Unfinished Business - Barbara Seranella
Page 16
Caroline sat up, waiting for the words "He's going to be fine. "
Instead Gomez handed her a tissue and said, "We know he's had a heart attack. The blood test will measure his levels of creatine phosphokinase. CPK is an enzyme in the muscle cells that leaks into the bloodstream when the muscle is damaged. This happens when there's been a heart attack."
"I thought you were certain of that," Caroline said, wondering how many times Nurse Gomez was going to repeat the words heart attack. It was as if she were trying to make a point or something.
"We still need to do the test. What we're trying to determine now is if the heart attack is still going on."
"And then what?"
"Your cardiologist will determine the best course of treatment. There are drugs we can administer that will attack clots. And if those don't give us results, an angiogram is possibly in order."
A second woman, dressed in white and carrying a metal clipboard, came into the room and conferred with the woman in scrubs. Gomez looked over the chart and then made a notation.
"Wait a minute," Mace said, sitting up in agitation. "What's this test?"
Caroline studied the monitors above him, wishing she knew what they all meant.
Gomez also glanced at the monitors. She turned to the woman with the chart and said, "Doctor said to give him two milligrams of morphine." She addressed Mace in that same overly loud voice she'd used earlier with them. "Sir, the cardiologist is on the way. Your wife and daughter can stay with you until she gets here. Try to relax and let the medicine do its work."
Caroline watched Mace's face soften as the morphine inserted into his IV entered his bloodstream.
"Don't tell anyone," he said again.
"Okay" she said, looking into his eyes and understanding him thoroughly. If there was one thing Mace strove for, it was control, especially over himself. He had to be feeling terribly vulnerable.
"Let's just get through this night."
* * *
On the way home from the party Munch remembered she was out of milk.
"Can we stop at the store?" she asked. "There's a little mom and pop place at the bottom of Chautauqua. l just need to run in for a minute."
The only parking was across the street. Garret locked his Camaro before following her to the store. She grabbed a quart of milk and headed for the register, where there were two customers ahead of her. While she waited, she picked up a copy of Auto Trader magazine and flipped through the import car section.
She was considering buying a Honda with a blown engine at work, and she wanted to check what that year's model sold for running.
Garret, meanwhile, picked up a copy of Sports Illustrated. Munch noticed with amusement that the sports magazines were placed next to Penthouse and Playboy. Munch's eye wandered to the cover of Penthouse. She gasped at the face of the model draped coyly around a grinning scarecrow.
"I know her," she said, picking up the magazine.
Garret looked up. "Who?"
"This is Robin," Munch said, pointing at the magazine. "The one I told you about. The customer that got raped." She stared.
"I've got to call Mace."
Garret stuffed his magazine back into the rack while Munch took the Penthouse to the counter.
"You're going to buy that?" he asked.
"Yeah."
"So you can show it to your cop friend?"
"What's your problem?"
"What's my problem? Oh, I don't know. Maybe I'm weird. Why should it bother me that my girlfriend wants to share some porno with another man?"
"This could be evidence or something," she said.
"Yeah, right."
Munch paid for the milk and the magazine. They stepped outside. The night was balmy with Santa Ana winds. Three teenage boys dressed in white T-shirts and baggy pants ran across the street. Munch watched them closely. The angle of the boys' path led directly toward Garret's Camaro. She and Garret were stuck on the opposite side of the street, waiting for another break in traffic.
The boys reached the sidewalk, jostling one another, looking over their shoulders. Suddenly one of them darted to his left and picked up a ficus tree in a huge wooden planter from the front of a pottery store. He ran down the street with the leafy branches resting on his shoulder, potting soil spilling on the sidewalk.
"Hey!" Munch yelled in a guttural tone, her best imitation of a cop voice. A voice that said, Stop, punk.
The boy dropped the tree. Unfortunately, the wooden planter split open on contact with the ground. The kid was still bent over when he turned to the direction of her voice and said in a high, almost hysterical voice, "I was just . . ." Then he stopped speaking, probably realizing that there was no excuse, no innocent explanation for what he had done. His two friends up ahead gestured for him to join them.
"I knew they were up to something," Munch said, feeling excited and powerful. Even heroic.
"Shut up," Garret said quietly.
She didn't look at him. They were both facing the street. Traffic still hadn't slowed. The three boys were moving away at a walk too cocky to run. She realized that her challenging the kids had automatically involved Garret, too. She didn't have the right to front him off like that. She had assumed that he'd be proud to do the right thing. She was wrong.
Chapter 19
As soon as they got back to her house, Munch noticed the empty space on the dinette table. The tape recorder that Emily Hogan had given her was gone. She looked quickly over to the shelves housing her stereo system. The receiver, turntable, and tape deck were all there.
"The tape machine is gone," she said out loud.
"What?" Garret said. "You mean the one the cops gave you?"
"Yeah," she answered, striding over to the table. "The box of tapes is gone, too."
"The TV's still here," he said.
"That isn't what he was after."
"How'd he get in?"
"I don't know." She picked up the phone and dialed the St. Johns' number, but to her surprise got their answering machine. "Where would they all be at—" she checked her watch "—ten-thirty at night?" she asked Garret.
He took off his coat and threw it on the couch. "Maybe they went to a movie or something." He walked past her, through the kitchen, and checked the back door. "It's locked," he reported. Together they inspected all the windows. None of the screens had been disturbed and none of the sills showed signs of being jimmied, pried, or broken.
Munch used the phone in her bedroom to call the police. She dialed 911. A woman's voice answered and asked the nature of her emergency
"I've been robbed," she said.
"Robbed?" the woman asked in a patronizing, almost jovial fashion. "Or burglarized?"
Munch stared at the phone in amazement. She was a fucking victim here and this woman was going to play semantic games?
"Someone broke into my house and stole a tape recorder. I guess that makes it a burglary."
The woman read back Munch's address and asked if that was where she was calling from. Munch confirmed that the information on the woman's screen was correct.
"And who are you?" the lady asked.
"Miranda Mancini," Munch told her, giving her seldom-used Christian name.
"We'll send an officer out to take a report."
Munch hung up and called the beeper number on Emily Hogan's business card. She was still waiting for the agent to return the call when the black-and-white patrol car pulled up in front of the house.
The officer was a dark-haired woman whose name plate identified her as L. Ducatee. She sat at the small dining room table and wrote down everything Munch told her, including the facts that there had been no sign of forced entry and that Munch was already the victim of menacing calls that were under investigation. Officer Ducatee advised her to lock her doors, then gave Munch a pamphlet with her name and badge number filled in at the top.
"A detective from Burglary will be getting in touch with you," Ducatee said. "If you want, we have a home safety
program. One of our counselors will come to your house and perform a safety inspection. It won't cost a thing"
"Thanks," Munch said. "I'll give it some thought."
The cop left. Munch locked the door after her, looked down at the phone that still hadn't rung, and then said to Garret, "What is this? Everybody's disappearing on me."
"I'm not," he said.
She took off her coat, the movement concealing her expression. His words were meant to be reassuring. So why did she feel exasperated? What more did she want from a guy? Maybe this was as good as it got. There was no Sir Galahad on his white steed, no such thing as a soul mate. She wasn't perfect and had no right to expect perfection from another. You had to take the good with the bad. The alternative was to be alone, which wouldn't be the end of the world, but for Asia's sake she'd like to have a more regular family with a positive male role model.
"Let's go to bed."
She didn't have to ask twice.
* * *
The cardiologist's name was Dr. Cameron Krueger. She stood about five feet two inches tall, had short gray hair, and was surprisingly obese. She waddled into the room out of breath and sat or rather leaned into the lone chair in the examination room. St. John realized that her excess fat made bending more than ten degrees at the waist a physical challenge. He waited for her verdict as she sat across from him, shaking her head over his lab results. The padding on her thighs forced her legs apart so that there was a distance of some two feet between kneecaps.
"So," she said, sweat beaded on her forehead, "how much did you smoke before you met me?"
"I don't really smoke," St. John said. "Just cigars."
He saw Caroline rolling her eyes and it pissed him off.
Dr. Krueger looked up from his chart. "You're having a heart attack. Your CPK levels haven't started to go down yet and your EKG still shows a pattern of ischemia, or insufficient blood flow, in the anterior or front wall of the heart muscle. We need to get you into a treatment room upstairs and see what's going on in there. The best way to see inside you is with an angiography. We basically inject dye into your blood vessels and film the results."
"Then what?" Caroline asked.
"That depends on what we find. Sometimes an angioplasty is enough to clear out the blockage. Other times, surgery is the answer."
"As in a bypass?" he asked.
"We'll know more after the procedure." The doctor handed him release forms to sign.
He looked at Caroline. "What do you think?"
"We have to find out what's going on. I think you should do it."
He signed his name at the bottom of the consent forms. Asia tugged at Caroline's shirt and said, "Excuse me, I have to go to the bathroom."
"Can you hold it for a minute longer?" Caroline asked.
"No, that's all right," St. John said. "Take her now."
Dr. Krueger looked at Caroline and said, "You can meet us upstairs. The cardiac unit is on the third floor. I'll come find you in the waiting room."
The attendants came in and kicked off the wheel locks on the gurney. St. John realized they were going to take him away now, just roll him out. He fought back sudden terror. The monitors betrayed his quickened pulse.
"We'll see you upstairs," Caroline said. She bent down and kissed him on the lips.
"Go," he said again. "I'm in good hands here." When Caroline and Asia had left the room he looked in the doctor's eyes and said, "Give it to me straight, Doc. Is this it?"
"I've seen worse," she said. "The important thing is to get you into treatment."
They wheeled him into an elevator and took him to the third floor. In the hallway they were met by a swarthy-complexioned man wearing surgical scrubs.
"This is my associate, Dr. Patel," Dr. Krueger said. "He's going to be performing your angiography/'
"How do you do, sir," Dr. Patel said in a postcolonial British accent common to educated East Indians.
"Just peachy Doc."
"Yes, quite," the doctor said with a knowing but not unsympathetic smile. "I assure you that you will receive the best possible care. I have performed this procedure hundreds of times."
They all entered a large room filled with people in surgical gowns. The sign on the door identified this place as the cardiac catherization laboratory St. John was helped out of his clothing and onto a motorized table. There he was strapped in and harnessed to various machines. A nurse brought out a shallow bowl of hot water and a razor with which she shaved the inside of his right thigh all the way to the groin. When she was done she swabbed the area with a reddish-brown solution that smelled like iodine.
"This isn't going to hurt, is it?" he asked the nurse, only half joking.
She replied with a weak smile. It didn't take a rocket scientist to read between the lines.
"You going to knock me out for this, Doc?" St. John asked Patel.
"Oh no, old boy You'll be with us for the duration. Not to worry. You'll be getting a local anesthetic. Here." He touched the crease where St. John's abdomen met his upper leg.
St. John closed his eyes. The image that came to him was of his father, years ago. St. John was eight, maybe nine. It was a warm summer evening. The back door was open and the orange trees his mother had planted before she died were in bloom. Their sweet scent washed over him as he sat on the front porch holding their cocker spaniel, Fluffy Digger was standing in the kitchen, ironing. Harry Caray was on the radio. The Cubs were winning for a change.
He opened his eyes again and saw that they had erected a surgical tent around his lower body. Dr. Patel kept up a patter as he worked, explaining how he was inserting a needle into the femoral artery followed by a guide wire. The guide wire would be inserted only a small distance, just enough to get the plastic catheter tube on its way to the aorta. One of the surgical nurses shuffled over to his side and checked his pulse. He noticed that she was wearing blue surgical booties. They were identical to the type criminalists wore when they were trying not to contaminate a crime scene.
He always knew when looking at crime scene photographs if the techs had been there already. The booties left their own distinctive marks, fuzzy oversized. He'd seen photos like that just the other morning, but something about them wasn't right. Dammit. He knew he'd hit on something important to think about. He just couldn't connect the dots through the cloud of whatever drugs they had him on. He closed his eyes to help him concentrate and the next thing he knew, Dr. Krueger was talking to him. He must have dozed off for a minute, because now the room was cleared of everyone but him and the cardiologist. "The angiogram showed a ninety-five percent obstruction in your left anterior descending artery" Dr. Krueger said without preamble. "If we do nothing besides pharmaceutical therapy there is a fifty percent chance that you'll have a heart attack in the next five years." She paused. "And there's a ninety percent chance that that heart attack will be fatal. When I was in medical school, they had a nickname for this particular lesion."
"What was that?"
"Widow maker."
"So what's your recommendation, Doc?" he asked. His tongue felt thick and furry like his brain.
"We're going to review the film and discuss the best method of treatment. We've left the sheath in your groin in place. We'd like to do a procedure called an angioplasty. Dr. Patel will go into your femoral artery again with a catheter. Only this time there will be a balloon attached. He will snake the catheter all the way to your lesion and then inflate the balloon. Hopefully he'll be able to get past the plaque and reestablish good flow through the artery. "
"Hopefully?"
"We have a ninety percent success rate with the balloon."
"What are the risks?"
"There's a two percent chance of rupturing the artery And in that event we'll have to go in and do immediate surgery. But don't worry we'll have a team of cardiac surgeons on standby in case of that eventuality."
"You said a ninety percent success rate. What happens the other ten percent of the time?"
"We can't get the balloon into the artery that is obstructed. In that case, you still have the option of surgery."
"Some option," St. John said.
"We've done this procedure hundreds of times. Dr. Patel is an excellent interventional cardiologist."
St. John smacked his dry lips. “Have you talked to my wife?"
"I'm going to speak to her now."
"When do you want to do all this?"
"Sometime tomorrow after we've all had plenty of time to discuss our best plan of attack. Meanwhile, we need you to stay quiet."
"I'll be good," he said.
* * *
Caroline looked up when Dr. Krueger entered the waiting room. Asia was asleep on the Naugahyde sofa and snoring loudly
"How's he doing?" Caroline asked.
"Fine, fine. He's sedated. The procedure went well." Then Dr. Krueger went over with Caroline what she had just explained to her patient.
"I don't know what he told you," Caroline said, "but he smokes a box of those little cigars a day."
"Don't worry" Dr. Krueger said. "Whatever a patient tells us that he smokes and drinks, we know to automatically double it."
"Can I see him?"
"Sure. He's going to be groggy You can leave your daughter here. I'll have the nurses keep an eye on her."
Caroline stroked Asia's cheek and didn't bother correcting the doctor. Maybe they'd all do a better job if they thought Mace had a young child.
The ICU was protected by electronically locked doors. Caroline had to identify herself by speaking into an intercom before they would buzz her in. Mace was in an alcove near the center of the ward. His color was better, but not by much. She lifted his hand to her cheek and willed health to his body, his heart. He started and grimaced, then opened his eyes. She saw him struggle to get his bearings.
"Does it hurt?" she asked.
He smacked his mouth. She found the water bottle on his bedside table and lifted the straw to his lips. He drank.
A nurse bustled into the room and headed right for him, speaking in a loud voice. "Mace?" she practically shouted. Caroline jumped back out of the woman's way.
St. John fixed a bloodshot eye on the woman. "I'm here," he said.