Lie Still, page 25
The question is, can you convince a jury that you—we—
didn’t do anything wrong. If Henry doesn’t die and he’s just left with permanent brain damage and they let some plain-tiff’s attorney wheel a comatose teenager into court, most juries will go nuts, no matter what the facts are.”
“This is depressing,” she said. She looked over at me. She put out a hand, taking mine. I stepped behind her and put my arms around her waist. She nuzzled her head back onto my chest. I leaned down and kissed her neck. She turned to me and our mouths met, softly at first, then wet with full intention.
“Time to eat,” she said, pulling away.
The coy looks melted into inviting smiles. Halfway through the plate of stir-fry I was cocking my head right, eyes closed, and digging my fingers into the golf ball in my left trapezius again. She suddenly stood up and said, “You need a back rub.” She held a hand toward me. When I took it she pulled me up and kissed me. I hadn’t planned on a sudden shift to the physical but it didn’t seem like a bad idea.
She disappeared into the back of the house and returned with a sheet, a towel, and a bottle of oil. She put the oil in the microwave, then pointed me to her bedroom. “Promise not to look at the room. It’s a mess.”
“It’ll remind me of home.”
She called after me, “You’re going to have to take your clothes off.”
“Oh damn,” I said.
Her bedroom furnishings were minimal: a bed, a nightstand, a dresser, and a bookcase. There was nothing on the walls.
I pulled off my shirt and sneakers and lay facedown with my feet at the head of her bed. She came in and lit two candles. Her massage oil was slightly hot, her hands very strong. She kneaded both my trapezii and all the strap muscles of my neck until they felt like they could never again raise my head. I could still tell where the knot was, but its angry barbs were gone.
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“You’re amazing,” I said through the pillow.
“I took an extra-credit course in nursing school,” she said.
She worked down each arm individually, then back to each shoulder. She worked down my back to the lumbar curve, then wiped her hands, reached under my stomach, and undid my pants. These she slid down and off, then pulled off my socks, leaving me naked. I turned my head and began to rise up slightly but she said, “Lie down and relax.”
It occurred to me: Why did I even start to get up? To what, exactly, was I going to object?
She straddled me and laid her hands back in the exact spot she had just left. From the small of my back she began deep circular strokes around my buttocks. “That feels amazingly good,” I said.
“These are your biggest muscles. And fine ones, at that.”
I was smiling like a fool. She worked down my thighs, calves, feet and toes. I was feeling whole and perfect, as if my flaws had disappeared.
“Flip over,” she said. I hesitated only an instant. She worked from the tops of my feet up my shins and the front of my thighs. She spread my legs slightly to get to my inner thighs and worked up to my abdominals, barely brushing my half-erect penis. She went on up my chest, working over my chest muscles, did the front of my neck, then my face, with small circles around the temples.
“Now you rest,” she said, and was gone. At that hour I should have fallen asleep in seconds, especially after the two glasses of wine, but my biologic clock was inverted and the procreational parts of my brain were on alert. I just drifted along, smiling drowsily. I did not, however, move.
Piano music came from the living room. I became aware of her moving beside me just before she touched my lips with her index finger, then straddled me again. Her legs were bare. She rubbed my chest again, then bent down and brushed her lips against mine. I smiled, eyes closed. Her cue. She kissed me, well. She had an urgency.
I kept my hands at my sides, my reciprocation strictly in my lips. She slid down my abdomen to kiss, lick, and soon LIE STILL
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enough suck my near-painful engorgement. She took me well into her mouth with a vigorous rhythm, but stopped just short of culmination.
I opened my eyes to see Robin’s breasts suspended over my face, but for a second I only smiled. She returned the smile and kissed me hard on the mouth. She rubbed her nipples around mine, then slowly rose over my face again for me to suck and kiss her breasts. They were wonderful, despite the obvious presence of silicone implants.
I got her to lie back so I could take a turn with my own mouth. I said, “It seems you have some redheaded genes on the back of a chromosome somewhere.”
She pulled me up to her again, saying, “It’s just the can-dlelight.” Then she rose, saying, “I need you in me.” She went to an old bookcase built into the far wall, retrieving what looked like a large pair of matching books, glued together. “Toy box,” she said. She took a tiny key from the drawer in the nightstand and put it into a nearly invisible slit in the edge of the upper book, turned it, and the cover popped up slightly.
“I got this at a place in North Beach in San Francisco called the Kitsch Kitchen. Isn’t it great?” she said.
Inside the box were some papers, a small stack of money neatly bound with a white paper strip, some silk scarves, condoms, spermicidal foam, and a dildo-shaped vibrator.
The bill on top of the stack was clearly a hundred. I said,
“Jesus, you must deal drugs or something.”
“Oh shit,” she said, “you’re not supposed to be looking.” She gave me an exasperated look. “My parents have a lot of money and my dad insists on sending me some every month. He doesn’t want Mom to know, so he sends cash. I never deposit it so the IRS doesn’t think I’m ‘dealing drugs or something.’ ”
“What are the scarves for?” I asked.
“If you’re bad I tie you to the bed,” she said with a smile as she tossed me a condom and took the foam into the bathroom.
I called, “What if I’m good?”
“Then I tie you to the bed to keep you here,” she called back.
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Completion of our lovemaking was exquisite, if conven-tional. I topped it off with a quick lapse into total unconsciousness. When I came around I opened my eyes to see Robin up on an elbow, staring at my face. The candles were still burning; little had changed. I offered an expectant smile.
She blinked, but said nothing, still looking at me intently.
She kissed me briefly, then went to the bathroom.
Her prodding me gently in the arm woke me up a second time. “It’s time for you to go home, sleepyhead.”
I frowned. “What time is it?”
She was wearing a plaid flannel nightgown now. “About one-thirty. I need my beauty rest. And you just need some rest, period.”
I looked at her. “I kinda like sleeping here.”
“But we hardly know each other.”
“I thought we were getting along pretty good.”
She smiled. “We are. So let’s not rush things.”
I scowled. I said, “Me-e! What about you?” She kissed me again, then pushed me out of bed.
At her door I hesitated to leave, pulling her toward me to kiss her. Her response was cool.
I rubbed my eyes, stumbled to my car, and drove back home, across the flooding Salt River.
14
Hoacham, Nebraska, Scenic Hub of Agriculture for the Republican Valley, has a unique bar. It’s at one end of the main street. When you approach it from the town side, the sign reads “Last Chance Bar and Grill.” From the other side, logically enough, it reads “First Chance Bar and Grill.” The locals are onto the ruse. They call it simply The Chance.
Now that’s down-home.
A few weeks ago I was back in the Hoacham ER, seemingly condemned to relive a key clinical part of my story.
That weekend Hoacham was the Scenic Hub of Asthma and its nasty little cousins. In the span of twenty-four hours I admitted to the hospital three little ones with unrepentant wheezing.
The worst off was a baby of eight months, never before sick but that night unable to adequately exhale. Probably set off by a common virus, but in his body, life-threatening. We gave heavy doses of nebulized inhaled drugs and crossed our collective fingers. In an hour he was worse.
Never having actually given an epinephrine shot myself, I asked the nurse to let me watch her do it. She was amused.
I did not bring up my experience in Glory.
When he continued to deteriorate I knew he needed to be on a ventilator and flown to Lincoln. I knew he needed 238
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chemical paralysis. I looked up my med choices in a text, chose one that would last long enough for a lengthy flight, got him drugged and intubated, and the helicopter came and rescued us all. As he sailed into the night I kept thinking how simple a sub-Q shot of adrenaline really is. I bet in the old days Dad gave them all the time.
H E N RY RO J E L I O , DAY F O U R
Arriving home from my early hours with Miss Robin, I stumbled directly into bed and did not wake up until almost eleven. Despite rising to unresolved career trouble and finding the mailbox holding only the usual solicitations and bills—the Daily Disappointment—I felt the midnight beginning of Henry, Day Four, might turn out to be a gold-star harbinger of things to come. I hadn’t the faintest niggling that the whole encounter was more or less than it seemed.
I went to a downtown park for a pickup basketball game, then home for a shower and something canned for lunch. In the middle of the meal, as I was trying to relive certain moments from our “date,” I realized I’d left my jacket at Robin’s house with my notes about Henry’s code and billing records from the Scottsdale ER tucked into the inner pocket. The perfect pretense to call too soon. I caught her by phone just as she was leaving for her meeting with Sally Marquam.
“Hi, you sweet thing,” I said.
“Oh. Look, I’m running out the door. You know: The Meeting.”
I explained about the jacket.
“Yeah,” she said, all business, “it’s on the couch.”
“If you could bring it with you to the hospital, I can get it then. I’ve got a four o’clock meeting with those same folks.
Actually, though, I’d prefer to take you out to a late dinner after your shift.”
“Mmm. I’d love to but I can’t. Best thing would be for you to come by and get it sometime. There’s a key on top of the LIE STILL
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outside light on the wall over the front terrace. You walk by the terrace coming to the front door. Just step over the rail.”
“When will you be home?”
“Oh, any time. Just come by.”
“If I’m letting myself in, what will the neighbors think?”
“They would call the police, so you better be quick.”
“Should I have waited a day or two before asking for a date? You know, be a little harder to get?”
She laughed. “I’d have been heartbroken.”
“But you might have said yes.”
There was a pause. “Call me soon.” She hung up.
From that inauspicious start, Day Four really went south.
At three-thirty I drove back out to Glory, moderately deflated over Robin’s deflection of my date request, trying to re-inflate myself by imagining her acceptance of the next invitation and where that might lead.
Glory was an odd town. It sprang from nothingness in the 1880s as the hub for the three copper mines in the nearby mountains. When the ore ran thin, though, the only things the mine companies left behind were tailings—mountainous piles of ugly, sterile dirt and rock, as if whale-sized moles had run amok. The town shriveled.
Glory was resuscitated a decade before my arrival. Ultra-cheap land just over the hills from Phoenician sprawl and a developer’s whispered-to-be-corrupt permission to tap into a cross-desert water conduit had turned the key. Laws were ignored. Fortunes were made.
With putting greens green, tennis courts hosed off, and swimming pools sufficiently chilled, the “culture” of leisure moved in on top of the old tailings. My patient population there was a mix of the over-sunned, over-jeweled wives of the over-leisured, concerned about the pain and swelling under the new face-lift, and farm workers who brought to the ER their sore throats and sore backs because they had no other doctor to see.
Ten minutes late for my appointment with Sally Marquam, I pilfered a cookie and coffee from the doctors’
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lounge. I thought I was going there for a friendly review of a bad case. Even when outcomes are horrible, all the partic-ipants usually line up on the same side. As I searched out the administrative wing I asked myself how Dad would handle this. He would stand erect, speak carefully and accurately, disparage no one, and invariably be right. Being old school, he would also be better dressed than I was.
From the first open door I passed, a female voice called,
“Come in, Dr. Ishmail. Please have a seat. I’ll let her know you’re here.” Evidently the woman was Ms. Marquam’s assistant. I did not know her, though she seemed to know me.
She said, “I’m Valerie.”
I sat in her anteroom. “Hi. I’m Malcolm.” I smiled weakly in her direction. She was young, busty, and blonde with impossibly long fingernails painted meat red to match her ear-rings and necklace. She smiled back. I rubbed my eyes, then spread an arm in each direction along the back of the couch and rested my head backward against a concrete planter.
With my vision contained on either side by a small palm plant, I closed my eyes, trying to conjure a vision of Robin’s breasts, ignoring the silicone.
“Are you asleep?” There was a pause, then again, “Are you asleep, Dr. Ishmail?”
I saw ceiling and palms, just as before, blinked a few times, then lifted my dead-weight head. Through the blur I could see standing sideways in front of me a female, half bent over at the waist, one hand still pointing to where she had touched my knee to waken me.
“I guess I must have dozed off,” I said as I pulled my arms into my lap and stretched my neck to either side. “Too many long nights lately.”
“So I understand. Please step this way, into my office. I’m sorry to have kept you waiting,” she said over her shoulder.
The office door said “S. J. Marquam, Vice-President.”
“I don’t want to be curt, but they’ve had me booked rather tight all day. I’ve still got a lot of people to see—
please go on in and sit down—mostly about this incident of the other night.” She called to her assistant.
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I sat in an armchair by the only window. With my eyeballs clear I got a better look: Ms. Marquam was probably in her early thirties, just under six feet, trim, wearing lightweight flannel and gold-rimmed eyeglasses and good-looking in a handsome way. Valerie, as her backup, sat cross-legged, notepad in hand.
Ms. Marquam laid out the objective—get it down in detail while memories were freshest. She said, “Sometimes something like this will generate a lawsuit years after the fact, and it’s best to have as much detail written down as possible.”
“Yes, and whatever I say can and will be used against me,” I said.
“Actually, not so. This is done as part of the hospital’s quality assurance process and is protected under state statute from discovery in court. The law protects formal quality improvement work from being used in lawsuits. They made it that way to encourage people like us to speak freely when problems arise.” She looked at me. “You will speak freely?”
“Of course. There isn’t anything to hide. Nobody did anything wrong. There wasn’t any malpractice.”
“I’m sure that’s true, but that does not prevent lawsuits.
We may need to prove it, in other words. Why don’t you just tell us what happened, in narrative, then we can go back over specific issues.”
I sat back in the big chair and closed my eyes. I was tired.
“Henry Rojelio. Thirteen-year-old kid. Apparently crazy, but probably pretty normal physiologically—except for his asthma. Came in with a wheeze. Doesn’t seem to want to use his inhalers. Apparently prefers the ER. Some people like ERs. Dad brought him in, dropped him off, disappeared.”
Sally began to interrupt me but stopped herself. She took a sheet of paper from Valerie’s pad and scribbled something, then nodded to me.
I went on to detail my encounter with Henry and his crooked penis and our one go-round with a neb. “He told Robin he wanted sub-Q epi. He seemed to think that was what he had come in for, and he seemed to know all the rest 242
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was a waste of time. She suggested we jump to that. I mean, we could have tried more nebs or continuous nebs or changed to a different drug in the inhaler, but they all do pretty much the same thing. I checked his chart. He’d gotten good results with epi each of the two visits I checked on, so it seemed like a good idea to sort of jump to the end, especially if we knew it worked and he had tolerated it well before.”
Sally wrote again. Then she said, “Go on.”
“I told her to go ahead.”
“Who?”
“The nurse. Robin.”
“Did you write it out? The order?”
“No, I don’t think I did. Verbal order.” She wrote again. “I think I was on the phone.” I waited. She looked up. I went on. “Next thing I know, Robin says he’s turning blue, and all hell broke loose.”
Another pause. “That’s it?”
“Pretty much.”
“Could you explain about the code?”
“Well, not much to explain. He was in full arrest—we ran a code. Took a while but we got him back.”
“You thought things went pretty well?”
I hesitated. “I guess you can’t say things ever go well at a code. That would be like saying you had a really nice funeral. But the procedural stuff went okay. They got a line right away. The drugs went in. I got him intubated.” I waited, but they were just looking at me. “He eventually responded.
In fact, we were about to quit. It had gone on too long. We tried one last round of drugs and that time they worked.” She reached over toward Valerie, who handed her several photocopies in a stack. She flipped two pages.
