Terminal

As soon as report was over and the bleary-eyed night shift had departed, the day’s work began in earnest. Janet found herself extremely busy. There were a lot of sick patients on the floor, representing a wide range of cancers, and each was on an individual treatment protocol. The most heartrending for Janet was an angelic boy of nine who was on reverse precautions while they waited for a bone marrow transplant to repopulate his marrow with blood-forming cells. He’d been given a strong dose of chemotherapy and radiation to wipe out completely his own leukemic marrow. At the moment he was completely vulnerable to any microorganisms, even those normally not pathogenic for humans.

By mid-morning, Janet finally had a chance to catch her breath. Most of the nurses took their coffee breaks in the utility room off the nurses’ station where they could put up their tired feet. Janet decided to take advantage of the time to have Tim Katzenburg show her how to access the Forbes computer. Every patient had a traditional chart and a computer file. Janet wasn’t intimidated by computers, having minored in computer science in college. But it still helped to have someone familiar with the Forbes system get her started.

When Tim was distracted for a moment by a phone call from the lab, Janet called up Helen Cabot’s file. Since Helen had been there less than forty-eight hours, the file was not extensive. There was a computer graphic showing which of her three tumors they had biopsied and the location of the trephination of the skull just above the right ear. The biopsy specimen was grossly described as firm, white, and of an adequate amount. It said that the specimen had been immediately packed in ice and sent to Basic Diagnostics. In the treatment section it said that she’d begun on MB-300C and MB-303C at a dosage of 100mg/Kg/day of body weight administered at 0.05 ml/Kg/minute.

Janet glanced over at Tim who was still busy on the phone. On a scrap of paper, she wrote down the treatment information. She also wrote down the alpha numeric designator, T- 9872, that was listed as the diagnosis along with the descriptive term: medulloblastoma, multiple.

Using the diagnostic designator, Janet next called up the names of the patients with medulloblastoma who were currently in the hospital. There were a total of five including the three on the fourth floor. The other two were Margaret Demars on the third floor, and Luke Kinsman, an eight-year-old, in the pediatric wings of the fifth floor. Janet wrote down the names.

“Having trouble?” Tim asked over Janet’s shoulder.

“Not at all,” Janet said. She quickly cleared the screen so that Tim wouldn’t see what she’d been up to. She couldn’t afford to arouse suspicion on her very first day.

“I’ve got to enter these lab values,” Tim told her. “It will only take a sec.”

While Tim was absorbed with the computer terminal, Janet scanned the chart rack for Cabot, Martin, or Sharenburg. To her chagrin, none of those charts was there.

Marjorie breezed into the station to get some narcotics from the pharmacy locker. “You’re supposed to be on your coffee break,” she called to Janet.

“I am,” Janet said, holding up her plastic foam cup. She mentally made a note to bring a mug into work. Everyone else had his or her own.

“I’m already impressed with you,” Marjorie teased from inside the pharmacy. “You needn’t work through your break. Kick back, girl, and take a load off your feet.”

Janet smiled and said that she’d be taking that kind of break after she was fully acclimated to the ward’s routine. When Tim was finished with the computer terminal, Janet asked him about the missing charts.

“They’re all down on the second floor,” Tim said. “Cabot’s getting pheresed while Martin and Scharenburg are being biopsied. Naturally the charts are with them.”

“Naturally,” Janet repeated. It seemed tough luck that not one of those charts could have been there when she had the chance to look at them. She began to suspect that the clinical espionage she’d committed herself to might not be quite as easy as she’d thought when she suggested her plan to Sean.

Giving up on the charts for the moment, Janet waited for one of the other shift nurses, Dolores Hodges, to finish up in the pharmacy closet. Once Dolores had headed down the hall, Janet made sure no one was watching before slipping into the tiny room. Each patient had an assigned cubbyhole containing his or her prescribed medications. The drugs had come up from the central pharmacy on the first floor.

Finding Helen’s cubbyhole, Janet quickly scanned the plethora of vials, bottles, and tubes that contained anti-seizure medication, general tranquilizers, anti-nausea pills, and nonnarcotic pain pills. There were no containers designated MB300C or MB303C. On the chance that these medications were secured with the narcotics, Janet checked the narcotics locker, but she found only narcotics there.