by Lyle, D. P.
“Migraines? I had a friend with those. They’d put her in bed for days sometimes.”
I nodded. “They can. But yours seem milder. At least so far.”
“What do I do?”
“We’ll draw some blood for a few tests and I’ll give you a couple of prescriptions. One for pain, and a mild tranquilizer for when you feel stressed.”
Divya drew the blood while I wrote out the prescriptions.
“Try these. They should help.” I handed them to her. “I’ll call as soon as we get the labs back.”
As Divya and I worked our way south from Sag Harbor toward Shadow Pond to hook up with Evan for lunch, Evan called. He was at a sandwich shop waiting for his order to be prepared. He suggested that rather than meeting at home we meet at the high school. He needed to talk with Jill.
“Actually that works out better,” I said. “We should take a look at our booth and I’ve got a couple of things to talk about with Jill, too.”
“I’ll meet you at the HankMed booth. Do you know where it is?”
“Jill said it was the first one on the left when you come through the entry gate. Should be easy to find.”
It was. But when we arrived there was no Evan and I didn’t see Jill anywhere. I gave her a call, but she couldn’t talk, saying she was in the middle of something but would be over in a few minutes. As I hung up, Evan arrived.
“Where’s Jill?” Evan asked.
“Busy. She’ll be here in a minute.”
Evan placed a bag on the table. “Lunch is served.” He began pulling plastic containers out and setting them on one of the two exam tables that were in the booth.
“Where did these come from?” Evan asked.
I stared at him. “What do you mean? You bought them. Just a few minutes ago.”
“I didn’t mean the sandwiches; I meant the exam tables. And that desk.”
A desk and a single chair sat toward the back of the canvas-covered booth and an exam table along each wall. I also noticed there were bright orange electrical cords stretching across the grass near the back of the booth and disappearing under the canvas in each direction. Two multi-plug outlets nestled among the electrical cables. Jill’s work, I was sure.
Divya popped open one of the plastic containers and lifted out half a sandwich. She took a bite.
“These are excellent,” she said. “Where did you get them?”
“You know that little sandwich shop over in East Hampton? The one on the corner?”
“Yes, but I’ve never been in there.”
“I go there all the time,” Evan said. “They also make great soups and pastries.”
I bit into a sandwich. It was good. And big. Ham and Swiss with crisp lettuce and fresh tomatoes stuffed between two slices of homemade wheat bread, it was a meal and then some.
Jill showed up.
“Sorry I’m late. I had a meeting with the EMS director. He’ll have a couple of his crews here throughout the weekend and we needed to go over some things.”
I handed her a sandwich and she took a bite.
“Thanks. I haven’t had anything since coffee early this morning.”
“I take it this is all your doing?” I waved a hand toward the desk and exam tables.
“These were stored in the hospital’s basement, collecting dust. I figured you could use them. Better than renting.”
“And cheaper,” Evan said.
“It’s so nice that our CFO is fiscally responsible,” Divya said.
Evan pointed a pickle spear at her. “Just looking after the bottom line.” He took a bite of the pickle. “I have some good news.”
“Like what?” Jill asked.
“I rented the last booth. To Marcy Davidson.” He removed two checks from his pocket and handed one to Jill.
“That’s great. I was afraid half the booths would be empty.”
“Not with Evan R. Lawson on the case.”
“You’re a case, all right,” Divya said.
“But I keep you in business. Jill, too, apparently.”
“You’ve been outstanding,” Jill said. “You know that, don’t you? I could never have pulled this off without you.” She looked at me and then at Divya. “You two also.”
“It’s even better.” Evan handed her the other check. “This is from George Shanahan over at Hamptons Savings and Loan.”
Jill looked at it. “This is even more than he promised.”
“He couldn’t resist the old Evan R. Lawson charm.”
Divya rolled her eyes. “Spare me. He probably gave you the extra to get you out of his office.”
“Wish I could afford that,” I said.
“Tease all you want,” Evan said, “but this brings our total to fifty percent more than our goal.”
Jill looked stunned. “You’re kidding. That much?”
“I would never lie about money.” Evan laid one hand on his chest as if reciting the Pledge of Allegiance.
“How on earth did you pull that off?”
“I guess I’m a salesman extraordinaire. You might even say a supersalesman.”
“Silly me. I thought you were a superspy,” Divya said.
“That, too.” He picked up his cell phone.
Evan R. Lawson is a superspy.
Divya glared at him. “I swear I’m going to steal your phone and flush it.”
Evan R. Lawson is right.
Divya shook her head. “Unbelievable.”
Jill took a final bite of her sandwich and wadded up the paper around the little bit that was left. She stood. “I need to get back to work. What are you guys up to?”
“A couple of patients to see,” I said.
“Dinner still on for tonight?” Jill asked while rummaging in her purse for her sunglasses.
“Around seven.”
She looked at Evan. “This is becoming a habit with you. Are you going to cook every night?”
“It’s my domestic side,” he said.
“Too bad you don’t have a domesticated side,” Divya said.
Jill settled her sunglasses in place. “I’ll bring some wine. What do you plan to cook?”
“I’m not sure yet. Just bring red.”
My cell phone rang.
Chapter 6
The call was from Todd Hammersmith, Nathan Zimmer’s assistant. One of the workers who had been prepping Nathan’s mansion for the big Fourth of July costume party was having chest pain. Todd went back and forth between talking to me and to Nathan, whom I could hear in the background. Confusing to say the least, but that was Nathan. The story I finally got was that the man had been helping move a piano, had developed chest pain, and was now lying on the floor. Conscious? Yes. Breathing? Yes. Did they call 911? No. Why not? This led to more discussion between Todd and Nathan.
I finally interrupted and told Todd to call 911 and that I’d be right there.
“Right where?” Evan asked after I disconnected the call.
“Nathan Zimmer’s place.”
“Count me in,” Evan said. “If you’re going to see Nathan, I’m going.”
Evan and his buddy Nathan. First-name basis. Slap on the back. Cigars and whiskey. I wondered if Nathan knew what good friends they were?
We climbed into the HankMed van, Divya driving, Evan riding shotgun, me in back. As she cranked the van to life, Divya said to Evan, “I thought you had appointments this afternoon.”
“Dude, it’s Nathan Zimmer.”
“I’m not a dude,” she said.
“Fooled me.”
“Funny.” Her brow wrinkled.
She accelerated through the gate and around the parking lot’s perimeter. Pure NASCAR.
“Just being around Nathan makes me
smarter,” Evan said, clinging to the dash for balance.
“Perhaps if Nathan makes you so smart you should go to work for him.”
“What would happen to HankMed then?”
“Nathan’s loss would be our gain.”
The tires squealed as Divya turned from the lot onto the street.
“Don’t you have that backwards?” Evan asked. “Wouldn’t it be Nathan’s gain and your loss?”
“I think not.”
“Go ahead. Make fun of me. But the smarter I am, the better HankMed does.”
Divya raised an eyebrow. “And all this time I thought it was because Hank and I did such stellar work.”
“That, too. But it took smarts to arrange the HankMed van.”
“True,” I said. “You did good there.”
“Being around people like Nathan Zimmer sparks such creative thinking.”
“Sort of like a viral infection?” I asked. I should have stayed out of it, but I couldn’t resist.
“Or the plague,” Divya added.
“Or the seeds of great ideas,” Evan replied.
“Seeds require fertile soil.” Divya slung the van through a hard left turn, pressing Evan against the passenger door. I clutched the arms of my captain’s chair.
“I have fertile soil,” Evan said.
“You have rocks.”
Their bickering continued during the twenty-minute drive. I tried to ignore them, but when they got to full boil there was no way. As Evan kept needling Divya, her foot got heavier. I held on as she weaved and swerved through traffic and took corners on what felt like two wheels. Somehow we survived Mr. Toad’s Wild Ride and reached Nathan Zimmer’s estate intact.
I grabbed the medical bag from the back and we climbed the broad stone steps to the mansion. Nathan’s estate was nothing like Shadow Pond, which rivaled the best France’s Loire Valley had to offer, looking like something King Louis would have built to escape Paris’s summer heat. Nathan’s version of a mansion was modern. Very modern. No French château here. All metal, glass, and acute angles. Still impressive, but in a very different way.
The front door stood open, so we walked in and followed the boot-printed paper pathway that stretched over the carpet to the great room. The room that was usually filled with very expensive furniture now stood mostly empty.
Its transformation into a colonial meetinghouse—or perhaps a presidential inauguration would be more like it—was well under way. A dozen flags and two massive crystal chandeliers hung from the thirty-foot ceiling. The stark white walls, glass, and chrome of the very modern home were now partially concealed behind flowing red, white, and blue striped drapes.
Nathan and Todd stood near one wall, looking over the shoulders of several workers kneeling around a man who was stretched out on the floor. The ever-present pulsing Bluetooth device hung from Nathan’s left ear. Both he and Todd turned when we entered.
“Dr. Lawson, I’m glad you’re here,” Todd said.
“Did you call nine-one-one?” I asked.
“I thought it might be better to wait for you,” Nathan said. “He thinks he might have just pulled something.”
I approached the group. The workers stood and cleared a path for Divya and me. The man lay next to a massive and elaborate grand piano, which was up on a rolling platform as if ready to be moved. He looked to be in his fifties, with thinning hair now damp with sweat, as was his face. He wore jeans and a blue work shirt, the front and armpits darkened with perspiration. He held one hand clamped over his chest.
I knelt next to him, my fingers automatically reaching to check his carotid pulse. It was fast but steady. “What’s the matter?”
The man was groaning and his words came out as gasps. “My chest. And my back.” He rolled slightly back and forth. “I can’t breathe.”
This was no pulled muscle.
I listened to his heart and lungs. His heart rate was rapid, his lungs clear. Divya checked his blood pressures in both arms.
“I get two-twenty over one-twenty on the right side and one-forty over ninety on the left.”
The concern I saw in her face told me that she was thinking the same thing I was.
“Do you have any medical problems?” I asked.
“High blood pressure. Had it for years.”
“Do you take any medications?”
“A couple of pills for that, but I don’t remember what they are. I ran out of them three or four days ago.”
“So you haven’t taken any meds for several days?”
He nodded. “My insurance company. They do this every month. They’ll only send me thirty pills and then half the time they’re a week late getting the new ones to me.”
Not an uncommon problem. This is what happens when the money changers take over medicine. Everybody in a pigeonhole. Everybody in line. The dollar trumps science. God forbid that someone might waste a couple of three-cent pills. Better that they have too few than too many. Welcome to the new medicine.
I looked at Divya. “Get the crash kit and the portable X-ray from the van.” I turned to Evan. “Help her bring the machine in.”
One of the workers stepped forward. “Anything we can do?”
“If you could help them get the equipment that would be great.”
He nodded. “Will do.”
I returned to examining the man. “What’s your name?”
“Jimmy Sutter.”
“How old are you?”
“Fifty-two.”
“What happened?”
“We were lifting the piano up on the platform there. So we can roll it out here. Just as we were settling it in place it hit me. Can you do something about this pain?”
“It’s coming. Where does it hurt?”
“All across my chest.” He ran his open palm from one side of his chest to the other. His breathing was still labored. “And in my back. Between my shoulder blades. It feels like something is ripping apart in there. You think I tore a muscle or something?”
“I’m going with the ‘or something’ right now.”
“What is it, Doc?”
“Just relax. We should know in a few minutes.”
Divya and the equipment arrived. While she started an IV, I opened up the crash kit. I drew up some morphine, and as soon as the IV was in place, gave him five milligrams. I then gave him five milligrams of lisinopril and ten milligrams of metoprolol.
“That should help your pain and lower your blood pressure.”
While Divya rechecked his blood pressure, I began setting up the X-ray.
“His blood pressure is coming down,” Divya said. “I’m getting one-eighty over one hundred on the right and one-ten over sixty on the left.”
I completed unfolding the X-ray machine and we gently moved Jimmy into position. I connected the machine to my laptop so we could see the images once they were taken. Four minutes later we had a diagnosis.
“You’re having an aortic dissection,” I said. “The tearing feeling that you’re sensing is exactly what’s going on. The aorta, the major blood vessel in the chest, has torn. From your high blood pressure and from the stress of lifting the piano.”
“So what does all that mean in English?”
“It means we have to get you to the hospital right now. It means you’re going to end up in the operating room to fix this as quickly as we can get you there.”
“Operation?”
“You don’t have much choice.”
“Even if I’m feeling better?”
“Are you?”
“A lot. The pain is much better. I’m not as short of breath.”
He did look better. More color in his face, his breathing easier, and even his sweating had decreased.
“That’s from the m
edicines we gave you,” I said. “The morphine is helping with the pain and the other medicines have lowered your blood pressure, but the damage has been done and it needs to be fixed.”
“Should I call the medics?” Nathan asked.
“No. He needs to get there now. We’ll call in a medevac helicopter.”
“I’m on it,” Divya said. She pulled out her cell phone.
“Or you can use mine,” Nathan said.
“Yours isn’t equipped for this.”
“I assume time is important here?” Nathan asked.
I nodded.
“Then mine is better. It’s here, right out back, and I can have my pilot ready to go in five minutes. Mine’s faster anyway. We can be at Hamptons Heritage before the medic chopper even gets here.”
A dilemma. Speed or better equipment? I opted for the former.
“Okay, let’s do it.”
Todd nodded and snapped open his cell phone.
“Is there someone I should call?” I asked Jimmy.
“My wife. Her name’s Roxanne.”
He gave me the number and I punched it into my cell. After she answered, I told her who I was and explained what was going on with her husband, telling her we were flying him to Hamptons Heritage. I then handed the phone to Jimmy so they could talk.
I looked at Divya. “We’ll ride with them.”
“Helicopter will be ready in five,” Todd said as he closed his cell phone.
“Do you have something we can move him on?” I asked Nathan.
“Like what?”
“A stretcher would be nice, but a wide board or something like that will do.”
He thought for a minute and then slowly shook his head. “Don’t have either of those.”
“A lounge chair will work,” I said. “One of the ones by the pool.”
Nathan snapped a finger and two of the workers headed toward the back.
I began reexamining Jimmy while Divya ran out to the van to restock our crash kit. Evan was in another world. I could hear him and Nathan talking while I worked.
“This looks so cool,” Evan said. “It’s like a presidential inauguration.”
“Presidential is what we’re going for,” Nathan said. “When the room is filled with people in their colonial attire it should look like an inauguration.”