hoping to get her even more off balance.
Her thin shoulders lowered a notch. I felt pressed to get back outside, but I knew how important the work was to her. Maybe if I gave it a moment’s attention now, I’d get her on my side, at least for the rest of the morning. I was dangerously distracted as it was and needed to avoid another fight with her.
“We finished the first phase last month,” she said, “and the initial...”
I tried to focus on what she was saying and ignore the feeling in my stomach of a fist that kept tightening. I was aware they’d gotten ambiguous results so far. Magnesium sulfate, cheaper than other cardiac agents, had shown initial promise, but hadn’t panned out as the wonder drug some earlier California studies had suggested it was. As she spoke, her disappointment showed. Still, to give her credit, negative finds in medicine were important, and the material was timely and fascinating. Even talking about it, her voice reverberated with a quiet authority that I hadn’t heard much in our recent exchanges, and her prickly defensiveness was momentarily gone.
“Fabulous for torsade de pointes,” she concluded. “Compared to the old magnesium sulfate protocol, our new version improved survival rates by twenty percent. Not much advantage for V. tach. or V. fib. though.” She shrugged, then added, “It’s too bad.”
I agreed. Torsade de pointes was a lethal but rare form of abnormal heart rhythm. I’d only read about it and in twenty years had never seen a case. The usual killers were ventricular tachycardia and ventricular fibrillation.
“But for unstable angina or MIs it might be promising,” she continued, sounding enthusiastic. “The study’s going to be extended into a second phase, and we’re going to see if magnesium sulfate protects these patients against going into V. tach. or V. fib.”
Trying to keep myself from glancing at my watch, I responded, “Hope so.” I meant it, especially for patients with unstable angina, a condition preceding a heart attack where the blood supply to the heart is increasingly shut off by clogged arteries, but the heart muscle isn’t yet permanently damaged. To reverse the process and prevent the impending heart attack, or MI, we use oxygen, nitroglycerine, bed rest, blood thinners, and sometimes surgery, but the patients often die anyway from the deadly rhythms Jones had mentioned. If magnesium sulfate could protect these patients against V. tach. and V. fib., it might improve survival rates and prevent this. In some cases its use would avoid the need to use thrombolytic agents costing three hundred to three thousand dollars a dose. Magnesium sulfate cost thirty cents a dose. It was a lot safer too.
But right now I had to deal with the ER. “Keep me informed,” I added, stepping to my closet, where I exchanged my jacket for a lab coat.
“I see you finally got the case breakdowns per shift you’ve been waiting for.” She casually gestured to the printouts, adding, “Everybody’s dying to see them,” as if that excused her own prying.
Again I resented her snooping. I was too anxious to have much patience anyway. “Since I haven’t had a chance to look at them myself, I’ve no idea what they are,” I answered rather coolly. “I haven’t been through my mail yet. Now, if you’ll excuse me, I’ve more calls to make, and they obviously need you in the ER. Tell Susanne we won’t be getting ambulances for the next three hours.”
With that I ended what had been probably the nicest moment I’d had with the woman in recent months. Neither of us mentioned our conversation on the phone the previous day. She tried to smile. And failed. I noticed that once again she was wearing something green underneath her lab coat, this time with earrings to match. But her attempts to be stylish had always seemed a bit obvious and did nothing for me. At the door she rather pathetically asked, “Please give me any feedback you might have on my
Her thin shoulders lowered a notch. I felt pressed to get back outside, but I knew how important the work was to her. Maybe if I gave it a moment’s attention now, I’d get her on my side, at least for the rest of the morning. I was dangerously distracted as it was and needed to avoid another fight with her.
“We finished the first phase last month,” she said, “and the initial...”
I tried to focus on what she was saying and ignore the feeling in my stomach of a fist that kept tightening. I was aware they’d gotten ambiguous results so far. Magnesium sulfate, cheaper than other cardiac agents, had shown initial promise, but hadn’t panned out as the wonder drug some earlier California studies had suggested it was. As she spoke, her disappointment showed. Still, to give her credit, negative finds in medicine were important, and the material was timely and fascinating. Even talking about it, her voice reverberated with a quiet authority that I hadn’t heard much in our recent exchanges, and her prickly defensiveness was momentarily gone.
“Fabulous for torsade de pointes,” she concluded. “Compared to the old magnesium sulfate protocol, our new version improved survival rates by twenty percent. Not much advantage for V. tach. or V. fib. though.” She shrugged, then added, “It’s too bad.”
I agreed. Torsade de pointes was a lethal but rare form of abnormal heart rhythm. I’d only read about it and in twenty years had never seen a case. The usual killers were ventricular tachycardia and ventricular fibrillation.
“But for unstable angina or MIs it might be promising,” she continued, sounding enthusiastic. “The study’s going to be extended into a second phase, and we’re going to see if magnesium sulfate protects these patients against going into V. tach. or V. fib.”
Trying to keep myself from glancing at my watch, I responded, “Hope so.” I meant it, especially for patients with unstable angina, a condition preceding a heart attack where the blood supply to the heart is increasingly shut off by clogged arteries, but the heart muscle isn’t yet permanently damaged. To reverse the process and prevent the impending heart attack, or MI, we use oxygen, nitroglycerine, bed rest, blood thinners, and sometimes surgery, but the patients often die anyway from the deadly rhythms Jones had mentioned. If magnesium sulfate could protect these patients against V. tach. and V. fib., it might improve survival rates and prevent this. In some cases its use would avoid the need to use thrombolytic agents costing three hundred to three thousand dollars a dose. Magnesium sulfate cost thirty cents a dose. It was a lot safer too.
But right now I had to deal with the ER. “Keep me informed,” I added, stepping to my closet, where I exchanged my jacket for a lab coat.
“I see you finally got the case breakdowns per shift you’ve been waiting for.” She casually gestured to the printouts, adding, “Everybody’s dying to see them,” as if that excused her own prying.
Again I resented her snooping. I was too anxious to have much patience anyway. “Since I haven’t had a chance to look at them myself, I’ve no idea what they are,” I answered rather coolly. “I haven’t been through my mail yet. Now, if you’ll excuse me, I’ve more calls to make, and they obviously need you in the ER. Tell Susanne we won’t be getting ambulances for the next three hours.”
With that I ended what had been probably the nicest moment I’d had with the woman in recent months. Neither of us mentioned our conversation on the phone the previous day. She tried to smile. And failed. I noticed that once again she was wearing something green underneath her lab coat, this time with earrings to match. But her attempts to be stylish had always seemed a bit obvious and did nothing for me. At the door she rather pathetically asked, “Please give me any feedback you might have on my
Similar Books
