The CCU was as busy as the lobby, but the personnel—doctors, nurses, technicians, and orderlies—moved with purpose, sure of their errands. The chief cardiologist was standing on one side of Chuck’s bed; Caroline and Charlie were on the other. The cardiologist nodded at Fenimore. Caroline glanced up and gave a wan smile. Charlie’s gaze was riveted to his son’s face. The father’s face, usually ruddy, was putty-colored. Chuck lay supine, eyes closed, his complexion ashen. A nurse was deftly connecting him to an echocardiograph machine. Fenimore glanced at the EKG above the boy’s head and saw that nothing much was going on. The rate was fast, but the tracing looked normal. Before he had a chance to speak to the Ashburns, the cardiologist signaled him to join him in the corridor.
“A strange business,” he said.
“What happened?”
He told Fenimore, “Chuck was coming into the dock after his practice, when he collapsed. Just slumped over his oars. He was in a singles, and by the time some of the crew members reached him, he was unconscious. Two of the boys took turns giving him CPR until the ambulance came, but he didn’t regain consciousness.”
“What tests have been done?”
“A cardiogram, a blood count, SMA-12, and electrolytes, and they’re about to do an echo.” The doctor drew Fenimore down the hall, away from the people outside the CCU, who were staring at them. He spoke in a hushed tone. “There’s something odd about this case, Fenimore.”
“In what way?”
“It seems he’s an SCD candidate. He has an ICD implant. The coach brought the boy’s wallet in and we found his interrogation card. But when we interrogated the ICD there was no sign of a cardiac event at any time.”
“Are you sure?” Fenimore shouldn’t have said that. It was insulting. But the doctor, intent on the case, took no offense. “Was the ICD functioning properly?” Fenimore asked.
“Perfectly.”
“You’re suggesting his collapse was caused by something else.”
The other doctor nodded. “We’ll know more when we have the lab tests.”
“How soon will that be?”
“About an hour. Mrs. Ashburn said you were an old family friend, and I thought you should know.”
“I appreciate it.”
The doctor excused himself.
Fenimore wasn’t sure what to do next. He couldn’t help the Ashburns until he saw the results of the lab tests. And he didn’t want to get involved with the group in the corridor. He looked at his watch. 1:45. He remembered it was Saturday and there should be a cardiology lecture. Scheduled each week, these lectures were open to HUP alumni who wanted to keep up in their specialties. Many were from out-of-town. He decided to check out the auditorium. As he made his way to another part of the hospital, he spied a familiar face. Ott—the architect for the marina. What was he doing here? Oh . . . he was probably on the faculty at the architecture school. But that was on the other side of campus. So what, Fenimore. People are allowed to cross the campus. He quickened his steps. If he was going to go to the lecture, he might as well be on time.
CHAPTER 27
Fenimore arrived at the auditorium a few minutes early. While waiting—and to take his mind off Chuck—he browsed among the display cases in the hall. One case contained an ornate brass doorknob that had opened the door of the first hospital in Pennsylvania in 1752. Another displayed reproductions of two famous paintings by Thomas Eakins—The Gross Clinic and The Agnew Clinic. In the first, the surgeon was clad in dark street clothes; in the second the surgeon wore white—a sign that during the interim, bacteria had been discovered and aseptic surgery had come into its own. Fenimore was about to head back to the lecture hall when a quote, neatly typed on a white card, caught his eye:
“The bedside study of disease, and the personal familiarity of the student with its manifold symptoms, can alone make the competent and skilled physician, and is justly regarded as the capping stone of a complete medical education.”
George W. F. Norris, M.D.
Professor of Ophthalmology, 1897
Capping stone, indeed, thought Fenimore. That was over a hundred years ago. Today we feed symptoms into a computer and diagnose the disease from a printout. The patient still lies in a bed, but, sadly, the bedside is often empty. Shaking his head, he returned to the auditorium.
Most of the seats were occupied, but the lecture had not begun. Fenimore scanned the audience for familiar faces. He waved to one. Then he spotted another at the back of the room. Daniel Burton, the doctor from Pine Lake, was just arriving. He remembered Burton telling him, during his examination, that he tried to get to these lectures. “When you live in the boonies, you have to make an effort to keep up,” he had said. Fenimore wondered if he knew about Chuck. He tried to think of a way to break the news without revealing the extent of his own friendship with the Ashburns. He went up to him and said casually, “Did you hear about Ashburn’s son? You know Chuck, right?”
He nodded. “What happened?”
“He collapsed during rowing practice. He’s in the CCU. They found he has an ICD implant, but when they interrogated it they found no evidence of cardiomyopathy.”
The doctor, to Fenimore’s surprise, appeared deeply distraught. Burton had not struck Fenimore as a particularly sensitive guy. “He’s doing okay, though,” he said hastily. “They were getting ready to do an echocardiogram when I left.”
“What should I do?” he asked. “Should I go over there?”
“Why don’t you wait until after the lecture. The lab tests should be back then, and you can take a look at them,” Fenimore said kindly.
Looking relieved, Burton took one of the last remaining seats in the rear. Fenimore found one up front just before the lights went down. Apparently, this lecture included slides.
It was a long, esoteric dissertation by an archeologist on the possible cardiac condition of King Tut in 1352 B.C. Fenimore had trouble concentrating, his mind returning again and again to Chuck and what the cardiologist had told him. If the boy’s collapse had not been caused by a cardiac event, what had caused it? His mind ran over the list of possibilities. Sunstroke, hyperthermia, hypoglycemia, seizure . . . But there were no signs or symptoms for any of these conditions. Fenimore suppressed a groan as another slide appeared. At least this one was right side up. He glanced at his watch. He had been here well over an hour. He was contemplating sneaking out when the lecture abruptly ended and the lights came up. Amid the smattering of applause, Fenimore made his way to the back of the room. As he approached Burton, the doctor gave a big yawn indicating his opinion of the lecture. Fenimore smiled in agreement.
“Whenever there’s a sleeper like this, I wonder why I bother,” Burton said.
“I know what you mean. I think I’ll go down to the river and take a row to wake me up. But first, let’s see Ashburn.”
“You know, Fenimore, I think I’d better get back. I didn’t know this would go on so long and I have patients to see at home. Could you ask the attending cardiologist to send me a report?”
“I’d be glad to.”
“Thanks. I’ll call Charlie tonight.” He dug his briefcase from under the seat and hurried out.
Fenimore scratched his head, wondering at this sudden change of mind. He finally decided Burton was one of those guys who avoided unpleasant situations whenever possible. Then why had he become a doctor? But Fenimore had more pressing things to think about. He made his way back to the CCU.
The cluster of concerned friends had vanished, but as Fenimore entered, pandemonium reigned. A nurse pulled him aside. “It’s the Ashburn boy.”
Careful to keep out of the way of doctors, nurses, and technicians, Fenimore edged toward Chuck’s bed. As he drew near, he saw a technician unhook the boy from the electrocardiograph machine and remove his IV lines. He turned away sharply as she drew the sheet over his face.
He looked around. Where were Caroline and Charlie? Nowhere in sight. He stopped a passing resident. “Where are the Ashburns?”
&
nbsp; He paused. “Went for coffee, I guess.”
“You mean, they don’t know?”
“I don’t think so. It all happened so fast.”
Oh my God. Fenimore rushed out, grabbed the first down elevator, and headed for the cafeteria.
They were at the back of the noisy, cavernous room, huddled over their coffee cups. It actually occurred to Fenimore that he didn’t have to do this. They hadn’t seen him yet. Someone else could do it when they returned to the CCU. A nurse or an intern. Someone not emotionally involved. He could turn around right now and walk out.
A nurse knocked his elbow with her overloaded tray. A nurse should know better than to eat so much, he thought inconsequentially. The knock triggered him into action. He approached the Ashburns’ table.
Caroline looked up, and Fenimore was spared words. His expression had conveyed his news without speaking. She stumbled to her feet, rattling the coffee cups. Charlie turned to see what had upset her. When he saw Fenimore, he also rose.
“I’m so terribly sor—” Fenimore began.
They turned away, toward each other, and fell into a clumsy embrace.
CHAPTER 28
Fenimore’s only desire was to get away, out of the hospital. He blinked as he stepped from the dim, stale lobby into the brilliant spring afternoon. The sycamores along Spruce Street strutted their crowns of new green leaves. The tulips and daffodils displayed their bright hues along the curbs, in pots and window boxes. The mingled scents of cherry blossoms, lilacs, and newly cut grass wafted from the Penn campus nearby.
It’s obscene, Fenimore thought—when Chuck has just died!
Amazed at the depth of his feelings, he tried to imagine what the Ashburns were feeling. He hoped they were beyond feeling. Numb. Comatose. Oh, how he hoped that!
In an attempt to ignore the burgeoning life around him, Fenimore bent his gaze on the dirty cement sidewalk and deliberately inhaled the noxious fumes of a passing bus. “Even in the city,” he moaned, “spring breathes her sweet breath into the darkest corners and crevices, the meanest backyards and alleyways. There’s no escape.” Before crossing Spruce Street, he was forced to look up at the traffic light and was struck by a cruel sight. On the opposite corner, a young couple waiting for the same light, their arms entwined, gazed at each other in an ecstasy of love and spring fever. When the light changed, Fenimore hurried past them, eyes averted, and was glad when he reached his car and could shut himself up inside—away from all signs of spring.
He maneuvered his car onto Chestnut Street and headed downtown with no special destination in mind. His only thought was to lose his thoughts in the chaos of the early commuter traffic.
By the time Fenimore reached Twentieth Street, he had recovered enough to remember his former intention to go for a row. The quiet of the river had always soothed his nerves in the past; maybe it would work today. Instead of continuing downtown to his office, he made a left and headed for the parkway. He had shoved a change of clothes into his trunk, on an impulse, a few days ago for just such an emergency. They would come in handy now.
He changed quickly, fetched his oars and his shell, and set his shell in the water. He slipped his feet into the shoes attached to the bottom and settled onto the seat. He was reaching for the oars when a voice called, “Hey, Doc.”
He turned to see Hank Walsh about to take off in his shell. He debated whether to tell him about Chuck. Since they were both in their shells and could only communicate by shouting, he decided against it. Why ruin his afternoon? He would learn the terrible news soon enough. Fenimore simply waved, pushed away from the dock, and began to row upriver.
Hank followed Fenimore slowly. Hank was taking it easy. The contest for Henley was over and he could relax. There was always next year. But he didn’t have to think about that for a while.
Unless Chuck didn’t make it.
He shook this bad thought from his head. Sure, Chuck will make it. I’ll go see him tonight. The fact that he had lost the race for Henley was gradually becoming a reality to Hank. But, after so many months of demanding the best of himself, relaxing didn’t come easily. At first he had felt resentful. All his hopes and dreams shattered in a few minutes. And it had been a close race—a matter of seconds. Was it worth the effort? Sure. Would I try again? Sure. There was always next year, he repeated. Meanwhile, it was nice to row lazily upriver, smell the cherry blossoms, and watch the reflection of a bird sail across the water.
Fenimore was surprised to see the Falls Bridge looming above him. He hadn’t realized he had come so far. Preoccupied with his thoughts, he had not noticed the landscape around him, only the landscape of his mind and emotions. He decided he had better get home and check on his newly adopted family. There might be certain obligations. He turned his shell and, facing upriver, began to row back to the boathouse.
The river was empty except for one other singles shell—a small speck in the distance. Fenimore felt calmer now. The river always had a calming effect on him, unless it was choppy. But he rarely went out in windy weather. He still didn’t have complete confidence in his rowing skills. That would come in time. Meanwhile, he wasn’t going to take any chances.
By the time he neared Peter’s Island, he realized that he had accepted the fact that Chuck would die young the moment the boy had refused to give up Henley. That’s why he had been so depressed. But he had expected Chuck to die in a shell—in the midst of a thrilling race—in a blaze of glory! Not in a hospital bed, hooked up to tubes and machines, surrounded by people in rubber-soled shoes.
And there were so many unanswered questions about how Chuck died. He had collapsed while rowing, but not while racing. He had been merely practicing, not demanding the best of himself. And why hadn’t the ICD registered something? Perhaps the lab reports would answer some of these questions. In his distress over the boy’s death, Fenimore had left the hospital without looking at the reports. He must get hold of them immediately.
He had reached the lower end of the island when the motor-boat shot out.
Damn fool! What’s he doing coming upriver on the east side? And why is his face covered? My God! He’s coming right at me!
The last thing Fenimore remembered was a loud crack—and the shock of cold water closing over his head.
Hank was daydreaming. He was thinking that now he would have more time for his girlfriend, Amanda. He let his oar trail in the water and watched the tiny waves eddy around it. He might even take her dancing like she’d been nagging him to do for months. He grinned. But only if she didn’t make him wear a tie.
Smack!
What the hell? A rock? He scanned the shore, taking his bearings. He was just south of Peter’s Island. There aren’t any rocks here. He craned his neck around the hull and saw it. A capsized shell. He scanned the river for the rower. No one broke the placid surface of the water. He yanked the string that released the Velcro straps on his shoes, rose cautiously, and dove in. He tried to push the other shell with his hands. It wouldn’t budge. That’s strange. Singles shells are light, and I’m pretty strong. He ducked under the shell and opened his eyes.
Through the murky water he made out a rower dangling upside down, his feet still locked in his shoes.
Hank reached up and yanked the string that held the straps, just as he had done with his own shoes. The straps loosened and the rower slipped free. Hank was ready to catch him, but he was unprepared for the impact of his body. It knocked him backward and down. By churning with one arm he managed to hold his own and slowly rise to the surface with his burden. When he broke through the water, he threw his head back and gulped air. Tossing the water from his eyes, he aimed for the island’s shore. It was only a couple of yards, but swimming with one arm was hard. Thank God I’m in shape, he thought, or I couldn’t do this. He dragged the man onto the grass and turned him over.
Holy shit!
He began CPR.
Hank had no idea how long the doctor had been underwater—and his expectations for his revival we
re low.
Press, release, pause. Press, release, pause.
As he worked, he spared a brief thought for the two abandoned shells that were floating downriver—worth eight thousand dollars apiece. Not to mention the oars. Maybe someone would rescue them.
Water gushed from the doctor’s mouth after every pressure, but there was less each time.
Hank paused to listen to his chest. Nothing. He felt the carotid artery. Nothing. He went back to work. With no means of transportation, how would he get off the island? It was getting dark. Would he have to spend the night here? With a dead man? At this thought, he renewed his efforts.
Press, release, pause. Press, release, pause. He checked the carotid again. Did he detect a faint throbbing?
Fenimore was conscious of severe pain in his abdomen. He had to stop it. He opened his eyes to see what was causing it.
A pair of dark eyes, two inches from his nose, stared down at him.
CHAPTER 29
The hospital room was undistinguished except for the abundance of flowers spilling over the windowsill, taking up the table provided for meals, even crowding into the corners. Jennifer and Mrs. Doyle had shoved them aside to prevent the medical staff from tripping over them and breaking their necks. Friends, patients, even one relative—a distant cousin from Saskatchewan whom Fenimore hadn’t seen for years—had read about the doctor’s accident in some obscure newspaper and remembered him florally.
Accident? Ha! Talk about euphemisms, thought Fenimore. That masked guy had run right into him on purpose. And if it hadn’t been for Hank . . . He shuddered. If he could only get out of here, he might be able to find the culprit.
This whole hospitalization was ridiculous. You either drowned or you didn’t. What was all this blather about “near drowning”? He felt fine. But his doctor had advised an observation period, because there’s this thing called “secondary drowning,” in which you can pop off days, even weeks, after your original drowning—the result of some infection, pneumonia, whatever. Of course he knew about this, but it was rare. He thought everyone was being overly cautious. “At your age . . .” was the depressing refrain he kept hearing. Was he really that old? Well, he’d put up with it for a day or two longer. Then he had to get out of here.
The Doctor Rocks the Boat Page 10