Sacred Trust

Dr. Wong entered the E.R. and greeted Lukas with a cheery smile and warm handshake. “Lukas, I hear you have one of my favorite patients visiting with you this morning.”

“Yes, and your patient is already asking for some clothes. Beverly will assist you.”

As soon as Cowboy was settled with his new doctor, Lukas heard Beverly’s cajoling voice through the door.

“Dr. Wong, you’re a kindhearted person,” she said. “What time do you get off?”

“Um, excuse me? Hold it, Beverly, you know I’m married.”

“I know that, silly. How would you like to help out a hungry house pet?”

“Forget it. I know all about Cowboy’s house pets. He just happens to be here because that ‘pet’ mistook his thigh for a drumstick. Isn’t that right, Cowboy?”

Lukas chuckled as he walked back to the central desk. Beverly wanted that Mustang.

His laughter died when he entered exam room eight with a chart for Mrs. Jane Conn. The eighty-six-year-old woman lay moaning in pain in spite of the morphine Lauren had just injected at Lukas’s order. A smooth, shiny sheath of mottled scar tissue obliterated half of Mrs. Conn’s face and showed up plainly beneath the nonrebreather oxygen mask she had received upon arrival. She had been brought here from her daughter’s home about thirty minutes ago, her pain unresponsive to oral medication or morphine suppositories. Lauren had established an IV where dark bruises attested to the failure of the new paramedic to do so.

Since Lauren and Beverly were both busy, Lukas checked the blood pressure himself. It was going down, and the heart rate was dropping, probably due to a decrease in pain—or Mrs. Conn was dying.

Lukas found Lauren and gave instructions for blood tests and X-rays. “You did say Mrs. Conn had filled out a do-not-resuscitate form for her family, didn’t you?”

“Yes, but we haven’t received it yet.” Lauren wrote his instructions down on a sheet. “Her daughter, Ivy Richmond, should have it.”

“I’ll need to get it from her, or we’ll have to take measures to resuscitate if…” He shrugged, hoping they would have no trouble getting the DNR form. He’d been forced to run codes on late-stage cancer patients before, and it had been very painful for everyone, especially for the patient.

As Lauren ran orders for the tests, Lukas listened once again to Mrs. Conn’s chest. He glanced up, and to his surprise, he saw her one unaffected eye watching him.

He took her hand. “Mrs. Conn, we’re trying to reduce your pain. How does—”

“Let me…” her damaged mouth twisted in an effort to form the hoarse words “…go.” Her eye held him a few seconds, then glazed over and closed.

Sadness overwhelmed Lukas as he watched her. He hated to see the pain, had always hated to see suffering of any kind. It was one of the things that had driven him to be a doc in the first place, and ironically, it had been one of his worst hindrances in premed vertebrate physiology. He’d always been physically sick afterward, even though the animals were anesthetized and even though he reminded himself over and over again that human lives would be saved because of the sacrifice.

Mrs. Conn’s moaning had stopped. Lukas placed a hand on her frail arm, then looked over to find the eye watching him again. He couldn’t read the expression, for there was little expression to be displayed on the harsh mask.

She moved her mouth.

Lukas leaned closer to hear her.

“Ready.” The word wasn’t even a whisper, but a breath of sound that barely carried past the barrier of the transparent oxygen mask. “I’m…ready.”

When he looked at her eye it was closed again. For some reason, some infinitesimal sign relayed itself to him—some lightening of expression on that scarred mask? He felt almost…a peace…assurance. Or was he just trying to comfort himself? Cancer was the hardest of all to take since Mom’s days of suffering. Lord, help her.

“Dr. Bower?”

He turned to find the X-ray tech waiting to do the portable chest. Lauren stepped into the room behind her.

“Lauren, where is Mrs. Conn’s daughter?” he asked.

“She’s in the private waiting room. I’m surprised Dr. Mercy isn’t already with her.”

“Dr. Mercy?”

“She’s Mercy Richmond, Ivy Richmond’s daughter and Mrs. Conn’s granddaughter. Dr. Mercy is a nickname a lot of her patients and staff members called her to keep from confusing her with her father, who was also a physician. He was Dr. Cliff, she was Dr. Mercy. If you haven’t met her yet, you will. She hasn’t had an E.R. shift in a couple of weeks. She has a family practice across the street.”

“Good,” replied Lukas. “We can call her when we need to. But I’m going to need to see Ivy Richmond soon. I need that DNR sheet, and she needs to be prepared.”

Lauren stood gazing at Mrs. Conn. “This has been a rough one. Everyone knows and loves Mrs. Conn. She used to do a lot of volunteer work here. Her daughter Ivy has made several large contributions to the hospital in the five years since her husband died.”

The X-ray tech finished her work in the room, and Lauren took Mrs. Conn’s vitals once more. “Down again. BP is 95 over 55 with a 90 pulse.”

“Thanks, Lauren. I’ll go have a talk with her daughter as soon as I check the test results.”

“Okay, I’ll go see Frankie again.” Lauren gave Mrs. Conn another sad look and walked out of the room.

Had there been time, Lukas would have sat with the patient, but he had to return to reassure the mother with the sick baby, talk to the girl with the sprain, and check on Frankie. Where was Mrs. Conn’s daughter, Mrs. Richmond? Why wasn’t she in here? More than likely she was exhausted and had found a sofa or chair on which to sleep.

When Lukas finished his round of the patients, he returned to Mrs. Conn and read the test results. As expected, they looked normal for an elderly woman with late-stage cancer. She continued to rest peacefully, but her blood pressure and respiration were falling.

He found the E.R. secretary at the central desk. “Carol, would you please call Dr. Richmond’s office and advise her of her grandmother’s condition? I’m going—”

Carol raised a hand. “Wait a minute, Dr. Bower. We received permission to treat Cindy Hawkins with the injured wrist. Also, I have Dr. Simeon on the line. You wanted to talk with him about his patient, Mr. Verris?”

After a quick consultation with Dr. Simeon, Lukas made arrangements to have Franklin Verris, the possible suicide attempt, admitted to ICU, then went back to check on the seventy-three-year-old gentleman one more time.

Shelly kept her vigil at her neighbor’s bedside. Lauren stood at the other side of the bed, adjusting an IV line.

“Any change, Lauren?” Lukas asked.

“I’m not sure. There’s no difference in his vitals, but his breathing seemed to change a moment ago. It’s been twenty minutes, and I’m getting ready to give him the next dose. Do you want me to go ahead with it?”

Lukas bent over Mr. Verris and gently raised his right eyelid. He took out a penlight and shone a beam directly at the pupil. There was a faint reaction. The man didn’t look as pale as he had looked before. But according to Dr. Simeon an overdose was highly unlikely. He had disagreed with Lukas’s request for Romazicon. However, Lauren was prepared for another dose, and since Lukas had already given the order, he decided to carry it out.

“Go for it, Lauren. I need to stay and watch him, but I also need to talk to Mrs. Richmond. I’ll be back.”

Chapter Two

L ukas opened the door to the private waiting room and saw a tall, slender woman pacing the floor. Her casual attire of jeans, jogging shoes and a “Hiking is Life” T-shirt skewed the impression he’d formed in his mind of a wealthy, polished benefactress of the hospital.

Mrs. Richmond’s long, dark brown hair was pulled back into a ponytail at the nape of her neck. She turned to face him, and he saw that the hair was liberally streaked with gray around the temples. Her large, dark eyes met his with deep gravity. She was at least sixty, and the gaunt face told him of recent weight loss. The prominent dark circles under her eyes told him she probably hadn’t slept well for weeks.

“Mrs. Richmond?”

“Yes.” Her voice held fear.

“I’m Dr. Bower, the emergency room physician on duty today. I need to speak with you about your mother.”

Mrs. Richmond nodded. “I should be in there with her, I know, but the moaning…I just couldn’t handle it, had to get away from it for a while.” She resumed her pacing. “She moaned all night. I gave her morphine suppositories twice as often as…” She turned back. “I’m sorry. I’m rambling. It’s just so hard to think straight these days.”