“I gotta be moving,” said Clark Reardon. My woman told me not to be late.” Clark had pulled a straight-back metal chair over to Jeoffry Washington’s bed.
“Well, it was great to see you, man,” said Jeoffry. “Thanks for coming in. I really appreciate it.”
“No problem,” said Clark, standing up. He raised his hand, and when Jeoffry put his out, he slapped it affectionately.
“So when you breaking outta here?” asked Clark.
“Pretty soon. Maybe in a couple days. I’m not sure. I still got this IV.” Jeoffry raised his left arm, indicating the coiled plastic tubing. “I had some inflammation in my legs right after the operation. At least that’s what Dr. Sherman told me, so they started giving me antibiotics. It was a little rough for a couple days, but it’s better now. The best thing that happened to me was when they took away the cardiac monitor. I tell you, the beep from that mother drove me crazy.”
“How long you been in here so far?”
“Nine days.”
“That ain’t bad.”
“Not from this end. But I tell you, I was pretty scared in the beginning. But I had no choice. They told me I was going to die if I didn’t get operated on. So what can you do?”
“Nothing! I’ll see you tomorrow night and I’ll bring in those books you wanted. Anything else?”
“I’d love a little grass.”
“Come on, man.”
“I’m just joking.”
Clark turned and waved at the door before disappearing down the hall.
Jeoffry surveyed his room. He was glad that he was leaving soon. The other bed in the semiprivate room was empty. His roommate had been discharged that day and no new patient had arrived. Jeoffry was sorry to be alone, especially now that Clark had left and he had nothing to look forward to. As far as Jeoffry was concerned, a hospital was not a place to be alone. There were too many frightening machines and procedures to face without support.
Jeoffry switched on the miniature TV set connected to the head of the bed. Toward the end of the second situation comedy, Miss DeVries, a spunky LPN, entered. Pretending she had some delectable treat for Jeoffry, she insisted he close his eyes and open his mouth. As he did so, he had a pretty good idea of what was coming, and he was right. It was a thermometer.
Ten minutes later she returned and exchanged the thermometer for a sleeping pill. Jeoffry took the pill with water he had on the side table while the LPN examined the thermometer.
“Do I have a temperature?” asked Jeoffry.
“Everybody has a temperature,” said Miss DeVries.
“How could I forget,” said Jeoffry. They’d been through this before. “Okay, do I have a fever?”
“That’s classified information,” said Miss DeVries.
Jeoffry never could understand why the nurses could not tell him if he had a temperature; correction, a fever. They always said that was up to the doctor, which was crazy. It was his body.
“What about this IV?” asked Jeoffry as Miss DeVries started for the door. “When’s it coming out so I can take a real shower?”
“That’s something I know nothing about.” She waved before disappearing.
Jeoffry twisted his head and looked up at the IV bottle. For a moment he watched the regular fall of each drop in the small chamber. Turning back to the TV and the evening news, he sighed. It was going to be a relief when his tether was removed. He reminded himself to ask Dr. Sherman about it in the morning.
When the phone first rang, Thomas sat up, confused as to where he was. On the second ring, Doris turned over to face him in the half-light of her apartment.
“Do you want to get it or should I?” Doris’s voice was thick with sleep. She pushed herself up on one elbow.
Thomas looked at her in the semidarkness. She appeared grotesque with her thick hair radiating from her head as if a thousand volts of electricity had passed through her body. Instead of eyes she had black holes. It took him a moment to remember who she was.
“I’ll get it,” said Thomas, staggering to his feet. His head felt heavy.
“It’s in the corner near the window,” said Doris, flopping back onto the pillow.
Groping with his hands, Thomas went along the wall until he got to the open doorway of the bedroom. In the living room, the bay window let in more light.
“Dr. Kingsley, this is Peter Figman,” said the thoracic resident when Thomas picked up the receiver. “I hope you don’t mind my calling, but you asked me to let you know if any service cases were going to the OR. We have a stab wound of the chest that’s due within the hour.”
Thomas leaned on the small phone table. The chill in the room helped organize his mind. “What time is it?”
“A little after one A.M.”
“Thank you,” said Thomas. “I’ll be right over.”
As Thomas stepped out of Doris’s vestibule to the street, the icy December wind sent a chill through his body. Pulling the lapels of his coat more tightly around his neck, he set off toward the Memorial. Every so often sudden gusts would swirl down the street, moving a line of papers and other debris against his feet, forcing Thomas to turn and walk backwards for a few steps. He was relieved when he rounded the corner and could see the complex of buildings that comprised Boston Memorial.
Approaching the main entrance, he passed the parking garage on his left. It was a cement structure, open to the elements. Although it was jammed during the day, now it was almost deserted. As he glanced in to admire his Porsche, he noticed another familiar car. It was a Mercedes 300 turbo diesel painted puke green. There was only one person in the whole hospital whose taste was that bad. The car belonged to George Sherman.
Thomas was practically at the hospital door, mulling over the absurdity of getting such a good car in such a terrible color, when he began to wonder why George was there. He turned to look again. It was his car all right. There was no chance of confusing it with another. Thomas glanced at his watch. It was 1:15 A.M.
Thomas went directly to the OR, changed, and while passing through the surgical lounge, saw one of the OR nurses knitting. He asked her if George Sherman had a case that night.
“Not that I know of,” said the nurse. “Hasn’t been a chest except for the stab wound you’re covering.”
Outside of OR room 18, Thomas met Peter Figman scrubbing. He was a baby-faced, slight fellow who appeared as if he didn’t have to shave yet. Thomas had seen him on numerous occasions but never had the opportunity of working with him. He had a reputation of being smart, dedicated, and of having good hands.
As soon as he saw Thomas, Peter launched into a detailed presentation of the case. The patient had been stabbed during a hockey game at the Boston Garden but was in stable condition, although there had been some trouble with his blood pressure when he’d first been admitted to the emergency room. He’d been typed and crossed for eight units of blood, but none had been given yet. The first thought had been that the knife had punctured one of the great vessels.
While Thomas listened to the presentation, he took a surgical mask from the box on the shelf above the scrub sink. He preferred the older-style masks that tied behind the neck and head as compared to the molded masks that were secured with a single elastic band behind the head. Tonight, however, he kept dropping one or the other of the straps. Then the mask slipped from his grasp and fell to the floor. Thomas cursed under his breath and took another. As he reached into the box, Peter noticed that the older man’s hand had a slight tremor.
Peter stopped his presentation. “Are you all right, Dr. Kingsley?”
His hand in the box, Thomas slowly rotated his head to look directly at Peter. “What do you mean, am I all right?”
“I thought maybe you weren’t feeling well,” said Peter timidly.
Thomas snapped the mask out of the box, pulling an extra one with it which fell into the scrub sink. “And why did you think I might not be feeling well?”
“I don’t know, just a hunch,” said Peter evasively. He was sorry now he’d said anything.
“For your information, I feel perfectly fine,” said Thomas, making no attempt to conceal his anger. “But there’s one thing I will not tolerate from the residents, and that is insolence. I hope you understand.”
“I understand,” said Peter, eager to drop the subject.
Leaving the resident to finish his scrub, Thomas pushed through the OR door. “For Christ’s sake,” thought Thomas, “doesn’t the kid realize I was just awakened from a deep sleep; everybody has a little tremor until they have a chance to fully wake up.”
The OR was a buzz of activity. The patient was already fully anesthetized and junior house staff were in the process of prepping the patient’s chest. Thomas walked over to review the X rays. Then, while his back was to the room, he held up his hand. The tremor was slight. He’d had worse. “Just wait until that cocky kid rotates on cardiac surgery,” Thomas mused with some satisfaction.
Thomas parked himself in the back of the OR and watched carefully as the case began. He was ready to intervene if needed, but to Peter’s credit, he was a good technical surgeon. Thomas quizzed all the residents about possible hemopericardium. None of them, including Peter, had thought of the diagnosis despite the fact that it had been discussed at the last death conference. When Thomas was certain the case was routine and would go smoothly, he stood up and stretched. He wandered over to the door. “I’ll be available if anything goes wrong. You fellows are doing a good job.”
When the OR door closed behind Thomas, Peter Figman glanced up and whispered: “I think Dr. Kingsley’s had one too many tonight.”
“I think you’re right,” said a junior resident.
Thomas had felt a sudden sleepiness steal over him as he’d sat in the OR. Fear of nodding off had driven him out. On the way to the surgical lounge he took several deep breaths. He couldn’t remember how many Scotches he’d had with Doris. He’d have to be more careful in the future.
Unfortunately, the lounge was occupied by two nurses on their coffee break. He’d planned to stretch out on the couch but decided he’d use one of the cots in the locker room instead. As he passed the window, he glanced out and noticed a light in one of the offices across the way in the Scherington Building. Counting the windows from the end, Thomas realized that it was Ballantine’s. He looked up at the clock over the coffee maker. It was close to 2:00 A.M.! Had the janitor just forgotten to turn it off?
“Excuse me,” called Thomas to the two nurses, “I’ll be in the locker room if they call me from surgery. In case I fall asleep, would one of you mind coming in and giving me a nudge?”
As Thomas went through the swinging doors to the locker room, he wondered if the light in Ballantine’s office had anything to do with the fact that George Sherman’s car was in the parking lot. There was something disturbing about those two facts.
The windowless alcove with the two cots was not completely dark. Light from the surgical lounge drifted through the short hall to the locker room. As usual the cots were empty. Thomas had the suspicion that he was the only person ever to use them.
Reaching into the pocket of his scrub shirt, he found the small yellow pill he’d placed there. Deftly he snapped the tablet in half. One half went into his mouth where he let it dissolve on his tongue. The other half went back into his pocket in case he needed it later. Before he closed his eyes, he wondered how long he had before he would get called.
At 2:45 A.M., the stairwell seemed to belong in a gigantic mausoleum rather than a hospital. The long vertical drop acted like a chimney of sorts, and there was a low-pitched whine of wind coming from somewhere in the bowels of the building. As the figure in the stairwell opened the door on the eighteenth floor, air hissed out as from a vacuum jar.
In usual hospital dress, the man was not afraid of being seen but still preferred not to be. He checked carefully to make sure the corridor was deserted for its entire length before allowing the door to close behind him. As it swung shut there was the same rude sucking noise.
One hand thrust into the pocket of his white coat, the man moved silently down the hall to Jeoffry Washington’s room. There he stopped and waited for a moment. There was no sound of activity coming from the nurses’ station. All that could be heard were distant, muted sounds of the cardiac monitors and respiratory machines.
In a blink of the eye the man was inside the room, slowly closing the door to the hall. The only light came from the bathroom where the door was cracked an eighth of an inch. As soon as his eyes adjusted to the dimness, he pulled his hand out of his pocket, gripping a full syringe. He dropped the cap from the needle into the opposite pocket and moved rapidly to the bedside. Then he froze.
The bed was empty!
His jaw straining to its limits, Jeoffry Washington yawned hard enough to bring tears to his eyes. He shook his head and tossed the three-week-old Time magazine onto the low table. He was sitting in the patient lounge across from the treatment room. Getting up, he pushed his IV pole ahead of him out of the lounge toward the semidarkened nurses’ station. He’d hoped that a stroll down the corridor would have helped his insomnia, but it hadn’t worked. He wasn’t any sleepier than he’d been tossing in his bed.
Pamela Breckenridge watched his progress through the doorless opening of the chart room. She’d become accustomed to his appearances over the past two nights. To save money she’d been brown bagging it rather than using the cafeteria, and Jeoffry would appear just as she was ready to eat.
“Is it possible for me to have another sleeping pill?” he called.
Pamela swallowed, told him it was, and directed the LPN to get Jeoffry another Dalmane. Dr. Sherman had obliged by adding a “repeat × 1” after his initial order.
As if he were standing at a bar, Jeoffry accepted the pill and the miniature paper cup of water the LPN extended toward him over the counter of the station. Jeoffry popped the pill and tossed off the water. God, what he wouldn’t have done for a few tokes of grass. Then he began the slow trip back up the corridor.
The hall darkened as he moved away from the nurses. Presently he saw his shadow appear in front of him on the vinyl floor, growing as he walked. The IV pole made it look as if he were some prophet clutching a staff. To open his door he thumped it with the wheeled footplate. Inside he hooked the door with his foot and shoved it closed. If there were any chance of dropping off to sleep, he had to shield himself from the noise and lights from the corridor.
Arranging the pole next to the bed, he turned and sat down, intending to lift his feet and stretch out. Instead he stifled a scream.
Like an apparition, a white-clad figure emerged from the bathroom.
“My God!” said Jeoffry, letting out his breath. “You really startled me.”
“Lie down, please.”
Jeoffry complied immediately. “I never expected you at this hour.”
Jeoffry watched as the visitor pulled out a syringe and started to inject the contents into Jeoffry’s IV bottle. He seemed to have some difficulty in the darkness as Jeoffry heard the bottle clank repeatedly against the pole.
“What kind of medication am I getting?” asked Jeoffry, unsure if he should say anything but sufficiently confused as to what was going on to overcome his hesitancy.
“Vitamins.”
To Jeoffry it seemed like a strange time to be getting vitamins, but the hospital was a strange place.
Jeoffry’s visitor gave up trying to get the needle into the base of the IV bottle and switched to the injection site in the plastic tubing close to Jeoffry’s wrist. This was far easier and the needle immediately slipped through the small rubber cap. Jeoffry watched as the plunger was rapidly depressed, causing the fluid to back up in the tubing, raising the level in the chamber above his head. He felt a twinge of pain but assumed it was just the rise in pressure in the IV.
But the pain did not disappear. Instead it got worse. Much worse.
“My God!” cried Jeoffry. “My arm! It’s killing me!” Jeoffry could feel a white-hot sensation that began at the IV site rise up in his arm.
The visitor grabbed Jeoffry’s hand to keep it still and opened the IV so it ran in a steady stream.
The pain that Jeoffry thought had been unbearable got worse and spread like molten lava into his chest. He swung his free hand over to grasp his visitor.
“Don’t touch me, you friggin’ faggot.”
Despite the pain, Jeoffry let go. To his bewilderment was added fear . . . a terrible fear that something awful was happening. Desperately Jeoffry tried to free his arm with the IV from the intruder’s grip.
“What are you doing?” gasped Jeoffry. He started to scream, but a hand was clamped roughly over his mouth.
At that moment Jeoffry’s body experienced its first convulsion, arching up off the bed. His eyes rolled up and disappeared inside his head. Within seconds the spasms increased to become a grand mal seizure, rocking the bed back and forth. The intruder dropped Jeoffry’s arm and pulled the bed away from the wall to reduce the banging. Then he checked the corridor and ran back to the stairwell.
Jeoffry convulsed in silence until his heart, which had begun to beat irregularly, fibrillated for a few seconds, then stopped. Within minutes Jeoffry’s brain ceased functioning. He continued to convulse until his muscles exhausted their depleted store of oxygen . . .
• • •
Thomas felt as though he’d just closed his eyes when the nurse bent over and shook him awake. He rolled over in a daze and looked into the woman’s smiling face.
“They need you in the OR, Dr. Kingsley.”
“Be right there,” he said thickly.
Thomas waited while the nurse beat a hasty retreat, then swung his feet to the floor. He paused a few minutes for the dizziness to clear. Sometimes, thought Thomas, sleeping for too short a time was worse than no sleep at all. He steadied himself at the entrance, then stumbled over to his locker. Getting out a Dexedrine, he washed it down with water from the drinking fountain. Then he changed into a fresh scrub suit, but not before he’d rescued the half pill he’d left in the soiled shirt’s breast pocket.
By the time Thomas got down to OR 18, the Dexedrine had cleared his head. He considered scrubbing right away but then decided it was better to find out first what he was up against.
The residents were standing around the anesthetized patient, their gloved hands resting within the sterile field. The scene did not look auspicious.
“What’s the . . .” began Thomas, his voice hoarse. He hadn’t spoken since awakening except for the few words to the nurse. He cleared his throat. “What’s the problem?”
“You were right about the hemopericardium,” said Peter with respect. “The knife penetrated the pericardium and cut the surface of the heart. There’s no bleeding, but we wondered if we should close the laceration.”
Thomas had the circulation nurse locate a stool and put it behind Peter. From that vantage point, he could see into the incision. Peter pointed to the laceration and bent to the side.
Thomas was relieved. The laceration was inconsequential, having missed any significant coronary vessels.
“Just leave it as is,” said Thomas. “The marginal benefits of suturing it aren’t worth the possible problems the suture might cause.”
“Good enough,” said Peter.
“Leave the pericardium open, too,” warned Thomas. “It will reduce the chances of running into a problem with tamponade in the postoperative course. It will serve as a drainage point if there is any bleeding.”
An hour later Thomas crossed from the hospital to the Professional Building. When he entered his office he felt unpleasantly wired from the Dexedrine. Over and over he kept worrying about Ballantine and Sherman’s presence in the hospital that night. It was obvious they were having some kind of secret meeting, and, as he wondered what they were plotting, he felt his anxiety mount. Now he knew he would be unable to sleep unless he took something.
He rarely got such a surge from a single Dexedrine but decided it was probably due to his general exhaustion. Going over to his desk, he gobbled another Percodan. Then, fearful that he might have trouble waking up in the morning, Thomas called Doris. He had to let the phone ring a long time. Mentally he retraced the complicated route from her bed to the phone by the bay window. He wondered why she didn’t get an extension.
“Listen,” said Thomas when she answered. “You’ve got to come into the office at six-thirty.”
“That’s only a couple hours from now,” protested Doris.
“Jesus Christ,” shouted Thomas angrily. “You don’t have to tell me what time it is. Don’t you think I know? But I have three bypasses starting at seven-thirty. I want you over here to make sure I’m up.”
Thomas slammed the phone down in its cradle, seething. “Goddamn selfish bitch,” he said out loud as he punched his pillow into submission.