The Queen of Hearts(96)
I felt my breath freeze in my lungs.
Nick began to pace. “It’s hard to explain,” he said, “but this would have been a very difficult thing to recognize. Pancreatic anatomy is notoriously difficult, and in these circumstances, with a tremendous amount of bleeding from the spleen, it would have been nearly impossible to discern. It’s an error any of us could have made under the circumstances. Hell, it has happened to me before. I’ve done exactly the same thing. Some things are unavoidable.
“And, let me also add, when Emma says she believes your child would have lived otherwise, she’s not telling you why she would have lived.” He looked directly at me, and I had the impression he was searching my face for something, or trying to tell me something. He sat back down, his elbows on his knees, leaning toward the Packards. “It’s miraculous that Emma kept her alive at all,” he said softly. “That initial surgery was heroic, considering the injuries, and very few people could have pulled it off.” Tears began running down Betsy Packard’s face, but Nick kept going. “She’s an immensely talented, immensely thoughtful surgeon. This—this tragedy—is in every way a disaster, but I believe it was unavoidable. I’ve looked over all the records, and I cannot see anything I would have done differently. Closing Eleanor’s abdomen after the surgery was a judgment call, and it could have gone either way. There were some miscues in recognizing what was happening after the surgery, but I don’t believe Emma bears any of the direct responsibility for that. Sometimes things go badly in medicine, and even the most competent people have losses. It makes our jobs unbearable at times.”
He was still speaking, but I no longer heard him. On the wall behind Boyd, a large painting hung under the warm glow of an art lamp: a black-haired, violet-eyed child. Unlike most expensive oil portraits, Eleanor was not seated, or even standing still: the artist had chosen to paint her in motion, charging toward the viewer, her mouth open, her hair streaming behind her. Had they known she would not live to see the end of the year, perhaps her family would have requested her to be painted in a more solemn manner, but as it was, the artist had portrayed her with an expression she must have often worn in life: impish, determined, and joyful, clearly caught in the instant before a burbling, delighted laugh erupted from her.
I cannot imagine my own expression as I looked at the painting, but something of it must have caught Betsy Packard’s attention because suddenly her arms were around me. A memory crossed my mind: comforting Zadie many years ago after she told me about screwing up an intubation. We’d clung to each other, my face wet with her tears, and this was what Betsy did for me now. I buried my face in her shoulder, reeling with a thousand wild emotions, still not having spoken a single word in my defense.
“This is over.” Betsy kept my hand in one of hers and walked to her husband, picking up his hand too. She brought my hand and Boyd’s hand together. “It’s over. Not once have you blamed me, honey. You’ve protected me by blaming her, but you don’t have to do that anymore. It’s over, Boyd. Please. Let something good come out of this.”
Boyd Packard nodded. He looked at me, and something in the mirrored pain on our faces connected, passing a wordless communication between us. He nodded again, releasing me. As he began to cry, his shoulders hitching like a little girl’s, Nick and I looked at each other, and then, silently, we headed for the door.
—
We stood outside, in the cooling night air, in front of Nick’s car. I had no idea how to interpret the evening’s turn of events, so I settled on painful honesty. “I don’t know what to say.”
“How about ‘thank you’?” Nick offered. He flipped his car keys into the air and caught them with a deft hand.
“It’s inadequate for what you just did for me. But yes: thank you.” I paused, then thought of something. “The duct of Wirsung. You cut it in a patient too?”
Nick grinned, lightness restored to his manner. “Nope,” he said. “You stand alone there, Dr. Colley. I’d never do something so asinine.”
I wanted to protest: it’s bad, but it’s hardly an unheard-of complication. I thought of the whole chain of missed chances surrounding the Packard girl’s death, and a larger question loomed. “But then why would you say—”
“I know what it’s like to lose a patient, Emma.” He met my eyes, serious again. “I haven’t inadvertently cut that particular duct, but I’ve made equally unfortunate errors. Bad shit happens sometimes, despite our best efforts; what’s the point in punishing you when you did what you thought was right? This wasn’t negligence; this was a case of everything going wrong that could go wrong.” He paused. “But I think you know me well enough to realize I didn’t help you because I was overcome by some infection of altruism, especially for someone who hates my guts.” He glanced down. “Zadie asked me to do it.”
His voice: so wounded and unguarded. He still loved her. Embarrassed, I closed my eyes, but my brain still burned with the afterimage of his face, so different from the way I usually saw it.
“I’m sorry, Nick.”
A blink, and his face recovered its usual self-assurance. “Don’t worry about it.”
“I owe you. I owe both of you.” I had no right to ask, but I couldn’t stop myself. “Do you think she’ll forgive us?”