Worst Case Scenario

RSS Feed Homepage

Articles: 1, 2

Chapter 54
2007-09-10 17:52:00
Angela bought a new dress in Nashville at Talbots for the occasion. What a difference two weeks had made. She couldn’t believe how things had turned out. The party tonight would be icing on the cake. Ironically, as Angela neared Weston Community Hospital’s physician’s entrance, the security guard that had just escorted her out of the hospital two weeks ago was standing near the front door. She thought of several witty things to say to him when she walked by him, but realizing most of them were obnoxious, she just decided to walk past him without saying anything. The party started at 7 PM, and Angela got there on time. This was a party she didn’t want to miss any part of. The party was in the conference room on the first floor of the building. There were hundreds of people already there when she got there, including many physicians wearing there white coats. “Congratulations Dr. Johnson” was prominently displayed over the entrance to the room. There was a ba...
More About: Chapter

Chapter 53
2007-09-10 17:51:00
Ken loved Carl and Nancy. They were like grandparents to him. And he sure hoped they were right about the roses. First, they had cost $45, and Carl didn’t specify the terms of the loan. Second, he hoped they worked—Ken had never felt so thoroughly overwhelmed with feelings for a woman before. Although it was difficult riding his bike holding the roses in one hand, this form of transportation would allow him to search the park for Angela more quickly. He was surprised that Angela had come to the park alone. He was surprised to pass Dr. Johnson’s yellow Hummer parked about four blocks away from the park. As far as he knew, Dr. Johnson didn’t have many friends on this side of Weston. Pulling into the parking lot, he noticed a Red 2007 Porsche Boxster. This was seemed out of place for Weston. He figured Angela would be at one of two places at the park—either at the top of the falls or at the swing set at the playground at the far end of the...
More About: Chapter

Chapter 52
2007-09-10 17:46:00
“Can you explain what possible motivation I would have for implanting a frozen embryo into Sarah Carson’s uterus?” Larry asked. “You know, that’s the thing that puzzled me the most,” Sarah started. “You don’t get to be chairman of a OB department and so well respected in your community if you practice shady medicine, so I can’t imagine you’ve ever done anything like this before, and I can’t understand why you would do it now,” she said. Dr. Johnson’s cell phone rang and he answered it. From hearing Larry talking to her grandson. He talked to his grandson for about four minutes, and then hung up. “Sorry, but that was my grandson. Now that he’s got his new kidney and is feeling better he wants to know when I’m going to get the bike that I promised I would get him after his transplant. He just got home from the hospital yesterday from his surgery and he already wants his bike. That’s okay, I’d do anything for that kid,” he explained. All ...
More About: Chapter

Chapter 51
2007-09-10 17:45:00
Ken tried to walk in to Carl and Nancy ’s house unnoticed. He was really pretty miffed at Angela. First she had essentially ignored the comment he made to her that implied that he loved her. How could she do that? How did she feel about him? And now she had indicated that she wondered if he had put a bogus frozen embryo in a patient’s uterus, and then documented in the chart that the pregnancy had been achieved naturally. This type of action was clinically appalling to him, and for her to think that he might have done this made him think that Angela really didn’t know who he was at all. Unfortunately, Carl was sitting in the front room when Ken tried to sneak in. “I heard the door slam shut over there. Everything okay?” he asked. “No, not really,” Ken answered. “What’s the matter?” Carl asked. “Carl, I’ll just cut right to the chase. You know how much I’ve always wanted to get married. I’m 42 years old now, and I’m starting to think time is running ou...
More About: Chapter

Chapter 50
2007-09-10 17:43:00
Angela was shocked. What had made Dr. Johnson change his mind? She quickly called over to Carl and Nancy's house and got directions to Cascades, and then headed over to Cascades park. She pulled into the parking lot. It was empty except for one other car. She did not see Dr. Johnson's Hummer and assumed he must be still coming. Cascades park was a beautifully wooded park, and had the unique feature of having some man-made water falls. They water falls were actually pretty ugly. They consisted of about 12 cement pools of water that looked like large stair steps. Each pool dripped over into the pool below it, and then the water at the bottom must have been pumped up to the top. For such state as beautiful as Tennessee, Angela thought it odd that a park would even take a stab at trying to imitate the natural beauty that surrounded them all around. There were some cement steps on either side of the man-made waterfalls, and Angela walked up to the top. She was surprised to see Dr. J...
More About: Chapter

Chapter 49
2007-09-10 17:35:00
How could she have known about the frozen embryo? As far as Larry knew, the only people that knew about the frozen embryo were himself, Dr. Adams, and Sarah Carson. All three, including himself, had very strong motivations not to reveal the details about Sarah’s conception. Maybe somebody in Dr. Adam’s lab had figured things out and let Angela know. Larry called Dr. Adams on his cell phone. “We got trouble Jay,” Larry started. “Larry, calm down. I can hear the tension in your voice again. When are you going to learn to trust me?” Dr. Adams replied. “No, I’m serious. This time we got big problems,” he said. “What’s the issue?” Dr. Adams asked. “Dr. Jackson knows about the frozen embryo,” Larry answered. “How could she know about the frozen embryo?” Dr. Adams asked. “That’s what I’m trying to figure out myself. Did you have anybody in your lab help you create the clone?” he asked. “You think I’m stupid?” Dr. Adams asked. “Did anyb...
More About: Chapter

Chapter 48
2007-09-10 17:31:00
Angela regretted implying that Ken might have been the one that implanted the frozen embryo as soon as she had made it. Everything he said was true, and her gut told her that it was Johnson who had implanted the bogus embryo. But Dr. Johnson's reaction to her had been completely unexpected. She had thought for sure that once he knew Angela knew something about the frozen embryo, that Dr. Johnson would want to know how she knew this, or what else she knew. Or at least, what Angela wanted in return for her silence. On the other hand, by agreeing to talk to her about it would almost be tantamount to him admitting that he had done it, so maybe he had played his cards right. Now, when she brought this up at the QA meeting, he would be thoroughly prepared to respond to her accusations. Given his nature, he would clearly be able to turn any such accusation around so that everybody there was sure that it was Ken Kessler that had implanted the frozen embryo. Heck, just simply the b...
More About: Chapter

Chapter 47
2007-09-10 17:29:00
Angela went into the family room where Ken was sleeping. Good to see he was concerned about how things were going. She gently shook him on the shoulder. “Hey, how'd it go?” Ken asked. “It didn't go,” she answered. “You've got to be kidding me,” he said. “Nope. I asked him if he wanted to talk with me about the frozen embryo he implanted in Sarah before the QA meeting or if he just wanted me to bring it up then,” she said. “And he didn't want to talk to you about it,” he asked. “No. And he sounded pretty convincing to me that he didn't know what I was talking about,” Angela said. “Angela, trust me, he knows exactly what you were talking about. If he sounded convincing it's because he's a good liar,” Ken said. “Or you're a good liar,” Angela said. “Are you accusing me of lying? You think that I put the embryo in Angela?” Ken asked. “I'm just saying that one of you must be lying, that's all,” she said. “That man is t...
More About: Chapter

Chapter 46
2007-09-10 17:23:00
Angela's phone rang about five minutes after she paged him. “This is Dr. Johnson, I was paged,” the caller explained. “Hi Dr. Johnson, I paged you. This is Dr. Jackson. Thanks for calling back,” she said. “Angela, I really don't think we have anything to talk about. I'm really sorry that things have turned out the way they have, but I don't think there's anything either of us can do to change anything,” Dr. Johnson said. “Actually, I think there is something that you could do that might change things,” Angela said. “I don't think so, Angela. I'm sorry,” Dr. Johnson said. “I think you could support me at the quality assurance committee so I could get my privileges reinstated,” Angela said. “Angela, you performed a symphysiotomy. I'm the chair of the department. It's my job to make sure that doctors that do this type of thing are disciplined,” Dr. Johnson said. “Dr. Johnson, I understand that. But you've never even listene...
More About: Chapter

Chapter 45
2007-08-31 00:22:00
Ken and Angela decided it would be best if Angela drove them home given that Ken had now been up for thirty hours in a row. Angela was feeling pretty down because she had just officially lost her job. Ken was exhausted but absolutely intrigued by the mysterious developments, especially Pastor Carson’s accusations that Ken had inserted some black market embryo into his wife’s uterus. During the two mile trip from the diner to Angela’s house, Ken fell deep asleep. When they got to her house, Angela had to shake Ken for almost three minutes before he woke up and was alert enough to get out to the car. She walked him over to Carl and Nancy’s house and told him that he needed to take a nap, and that she would talk with him after her meeting with the quality assurance committee at the hospital. “No, Angela. That won’t work. We have to call Central Tennessee Medical Supply about that $50,000,” he protested. “Ken. You are exhausted. You need to get some sleep. ...
More About: Chapter

Chapter 44
2007-08-31 00:18:00
Ken closed the door to the cleaning supply closet just as the person entering the clinic opened the door to the office. Ken had showered for over 24 hours and hoped he Angela would assume his body's odor was coming from the cleaning supplies. Maybe he should preemptively strike, and assign the blame himself. The closet was very small, only about three feet deep by four feet wide. There was a vacuum sitting on the floor along with a bucket with some rags in it, which left little room for the two, and consequently they were standing snug against each other. “Who just came in?” Angela asked. “Ssshhhh,” Ken said. “If somebody finds us, we are really going to be busted,” he whispered into Angela’s ear, enjoying the smell of her perfume. It had been so long since he had been this close to a woman, and he was surprised with the adrenaline surge he was experiencing because of it. He was overwhelmed by the moment, her beauty, her scent, just everything about her. H...
More About: Chapter

Chapter 43
2007-08-01 21:36:00
Driving back to Weston at 1 AM after having warm pie and milk with Angela’s mom, Ken was glad he had downed the two energy boost drinks on the way to Taylorville. Angela sleeping so peacefully in the passenger’s seat didn’t make it any easier for him to stay awake for the four hour drive back either. But he didn’t want to miss the opportunity of being able to get in to the office while Angela was still an employee, so he had to keep driving. Angela was clearly exhausted, as she slept like a baby even though he had opened all of the car’s windows to help keep him awake. They really needed to make the drive in three hours, in order to have a chance of getting to the office by 5 AM. Even then, that would only give them a maximum of two hours before the first office worker would arrive at the office. Fortunately, the traffic on the interstate was sparse, and the state patrol must have been taking the night off, because he never saw a single patrol unit the entire way b...
More About: Chapter

Chapter 42
2007-07-18 17:44:00
Ken had already gone to sleep when Angela had called him and asked him to go on a road trip with her. The whole situation was entirely unusual. He had just met this girl yesterday, thanks to Carl and Nancy. And now, just barely more than twenty four hours later, she’s asking him to go on a road trip with her. Had Ken’s life not been so tumultuous in the last six months, he probably would have politely declined. But he knew what Angela must be going through, and he knew she clearly needed a friend, so he said yes. That she was a beautiful tall brunette helped too. After talking with her this morning, Ken was starting to have a crush on Angela. He was sure that his feelings were not reciprocated, him being fifteen years older than her and currently homeless. He put on some clothes, tried to comb his hair, grabbed his tooth brush and a change of clothes and headed for the front door. “Where you going, Ken?” Carl asked. What to say? Carl and Nancy would not appro...
More About: Chapter

Chapter 41
2007-07-18 17:40:00
Usually a cautious driver, Angela surprised herself as her Volvo S80’s wheels screamed as she floored it pulling out of the hospital parking lot. How dare they remove her from the hospital like that. Especially in front of a patient. Nobody deserved to be treated like that. She looked in the rear view mirror and saw the security chief standing on the steps of the doctor’s entrance, watching to ensure she left the hospital. He sure thought he was tough. And the nurse. Why did the nurse dislike her so much that she took such pleasure telling her about the fax they had received. She was giddy about the whole thing! Unpleasant as this incident had been, it had made one thing abundantly clear to Angela. At the very least, the hospital, and probably Dr. Johnson, did not have her best interests in mind. Otherwise they would have been a little more professional about informing Angela of her suspension of her privileges. All she was doing was talking to a pa...
More About: Chapter

Chapter 40
2007-07-18 17:12:00
Talking with Ken had only further confused Angela. What he had said made sense, but he was clearly encouraging her to fight both the hospital and Dr. Johnson, something he had been unwilling to do himself. Although now she didn’t feel that he was back in town to take his old job back—he claimed he was back in town to get back on track because this is “where he was derailed”, she still wondered if he had some selfish motive behind his recommendation that she put up a fight. On the one hand, he was somebody who might be able to intimately understand what she was going through, having himself been fired by Dr. Johnson. But on the other hand, why listen to him? He was very bitter, likely because of how he had handled dealing with his departure from Johnson's office. And, unbelievably, the guy was homeless. How could this be possible, she wondered. Plus, Angela didn’t consider herself much of a fighter. Her mom certainly was. Angela and her mom had been through a...
More About: Chapter

Chapter 39
2007-07-18 17:07:00
Mr. Cotts walked into the boardroom five minutes late without apology. The same people were in attendance as at the previous two meetings to discuss the Carson case. “It’s 7:05 PM, an hour after I’m usually sitting down for dinner, so I hope we can take care of this expeditiously,” Mr. Cotts started. He looked at Dr. Varghese. “Kamel, can you summarize what the med exec committee decided about Dr. Jackson?” “We just met earlier this afternoon, and it was decided to temporarily suspend Dr. Jackson’s hospital privileges,” he said. “Temporarily? Excuse me? What does she have to do to justify having her priviliges permanently revoked—murder somebody?” Mr. Cotts asked. “We’re just following the hospital bylaws, sir,” Dr. Varghese said. “Are you telling me that the hospital bylaws state permit a doctor to screw up any way imaginable and their privileges are only temporarily revoked? Someho...
More About: Chapter

Chapter 38
2007-07-18 17:05:00
Angela woke up the next morning after the surprise blind date not really knowing what to do. The practice manager at the office had called and told her that Dr. Johnson had canceled all of her patients indefinitely and that he would assume all call responsibilities until further notice. Essentially, Dr. Johnson was giving an ultimatum: quit or be fired. Angela had never been so embarrassed in her life. That’s probably why she hadn’t called any of her former attending physicians at her residency program for advice. This would have just confirmed their suspicions that she was not cut out to be an OB/GYN. She also felt like she was on borrowed time. Even though Dr. Johnson had not set a specific deadline for her to make a decision, she knew that the longer she waited, the greater the chance that she might find out that Dr. Johnson and the hospital had acted first, with the hospital revoking her admitting privileges and Dr. Johnson firing her. While wai...
More About: Chapter

How far would you go to get a kidney for a child y...
2007-07-14 17:58:00
How far would you go to get a kidney for a child you loved?Would you:tell a small lie?tell a big lie?smear placenta cream with Vitamin E all over your body?Click here only if you want to read a novel in progress about an OB/GYN willing to do anything to get a kidney for his grandson.PLEASE NOTE:This novel should not be construed as medical advice for how to obtain or perform a kidney transplant. Individuals needing such advice are advised to seek professional advice from their piano teachers.If unfortunately you are a clone who was cloned to be a kidney donor for an obstetrician's grandson, please click here.If you are an OB/GYN, please click here.If you came to this site to claim yourfree McDonald's certificate, click here.
More About: Child , Kidney

Mr. T's Advice to OB/GYNs
2007-07-14 17:56:00
"Few people know I used to be a busy OB/GYN. I pity the fool who practices obstetrics."
More About: Advice , Vice , Ice T

Chapter 37
2007-07-14 05:31:00
Angela felt a little bad accepting Nancy's invitation to come over for dinner, as she had not yet written a thank you note nor returned the favor for the lunch that Carl and Nancy had so far. But she couldn't resist. Carl and Nancy were so warm, and she just felt more at peace with things whenever she was with Nancy. She wondered who the other guest would be. At least Angela would get to meet somebody else from Weston, she thought. Angela locked her doors, ensured she had her house keys, and walked over to Carl and Nancy's, and arrived at 6:15, fifteen minutes late. She hadn't intended to be late, but had fallen asleep and had not bothered to set the alarm. “Hello young lady,” Carl said, opening the door. “Hi Carl. How are you doing?” she asked. “I really can’t complain. I've got a wonderful wife and a great new neighbor. What more could you ask for?” “I don't know. Having a spouse to go through life with sounds pretty good to me...
More About: Chapter

Chapter 36
2007-07-14 04:56:00
Angela had been anxiously awaiting Wednesday to talk with Dr. Johnson to get his opinion on what had happened. She was finished seeing her last patient at 3:45, and waited for him in her office until he was done. She heard him say goodbye to his last patient at 6:20. She figured he'd come down to her office when he was done, but he didn't. She waited an additional fifteen minutes and then finally went down to his office. His door was opened, but she knocked anyway. “Come on in, Angela, let's talk,” he said with his usual warm voice. “Where do you want to start?” he asked. “Well, I'd really appreciate your opinion about everything that happened at the hospital my first night on call,” she said. “Hmmm. What is my opinion? This is kind of hard for me to answer. Well, I'm a little puzzled by the whole situation, to be totally honest with you, Angela. I certainly have heard about a pubic symhysiotomies—they’re mentioned in every textbook discuss...
More About: Chapter

Chapter 35
2007-07-11 04:35:00
As soon as all were assembled in the boardroom again on Tuesday, Mr. Cotts started the meeting by asking the hospital attorney a question: “Claire, would you mind summarizing the worst case scenario here, as far as the hospital is concerned, please?” “My understanding of the situation is that Dr. Jackson performed a pubic symphysiotomy to address a shoulder dystocia. From my research, this procedure is almost never performed in the United States for obvious reasons. The patient cannot walk at this point. Dr. Rollins, the orthopedist, is managing her recovery from the symphysiotomy. At this point, he does not feel that the pubic symphysis needs to be surgically repaired, but he told me that might become necessary. He said that best case scenario is that she will be able to walk using a walker in two weeks, and might be able to walk normally in three months. He says that the worst case scenario is that she will not be able to start walking for four to six weeks, and th...
More About: Chapter

Chapter 34
2007-07-11 04:03:00
Ken felt awkward staying at Carl and Nancy’s house, but after two days he was amazed how just being around these content people had recharged his batteries. He was also thoroughly enjoying Nancy’s cooking. Tonight, during supper, Ken wasn’t quite clear how to broach the subject of the beautiful woman he had seen living in the house next to Carl and Nancy, so he just decided to be blunt.“Who’s your neighbor?” Ken asked. “She’s pretty isn’t she,” Carl said. “Carl, I can’t believe you said that,” Nancy said. “Nancy, as you are aware, I am a male. You should worry if I say those things when you’re not listening, and I assure you I don’t,” Carl said. “Well after thirty years of marriage, you better not be saying those kinds of things when I’m not listening,” Nancy responded. “Do you think she’s pretty, Carl?” Nancy asked. “That’s the question I was asking Ken. Now let’s give Ken a chance to respond, okay d...
More About: Chapter

Chapter 33
2007-07-11 03:39:00
Only four of the eighteen patients scheduled to see Angela on Tuesday morning showed up. The rest either canceled or just didn’t come. Elva Sanders was a sixty seven year old patient who wanted to see a gynecologist because her “uterus was falling out.” Jessica Richards was a pregnant patient that Dr. Johnson had been seeing. She was two weeks away from her due date. On exam, Angela realized that Jessica's baby was in a breech presentation and would need a cesarean section. Sarah Edwards had been referred to Angela by a Family Physician for evaluation of an abnormal pap smear. Linda Fry had been instructed to see a gynecologist 48 hours after she was discharged from the emergency room for follow up on her pelvic pain. Angela had enjoyed interacting with each of these patients. And since only four showed up, she had plenty of time to spend with each patient, something that she liked doing. Why the other fourteen didn't show up Angela wasn't sure why, but she was...
More About: Chapter

Chapter 32
2007-07-11 03:16:00
Angela woke up at 6 AM on Monday determined to have a good day. She completed her two mile run in fourteen minutes. She ate some oatmeal, showered, and put on her a new blue skirt that she had bought in Atlanta before she moved to Weston. Angela arrived at the office at 7:55, five minutes before her first patient was scheduled. She said polite “hellos” to everybody, but did not spend a lot of time making small talk with the staff. She went to her office and pulled out her laptop out of her leather bag and started doing an internet search on management of shoulder dystocia. Before she went and talked with Sarah and James, she wanted to make sure she had done everything she was supposed to for a shoulder dystocia. She sent a helpful review to the printer, and en route to picking up the document passed by the waiting room, which was empty. This did not help ease the discomfort she was already feeling from the fact that nobody was talking with her. “Uh, Dr. Jac...
More About: Chapter

Chapter 31
2007-07-11 00:57:00
Nancy wasn’t expecting anybody, and so was somewhat surprised when she heard the knock at the front door. “May I help you?” she asked. “You don’t recognize me do you?” the unkempt man asked. “I don’t think I can help you, and would appreciate it if you would leave. Why don’t you go to the homeless shelter downtown,” Nancy replied, and closed the door. “Nancy!” the man yelled, knocking again. That voice sounded somewhat familiar, but Nancy couldn’t really place it. She was even more puzzled about how the man knew her name. Had Carl been home, maybe she would have been more accommodating, but in his absence, Nancy had decided not to take any chances.Now the man started ringing rang the doorbell. “If you don’t leave, I’m going to call the police,” Nancy yelled through the doorbell. “Nancy, it’s me, Ken,” Ken replied. Ken Kessler, of course. That was Ken’s voice. Nancy jerked the door open. “Ken? Is that ...
More About: Chapter

Chapter 30
2007-07-11 00:21:00
Neal Cotts sat at the head of the massive mahogany table in the hospital boardroom. Dr. Johnson sat directly to his right. Across from him sat Claire Armstrong, the hospital attorney. Dr. Varghese, the hospital’s chief of staff sat to the left of Ms. Armstrong. Mr. Cotts had been the chief executive officer of Weston Community Hospital for the last twenty years, and he had overseen the growth of the hospital from a small, 50 bed hospital to a very profitable 200 bed hospital that offered very respectable care. He was the least educated and the most highly paid of anybody in the room, but since this meeting was being held in the boardroom of his hospital, everybody looked to him to start the meeting. After several minutes of small talk about his recent trip to Aruba, Mr. Cotts took the lead. “Well, I’d love to keep talking about how beautiful Aruba was. Actually, given what has just happened here, I wish I was still there on the beach. But unfortunately I don’t...
More About: Chapter

Chapter 29
2007-07-10 23:06:00
Larry slammed the phone down long enough to get a dial tone and then immediately dialed Dr. Adams. “THEY’RE TRANSPLANTING BOTH KIDNEYS AND MY GRANDSON ISN’T EVEN GETTING ONE OF THEM!” he yelled. “Larry, what’s going on? It’s one o’clock in the morning,” he said. “I just called over the OR at University Hospital. They’ve already removed the kidneys. They’re putting one of the kidneys in some other kid who’s already on the table, prepped and ready to go. They haven’t called my daughter to have her bring Jimmy in,” Larry said. “I thought you said Jimmy was next in line for a kidney if one that matched became available,” Dr. Adams said. “That’s what they told us!” Larry said. “What about the other kidney?” Dr. Adams asked. “I’m not sure, but from talking with the OR I think they already shipped it off to another hospital for another recipient,” Larry said. ...
More About: Chapter

Chapter 28
2007-07-10 04:31:00
As instructed, the charge nurse on labor and delivery at Weston Community had notified Dr. Johnson at 6PM that the University Hospital NICU had called to say that the Carson baby had died. Now it was midnight, and his daughter had not received any call from the transplant coordinator about an available kidney. Larry knew this was a time where he had to be especially cautious not to raise suspicion. He suspected people already wondered if he had coerced the Carsons into continuing the pregnancy because he had a grandson in need of a kidney transplant. But six hours ago, when he learned of the clone's death, he figured he would be at University Hospital by now, sitting in the waiting room with his wife and daughter while his grandson was having receiving a new kidney. But instead, he was at his home, unable to sleep, wondering what was going on. He had called his daughter several times to make sure she had her phone on, which she did. Larry decided it was time to find out what...
More About: Chapter

Chapter 27
2007-06-24 05:20:00
Angela woke up a little confused when the doorbell rang. At first she thought it was her pager, but then somebody rang the doorbell again when she was looking for her pager and she realized someone was at the door. 5:30 PM. The stress must be getting to her. After got home from the hospital around 10 AM and had gone into her bedroom to lie down for just a few minutes. “Nancy and I are cooking some burgers on the grill. Want to come over?” Mr. Trotter asked. “That is so nice of you to offer, Mr. Trotter. Thank-you, by the way, for taking me to the hospital. I’d love to come over, but I actually have a lot of unpacking to do,” Angela replied. “How did everything go over at the hospital yesterday anyways?” Mr. Trotter asked. Something in the way he asked made Angela wonder if he already knew the answer to the question. “Uh, so-so,” Angela said. “You sure you don’t want to come over? I know can be lonely moving into a new town by you...
More About: Chapter