Authors: Peter Clement
Tags: #Fiction, #Thrillers, #Suspense, #General, #Medical, #Thriller
He drew closer.
Through the window of the nearest compartment he watched a team of green-clad figures wearing both goggles and full plastic visors. They worked feverishly on a muscular, ebony-skinned man who had fought similar battles shoulder to shoulder with Earl in ER but now struggled for his own life. Teddy Burns had been a respiratory technician at St. Paul's for over twenty years. Just weeks ago the two had joked how neither of them was getting enough sleep, and they'd shared bragging rights over who had the bigger circles under his eyes.
"Too damn proud to let the ship sink- that's us in a nutshell," Teddy had said with a wink, and rushed off.
Now those same dark, deep-set eyes desperately searched the masked faces who towered above him. Teddy's chest heaved as he bucked the tube his rescuers had inserted down his throat to hook him up on a respirator. His gaze found Earl's, and the creases in his face furrowed, angrily funneling in on the outrage that protruded from his mouth, as if ending up like one of his past patients meant the ultimate indignity.
Earl shuddered and placed the palm of his gloved hand against the pane separating them, hoping that Teddy would see it as a gesture of wishing him well.
But Teddy looked away instead, seemingly in disgust that such niceties would be offered in the midst of his agony.
Stewart Deloram, recognizable from the others by black eyebrows that were equally as unruly as his hair and which no protective gear could hide, expertly inserted a clear plastic tube between Teddy's left ribs.
It instantly filled with a foamy, pink fluid.
Kir royale, Earl thought, remembering Teddy's own unique turn of phrase to describe bloody pleural exudates when he taught medical students. Its presence meant the virus had attacked the lining of his lungs.
And a quick glance at his biochemistry results posted on the windows told Earl the infection had also damaged his liver, kidney, and muscle tissue.
Multisystem failure.
The faces of two teenage sons whom Teddy had so proudly brought to work from time to time flashed to mind, and Earl's stomach gave a sickening lurch.
Stewart emerged minutes later, having discarded his outer layer of contaminated gear just inside the airtight door, then immediately double-gowned, double-gloved, and masked himself again, including shoe and hair covers.
So many steps, so easy to miss one, Earl thought.
After nurses and doctors in Toronto started getting infected, mostly in ER and ICU despite wearing full protective gear, he and Stewart had sat side by side in each other's units, trying to figure out what extra precautions might prevent the same thing from happening at St. Paul's.
"You look like a pair of Georgia crackers sittin' on the veranda," Thomas had teased them, exaggerating his southern drawl.
Earl had laughed, then fired back, "And I suppose guys from Tennessee never pulled up a couple of chairs on a porch?"
"Ah, but we call them deep thinkers."
"Well, sit yourself down, Mr. Deep Thinker, and help us out."
Within fifteen minutes the three of them had identified a half dozen obvious breeches, from masks being improperly tied to people scratching their heads or raising their goggles and rubbing their eyes. Around infected patients during airway procedures- the spray zone, they called it- one cough and the virus could land on hair, eyewear, shoes, anywhere. If staff took off their gloves first before removing head and footwear, or if they retied a lace before taking off their gloves and then went home and pulled off their shoes, or did any of a number of variations of the same scenario, the SARS virus could end up on their fingers.
"Then it's pick your nose and die," Thomas had drawled, driving the point home to anyone who disputed the possibility. The phrase became their watchword in a campaign to heighten people's vigilance against contaminating themselves.
Teddy Burns had been the latest proof that they hadn't done enough.
"What are his chances?" Earl asked when Stewart finished changing.
The weariness in Stewart's gaze trebled. "I don't know." He pulled Teddy's chart from a wall slot beside the test result sheets and flipped to the progress notes. "Did you hear the latest rumors out of the CDC?" he asked while scribbling a few lines to describe what he'd done. "That intensive care and emergency staff will have to wear Stryker suits all the time?"
Earl's heart sank. Critical care workers across North America had been dreading it might come to that.
Stewart was referring to the outfits with self-contained oxygen supplies that personnel in level four virology labs or investigators at the hot zone site of a virulent outbreak would wear. "Space suits," the residents called them. The thought of ending up in one as a part of the new normal for ER left Earl feeling defeated. Gloves and masks created barriers that were distancing enough, but at least he could still speak to those under his care, allay their fears with the sound of his true voice. But to confront already frightened patients while dressed like something out of a science fiction movie and talk to them with the muffled tones of a voice coming through a completely enclosed hood- that tore it, stripped the final human touches from the profession he loved. People like Teddy Burns would die in total isolation, barely able to see, feel, or hear the ones taking care of them.
Earl hesitated, not sure this would be the best time to bring up his own problem.
"Out with it, Earl," Stewart said, but didn't look up. "What do you want?"
"I need a favor about the Matthews case."
Stewart's pen stopped in midstroke. "Oh?"
"Yeah. I just came from her post. The gross showed tumor as expected and no surprises." He handed over the folder. "These are the morphine levels found in her blood, and the resuscitation team's observations, including an estimated time of death. The rest are lab reports, nursing notes, the times of the injections and the doses. Plus her height and weight."
"So?"
"I want you to calculate backward and figure out the dose she must have received before she died." Complex formulas existed in obscure pharmacology references involving the metabolic breakdown rate and body dispersion quotients for just about every drug in the world. They made the exercise possible, and Stewart read that kind of thing as light reading.
"Wait a minute. You figure someone gave her more than what you prescribed?"
"In a word, yeah."
His eyes narrowed, suspicion displacing fatigue. "Why are you asking me to figure it out? You could do it yourself."
"And Wyatt would immediately demand an independent opinion. He's lit a fire under pathology to have the slides ready early next week, plus scheduled death rounds for the day after. In other words, he's hot to nail me. I need you in my corner on this."
Stewart continued to scrutinize Earl, his brow unfurling slightly. "Yes, of course. I'd be glad to help you out. But who do you suspect screwed up? I've pissed off too many people at St. Paul's already not to check out whom I'll offend this time."
Earl told him his theory about the nurses and the double dose.
Stewart's forehead relaxed the rest of the way. "Count on me."
Evidently Yablonsky and company weren't on his don't-mess-with list.
"But what if I don't get the results you expect?" he asked.
"Then I'm probably screwed." Earl got up to leave, then added, "Oh, by the way, I heard about some other peculiar goings-on up there that I've been meaning to ask you about."
The frown returned.
"Wyatt told me some patients have been complaining they'd had near-death experiences, and when his nurses asked you to look into it-"
"That was bogus!"
"Bogus?"
A flush spread over Stewart's face from under his mask. "Yes. The ones I talked to no more had a near-death experience than you or I."
"I don't understand."
"I told Wyatt it probably resulted from all the media reports my work has generated. The power of suggestion, combined with all those drugs they're on, can make for some pretty potent dreams."
"But Wyatt said that after interviewing some of the patients you accused him of trying to set you up."
His color deepened. "Well, that's not exactly true…"
"And according to the nurses, you stormed off the ward mad as hell."
"Mad? Not at all. Annoyed, maybe, that they'd wasted my time, making me check out crap reports."
Earl's curiosity grew. Stewart never minimized a slight or perceived wrong, yet here he seemed intent on portraying whatever happened up there as inconsequential. "Explain crap."
"The accounts were made up. Trust me, I've analyzed enough true experiences to know the components common to the real thing. These just weren't authentic."
For a man who always had at least ten reasons to support an opinion, and in any discussion would usually machine-gun Earl with them, "Trust me" sounded positively evasive. "Look, I'm not blaming you for anything, Stewart. It's just if you found something screwy going on in Wyatt's department, I want to know about it."
Stewart's ears became glowing red half shells. He took a breath, then exhaled slowly, practicing one of the many self-control techniques Earl knew he'd tried to learn over the years. "Okay, I first got a little steamed and figured Wyatt and the nurses had primed their patients to try to dupe me into believing a bunch of trumped-up accounts."
"Dupe you? Why the hell would they want to do that?"
The pupils of his eyes flared wide with anger. "To discredit me and my work." He leaned forward, continuing to speak with a hushed urgency that Earl found uncomfortable. "You see, if I fell for it and incorporated those stories as part of my research cases, then they could expose what happened, and it'd be ammo for all those who say my publications aren't real science."
Lord help him. "Stewart, for what conceivable reason would Wyatt and a floor full of palliative care nurses even want to do such a thing, let alone go to all that trouble? And how do you figure they got the patients to cooperate?"
Stewart took another protracted breath. "Well, I had to admit afterward that that part didn't make sense."
Thank God, Earl thought, grateful to see that a flicker of reason had once again prevailed, however barely.
A layperson might label Stewart paranoid. Earl knew better. He read him as someone bright enough to scan twelve steps ahead of everybody else and see possible scenarios that might mean very real trouble. A great asset in ICU, but a little hard to take in everyday life. What distinguished him from a truly crazy person? He could admit later, although it took a little encouragement, that perhaps his predictions, when they were based on his social exchanges with people, weren't all that probable. Stewart appeared to have once more cleared that hurdle as far as Wyatt was concerned, but Earl still sensed that he was holding something back. "You haven't explained why you thought the accounts were bogus," he said, trying not to sound confrontational.
The flush receded. "I just knew, that's all. Pattern recognition. Hey, some things aren't quantifiable."
Bullshit! Stewart could and would quantify anything remotely to do with his research, including how to recognize bogus data. But in an attempt to render him less defensive, not more, Earl nodded and took another tack. "So you don't think Wyatt is up to anything. Believe me, it might help my situation if I had something on the guy."
Stewart immediately relaxed. He sank back in his chair, his high color returning the rest of the way toward normal, and cocked a bushy eyebrow as if Earl were the crazy one now. "I meant only that the idea of Wyatt recruiting patients and nurses to discredit me didn't make sense. But don't think he wouldn't sabotage another researcher's work, even outside his field. That hothead's so bitter about losing the limelight, he can't stand to see anybody else step into it." Stewart raised his head a little, as if posing for a profile shot. "Especially when that person is as controversial as I am."
4:00 p.m.
All researchers were crazy.
Every one of them secretly believed that his or her work in whatever little corner of the scientific world, however obscure, deserved a Nobel prize. Lifelong feuds, suits, countersuits, allegations of plagiarism, fraud, and the theft of data, suicides, murders- all committed over impugned reputations. The high drama of behind-the-scenes passions remained legend, and this in a profession supposedly dedicated to the cool practice of objective reason.
And Stewart carried that fire in spades, Earl thought, steaming into the elevator. He just wished he could keep St. Paul's free of it.
Some VP, medicals, he knew, spent half their workweek pulling prima donnas from each other's throat. Stewart's wacky story hadn't made sense, but if it had even a speck of truth to it, he'd better check it out and nip in the bud whatever was developing between Stewart and Wyatt. One thing was for certain- Stewart had been hiding something. Earl felt that in his bones.
The ride to the eighth floor took five minutes this time. Small groups of masked patients dressed in robes and pushing their portable IV stands tottered off at each stop, insisting loudly to each other that they should file a complaint about all the waiting they'd had to do in physio that afternoon. He thought nothing of it until he remembered that part of his new position meant he'd be the one who would ultimately answer to them.
Monica Yablonsky stiffened as he approached her desk, and she started to fidget with her glasses again.
"Mrs. Yablonsky, I want to see that list you were to prepare for me, the one Dr. Deloram used when he came here to interview patients who'd reported-"
"I know the one you mean, Dr. Garnet." She drew herself into a parade square stance, erect, as if ready for inspection. "Except I'm afraid it won't do you much good."
"Why?"
Her eyes avoided his. "There were only five names to begin with."
"Then I'll talk to those five."
"But you can't."
"And why not?"
"Three of them already died. The other two are comatose."
4:25 p.m.
Medical Records hadn't picked up the files of the deceased to store them in the archives yet, so he'd looked at them on the spot.