Chapter 3 - The Price of a Life
Twenty minutes later, the curtain to Bay Four was yanked back with a sharp metallic clatter.
Barbara and William Vance walked into the small room.
William was still holding his encrypted corporate tablet, his leather loafers silent against the floor. Barbara was holding a silk scarf over her nose, looking around the emergency room as if the presence of sick people were a personal insult to her sensibilities.
Claire was standing beside Maya’s bed, holding a bright yellow emergency consent form and a clip-board containing the preliminary blood test results.
"Mr. and Mrs. Vance?" Claire asked urgently, stepping into their path. "Thank God you're here. Your daughter’s condition is rapidly destabilizing. Her hemoglobin levels just came back from the lab at 5.2. Normal is fourteen. She is bleeding heavily into her abdominal cavity."
William didn't look at Maya, who lay motionless on the bed, her eyes half-closed, her chest rising in faint, irregular shallow twitches.
William looked at his tablet. "How did she split her incision? Did she drop something?"
"She was lifting heavy boxes!" Claire said, her voice rising in unfiltered anger. "Her medical records show she underwent major exploratory surgery less than twenty-one days ago! She shouldn't have been lifting five pounds, let alone heavy crates!"
Barbara clicked her tongue softly, adjusting her silk scarf. "Well, nobody told us she had surgery. She never calls. She disappears for months on end and expects us to keep track of her medical history."
"That is irrelevant right now!" Claire snapped, thrusting the yellow consent form into William’s hands. "We need to run an immediate, contrast-enhanced emergency CT scan to locate the active arterial bleeder, and then transfer her directly to the trauma operating suite for a laparotomy. I need your authorization for the contrast procedure and the surgical transfer."
William took the paper, his eyes scanning down the page to the billing and insurance authorization section at the bottom.
His eyebrows pulled together into a sharp, calculating line.
"This scan is out-of-network," William stated flatly. "And the emergency surgical suite activation fee is twelve thousand dollars baseline, exclusive of anesthesiology."
Claire stared at him in utter, unadulterated disbelief. "Sir... your daughter is dying. She is going into hypovolemic shock."
William crossed his arms over his broad chest. "She is thirty years old. Does she not have her own government health insurance?"
"Her federal benefits card isn't pulling up in our local system!" Claire yelled, her hands trembling with rage. "The system is returning a classified block code! Until her federal portal clears, we need a secondary financial guarantor to authorize the emergency imaging, or the hospital administration will flag it as an uncompensated transfer!"
Barbara stepped forward, laying a hand on her husband’s arm, her voice dropping into a low, persuasive purr.
"William," Barbara whispered, loud enough for Maya to hear through the haze of her fading consciousness. "The wedding reception tomorrow night is costing two hundred and fifty thousand dollars. The deposit for the orchestra is due at midnight. We are not authorizing tens of thousands of dollars in unnecessary, marked-up emergency tests because Maya wants to throw a scene and ruin her sister's weekend."
"Mrs. Vance!" Claire shouted, stepping directly into Barbara’s face. "This is not a scene! Look at her! Look at the monitor!"
Above the bed, the cardiac monitor was beeping slower now. Not because Maya was recovering, but because her heart muscle was beginning to fail from lack of oxygenated blood.
BEEP... BEEP... BEEP...
Heart Rate: 42.
Blood Pressure: 60/35.
William pulled a gold fountain pen from his breast pocket. He flipped the consent document over, drew a long, thick black line through the authorization box, and wrote three words across the bottom in sharp, clear calligraphy:
REFUSED CARE - FINANCIAL.
He signed his name with a flourish—William H. Vance—and slapped the clipboard back into Claire’s chest.
"We are transferring her to a VA facility in Hartford in the morning," William said, his voice entirely calm, devoid of any emotion, like an executive closing a minor subsidiary branch during a quarterly review. "They can handle her government paperwork there. We have a rehearsal dinner in forty-five minutes, and our guests are arriving at the yacht club."
"You can't leave her!" Claire screamed, tears of sheer frustration springing to her eyes. "She won't survive until the morning! She won't survive the next hour!"
"That is her choice," Barbara said coldly, turning toward the curtain. "She should have thought about that before she decided to interrupt her family."
William adjusted his tie, touched his wife’s elbow, and walked out of the bay.
May you like
They walked away.
They left the emergency room, their footsteps echoing cleanly down the hallway, leaving their daughter lying on a narrow vinyl bed in a curtained box, bleeding to death under the buzzing fluorescent lights.
