The Children's Ward

by Patricia Wallace

  It was just plain sweltering under all those lights at the nurse’s station. It wasn’t quite as bad in the patients’ rooms, but she didn’t think it would be kosher to wander from room to room, just to get a little air.

  She almost never worked on the medical floor, but it was just her luck to get tagged on the day their heating went on the fritz.

  Well, her shift was more than half over, so she’d gotten through the worst of it. And there was always a chance that engineering would get around to cooling things off.

  How hard could it be, anyway? All of the environmental factors—temperature, air filtration and circulation, even the lights—were programmed into the computer. Someone had made a mistake when they were entering the settings. A simple mistake to make, a simple mistake to fix.

  They had better do something about it soon, she thought. Even if they didn’t care about the nurses—and she often suspected that nurses were regarded as a necessary evil in the eyes of administration—they should think of all the money this excess heating was going to cost them.

  The hospital had gotten very cost-conscious of late, and she wouldn’t be at all surprised to hear that whomever had made this particular mistake got called on the carpet for it.

  If they put the punishment up for a vote, she was voting for a hanging.

  Fifty-two

  Her experience with magnetic resonance scans was, at best, limited, so she took her time reviewing them. The medical community was very excited about the technology which promised to replace computed tomography as the diagnostic imaging modality. She had read with interest arguments in favor of either method but, looking at the clear MR images, there seemed little doubt of its superiority.

  Behind her, Tucker Smith was helping the engineer who appeared to be less than enthusiastic about his assistance.

  “If you’d get out…move…”

  “What? Over here?”

  “There or anywhere but where you’re at.”

  Quinn smiled to herself and put up the sagittal scans on the viewer, glancing at her watch as she did so. Eleven-thirty. The morning had passed slowly.

  She was used to more activity than this. Seeing patients and doing work-ups was what she was used to; caring for only four patients was scarcely enough to keep her occupied. The other work, especially reviewing the videotapes, was more time-consuming but definitely less satisfying.

  Joshua was still seeing private patients in addition to the children but he had turned down all of her offers to assist with those cases.

  “You’re really the primary physician for the kids,” he’d said. “I want you to be readily available when they need you. I don’t want you to get hung up treating my private patients— some of whom are very ill—and not be able to respond quickly to calls from the ward.”

  He’d made it easy for her to assume care for them, and in fact gave her total autonomy within the limitations of the research protocol. But it was his program and, now in motion, there was little for her to do besides evaluate test results, view the tapes, and respond to problems as they arose. Russell’s fainting spell and Courtney’s seizure, even occurring on the same day, did not begin to approach the level of intensity she was used to working with.

  She returned her attention to the scans.

  “You’re sure that thing is off?”

  “Power’s totally off,” Tucker Smith said.

  “Then I’m going inside to cut the hole for the speaker.”

  Quinn turned as the engineer went through the door into the scanning room. “Would it be possible for me to look at some other scans? These look normal to me but…”

  “Sure,” Tucker bounded across the room. “We haven’t taken many yet but I’ve got tons of reference scans…I’ve been collecting them.”

  The sound of an electric saw filtered into the room. Even with the door closed, Quinn could smell the wood dust.

  Tucker found what he was looking for and brought a stack of large manila envelopes over to the viewing area. The envelopes were marked with the anatomical areas and he thumbed through them.

  “Brain scan, right?” “Yes.”

  “Got a lot of those.” He handed her three bulging envelopes. “Transverse, sagittal, and coronal. I don’t have them divided into adult and juvenile, but the ages should be marked somewhere on the scans themselves.” He nodded his head emphatically.

  “Thank you.” His eagerness to please reminded her of a puppy she’d once had; she was tempted to scratch behind his ears.

  Then he was off, sticking his head around the door to ask the engineer if he needed any more help.

  Quinn looked through the stacks of scans until she located what she wanted: a series labeled Jane Doe, age nine, diagnosis normal brain.

  They were essentially identical to Abigail’s scans.

  There were no masses, no abnormalities, in Abigail’s brain.

  Even though she had read all of the consultations, reports, and conclusions from the various medical experts—which all pointed to the presence of a tumor—for some reason, Quinn was not surprised.

  “What? What’s going on here?”

  Quinn turned, recognizing panic in Tucker Smith’s voice. He was standing in front of the console, trying to remove the dustcover.

  “What’s wrong?” She joined him at the console.

  “Power’s coming up,” he said tersely, finally wrenching the cover off the machine.

  The power button was glowing amber.

  He pushed at the button. “It’s stuck…get him out of there.”

  Looking through the window she saw the engineer flying backward toward the scanner, his face frozen into a grimace. The saw was imbedded in his upper chest. He struck the scanner with an impact that they heard in the shielded room.

  Quinn started toward the door.

  “No, wait…don’t go in there. If there’s any loose metal…” Tucker began to pound on the console with the side of his fist. “Off, God damn it.”

  “Is there an electric breaker we can throw?”

  “I think…wait…it’s off.”

  Without thinking Quinn hurried into the scan room where the engineer, released from the magnetic pull of the saw to the machine, had slumped to the floor. Kneeling beside him, she felt for a carotid pulse.

  Blood was welling from the chest which was split by the saw blade.

  “Get some help,” she called to Tucker who stood in the door, eyes wide with fear.

  The toothed edge of the saw blade was buried in the man’s sternum and she was unable to pull it free. The only thing she could do until help arrived was try to keep pressure on the bleeders, to try and staunch the flow.

  The code team, when they arrived, worked rapidly to try and save the dying man. They worked in silence, without the customary bits of conversation which generally served as an outlet for tension. Someone managed to get the saw blade free from his chest.

  They transferred him to a gurney just as his heart stopped.

  They were unable to bring him back.

  Someone handed Quinn a towel and she wiped her hands.

  “I’ve called the coroner,” someone said.

  As she passed through the control room she noticed Tucker Smith standing, looking at the computer console, tears running down his face.

  Fifty-three

  Lunchtime.

  Anne locked the department door and went back to the desk to check the schedule. No one due until 1:30. She had all the time in the world.

  The employee lounge was a small room lined on one wall with metal lockers and furnished with a couch and two recliners. A bar-size refrigerator was crammed between the couch and the wall. A two-cup coffee maker sat atop the refrigerator. The coffee, filters and cups were located on a foot-long, six-inch wide shelf above the coffee maker.

  She took the coffee decanter and went through the department to the bathroom where she filled it with water from the sink, careful not to crack the glass against the porcelain. The last time someone had b
roken the decanter it had taken two weeks to get a replacement and she’d had to bring coffee in a thermos from home.

  Waiting for it to fill, she looked at her reflection in the mirror.

  “Smile,” she told herself. The result was painful to look at.

  Back in the lounge she began making the coffee, measuring precisely one and a half of the tiny scoop that came with the maker. She poured the water into the reservoir, switched it on and put the decanter underneath.

  Her lunch from yesterday was still in the refrigerator and she took it out and went to the couch. She hadn’t much of an appetite but she’d been tested as a borderline hypoglycemic and knew it was foolish not to eat something.

  An egg salad sandwich, two small tangerines and some of the Christmas cookies that her mother had sent her from Boston.

  Boston, where Christmas looked like Christmas. Snow and fireplaces and hot apple cider…

  And slippery sidewalks, ice-crusted windshields, frostbite, power outages, and dirty melting snow…

  She was not homesick for Boston; it had never really been her home, just the last six months before she’d turned eighteen. What she wanted was to get away from the last twenty-eight hours.

  She remembered hearing nurses talk about how they handled stress and what they called burn-out. Talking about it seemed to help, keeping busy…and time.

  There was no one she felt she could talk to.

  The coffee was finished dripping and she put aside her untouched lunch to get up and pour a cup.

  She filled her mug and wrapped her hands around it, warming her fingers. It had still been raining when she’d last looked, not hard but steady, and the temperature inside was cooler than usual. Maybe the air conditioning was still on.

  She went back to the couch, placing the coffee mug on the floor by her feet, and picked up the sandwich. The bread was a little soggy but she ate, methodically, not tasting much of anything.

  When she had finished eating she crumpled up the paper bag and tossed it at the wastebasket which she hit easily.

  Should she go over to the ward and check on Russell Delano?

  Or should she just try and forget the whole incident?

  Leaning back on the couch, she rubbed her forehead as if that would help her think clearer, and closed her eyes.

  Someone was rattling the department door.

  She glanced at her watch; it wasn’t even one yet.

  “Great,” she said, getting to her feet.

  By the time she got to the door, the rattling had stopped. She contemplated opening the door and looking down the hallway but she didn’t really want to deal with anything at this particular moment, so instead she double-checked the lock and turned away.

  She noticed with some surprise that the whirlpool was clouded with steam.

  She must have turned the temperature up too high.

  But the temperature indicator showed that it was within the normal range. She tapped the face of the dial.

  It must be steaming so much because of the cooler air temperature in the department.

  She looked over the edge of the tank. The water was…bubbling.

  None of the air jets were on.

  It almost looked like it was boiling. She looked for a second time at the temperature gauge.

  Maybe air bubbles, formed by the air jets, had remained along the side of the tank and were only now coming to the surface.

  But all the steam…what would cause that? She had to admit that the air temperature was not really cold enough to account for all of the steam.

  Cautiously, she held her hand above the water.

  There was very little heat emanating from the surface.

  She took a breath and dipped her fingers slowly into the water.

  It was lukewarm, exactly as it was supposed to be.

  She submerged her hand and moved it toward the side of the tank where the bubbles continued to rise.

  Something grasped her hand. Something very much like fingers closed around her wrist and pulled forcefully.

  She opened her mouth to scream.

  With a force that dislocated her shoulder, something pulled her into the tank, and the scream was lost in the water which bubbled furiously.

  Gradually, the water stilled and the steam dissipated.

  Fifty-four

  “The poor thing’s dead to the world,” Mary Aguilar informed Joshua as he neared Abigail’s bed. The child lay on her side, head cradled on her right arm.

  “Has she been like this for very long?” Joshua picked up the girl’s left arm, then let it fall limp to the bed.

  “Actually, until fifteen minutes ago, I thought she was going to stare a hole right through the wall. Her pupils were contracted and I swear she didn’t blink the entire time I was taking her vitals.”

  “How long was that?”

  “I don’t know…maybe only five minutes, but I’ve never seen anyone look so…intense.”

  “What were her vitals?”

  “Blood pressure was one-fifty over ninety…”

  “That’s high for her.”

  “Respirations twenty-four, pulse one hundred and temperature 98.6°.”

  Joshua nodded. “Take her blood pressure again.”

  Mary wrapped the blood pressure cuff around Abigail’s left arm, placing the stethoscope at the antecubital area, and inflating the cuff.

  “What is it?” he asked as Mary took the stethoscope out of her ears.

  “One hundred over seventy.”

  “Well.” He looked at the sleeping face. “Whatever was going on with her is obviously over for now.” He drew the covers up around her shoulders.

  Back at the nurse’s station Joshua became aware of Mary watching him expectantly.

  “What? Is there something else?”

  “Did you hear about the accident in the scan room?”

  “Yes I did; I’m a little surprised you heard about it all the way out here.”

  “I hear all kinds of things,” she said cryptically. “Not all of it accurate, but,” she shrugged, “most of it interesting.”

  “I’m amazed at the speed that these things get around.”

  “So…tell me.”

  “I gather there was some type of equipment malfunction and the magnet was turned on…and unfortunately, the engineer was caught between an electric saw and the magnet. It was a freak accident.”

  “I heard Dr. Logan was there when it happened…”

  “She’s still over there with the coroner.”

  “How terrible for her.”

  “She’s handling it.” He noticed Mary smile. “Now what?”

  “Nothing…just pleased that Dr. Logan is working out so well. You’ve made an excellent choice…” The smile widened and she turned away.

  Fifty-five

  The engineer, Quinn learned, had been forty-one, married, with two children. His name was Lloyd Marshall and he was, by all accounts, a good man.

  She watched them roll the good man away on the gurney.

  Tucker Smith was giving his statement to a fresh-faced deputy coroner who looked badly out of place in a room with so much blood on the floor. The chief coroner was supervising the removal of the saw from where it had been placed on the floor. Bits of bone fragments adhered to the blade.

  She arched her back, stretching muscles that had tightened from standing too long in the same place. She had given her statement, what there was of it, but the coroner had asked her to stay.

  There was very little she could do to help unless it was to give Tucker Smith something to calm him down. His leg was jiggling, his complexion was ashen, and every few minutes he looked at the scanner as if he expected it to leap at his throat.

  She wondered if he would ever again be able to push the power button.

  “Dr. Logan.” The chief coroner had come up beside her. He was still wearing his raincoat which had been dripping wet when he’d first arrived. It was bone dry now.

  “Yes?”

  �
��We’re just about finished here.” He indicated the saw which, bagged and sealed, was being carried past them. “I’d like to ask you a couple of questions, off the record.”

  “Off the record?”

  “If you don’t mind. Did you notice any…animosity between Marshall and Smith?”

  Quinn looked at Tucker Smith. “I don’t think he was capable…either physically or emotionally…of doing this. Look at him.”

  The coroner nodded. “Actually, I’d come to the same conclusion, but it was a very violent death for Mr. Marshall and I feel obligated to consider every possibility.” He hesitated. “It’s hard for me to imagine that a magnet could do this either.”

  “It’s a very powerful magnet,” she commented, and pointed to the warning signs posted at both doors which cautioned against bringing large metal objects into the room.

  “Modern science.” He regarded the scanner, then looked back at Quinn. “Thank you, that’ll be all.”

  Quinn wondered if it would.

  Fifty-six

  “David, are you listening to me?” Tiffany looked sideways at her husband, unwilling to take her eyes off the road. He was driving but on more than one occasion she had alerted him to dangers he was seemingly unaware of.

  “Hmm.”

  “I don’t want you to upset Courtney by telling her about the house.”

  “She’ll have to know sometime,” he said dryly.

  “Sometime but not now.” She tensed as he pulled into the opposite lane to pass a slow-moving truck. She hated two-lane roads.

  “Whatever you say. Although I think it might be a shock to her when she comes home and sees the black walls…” he laughed suddenly. “Of course, she might think it’s just one of your more avant-garde attempts at decorating.”

  She chose to ignore the remark. “I’ll tell her before she is discharged. She was so sick yesterday, I don’t want her to have a relapse or something.”

  “I doubt if she’ll care.”

  “What do you mean? Of course she’ll care, it’s her home.”

  He turned to look at her and instinctively she reached for the steering wheel.