The Surgeon's Delimma (Wards of Avalon Book 1) Read online

  The Surgeon’s Dilemma

  By Brina Cary

  Copyright 2016 Brina Cary

  Chapter 1

  2004

  Oliver Brooks knew what was coming. Looking towards the waiting room he saw the patient’s father. The man wore jeans, a t-shirt with a picture of a unicorn on it, and ratty old tennis shoes. His daughter was Oliver’s patient, little Lucy Woods. She was twelve years old. Twelve. If only he knew a way to fix it, to make it all better. Even with all the lives he had saved there was always a loss. Lucy Woods had an extremely advanced for of brain cancer. The tumor had advanced further than they had suspected. Under it lay a blood clot… one they never expected. After seven hours of surgery the clot came loose. He should have caught it, should have been prepared for it.

  Past tense. At 11:05am on June 10, 2004, Lucy Woods had been relegated to the past tense.

  The unicorn shirt caught his attention once more. Unicorns were her favorite…

  “Mr. Woods,” he called, his voice breaking. Lucy’s father turned towards him, hope evident in his eyes. Unfortunately, he was about to destroy that hope. “Mr. Woods, why don’t we go in here to talk.” He motioned to a room across the hall from the waiting room. It was more private, more intimate. The discussion that was about to happen required it.

  Mr. Woods refused to move. His eyebrows creased and his face took on a slight red tinge. “Doctor? Whatever it is, please just tell me.”

  “Mr. Woods, please. Let’s go over here.”

  He got up and followed Oliver across the hall to the room bathed in low light and serene colors. There was a couch for family members and a chair directly across from it for doctors.

  As they sat, Oliver took a deep breath. He leaned forward and placed his elbows on his knees. “Lucy… There was a complication.”

  “Dear, God…” Oliver’s heart broke for the man as his hands flew to his face. “She’s ok though, right!?! Please say she’s alright!”

  Oliver sighed deeply, “All of the images that we did… Mr. Woods, we didn’t catch a blood clot on the other side of the tumor. It didn’t show.” Lucy’s father sat on the couch that was reserved for these types of discussions. It was supposed to be soft and comforting, surrounded by the green paint on the walls. The overall effect was supposed to be calming. It never was. “Mr. Woods, when we began cutting the tumor away the blood clot gave way. Your daughter… We couldn’t save your daughter. I’m sorry. I’m truly sorry.” There would never be a moment that he would ever forget this. It was his fault. Oliver should have known.

  “This can’t be right.” Oliver watched hopelessly as Lucy’s father shook his head, denying the possibility that his daughter was dead. “No. No, it’s not right.”

  “I’m sorry, Mr. Woods.”

  Lucy’s father stood quickly and pointed accusatory at Oliver. “This is your fault!” He began walking towards the door and turned back. “How dare you! Lucy was scared and you told her it would be ok! You lied to my daughter and you lied to me… I didn’t want to do this! I didn’t want her to have the surgery this soon! This is your fault. I’m going to make sure you get what’s coming to you!” The angry man pushed Oliver hard and stormed out of the room.

  Oliver knew he was right. It was his fault. He should have known. There was always a chance that something could go wrong. If only Oliver had reviewed the scans himself, just one last time. Maybe then he would have seen it. Maybe then Lucy would be going into the Recovery Room instead of the Morgue.

  Chapter 2

  2007

  Oliver was exhausted. His muscles ached, his eyesight was blurry, and he couldn’t even remember the last time he ate. As a neurosurgeon he had set hours, but now those set hours were frantic grasps of light sleep before going again. Between Avalon, where he was a surgeon, and here at the clinic, where he was the only physician, he had worked for hours and hours. Working at the clinic wasn’t the same as working at the hospital either. It put him right there with people. He actually had to speak with them, touch them, and evaluate them. There was no relying on scans and images. Or other people’s findings. Working at the clinic, with people that really needed him, meant he had to find out what was wrong on his own terms.

  It was different from Avalon, but it made him feel better. It made him feel like there was hope. Since Lucy Woods, there hadn’t been much of that for him.

  Oliver was still trying to atone for Lucy and the life that she had lost… He didn’t know whether there was a life after death, but he truly hoped there was one for her. He hoped it was full of unicorns, flowers, and rainbows. He hoped it was full of all the things she enjoyed. Oliver’s goal was to help as many children in Lucy’s name as he could. There was still a long way to go, but between cases of strep throat, flu, and pneumonia… He felt that he was heading in the right direction. His clients couldn’t pay, but somehow everything was always taken care of. Some anonymous benefactor bankrolled the clinic. Oliver only hoped that no one ever found out who the “anonymous benefactor” was. If they did then he wouldn’t be able to walk through the doors anymore. He’d also lose his job at Avalon Hospital.

  Looking at the bright pink clipboard on the door, he knew instantly that it was Synthia MacLemore’s daughter. Once again. ‘Seriously? They had been in five times in the last month.’ Each time it was something different, but it was starting to make him nervous. Synthia was a sweet young single mom, but Oliver suspected something was going on… The infections that Daniella had didn’t make sense. According to Synthia, the child hadn’t been around anyone that was ill. Yet, she had a white blood cell count through the roof, fevers of a hundred and two, swollen lymphnodes, and negative lymphoma and leukemia tests. The whole thing was confusing the heck out of him. Only one possible cause remained…

  Oliver remembered his days as an intern in his very first few months. He was spending some time in the ER learning about ER rotations and a child came in that was very sick. The resident called in a social worker. After the police came and took the parents into custody, Oliver learned that one of the parents had been deliberately causing the child to be sick in a demented attempt at saving the marriage. That was Oliver’s last time in the ER.

  Could Synthia be doing the same thing? Oliver had never seen a husband before. However, people eluded him sometimes. If Synthia wasn’t doing it, maybe someone else was?

  Opening the door and catching Synthia unaware with Daniella, he caught them in an unguarded moment. Synthia had paper cutouts of hearts attached to the lenses of her sunglasses and was making Daniella laugh with her actions. As he watched Synthia pretend to be a movie star and Daniella pretend to be the paparazzi with her mother’s outdated cell phone, taking pictures, Oliver knew that Synthia wasn’t capable of child abuse. There had to be something else going on. Either someone else was involved or there was something he was missing. He cleared his throat and watched amusedly as Synthia snatched the glasses off her face to hide her antics.

  “Hi, Daniella. How are you feeling today?”

  Daniella beamed a bright smile at him as she whispered, “mommy says I’m going to be all better soon.”

  “Did she now? Well, you know she’s right. Mom’s always are,” he gave her a conspiratorial wink before turning to Synthia. “How are her symptoms?”

  “It’s the strangest thing. Yesterday she was fine. Absolutely fine. Then this morning she woke up hoarse as can be. Her throat is white too. I’m worried that it might be strep, but there’s no reason that it could be. She hasn’t been around anyone with it!”

  Another infection? “Daniella, do me a favor and open your mouth really wide for me.” He grabbed the pen light from hi
s jacket pocket and shined it in her throat. The back was encased with strep alright. He saw her two days ago though, it wasn’t possible to move this quickly… “Daniella, can you do me a favor?” She nodded happily. “Can you go get Nurse Beckett to swab your throat? Tell her that I said to give you two suckers when you’re done.”

  Daniella hopped down from the little table and ran out of the room.

  Once Daniella was out of sight he leaned against the patient table. “Ms. MacLemore,” he began.

  “Synthia,” she interrupted.

  He nodded. “Synthia, Daniella didn’t have strep when you brought her in two days ago.”

  “Could it have just been hiding and causing all of this?”

  He shook his head, “I’m afraid not. I’m concerned that something else might be going on.” With strep, Oliver knew that Daniella wasn’t being harmed by someone else. It wasn’t something easy that he could fix either. “I think something might be wrong with her immune system. It’s weird to come on now without showing signs before. Normally, things like this show signs early.”

  “How early?”

  “She would have shown signs within hours of being born… I would like to talk to a friend at a local hospital about your daughter’s symptoms. He’s a really good guy and he’s one of the best in his field. Are you ok with that?” Oliver watched her face for signs that she might resist. If she did, he’d still talk to Jack. He just wouldn’t tell her. As long as he didn’t use names or provide her medical information, and just kept it all as hypothetical then he would be alright.

  “Is it serious?”

  “I honestly don’t know. My friend is an immunologist and can give me a better idea of how to help your daughter.”

  “Immunologist?”

  “He helps people with immune issues.”

  “Doc, I’m not an idiot. I know what an immunologist is. I just don’t understand why Daniella needs one. I’ve never been ill. Did I do something wrong? Did I not do something that I should have?”

  The fear on her face took Oliver by surprise. It was something that he just wasn’t prepared for, even after all of the cases he saw every day, he just wasn’t prepared for the fear. It made his chest ache. Absently, he tried to rub the achy feeling away.

  “Honestly, I don’t know that there’s an issue. She could just be at that age where most kids are germ factories. Let me talk to him and I’ll get back with you. In the meantime, here is my personal cell. You call me if anything happens. I don’t care what time it is. Ok?” He handed her the card and she took it without a fight. That act told Oliver a lot. Synthia was a proud woman, he had learned that over the last few months that she’d been bringing Daniella to see him. For her to eagerly accept his help, Oliver now knew that she would do whatever was needed to help her daughter. That could very well save her daughter’s life if what he suspected turned out to be the case.

  Chapter 3

  On the third knock to the wooden frame, Oliver watched as Jack’s shoulders hunched. He smiled at the answering sigh, Jack’s way of saying that he hoped the interruption at his door was quick. Oliver laughed at his friend’s antics. “Hey, Jack.”

  “Oliver!” Jack jumped up from his desk and Oliver entered the room. “Hey! How’s everything going? It’s been forever since I’ve seen you.”

  They both went quiet. It had been a while, but they both knew why. Oliver had pulled back from everyone after Lucy’s death.

  Oliver cleared his throat, and stared down at the dirty red carpet. It had been close to ten years since it had been replaced. The hospital had offered new carpet twice; however, Jack had refused both times. Oliver took a deep breath. “Jack, I’ve got a favor that I need to ask you.”

  “Anything. Just name it.”

  Jack was serious too. Oliver felt like a heel for avoiding him as much as he had. It had just been hard to do anything else. “I need this to stay a secret. It can’t leave these walls.”

  Jack motioned for them to sit in the chairs in front of his desk. Upon sitting, the turned the chairs towards each other. “Oliver, are you in trouble?”

  “What?” What kind of question was that? He shook his head, “No, it’s nothing like that.” He took a deep breath. He was about to tell someone, for the first time, just what he was doing outside of the hospital. “Jack, there’s a reason I’ve been so anti-people.” He sighed deeply. “I started a non-profit clinic after… When I’m not here, I’m there.”

  “What!?!”

  Oliver knew just how bad it looked. He had broken the rules. He had broken them to atone for Lucy.

  “Man, do you realize just how much trouble you could be in if they found out?”

  “Yes, that’s why I didn’t tell anyone. I see patients there, as a primary care doctor.”

  “So, from neurosurgeon to primary care doctor?”

  “Yep.”

  “You realize that’s kind of like going from Bruce Wayne to Batman everyday, right?”

  “So do you want to be Commissioner Gordon or not?” He had to speak Jack’s language. That’s the only way he could get him to agree to help.

  “Oh, I’m totally in. You know how big of a geek I am. What do you need?”

  “I have a patient. She’s five years old, but keeps getting recurrent infections. Her latest is strep throat. Two days before I saw her for that, her throat was fine. There was no evidence of strep. None. Then when I saw her again with the strep… Her throat looked like it had gone untreated for over a week. Her white blood cell count was nineteen.”

  “Nineteen thousand?”

  He nodded, “An hour later it was twenty-two. In the last month there’s been a handful of other infections too. Things that just don’t make sense. I keep thinking about the ER… the Sanders case. Normally without there being a history of immune issues in the family, this could possibly signal something like child abuse, but the mom is a sweetheart. She loves the kid and no one else is harming her…”

  “So, what are you thinking?”

  The look on Jack’s face, told Ollie that the question was rhetorical; however, he took a deep breath to answer anyways. “I’m thinking something is wrong with her immune system, but I can only do so many blood tests at the clinic. We just don’t have the equipment.”

  “Are you asking me to break protocol?”

  “I’m simply asking for your help.” If that meant breaking protocol then that too.

  “Fine. I have a study going on right now that’s looking at immune deficiencies in children. I’m going to give you six tubes. I need them filled at least a fourth of the way full and given back to me. I can say they’re for research, as long as the mom agrees.”

  Oliver knew just how big of a risk Jack was taking for him. If the Research Compliance Officer found out… “Thank you.”

  “Oh, I’m going to ask you for a favor in the future and you’re going to do it, no questions asked. Got it, Batman?”

  He understood and he would do it. Jack was helping him to help keep a child alive. There wasn’t much that he wouldn’t do in exchange. “Jack, I really appreciate…”

  “Don’t worry about it. Just remember that you owe me. Now about the samples, I need them as soon as they’re taken.”

  “Traffic is about fifteen minutes.”

  “Pack them in a cooler with dry ice. Give them only to me.”

  “I’ll have them for you tomorrow morning. I can get Synthia to bring her in on her way to school.”

  “Good. It’ll take about a week to get the results back. I’ll let you know as soon as I have them.”

  “Jack…”

  “I said don’t worry about it. Just know that the favor I ask is going to be payment enough.” The grin Jack flashed Oliver told him all that he needed to know. It was going to involve some serious entertainment on Jack’s part. They had been friend’s since their college freshmen days, going through medical school together. They knew everything there was to know about each other. Heck, Oliver had even taken Jack out to t
he bar on occasion to forget about his latest conquest that broke up with him. Jack was a great friend, but that’s as far as it went. He knew that Jack wanted more, but he just wasn’t drawn to him in a romantic way. He hoped one day that Jack found a great guy that was though.

  The guy had been through a lot in college. It took six weeks before Oliver realized that the reason Jack never spoke was because he thought Oliver hated him because he gay. The look on his face when Oliver had told him that he didn’t care as long as he didn’t bring anyone over when it was exam time… He didn’t think he’d ever forget it. Jack had looked so relieved. They’d been friends since.

  “Don’t forget. First thing in the morning. I’ll have to get Ada to mail it out to our external lab for testing. It could just be a regular immune deficiency, but normally those crop up before five years old.” Oliver felt hope being crushed at Jack’s next words. “It could be something worse. Something that’s more your department than mine. You need to be prepared for that.”

  As Oliver nodded and prepared to walk out the door, he was stopped by Jack’s laughter. “What?”

  “I just realized that this is why you quit hanging out.”

  “I didn’t want to tell you because then you wouldn’t have plausible deniability.”

  “Plausible deniability? Ollie, you’ve been watching way too many cop shows.”

  Chapter 4

  Oliver lay in his king sized bed looking at the skylights above. It was actually a clear night. He could see the stars above. As a child he had been given just about anything he could have ever wanted, except time with his family. His mother died when he was nine and his father’s new wife couldn’t be bothered with him. The required parent visits to his boarding schools, the occasional Christmas card, etc was all the time his father spent with him. The boarding schools had served him well though. Oliver hadn’t even needed a single dime from his father to pay for college or med school, but that didn’t stop the man from bragging about his successful neurosurgeon son — the one he didn’t raise.