to school. Did you ever notice it was missing?’
He stared at her. ‘The little shit! How did he get –’
‘This isn’t helping!’ Claire cut in. ‘We need to focus on Taylor. On how to explain his behavior.’
Paul turned to his wife. ‘I’ve asked Adam DelRay to take over. He’s upstairs looking at Taylor now.’
Paul’s blunt announcement left Claire speechless. So this was why DelRay had written orders; he was the new attending. She’d just been fired from the case.
‘But Dr Elliot’s his doctor!’ Wanda protested.
‘I know Adam, and I trust his judgment.’
Meaning he doesn’t trust mine?
‘I don’t even like Adam DelRay,’ said Wanda. ‘He’s your friend, not mine.’
‘You don’t have to like him.’
‘If he’s taking care of my son, I do.’
Paul’s laughter was grating. ‘Is that how you choose a doctor, Wanda? Pick whoever gives you the most warm fuzzies?’
‘I’m doing what’s best for Taylor!’
‘And that’s exactly why he ended up here.’
Claire’s temper at last burst through. ‘Mr Darnell,’ she said, ‘this is not the time to be attacking your wife!’
He turned to Claire, and his contempt was clearly meant for her as well. ‘Ex-wife,’ he corrected. And he turned and walked out of the chapel.
She found Adam DelRay sitting at the nurses’ station, writing in Taylor’s chart. Although it was late in the evening, his white coat was starched and fresh, and Claire felt rumpled by comparison. Whatever embarrassment he’d suffered earlier that day during the crisis with Katie Youmans had been conveniently forgotten, and he regarded Claire with his usual irritating self-confidence.
‘I was about to page you,’ he said. ‘Paul Darnell just decided –’
‘I’ve already spoken to him.’
‘Oh. So you know.’ He gave an apologetic shrug. ‘I hope you don’t take it personally.’
‘It’s the parents’ decision. They have a right to make it,’ she acknowledged grudgingly. ‘But since you’re taking over, I thought you should know the boy has an abnormal peak on gas chromatography. I suggest you order a comprehensive drug screen.’
‘I don’t think that’s necessary.’ He set the chart down and stood up. ‘The most likely drugs have been ruled out.’
‘That peak needs to be identified.’
‘Paul doesn’t want any more drug tests.’
She shook her head, puzzled. ‘I don’t understand his objections.’
‘I believe he reached that decision after speaking with his attorney.’
She waited for him to walk away before picking up the chart. She flipped to the progress notes and with growing dismay read DelRay’s entry.
History and physical dictated.
Assessment:
1. Acute psychosis secondary to abrupt Ritalin withdrawal.
2. Attention Deficit Disorder.
Claire dropped into the nearest chair, her legs suddenly unsteady, her stomach queasy. So this was their criminal defense strategy. That the boy was not responsible for his actions. That Claire should be blamed, because she took him off the Ritalin, triggering a psychotic break. That she was the one who should be blamed. I’m going to end up in court.
This was why Paul didn’t want to find any drug in the boy’s bloodstream. It would shift the blame away from Claire.
Agitated, she flipped to the front of the chart and read DelRay’s orders.
Cancel comprehensive drug/tox screen.
Refer all future questions and lab reports to me.
Dr Elliot is no longer the attending physician.
She slapped the chart shut and felt her nausea intensify. Now it was no longer just Taylor’s life on the line; it was her practice, and her reputation as well.
She thought of the first rule of defensive medicine: cover your ass. You can’t get sued if you can prove you didn’t make a mistake. If you can back up your diagnosis with lab tests.
She had to get a sample of Taylor’s blood. This was her last chance to draw the specimen; by tomorrow, any drug would be cleared from his system, and there’d be nothing left to detect.
She crossed the nurses’ station to the supply room, pulled open a drawer, and collected a Vacutainer syringe, alcohol swabs, and three redtop blood tubes. Her heart was racing as she walked up the hall to Taylor’s room. The boy was no longer her patient, and she had no right to be doing this, but she needed to know what drug, if any, was circulating in his bloodstream.
The state trooper gave her a nod of greeting as she approached.
‘I need to draw blood,’ she said. ‘Would you mind holding down his arm for me?’
He didn’t look happy about it, but he followed her into the room.
Draw it quick and get out of here. With shaking hands she snapped on the tourniquet and twisted off the needle cap. Get out of here before someone finds out what you’re doing. She swabbed Taylor’s arm with alcohol and he gave a shout of rage, twisting against the trooper’s restraining grip. Claire’s pulse accelerated as she pierced the skin and felt that subtle and satisfying pop as the needle penetrated the vein. Hurry. Hurry. She filled one tube, slipped it into her lab coat pocket, then squeezed another into the Vacutainer. Dark blood streamed out.
‘I can’t hold him still,’ said the trooper, wrestling for control as the boy bucked and cursed.
‘I’m almost done.’
‘He’s trying to bite me!’
‘Just keep him still!’ she snapped, her ears ringing with the boy’s shrieks. She slipped the third tube into place and watched as a fresh stream of blood shot out. Just one more. Come on, come on.
‘What the hell is going on in here?’
Claire looked up, so startled she let the needle slip out of the vein. Blood dribbled from the puncture wound and dripped onto the sheets. Quickly she snapped off the tourniquet and applied gauze to the boy’s arm. Cheeks burning with shame, she turned to face Paul Darnell and Adam DelRay, who were staring at her incredulously from the doorway. Two nurses peered over their shoulders.
The
