couldn’t remember the last time she had seen it—maybe never.
The empty chairs in the observation deck filled quickly as more interns came to watch the rare procedure.
The operating team had turned on the microphones. The entire room watched in silence as the surgeons worked on Muir, removing chunks of his colon as they fought to save his life. Unable to keep up with the furious pace of the infection, they failed. His organs shut down, one by one.
“Let’s call it.” The lead surgeon said as he pulled off his gloves and threw them in a disposal bin. "Time of death…8:26 am.”
Confused, she slouched back in her seat. Muir had been ill. There was no doubt about that but something was wrong. No one dies from a CDI that quickly.
Robinson needed to know but she had no idea what to tell him. She took one last look at Muir’s body and jumped from the seat. Her tiredness was gone.
Ten minutes later, she sat in the waiting room outside of Robinson’s office tapping her foot impatiently . “He’s very busy,” his secretary had scolded her, “You can’t just show up and expect a meeting, Dr. Ling, but I’ll see what I can do.”
The more Mei thought about it, the more it bothered her. She didn’t see a lot of C. diff patients in the E.R. but even so, everything about this case seemed wrong. The patient was middle-aged, not elderly. There was nothing to suggest he was at risk. Most surprising of all was how quickly the infection spread through his intestines.
The phone buzzed and the woman at the desk picked it up, listened for a second and then spoke. “You can go in now.”
Mei stood and steeled herself for the inquisition that would come. Robinson’s office was on the north side of the 16th floor of the administration building. It had a commanding view of the city. Through the large plate glass window, she could see the iconic spire of the Empire State Building towering over the streets of Manhattan.
The walls were covered with artwork, mostly prints of famous renaissance works she recognized but had no idea who the artist was. His degrees and awards were displayed in glass-covered plain black frames and filled the wall behind his desk. A large floor globe on an ornate stand sat in the corner.
She half-expected him to be sitting in a smoking chair puffing on a pipe. But he wasn’t, he was sitting behind a large oak desk glaring at her.
He beckoned her forward. “This couldn’t wait until the staff meeting on Friday, Dr. Ling?” he asked with an impatient huff.
“Sit…Sit,” he added even more impatiently.
She pulled out one of the ornate chairs and sat.
“You have my undivided attention,” he said as he clasped his hands together and looked at his watch, “for the next fifteen minutes. What can I do for you, Dr. Ling?”
She didn’t waste any time. “The British patient from yesterday—I’d like to request an autopsy and file a NORS report.”
He pushed his bifocals down to the tip of his nose and peered at her over them. “What British patient?”
“The one with the C. diff infection. You saw him during rounds yesterday. He died this morning.”
“The obese man with diarrhea,” she added, jogging his memory.
Robinson wore a look of distaste on his face as he remembered and frowned. “What about him?”
“I think we should file an outbreak report with NORS and request an autopsy.”
The National Outbreak Reporting System (NORS) had been launched a few years earlier to track gastrointestinal outbreaks across the country.
“A report?” he scoffed. “One foreigner with a C. diff infection is hardly an outbreak.”
“Or have there been others?” He leaned forward suddenly, his brow wrinkled as he studied her.
He was worried about his ER, it’s reputation. No hospital wanted the stigma of a C. diff outbreak. She shook her head. “No, no other cases.”
He relaxed.
“Come see me when you have more cases—even one more would be a good start.” He removed his glasses