“You know,” I said dreamily, “an awful lot of happiness for the two of us”—and then I eyed her tummy and corrected myself—”make that the three of us, depended on that maitre d’ in London putting us together.”
More than just her toes were starting to stir in my lap.
“Things that important can’t just be left to chance,” she answered softly.
“What?”
“I slipped him five pounds and asked him to put me at your table.”
“You what?”
“I was feeling like I am now. Take me upstairs to bed.”
Her eyes opened and were intensely blue, and not a hint of sleep lurked in them.
“It’s okay for him still?” and I cupped my hand lightly over the mound above her groin.
She put her hand on mine and pressed. “Don’t worry,” she whispered, “I’m a specialist. I’ll teach you the ways.”
* * * *
Next morning I felt rested even when I awoke at five-thirty. Then I heard the garage door closing and felt the emptiness of the house. Janet seemed to defy the pregnancy, daring it to slow her down. I worried when she didn’t accept body messages to rest. She scoffed that anything less than her usual workload would drive her mad.
So that morning after showering and dressing. I sat alone with coffee and Muff and planned out my day.
It was still dark, but first I called emergency to catch Kradic’s night resident before sign-out.
“Emergency.”
“Hi, it’s me. Is the resident there? I’d like to speak with him or her, please.” I’d had a bit of hesitation calling Kradic directly with my question. Given his usual defensiveness, he’d probably think I was checking up on him, even if, as I hoped, his answer provided a completely innocent explanation as to why the DOA had a cardiac needle track. And my reluctance had a darker cause. I hated to admit it, but I was starting to take precautions with my staff. My logical insistence that no one had an obvious motive to kill Kingsly and my best determination to resist unfounded suspicions were being eroded. An unpleasant wariness was creeping into my feelings about individual physicians, especially with the ones who were difficult. Until Kingsly’s killer was caught, that uneasiness would be there.
“He’s busy. But just a minute, please, I’ll ring Dr. Kradic’s room—”
“Hold it! Don’t wake him—” But it was too late, and I was left listening to his phone buzz, feeling stupid for not avoiding him as I’d planned. I was relieved when there was no answer.
The clerk came back on the line. “He doesn’t seem to be there. Doctor. Should I page him?”
He was probably having an early breakfast. At least he’d better have been. “No, let me speak to the resident. Is he still busy?”
More clicks, unanswered rings, then finally someone picked up. “Emergency, Miss Claymore speaking.”
“Miss Claymore, it’s Dr. Garnet. I’m trying to locate the resident.”
“The resident’s with a patient. But Dr. Kradic should be in his room asleep. Shall I buzz him?”
“No, I’ve already done that. Could you please see if the resident could come to the phone?”
“One moment, please.”
This circling on hold like stranded aircraft over a dysfunctional airport would get worse once the day really started.
Finally someone picked up. “Dr. Todd here.”
I didn’t groan out loud, but he might have heard me exhale with a bit more vehemence than usual. Sleeping with a staff person wasn’t anything I could officially censure a resident for, but it sure raised doubts about his judgment and, in this case, his taste.
I tried to sound casual. “Hi, Dr. Todd. Look, I’m sorry to bother you, but did you or Dr. Kradic do any practice procedures on the DOA early Monday morning? In particular, did either of you pass a cardiac needle?”
“Not me, but I wasn’t there. Laura Tran covered the rest of my shift that night. It was my fiancée’s birthday, and we had a midnight supper planned.”
So much for fidelity, I thought, first thinking of his poor fiancée, then wondering if Jones knew, or cared. Maybe it even aroused her. “Any idea where Dr. Tran is?” I asked, refocusing on why I’d called.
“Tahiti.”
“What?”
“Tahiti. She left Tuesday morning. That’s why she did the switch; I’m covering her now to add an extra day onto her vacation.”
We paid these residents too much.
“When will she be back?”
“Two weeks from today.”
Way too much.
I hesitated, then accepted that Kradic would have to be asked outright, whatever he might make of it.
“Dr. Todd, listen, in case I miss Dr. Kradic, could you ask him to call me when he goes off duty this morning?”
He seemed puzzled but answered, “Sure, but Dr. Jones is here early for sign-out rounds. Do you want to ask her?”
God, no! “No, it’s all right, just ask—” Again it was too late. He’d put her on the line.
“Yes, Dr. Garnet,” she began icily.
“Ah, Valerie, I was just looking for Dr. Kradic. Dr. Todd has the message—”
“I can give it to him,” she said, almost like a command to let her do it. “He’ll be down from breakfast for sign-out in a minute.”
Christ, she was testy. Probably it was her resentment of Kradic and having to do sign-out with him, but I never really knew what fired her nasty moods.
“Thanks, Valerie. Sorry to have disturbed you, but Dr. Todd has it covered.” I hung up without waiting for a reply. I wasn’t going to risk her setting off Kradic with a question about needling hearts. Damn! He’d be surly enough with it coming from me, even if I was asking through a resident And once again there was that unwelcome cautiousness about who I confided in and what I said. Then, as if for finishers, a frisky afterthought tumbled into my mind. Was Jones in early so she and Todd could have a little morning screw before starting rounds? Shit! I was going to have to make time for our talk as soon as possible.
I felt exhausted and had accomplished nothing. Tahiti! What a great idea. Made me jealous. Especially since I had to deal with the injunction issues.
Our high-priced legal protection from Albany had handed me a pretty big card, but I had to play it carefully. One chance to knock Hurst off his injunction crap would be all I’d get. Today was going to need a finesse that had nothing to do with medicine but everything to do with protecting our patients from bureaucratic chiseling.
After three cups of coffee, two croissants, a riffle through old newspapers, and a twenty-minute soak in the bathtub, I had my plan. I left a message on Carole’s answering machine to assemble our entire staff that afternoon at five o’clock.
It was after six-thirty and time for Muff and me to make our tour again. The weather had changed exactly as the experts had predicted. It was unusually dark for this time under a black, overcast sky, and a thick fog made it difficult both to see and breathe. The temperature must have dropped below freezing as well, because everything was coated with an icy film. My leather soles skidded over broken concrete while Muffy had no trouble getting traction with her built-in four-wheel drive. I mimicked an aging Nureyev trying to keep my balance as she tugged me along on her leash.
I heard the car before I saw anything. If I hadn’t already been lurching into the gutter from an unexpected skid behind Muff, it would have hit me.
Black, no lights, and exploding out of the darkness behind us—only the roar of its engine gave me the cue to leap into my forward fall and roll as the tires brushed my face. My left hip took the landing full force on cement and the pain made me yell involuntarily in agony and feel a surge of nausea. By the time I reopened my eyes, the car was past and I could see it disappearing down the lane.
I watched in sick horror as it reached the street, spun around, and, with another roar of acceleration, started back at me.
Chapter 9
The pain in my hip came in waves, like the hot vomit
at the back of my throat. It took a few of these crescendos before I even started to move. I could see the grille on the front of the car hurtling toward me, swerving on the ice as it came. There was no time to get up. It careened over to the side of the alley where I lay. I managed to roll farther in under an overhanging cedar hedge and grab the small trunks at its base. I flattened myself against them and felt the wheels whip by my back and legs. The bushy outgrowth above had kept the car from running over me.
It sped on toward the far end of the lane and disappeared into the fog and darkness. I let go of my handholds under the hedge, rolled back out to the edge of the cement, and began scrambling to my feet. I slipped on the ice and went back down. More pain lanced through my hip. I sat there, staring toward the sound of the motor, which was receding into the murk. Then I heard the tires squeal in the distance.
Turning away, or coming back?
The motor roared again.
I realized my hands were empty. I heard the rising yelps begin like the crescendo of a chill. They turned to screams of blind animal panic.
“Muff!” I gasped, forgetting my own pain.
I could hear the car coming back up behind me.
Muffs high-pitched shrieks were pulsing now. Bedroom windows lit up.
I was pleading, “No, please, no” as I struggled to reach her.
The car sounded as if it were on top of me. I glanced quickly over my shoulder but saw nothing coming out of the darkness—yet.
I pushed myself to my feet to look. Muff is black, impossible to see in the dark. How many times had I fallen over her on a nocturnal trip to the toilet? I thought, limping and stumbling toward her cries. I was still unable to see her in the dim light of the lane. The noise of the approaching car was right at my back.
The yelping weakened, but now seemed to come from a black hollow under a cedar hedge.
I hobbled over, reached down, blindly scooped into the shadow with my arms, and came up with her.
Over my shoulder I saw the car, headlights off, looming out of the mist and heading for me.
I stumbled forward again. “Muff, Muff,” I repeated, staggering under her weight, looking for a safe place to leap from the narrow alley.
The car accelerated on my heels.
I planted my left foot and lunged right against a mesh of bare branches from a tall lilac hedge. It was like going through the breakaway protective fence behind the end zone in high school football—only this barrier didn’t break away. Muff and I crashed to the ground under a shower of roots and sticks.
The car flew by and this time kept on going.
I was thinking only of Muff. She’d fallen out of my arms as I hit the ground. It was even darker here under the hedge, but I crawled toward her sounds, trying to calm her, saying her name. She was reduced to whimpering now.
I touched her; she was trembling, shaking. She struggled toward me but fell back. I found her head. She whimpered again, then gave my hand a feeble lick.
I felt down her front paws. Nothing. I kept talking softly, rubbing her head, and continued to explore. My hand slipped inside the rip in her open belly and into her intestines before I realized what had happened.
They writhed like snakes in spasm from my touch. Her yelps wailed to full crescendo again.
I recoiled and pulled my hand back. I couldn’t see what I’d just felt, but I tried to cradle her spilling organs from falling out onto the dirt.
Porch lights were going on.
Muffs cries were weakening again. Someone started screaming, “Help me! Help me!”
Before I passed out, I realized it was me.
* * * *
I first heard the siren as if in a dream, distant, having nothing to do with me. It was an annoyance. I wanted to go back to sleep and I fought coming to. Then they were shrieking in my ear, and I was awake. My mouth was full of vomit. I was surrounded by a circle of neighbors, most of them huddled in their bathrobes. Two ambulance technicians were trying to move Muffy off me. The shrieks were hers, from fear as much as pain. Through bits of sour particles I tried to yell “No,” but nothing came out. I tried again, but managed only to squeak, “Stop!”
They ignored me and continued to pull her away. She started to writhe. Panicked, she snapped at one of the drivers.
“Shit!” he yelled, and dropped her. She shrieked again and tried to struggle up.
I finally managed to shout, “Leave her!”
The two startled techs backed away. I was up on all fours now and crawling to her, comforting her by saying her name, lying that it was okay. I put my hand back on her torn and eviscerated abdomen.
The techs were looking at me as if I were mad. The older one seemed frozen, undecided what to do. The bigger one said, “Hey, you shouldn’t move.”
Now the older one seemed to decide his partner was right, and both yelled in horrified unison, “Don’t move!”
But I’d already broken every basic rule on page one of their trauma manual. And apart from my hip still throbbing, everything seemed to work all right.
Yet they were on me like a tag team, trying to pry me away from Muffy, immobilize my neck, take my vitals, and tell me in that familiar professional cant, “Lie back, be calm, just let go of the dog, sir!”
“Look, I’m all right. Help me save the dog. I tell you, I’m all right.”
“We can’t do that, sir,” the older man said. “You’ve been hit by a car, and we have to get you to a hospital. They’ll check you out there.” His grip on me was getting tighter. Muffy, sensing the struggle, started to writhe again.
“Guys, look at me! I’m chief of emergency at St. Paul’s. I know what you’re trying to do, and I appreciate it, but I’m okay.” They paused; I was going to have to convince them to cut some major comers and violate some biggies. In fact, they should be canned if they listened to me, and I knew it.
“Look, no neck pain, I can move it all around; I fainted, wasn’t knocked on the head; my hip hurts but I can move it too; I’m not bleeding, and I know what day of the week it is. I need help with the dog! Will you?”
The bigger of the two had been getting ready to strap me down. Immobilization must have been his specialty. The older attendant peered at me. Of the two, he had seemed the more intent on getting me into the ambulance and to a hospital. I realized I must be smeared with dirt and vomit. But his partner, the one with the straps, appeared to hesitate. He looked hard at my face. I took a chance. “Didn’t I teach you prehospital care last year at the university?”
I teach them all every year at the university, sooner or later, as part of Zak’s refresher program. I hoped this guy hadn’t cut classes.
He took an even harder look. “Holy shit, it is you. What the hell happened here?”
These guys respected rank above all else, and I was pulling it. I felt a little guilty. They should have told me to suck rocks and gone by the book.
“I’ll tell you later. Meantime, can we get my dog to the Buffalo Animal Hospital? They’re equipped for surgery there, and we can still save her.” Muffy had sensed the change, to talk from yelling, and was quieter, but she still whimpered and shook under my hands.
The older one looked pretty skeptical, but my former student was a little more receptive. “Gee, Doc, I don’t know. I mean, we’d like to help you, but a dog, I don’t know—” His reservations were understandable.
“Look, I’ll settle it with Zak. I’ll take full responsibility; I’ll tell him I forced you,” The guy still looked doubtful.
“In writing,” I added.
It helped. But they were still hesitating. “And of course I’ll sign a release of liability for myself,” I added.
That did it. Being responsible for blowing my case was apparently their biggest worry. I quickly signed triple forms proclaiming I was an ass and hadn’t the sense to do what they thought was good for me.
Muffy was breathing hard; each expelled breath ended in a weak whine. The wound, as best I could see in their headlights and the gra
y, belated start of dawn, looked surprisingly clean and straight. She must have been sliced from catching a fender edge on the first pass as we both leaped clear.
A few of the neighbors, shivering in their bathrobes, asked if I was all right. Someone offered to go back and lock the house.
From the ambulance kit I took a large sterile pad and put it over Muffy’s abdomen. I held it in place as the other two men lifted her gently, and, now unprotesting, onto the stretcher. I didn’t really know if all that stuff I’d said about being all right was true. As I stood and walked beside Muffy to the ambulance, I felt my knees start to buckle. I hoped that neither of the attendants noticed, but I caught the bigger guy checking his shirt pocket to make sure my signed release was handy.
As I climbed through the rear doors, I noticed the sign on the vehicle’s side panel. This was one of me rogue private companies we kept an eye on. But for a ride to the vet, I figured it didn’t matter, and got Muffy settled down in the back while the attendants climbed into the front.
“Siren, Doc?”
“Why the hell not?”
He hit the switch.
Never had the clientele of Buffalo’s leading animal hospital had an arrival like it. We’d phoned ahead in the ambulance, so Dr. Sophie had her team ready at the door. She was an old friend from shared premed classes during university days. Our arrival with full lights and siren raised her eyebrows, but she and her colleagues swept Muffy away and into the OR. I wished my unit were that fast.
I thanked the drivers and assured them I wouldn’t forget to call Zak and put in a good word.
After their departure I felt helpless with nothing to do. I was smeared with Muffy’s blood and juices from her innards. Awkwardly I took a seat in Sophie’s waiting room. Her other “patients” sniffed the gore on my shirt and backed away. The owners looked miffed that I’d gotten priority treatment. Muffy’s emergency surgery had pulled most of Sophie’s staff from conducting routine visits.
“Car accident,” I offered, hoping forgiveness would follow. I got a bunch of “Likely story!” stares instead.
Lethal Practice Page 15