The Good Nurse: A True Story of Medicine, Madness, and Murder by Charles Graeber Read Free Book Online Page B

Center. The question was, how much dig would have been required for the numbers they saw in Gall’s blood work. The only part they needed help with was the math.

25
    July 7, 2003
    T he hold music is lite jazz, upbeat and hopeful. The recorded voice said, “Thank you, a poison specialist will be with you shortly, please…”
    Then: “New Jersey Poison Control Center, can I help you?” 1
    “Uh, yeah.” The caller identified herself as Nancy Doherty, calling from the pharmacy department of Somerset Medical Center. “It’s actually not something that’s happening now—we’re trying to investigate, um, a ‘didge’ toxicity that occurred in a patient and I don’t know if you have somebody that I could discuss it with…”
    “Okay,” the operator said, figuring the date. “So this is a case that happened…”
    “It happened… um… a couple… well, the person is actually…”
    Dead. But Nancy stopped herself.
    “Six twenty-eight, it happened,” she said.

    N ew Jersey Poison Control pharmacist Dr. Bruce Ruck 2 called back to Somerset Medical Center ten minutes later. He was put on hold and listened to Vivaldi behind a professional female voice: “At Somerset Medical Center, patient safety comes first…”
    “Nancy Doherty.” Nancy’s rounded Jersey vowels were a shock after the clipped broadcaster English: Nyancy Dowyty.
    “Nancy, hi, it’s Bruce Ruck.” Broose shared Doherty’s accent and much of her training. He knew that Nancy was only a messenger, tasked with handling a serious internal matter at Somerset.
    “Yeah,” Nancy said. She exhaled into the phone. “It’s… getting real… complicated.”
    Doherty was calling on the instruction of her bosses, to get helpfiguring the probable drug dosages in two patients. She told Bruce that the first patient coded in their Cardiac Care Center three weeks ago, on June 16. A blood test revealed the patient had excessive levels of the heart drug digoxin. In small doses, “didge” helps stabilize heart rhythm. But Nancy was not calling about small doses.
    “Then on the twenty-eighth, on the same unit, we had another dig toxicity….”
    “Wait,” Ruck said. That couldn’t be right. Two patients, same drug, different nights? “And this was in the same unit ?”
    “Yeah.”
    Ruck asked about the first patient, Mrs. Han—had she come into the hospital with dig toxicity?
    No, Nancy said. “We called the lab. She had normal dig levels when she came in.” 3
    “Oh my,” Bruce said. “Nancy, what hospital are you in again?”
    “Somerset Medical Center,” Nancy said. “I feel like I’m a detective.”
    “Well, it sounds scary to me!” Bruce said.
    “Yeah,” Nancy said. She sounded relieved, hearing another pharmacist acknowledge that.
    Nancy put Ruck on hold, so she could explain the rest from the privacy of her office. “Patient 4, the Reverend Gall—” Nancy read his dig numbers from the lab reports: 1.2. on the twentieth, 1.08 on the twenty-second, 1.59, 1.33,… and then, just after dawn on the twenty-eighth, it suddenly jumped to 9.61.
    “So after the twenty-seventh, before he spiked—when did he get his next dig?”
    “He never got another dig,” Nancy said. His digoxin levels spiked a full day after doctors took him off the drug.
    “First thing I think of is lab error…”
    “Well, they’re telling me they retested it.”
    “Mmm,” Ruck said. “Then it couldn’t have gone up to nine-point something…”
    Bruce wasn’t getting it. “He coded,” Nancy said. “He died, okay? All right?”
    Ruck was struck silent. “Okay,” he said finally. “Let me slow myself down. I’m going to take a deep breath.”
    “I know…,” Nancy said.
    “I apologize. Okay.”
    “All right.”
    “First of all,” Bruce began, “as far as I’m concerned, on the twenty-seventh to the twenty-eighth? It’s impossible for the level to go up like it did… unless he got more digoxin. Right?”
    “Okay…”
    “Let’s take that,