Chapter 10 - The Cost
The cost to Grace Holloway was not what she had expected.
She had expected to be transferred. She had expected to be reprimanded. She had expected to be told, by some senior officer in some office in some building, that she had done the right thing but that the right thing had consequences and that the consequences were that she was going to be assigned to a hospital in the middle of nowhere for the next three years.
What happened instead was different.
Admiral Wells called her into her office on a Wednesday afternoon, six weeks after the Article 32 hearing, and she said, "Lieutenant Holloway, I want to tell you something, and I want you to listen to me carefully and not interrupt."
"Yes, ma'am."
"The Navy has a problem. The Navy has a problem with medical record fraud. It is not a problem that is limited to Commander Whitfield. It is a problem that is systemic. It is a problem that exists because the system rewards physicians for discharging patients and does not reward them for keeping patients. It is a problem that exists because nurses are trained to report up the chain of command and the chain of command is staffed by physicians who have an interest in not hearing the report."
Grace did not say anything.
"The Navy is going to fix this problem. The Navy is going to fix this problem by creating a new office — a patient safety office — that reports directly to the surgeon general and that has the authority to investigate any patient safety concern at any naval medical facility in the world. The Navy is going to staff that office with physicians and nurses and investigators. And the Navy is going to hire a nurse to be the deputy director of that office."
Wells paused.
"I have recommended you for that position," she said.
Grace stared at her.
"Ma'am," she said. "I have nine years of experience. I am a lieutenant. I have never worked at the headquarters level. I have never—"
"You are a lieutenant with nine years of experience and you kept a second chart because you could not trust the first one. You are exactly the person I want in that office." Wells leaned forward. "Lieutenant Holloway, I am not asking you whether you want the job. I am telling you that the job is being created and that you are going to be in it. The only question is whether you want to be the deputy director or whether you want to be the director."
"Ma'am—"
"You are not going to be the director. The director is going to be a captain. You are going to be the deputy director. You are going to be the person in that office who has actually stood in a corridor and told a commander that she was not going to discharge a child. You are going to be the person who is going to make sure that the next time a nurse at a naval medical facility anywhere in the world keeps a second chart, she has somewhere to send it."
Grace's eyes stung.
"Ma'am," she said. "I don't know what to say."
"You don't have to say anything. You have to say yes." Wells stood up. "Will you take the job?"
Grace Holloway looked at her.
"Yes, ma'am," she said. "I will take the job."
"Good." Wells held out her hand. "Then let me be the first to congratulate you, Deputy Director Holloway."
Grace shook her hand.
Then she went home and sat in her car in the parking lot of her apartment building and cried.
She did not cry for long. She cried for nine minutes. She had been keeping count of things for nine years and she knew that she cried for nine minutes.
May you like
Then she wiped her face and went inside.
She had to study. She had a lot to learn. She had a job to do.
