A Mother's Trial Read Online Free Page B

NPO was a standard medical procedure for a patient suffering from diarrhea. Tia had once gone for weeks NPO. In Mindy’s case, sometimes it seemed to work to make her NPO, sometimes it didn’t.
    This time it was successful. The rest of the night passed without incident. At 6:45 A.M. that Friday morning, just as the day nurses came on shift, Priscilla watched the nurse draw Mindy’s blood to check her electrolytes. This, too, had become regular procedure. Still, Mindy screamed as the needle entered the vein. The night nurse went off duty, and Priscilla fell into Debby Roof’s arms as she came on the ward to start her shift. Priscilla had not talked to Debby since the birthday lunch the day before. She told Debby all about the wrong medication and the change in Mindy’s treatment. How she had fought to keep Arnhold from tying Mindy down. About Mindy’s deterioration.
    “This is just like it was with Tia,” she sobbed. “It’s happening again, and I can’t control it, or stop it. And Sara’s worried now. I can tell!”
    “But Mindy’s better, Priscilla,” Debby protested. “See, she hasn’t had any stool since she was made NPO. It’ll be all right.”
    At eight-thirty, Mindy’s NG tube was unclamped and the formula drip resumed. She was given another dose of cholestyramine through the tube. It might help prevent the diarrhea.
    Priscilla, as she customarily did after spending a night at the hospital in her clothes, went home for breakfast and to change.
    “I’ll be back later,” she promised Debby.

7
     
    At five-thirty that Friday afternoon, Dr. Sara Shimoda planned to meet with Drs. Arnhold, Callas, and Estol Carte. She was on the point of leaving for the weekend with her husband and daughter to visit her parents near Fresno. Arnhold would be on call that night, with Carte and Callas to share hospital duties over the weekend. Sara needed to talk to them.
    Mindy’s deterioration remained uppermost in her mind. She was also concerned about the results of the test for sodium that had been run on Mindy’s stool sample collected on Wednesday, the same day Sara had presented Mindy’s case at the staff meeting.
    Like most doctors, Sara almost never ordered stool sodium tests. Serum sodium tests were valuable, and often essential, diagnostic tools. But stool sodiums were rarely significant because a test of the amount of sodium in a patient’s stool simply reveals what the person has eaten. If a patient has consumed a high-sodium meal of ham and potato chips, the excess sodium in his gastrointestinal tract will be thrown off in the urine and the stool. So the level of sodium in a person’s excretions will vary quite a bit depending on his day’s menu. In a normal, healthy child, a stool sodium might range between 20 and 90 milliequivalents per liter, with 20 or 30 as a good average. When a child is suffering from diarrhea, the level of sodium concentrated in the stool can go higher. Every doctor knew this, and knew a stool test would reveal this. So there was usually no point in testing stool sodium. Most doctors, no matter how long they had practiced, never had occasion to order the test.
    But because Mindy’s illness was beginning to look suspicious, because it might somehow be related to her intake, Sara had ordered a stool sodium test. And the results were indeed significant.
    Sara had already calculated Mindy’s known sodium intake. In the period preceding the time the stool sample had been collected on Wednesday, Mindy had received 14 milliequivalents of sodium: 10 by IV and 4 by Cho-free formula. There should have been an equal amount coming out.
    But the lab test result was astonishing. On the sample collected Wednesday afternoon, Mindy’s stool sodium level had reached an incredible 251 milliequivalents. This was totally unexplainable.
    Nothing in medical school had prepared Sara for this. As late as this afternoon, before she had received these results, she’d still been trying to find a