Now this, Tess could do. This was business, and she and Charlie consulted on patients all the time.
“Yep.” She tapped through the tablet she’d tucked under her arm when she’d left the library, offering it up as she pressed the button for the elevator again.
“Ugh,” Charlie said, scanning the results, then the updated vitals that had been recorded in his electronic chart. “Well, his glucose levels are much more stable, but…”
“They won’t stay that way for long on his current course of treatment. I know.”
“So, what are you going to do?” Charlie asked, and finally, finally, the dammed elevator doors opened.
“I’m going to find him a new course of treatment.”
“Does Rosenthal know that?” Charlie asked wryly, passing the tablet back to Tess.
Tess couldn’t help it. She let her triumphant smile sneak out. “He’s about to.”
“Good luck!” Charlie waved as Tess jumped onto the elevator and hit the button for the fourth floor. Thankfully, Rosenthal was in his office, and he ushered her over the threshold with a polite smile.
“Dr. Michaelson. I take it you’re here to talk about Declan Riley.”
For a brief second, she was tempted to let her sarcasm flag fly and tell him no, she was there to ask whether or not he thought the Remington Rogues had a shot at winning The Cup again this year, but she clamped down on the nervous urge. Pissing him off wouldn’t work in her favor, and he could probably make a great case with his colleague, Dr. Gupta, for Declan’s eligibility for this trial.
“I am. Have you had a chance to review the medical records he brought with him from the VA?” Please, please, please, please…
Dr. Rosenthal nodded. “I have.” Yes! “They’re very thorough, and his last set of scans is fairly recent. Five months ago, I believe. I’ve ordered another MRI, just to be sure,” he added, likely because he’d caught the way Tess had opened her mouth to argue. “But unfortunately, after examining him and reviewing his health history, I’ve come to the same conclusion as his endocrinologist at the VA. Those ACE inhibitors, along with a continued health care routine and regular glucose monitoring, is really all he can do until a kidney becomes available.”
Tess’s brows flew up. “I’m sorry?”
“Come on, Tess,” Rosenthal tried. But she wasn’t having it.
“Come on, what? He’s the perfect candidate for a trial.”
It was Rosenthal’s turn to lift his salt and pepper brows at the stretch, but Tess was in for a penny. No sense in not taking aim at the whole damn pound. “The treatment he’d get as a trial participant could make a huge difference in his quality of life, not to mention in preserving his health so that when a kidney does become available, the surgery has a greater chance of success.”
“It could,” Rosenthal allowed. “But there’s a lot more to Mr. Riley’s situation than that.”
An exasperated huff crossed Tess’s lips, unbidden. “You know as well as I do that meds are only going to hold his health together for so long. He’s going to be waiting years for a kidney! And in that time, dialysis will become a real probability.”
“Probabilities aren’t guarantees. It depends on the timing,” Rosenthal allowed at the high-level frown Tess had let escape. “Look, I want to help Mr. Riley, Tess. I really do. But you’re talking about getting a lot of stars to align, just right. Finding a trial where he’d be a good fit—”
“I already did.”
Well, that got him. Tess pulled out the tablet, willing her hands to steadiness she sure as shit didn’t feel as she opened the page for the trial and handed it over. “Dr. Gupta is about to start a trial right here in Remington, isn’t she? For a new medication that could slow kidney damage in nephropathy patients?”
“Yes, but…” Rosenthal took the tablet, shaking his head a few seconds later. “The VA won’t cover this. At least, not at this stage in the game, with him still being relatively stable. In fact, I’m willing to bet it’s why his doctor there never mentioned a trial as an option in the first place.”
Tess blinked, certain she’d misheard. “Are you serious? Why the hell not?”
“Because there’s already a viable treatment plan in place.”
Oh, for the love of… “It’s not viable long-term!”
“Maybe not,” Rosenthal agreed. “But it’s viable right now, and as far as they’re concerned, right now is what counts.”
“So, what? They’re just going to wait until he gets sick enough to need different care? This trial is happening now. It’s a serious shot at avoiding him getting that sick at all!”
“Or not. Today’s blood sugar crash notwithstanding, Mr. Riley’s health is stable, for now. Could a trial help him continue to stay that way? Of course, it’s possible. But it’s not certain, and it could be construed as an unnecessary and very expensive risk.” Rosenthal handed the tablet back to Tess, who was trying her very best not to give in to her desire to throw it. “Plus, you know most insurance plans deny coverage for trials, especially ones this extensive. Medication, monitoring, testing. For God’s sake, Tess, he’ll need a specialized home health care worker to come out three times a week at the outset.”
“Not all insurance denies coverage for trials like this,” Tess argued. “Ours doesn’t.”
“Neither one of us needs a kidney,” Rosenthal said gently.
Nope. No way. She wasn’t going to let go so easily. Not when she could help her patient get better. “He could at least try. Maybe they’d appeal. Maybe—”
“Maybe he’d get his hopes up for something that isn’t possible.”
Rosenthal delivered the words quietly. But staying quiet had never been Tess’s strong suit.
She’d be goddamned if she started now.
“There are lots of things that are impossible, Dr. Rosenthal. But getting Declan Riley into this trial so that he can have a healthy life while he waits for a kidney isn’t one of them. In your professional, medical opinion, does this trial have the potential to do that?”
“Well, yes, but—”
Tess knew—she knew—that cutting him off was brash. She did it anyway. “And do you think it gives him a better shot than his current treatment plan?”
“It definitely could, yes,” Rosenthal said.
And that was all Tess needed. “If it’s the best chance he has, I don’t care how impossible it seems. I’m going to get him the care that might save his life. Whether you help me or not.”
“I am an absolute fucking idiot.”
Just as she had before, Tess aimed the words at no one in particular. But unlike before, this time, she got an answer.
“You’re not an idiot,” Charlie said, pushing back against her chair in the attendings’ lounge, and her husband—also both her and Tess’s intern—Parker Drake, nodded his agreement.
“You’re just in an untenable position,” he said.
“If by ‘untenable’ you mean ‘shitty enough to be a level-three biohazard’, then yep. Untenable fits.”