Comfort Zone

Chapter 26

Early the next morning Miriam headed back to room 729. If her patient wasn't already awake and alert, she would wait outside the room while the nurse injected the flumazenil. Within a few minutes, Xanax would be reversed. If Lilly Fielding woke up, Miriam would enlist the help of Edna or the head nurse—if she forgave Miriam for calling her difficult—to go in the room and witness the patient's true decision about the pacemaker. She knew there was a risk of seizures from Xanax withdrawal, but figured the risk was small. She'd planned every detail.

The patient's nurse denied finding Ms. Fielding awake, but also denied having the antidote.

A fuming call to the pharmacy brought only an apology. Flumazenil was out of stock due to a shortage; the pharmacist would make some calls to try to locate the medication but it would take time.

Miriam calmed herself as best as possible for her next plan: confrontation.

"I heard you've been feeding your mother," Miriam said to Marilyn, who appeared clean and well rested despite the fact that she never seemed to leave the bedside. She tried to modulate her voice to sound friendly and caring but knew she failed. "You may or may not know that this can be dangerous if she's sleepy. The food can go down the wrong way into the breathing tube and then go into the lungs instead of the stomach. She could get pneumonia."

"I'm very aware of that."

"Have you had a chance to explain her condition when she's awake?"

"She asked why she was attached to a box and I explained what happened to her."

"Did you tell her the doctors recommend a pacemaker?"

"She fell back asleep before that discussion could take place."

Temporary pacemaker in place for three days and three hours. Not that I'm counting.

Miriam bumped into the cardiologist at the nurses' station. He'd shaved off his goatee but she decided it was too personal to mention. He didn't mention his discussion with Marilyn either, but said he was keeping tabs on the pacemaker, then shrugged that he had nothing new to add. The patient might wake up, but if she didn't was hospice a possibility?

As she had time before the office, Miriam decided to see another patient. On her way to his room, she was dismayed to pass an elderly, Asian-appearing man on a gurney, struggling to get up. "I absolutely refuse treatment!" the man said, as the transporter tucked the cover sheet around him.

A young man with a stern face stood next to him. "Papa, you must go to the test! I will go with you to make sure it's done!"

"This is an outrage," she heard the man protest as he was wheeled away, son in tow.

Should I intervene? Miriam thought. Clearly the man was being given care against his will, but was it right for her to get involved? Hesitantly, she approached the patient's nurse and asked who his doctor was.

Tim Courtney. She knew the name. Did he know about this, should she inform him? He was generally known as the do- it-my-own-way type, had once gotten angry when an ethics consult was called on one of his patients without his OK. She doubted he would take kindly to her call.

I'm not expected to take on all the ethical lapses in the hospital, am I? The face of the man on the gurney accused her, but she continued down the hall, quickly saw her patient, and headed to the nurses' station to write the note.

"How may I be of exceptional service?" Ms. Carmen spoke into the phone.

A disheveled man stood near her desk, clutching an IV pole, faded blue gown open to the back.