by Robin Cook
In a panic Cassi groped for the call button. She hoped someone would come soon and help her.
“What is it, Dr. Cassidy?” asked a nurse coming into the room a few minutes later.
“I feel panicky,” said Cassi. “I can’t take the patches. I want them off.”
“As a doctor, you know we can’t do that. It’s against orders. I’ll tell you what I’ll do,” said the nurse. “I’ll go call your doctor. How does that sound?”
“I don’t care what you do,” said Cassi. “I don’t want eye patches.”
The nurse left and Cassi was again plunged into darkness. Time dragged. When she allowed herself to listen, she could hear reassuring sounds of people moving up and down the corridor.
Finally the nurse came back. “I talked with Dr. Obermeyer,” she said cheerfully. “He said to tell you he’d be stopping by shortly. He also told me that your operation went fantastically well but it is imperative that you rest. He ordered another sedative, so if you’ll just roll over, I’ll give it to you.”
“I don’t want another sedative! I want these patches off!”
“Come on now,” urged the nurse. She pulled back Cassi’s covers.
For a moment Cassi hovered between defiance and compliance. Then she reluctantly rolled over and got the shot.
“There,” said the nurse. “That should make you feel a little calmer.”
“What was it?” asked Cassi.
“That’s a question you’ll have to ask your doctor. Meanwhile, lie back and enjoy poor health. How about your television. Want it on?” Without waiting for an answer she turned on the set and went out.
Cassie found the voice of the newscaster reassuring. Soon the sedative began to have an effect and Cassi fell asleep. She woke briefly when Dr. Obermeyer stopped in to tell her in person how well her operation went. He said that he expected the vision in her left eye to be about normal when the patch came off, but that the next few days were critical and that she should try and be patient. He also told her that he’d left a standing order for sedatives and that she should ask for medication whenever she felt anxious.
Feeling better, Cassi drifted back to sleep. When she awoke some hours later, she could hear voices whispering in her room. Listening, she recognized one of them.
“Thomas?” she said.
“I’m here, dear.” He picked up her hand.
“I’m afraid,” she said, shocked to feel tears running out from under the bandages.
“Cassi, why are you crying?”
“I don’t know,” said Cassi, remembering that it was because Robert was dead. She started to tell Thomas but began to weep so hard she couldn’t talk.
“You have to get control of yourself. It’s important for your eye.”
“I feel so alone.”
“Nonsense. I’m here with you. You have a bevy of attentive nurses. You’re in the best hospital. Now just try to relax.”
“I can’t,” said Cassi.
“I think you need more sedatives,” said Thomas. Cassi could hear Thomas talk to the other person in the room.
“I don’t want another shot,” she said.
“But I’m the doctor and you’re the patient,” said Thomas.
Afterward Cassi was glad he’d insisted. She felt herself drift off into merciful sleep while Thomas was talking to her.
Thomas pressed the nurse’s call button. When the nurse arrived, he stood up from his perch on the bedside. “I want you to give her two sleeping pills this evening. She was wandering the halls last night after one dose, and we certainly don’t want her up tonight.”
The nurse left, and Thomas waited a little longer to make sure Cassi remained asleep. Within minutes her mouth fell open and she began a throaty, uncharacteristic snoring. Thomas walked to the door, hesitated, then returned to the bureau and opened the bottom drawer. As he’d expected, the SSD data had not been touched. Under the circumstances he didn’t want Cassi to be pulling it out as soon as her patches came off.
Quickly he picked up the computer printout and slipped it under his arm. With a final glance over at Cassi, Thomas left the room and walked down to the nurses’ station. He asked for the head nurse, Miss Bright.
“I’m afraid that my wife is not standing up too well to the stress,” said Thomas apologetically.
Miss Bright smiled at Dr. Kingsley. She knew him professionally very well. It was a surprise to hear him admit anyone might have a human weakness. For the first time she felt sorry for him. Obviously having his wife in the hospital was a strain on him, too.
“We’ll take good care of Cassi,” she said.
“I’m not her doctor and don’t want to interfere, but as I told the other nurse, I think for psychological reasons she should be kept under pretty heavy sedation.”
“I’ll see to it,” said Miss Bright. “And don’t you worry.”
Cassi could not remember having had dinner, although the nurse who brought in sleeping pills assured her that she had.
“I don’t remember it at all,” said Cassi.
“That’s not a very good recommendation for the hospital kitchen,” said the nurse. “Nor for me. I fed it to you.”
“What about my diabetes?” asked Cassi.
“You’ve been doing fine. We gave you a little extra insulin after your meal, but otherwise it’s all in here.” The nurse knocked the IV bottle with her knuckle so Cassi could hear. “And here’s your sleep meds.”
Cassi dutifully put out her right hand and felt two pills drop into her palm. She put them in her mouth. Then, reaching out again, she felt the glass of water.
“Do you think you need a sedative too?”
“I don’t think so,” said Cassi. “I feel like I’ve slept all day.”
“It’s good for you. Now your night table is right here.”
The nurse took the glass from Cassi, then guided her hand over the bedside rail so she could feel the water glass, pitcher, telephone, and call button.
“Is there anything else?” asked the nurse. “Do you have any pain?”
“No, thank you,” said Cassi. She was surprised she’d had so little discomfort from the operation.
“Do you want me to switch off the TV?”
“No,” said Cassi. She liked the sound.
“Okay, but here’s the switch.” The nurse guided Cassi’s hand to the button by the side of the bed. “Have a good night’s sleep, and if you want anything, give us a call.”
After the nurse left, Cassi did a little exploring of her own. Reaching out, she touched the side table. The nurse had pulled it away from the wall so it would be slightly more accessible. With some difficulty she pulled out the metal drawer and felt for her watch. Thomas had given it to her, and she wondered if she should have it put in the hospital safe. She didn’t find it immediately. Her hand touched her own vials of insulin and a handful of syringes. The watch was under the syringes. It was probably safe enough.
She pulled her hand back under the covers. As the medicine took hold she realized why people were tempted to misuse it. It made reality recede. The problems were there, but at a distance. She could think of Robert without feeling the pain of his loss. She remembered how peacefully he had been sleeping last night. She hoped his death had been as calm.
Cassi suddenly pulled herself back from the abyss of sleep. With a jolt she realized that she must have been one of the last people to see Robert alive. She wondered at what time he’d died. If only she’d been there maybe she could have done something. Thomas certainly might have saved him.
Cassi stared into the darkness of her eyelids. The memory of Thomas coming into Robert’s room replayed itself slowly in her mind. She remembered her shock at seeing him. Thomas had said that when he hadn’t found Cassi in her room, he’d assumed she was visiting Robert. That had satisfied her at the time, but now Cassi wondered why Thomas would have been visiting her in the middle of the night.
Cassi tried to imagine what the autopsy on Robert showed, wondering sp
ecifically if a definitive mechanism of death was found. She didn’t want to think about such things, but she found herself worrying if Robert had been cyanotic or if he’d convulsed at the time of his death. All at once Cassi began to fear that Robert might have been a candidate for his own study. He could have been case twenty. What if the last person to see Robert alive had been Thomas? What if Thomas had gone back to Robert’s room after he’d left her? What if Thomas’s sudden change of behavior was not as innocent as it appeared?
Cassi began to shake. She knew she was being paranoid, and knew how self-fulfilling delusions could be. She understood the stress she’d been under, and she’d had an enormous amount of drugs, including the sleep medication that she could already feel sapping her ability to think.
Yet her mind would not give up its horrifying thoughts. Involuntarily she found herself recognizing the fact that the first SSD case occurred at the same time as Thomas’s residency. Cassi wondered if any of the deaths coincided with the nights Thomas had spent in the hospital.
All at once she became aware of her utter dependency and vulnerability. She was alone in a private room with an IV running, blindfolded and sedated. There was no way for her even to know when someone came into the room. There was no way for her to defend herself.
Cassi wanted to scream for help, but she was paralyzed with fear. She drew herself up into a ball. Seconds passed, then minutes. Eventually Cassi remembered the call button. Ever so slowly she inched her hand in its direction, half expecting her fingers to encounter some unknown enemy. When she touched the plastic cylinder, she pressed the button, holding it down with her thumb.
No one came. It seemed as if she had been waiting for an eternity. She let the button out and pushed it again several more times, praying for the nurse to hurry. At any second she expected something terrible to happen. She didn’t know what, just something terrible.
“What is it?” asked the nurse curtly, pulling Cassi’s hand away from the call button. “You only have to ring once, and we’ll come as soon as we can. You have to remember there are a lot of patients on this floor and most are sicker than you are.”
“I want to change rooms,” said Cassi. “I want to go back to a semiprivate.”
“Cassi,” said the nurse with exasperation. “It’s late at night.”
“I don’t want to be alone!” shouted Cassi.
“All right, Cassi. Calm down. As soon as we finish our medication records, I’ll see what I can do.”
“I want to talk to my doctor,” said Cassi.
“Cassi, you do know what time it is, don’t you?”
“I don’t care. I want to talk with my doctor.”
“All right. I’ll put in a call if you promise to lie still.”
Cassie allowed the nurse to straighten her legs.
“There, that must feel better. Now you relax and I’ll call Dr. Obermeyer.”
By the time the nurse left, Cassi’s panic had lessened. She realized she was behaving irrationally. She was acting worse than her own patients. Thinking of Clarkson Two reminded her of Joan. She was the one person who would understand and wouldn’t be angry at being awakened. Groping with her hand, Cassi found the phone and lifted it onto her stomach. With the receiver propped up between her shoulder and the pillow, she got the hospital operator. After Cassi explained who she was, the operator put the call through to Dr. Widiker.
The phone rang for a while, and Cassi began to worry that Joan had a late date. She was about to hang up when Joan answered.
“Oh, thank God,” said Cassi. “I’m so glad you’re home.”
“Cassi, what’s the matter?”
“I’m terrified, Joan.”
“What are you terrified of?”
Cassi paused. With Joan on the line, she realized exactly how silly her fears were. Thomas was the most respected cardiac surgeon in the city.
“Has it something to do with Robert?” asked Joan.
“Partly,” Cassi admitted.
“Cassi, listen to me,” said Joan. “It’s natural you’re upset. Your best friend has just died and you’ve undergone surgery. Your eyes are bandaged. You mustn’t let your imagination run riot. Ask the nurse for a sleeping pill.”
“I’ve already had a lot of drugs,” said Cassi.
“Either you had too little or the wrong kind. Don’t try to be a hero. Do you want me to call Dr. Obermeyer?”
“No.”
“Is there anything I can do?”
“Do you know if Robert Seibert was cyanotic when he was found or if there was evidence he convulsed?”
“Cassi, I don’t know! And it’s not the sort of thing you should be torturing yourself over. He’s dead. That’s more than enough for you to deal with right now.”
“I guess you’re right,” said Cassi. “Just a minute, Joan. Someone’s here.”
“It’s Miss Randall,” said the nurse. “Dr. Obermeyer is trying to call you.”
Cassi thanked Joan and hung up. The receiver was barely back in the cradle when it rang again.
“Cassi,” said Dr. Obermeyer, “I got a call from the nursing office staff that you were upset. I don’t know how to convince you that everything is fine. Your surgery went extremely well. I’d expected to find the usual diabetic pathology but I didn’t. You should feel relieved.”
“I think it’s the patches over my eyes,” said Cassi apologetically. “I feel terrified of being alone. I’d like to be transferred into a room with another patient. Now.”
“I think that’s asking a bit much from the nursing staff, Cassi. Perhaps tomorrow we can think about transferring you. For now I’m more interested in getting you relaxed. I’ve advised the nurses to give you another sedative.”
“The nurse is here right now,” said Cassi.
“Good. Take the shot and go to sleep. I guess I should have expected this. Doctors and doctors’ wives always make the worse patients. And you, Cassi, are both!”
Cassi allowed herself to be given yet another shot. She felt Miss Randall give her a final pat on the shoulder. Cassi was alone again, but it didn’t matter. Drug-induced sleep descended like a silent avalanche.
Cassi awoke from a violent dream filled with wild noise and clashing colors. Despite the heavy sedation, a faint throbbing pain in her left eye reminded her immediately that she was in the hospital.
For a moment she lay perfectly still, her ears straining to pick up the slightest sound. Behind the bandages wild colors continued to dance before her eyes, presumably caused by the pressure of the bandages. Cassi heard nothing save for the distant, muffled sounds of the sleeping hospital. Then she thought she felt something. She waited and felt it again. It was the plastic tube of her IV line. Her pulse quickened. Was it her imagination?
“Who’s there?” called Cassi, suddenly finding the courage to speak.
There was no response.
Cassi lifted her right hand and swung it over the left side of the bed. No one was there. Reaching down, she felt the tape that secured the IV to her arm. Quickly she traced her finger up the plastic tube and pulled gently. The sensation was exactly the same twitch she’d felt. In the darkness someone had touched her IV line!
Trying to control her mounting fear, Cassi groped on the night table for the call button. It wasn’t there. She touched the pitcher, the phone, the water glass, but nothing else. She felt over a larger area, moving her hand faster, feeling her sense of isolation and vulnerability mounting. There was no call button. It was gone.
Cassandra found herself frozen by the power of her own imagination. Someone was in her room. She could sense a presence. Then she smelled something familiar. Yves St. Laurent cologne.
“Thomas?” called Cassi. Pushing herself up with her right elbow, she called again. “Thomas!”
There was no answer.
Cassi felt herself break out in a profuse sweat. In seconds her entire body was drenched. Her heart, which had already been beating quickly, began to pound. Cassi knew instantly what was
happening. It had happened before, but never with such devastating swiftness. She was having an insulin reaction!
Desperately she grabbed for the patches, trying to get her fingers under the plastered-down edges of the adhesive. Her left hand, previously immobilized because of the IV, also tore at the bandages.
Cassi tried to call out, but her voice had no strength. The bed began to spin. She threw herself to the side, against the raised rail. Thrashing wildly, she again tried to find the call button. Instead she inadvertently tipped over the bedside table sending the phone, the pitcher of ice water, and the glass crashing to the floor. But Cassi didn’t hear. Her body was already locked into the grip of full-fledged grand mal seizure.
Carol Aronson, the night charge nurse on seventeen, was in the medication room drawing up an antibiotic when she heard the distant tinkle of breaking glass. She hesitated for a moment, then stuck her head into the chart area where she exchanged a questioning glance with Lenore, the LPN. Together the two women left the nurses’ station to investigate. Both had the uncomfortable feeling that someone had toppled out of bed. They’d advanced only a short way down the hall when they heard the clatter of Cassi’s side rails.
The women rushed into the room. Cassi was still convulsing wildly, her arms jammed through the rails, banging them back and forth.
Carol, who was aware Cassi was diabetic, knew immediately what was happening.
“Lenore! Call a code and bring me an ampule of fifty-percent glucose, a fifty cc syringe, and a fresh bottle of D5W.”
The LPN ran out of the room.
Meanwhile Carol managed to pull Cassi’s arms from between the rails. Next she tried to get a tongue depressor between Cassi’s clenched teeth but that was impossible. Instead she stopped the rapidly running IV, and concentrated on keeping Cassi from hitting her head against the top of the bed.
Lenore returned and Carol took the D5W and immediately changed the IV bottle. She put the old bottle aside, knowing the doctor would want to check the insulin level. Then she opened the IV all the way and transferred the fifty-percent glucose from the ampule to the large syringe. When she finished, she debated using it. Technically she was supposed to wait for a doctor to arrive, but Carol had spent enough time in crisis medicine to know that under the circumstances the glucose should be the first thing tried and that it certainly couldn’t hurt. She decided to give it. The amount of perspiration on Cassi’s body suggested a severe insulin reaction.