Chapter 15

I met with Susan Hudson the following morning. She was a dark-haired, dark-eyed woman in her fifties who seemed to navigate an incredibly difficult job with relatively good cheer. Spending most of the day on the phone arguing with insurance companies, speaking to patients about various past-due accounts, or letting people know that one procedure or another wasn’t covered by their health plans would have made me absolutely miserable. She was nonetheless friendly and apparently relieved that I’d come in, which I hadn’t anticipated. Motioning for me to take a seat in one of the chairs in front of her desk, she made a quick call, telling someone that I’d arrived. Less than a minute later, a physician entered the office.

“Dr. Adrian Manville,” he said to me, offering his hand. “I’m the chief medical officer here,” he said.

“Dr. Trevor Benson,” I replied, wondering why he had decided to join us.

“You’re a physician?” he asked.

“Orthopedic surgeon,” I said. “Retired. I hope I didn’t do anything wrong by transporting Callie to the hospital myself.”

“Not at all,” Manville responded, taking a seat. “We appreciate you coming in today.”

“I’m still a little confused as to why you needed me.” I met Manville’s gaze. “Or why you’re here. I thought this was just about my late grandmother’s social security number.”

Susan reached for a file beside her computer. “We weren’t sure what else to do. I understand you’re not family, but we were hoping you’d be able to shed some light on the situation.”

“We?”

“The billing department,” she said. “The hospital. No one here is exactly clear on how we should proceed.”

“I doubt I can be helpful. I don’t know anything. I’ve only met Callie a couple of times and I don’t even know her last name.”

“Well, we don’t, either.”

“Excuse me?”

“She doesn’t have any identification, and we’re having trouble verifying anything about her.”

My eyes flashed toward Manville, then back to her. “Maybe you should start from the beginning? Tell me what you do know.”

“Of course,” Susan said. “As I mentioned on the phone, Callie is using your grandmother’s social security number. Frankly, we were fortunate to catch it. Your grandmother was last here as a patient a long time ago, before all the records were computerized. We’ve been catching up, but it takes time and we got lucky. Do you have any idea how the patient could have gotten it?”

“I’d be guessing, but I’m assuming that either she found it, or my grandfather gave it to her.”

Susan’s pen hovered in place over the file. “Why would your grandfather have given it to her?”

“Because he always had a fondness for strays. I think she does, too, by the way.”

“Excuse me?”

“He would feed stray animals if they happened to enter his property,” I explained. “Maybe Callie showed up and he thought she needed his help, too.”

“It’s illegal to knowingly let someone use another person’s social security number.”

“It’ll be hard to press charges,” I said. “As I mentioned on the phone, my grandfather passed away last fall.”

She scrutinized the file and made some notes before setting her pen aside. “It’s complicated, but because Callie’s treatment falls under a charity program we have at the hospital, we’re going to need her to be truthful on her admittance forms. There are reporting requirements and paperwork, and the documents need to be accurate.”

“Have you tried asking her?”

“I have,” she said. “So has Dr. Manville and some other administrators. That’s in addition to her regular physicians. At first, we thought the head trauma might have left her confused, but when we spoke to her employer, he verified that was the same social security number she’d given him when she’d been hired. Further, the previous address she listed on the form doesn’t exist. After we pointed those things out to her, she stopped answering our questions about it.”

Dr. Manville cleared his throat. “She’s also begun asking when she can be discharged, and that’s concerning, too, but for entirely different reasons. Are you sure there’s nothing you can tell us about her?”

I shook my head, realizing that everything I’d heard seemed consistent with what I knew of Callie. “Her name is Callie. She told me she wasn’t from New Bern, but I don’t have any idea where she lived before. Currently she lives in a trailer park near my house and she works at Slow Jim’s Trading Post.” I paused, looking over at Dr. Manville. “But this is less about a billing issue than something else, right? I’m guessing you think there’s a possibility that there might be something seriously wrong with her beyond her head injury. Maybe because she fainted before falling off the ladder, or because of her pallor, or maybe because of something the tests have shown. Maybe even all three. That’s why you’re worried about her insisting that she be discharged.”

I offered it as a statement, not a question, and Manville straightened slightly in his seat.

“As you know, there are issues regarding medical privacy,” Manville hedged. “We can’t divulge a patient’s medical information without their consent.”

That was true, but I could tell by his expression as he spoke that my assumption was correct.

Susan cleared her throat. “We were hoping you would speak with her, so that at the very least, she’ll stay in the hospital long enough to receive the care she needs. And so that we can have accurate information on file and there are no remaining financial obligations for which she might be responsible.”

“Wouldn’t either of you be more appropriate for that?”

“We’ve been trying our best, but she still insists on being discharged,” Susan said. “She says that she feels fine.”

“You should speak with Claude,” I said. “Callie works for him, and he knows her a lot better than I do.”

“He came in yesterday,” Susan said. “He was the one who’d initially filled out the forms and he left his contact information, so we reached out to him. He didn’t have any luck with her—she wouldn’t answer his questions, either—so he suggested that we ask you. He says that because she knew and liked your grandfather, you might be able to get through to her.”

He obviously didn’t know that she’d practically screamed at me the day she collapsed. “I highly doubt she’ll be willing to open up to me.”

“Could you at least try?” Manville said. “It’s important medically. For Callie’s sake. We understand you’re under no obligation to help, but…”

After he trailed off, it was a few seconds before I finally nodded. My grandfather would have wanted me to help her, whatever that meant. Because she’d been important to him, he would have wanted me to treat her that way, too.

“I can’t make any promises that she’ll cooperate, but I’d be happy to speak with her.”

“Thank you.”

“I do have one condition, though.”

“Yes?”

“Can you get me a HIPAA form? So I can review her case and speak with her physicians?”

“Yes, but you’d still have to convince her to sign it.”

“Let me worry about that.”

Susan pulled out a HIPAA form and after borrowing a pen, I was on my way to Callie’s room on the third floor.

The hospital, like every hospital, flooded me with a sense of déjà vu. As soon as I stepped out of the elevator, I saw the same fluorescent lights, the same speckled tile flooring, the same off-white paint on the walls that I remembered from my residency, in Pensacola, and even Kandahar. I followed a sign indicating room numbers, turning down a hallway as I debated which approach to take when I came face-to-face with Callie. I had no doubt that both Susan and Claude had tried the friendly, we’re here to help you approach, while Manville and her other physicians had probably leaned toward the we’re the professionals here and you should listen to us style of communication. And yet, Callie still insisted on being discharged, despite her illness. But why?

Because she was angry they were taking away her independence?

Possible, I thought. More likely was the notion that Callie was afraid and possibly on the run. Maybe from her family, from a boyfriend, or from the law, but it was definitely something. I guessed that as soon as she exited, she’d vanish within hours. She’d hit the road and start over somewhere else. It was also possible she’d use my grandmother’s social security number again. I didn’t personally care whether she did or not, though I had little doubt it would eventually land her in trouble again. I was more concerned that she’d end up in another hospital, maybe when it was too late to help her, if her condition was as dire as Dr. Manville’s presence suggested. At the same time, she was old enough to make her own decisions…

Or was she?

Was she truly old enough to be on her own? Or was she a minor who’d run away from home?

I walked past the nurses’ station, making for Callie’s room. Outside, I hesitated only briefly before pushing my way inside with a brisk step. The television was tuned to a daytime talk show, the volume low. Callie was lying in bed, her arm in a cast and her head wrapped in gauze; I surmised she’d had a craniotomy to drain a subdural hematoma. She was hooked up to monitors and her vitals seemed fine. Seeing me, she pointedly turned away, focusing on the television again. I waited for her to speak, but she said nothing.

I walked toward the window and stared out at the view, noting the cars in the lot and the heavily clouded sky. Though the rain had finally stopped yesterday, it had remained gloomy, with more rain in the forecast. After a moment I turned from the window and took a seat in the chair nearest the bed. Callie continued to ignore me, so I figured I’d treat her like any other patient and go straight into it.

“Hi, Callie,” I said. “I’ve been told you’re not answering important questions and that you want to leave the hospital. Is that right?”

Her lips compressed but otherwise she gave no sign of having heard me.

“People here are on your side and it’s not a good idea to ignore what they’re telling you. I assume that in addition to your broken arm, you had some buildup of fluid around your brain, which meant you had to have it drained. How are you feeling now?”

She blinked but said nothing.

“It was a very nasty fall. I don’t know if you’re aware, but I was the one who brought you to the hospital. Is there anything you can remember about it? I was told that you might have fainted or passed out beforehand.”

She finally turned to face me but ignored my question. “When can I get out of here?”

“It takes time to heal,” I said. “And head wounds should never be taken lightly.”

“The doctor said that I would only have to stay for a couple of days. I’ve been here longer than that.”

That was before he knew how sick you are.

“Have you considered answering their questions?”

“I did.” Her voice was truculent.

“Not all of them. And you’re not telling the truth.”

Her eyes narrowed. “Go away. I don’t want to talk to you.”

I continued to hold her gaze. Following a hunch, I asked, “Have they done a bone marrow biopsy yet?”

One of her hands moved reflexively toward her hip. It was the most common spot for a bone marrow biopsy, so I took that as a yes, even though she hadn’t answered. Whether she’d received the results was a different question, but not one that I needed answered right now. On her bedside table was a magazine and I reached for it. I laid the form on top of it along with the pen and leaned forward, setting it next to her on the bed.

“I’m going to need you to sign this form,” I said. “It’s a HIPAA form, and it gives me the right to speak with your doctors, review your charts, and discuss your case. You can consider me your advocate if you’d like. Believe it or not, I’m here to help you.”

“I don’t need your help.”

“You don’t know that. I can answer questions, explain your diagnosis, discuss treatment options with your doctors. You need to be truthful and answer their questions. And for now, you need to stay here.”

“You can’t tell me what to do.”

“I think I can.” I leaned back, keeping my tone conversational. “If you leave the hospital, one of two things is going to happen. Either you’re going to end up in another hospital, or you’re going to end up in jail.”

“I fell!” she snapped. “And I didn’t ask to come here—you dragged me here. I would have told them that I can’t pay.”

“It’s not about your bill,” I said. “You’re using my late grandmother’s social security number,” I said. “That’s a federal crime. You also broke my back door, so you could stay at my house after your trailer burned down. That’s breaking and entering, as well as trespassing. I might even tell them that you’re both a minor and a runaway.” I paused. “Unless, of course, we can make a deal.”

Frankly, I had no idea whether the police would even be interested in any of it, except for her being a possible runaway, and I wasn’t even sure about that. But if nice or professional concern hadn’t worked to get her to be more cooperative, then maybe threatening her would. I pulled my cell phone from my pocket, making sure she saw it. “I’ll call the police from here,” I said. “You can listen in, if you’d like.”

When she focused on the television again, I went on. “It wasn’t that hard to figure out. The only thing I’m not sure about is how you met my grandfather in the first place. Were you walking by the house late one night? Maybe it was raining or you were just worn out and you spotted the barn? You snuck in there, saw the cot—the same one I saw—and crashed for the night. Maybe you stayed a few nights, but I’m guessing my grandfather eventually found you. And instead of running you out once he found you, he probably gave you something to eat. Maybe even let you stay a night or two in the guest room. That’s the kind of guy he was. After that, you began to trust him. But you found the social security card in a box beneath the bed. After you helped him with the honey, he suggested to Claude that he hire you, and you used my grandmother’s social security number. After that, he passed away. When your place burned down, you broke into the house through the back door and stayed until you were able to rent another trailer. You ate peanut butter and jelly sandwiches and apples while you were there, kept the place clean, and used candles since the power was out. Have I about summed it up?”

Though she didn’t answer, her wide-eyed stare confirmed that I was more right than wrong about all of it.

“I also know what you’re thinking right now—that you’ll bolt from the hospital as soon as I walk out of here. In your condition, I’m guessing you won’t get far. Especially since I’ll let the nurses know what you’re thinking, and I’ll be waiting downstairs for the police to arrive.” I paused, letting all of that sink in before leaning forward and tapping the form. “Your other option is to sign this form, be more cooperative with the people here, and agree to stay in the hospital until you’re better. If you do those things, I won’t contact the police.” When she made no move toward the form, I held up my cell phone. “I’m losing patience,” I said, fixing her with a look that let her know I was serious.

Finally, reluctantly, she reached for the form and scribbled her name at the bottom.

“I didn’t steal your grandmother’s social security number,” she said, putting the pen down. “He gave it to me.”

Maybe, I thought. Maybe not. “Where are you from, Callie?”

“Florida,” she answered, almost too quickly. Wherever she was from, it wasn’t Florida.

“How old are you?”

“Nineteen.”

Not a chance, I thought. I remembered the way she’d reacted when I’d asked about her parents. “Do you have any family you need me to contact?”

She turned away.

“No,” she said, “there’s no one.”

Again, I didn’t believe her.

I brought the signed HIPAA form to the nurses’ station, where they promised to enter it into Callie’s medical records. I learned the names of her other doctors—one was an oncologist, which further raised my concerns—and when they would be making rounds. I let them know I’d be returning to the hospital later to speak with the oncologist, if she was available. After that, I went back to Callie’s room and sat with her awhile. I asked her about favorite books and movies, trying to make small talk, but I could tell she wanted nothing to do with me and I eventually left her room.

By then, the clouds had opened up again and I splashed my way to my SUV. Back at home, I made a late lunch, read about bone marrow biopsies and transplants, and then—killing time—called the contractor I’d hired. I told him that I wanted work started on the roof as soon as I moved to Baltimore, which would hopefully give him enough time to make the arrangements. The tarp, after all, would only last so long.

I thought about the lies Callie had told me, especially the last one. There had to be someone in her life. I suspected either one or both parents were still alive, but even if she didn’t want to speak to them, wasn’t there someone else? Brothers or sisters, aunts or uncles, grandparents? Even a favorite teacher or friend? Anyone? When people were in the hospital, they almost always wanted support from those they cared about; when faced with something possibly life-threatening, that desire became almost universal. It seemed almost hardwired into human nature, which made me think something awful had happened to her to make her disavow them.

It was possible, of course, that they had a terrible relationship, even abusive. In that case, I supposed I could understand her reluctance to see or speak to them, but depending on what I learned from the oncologist, she might be risking her life by not bringing them here no matter what.

The hours moved slowly throughout the rest of the day, but eventually it was time to go back to the hospital. I swung by the Trading Post for a coffee and talked with Claude a bit. Like me, he hadn’t a clue what was going on with Callie or why she wouldn’t answer questions. He mentioned nothing about the false social security number that Callie had been using and I wondered if he’d been told about that, guessing that he probably hadn’t.

Later, as I pushed through the hospital doors, I realized something else: Since Callie had fallen from the ladder, my hands hadn’t trembled, nor had I felt on edge. I’d had no difficulty sleeping and was even feeling more like my old self again. It seemed that in trying to save Callie, I’d somehow ended up saving myself.

I was early for rounds and settled in to wait. Most of the physicians had offices in town and wouldn’t leave for the hospital until after their last patient had departed. The nurses on duty described Dr. Mollie Nobles, Callie’s oncologist, as having short blond hair cut in a bob and blue eyes, making her nearly impossible to miss. The neurologist, I was told, may or may not be coming, since he’d already been by earlier in the morning.

I took a seat in the lobby near the elevator on Callie’s floor, watching people stride past me in both directions, while also noting the quiet efficiency of the nurses as they darted in and out of rooms. I’d always believed nurses were underappreciated. Half an hour passed, then an hour, but after a couple of years of doing not much of anything, I’d become good at waiting. One by one, physicians began exiting the elevator, but the first four were not the ones I needed. Excellent detective that I am, I noticed that all of them had been males.

The blue-eyed blonde with a bob cut arrived a few minutes after that, looking harried as she exited the elevator, files in hand.

“Dr. Nobles?” I asked, rising from my seat.

She turned. “Yes?”

“I was hoping I could speak with you about Callie.” I introduced myself, indicating that there was a HIPAA form on file. “I know you’re busy and probably have a lot of patients to visit, but I’d really love a few minutes of your time.”

“You’re with Callie?”

“Kind of,” I hedged. “For now, anyway.”

“How well do you know her?”

“Not well. I spent some time with her this afternoon, but I’m not family. I’m not sure she’d even consider me a friend. But it’s important that I speak with you about her situation.”

“Who are you?”

I explained my relationship, adding that I was also a physician, and we went through the same song and dance that I had with Dr. Manville.

When I finished, she looked down the hall toward Callie’s room, then back to me again. “Yeah,” she finally said. “Okay. You said the form is on file?”

When I nodded, she went on. “I’ll need to check on that, but do you want to meet in her room in a few minutes?”

“Is there any way we could speak someplace more private?”

She glanced at her watch and did a quick mental calculation. “All right. But it can’t be long. I’ve got a full house tonight,” she said. “Let’s go to the lounge.”

After she checked the computer in the nurses’ station, we took the elevator down to the lounge and found a seat at a small table.

“What can I do for you?” she asked.

“I was wondering if you had the results of the bone marrow biopsy yet.”

“If you don’t know her that well, how do you know she had a bone marrow biopsy? And why did she give you permission to speak with me in the first place?”

“I blackmailed her.”

“Excuse me?”