Dead Certain

and was about to have another, that and the fact that the pain meds were making her goofy. I patted her on the hand, told her that she couldn’t have picked a better place for her appendix to go bad on her, and ordered the nurses to get her up to the OR stat.”
    “So what happened to McDermott? Did her appendix rupture before he made it to the hospital?”
    “Nope. He was scrubbed and ready to go when she got there. The only problem was that the OR coordinator called at the same time to say that Farah Davis was in OR four and needed a pair of hands stat. Apparently she had a patient with a uterine rupture and she couldn’t control the bleeding. She was asking for an assist from McDermott.”
    “What did he do?”
    “He had them page me to surgery and when I got there told me to get scrubbed and remove Mrs. Estrada’s appendix.”
    “So what did you do?”
    “I took out Mrs. Estrada’s appendix.”
    “How did it go?”
    “Piece of cake. Believe me, it’s a lot harder to give a good haircut than it is to take out an appendix. After I finished the appendectomy, I took a minute to irrigate her abdomen and check out her gallbladder since I was in the neighborhood.”
    “How did you do that?” I asked, not sure that I wanted to know.
    “All I did was slide a couple of fingers into the incision and move them toward the liver and gallbladder, gently pressing the liver with one hand to bring the gallbladder into reach.”
    “And what did you find?”
    “Nothing. That was the weird part. I didn’t feel anything at all. No stones.”
    “So then what?”
    “I closed her up and sent her to recovery.”
    “Any complications?”
    “None. I’ve just spent the last three hours going over and over every step of the procedure in my mind. Other than the fact that I didn’t find gallstones, there was nothing remarkable about it. The whole procedure couldn’t have taken more than twenty minutes from scalpel to suture.“
    “Did you tell McDermott about not finding the gallstones?”
    “Yeah. He told me it was no big deal. I guess sometimes the stones are so small that you can’t feel them. Not only that, but the tiny ones can actually cause more trouble than the big ones. He also made some crack about my knowing more about gunshots than gallbladders.”
    “I thought you said the stones showed up on ultrasound,” I pointed out.
    “You’re right, but that wouldn’t necessarily mean that you’d be able to feel them with your finger. Still, I must confess it bothered me, so I looked at the films when I pulled her chart. I’ve got to tell you this woman had stones —I mean, we’re talking cherry pits.”
    “So when did you bring it up again with McDermott? „
    “The next time McDermott and I had words, Mrs. Estrada was already dead. She coded around four o’clock this afternoon. She’d already been moved out of recovery into a regular room. The floor nurse went in to check her vitals and found her in full arrest.”
    “Were you there?”
    “No, I was busy checking your Mr. Delius out of CCU. But as soon as I got the page, I was out of there like a bat on speed. Not that it made any difference. By the time I got to her room, there was nothing left for me to do except pronounce her and break the news to the family.”
    “How did they take it?”
    “About as well as can be expected, which is to say pretty terrible. The husband kept on asking me how something like this could have happened, and I didn’t have any answers for him.”
    “Was her death like the others?”
    “You mean the other postsurgical deaths? Only in that I have no more idea of what caused it than anyone has about any of the others.”
    “What did McDermott have to say?”
    “Oh, McDermott said plenty,” replied Claudia, barely suppressing a shudder. “They had to page him at his office at Northwestern, and he was still ballistic by the time he got to Prescott Memorial. I was in the hall talking to one of the nurses on the floor where it happened, and he just shot out of the elevator and tore into me. We actually drew a crowd. Patients even came out of their rooms to see what was going on. I have never felt so humiliated in my entire life.”
    Having been on the receiving end of more than one unfair tirade, I knew just how devastating they could be. “Did he say anything of substance?”
    “You mean besides the fact that he thought I was incompetent and incapable of performing even the most basic procedure without him