If I Should Die

by Hilary Norman

  “Maybe, but – ”

  “But nothing.”

  Lally stopped talking.

  “We need to do this right away, Lally,” Lucas Ash said again, patiently. “Most probably, if we didn’t, you’d be okay, get away with it. But you’d be running an unnecessary risk.”

  “You mean I might have a seizure or something.”

  “I mean, in theory, that you could die. Which would be an awful waste, don’t you think, considering that a pacemaker would take care of the problem completely.”

  Lally was silent for another moment.

  “Okay,” she said.

  “You’re sure? You understand what I’ve told you?”

  “I think so.”

  “If you wanted a second opinion, I’d have no objection, provided there was no delay.”

  “I don’t need a second opinion,” Lally said. “I trust you.”

  “You trust him?” Hugo, in the waiting room, had gone from pale to ashen.

  “Yes, I do.” Lally sat down beside him on a navy blue couch. “And so does Charlie Sheldon, which is more important.”

  “But shouldn’t you have a second opinion?”

  “No, not really.” The unreality had come back, filling her with a delusive and definitely temporary calm. “In a way, Dr Ash is the second opinion – it was obvious Charlie knew what was going on the minute he listened to my heart.”

  “But why do they have to do it right now?”

  “Because it would be pretty dumb to risk me dropping dead for the sake of one more day.”

  “Don’t say things like that,” Hugo said furiously.

  “Only if you promise to stop looking so scared.” Lally managed a smile. “Nothing’s going to happen to me, Hugo, I promise.”

  Hugo’s brown eyes were tender and terrified. “Aren’t you scared?”

  “What do you think?”

  “I’d better call Joe.”

  “No,” Lally said quickly.

  “You have to tell him.”

  She shook her head vehemently. “No, I don’t. Joe’s worried enough about Jess and the baby. It might be different if this thing were a week away and he could maybe fly out.”

  “He’s your brother, Lally,” Hugo said. “He has a right to know.”

  “And I have a right not to scare him.” Lally was immovable. “You’re not to call him, Hugo. A preoccupied cop is a vulnerable cop – Joe’s told me that himself, and I don’t want to have to start worrying about him.” She laid a hand on his arm. “Promise you won’t call him.”

  “If that’s what you want. I still don’t agree.”

  “Promise me, Hugo.”

  “Okay, I promise.” Hugo was silent and wretched for a moment. “Do you want me to be with you when they do it? I could hold your hand.”

  “And have you pass out in the middle of things?” Lally said lightly. “I don’t want Lucas Ash having to concentrate on anyone except me.”

  “I wouldn’t pass out.”

  “Maybe not, but you’d hate every second of it, and I’ve got better things to do than feel sorry for you.”

  “You make me sound like such a wimp.”

  Lally put her arms around him. “You’re anything but a wimp, Hugo Barzinsky. You’re a strong, sensitive, wonderful man, and I don’t know where I’d be without you.”

  Hugo blushed.

  The procedure began at four o’clock. Lally was wheeled into the catheter laboratory in the Department of Cardiology, fully conscious and as appraised as possible of what was going to happen to her. Charlie Sheldon had come over to Holyoke to see her, and that had helped a little. Charlie was not a liar. If he said that having a pacemaker implanted was nowhere near as nice as a day on the beach, but nowhere near as nasty as having a tooth pulled, she was inclined to believe him. And she did trust Lucas Ash, even if he was too handsome to be real.

  There were two other people in the laboratory.

  “Hi, Lally, I’m Joanna King.” A statuesque black woman of about thirty came over to shake her hand warmly. “I’m a radiographer, and I’m going to be monitoring the implantation on our X-ray equipment.”

  “Thank you.” Lally didn’t know what else to say, though even in her white coat, the woman looked more like a Paris model than a radiographer, and she was beginning to wonder what it was about this place that made everyone look so good.

  “And this is Bobby Goldstein.” Lucas Ash indicated the young, kindly-faced, bespectacled technician on the other side of the room. Goldstein, busy doing something, raised a hand to wave to her. “Bobby’s going to be in charge of operating your box of tricks, okay?”

  “Okay.” Her voice sounded hoarse.

  Sitting there, waiting for them to start, Lally was part relieved, part alarmed that they were clearly not in an operating theatre. The laboratory was scrupulously clean, and there was an instrument trolley, but Mozart was playing from a speaker in one corner, and there was no daunting operating table and not too much dazzling steel or harsh lighting, and there was no awful, sickly smell – but then again, if something went wrong, she couldn’t help wondering, where was the resuscitation equipment?

  The pacemaker consisted of a little generator box like the one Dr Ash had shown her in his office, two insulated wires that would be attached to the box and that would carry the electrical pulses from the generator to her heart, and at the end of those wires, two tiny electrodes that would ultimately be planted in the right atrium, the upper chamber, and the right ventricle, the lower chamber. Aside from the prick of the local anaesthetic that would deaden the entry point on her chest, Lucas Ash had assured Lally that there would be no actual pain, just some unusual sensations, not even any significant discomfort. The puncture would be made on her chest a little way under her left shoulder, and the wires would be introduced into the sub-clavian vein and advanced, slowly and carefully, under Joanna King’s X-ray supervision, towards their destination.

  “Once the electrodes are firmly in place in your heart,” Bobby Goldstein told Lally before they began, “I get to take over for a while, testing to see that they’re perfectly positioned, and taking all kinds of measurements.”

  “And when Mr Goldstein’s finished,” Lucas Ash went on, “I’ll link the generator box to the two wires, and then I’ll make a small pocket under the skin above your left breast, tuck the box into the pocket and suture you up – and then the whole device will be programmed precisely to your body’s needs – ”

  “Taking my dancing into account,” Lally said, tensely.

  “Absolutely, just as I explained earlier.” The cardiologist was patient and gentle. “Your pacemaker knows everything it needs to about the effects and demands of extreme exercise – do you remember, Lally, or would you like me to go over the details again?”

  “No, I remember.”

  “You’re sure? I don’t mind. There’s no rush.”

  “I’m sure.” She made a small grimace. “About that, anyway.”

  “What aren’t you sure about?”

  “I’m not sure I should have bothered getting up this morning.”

  Lally had never believed in the word ‘discomfort’. If a doctor or dentist said that something was going to cause a little discomfort, then to her mind that usually meant it was going to hurt. Likewise, if they said that something was going to hurt a little, more than likely it was going to hurt one hell of a lot.

  She sat very still when Dr Ash began, trying desperately to relax and give herself up to the Mozart, but she was rigid as steel, and though Lally seldom perspired outside the dance studio, she could feel beads of sweat trickling down her back under her hospital gown. Joanna King was concentrating too hard all through the procedure to watch Lally’s face, but Bobby Goldstein saw her terror, and until he was needed to do his stuff, he pulled up a stool and sat quite close beside her, and at one point, when Lally felt a strange sensation and winced involuntarily, the technician took her hand in his and squeezed it, and for the second time that day, Chris
Webber’s face sprang unexpectedly into her mind, and for just a few precious moments, Lally stopped thinking about the wires prodding into her heart.

  It was all over in less than an hour.

  “That’s it,” Lucas Ash told her.

  “Is it working?”

  “Perfectly.”

  “Why are you holding your breath?” Bobby Goldstein asked.

  Lally flushed and took a tentative breath.

  “See? Nothing awful happened, did it?” Dr Ash smiled, and patted her right hand. “Nor will it, Lally, not now.”

  “And that’s really it?” She could hardly believe it.

  “You can relax,” Goldstein told her. “Your heart’s working perfectly.”

  “And it’s going to go on that way for another ten years or so,” Lucas Ash added. “And even then, the only thing that should need replacing is the little box, which is really no big deal.”

  Lally felt her body relax, had not entirely realized until that instant how rigid she had remained throughout the operation. Suddenly she wanted to cry with relief and, to her shame, the tears did begin to well up in her eyes, and she scrubbed at them hastily.

  “Here.” Joanna King handed her a box of Kleenex. “Go right ahead.”

  “I’m sorry,” Lally wept.

  “A lot of patients weep when it’s over,” Bobby Goldstein assured her.

  “Hell,” Joanna King said, with just the merest touch of scorn, “I’ve seen the biggest, toughest, most composed men cry all the way from start to finish.”

  “But it didn’t even hurt,” Lally sobbed, in wonder.

  “Didn’t I tell you it wouldn’t?” Lucas Ash asked, mildly.

  “Yes, but I didn’t believe you – ” Lally blew her nose. “I mean how could wires being poked through my veins right into my heart not hurt?”

  “Well, that small wound will start hurting a little when the local wears off,” Ash pointed out, “but we’ll give you something for the pain, and in a day or two even that will be reduced to a minimal soreness.” He paused. “The big thing is that it’s all over, all taken care of, and you can relax.”

  “I’ll be seeing you a few times during your stay,” Goldstein told her, “to do some more measuring and to make any tiny corrections to your programming that may be necessary.”

  “The idea,” Lucas Ash went on, “is that you get to go home without fear and without symptoms.”

  Lally blew her nose again.

  “Have any of you ever known a pacemaker to go wrong?”

  “Not for many years,” Dr Ash replied steadily and honestly. “In the old days – and then only very seldom – generators displayed a few minor faults, and occasionally wires fracture, but those problems are so rare as to be discountable – you really are more likely to be knocked down by a bus.” He paused. “Infection, of course, is still a potential hazard, as with any surgical procedure, but I applied a local antibiotic before I sutured you up, so that’s not likely to be a problem, either.”

  “All you have to do now,” Joanna King said, “is to let yourself get tucked up in bed and looked after for a few days.”

  “And then a little more rest, a little monitoring,” the cardiologist added, “and if everything looks as good as it does now – and there’s no reason why it shouldn’t – then you’ll be able to forget all about it.”

  “Back to normal,” Lally said, and smiled for the first time.

  “Absolutely.”

  Chapter Ten

  Monday, January 11th

  Joe Duval and Linda Lipman arrived for duty at Hagen Industries at eight-thirty Monday morning. Lipman was everything Joe had hoped she would be: pin-striped suit about nine years out of date, the new frosting she’d had put into her fair hair dyed right out, sensible shoes, colourless nail varnish, the picture of the effective statistician in the field, not a hair out of place but far too busy to concern herself with up-to-the-minute fashion.

  “I love your horn-rims,” she said, grinning at Joe’s glasses as he parked their car. “Can you see anything through them?”

  “They’re clear glass.”

  “Don’t leave them lying around.”

  “Got your stopwatch?” Joe switched off the ignition.

  “Got your clipboard?”

  “Check.”

  “Let’s go.”

  “We were hoping, as you know,” Al Hagen told them in his office ten minutes later, “that Schwartz might be able to link both devices to a single production batch, to give us a better chance of tracking down every potentially dangerous unit.”

  “But that hasn’t proven possible?” Joe asked.

  “Regrettably, no. In the first place, whereas Mr Long had what we call a single chamber demand pacemaker, Mrs Ferguson had a dual chamber pacemaker, which means that if it was some kind of production problem, we’re looking for at least two suspect batches.”

  “But you haven’t traced them,” Lipman said.

  “We’re getting there, but slowly,” Hagen replied. “Our paperwork logs details of each production batch included in every shipment, so although we had no serial numbers to go on immediately, we were able to narrow the problem down to three possible suspect batches in the Boston case, and just two batches in the Chicago case.”

  “That’s good news, isn’t it?” Joe presumed.

  “I wish I could say it was.” Hagen was grim-faced. “We produce pacemakers in batches of one hundred, which for safety’s sake are divided down into three segments of thirty-three each, to be delivered at three-monthly intervals, with one master copy held back for security. Two out of the five batches in question were produced last September, one in October and another two in December.” He paused. “Looking only at the September batches, chances are every one of the devices in the first segment, and a number of the second segment, will have been implanted in patients by now.”

  “Surely you can trace the patients,” Lipman said.

  “Until we can narrow this down further, Detective, we’re talking about a minimum of over two hundred devices, many of them inside human beings all over the United States, some perhaps even further afield.”

  “But you still have the final segment of thirty-three from each batch to examine, plus the master copies,” Joe said.

  “Yes, we do. And logically, whatever problem caused these two tragedies ought to have been evident in those control copies.”

  “But they haven’t been?” Joe asked.

  “Not a trace – everything just as it should be.” Hagen shook his grey head. “And it’s going to be a long, slow job checking each and every one of the other devices – we don’t want to take any risks.” He slipped his right index finger up under his glasses and rubbed the bridge of his nose. “On one hand, the fact that the master copies were perfectly normal makes me more hopeful that the other pacemakers are all sound too. On the other hand, it makes me even more nervous, because we still have no hard proof.”

  “Surely you can recall the devices that haven’t been implanted?” Lipman said.

  “You make it sound so simple, Detective.”

  “That part of it does seem simple to me.” Lipman was terse. “Aside from anything else, the FDA are bound to force a recall.”

  “Detective Lipman, the Food and Drug Administration will know that it’s too soon to quantify the real risk. Those two hundred or so suspect devices could, God forbid, be just the beginning.” Hagen’s colour was heightening. “If we wanted to play it one hundred per cent safe, we’d be talking about recalling and checking thousands of pacemakers.” He turned to Joe. “Do you begin to understand what might happen, Lieutenant?”

  “I think I can imagine,” Joe said.

  “I suppose you imagine a warning going out to hospitals and physicians and cardiologists – maybe you go further, and picture the panic and chaos if the press and TV networks get hold of the story.”

  “Naturally we do,” Lipman said.

  Hagen turned his attention to her. “Suppose you had a
pacemaker fitted, Detective, and you got wind of the news. What would you do?”

  “I’d run like hell straight back to my doctor.”

  “And what would you want him to do?”

  “Tell me that my pacemaker was safe.”

  “And if he couldn’t be sure?” Hagen paused. “You’d ask him to take it out and put in one guaranteed not to blow up.”

  “I guess so,” Lipman agreed.

  “Can you imagine what removing a potentially explosive device from a living, breathing human being would entail?” Hagen was white-faced again now. “If you were a surgeon, would you care for the risk? If you were on the board of governors of a hospital, would you give permission for your operating theatres to be used?”

  Lipman did not answer. She, too, had grown paler.

  “I could go on.”

  “We get the picture,” Joe said.

  “This isn’t like the Anacin scare, Lieutenant Duval. You can’t just tell people not to swallow their pills. That’s why we’ve been praying that Fred Schwartz would at least be able to focus in more tightly. If we could pinpoint two batches that we knew for certain to be faulty – and I have to tell you that still seems almost an impossibility to all of us in the company – then at least the nightmare scenario of operating theatres on red alert could be kept to a minimum.”

  They all sat in silence for a long moment.

  “What’s Mr Schwartz doing now?” Joe asked finally.

  “Obviously, he’s begun testing the undelivered devices from the batches we’ve discussed, and then he’s going to start examining and testing every single master copy set aside from every batch produced in the last six months.” Hagen paused. “I have to tell you that Schwartz still believes there’s no way this can have happened in this facility.”

  “What do you believe, Mr Hagen?” Lipman asked.

  “I don’t know what to believe right now.” Hagen paused again. “Since you and Lieutenant Duval are from the Violent Crimes Division, it’s pretty clear you’re looking for a more sinister cause than an accident.”

  “Since Mr Leary and Mr Schwartz have both made it plain that nothing normally in your pacemakers could explode on its own,” Joe said steadily, “criminal intent does have to be a consideration.”