Chương 10
I knew the tactic.
Patel had used silence on residents, corpsmen, and one lieutenant who tried to explain why he had prescribed an antibiotic to a patient allergic to it.
Silence made people volunteer information they had been planning to hide.
I decided not to help.
Finally, she sat.
“Mercer called.”
“That was fast.”
“He seemed motivated.”
“I inspire efficiency.”
Her eyes lifted.
“Do not joke your way through this conversation.”
The words were quiet.
My mouth closed.
Patel folded her hands.
“Start with the canceled flight.”
I told her.
Not everything at first.
I described the rotor noise, the increase in pulse, the trembling, the difficulty getting a full breath.
I described leaving the aircraft.
I described lying about arm pain.
Patel did not interrupt.
That made it worse.
When I finished, she asked, “How long did the symptoms last?”
“About twelve minutes.”
“Were you alone?”
“No.”
“Who saw you?”
“A flight medic.”
“Name?”
“Petty Officer Reeves.”
“Did Reeves know what was happening?”
“I told him I felt sick.”
“Did he believe you?”
“Probably not.”
Patel made a note.
“Any similar episodes?”
I hesitated.
Her pen stopped.
“Ward.”
“Not exactly.”
“That phrase usually precedes an answer I will dislike.”
I looked at the floor.
“There have been moments in clinic.”
“What moments?”
I told her about the sailor with the hand laceration.
Patel's expression did not change.
“Anything else?”
A memory surfaced.
A trauma simulation two weeks earlier.
A mannequin bleeding artificial blood across a training room floor while someone played recorded rotor noise to make the scenario more stressful.
I had reached over and turned the speaker off.
When the instructor asked why, I said it was distracting the junior corpsmen.
No one challenged me.
“Yes,” I said.
Patel waited.
I told her that too.
She set the pen down.
“How many things are you going to remember only after I ask the right question?”
“I don't know.”
“That's the problem.”
“I understand.”
“No.”
Her voice sharpened slightly.
“You understand the vocabulary.”
I looked at her.
She leaned back.
“You are one of the best operational physicians I have.”
The compliment made me more nervous than criticism would have.
“You are also behaving exactly like the patients who frighten us most.”
“That seems excessive.”
“The competent ones.”
I said nothing.
“The ones who know how assessments work.”
Her gaze stayed on mine.
“The ones who can describe symptoms in language that sounds controlled.”
My face heated.
“I haven't manipulated anyone.”
“You lied to a flight crew.”
“I reported arm pain.”
“That was not why you got off the aircraft.”
“No.”
“You concealed symptoms from your chain of command.”
“Yes.”
“You continued treating patients without telling me that fear responses were affecting your clinical behavior.”
“I did not compromise patient care.”
“You don't know that.”
“I know what I did.”
“You know what you noticed.”
That stopped me.
Patel picked up her mug, discovered it was empty, and set it down again.
“I am not accusing you of harming anyone.”
“Then why remove me?”
“Because the purpose of a safety system is to act before harm.”
I looked toward the deployment photographs.
Patel appeared in one of them beside a field hospital in Afghanistan, younger and thinner, holding a bottle of water.
“You think I'm unsafe.”
“I think you have impaired judgment about your own condition.”
The distinction did not comfort me.
She saw that.
“I would make the same decision for any physician under my command.”
“Any physician?”
“Yes.”
“Even you?”
Her expression went still.
I regretted the question.
Then she said, “Especially me.”
The answer was too fast to be invented.
I looked at her.
She glanced at the chipped mug.
“I spent four months after my second deployment taking sleep medication that wasn't prescribed to me.”
I had no idea what to say.
Patel's mouth tightened.
“My sister is a pharmacist.”
“That seems professionally inconvenient.”
A tiny smile appeared and vanished.
“She supplied exactly nothing.”
“Oh.”
“I took my husband's medication.”
The room changed.
Patel looked annoyed by the confession, as if vulnerability were another administrative burden.
“I was sleeping three hours a night.”
She rubbed one thumb along the mug handle.
“I convinced myself it was temporary.”
I waited.
“It became six months.”
“What happened?”
“I made a dosing error.”
My stomach tightened.
“Patient harmed?”
“No.”
She exhaled.
“Because a nurse caught it.”
The words settled between us.
“I reported myself the next morning.”
“Were you removed from care?”
“For twenty-three days.”
I looked at her.
“You never told me.”
“It wasn't your business.”
“That seems unfair.”
“It is.”
She leaned forward.
“My point is not that we are the same.”
“I know.”
“My point is that medical knowledge does not make physicians immune to self-deception.”
She tapped one finger on the desk.
“Sometimes it improves our vocabulary for it.”
I thought about Mercer.
That was irritating.
Patel looked at the computer.
“I am placing you on administrative clinical duty pending the trauma evaluation and occupational medicine review.”
“How long?”
“Minimum one week.”
My chest tightened.
“Administrative duty doing what?”
“Chart review, training revisions, nonpatient tasks.”
“That's punishment.”
“No.”
“It feels like punishment.”
“I know.”
“I passed every physical benchmark.”
“This is not about grip strength.”
“I know.”
“Then stop arguing with the part you know isn't in dispute.”
I looked away.
She waited until I looked back.
“You can be angry with me.”
“I am.”
“Good.”
That surprised me.
“Good?”
“I would rather you be angry than agreeable because you think agreeable gets you cleared faster.”
I leaned back.
“That was disturbingly specific.”
“I supervise physicians.”
She opened a drawer.
Inside were packets of almonds, three pens, and an astonishing number of peppermint candies.
She handed me one.
I stared at it.
“What is this?”
“A peppermint.”
“I know what it is.”
“Then this assessment is progressing.”
I took it.
The wrapper crackled too loudly.
May you like
Patel turned the computer screen slightly away from me and typed.
“Mercer recommended a clinician named Dr. Samuel Vance.”
