Manitou Blood (2 page)

“What's the bad news?”

George Gathering opened the plastic folder that he was carrying and took out three sheets of test results. “I'd call it
bewildering
, rather than bad. She must have vomited more than two liters of blood, not counting the blood she brought up before we got into her emergency. By rights, she should be dead.”

“I thought it might have been a perforated ulcer.”

“Well, that was
my
first guess, too. But we haven't found any serious erosion of the stomach lining, although I think it's worth doing another X-ray. We haven't found any varices
in the esophagus, either. Her liver's healthy, and she has no portal hypertension.

“So where was all that blood coming from?”

“We're not sure yet. But you know how ulcers can hide themselves out of plain sight.”

“Still—this is very unusual, wouldn't you say? Usually, if a patient's bringing up
that
much blood—well, it's almost impossible to stop it.”

“Like I say, I want to try another X-ray. But she has some other unusual symptoms, too.”

“Oh, yes? Like what?”

“Her digestive chemistry is seriously out of whack for a young woman of her age. Her stomach lining is secreting less intrinsic factor than an eighty-year-old's. Which means of course that she isn't absorbing vitamin B12.”

“So she's anemic?”

“Yes, she is. Not only that—or maybe
because
of that—she's hypersensitive to sunlight. We cleaned all that silver paint off her, but when we tried to put her in a bed by the window she literally screamed. We had to move her into a room of her own with all the blinds pulled down.”

“What's her history?”

“She says that her name is Susan Fireman. She's twenty-three years old and she's a third-year fashion student at The Beekman College of Art and Design. She shares a loft on East Twenty-sixth Street with two other girls and one of their boyfriends. The mime thing is just a hobby, apparently.

“Her medical records are still held by her family doctor in New Rochelle . . . that's where her parents live. We're trying to contact him now. Apart from the usual childhood diseases, though, she says that the only problems she's ever had are painful periods and an allergy to steamers.”

“Have you contacted her parents?”

“Not yet. She specifically requested us not to. She says that her dad has a serious heart condition and she doesn't want to worry them.”

“I see. Has she been out of the country lately?”

George sorted through his notes. “The last vacation she took was to Mexico, last October, eleven days in Cancun.”

“Have any of her friends or acquaintances shown any signs of sickness?”

“Not so far as she's aware. But there's one other symptom. She's been having a persistent nightmare.”

“A
nightmare?
Nightmares don't make you vomit blood.”

“Of course not. But for some reason she seemed to think it was important. She's been having it night after night, for more than a month. Always the same one.”

“Go on.”

“She thinks that she's deep inside a ship, somewhere in the middle of the ocean. But she's shut up inside a box, and it's totally dark, and she can't get out.”

“That's it?”

George closed his folder. “That's it. But she says that it's so realistic that she doesn't like to go to sleep any more.”

“Yes,” said Frank. He thought about the time that his father had taken him to the circus, when he was five, and a clown had come right up to him and screamed in his face. “I used to have a nightmare like that.”

Frank had given his assistant Marjorie the day off today, so that she could visit her elderly mother in Paramus. He put on his Armani half-glasses to check his e-mail, most of which was spam from pharmaceutical companies. Then he sorted quickly through his letters, tossing aside the circulars and tearing open the envelopes that looked as if they might contain checks. He called Pediatrics to check when he was due for his afternoon clinic (3:45, on the sixteenth floor.) Then he bought himself a large double-strength espresso from the vending machine and went down to the eleventh floor to visit Susan Fireman.

“I've been praying on my knees for this heat to let up,” said Sister Dominica, in the elevator. “I had to use the subway
this morning, and I do believe that the Lord was giving me a preview of the Other Place, in case I was ever tempted to misbehave.”

Sister Dominica must have weighed over 225 pounds and her face was pale and knobbly like an Idaho potato. She might have been
tempted
to misbehave, thought Frank, as the elevator doors opened yet again, and more people crowded in, but where was she going to find somebody to misbehave
with?

He walked along the shiny corridor to Room 1566. The door was ajar, but it looked as if Susan Fireman were sleeping, so he stepped quietly inside without knocking. The blinds were all drawn down over the windows, but a faint, moth-shaped twist of sunlight quivered on the wall, illuminating a picture of Jesus, standing by the sea of Galilee. The air-conditioning had been turned to Nome, Alaska, and Frank couldn't stop himself from shivering, just like Susan Fireman had shivered at the top of her imaginary ladder.

Frank went up to her bedside and looked down at her. She was breathing steadily, with an oxygen tube in her nostrils. Her face was so white that her skin was almost translucent, like a death mask molded out of candle wax, but she seemed to be peaceful. The nurses had combed most of the silver paint out of her short dark-brown hair, but it was still dry and tangled and out of condition.

He balanced his cup of coffee on the bright red crash cart next to her bed and checked her monitor. Her blood pressure was low and her pulse was a little too quick, but there was no arrhythmia. He was tapping the touch-sensitive screen to check on her CO2 and her FiO2 when he became aware that her eyes were open, and that she was watching him.

“Oh . . . you're awake,” he smiled. “How are you feeling?”

“Sick,” she whispered.

“You
can
talk, then?”

She nodded. “Yes . . . but only when I have to.”

“Is there a reason for that?”

“Not really. But if you stay silent, you can never tell lies, can you? And nobody can ever misquote you.”

He finished checking her vitals. “I don't think I'd last very long in
my
line of work, if I had to mime everything.”

“Oh . . . you'd be surprised,” she said. She circled her head around and around, with her eyes crossed. “Dizzy spells,” she explained.

“Okay,” Frank conceded. “I guess it's just as well that you're so good. There's no way I would have stopped to watch you, otherwise.”

“You don't like mimes?”

“Unh-hunh. All that smelling pretend daisies and leaning up against pretend walls—that doesn't do anything for me, I'm afraid.”

“I see. You're one of those people who refuse to believe that things exist unless you can actually see them.”

“When it comes to walls, yes.”

“How about ladders?”

“Okay . . . for a split second, yes, you did make me believe that you
were
climbing a ladder.”

She gave him a faint, sloping smile. “I could have climbed higher, but I lost my nerve.”

“Sure,” he said. He leaned over her and shone his flashlight into her eyes, one after the other.

“You took care of me,” she told him.

“Hold still. Of course I took care of you. It's my job. You were lucky that the finest gastroenterologist in the entire Western hemisphere happened to be watching you when you started to bring up all that blood.”

“Do you have any idea what's wrong with me?” she asked him.

“Not yet. You have very low blood pressure, which is
causing us some serious concern. Your CBC shows that you also have pernicious anemia, which is probably caused by an inability to absorb sufficient quantities of vitamin B12. But neither of those conditions would directly cause you to hemorrhage, and so far we haven't been able to detect any lesions in your digestive tract or any vesicles in your esophagus.”

“I'm not sure I know what any of that means.”

“It means, simply, that we haven't yet discovered what's wrong with you.”

She didn't answer him directly, but turned her face away, so that she was staring at the picture of Jesus. “He looks sad, don't you think?”

“Have you been feeling at all sick lately?” Frank asked her.

“No, not exactly. I've been feeling . . .
different
.”

“Are you on any medication? Antianxiety agents? Antidepressants? How about diuretics?”

“I take ginger and yarrow, for menstrual cramps.”

“Okay . . . how about alcohol? How much do you drink, on average?”

“A glass of red wine, sometimes. But not very often. I get drunk very easily, and I don't like losing control.”

“Street drugs?”

“Never. Well, once, but that was over a year ago.”

“Tell me about your diet. Are you a vegetarian?”

She nodded, although she still kept her face turned away.

“Sometimes strict vegetarians suffer from vitamin B12 deficiency,” Frank told her. “It's pretty easily sorted, though, with tablets or injections.”

He scribbled a few notes, and then he said, “Dr. Gathering tells me you're very sensitive to sunlight. How long have you suffered from that?”

“I don't know . . . three or four days. Maybe longer. I can't really remember.”

“Is it just your eyes, or is your skin sensitive, too? Do you get a rash or anything like that?”

Susan Fireman shook her head. “I can't go out without my makeup, even if the sun's not shining.”

“What happens if you don't wear makeup?”

“It
hurts
. It feels like I'm standing an inch too close to a furnace.”

Frank made a note to talk to Dr. Xavier, the skin specialist. Then he said, “You've been having recurrent nightmares, too, I understand?”

Susan Fireman pulled a dismissive face, as if she didn't want to talk about it.

“A recurrent nightmare can sometimes be a symptom of an underlying medical problem. It's your body sending a warning to your brain that something might be seriously wrong.”

“I don't know . . . this feels more like a
memory
than a nightmare.”

“You keep dreaming that you're on board a ship, is that it? And you're shut up inside a box, in the dark.”

“Not just shut up. The lid's screwed down tight. And there are more boxes stacked on top of my box, so that I couldn't possibly get out, even if it
wasn't
.”

“I see. So how do you know you're on board a ship?”

“Because I can feel it moving. It pitches up and down, and then it rolls. And I can hear timbers creaking, and the sound of the ocean. Sometimes I hear somebody shouting, in a very singsong way, and that frightens me more than anything else.”

“Do you know who it is?”

Susan Fireman turned back and looked at him. “It's a boy, by the sound of it. He shouts out something like
tatal nostru
, over and over again. There's a whole lot more but when I wake up I can never remember it.”

“Tattle nostrew? Do you have any idea what language that is?”

“None. But it frightens me, because the boy sounds so frightened.”

Frank said, “We're going to have do some more tests. Some allergy tests, and some eye tests, and at least one more X-ray, to see if we can find an ulcer. I think we need to contact your parents, don't you, and let them know what's going on?”

“My dad's real sick. I don't want him upset.”

“Well, maybe we could talk to your mother first, and let
her
decide how to tell him.”

Susan Fireman thought for a moment, and then she said, “No . . . leave it for now. Please. I'll tell her myself.”

“Is there anyone else you want us to talk to? How about the people you share with?”

“No—don't tell them.”

“Don't you think they're going to be worried, when you don't come home?”

“
Please
. . .”

Frank tucked his notebook back in his pocket. “Okay, you're the boss. I'll come back later and see how you're getting along.”

He was walking back through his office door when his beeper went off. It was Dr. Gathering, and it said urgent. He pressed his phone button and said, “George? What's happening?”

“Willy's sent me up the final results of Susan Fireman's bloodwork. She's anemic, no question about it, but there's something else, too. Willy says that she has some enzyme in her bloodstream that he can't identify. He might have to send it off to Rochester.”

“Well, I've just been down to talk to her, and there's definitely something unique about her.”

“That's not all, Frank. Willy also tested a sample of the blood that she vomited.”

“Yes?”

“It's not hers. In fact, it's two different blood types altogether.
She's type AB, but the blood that she vomited was a mixture of type A and type O.”

“What?”

“I'm afraid so, Frank. That blood didn't get into her stomach from internal bleeding. She
drank
it.”

While Frank and George sat on the low-slung leather couch and watched him, Dr. Pellman skimmed through the results of the blood tests, tapping his ballpoint pen furiously against his teeth. Eventually he threw himself back in his chair and said, “
Christ
.”

“We thought you ought to see it ASAP,” said George.

“Well, you're damn right about that. We need to call the police, and we need to call them now.” He leaned across his desk and flipped his intercom switch. “
Janice?
”