Marker (54 page)

Read Marker Online

Authors: Robin Cook

"You can't just sit here in the hospital," Laurie said. "If you really think you can't sleep, why don't you do what I suggested earlier and go back to my office? If you have to be awake, you might as well make use of the time."

"You know, I might just do that," Jack said. It crossed his mind that he could bring all that material back to the surgical lounge. After all, the night shift was in the hospital. It might help to pass the time if he tried to talk to a couple of the people on Roger's lists, although, when he thought about it again, he had to admit that Roger's fate took away some of his enthusiasm for the idea.

"Sorry to interrupt here," Thea said. She had appeared at the foot of the bed. "You people are going to have to wind things up. We've got a couple of cases coming in imminently."

"Just a moment longer," Jack said to Thea, who nodded and retreated back to her command post.

"Listen," Jack said to Laurie, bending over to be close to her ear. "Before I go, I want to be absolutely sure you feel comfortable here. Be honest! Otherwise, I'll just park myself right outside the door and refuse to budge."

"Perfectly comfortable. You should get some sleep."

"I'm telling you, I'm not going to sleep! I'm charged up, ready to do a triathlon."

"Okay! Calm down! Then go back to my office so you can at least keep yourself busy.

Bring everything back here."

"You're sure you're comfortable?"

"I'm very sure."

"Okay," Jack said, giving Laurie's forehead a kiss before straightening up. "You can get some sleep for both of us. I'll be back and try to come in here in a few hours if that Brunnhilde lets me." He hooked a thumb over his shoulder.

"I'll be fine," Laurie said. "Don't worry!"

With a final squeeze of Laurie's hand, Jack walked back to the central desk. While Thea was on the phone, standing behind her desk chair, Jack wrote down his name and cell phone number.

"Thanks again for letting me come in here," Jack said when she hung up and looked at him.

"Don't mention it," Thea said. She went up on her tiptoes, looking at something over Jack's shoulder, and shouted: "You got it, Claire. That's the line I was talking about. I don't think it's running right." She looked back at Jack. "Sorry! Don't worry about your wife. We'll take good care of her."

"I've written down my cell phone number," Jack said. He handed the paper to Thea.

"If there is any change in her status in any way or form, I'd appreciate hearing about it."

"We'll do our best," Thea said. She glanced at the paper, then tossed it onto the desk in front of her. She flashed Jack a brief smile and a quick wave, then turned to one of the nurses who'd approached with a question.

With a final look in Laurie's direction, Jack walked out of the PACU. He crossed through the surgical lounge. The faces had changed, but the scene hadn't. Inside the men's locker room, he quickly changed out of the scrubs and put on his clothes.

The main lobby of the hospital was eerily quiet and a far cry from its daytime bustle.

As he exited through the front door, he was pleased to see that a few taxis were patiently waiting in the taxi line. The rain that had been forecasted had started.

The cab dropped Jack off at the morgue's loading dock, and he walked in past the security office. Carl Novak, the night security officer, bounded out of his chair as if caught unawares, causing the paperback book he was reading to fall to the floor. He leaned out his door and called after Jack, "Is something up that I should know about, Dr.

Stapleton?"

"Nope," Jack called over his shoulder.

The night mortuary tech, Mike Passano, had a similar reaction when he heard Jack's voice echo about the tiled morgue and Jack passed the mortuary office. While Jack waited for the elevator, Mike's head appeared. "Is a case coming in that we'll be posting?" he asked.

"Nope," Jack said. "I just love this place so much, I can't stay away."

The fifth floor was barely illuminated, such that the orange office doors appeared a muddy gray-brown. Once inside Laurie's office, Jack flipped on the overhead light and squinted in its relative glare. He sat down in Laurie's chair and surveyed all the series material on her desk. There were two neat piles of hospital charts. Next to them were Roger's lists and a ruled notepad. On the pad was a list of the ways Laurie had determined that the cases were related. On the wall above the desk were two Post-it notes: one a reminder to show Sobczyk's EKG segment to a cardiologist, and the other questioning what kind of lab test an MASNP was. Looking down on the desk was another Post-it wrinkled enough to make it hard to read. Jack spread out the wrinkles.

On it was written in Laurie's handwriting: "positive MEF2A," followed by a large question mark. Jack had no idea what MEF2A stood for.

What Jack didn't see was the CD that he remembered Laurie making in Roger's office, and he briefly looked under the charts and under Roger's lists. He even opened Laurie's desk drawers, which were extraordinarily neat, in sharp contrast to his. There was no CD. He scratched his head. Where would she have put it? Then he glanced at his watch.

It was almost one-thirty in the morning.

After taking a deep breath, Jack tried to organize his thoughts. His heart was racing from the coffee and his mind was going a mile a minute. It was hard to concentrate on anything. He didn't like being away from the Manhattan General Hospital with Laurie in such a vulnerable state, yet it truly would have driven him crazy to sit in the surgical lounge hour after hour, staring at the clock. As Laurie had suggested, he had it in his mind to take all the material on her desk back to the surgical lounge. But before he did that, he had another idea. He thought he could take the time to possibly get answers to the three Post-it questions. With several hospitals literally next door, it would be a quick errand and might have some significance.

Getting to his feet, Jack shuffled through the charts until he found Sobczyk's. The EKG

segment was easy to find, since Laurie had it marked with a ruler. He looked at it again, and again admitted that it made no sense to him. In fact, it was his opinion that no one would be able to make any sense of it. It was essentially the serendipitous recording of cardiac conduction cells in the throes of cellular death. Carefully, he extracted the page with the recording from the rest of the chart. Taking it and the other two Post-it notes, he stepped out of Laurie's office, leaving the light on, and walked back to the elevator.

When he pressed the button, the door immediately opened. That never happened in the daytime. It was as if he was the only person in the building.

As he rode down to the basement level, he mapped out his strategy, despite his mind jumping all over creation. He thought he'd run over to the NYU Bellevue medical center, pop in to the ER, and have the on-call cardiology resident paged. Jack couldn't imagine that that would take too long, as the resident might very well be in the emergency unit already. Then Jack thought he'd head to the laboratory and see if he could find the night supervisor. If anybody could tell him what kind of test an MASNP was and what a positive MEF2A meant, it would be a hospital laboratory supervisor. Vaguely, he wondered if the two unknowns were related.

It was still sprinkling outside, so Jack literally ran up First Avenue with the page from Sobsczyk's chart protected under his coat. The emergency room looked pretty much the same as Manhattan General's had looked when Jack had gone in to see Laurie. The crowds generally didn't thin out until after three in the morning. Jack went to the main desk and caught the attention of one of the nurses, who looked like he could have been a bouncer in a club. His name was Salvador, and he had on what looked like a dozen gold chain necklaces nestled on a remarkably hairy chest.

"I'm Dr. Stapleton," Jack said. "Do you happen to know who the on-call cardiology resident is?"

"I don't, but I'll find out," he said before bellowing the question to a colleague within the treatment area, which the main desk opened onto on its opposite side. He put his hand behind his ear to catch the response. The other individual was out of Jack's line of sight.

"Dr. Shirley Mayrand," the nurse said, redirecting his attention to Jack.

"Do you know if Dr. Mayrand is in the emergency room at the moment?"

The nurse shrugged his shoulders. "No idea."

"How can I page her?"

"I can do it for you." Salvador said. He picked up the phone and dialed the page operator. "Should I page her for the emergency room?"

Jack nodded. "I'll wait right here." He turned around and gazed at the scene. If nothing else, it was visually entertaining. Spread out in front of him and filling the vinyl waiting-room chairs was an egalitarian slice of New York City life in both its glory and banality. From crying infants to the tottering aged, from homeless bums to folks in fancy clothes, from the drunks to the mentally anguished, from the injured to the sick, they were all there, waiting to be seen.

"Hold your horses," Thea shouted at her jangling phone. She was trying to fill out a supply requisition form. Giving up, she picked up the phone. It was the night shift OR

supervisor, Helen Garvey.

"What's your bed count?" Helen demanded without mincing words.

"Occupied or empty?" Thea questioned.

"Now, that's one of the dumber questions I've heard tonight!"

"You're in a bad mood."

"I have a right to be. According to the ER, we're about to be inundated with trauma cases, and the first wave is on its way up. There was a head-on collision with a bus and a van, and the bus went over a guardrail. As I understand it, they distributed the victims, but we got the lion's share. I've contacted all the on-call people so we can be running up to twenty ORs. It's going to be a long night."

"I've got thirteen patients with only three empty beds."

"That's not encouraging. What are the patients' statuses?" Thea let her eyes roam around her domain while she mentally reviewed each case. "Everybody is in good shape except for an abdominal aneurysm re-bleed. He's got to stay, because he might have to be opened up yet again. He's still losing blood out of his drain." "So the others are stable?" "At the moment."

"Then clean house, because you're next for this tidal wave." Thea hung up the phone.

She was psyched. Challenges like this were her forte. "Listen up!" she called out to her troops. "We're switching to disaster mode, and this is no drill."

The release of the wheels jolted Laurie from her drugged slumber to a semiwakefulness. Her eyes squinted against the bright overhead fluorescent lights, and for a moment, she was disoriented to time and place. There was another jolt when the bed began to move, and the jostling brought a brief but sharp reminder that she had had intra-abdominal surgery. All at once, Laurie knew where she was, and the large clock over the PACU room's door, which she was approaching, told her the time: It was twenty-five minutes past two.

Turning her head to the side in response to a babble of voices, Laurie caught a glimpse of the flurry of activity at the central desk. Bending her head back so she could see behind her, she looked up at the face of the orderly pushing her. He was a rail-thin, light-skinned African-American with a pencil-line mustache and graying hair. The muscles of his neck stood out as he strained to angle Laurie's bed toward the swinging doors.

"What's happening?" Laurie questioned.

The orderly didn't answer, focusing instead on stopping the bed's forward motion before backing it up a few steps. The PACU's doors had burst open. Another bed was coming into the room with a patient fresh from surgery. There was a person at the foot of the bed, pulling, and another at the head, pushing. An anesthesiologist walked alongside, maintaining the patient's airway patent by holding the individual's chin back.

All three seemed to be talking at the same time.

Laurie repeated her question to the orderly behind her. She felt the stirrings of apprehension in the pit of her stomach. Something was up. Her understanding was that she was not be moved until Laura Riley came in to see her in the morning.

"You're going to your room," the orderly said, preoccupied with maneuvering Laurie's bed to allow the incoming patient to get by.

"I was supposed to stay here in the PACU," Laurie said with building alarm.

"Here we go," the orderly said as if he'd not heard Laurie. He grunted as he managed to get the bed rolling forward again.

"Wait!" Laurie yelled. The effort of her outcry made her wince with pain from her incision.

Shocked by Laurie's outburst, the orderly halted the bed yet again. He looked down at her with concern. "What's the matter?"

"I'm not supposed to be leaving here," Laurie stated. She had to talk loudly to be heard over the general level of conversation in the room. To keep the pain to a minimum, she had to press her hand gently over the upper part of her abdomen to avoid jostling the lower part. Earlier, when Jack had visited, she'd had very little discomfort from the operation. Unfortunately, that had changed.

"I got strict orders to take you to your room," the orderly said. His expression was half defiant, half confused. He took a piece of paper out of his pocket and glanced at it.

"You're Laurie Montgomery, aren't you?"

Ignoring the orderly's question, Laurie lifted her head off her pillow and looked over at the central desk, which was a beehive of activity. Ahead, the doors to the hall burst open again and another patient, fresh from surgery, was whisked into the room. Once again, the orderly had to back Laurie's bed up to allow them to pass.

"I want to talk to the charge nurse," Laurie demanded.

With obvious indecision, the orderly looked back and forth between Laurie and the central desk. He shook his head with frustration.

"You're not taking me anywhere," Laurie stated. "I'm supposed to stay here. I need to talk with a supervisor. Anyone in control."

Shrugging his shoulders in resignation, the orderly walked over to the counter, leaving Laurie and her bed stranded in the middle of the room. He was holding in his hand the piece of paper he'd taken from his pocket. Laurie watched as he tried vainly to get someone's attention. When he did, the person pointed out a square-built woman with a helmet of blond hair. Laurie watched as the orderly showed Thea his paper then pointed in Laurie's direction.

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