Medical Judgment. Richard L. Mabry, M.D.

Medical Judgment - Richard L. Mabry, M.D.


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rose and stretched, hearing his neck pop and feeling the muscles in his shoulders rebel at the movement. “We never know. I’ll just keep checking on all the leads. Meanwhile, what are you doing about security?”

      The two of them moved toward the door of the records room. When she reached it, Sarah stopped with her hand on the doorknob. “I’ve been locking my garage door manually since you showed me how the emergency release lever could be tripped with a coat hanger. I’ll get a security guard to walk me to my car when I leave the hospital tonight. I make sure all my doors and windows are locked. I think that’s about all I can do.”

      “Anything else?”

      “I’ve been thinking about an alarm system for the house,” she said.

      “Probably a good idea,” Larson said. “And don’t forget, you have all my numbers. Call anytime you want, even if you think it’s something trivial. I promise you won’t be a pest.”

      She thanked him and went out the door. He followed, then stood watching her walk down the hallway. Sarah, you could never be a pest. Why couldn’t I have married someone like you?

      * * *

      When Sarah entered the ER, she walked into what might seem to the uninitiated to be chaos set against a background of shouts, moans, beeps, and various other noises. To her, it was home.

      “Glad to see you,” Dr. Craig Perkins said as he passed her. “You sure you’re okay working today?”

      “I’m fine. What’s going on, and where shall I start?”

      After getting a quick update on the patients in the ER, Sarah said, “I’m on it. You take off.”

      As Sarah approached the first enclosure, she heard a child crying inside. She pulled aside the curtain to see a neat but plain-looking woman, probably in her early twenties, holding a young girl in her arms. The child looked to be about two . . . the same age as Jenny. Sarah blinked hard and swallowed to loosen the lump in her throat. She’d been warned there would be emotional triggers at random times, but so far she hadn’t encountered one during an ER tour. Now she had. Sarah fought back the impulse to cry.

      Sarah took a few calming breaths. “How can I help you?”

      “My daughter . . . my daughter fell this afternoon. I didn’t think much about it. I mean children are always falling. But she’s still crying, and I’m afraid her arm is broken.”

      Gently, Sarah touched the arm. The little girl jerked it away, but not before the doctor noted it was slightly swollen just above the wrist. She hadn’t been able to feel any crepitus, the grating sensation caused by ends of bone rubbing together, but that might not be present if the fracture were non-displaced. In any case, an X-ray was going to be necessary. If the arm were fractured, the mother would have to care for a little girl with a cast on her arm for four to six weeks. But at least her daughter’s alive.

      Sarah stuck her head out of the cubicle and called to Connie, who was working that shift. The nurse hurried over.

      “You want an X-ray?” she asked.

      “It’s a possible Colles’ fracture,” Sarah said. “I’ll put a short arm splint on it until we can get the X-rays. Maybe that will stop some of the pain and prevent any neurovascular injury.”

      Later, after Connie left to escort the mother and daughter to get the X-ray, Sarah leaned on the wall in the vacant cubicle and fought to calm the storm she felt inside. They warned me about triggers, but this one caught me off guard. How long will I have to be alert for them? Thus far, she’d had no such reaction when called upon to treat an adult trauma victim. But this child, who was about Jenny’s age, had made her heart feel like it was breaking. Jenny. I miss Jenny. I miss her so much.

      As it turned out, the little girl’s arm wasn’t broken, and a relieved mother left the ER with her daughter’s wrist supported by an elastic bandage. Sarah didn’t see them go, because she was already involved with the next patient. And she knew that would be the way things went for the balance of her tour.

      It was almost midnight when Sarah, feeling rather foolish, walked beside the security guard to her car in the physicians’ parking lot. “You know, I appreciate this.”

      He touched the holstered pistol on his hip. “Doctor, it’s part of my job. Not many people want to tangle with an armed man, and I’d always rather prevent a problem than deal with the consequences after it’s too late.”

      Sarah kept her car doors locked as she drove through the deserted streets. At her house, she stopped her car in front of the locked garage door. She automatically reached for the opener clipped to her sun visor, then pulled her hand back. It wouldn’t work, because the door was locked. Sarah ran her choices through her head and decided a quick run to the front door was safer than getting out, unlocking the garage door, then pulling in. And it would be daylight when she left the next day, so getting into her car in the driveway shouldn’t put her at risk then.

      She started to breathe a silent prayer for safety but stopped, remembering the apparently ineffective prayers she’d offered when she got the news of the wreck that claimed the life of her husband and child. Maybe speed and determination would substitute for divine protection. Sarah shook her head, opened the car door, and dashed for her house, reaching over her shoulder to beep her car locked as she went.

      * * *

      The man was grateful that the color of his vehicle allowed the car to blend into the darkness. He’d found a parking place between two other cars, almost directly across the street from Dr. Gordon’s house. He was in a spot equidistant from the streetlamps at either end of the street. Black clothes let him merge with the shadows inside his vehicle.

      The houses on the block were all dark by now. The exceptions were what seemed to be nightlights. No bluish illumination from TV sets flickered through partially covered windows. Aside from the occasional bark of a dog, the neighborhood was quiet.

      Each time a pair of headlights came down the street, the man slid down behind the wheel until he wasn’t visible through the windshield. Twice he’d done it, only to see the headlights pass and be replaced in his rearview mirror with the twin red dots of taillights receding in the distance.

      This time, the vehicle bearing the headlights slowed as it approached the doctor’s house. After it turned into the driveway, he eased up from his hiding place behind the steering wheel and watched the car stop with its nose just feet from the locked garage door.

      He knew it was locked, because less than an hour ago he’d parked farther down the street, walked innocently past Gordon’s house, then ducked back to try his coat hanger trick on the door. He could trip the emergency release lever but was unable to budge the door. So she’s discovered how to lock it. That may make her safer in the short term, but it’s inconvenient for her, and all it means for me is that it’s time to step up the action.

      Dr. Gordon sat for a moment in her car, apparently deciding how to proceed. Either way, the man was prepared. He pulled his pistol from his waistband, lowered the driver-side window of his vehicle, and, resting the pistol barrel on the window ledge to steady it, aimed the Beretta toward Gordon’s front door.

      When the car door opened and she started her dash toward the house, the man smiled. He took in a deep breath, let it partway out, and gently took up the tension on the trigger. The noise of the gunshot was no more than a flat clap that quickly died away. A dog a few houses down the way let loose a series of sharp barks. Then everything was quiet once more.

      The man rolled up the car window, carefully stowed the pistol, and drove away, not turning on his lights until he reached the end of the block.

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