Ten

Cassi had not been a hospital inpatient since college. Now with medical school and internship behind her, it was a very different experience, just as Robert had suggested. Knowledge of all that could happen made the process far more frightening. Since she’d ridden into the hospital with Thomas, she was there far too early to be admitted. In fact, she’d been told she would have to wait until ten before the proper clerks were available. When Cassi protested that people were admitted all night long through the emergency room, the secretary just repeated that Cassi had to come back at ten.

After spending three unproductive hours in the library, much too nervous to concentrate on anything more demanding than Psychology Today, Cassi went back to admitting. The personnel had changed, although their attitude hadn’t. Instead of smoothing the way through the admitting procedure, they seemed intent on making it as harrowing as possible, as if it were a rite of passage. Now Cassi was informed that she had no hospital card, and without one she could not be admitted. A disinterested clerk finally told her to go to the ID office on the third floor.

Thirty minutes later, armed with a new ID which looked suspiciously like a credit card, Cassi returned to admitting. There she was confronted with another seemingly insurmountable problem. Since she used her maiden name, Cassidy, in the hospital because it was the name on her medical degree, and since Thomas had taken out her health insurance under Kingsley, the secretary claimed they needed her marriage certificate. Cassi said she didn’t have it. It wasn’t something she’d imagined she’d need to be admitted to the hospital, and surely they could just call Thomas’s office and get it straightened out. The clerk insisted the computer had to have the certificate. She was only the machine’s handmaiden, or so she said. This impasse was finally solved by the admitting supervisor who somehow got the computer to accept the information. Finally Cassi was assigned a room on the seventeenth floor, and a pleasant woman in a green smock, with a badge that said MEMORIAL VOLUNTEER, escorted Cassi upstairs.

But not to seventeen. First Cassi was taken to the second floor for a chest X ray. She said she had just had one six weeks ago during a routine physical and did not want another. X ray claimed anesthesia would not anesthetize anyone who was not X-rayed, and it took Cassi another hour to get the chief of anesthesia to call Obermeyer, who in turn called Jackson, the chief of radiology. After Jackson checked Cassi’s old film, he called Obermeyer back, who called back the chief of anesthesia, who called back the radiology clerk to say that Cassi didn’t need another chest film.

The rest of Cassi’s admission went more smoothly, including the visit to the lab for standard blood and urine analysis. Finally Cassi was deposited in a nondescript light blue hospital room with two beds. Her roommate was sixty-one and had a bandage over her left eye.

“Mary Sullivan’s the name,” said the woman after Cassi had introduced herself. She looked older than her sixty-one years because she wasn’t wearing her dentures.

Cassi wondered what kind of surgery the woman had had on her eye.

“Retina fell off,” said Mary, as if noting Cassi’s interest. “They had to take the eye out and glue it back on with a laser beam.”

Cassi laughed in spite of herself. “I don’t think they took your eye out,” she said.

“Sure did. In fact, when they first took my bandage off I saw double and thought they’d put it back in crooked.”

Cassi wasn’t about to argue. She unpacked her things, carefully storing her insulin and syringes in the drawer of her nightstand. She would take her normal injection that evening, but after that she was not to medicate herself until she was cleared to do so by her internist, Dr. Mclnery.

Cassi changed into pajamas. It seemed a silly thing to do at that time of day, but she knew why it was a hospital rule. Putting the patients into bedclothes psychologically encouraged them to submit to the hospital routine. Cassi could feel the change herself. She was now a patient.

After all her years at the hospital, she was amazed at how uncomfortable she felt without the status of her white coat. Just leaving her assigned room made her feel uneasy, as if she were possibly doing something wrong. And when she emerged on the eighteenth floor to visit Robert, she felt as if she were an intruder.

There was no answer when she knocked on 1847. Quietly she pushed open the door. Robert was flat on his back, snoring gently. At the corner of his mouth was a single drop of partially dried blood. Cassi went alongside the bed and gazed at him for a few moments. It was obvious he was still sleeping off his anesthesia. Like a true professional, Cassi checked the IV. It was dripping smoothly. Cassi kissed the end of her finger and touched it to his forehead. On her way to the door, she noticed a pile of computer printouts. She went over and glanced at the first page. As she expected it was the data from the SSD study. For a moment she considered taking it with her, but the thought of Thomas’s finding it in her room made her hesitate. She’d read it with Robert later.

Besides, it she were to take her friend’s new theory seriously, it was not the sort of evidence she cared to have in her room the night before an operation.

 

Thomas opened the door to his waiting room and crossed to the inner office. He nodded a greeting to the patients and mentally cursed the architect for not providing a separate entrance. He’d prefer to be able to get to his office unseen. Doris smiled as he approached but didn’t leave her seat. After the episode the day before, she felt a little gun-shy. She handed him his messages.

Inside his office, Thomas changed to the white coat he liked to wear when he saw his patients. He felt it encouraged not just respect but obedience. Sitting at his desk, he ran quickly through the multitude of phone calls until he got to Cassi’s. He stopped and stared at the pink slip. Room 1740. Thomas frowned; it was a semiprivate directly opposite the nurses’ station.

Snatching the phone off the hook, Thomas put in a call to the director of admissions, Grace Peabody.

“Miss Peabody,” said Thomas with irritation. “I’ve just learned that my wife has been admitted to a semiprivate. I really wanted her to have her own room.”

“I understand, but we are a little crowded right now, and she was classified as a semi-emergency.”

“Well, I’m sure you can find her a private room since I feel it’s important. If not, I’ll be happy to call the hospital director.”

“I’ll do the best I can, Dr. Kingsley,” said Miss Peabody with irritation.

“You do that,” said Thomas and slammed the phone down.

“Damn!” He hated the pea-brained bureaucrats who were running the hospital these days. They seemed intent on creating maximum inconvenience. He had trouble imagining how anyone could be so shortsighted not to give the wife of Memorial’s most famous surgeon a private room.

Glancing at the schedule that Doris had placed on his desk, Thomas massaged his temples. His head had begun to pound.

Hesitating only briefly, he yanked open the second drawer. After three bypasses and with twelve office patients on the agenda, he deserved a little help. He got out one of his peach-colored tablets and gulped it down. Then he pressed the intercom button and told Doris to send in the first appointment.

Office hours went better than Thomas had anticipated. Out of the twelve patients there were two postop visits that required no more than ten minutes each. Of the other ten, Thomas signed up five bypass cases and one valve replacement. The other four patients weren’t operative and should not have been sent to Thomas in the first place. He got rid of them quickly.

After signing several letters, Thomas called Miss Peabody back.

“How does room 1752 sound?” asked Miss Peabody haughtily.

Room 1752 was a private corner room at the end of the corridor. Its windows faced west and north with a fine view of the Charles River. It was perfect, and Thomas said so. Miss Peabody hung up without saying good-bye.

Thomas changed back to his suit coat and, after telling Doris he’d see her later, left for the Scherington Building. He made a brief stop in X ray to see some films before going to visit Cassi.

When he reached seventeen, he was surprised to find his wife still in 1740. He pushed in without knocking.

“Why haven’t you moved?” he demanded.

“Moved?” asked Cassi, confused. She’d been talking with Mary Sullivan about having children.

“I made arrangements for you to have a private room,” said Thomas irritably.

“I don’t need a private room, Thomas. I’ve been enjoying Mary’s company.”

Cassi tried to introduce Thomas, but he was already pressing the call button.

“My wife is going to be treated properly,” said Thomas, glancing down the hall to see where the nursing staff was hiding out. “If any of these supposedly indispensable hospital administrators have a member of their family in this hospital, they always make sure they have a private room.”

Thomas succeeded in causing an uproar and acutely embarrassing his wife. She had not wanted to bother the nurses when she was feeling well, but for almost a half hour, the entire staff was kept busy moving Cassi to her new room.

“There,” said Thomas finally. “This is much better.”

Cassi had to admit the room was more cheerful. From her position in bed she could see the wintry sun touching the horizon. While she hadn’t liked all the fuss, she was touched by Thomas’s apparent concern.

“Now I have some good news,” he said, sitting on the edge of the bed. “I talked with Martin Obermeyer, and he said you should feel fine in a week for sure. So I went ahead and reserved a room in a small hotel on the beach in Martinique. How does that sound?”

“That sounds wonderful,” said Cassi. The idea of a vacation with just the two of them was something to look forward to even if for some reason it didn’t work out.

There was a knock at the partially opened door, and Joan Widiker peered around the edge.

“Come in,” said Cassi, and introduced her to Thomas.

“I’m pleased to meet you,” said Joan. “Cassi has spoken of you often.”

“Joan is a third-year psychiatry resident,” explained Cassi. “She’s been a big help to me, especially in building up my confidence.”

“It’s nice to meet you,” said Thomas, feeling an instant antipathy. He could tell she was one of those women who wore their femininity up front like a badge of privilege.

“I’m sorry to barge in like this,” said Joan, sensing she was interrupting. “I really just stopped by to tell Cassi that all her patients are being well taken care of. They all wished you the best, Cassi. Even Colonel Bentworth. It’s the strangest thing,” laughed Joan. “Your having a medical problem seemed to have had a therapeutically beneficial effect on them all. Maybe all psychiatrists should have surgery once in a while.”

Cassi laughed, watching her husband straighten his coat.

“I’ll come back another time,” he said. “I’ve got rounds.” Turning back to Cassi he gave her a kiss. “I’ll see you in the morning before surgery. Everything is going to be fine. Just get a good night’s sleep.”

“I can’t stay either,” admitted Joan after he left. “I have another consult on the medical floor. I hope I didn’t chase your husband away.”

“Thomas is just being wonderful,” beamed Cassi, eager to share the good news. “He’s been so considerate and supportive. We’re even going on a vacation. I guess I was wrong about the extent of his drug taking.”

Joan questioned Cassi’s objectivity, remembering the degree of her dependency on Thomas. But she kept her thoughts to herself and just told Cassi how glad she was that things were working out well. Wishing her all the best, Joan departed.

For a while Cassi lay in her bed watching the sky change from pale orange to a silvery violet. She wasn’t sure why Thomas was being so nice to her. But whatever the reason, Cassi was infinitely thankful.

As the sky finally became dark, Cassi began to wonder how Robert was doing. She didn’t want to call in case he was still asleep. Instead she thought she’d run up there and see for herself.

The stairwell was conveniently opposite her room, and Cassi climbed quickly to the eighteenth floor. Robert’s door was closed. She knocked quietly.

A sleepy voice told her to come in.

Robert was awake but still groggy.

In response to Cassi’s question, he assured her that he had never felt better. His only complaint was that his mouth felt like a hockey game had been played in it.

“Have you eaten?” asked Cassi. She noticed the computer printout had been moved to his night table.

“Are you kidding?” asked Robert. He held up his arm with his IV. “Liquid penicillin diet for this guy.”

“I’m having my surgery in the morning,” said Cassi.

“You’re going to love it,” said Robert, his eyelids resisting his attempts to keep them open.

Cassi smiled, squeezed his free hand, and left.

 

The pain was so intense Thomas almost cried out. He’d stumbled against the antique trunk Doris kept at the foot of her bed. He was searching for his underwear in the dim light. Deciding he didn’t care if he did wake her up, he switched on the lamp. No wonder he hadn’t been able to find his shorts. She’d thrown them all the way across the room, where they had caught on one of the knobs on her bureau.

After finding all his clothes, Thomas switched off the light and tiptoed into the living room, dressing rapidly. Being as quiet as possible, he let himself out. When he reached the street, he checked his watch. It was just before 1:00 A.M.

He went directly to the surgical locker room, took off the clothes he’d just put on, and donned a scrub suit. Walking down the corridor, he paused outside the one OR that was in use. He tied on a mask and pushed through the door. The anesthesiologist told Thomas that the patient had suffered a dissecting aneurysm following a catheterization attempt that afternoon.

One of the staff abdominal surgeons was the attending on the case. Thomas went up behind him.

“Tough case?” asked Thomas, trying to see into the incision.

The doctor turned around and recognized Thomas. “Awful. We haven’t determined yet how far up the aneurysm goes. May extend into the chest. If it does, you’d be a Godsend. Will you be available?”

“Sure,” said Thomas. “I’ll probably catch a little sleep in the locker room. Give me a call if you need me.”

He left the OR and wandered back down the hall to the surgical lounge. Three nurses who’d just finished a case were taking a break there. Thomas waved at them and continued on to the locker room.

 

Cassi’s evening had passed pleasantly enough. She’d given herself her insulin, eaten a tasteless dinner, showered, and watched a little television. She’d tried to read her psychiatry journal but finally had given up, realizing she could not concentrate. At ten o’clock she’d taken her sleeping pill, but an hour later she was wide awake trying to analyze the consequences of Robert’s findings. If there really was sodium fluoride in Jeoffry Washington’s vein, then someone in the hospital was a murderer. Given the fact that she would be coming back from the OR tomorrow groggy and helpless, it was not surprising the thought kept her from sleeping.

She was restlessly turning from side to side in the dark when she heard a sound. She wasn’t positive but she thought it had been the door.

Cassi lay on her side, holding her breath. There were no more noises, but she felt a presence as if she were no longer alone in the room. She wanted to roll over and look, but she felt irrationally terrified. Then she heard a very definite noise. It sounded like a glass object touching her night table. Someone was standing directly behind her.

Breaking the paralysis her terror engendered took every ounce of mental strength Cassi possessed. But she forced herself to turn toward the door.

She gave a muffled cry of fright as she found herself staring at a shadowed figure in white. Her hand shot out and flipped on her bedside reading lamp.

“My God! You startled me!” said George Sherman, pressing a hand to his chest in a theatrical demonstration of distress. “Cassi, you’ve just taken ten years off my life.”

Cassi saw a huge bouquet of dark red roses in a vase on her night table. Attached to the side was a white envelope with “Cassi” written on it.

“I’m sorry. I guess we scared each other,” said Cassi. “I had trouble falling asleep. I heard you come in.”

“Well, I wish you’d said something. I expected you’d be asleep and didn’t want to wake you.”

“Are the beautiful roses for me?”

“Yes, I thought I’d be through much earlier, but I got tied up at a meeting until a few minutes ago. I’d ordered these flowers this afternoon and wanted to be sure you got them.”

Cassi smiled. “That was so kind of you.”

“I heard you were to be operated on in the morning. I hope everything goes well.” He suddenly seemed to realize she was sitting up in her nightgown. He reddened, whispered a fast goodnight, and beat a hasty retreat.

Cassi smiled in spite of herself. The vision of him knocking her wine into her lap came back to her. She detached the envelope from the roses and slipped out the card. “All the best from a secret admirer.” Cassi laughed. George could be so corny. At the same time she could understand his reluctance to sign his name after the scene Thomas had pulled at Ballantine’s.

Two hours later Cassi was still wide awake. In desperation she threw back the covers and slid out of the bed. Her robe was draped over the chair, and she pulled it on, thinking maybe she’d see if Robert was awake.

Talking to him might finally calm her down enough to sleep.

If Cassi had felt out of place walking the hospital dressed as a patient that afternoon, now she felt positively delinquent. The corridors were deserted, and within the stairwell there wasn’t a sound. Cassi hurried up to Robert’s room hoping no one in authority would spot her and send her back to seventeen.

She ducked inside the darkened room. The only light came from the bathroom whose door was slightly open.

Cassi could not see Robert but she could hear his regular breathing. Silently moving over next to the bed, she got a glimpse of his face; he was still fast asleep.

She was about to leave when she again noticed the computer printout on the night stand. As quietly as possible she picked it up. Then she moved her hand blindly over the surface of the table to search for the pencil she’d seen that afternoon. Her fingers found a water glass, then a wristwatch, and finally a pen.

Retreating to the bathroom, Cassi tore a blank sheet from the printout. Pressing against the edge of the sink she wrote: “Couldn’t fall asleep. Borrowed the SSD material. Statistics always knock me out. Love, Cassi.”

When she came out of the lighted bathroom, Cassi found it even harder to see as she made her way back to the night stand. Feeling her way, she propped her note on the water glass and was about to leave when the door slowly swung open.

Suppressing a cry of fright, Cassi nearly collided with a figure coming into the room. “My God, what are you doing here?” she whispered. Some of the computer papers slipped from her hands.

Thomas, still holding the door, motioned for Cassi to be quiet. Light from the corridor fell on Robert’s face, but he did not stir. Convinced he was not going to wake up, Thomas bent to help Cassi gather her papers.

As they stood up, Cassi whispered again, “What on earth are you doing here?”

In answer, Thomas silently guided her out into the hall, pulling the door shut behind them. “Why aren’t you asleep?” he said crossly. “You’ve got surgery in the morning! I stopped by your room to make sure everything was in order only to find an empty bed. It wasn’t hard to guess where you might be.”

“I’m flattered you came to see me,” whispered Cassi with a smile.

“This is not a joking matter,” said Thomas sternly.

“You’re supposed to be asleep. What are you doing up here at two A.M.?”

Cassi held up the computer sheets. “I couldn’t fall asleep so I thought I’d be industrious.”

“This is ridiculous,” said Thomas, taking Cassi’s arm and leading her back to the stairs. “You should have been asleep hours ago!”

“The sleeping pill didn’t work,” explained Cassi as they went downstairs.

“Then you’re supposed to ask for another. My word, Cassi. You should know that.”

Outside her room, Cassi stopped and looked up at Thomas. “I’m sorry. You’re right. I wasn’t thinking.”

“What’s done is done,” said Thomas. “You get into bed. I’ll get you another pill.”

For a moment Cassi watched Thomas resolutely walk down the corridor toward the nurses’ station. Then she turned into her room. Putting the SSD data on her night table, she tossed her robe onto the chair and kicked off her slippers. With Thomas in charge she felt more secure.

When he returned with the pill, he stood by the bed watching as she swallowed it. Then, half-teasing, he opened her mouth and pretended to search inside to see if it was gone.

“That’s a violation of privacy,” said Cassi, pulling her face away.

“Children must be treated like children,” he laughed.

He picked up the printout, carried it over to the bureau, and dumped it into a lower drawer. “No more of this stuff tonight. You’re going to sleep.”

Thomas pulled the chair over to the bed, switched off the reading light, and took Cassi’s hand.

He told Cassi he wanted her to relax and think about their upcoming vacation. Quietly he described the untouched sands, the crystal water, and the warm tropical sunshine.

Cassi listened, enjoying the images. Soon she felt a peace settle over her. With Thomas there she could relax. Consciously she could feel the sleeping pill begin to work, and she realized that she was falling asleep.

 

Robert was caught in the netherworld between sleep and consciousness. He’d been having a terrifying dream: he was imprisoned between two walls that were relentlessly closing in on him. The space where he stood became smaller and smaller. He could no longer breathe.

Desperately he pulled himself awake. The entrapping walls were gone. The dream was over, but the awful sense of suffocation was still there. It was as if the room had been sucked dry of its air.

In panic he tried to sit up, but his body would not obey. Flailing his arms in terror, he thrashed around looking for the call button. Then his hand touched someone standing silently in the dark. He had help!

“Thank God,” he gasped, recognizing his visitor. “Something’s wrong. Help me. I need air! Help me, I’m suffocating!”

Robert’s visitor pushed Robert back onto the bed so roughly the empty syringe in his hand almost dropped to the floor. Robert again reached out, grabbing the man’s jacket. His legs kicked at the bed rails setting up a metallic clamor. He tried to scream, but his voice came out muffled and incoherent. Hoping to silence Robert before anyone came to investigate, the man leaned over to cover his mouth. Robert’s knee flew up and thumped the man on the chin, snapping his teeth on the tip of his tongue.

Enraged by the pain, the man leaned his entire weight on the hand clamped over Robert’s face, pushing his head deep into the pillow. For a few minutes more Robert’s legs jerked and twitched. Then he lay still. The man straightened up, removing his hand slowly as if he expected the boy to struggle anew. But Robert was no longer breathing; his face was almost black in the dim light.

The man felt drained. Trying not to think, he went into the bathroom and rinsed the blood out of his mouth. Always before when he dispatched a patient, he had known he was doing the right thing. He gave life; he took life. But death was only administered to further the larger good.

The man remembered the first time he had been responsible for a patient’s death. He had never doubted it was the right thing to do. It had been many years ago, back when he was a junior resident on thoracic surgery. A crisis had arisen in the intensive care unit.

All the patients had developed complications. None could be discharged, and all elective cardiac surgery in the hospital had come to a halt. Every day at rounds the chief resident Barney Kaufman went from bed to bed to see if anyone was ready to be transferred, but no one was. And each day, they stopped last by a patient Barney had labeled Frank Gork. A shower of emboli from a calcified heart valve had been loosed during surgery and Frank Gork, formally Frank Segelman, had been left brain-dead. He’d been on the unit for over a month. The fact that he was still alive, in the sense that his heart was beating and his kidneys were making urine, was a tribute to the nursing staff.

One afternoon Kaufman looked down at Frank. “Mr. Gork, we all love you, but would you consider checking out of this hotel? I know it’s not the food that’s keeping you here.”

Everyone snickered but the man who had continued to stare into Frank’s empty face. Later that night, the man had gone into the busy intensive care unit and walked up to Frank Gork with a syringe full of potassium chloride. Within seconds Frank’s regular cardiac rhythm degenerated with T waves peaking, and then flattening out. It had been the man himself who called the code, but the team only made a halfhearted attempt at resuscitation.

After the fact everyone was pleased, from the nursing staff to the attending surgeon. The man almost had to restrain himself from taking credit for the event. It had been so simple, clean, definite, and practical.

The man had to admit that killing Robert Seibert had not been like that. There wasn’t the same sense of euphoria of doing what had to be done and knowing that he was one of the few with the courage to do it. Yet Robert Seibert had had to die. It was his own fault, dredging up all the so-called SSD series.

Returning from the bathroom, the man quickly searched the room for any papers relating to Robert’s research. Finding none, he moved to the door and opened it a crack.

One of the night nurses was coming down the hall with a small metal tray. For a terrifying moment the man thought she might be coming to see Robert. But she turned into another room, leaving the corridor free.

His heart pounding, the man slipped into the hall. It would be a disaster to be seen on the floor. When he was a resident, he had reason to be in the corridors or patients’ rooms or even the intensive care unit at all hours of the night. Now it was different. He had to be more careful.

When he reached the safety of the stairwell, panic overtook him. He plunged down three floors without pausing for breath and kept up this frantic descent until he’d passed the twelfth floor. Only then did he begin to slow down. At the landing on five, he stopped, flattening his back against the bare concrete wall, his chest heaving from his exertion. He knew he had to collect himself.

Taking a deep breath, the man eased open the stairwell door. Within a few moments he felt safe, but his mind wouldn’t stop racing. He kept thinking about the SSD data, realizing that Robert probably had a source in his office, very likely a floppy disc. With a sigh the man decided he’d better visit pathology right away, before Robert’s death was known. Then the only problem would be Cassi. He wondered exactly how much Robert had told her.