Thursday, August 9, 2012

Sharing Another Chapter - The First To Say No...by Charles C. Anderson

The emergency room entrance of Parkview Hospit...
The emergency room entrance of Parkview Hospital in Fort Wayne, Indiana. (Photo credit: Wikipedia)
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8.
 Dr. Kate Taylor watched the clock all through her shift Wednesday night.  Would Elita be there at seven in the morning?  She had not heard a word since leaving her next to her car in the parking deck three nights before.
At six o’clock Thursday morning she retreated to her office with a few charts.  She sat on the couch and thought of her best friend.

Dr. Elita Romanov had immigrated from Chechnya in 2002 and subsequently attended medical school at Emory University in Atlanta.  Her Chechen name had been Elita Ramazanov, but she had shortened it upon her arrival in America.  She completed her internship and residency in emergency medicine at George Washington University Medical Center in Washington, D.C., and met Kate there.  Kate was doing a fellowship year in critical care medicine, having completed her own training in emergency medicine at Eastern Virginia Medical School in Norfolk, Virginia.

Kate loved working with Elita, who had a knack for getting along with even the grouchiest of colleagues and attending physicians.  Because they spent time together outside the ED, playing tennis and jogging, and both were single, Kate sometimes felt that other people in the hospital thought they were a gay couple. 

Their emergency department was unusual in its physician staffing.  A man was usually head of such a large and busy department.  There were six ED physicians at Parkview Hospital ED.  The four men were competent and friendly, but the hassles of being an ED physician at Parkview made them very possessive of their time away from work.  The men didn't live in Parkview.  They would work at Parkview Hospital until a better job came along.  Elita and Kate lived within a few blocks of each other in the neighborhood. 

The door opened and Elita walked in.  She closed the door behind her. Kate jumped to embrace her.  They held each other for several seconds before Elita backed away and reached for Kate’s hands.

“I’m fine.  And my scalp swelling has gone down.” She lightly touched the back of her head. “My hair is just long enough to cover up the bruise.”

They sat down on the couch and faced each other.

“The newspaper said the police think it was part of a gang hit by the Crips on the Plagues,” Kate said, “a reprisal for interfering with their businesses in Watertown.”

“I’ve been staking out my condo for the past two days,” Elita said. “Nobody has been near my door.  Nothing suspicious.”

“I’m so relieved.”

“I read about Jennifer in the newspaper,” Elita said. “How is she?”

"I saw her at six-thirty last night in the ICU," Kate said. "She has a tracheostomy and a nasogastric feeding tube.  Her jaws are wired.  She's scared to death.  All I could tell her was that a man hit her.  She looked so incredulous.  Can you imagine waking up, unable to talk, unable to open your mouth, your face swollen like a pumpkin, able to feel the suture lines in your face but afraid to look in a mirror?"

“No trouble imagining that at all,” Elita said. “And what explanation did you give her for why Jack Hopkins hit her?" she asked.

"I just shook my head," Kate said, "like I didn't know and it was my fault."

Elita leaned over and hugged her again. “You know it isn’t your fault. I'll go up and talk to her later today."

"We’re going to have to stop pretending that there is something noble about helping junkies, and drunks, and criminals in a gang abuse innocent people,” Kate said.

"In my native country, we do not have these problems," Elita said.  "The government gives people incentives to change.  The U.S. government gives people incentives not to change."

"I don't have any faith in rehab for sociopaths," Kate said. “I will have to tell you later about my experience with Jack Hopkins in the park and the death of Cassandra Smith.”

Elita raised her eyebrows. “I look forward to that.”

There was a knock at the door. "Good morning," Dr. Baker said, appearing in the doorway. Kate picked up her coat. 

Dr. Romanov said, "Good morning, Jim. I’ll finish your charts, Kate.  Run along.”

Once outside the building, Dr. Baker asked, "Have you talked to the police about Jennifer?"

Before answering, Kate looked around. It was a clear fall day, with a light breeze. She took a step ahead of Dr. Baker and started walking home.

"The hospital told me not to,” Kate said as he jumped to catch up.  "I've called the police four times in the past about Jack’s assaults.  He has plenty of money for a good lawyer.  Jack pleads diminished capacity due to his seizure disorder, and the judge says that he doesn't know that he's hurting people.  It's not true.  Jack told me he knew exactly what he was doing.”

"I don't blame you for being angry.  We all feel responsible when something happens on our watch. But it wasn't your fault.  I heard that you didn't even know he was in the ED."

They walked in silence for a few minutes along the sidewalk closest to the park. "I can hardly believe what has happened to my neighborhood," Kate said.  "Many of Watertown's finest restaurants and cafes were once located on this street." 

"I read somewhere that Parkview had one of the largest intact neighborhoods of Victorian architecture in the United States," he said. “Most every house has columns or double porches.”
 
"All that elaborate molding in the front of the houses was hand carved,” she said, pointing toward a house.

"I like the way the canopy of trees grows over the sides of the streets," he said. "These trees look 150 years old."

"Most of the houses in Parkview were built between the Civil War and the 1920s,” she said.  “The twelve-acre park was supposed to be common ground. Up until the last decade, this was one of the most prestigious places to live in all of Watertown."

"I don't know anyone who would walk through the park today," he said, "not without a big dog, or pepper spray, or a pistol in their pocket.”

“Look around you at the empty houses,” Kate said.  “Each one represents a family that has given up.  Civilization has been at war with the Plagues here in Parkview for ten years now, and civilization is losing.  I don't want to give up.  I'm losing my job, my neighborhood, and my hospital.  And I don't know what to do."

"I guess you know all about the threat to close the hospital," Jim said.

"I met with Chris McMahan last week."

"What did he say?"

"Parkview Hospital's parent company, New Century Health, has given us one more year to improve our bottom line.  If we can't, we're history.  They're already building a new hospital in Harman County.  They've applied for a certificate of public need (COPN) to build this hospital without closing Parkview, but the decision about closure won't be made for about a year."

"We might be happier in Harman County."

Kate smiled at his use of the word “we.” The November wind freshened.  She turned her collar up.
"I've asked Mr. McMahan to spend a night shift with me in the ED," Kate said. "I want him to see how our hospital is making things worse.  Sometimes he just looks too content for a guy whose hospital is about to be closed." 

She stopped on the sidewalk and looked toward the park.

"Thank you for walking with me today," she said, reaching for his hand. "When I was a child my real father took me to this park every day.  He worked nights, on the docks.  Every afternoon we would go to the fountain.  He would pick me up and hold my right hand while I walked around the marble rim of the fountain.  I felt safe because I could look down at the pennies on the bottom without fear of falling in.  Sometimes he would put his arms around me from behind and hold me while I leaned out and threw pennies into the water.  I remember watching those pennies turn over and over as they reflected the sunlight on their way to the bottom."

"Did you make a wish?" he asked.

"Not for myself.  I wished that every child in the world could have a daddy like mine."

"That's beautiful."

"After we played at the fountain he pushed me on a swing set nearby, one of those with a leather seat.  They're gone now.  He kept asking me if he pushed too hard, or if I was going too high."

"He sounds like a loving father."

"He was.  He gave me a bicycle for my seventh birthday and taught me how to ride it in this park.  He would run along beside me to catch me if I lost my balance."

"What happened to your father?"

"He died of a cerebral aneurysm when I was eight.  My mother remarried when I was nine."

"What was your step-father like?" he asked
.
She started to walk again, then stopped, turned toward him, and lowered her forehead to his chest.  Her arms fell limp to her sides.  He held her while she cried silently.

She whispered, "He raped me from age ten until age thirteen, when my mother poisoned him."

He grasped the shoulders of her coat and guided her backward. "Sit down with me under this tree, Kate."

"I'm so sorry," he said, settling in beside her with his right arm around her shoulders.  "Now I understand so much more about you.  Thank you for telling me."

She sniffed and looked away from his face.  "You mean now you know why I'm damaged goods?"

He reached into his pocket and handed her his navy handkerchief. "I'm going to hug you, Kate, and you’re going to have to fight me if you try to stop me," he said, pulling her close. "You are not damaged goods to me.  I have waited so long for you to trust me with anything important about yourself."

The hug began to feel better and better to Kate.  She was uncertain what to do. She pulled backward and looked toward the fountain in the park.

"I never even talked to my mom about what my step-father did to me until this week.  Something happened that brought it all back.”

“Tell me about it,” he said.

“Can I ask you a question?"

He reached for her chin and forced eye contact.
The words came out slowly. "Can you understand why this park and that fountain are too important for me to move to Harman County?"

"Of course.  They are your connection to your real father."

She wiped her eyes with his handkerchief.  "They are my only clear recollections of interaction with my father.  After he died I came to the fountain and thought about him a lot.  I talked to him and prayed about him.  I felt so close to him there."

"It must have been comforting."

"It was, but not for long."

"What happened?"

"Until yesterday, I haven't gone to the park since I was thirteen.  I've been too afraid," she said.

"Go on."

"When I was thirteen, a man chased me around the fountain.  He tore off my shirt and bra."

He waited patiently for her to continue. "It's all right," he said. “I’m here.  I won't let anyone hurt you."

"I jumped into the fountain and he came in after me.  It was only two feet deep, but he got hold of my foot.  I kicked him and he lost his balance.  I jumped out while he was choking on the water and ran home."

"What a horrible experience," he said. "But he can't hurt you now.  That was more than twenty years ago."

She looked up into his eyes.  Two steady streams poured down her cheeks. "No, Jim, that man is still at the fountain.  He was there yesterday and he plans to stay."

"Why did you go into the park?”

"I needed to remember how my dad comforted me.  I was thinking of Jennifer.  That man who hit her almost got me yesterday.  It's Jack Hopkins."

She looked up at him.  As he turned his head slowly toward her, she saw his pupils dilate. His eyebrows approached each other and his forehead developed deep furrows of concern. His lips and jaw tightened. "How long have you known that Jack Hopkins was the same man who tried to rape you when you were thirteen?"

"Since yesterday," she said. "He bragged about it.  He also admitted that he beat up on people to make them afraid of him, and it had nothing to do with his seizures."

"What else do I need to know?”

"He knows that my mom poisoned his dad.”

“Give me some time to think about this,” he said. “I don’t want you walking by this park alone.  Promise me you won’t do that again.”

She nodded.

Jim stood up and pulled Kate to her feet.  They walked in silence, hand in hand.  When they arrived at Kate's house, he put both arms around her and squared her body to his. It was the first time she had wanted to hold a man face-to-face since her father died.  It felt good.

He said, "I want you to know that you are important to me.  Anything or anyone that threatens you is my enemy. I can make Mr. Hopkins disappear.”

I want to do that myself.

"Thank you, Jim.  Don’t do anything now.  He’s only one of many Plagues who prey on our hospital staff.  We need a larger solution and answers to some basic questions. But thanks for offering.”

“Then what can I do?”

“The administrator and the board no longer listen to me,” she said.  “They might listen to you.  I need to understand why Parkview Hospital is on a mission to subsidize self-destructive behavior. I need to know how a successful hospital that made money could turn into a nightmare that loses money in only five or six years.  Maybe you could shed some light.”

He kissed her on the forehead and quickly jumped into his car. “I’ll get on it right away.”

She stood in her bay window and watched him drive back to Parkview Hospital. How could he make Jack Hopkins disappear? 


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