Comfort Zone

Chapter 30

The two interns conferred together, the young woman with reddened eyes, the young man awkwardly patting her shoulder. Miriam was glad to see it was Dugan's intern that Ariana had recruited for the task. They edged toward the door of room 729 hesitantly, then, appearing to Miriam to grow slightly taller, straightened their white coats and walked inside. She heard the raised voice of Marilyn Fielding, but the two young doctors did not come out.

Miriam smiled slightly, thinking of what it was like to be so young and fresh, with little experience to jade you or make you think in the well-trodden ways that sometimes made you miss the truth. She hoped that Ariana would keep open, and wouldn't be stained by her slip-up. People always joke that we bury our mistakes, but the truth is far grimmer, Miriam thought, as memories of Herbie Winters flooded her brain. "No one's perfect," he'd said, "but the crazy thing is I once knew a perfect fool and..." With difficulty, Miriam pushed thoughts of Herbie, and his entertaining but painfully long stories out of her mind.

All those jokes about doctors wanting to be God, or thinking they are, she thought. What's our role anyway? Doctors should never be too tired to make good decisions, should never let self-interest get in the way of proper care. They should treat all patients equally without personal preference, never let greed or ego get in the way, never get angry but be compassionate and objective at all hours lest a misjudgment, an error occur. Humans make mistakes, get tired, and make poor decisions based on self-interest without being aware of it.

Too bad we're human, she thought.

Human, like Ariana and herself. Shit happens, Tatiana would say. A few years before, a seasoned critical care nurse at another hospital had inadvertently killed an infant by measuring out the wrong dose of medication. She'd lost her job, and shortly after committed suicide.

Almost one hundred thousand people die of medical errors yearly. Miriam knew about the Institute of Medicine report "To Err is Human," which sent shock waves through the country and triggered a tsunami of changes. State medical boards began demanding that professionals get educated on the issues when they renewed their licenses. The key point was that when an error occurred, it was a system problem, and that system had to be examined and tweaked for safety. Label medicines better. Communicate better. Don't use abbreviations that could be misunderstood.

To counteract surgery done on the wrong side of the body, body parts had to be clearly marked. To counteract poor judgment from exhaustion, the house staff could only work limited hours, i.e. no more marathon on-call sessions.

Electronic prescribing replaced sloppy handwritten prescriptions, and hospital pharmacies developed medication tracking systems, in order to save infants and others from death, and nurses and others from making horrific errors.

But mistakes still happened, and there were guidelines about when and how to tell patients about them. You could even say you were sorry without admitting blame.

We're just human, Miriam thought. You can't legislate, educate, or sue human nature out of the equation. And can you imagine there have to be guidelines to tell us how to say I'm sorry?

Miriam hovered as close to room 729 as she could without pressing her ear to the wall, and finally heard the welcoming sound: the buzz of a phone and Marilyn Fielding's voice, initially calm then increasingly agitated.

"The sprinklers? All of them? How could that possibly happen, what did you do? All my papers? Everything?" A moment later she was out the door running toward the elevators, keys in hand.

She scarcely noticed Miriam as she ran past, surprisingly fast on her high heels.

"What now?" Ariana said.

"Now we wait."

The three sat in chairs around the bed. Miriam watched Judge Judy berate a middle aged couple while the two interns sat hunched over their phones.

The show progressed, the couple got their just desserts. If the three got restive, no one admitted it. Miriam had shared with them the possibility that the patient had been sedated with Xanax. If true, its effect would eventually wear off, though no one could predict when. She could only hope it happened before the daughter's return.

Miriam's cell went off. Belle, asking some questions. It rang again. Edna, with a question.

"Can you meet me in Fielding's room for the answer?" Miriam asked her.

Ms. Fielding's room faced west. When the hot afternoon sun shone in, they closed the blinds until only a knife of sunlight bisected the bed, but still, the air conditioning was outmatched. The group of now four began to sweat. Every time Lilly moved or mumbled, Miriam's heart leapt, only to feel defeated when the woman remained asleep. They tried to rouse her but, though she appeared slightly more responsive, the change was just that: slight.

Miriam's confidence in her plan was rapidly dwindling, and her guilt and disappointment mounting. Maybe the flooding of Marilyn's house was in vain. Maybe she'd added to the woman's list of problems for nothing. Maybe--

"What the hell is going on?"

Lilly Fielding had woken up.

Quickly and succinctly, Miriam explained why she was in the hospital.

"You need a pacemaker, Ms. Fielding. Immediately. It's a relatively simple procedure, done by a cardiologist, and it would likely give you many more years of life. I hope you'll consent but it's your choice. If you insist on no treatment, your heart will probably stop working soon, and you'll die.

"Ms. Fielding, what do you want? It's your body, your life. Will you agree to a pacemaker?"

"Hell, yes," Ms. Fielding said, sitting bolt up in the bed. "Do I look like a fool? I volunteer in the pharmacy after all. I allow—no I order—you to do anything and everything I need to get better! Who on earth told you different?"

Silence.

"I see. I think it's time I changed my will. Well now you know what I want. Call the cardiologist, call my lawyer—"

With horror and fascination, her visitors watched the vibrant woman become pale and begin to sway, as the heart monitor registered her heartbeat. Fifty...forty-five...thirty...

"I want to...live," Lilly Fielding said.

And then she died.