Read Online Sisterhood by Michael Palmer - Free Book Online Page B
Authors: Michael Palmer
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“Her husband, Peter, is a professor at Harvard. Economics. She was referred to me by an internist because of a suspected cancer of the rectum. Several weeks ago, I performed a Miles’s resection on the woman. The tumor was an adenocarcinoma extending just through the bowel wall.
“However, all the nodes I took were negative. I feel there’s a very good chance that my clean-out may have gotten the whole thing.”
David looked up from the coffee stain he was absently erasing with his thumb. The five-year survival rate after removal of a rectal cancer with such extension was under 20 percent. A chance? Certainly. A “very good chance”? He leaned back and wondered if it was worth asking Huttner to clarify the reasons for his optimism. It would not, he decided, be wise to question him about anything.
Comfortable in the blanket of his own words, Huttner continued his presentation. “As always seems to happen when we work on nurses or doctors, everything that could have gone sour postoperatively seems to have done so. First, a pelvic abscess—I had to go back in and drain it. Next, a pneumonia. And then a nasty decubitus ulcer over her sacrum. Yesterday she developed signs of a bowel obstruction and I had to slip down a tube. That seems to be correcting the problem, and I have a feeling that she may have turned the corner.”
Huttner folded his hands on the table in front of him, indicating that his presentation was done. An almost imperceptible tic had developed at the corner of his right eye. He must be absolutely exhausted, David thought. Uncomfortable and anxious to do anythingother than stare, David returned to the chart. “If she needs to be operated on for the obstruction?” he asked, already praying it would not happen.
“Then you go ahead and do it if that’s your judgment. I’m leaving you in complete charge,” Huttner said somewhat testily.
No more questions, David resolved. Whatever you want to know, figure it out for yourself. Just get through this night.
But already another potential problem was becoming obvious. He tried to reason it through, but quickly realized that only Huttner could supply the answer. His resolve stretched, then snapped.
“If she should arrest?” he asked softly.
“Dammit, man, she’s not going to arrest,” Huttner snapped with startling vehemence. Then, sensing the inappropriateness of his outburst, he took a deep breath, exhaled slowly, and added, “At least, I hope she doesn’t arrest. If she should, I want a full Code Ninety-nine called on her, including tracheal intubation and a respirator if need be. Clear?”
“Clear,” David said. He looked down at the chart again. Whatever criticisms might be leveled at Wallace Huttner, undertreating Charlotte Thomas certainly could not be one of them. Thousands of dollars in laboratory work, hospital care, and radiologic studies had already been done. Still, at least on paper, the woman appeared far from “turning the corner.”
“Shall we go see the patient?” Huttner’s tone was more order than request.
David was about to comply when he noticed the report of Charlotte’s liver scan. The words burst from the page: “Multiple filling defects consistent with tumor.” Numbness crept over him as he stared at the reading. Rarely had he heard of a patient surviving long with the spread of rectal cancer to the liver. Certainly, with this kind of disseminated disease, there could be no way tojustify the aggressive therapy being given Charlotte Thomas. If, as in the Merchado case, this report had somehow been overlooked, whatever remained of his relationship with Huttner was about to disappear with the finality of a nuclear explosion.
“What is it this time, doctor?” Huttner asked acidly.
“Oh … probably nothing,” David said, wishing he were anyplace else. “I … ah … I was just reading this liver scan report.”
“Hah!” Huttner’s exclamation cut him short. “Multiple defects consistent with
“However, all the nodes I took were negative. I feel there’s a very good chance that my clean-out may have gotten the whole thing.”
David looked up from the coffee stain he was absently erasing with his thumb. The five-year survival rate after removal of a rectal cancer with such extension was under 20 percent. A chance? Certainly. A “very good chance”? He leaned back and wondered if it was worth asking Huttner to clarify the reasons for his optimism. It would not, he decided, be wise to question him about anything.
Comfortable in the blanket of his own words, Huttner continued his presentation. “As always seems to happen when we work on nurses or doctors, everything that could have gone sour postoperatively seems to have done so. First, a pelvic abscess—I had to go back in and drain it. Next, a pneumonia. And then a nasty decubitus ulcer over her sacrum. Yesterday she developed signs of a bowel obstruction and I had to slip down a tube. That seems to be correcting the problem, and I have a feeling that she may have turned the corner.”
Huttner folded his hands on the table in front of him, indicating that his presentation was done. An almost imperceptible tic had developed at the corner of his right eye. He must be absolutely exhausted, David thought. Uncomfortable and anxious to do anythingother than stare, David returned to the chart. “If she needs to be operated on for the obstruction?” he asked, already praying it would not happen.
“Then you go ahead and do it if that’s your judgment. I’m leaving you in complete charge,” Huttner said somewhat testily.
No more questions, David resolved. Whatever you want to know, figure it out for yourself. Just get through this night.
But already another potential problem was becoming obvious. He tried to reason it through, but quickly realized that only Huttner could supply the answer. His resolve stretched, then snapped.
“If she should arrest?” he asked softly.
“Dammit, man, she’s not going to arrest,” Huttner snapped with startling vehemence. Then, sensing the inappropriateness of his outburst, he took a deep breath, exhaled slowly, and added, “At least, I hope she doesn’t arrest. If she should, I want a full Code Ninety-nine called on her, including tracheal intubation and a respirator if need be. Clear?”
“Clear,” David said. He looked down at the chart again. Whatever criticisms might be leveled at Wallace Huttner, undertreating Charlotte Thomas certainly could not be one of them. Thousands of dollars in laboratory work, hospital care, and radiologic studies had already been done. Still, at least on paper, the woman appeared far from “turning the corner.”
“Shall we go see the patient?” Huttner’s tone was more order than request.
David was about to comply when he noticed the report of Charlotte’s liver scan. The words burst from the page: “Multiple filling defects consistent with tumor.” Numbness crept over him as he stared at the reading. Rarely had he heard of a patient surviving long with the spread of rectal cancer to the liver. Certainly, with this kind of disseminated disease, there could be no way tojustify the aggressive therapy being given Charlotte Thomas. If, as in the Merchado case, this report had somehow been overlooked, whatever remained of his relationship with Huttner was about to disappear with the finality of a nuclear explosion.
“What is it this time, doctor?” Huttner asked acidly.
“Oh … probably nothing,” David said, wishing he were anyplace else. “I … ah … I was just reading this liver scan report.”
“Hah!” Huttner’s exclamation cut him short. “Multiple defects consistent with
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