DOCTOR'S ORDERS

by Pam Skochinski

Agnes alternately fussed and fumed while lying in the uncomfortable hospital bed waiting for someone, anyone, to come tend to her. It's not like she really needed anyone. She hadn't set foot in this hospital for almost 20 years. And she wouldn't have now if she hadn't stupidly tripped and fallen in her own kitchen. Time and tests would tell if she'd broken her hip.

A nurse entered the room dragging along a machine to take her vital signs. A machine! When Agnes had been a nurse in this self-same hospital, she'd not needed a machine. A stethoscope, her fingers and ears had been all she'd needed. She bit her tongue and let the nurse do her job.

“Your vitals look good, Ms. Darcy,” the nurse informed her, recording all the numbers neatly on the chart at the end of the bed. “We'll get you to x-ray and have the doctor take a look at you.” She scrawled a few more notes on the chart. “And we'll get you some stronger pain medication when the doctor signs off on the order.”

Hours later, Agnes was still in pain, had not been
x-rayed, and no nurse answered her call button. She lay back in bed, closed her eyes, and tried to pretend that she was home in her own bed, but the unmistakable smell of the hospital, antiseptic barely masking the smell of sickness, fear, and death, intruded. Against her will, she began to remember working at this hospital. There were only a few good memories in the beginning, when she was young and new at the job. It hadn't taken her long to realize the nursing and support staff were the real healers. Doctors were nothing more than glorified hand-holders.

Despite the pain and discomfort, Agnes dozed off only to awake, startled, hearing a distinct rustling sound. She opened her eyes to see a tall, gaunt man, neither doctor nor nurse, standing at the foot of her bed. He looked at her sadly and then reached down and picked up her chart. With a small smile, he made a notation on her chart and signed it with a flourish.

“Hey!” Agnes was irate. She looked away for just a second to find her call button and the man disappeared.

The nurse answered the call promptly this time. Agnes tried to tell her that some strange man had put something on her chart. The nurse looked at her quizzically. “While you were sleeping, the doctor must have stopped by to see you. See, he signed your medication order.”

“It wasn't a doctor that signed it.” Agnes protested.

“Nonsense, Dr. Spencer has worked here forever. He has a very recognizable signature.”

Dr. Spencer! With a flare of anger, she remembered him. Insufferable know-it-all. Once, she'd questioned him about the diagnosis and treatment of a patient. He had shouted at her, embarrassing her in front of the staff and the patient. Agnes had been secretly pleased that she was right and he was wrong. Dr. Spencer had double-dosed the patient and the patient had died. But, to Agnes's dismay, nothing was ever said to Dr. Spencer. Oh, but if the mistake had been hers, discipline would have fallen like a heavy hammer.

From that moment on, Agnes was determined to bring Dr. Spencer's incompetence to everyone's attention. She began writing out improper orders and forging the physician's signature, making bolder and bolder diagnoses and prescriptions. Despite Agnes's interventions, many of the patients recovered. Then, there was a string of 10 or so patients who died suddenly and inexplicably. But, instead of suspicion falling on Dr. Spencer, she started hearing whispers behind her back. Well, she wasn't one to put up with poor working conditions. She quit. Her next job, working at the county-run nursing home, was much more rewarding. And if a patient died there, it was expected; they were old.

Lost in her memories, Agnes started when the nurse came back with some pills for her to take. She swallowed them dutifully, and in just a few moments, Agnes felt the fingers of pain lift slightly and her mental processes dull. Perhaps she had just imagined the strange man at the foot of her bed.

She was dozing in and out of a narcotics-induced slumber when she heard “Lollipops, candy, suckers, and sweets.” This was sung to the sound of a child skipping rope.

Agnes opened her eyes. Children weren't allowed on the floor alone. Especially making noise and disturbing the patients.

The little girl looked vaguely familiar. Agnes was especially annoyed when the little girl walked right over to the chart at the end of the bed and picked it up. “Hmmm. . . You're just a little too sweet. Naughty, naughty!”

Agnes froze in horror. She remembered this little girl. She'd been a patient under Agnes's care, a diabetic who had gone into an insulin-induced coma. With the orders Agnes had written, she had never recovered.

"Let's see what we can give you to fix that.” The little girl made a notation on Agnes's chart and signed it with the now familiar flourish.

“Hey, leave that alone!” Agnes reached for her call button and, with dismay, heard it skitter to the floor.

She was so tired she could hardly keep her eyes open. It seemed like just a few seconds before the nurse came in and glanced at the chart. Agnes thought the nurse looked at her suspiciously, and was sure rumors were circulating around the hospital about her. Maybe, Agnes thought hopefully, the nurse would be suspicious about the notations in the chart. But, to her dismay, the nurse just remarked, “Wow, I must have just missed Dr. Spencer. I'll get these orders filled right away.” Agnes desperately tried to protest, tried to tell her about the little girl making the notation on her chart, but the words came out in a drunken slur.

A commotion down the hall distracted the nurse and Agnes recognized it as signifying some emergency. The nurse left and Agnes tried to sit up in bed, to reach her chart. But pain shot through her, and she lay back down, gasping and gripping her side. She closed her eyes, willing the pain medications to work on the pain and not just make her sleepy. The noise from down the hall got louder and louder until it sounded like it was right in the same room.

She opened her eyes and the room seemed hazy. Then, she realized it was full of people talking, rustling, murmuring. The nerve of these folks, Agnes thought. Didn't they know it was a hospital?

Then she began to make out the faces of the people in her room. She recognized them. They had all been her patients. Dead patients. Agnes flailed wildly. A colorless woman with long, limp blond hair came over to the side of the bed. She looked deep into Agnes's eyes and then reached out and took one of Agnes's hands. Just for a second, Agnes thought the woman was going to help her. Instead, she found that her hand had been tied down with a restraint. And old man appeared on the other side of the bed and tied down Agnes's other hand.

Agnes sobbed and shook her whole body from side to side. She watched as another of her past patients wrote out an order for an anticonvulsant and penicillin. Agnes cried out with loud, racking sobs, hoping to attract the attention of one of the nurses. Agnes was allergic to penicillin, but it had not been mentioned when she was admitted and now she would be unable to tell anyone.

The heart monitor beeped loudly and Agnes was dismayed to see that her heart rate was racing. If she didn't calm down, she'd have a heart attack. She closed her eyes and took deep, calming breaths, willing the chirp, chirp of the heart monitor to slow. She was dreaming. That was the only explanation for all of this. Narcotics sometimes had strange effects on people. She peeked out of half-opened lids and saw an empty room. Yes, she sighed with relief, it had only been a dream. Agnes fell into a restless slumber.

The night nurse came in and without waking Agnes, took a look at her chart and quietly and efficiently administered all the medications the doctor had ordered.

Less than an hour later, alarms went off and a code was called. Despite the heroic efforts of the staff, Agnes Opal Darcy was dead.