Rogue

Chapter 5

Maxine was sound asleep at four A.M. when the phone rang at her bedside. It took longer than usual to wake her up, as she had been sleeping deeply. She often fell into a deeper sleep when her children weren't around. As she glanced at the clock, she hoped that nothing had gone wrong at Blake's apartment. She wondered if Sam had had a nightmare and wanted to come home. She answered the phone automatically, before fully waking up and without thinking.

“Dr. Williams,” she said briskly, to mask the fact that she'd been sound asleep, although who would have expected her to be otherwise at four A.M.?

“Maxine, I'm sorry to call you at this hour.” It was Thelma Washington, the doctor on call for her over the Thanksgiving holiday and weekend. “I'm at New York Hospital with the Andersons. I thought you'd want me to call. Hilary overdosed last night. They found her at two A.M.” She was a bipolar fifteen-year-old with a heroin problem, who had attempted suicide four times in the past two years. Maxine was instantly awake. “We got her in as fast as we could. The paramedics administered naloxone, but it's not looking good.”

“Shit. I'll be right in.” Maxine was already standing up as she said the words.

“She hasn't regained consciousness, and the attending doesn't think she will. It's hard to say,” Thelma filled her in.

“She made a miraculous recovery last time. She's a pretty tough little kid,” Maxine commented.

“She'll have to be. It seems like she took one hell of a cocktail. Heroin, cocaine, speed, and the blood workup shows rat poison. They've apparently been cutting street heroin with some pretty nasty stuff these days. They had two kids die of it here last week. Maxine… don't get your hopes up. I don't mean to sound negative about it, but if she makes it through this, I'm not sure how much of her there'll be left.”

“Yeah, I know. Thanks for calling me. I'll get dressed and be right in. Where is she?”

“Trauma ICU. I'll be waiting for you here. Her parents are pretty upset.”

“I'll bet.” The poor people had been through it four times with a child who had been difficult since she was two. She was a nice kid, but between her bipolar disease and her heroin addiction, she had been on the fast track to disaster since she was twelve. Maxine had been seeing her for two years. She was the only child of extremely dedicated, loving parents who had done everything they could. There were some kids that, no matter how hard you tried, you just couldn't help.

Maxine had hospitalized her four times in the last two years, with very little effect. The minute she was discharged from the hospital, she was off and running again with the same disastrous friends. She had told Maxine repeatedly that she couldn't help herself. She just couldn't stay clean, and she claimed that the medications Maxine prescribed for her never took the edge off like what she bought on the street. Maxine had been afraid of this outcome for the last two years.

She was dressed in less than five minutes in loafers, a heavy sweater, and jeans. She grabbed a warm coat out of the closet, picked up her purse, and rang for the elevator. She found a cab immediately, and was at the hospital fifteen minutes after Thelma Washington, her relief doc, had called. Thelma had gone to Harvard with her, was African-American and one of the best psychiatrists she knew. And after school, and over the years of covering each other's practices, they had become friends. Privately or professionally, she knew she could always count on Thelma. They were very similar in many ways, and equally dedicated to their work. Maxine felt completely at ease leaving her patients in her hands. Maxine saw Thelma before she saw the Andersons, and Thelma quickly brought her up to speed. Hilary was in a deep coma, and so far nothing they had administered to her had brought her around. She had done it alone at home, while her parents were out. She hadn't left a note, but Maxine knew she didn't need to. She had often told Maxine that she didn't care if she lived or died. For her, and for others like her, being bipolar was just too hard.

Maxine looked upset as she read the chart, and Thelma stood by. “Jesus, she took everything but the kitchen sink,” Maxine said, looking grim, and Thelma nodded.

“Her mother said her boyfriend dumped her last night, on Thanksgiving. I'm sure that didn't help.” Maxine nodded and closed the chart. All the right things had been done. All they could do now was wait to see what happened. It was no secret to either of them, or to Hilary's parents, that if she didn't regain consciousness soon, there was a good chance she would be brain damaged forever, if she lived, which was still doubtful. Maxine was surprised she had survived what she'd taken.

“Any idea when she did it?” Maxine asked, as the two women walked down the hall together. Thelma looked tired and worried. She hated cases like this. Her own practice was far more mellow than Maxine's, but she liked covering for Maxine. Working with her patients was always a challenge.

“Probably a few hours before they found her, which is the problem. The stuff had plenty of time to work through her system. It's why the naloxone didn't help, according to the paramedics who brought her in.” Naloxone was a drug that reversed the effects of powerful narcotics, if administered soon enough. It made the difference between life and death in overdoses, and had saved Hilary four times before. It had made no difference this time, which was a very bad sign to both physicians.

Maxine went in to see Hilary before she saw her parents. She was on a respirator, with a trauma ICU unit still working on her. She was naked on the table, covered by a thin drape. The machine was breathing for her, she was immobile, and her face was gray. Maxine stood looking at her for a long moment, spoke to the team that had been with her since she got there, and had a word with the attending. Her heart was holding up, although the monitor had reported arrhythmia several times. There was no sign of life in the fifteen-year-old girl, who looked more like a child lying there. Her hair was dyed black, and she had tattoos up and down both arms. Hilary had marched to her own drummer, despite her parents' efforts to convince her otherwise.

Maxine nodded at Thelma, and together they went to see the parents in the waiting room. They had been with Hilary initially until the team asked them to leave. It was too upsetting to her parents to watch what was happening, and the residents and nurses needed room to move.

Angela Anderson was crying when Maxine walked in to see them, and Phil had his arms around her, and had obviously been crying too. They had been through this before, but it didn't get easier, only harder, and they were acutely aware that Hilary might have gone too far this time.

“How is she?” they both asked in unison, as Maxine sat down with them and Thelma left the room.

“About the same as when she came in. I just saw her. She's putting up a good fight. She always does.” Maxine smiled sadly at them, it made her heart ache to see the agony in their eyes, and she was sad too. Hilary was such a nice girl. So troubled, but so sweet. “There were some poisons in the drugs she took,” Maxine explained. “That happens on the streets. Mostly, I think our problem is that it all had time to work through her system before she was found. And there's only so much a heart can take. She took a very heavy dose of some very powerful drugs.” It wasn't news to them, but she had to give them some kind of warning that this might not have a happy ending. There was nothing else she could do. The trauma team was doing everything they could.

Thelma brought them all coffee a few minutes later, and then Maxine went back to see Hilary again. Thelma followed her out, and Maxine told her to go home. There was no point in both of them being up all night. Maxine was going to stay. She thanked Thelma before she left, and stuck around to see how Hilary's heart was doing. Its beating was becoming more irregular, and the resident said her blood pressure was coming down, none of it good signs.

For the next four hours, Maxine went back and forth between the Andersons and their daughter, and at eight-thirty, Maxine decided to let them come in to the unit to see her. She was well aware by then that it might be the last time they'd see their daughter alive. Hilary's mother sobbed openly as she touched her, and bent to kiss her, and her father stayed to be with his wife, but he could hardly bear to look at their child. The respirator was still breathing for her, but it was barely keeping her alive.

And as soon as they settled in the waiting room again, the attending physician came in and motioned to Maxine, who followed him back out into the hall. “It's not looking good.”

“Yeah,” Maxine said, “I know.” She followed him back to Hilary's area of the ICU again, and almost as soon as they walked in, the monitor set off an alarm. Hilary's heart had stopped. Her parents wanted everything possible done, and the cardiac team did all they could to jolt her heart back to life. Electric shock was administered as Maxine watched, looking grim. They massaged her heart, and administered the paddles several times, to no avail. They worked on Hilary's lifeless form for half an hour, until the resident finally signaled to the rest of the team. It was over. Hilary was gone. They all stood looking at each other for a long, painful moment, and then the resident turned to Maxine, as they turned off the respirator and took it out of Hilary's mouth.

“I'm sorry,” he said softly, and left the room. There was nothing left for him to do.

“Me too,” she said, and then went to find the Andersons. They knew the moment she walked in, and Hilary's mother began to scream. Maxine sat with them for a long time, and held her in her arms as she cried. She hugged Phil too. They asked to see Hilary again, and Maxine led them into the room. They had put her in a room by herself, for them, before taking her to the morgue. Maxine left them alone with her for nearly an hour. And then finally, heartbroken and devastated, they went home.

Maxine signed the death certificate, and all the appropriate forms. It was after ten o'clock in the morning when she finally left, and went downstairs. She was coming out of the elevator when a nurse she knew called her name. Maxine turned and her eyes were grim.

“I'm sorry…I just heard…,” the nurse said kindly. She had been there the last time Hilary came in, and helped to save her life. The team had been just as good this time, but Hilary's chances of survival had been considerably worse. As they spoke, Maxine noticed a tall man in a white doctor's coat standing nearby, watching them, and she had no idea who he was.

He waited until Maxine finished talking to the nurse, who went upstairs for her shift in ICU, and then he approached.

“Dr. Williams?” he asked cautiously. He could see that she was busy, and looked somewhat disheveled and tired.

“Yes?”

“I'm Charles West. The idiot who gave you a hard time about Jason Wexler a few weeks ago. I just thought I'd say hello.” She wasn't in the mood to talk to anyone, but she didn't want to be rude. He'd been nice enough to call and apologize, though, so she made an effort now.

“Sorry, it's been a long night. I just lost a patient in the ICU. A fifteen-year-old who overdosed. You never get used to it. It breaks your heart every time.” It reminded them both of what could have happened to Jason if she'd listened to him, and they were both glad she knew better and hadn't.

“I'm sorry. It doesn't seem fair, does it? I'm here to see a ninety-twoyear-old patient with a broken hip and pneumonia, and she's doing fine. And you lose a fifteen-year-old. Can I buy you a cup of coffee?”

Maxine didn't even hesitate. “Maybe some other time.” He nodded, she thanked him again, and left. He watched her walk across the lobby. He was startled by how she looked. Somehow he had assumed that she was older than she appeared. He had expected a battle-ax of sorts. He had read about her on the Internet, but there was no photograph. She had never put one up. It didn't seem important to her. Her credentials and CV were enough.

Charles West got into the elevator thinking about her, and the kind of night she must have had. The look in her eyes said it all. He had been startled when he'd heard the nurse call out to her, and something had compelled him to wait and talk to her. And all he could think about as he got off the elevator was that he hoped that somehow destiny would cross their paths again.

Charles West was the last thing on Maxine's mind as she hailed a cab and rode home. She was thinking of Hilary and the Andersons, and the terrible loss they'd sustained, the unthinkable agony of losing a child. Maxine hated moments like this, and as a tragedy such as this always did, it made her that much more determined to save all the others from themselves.