Medical ethics: where does a doctor's duty lie? |
A DOCTOR'S DUTY CHARACTERS Christopher Lawson: Main character. 27 years old. First year medical intern at the Lewisville Memorial Hospital. Karen Spriggs: 26. His best friend and ex-girlfriend. Despite their failed relationship, they remain on good terms. Jason Saxby: 26. Karen's new boyfriend. Eric Geddings: 29. Senior resident on Christopher's team. William Strickland: 55. The attending on Christopher's team. Charlie Mackelman; Alison Strouss; Lena Byrd: Christopher and Karen's friends. Adam Peterson; Jessica Bryant; Timothy Wright: other interns and residents on Christopher's team. Jenny McIntyre: 45. Nurse on the sixth floor of Lewisville Memorial. Receptionist and technician: Employees at the Medical Records Department of Lewisville Memorial. Various nurses and restaurant patrons. SETTING The Lewisville Memorial Hospital serves as the teaching hospital for the local medical school. Like most college towns, Lewisville has a healthy mix of establishments catering to the younger generation. Besides the regular hangouts, the hospital itself also boasts its own canteen for visitors and staff. The year is 2009. *** SCENE 1 Tommy's Taproom (A neon sign proclaims the name of the establishment. Music and what sounds like a football game are playing in the background. A single spotlight shines on one specific table, around which are gathered CHARLIE, ALISON, and LENA, with their drinks and menus.) ALISON How's the married life treating you, Charlie? Has Mary gotten you trained yet? CHARLIE Very funny. I will have you know that I was already housebroken by the time she got her hands on me, thank you very much. LENA So... when're the kids due? CHARLIE What? We've barely been married two months! ALISON Get cracking then! Lena and I want little Charlies and Maries to corru-- I mean, to babysit! LENA (rubs hands together with an evil, gleeful grin) Ooo... little Charlies and Maries... CHARLIE (shudders dramatically as the girls laugh) Oh God help us... (Enter CHRISTOPHER, dressed casually in a t-shirt and jeans. He sees his friends and heads over to the table.) CHRISTOPHER Hi guys! Long time no see! CHARLIE Thank goodness you're here. These two are already plotting about how to turn my future children into their own private army. CHRISTOPHER (pulls out a chair and sits) In that case, I want to be their most trusted military advisor. CHARLIE Et tu, Brute? (The others laugh at his doleful expression.) LENA And how about you, Chris? Ready to sally forth and save lives yet, Dr. Lawson? CHRISTOPHER Pfft, yeah right. As though a medical intern is anything but the lowest peon in the chain of command. ALISON You're enjoying it though? CHRISTOPHER (with a genuine smile) Yeah, I am. You see some really nifty stuff. Like we had this one dude-- CHARLIE Oh no, now you've done it... (looks around as though for rescue) Where's Karen anyway? Isn't she supposed to be here? ALISON (leans over as though imparting a great secret) You know she's got a new boyfriend, right? He's supposed to be totally hot. She's bringing him tonight-- (LENA nudges her in the side) ALISON What? Oh... sorry Chris... CHRISTOPHER Honestly, you two. We haven't been an item for almost a year now, you don't have to walk on eggshells or anything. It's not like we haven't both of us dated other people since, and we're still best friends and all. Besides, Karen already told me the news over the phone last week. (Enter KAREN and JASON. KAREN heads straight for the table while JASON hangs back a little in the shadows, waiting to be introduced.) KAREN Guys! It's so good to see you! (swoops down and gives CHRISTOPHER a one-armed hug and blows kisses to the other three, which ALISON and LENA return) Oh, it feels like it's been forever! LENA Well? (glances meaningfully at the hovering JASON) So let's meet the hunk! KAREN Not if you keep eyeing him like a starving man with a sirloin steak! He's mine! (hooks her arm through JASON's and pulls him into the light) (CHRISTOPHER jerks as he sees the newcomer's face and stares at him in astonishment.) KAREN Everyone, this is Jason Saxby. Jason, these are my friends Charlie, Alison, Lena, and Christopher. JASON (shakes hands with CHARLIE, who is closest.) Nice to meet all of you. Karen's told me so much about her "crew." ALISON (takes his hand next) Surely some of it must have been good? JASON Er, well, she did tell me that if I made her mad, y'all would make sure they never found my body. LENA (nods with mock-solemnity as she accepts his hand) Yeah, sounds about right. KAREN (grinning) Aren't they the sweetest bunch? JASON Oh, of course. Yes. Sweet was... exactly the word I was hunting for... (He turns at last to shake CHRISTOPHER's hand and gets a good look at his face. He starts and looks stunned.) Oh! Dr. Law-- that is, Christopher, was it? (He gives a nervous laugh.) Fancy meeting you here. CHRISTOPHER (shakes JASON's hand slowly and eyes him with a thoughtful frown.) Mr. Saxby. KAREN You two know each other? JASON No, not really. Well, ah, Dr. Lawson here was on the medical team that took care of me when I was at Lewisville Memorial a while back. I don't suppose you remember me, doc? CHRISTOPHER Actually I do, Mr. Saxby. I hope you're doing better now than you were? Taking care of yourself like we discussed? JASON (nervous) Sure, sure. No problem. KAREN (frowns at CHRISTOPHER) Lighten up, you two; you aren't at the hospital now! You're not gonna to call each other "Mr. Saxby" and "Dr. Lawson" all through dinner are you? JASON (shakes himself and musters up a smile) Right. 'Course not, love. (pulls out a chair for KAREN and then one for himself) Has everyone ordered already? CHARLIE This place isn't quite highbrow enough to have waiters, so we'll have to pick up what we want from the bar. We've all been here so many times I know what everyone else wants, but what about you, Jason? (pushes chair back and stands to go get their order) JASON (also stands) Why don't I just go with you and help you carry everything back? (CHARLIE and JASON exit) LENA (looks offstage as though eyeing the boys' progress and gives a low, suggestive growl at KAREN.) I call dibs on his brother if he has one! KAREN I know! Isn't he dreamy? And he's so sweet and caring. ALISON You certainly look very happy. I haven't seen you glow like this since we dumped that tubeful of glitter over you in second grade. KAREN Ha ha, Alison. Like I needed to be reminded of one of the most traumatic events of my early childhood! (relaxes and smiles gently) Seriously though, Jason is... he's... well, I don't even know how to explain it! (drops her voice further) I know it sounds silly, but there's like this connection between us. Being with him makes me so happy. I... I really think he might be "the one." CHRISTOPHER (sharply) "The one?" You can't have known each other for more than two weeks! KAREN Well, but... I mean... Actually, for your information, it's been almost three weeks. And I'm not saying I'll walk down the aisle with him this minute, Christopher! But... LENA But you wouldn't mind, isn't that right? Girl, I say go for it! KAREN Are you all right, Chris? You don't... that is, I wouldn't have brought him if I thought you'd mind. CHRISTOPHER (sighs and pinches the bridge of his nose) No, it's just... I know what you're thinking, and I am not jealous. Well, okay, maybe a tad bit, but we both know the two of us wouldn't have worked out. (shares a weak smile with KAREN) It's more like... I mean, how well do you know this guy? Isn't it a little early to be talking about cakes and weddings? KAREN Oh, Chris... You're right, I don't know that many facts about him; somehow they don't seem all that important compared to how he makes me feel. But it's sweet of you to worry about me. (teasingly) I don't suppose you can add to my limited repertoire of knowledge, O Dr. Lawson? CHRISTOPHER (hesitates as though about to speak, then stops and drops his eyes to the table instead) No. Not really. LENA Then stop spoiling our fun! ALISON Speaking of fun... (Enter CHARLIE and JASON with trays of food and drinks, which they deposit on the table.) CHARLIE The unhealthiest food we could find on the menu! Good thing Chris here will know what to do when our arteries all clog up. Dig in, everyone! (Curtain falls.) *** SCENE 2 Lewisville Memorial Hospital, 6th floor nursing station (Scene opens with the lights out. In the dark, a phone rings. The lights come on to reveal a nursing station in the background. A couple of nurses in colorful scrubs are seated at computers or flipping through charts. One of these answers the phone.) JENNY (talks into the receiver) Lewisville Memorial Hospital, 6th floor nursing station, this is Jenny, how may I help you? (The rest of the conversation is too low to be heard. Enter DR. STRICKLAND, ERIC, JESSICA, TIMOTHY, and ADAM all in a group with the attending leading. Enter CHRISTOPHER trailing a couple of steps behind them. All are dressed in long white lab coats and the interns and residents are carrying clipboards and papers.) DR. STRICKLAND All right, good. What else? (stops at the nursing station and leans against the counter as he listens) (The others all gather around in a rough circle, except for CHRISTOPHER, who looks distracted and is clearly not paying attention.) JESSICA (reads from her paper) So she's on day two of ten of IV Levaquin for her pneumonia. Her chest x-ray from yesterday afternoon showed some improvement... Uhm, she was still wheezing slightly on the right when I saw her this morning. But overall she's looking a lot better. DR. STRICKLAND Good! Do you have discharge plans? JESSICA Well, I'd feel more comfortable with keeping her here for one more day. I mean, she's still coughing a little and her white count is still a bit high... DR. STRICKLAND All right, I'm fine with that. JESSICA I think she'll be ready to go home tomorrow on another week of oral Levaquin. DR. STRICKLAND Sounds good. (JESSICA scribbles a note on her paper.) DR. STRICKLAND (rubs his hands together and looks around at the rest of the team) All right, was that the last one? ERIC (checks a list on his board) One more. Monroe in 658. He's Christopher's. CHRISTOPHER Huh? What? ERIC Room 658? Your patient? CHRISTOPHER Oh. Oh, right. (flips through his clipboard looking for the right page) Er, sorry... Ah, here it is. So, uh, 22-year-old African American male with a history of sickle cell, in for an acute pain crisis. Describes pain in his back and legs typical of his previous episodes... Uhm, no difficulty breathing and review of systems otherwise normal. Was put on a Dilaudid drip-- ERIC Morphine. CHRISTOPHER What? ERIC A morphine PCA. He's allergic to Dilaudid. CHRISTOPHER Oh. Oh yeah. Morphine PCA. DR. STRICKLAND How much has he been using? CHRISTOPHER I'm sorry? DR. STRICKLAND Morphine, Dr. Lawson! How much morphine has your patient been using? Is his pain controlled? CHRISTOPHER Uh... Well, that is... (flips through a few more pages) I'm not too sure... ERIC (frowns at CHRISTOPHER as he answers) About 10 mg in the past 24 hours. He was in no acute pain this morning. CHRISTOPHER Right. Thanks. Uhm, so I guess we're just waiting for his pain to resolve. DR. STRICKLAND What about previous admissions? CHRISTOPHER Uhm... DR. STRICKLAND (rubs his forehead as though frustrated) This is your patient, is it not, Dr. Lawson? Based on how many prior admissions he's had, is he a candidate for hydroxyurea? CHRISTOPHER I... I'm not sure, sir. DR. STRICKLAND Then I suggest you find out, Doctor, since that would be good to know, wouldn't it? CHRISTOPHER Yes sir. Sorry, sir. DR. STRICKLAND (looks around at the others) Right then. We'll break for now so you can go finish your notes and follow-up on what we discussed this morning. Plan to meet back in the basement classroom after noon conference. Come ready to update me on what you've done and your plan for all your patients. (DR. STRICKLAND, TIMOTHY, ADAM, and JESSICA exit. CHRISTOPHER is about to follow when ERIC stops him.) ERIC Christopher, wait a minute, will you? (waits until the others are gone, then pulls CHRISTOPHER a few steps away from the nursing station so as not to be overheard) Anything you want to tell me, Chris? CHRISTOPHER What do you mean? ERIC I mean is there anything going on that you'd like to share? (waits a beat) Look, you're a bright kid and you care a lot about what you do, but I'm not gonna lie to you. Your recent performance hasn't exactly lived up to your past records. Like today, for example. CHRISTOPHER Yeah, I'm sorry. I just didn't get enough sleep last night, I guess. ERIC I'm not talking about a one-day occurrence, Chris. Look man, I know what it's like being a first-year intern; I went through it too, right? I know about the stress and the late hours and the deadlines, but dude, you've just got to tough it out. Especially now, when you're applying for a residency. To have a shot at a good program, you've really got to be on top of your game, and lapses like today aren't going to help. CHRISTOPHER I know, I know. ERIC All right, man. Well, no hard feelings, yeah? I'm not trying to beat you down or anything, just trying to make sure you don't screw over your career before it even starts. CHRISTOPHER Yeah, man. I understand. Thanks, Eric, for looking out for us. ERIC No prob. That's what senior residents are for, ain't it? Okay then, go take care of your patients. I'll see you after lunch. (exits) (CHRISTOPHER dithers a bit, fiddling with his papers and looking lost. Finally, he runs his fingers through his hair and gives a little nod, as though coming to a decision about something. He approaches the nursing station, and JENNY looks up and smiles.) JENNY Finished rounds, Dr. Lawson? Anything you'd like us to do? CHRISTOPHER Uh, not at the moment, thanks Jenny. Look, I was wondering... there was a patient who was on this floor for a while and got discharged maybe a couple of weeks ago. I wanted to look up something about his case. Do you keep the old chart records on the floor somewhere? JENNY Oh, no. There's just way too much of it. Once they get discharged, we send all their papers down to the Medical Records Department. Do you know where that is? Second floor, take a left from the elevators and follow the signs. CHRISTOPHER Ah. Uh, thank you. Second floor, did you say? JENNY That's right. It's such a hassle, isn't it? I'll be so happy when we transfer everything to electronic records. CHRISTOPHER Yeah, me too. Thanks again, Jenny. See you later. (exits) (Curtain falls.) *** SCENE 3 Lewisville Memorial Hospital, Medical Records Department (Scene opens to show the waiting area for the Medical Records Department. Off to one side a bored RECEPTIONIST is manning the desk. CHRISTOPHER is loitering nearby next to a fold-up table and chairs, looking at the pictures on the walls. Every now and then, his eyes trail to a door that leads deeper into the office, through which can be seen the first of what must be many filing cabinets.) (Enter TECHNICIAN, carrying a messy folder crammed full of papers.) TECHNICIAN Here you go, Doc. Sorry it took a while to find. Anything else I can get you? CHRISTOPHER (accepts the folder and checks the name as though verifying it's the one he wants) No, that's all. Thank you. TECHNICIAN You're welcome. I can't let you leave with it, but feel free to take a seat while you look for what you need. (exits) (CHRISTOPHER pulls out one of the chairs and sits. He beings to riffle through the papers, occasionally pausing and squinting as though trying to decipher handwriting. Enter TIMOTHY, holding a form. He hands it to the RECEPTIONIST.) RECEPTIONIST Thank you, sir. Give me one sec... (begins to type something into her computer) (TIMOTHY looks around and sees CHRISTOPHER, deeply engaged in his reading.) TIMOTHY Heya, Chris! What's up? CHRISTOPHER Huh? Oh! Hi, Tim. Uh, what're you doing here? TIMOTHY (pulls out the other chair and sits) Eh, Patterson in 670 wants us to burn a CD for him with his x-rays and CTs and MRIs on it so he can have 'em when he goes to see his specialist next month, so I had to deal with the paperwork. As though we didn't have enough going on. CHRISTOPHER (flips the page, only half-listening) Yeah... TIMOTHY What've you got there? (CHRISTOPHER doesn't answer and TIMOTHY leans over to see.) TIMOTHY Saxby? Saxby... Oh! I remember now! Came in with that bad cough that turned out to be PCP? CHRISTOPHER That's him. TIMOTHY Thought we got rid of him weeks ago? What're you looking for? CHRISTOPHER Oh... nothing in particular. Just wanted to verify something. TIMOTHY (leans back in his chair and puts his hands behind his head) He was a nice guy. Had me cracking up, the way he was talking to you and Eric and Dr. Strickland. Pity about the HIV. CHRISTOPHER (freezes momentarily) Yeah... pity. (puts the papers down and looks at TIMOTHY) So it was AIDS? I thought so, but I wasn't sure if I was remembering the right patient. TIMOTHY Well, yeah. It's not like we see a lot of healthy people walking around with PCP, is it? CHRISTOPHER (rubs his eyes as though tired) No, I suppose not. That's right, I remember now. He didn't seem all that surprised when we told him. TIMOTHY Nope. Wasn't on any anti-retroviral therapy either, though I heard you calling the Ryan White Clinic to make an appointment for him. CHRISTOPHER (slumps back in his chair and sighs) Yeah. TIMOTHY All right there, Chris? CHRISTOPHER (hesitates a beat) Yeah... I wonder though... does that kind of thing get reported to anyone? Like, tracking-wise? TIMOTHY Hrm... I think so. I think the lab automatically reports positive test results to the state Health Department. CHRISTOPHER And the Health Department notifies anyone who might have been exposed through that person? TIMOTHY Now that I'm not sure about. I think it's different from state to state. Plus it's all a muddle when you throw in the federal laws on patient privacy and all that. Too complicated for me. I only treat 'em, I don't trace 'em! CHRISTOPHER (manages a weak smile) I guess. But I mean... if they're putting others at risk, don't we have a duty to warn their partners? TIMOTHY (frowns) Well, maybe... but that's shaky ground, I think, especially if we're talking about disclosure without patient permission. And then where do you draw the line between warning someone and violating your patient's trust and privacy? (shakes his head and chuckles) Now you're making my head hurt! Quit asking difficult questions! CHRISTOPHER Heh, sorry, didn't mean to actually make you think or anything like that. TIMOTHY Heaven forbid! (A pause) Oh hey! Have you finished applying to all your residency programs? Gotten any interviews yet? CHRISTOPHER A couple. Waiting to hear back from the rest. TIMOTHY Man, I'll be so glad when all this is over with and we know where we're going next year, y'know? I keep feeling like we're walking on eggshells, like there's this huge spotlight on us or something. CHRISTOPHER Like they're examining all of us under a microscope, looking for the slightest hint that we've slipped up and won't make the cut for their program? TIMOTHY (laughs) Yup! God, whether I match or not, I'm planning on getting totally pissed the night I find out! CHRISTOPHER Hah, yeah. I'll be right there with you, buddy. TIMOTHY Haha, Eric will have our heads on a pike if we come in with a hangover the morning after! RECEPTIONIST Dr. Wright? Here's the x-ray you were looking for. TIMOTHY All right! Just in time for lunch! (jumps up and accepts the disc the RECEPTIONIST hands him) Thanks, Miss! I'll catch you later, Chris! (waves and exits) CHRISTOPHER (sits as though deep in thought for a moment, then pulls out a cell phone and dials a number) Hey, Karen? Yeah, how're you doing? ...Good, good. Listen, I was wondering if you wanted to get together for lunch tomorrow? We didn't really have a lot of time to chat last night and I thought we'd catch up some... Yeah, I have an hour free. Meet in the canteen at noon then? All right, see ya! (hangs up and pockets the phone; closes the folder and hands it to the RECEPTIONIST) Thank you, ma'am. Have a nice day. (exits) (Curtain falls) *** SCENE 4 Lewisville Memorial Hospital, Canteen (Scene opens showing a couple or three cheap canteen tables with attached chairs. CHRISTOPHER enters, again in his white lab coat, and looks around. He picks a seat and sinks into it. KAREN and JASON enter a moment later. KAREN sees CHRISTOPHER at once and makes her way over, with JASON in tow.) KAREN Hi, Chris! Wow, don't you look professional in that lab coat! CHRISTOPHER (sits up straight at KAREN's approach) Hi, Karen. (rises to greet her and sees JASON behind her; stiffens and hesitates.) Oh. Oh... uh, hi, Jason. JASON Dr. Lawson. KAREN I told Jason I was meeting you for lunch and he asked if he could tag along. I hope you don't mind? CHRISTOPHER N-No, of course not... (They all take seats) KAREN So, saving lives, Dr. Lawson? CHRISTOPHER Always. KAREN I knew it! You're gonna make a great doctor, Chris; and when you're all rich and famous, don't forget the friends who helped you get there, right? CHRISTOPHER Hah, yeah... I couldn't've made it without all those cookies you baked me in med school. KAREN (snickers) Sugar: brainfood of champions! CHRISTOPHER So, uh, how did you say you two met? KAREN Oh y'know, the usual. Biker bar, rock music, enough alcohol to sterilize this hospital... JASON (snorts) I must've missed that room on the museum tour. CHRISTOPHER Riiight... our little Karen at a biker bar. I'm sure going to believe that. KAREN (sticks out her tongue) Okay, fine. So it was actually during the school field trip to the museum, but that sounds so much less interesting... JASON Only to someone who wasn't there and can't recall the impressive racket of those little bra-- I mean, cherubs. KAREN I thought you handled yourself very well, Mr. Saxby. I'm sure anyone else would have been scarred for life if three second-graders had attached themselves to his or her ankle like that. JASON Yup, that's me. Defender of little children against life-sized, automated T-rexes. CHRISTOPHER I remember that exhibit. Karen jumped a foot in the air the first time that monster roared at us. KAREN I did not! Well, maybe a couple of inches. Totally beside the point! JASON and CHRISTOPHER Suuure... (They grin at each other) KAREN Boys! Fine, I'm going to the restroom. You two behave yourselves! (stands and exits) (CHRISTOPHER and JASON sit and stare at each other for a couple of seconds) JASON Would you think it terribly rude of me if I asked why you wanted to see Karen today? (CHRISTOPHER looks away and doesn't answer.) JASON (frowns) Because if it's why I think it is, that's against the law. CHRISTOPHER I know the law, Mr. Saxby. I also know I have a duty to warn someone I think might be in danger. JASON I would never put Karen in danger! So you were planning on telling her then? CHRISTOPHER I... I don't know what I had planned, all right? Are you going to tell her? JASON (slumps) I... CHRISTOPHER Well? JASON Yes, all right? It's just hard, y'know? (shoots CHRISTOPHER a glare) And I don't need my doctor of all people blabbing about it. CHRISTOPHER When are you going to do it? (pauses) We have counselors if you need help or want to talk to someone... JASON (looks disgusted) Yeah, I know all about your counsellors and what a lot of help they can be. Didn't keep my previous girlfriend from running away screaming when she heard. Thank God my mom hadn't liked her anyway, or she might've found out too. CHRISTOPHER No one knows? JASON Look, don't give me the you-need-a-support-network talk, all right? I've heard it all before. CHRISTOPHER Did you at least keep your appointment at Ryan White? JASON I... No... (runs his fingers through his hair) I will though. I made another one for two weeks from now. I just... I didn't have much of a reason before, y'know? Before I met Karen, I mean. CHRISTOPHER If you stick to your anti-viral regimen and take appropriate precautions, there's no reason you can't-- JASON (rolls his eyes) Live a normal, healthy, productive life? Yeah, I've had that talk before too. Thanks, doc. That's a lot of comfort, I'm sure. CHRISTOPHER We can't help you if you don't help yourself. JASON (grits his teeth) Could you, for maybe two seconds, quit with the lecturing? CHRISTOPHER (sighs) Right. Sorry. Bit of a reflex. (Enter KAREN) KAREN Why is there always a line? (CHRISTOPHER and JASON both jump at her voice, and then pointedly avoid looking at each other.) KAREN (looks between CHRISTOPHER and JASON and raises an eyebrow) Did something happen while I was gone? CHRISTOPHER (hesitates) No, not really. KAREN Oookay... So what did you want to talk to me about, Chris? (sits down) CHRISTOPHER Uhm... (stares at JASON's hand, which has clenched into a fist at KAREN's question) (JASON is stiff as he stares at the table, but keeps silent.) CHRISTOPHER Uh, n-not much. Just wanted some company for lunch, I guess. KAREN (huffs) You called me out here just because you were lonely for lunch? (rolls her eyes) Oh, Chris. What am I gonna do with you? I know! You need a girl! You know, my younger cousin is starting med school in the fall... CHRISTOPHER Oh God... (They all chuckle as the curtain falls) *** SCENE 5 Outside cafe (Scene opens at an outside cafe. CHARLIE and CHRISTOPHER are seated at a small table. CHARLIE is sipping on a coffee while CHRISTOPHER has his forehead resting on the table. Enter ALISON as they begin talking.) CHARLIE All right there, buddy? CHRISTOPHER Oh God... I'm so glad that's over... ALISON (approaches the table and looks at CHRISTOPHER with concern) What's over? CHARLIE His residency interviews. Y'know, the ones with awkward questions like... describe yourself in three words? ALISON Handsome, charming, and smart? CHRISTOPHER (snorts a laugh as he sits up straight) Thanks for the vote of confidence. CHARLIE Now how come none of the ladies ever say that about me? ALISON You're married. That automatically renders you pudgy, lazy, and too dumb to take the trash out when the can is overflowing without first getting yelled at. CHARLIE Wait, that was more than three words... CHRISTOPHER (laughs) I'm sure Mary appreciates the description though. ALISON (sits at the table) So, anyone know why Karen invited us all here? CHRISTOPHER Nope. Have you guys seen a lot of her in the past couple of weeks? I've been so busy with applications and stuff... CHARLIE Nah. She's been spending a lot of time with that Jason fella. Nice looking kid. We should invite him to more of our little gatherings, especially if things between those two are getting serious. CHRISTOPHER Wait, what? ALISON You don't know? They've become practically attached at the hip. CHRISTOPHER Oh. Er, okay... (Enter KAREN, looking very excited. She bounces over to the table and stands grinning at her friends.) KAREN Hi guys! What's up? CHARLIE Well, you are, apparently. Finally struck the lottery, huh? KAREN Ha ha ha, aren't you the funny one? But... you're actually pretty close this time! ALISON You robbed a bank? KAREN (sticks her tongue out) No! Here, I'll give you guys a hint! (leans on the table by propping her hands on the surface) CHARLIE You've gotten into some kind of street drug and can't keep your bala-- ALISON (jumps up with a high-pitched squeal) Oh my God! Karen, is that a ring? KAREN We have a winner! (CHRISTOPHER suddenly slumps down in his chair) ALISON Oh, let me see it! (grabs KAREN's hand and turns it this way and that) Ooh... it's beautiful! Congratulations! KAREN (hugs ALISON and sniffles with a smile) Thank you! CHARLIE (rises and slaps KAREN on the back) Congrats, Special K! KAREN Thanks, Charlie! (looks at CHRISTOPHER, who hasn't moved) Uh... ALISON So c'mon! Details, details! (tugs KAREN until they're both sitting again) CHARLIE This calls for celebratory cupcakes! Be right back. (exits into the coffee shop) ALISON Well? How, when, and where! We already know the who, what, and why parts! KAREN Oh, it was so romantic... and I wasn't expecting it at all! (shoots another concerned look at CHRISTOPHER) Chris? CHRISTOPHER Huh? Oh. Yeah... Congrats, Karen... (KAREN and ALISON both frown at him. ALISON lifts her head as though seeing someone coming down the street.) ALISON There's Lena! Let's go tell her the news! (Enter LENA. ALISON and KAREN both jump up. ALISON dashes off, but CHRISTOPHER rises and grabs KAREN's arm. The conversation between the two girls is not audible, but LENA looks very surprised before clapping her hands and bouncing up and down.) CHRISTOPHER Karen, wait! I... Did Jason ever... I mean... KAREN Are you all right, Chris? Did Jason ever what? CHRISTOPHER Did he ever tell you... anything? KAREN What're you talking about, Chris? Anything about what? CHRISTOPHER (shudders and drops his hand; has some difficulty forcing the words out) Did you... how far have you two...? KAREN Christopher Lawson, don't you turn into an old maid on me now! C'mon, you don't really believe in waiting 'til after the vows, do you? (sees ALISON and LENA beckoning) I'll be right back! (joins the girls at the other end of the stage) (Lights dim until only a single spotlight is still shining on CHRISTOPHER. For a moment, he stares at the tabletop, then sinks slowly back into his chair with a groan. As the final spotlight fades, he lowers his head into his hands.) (Curtain falls.) THE END *** Author's Note: In an attempt to (hopefully) stave off any hate mail, let me first say that I am not implying anything about what Christopher should or should not have done. Medical ethics remains a murky area at times, especially with highly-charged topics like the one above. Where the law ends and a provider's own judgment of the issue begins is sometimes difficult to define, and in cases where federal law is vague and state laws differ, healthcare professionals are often left to muddle through as best they might. I'm not sure what my own response to such a situation would've been. Patient privacy is one of the most important concerns of anyone in healthcare... but when pitched against the duty to warn, it's hard to tell which one should win. The only advice I could've offered Christopher would've been to talk to someone he trusted who would understand the issues, like Eric or Dr. Strickland or some other attending; even if they couldn't tell him what to do, they might've been able to refer him to someone who could, or at the very least the hospital's legal counsel. For those who are interested, AVERT.org has a very good article about this issue, although it doesn't offer anything specific for those in healthcare. (http://www.avert.org/criminal-transmission.htm) Keep in mind that intercourse with someone with HIV does not immediately guarantee transmission, and the use of condoms and especially modern highly active anti-retroviral therapy (HAART) can dramatically decrease not only the virus itself but also the risk of transmission. And finally (if anyone is still reading this extremely long-winded author's note...), please remember that those with HIV/AIDS are living with a disease, but that the stigma associated with it can be just as devastating as the virus itself. Thank you for reading and please review! |