Authors: Robin Cook
Tilting her head back, Susanne looked at the IV bottle to see what it was. It was upside down, so she couldn’t read the label.
She started to turn over, but a sharp pain reminded her of her recently sutured incision. She decided to stay on her back.
Gingerly she took a deep breath. She didn’t feel any discomfort until right at the end of inspiration.
Closing her eyes, Susanne tried again to calm down. She knew that she still had a significant amount of drugs “on board” from the anesthesia, so sleep should be easy. The trouble was, she didn’t know if she wanted to be asleep with so many people coming in and out of her room.
A very soft clank of plastic hitting plastic drifted out of the background noise of the hospital and caught Susanne’s attention. Her eyes blinked open. She saw an orderly off to the side by the bureau.
“Excuse me,” Susanne called.
The man turned around. He was a handsome fellow in a white coat over scrubs. From where he was standing, Susanne could not read his name tag. He appeared surprised to be addressed.
“I hope I didn’t disturb you, ma’am,” the young man said.
“Everybody is disturbing me,” Susanne said without malice. “It’s like Grand Central Station in here.”
“I’m terribly sorry,” the man said. “I can always return later if it would be more convenient.”
“What are you doing?” Susanne asked.
“Just filling your humidifier,” the man said.
“What do I have a humidifier for?” Susanne said. “I didn’t have one after my last cesarean.”
“The anesthesiologists frequently order them this time of year,” the man said. “Right after surgery, patients’ throats are often irritated from the endotracheal tube. It’s usually helpful to use a humidifier for the first day or even the first few hours. In what month did you have your last cesarean?”
“May,” Susanne said.
“That’s probably the reason you didn’t have one then,” the man said. “Would you like me to return?”
“Do what you have to do,” Susanne said.
No sooner had the man left than the original nurse returned. “You were right,” she said. “The orders were to pull the IV as soon as the bottle was through.”
Susanne merely nodded. She felt like asking the nurse if missing orders was something she did on a regular basis. Susanne sighed. She wanted out of there.
After the nurse had removed the IV, Susanne managed to calm herself enough to fall back asleep. But it didn’t last long. Someone was nudging her arm.
Susanne opened her eyes and looked into the face of another smiling nurse. In the foreground and between them was a five-cc syringe.
“I’ve got something for you,” the nurse said as if Susanne were a toddler and the syringe candy.
“What is it?” Susanne demanded. She instructively pulled away.
“It’s the pain shot you requested,” the nurse said. “So roll over and I’ll give it to you.”
“I didn’t request a pain shot,” Susanne said.
“But of course you did,” the nurse said.
“But I didn’t,” Susanne said.
The nurse’s expression changed to exasperation like a cloud passing over the sun. “Well then, it’s doctor’s orders. You are supposed to have a pain shot every six hours.”
“But I don’t have much pain,” Susanne said. “Only when I move or breathe deeply.”
“There you are,” the nurse said. “You have to breathe deeply, otherwise you’ll get pneumonia. Come on now, be a good girl.”
Susanne thought for a moment. On the one hand she felt like being contrary. On the other hand she wanted to be taken care of and there was nothing inherently wrong with a pain shot. It might even make her sleep better.
“Okay,” Susanne said.
Gritting her teeth, she managed to roll to the side as the nurse bared her bottom.
4
WEDNESDAY, 2:05 P.M., MARCH 20, 1996
“You know, Laurie’s right,” Chet McGovern said.
Chet and Jack were sitting in the narrow office they shared on the fifth floor of the medical examiner’s building. They both had their feet up on their respective gray metal desks. They’d finished their autopsies for the day, eaten lunch, and were now supposedly doing their paperwork.
“Of course she’s right,” Jack agreed.
“But if you know that, why do you provoke Calvin? It’s not rational. You’re not doing yourself any favors. It’s going to affect your promotion up through the system.”
“I don’t want to rise up in the system,” Jack said.
“Come again?” Chet asked. In the grand scheme of medicine, the concept of not wanting to get ahead was heresy.
Jack let his feet fall off the desk and thump onto the floor. He stood up, stretched, and yawned loudly. Jack was a stocky, six-foot man accustomed to serious physical activity. He found that standing at the autopsy table and sitting at a desk tended to cause his muscles to cramp, particularly his quadriceps.
“I’m happy being a low man on the totem pole,” Jack said, cracking his knuckles.
“You don’t want to become board certified?” Chet asked with surprise.
“Ah, of course I want to be board certified,” Jack said. “But that’s not the same issue. As far as I’m concerned, becoming board certified is a personal thing. What I don’t care about is having supervisory responsibility. I just want to do forensic pathology. To hell with bureaucracy and red tape.”
“Jesus,” Chet-remarked, letting his own feet fall to the floor. “Every time I think I get to know you a little, you throw me a curveball. I mean, we’ve been sharing this office for almost five months. You’re still a mystery. I don’t even know where the hell you live.”
“I didn’t know you cared,” Jack teased.
“Come on,” Chet said. “You know what I mean.”
“I live on the Upper West Side,” Jack said. “It’s no secret.”
“In the seventies?” Chet asked.
“A bit higher,” Jack said.
“Eighties?”
“Higher.”
“You’re not going to tell me higher than the nineties, are you?” Chet asked.
“A tad,” Jack said. “I live on a Hundred and Sixth Street.”
“Good grief,” Chet exclaimed. “You’re living in Harlem.”
Jack shrugged. He sat down at his desk and pulled out one of his unfinished files. “What’s in a name?” he said.
“Why in the world live in Harlem?” Chet asked. “Of all the neat places to live in and around the city, why live there? It can’t be a nice neighborhood. Besides, it must be dangerous.”
“I don’t see it that way,” Jack said. “Plus there are a lot of playgrounds in the area and a particularly good one right next door. I’m kind of a pickup basketball nut.”
“Now I know you are crazy,” Chet said. “Those playgrounds and those pickup games are controlled by neighborhood gangs. That’s like having a death wish. I’m afraid we might see you in here on one of the slabs even without the mountain bike heroics.”
“I haven’t had any trouble,” Jack said. “After all, I paid for new back-boards and lights and I buy the balls. The neighborhood gang is actually quite appreciative and even solicitous.”
Chet eyed his officemate with a touch of awe. He tried to imagine what Jack would look like out running around on a Harlem neighborhood blacktop. He imagined Jack would certainly stand out racially with his light brown hair cut in a peculiar Julius Caesar-like shag. Chet wondered if any of the other players had any idea about Jack, like the fact that he was a doctor. But then Chet acknowledged that he didn’t know much more.
“What did you do before you went to medical school?” Chet asked.
“I went to college,” Jack said. “Like most people who went to medical school. Don’t tell me you didn’t go to college.”
“Of course I went to college,” Chet said. “Calvin is right: you are a smartass. You know what I mean. If you just finished a pathology residency, what did you do in the interim?” Chet had wanted to ask the question for months, but there had never been an opportune moment.
“I became an ophthalmologist,” Jack said. “I even had a practice out in Champaign, Illinois. I was a conventional, conservative suburbanite.”
“Yeah, sure, just like I was a Buddhist monk.” Chet laughed. “I mean I suppose I can see you as an ophthalmologist. After all, I was an emergency-room physician for a few years until I saw the light. But you conservative? No way.”
“I was,” Jack insisted. “And my name was John, not Jack. Of course, you wouldn’t have recognized me. I was heavier. I also had longer hair, and I parted it along the right side of my head the way I did in high school. And as far as dress was concerned, I favored glen-plaid suits.”
“What happened,” Chet asked. Chet glanced at Jack’s black jeans, blue sports shirt, and dark blue knitted tie.
A knock on the doorjamb caught both Jack’s and Chet’s attention. They turned to see Agnes Finn, head of the micro lab, standing in the doorway. She was a small, serious woman with thick glasses and stringy hair.
“We just got something a little surprising,” she said to Jack. She was clutching a sheet of paper in her hand. She hesitated on the threshold. Her dour expression didn’t change.
“Are you going to make us guess or what?” Jack asked. His curiosity had been titillated, since Agnes did not make it a point to deliver lab results.
Agnes pushed her glasses higher onto her nose and handed Jack the paper. “It’s the fluorescein antibody screen you requested on Nodelman.”
“My word,” Jack said after glancing at the page. He handed it to Chet.
Chet looked at the paper and then leaped to his feet. “Holy crap!” he exclaimed. “Nodelman had the goddamn plague!”
“Obviously we were taken aback by the result,” Agnes said in her usual monotone. “Is there anything else you want us to do?”
Jack pinched his lower lip while he thought. “Let’s try to culture some of the incipient abscesses,” he said. “And let’s try some of the usual stains. What’s recommended for plague?”
“Giemsa’s or Wayson’s,” Agnes said. “They usually make it possible to see the typical bipolar ‘safety pin’ morphology.”
“Okay, let’s do that,” Jack said. “Of course, the most important thing is to grow the bug. Until we do that, the case is only presumptive plague.”
“I understand,” Agnes said. She started from the room. “I guess I don’t have to warn you to be careful,” Jack said.
“No need,” Agnes assured him. “We have a class-three hood, and I intend to use it.”
“This is incredible,” Chet said when they were alone. “How the hell did you know?”
“I didn’t,” Jack said. “Calvin forced me to make a diagnosis. To tell the truth, I thought I was being facetious. Of course, the signs were all consistent, but I still didn’t imagine I had a snowball’s chance in hell of being right. But now that I am, it’s no laughing matter. The only positive aspect is that I win that ten dollars from Calvin.”
“He’s going to hate you for that,” Chet said.
“That’s the least of my worries,” Jack said. “I’m stunned. A case of pneumonic plague in March in New York City, supposedly contracted in a hospital! Of course, that can’t be true unless the Manhattan General is supporting a horde of infected rats and their fleas. Nodelman had to have had contact with some sort of infected animal. It’s my guess he was traveling recently.” Jack snatched up the phone.
“Who are you calling?” Chet asked.
“Bingham, of course,” Jack said as he punched the numbers. “There can’t be any delay. This is a hot potato I want out of my hands.”
Mrs. Sanford picked up the extension but informed Chet that Dr. Bingham was at City Hall and would be all day. He had left specific instructions he was not to be bothered since he’d be closeted with the mayor.
“So much for our chief,” Jack said. Without putting down the receiver, he dialed Calvin’s number. He didn’t have any better luck. Calvin’s secretary told him that Calvin had had to leave for the day. There was an illness in the family.
Jack hung up the phone and drummed his fingers on the surface of the desk.
“No luck?” Chet asked.
“The entire general staff is indisposed,” Jack said. “We grunts are on our own.” Jack suddenly pushed back his chair, got up, and started out of the office.
Chet bounded out of his own chair and followed. “Where are you going?” he asked. He had to run to catch up with Jack.
“Down to talk to Bart Arnold,” Jack said. He got to the elevator and hit the Down button. “I need more information. Somebody has to figure out where this plague came from or this city’s in for some trouble.”
“Hadn’t you better wait for Bingham?” Chet asked. ‘”That look in your eye disturbs me.”
“I didn’t know I was so transparent,” Jack said with a laugh. “I guess this incident has caught my interest. It’s got me excited.”
The elevator door opened and Jack got on. Chet held the door from closing. “Jack, do me a favor and be careful. I like sharing the office with you. Don’t ruffle too many feathers.”
“Me?” Jack questioned innocently. “I’m Mister Diplomacy.”
“And I’m Muammar el Qaddafi,” Chet said. He let the elevator door slide closed.
Jack hummed a perky tune while the elevator descended. He was definitely keyed up, and he was enjoying himself. He smiled when he remembered telling Laurie that he’d hoped Nodelman turned out to have something with serious institutional consequences like Legionnaires’ disease so he could give AmeriCare some heartburn. Plague was ten times better. And on top of sticking it to AmeriCare, he’d have the pleasure of collecting his ten bucks from Calvin.
Jack exited on the first floor and went directly to Bart Arnold’s office. Bart was the chief of the PAs, or physician’s assistants. Jack was pleased to catch him at his desk.
“We’ve got a presumptive diagnosis of plague. I’ve got to talk with Janice Jaeger right away,” Jack said.
“She’ll be sleeping,” Bart said. “Can’t it wait?”