Solemn Oath (11 page)

“I hope not.”

Beverly placed her purse under the desk, glanced around
the empty E.R., then back at Lukas awkwardly. “I guess Lauren's our double-coverage nurse today, isn't she?”

“I think so.”

“She should be here about noon, then.”

“Yes.” Lukas got tired of the tension and turned to go to his call room, when he heard Beverly clear her throat behind him.

“Um, Dr. Bower?”

He turned back. “Yes?”

She took a deep breath. “You got a raw deal with the Dwayne Little case this spring.”

Lukas couldn't prevent his surprise from showing. “Yes, I did.” And she hadn't helped the situation. It was her refusal to back him up—

“I hear we're being investigated by COBRA.”

“Yes, we are.” He waited for her to say something more, to admit she was wrong, that she'd behaved like a coward and allowed Bailey Little to coerce her, and that she would rectify the situation immediately.

“You want some coffee?” she asked, turning toward the break room in the back. “I'm going to make a new pot.”

“No, thanks, I think I'll take a nap while the place is quiet.” He kept his disappointment to himself.

A
fter three and a half months of weekly visits, Mercy Richmond knew she could enter the Knight household without waiting for them to answer her knock. Like many citizens of Knolls, Clarence and Darlene left their doors unlocked and their fifteen-year-old car sitting out in the drive with keys in the ignition. She shook her head as she gave a quick rap at the threshold and opened the door. Her own mother was the same way.

“Hello, anybody here?” she called out, knowing there would be. Even after losing a great deal of weight, Clarence had a lot more to lose, and he remained in his bed most of the time. His sister, Darlene, was afraid to leave him in case he needed her, and so she earned an unsteady income by indexing nonfiction books for publishers on her home computer. In spite of her poor physical condition, she continued to refuse state aid. Clarence had been forced to accept help only when he realized the burden of his extensive medical problems could worsen his sister's condition. Both were in their forties.

“Hello? It's Mercy.' She stepped farther into the small, dilapidated ranch-style house. “Darlene? Clarence?”

“In here” came a voice deep enough to vibrate the walls. It echoed from Clarence's bedroom at the end of a short hallway.

Clarence Knight had been a hardworking mechanic, in good physical health and only slightly above average weight just a few years ago. Then several unexpected blows had hit him in succession: he had lost his job, developed pneumonia and gone into the hospital for a couple of weeks. Then he lost his insurance, and he couldn't find a job. He had to sell his house to pay the hospital bills, and he moved in with his younger sister, Darlene, who suffered from asthma. With Clarence's depression had come the weight, and it had snowballed into a near tragedy before Lukas Bower had discovered the problem last spring and invited Mercy to donate weekly time and money to help Clarence and his sister.

Mercy lugged her medical paraphernalia to the open door of the room, then stopped and greeted them. Clarence looked no different from usual, dwarfing his old standardsize bed with rolls of thick flesh, huge arms and legs and a heavy growth of dark beard and mustache that matched his hair. His dark brown eyes welcomed her, but they held worry. He wore very little clothing because he was always hot, and just like anybody on a diet, he refused to buy more clothes until he had reached his target weight—not that he could have afforded clothing had he needed it. Since he never left the house, why bother?

Clarence gestured toward his sister, Darlene, who occupied the only chair in the room. She was as slender as Clarence was huge, and she kept her prematurely graying hair cut short—and she cut it herself. She never wore makeup, never dated, always kept busy. And she treated Clarence to the same adoration with which she had treated him since they were children.

Today she sat bent forward, shoulders stiff, back straight in what was known in the E.R. as the respiratory position, with obvious inspiratory and expiratory wheezing. The expiratory was much worse. Classic signs of an asthma attack.

“I tried calling your office this morning, Mercy,” Clarence said in his growling voice. “All I got was your machine.”

Mercy stepped to Darlene's side and put her things down. “You have my home number, Darlene. Why didn't you use it when you started having trouble?”

“She wanted to try to treat herself before she called you,” Clarence answered for his sister, heaving himself up to a sitting position, quaking the bed in the process.

“And did it work?” Mercy pulled out her stethoscope and listened to Darlene's chest. “No need to answer that.”

“I tried to get her to call,” Clarence said. “The weather changed last night, and she was out in it, cleaning out the rain gutters. That's what made her worse.”

Mercy grimaced at her patient and took her blood pressure. “Darlene, you know better.” She kept her voice gentle but could not hide all the frustration she felt. “Independence is a wonderful thing, but risking your health like that could make you more dependent in the end.”

Darlene's blood pressure and heart rate were a little elevated. She was agitated, but not crashing. Her skin wasn't cool or clammy, and though her capillary refill was a little sluggish, it wasn't bad. Yet. The peak flow meter didn't register great numbers when Darlene exhaled into it.

“She ran out of her inhaler,” Clarence said.

Mercy reached into her bag and pulled out two different types of inhalers. “Time for a breathing treatment. And, Darlene, I want you to start taking your steroid again. I want to see you first thing in the morning in my office.”

Darlene shook her head. “Not tomorrow.”

“Please don't argue with me. This is your life we're talking about.” Mercy began the treatment, giving Darlene no further chance to reply. Between treatments, she did a bedside glucose test on Clarence and was glad to see that his blood sugar was 260, much lower than it had been, even
though it was still high. His blood pressure was lower, as well, at 160 over 98.

“How's that strain doing?” Mercy asked him as she reached down and kneaded the huge calf of his left leg. At his size and in his eagerness to recover, he had a bad habit of moving too quickly or overdoing his walks through the house. Strained muscles were common. He seldom got outside because of the steps.

“A little better,” he said. “I'm trying to stay in bed, but I'm doing arm exercises.”

“Do you still get short of breath when you get up?”

“Not as much.”

“Still getting depressed?” She warmed the stethoscope in her hand and placed it on his chest.

“I hate being on welfare.”

“I know. Just keep losing that weight and we'll get you healthy again. Are you still taking your Lasix?”

He grunted. “Don't you see that path to the bathroom?”

She heaved him forward and listened to his back, then nodded and straightened.

Clarence lay back after the exam, his bulk causing the bed to groan. He watched his sister with worry. “Wish you'd drag her to the hospital with you, Doc. I know I'm okay, but she just seems set on staying here with me. I can't talk sense into her.”

Mercy sighed and bent over with another breathing treatment for Darlene. “She's your sister, Clarence. What do you expect?” His brow lowered in what appeared to be an angry glare, but Mercy had learned over the months that was his worried look.

“You've kept her breathing this long.” He shrugged his burdensome shoulders. “I guess she thinks you can do miracles right here in the house, so why leave me alone to go to your office?”

“Stop talking about me like I'm not here,” Darlene wheezed.

Mercy knelt beside her. “Darlene, I know what you're thinking—that you've been this bad before and our treatments kept you going. But you're not using your medication as often as you should be, and I've warned you about the danger of hoarding it for an emergency. If you wait to take it until you can't breathe, you're just guaranteeing that there
will
be an emergency.”

Darlene nodded, still concentrating hard on each inhalation.

“You've pushed your body to the limit, sis,” Clarence growled. “What's gonna happen to me if you…don't take care of yourself?” He glanced quickly at Mercy, then away. Mercy had used that very same argument on him this spring when his refusal to accept medical care endangered not only his life but Darlene's.

Darlene's jaw set in a firm line. “What happens to you if I leave now and end up in the hospital?”

Brother and sister held each other's stare for a long moment. Unfortunately, during that moment Mercy felt her skin tingle with the precursor to another bout of weakness and hot sweats. She nearly groaned aloud. Not now!

Clarence sighed heavily. “I can get my own food, sis. You need medical help.” He had come a long way from the angry, belligerent man who hated all doctors and partially blamed them for the shape he was in.

“So are you going to come see me tomorrow, Darlene?” Mercy started to get to her feet, but her legs quivered from the sudden weakness that had overtaken her. She stayed where she was.

“Not tomorrow,” Darlene said. “I feel better. I'm breathing better.”

“Not much,” Mercy said, breathing deeply herself to try to fend off the wave of heat she knew would attack her soon.

“Just until Monday,” Darlene said. “I've got a deadline.”

Clarence bent his huge upper body forward. “Is it worth your life?”

Once again, Mercy pulled out her peak flow meter and tested Darlene's air flow. This was so frustrating! But she knew from experience that it wouldn't help to argue with either of the Knights. She also knew that it had taken just this streak of stubborn independence on both their parts to fight their way out of a second-generation welfare family. Clarence intended to fight his way back to health and discontinue state aid.

The wave washed through Mercy in spite of her silent, desperate attempts to stop it. Beads of perspiration attacked her from every pore, but she resisted the urge to grab a handy piece of paper or magazine and fan herself.

Stress. That was all this was. That, and lack of sleep last night because of Tedi, and worry about what Theo might do now that he was out of the detox center.

“You need to be resting, Darlene,” she said at last, wondering if they could see the sweat dripping from her face and neck and darkening her clothes.

“I need to make a living. This house isn't paid for.” Once again, Darlene's jaw jutted out stubbornly. “Monday. I said I'll come in Monday if I'm still having trouble.”

Clarence explained. “Darlene got her check late last month, and we had trouble making the house payment.” A hint of old bitterness entered his voice. “We had trouble like this before, and they threatened to call in the loan, even though we got the payment to them.”

Mercy finally pushed herself to her feet. “I thought you had your house paid off.”

“Second mortgage,” Darlene said. “Had to get a new computer and have some work done on the car.”

The heat continued to spread across Mercy's body. She took a slow, deep breath.

“Doc, you okay?” Clarence asked, his voice softening. “Something wrong?”

“I'll be fine, just a little flushed.” Probably nothing that couldn't be cured by a disappearing ex-husband. “Darlene, I want to see you in my office as soon as you can get there. Don't worry about waiting for an appointment.” She turned to Clarence. “If she refuses to come in, I want you to sit on her. We need to keep ahead of this thing, or she's going to be in serious trouble. I want both of you to drink plenty of water, no sodas, not even diet sodas. Try not to stress out too much, and get plenty of sleep.” In other words, she wanted them to do a better job of taking care of themselves.

 

Estelle Pinkley was well acquainted with the hot seat, and she knew she could hold ground against Bailey Little. She refused to be intimidated by his steely glare at her across the conference table—the crafty attorney had seldom won a case against her in the courtroom when she practiced law. That this morning's combined meeting of twenty people held not only medical staff but also influential business owners and elected city officials did not frighten her, either. They knew and respected her for her ability to lead, especially the doctors. Besides, one did not show fear when facing down the enemy, and Bailey Little was a ravenous wolf in attorney's clothing.

As hospital board president, Bailey called the meeting to order and dispensed quickly with preliminaries. Several had complained about the suddenness of this meeting.

“I'd like to know why three active members of our medical staff are not present,” Estelle interjected before Bailey could continue.

Bailey raised a silver brow that matched the steel of his hair. “It isn't my responsibility to take roll call, Mrs. Pinkley.”

“But it
is
your responsibility to contact all members when you call a special meeting.” Tension that had already
permeated the room now crackled with energy. “Dr. Mercy Richmond, Dr. Robert Simeon and Dr. Lukas Bower are all absent, and I would like you to state for the record if you called them.” All three doctors had, from time to time in the recent past, resisted Bailey Little's requests and suggestions. “I'm sure we are all aware of the reason for Dr. George's absence.”

Bailey waved his hand dismissively. “A secretary was issued a list of people to contact. If they weren't available it's no longer my responsibility.”

Estelle did not pursue the issue further. Her point was made. The medical staff could usually be counted on to support one another, except in cases of negligence.

“In fact,” Bailey continued, leaning forward and making eye contact with as many as possible, “of the three points we're gathered here to discuss, two of them involve two of our absent physicians.”

Estelle glanced around the room. No one was surprised. Bailey was suing both Dr. Bower and Dr. George for medical malpractice. He had also attempted to use his influence to sway opinion within the hospital board to have Dr. George permanently removed from the medical staff. The best he could do was relieve Jarvis of hospital privileges until the doctor was completely recovered from the TB encephalitis. Ironic that tonight was Jarvis's get-well party.