“Hold on Mrs. Pierce. I need to—” But I could see the hair pattern on the baby’s head as it crowned. I quickly assessed the position of the baby, and then worked with Ms. Pierce as she pushed.
While the baby was crowning when I arrived, it was still another forty-five minutes before the nine pound, three ounce boy was delivered. Then I had to suture Mrs. Pierce’s perineum where it tore during the delivery.
“Congratulations,” I said as she held her baby and the nurses prepared to move her up to the labor and delivery area.
“Thank you, Dr. Foster.” She had the glow of a woman who’d just worked hard and now held a miracle.
I washed up, and then made my way back to Ms. Mason.
“Dr. Foster.” Peggy rushed up to me, the expression on her face sent a chill through me.
“What?” I prepared myself to jump into action to save Ms. Mason.
She stared up at me and I noted tears in her eyes.
Ah fuck. “What?” I demanded more harshly. I started to move toward Ms. Mason’s area.
“She died,” Peggy said, gripping my arm.
“What?” I couldn’t seem to find more words.
“I’m sorry.”
“Why didn't you come get me? I told you to get me.”
“It was sudden. She started to complain that she couldn’t breathe, and then …”
Jesus. I couldn’t catch my breath either. I was vaguely aware that I was a doctor in an emergency room surrounded by staff and patients. I needed to keep my shit together. At the same time, the terror that grabbed a hold of my heart and threatened to pulverize it made it difficult to hold back my anguish. Ms. Mason was a sweet woman who’d been instrumental in giving me a good start in school. I remembered accidentally calling her mom a lot in kindergarten, something I learned was normal with young children and their teachers. It was a sort of transference from one motherly figure to another. She was a beloved pillar of the community, and she’d died on my watch.
“What the hell?”
Peggy guided me away from everyone else. “We did all we could. Sometimes these things—”
“Don’t.” I was harsh in my tone. Yes, sometimes we couldn’t save people. We hadn’t been able to save Mia’s mother. Ms. Mason wasn’t the first patient I’d ever lost. But I knew in my gut that had I done something different, she could have been saved. “What did the test say?”
Peggy shook her head. “They never got done.”
“What?” That didn’t make sense. I remembered ordering them.
“I don’t know what happened. When she said she was having trouble breathing, I started to check on the tests, but then … that’s when she lost consciousness.”
I ran my hands through my hair, willing myself to wake up from this nightmare.
“We were able to get Dr. Balding in, but it was too late.”
I couldn’t respond as I retraced my actions in my head.
“She had all the signs of a flu—”
“She also could have had an embolism.” I snapped.
“She didn’t say she had chest pains or difficulty breathing. Not while you were there. This isn’t your fault, Dr. Foster.”
I glared down at her. “Then whose fault is it? I was her doctor. She came here expecting me to help her.”
Peggy’s eyes were sympathetic, and showed her own feelings of guilt.
“Is her family here? Have they been told?” I asked.
“The grandson wasn’t in the waiting room. He told the desk clerk he had to go out but he’d be back to bring her home.”
I closed my eyes. I wasn’t the only one letting Ms. Mason down. I opened my eyes. “We need to call her son. I want to review the notes and find out what happened.”
“I’ll call.”
I went to the computer and reviewed what I’d entered. I’d done everything right. I had a niggling something more serious was going on and ordered the tests. Why weren’t they done? We’d have to have an autopsy to determine what happened, but I had a strong suspicion a pulmonary embolism was to blame. The swollen legs. The clammy skin. The erratic heart rate. The only symptoms she hadn’t mentions weren’t chest pains and shortness of breath, but perhaps that’s what she meant by achy all over.
Fuck. I was having my own shortness of breath. I went to the lounge to get some water. There was an idea that doctors were impervious to death. That we had to be to maintain the ability to be objective. There is some attempt to remain detached, of course, but in a small town where everyone knows everyone, it was hard not to feel an extra attachment. And in emergency medicine, when you lose someone, there is the second guessing. What could I have done differently? The guilt of that was like an anvil on the lungs.
I grabbed a bottle of water from the refrigerator and downed it, but the cool liquid did nothing to calm my rattled nerves.
“Nick?”
I turned to see Mia walking toward me. The sadness in her eyes told me she’d heard. Perhaps she was here to find out if I fucked up and would need a lawyer. I wish to hell I knew.
“I heard what happened. I’m so sorry.”
I swallowed. “I can’t talk about it now.” I had to keep it together to let her family know.
She nodded. “Would you like me to join you?”
“Is the hospital worried?”
It took her a moment to process what I meant. “I’m not here for the hospital. I know Ms. Mason meant a lot to everyone and losing her can’t be easy. Peggy says it was just her time—”
“Don’t.” I held my hands up, as I tried to rein in my anger. I didn’t want to take my frustration out on her. “All those platitudes about we did all we could and it was just her time … that doesn’t help.”
She nodded.
“Dr. Foster?” Peggy stood in the doorway of the lounge. “Mr. Mason, the son, is here.”
I closed my eyes and prayed for
