Jang patted me on the back and whispered, “Good job,” as I hung up the phone and replayed the conversation in my head. Was she threatening me? It sure sounded like it. What would she do? Should I be worried? I tried to block her words out of my mind. I had work to do.
I sat down at a computer in the center of the ICU and prepared to write a death note—a medical-legal document explaining what had happened to Dan Masterson and what we had done about it—but I found myself unable to focus, not wanting to relive the failed resuscitation.
I turned away from the computer and leaned back in my chair. What would I say to Darby Masterson? And what about the hep C? Was I supposed to tell her about that, too? How much shit could I drop on one person? Your husband is dead, Darby, and oh by the way, I think he had hepatitis. I checked my pager and saw that while I was performing CPR, I’d missed nearly a dozen messages.
As I scrolled through the missed pages, I struggled to go back about my business as though nothing had happened. But that was what I needed to do. That hour with Dan Masterson was an hour where I had not been thinking about my other critically ill patients, and when I looked up from my pager, a line of nurses had formed to tell me what was happening around the unit. The Italian man had spiked another fever, and the Vietnamese woman had too much carbon dioxide in her blood. Oxygen was getting into her lungs, but carbon dioxide wasn’t getting out, and that mismatch would soon cause her blood to become dangerously acidic.
I leapt out of my chair as a series of blood-gas equations flashed across my mind, like breaking news interrupting regularly scheduled programming. I needed to adjust both the frequency and amount of air being delivered by her ventilator, and quickly.
“Get some air,” Jang said, intercepting me as I approached her room. “Take a breather.”
I wasn’t sure why he was still in the ICU; he had patients to see in other wings of the hospital. “I’m okay,” I said.
He grinned and gently placed his hand on my chest. “I know you are. Just take five. Really. This is why I’m here.”
“I’m fine. I promise you I’m fine.”
He pointed at the exit. “Go.”
I reluctantly stepped out of the unit, in search of food and a place to eat it, and noticed that my underarms were soaked with sweat. There were dark stains on my scrub pants—presumably blood or some other bodily fluid once belonging to Dan Masterson—and I still had a dozen more hours on call and untold obstacles to hurdle before I would be able to take a shower.
What did Mrs. Masterson mean by I am coming in now to find you? As I stood staring into the abyss of a vending machine several minutes later, my mind wandered across the hundreds of family members I had interacted with over the year. They were so unpredictable, so different. It was from them I learned that Carl Gladstone was a Yankees fan, that Denise Lundquist’s best friend was her brother. Families provided invaluable windows into our patients’ lives, transforming two-dimensional stories about chest pain into three-dimensional experiences for us to dissect and analyze as we went about our days. Peter Lundquist never left Denise’s side, gently weeping as he watched her sleep. He prefaced every inquiry with I don’t want to bother you, Dr. McCarthy, but I have a tiny question about Denise. Then he’d ask something that was not a tiny question, something like Do you think we’ll still be able to have children? (They would.)
Families, in some ways, became our second set of patients. They needed time and attention, and if you failed to provide that, things could deteriorate quickly. Medicine is complicated and it is a skill to simplify things in a way that doesn’t oversimplify, to accurately convey in plainspoken language what is actually happening inside another person’s body. I made a conscious effort to do it, so it was irritating to see others doctors use medical jargon with families. Just talk like a normal person, I wanted to say. Pretend you’re not a doctor. But for some, that simply wasn’t possible.
Half an hour later, the nurse manager paged me that Dan Masterson’s next of kin had arrived and had asked for me by name at the front desk. I passed Dr. Jang as I reentered the ICU—he was being called away to the emergency room—and as I sat down at a computer and waited for Darby Masterson to arrive, her voice began playing on a continuous loop in my head: I am coming in now to find you, Dr. McCarthy. You. The one responsible.
What if she had a gun? There was no metal detector at the front desk, just a drowsy security guard. And if she used it, would she even be guilty of anything? Wasn’t this a heat-of-the-moment thing? A doctor told me my husband was dead, Your Honor, and I went temporarily insane. I just started firing and now I throw myself at the mercy of the court.
When Darby Masterson entered the intensive care unit, a trio of nurses met her at the door. I eyeballed her from a distance—about twenty feet away on the other side of the unit—and quickly discovered she wasn’t quite what I had imagined. She was tall with very pale skin and had the soft paunch of a new mother. Long, dark black hair fell to her mid-back. She wore blue jeans, a dark blue sweatshirt, and gray tennis shoes. She did not look like a woman about to commit a violent act; she looked more like a victim, which she was.
As the nurses guided her into the room where her husband’s body had been placed, we did not make eye contact. The room was closed off with a curtain, and the nurses stepped outside to give her privacy. I stared at the partition, trying to imagine what was happening on the other side and what I would say to her. Not long after she entered the room, I could hear the wails—the same sounds she’d made on the phone when I told her what had happened—but they were an octave lower now. I took a few steps back, as though the added distance might give her more privacy.
As the minutes ticked by, I tried to busy myself with other work—adjusting ventilators, writing notes, entering orders—but I couldn’t focus. I kept waiting for Darby Masterson to emerge from her husband’s room, but she never did. Hearing her unending sobs through the curtain, I knew this was not a woman who planned to attack me; this was a devastated widow who was here to grieve. And she deserved some semblance of an explanation, even if it was incomplete. I had to go in there; I had to talk with her. But given the amount of work that lay ahead of me, it couldn’t be on her schedule. I needed to get this over with, and soon.
I could feel the nurses watching me as I slowly made my way across the unit toward Masterson’s room. You just gotta do it. There was no way around this. It felt like I was about to do something very bad, as though my slow steps reflected inner turmoil. My mind wanted one thing—to enter the room—but my body wanted something else. When I was a few feet from the curtain, I announced myself and asked if I could enter. A faint voice said I could.
I opened the curtains to find Darby Masterson weeping at her husband’s side. “I’m sorry to interrupt,” I said, gently approaching the bed, “but I believe you were looking for me. I’m Dr. McCarthy.” She stood up and turned away from her husband’s body. She ran her hands through her dark hair and walked toward me. We stood a few feet apart, two strangers inexplicably thrown together through catastrophe. It took everything I had not to run away from her. “I am so sorry,” I said.
She lunged at me and I briefly flinched, but chose to stand my ground. There was no violence, of course. Mrs. Masterson threw her arms around me and gave me a hug. I closed my eyes as her wet cheek met my collarbone and our abdomens lightly touched. Again my eyes glazed with tears. “I just want someone here to know about my husband,” she whispered. “That’s all I want.”
“We did everything we could. We’re still sorting everything out. I am so sorry for your loss.”
“I just want someone to know.”
“Tell me…tell me about him.”
She took a seat and cried for several minutes. I wiped my eyes on my scrubs sleeve as I sat next to her and tried to imagine what she was going through. I simply couldn’t. I ached for a blanket or a towel to cover my pants, to hide her husband’s blood splatter. “My husband,” she said, as she wiped the tip of her nose with a tissue, “I loved him so much.”
I nodded, still not sure what I should say. “What was he like?”
Darby smiled through the tears and looked over at him. “He was a weird guy.” She let out a sound that could almost be described as a laugh, and I tried to match her facial expression. “He wasn’t a people person, he wasn’t someone with a lot of friends. He was just a quirky guy who made me smile. No matter what kind of day I had, I knew he’d make me laugh when I got home.”
“Sounds like a wonderful man.” I wondered what tense I should use. Was it cruel to use the past tense, or simply accurate? “I wish I’d known him.”
“He could also be moody,” she said. “Lock himself in a room and surf the Internet for hours. Probably do it for days if I didn’t stop him.” I bowed my head and thought of Dan stumbling on nitric oxide therapy, reading the testimonials, ordering the package, hiding it away, and somehow inhaling the stuff into his body. This funny, moody guy had a secret, and I still wasn’t sure if it was my job to reveal it. “I just don’t understand,” she said. “How could this happen?”
I looked at her and asked, “What do you know about your husband’s medical conditions?”
She shook her head. “He was a pretty healthy guy.”
“And did he take any medications?”
“Not that I know of. Maybe a multivitamin or something.”
I paused, and tried to summon the wisdom to handle this properly. On the one hand, she deserved to know everything. On the other, I hadn’t seen documentation that he actually had hep C or any other disease. It was something that had been told to me by another doctor; something that Dan Masterson said about himself, but he didn’t arrive with any medical records to prove it. What if he hadn’t used nitric oxide? What if he didn’t have hepatitis? “Your husband lost consciousness shortly after he arrived in our emergency room. We still don’t know why, but it appears he was using an alternative medicine to treat a medical condition. An infection. We weren’t able to test him for it before—”
Her face went blank. “An infection?”
“Yes.”
“What infection? What alternative medicine?” She shook her head. “What are you talking about?”
“He mentioned something to a doctor in the ER about nitric oxide therapy.”
“Nitric oxide?” She straightened her back and looked at the ceiling. “For what?”
This was it. Darby Masterson deserved the truth, but I wasn’t certain what the truth was. “People are trying it for all sorts of things,” I said. “I didn’t get to speak with your husband and he didn’t come with any medical records, so we don’t know for sure. But you’re going to need to get tested—”
Darby flinched. “Tested for what?” We both looked at the corpse, and I considered my words. “Tested for what, Dr. McCarthy?”
I didn’t know what to say. “It would be irresponsible for me to speculate,” I said, “but it would be irresponsible for us to ignore what he said in the emergency room.”
“What did he say?” Her eyes narrowed slightly, bracing for my answer.
From what I understood, hep C was usually spread by sharing needles; I wasn’t sure if it was sexually transmitted, too. “You’re going to need to get tested for a number of things, mostly viral diseases. I really can’t say much more than that. Not without more information.”
She stood up, and I joined her. Standing over her husband, I said, “I’m going to make a list of things you need to get tested for. And if I find out any more information, I will give it to you. I promise you that. We’re still piecing together what happened here tonight.”
“I am just very confused right now.” She took her husband’s hand in hers and nodded. We both wiped tears from our eyes.
“I…I just want you to—”
“Do you think I could have another moment alone?” she asked. “With my husband? Can we talk about this stuff a little later?”
“Of course.” I slowly backed away from the Mastersons and slipped around the curtain and out of the room.