Writing Wrongs

Chaos was never so organized. Charts weren't filed alphabetically but rather in numerical order. These conflicted with the electronic files that had automatically acquired numerical IDs when the new system had been implemented. It was an arduous process, and the legacy patient charts were left until the end. They had the soul of the hospital, but histories could unintentionally be merged with other patients unless someone double-checked. The long-standing and much-procrastinated problem had yet to be resolved. The charts couldn’t be deleted, but they did need a new home in the Electronic Medical Record. If death couldn’t be certain, it could provide a guideline for which files could be destroyed or, at the very least, assigned a new number and put into the EMR as a legacy file. The worst came to be when the director of the Emergency Department lost his grandfather, and his chart was found duplicated and merged with another patient. Heads were rolling.

“It’s going to take some doing, that’s for sure,” said Amelia, the Medical Coder, from her corner office.

“Don’t look at me. I’ve got more to do than I can handle on any given day.” Audrey, the Health Information Technician, was the first to declare that she would not be volunteering her services. She really did have more on her plate than anyone wanted to add to. Her mood was one of permanent, albeit amusing irritability.

Emma got nervous. As the Medical Records Clerk, she was at the bottom of the totem pole. She had classes at the university three nights a week and worked the night shift on the weekends. Another work project might drive her into the ground of exhaustion instead of getting her ahead in life. She was young, but not looking to test the limits of shortening her lifespan.

“Why don’t we just talk to Erica about it? Nothing ventured, nothing gained, right?" She smiled weakly as she looked around at her co-workers. Some of them smiled to themselves, and the others kept their heads down.

The ER director’s deceased grandfather escalated the issue for everyone. Emma knew instinctively that when she suggested “we,” it meant her. It wasn't because she didn’t have her own job to do, but because grunt work tended to fall into her lap. She considered writing a letter stating the deeper problems in their department. Sending an email was another option, but it felt a little too casual under the circumstances. Emma grabbed a sandwich and used her lunch hour to jot down everyone’s complaints. She felt confident that she’d be able to lay it all out on Erica’s table for her to come up with a plan of action. She picked up the phone, called her boss's office and requested a meeting with her in person. Erica, the department's director, was already well aware of the situation. By the end of the week, Emma had an appointment scheduled to discuss the problem of the legacy files.

Erica was energetic, animated and intelligent and could bounce her immediate thoughts off anyone and talk herself happy about the solutions she came up with. They decided on Rosie. It was a collaboration, given that Rosie was the young woman who had trained an even younger Emma two years ago. Rosie had taken a calculated risk and applied to fill in for the maternity leave in the Radiology Department. She got the job and kept it.

Rosie was brought up from X-Ray to spend as much time as was needed on the files, and Emma was relieved. She couldn't wait to share it with the others.

“Rosie,” Erica began, “It’s not only your work experience and your knowledge of medical records that we’ve chosen you for this. You are trustworthy, just like all my staff in the department.”

Rosie smiled, blushed and thanked Erica for the distinction. Erica went on to assure Rosie that she didn’t need to fear losing her position in Radiology.

“The powers that be want you to know that you’ll be well compensated for your time. We need someone who can dedicate all their energies to this project until it’s finished. I believe you’re the best person for the job.”

Everyone thought the same thing, and Rosie was excited about the project and about working with the ladies in the department once again, if only to get the job done. If she worried about anything, it was honouring a man's memory to the best of her ability in the capacity allowed her.

Audrey was glad to see her. That alone was proof positive that a long-standing problem was finally going to be addressed. However, with all the rainbow colours being distributed by Rosie's arrival on the scene and back in the department, Audrey couldn't help but feel a little insecure with Rosie's command. She clearly had a favour because of the project, and Audrey was cool towards Rosie. Audrey had grown used to the change that Rosie's absence had brought to the office. It was a subtle change that benefited Audrey, and she feared losing it, even if this was only temporary.

Just remember that, Audrey. It's only temporary.

There was only one problem. Rosie had an enemy. Mallory had been the one to take the maternity leave in X-Ray when Rosie filled her shoes. But no one expected Rosie to learn everything so quickly and surpass Mallory in professionalism and personality. No one expected her to organize Mallory’s position in such a way as to not only make it easier to do the job but also surprise everyone with how badly Mallory was doing hers. No one expected much from Mallory after that. When Mallory returned, it was in a lesser capacity, with fewer hours. Rosie had won with hard work and a cool head. She'd become a breath of fresh air. Mallory still worked in the department, but Rosie’s excellence had awarded her all of Mallory’s duties and then some. As everyone tended now to turn a blind eye to Mallory’s mistakes, Mallory became somewhat invisible. With her deep resentments, she'd become dangerously toxic while Rosie flourished.

“I see everything—bone deep,” she would recite ominously. And everyone would laugh because she'd blown her chances for advancement in X-Ray. Mallory was furious that she hadn’t been picked for the Legacy Project. In her mind, it was an easy job that didn’t require much effort. In her mind, there wasn’t a job on earth that could challenge her work ethic. One had to wonder if motherhood fit into that category, too. Still, no one asked because the less they knew about her life, the better it was for the department and their work environment.

Mallory was so ostracized that she could almost float around the hospital invisibly, finding things out she had no business knowing, but that satisfied her curiosity and added to her arsenal of weapons she could someday use against anyone. When the situation with the director’s grandfather came to light, Mallory wanted to know about the duplicate patient. She wanted to know who it was and what was in the chart. How had the old man bit the dust? Anything she could use that could cause trouble, Mallory was storing up for future use. She somehow had to place blame on Rosie for the charts getting mixed up. She would go to any lengths to make her look bad, not only to win her job back but also to get Rosie out of the hospital altogether. Rosie, after all, had worked in medical records before. Surely that could be dredged up and made to work against her, in Mallory’s psychotic mind.

With a little eavesdropping here and some snooping there, some unauthorized secret night shift scrolling and a few good lies when needed, Mallory learned who the second patient was. Her evil plan seemed to develop right before her eyes. If informing the duplicate patient about the mix-up could cause any trouble at all, Mallory had no time to waste.

“Hello?” The voice on the phone was young and female.

“Yes, good morning," replied Mallory. "This is Sanctuary Memorial Hospital. Is this Gwen Larkin?” Mallory made the most of what could be called her work experience to sound like a healthcare professional.

“Yes, this is she. How can I help you?”

Her plan was coming to life, and Mallory concealed the darkness within her by transforming her voice into one of deep concern. She began to tell the young woman that a terrible mistake had been made as a result of hospital negligence. She wished to apologize on behalf of the hospital because it had resulted in the death of a very important person linked to senior hospital staff.

“Because I’m not at liberty to disclose more information, the hospital feels that you have the right to contact the Medical Records Department yourself and pursue legal action regarding your patient file.”

“Oh...Oh my. Um, Ok.”

Gwen didn’t sound angry, as Mallory had hoped. She didn’t even sound scared. This frustrated Mallory, but she worked hard to remain unruffled and get through the call. She could see Rosie in her mind’s eye, and it was enough to bring a strange smile to her lips. What eluded her at that moment was Emma, who worked nights on the weekends and was privy to the snippets of conversation that Mallory was generating all over the hospital in her pursuit of trouble.

“This is the number to call, and you’ll be speaking with Erica Downing. She’s the Director of Patient Information. She’ll need to know how you would like to proceed. Justice is bone deep, dear. You have to take all that’s yours.” Mallory gave Gwen Erica’s number.

“Um, ok. Thank you. May I ask what your name is?” Gwen asked.

“Thank you for your cooperation. Feel free to call at any time. Goodbye.” Mallory hung up, a little shaken because she didn’t have any legal name to give her, but triumphant because she didn’t have to do anything else but stand back and watch the fallout. She had used a VPN for the VoIP call she'd placed from home. Since Rosie was now on the case in an official capacity, she would have to be implicated as a party to the hospital’s lapse. Or so Mallory thought.

Gwen had different ideas altogether. She had no intentions of suing anyone. She was 23 and a graduate in Communications. This had all the makings of a scandalous story, and she couldn't wait to start writing. She wouldn’t go to the police or the newspaper, even though it might be newsworthy. In her eyes, the hospital would be viewed in a positive light anyway, as coming forward and doing the right thing. At the right time, it would make headlines. For now, Gwen decided that a fabulous novel about a fictional disgrace in the healthcare industry literally had her name written all over it. As far as she was concerned, she had creative license, and she was going to use it very carefully.

At Mallory’s anonymous insistence, Gwen did contact the hospital to make sure she was part of the mix-up. The hospital confirmed that she was, but that measures were being taken to ensure the problem wouldn't happen again. Gwen’s information was indeed secure. Erica was flabbergasted. She knew nothing about the young woman's being contacted. There had already been a breach of privacy, as well as legal implications to consider. This hurtful stab in the dark was neither warranted nor even on record.

Someone was up to no good. The ER director was just as confused, but was also in no mood to deal with a prank call. His grandfather was gone, and he was angry that someone would try to do more damage when the family was grieving. It was a cruel joke, and someday, someone would have to give an account for adding fuel to the hospital’s reputational fire. Mallory hoped Rosie would be suspected of taking matters into her own hands and creating patient misidentification on purpose, but Rosie’s hands were clean.

Mallory decided to take it one step further and make copies of both charts, just in case. She could study them at her leisure and come up with new ideas to make Rosie's life more miserable than she had previously thought possible. Misleading a Security guard into giving her the code to the adjoining doctors' lounge, she planned to sneak into the Records Department. It was Saturday night. She expected to encounter doctors dictating charts or sleeping, but the lounge was empty. Her spirits soared. All she needed was to walk through the door of the transcription room and let herself into Records. There, she could take all the time she needed. She wasn't even working tonight.

"I could've come wearing a ski mask and a black beanie," she laughed to herself and then froze when she saw Emma.

"What are you doing here, Mallory?" Emma wasn't, but she wasn't surprised to see her, either. "How did you get in?"

Mallory rethought the disguise and told Emma she'd come in through the doctor's lounge because she'd been asked to look for a chart for the Emergency Department.

"That's my job, Mallory." Let me give them a call and find out which chart they need."

As Emma picked up the phone, Mallory fled. She was off the premises in less time than it took to conduct a fire drill. Gwen never bothered to tell anyone that she would be using the incident for a book. Emma wondered if she'd heard enough of the right clues about Mallory to call the police, but a year later, Gwen had a Crime Thriller to call her own, and Mallory was on the run.

An elaborate scam unfolded on Gwen's pages. Unnecessary surgeries, procedures and doctors’ appointments were fabricated to make patients believe they had conditions and diseases they did not. Medical and diagnostic tests were ordered, and expensive medications were prescribed at the hands of corrupt doctors who wanted nothing more than to profit from unsuspecting patients. They were padding their bank accounts while paying for their new cars, homes, vacations and drug addictions, and it all came to life in the form of Gwen's book. It was a hospital scandal funded by charts that were duplicated on purpose and merged with other patient charts to make healthy people look sick and sick people sicker.

Thirteen years ago, Gwen had passed through the Emergency Room with an ear infection, and a chart had been created for her that matched the numerical ID of Grandfather Wyatt Dune. His grandson, Henry, read the book when it was released. His grief came back to the surface with a vengeance, but there was no one yet to sue or blame. He understood that no one had explained to Gwen that it was his grandfather's chart that had been accidentally merged with hers. He just needed to find out who had called her.

Gwen was so excited about the finished product that she wanted it out in the world as quickly as possible. It was her first novel, and she was confident. She’d been so inspired that even with a day job, she'd spent every spare minute and every weekend without fail on the book. She wasn’t doing it maliciously. She only wanted the world to enjoy the fruit of her imagination, fueled by the event that had happened to her. It had felt like she had been handed a gift to unwrap and write about to her heart’s content.

It wasn’t hard to have her book publicized. The university’s newspaper hailed her as a breakout author, and everyone wanted to read her first novel. Almost everyone who worked in the hospital had read or was reading the book, including patients. The hospital morale imploded with an overwhelming blow of embarrassment. Even if there wasn’t anything life-threatening about it or criminally wrong, it was the universal staff secret that carried a weight of pain that had not subsided.

Wyatt Dune had died of natural causes. Old age had claimed his long life, and everyone missed him. He just happened to be the grandfather of the director of the Emergency Department. Gwen's book should not have been part of the legacy of a man who had loved his life and the people in it. It was almost blasphemous, even though no one openly discussed it.

Rosie had done what Rosie does—another outstanding job. It was a high point of the debacle. While she couldn’t do anything about the book itself, she had given new dignity to the legacy charts by giving them all new alphanumeric IDs. She went a step further and preserved all their contents in full in the EMR so that the physical copies could be destroyed. At least something could be deleted and forgotten. Her work shone brightly in the worst of the crisis. She had surpassed what was expected of her and was valued even more for her place in the hospital.

More importantly, Rosie had been oblivious to the scandal because she was so involved in the project that no one was about to disturb her. It wasn’t until she came out of it that she learned of the book. No sooner had questions come out of her mouth than Audrey put a copy of the book in her hands. It was Audrey's way of seeing Rosie off again to the X-Ray Department. Rosie had done what she needed to do, and Audrey wanted her space back.

Rosie looked down at the cover and read the title, then looked up at Audrey. “Bone Deep?” Their eyes met. They had Mallory's famous words in common, if not a deep camaraderie. Gwen remembered them, too, and Bone Deep was born. She was safe, and what mattered most to her and everyone else was that Mallory had been arrested. Legacies are built over a lifetime, and some leave nothing of value.