The usual chorus of muffled cries drifted toward me, stoking a sense of dread that soured the pit of my stomach.
I also heard the distant sounds of nurses talking at the far end of the corridor, their carefree voices erupting into laughter.
But no one appeared.
Occasionally a flicker from a late reveler's fireworks came through the window and illuminated the floor in front of my hiding spot, but where I stood remained pitch-black. Nevertheless, the sooner I got in the room and completely out of sight, the easier I'd feel.
I started forward, having already chosen tonight's victim. I figured the holiday meant fewer doctors, and with rookies all over the place, the nurses in other parts of the hospital should be preoccupied, riding herd on the newcomers. They'd never notice me prowling about; the bunch on duty here would be their usual lazy selves. Perfect conditions to run another subject.
Locating the room number, I slipped inside the door and softly closed it behind me.
I stood perfectly still, letting my eyes adjust to the lack of light. Someone, presumably those idiotic nurses outside, had closed the Venetian blinds, blocking out the possibility that even a glimmer of illumination from the city, moon, or stars would reach the inhabitant who lay dying in the bed.
Fools, I thought. Cut off all sense of day or night, and a patient could become confused, perhaps psychotic. The observation came as a reflex, my training completely at odds with what I intended to do. The incongruity set my stomach churning, and bilious hot juices rose to the back of my tongue. I swallowed repeatedly and managed to send the acidic mix down the way it'd come up.
The ragged breathing of the woman I'd come for filled my ears. Sometimes the sound caught in her throat and ceased altogether, only to restart seconds later, when she would gasp, then exhale with a soft moan.
I tiptoed over to the blinds and opened them a sliver, just enough to admit an orange glow reflected from sodium lamps in the parking lot below. It cast her thin face in garish pumpkin shades, as if she'd applied too much makeup, and I could see that her mask had slipped down to her chest like a bib. She continued to breathe fitfully, yet remained asleep, completely unaware of my presence. But she could be roused awake. I'd made sure of that before picking her.
A cold loathing seeped through me.
I stepped over to the IV line that kept her hydrated and got to work. Even though she might die as a result of the drugs I would give her, I held with techniques instilled by years of practice and sterilized the side port with an alcohol swab so as not to risk infection. The maneuver also allowed me to think I'd given the subjects their best chance should they survive. Somehow that indulgence made it easier to get through what I did to them.
I pulled out the first of the two syringes I'd brought, removed the cap, and jabbed it in.
Slowly I began to empty half the contents, fifty milligrams of esmolol, a potent, short-acting drug that doctors used to lower pulse and pressure. It would bring her into a state of near shock. With my free hand I gently reached for her wrist and monitored her pulse with my fingers. The skin already felt clammy. She gave no reaction to my touch.
The beat slowed and grew weaker, then disappeared altogether, as it usually did once the systolic pressure fell below 90. Shifting my hand to her neck, I palpated for the carotid artery.
She stirred in protest and made little cries that sounded like mewing.
Ignoring her, I picked up the throb of the larger vessel, then continued the injection until that impulse nearly disappeared as well, which meant her pressure had fallen to just above 60.
I quickly switched syringes, and slowly gave the second ingredient, a hundred milligrams of ketamine. Normally used to induce awake anesthesia, this agent would also offset the fall in pulse and blood pressure, though not enough to reverse the near shock state. But what I really used it for had to do with a unique side effect: the blockade of certain neuroreceptors in the brain.
I finished delivering the dose, capped and pocketed both syringes so there'd be no accidents if she struggled- I'd taken that precaution ever since the Algreave woman- and waited a minute by my watch, giving time for the ketamine to have its full effect.
It felt like an hour.
The woman's breathing seemed to grow deafening as sputum rattled deep in her airway. In a treatment situation I would have suctioned her out to prevent her from choking on her own spit, an act of basic nursing. Instead I switched on the microcassette, shook her, and whispered, "Can you hear me?"
She moaned.
"Can you hear me?" I repeated.
Her reply was little more than a breath. But I could make it out.
"Yes," she said.
Show time.
I took the microcassette out of my pocket, brought it close to her mouth, and began to coax her along with the usual questions, following my format in the same methodical way a doctor would take a medical history.
"Any more pain?"
"No…"
"Do you see anything?"
"No…"
"Look harder."
Her gravelly, faint voice seemed to exhale from a corpse.
After a few minutes more she abruptly released a shrill cry, and her limbs thrashed about under the bedclothes.
"There're worms…"
"What?"
"They're all over me…"
"What are?"
"Oh, God, help me…"
"Take it easy."
"They're under my skin…"
"No, they're not."
"In my mouth… my nose…"
"You're imagining-"
"… behind my eyes… coming in through my ears…"
"Stop it!"
"They're eating me…" Her voice became a high-pitched shriek, piercing the dark like the cry of a hawk.
I snatched the syringe of ketamine from my pocket, plunged it into her IV, and pushed the plunger, giving her another twenty milligrams.
The scream died in her throat.
When they talked of heaven, it all sounded the same. But each one had a unique vision of hell.
I listened for the approach of running feet.
None came.
Would she remember? Most didn't. But some did, and that could be trouble. Already the nurses were starting to talk.
Anyway, I had enough material from her.
Snapping off the microcassette and retrieving the syringe, I closed the blinds, once more plunging myself into complete darkness. I felt my way to the door, stood there a moment, and, steadying my own breathing, listened for any sounds in the corridor.
Only the usual cries.
Behind me the old woman's respirations reverted to the fragmentary volleys of before, tapering out or choking off abruptly, then starting again. The gurgling noises made my skin crawl.
I opened the door a crack.
Nobody.
But I could still hear the nurses' voices from the far end of the hallway. No surprise there. They'd be sitting on their asses drinking coffee all night. I got ready to slip out of the room and make for the back staircase. I swung the door open another foot and carefully glanced in both directions.
The linoleum gleamed in the half-light, completely empty.
Toward the stairwell, there was only welcoming darkness.
I went to step out, and froze.
Something had moved down there, along the far wall. It had been little more than a dark shape gliding through black.
Then nothing.
Had I imagined it?
No, there it went again.
A figure emerged from the murk, tall and amorphous. It crept slowly from door to door on the opposite side of the hallway, pausing now and then, the way I had done coming in.
What the hell?
I stayed absolutely motionless and remained inside the room, watching, not moving the door, hoping the shadows would shield me as much as they did the form in the corridor. Except as the person drew closer, compared to the darker shroud of protective clothing, the w
hite mask and upper face emanated as a pale smudge and appeared to float along by itself, like a bodiless head. Which meant I might become visible too. And behind me the noises from the old woman grew louder, certainly enough to attract attention.
My mouth went dry, and in a flash of panic I nearly leapt back into the room.
But no. This had to be done slowly.
The figure, paying no attention to the doorways on my side, continued to hug the opposite wall, focused only on the end of the passageway where the nurses' voices kept up a steady patter.
Apparently it was someone who didn't want to get caught either. It might be a man or woman. Everybody looked androgynous these days. I tried to see the eyes well enough to make an ID but couldn't with the distance and semidarkness.
The figure stopped and glanced back toward the stairs, as if making sure no one followed.
Definitely up to no good.
Nevertheless, I couldn't afford to be caught by whoever it might be, creep or not.
The person disappeared into a room twenty feet away.
I couldn't believe my luck.
But neither did I dare risk making a break now.
Whoever it had been might come back out.
I slowly closed my door, leaving a crack wide enough to see when he, or she, left.
It took me a few minutes to realize the old woman was no longer making any noise.
Her breathing had stopped completely.
Shit!
When the nurses found her, they'd call a code. It shouldn't matter, but the prospect of some eager-to-be-a-star resident getting suspicious always worried me.
Total silence now reigned at my back, and the quiet thickened around me, making it difficult to get enough air.
At that moment the person who had snuck into the far room slipped back out and stole away into the darkness, heading for the back steps.
Five minutes later I did the same.
What could be going on? I wondered once I reached the stairwell. Hearing no one below, I started downstairs.
Newspapers had accounts of the sick things male orderlies, nurses, or doctors sometimes did to comatose female patients of any age.
But this could be anyone doing anything to the patient in that room. In the morning I'd check whether an incident of some kind had been reported. No question I had to find out. If some other scam was in the works, crossed paths might increase my own chances of getting caught. Hell, St. Paul's, with over five thousand employees, including doctors, had the population of a small town. Like any community that size, it would have its share of weirdos with black secrets. Who knew what perverted stuff went on in this place?
Saturday, July 5, 11:00 a.m. Buffalo, New York
Earl loved it when doctors decided to party.
For a few hours they sloughed off the demands on them from a never-ending maze of corridors filled with patients, pain, and loss to become as goofy as schoolkids let out for vacation. The decompression- extreme at the best of times, because all physicians believed if anyone had a God-given right to play, they did- felt even more of a release than usual. Out here, away from work, they also felt freed from the threat of SARS.
But the public didn't. Despite the makings of a perfect day for another successful St. Paul's Annual Hospital Bed and Bedpan Run for Fun- blue sky, a steady breeze off Lake Erie to cool the downtown core, the good turnout by staff and residents alike- the ranks of spectators lining the curb remained sparse. Hospitals had come to be seen as reservoirs of the virus. No one wanted to be around the people who staffed them.
"At least nobody tied bells around our necks," Sean Carrington quipped, referring to the historical treatment of lepers.
Rules for the event were simple. Contestants gathered at the starting line in Buffalo's so-called theater district- two playhouses, one multiplex- and chose a standard-issue, regulation-size hospital bed from a collection slated for the scrap heap. Divided into teams of five- one to ride, four to push- they attempted to safely transport their passenger and the contents of a half-full bedpan (apple juice being the fluid of choice) over a circuit comprising two complete city blocks.
Prior to the race, local politicians and business leaders backed their favorite teams, grandiosely presenting checks the size of air mattresses bearing five-figure amounts while the various competitors christened their chariots with flying banners intended to draw in the cash donors. The Go-Go Train was Urology's entry; the Cutting Edge carried the colors for Surgery; Janet's department would attempt to do itself proud on the Baby Bucket. Earl's crew had simply called their entrant ER, blatantly capitalizing on the popular TV show. But the favorite and champion for the last five years, Jimmy's Flying Angels, brought in the most bucks. Nobody minded, because he invariably divided up the loot with the fairness of a saint. "God bless St. Paul's," he called out to the small crowd after graciously receiving a check for fifty thousand dollars from a beaming, red-faced little man who ran a well-known pest extermination company called Hasta La Vista, Baby.
Then Jimmy rivaled the sun with a flashing grin and added, "For the course of the race, however, I will not be showing Christian kindness."
The other team leaders protested and strutted their feigned indignation in a show worthy of pro wrestlers.
"Hey, Father, unfair!"
"I'll tell your boss!"
"Divine tampering!"
But they evoked only strained laughter from the audience.
"Either our jokes are worse than ever," Thomas Biggs whispered to Earl, "or the few good citizens brave enough to show up aren't that happy to be here."
"Bit of both, I'd say," muttered Sean from behind them. "I tell ya again, we'll all be in cowbells before long."
As the presentations to other teams continued, Earl mugged for the hospital photographer, pulling deranged faces and using a grease gun like a syringe to lubricate the wheels of his team's bed.
"Set to get whipped?" Jimmy said with a sweet smile, sidling up to him.
Earl pretended to cower before him, and Jimmy flexed his muscles Atlas style, showing off a physique that most bodybuilders would die for. The photographer snapped away. "How about a quote?" she asked.
"In a two-K race, chaplains who run ten K a day ought to carry rocks as a handicap," Earl said.
"Nan, you're thinking of Hippomenes, and he was carrying golden apples to distract a woman he was chasing," Jimmy retorted. As soon as the woman left, his smile vanished and he glanced to where, a few feet away, Susanne Roberts, Michael Popovitch, Thomas, and J.S. were passing floppy straw hats to a half dozen spectators, enticing them to empty their pockets of small change.
"Can I have just a word with you in private?" Jimmy asked. "It won't take more than a minute."
Earl had already discovered that being VP, medical meant he'd never be lonely. He couldn't go to a hospital function without somebody collaring him for "just a word in private." But he'd hoped a zany affair where they all turned into clowns would somehow protect him from politics for at least a few hours. No such luck. And Jimmy, though on the side of the angels, could be a veritable Cardinal Richelieu when it came to exerting influence on the powers that be at St. Paul's.
"Sure."
They walked to a quiet alcove between a Starbucks and a wannabe Irish tavern with leprechauns painted on the windows.
Jimmy eyed the half-empty street. "Not the best turnout from our good citizenry."
"What's up?" Earl was impatient to dispense with whatever business the man had in mind so he could get back to his team. He'd few enough opportunities to shed his role as big boss and just be good old Earl with them.
"First let me say I thought you handled the Baxter case really well," the priest began. "That had to be the roughest case of that kind I've seen."
"Thanks, Jimmy."
"Are you going to use it for teaching rounds?"
"Of course."
"Will you invite the oncology department?"
"Anyone's welcome. Now, Where's this leading?"
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"Just that seeing the way you were willing to sedate Baxter so he wouldn't suffer, I knew I could come to you without being accused of overstepping my bounds."
Earl bristled at being buttered up. "Cut the stroking, Jimmy. I know you're after something," he said, comfortable enough with the man to be blunt. Although they were not close friends- they only socialized in the context of hospital business- he liked Jimmy, and sensed that Jimmy liked him. But neither man offered to extend their relationship, as if they both knew intuitively to leave their friendship within boundaries where it could remain comfortable.
The priest's face sagged, and a sadness he rarely showed settled into his eyes. "You're going to get a complaint about me from some of our oncologist colleagues."
"What?"
"These last few days I've been holding up what you did for Baxter, or at least were prepared to do, as an example of what they might well emulate, and some of them got a tad upset about it."
"You didn't."
"I just wanted to warn you-"
"Jimmy, you know damn well not to interfere in how doctors practice."
"Who's interfering? When someone does the right thing, as you did, I simply make a joyful noise about it."
"A joyful noise?"
"Right. Jesus always went on about the need to make a joyful noise. I take him at his word."
"And which doctors, specifically, did you see fit to make this joyful noise to?"
"Well, Peter Wyatt, the chief of that bunch, for one. I always figure it's best to deal with the top man…"
Earl groaned. Wyatt personified the old-boy network at St. Paul's, though he himself hadn't yet reached sixty. But mentally Wyatt allied himself with those from an era where doctors were above mere mortals and not to be questioned, especially by underlings outside the medical hierarchy. "Jimmy, don't give me that naive crap. You knew going to him would stir up a hornet's nest."
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