Chapter 5 - Exposure and Entitlement
By the time the clock on the trauma bay wall struck 11:45 PM, St. Jude’s Mercy Hospital had ceased to function like a civilian hospital.
Both patients were alive.
Marcus Doyle had been stabilized, his chest tube draining clear serosanguinous fluid, his color fully restored, and was now sleeping under light sedation in the Surgical Intensive Care Unit under the personal guard of two armed Navy SEALs who refused to leave the room. Young Corpsman Miller was in Operating Room Two, where the chief of vascular surgery had just successfully placed an endovascular stent across his femoral artery, loudly telling anyone who would listen that whoever placed the Foley balloon tamponade had performed a miracle that saved the boy from brain death by less than sixty seconds.
Yet inside the main emergency department, the atmosphere was thick with impending violence.
Dr. Julian Reeves was not in the ICU. He was not checking on Miller. He was pacing the length of the central administrative corridor outside the executive offices, his voice echoing off the mahogany wainscoting.
“It is a question of legal liability! It is a question of pure, unadulterated medical anarchy!” Reeves raged, waving his arms at Dr. Arthur Vance, the Chief of Surgery, and Eleanor Sterling, the hospital’s Chief Operating Officer and head of Risk Management.
Reeves had changed into a fresh, pristine white lab coat, but his hair was disheveled, and his eyes were bloodshot with hysterical fury.
“Nora Callahan is an intake nurse!” Reeves shouted, slamming his hand onto the edge of Sterling’s desk. “She had no authority, no credentialing, and no legal right to touch a scalpel or insert a thoracic drain! She committed felony battery! She assaulted me—physically struck me in the chest when I attempted to exercise clinical oversight! And then she performed an unauthorized, cowboy procedure in the back of a civilian truck!”
Arthur Vance, a sixty-two-year-old cardiothoracic veteran who had spent thirty years cutting into human chests, sat behind the desk with his reading glasses perched on the tip of his nose. He didn't look impressed.
“Julian,” Vance said calmly, his gravelly voice low and measured. “According to the telemetry data and the monitor logs, Marcus Doyle’s oxygen saturation was seventy-four percent with a systolic pressure of sixty. He had a massive tension pneumothorax. If someone hadn't decompressed that hemithorax within ninety seconds, he would have coded. Why didn't you place the needle?”
Reeves’s face flushed a violent, mottled red. “The patient had blast polytrauma! Standard operating procedure dictated a full-body polytrauma CT scan to assess for occult retroperitoneal hemorrhage before undertaking invasive interventions! I was following standard protocol!”
“Standard protocol for a patient with an uncompromised airway, maybe,” Vance countered, leaning forward, his bushy gray eyebrows knitting together. “You don't send a crashing tension pneumothorax to radiology, Julian. That’s Medical School 101. A first-year resident knows that. You send a man to CT with a tension pneumothorax, he comes out in a body bag.”
“That is an administrative opinion!” Reeves snapped, turning toward Eleanor Sterling. “Eleanor, look at the risk exposure! What happens if the Navy sues us? What happens if that sailor loses his leg due to her balloon stunt? Callahan must be suspended immediately, stripped of her badge, and escorted off this property by armed security! I want criminal charges filed with the district attorney by morning!”
Eleanor Sterling, a sharp-featured woman in an immaculate charcoal suit, tapped a silver pen against a thick, manila folder lying on her blotter.
“Julian,” Sterling said quietly, her voice chillingly devoid of emotion. “Do you know what is inside this folder?”
Reeves paused, blinking. “Her personnel file? Her termination papers, I hope.”
“This is Nurse Callahan’s redacted Department of Defense credentialing transfer,” Sterling said, opening the folder. “When she was hired three years ago, her application came through a specialized transitional placement program operated directly by the Bureau of Medicine and Surgery under the Department of the Navy. It was personally signed off by the Surgeon General of the United States.”
Reeves scoffed, though the sound lacked conviction. “I don't care who signed her paperwork. She’s an RN!”
“She holds an active, unrestricted medical license as a Board-Certified General and Trauma Surgeon,” Sterling read, her eyes scanning the paper. “She holds a dual master’s in Trauma Critical Care and Combat Emergency Medicine from Johns Hopkins. For seven years, she served as the Lead Medical Officer for DEVGRU—Seal Team Six. She has performed over four hundred emergency surgical procedures under active fire. Her clinical privileges at St. Jude’s were quietly classified under an administrative blind trust because she specifically requested to work as a general floor nurse without physician privileges.”
Reeves’s jaw worked soundlessly. The color drained from his face once more, leaving him looking hollow and frail under the harsh office lights.
“She... she’s a surgeon?” Reeves whispered. “Then why... why was she cleaning bedpans? Why was she letting me...”
“Because,” a deep, gravelly voice echoed from the doorway, “some people serve because they give a damn about human life, Doctor. And others serve because they like the way their name looks on a television screen.”
Reeves spun around.
Standing in the doorway of the executive office was a tall, silver-haired man wearing the immaculate service dress blues of a Navy Captain. Beside him stood Master Chief Ray Hollis and Captain Thomas Vance, the commander of Naval Special Warfare Group Two.
The Captain stepped into the room, his eyes fixing on Julian Reeves with the cold, unyielding weight of an approaching storm.
May you like
“Dr. Reeves,” the Navy Captain said, his voice dropping like an iron portcullis. “I am Captain Bradley Mercer, Chief Medical Officer for Naval Special Warfare Command. And you and I are about to have a very long, very public conversation about what happened to my men tonight.”
***
