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Reaching up, Jazz grasped the IV line and opened it so it flowed freely. She waited for a few minutes, to be sure it was running well. When she was certain the IV was functioning perfectly, she got out the syringe with the potassium. Using her teeth to take off the needle cap, she inserted the needle deep into the IV port.

After looking back at the door to the corridor and listening for a moment for any suspicious sounds, Jazz made the injection with strong, sustained pressure. It only took five seconds. She knew that the more the potassium arrived at the heart in a concentrated bolus, the more effective it would be. As usual, as she injected, she saw the fluid level rise in the micropore chamber below the IV fluid bag.

As soon as the syringe was empty, Jazz withdrew the needle and replaced the cap.

She then pulled the pillow from under her arm as Laurie stirred, moaned, and popped open her eyes.

"Bon voyage!" Jazz whispered. With the pillow in her right hand poised for action and the syringe in her left, Jazz then bent over Laurie because she thought Laurie had mumbled something. Jazz started to ask her to repeat herself when Jazz recoiled in shocked surprise at the sound of the door to the room being slammed against its doorstop. In the next instant, an apparent maniac dashed into the room. Jazz was momentarily dumbfounded by the sudden, whirlwind arrival in the silent and dimly lit environment, particularly because she was tense and engrossed in what she was doing, and also because she thought she'd been so careful to avoid surprises. Except for taking a reflexive defensive step back, Jazz was momentarily paralyzed.

"How is she?" Jack barked as he rushed to the foot of Laurie's bed. His breaths were coming in noisy heaves. His hair was dripping and plastered to his forehead. He appeared like a wild man with an unshaven face, red eyes, wet clothes, and soggy shoes.

He leaned with both hands on the metal foot of the bed as if exhausted but quickly revived. It was apparent he immediately didn't like what he saw. His eyes darted to Jazz, who had not answered him. He saw the pillow and the syringe in her hands. His attention reverted back to Laurie, who was softly moaning and fighting weakly and futilely against the wrist restraints.

"What's going on?" Jack demanded. He rushed around the side of the bed to Laurie's right, across from Jazz. "Laurie!" Jack yelled. His hand briefly clutched Laurie's wrist, but then shot up and gripped Laurie's forehead to keep her from moving her head from side to side. "What the hell are the restraints for?" Jack cried, but he didn't wait for an answer. On closer inspection, it was apparent Laurie was in a worsening, desperate state and possibly agonal. Her face reflected a mixture of terror, confusion, and pain.

"Hit the lights!" Jack yelled. "Call a code!"

Jazz still didn't respond other than to take yet another step back, stunned by the unexpected events.

"Fuck!" Jack screamed at the nurse's paralysis. His voice reverberated off the sleeping hospital's walls. He needed help fast, but he didn't want to leave Laurie alone even for a few seconds.

In frantic, desperate frustration, Jack yanked the bed away from the wall. Its locked wheels made a screeching sound on the composite flooring. After pushing the night table to the side, causing the collection of objects on its surface to crash to the floor in a clatter, Jack squeezed himself between the head of the bed and the wall.

With his foot, Jack released the wheel locks. Gritting his teeth and allowing a battle-like yell to escape from his lips, he pushed the bed farther from the wall, yanking out its power cables in the process. With a grunt, he angled the rolling bed toward the door. It picked up speed, and although it hit the door and then the opposite jamb, they were glancing collisions and didn't interrupt his forward progress. In seconds, he was out in the hall, and using all his strength, he got the bed rolling at a good clip down the hallway toward the bright lights of the nurses' station.

"Call a code!" Jack shouted at the top of his lungs as he pushed. An unfortunate housekeeping cart loomed in the way, but Jack ignored it. The bed with Laurie in it had considerably more inertia, and the hapless cart was bowled over with a crash, spilling its supply of individual hand soaps and other material out onto the floor. Next came a walker, which was nearly crushed by the bed's momentum. "Call a code!" Jack yelled again. Nurses, nurse's aides, and even ambulatory patients began appearing in doorways to see Jack streak by.

Jack tried to slow the bed down as he closed in on the nurses' station with only partial success. The bed caromed off the counter, taking with it all the charts that had been left on the top, as well as a vase of cut flowers that had yet to be delivered to one of the patients. In the bright light, Jack could see how bad Laurie looked. She was ghostly pale and unmoving. Her eyes, with dilated pupils, blankly stared up at the ceiling.

Stripping off his wet coat and jacket and letting them fall to the floor, Jack moved to Laurie's side. After quickly determining that she was definitely not breathing and had no pulse, he pulled Laurie's chin back, pinched her nose and sealed his mouth over hers. He breathed into her several good breaths, then vaulted up onto the bed and began closed-chest cardiac massage. Seconds later, several nurses were at his side. One produced an Ambu bag and began respiring Laurie, carefully pacing herself with Jack's compressions. She inflated Laurie's lungs after Jack had applied five compressions.

Another nurse wheeled over a bottle of oxygen and connected it to the Ambu bag.

"Has a code been called?" Jack yelled out.

"Yes," the nurse said who was breathing for Laurie.

"Well, where the hell are they?" Jack demanded.

"It's been less than a minute since they've been called."

"Damn, damn, damn," Jack sputtered through clenched teeth. He was out of breath from the running, the pushing, and now the compressions. Silently, he lambasted himself for having left Laurie, even if it had been her suggestion. He should have parked himself outside the PACU as he had threatened. From his position looming over her, he could tell her color was a tiny bit better prior to starting the CPR, so they were making a little progress. "What are her pupils doing?" Jack asked the nurse who was bagging her.

"Not a lot of change."

Jack shook his head in frustration. "How long does it usually take for the resuscitation team to get here?" he yelled between compressions. If what he had suspected had happened to Laurie, her life was clearly in the balance until resuscitation team arrived, and even then, he didn't know what the chances were. One thing he was dead certain of: CPR alone wasn't going to hack it. She had to be treated.

As if an answer to a prayer, an elevator door opened out in the lobby and a cardiac crash cart rattled out. Accompanying it were four medical residents, two women and two men who came running. The leader of the pack was Caitlin Burroughs, who looked as if she had been in Shirley Mayrand's medical-school class for gifted toddlers. If Jack had seen her on the street, he would have thought she was a high-school senior, not a senior medical resident. The men looked young, too, but not nearly in Shirley or Caitlin's league.

One of the residents immediately took over the Ambu bag from the nurse. Two of the others started attaching EKG leads. They obviously knew how to work as a team.

"What's the story here?" Caitlin barked, checking Laurie's pupils.

"Hyperkalemia," Jack shot back.

"That's a rather specific diagnosis," Caitlin exclaimed. She spoke in a rapid, staccato fashion. She might have looked young to Jack, but she exuded confidence that could only have come from experience. "How do you know her potassium is too high? Is she a renal patient?"

"No renal disease," Jack snapped back. He wasn't one hundred percent sure Laurie was suffering from high potassium, but he was a hundred percent sure that if they didn't act immediately, and it turned out that she was hyperkalemic as he suspected, they'd lose her for certain, and she'd end up a statistic in her own series. "It would take too long right this minute for me to tell you how I know, but I know," Jack continued emphatically. "We have to treat for high serum potassium, and we have to do it now!

This second."

"How come you're so sure? And, by the way, who are you?"

"I'm Dr. Jack Stapleton," Jack blurted. "I'm a medical examiner here in the city. Listen!

You've had a series of unexpected cardiac deaths in this hospital since January. All have been unsuccessful resuscitation attempts on young healthy people just like this patient.

A red flag has gone up over at the OCME. We think it's purposeful, iatrogenic hyperkalemia."

"We've got almost nothing on EKG," one of the residents announced, standing by the machine mounted on the crash cart. EKG tape was spewing out the side, tracing poorly formed complexes.

Caitlin grabbed a quick look. Whatever she saw pushed her over the edge into Jack's camp, and she began barking out orders that had the nurses scurrying. She wanted calcium gluconate; she wanted twenty units of regular insulin along with a fifty-gram dose of glucose; she wanted sodium bicarbonate; she wanted cation-exchange resin set up for a retention enema; she wanted blood sent for stat electrolytes; and, most important from Jack's perspective, she wanted a surgical resident paged to help with emergency peritoneal dialysis. In Jack's mind, it was the dialysis that could potentially save the day.

While the nurses were busy carrying out the orders and obtaining and drawing up all the medication, one of the male residents climbed up on the bed and relieved a reluctant Jack, but as soon as the man started his compressions, Jack acknowledged the resident was probably doing a better job. As an ophthalmologist-turned-medical examiner, Jack was out of practice when it came to CPR. He was also exhausted, but it was hard for him to stand there at the foot of the bed and do nothing while Laurie's life hung in the balance. While concentrating on doing the chest compressions, he'd been less able to think about the potential tragedy of what he was witnessing.

Jack hadn't run all the way from the OCME to the Manhattan General Hospital, but he had run quite far just the same. He'd run almost ten blocks up First Avenue without seeing an empty taxi. A number of cars had passed him and sprayed him with water, but none had stopped. Then his luck changed. Near the UN headquarters, a police patrol car had pulled over in front of him, apparently thinking he was fleeing from a crime. When Jack flashed his medical examiner badge and breathlessly said he was on an emergency run to the Manhattan General, the police had told him to jump in. They took him nonstop with their siren blaring. If it had crossed their minds why a medical examiner who deals with dead bodies had an emergency in the middle of the night requiring him to sprint up First Avenue, they hadn't let on.

As Laurie's hyperkalemic treatment began to bring down the high potassium that Jack feared was coursing around in her blood, an anesthesiologist showed up. He proceeded to deftly intubate Laurie so she could be respired with more certainty. When he straightened up after finishing the procedure, Jack caught his name. It was José Cabreo, and Jack did a double take. He remembered the man's name from Roger's lists. Jack found himself watching José's every move and was relieved when the anesthesiologist quickly left.

The peritoneal dialysis was started percutaneously without a hitch, using a large bore trocar. Jack averted his eyes as the trocar was punched through Laurie's abdominal wall, but he was close enough to hear the popping sound it made as it went through the fascia, and he winced. A moment later, he watched as isotonic fluid free of potassium was then run into her abdomen. Jack secretly crossed his fingers and prayed that the procedure would help. He was aware that with the extensive surface area within the abdomen as a result of the loops of intestine combined with the rich plexus of blood vessels, peritoneal dialysis was the most efficient even if passive way to lower potassium or any other elevated electrolyte in the blood.

Unfortunately, after ten minutes of the aggressive therapy, there was disappointingly little change in Laurie's status. Caitlin ordered more calcium gluconate and injected it herself. Jack heard this from afar, as he'd begun pacing between Laurie's bed in front of the nurses' station and the elevator lobby. It wasn't the caffeine that was propelling him now, it was his mounting fear and guilt. His nagging concern was that this episode might be another instance of his being a jinx to those he loved. The thought haunted him mercilessly. In one night, he already had lost a potential child; now he was on the verge of losing the person he loved. To make matters worse, he knew he was at least partially to blame.

When the stat Woodwork came back, Caitlin brought it over to Jack. "Well, you were absolutely right," she said while pointing to the highlighted abnormally high potassium level. "That's about as high as I've ever seen it. After this is all over, I'd like to hear how you knew."

"I'll be happy to tell you," Jack said, "provided Miss Montgomery pulls through." If Laurie didn't make it, he didn't know if he'd be willing to talk to anybody.

"We're doing our best," Caitlin said. "At least her color is good and her pupils have definitely come down."

As the minutes inexorably passed, Jack kept his distance. As a bystander, it was progressively upsetting to him to see Laurie splayed out on the bed with a stranger pounding on her chest and another dispassionately squeezing the breathing bag. The ambulatory patients who had earlier come to their respective doors to watch the unfolding drama had gone back to their beds. Most of the floor nurses had also been called away by the needs of their own patients.

It was twenty minutes to six when the first truly optimistic sign occurred, and it was Caitlin who noticed it. "Hey! Gang!" she shouted. "We're getting some electrical activity in the heart!" The medical resident who was not currently doing either the closed chest massage or the breathing-bag compression rushed over to the EKG machine to look over Caitlin's shoulder. "Send off another stat potassium level," Caitlin yelled to the nurse who was assisting them.