Royal Pains : Sick Rich (9781101559536) (5 page)

Chapter 6

The call was from Todd Hammersmith, Nathan Zimmer's assistant. One of the workers who had been prepping Nathan's mansion for the big Fourth of July costume party was having chest pain. Todd went back and forth between talking to me and to Nathan, whom I could hear in the background. Confusing to say the least, but that was Nathan. The story I finally got was that the man had been helping move a piano, had developed chest pain, and was now lying on the floor. Conscious? Yes. Breathing? Yes. Did they call 911? No. Why not? This led to more discussion between Todd and Nathan.

I finally interrupted and told Todd to call 911 and that I'd be right there.

“Right where?” Evan asked after I disconnected the call.

“Nathan Zimmer's place.”

“Count me in,” Evan said. “If you're going to see Nathan, I'm going.”

Evan and his buddy Nathan. First-name basis. Slap on the back. Cigars and whiskey. I wondered if Nathan knew what good friends they were?

We climbed into the HankMed van, Divya driving, Evan riding shotgun, me in back. As she cranked the van to life, Divya said to Evan, “I thought you had appointments this afternoon.”

“Dude, it's Nathan Zimmer.”

“I'm not a dude,” she said.

“Fooled me.”

“Funny.” Her brow wrinkled.

She accelerated through the gate and around the parking lot's perimeter. Pure NASCAR.

“Just being around Nathan makes me smarter,” Evan said, clinging to the dash for balance.

“Perhaps if Nathan makes you so smart you should go to work for him.”

“What would happen to HankMed then?”

“Nathan's loss would be our gain.”

The tires squealed as Divya turned from the lot onto the street.

“Don't you have that backwards?” Evan asked. “Wouldn't it be Nathan's gain and your loss?”

“I think not.”

“Go ahead. Make fun of me. But the smarter I am, the better HankMed does.”

Divya raised an eyebrow. “And all this time I thought it was because Hank and I did such stellar work.”

“That, too. But it took smarts to arrange the HankMed van.”

“True,” I said. “You did good there.”

“Being around people like Nathan Zimmer sparks such creative thinking.”

“Sort of like a viral infection?” I asked. I should have stayed out of it, but I couldn't resist.

“Or the plague,” Divya added.

“Or the seeds of great ideas,” Evan replied.

“Seeds require fertile soil.” Divya slung the van through a hard left turn, pressing Evan against the passenger door. I clutched the arms of my captain's chair.

“I have fertile soil,” Evan said.

“You have rocks.”

Their bickering continued during the twenty-minute drive. I tried to ignore them, but when they got to full boil there was no way. As Evan kept needling Divya, her foot got heavier. I held on as she weaved and swerved through traffic and took corners on what felt like two wheels. Somehow we survived Mr. Toad's Wild Ride and reached Nathan Zimmer's estate intact.

I grabbed the medical bag from the back and we climbed the broad stone steps to the mansion. Nathan's estate was nothing like Shadow Pond, which rivaled the best France's Loire Valley had to offer, looking like something King Louis would have built to escape Paris's summer heat. Nathan's version of a mansion was modern. Very modern. No French château here. All metal, glass, and acute angles. Still impressive, but in a very different way.

The front door stood open, so we walked in and followed the boot-printed paper pathway that stretched over the carpet to the great room. The room that was usually filled with very expensive furniture now stood mostly empty.

Its transformation into a colonial meetinghouse—or perhaps a presidential inauguration would be more like it—was well under way. A dozen flags and two massive crystal chandeliers hung from the thirty-foot ceiling. The stark white walls, glass, and chrome of the very modern home were now partially concealed behind flowing red, white, and blue striped drapes.

Nathan and Todd stood near one wall, looking over the shoulders of several workers kneeling around a man who was stretched out on the floor. The ever-present pulsing Bluetooth device hung from Nathan's left ear. Both he and Todd turned when we entered.

“Dr. Lawson, I'm glad you're here,” Todd said.

“Did you call nine-one-one?” I asked.

“I thought it might be better to wait for you,” Nathan said. “He thinks he might have just pulled something.”

I approached the group. The workers stood and cleared a path for Divya and me. The man lay next to a massive and elaborate grand piano, which was up on a rolling platform as if ready to be moved. He looked to be in his fifties, with thinning hair now damp with sweat, as was his face. He wore jeans and a blue work shirt, the front and armpits darkened with perspiration. He held one hand clamped over his chest.

I knelt next to him, my fingers automatically reaching to check his carotid pulse. It was fast but steady. “What's the matter?”

The man was groaning and his words came out as gasps. “My chest. And my back.” He rolled slightly back and forth. “I can't breathe.”

This was no pulled muscle.

I listened to his heart and lungs. His heart rate was rapid, his lungs clear. Divya checked his blood pressures in both arms.

“I get two-twenty over one-twenty on the right side and one-forty over ninety on the left.”

The concern I saw in her face told me that she was thinking the same thing I was.

“Do you have any medical problems?” I asked.

“High blood pressure. Had it for years.”

“Do you take any medications?”

“A couple of pills for that, but I don't remember what they are. I ran out of them three or four days ago.”

“So you haven't taken any meds for several days?”

He nodded. “My insurance company. They do this every month. They'll only send me thirty pills and then half the time they're a week late getting the new ones to me.”

Not an uncommon problem. This is what happens when the money changers take over medicine. Everybody in a pigeonhole. Everybody in line. The dollar trumps science. God forbid that someone might waste a couple of three-cent pills. Better that they have too few than too many. Welcome to the new medicine.

I looked at Divya. “Get the crash kit and the portable X-ray from the van.” I turned to Evan. “Help her bring the machine in.”

One of the workers stepped forward. “Anything we can do?”

“If you could help them get the equipment that would be great.”

He nodded. “Will do.”

I returned to examining the man. “What's your name?”

“Jimmy Sutter.”

“How old are you?”

“Fifty-two.”

“What happened?”

“We were lifting the piano up on the platform there. So we can roll it out here. Just as we were settling it in place it hit me. Can you do something about this pain?”

“It's coming. Where does it hurt?”

“All across my chest.” He ran his open palm from one side of his chest to the other. His breathing was still labored. “And in my back. Between my shoulder blades. It feels like something is ripping apart in there. You think I tore a muscle or something?”

“I'm going with the ‘or something' right now.”

“What is it, Doc?”

“Just relax. We should know in a few minutes.”

Divya and the equipment arrived. While she started an IV, I opened up the crash kit. I drew up some morphine, and as soon as the IV was in place, gave him five milligrams. I then gave him five milligrams of lisinopril and ten milligrams of metoprolol.

“That should help your pain and lower your blood pressure.”

While Divya rechecked his blood pressure, I began setting up the X-ray.

“His blood pressure is coming down,” Divya said. “I'm getting one-eighty over one hundred on the right and one-ten over sixty on the left.”

I completed unfolding the X-ray machine and we gently moved Jimmy into position. I connected the machine to my laptop so we could see the images once they were taken. Four minutes later we had a diagnosis.

“You're having an aortic dissection,” I said. “The tearing feeling that you're sensing is exactly what's going on. The aorta, the major blood vessel in the chest, has torn. From your high blood pressure and from the stress of lifting the piano.”

“So what does all that mean in English?”

“It means we have to get you to the hospital right now. It means you're going to end up in the operating room to fix this as quickly as we can get you there.”

“Operation?”

“You don't have much choice.”

“Even if I'm feeling better?”

“Are you?”

“A lot. The pain is much better. I'm not as short of breath.”

He did look better. More color in his face, his breathing easier, and even his sweating had decreased.

“That's from the medicines we gave you,” I said. “The morphine is helping with the pain and the other medicines have lowered your blood pressure, but the damage has been done and it needs to be fixed.”

“Should I call the medics?” Nathan asked.

“No. He needs to get there now. We'll call in a medevac helicopter.”

“I'm on it,” Divya said. She pulled out her cell phone.

“Or you can use mine,” Nathan said.

“Yours isn't equipped for this.”

“I assume time is important here?” Nathan asked.

I nodded.

“Then mine is better. It's here, right out back, and I can have my pilot ready to go in five minutes. Mine's faster anyway. We can be at Hamptons Heritage before the medic chopper even gets here.”

A dilemma. Speed or better equipment? I opted for the former.

“Okay, let's do it.”

Todd nodded and snapped open his cell phone.

“Is there someone I should call?” I asked Jimmy.

“My wife. Her name's Roxanne.”

He gave me the number and I punched it into my cell. After she answered, I told her who I was and explained what was going on with her husband, telling her we were flying him to Hamptons Heritage. I then handed the phone to Jimmy so they could talk.

I looked at Divya. “We'll ride with them.”

“Helicopter will be ready in five,” Todd said as he closed his cell phone.

“Do you have something we can move him on?” I asked Nathan.

“Like what?”

“A stretcher would be nice, but a wide board or something like that will do.”

He thought for a minute and then slowly shook his head. “Don't have either of those.”

“A lounge chair will work,” I said. “One of the ones by the pool.”

Nathan snapped a finger and two of the workers headed toward the back.

I began reexamining Jimmy while Divya ran out to the van to restock our crash kit. Evan was in another world. I could hear him and Nathan talking while I worked.

“This looks so cool,” Evan said. “It's like a presidential inauguration.”

“Presidential is what we're going for,” Nathan said. “When the room is filled with people in their colonial attire it should look like an inauguration.”

“Which brings up a question,” Evan said. “About costumes.”

Good grief.

“What costumes?” Nathan asked.

“I couldn't decide what to be,” Evan said. “What do you think?”

Nathan eyed him. “Maybe a banker or a silversmith. Or I think a bookkeeper would be perfect.”

“Why does everyone keep saying that? Is it because I'm an accountant?”

“No,” Nathan said. “It's because you look smart. Bookish.”

“You think so?” Evan asked. “Not like a superspy?”

Nathan studied Evan for a minute and then shook his head. “I'd go with bookkeeper.”

One of the workers walked up. “Mr. Zimmer, should we go ahead and move the piano?”

“Sure.”

The man nodded, and he and three of his coworkers began rolling the huge Steinway out of the room.

“It's beautiful,” Evan said.

“It was a gift,” Todd said. “From Van Cliburn.”

“
The
Van Cliburn?”

Nathan shrugged. “A guy I did business with—actually a guy who invested with me—was a friend of Mr. Cliburn's. I offered him some free advice. On a couple of investments. It worked out. This was his thanks.” Nathan waved a hand toward the piano.

“Do you play?” Evan asked.

“When I was younger. Too busy now.”

“Which is unfortunate,” Todd said. “He's very good.”

“Maybe at one time, but not so much now.”

“Isn't it like riding a bicycle?” Evan asked. “Once you know how to do it you can do it forever?”

“Perhaps, but that doesn't qualify you for the Tour de France. The piano is the same way. I can still play, just not at the level I would like.”

Divya returned with the restocked crash kit just as two of the workers appeared with a lounge chair. Divya and I hooked Jimmy up to our portable cardiac monitor and then settled him on the chair. Four workers carried him and his makeshift stretcher to the helicopter pad, a hundred yards away. The copter's rotors were spinning, the pilot busy with his instruments. We loaded Jimmy through the side door.

The helicopter was large and plush. The passenger area probably held a dozen people. A row of dark brown leather captain's seats stretched along one side and a matching bench seat along the other. We set the stretcher on the bench and strapped it in with a pair of the seat belts. Divya rechecked Jimmy's blood pressure while I adjusted his IV.

“Blood pressure is still good,” Divya said.

“How's the discomfort?” I asked.

“Better.”

“You guys ready?” the pilot asked.

“Yeah.”

We buckled ourselves into a pair of the captain's chairs and held on as the copter jerked skyward. I looked out the window toward Nathan, Todd, and Evan, who stood watching, each shielding his eyes from the rotor blast. They rapidly shrank as the copter nosed up, turned out over the ocean, gained more altitude, and whipped around, aiming for Hamptons Heritage.