{"id":5581,"date":"2010-09-10T03:26:44","date_gmt":"2010-09-10T08:26:44","guid":{"rendered":"http:\/\/www.daysongreflections.com\/\/?p=5581"},"modified":"2010-09-09T23:28:53","modified_gmt":"2010-09-10T04:28:53","slug":"medical-error-by-richard-l-mabry-md","status":"publish","type":"post","link":"https:\/\/www.daysongreflections.com\/?p=5581","title":{"rendered":"Medical Error by Richard L. Mabry, MD"},"content":{"rendered":"

<\/a>\"\"<\/a>It is time for a FIRST Wild Card Tour<\/a><\/strong><\/span> <\/strong> book review! If you wish to join the FIRST blog alliance, just click the button. We are a group of reviewers who tour Christian books. A Wild Card post includes a brief bio of the author and a full chapter from each book toured. The reason it is called a FIRST Wild Card Tour is that you never know if the book will be fiction, non~fiction, for young, or for old…or for somewhere in between! Enjoy your free peek into the book!<\/strong><\/span><\/p>\n

You never know when I might play a wild card on you!<\/em><\/span><\/p>\n


<\/p>\n

Today’s Wild Card author is: <\/strong><\/div>\n


<\/p>\n

Richard L. Mabry, MD<\/a><\/span><\/strong><\/div>\n


<\/p>\n

and the book:<\/span> <\/span><\/strong><\/p>\n


<\/p>\n

Medical Error (Prescription for Trouble Series) <\/a><\/span><\/strong><\/p>\n

Abingdon Press (July 12, 2010)<\/p>\n

***Special thanks to Maegan Roper, Marketing\/PR Manager, Christian Fiction, Abingdon Press for sending me a review copy.***<\/p>\n

ABOUT THE AUTHOR:<\/span> <\/span><\/strong><\/div>\n

\"\"<\/a>Dr. Richard Mabry built a worldwide reputation as a clinician, researcher, author, and teacher before retiring from medicine. He entered the field of non-medical writing after the death of his first wife, with the publication of his book, The Tender Scar: Life After The Death Of A Spouse.<\/p>\n

Richard describes his work as “medical suspense with heart.” Medical Error is his second novel. His first novel, Code Blue, was published by Abingdon Press in April of 2010, and will be followed next spring by the third book in the Prescription For Trouble series, Diagnosis Death.<\/p>\n

He and his wife, Kay, live in North Texas.<\/p>\n

Visit the author’s website<\/a>.
\n Visit the author’s blog<\/a>.<\/p>\n

Product Details:<\/p>\n

List Price: $13.99
\n Paperback: 288 pages
\n Publisher: Abingdon Press (July 12, 2010)
\n Language: English
\n ISBN-10: 1426710003
\n ISBN-13: 978-1426710001<\/p>\n

\n<\/embed><\/object>\n<\/p>\n

AND NOW…THE FIRST CHAPTER:<\/span> <\/strong>
\n <\/span><\/p>\n

\"\"<\/a><\/p>\n

Eric Hatley\u2019s last day alive began routinely enough.<\/p>\n


<\/p>\n


<\/p>\n

He paused beside his brown delivery truck, shifted the bulky package, and turned in a tight circle to search for the right apartment.<\/p>\n

Shouts filled the air. Firecrackers exploded all around him. A dozen red-hot pokers bored holes through his gut.<\/p>\n

The package flew from his arms. He crumpled into a privet hedge at the edge of the sidewalk, clutching his midsection and recoiling when his fingers encountered something wet and slimy.<\/p>\n

A wave of nausea swept over him. Cold sweat engulfed him.<\/p>\n

Eric managed one strangled cry before everything faded to black.<\/p>\n

* * *<\/p>\n

Dr. Anna McIntyre bumped the swinging door with her hip and backed into Parkland Hospital\u2019s Operating Room Six, her dripping hands held in front of her, palms inward. \u201cLuc, tell me what you\u2019ve got.\u201d<\/p>\n

Chief surgical resident, Dr. Luc Nguyn, didn\u2019t look up from the rectangle of abdomen outlined by green draping sheets and illuminated by strong surgical lights. \u201cUPS driver, making a delivery in the Projects. Got caught in the crossfire of a gang rumble. Took four bullets in the belly. Pretty shocky by the time he got here.\u201d<\/p>\n

\u201cFind the bleeding source?\u201d<\/p>\n

\u201cMost of it was from the gastric artery. Just finished tying it off.\u201d<\/p>\n

Anna took a sterile towel from the scrub nurse and began the ritual of gowning and gloving made automatic by countless repetitions. \u201cHow about fluids and blood replacement?\u201d<\/p>\n

Luc held out his hand, and the nurse slapped a clamp into it. \u201cLactated Ringer\u2019s, of course\u2014still running wide open. We\u2019ve already pushed one unit of unmatched O negative. He\u2019s finishing his first unit of cross-matched blood. We\u2019ve got another one ready and four more holding in the blood bank.\u201d<\/p>\n

\u201cHow\u2019s he responding?\u201d<\/p>\n

\u201cBP is still low but stable, pulse is slower. I think we\u2019re catching up with the blood loss.\u201d<\/p>\n

Anna plunged her hands into thin surgical gloves. \u201cLab work?\u201d<\/p>\n

\u201cHematocrit was a little over ten on admission, but I don\u2019t think he\u2019d had time to fully hemodilute. My guess is he was nine or less.\u201d<\/p>\n

Anna turned slightly to allow the circulating nurse to tie her surgical gown. \u201cBowel perforations?\u201d<\/p>\n

\u201cSo far I see four holes in the small intestine, two in the colon.\u201d<\/p>\n

\u201cOkay, he\u2019ll need antibiotic coverage. Got that started?\u201d<\/p>\n

Luc shrugged. \u201cNot yet. We don\u2019t know about drug allergies. His wallet had ID, but we\u2019re still working on contacting next of kin. Meanwhile, I have Medical Records checking his name in the hospital computer for previous visits.\u201d<\/p>\n

\u201cAnd if he\u2019s allergic\u2014\u201c<\/p>\n

The nursing supervisor pushed through the swinging doors, already reading from the slip of paper in her hand. \u201cThey found one prior visit for an Eric Hatley, same address and date of birth as on this man\u2019s driver\u2019s license. Seen in the ER two weeks ago for a venereal disease. No history of drug allergy. They gave him IM Omnilex. No problems.\u201d<\/p>\n

The medical student who\u2019d been assisting moved two steps to his left. Anna took his place across the operating table from Luc.<\/p>\n

Luc glanced toward the anesthesiologist. \u201cTwo grams of Omnilex IV please.\u201d<\/p>\n

Anna followed Luc\u2019s gaze to the head of the operating table. \u201cI don\u2019t believe I know you. I\u2019m Dr. McIntyre.\u201d<\/p>\n

The doctor kept his eyes on the syringe he was filling. \u201cYes, ma\u2019am. I\u2019m Jeff Murray, first year anesthesia resident.\u201d<\/p>\n

A first year resident on his own? Where was the staff man? \u201cKeep a close eye on the blood and fluids. Let us know if there\u2019s a problem.\u201d Anna picked up a surgical sponge and blotted a bit of blood from the edge of the operative area. \u201cOkay, Luc. Let\u2019s see what you\u2019ve got.\u201d<\/p>\n

In the operating room, Anna was in her element. The green tile walls, the bright lights, the soft beep of the monitors and whoosh of the respirator, the squeak of rubber soles as the circulating nurse moved about the room\u2014all these were as natural to her as water to a fish or air to a bird. Under Anna\u2019s direction, the team worked smoothly together. Conversation was at a minimum, something she appreciated. Do the job in the OR, talk in the surgeons\u2019 lounge.<\/p>\n

\u201cI think that\u2019s got it,\u201d Luc said.<\/p>\n

\u201cLet\u2019s check.\u201d Anna\u2019s fingertips explored the depths of the patient\u2019s belly with the delicate touch of a concert violinist. Her eyes roamed the operative field, missing nothing. Luc had done an excellent job. He\u2019d do well in practice when he finished his training in three months.<\/p>\n

Anna stepped away from the table. \u201cI think you\u2019re through. Routine closure, leave a couple of drains in. Keep him on antibiotic coverage for the next few days.\u201d<\/p>\n

Luc didn\u2019t need to hear that, but she figured the medical student did. She might as well earn her Assistant Professor\u2019s salary with a little low-key teaching.<\/p>\n

She stripped off her gloves and tossed them in the waste bucket at the end of the operating table. \u201cIf you need me\u2014\u201c<\/p>\n

\u201cLuc, we\u2019ve got a problem. Blood pressure\u2019s dropping, pulse is rapid.\u201d A hint of panic rose in the anesthesiologist\u2019s voice.<\/p>\n

The scrub nurse held out fresh gloves, and Anna plunged her hands into them. \u201cHe must be bleeding again. Maybe one of the ligatures slipped off.\u201d<\/p>\n

\u201cNo way,\u201d Luc said. “Everything was double-tied, with a stick-tie on the major vessels. You saw yourself, the wound was dry when we finished.\u201d<\/p>\n

\u201cWell, we\u2019ve got to go back in and look.\u201d Anna turned to the anesthesiologist. \u201cRun the IV wide open. Hang another unit of blood and send for at least two more. Keep him oxygenated. And get your staff man in here. Now!\u201d<\/p>\n

He snapped out a couple of requests to the circulating nurse before turning back to Anna. \u201cHe\u2019s getting hard to ventilate. Do you think we might have overloaded him with fluid and blood? Could he be in pulmonary edema?\u201d<\/p>\n

\u201cI want your staff doctor in here now! Let him evaluate all that. We\u2019ve got our hands full.\u201d Anna snatched a scalpel from the instrument tray and sliced through the half-dozen sutures Luc had just placed. \u201cDeavor retractor.\u201d She shoved the curved arm of the instrument into the edge of the open wound and tapped the medical student\u2019s hand. \u201cHold this.\u201d<\/p>\n

Anna grabbed a handful of gauze sponges, expecting a gusher of blood from the abdomen. There was none. No bleeding at all within the wound. So why was the blood pressure dropping?<\/p>\n

\u201cPressure\u2019s down to almost nothing.\u201d The anesthesia resident\u2019s voice was strained. \u201cAnd I\u2019m really having trouble ventilating him.\u201d<\/p>\n

Dr. Buddy Jenkins, one of the senior anesthesiologists, pushed through the swinging doors. \u201cWhat\u2019s going on?\u201d<\/p>\n

Anna gave him the short version. \u201cBlood pressure\u2019s dropping, pulse is climbing. We\u2019ve gone back into the belly, but there\u2019s no bleeding. And there\u2019s a problem ventilating him.\u201d<\/p>\n

Jenkins moved his resident aside, then slipped a stethoscope under the drapes and listened for a moment. \u201cWheezes. And no wonder. Look at his face.\u201d<\/p>\n

Anna peeked over the screen that separated the patient\u2019s head and upper body from the operative field. Her heart seemed to skip a beat when she saw the swelling of the lips and the red blotches on the man\u2019s face.<\/p>\n

\u201cIt\u2019s not blood loss,\u201d Jenkins said. \u201cHe\u2019s having an anaphylactic reaction. Most likely the blood. Did you give him an antibiotic? Any other meds?\u201d<\/p>\n

Anna\u2019s mind was already churning, flipping through mental index cards. Anaphylaxis\u2014a massive allergic reaction, when airways closed off and the heart struggled to pump blood. Death could come quickly. Treatment had to be immediate and aggressive.<\/p>\n

\u201cHe had two grams of Omnilex,\u201d Luc said. \u201cBut his old chart showed\u2014\u201c<\/p>\n

Jenkins was in action before Luc stopped speaking. \u201cI\u2019ll give him a cc. of diluted epinephrine by IV push now, then more in a drip.\u201d He turned to the anesthesia resident. \u201cGet that ready\u2014 one milligram of epinephrine in a hundred milliliters of saline.\u201d<\/p>\n

\u201cLuc, you two close the abdominal wound,\u201d Anna said. \u201cI\u2019m going to break scrub and help Dr. Jenkins.\u201d<\/p>\n

Jenkins handed her a syringe. \u201cGive him this Decadron, IV push. I need to adjust the ventilator.\u201d<\/p>\n

Anna injected the contents into the patient\u2019s intravenous line. She said a quick prayer that the epinephrine and steroid would turn the tide, that they hadn\u2019t been too late in starting treatment.<\/p>\n

The team battled for almost half an hour, at first gaining ground, then losing it steadily. Finally, Jenkins caught Anna\u2019s eye. They exchanged glances. There was no need for words.<\/p>\n

She sighed and stepped away from the table. \u201cI\u2019m calling it.\u201d Her voice cracked. \u201cTime of death is eleven oh seven.\u201d<\/p>\n

Luc let the instrument he\u2019d been holding drop back onto the tray. Jenkins picked up the anesthesia record and began to scribble. Murray, the anesthesia resident, turned back to his supply table and started straightening the mess. The medical student looked at Anna. She nodded toward the door, and he slipped out of the room. She didn\u2019t blame him. This was probably the first patient he\u2019d seen die.<\/p>\n

Anna tossed her gloves and mask into the waste container. She shrugged, but the tension in her shoulders didn\u2019t go away. \u201cAny idea why this happened? The blood was supposed to be compatible. He\u2019d tolerated Omnilex before. What else could have caused it?\u201d<\/p>\n

No one offered an answer. And she certainly had none. But she intended to find out.<\/p>\n

The OR charge nurse directed Anna to the family room, where she found Hatley\u2019s mother huddled in a corner, twisting a handkerchief and occasionally dabbing at her eyes. The room was small and quiet, the lighting was soft, the chairs as comfortable as possible. A box of tissues sat on the table, along with a Bible and several inspirational magazines. Soft music playing in the background almost covered the hospital sounds drifting in from the nearby surgical suite.<\/p>\n

Anna whispered a silent prayer. She\u2019d done this dozens of times, but it never got any easier. She knelt in front of the woman. \u201cMrs. Hatley, I have bad news for you.\u201d<\/p>\n

Anna stumbled through the next several minutes, trying to explain, doing her best to make sense of a situation that she herself couldn\u2019t fully understand. When it came to the matter of permission for an autopsy, Anna wasn\u2019t sure of the medico-legal situation here. Hatley had died after being shot, but his injuries weren\u2019t the cause of death. Would she have to call the County Medical Examiner and get him to order one? The weeping mother solved the problem by agreeing to allow a post-mortem exam.<\/p>\n

There was a light tap at the door, and the chaplain slipped into the room. \u201cI\u2019m sorry. I was delayed.\u201d He took the chair next to Mrs. Hatley and began speaking to her in a low voice.<\/p>\n

Anna was happy to slip out of the room with a last \u201cI\u2019m so sorry.\u201d Outside, she paused and took several deep breaths.<\/p>\n

It took another half-hour for Anna to write a chart note, dictate an operative report and final case summary, and change into clean scrubs. She was leaving the dressing room when her pager sounded. The display showed her office number followed by the suffix \u201c911.\u201d A \u201cstat\u201d page\u2014respond immediately.<\/p>\n

As she punched in the number, Anna wondered what else could possibly go wrong today. \u201cLisa, what\u2019s up?\u201d<\/p>\n

\u201cDr. McIntyre, there are two policemen here. They want to talk with you. And they say it\u2019s urgent.\u201d<\/p>\n

* * *<\/p>\n

Nick Valentine looked up from the computer and grimaced when he heard the morgue attendant\u2019s rubber clogs clomping down the hall. The summons he knew was coming wasn\u2019t totally unexpected. After all, he was the pathologist on autopsy call this week, which was why he was sitting in this room adjacent to the morgue of Parkland Hospital instead of in his academic office at the medical school. But he\u2019d hoped for some undisturbed time to get this project done.<\/p>\n

The attendant stuck his head through the open door. \u201cDr. Valentine, you\u2019ve got an autopsy coming up. Unexpected death in the OR. Dr. McIntyre\u2019s case. She asked if you could do it as soon as possible. And please page her before you start. She\u2019d like to come down for the post.\u201d The man\u2019s head disappeared like that of a frightened turtle. More clomps down the hall signaled his departure.<\/p>\n

There was nothing new about an attending wanting a post-mortem done ASAP. You\u2019d think they\u2019d realize there was no hurry any more, but that didn\u2019t seem to stop them from asking. At least she was willing to come down and watch instead of just reading his report. Nick turned to the shelf behind his desk and pulled out a dog-eared list headed \u201cFrequently Needed Pager Numbers.\u201d He ran his finger down the page. Here it was: Department of General Surgery. Anna E. McIntyre, Assistant Professor. He picked up the phone and punched in her number. After he heard the answering beeps, he entered his extension and hung up.<\/p>\n

While he waited, Nick looked first at the pile of papers that covered half his desk, then at the words on his computer screen. He\u2019d put this off far too long. Now he had to get it done. To his way of thinking, putting together this CV, the curriculum vitae that was so important in academics, was wasted effort. Nick had no interest in a promotion, didn\u2019t think he\u2019d get one even if his chairman requested it from the dean. But his chairman wanted the CV. And what the chairman wanted, the chairman got.<\/p>\n

The phone rang. Probably Dr. McIntyre calling back.<\/p>\n

\u201cDr. Valentine.\u201d<\/p>\n

\u201cNick, this is Dr. Wetherington. Do you have that CV finished yet?\u201d<\/p>\n

\u201cI\u2019m working on it.\u201d<\/p>\n

\u201cWell, I need it soon. I want you to get that promotion to Associate Professor, and I have to be able to show the committee why I\u2019ve nominated you. Don\u2019t let me down.\u201d<\/p>\n

Nick hung up and riffled through the pile on his desk. Reprints of papers published, programs showing lectures delivered at medical meetings, textbooks with chapters he\u2019d written, certificates from awards received. His professional r\u00e9sum\u00e9 was pitifully small, but to Nick it represented the least important part of his job. What mattered most to him was what he was about to do: try to find out why the best efforts of a top-notch medical staff failed to save the life of some poor soul. If he did his job well, then maybe those doctors would be able to snatch some other patient from the jaws of the grim reaper.<\/p>\n

His phone rang. \u201cDr. Valentine, are you about ready?\u201d the morgue attendant said.<\/p>\n

Nick looked at his watch. Almost half an hour, and Dr. McIntyre hadn\u2019t responded to the page. He hated to start without her, but he might have to. \u201cGive me another ten minutes.\u201d<\/p>\n

While he waited, Nick figured he might as well try to make Dr. Wetherington happy. Now when did he deliver that paper before the American Society of Clinical Pathology? And who cared, anyway?<\/p>\n

* * *<\/p>\n

Her administrative assistant met Anna at the doorway to the outer office. \u201cDr. McIntyre, I didn\u2019t know what to do.\u201d<\/p>\n

\u201cThat\u2019s all right, Lisa. I\u2019ll talk with them.\u201d Anna straightened her white coat and walked into her private office, where two people stood conversing in low tones. Lisa had said, \u201cTwo policemen,\u201d but Anna was surprised to see that one of them was a woman.<\/p>\n

The man stepped forward to meet Anna. \u201cDoctor McIntyre?\u201d<\/p>\n

Anna nodded.<\/p>\n

He pulled a leather folder from his pocket and held it open for her inspection. Anna could see the gold and blue badge pinned to the lower part of the wallet, but couldn\u2019t read the words on it. The card in the top portion told her, though. It carried a picture beside the words, US Drug Enforcement Administration.<\/p>\n

Lisa had been wrong. These people were from the DEA, not the police. Still, an unannounced visit from that agency made most doctors sweat. You never knew when some innocent slip might get you into trouble.<\/p>\n

The man flipped the credential wallet closed. \u201cThis won\u2019t take long.\u201d<\/p>\n

\u201cGood. I\u2019ve just finished an emergency case, and I still have a lot to do.\u201d Anna moved behind her desk and sat.<\/p>\n

\u201cYour chairman said you\u2019d give us as much time as we need.\u201d<\/p>\n

Anna glanced pointedly at her watch. \u201cWell, have a seat and let\u2019s get to it. What do you need from me?\u201d<\/p>\n

The man lowered himself into the chair, his expression slightly disapproving. His partner followed suit. \u201cWe have some things we need for you to clear up.\u201d<\/p>\n

\u201cCould I see those credentials again?\u201d Anna said. \u201cBoth of you.\u201d<\/p>\n

They obliged, laying the open wallets on the desk. Anna pulled a slip of notepaper toward her and began copying the information, occasionally glancing up from her writing to match the names and faces on the ID\u2019s with the people sitting across from her. The spokesman was Special Agent John Hale, a chunky, middle-aged man wearing an off-the rack suit that did nothing to disguise his ample middle. Anna thought he looked more like a seedy private eye than an officer of the law.<\/p>\n

The woman, the silent half of the pair so far, was Special Agent Carolyn Kramer, a woman who reminded Anna of a California surfer bunny, complete with perfect tan and faultlessly styled short blonde hair. The resemblance stopped there, though. Kramer\u2019s eyes gleamed with a combination of intelligence and determination that told Anna she\u2019d better not underestimate the woman. Kramer wore a stylish pants suit that had probably cost more than Anna made in a week, How could a DEA agent have money for an outfit like that?<\/p>\n

Anna handed the badge wallets back to Hale and Kramer. \u201cAll right, how can I help you?\u201d<\/p>\n

Hale pulled a small notebook from his inside coat pocket and flipped through the pages. \u201cDoctor, recently you\u2019ve been writing a large number of Vicodin prescriptions, all of them for an excessive amount of the drug. Can you explain that?\u201d<\/p>\n

\u201cI don\u2019t know what you mean,\u201d Anna said. \u201cI\u2019m pretty sure I haven\u2019t written any more Vicodin \u2018scripts than usual, and I certainly haven\u2019t changed my prescribing practices.\u201d<\/p>\n

Hale nodded, stone-faced. \u201cWhat are those practices?\u201d<\/p>\n

\u201cI prescribe Vicodin for post-operative pain in many of my patients, but always in carefully controlled amounts, usually thirty pills at a time. By the time they\u2019ve exhausted that first prescription I can generally put them on a non-narcotic pain reliever. It\u2019s rare that I refill a Vicodin \u2018script.\u201d<\/p>\n

Apparently it was Kramer\u2019s turn in the tag-team match. She picked up a thick leather folder from the floor beside her chair, unzipped it, and extracted a sheaf of papers held together by a wide rubber band. \u201cWould you care to comment on these?\u201d Her soft alto was a marked contrast to Hale\u2019s gruff baritone,<\/p>\n

Anna\u2019s eyes went to the clock on her desk. \u201cWill this take much longer? I really have things I need to do.\u201d<\/p>\n

Kramer seemed not to hear. She held out the bundle of papers.<\/p>\n

\u201cOkay, let me have a look.\u201d Anna recognized the top one in the stack as a prescription written on a form from the faculty clinic. She pulled it free and studied it. The patient\u2019s name didn\u2019t stir any memory, but that wasn\u2019t unusual. She might see twenty or thirty people in a day. The prescription read:<\/p>\n

VICODIN TABS<\/p>\n

Disp. [#100]<\/p>\n

Sig: 1 tab q 4 h PRN pain<\/p>\n

At the bottom of the page, three refills were authorized. The DEA number had been written into the appropriate blank on the lower right-hand corner.<\/p>\n

Anna squinted, closed her eyes, then looked again. There was no doubt about it. The DEA number was hers. And the name scrawled across the bottom read: Anna McIntyre, MD.<\/p>\n

\u201cCan you explain this?\u201d Kramer asked.<\/p>\n

A familiar vibration against her hip stopped Anna before she could reply. She pulled her pager free and looked at the display. The call was from the medical center, but she didn\u2019t recognize the number. Not the operating room. Not the clinic. She relaxed a bit when she saw there was no \u201c911\u201d entry after the number. If this was about the autopsy, she\u2019d have to miss it.<\/p>\n

Hale picked up the questioning as though there had been no interruption. \u201cWhat can you tell us about all these prescriptions for Vicodin?\u201d<\/p>\n

\u201cI suppose the most important thing I can tell you is that I didn\u2019t write them.\u201d She riffled through the stack, paying attention only to the signature at the bottom of each sheet. \u201cNone of these are mine.\u201d<\/p>\n

\u201cThat\u2019s your number and name. Right?\u201d Kramer said.<\/p>\n

\u201cRight. But that\u2019s not my signature. It\u2019s not even close.\u201d<\/p>\n

\u201cCan you explain how someone else could be writing prescriptions on your pads using your DEA number?\u201d Hale asked.<\/p>\n

\u201cI have no idea.\u201d Anna made no attempt to keep the bitterness out of her words. \u201cSorry, I\u2019ve just lost a patient, and I\u2019m not in the best of moods. Can\u2019t we wind this up? I didn\u2019t write those \u2018scripts, and I don\u2019t know who did.\u201d<\/p>\n

Obviously, Hale didn\u2019t want to let the matter go. \u201cYou\u2019re sure there\u2019s nothing you want to tell us?\u201d<\/p>\n

\u201cWhat would I have to tell you? I said I don\u2019t know anything about this.\u201d<\/p>\n

Kramer spoke, apparently filling the role of good cop. \u201cTake a guess. Help us out here.\u201d<\/p>\n

Anna felt her jaw muscles clench. These people were relentless. She had to give them something, or this would never end. \u201cI really don\u2019t know. I mean, we\u2019ve got an established routine, and all the doctors here are pretty careful.\u201d<\/p>\n

Kramer pulled a silver ballpoint from the leather folder and began twirling it between her fingers. \u201cWhy don\u2019t you walk us through that routine?\u201d<\/p>\n

Anna wanted to follow up on Hatley\u2019s autopsy, talk with her department chair about today\u2019s events, eventually sit down and try to relax. She was drained. The agents, on the other hand, seemed to have unlimited time and energy.<\/p>\n

\u201cDoctor?\u201d Kramer\u2019s voice held no hint of irritation. Patient, understanding, all the time in the world. Just two women chatting.<\/p>\n

\u201cSorry.\u201d Anna tried to organize her thoughts. \u201cThe prescription pads in the faculty clinic are kept in a drawer in each treatment room. That way they\u2019re out of sight, although I guess if someone knew where they were he could latch onto one when no one was in the room.\u201d She looked at the agents. Kramer simply nodded. Hale scowled. \u201cHey, we know it\u2019s not perfect, but that\u2019s the way we have to do it. Otherwise, we\u2019d waste all our time hunting for a pad.\u201d<\/p>\n

\u201cAnd do you ever forget and leave the pads sitting out when you\u2019ve finished writing a prescription?\u201d Kramer asked.<\/p>\n

\u201cSure. Especially when we\u2019re in a hurry.\u201d Anna\u2019s cheeks burned.<\/p>\n

Hale turned a page in his notebook and frowned. \u201cHow about your DEA number?\u201d<\/p>\n

\u201cYou\u2019ll notice those aren\u2019t printed on the forms. Each of us has to fill in our number.\u201d<\/p>\n

\u201cMaybe someone else had access to your number. Do nurses ever write the prescriptions for you?\u201d This came from Kramer. Anna felt as though she was watching a tennis match, going back and forth between the two agents.<\/p>\n

\u201cWhen we have a nurse in the room with us, yes, she\u2019ll write the prescription. I don\u2019t know what the other doctors do, but I sign the prescriptions after she writes them. And I add the DEA number to the narcotic \u2018scripts myself.\u201d<\/p>\n

The questioning went on for another half hour. Anna\u2019s throat was dry, her eyes burned, she felt rivulets of sweat coursing between her shoulder blades. Finally, she\u2019d had enough. \u201cLook, am I being charged with something? Because if I am, I\u2019m not saying another word without a lawyer.\u201d<\/p>\n

Hale replaced his notebook in his pocket. Kramer picked up her folder and purse. They let the silence hang for a moment more before exchanging glances, then standing.<\/p>\n

\u201cRight now, we\u2019re simply investigating, Doctor,\u201d Hale said. \u201cYou may be hearing from the Texas Department of Public Safety and the Dallas Police as well. Also, since your DEA number and identity have been compromised, I\u2019d advise you not to prescribe any controlled substances for now. You\u2019ll receive formal notification in writing tomorrow about applying for a new permit.\u201d<\/p>\n

The agents walked out, leaving Anna with her hands pressed to her throbbing temples.<\/p>\n

* * *<\/p>\n

Nick stepped back from the autopsy table, pressed the pedal under his right foot, and spoke into the microphone hanging near his head. \u201cNo other abnormalities noted. The balance of findings will be dictated after review of the histopathology specimens and the results of the toxicology tests. Usual signature. Thanks.\u201d He turned away from the body and gestured to the morgue assistant to close the incisions. \u201cI\u2019ll be in the office if you need me. Thanks for your help.\u201d<\/p>\n

Nick removed his goggles and stripped off his mask, gown, and gloves. He was standing at the sink outside the autopsy room, drying his hands, when he heard footsteps hurrying down the corridor toward him. He turned to see a woman approaching. The attractive redhead wore surgical scrubs, covered by a white coat. As she neared him, he could make out the embroidered name above the breast pocket: Anna McIntyre, MD. She stopped in front of him, and the set of her jaw and the flash of her green eyes told Nick she was in no mood for light banter.<\/p>\n

\u201cDr. McIntyre?\u201d<\/p>\n

She nodded.<\/p>\n

\u201cNick Valentine. I paged you, but when you didn\u2019t answer I had to go ahead and get started. Sorry.\u201d<\/p>\n

She waved away his apology. \u201cNo, it\u2019s my fault. I couldn\u2019t break free to answer your page. What can you tell me?\u201d<\/p>\n

\u201cWhy don\u2019t I buy you a cup of coffee and I\u2019ll tell you what I\u2019ve found so far? If we go to the food court, we can get away from the smell down here. I hardly notice it anymore, but I\u2019ve learned that my visitors aren\u2019t too fond of the odor of chemicals.\u201d<\/p>\n

She hesitated for a few seconds. \u201cOkay. Lead the way.\u201d<\/p>\n

It seemed to Nick there was a Starbucks on every corner of every major city in the US. Most important to him, however, was the one here in the basement of the Clinical Sciences Building at Southwestern Medical Center. As he waited to order, he sniffed the rich aromas that filled the air. The smell of coffee never failed to lift his spirits. Maybe it would do the same for the woman who stood stoop-shouldered beside him. For most doctors, caffeine was the engine that helped propel them through long days and longer nights. Maybe all she needed was a booster shot.<\/p>\n

When they were seated at a corner table with their venti lattes Nick filled her in on his findings at the autopsy he\u2019d just completed. \u201cThat\u2019s about it,\u201d he concluded. \u201cI\u2019ll sign the death certificate with the preliminary cause of death as anaphylaxis due to an unknown cause.\u201d<\/p>\n

\u201cBut you won\u2019t have a final diagnosis until\u2014\u201c<\/p>\n

\u201cRight. I\u2019ll review the tissue samples and the results of the toxicology screen, but I doubt that we\u2019ll find anything there. I\u2019m going to have some tests run on the blood samples I took, and maybe that will help us. I\u2019ll need to research whether there\u2019s a good blood test for a drug reaction or latex allergy. The long and short of it is that we may never know the real reason he developed anaphylaxis and died.\u201d<\/p>\n

\u201cI hadn\u2019t even thought of latex allergy,\u201d she said. \u201cBut that\u2019s pretty rare, isn\u2019t it?\u201d<\/p>\n

\u201cLess than one percent of the population. Seen in people chronically exposed to latex: surgeons and nurses, industrial workers, patients with lifelong indwelling catheters.\u201d He felt himself slipping into his lecture mode and made an effort to pull back. \u201cI mean, we could talk about all these uncommon things, but I\u2019ll bet you learned the same thing in medical school that I did. When you hear hoof beats\u2014\u201c<\/p>\n

\u201cThink horses, not zebras.\u201d She managed a tiny smile. \u201cYes, I know. So we should concentrate on the blood or the antibiotic. If it was the blood, there\u2019s a problem in the blood bank because he got one unit of unmatched O negative, which should have been okay, and one unit that was supposedly compatible by cross-match.\u201d<\/p>\n

\u201cThe residuals in both bags of blood are being re-typed and cross-matched against your patient\u2019s blood as we speak. We\u2019ll know the answer by the time we finish our coffee.\u201d He drank deeply from his cup. \u201cDon\u2019t you think an antibiotic reaction is the most likely cause?\u201d<\/p>\n

She took a sip of coffee. \u201cProbably, although I hope not. Choosing an antibiotic wasn\u2019t a routine matter, because we didn\u2019t know if Hatley had any drug allergies. The resident\u2014one of our sharpest ones, by the way\u2014thought he\u2019d see if we could get the information another way. He had medical records check for a previous visit for the patient. They found a recent emergency room visit by the patient where he tolerated Omnilex. Since that antibiotic\u2019s the best choice to cover spillage from a perforated bowel, I agreed with Luc when he ordered it.\u201d<\/p>\n

\u201cBut\u2014\u201c<\/p>\n

\u201cI know. If you give that drug to a patient who\u2019s allergic to it or to penicillin, their reaction is likely to be severe\u2014like this one. But I thought, since we had that history of tolerance, it was okay.\u201d She blinked hard. \u201cI should have known better. Should have made him use a different drug.\u201d<\/p>\n

Nick sensed he was treading on thin ice here. Maybe he should change the subject. Besides, he wanted to know more about this woman. \u201cYou know, I\u2019ve seen you in the halls, but we\u2019ve never actually met. Did you train here?\u201d<\/p>\n

She hesitated before reeling off what had apparently become a stock answer. \u201cRaised in Oklahoma. Graduated from med school in North Carolina. Duke, actually. Lucky enough to get a surgery residency here at Parkland, and when I finished I was offered a faculty position in the Surgery Department. I\u2019ve been here a little less than a year now.\u201d<\/p>\n

Nick held up a hand, palm out. \u201cI know better. You don\u2019t get a surgery residency here because you\u2019re \u2018lucky.\u2019 You get one because you\u2019re good. Let me guess. AOA at Duke?\u201d If Anna was Alpha Omega Alpha, she must have been in the top ten percent of her class.<\/p>\n

\u201cRight. But I don\u2019t guess it\u2019s enough to be bright if you foul up and cost a patient his life.\u201d She drank from her cup, and Nick noticed that she kept swallowing several more times after that.<\/p>\n

Nick was barely aware of the activity around him, the ebb and flow of people, the sounds of pagers punctuating dozens of conversations. All he saw was Anna. She was one of the prettiest women he\u2019d encountered in quite a while. But he was certain there was more to this trim, green-eyed redhead than striking good looks. Right now she was focused on medicine\u2014it was obvious she cared a great deal about her patients, and this loss hit her hard\u2014but Nick had a sense that in a different setting she\u2019d be fun to know. And he intended to see if he couldn\u2019t arrange that. Anna shifted in her chair. He couldn\u2019t let her leave yet.<\/p>\n

\u201cWait a minute,\u201d he said. \u201cAren\u2019t you curious about me at all? There may be a prize if you can answer all the questions later.\u201d<\/p>\n

Did he see the ghost of a grin? \u201cSure. Why not? What\u2019s your story\u2014the Reader\u2019s Digest version?\u201d<\/p>\n

Nick moved his cup aside and leaned forward with his elbows on the table. He wasn\u2019t sure how much longer he could draw out their time together, but he was determined to give it his best shot. \u201cMy roots are Italian. Named for my grandfather. He was Nicolo Valentino when he got off the boat, changed his name when he got his citizenship. I\u2019m Nicolo the Third.\u201d He ticked off the points on his fingers. \u201cWorked my way through pre-med at Texas Tech. Got into the med school there by the skin of my teeth. Managed to get a residency in pathology here at Southwestern. When I finished, they had an opening in the department.\u201d He held out his hand, palm up, fingers spread, thumb tucked under. \u201cSo here I am\u2014four years in the department, still an Assistant Professor. Up for promotion now, and I suspect that if I don\u2019t make it they\u2019ll cut me like a dead branch from a tree.\u201d<\/p>\n

Nick\u2019s last sentence rang a faint alarm bell in his head. He had to finish that project or the chairman would be royally ticked off, but it only took Nick a second to put that chore out of his mind. He was sitting with the most beautiful woman he\u2019d ever met. He wanted to get to know her better, and he intended to keep her here as long as possible, even if it meant incurring Dr.. Wetherington\u2019s wrath.<\/p>\n<\/div>\n

MY REVIEW:<\/strong><\/p>\n

Medical Error<\/a> is the first book I’ve read by Dr. Mabry but I don’t intend for it to be my last. I plan to pick up a copy of Code Blue<\/strong><\/em> asap and look forward to reading Diagnosis Death<\/strong><\/em> upon its release. Hoping it will be on my ‘to review’ list also. Medical Error<\/a> was one of those books I couldn’t put down – it kept me up way TOO late. Filled with compelling characters, medical drama, riveting suspense, a strong message of faith, plus a bit of a love triangle, the twists and turns of the plot kept me flipping\u00a0 the pages.<\/p>\n

After a patient dies on the operating table on her watch, Dr. Anna McIntyre soon finds that is the least of her troubles. She also learns that she is under investigation by both the FBI and the city police force, her identity has been stolen, and it is up to her to find some answers. As Anna works with Dr. Nick Valentine, a pathologist and her attorney Ross Donovan to solve the mystery, she finds herself drawn to both men.<\/p>\n

Why has someone stolen Anna’s identity and how did they manage to do it? How is her stolen identity connected with mysterious deaths and forged prescriptions? Who could be setting her up? Will Anna choose Nick or Ross? You can find the answers to these and other questions if you pick up a copy of Medical Error<\/a> for yourself. I highly recommend that you do so.<\/p>\n","protected":false},"excerpt":{"rendered":"

It is time for a FIRST Wild Card Tour book review! If you wish to join the FIRST blog alliance, just click the button. We are a group of reviewers who tour Christian books. A Wild Card post includes a brief bio of the author and a full chapter from each book toured. The reason […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[8,60,59,41,33],"tags":[],"class_list":["post-5581","post","type-post","status-publish","format-standard","hentry","category-books","category-contemporary-fiction","category-medical","category-romance","category-suspense"],"_links":{"self":[{"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=\/wp\/v2\/posts\/5581","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5581"}],"version-history":[{"count":5,"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=\/wp\/v2\/posts\/5581\/revisions"}],"predecessor-version":[{"id":5586,"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=\/wp\/v2\/posts\/5581\/revisions\/5586"}],"wp:attachment":[{"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5581"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5581"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.daysongreflections.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5581"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}