Terminal

“I’m terribly sorry,” Janet said.

“It’s okay,” Marjorie said. She stood up and shrugged. “As I said, accidents happen. Let’s call Ms. Richmond.”

Janet followed Marjorie back to the nurses’ station where Marjorie placed a call to the director of nursing. After she explained what had happened, she had to get out the ledger from the medicine refrigerator. Janet could see the vials for the other two patients as she did so.

“There was 6cc in the larger and 4cc in the smaller,” Marjorie said into the phone. She listened, agreed several times, then hung up.

“No problem,” Marjorie said. She made an entry into the ledger, then handed the pen to Janet. “Just initial where I indicated what was lost,” she said.

Janet wrote her initials.

“Now head over to Ms. Richmond’s office in the research building, seventh floor,” Marjorie said. “Bring these labels with you.” She put the broken glass fragments with their attached labels in an envelope and handed them to Janet. “She’ll give you several new vials, okay?”

Janet nodded and apologized again.

“It’s all right,” Marjorie assured her. “It could have happened to anyone.” Then she asked Tim to page Tom Widdicomb to get him to mop up the pharmacy closet.

With her heart pounding and knowing her face was flushed, Janet walked toward the elevators as calmly as she could. Her ruse had worked, but she didn’t feel good about it. She felt like she was taking advantage of Marjorie’s trust and good nature. She was also concerned that someone might stumble across the unlabeled vials in the utility drawer. Janet would have liked to have removed them, but she felt she couldn’t risk it until later when she could give them directly to Sean.

Despite her preoccupation with Helen’s drugs, as Janet came abreast of Gloria’s door she noticed it was closed. Having just started her IV, this disturbed her. Except for the one incident when Marjorie had introduced Janet to Gloria, Gloria’s door was always ajar. Gloria had even commented that she liked to have it open so she could stay in touch with life on the ward.

Perplexed, Janet stopped and stared at the door, debating with herself what she should do. She was already behind with her work so she should get over to Ms. Richmond’s office. Yet Gloria’s door bothered her. Fearing Gloria might be feeling poorly, Janet stepped over to the door and knocked. When there was no response, she knocked again louder. When there was still no answer, Janet pushed the door open and peered inside. Gloria was flat on the bed. One of her legs was dangling over the side of the mattress. It seemed an unnatural position for a nap.

“Gloria?” Janet called.

Gloria didn’t respond.

Propping the door open with its rubber foot, Janet approached the bed. Off to the side was a slop bucket with a mop, but Janet didn’t see it because as she got closer she noted with alarm that Gloria’s face was a deep cyanotic blue!

“Code, room 409!” Janet shouted at the operator after snatching the phone from its cradle. She tossed the envelope with the glass shards on the bedside table.

Pulling Gloria’s head back and after making certain her mouth was clear, Janet started mouth-to-mouth resuscitation. With her right hand pinching Gloria’s nostrils, Janet forcibly inflated Gloria’s lungs several times. Noting the ease with which she was able to do this, she became confident there was no blockage. With her left hand she felt for a pulse. She found one, but it was weak.

Janet blew several more times as people began to arrive. Marjorie was there first, but soon others followed. By the time Janet was relieved from her resuscitative efforts by one of the other nurses, there were at least ten people in the room trying to help. Janet was impressed by the quick response: even the housekeeper was there.

Gloria’s color responded quickly, to everyone’s relief. Within three minutes several doctors including an anesthesiologist arrived from the second floor. By then a monitor had been set up showing a slow but otherwise normal heartbeat. The anesthesiologist deftly inserted an endotracheal tube and used an Ambu bag to inflate Gloria’s lungs. This was more efficient than mouth-to-mouth, and Gloria’s color improved even more.

But there were bad signs as well. When the anesthesiologist shone a penlight into Gloria’s eyes her widely dilated pupils did not react. When another doctor tried to elicit reflexes, she was unable to do so.

After twenty minutes Gloria started to make efforts to breathe. Minutes later, she was breathing on her own. Reflexes also returned but in a fashion that did not bode well. Her arms and legs extended while her hands and feet flexed.

“Uh oh,” the anesthesiologist said. “Looks like some signs of decerebrate rigidity. That’s bad.”

Janet did not want to hear this.

The anesthesiologist shook his head. “Too long without oxygen to the brain.”

“I’m surprised,” one of the other doctors said. She tilted the IV bottle to see what was running in. “I didn’t think respiratory failure was a complication of this regimen.”