Twelve Patients: Life and Death at Bellevue Hospital Read Online Free PDF

No beeps, so that’s a good sign. She picks up immediately and tells me something has come up in the Mexican consulate; the minister is delayed again. He will make it in by late afternoon. He’ll call. She got the Guerra release files again and hand-delivered the right form back to the prosecuting attorney’s office. She wants me to call them to expedite it, sign it, and return ASAP. They won’t pay attention to her.
    My beeper goes off several times and I retreat to the nursing station for a phone, a computer, and a modicum of quiet. Medical Director Ed Fishkin from Brooklyn’s Woodhull hospital is on the line about our lack of ICU beds and their inability to transfer three patients who have been waiting for more than a day. A young woman has falciparum malaria after returning from Southeast Asia. And she is in her third trimester of pregnancy and cannot breathe. We need an ICU bed and a team from high-risk OB, pulmonary, and critical care medicine right now.
    The next call is from my daughter, Marina, inviting me out to dinner at a small bistro on First Avenue, our usual place when Diana is out of town giving a lecture. Marina was back after a post-BA year studying in Israel and was settling into a new job in Midtown. Sometimes the five of us would go out, including my son, Alexei, who lives in Brooklyn with his wife, Gladys. Diana complained that all the best family dinners happened when she wasn’t around, but she understood and appreciated the family support system.
    After getting an ICU bed, I make a call to the prosecuting attorney’s office and tell her assistant about the urgency. I promise to email the attorney. I put in a few words like “justice” and “the American way” and “my friend at the
New York Times
” in the hope of hurrying this along.
    I report in to Patty.
    “
Jefe
, I have a turkey sandwich on your desk for when you get backdown here.” She then puts through my voice messages—all routine except the one from Diana sending me hugs and kisses from Santiago, plus she’s found me the perfect novel by Faciolince and pulsating
vallenato
recommended by her friends in Colombia. Our long-standing tradition from her innumerable travels: She finds the most interesting book everyone is talking about and the CD that you can’t live without.
    I wind my way back through the gate and pick up my cell phone, then head back to my office. Too late I remember that sanctimonious Dr. Faruz is waiting. He’d been in several times in the past couple of weeks already, complaining that another department was poaching on his area. As new technologies have developed, several departments (not infrequently with a monopoly source of income) have been losing ground on what they see as their immutable rights to turf. Interventional cardiology with catheterization has reduced the volume of bypass surgeries dramatically worldwide. There are medical winners and losers in the financial game. This is why Faruz was waiting for me, though inevitably the tensions would be expressed in terms of quality and patient safety, competency, and so on. I was not sympathetic. Times change, new procedures come online all the time. Departments that try to hold on to things using technical and bureaucratic stratagems to control their monopolistic practices are not just hurting themselves. In the long run, they limit the institution’s ability to stay vibrant and adaptive and will ultimately hurt our patients.
    I’m not in the mood for Dr. Faruz—I just want my turkey sandwich.
    As I put my hand on the back door to my office, I hear my name called from behind. Beth, the head of the forensics unit, is on her cell phone and waves at me to wait. She listens intently into the phone. When she hangs up, she asks me if I have some free time to go with her to CPEP to see a new prisoner who was brought in recently. I think about my sandwich, then look at my phone and see that Patty has moved the appointment with the Mexican minister of health