thank you,” was the reply. They reached the room where Wallberg’s body lay.
Harris said, “Please let me know if there’s anything else we can do.”
“Thank you, but I can’t think of anything right now.”
“I understand,” Harris said and turned away from the widow of a patient who had died under his knife. He went back to the surgery area where he dictated his surgical report. It was detailed and lengthy. Soon he would have to face the scrutiny of his fellow doctors as this was a surgical death, and all such are peer reviewed.
Harris now realized he had no way of getting home. It was 2:00 a.m. and he was scheduled to perform a 7:00 a.m. surgery that morning. To go home he would have to call his wife, wake her up and have her come to the hospital. It wasn’t worth it. He went to the dormitory area set aside for house staff on night call. He grimaced at his appearance in the mirror. He noted his disheveled hair. His gray eyes had lost their luster. The muscles of his wiry frame that he tried to maintain with semi-regular exercise seemed flaccid. His shoulders drooped making him look shorter than his six feet. He called the hospital operator and asked for a 6:15 AM wake up call. He fell exhausted into bed, his last thought on the man he had just operated upon; a man who had raped his wife.
CHAPTER 2
As Dr. Harris was falling asleep after his most hectic of nights, his mind went over the details of the evening that led up to the death of Victor Wallberg. Office hours that were supposed to end at 4 p.m. had ended at 7:45. He got home at eight and his wife greeted him as he entered the kitchen through the door that led to the three-car garage. She gave him a quick hug and turned to the microwave to heat the dinner she had prepared earlier for him. Laurel had long since accepted the long hours Cliff’s work demanded. In a good week he managed two or three evenings with his wife and family. She accepted the fact that he was a serious dedicated surgeon who believed in putting his patients first. Laurel sat with him while the meal was warming, bringing him up to date on the activities of their twin twelve-year-old daughters. Halfway through his meal the phone rang. Laurel picked up the phone, listened for a moment and handed it to Cliff with a grimace of distaste on her face. “I don’t believe this,” she said, handing him the phone.
“Is this Dr. Harris?” said a croaking, strained voice.
“Yes, who’s this?”
“It’s Victor Wallberg.”
Harris stared at Laurel, an expression of amazement on his face. “You’ve got a lot of nerve calling me, you bastard. I don’t get it.”
Wallberg’s voice was strained and barely audible. “I have no place to turn. I can’t move. Something bad’s happening… I’ve got a pain in my belly like…you couldn’t believe…it even hurts to talk. I’m desperate.”
Jesus, he sounds like he’s in extremis, thought Harris. “Is your wife there?”
“She’s at a friend’s house,” was the reply through gritted teeth.
“Can you call your regular doctor?”
“I don’t have one,” Wallberg said, followed by a deep moan. “I know how you feel, doc, but I think I’m dyin’ here.” Wallberg’s usual tone of arrogant command had been replaced by the fearful voice of a man in a high state of pain and anxiety.
For perhaps the first time in his life, Cliff Harris regretted the Hippocratic oath he had taken upon becoming a physician. With a sigh of frustration he said, “All right, I’ll be right over.”
It was obvious that Wallberg was in danger. There was no sense wasting time with any further phone questions. Wallberg had to be desperate to call him. However, the man now had become a patient. Once Harris told him he’d be right there, in his mind it meant he had a verbal contract to care for this patient, and that contract had to be fulfilled.
Harris turned to his wife, “I have to go next door. Wallberg sounds like he’s dying. I’m going over there and see what I can do. I’ll fill you in later.”
“But…” Laurel began to expostulate and stopped when she saw the expression on her husband’s face.
Harris donned his heavy coat and picked up his medical bag. The crisp cold of a northern Illinois winter struck his face as he quickly crossed the wide expanse of the two lawns that typically separated homes in the upscale community of Barrington Woods. As Harris approached the front door, it opened to reveal his neighbor bent over in an almost ninety-degree stoop. The effort to come to the door and open it had been exhausting and painful and Harris helped the man to a nearby couch. Wallberg could not lie flat. In order to be examined he had to lie on his back and keep his knees elevated. Seeing this, an alert rang in Harris’s mind that was reinforced when he saw that Wallberg had unstrapped his belt and unzipped his pants. Both signs suggested an abdominal emergent event, confirmed by a quick look at Wallberg’s features; his teeth were clenched and there were wrinkles on his face etched there by pain. His abdomen was markedly distended and exquisitely and diffusely tender. Harris attempted deep palpation but it was impossible. The sudden release of his palpating fingers elicited an agonized guttural groan from the throat of the patient. Clearly he had rebound tenderness, a sign of peritoneal irritation. Examination with a stethoscope revealed high-pitched bowel sounds. Harris knew he was dealing with a surgical belly. There were unmistakable signs of an intestinal obstruction, with possible perforation and peritonitis. Wallberg’s pulse rate was 116 and his respiratory rate was thirty-four. An immediate operation was called for.
“We’ve got to get you to the hospital,” Harris said with conviction.
“I knew it,” Wallberg replied in a weak voice, perspiration bathing his face.
“Are you allergic to any medicines?”
“No.”
Harris called Laurel and told her he was taking Wallberg to the hospital. He asked her to call the paramedics and tell them to hurry. If there was going to be any delay to call him back. Then he called the hospital emergency room. “I’ll be there in about fifteen minutes with a patient exhibiting all the signs of a surgical abdomen. Have you got a pen in your hand?”
“Uhh…yes,” the emergency room nurse replied.
“Write these orders down. I don’t have time for a full diagnostic work up, but we’ll at least get the routine pre-surgical blood tests and make sure the CBC, electrolytes, BUN. and creatinine are done, stat. Also a stat type and cross match for four units of whole blood. He’ll need an immediate intravenous. Start normal saline and pour it in when we arrive. Get a blood culture. He’ll need a pre-op antibiotic, so give him a bolus of two grams of Ancef after the blood culture. Have the emergency room x-ray ready for an abdominal obstructive series. After that you’ll need to insert a gastric suction tube, and a Foley catheter. Call surgery for me and tell them to be ready in one-half hour. Get anesthesia on call, stat. See you. Be ready. You got it all? Read it back quickly.” The nurse did so, accurately and completely.
There were a few minutes of anxious waiting before the ambulance arrived. Harris identified himself to the paramedic and with his help placed Wallberg in the ambulance amid much groaning and cursing on the part of the patient. Wallberg lay on his side with his knees almost touching his chest. Harris sat facing Wallberg, assessing his condition while the paramedic monitored the patient’s vital signs. As they sped to the hospital Dr. Harris said to Wallberg, “I’ve got five minutes to learn all I can about your
