Foreign Body

by Robin Cook

  SAME TIME IN A SECTION OF NEW DELHI

  On a busy business street, wedged between typical, three-storied, reinforced-concrete commercial buildings whose façades were almost completely covered by signs in both Hindi and English, stood the starkly modern five-story Queen Victoria Hospital. In sharp contrast to its neighbors, it was constructed of amber-mirrored glass and green marble. Named after the beloved nineteenth-century British monarch to appeal to the modern medical tourist as well as the rapidly expanding Indian upper middle class, the hospital was a beacon of modernity thrust into the center of India’s timelessness. Also in contrast to its neighboring plethora of small businesses, which were, for the most part, still open, busy, and casting harsh blue-white fluorescent light into the street, the hospital looked bedded down for the night, with little of its soft, interior illumination penetrating the tinted glass.

  Except for two tall, traditionally costumed Sikh doormen standing at either side of the entrance, the hospital could have been closed. Inside the day was clearly winding down. As a tertiary hospital with no real emergency department, the Queen Victoria handled only scheduled elective surgery, not emergencies. The soiled dinner dishes had long since been picked up, washed, and hidden away in their cupboards, and most of the visitors were gone. Nurses were handing out evening medications, dealing with drains and dressings from the day’s surgeries, or sitting within bright cones of light at nurses’ stations to finish up their computerized charting duties.

  After a hectic day involving thirty-seven major surgeries, it was a relaxed and quiet time for everyone, including the one hundred and seventeen patients: everyone, that is, except Veena Chandra. While her father was trudging out of the rank, loathsome landfill, Veena was struggling in the half-light of an anesthesia room in the empty operating-room suite, where the only light was filtering in from the dimmed central corridor. Veena was attempting with trembling fingers to stick the needle of a 10cc syringe into the rubber top of a vial of succinylcholine, a rapidly paralyzing drug related to the curare of Amazonian poison dart fame. Normally, she could fill such a syringe with ease. Veena was a nurse, having graduated from the famous public hospital the All India Institute of Health Sciences almost three months ago. Following graduation she’d been hired by an American firm called Nurses International, which had, in turn, hired her out to the Queen Victoria Hospital after providing her with some specialized training.

  Not wishing to stick herself with the needle, which could prove deadly, Veena lowered her arms for a moment and tried to relax. She was a ball of nerves. She truly didn’t know if she was going to be able to do what she’d been tasked with and had agreed to do. It seemed incredible that she’d been talked into it. She was supposed to fill the syringe, take it down to Maria Hernandez’s room, where the woman was hoped to be sleeping off the anesthesia from the hip-replacement surgery she’d had that morning, inject it into her IV, and then beat a rapid retreat, all without being seen by anyone. Veena knew that not being seen by anyone on a nearly full hospital floor was highly unlikely, which was why she was still dressed in her traditional white nursing uniform she’d had on all day. The hope was that if someone did see her, they wouldn’t think it odd she was in the hospital even though she worked days, not evenings.

  To help her calm down, Veena closed her eyes, and the moment she did so she was instantly transported back four months to the last time her father threatened her. They were at home, his parents in the living room, her mom at the hospital, and her sisters out indulging in Saturday-afternoon activities with friends. Totally unexpectedly, he had cornered her in the bathroom. While the television blared in the next room, he began shouting, then cursing at her. He was very clever in how he hit her, never leaving a mark on her face. His rage was unexpectedly volcanic, and it was all Veena could do not to cry out. Since it hadn’t happened for more than a year, Veena had assumed that the problem was over. But now she knew for sure it would never be over. The only way to escape her father’s clutches was for her to leave India. Yet she feared for her sisters. She knew he was unable to control his urges. If she left, he would undoubtedly single out one of her sisters and start anew, and that she could not abide.

  The sudden crash of metal against the composite floor brought Veena back to the present, her heart skipping a beat. Feverishly, she stashed the vial and syringe in a drawer packed with IV needles. Suddenly, the bright lights came on in the main corridor of the OR. With her pulse pounding, Veena went to the small wired-glass window and glanced out. Within the darkened anesthesia room, she was confident she would not be visible. To the right she saw that the main doors to the outer hall were momentarily propped open. A second later two members of the janitorial crew appeared, wearing hospital scrubs. Both men carried mops. They picked up the empty buckets they’d dropped moments before and started down the corridor, passing within feet of Veena.

  Relieved to a degree that it was only a cleaning crew, Veena turned back into the room and retrieved the vial and syringe. She was now more nervous than she’d been just moments earlier. The unexpected arrival of the janitors reminded her how easy it would be for her to be caught in the OR, and if she was caught, how hard it would be to come up with an explanation of what she was doing there. With her trembling even worse, she persisted and managed to guide the needle into the vial. Exerting negative pressure, she filled the syringe to the level she’d predetermined. She wanted a good dose, but not too big.

  Veena’s short, unpleasant reverie had reminded her with painful clarity why she had to do what she’d been tasked with. She’d agreed to put to sleep an aged American woman with a history of heart problems in return for a guarantee from her employer that her mother and her sisters would be protected into the foreseeable future from her abusing father. It had been a difficult choice for Veena, made impulsively with the idea that it would be the only opportunity she would have to obtain any kind of freedom, not only for herself but also for eleven of her friends, who had all joined Nurses International at the same time.

  Putting away the vial and throwing away the packaging from the syringe, Veena walked toward the door. If she was going to go through with the plan, she had to concentrate and be careful. Above all, she had to try to avoid being seen, especially near her victim’s room. If she happened to be confronted in any other part of the hospital, she would explain that she’d returned that evening to use the library facility to study Maria Hernandez’s condition.

  Veena cracked the door and slowly eased it open to get her head out to see up and down the corridor. Presently, several of the cleaning people could be seen chatting and mopping. As they had started at the very end and were working toward the doors, their backs were conveniently turned in Veena’s direction. Stepping into the corridor, Veena let the door close gently before silently heading out of the OR area. Just before she let the main entrance doors swing shut, she glanced back at the cleaning crew. She felt palpable relief. They were oblivious to her presence.

  Forgoing the elevator lest she not only run into someone but be forced to converse, Veena used the stairwell to descend to the fourth floor. There she again cracked the door before gazing the length of the dimmed corridor in both directions. No one was in view, even at the nurses’ station, which was by contrast an oasis of bright light in the center of the floor. Apparently, the nurses were out in the rooms attending to their charges. Veena hoped no one would be in Maria Hernandez’s room, which was in the opposite direction. From where she was in the stairwell, it was on the right, three doors down. All she could hear were muted sounds from multiple TVs and distant beeping from the nearby monitors.

  To gather her resolve, Veena let the door slip shut while she closed her eyes and leaned her head back against the concrete block of the stairwell. Step by step, she went over what she was about to do to avoid any possible errors, thinking back to how she had reached this unimaginable point in her life. Everything had fallen into place this afternoon, as she returned to the bungalow after work. She and the o
ther eleven nurses hired by Nurses International were required to live at what sounded like a small cabin in American English but was in reality an enormous British Raj-era mansion. They lived there in luxury along with the Nurses International four-person administration. Yet coming through the front door she had felt her pulse quicken and her muscles tense just like she always did. Veena had to be constantly on guard.

  As an acculturated Hindu woman, Veena recognized she had a powerful inclination to bow to male authority. When she joined Nurses International, mainly for their promised help in her goal of emigrating to America, she naturally treated Cal Morgan, the head of the organization, as she was expected to treat her own father. Unfortunately, this natural response was not without problems. As a typical thirty-two-year-old American male, Cal interpreted Veena’s culturally motivated attention and respect as a come-on, which created numerous episodes of misunderstanding. The situation was difficult for both of them and persisted because of a continued lack of communication. Veena feared compromising her chances of Nurses International giving her her freedom by helping her emigrate, and Cal feared losing her because she was their best employee and the leader among the others.

  That afternoon, like all workday afternoons, once inside the mansion and despite the tension between them, Veena sought out Cal in the paneled library, which he had commandeered as his office. At the end of each shift the nurses were required to report to one of the four principals of the firm, President Cal Morgan, Vice President Petra Danderoff, Computer Head Durell Williams, or Psychologist Santana Ramos, whichever individual had hired the nurse in question. Veena had to report to Cal because she had been his hireling some two months earlier, when the company was being formed. Each day Veena and the others were tasked, in addition to their normal nursing duties, to surreptitiously download reams of patient data from the central computers of the six private hospitals where they’d been hired out and bring it back and report it to their assigned administrator. During their month of U.S. training, they had been specifically instructed in this activity. As an explanation, they had been told that one of the primary functions of Nurses International was to obtain surgical outcome data. Why the company was interested in such data had not been explained, and no one particularly cared. The complicated, clandestine effort seemed a small price to pay to be already compensated with American nurse salaries, which were ten times what their Indian coworkers were being paid, and, more important, to be given the promise of being relocated to America after six months.

  Already tense as usual, when Veena had walked into Cal’s office that afternoon, he had magnified her anxiety by ordering her to close the door behind her and sit down on the couch. Fearful of another seduction scene, she’d done as she was asked, but he shocked her with something else entirely. He had told her that he’d learned that day the whole story about her father and how he was extorting her. Stunned and humiliated, Veena was also furious at her best friend, Samira Patel, because she knew instantly it had to have been she who’d revealed Veena’s darkest secret. Samira was a nurse who’d trained with Veena and who’d joined Nurses International along with her. She too wanted to emigrate to the United States, but for a more generic reason. Familiar with the freedoms of the West from images on the Internet, she despised what she considered the restrictions life in India placed on her. She was what she liked to describe as a free spirit.

  After Cal had revealed what he knew, Veena had stood up with the idea of fleeing without even thinking of where she would go, but Cal had grabbed her arm and urged her to sit back down. To her surprise, in lieu of blaming her and condemning her as she had always feared, he’d convincingly sympathized with her, and had been angry that she thought she was somehow responsible for her father’s behavior. He’d then gone on to persuade her that he could help her if she’d help him. He’d guaranteed that her father would never again lay a hand on her, her sisters, or her mother. And if he did, he would disappear.

  Convinced Cal was being deadly serious, Veena had asked what she was to do for him. Cal had then gone on to explain that the surgical-outcome data they were amassing was proving to be disappointing. The data was too good, and they had come to realize they needed to create some of their own bad data, and he’d told her how they envisioned doing it using succinylcholine. At first Veena had been shocked by the plan, especially since she had no idea why they needed this “bad data,” but the more Cal talked, saying that she would have to do it only once, and that she would be free from her father and able to emigrate without the guilt of putting her sisters and mother at risk, and the more she recognized she would never get such an offer again, she had impulsively decided to cooperate. And not only did she agree to cooperate, she wanted to do it immediately, that very night, lest she think too much about what she was actually doing.

  With a renewed sense of determination to get the business over with and a clear idea of the sequence of events she needed to follow, Veena took a deep breath. She then straightened up from where she was leaning against the stairwell wall, opened her eyes, and checked again to be sure the corridor beyond was empty. With tension quickening the pulses in her temples, she started toward the Hernandez room at a brisk walk. No sooner had she taken several steps when one of the evening nurses emerged from the room directly opposite Hernandez’s, bringing Veena to a sudden halt. Luckily for Veena, the nurse was unaware of her presence. Concentrating on the medication tray in her hands, she headed farther down the corridor, away from the nurses’ station. As suddenly as she had appeared, she disappeared into another patient room.

  Breathing a silent sigh of relief, Veena checked in the direction of the nurses’ station. All was quiet. She hurried on, reaching Hernandez’s door in seconds. Pushing it open, she stepped in and returned the door to its near-shut position. Although the TV was on, the volume was low. The overhead lights were dimmed, causing the corners of the room to be lost in shadow. Veena had no trouble seeing Mrs. Hernandez. The woman was fast asleep, with the head of her bed elevated about forty-five degrees. The fluorescent-like light emanating from the TV dimly illuminated her facial features while leaving her orbits in deep shadow, giving her a ghastly appearance, as if she were already dead.

  Thankful the woman was asleep, and wanting the anxiety-producing affair over with as soon as possible, Veena rushed to the bedside, pulling the syringe from her pocket. She was careful not to nudge the noisy, metal bed rails as she reached for the IV line. She was also careful not to pull on it for fear of attracting the patient’s attention and waking her. Holding the IV port in one hand, she used her teeth to remove the needle cover. Then, holding her breath, she inserted the needle. When she could see the needle tip within the lumen of the IV line, she prepared to slowly depress the plunger. Instead, she almost leaped out of her shoes. For no discernible reason, Mrs. Hernandez rolled her head in Veena’s direction and looked up into Veena’s face. A slight smile played across her lips.

  “Thank you, dearie,” she said.

  Veena felt her blood run cold. Knowing she had to act that instant or she’d never be able to do it, she forcibly depressed the plunger of the syringe, shooting the bolus of succinylcholine into the patient’s bloodstream. What had pushed her over the edge was sudden, inappropriate defensive anger that the woman had the insensitivity not only to wake up but to thank her, apparently thinking Veena was giving her medication to help her.

  Although Veena hadn’t seriously thought about what she’d be forced to witness after injecting the paralyzing drug, she was horrified by what she did see. Contrary to a peaceful, cinema-like passing, which had been her general assumption and what Cal had intimated, it was anything but. Within seconds Mrs. Hernandez’s body reacted to the large dose of succinylcholine with rapid fasciculation of her musculature. It started with her facial muscles giving her waves of grotesque facial contortions. Adding to the unexpected horror was the intense fear that clouded her eyes. As her hand lifted in a vain attempt to reach out to Veena for help, it too started to jer
k about uncontrollably. And then came a sudden ominous, purple darkness that spread over her face like the shadow that seeps across the face of the moon during a lunar eclipse. Unable to breathe yet fully conscious, Mrs. Hernandez was being rapidly suffocated and turning deeply cyanotic.

  Horrified at what she had wrought and wanting nothing more than to flee, Veena was forced by her guilt to remain rooted to her spot and watch her patient’s death throes. Luckily for both it was soon over, and Mrs. Hernandez’s eyes gazed blankly out at eternity.

  “What have I done?” Veena whispered. “Why did she have to wake up?”

  At last breaking free from her psychologically induced paralysis, Veena turned and raced from the room. Without even thinking of the consequences, she ran headlong down the hall, only vaguely aware that the nurses’ station was still empty. During the day there was always at least a ward clerk, but not in the evening and not at night.

  In the elevator Veena was only dimly aware that she was alone. She kept seeing Mrs. Hernandez’s face in all its twitching horror. There were people in the hospital lobby, even a few ambulating patients and their family members, but no one gave Veena a second look. She knew what she had to do, and that was to get away from the hospital as soon as she possibly could.