Honey said. "How much does one of those cost?"
Bowman laughed. "If you have to ask, you can't afford it. "
But Paige wasn't listening. She was staring at the car, and thinking about the penthouse, the lavish parties, and the boat. I was smart enough to have a clever father. He left all his money to me. And yet Bowman worked at a county hospital. Why?
Ten minutes later, Paige was in the personnel office, talking to Karen, the secretary in charge of records.
"Do me a favor, will you, Karen? Just between us, Harry Bowman has asked me to go out with him and I have a feeling he's married. Would you let me have a peek at his personnel file?"
"Sure. Those horny bastards. They never get enough, do they? You're darn right I'll let you look at his file. " She went over to a cabinet and found what she was looking for. She brought some papers back to Paige.
Paige glanced through them quickly. Dr. Harry Bowman's application showed that he had come from a small university in the Midwest and, according to the records, had worked his way through medical school. He was an anesthesiologist.
His father was a barber.
Honey Taft was an enigma to most of the doctors at Embarcadero County Hospital. During the morning rounds, she appeared to be unsure of herself. But on the afternoon rounds, she seemed like a different person. She was surprisingly knowledgeable about each patient, and crisp and efficient in her diagnoses.
One of the senior residents was discussing her with a colleague.
"I'll be damned if I understand it," he said. "In the morning, the complaints about Dr. Taft keep piling up. She keeps making mistakes. You know the joke about the nurse who gets everything wrong? A doctor is complaining that he told her to give the patient in Room 4 three pills, and she gave the patient in Room 3 four pills, and just as he's talking about her, he sees her chasing a naked patient down the hall, holding a pan of boiling water. The doctor says, 'Look at that! I told her to prick his boil!' "
His colleague laughed.
"Well, that's Dr. Taft. But in the afternoon she's absolutely brilliant. Her diagnoses are correct, her notes are wonderful, and she's as sharp as hell. She must be taking some kind of miracle pill that only works afternoons. " He scratched his head. "It beats the hell out of me. "
Dr. Nathan Ritter was a pedant, a man who lived and worked by the book. While he lacked the spark of brilliance, he was capable and dedicated, and he expected the same qualities from those who worked with him.
Honey had the misfortune to be assigned to his team.
Their first stop was a ward containing a dozen patients. One of them was just finishing breakfast. Ritter looked at the chart at the foot of the bed. "Dr. Taft, the chart says this is your patient. "
Honey nodded. "Yes. "
"He's having a bronchoscopy this morning. "
Honey nodded. "That's right. "
"And you're allowing him to eat?" Dr. Ritter snapped. "Before a bronchoscopy?"
Honey said, '"'The poor man hasn't had anything to eat since - "
Nathan Ritter turned to his assistant. "Postpone the procedure. " He started to say something to Honey, then controlled himself. "Let's move on. "
The next patient was a Puerto Rican who was coughing badly. Dr. Ritter examined him. "Whose patient is this?"
"Mine," Honey said.
He frowned. "His infection should have cleared up before now. " He took a look at the chart. "You're giving
him fifty milligrams of ampicillin four times a day?"
"That's right. "
"That's not right. It's wrong. That's supposed to be five hundred milligrams four times a day. You left off a zero. "
"I'm sorry, I . . . "
"No wonder the patient's not getting any better! I want it changed immediately. "
"Yes, doctor. "
When they came to another patient of Honey's, Dr. Ritter said impatiently, "He's scheduled for a colonoscopy. Where is the radiology report?"
"The radiology report? Oh. I'm afraid I forgot to order one. "
Ritter gave Honey a long, speculative look.
The morning went downhill from there.
The next patient they saw was moaning tearfully. "I'm in such pain. What's wrong with me?"
"We don't know," Honey said.
Dr. Ritter glared at her. "Dr. Taft, may I see you outside for a moment?"
In the corridor, he said, "Never, never tell a patient that you don't know. You're the one they're looking to for help! And if you don't know the answer, make one up. Do you understand?"
"It doesn't seem right to . . . "
"I didn't ask you whether it seemed right. Just do as you're told. "
They examined a hiatal hernia, a hepatitis patient, a patient with Alzheimer's disease, and two dozen others. The minute the rounds were over, Dr. Ritter went to Benjamin Wallace's office.
"We have a problem," Ritter said.
"What is it, Nathan?"
"It's one of the residents here. Honey Taft. "
Again? "What about her?"
"She's a disaster. "
"But she had such a wonderful recommendation. "
"Ben, you'd better get rid of her before the hospital gets in real trouble, before she kills a patient or two. "
Wallace thought about it for a moment, then made his decision. "Right. She'll be out of here. "
Paige was busy in surgery most of the morning. As soon as she was free, she went to see Dr. Wallace, to tell him of her suspicions about Harry Bowman.
"Bowman? Are you sure? I mean . . . I've seen no signs of any addiction. "
"He doesn't use it," Paige explained. "He sells it. He's living like a millionaire on a resident's salary. "
Ben Wallace nodded. "Very well. I'll check it out. Thank you, Paige. "
Wallace sent for Bruce Anderson, head of security. "We may have identified the drug thief," Wallace told him. "I want you to keep a close watch on Dr. Harry Bowman. "
"Bowman?" Anderson tried to conceal his surprise. Dr. Bowman was constantly giving the guards Cuban cigars and other little gifts. They all loved him.
"If he goes into the dispensary, search him when he comes out. "
"Yes, sir. "
Harry Bowman was headed for the dispensary. He had orders to fill. A lot of orders. It had started as a lucky accident. He had been working in a small hospital in Ames, Iowa, struggling to get by on a resident's salary. He had champagne taste and a beer pocketbook, and then Fate had smiled on him.
One of his patients who had been discharged from the hospital telephoned him one morning.
"Doctor, I'm in terrible pain. You have to give me something for it. "
"Do you want to check back in?"
"I don't want to leave the house. Couldn't you bring something here for me?"
Bowman thought about it. "All right. I'll drop by on my way home. "
When he visited the patient, he brought with him a bottle of fentanyl.
The patient grabbed it. "That's wonderful!" he said. He pulled out a handful of bills. "Here. "
Bowman looked at him, surprised. "You don't have to pay me for that. "
"Are you kidding? This stuff is like gold. I have a lot of friends who will pay you a fortune if you bring them this stuff. "
That was how it had begun. Within two months, Harry Bowman was making more money than he had ever dreamed possible. Unfortunately, the head of the hospital got wind of what was going on. Fearing a public scandal, he told Bowman that if he left quietly, nothing would appear on his record.
I'm glad I left, Bowman thought. San Francisco has a much bigger market.
He reached the dispensary. Bruce Anderson was standing outside. Bowman nodded to him. "Hi, Bruce. "
"Good afternoon, Dr. Bowman. "
Five minutes later when Bowman came out of the dispensary, Anderson said, "Excuse me. I'm going to have to search you. "
Harry Bowman stared at him. "Search me? What are you talking about, Bruce?"
"I'm sorry, doctor. We have orders to search everyone who uses the dispensary," Anderson lied.
Bowman was indignant. "I've never heard of such a thing. I absolutely refuse!"
"Then I'll have to ask you to come along with me to Dr. Wallace's office. "
"Fine! He's going to be furious when he hears about this. "
Bowman stormed into Wallace's office. "What's going on, Ben? This man wanted to search me, for God's sake!"
"And did you refuse to be searched?"
"Absolutely. "
"All right. " Wallace reached for the telephone. "I'll let the San Francisco police do it, if you prefer. " He began to dial.
Bowman panicked. "Wait a minute! That's not necessary. " His face suddenly cleared. "Oh! I know what this is all about!" He reached in his pocket and took out a bottle of fentanyl. "I was taking these to use for an operation, and . . . "
Wallace said quietly, "Empty your pockets. "
A look of desperation came over Bowman's face. "There's no reason to . . . "
"Empty your pockets. "
Two hours later, the San Francisco office of the Drug Enforcement Agency had a signed confession and the names of the people to whom Bowman had been selling drugs.
When Paige heard the news, she went to see Mitch Campbell. He was sitting in an office, resting. His hands were on the desk when Paige walked in, and she could see the tremor in them.
Campbell quickly moved his hands to his lap. "Hello, Paige. How're you doing?"
"Fine, Mitch. I wanted to talk to you. "
"Sit down. "
She took a seat opposite him. "How long have you had Parkinson's?"
He turned a shade whiter. "What?"
"That's it, isn't it? You've been trying to cover it up. "
There was a heavy silence. "I . . . I . . . yes. But I . . . I can't give up being a doctor. I . . . I just can't give it up. It's my whole life. "
Paige leaned forward and said earnestly, "You don't have to give up being a doctor, but you shouldn't be operating. "
He looked suddenly old. "I know. I was going to quit last year. " He smiled wanly. "I guess I'll have to quit now, won't I? You're going to tell Dr. Wallace. "
"No," Paige said gently. "You're going to tell Dr. Wallace. "
Paige was having lunch in the cafeteria when Tom Chang joined her.
"I heard what happened," he said. "Bowman! Unbelievable. Nice work. "
She shook her head. "I almost had the wrong man. "
Chang sat there, silent.
"Are you all right, Tom?"
"Do you want the 'I'm fine,' or do you want the truth?"
"We're friends. I want the truth. "
"My marriage has gone to hell. " His eyes suddenly filled with tears. "Sye has left. She's gone back home. "
"I'm so sorry. "
"It's not her fault. We didn't have a marriage anymore. She said I'm married to the hospital, and she's right. I'm spending my whole life here, taking care of strangers, instead of being with the people I love. "
"She'll come back. It will work out," Paige said soothingly.
"No. Not this time. "
"Have you thought about counseling, or . . . ?"
"She refuses. "
"I'm sorry, Tom. If there's anything I . . . " She heard her name on the loudspeaker.
"Dr. Taylor, Room 410 . . . "
> Paige felt a sudden pang of alarm. "I have to go," she said. Room 410. That was Sam Bernstein's room. He was one of her favorite patients, a gentle man in his seventies who had been brought in with inoperable stomach cancer. Many of the patients at the hospital were constantly complaining, but Sam Bernstein was an exception. Paige admired his courage and his dignity. He had a wife and two grown sons who visited him regularly, and Paige had grown fond of them, too.
He had been put on life-support systems with a note, DNR - Do Not Resuscitate - if his heart stopped.
When Paige walked into his room, a nurse was at the bedside. She looked up as Paige entered. "He's gone, doctor. I didn't start emergency procedures, because . . . " Her voice trailed off.
"You were right not to," Paige said slowly. "Thank you. "
"Is there anything I . . . ?"
"No. I'll make the arrangements. " Paige stood by the bedside and looked down at the body of what had been a living, laughing human being, a man who had a family and friends, someone who had spent his life working hard, taking care of the ones he loved. And now . . .
She walked over to the drawer where he kept his possessions. There was an inexpensive watch, a set of keys, fifteen dollars in cash, dentures, and a letter to his wife. All that remained of a man's life.
Paige was unable to shake the feeling of depression that hung over her. "He was such a dear man. Why . . . ?"
Kat said, "Paige, you can't let yourself get emotionally involved with your patients. It will tear you apart. "
"I know. You're right, Kat. It's just that . . . it's over so quickly, isn't it? This morning he and I were talking. Tomorrow is his funeral. "
"You're not thinking of going to it?"
"No. "
The funeral took place at the Hills of Eternity Cemetery.
In the Jewish religion, burial must take place as soon as possible following the death, and the service usually takes place the next day.
The body of Sam Bernstein was dressed in a takhrik-him, a white robe, and wrapped in a talit. The family was gathered around the graveside. The rabbi was intoning, "Hamakom y'nathaim etkhem b'tokh sh'ar availai tziyon veeyerushalayim. "
A man standing next to Paige saw the puzzled expression on her face, and he translated for her. " 'May the Lord comfort you with all the mourners of Zion and Jerusalem. ' "
To Paige's astonishment, the members of the family began tearing at the clothes they were wearing as they chanted, "Baruch ata adonai elohainu me lech haolam dayan ha-emet. "
"What . . . ?"
"That's to show respect," the man whispered.
"From dust you are and to dust you have returned, but the spirit returns to God who gave it. " The ceremony was over.
The following morning, Kat ran into Honey in the corridor. Honey looked nervous.
"Anything wrong?" Kat asked.
"Dr. Wallace sent for me. He asked me to be in his office at two o'clock. "
"Do you know why?"
"I think I messed up at rounds the other day. Dr. Ritter is a monster. "
"He can be," Kat said. "But I'm sure everything will be all right. "
"I hope so. I just have a bad feeling. "
Promptly at two o'clock, she arrived at Benjamin Wallace's office, carrying a small jar of honey in her purse. The receptionist was at lunch. Dr. Wallace's door was open. "Come in, Dr. Taft," he called.
Honey walked into his office.
"Close the door behind you, please. "
Honey closed the door.
"Take a seat. "
Honey sat down across from him. She was almost trembling.
Benjamin Wallace looked across at her and thought, It's like kicking a puppy. But what has to be done has to be done. "I'm afraid I have some unfortunate news for you," he said.
One hour later, Honey met Kat in the solarium. Honey sank into a chair next to her, smiling.
"Did you see Dr. Wallace?" Kat asked.
"Oh, yes. We had a long talk. Did you know that his wife left him last September? They were married for fifteen years. He has two grown children from an earlier marriage, but he hardly ever sees them. The poor darling is so lonely. "