“I’ve been wracking my brains trying to figure out how this could’ve happened.”
“Kate. Please.” Ira sighed and pinched the bridge of his nose. “You know better than that. None of this was your fault. Sometimes the darkness takes over.”
She gave him a skeptical look. They’d known each other for a very long time. “Seriously? Sometimes the darkness takes over? That’s supposed to reassure me?”
“I’m not in the business of reassuring anyone.”
“Right, we aren’t supposed to comfort and reassure our patients, we’re supposed to redirect them toward the path of self-recovery… blah blah blah.”
“Exactly.”
“I was being sarcastic.”
“I know you were.”
She felt the old reproach like the hum of an oncoming electrical storm. The events that had shaped her life would never go away, but at least she’d managed to set them aside for a period of time… to place them in a box and mentally tape the lid shut, put the box inside a closet and lock the door. But Nikki McCormack’s death had just blown the closet door off its hinges.
“Look, you can handle this, Kate. You’ve suffered more hardships than most people encounter in a lifetime.” He folded his hands on the desktop. “But here’s the deal. Nikki’s death reflects on me as well. It reflects on the entire department. And I know what you’re thinking. So I want you to know: what happened last night had absolutely nothing to do with your sister. Do you accept that?”
“Intellectually, yes.”
“Well, I need you to accept it here.” Ira tapped his chest. “Completely.”
Savannah Wolfe, with her wavy golden hair, her delicate sea-green eyes and excitable laugh had been such a happy, trusting twelve-year-old, that any predator in the neighborhood could have taken advantage of her. She was the kind of enterprising kid who rescued ants from the driveway and raised baby birds with broken wings. Even the smarmiest dog food commercials made her cry. She was willing to help anyone—friends, neighbors, strangers—even a grown man with bloodshot eyes. All he had to do was ask. “Hey, little girl… couldja help me out a second?”
Kate felt a painful throbbing behind her eyes. “Look, I understand these shaky old feelings about my sister don’t apply, but…”
“Push aside your emotions.” Ira crossed his arms. “I need you to handle this like a professional.”
“Of course I can handle it,” she said defensively.
“The only thing that counts is that you provided standard care for her symptoms. That’s all the hospital wants to know. Did you provide standard care?”
There was a lull before the impact struck. “Standard care?”
“Legally, that’s all the hospital requires. Did you use the proper quantifiers to make an accurate diagnosis?”
She nodded with dull recognition.
“The hospital doesn’t want to hear what you could’ve done differently, Kate. You have to quit second-guessing yourself. It doesn’t help anyone. You’re a brilliant psychiatrist, extremely well qualified, with excellent references. You were treating Nikki for bipolar disorder. You were monitoring her medication and redirecting her behavior in talk therapy. The patient appeared to be stabilized and you were documenting her improvement. Nothing else matters. Now,” he said, leaning forward, “can you handle it?”
“Yes,” Kate responded, not entirely sure. She’d never lost a patient before. It was brand new territory for her. And Ira wasn’t acting like himself. She’d never seen this Ira before. This covering-his-ass Ira.
“When you talk to Risk Management, I want you to give them your clinical observations—period. Don’t get emotional. Do you need an attorney?”
“An attorney?” Kate repeated, her heart beginning to race. Getting sued for malpractice was every doctor’s worst nightmare.
“The hospital is going to have the hospital’s best interests at heart. Just in case a tort action should arise. It’s only natural. You need to take care of yourself.”
Tort action? Lawsuit?
“Here. I’ll give you the name of my attorney. I’d highly recommend him.” He opened his desk drawer and handed her a business card. “Tell him I referred you.”
“Thanks.”
“And don’t worry. Everything’s going to be fine. We’ve all been through it before. Now if you’ll excuse me, I’ve had a rough night and I’ve still got a mountain of paperwork to do. Sorry to kvetch. I’m going to file my progress reports and head home. I’d advise you to do the same.”
Kate noticed the shift of light in his eyes. “Ira,” she said. “Did you leave those peanuts in my office?”
He gave her a quizzical look. “What peanuts?”
“There’s a jar of Planters Peanuts on my bookshelf.”
“No. Maybe James?”
“I already asked. He didn’t do it.”
“Well, I wouldn’t give it too much significance. Probably someone’s playing a little joke. Anyway, let’s talk again in the morning, shall we?”
She stood up and clasped his hand. “Thanks, Ira.”
“Don’t worry. You’ll get through it. Just think of this as a rite of passage.”
Kate hurried down the corridor, ducked into her office, grabbed her coat, knotted her scarf and put on her winter gloves. She took the elevator down to the first floor, where she crossed the busy hospital lobby and pushed on the automatic glass doors like they were two giant pillows. She went outside and bummed a cigarette from one of the residents. She breathed nicotine deep into her lungs and recalled her sister’s final words to her.
“How long do I have to wait?”
“Just a few minutes. I’ll be right back,” Kate promised.
“Where are you going?”
“Right over there. See those trees? Don’t be scared.”
“I’m not scared.”
“I know, you’re my brave little bud.”
“I’m not scared of anything, Katie.”
She suppressed a hiccupy sob, and the other smokers turned to stare at her. She coughed a few times, masking her anguish, and they politely looked away. She stood there coughing and smoking and watching her breath fogging the winter air.
4
KATE DIDN’T WANT TO go home, not when there was so much work to be done. She took the elevator back up to Admissions to talk to Yvette Rosales about Nikki McCormack’s state of mind eight months ago, since Yvette was the nurse who’d admitted her. The Psych Unit staff was always busy. The phones were constantly ringing. A nurse’s job was never done.
Kate walked past the orderlies and RNs in their colorful scrubs on her way to the nurses’ station, a sort of bureaucratic port in a brain-chemical storm. Tamara Johnson was a beefy middle-aged woman who knew where all the bodies were buried. Head nurse and chief bottle-washer.
“Morning, Tamara. Have you seen Yvette around?”
Tamara wagged her heavy head. “She’s due any minute. Probably wanted her Dunkin’s and missed her bus again. I swear she takes that bus as an excuse to be late all the time. How’re you holding up, Doc?”
“Not great.”
“Yeah, I know. I remember when we admitted Nikki. Scrawny little thing. Bold as could be. She took one look around the place and pronounced everybody else insane.” Tamara laughed. “Not her. Just ‘every other crazy-assed mofo’ in the room.”
“That’s our Nikki,” Kate said with a pained smile.
“Would you like coffee? I just made a pot.”
“No, thanks. I’ll wait over there.”
Kate had brought some paperwork with her and found a seat. The admitting room was an ode to mediocrity— corduroy sofas, imitation-leather chairs, watercolor prints on the exposed brick walls. There were glossy brochures on display at every table.
She opened a manila folder and reviewed her notes. At the time of her admission last June, Nikki was becoming uncontrollable at home. She fought constantly with her parents, took drugs, and drank alcohol. Her stepfather was a strict disciplinarian, and the rebellious teenager missed her dad. The divorce had been especially hard on her.