was finished, her patient still lay with her back turned.
"We'll be transferring you out of the SICU," said Abby. "You can go to a room on the ward. It'll be quieter there. Not so many disturbances."
No answer. Just a deep breath, a long sigh.
Abby left the cubicle feeling more defeated, more useless than ever. There was so little she could do. An absence of pain was the best she had to offer. That, and a promise to let nature take its course.
She opened Mary's chart and wrote: "Patient expresses wish to die. Will increase morphine sulphate for pain control and change code status to do not resuscitate." She wrote the transfer orders and handed them to Cecily, Mary's nurse.
"I want her kept comfortable," said Abby. "Titrate the dose to her pain. Give her as much as she needs to sleep."
'what's our upper limit?"
Abby paused. Considered the fine line between comfort and unconsciousness, between sleep and coma. She said, "No upper limit. She's dying, Cecily. She wants to die. If the morphine makes it easier, then that's what we should give her. Even if it means the end comes a little sooner."
Cecily nodded, a look of unspoken agreement in her eyes.
As Abby started towards the next cubicle, she heard Cecily call out: "Dr. DiMatteo?"
Abby turned. "Yes?"
"I... just wanted to tell you. I think you should know that, well . . ." Nervously Cecily glanced around the SICU. She saw that some of the other nurses were watching. Waiting. Cecily cleared her throat. "I wanted you to know that we think you and Dr. Chao did the right thing. Giving the heart to Josh O"Day."
Abby blinked away an unexpected flash of tears. She whispered, "Thank you. Thank you so much."
Only then, as Abby looked around the room, did she see all the nods of approval.
"You're one of the best residents we've ever had, Dr. D.," said Cecily. "We wanted you to know that, too."
In the hush that followed, a pair of hands started clapping. Another joined in, then another. Abby stood speechless, clutching a chart to her chest, as all the SICU nurses burst out in loud and spontaneous applause. They were applauding her.
It was a standing ovation.
"I want her off the staff and out of this hospital," said Victor Voss. "And I'll do whatever the hell it takes to accomplish that."
Jeremiah Parr had faced numerous crises during his eight-year tenure as president of Bayside Medical Centre. He'd dealt with two nursing strikes, several multimillion-dollar malpractice suits, and militant Right-to-Lifers rampaging through the lobby, but never had he faced such outright fury as he saw now in the face of Victor Voss. At 10 a.m. Voss, flanked by his two attorneys, had marched into Parr's off.ace and demanded a conference. It was now close to noon and the group had expanded to include Surgical Residency Director ColinWettig and Susan Casado, the attorney representing Bayside. Calling Susan was Parr's idea. As yet there was no talk of any legal action, but Parr couldn't be too cautious. Especially when dealing with someone as powerful as VictorVoss.
"My wife is dying," said Voss. "Do you understand? Dying. She may not survive another night. I lay the blame squarely on those two residents."
"Dr. DiMatteo is only in her second year," said Wettig. "She wasn't the one who made the decision. Our Chief Resident did. Dr. Chao is no longer in our programme."
"I want Dr. DiMatteo's resignation as well."
"She hasn't offered it."
"Then find a reason to fire her."
"Dr. Wetfig," said Parr, calmly. Reasonably. "We must be able to find some basis for termination."
"There's no basis at all," said Wetfig, stubbornly holding his ground. "All her evaluations have been outstanding and they're all on record. Mr Voss, I know this is a painful situation for you. I know it's only normal to want to lay blame somewhere. But I think your anger is misdirected. The real problem lies in the shortage of organs. Thousands of people need new hearts and there are only a few to go around. Consider what
"We'll be transferring you out of the SICU," said Abby. "You can go to a room on the ward. It'll be quieter there. Not so many disturbances."
No answer. Just a deep breath, a long sigh.
Abby left the cubicle feeling more defeated, more useless than ever. There was so little she could do. An absence of pain was the best she had to offer. That, and a promise to let nature take its course.
She opened Mary's chart and wrote: "Patient expresses wish to die. Will increase morphine sulphate for pain control and change code status to do not resuscitate." She wrote the transfer orders and handed them to Cecily, Mary's nurse.
"I want her kept comfortable," said Abby. "Titrate the dose to her pain. Give her as much as she needs to sleep."
'what's our upper limit?"
Abby paused. Considered the fine line between comfort and unconsciousness, between sleep and coma. She said, "No upper limit. She's dying, Cecily. She wants to die. If the morphine makes it easier, then that's what we should give her. Even if it means the end comes a little sooner."
Cecily nodded, a look of unspoken agreement in her eyes.
As Abby started towards the next cubicle, she heard Cecily call out: "Dr. DiMatteo?"
Abby turned. "Yes?"
"I... just wanted to tell you. I think you should know that, well . . ." Nervously Cecily glanced around the SICU. She saw that some of the other nurses were watching. Waiting. Cecily cleared her throat. "I wanted you to know that we think you and Dr. Chao did the right thing. Giving the heart to Josh O"Day."
Abby blinked away an unexpected flash of tears. She whispered, "Thank you. Thank you so much."
Only then, as Abby looked around the room, did she see all the nods of approval.
"You're one of the best residents we've ever had, Dr. D.," said Cecily. "We wanted you to know that, too."
In the hush that followed, a pair of hands started clapping. Another joined in, then another. Abby stood speechless, clutching a chart to her chest, as all the SICU nurses burst out in loud and spontaneous applause. They were applauding her.
It was a standing ovation.
"I want her off the staff and out of this hospital," said Victor Voss. "And I'll do whatever the hell it takes to accomplish that."
Jeremiah Parr had faced numerous crises during his eight-year tenure as president of Bayside Medical Centre. He'd dealt with two nursing strikes, several multimillion-dollar malpractice suits, and militant Right-to-Lifers rampaging through the lobby, but never had he faced such outright fury as he saw now in the face of Victor Voss. At 10 a.m. Voss, flanked by his two attorneys, had marched into Parr's off.ace and demanded a conference. It was now close to noon and the group had expanded to include Surgical Residency Director ColinWettig and Susan Casado, the attorney representing Bayside. Calling Susan was Parr's idea. As yet there was no talk of any legal action, but Parr couldn't be too cautious. Especially when dealing with someone as powerful as VictorVoss.
"My wife is dying," said Voss. "Do you understand? Dying. She may not survive another night. I lay the blame squarely on those two residents."
"Dr. DiMatteo is only in her second year," said Wettig. "She wasn't the one who made the decision. Our Chief Resident did. Dr. Chao is no longer in our programme."
"I want Dr. DiMatteo's resignation as well."
"She hasn't offered it."
"Then find a reason to fire her."
"Dr. Wetfig," said Parr, calmly. Reasonably. "We must be able to find some basis for termination."
"There's no basis at all," said Wetfig, stubbornly holding his ground. "All her evaluations have been outstanding and they're all on record. Mr Voss, I know this is a painful situation for you. I know it's only normal to want to lay blame somewhere. But I think your anger is misdirected. The real problem lies in the shortage of organs. Thousands of people need new hearts and there are only a few to go around. Consider what
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