Chapter 43: Collateral
On Friday the ninth I took the graph paper to the hospital.
Not to a doctor. To Medical Records. It is in the basement of the west building, past the vending machines, behind a window with a ticket machine and a laminated notice about turnaround times.
I want to describe what happened, because it took an hour and forty minutes and it explains a thing about buildings.
The whole of that department exists to give information out.
It has forms for requests, forms for authorizations, forms for expedited requests, and a price list per page.
It has nothing whatsoever for a person who wants to put something in.
The first clerk asked whether I was the patient’s parent or legal guardian.
I said no. I said I was not asking for a record. I was trying to give them one.
She looked at me the way you look at somebody who has said a thing that is grammatically correct and structurally impossible.
“Give us one.”
“Six months of dated observations on the patient. Made by me. His physician has them. I want them in the file here as well.”
She went and got a supervisor, which took nineteen minutes. The supervisor was polite and completely clear.
“We don’t accept documents from members of the public. Anything that goes in the chart goes in through a clinician.”
“I’m not a member of the public. I’m his nanny.”
“Are you on his consent form?”
“No.”
“Then for our purposes you’re a member of the public.”
I asked what would happen if I put the pages through the door anyway.
“They’d be scanned into a correspondence tray and reviewed by somebody in three weeks.”
“Then almost certainly destroyed, because unattributed clinical material in a chart is a liability.”
I said I would attribute it. I would sign every page.
“Then it’s attributed clinical material from an unlicensed person in a dispute with the family,” she said, not unkindly. “That’s worse.”
She was right. That is the thing I keep having to write down.
She was right, and every person who told me no that month was right.
I sat on the plastic chairs outside for a while with the wallet on my knees.
While I sat there I did a stupid thing, and I am putting it in because I have promised to put the stupid things in.
I went through the mechanism in my head as though I were qualified to.
Something by mouth. That was the whole of my theory, and I held it for eleven days.
He has the same bottle at half past six. He has vitamin D drops.
He had two doses of salbutamol in May, and acetaminophen for four days after the fourteenth of September.
Four things go into that child, I thought, and they all go in through somebody’s hand, and I can count all four.
I was so pleased with that reasoning that I did not notice it was a list of everything I could see.
It took me until the spring to understand that the answer was not on any list I was capable of writing that autumn.
At ten past two a clerk came out with a tray and stopped in front of me.
His badge said Okonjo, and underneath it, in smaller letters, twenty-two years.
“You’re the one who wants to put something in,” he said.
I said I was.
“You can’t. But a doctor can, and it has a name, and nobody at that window will say it to you, because it isn’t their form.”
He wrote two words on the back of a compliment slip.
Collateral history.
“An outside document, entered by a treating physician, with an attestation from whoever wrote it. It goes in as its own item. It gets a date and a source line.”
I asked why he had come out.
“Because you’ve been sitting there forty minutes with a ruler in your bag,” he said, “and people with rulers are usually right about something.”
I telephoned Wabash from the lobby, standing under a television with the sound off.
Ms. Pryor put me through in under a minute, which had never happened.
I told Dr. Moreno the two words.
There was a silence of the kind he does, and then he said, “Who told you that?”
“A records clerk in a basement.”
“Then he knows more about the mechanics of that hospital than three consultants I could name.”
I asked whether he would do it.
“Yes. Bring the original on Monday, and bring the recorder.”
Then he said the part I had not thought about at all, slowly, so that I would hear every word of it.
“Miss Carter. If I enter your log, your name goes on it, permanently, with your address and your relationship to the household.”
“All right.”
“It will be read by the family’s lawyer within a month.”
“All right.”
“And there is one line I will have to write on the attestation that you are not going to like.”