October 8, 1997
Ned Ashton was hardly surprised to see his grandfather already waiting inside the Board Room at Port Charles General Hospital when he arrived at quarter of eight. His Grandfather held the belief that tardiness began at least ten, if not fifteen, minutes before the agreed upon meeting time.
"Good morning, Grandfather," Ned said as he sat down across the table from him.
"Did you know that Ross Chandler plans on coming back to Cortlandt Industries?" Edward asked.
Ned wasn't sure it was really considered coming back since he didn't think Ross had ever worked at Cortlandt Industries. Although he was Palmer Cortlandt's son he had been raised by his maternal uncle, Adam Chandler and had been a Chandler Executive as far back as Ned had any interest of Corporate America. "I think Celia mentioned something about that. Apparently, our material sciences division is doing a site survey of that old military base in Corinth, PA. Cortlandt Industries is considering purchasing the property."
"That I didn't know. Just make sure your cousin understands the man is a convicted rapist. Under no circumstances should she consider taking a meeting with him alone."
Ned doubted that would be a problem. Celia had lost any trace of naivete during her brief marriage to the sociopath Grant Andrews. He had quite literally tried to kill her. "I think Celia would tell you that she can take care of herself," Ned said.
"Exactly, which is why I am mentioning this all to you so you can suggest it in a way that she will take heed. Also, your grandmother is concerned about your other cousin, Amy. She fears that Katherine is leaving her to do the lion's share of the work."
Ned had as little as possible to do with the day to day operations of Deception Cosmetics but he could agree that his grandmother's assessment was likely accurate. He also knew that the arrangement suited Amy perfectly. Or at least as perfectly as anything could suit her after everything she had been through. "Tell grandmother that I will touch base with Amy again. When we spoke last week, she said everything was fine and that her new assistant is great," he said as the door to the board room opened and his uncle, Dr. Alan Quartermaine stepped inside.
Alan glanced quickly at the clock on the wall which read six minutes before eight and then released a sigh. "I was afraid I was going to be late. I scheduled a seven AM hernia repair and anesthesia got a late start. Fortunately, the procedure went smoothly and very swiftly and here I am."
"Where is your wife?" Edward asked.
"His wife is right here," Dr. Monica Quartermaine said as she also came through the door into the board room with her brother, Scott Baldwin and her father, Lee Baldwin. Scott was also a board member and Lee was hospital pro-counsel along with Alexis Davis.
"You seem to be forgetting that some of us need to make rounds before these eight AM meetings, Edward," Monica said as she grabbed a bottle of water from the refreshments table and sat down at the table.
Stuart Longsworth Jr., Eleanor Farnsworth Murdoch, and Amanda Barrington trickled in moments before eight o'clock and then just before the clock ticked eight o'clock Alexis Davis joined them.
Edward Quartermaine scowled in Alexis's general direction. "Your cousin is late. When Steve Hardy was the CEO of this hospital, he was always punctual."
Alexis looked flustered as she shuffled through a stack of folders, perhaps to avoid Edward's eyes. "Stefan may have been detained with traffic," she offered without looking up.
"Dr. Monica Quartermaine, to the PICU STAT. Dr. Monica Quartermaine, PICU," the overhead paging system blared.
When Monica stepped out, Edward turned to Stuart Longsworth Jr. "I hope that isn't relating to your granddaughter," he said.
"Oh, no, Audra is admitted up on 5 East in the new Pediatrics Unit your family donated. Joey called this morning to say that the fever was going down after they did the infusion. Audrey says I should apologize to Monica. I think dad and I were a little hard on her last night. I reread over the information about that IVIg and I think now I understand that she just wanted to be certain of the diagnosis before she started it because there are risks. Apparently, Monica was thinking of all the right things and made the diagnosis so quickly that Audra didn't technically even meet the criteria until last night ," Stuart said.
"I'll pass on your apology. I think you'll find that Monica has become quite adept at respecting and diplomatically dealing with assertive advocacy even if it goes against the medical literature, or her personal beliefs. She is a Quartermaine after all," Alan said.
Amanda and Eleanor laughed.
"I think you're forgetting she has been a Baldwin much longer than a Quartermaine," Scott challenged.
"Touche! Alexis, do you think Stefan will be arriving soon? I hate to suggest we should start without him but I have another case scheduled for nine AM and I would hate to hold up the OR schedule," Alan said.
"Yes, and I have a meeting at ELQ at ten. Unlike some people, I believe in being a punctual CEO," Edward said.
Alexis continued shuffling her folders as if that would cause her cousin to appear. Perhaps it would.
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Dr. Monica Quartermaine listened as the PICU attending, Dr. Robert Lake, told her about the sixteen-year-old female who had presented intoxicated to the ED late Frida night. Apparently, her blood alcohol level had been 0.12 and her drug screen had been positive for both cocaine and ectasy. She had been admitted to Dr. May's service early Saturday morning due to concerns for early rhabdomyolysis and was treated with a bicarbonate infusion. She had improved and was going to be discharged on Monday but had syncopized so the discharge was cancelled. The syncope work up hadn't revealed much although the patient had refused echocardiogram and EKG. Early in the morning her rhythm had gone into atrial fibrillation with rates in the 140s-150s and she had been transferred to the PICU.
"So, I'm not really sure about a Beta Blocker since she used cocaine a few days ago."
"That is a concern, although less likely if she really hasn't used anything since Friday. I would wonder if she did get something last night or early this morning which explains the rhythm disturbance. You might want to repeat the drug screen along with CMP, CBC, coags, free T4/TSH, CK with cardiacs and an EKG. I would give Diltiazem 10mg IV push now and then start a drip at 5mg/hr. Do her parents know that you are consulting me specifically?"
"Isn't Dr. Kirk out of town?" Dr. Lake asked.
"He is, and I am willing to see this consult as long as the patient and her parents are in agreement with that. If they aren't then I can make hypothetical recommendations to help you get her a bit more stable and then you're going to need to transfer to another hospital with pediatric cardiology and PICU beds available."
"Yeah, I explained that, they aren't happy but they will see you."
"Ok, why don't you get the Diltiazem started and I will let cardiac procedures know that I will need the echocardiogram machine for a bedside echocardiogram," Monica said. She took and released another deep breath before she picked up the phone. She had a feeling that dealing with the Petersons was not going to be a pleasant experience.
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Stefan Cassadine glanced at his watch and frowned as he took quick strides down the connector from the Port Charles General Hospital North Wing to the Administrative Pavillion. It did not do to have the CEO be late for a board meeting as a matter of course and he was certain that Edward Quartermaine was chastising his tardiness. He had made the mistake of stopping at Wyndemere to retrieve a file and been surprised to find Katherine Bell on his desk. By the time he pried himself from her clutches and caught the launch over to the mainland it was impossible that he might arrive at the hospital by eight AM.
Nevertheless, it was futile to lament the situation further. So, with a deep breath, he exited the elevator, pulled the boardroom door open confidently, and stepped inside.
Edward Quartermaine extended a look of disgust. "Good morning Mr. Cassadine, itis about time you showed up. We just finished going over the quarterly financials and approved the expenses. Now, onto new business…Discussion of potential collaboration with Mercy Hospital. Let's be frank, I think that is a bad idea. Any other discussion," he said.
"I reached out to Monseigneur Farrington, he is interested in a cooperative strategic plan," Stefan said.
"How can we enter into a cooperative plan with a hospital that started trying to overtake our hospital before our former CEO was even buried. Steve Hardy would consider that farcical and I do as well," Edward asserted.
"While I would be wary to consider a cooperative plan based on history, HRSA has been calling for community integration. If we plan to file any certificate of needs for expansion, we will need to justify them in the context of the health care resources of Chapparal County. I could see sharing information to allow both facilities to better target resources but I will oppose any lead in to a merger," Dr. Alan Quartermaine said.
"There are no plans to merge the two facilities. I assure you that neither the Monseigneur nor I want that," Stefan Cassadine said. It was a bald lie but no one else at the table seemed to notice.
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When she stepped into Tiffany Perkins' room Dr. Monica Quartermaine took note that the Diltiazem Drip had been started and the heart rate displayed on the monitor ranged from 100-120. Because of the irregular irregularity of atrial fibrillation heart rates seemed to be all over.
"Dr. Lake filled me in on your hospital course thus far. I would like to do a quick exam and then we can discuss my recommendations unless you have any questions you want to ask before I do that."
Tiffany Peterson crossed her arms across her chest and rolled her eyes. "Let's just get this over with."
After performing her physical exam, Monica coiled her stethoscope back into her pocket and was just about to speak when Faye Peterson came back into the room.
"Just let me be clear I don't have anything against you, Monica," Faye said as she sat down.
"I understand that the situation is awkward. Our most reasonable approach is likely to focus solely on Tiffany's cardiac issues. I'm not sure how much Dr. May or Dr. Lake may have explained but your daughter's heart went into an abnormal rhythm this morning. It is something we call atrial fibrillation. I started an infusion which should slow the heart rate and hopefully also result in the rhythm normalizing back to sinus," Monica said.
"What if that doesn't work?" Faye asked.
"In that case, then we may consider using a synchronized cardioversion but we would have to do more tests before we could be sure it would be safe. For now, we're going to check some lab work, and obtain an echocardiogram or ultrasound of the heart to exclude an anatomic cause."
"That other doctor said this was from those drugs your brother gave her. I notified the police detectives to come back and see if there are more charges they need to file," Faye said.
"Mother! I told you I didn't want to talk to them!" Tiffany protested.
"While both ecstasy and cocaine intoxication can cause dysrhythmias, including atrial fibrillation, it would be unlikely for them to cause this three or four days after exposure," Monica said. She didn't explain to Mrs. Peterson that in her professional opinion, the atrial fibrillation likely was related to ecstasy use. She strongly suspected that the repeat drugs screen Dr. Lake was sending would be positive indicating more recent use. That was not going to be a fun conversation and there was no reason to start down that road without being sure that there had been repeated use.
"Is that all?" Faye asked.
"Unless you have any questions. Someone will be coming to do the echocardiogram and we will discuss more after I have had a chance to read the echocardiogram and review the labs I asked Dr. Lake to send."
"Ok, well thank you. I am going to give your name to Detective Garcia. He may want to talk to you."
"Of course, we always cooperate with law enforcement as allowed while maintaining patient confidentiality," Monica said and then she carefully exited the room before she said something she would surely regret.
Trina Curtis was standing immediately outside the door. "Hey Dr. Quartermaine, Dr. Lake wants us to call you with any questions about the Diltiazem Drip."
"That is fine."
"Ok, great, and they should be coming to do the echo in about thirty minutes. The tech said she would flag it in the system for your STAT read."
"Yes, thank you," Monica said.
"Dr. Quartermaine, there is a call for you," the unit clerk called.
Monica walked around the counter and picked up the phone. "Hello, this is Dr. Quartermaine."
"Hello, Dr. Quartermaine, this is also Dr. Quartermaine. I just wanted to make sure everything was ok. I'm about to go scrub on my next case."
"Dr. Lake just needed a STAT consult on a patient transferred up from 5 East. I have taken care of that and I am about to go find my resident so I can round. I need to do a TEE for one of Dr. Cahill's patients but I should be getting out of here early enough to get a nap before I pick up the kids at school. How was the board meeting?"
"SJ Longsworth sang your praises. Stefan Cassadine was about ten minutes late so father let him have it. We discussed a collaborative agreement with Mercy Health Systems but it was tabled until we have had a chance to do more due diligence. Have a good day; I love you. I have second trauma call so I may be here for a while."
"Thanks, I love you too!" Monica said. With a smile she realized that every day she was more convinced of that fact. She and Alan had been through a lot but they were going to get through a lot more.