Nothing Lasts Forever

chapter Fourteen
It was New Year's Eve again, and Paige, Kat, and Honey ushered in 1994 at Embarcadero County Hospital. It seemed to them that nothing in their lives had changed except the names of their patients.

As Paige walked through the parking lot, she was reminded of Harry Bowman and his red Ferrari. "How many lives were destroyed by the poison Harry Bowman was selling?" she wondered. "Drugs were so seductive. And, in the end, so deadly."

Jimmy Ford showed up with a small bouquet of flowers for Paige.

"What's this for, Jimmy?"

He blushed. "I just wanted you to have it. Did you know I'm getting married?"

"No! That's wonderful. Who's the lucky girl?"

"Her name is Betsy. She works at a dress shop. We're going to have half a dozen kids. The first girl is going to be named Paige. I hope you don't mind."

"Mind? I'm flattered."

He was embarrassed. "Did you hear the one about the doctor who gave a patient two weeks to live? 'I can't pay you right now,' the man said. 'All right, I'll give you another two weeks.'"

And Jimmy was gone.

Paige was worried about Tom Chang. He was having violent mood swings from euphoria to deep depression.

One morning during a talk with Paige, he said, "Do you realize that most of the people in here would die without us? We have the power to heal their bodies and make them whole again."

And the next morning: "We're all kidding ourselves, Paige. Our patients would get better faster without us. We're hypocrites, pretending that we have all the answers. Well, we don't."

Paige studied him a moment. "What do you hear from Sye?"

"I talked to her yesterday. She won't come back here. She's going ahead with the divorce."

Paige put her hand on his arm. "I'm so sorry, Tom."

He shrugged. "Why? It doesn't bother me. Not anymore. I'll find another woman." He grinned. "And have another child. You'll see."

There was something unreal about the conversation.

That night Paige said to Kat, "I'm worried about Tom Chang. Have you talked to him lately?"

"Yes."

"Did he seem normal to you?"

"No man seems normal to me," Kat said.

Paige was still concerned. "Let's invite him for dinner tomorrow night."

"All right."

The next morning when Paige reported to the hospital, she was greeted with the news that a janitor had found Tom Chang's body in a basement equipment room. He had died of an overdose of sleeping pills.

Paige was near hysteria. "I could have saved him," she cried. "All this time he was calling out for help, and I didn't hear him."

Kat said firmly, "There's no way you could have helped him, Paige. You were not the problem, and you were not the solution. He didn't want to live without his wife and child. It's as simple as that."

Paige wiped the tears from her eyes. "Damn this place!" she said. "If it weren't for the pressure and the hours, his wife never would have left him."

"But she did," Kat said gently. "It's over."

Paige had never been to a Chinese funeral before. It was an incredible spectacle. It began at the Green Street Mortuary in Chinatown early in the morning, where a crowd started gathering outside. A parade was assembled, with a large brass marching band, and at the head of the parade, mourners carried a huge blowup of a photograph of Tom Chang.

The march began with the band loudly playing, winding through the streets of San Francisco, with a hearse at the end of the procession. Most of the mourners were on foot, but the more elderly rode in cars.

To Paige, the parade seemed to be moving around the city at random. She was puzzled. "Where are they going?" she asked one of the mourners.

He bowed slightly and said, "It is our custom to take the departed past some of the places that have meaning in his life - restaurants where he ate, shops that he used, places he visited ..."

"I see."

The parade ended in front of Embarcadero County Hospital.

The mourner turned to Paige and said, "This is where Tom Chang worked. This is where he found his happiness."

Wrong, Paige thought. This is where he lost his happiness.

Walking down Market Street one morning, Paige saw Alfred Turner. Her heart started pounding. She had not been able to get him out of her mind. He was starting to cross the street as the light was changing. When Paige got to the corner, the light had turned to red. She ignored it and ran out into the street, oblivious to the honking horns and the outraged cries of motorists.

Paige reached the other side and hurried to catch up with him. She grabbed his sleeve. "Alfred ..."

The man turned. "I beg your pardon?"

It was a total stranger.

Now that Paige and Kat were fourth-year residents, they were performing operations on a regular basis.

Kat was working with doctors in neurosurgery, and she never ceased to be amazed at the miracle of the hundred billion complex digital computers called neurons that lived in the skull. The work was exciting.

Kat had enormous respect for most of the doctors she worked with. They were brilliant, skilled surgeons. There were a few doctors who gave her a hard time. They tried to date her, and the more Kat refused to go out with them, the more of a challenge she became.

She heard one doctor mutter, "Here comes old iron-pants."

She was assisting Dr. Kibler at a brain operation. A tiny incision was made in the cortex, and Dr. Kibler pushed the rubber cannula into the left lateral ventricle, the cavity in the center of the left half of the brain, while Kat held the incision open with a small retractor. Her entire concentration was focused on what was happening in front of her.

Dr. Kibler glanced at her and, as he worked, said, "Did you hear about the wino who staggered into a bar and said, 'Give me a drink, quick!' 'I can't do that,' the bartender said. 'You're already drunk.' "

The burr was cutting in deeper.

"If you don't give me a drink, I'll kill myself."

Cerebral spinal fluid flowed out of the cannula from the ventricle.

"I'll tell you what I'll do," the bartender said. "There are three things I want. You do them for me, and I'll give you a bottle. "

As he went on talking, fifteen milliliters of air were injected into the ventricle, and X-rays were taken of the anterior-posterior view and the lateral view.

" 'See that football player sitting in the corner? I can't get him out of here. I want you to throw him out. Next, I have a pet crocodile in my office with a bad tooth. He's so mean I can't get a vet to go near him. Lastly, there's a lady doctor from the Department of Health who's trying to close up this place. You f*ck her, and you get the bottle.' "

A scrub nurse was using suction to reduce the amount of blood in the field.

The wino throws out the football player, and goes into the office where the crocodile is. He comes out fifteen minutes later, all bloody, and his clothes torn, and he says, "Where's the lady doctor with the bad tooth?"

Dr. Kibler roared with laughter. "Do you get it? He f*cked the crocodile instead of the doctor. It was probably a better experience!"

Kat stood there, furious, wanting to slap him.

When the operation was over, Kat went to the on-call room to try to get over her anger. I'm not going to let the bastards beat me down. I'm not.

From time to time, Paige went out with doctors from the hospital, but she refused to get romantically involved with any of them. Alfred Turner had hurt her too deeply, and she was determined never to go through that again.

Most of her days and nights were spent at the hospital. The schedule was grueling, but Paige was doing general surgery and she enjoyed it.

One morning, George Englund, the chief of surgery, sent for her.

"You're starting your specialty this year. Cardiovascular surgery."

She nodded. "That's right."

"Well, I have a treat for you. Have you heard of Dr. Barker?"

Paige looked at him in surprise. "Dr. Lawrence Barker?"

"Yes."

"Of course."

Everyone had heard of Lawrence Barker. He was one of the most famous cardiovascular surgeons in the world.

"Well, he returned last week from Saudi Arabia, where he operated on the king. Dr. Barker's an old friend of mine, and he's agreed to give us three days a Week here. Pro bono."

"That's fantastic!" Paige exclaimed.

"I'm putting you on his team."

For a moment, Paige was speechless. "I ...I don't know what to say. I'm very grateful."

"It's a wonderful opportunity for you. You can learn a lot from him."

"I'm sure I can. Thank you, George. I really appreciate this."

"You'll start your rounds with him tomorrow morning at six o'clock."

"I'm looking forward to it."

"Looking forward to it" was an understatement. It had been Paige's dream to work with someone like Dr. Lawrence Barker. What do I mean, "someone like Dr. Lawrence Barker"? There's only one Dr. Lawrence Barker.

She had never seen a photograph of him, but she could visualize what he looked like. He would be tall and handsome, with silver-gray hair, and slender, sensitive hands. A warm and gentle man. We'll be working closely together, Paige thought, and I'm going to make myself absolutely indispensable. I wonder if he's married?

That night, Paige had an erotic dream about Dr. Barker. They were performing an operation in the nude. In the middle of it, Dr. Barker said, "I want you." A nurse moved the patient off the operating table and Dr. Barker picked Paige up and put her on the table, and made love to her.

When Paige woke up, she was falling off the bed.

At six o'clock the following morning, Paige was nervously waiting in the second-floor corridor with Joel Philips, the senior resident, and five other residents, when a short, sour-faced man stormed toward them. He leaned forward as he walked, as though battling a stiff wind.

He approached the group. "What the hell are you all standing around for? Let's go!"

It took Paige a moment to regain her composure. She hurried along to catch up with the rest of the group. As they moved along the corridor, Dr. Barker snapped, "You'll have between thirty and thirty-five patients to care for every day. I'll expect you to make detailed notes on each one of them. Clear?"

There were murmurs of "Yes, sir."

They had reached the first ward. Dr. Barker walked over to the bed of a patient, a man in his forties. Barker's gruff and forbidding manner went through an instant change. He touched the patient gently on the shoulder and smiled. "Good morning. I'm Dr. Barker."

"Good morning, doctor."

"How are you feeling this morning?"

"My chest hurts."

Dr. Barker studied the chart at the foot of the bed, then turned to Dr. Philips. "What do his X-rays show?"

"No change. He's healing nicely."

"Let's do another CBC."

Dr. Philips made a note.

Dr. Barker patted the young man on the arm and smiled. "It's looking good. We'll have you out of here in a week." He turned to the residents and snapped, "Move it! We have a lot of patients to see."

My God! Paige thought. Talk about Dr. Jekyll and Mr. Hyde!

The next patient was an obese woman who had had apacemakerputin. Dr. Barker studied her chart. "Good morning, Mrs. Shelby." His voice was soothing. "I'm Dr. Barker."

"How long are you going to keep me in this place?"

"Well, you're so charming, I'd like to keep you here forever, but I have a wife."

Mrs. Shelby giggled. "She's a lucky woman."

Barker was examining her chart again. "I'd say you're just about ready to go home."

"Wonderful."

"I'll stop by to see you this afternoon."

Lawrence Barker turned to the residents. "Move on."

They obediently trailed behind the doctor to a semi-private room where a young Guatemalan boy lay in bed, surrounded by his anxious family.

"Good morning," Dr. Barker said warmly. He scanned the patient's chart. "How are you feeling this morning?"

"I am feeling good, doctor."

Dr. Barker turned to Philips. "Any change in the electrolytes?"

"No, doctor."

"That's good news." He patted the boy's arm. "You hang in there, Juan."

The mother asked anxiously, "Is my son going to be all right?"

Dr. Barker smiled. "We're going to do everything we can for him."

"Thank you, doctor."

Dr. Barker stepped out into the corridor, the others trailing behind him. He stopped. "The patient has myocardiopathy, irregular fever tremors, headaches, and localized edema. Can any of you geniuses tell me what the most common cause of it is?"

There was a silence. Paige said hesitantly, "I believe it's congenital ... hereditary."

Dr. Barker looked at her and nodded encouragingly.

Pleased, Paige went on. "It skips ... wait ..."

She was struggling to remember. "It skips a generation and is passed along by the genes of the mother." She stopped, flushed, proud of herself.

Dr. Barker stared at her a moment. "Horseshit! It's Chagas' disease. It affects people from Latin American countries." He looked at Paige with disgust. "Jesus! Who told you you were a doctor?"

Paige's face was flaming red.

The rest of the rounds was a blur to her. They saw twenty-four patients and it seemed to Paige that Dr. Barker spent the morning trying to humiliate her. She was always the one Barker addressed his questions to, testing, probing. When she was right, he never complimented her. When she was wrong, he yelled at her. At one point, when Paige made a mistake, Barker roared, "I wouldn't let you operate on my dog!"

When the rounds were finally over, Dr. Philips, the senior resident, said, "We'll start rounds again at two o'clock. Get your scut books, make notes on each patient, and don't leave anything out."

He looked at Paige pityingly, started to say something, then turned away to join Dr. Barker. Paige thought, I never want to see that bastard again.

The following night, Paige was on call. She ran from one crisis to the next, frantically trying to stem the tide of disasters that flooded the emergency rooms.

At 1:00 A.M., she finally fell asleep. She did not hear the sound of a siren screaming out its warning as an ambulance roared to a stop in front of the emergency entrance of the hospital. Two paramedics swung open the ambulance door, transferred the unconscious patient from his stretcher to a gurney, and ran it through the entrance doors of ER One.

The staff had been alerted by radiophone. A nurse ran alongside the patient, while a second nurse waited at the top of the ramp. Sixty seconds later, the patient was transferred from the gurney to the examination table.

He was a young man, and he was covered with so much blood that it was difficult to tell what he looked like.

A nurse went to work, cutting his torn clothes off with large shears.

"It looks like everything's broken."

"He's bleeding like a stuck pig."

"I'm not getting a pulse."

"Who's on call?"

"Dr. Taylor."

"Get her. If she hurries, he may still be alive."

Paige was awakened by the ringing of the telephone.

"H'lo ..."

"We have an emergency in ER One, doctor. I don't think he's going to make it."

Paige sat up on the cot. "Right. I'm coming."

She looked at her wristwatch. 1:30 A.M. She stumbled out of bed and made her way to the elevator.

A minute later, she was walking into ER One. In the middle of the room, on the examining table, was the blood-covered patient.

"What do we have here?" Paige asked.

"Motorcycle accident. He was hit by a bus. He wasn't wearing a helmet."

Paige moved toward the unconscious figure, and even before she saw his face, she somehow knew.

She was suddenly wide awake. "Get three IV lines in him!" Paige ordered. "Get him on oxygen. I want some blood sent down, stat. Call Records to get his blood type."

The nurse looked at her in surprise. "You know him?"

"Yes." She had to force herself to say the words. "His name is Jimmy Ford."

Paige ran her fingers over his scalp. "There's heavy edema. I want a head scan and X-rays. We're going to push the envelope on this one. I want him alive!"

"Yes, doctor."

Paige spent the next two hours making sure that everything possible was being done for Jimmy Ford. The X-rays showed a fractured skull, a brain contusion, broken humerus, and multiple lacerations. But everything would have to wait until he was stabilized.

At 3:30 A.M., Paige decided there was nothing more she could do for the present. He was breathing better, and his pulse was stronger. She looked down at the unconscious figure. We're going to have half a dozen kids. The first girl is going to be named Paige. I hope you don't mind.

"Call me if there's any change at all," Paige said.

"Don't worry, doctor," one of the nurses said. "We'll take good care of him."

Paige made her way back to the on-call room. She was exhausted, but she was too concerned about Jimmy to go back to sleep.

The telephone rang again. She barely had the energy to pick it up. "H'lo."

"Doctor, you'd better come up to the third floor."

"What the hell did they teach you in medical school? Don't you even know the difference between heartburn and a heart attack?"

"I thought ..."

"The problem is, you didn't. If you ever wake me up again in the middle of the night for a heartburn case, I'll have your ass. You understand that?"

Paige stood there stiffly, her face grim.

"Give her some antacid, doctor," Lawrence Barker said sarcastically, "and you'll find that she's cured. I'll see you at six o'clock for rounds."

Paige watched him storm out.

When Paige stumbled back to her cot in the on-call room, she thought, I'm going to kill Lawrence Barker. I'll do it slowly. He'll be very ill. He'll have a dozen tubes in his body. He'll beg me to put him out of his misery, but I won't. I'll let him suffer, and then when he feels better ... that's when I'll kill him!