Bad Blood. James Baehler
vitality and her dark, unkempt hair evidenced the first barely visible signs of gray. Harris had noted that as some wives aged, they put on weight or they lost their animation or they neglected their appearance. Marilyn Wallberg had managed to touch all three bases. Not for the first time Harris thanked the stars that his wife, Laurel, had retained the look and enthusiasm of youth. In fact, with maturity, he now considered her even more beautiful than when they had first met in college.
The Wallberg’s had moved to Barrington Woods when Wallberg assumed a position as CEO of Technical Dynamics Inc. three years earlier and moved next door to the Harris’s. When Harris walked into the waiting area Mrs. Wallberg was sitting quietly in the waiting room.
As Dr. Harris reported his findings at surgery her expression never changed. She listened intently with her eyes fixed on Harris’s face, her features registering no visible response. “He should do well now,” ended Dr, Harris.
“Thank you so much for your help, doctor. I know it must have been difficult for you and I appreciate it.” She gave him a grateful smile.
“No thanks are necessary, Mrs. Wallberg. Your husband required immediate medical care and I provided it.
“Well, anyway, I want you to know I’m grateful.” Harris gave her a reassuring smile.
Harris returned briefly to the ICU where he told the nurses that Mrs. Wallberg was in the Waiting Area and that when Wallberg awakened she might want to see him. Harris went back to the surgical locker where he helped himself to a glass of orange juice and was exhaustedly contemplating the day’s events when he received the cell phone call, and the chain of events unfolded that resulted in the massive bleeding, the second operation, and the death of his patient.
CHAPTER 3
All clinical departments of a hospital have a department chairperson who has full responsibility for the medical affairs within the department. This is a physician usually appointed by the Board of Trustees whose job description is fully detailed in the medical staff bylaws. In essence the four most important responsibilities of any department head are education, credentialing, peer review, and performance improvement. The latter is ongoing and involves physicians and all hospital employees in a collaborative effort to develop systems promoting patient safety and quality of care.
Over the years it has been recognized that most tragic occurrences in hospitals are more often than not a system failure rather than a physician’s error. This is not to say that physicians do not make errors or mistakes in judgement. They do, and it is for this reason that in all accredited hospitals, a peer review committee reviews the performance of each physician. Criteria are established for each department mandating peer review for certain untoward events. A hospital death, by rule, must be reviewed, and an intra-operative death receives particular scrutiny.
At Barrington Community Hospital Victor Wallberg’s chart was immediately placed on the death review list of the Department of Surgery. The surgical peer review committee consisted of seven members who took turns on a monthly basis reviewing the charts of surgical procedures that did not meet pre-established criteria. Each procedure was detailed in a case review form. Deaths and other unusual incidents would then be reviewed each month at a meeting of the surgical committee. Cases were either cleared or set aside for further review. Those set aside required either a written response from the surgeon or a personal appearance before the committee. In an intra-operative death a personal appearance was mandatory.
The evening after the death of Victor Wallberg, Cliff and Laurel sat in their living room discussing Cliff’s expected appearance before the review committee. Cliff was obviously tense and Laurel sought to alleviate his anxiety. “I’m sure the review committee will find you did everything possible to save Victor Wallberg’s life.”
“Ordinarily, I wouldn’t have any concerns,” Cliff said, “but I did get into a shouting match with Sanjay in the OR and the use of heparin in treating a case of DIC is not that well known. If I have to educate the members of the committee about it, I may have a problem.”
“I’m sure they’ll understand once you explain it to them,” Laurel said with certainty.
“I hope you’re right. I’ve never been reprimanded by the committee before and I would hate to have that black mark on my record now.”
“I can’t believe it would come to that,” Laurel said shaking her head with conviction.
Gloomily, Cliff said, “It could be worse. They could order me to take some remedial training and suspend my hospital privileges until I was, in effect, recertified again.”
Laurel was appalled. “Oh, Cliff! That couldn’t possibly happen!”
“It might. I don’t believe it would come to that, but remember these hearings are secret. There’s no telling what may come out of it this time.”
Cliff and Laurel mulled over the problem for some time and then decided the only sensible course was to get a good night’s sleep and deal with whatever happened as it came along. They walked down the long corridor to their bedroom, arms around one another, each endeavoring to draw strength and encouragement from the other.
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Marilyn Wallberg’s older brother, Richard Spehn, of Chicago, drove out to Barrington Woods to be with her and offer whatever assistance he could provide in her bereavement. He was a businessman and investor who had a number of business interests including a string of Subway sandwich franchises in and around the city. A high energy level and an astute business sense had allowed him considerable financial success at a relatively early age. A native of Chicago and a product of the Catholic school system, at age forty-five Spehn retained much of the physique of the defensive back that had earned him a year at Marquette University. There he found the college’s requirement that he actually attend classes while performing on the football field conflicted with the demands of the sandwich delivery service he established and the temporary loan business with ten percent interest per week that he personally conducted. After a number of admonitions went unheeded, Spehn was dropped from the school’s roster of accredited and enrolled students. Spehn was then free to devote his full attention to building his little business empire and soon added a coin laundry near the school and eventually opened a small take-out hamburger stand. At the age of twenty-five, he sold out his business interests in Milwaukee and returned to Chicago where he bought his first Subway sandwich shop, eventually owning eleven more. He saw business as a game and he competed in it as fiercely as he did on the handball court or the golf course. He was devoted to his family and to his only sister, Marilyn Wallberg. Spehn accompanied his sister to the Fenster Funeral Home in Barrington Woods where the funeral director expressed his sympathy for her loss and then proceeded to guide her through the process of funeral selection. In a business-like manner Marilyn said, “My husband’s desire was for cremation, so if I assume correctly that you have only one way of doing that, then we’ve not much to talk about. He will be cremated.”
“It’s not a problem,” said the funeral director. We can arrange that easily.”
With her brother offering little comment, Mrs. Wallberg and the funeral director soon came to an understanding as to how the services and the cremation were to be handled. They left the funeral parlor and returned to the Wallberg home where the two children awaited them. Both the older boy, a senior in high school, and the fourteen-year-old daughter were disconsolate at the loss of their father and fearful of what the future held for them. Victor Wallberg had been a difficult and demanding father, insisting that they excel in school and at whatever other activity they might engage in, but they knew he loved them and wanted the best for them. With tears in their eyes they hugged their mother upon her return, sitting next to her on the sofa and holding her hands.
Her brother said, “Kids, do you mind if I talk to your mother privately for a little while.” With some urging from their mother, the two children retired to their rooms.
“What is it, Richard?”
“I was wondering about your finances. I know Victor made a lot of money