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“John, how’s that hand doing? ” Rip Pearson motioned John Ramsey to a seat on the edge of the exam table. “That’s what I wanted to ask you. It’s getting pretty sore,” John said. “Do you think I should be on an antibiotic?” “Let’s take a look.” Rip swung a lamp away from the wall on its hinged arm and focused the light on John’s hand. “If that’s your primary question today, at least you don’t seem to be worrying about HIV with every breath.” If you only knew. “Oh, I’m worried about that, too. I’m just trying to live with it.” John winced as Rip pressed on the soft tissue at the base of his right thumb. “Well, this looks like it’s getting a bit red. Feels warm. It’s swollen, and I think there’s a little fluctuance here.” John knew what that meant. For years he’d taught medical students the four cardinal signs of inflammation. Calor, dolor, rubor, and tumor. Heat, pain, redness, and swelling. “So where do we go from here?” Rip was already reaching for a pair of latex gloves. “I think I’d better stick a needle into that area and see if I can aspirate some pus for a culture.” He opened a cabinet and extracted a large syringe, a needle, and several sealed foil packets containing antiseptic swabs. Rip’s hand stopped and hovered over a rubber-stoppered vial. “Want a local anesthetic?” “No, I’ll be fine. Besides, the fewer times you stick a needle into that area, the less chance of spreading the infection.”
“Right, of course. You haven’t lost a step, have you?” Rip said.
“Maybe one or two, but I think I can still remember a few things.”
John tried to relax as he felt the cool antiseptic on his skin.
“Little stick.” John thought about what a total misrepresentation those two words were. They could mean anything from the mosquito bite of an immunization to the searing pain he was currently feeling in his hand. He hazarded a look and saw that Rip was moving the needle around, looking for a pocket of pus. John winced as he felt the grinding of needle tip against bone. “We may not have any-Oh, there you are. Come to Daddy.” Rip pulled back on the plunger of the syringe and a tiny amount of reddish-yellow pus oozed into the tip of the barrel. “Not much, but it should be enough to culture.” He pulled the needle out and applied a sterile gauze pad to the puncture wound.
“Hold pressure on that for a minute, will you?” “I don’t like the looks of what you got,” John said. “No, but let’s wait until we see what the culture shows.” He put a few drops of pus on two swabs and plunged them into tubes containing culture medium. “I’ll get an aerobic and anaerobic culture, and��� ” Rip forced the last drop from the tip of the syringe onto a clean slide, then used the edge of another slide to create a thin film of pus on the glass. “Let’s get someone to stain this so we can have a look.” Soon the two men watched a lab tech put the stained slide on the stage of a binocular microscope, apply a drop of oil to one of the lenses, and rack the assembly down until the lens barely touched the slide. John remembered how many slides he’d cracked before he mastered the technique of using the oil immersion lens. For the tech it appeared to be old hat, though. He brought everything into focus, stepped back, and gestured for Rip and John to have a look. Rip bent over the ‘scope, and after a few seconds of moving the slide back and forth, his face tightened. He stood up and gestured for John to take his place. John removed his glasses and applied his eyes to the scope. He fiddled with the knobs to bring the field into focus, and when he did, he knew why Rip’s expression had changed. Amidst the debris of dead white blood cells he saw round blue organisms. Most were single or in pairs, but many formed chains and grapelike clusters. A second-year medical student could have made the diagnosis: Staphylococcus. John straightened.
“It’s Staph, all right. Think it’s Staph luciferus?” “Too soon to tell. Could simply be a coagulase-negative Staph, a non-pathogen.
We’ll have to wait for the culture results.” “So what do we do?” “I don’t think we need to get out the big guns until we have confirmation. Why don’t I just put you on a broad-spectrum antibiotic now? We can change it later if we need to.” John tried to keep his expression neutral, but his insides were churning. What else, Lord?
And why me?
The man’s nametag said he was Wes, the owner of this gun store. He looked pointedly at his watch. Five o’clock, time to close. But he couldn’t ignore a potential sale. “This one?” Wes reached into the glass-topped case. His hand hovered in midair over the rows of handguns displayed there and settled on a small revolver. “Yes, that one,” Sara said. “You know, you don’t want to just pick one that’s pretty,” Wes said. “I mean, this one’s nice-blued steel, rubber grips and all. But-” “May I see it, please?” Sara held out a hand that was rocksteady. Wes handed her the revolver butt-first. She balanced it in her hand, snapped the cylinder out and checked that the gun was unloaded, snapped it back into place and dry-fired the weapon four times rapidly. “Trigger pull’s not too bad. Good balance. I like the weight-about a pound, isn’t it?” Sara enjoyed seeing the startled look on Wes’s face. She was a woman. Women weren’t supposed to know about guns. Well, she did. She knew that the Taurus Ultra-Lite weighed seventeen ounces, had a two-inch barrel, held five. 38 caliber bullets, and was a favorite among off-duty policemen. After a couple of phone calls to the policewoman she’d met after the shooting incident, followed by a little research on the computer, Sara knew just what she wanted. “How much?” she asked. Wes scratched his head.
“That one’s four hundred and eighty dollars, but I might be able to do better than that.” Sara waved the pistol back and forth in a “no you don’t” gesture, enjoying the look on the man’s face as she used the weapon to make her point. “You will definitely do better than that, since this tag hanging from the trigger guard says four hundred thirty.” “Oh, I must have misremembered,” Wes said. “I guess that’s the price, then.” “Do you really want this sale? I can go to any of the stores around here, drop a credit card on the counter, and buy this gun for that price with a box of. 38 caliber cartridges thrown in.” With the revolver still in her right hand, she opened her purse and reached in with her left, coming out with four crisp one hundred dollar bills. She put them on the counter, but kept her hand on them.
“I’ll give you four hundred cash, and I want the Taurus, a box of ammunition, and a cleaning kit.” Wes was silent for a moment, but she could tell by the expression on his face that she’d won. “Okay, I guess I can do that. And I’ll be glad to keep it for you until you get your concealed handgun license. I’ve got the forms here somewhere.”
Sara put the gun on the counter, opened her wallet, and produced a laminated card about the size of a driver’s license. The upper left portion carried the word Texas in flowing script, with the words Concealed Handgun License centered along the top. Sara’s picture smiled out from the left side of the license. Wes checked the expiration date and said, “Okay, looks like this is good for another year.” She tapped the four bills. “So is it a sale?” The bills disappeared into Wes’s pocket. “Sure. Let me get you a box of ammo and the cleaning kit.”
A peculiar double-buzz beside him brought Jack Ingersoll awake with a start. He opened his eyes and looked around at unfamiliar surroundings. This wasn’t his bedroom. The walls were done in a subtle print of plum on a gold background. The bed where he lay was smaller than his own king-sized one. The source of the buzzing was a phone on a bedside table to his left, not in its familiar position to his right. Heavy drapes were half-open, revealing deep twilight outside.
He fumbled the receiver offits cradle. “Dr. Ingersoll.” “Herr Professor, you wished to be awakened at seventeen thirty hours.”
“Thanks. Er, Danke.” He hung up the phone and let his thoughts settle.
He was in Germany, for the international conference. This was a five-star hotel, the Hessis��� something or other. He had an important presentation to make tomorrow, but tonight there were a cocktail reception and by-invitation dinner for the speakers and VIP’s. His head was still fuzzy, the combined
effects of an overnight transatlantic flight, too much complimentary champagne on the aircraft, and the worst jet lag he’d ever experienced. He stumbled out of bed and found that he’d slept in his shirt and pants. He pulled a plastic laundry bag offa hanger in the closet and consigned his wrinkled clothes and dirty linen to it. Half an hour later, fresh from a shower and shave, Ingersoll adjusted the knot in his red paisley tie, tugged the cuffs of his white shirt from the sleeves of his dark blue suit, and prepared to leave his room. He had one hand on the doorknob when the peculiar ring of the phone stopped him. He checked his watch and found it was still on U.S. time. The bedside clock showed five minutes until six. Oh, well. It wouldn’t hurt to be a few minutes late to the cocktail party. He expected it to be a bore, but as a speaker he supposed he should put in an appearance. He lifted the receiver and answered. “Jack, is that you?” Bob Wolfe’s voice betrayed none of the fatigue Jack felt. “Yes. Is this Bob?” “Right. I presume you’re going to the Messe.” “What?” “The conference center. Sorry. I get over here enough that I’ve picked up some German, and I tend to lapse into it.” Wolfe chuckled. “I was headed over for the cocktail party myself, and wondered if you’d like to walk over together.”
Ingersoll’s immediate reaction was “No.” Wolfe probably wanted to squeeze him some more, make sure he hewed to the company line. Then again, Wolfe was the direct line to Jandra’s purse strings, and Ingersoll needed to make sure they didn’t suddenly tighten. “Sure,” he said. “Are you at the Hess��� the main hotel?” “The Hessischer Hof.
Yes, I’m in the lobby right now. I’ll wait here for you.” “See you in a few minutes.” Ingersoll depressed the cradle, dialed the operator, and arranged for his laundry and dry cleaning to be picked up from his room while he was gone. He rummaged through his briefcase until he found his registration slip for the conference. Then, as reluctant as a boy on his way to school without having done his homework, he stepped into the hall and looked for the elevator. Wolfe rose from one of the sofas in the lobby as Ingersoll approached. “Would you like a drink in the bar here before we face the crowd?” Ingersoll looked at his watch, which told him it was a quarter past noon in Dallas. “I’ve got to reset that,” he mumbled. “It’s six fifteen local time,” Wolfe volunteered. “Your dinner is at seven thirty. It’ll take you fifteen minutes to pick up your registration packet and badge. Unless you then want to stand around at the cocktail party for an hour, talking to doctors whose accents make it impossible to understand them, I’d suggest we have a drink here first.” They found a quiet corner in the bar and ordered. A patron two tables away lit a cigarette, and Ingersoll waved his hand in front of his face. “I keep forgetting how many people in Europe still smoke. “It makes me appreciate my nonsmoking room,” Ingersoll said. “By the way, thanks for the upgraded accommodations. If I read the signs correctly, all the rooms on that floor are nonsmoking.” “No problem. We just want you to be happy,” Wolfe said. And you want me to keep you happy, too, I’ll bet.
“So far I have no complaints.” “Have you finished the PowerPoint for your presentation tomorrow?” “I put the finishing touches on it during the flight over. I think it’ll go well.” “You have it on your laptop?”
“Uh, of course.” Ingersoll was uncomfortable with the way this was going. “Tell you what.” Wolfe drained the last of his drink. “Let’s pop back upstairs to your room for a minute and I’ll copy it onto this.” He produced a small keychain drive from his pocket. “I’ll review it while you’re at the VIP dinner, and if I see any errors I can let you know in the morning.” Ingersoll sat stunned. “I, I��� “
“You don’t mind, do you?” Wolfe signaled for the check. “After all, we’re all in this together.” Ingersoll had already finished his drink.
He lifted the glass to his lips, tapped it, and crunched the single ice cube that slid into his mouth. Yeah, we’re in this together. But it’s pretty clear now who’s calling the tune.
Ingersoll sneaked a look at his watch, now set to the correct time. Only another half hour until the cocktail party for all the conference attendees would be over. Already those who’d been here since the party began were drifting out to have dinner. Most of those remaining wore nametags with one or more colored ribbons that proclaimed they were a speaker, moderator, panelist, or officer of one of the sponsoring societies. ” Entshuldig.” Someone jostled his elbow, but fortunately the glass he held was almost empty. He supposed he’d just heard the German word for “excuse me.” “No damage done,” he said, and turned to find Dr. Gruber standing there with another man.
Gruber’s companion was a red-faced man who seemed to be stuffed into his ill-cut brown suit like a sausage in a casing. He wore horn-rimmed glasses and an expression of concern. The man stuck out his hand.
“Professor Ingersoll, I am Dr. Rohde. I believe my colleague, Dr.
Gruber, mentioned me.” Rohde continued to pump Ingersoll’s hand. “It is an honor to meet you.” There was a tap on his shoulder. “Professor Ingersoll, we’ll be leaving in a moment. Please meet us at the doorway.” “Well, gentlemen, I’m sorry not to be able to visit with you,” Ingersoll said, relieved at his rescue. “As you see, I have to leave now.” Disappointment clouded Rohde’s face. “I understand,” he said. “I had several questions for you. But I will ask them during the open discussion after your paper tomorrow. Auf wiedersehen.” As Ingersoll moved toward the door, he wondered if he’d avoided an uncomfortable conversation this evening, or been set up for a potentially disastrous public grilling tomorrow.
“Put that thing away.” Rip’s words were almost lost in the noise of the medical center’s food court as medical students, residents, and staffsnatched bagels and pastries to augment their breakfast coffee.
He looked around but no one seemed to be paying attention to him and Sara, tucked away at a corner table. Sara had told him she had something to show him, but when she opened her purse the last thing he’d expected to see was a revolver. She closed her purse and dropped it onto the floor beside her chair, where it settled with a slight thud. Rip flinched at the noise. He leaned closer to Sara. “What are you doing with a gun? Where did you get it? Do you know-?” Sara patted the air in a calming gesture. “What am I doing with it? The next time someone shoots at me, I plan to shoot back. Where did I get it? You might be surprised to learn that they sell these things in stores all over the city. And as for your next question, I already have a current concealed carry permit, and I know how to shoot.” “Why would you have a gun permit?” Sara glanced to either side of them and confirmed that the adjacent tables were empty. “When Jack and I were married, he insisted we both have guns for protection. His argument was that sometimes we had to come out at night for an emergency, and hospitals aren’t always in the best part of the city. He bought a gun for each of us. We both took the classes, got the permit. I carried the gun in my purse when I went out at night. He used an ankle holster for his.
But when nothing happened, we gradually stopped carrying them, and I was glad. I hated to have them around. When we divorced, I told him to take my gun with him. Now I wish I’d kept it.” “Is it safe for you to carry that around? What if you drop your purse?” “The cylinder holds five cartridges. I keep the hammer down on an empty chamber. I make sure the safety’s on. The gun’s a one-pound paperweight until I need to use it.” She pointed her finger and dropped her thumb like the hammer of a gun coming down. “But when I need to use it, it’ll be there.” Rip shook his head. “I don’t know what’s happened to you.
Right after that shooting, you told me you were scared to death. You were ready to jump at your shadow. Now you’ve turned into a gunslinger who’s itching for a fight. What made the difference?” Sara had wondered that herself. Was it the aftereffects of the shooting that changed her? Was she ready to fight back because, all around her, patients were developing serious, potentially lethal illnesses from medication she’d agreed to give them? Had her attitude hardened after Mark found the rec
order in the attic? Maybe it was the cumulative effect of all these events. Whatever the reason, she had to agree with Rip. She’d changed.
15
Bob Wolfe closed his laptop computer and rubbed his eyes. He’d been over Jack Ingersoll’s presentation repeatedly, running it again and again last night until he literally fell asleep at the computer.
He awoke long enough to set an alarm for 5:00 a.m. and fall into bed, fully clothed. His biologic time clock was all fouled up, so this morning he was dependent on a combination of strong, black coffee and nervous energy to keep him going. At 7:00 a.m. he picked up the phone and dialed the number for Ingersoll’s room. The call was answered after two rings, and Wolfe silently cursed Jack for sounding so chipper this morning. “This is Bob Wolfe. How are you this morning?”
“Fine, fine. The dinner last night was shorter than I’d expected-I guess most of the attendees were as jet-lagged as I was-so I managed to get a good night’s sleep.” There was an audible gulp, followed by the clink of china on china. “I’m just having a room service breakfast before I get dressed and leave for the conference.” “I suppose I’ll see you there.” Wolfe swallowed some of his cold coffee. “I just wanted you to know that I’ve been over your presentation, and I think you’ve nailed it. No inaccuracies that I can see.” “That’s good.”
Another pause, another clink. “I guess I’d better get moving.” “Good luck-” It took a second for the click on the other end of the line to register. Wolfe dropped the phone into the cradle and stared into space. Up until now, Ingersoll had been eager to cooperate with Jandra, striving to keep the carrots coming while avoiding the stick.
Maybe the dinner last night had convinced him that he truly was a VIP, that he didn’t need Jandra’s approval and backing. If that was the case, a dose of the stick might be in order. And it ought to be administered before Ingersoll made his presentation at the midmorning general session. Wolfe grinned with self-satisfaction as he picked up the phone, dialed “0,” and asked in passable German for Herr Generaldirektor Lambert. He was told that Herr Lambert wouldn’t be on duty for another two hours. “Then reach him at home. I expect him to call me in my room within five minutes.” “Begging your pardon, Herr Wolfe-” “I represent Jandra Pharmaceuticals. Herr Lambert knows the value of our business. Give him the message!” Wolfe slammed the receiver into its cradle and began to pace. He checked his watch every few seconds. This had to be done before Ingersoll left for the conference. Three minutes after he’d bullied the desk clerk, his phone rang. “Dr. Wolfe.” “Herr Doktor, this is Wilhelm Lambert,” the general manager said in flawless English. “How can I help you?” “Thank you for calling back so quickly. As soon as we hang up, I want you to phone Professor Ingersoll’s room and give him this exact message.”
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