Critical Condition

by Peter Clement

  "Hi, love, it's me."

  No response.

  The respirator steadily hissed and caused her chest to rise and fall, but her eyes, usually quick to spring open whenever he spoke to her, remained closed.

  "Kathleen?" He took her hand, inserting his fingers into her palm. Lately she'd give a little squeeze of recognition even when she was half-asleep.

  Nothing.

  He reflexively glanced at her monitors, his ER instincts leaping to the worst of possible conclusions.

  They showed her vitals were completely normal.

  In the wastebasket by her bed, he caught a glimpse of an empty brown vial.

  Midazolam.

  Shit! he thought. They'd sedated her again, and ignored the need to reposition her.

  Seething, he whirled about and headed to the charting area where a half dozen nurses were busily writing in assorted black binders. It was the usual ritual at this time of night during the lead-up to shift change at eleven. But for Richard, the sight meant they had put paperwork above their tending to Kathleen. "Is that how you do things now?" he said in a coarse, raw whisper, his vocal cords strung as taught as the tendons in his neck. "Knock your patients gaga, so you can leisurely sit around and document their numbers? What about real care, such as turning them before they get pressure sores?"

  Six jaws dropped in unison.

  The supervisor half rose from her chair, her bobby pins glinting under the fluorescent lights and making the bun in her hair look baled. "I beg your pardon," she said, summoning her wrinkles into a portrait of disapproval.

  He waved her down and leaned over the table at them. "Who's taking care of Dr. Sullivan tonight?"

  "I am," replied the young woman with whom he'd had his initial confrontations and had since entered into an uneasy truce. Her pretty face tilted toward him, her blond spikes providing a fetching setting for her most striking feature, a pair of lucent aquamarine eyes.

  Shark waters, thought Richard, reminding himself to watch his step since it was probably she who'd complained to Ingram about him. "Why is Dr. Sullivan sedated?" he asked as politely as he could. Her tightly drawn lips curled upward at the corners. "Because Dr. Sullivan had another panic attack, Dr. Steele." Her tone had an insolent sweetness to it. It reminded him of the way addicts talked when they were stringing a line in ER to score drugs— half smirk, half menace.

  "Did you bother to ask her what was wrong?"

  "Ask her? She was freaking out. Why should I ask her?"

  "Because, she probably was afraid of something. Something that you should have taken the trouble of finding out by removing the respirator, covering her trach tube, and letting her talk."

  "Really Dr. Steele, I've seen the signs of panic in patients here often enough before—"

  "Dr. Sullivan hasn't been having panic attacks. She's been frantically trying to tell us that on her first night in this place Drs. Tony Hamlin and Matt Lockman did something to her during her angiogram, and all of us, myself included, were too ready to write her off as delusional from morphine to pay her any heed."

  She reared back, gaped at him with mock incredulity, and took a slow glance around at her colleagues. Recruiting a similar show of disbelief from each of their faces, she soon had all of them regarding him as if he was nuts. Cocking a hip and perching her hand on it, she said, "Surely you don't believe—"

  "Yes, and so does the NYPD. In fact, Hamlin was probably killed to keep whatever he was up to secret."

  "Why, this is preposterous—"

  "Is it? I just got back from Matt Lockman's home. Found him strung up in the shower with his chest cut open and his heart taken out. It appears whoever killed Hamlin killed him as well."

  It took a few seconds for this tidbit to register.

  Spikehead remained speechless.

  One by one the other nurses dropped the smug little smiles they'd been exchanging with each other.

  The supervisor went rigid where she sat, stiffly leaning away from him as if putting distance between them could let her ignore what he'd said. Better watch it, he thought, or the weight of all those bobby pins will topple you backward. "You . . . you . . . you're not serious?" she managed to stammer.

  "I'm afraid so. And the police will be questioning whoever's been associated with any patients those two have worked on together, so get ready."

  The woman swallowed and took a big breath, then exhaled long and slow. Richard could smell the residue of cigarettes. "Oh, my God," she murmured.

  Kathleen's nurse looked away.

  The rest glanced nervously at each other, the way people do when they hope someone in their midst can explain away bad news.

  "I want to know what was happening when Dr. Sullivan became frightened," Richard said. "What set her off?"

  Everyone turned toward Spikehead. She diverted her gaze to study the middle distance of the room, as if the answers he wanted from her might appear there.

  He grew impatient. "I'm waiting."

  "It was nothing," she said. "Her call button had slipped away from where I had pinned it near her hand." Her voice bristled with resentment. "And yet you didn't bother to find out what she was trying to call you for. Just knocked her out."

  She made no reply.

  Richard fought his urge to hoist her off her chair by the ring in her nostril. "Is that how you prefer patients? Gorked and on machines, so they don't bother you?"

  The others gasped in unison.

  She snapped her head up and locked eyes with him.

  "Dr. Steele!" said her supervisor. "You're out of line."

  "Oh, no, I'm not, and you know it. This woman's been hostile to Kathleen from day one." Turning back to the younger nurse, he added, "I don't know what your problem is, lady, but I advise you to keep it out of the workplace. And if you have difficulty with the fact that she's a well-known celebrity or that she's dearer than life itself to me, or that as chief of ER I'm in a position to be a pain in the ass making sure she gets what she needs, that's just too goddamned bad. Now get over there and reposition her before she ends up with a hole in her skin." He pivoted and made for the door. "The minute she wakes up, phone me," he called over his shoulder. "I'll be in medical records all night." He was so angry he nearly bowled over a cleaner who was mopping the floor in the hallway outside. "Sorry," he said, stepping around him and hurrying off down the corridor.

  Chapter 9

  "Where is it?" muttered Richard, rifling through his desk. He'd dropped by ER, needing the pass card that gave him access to the hospital computer network and the electronic records of all patients admitted through ER.

  A solitary yowl from a siren outside announced the arrival of an ambulance. It was the heads-up signal alerting the nurses and staff to get ready for trouble— not a cardiac arrest, because then drivers arrived with everything going full blast. No, now they were bringing in somebody only half-dead who was going the rest of the way fast.

  Instinctively he tensed, twenty years in the pit having conditioned him to go on full alert at the sound. But this was someone else's problem at the moment, since his shift was long over. He returned to his search, finding what he'd been looking for in a petty-cash box. He could keep his department in order, but his desk defeated him on a regular basis.

  But instead of heading toward the elevators for the basement, he walked through the sliding doors that separated his administrative cubbyhole from the bustle of emergency proper. Better check out that ambulance, he thought, unable to shake entirely his tendency to be a mother hen. At least he handled it better than he had years before when Luana had died after a six-month battle with pancreatic cancer. He shuddered under the sting of a thousand memories flying out of the past and striking deep, fixing themselves like barbs inside his head.

  "So what if I still take small hits of the same fix," he'd rationalized to Jo O'Brien recently over one of the many cups of tea they'd begun to have together most afternoons.

  "In the few shifts I still work, dealing with the pain and
tragedy of strangers gives me a sense of being in control for a few hours. Otherwise I sit around helpless, feeling suffocated, afraid that Kathleen will die. I tell you, Jo, even the air clings like a shroud then."

  But he repeatedly promised himself, as all junkies do, that he'd never let his need to kill the pain get out of hand again, that he'd not fail Chet, Lisa— or Kathleen— this time. Images from the past of his son looking at him— eyes bleak with misery and panic as they searched for comfort; eyes demanding at least a clue as to what wrong he, Chet, must have committed for his father to have preferred work over him; eyes shimmering with fear that he, Chet, was somehow a disappointment— all bore witness, floating watchfully over him and keeping him in check each time he fled to the pit now. Even so, Chet sometimes still watched him as if the fault lines along which he'd once cracked were visible and might open again. Tonight, however, it wasn't a need to lose himself that made Richard detour. His sole focus remained on getting downstairs and digging out some answers. But as chief, he couldn't ignore his department for the night anymore than a parent could fail to look in on a sleeping child. He simply intended to do a walk-through and let everyone know that he was "in the house" as the old-timers at NYCH put it. When the nurses and staff knew he was around, it had a leveling effect that made the work go more smoothly. Might as well take advantage of it, he figured, since he was going to be nearby anyway.

  "Dr. Steele," said Jo O'Brien. "What are you doing here? Is Dr. Sullivan all right?" A frown creased her face.

  "Apart from some needle-happy rookie oversedating her again, she's no worse." He deliberately said nothing about Lockman. He wanted to keep his visit short.

  Her generous chin-line stiffened. "You're not serious."

  "Afraid so."

  "I bet I know the one. Well, looks like I'll have to pay her a visit and let the woman know that she's dealing with a friend of mine."

  Despite everything, Richard smiled. "I'd appreciate it, Jo. All of them up there are mighty pissed off at me right now."

  "Pissed off at you, Mr. Diplomacy? Come on," Jo said with a wink.

  As she spoke, her eyes slid past him toward the triage area. He turned to see two ambulance attendants wheeling in a plump man about his own age sitting bolt upright on a stretcher. He wore a lime-green sports jacket and a straw cowboy hat. A pair of white-tipped shoes stuck out from the bottom of the sheet. An oxygen mask adorned his face.

  Jo hurried down the hall to meet the new arrivals.

  From fifty yards away Richard could see the patient's labored breathing and could tell by the way he clutched his fist in front of his chest as he spoke that he was probably complaining of chest pain. Out of habit he stepped into the nursing station and took a look at the on-duty sheet for cardiology. Spotting Francesca Downs's name, he knew if the man needed an angioplasty or emergency bypass procedure there'd be no delays the way there were with some of the surgeons. She was tops as far as that stuff went. But maybe he could catch her later and ask if she'd also been up to any extracurricular activities lately.

  He walked back into the hallway in time to see Jo wheel the new arrival into one of the cardiac monitoring rooms. A dumpling-shaped woman dressed like Dale Evans trotted along behind, saying, "We were in our line dancing class when he suddenly felt dizzy. So I called 911 and made him lie down right on the floor. He's a pilot, you know, flies 747s . . ."

  Not anymore he won't, Richard thought.

  A couple of residents ran through the doorway after them, followed by the staff doctor on duty. They didn't even seem to notice he was there.

  Glancing into the rest of the treatment areas he saw that everything else was pretty much under control.

  Before leaving he used one of the phones at triage to call Chet and Lisa, saying simply that Kathleen remained stable, but he'd be staying in the hospital to catch up on some paperwork. He wasn't about to tell them over the phone all that had happened.

  "No problem, Dad," Chet said. "Lisa's made popcorn, and we rented The Mummy again."

  Richard smiled despite everything. "Remember, it's a school night," he warned. Obviously he wasn't missed there either. At least Chet sounded secure when Lisa was around.The hospital, like most large midtown structures built in the 1950s, had a multilayered basement. Medical records were at the very bottom, like sediment. The bomb shelter one of the clerks had initially christened it, at a time when Eisenhower was president and movies advocating Duck and Cover were being shown at schools throughout the nation. The label stuck.

  On the ride down, as he planned how to tackle Hamlin's charts, his dread of losing Kathleen spiraled after him with the persistence of a vulture. Stepping into a long lime-green corridor that had a low ceiling lined with pipes and square metal ducts, he felt the silence weigh as heavy as the fifty feet of stone into which the foundation had been sunk. The walls seemed to close in on him, the air stuffy and unbearably hot; the harsh fluorescent lighting overhead hurt his eyes. He turned right and walked briskly, his leather soles slapping against the concrete floors with a loud echo.

  Reaching a solid metal door, he punched in a four-digit code he knew as well as his own phone number. As confidential as it was supposed to be, it hadn't changed for years, and there wasn't anybody, practically, in the whole hospital who didn't have it. Everyone— from ward clerks, through the nursing staff, all the way up to doctors— had cause to come here, either to fetch charts, return them, or sign off some forgotten piece of paperwork. This shuffle of records and people in and outmatched the comings and goings of patients upstairs. The hospital attracted a quarter million visits a year, what with the ER, the clinics, and ten floors of eighty beds each. It was a wonder they didn't lose more files than they did.

  The soft rushing noise of air-conditioning replaced the silence in the darkened room, and he welcomed the coolness. A slightly sharp odor made the inside of his nose tingle, proclaiming that the acid-free-paper movement hadn't made a dint in this realm.

  Reaching along the wall he felt out a long array of switches and flipped them up three at a time. Lights flickered to life one section after another as far back as he could see, illuminating rows and rows of shelves, each stuffed with manila folders, all of it holding a half century's worth of medical histories, a chronicle of New York by its diseases. He'd never failed to feel overwhelmed by how many stories of so many lives were deposited here, all of them beginning with the uncertainty of a tentative diagnosis, each sustained through the hope of treatment, and, ultimately, every one of them with a conclusion, for better or worse. Sometimes, late at night while working alone on an audit, he would think he'd hear whisperings, and wonder if the souls whose journeys had ended here were trying to tell their tales. A running quip around the hospital predicted that if the Internet gurus ever did manage to do away with paper charts and finally compact all this information into microchips, the resulting space would solve Manhattan's parking problems. But to Richard, the real joke would be if the subsequent underground lot was full of voices and forever haunted.

  He walked over to a bank of computers in a big open section that served as a reception area, sat down at one, and inserted his card. The screen welcomed him by name.

  He typed in Hemorrhagic Stroke, added Dr. Tony Hamlin, and got to work.

  "Damn them!" he muttered, peering through the ICU doors when they next slid open and seeing the nurses still hovering over Sullivan.

  "Harold Glass," as he'd called himself tonight, began to mop farther down the hall, afraid that his hanging about any longer would attract attention. He'd already pressed his luck, taking as much time as he could when he'd gone back in to clean the floor just before change-of-shift. But the nurses had remained clustered around Sullivan the whole time, turning and attending to her, making it impossible to approach her again. And so far the new crew seemed intent on checking her every few minutes. He had no idea why she'd suddenly become the center of attention, but it was ruining his plans. He had to rethink what he was going to do.

 
; Not that the alternative was hard to figure out. The list had sentenced Steele to be the fourth to die. And yet here the man was. It was as if God had offered him up instead, even to the point of having him announce he'd be in medical records. A more secluded, isolated part of the hospital at this time of night he couldn't imagine, perfect for a kill, in case things got loud.

  Growing excited, he parked his mop and bucket in a corner and walked briskly down the hallway, trying to keep a clear head. It was no small matter to disobey orders. But could it be God was presenting such a golden opportunity because the mortal who had drawn up the list had been in error? After all, why was it important to the Lord that Steele should die after Sullivan? It certainly made no tactical sense, because if he killed her first, even if no one else realized she'd been executed, surely Steele would know, and his rage, fed by the wrath of Satan, would make him all the harder to destroy. Wasn't it better for him to do God's work by taking Steele out now? In fact, this might be His steering a clear path through the man-made agendas that contaminated the mission.

  His heart racing, he pivoted and headed back to where he'd left his cleaning equipment. But what about a weapon? Should he first bash him unconscious, the way he did Lockman? But that was different. The stupid bugger had left the window open, and all he had to do was climb up the vines and clobber him with a hammer in his sleep. Even then it had taken more than a single whack to knock him out, and he'd fought back a bit. If the first hit failed to take Steele completely unawares, "Harold Glass" could end up having to finish him off while dodging about trying to protect himself. Besides, he hadn't brought anything heavy with him this time, and he might not find something lying around down there big enough to finish the job in a single blow.