Critical Judgment (1996)

by Michael Palmer

  Barbara met Abby by the door to Kelly's cubicle.

  "I came in as soon as Lew called," she whispered. "It doesn't look good in there."

  "It isn't."

  "Well, my husband's got a virus, so I may or may not stay the night depending on how he is and how Lew feels after his shift is done."

  "I can special her, but I'm on the schedule for tomorrow at eight A.M.," Abby said. "A sixteen-hour shift, no less."

  Abby had started her day with the visit to Dotty Schumacher and her Strudel. She'd been sleep deprived when she'd gone to bed late the previous evening, and not much less sleep deprived when she awoke. Now, with all that had happened today, she was operating on raw, nervous energy. There was no way to guess how much fuel remained in her tank. But it was a safe bet that without five or six hours of decent sleep, she would never make it through her shift tomorrow without crashing.

  "Don't you worry," Torres said. "Lew or I will handle things here. I stopped by the ER. He said for you to call as soon as you're ready to go down to the MRI unit. What's that all about?"

  "Maybe nothing. I'll tell you as soon as I get back. Meanwhile, don't let anyone near her who doesn't have an ID tag."

  "I used to do some per diem, and before that I was a med/surg nurse on two. I know a lot of the staff here."

  "Any doubts about anyone, just bring them over to be eyeballed by one of the unit nurses."

  "Done."

  Barbara Torres moved into Kelly's room and set to work. Abby called Lew in the ER. Spanish class for Hector Ortega would commence in three minutes.

  The air seemed heavy, like it was liquid or something. It even had a weird taste....

  Claire Buchanan's words played over and over in Abby's head as she made her way cautiously down the back stairs to the radiology unit. The lights in the main corridor were dim, and the place seemed totally deserted. Several years ago she had bought herself a running watch as part of a pledge to jog more. The pledge lasted only a few weeks, if that, but the twenty-three-dollar watch was like Old Man River. Now, as she entered the blackened MRI unit, she put the watch in countdown mode, set it for twenty minutes, and began.

  She first entered the control room, which was connected by a door to MRI radiologist Del Marshall's office. The area, housing the huge, complex electronic console and monitoring screens, was the purview of the imaging technologist. Beyond it, in a room the size of a large closet, was the integrating computer itself. The control area was separated by a heavy glass wall from the room housing the MRI machine.

  The entire unit, including Marshall's office, was totally dark. Abby flipped on the lights in the main room and pulled the print curtains closed on the control-room side of the glass, cutting down on much of the glare. Then she stepped inside the pitch-black radiologist's office and closed the door. There was no light filtering in from the control room. As a last precaution she pulled a wastebasket over and left it by the door from the office to the main hall. The noise of the door bumping it might give her a few seconds of advance warning. Of course, doing anything beneficial with those seconds would be something else again.

  She closed Marshall's office door behind her and passed through the control area to the actual MRI unit. The watch read 18:43.

  As a resident Abby had taken a tour of the MRI unit serviced by the St. John's radiologists. Now she wished she had paid more attention. The machine was massive--a seven-foot-long tube, less than two feet in diameter, set inside the housing of the electromagnet, which was a huge gleaming cube, seven feet on a side. Extending from the cylinder was the track and movable platform on which the patient was placed to glide electronically into the machine.

  Abby examined the track quickly, then peered into the tube. The opening was wide enough to admit an average-sized person. She suspected that anyone above 250 or so would have a problem even fitting inside, let alone fitting inside and remaining sane for three-quarters of an hour with shoulders pressed against the sides and nose just inches from the top. Claire Buchanan wasn't large, but she was claustrophobic. Abby's estimation of the woman's determination went up several notches. Claire had wanted so much to be well again that she was willing to enter the lair of her dragon.

  "What went wrong, Claire? What went wrong?"

  Abby sang the words softly, tunelessly as she crawled around the base of the machine, looking for something, anything, out of place. At the rear of the unit the track extended several feet so that patients could be positioned with their torso and head outside and their lower body inside. In that way the pelvis and legs were easily scanned. Below the opening were the hydraulics that helped move the sled along the track. Nothing among the cables seemed unusual. Abby cursed herself for having absolutely no idea what she was looking for.

  Suddenly, from beyond the control room, she heard the soft sound of the office door striking the waste can. She was as far away from the door to the waiting room and hallway as she could possibly be. There was no chance she could make it. She huddled behind the scanner and peered over the track, through the long cylinder. The door from the office to the control room opened, backlighting the curtains she had drawn. Seconds later they were pulled apart. From her position it was impossible to see who was there. She glanced at her watch. Fifteen minutes left. Unless Lew had failed miserably, it wasn't the X-ray technician.

  She held her breath as the door from the control room slowly opened. She could see who the intruder was only if he or she passed directly beyond the cylinder opening. Abby sensed the footsteps moving around toward where she was crouched. Silently, she pulled herself facedown onto the track and then into the narrow cylinder. The footsteps continued around to where she would surely have been seen had she stayed crouched next to the hydraulics. Then they turned and headed back toward the front of the room. Abby pushed herself backward again until only her upper half was in the cylinder. She extended her neck, lifting her head so that she could see in front of her.

  Suddenly, a man's broad back appeared to the left of the track. He was wearing white. Abby's mind was swirling. Was this a radiologist? If so, what was he there for? An emergency MRI? The man stepped away. He was wearing bright white coveralls, not a clinic coat. He began singing a woeful rendition of the "Folsom Prison Blues" as he dusted the floor. Abby barely took a breath as the janitor sang and dusted around her. She watched the time flash down on her watch. Eleven minutes. Ten. The singing stopped. Moments later the lights went out. The doors opened and closed. Soon the silence and the darkness were total.

  Abby waited an extra thirty seconds, then managed to roll over so that she was facing upward. How on earth had claustrophobic Claire allowed herself to be scanned even once, let alone a second time?

  The air seemed heavy, like it was liquid or something....

  She took Lew's penlight from her breast pocket and ran the beam over the white enamel inside the tube. Inch by inch, she worked her way out of the cylinder in the direction she had entered, keeping her body extended by keeping her feet on the track. She was about eighteen inches from the opening when she saw them--a single row of minuscule pores in the enamel, extending in an arc directly over where a typical patient's nose or mouth would be. She held the light inches away from the openings--a row of, perhaps, thirty holes that were little more than pinpricks. Were they standard in an MRI? If so, what would they be for?

  Abby's pulse was racing as she pulled herself out of the cylinder and turned on the overheads. There were eight minutes left by her watch. She took a step back and ran her gaze around the margin of the opening. At the twelve o'clock position there was a small fan that was used, she assumed, to keep air circulating over the patient during the test. At three o'clock there was a clear Plexiglas disc attached to the housing by a rivet and hinge in such a way that it could be swung over the opening and fixed in place, effectively sealing the cylinder at that end. Abby went around and checked the other end. There was no similar piece there. Was that a standard part of the equipment?

  Six minutes.


  Abby hurried to the phone on the wall by the door and called Lew.

  "Is the X-ray tech still there?" she asked.

  "He's busy conjugating the verb ir. 'To go.' "

  "Well, menos prisa, por favor."

  "Go slow. Where did you learn--?"

  "Lew, I've found something, but I need more time."

  "Tell me."

  "Can you see Hector right now? We can't let him come back here yet."

  "He's right over there at the nurses' station, wondering how so many people in the world who are not as smart as he is can speak Spanish so well. But a guy's just been brought in with a fractured hand from punching a tree instead of his girlfriend. Hector knows him and knows he's got work to do."

  "Fifteen minutes. Can you give me that much?"

  "What have you found?"

  "Lew, there are tiny holes inside the cylinder just above where the patient's nose and mouth would be. Do you know if they're supposed to be there?"

  "No idea."

  "There's more. There's a Plexiglas plate that can be swung over the opening at that end, sealing it off and creating an enclosed space."

  "But what for?"

  "I don't know. Listen, Lew, I need to look some more, and I want to call the radiology resident on duty at St. John's. Can you give me fifteen minutes?"

  "I can try. Maybe I'll have him conjugate hacer el amor."

  " 'To make love.' From what I know of Hector, that might do it. I'm at extension three-three-eight-four. Call if you lose him. I'm going to check with St. John's, then I'm going to try to figure out what comes out of those little holes."

  "Just be careful and keep me informed. Kelly underestimated those people."

  "So did I."

  Abby hung up, reset her watch for a thirteen-minute countdown, and used the switchboard operator to call St. John's. It took just a one-minute conversation for her to confirm what she intuitively suspected: there are no holes inside the standard MRI, and no technical reason ever to close off one end of the cylinder.

  ... It even had a weird taste....

  She returned to the massive housing and first examined the cables and tubes making up the hydraulic system for the sled, then the base of the machine. Nothing.

  Nine minutes.

  Feeling just a bit panicky from the press of time, she stepped back again, searching for something, anything, that looked out of place. It was fully half a minute before she realized she had not inspected the top of the unit. She pulled over a wooden straight-backed chair and stood on it. The missing piece was there--a small bundle of clear plastic tubes, each slightly smaller than IV tubing, rising from the floor next to the hydraulics, and running around the outside of the housing to a spot just above the ventilation fan. From there the bundle dropped into the machine through a black-rubber gasket.

  Seven minutes.

  Abby traced the bundle of tubes back down to the floor at the base of the unit, where they disappeared into a white enamel shield. Using the penlight, she tried peering down behind the shield. As far as she could tell, the tubes seemed to come right out of the tiled floor. Lying prone on the floor and using the penlight for an up-close examination, she studied the foot-square beige tiles, and the gray grout between them.

  Six minutes.

  Five.

  Just as she was about to give up, she saw it--a thin space, less than a millimeter, through the grout bordering a two-foot square of tile. It was virtually invisible except at almost microscopic range and had to be a trapdoor of some sort. At that moment the wall phone began ringing. Abby sprang up and dashed to it.

  "Hector's just gotten a call," Lew said. "One of the floors is sending someone down for an emergency belly film. He's meeting them in two minutes."

  "Damn!"

  "I really can't keep him here without having it look terribly suspicious."

  "Lew, I've found it! The MRI machine is rigged to function as some sort of inhalation chamber. That was why Claire experienced what she did. The gas, whatever it is, comes up through the floor in six small tubes and enters the cylinder at the top, right by those little ports I told you about. If that Plexiglas panel is in place, it would be possible to deliver a very closely controlled dose."

  "An inhalation chamber. God, as if that thing didn't feel enough like being pushed into a tomb."

  "There's more. I traced the tubes down, and they seem to go straight into the floor. Lew, I think there's a trapdoor in the tile right near where they go in. I want to find a way to open it."

  "What about Hector?"

  "If all he's doing is a standard set of abdominal films, there's no reason why he should come in here. I'm going to chance it."

  "I don't know if that's wise."

  "I'll be back in the ER in ten minutes."

  "Just--"

  "I know. I know. It seems that 'be careful' is all you've been saying to me lately."

  "I'm crazy about you. How's that?"

  "That's much better," she said. "I'll see you in ten."

  She went out and closed the curtain in the control room. Next she returned and checked the walls in the main room for any switch that might unlock the panel in the floor. Then she stopped, calmed herself, and struggled to overcome her limited mechanical aptitude. She began by reasoning the situation out piece by piece, the way she did in the ER when her first rapid-fire treatment of a crisis failed to work. Whatever was going on in the MRI scanner, it was unlikely that more than a very few people were in on it. Dozens of explanations could be given to any technician or physician who questioned the tubes or the Plexiglas. And the patients, many of whom wore coverings on their eyes to help them relax, were unlikely even to notice the pores in the cylinder, or to think them abnormal. A switch on the wall would be too prone to being thrown by mistake. Instead, she concluded, it had to be a lever, most likely concealed beneath the electromagnet housing itself. Something mechanical, not electric.

  Abby got down on her hands and knees once again, feeling up underneath the cylinder where the track came out. It took several careful minutes, but finally her hand closed on a smooth curved handle hidden high up behind the housing, well away from any place it could be accidentally pulled. It was metal of some sort, although if so, it certainly had to be nonferromagnetic. She composed herself with a deep breath, curled her fingers around the handle, and pulled. With a soft pop the latch released. The four-tile segment of floor opened half an inch at one side. Abby's pulse was hammering again as she crawled over, lifted the hatch, and peered inside. Below her was a ladder, set in concrete, dropping six feet or so to the start of a concrete tunnel. The narrow plastic tubes, extending through the tunnel wall, appeared to run along the length of ceiling. The floor of the tunnel was slatted wood, like the floor of a sauna.

  It took a few seconds for Abby to re-create the orientation of the hospital and the radiology suite and to get her bearings. But when she did, she became certain of what she already suspected--the tunnel was headed straight toward the Colstar cliff. From outside the unit, voices became audible. People were closer than she would have expected given the room where Hector would have been working. She hurried across and killed the overhead lights. Then she returned to the trapdoor, using the penlight. Suddenly there was a scraping, as if someone's shoe had brushed against the hallway door.

  Quickly, she dropped onto the ladder and lowered herself into the tunnel. Then she checked that she could open the hatch from underneath before pulling it down over her.

  She crouched at the base of the ladder and waited. A minute passed. Two. There was no sound from above. The tunnel was almost exactly her height--perhaps an inch or so more. The air was stagnant and dusty, the darkness total. Abby shined the penlight into the blackness. It illuminated a few feet, no more. Again she listened for sounds from above. Again there was nothing.

  She had come too far, learned too much, to turn back now. Moving inches at a time, hunching her shoulders, and keeping the weak light trained on the floorboards, she took he
r first tentative steps toward what she knew was the man-made cavern within the Colstar cliff.

  CHAPTER THIRTY-SIX

  The concrete tunnel sloped downward and seemed to make a gradual bend to the right. As she moved through it, Abby tried to estimate where she might be relative to what she remembered of the terrain and the layout of PRH. Under the service parking lot behind the hospital.... Under the long gravel-and-dirt lot, staked out with flag sticks for some future addition.... Under the high chain-link fence topped with barbed wire.... Under the broad meadow of boulders, jagged rock, and wildflowers that led to the Colstar cliff.... And, finally, somewhere near or under the cliff itself.

  Progress was slow. There was a row of bare incandescent lightbulbs, set about ten feet apart along the center of the ceiling, but none of them was lit. Abby cursed herself for not thinking to look for a switch somewhere around the ladder, although it was doubtful she would have felt safe turning it on. Running parallel to the row of lights was the bundle of six narrow plastic tubes, each color-coded by bands of tape spaced along its length: yellow, red, blue, green, pink, and black.

  The small penlight succeeded a little in piercing the dark, but the blackness was consuming when Abby turned it off. Gradually, the damp, musty taste to the air began to subside. Her estimate put her well beyond the base of the Colstar cliff now, but there was absolutely no way to know her position with any certainty. From somewhere up ahead, she could feel a faint breeze and hear the low hum of air-conditioning. Then, as she continued the gentle curve to the right, she saw a faint light. Her heart was pounding in her throat as she moved forward. Twice she had to stop and brace herself against the wall just to allow her pulse to slow down. With each step the light grew larger and brighter, until finally she could make out the outlines of a doorway. Her best guess was that she had traveled a quarter of a mile from the hospital. Maybe more.

  Except for the faint hum of the air-conditioning unit, the silence was absolute. Abby turned off the penlight and inched her way along the wall. Her fight and flight reflexes were turned up to the maximum, but she knew that nothing was going to override her anger and her overwhelming curiosity. The light flowing through the doorway was fluorescent. As she moved to the end of the passageway, she realized that it was coming from around the side of a whitewashed concrete wall twenty feet away. She stepped around the doorway and was standing within a dimly lit space that rose into the rock as far as she could see. At the center of the space was an elevator, enclosed in a concrete shaft. A metal staircase wound around it like a serpent. At the base of the stairs, riveted to the stone wall, was a professionally painted sign: