The resulting medical malpractice case pits a flamboyant young personal injury trial lawyer against a successful, and established, defense attorney. Former all-American basketball player Rob Vargas-handsome, charismatic, and brash-represents the plaintiffs. His opponent is Harvard-educated Talmadge Harrison-patrician, urbane, and brilliant. It's a highly charged case, and it's being tried before a biased judge determined to influence the jury and the outcome.
Sparks fly from the beginning, and continue throughout the trial, as the attorneys battle to explain the deaths of Sarah's daughter and her babies and to assign the blame. But could something other than medical malpractice have been involved in the events that changed Sarah Tyler's life so drastically-something far more complex and frightening?
|Product dimensions:||6.00(w) x 9.00(h) x 0.76(d)|
Read an Excerpt
By Thomas Johnson
iUniverse, Inc.Copyright © 2006 D. Thomas Johnson
All rights reserved.
Six minutes after she left the Oval Office, where she briefed the President on Iran's efforts to develop a nuclear device, Dr. Sarah Tyler sat surrounded by five Cabinet members and the Directors of two Federal intelligence and law enforcement agencies at a huge mahogany table in a finely appointed conference room in the West Wing of the White House. The discussion focused on the efforts—extensive but only modestly successful to date—of Federal agencies to identify and locate members of al-Qaeda who had infiltrated into the United States.
During the meeting, a top secret message informed the group of an unsuccessful assassination attempt on the United States Ambassador to Israel. Emotions ratcheted up; rhetoric became strident. The initial reactions of the participants varied sharply, and the discussion of an array of responses was as divisive as it was unproductive until Sarah Tyler, the President's personal advisor on Middle Eastern affairs, calmly guided the deliberation to a consensus that involved a realistic plan of addressing all aspects of the complex problem, including the media coverage the incident was certain to garner. Then, she called the President on a secure line, reported the problem and proposed plan, and received the Chief Executive's approval. Three conference calls later and within twenty-five minutes after being advised of the incident, the group returned to its agenda.
As the Director of the CIA discussed the most recent intelligence about Middle Easterners with ties to known terrorist organizations entering the United States through Canada, Sarah Tyler's administrative assistant quietly entered the room and handed her a note. Sarah discreetly excused herself and slipped out of the room. She hurried to the small anteroom where the assistant led her and, excited with anticipation, picked up the phone.
When she heard Barry Moffatt's voice, Sarah knew something was wrong. "Sarah, this is Barry. Ginger ..." Barry's voice cracked and Sarah thought she heard her son-in-law choke back a sob.
Adrenaline pumping, Sarah said, "Barry, is Ginger alright?"
A moment passed before another voice came on the line. "Dr. Tyler, this is Dr. Alan James, Ginger's obstetrician. I'm so sorry to have to deliver this terrible news. We had some serious problems during Ginger's delivery and, as hard as we tried, we weren't able to save Ginger and her babies."
Anguish overcame Sarah like a wave of nausea. As if someone had pulled a plug, the blood drained from her face, taking the color with it. Her knees buckled, and she collapsed into the chair by the desk. The small room started to spin and close in on her. She began to hyperventilate. She grasped the arm of the chair to steady herself.
"Are you still there, Dr. Tyler?" the doctor asked.
"Oh God. That can't be, it can't be," she heard herself saying, calling on God as if divine intercession could undo what had happened, refusing to accept the finality of the devastating truth. "Please, Dr. James, tell me it's not true." When he did not respond, she asked incredulously, "How could that have happened?"
"I wish I could explain it, Dr. Tyler. We induced labor and Ginger progressed well for the first hour. I wasn't there when the anesthesiologist gave the epidural, but Ginger went into respiratory and cardiac arrest shortly after he gave it. Her heart didn't respond to defibrillation. We performed CPR for half an hour, but we couldn't save her." When Sarah did not respond, he added, "I am so sorry."
"And the babies? You couldn't save Cole and Carrie?" she asked.
"There was nothing we could do. I'm sorry."
Sarah Tyler, normally the paradigm of self-control, even in times of national crisis, disconnected the phone in shock. Her composure swept away along with her ebullience, she wept as only a mother who has lost a child can weep, sobs racking her body. The rest of Sarah's day passed in a fog; later, she could not remember anything she did following the call that would haunt her for the rest of her life.
As she approached fifty, Sarah Tyler was a mature version of the sixth grader in the only school picture she kept. Dark brown hair cut stylishly short had replaced lighter colored pigtails. Makeup now covered the vestiges of childhood freckles. Crows feet were appearing around her eyes and small wrinkles around the corners of her mouth when she smiled, revealing perfectly aligned white teeth instead of the braces in the photograph. Her lips were fuller now, her smile more womanly. But the eyes were the same—deep brown set in a background of white surrounded by big lashes, striking, always gleaming. One could not look Sarah Tyler in the eyes without seeing alertness, perceptiveness, enthusiasm, and purpose. Her attractive features, flawless complexion, and slender figure caught the attention of men and aroused the envy of women. She preferred conservative clothes over trendy fashions and ostentatious bling. Cultured and cosmopolitan, she stood tall and walked gracefully.
Sarah Tyler was Sarah Preston when she graduated from Yale with a degree in Middle Eastern history and languages and entered graduate school at the University of Chicago that fall. Two years later she married George Tyler, a pharmaceutical representative with whom she was mismatched and unequally yoked, and ten months later bore a daughter they named Ginger. George Tyler's financial irresponsibility and blatant affairs fractured their marriage, culminating in their divorce before Sarah received her doctorate. George Tyler disappeared from her life and became nothing but a negative memory. She had a few relationships over the years, but the right man had never come along and so she remained single. She accepted dual teaching appointments at the Lyndon B. Johnson School of Public Affairs and the University of Texas graduate school. Having distinguished herself in both positions, she rose to the rank of Associate Professor. A few years later the President asked her to serve on his staff at the White House.
Sarah Tyler's official position was presidential advisor. She served as liaison between the President and all of the agencies reporting to him on foreign affairs. Her responsibilities involved analyzing reports and other information collected and generated by the Departments of State and Defense, the National Security Advisor, the CIA and FBI, the Attorney General, and several other agencies concerning terrorism around the world, coordinating the efforts of those departments and agencies as directed by the President, keeping the President fully advised, and assisting him in his decisions relating to the war on terrorism.
Sarah Tyler quickly became indispensable to the President. Her office in the West Wing of the White House buzzed with activity from early morning until late at night. Long hours and seven day work weeks were commonplace for her. Her personal life took on a low priority and became subsumed into her work.
During her years working for the President, Sarah developed an expertise in taking control without threatening superiors, offending equals, or abusing inferiors. She did it reflexively and unobtrusively. She spoke in an unhurried cadence, firmly but softly, articulately. Intuitive with sharp political instincts, she demonstrated an uncanny ability to analyze and decide complex issues.
Sarah had difficulty getting her mind around the fact that Ginger's death and the loss of the babies was real. A sedative helped her get to sleep that night. When she finally dozed off, she slept fitfully and awakened suddenly several times, thinking she was in the middle of a nightmare, hoping it was a nightmare. Then, the realization that the unthinkable had happened, that her only daughter and Cole and Carrie were gone, hit her like a vicious blow to the mid-section. She paced the floor, intermittently sobbing and searching for explanations. She would have no peace until she had answers to the questions that raced through her mind.
The President authorized a Secret Service agent to accompany Sarah to Texas for the funeral services. Sarah and Agent Donald Adams arrived in Fort Worth at noon on Saturday, the day after the tragic incident. A dark sedan—the ubiquitous government-issued vehicle—and an equally nondescript driver awaited them. Sarah could not bring herself to stay at Ginger's house, so she checked into the downtown hotel where the Secret Service had reserved a room for her. Donald Adams occupied the room adjoining hers.
Sarah met with Ginger's husband Barry Moffatt that afternoon before her 4:00 o'clock appointment with Dr. Alan James. Even though she knew seeing Barry and discussing Ginger's death with him would evoke a strong emotional response, she was not prepared for the impact it caused. When Sarah and Barry saw each other, they fell into each other's arms weeping.
Sarah had planned to attend the birth and would have been at the hospital if an increased risk in terrorist activity around the globe had not required that she stay in Washington. She wrestled with guilt at not having been at Ginger's side. Overwrought with regret that she had not seen Ginger during the last three months of her pregnancy, she repeatedly replayed over in her mind the events that precluded her traveling to Fort Worth to be with her daughter. She blamed herself for the higher priorities she had given to other matters over the last year, matters that in retrospect she realized were not as important as she thought at the time. All the anchors in her life, all points of reference, seemed to be moving at random. Everything seemed upside down to her.
Uneasy feelings about the competency of Ginger's doctors crept into Sarah's mind. She had never met either Dr. James or Dr. Baluch, the anesthesiologist, even though she had spoken with Dr. James three times. She had thought about checking with her personal doctor about their qualifications and made the decision to do it, but she had never gotten around to it. What if she had discovered they were not highly considered professionally? She could have recommended that Ginger get another opinion or even change physicians. Sarah had no indication that either doctor was not well qualified, but what if? That question had awakened her last night. What if? She could not expel that demon question from her mind.
Until meeting with Barry, Sarah did not know that he shared her feelings of guilt, but his feelings had a different genesis. He had been in the room with Ginger when Dr. James ruptured Ginger's membranes to induce her labor and had intended to remain in the room until the babies were born. But when the anesthesiologist arrived to place the epidural anesthetic, the nurses made him leave the room so he decided to go to the gift shop. He did not know what the Code Blue announcement over the loud speaker meant and had no inkling that it originated in Ginger's room. As he was returning from the gift shop, he was surprised to see doctors and nurses running toward Ginger's delivery room. The Code Blue was under way, and all he could do was watch from the hall in confusion and horror as his wife and babies died. The thought that if he had not stayed in the gift shop so long this nightmare would not have happened and that he would have a healthy wife and twin babies obsessed him. He could not rid his mind of the guilt that possibility engendered.
Sarah and Barry also shared the enormous burden of personal loss experienced by those who have one close to them taken away in the prime of life, leaving a void that no other person or thing can fill. This feeling of loss was multiplied in their case because of the loss of Cole and Carrie, who would have been the first children for Barry and first grandchildren for Sarah. Barry and Ginger had picked the names as soon as the sonogram revealed Ginger was carrying boy and girl twins. The burden of loss weighed heavily on both sets of shaking shoulders as the two stood with their arms around each other.
After a while, as they sat and talked, feelings of anger became evident in Barry's comments. "Ginger and I put her life and the lives of Cole and Carrie into their hands, Sarah. They're the experts. We trusted them. They assured us everything would be okay, but they let all three of them die. I can't help thinking that those doctors and the hospital caused it. I'm not going to let them get by with it." Sarah noticed that Barry clenched his teeth and his fists simultaneously.
Sarah looked into space as her mind massaged what Barry had said. Ginger expected to go home with her first babies. Barry and Sarah expected Ginger and her twins to go home healthy. Barry and Ginger had looked forward to the happiness all young couples expect. Instead, Ginger and her babies were dead. The happy future they had envisioned would never happen; it had vanished like a vapor.
Sarah's analytical skills and the daily requirements of her work caused her to question everything, explore every possibility. Barry's suspicions reinforced her nagging worries that the doctors and nurses had somehow failed, causing the deaths.
Barry insisted on accompanying Sarah to meet with Dr. James. As Agent Donald Adams negotiated the dark sedan through a construction zone and approached Dr. James' office, the question of how the doctors had performed professionally hovered in Sarah's mind.CHAPTER 2
When Sarah, Donald Adams, and Barry arrived at the office of Dr. Alan James, they found the front door unlocked and the waiting room vacant. The door to Dr. James' private office stood open. As he stepped out of the door to meet Sarah, his face showed surprise to see Barry and another man with her. He introduced himself to Sarah professionally, extending his hand, which Sarah shook with a firm grip. Barry's lukewarm demeanor and obvious reluctance to shake the doctor's hand put Dr. James on the defensive even before the discussion began. The Secret Service agent waited in the foyer while the doctor conferred with the relatives of Ginger Moffatt around a small table surrounded by three walls filled with credentials in his office.
Dr. James opened the discussion. "Dr. Tyler, Mr. Moffatt, first let me reiterate how sorry I am about what happened. I have relived the events many times. I have reviewed all the records and my notes. I have also reviewed the case with two colleagues, the charge nurse, the labor and delivery nurse, and the anesthesiologist, Dr. Baluch. Frankly, I'm at a loss to explain what went wrong. Sometimes, things don't go as planned for reasons we fail to understand. I'm afraid this is one of those times."
Sarah responded. '"Dr. James, I appreciate your candor, but, as you can imagine, we are stunned at the outcome and have a hard time understanding why you can't tell us anything more about the reasons for what happened. Why don't you start with what you expected and tell us what and when things started going wrong."
Dr. James leaned forward in his chair, referred to his notes, and answered professionally. "All right, Dr. Tyler. Ginger's prenatal course was uneventful. She was approximately three weeks from her expected date of delivery but was apprehensive about going into labor prematurely. She didn't want an obstetrician she had never met to deliver her babies. Since I was going to be out of the city for a week starting today, I told her it was possible to induce labor, although we rarely do that with twins. She elected to have labor induced if she had not delivered by Thursday morning. She was in good health generally with no contraindications for inducing labor. She was admitted to City General Hospital at 7:00 Thursday evening, prepped, and her induction started at 9:00. I ruptured her membranes and stayed in her room for about fifteen minutes. Since delivery usually occurs twelve to twenty-four hours later in a first pregnancy, I instructed the nurses to call me with progress reports and then left the hospital."
Barry Moffatt frowned and glanced at Sarah.
Excerpted from Perfect Justice by Thomas Johnson. Copyright © 2006 D. Thomas Johnson. Excerpted by permission of iUniverse, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.