Carolyn Jourdan - Nurse Phoebe 02 - The School for Mysteries

by Carolyn Jourdan

  She opened the stopcock on the bag containing the contrast medium and let about a fourth of a cup of the liquid to flow through the enema tip into the plastic cup. Then she closed the valve.

  She thought about what she wanted to say, then dipped her index finger into the liquid and began to write across the top of the x-ray table.

  Chapter 12

  When Phoebe finished writing her message she wiped the dye off her finger and returned to the control area where she donned a kilt, tunic, and neck guard. Then she went into the fluoroscopy suite and positioned the cross hairs of the x-ray machine atop what she’d written and touched the on switch and took a single exposure. She didn’t know how to calibrate the machine, so she could only hope that its automated features would set it on something that would work for her purposes.

  She went back to the control area to view the image she’d made. After several seconds it began to emerge on the monitor facing the room she’d been in. It was perfectly legible. Good. Now she needed to enter some patient identification information and figure out a way to get it to a place where Charlie, and only Charlie, would see it.

  She typed on the keyboard, naming the patient Zinc Phoebe Zinc, using a hybrid of her own name and the naming convention employed by the hospital to identify John Doe emergencies—people who came in without any identification, or who’d had their clothes cut off in the ambulance or helicopter, or who were in too dire a condition to wait for anyone to go through their pockets.

  John Does were named in order, starting with Alpha Alpha and progressing to Zinc Zinc, at which point it started all over again with Alpha Alpha.

  Phoebe put her own distinctive name in the middle to attract Charlie’s attention. She knew it was possible to send the image and a message to his email, but she didn’t know how to do that. So she returned to the fluoroscopy suite and removed the heavy nine-by-twelve-inch metal-edged cassette from underneath the table and carried it down the hall to Charlie’s office where she left it propped against his door.

  “We’re lucky it’s the middle of the night,” she said to Nick, when she’d returned to their hiding place. There’s hardly anyone around. The equipment in this area almost never gets used until the day shift.”

  She’d gleaned what supplies she could during her outing and shared them with Nick: pillows, blankets, a sipping cup with a bendable straw, and bottled water. She put a pillow under his head, covered him with a couple of blankets, and made him take a few sips of the water.

  She set a small plastic urinal for bed-bound male patients beside Nick. “If you need to pee,” she said, “go in here.”

  He mumbled something incomprehensible.

  “Are you hurting in your head or neck?”

  “Uhn nnn.”

  “Can you wiggle your fingers and toes?”

  She touched his hands and feet to confirm that they were still in working order.

  “Can you move your arms and legs?”

  He could. That was good news.

  “Go back to sleep,” she said, “It’ll help you get better. I’ll watch over you and won’t leave you again.”

  Phoebe sat beside him in the dark and stared at nothing. Her patient’s breathing was deep, slow, and even. She belatedly realized that for a guy with agoraphobia, the snug, dark little hideaway she’d found was darn near perfect.

  Now all they could do was wait.

  Charlie worked for several hours in the small reading room next to the Emergency Room until he caught up. Then, at about 3:00 in the morning, he decided to take a break. He approached his office with a cup of coffee in one hand and his key in the other. There was an x-ray cassette propped against the door. Residents, he thought, what now?

  He unlocked the door, picked up the heavy cassette, and carried it with him as he went inside. There were no notes explaining what was wanted, but that was typical. He juggled his coffee and the awkward cassette and went to the central control area. He tapped a key to wake up the screen, and logged into the special software system used by radiologists, called PACS, short for Picture Archiving and Communications System.

  There was a message waiting for him. He opened it and it said, please read the image on the cartridge immediately.

  Yeah, uh huh, sure, he thought, that image and a zillion more that awaited him.

  Since the advent of CT, MRI, PET, and their even more exotic cousins, there was an endless flood of images to be read. It was a never-ending parade of human suffering. And nowadays many of them were true emergencies. Radiology had gone from being one of the most laid back departments in the hospital, to a place where surgeons stood in the doorway holding gloved hands in the air, waiting for him to tell them whether they needed to operate on someone who’d just come in on a helicopter with no pulse and no blood pressure.

  Before all the new advances in imaging, radiology wasn’t able to help much in some of the common critical care situations. Now it was crucial in the early decision-making process for all sorts of serious injuries and ailments. It had become an emergency medicine tool.

  Charlie tried to keep in mind that although he was looking at static black and white shadows, somewhere there was a real live person who was bleeding, puking, screaming, or dying a few floors away.

  He stood the x-ray cartridge on end and jammed it into the reader-scanner and waited. Then he turned to watch the monitor. He often had no idea what the images would be or what he was supposed to be looking for, and this time, yet again, he was forced to play the medical version of what’s wrong with this picture?

  From many years of experience, without being consciously aware of it, he braced himself. If this image hadn’t been something unusual, it wouldn’t have been delivered this way. It was then that he noticed the patient’s name was given as Zinc Phoebe Zinc. What the hell?

  The image revealed itself gradually from top to bottom as it was read by the scanner. It was definitely unique. In fact it was like nothing he’d ever seen before—and he’d seen everything.

  There were no bones, no internal organs, no human parts whatsoever, just white cursive writing scrawled across a blank black field. He tilted his head to read it. It said, Charlie Im in the old darkroom come NOW its Phoebe.

  Chapter 13

  “I’ve heard of disappearing ink,” Charlie said from the doorway, “but you’ve invented an appearing ink, at least for radiological purposes.” He flipped a switch Phoebe hadn’t known was there and the room was illuminated with soft red lights that were darkroom safe. He saw the man in the floor and knelt beside Nick.

  “What exactly are we looking for?” Charlie said with his typical calm. This wasn’t the first time Phoebe had involved him in one of her quirky cases.

  “He fell out of a helicopter,” she said.

  Charlie looked up at her in surprise.

  “Well, to be honest,” she admitted, “he was thrown out.”

  “Why?”

  “I’m not really sure, but I’ve noticed he has a way of getting on your nerves.”

  “Go ahead,” Nick murmured, “talk like I can’t hear you.”

  “How did he survive the fall?”

  “Lucky bounce,” Phoebe said.

  “Why is he on the floor of my darkroom instead of in a bed in the Emergency Room?”

  “Some scary people are after him. They followed us here, to finish the job I presume.”

  “How did you get him in here?”

  “It wasn’t easy.”

  “You somehow sneaked him in here, concocted a way to get a message to me, and then hid with him until I found you?”

  Phoebe nodded. “And there’s another factor. He’s agoraphobic.”

  “That, I can fix. It’s common for us to have to medicate people for MRIs. The meds for claustrophobia ought to work just as
well for the reverse problem.”

  “Oh good.”

  “What are his symptoms?”

  “He’s sore, he can barely stand on his own, but nothing else that I know of for sure. He’s been intermittently groggy and fainty, but his mind seems fine.”

  “It would be normal for him to be addled and in shock for a few hours after a bad fall. And the syncope could be related to his anxiety issues. But, if he’s not badly injured, his condition should improve rapidly.”

  Nick groaned.

  “Help me get him up,” Charlie said.

  Charlie was six-one and built like a pro football player. He held Nick without too much trouble, but Phoebe had to turn the door very slowly and tuck stray hands and feet inside as it spun away from her.

  She waited her turn, then followed them out into the hallway. Mercifully, it was still empty, although she could hear sounds of people in the area.

  “This was a good place to hide him,” Charlie said. “It’s brilliant, actually.”

  Phoebe retrieved the wheelchair and he lowered Nick into it. “Let’s go for the full body scan,” Charlie said. “It’ll be quicker and I won’t need to involve any of the x-ray techs.”

  Charlie rolled the chair to the GE LightSpeed Scanner and handed Nick a couple of pills he’d taken out of a nearby cabinet. He held a plastic cup of water and steadied Nick’s head so he could take them. Then Phoebe helped him transfer their patient to the sled that would carry him in and out of the scanner.

  Charlie went to a control area and flipped a bunch of switches. This was the part of radiology he called knobology. The radiologists and their technicians had to know how to operate all sorts of extremely complicated devices. “How many images will you take?” Phoebe asked.

  “More than either of us can stand,” he said, frowning. “But even with all the images in the world there are still significant limits to what we can see with this, you know.”

  Charlie studied the screens while Nick rode the slow-moving sled deeper into the maw of the scanner. “We can see broken bones or internal bleeding, but there could be multiple fatal soft tissue injuries that will never show up on a radiograph.”

  “Like what?” Phoebe asked.

  “Like tears in vital organs. A hard jolt can tear our guts loose from the surrounding tissue. And that can rip a hole in an organ or tear a blood vessel. Then you die.”

  Phoebe nodded as she watched the images appear and morph on the computer monitors that were rotated 90º so as to stand on end. Charlie adjusted his viewing angles. He’d taught her the names of the slices in each of the three dimensions—coronal, sagittal, and transverse.

  Watching him cursor up and down the body was like riding in a glass elevator through Nick’s guts. Every time she watched Charlie do this she thought about the saying that beauty was only skin deep. She’d learned from hanging out in Radiology that it was just the opposite—the most extraordinary beauty began just beneath the skin.

  There was nothing on earth more holy or more beautiful than the human body. A Charlie-eyed view of anatomy gave a deeply moving window onto the assurance that each of us was made in the image and likeness of God. Phoebe didn’t know exactly what that meant, but seeing the images playing across the computer monitors, she believed it was true.

  “He looks like he’s in pretty good shape, especially considering what happened.”

  Charlie turned half a dozen switches off, and went to tell Nick what he’d found. He suggested that Nick and Phoebe change into scrubs to make them less noticeable and then he showed Phoebe one of the changing rooms where dozens of sets of blue and green scrubs were in neat stacks organized by size and color.

  Charlie changed Nick while Phoebe changed herself. When they were both in clean, nondescript clothes, Charlie and Phoebe rolled their patient back to the darkroom and tucked him in again.

  “You realize of course that you don’t know anything about this guy except that he’s trouble,” Charlie said.

  “I know that he’s in trouble,” Phoebe corrected him.

  “And he’s gotten you in involved in whatever that is,” Charlie said. “Just so you know, I’ve taken measures to minimize his ability to create any further difficulties for the next few hours.”

  Phoebe looked over at their patient. Whatever Charlie had given Nick was already taking effect. He was snoring with his mouth wide open.

  Chapter 14

  “You must be starving,” Charlie said. “I’ll go get some food and bring it to you. Be right back.”

  She heard the door scrape gently and he was gone.

  He returned with a couple of bulging paper bags. He set them on the counter and methodically emptied them, revealing three bagels, half a dozen small containers of cream cheese, a couple of bananas, two individual boxes of Raisin Bran, a half pint of milk, three bottles of water, two paper bowls, and a handful of plastic knives and spoons.

  He woke Nick and offered him something to eat, “No, thanks,” he slurred.

  “Have you urinated yet, since the fall?” Charlie asked.

  Nick shook his head.

  “Then we need for you to drink this,” Charlie said, and held Nick’s head with one hand and a bottle of water with the other. He helped Nick drink a decent amount of it. “It’s important that you stay hydrated,” he said, then gently lowered Nick’s head to the pillow.

  Charlie pulled two stools out from under the dusty counter and he and Phoebe sat in the red twilight companionably. He was perfectly at ease, she realized. Sitting in the dark, or near darkness, with all hell breaking loose around him was normal for him.

  It made her smile.

  His calm companionship was a healing balm. It was already working miracles on Nick. A couple of painkillers and knowing that he wasn’t obviously injured had really comforted him. He suffered from the impact with the rope platform, but the damage didn’t seem to be anything beyond a sprained wrist, bruised ribs, some abrasions, and a blooming black eye. He was one lucky guy.

  “So,” said Charlie, “what’s next?”

  “I’m not sure,” said Phoebe, as she gobbled some Raisin Bran and then tilted the bowl so she could drink the milk. “I haven’t had time to think that far ahead. I guess I need to find somewhere more comfortable to hide him until he can figure out a longer-term solution. Can we go to your office? I need to use your phone.”

  Phoebe dialed her good friend and former co-worker Waneeta—a name that was pronounced like Juanita, but given to her by a mother who was a terrible speller. Phoebe brought her friend up to speed as quickly as possible.

  Waneeta had been Phoebe’s dispatcher at the rural home health care agency where they’d used to work, so she listened calmly without interrupting, then offered practical advice, saving the histrionics for later.

  Neither of the women was unduly worried about Leon and Ivy because they were two of the most wilderness savvy people imaginable and they were on their home turf. Waneeta promised to check on them as soon as she hung up and relay Phoebe’s update.

  Phoebe told Waneeta about the new job and they discussed what to do with her patient while she went to work. Phoebe was beginning to feel that the mystery man was now safe enough and stable enough to consider what her further involvement should be, if any. She wondered if she should bail now. She thought maybe she should.

  Before giving any advice on this, in typical fashion, Waneeta asked if he was good looking, if he was married, and his age. Phoebe noticed she didn’t ask if he was a criminal. Waneeta’s priorities were skewed very much to the romantic, which was one of the reasons she was currently on her fourth marriage. Phoebe thought Waneeta’s new guy was a gonna be a keeper, though. Fourth time was a charm in this case.

  In light of the time constraints they decided Phoebe should leave Nick sleeping where he was a
t least until the end of her first shift. Phoebe promised to get back in touch at the first opportunity and Waneeta wished her good luck.

  As soon as she hung up the phone, Waneeta prayed for Phoebe’s safety, then dialed Leon’s number and left a message on his answering machine. Then she dialed Ivy’s where he was likely to be staying if he wasn’t at his own house.

  After they left Charlie’s office, he and Phoebe made a detour on the way back to the darkroom to pick up some medicine and supplies for Nick, then Charlie veered off unexpectedly and opened a glass door and held it open for Phoebe. It gave onto a small loading dock in a narrow dark alley. Buildings loomed on either side. There was a bench bolted down onto the small square of concrete.

  Phoebe sat down and Charlie sat beside her, draping a pale blue hospital blanket around them both. He realized she was shaking, so he moved closer and put his arm around her. That helped.

  He stared up at the stars as Phoebe had often seen him do when they came out of the hospital at night. Phoebe supposed it was an automatic gesture for him whenever confronted with a black field sprinkled with pale white. He was reading the night sky, just as he read radiographs.

  “There’s Venus,” he said pointing. “And see the three stars in a row? That’s Orion’s belt. You can see the Pleiades, the Seven Sisters, in your peripheral vision, they’re too faint tonight to be seen by looking directly at them.”

  Phoebe tried to do what he said and it worked. Hmmm, peripheral vision was more light-sensitive than direct vision. She thought about the fact that certain things were seen best by not looking at them directly. Some were too faint to be seen head on—like stars. Others were too bright—like solar eclipses. Gradually she stopped shaking.