A/N: This note is addressed to the moronic troll skulking around this story. Since you do not have the courage or the integrity to put your name on your comments they will be removed or moderated. And the next time you decide to accuse someone of plagiarism, you should take the very simple step of checking the publication date on the stories in question. You will find that my work pre-dates whatever other story you think I stole from. "Just saying"

A/N-2: The movie reference in my last author's note is from Amadeus.

Alice I

Checks & Balances

Chapter 16

To say that Johnny was relieved after the chest tube came out would have been quite an understatement. He was more sore and surprisingly weaker than he had thought he would be after being in the hospital for only four days however, and Dr. Brackett admonished him not to be impatient with his recovery.

As they walked slowly down the corridor, with a nurse following behind pushing a wheel chair in case Johnny needed to sit, the young man looked over at the doctor. "So what did happen, Doc? How did radiology manage to mix up the x-rays?"

The question seemed to make Doctor Brackett somewhat uncomfortable, which seemed very strange to Johnny. "Honestly, Johnny, I have no idea how the mix up happened."

"I can answer that for you." A deep voice called from ahead of them. The elevator door had just opened and one of the first passengers off was the hospital administrator Nathan O'Brien. He stepped forward and shook Johnny's hand. "You must be paramedic John Gage."

Johnny took the proffered hand, looking between Dr. Brackett and the man in front of him. "Uh, hello."

"My name is Nathan O'Brien. I'm the hospital administrator."

As the man spoke Dr. Brackett noticed that Johnny was leaning more heavily on his IV pole and motioned for the nurse to bring the chair forward. As Johnny sat down Mr. O'Brien continued. "Let me first apologize on behalf of Rampart for the problems you experienced. If you would let me..." and the man moved around to the back of the chair to take over pushing it. "I'd like to take you down to radiology so I can show you exactly what happened and what we are doing to ensure that the same mistake will never happen again."

"Lead the way then." Johnny said, as he pulled his IV pole over to roll forward between the feet of the wheel chair. As they moved into the elevator the enigmatic administrator continued. "I went down to the radiology department myself and asked the technologists there to walk me through the process of taking an x-ray of a patient and what happens to the pictures from the start to finish. It took some detective work, but we finally figured out how the mix up occurred."

The elevator dinged and the hospital administrator wheeling a patient along in a wheelchair with the head of the ER trailing behind was a sight to see when they all exited on the ground floor at the far end of the ER hallway.

"I went down there myself" Dr. Brackett confessed, "But for the life of me, I couldn't figure it out so I am very curious to know what you found, Nathan."

The trio entered the Radiology department from a back entrance near the Special Procedures rooms. They took a short trip down the interior hallway on one side of the department, past huge file racks for X-Ray film folders with what looked to Johnny like some odd cryptic numbering system. All the film jackets had two brightly colored green stickers that were clearly meant to indicate the month and year, because the green stickers were covering a gold and blue sticker which covered several other layers of numbers all also in different colors. Then there were three black letters down the side and under that what looked like four more random numbers.

As O'Brien moved through the department he pointed out the different imaging areas within radiology. As they drew closer to the end of the hall there was a large area to the left with a counter on either side and above each counter there were two large banks of viewing light boxes stacked together. There were several films up with folders placed on the counters underneath each separate study. O'Brien stopped the wheelchair and said, "This is the ER control area. This is where all of the films that are done for, or requested by, the ER are taken and developed. We have two dedicated ER diagnostic rooms." He pointed to the open doors on either side of the far end of the work area. Johnny couldn't see much of the room on the left, but the room on the right he could see into a bit and recognized the x-ray table.

"This room," O'Brien indicated a closed door that was directly opposite the hallway "is the darkroom." We have a full time darkroom tech who runs films from the ER rooms as well as overflow from our GI rooms. That is the control area just behind us to the right. As it turned out the error happened very innocently. The department was slammed the day you had your x-ray Mr. Gage..."

"Please call me Johnny."

"All right, Johnny. Your films were taken in room 13 there on the right. The gentleman your study was mixed up with had his films done in room 12 on the left. When the technologist finished your study she put the cassettes on the counter outside her room with a 'flash card' like this." he said, holding up a small card with a name, date of birth, and other pertinent information on it.

"This card is used by the darkroom tech to put the patient name and information right onto the image. He has a device that is used in the dark room to do this. Only completed studies with all the film cassettes and flash card are set on the counters. In your case, Johnny, one of our house keeping staff had to come down to clean up a spill that occurred here."

As O'Brien said this one of the techs reached over and removed a cup of coffee that was sitting on one of the counters and slunk away to one of the x-ray rooms.

"At some point the identification cards for your films and that of the other patient fell from the counters and landed on the floor. The house keeper tried to get someone's attention but every tech was in the middle of a patient exam and the darkroom tech was busy running films." O'Brien pointed to a large machine that seemed to come right out of the back wall.

It was quite noisy now that Johnny's attention was directed to it. Just at that moment a film dropped out of the machine into a catch bin. It was quickly scooped up by a tech and tossed up on one of the light boards over the appropriate folder.

"The cards had somehow landed on the floor directly opposite to the counter they fell from. Not knowing what else to do, Raul, the housekeeper, put the cards back onto the counter he found them by."

Johnny whistled. "Jeese, so how did you figure this out?"

"Well I spoke with every person who was working that afternoon and finally someone mentioned calling housekeeping about a spill in control. I spoke with the housekeeper who responded to the request and he told me what had happened. He feels absolutely terrible about all of this and his wife has been making special meals for you ever since they realized what had happened."

The look of surprise on Johnny's face was comical. His expression seemed to toggle between blushing with pleasure and mild disappointment. "Man, and I though the cafeteria menu had suddenly gotten better." Johnny looked up at the administrator of the hospital and seemed to suddenly realize what he had just said, "Uh, um, sorry."

O'Brien couldn't help laughing as Johnny stammered. "No need to worry, Johnny. I've eaten the hospital food myself and completely understand. What I wanted to show you was what we plan to do to avoid any other incident like this occurring."

He pointed to an odd looking contraption that was sitting underneath the counter. It looked rather like a large metal box attached to a base plate and frame with some sort of black rubber-like accordion material attached to the frame that circled the center of the box.

This is called a pass box. What we are going to do is cut a hole in the wall between each of the x-ray rooms and their shared dark room. The pass box is installed and sealed tightly so that there is no leakage of light into the darkroom."

He reached under the counter and turned the pass box so that both Johnny and Dr. Brackett could see the front of the box. There were two doors with a toggle handle between them. One door was labeled 'EXPOSED' the other 'CLEAN'.

"There is another identical set of doors on the other side. The way this works is the films are taken in the x-ray room and the technologist puts the films into the pass box labeled exposed. The darkroom tech can then open the box on the other side from inside the darkroom and run the films from there. Now until we get the new flasher machines the tech will put the patient identification card in the pass box with their films. Now that is not to say that in the type of safety lighting used in the dark room that a card mix up won't happen. We will soon we will have a solution for that as well."

O'Brien picked up an x-ray cassette from a cart of them near the right side of the control area. He held the cassette up and showed it to them. There was a small black sliding door inch tall and about 3 inches wide at the top left corner of the cassette. This window will open only when the cassette is put into something called a flasher. It opens the slide door and shines a light onto the flash card which fits into the top of the machine and imprints the information on the identification card right onto the film. It is the same principal as what is used in the dark room, but this will allow the technologist to flash the patient name onto the film at the time the exam is done so it would then be absolutely impossible to mix up the wrong ident card with the wrong films. The pass boxes are an added measure of protection against inadvertent mix ups, and it will also increase the efficiency of the darkroom. From my perspective this is a win, win."

Dr. Brackett looked rather impressed by the whole thing. Johnny shook his head slowly then said, "Wow. You are going to have to spend some bucks on your renovations huh?"

"Undoubtedly, especially considering that the walls are lead lined and will make cutting a hole between room more of a challenge. Still, I believe that it's worth it. Patient safety should be our first consideration."

"But a more efficient darkroom certainly can't hurt anyone's bottom line." Dr. Brackett added.

By the time Johnny got back to his room, he wanted to take a nap, but he had breathing exercises to do with the respiratory therapist first. He couldn't believe how much - just breathing - could completely wipe him out.

Roy was able to stop by for a quick visit after a run shortly before the dinner trays were due to arrive. "How ya feelin', Junior?"

"Pretty good. Doc says as long as I have a good night I can go home tomorrow."

Though he was visibly exhausted, the grin on the young man's face showed his enthusiasm at the prospect of leaving the hospital.

"That great! I'll swing by after I get off shift in the morning and bring you home."

Johnny sat up a little straighter in bed. "Actually can you take me back to the station? I will need to get my car."

"Already taken care of, Pally. Chet made a run out to your apartment with Mike following in Big Red."

The look on Johnny's face was priceless. "Oh, man, that should get old lady Gower griping again. I'm sure I'll hear all about how it is never a good idea to have a big fire truck roll up into the complex, unless of course, there's a fire."

Roy was genuinely shocked. "You have a neighbor who doesn't like fire trucks?"

Johnny thought about that for a second then said easily, "Nah, it isn't fire trucks, it's anything and everything that doesn't fit into her view of how things should be. She went absolutely nuts on the garbage collector when the schedule changed and they began to pick up the garbage in the morning instead of the afternoon. They left little notes on all the mailboxes, which she also complained about, saying that it is a federal offense to tamper with the mail."

"How is leaving notes on mail boxes tampering with the mail?"

Johnny began to look more and more alert as he spoke, shaking the heavy feeling of fatigue with talk of home. "Well according to Mrs. Gower, only a federal mail employee can put any kind of mail in the box, and apparently, according to her, that includes notifications attached to the outside of them. Honestly, I think she is happiest when she is complaining about someone or something."

"Well that should make for a wonderful home coming. You wanna stay with us?"

Johnny thought about it for a moment. He knew that Roy had spent more time sitting in a chair worried about him than anyone. The last thing John wanted was for Roy or Joann to fuss over him any more. "Thanks for the offer, but I really would like to sleep in my own bed. Say I met the hospital administrator this afternoon."

Roy stepped over an sat down in the chair next to Johnny's bed. "Nathan O'Brien. What did you think of him?"

"I have to admit, for a suit, he is all right. He figured out how the mix up with the x-rays happened. Simple human error, actually. The identification cards fell on the floor and they got picked up and put back on the wrong films. So get this, he didn't go looking for someone to fire. After what you got put through I'm kind of surprised. Instead he ordered some pretty fancy equipment that will take all the guess work out and keep this from happening again. It is gonna cost the hospital some money too. They will be punching holes in the walls from two x-ray rooms into the dark room."

Roy whistled. "Wow, I gotta say I'm a bit surprised as well. I liked Mr. O'Brien when I met him, so I guess it shouldn't come as a surprise that his goal is to fix the problem rather than looking for someone to blame. I think Rampart is lucky to have him."

Just then there was a knock on the door and a tall hispanic man stepped into the room, followed by a very tiny woman. She was also hispanic, but she couldn't have been any taller than four foot eight or nine, and she was holding a foil covered dish in her hands. "Excuse me, senior. My name is Raul Oquendo. This is my wife, Alejandra. Senior, Gage, I have come to apologize. I now understand that because I placed your name card on the wrong table, you became very ill and could have died. We have both prayed for you since we found out what happened."

The young woman stepped forward and put the dish down on the rolling table next to the bed. "I asked a fireman named Marco what food you like so I could make some food that maybe is a little better than food from the cafeteria."

"I'll say. Thank you very much, the food was fantastic, but you didn't have to do that." Johnny looked up at Raul. "You know what? Accidents happen. Heck, it's accidents that my partner and I deal with all day long."

"Alejandra made for you a special dinner." Raul stepped back a little and let his wife take the tin foil wrap off the top of the dish. Inside were three packages, or what looked like little pacakages made from tortillas. "These are Chimichangas. Each one different: beef, chicken, and pork. The tortillas are loaded with meat, vegetables, and salsa ranchera."

Johnny sniffed the meal appreciatively. "Wow, Mrs. Oquendo, these smell terrific. I'm going to be discharged tomorrow, but I'll make sure your dish gets cleaned and left with the nurses."

The HT in Roy's hand chirruped to life, with LA dispatch requesting squad 51 to respond. "That's my Q, Junior. I'll see you tomorrow. It was nice to meet you Mr. and Mrs. Oquendo." Roy shook hands with Raul before he stepped to the door speaking to the dispatcher as he left the room.

The Oquendo's only stayed for a few more minutes and as much as Johnny enjoyed the food and was very glad to have an opportunity to thank the cook, he was ready to sleep for the rest of the night and was glad for some peace and quiet.

As he lay there quietly in the darkened room, Johnny thought about all of the things that happened and how everything in the end turned out. There were procedures and protocols in place both at Rampart and within the fire department to prevent bad things from happening, but sometimes they just happened anyway, sometimes people just fall through the cracks like Johnny did. Even though Johnny had serious consequences from a simple rescue, he felt good. The fire department had shown complete support for their men, the doctors handled the mistake with speed and efficiency, the hospital administrator fixed the problem instead of just firing someone. All in all even though a system of checks and balances isn't always foolproof, the LA County fire department and Rampart General Hospital came pretty damned close. With those thoughts running through his head, Johnny Gage drifted off to sleep.

The End

Final A/N: I am aware that the term hospitalist was not around in the 70s, but I don't know what the main doctor in the hospital would have been called back then. That is the reason I included an explanation of what a hospitalist is.
I have always welcomed constructive comments on any of my stories, but if you are just going to nit-pick a story that is clearly extremely well researched, saying that the story is "just to unbelievable at points that it makes it hard to read..." and then point out only one item (the hospitslist) as an example of how poorly written the story is, may I recommend you find another way to occupy your time.
The only reason I did not delete this unsigned review is because it is actually a comment about the story, however unsupported it may be.