Foreign Body

by Robin Cook

  Charu and Samira knew each other only from nurses’ report during the shift change when the day nurses communicated to the evening nurses each patient’s status and specific needs.

  “I just wanted to check on my patient,” Samira said, her voice more hesitant than she would have preferred. “I’ve been in the library studying up on knee-replacement surgery.”

  “Really?” Charu questioned, with a tone that suggested doubt.

  “Really,” Samira echoed, trying to sound forceful.

  Charu eyed Samira with a look of disbelief but didn’t voice it. Instead, she added, “Mrs. Benfatti is visiting.”

  “Will she be leaving soon? I wanted to ask Mr. Benfatti a few questions about symptoms.”

  Charu merely shrugged before pushing past Samira.

  Samira watched her as she headed in the direction of the desk. Samira was in a quandary about what to do. She couldn’t hang around the floor waiting for Mrs. Benfatti to leave, yet if she returned to the library, she wouldn’t know when the wife departed. On top of that, she wondered if running into Charu meant she should abort the effort altogether. Of course, the trouble with doing that was that it might be a week before she had another American patient with some kind of history of heart trouble who would make an appropriate target. By then the benefits of competing with Veena probably wouldn’t accrue.

  Samira was still debating the issue when she was surprised yet again. This time it was Mrs. Lucinda Benfatti, who was a moderately tall, heavyset woman in her mid-fifties with tightly permed hair. Having met Samira that day, she recognized her immediately. “My word, you do put in a long day.”

  “Sometimes,” Samira stammered. Her mission during which she was to avoid being seen was devolving into a bad joke.

  “What time do you work until?”

  “It varies,” Samira lied. “But I’ll be heading home shortly. How is the patient doing? I wanted to stop by and check.”

  “Well, aren’t you a dear! He’s doing reasonably well, but he’s not good with pain, and he’s having a lot of pain. The nurse who was just in here gave him an additional pain shot. I hope it works. Why don’t you go in and say hello. I’m sure he’d be glad to see you.”

  “I’m not sure that’s appropriate, since he just had a pain shot. I don’t want to bother him.”

  “It’ll be no bother. Come on!” Mrs. Benfatti took Samira by the elbow and walked her into her husband’s room. The lights had been dimmed, but the overall level of illumination was reasonably bright, since the large, flat-screen TV was on and tuned to the BBC. Mr. Benfatti was propped up in a semi-recumbent position. His left leg was encased in a device that was slowly but constantly flexing the knee joint thirty degrees several times a minute.

  “Herbert, dear,” Mrs. Benfatti called out over the sound of the TV. “Look who’s here.”

  Mr. Benfatti lowered the TV’s volume with the remote and looked over at Samira. He recognized her and, like his wife, commented on the impressive length of Samira’s workday.

  Before Samira could comment, Mrs. Benfatti intervened. “I don’t know about the rest of you people, but I’m exhausted. I’m going back to the hotel and collapse. Good night again, dear,” she said, kissing Herbert’s broad forehead. “Hope you sleep well.”

  Mr. Benfatti’s right hand waved weakly. His left hand, with the IV going into his arm remained perfectly still. Mrs. Benfatti said good-bye to Samira and departed.

  Samira found herself in an awkward predicament. She wasn’t interested in getting into a conversation with the man if she was going to go through with her plan, yet she couldn’t just stand there. Plus, having run into Mrs. Benfatti, was there more reason to cancel? The only thing that was for certain was what she’d thought was going to be so simple was turning out to be anything but. Unable to make up her mind, Samira just dumbly remained rooted to her spot.

  Mr. Benfatti waited for a moment before inquiring: “Is there something I can do for you, like run down to the kitchen and rustle you up a snack?” He chucked briefly at his own attempt at humor.

  “How is your knee feeling?” Samira questioned, while she tried to organize her thoughts.

  “Oh, great,” Mr. Benfatti scoffed. “I’m ready to go for a jog.”

  Unconsciously, Samira’s hand slipped into her pocket, and her fingers encountered the full syringe. With a start, she was reminded why she was there.

  While Mr. Benfatti carried on about the details of the pain he’d been suffering, Samira struggled with what to do. Recognizing there was no rational way to make a decision short of the crystal ball she didn’t have, she opted for the more simple choice of acknowledging her impetuosity and just proceeding as planned. The deciding factor was the realization that Mr. Benfatti would not be discovered for hours maybe, since his wife had just left and the nurse had just given him a shot. What that meant was that Samira would have lots of time to be far from the scene when he was discovered. She pulled the syringe from its hiding place. Using her teeth to remove the needle cap, she reached for the IV port below the millepore filter.

  Mr. Benfatti had seen Samira suddenly approach the bed, had caught sight of the syringe, and had stopped his diatribe about pain. “What’s this?” he questioned. When Samira ignored him and raised the needle up to the IV port to inject, he reached out with his right hand and grasped Samira’s right wrist. In the next instant, their eyes locked. “What am I getting?”

  “It’s something for your pain,” Samira nervously improvised. The fact that Mr. Benfatti was holding her terrorized her. For a second, she irrationally worried that what she was about to give Mr. Benfatti would pass into her from the contact.

  “I just got a pain shot two seconds ago. Isn’t this overdoing it?”

  “The doctor ordered another. This is more, to get you to sleep longer.”

  “Really?”

  “Really,” Samira repeated, reminding her of the unpleasant conversation she’d just had with Charu. She looked down at Mr. Benfatti tightly gripping her wrist. The man was strong, and although she wasn’t yet experiencing pain, it was close. He was restricting her blood flow.

  “Is the doctor here?”

  “No, he’s gone for the day. He called this in.”

  Mr. Benfatti maintained his grip for several more seconds and then suddenly released it.

  Samira let out a silent sigh of relief. The very tips of her fingers had begun to tingle. Without wasting another moment, she struggled to get the needle inside the port, being especially careful in her haste not to prick herself. With succinylcholine, even a small amount could create problems. Without delay, Samira emptied the syringe. A second later a cry began to issue from Mr. Benfatti’s lips, causing Samira to clamp a free hand over the man’s mouth.

  Mr. Benfatti responded by reaching for the nurses’ call button clasped to the edge of his pillow, but Samira was able to yank it out of reach with the hand holding the syringe. Almost immediately, she felt the resistance she’d had against her hand cupped over the man’s mouth melt away. Taking her hand away, Samira noticed a kind of wriggling under the man’s skin, as if suddenly his face had been infiltrated by worms. At the same time, his arms and even his free leg began to briefly and uncontrollably jerk. The next second, the twitching stopped. In its place was a darkening of his skin that was particularly apparent due to the white light from the TV. It had started slowly, then picked up speed until all of Mr. Benfatti’s exposed skin was an ominous dark purple.

  Although Samira had purposely avoided looking into the man’s eyes while he’d gone through his rapid death throes, she did now. The lids were only half open and the pupils blank. Backing up toward the door, Samira collided with a chair and grabbed it to keep it from falling over. The last thing she wanted was for someone to appear, questioning a crashing noise. Taking one last look at Benfatti from the doorway, Samira was momentarily hypnotized by the fact that the man’s leg was still rhythmically being mechanically flexed and extended as if he were still alive.

/>   Turning around, Samira fled from the room but then forced herself to slow to a walk by sheer will to keep from attracting attention. Maintaining her eye on the nurses’ station, where she could see all four nurses, Samira made her way to the stairwell. Only when she was inside did she allow herself to breathe, surprised that she’d been holding her breath. She’d been totally unaware.

  After picking up the books and turning out the light in the library, Samira descended to the lobby floor. She appreciated that the lobby was empty and appreciated even more that the doormen had gone off duty. Out on the street Samira caught an auto rickshaw, and as they pulled away, she glanced back at the Queen Victoria Hospital. It looked dark, shadowy, and, most important, quiet.

  During the ride home, Samira felt progressively better at what she had accomplished, and the fear, anxiety, and indecision she had experienced rapidly faded into the background. As the auto rickshaw reached the bungalow’s driveway, it seemed to her that such problems were mere blips on the radar screen.

  “I have to leave you here,” the driver said in Hindi, as he pulled to a halt.

  “I don’t want to get out here. Take me up to the door!”

  The driver’s eyes nervously flashed in the darkness as he looked back at Samira. He was clearly afraid. “But the owner of such a house will be angry, and he might call the police and the police will demand money.”

  “I live here,” Samira snapped, followed by choice Internet-learned expletives. “If you don’t take me, you won’t be paid.”

  “I chose not to be paid. The police will demand ten times as much.”

  With a few more appropriate words, Samira climbed from the three-wheeled scooter, and without looking back started hiking down the drive. In the background she heard a burst of equivalent profanity before the auto rickshaw noisily powered off into the night. As she walked, Samira mulled over how she was going to describe her experience taking care of the American. It didn’t take her but a moment to decide to leave out the minor concerns and concentrate on the success: Mr. Benfatti had been taken care of. That was the important thing. She surely wasn’t going to complain like Veena had.

  Entering the house, she found everyone, all four officers and all eleven other nurses, in the formal living room watching an old DVD called Animal House. The moment she walked into the room, Cal paused the movie. Everyone looked at her expectantly.

  “Well?” Cal questioned. Samira was enjoying teasing the group. She’d taken an apple and sat down as if to watch the movie without providing a report.

  “Well what?” Samira questioned, extending the ploy.

  “Don’t make us beg!” Durell threatened.

  “Oh, you must mean what happened to Mr. Benfatti.”

  “Samira,” Durell playfully warned.

  “Everything went fine, exactly as you all suggested it would, but then again, I didn’t expect anything different.”

  “You weren’t scared?” Raj asked. “Veena said she was scared.” Raj was the only male nurse. Despite his bodybuilder appearance, his voice was soft, almost feminine.

  “Not in the slightest,” Samira said, although while she spoke she remembered how she’d felt when Benfatti was gripping her arm hard enough to hinder the blood flow.

  “Raj has volunteered for tomorrow night,” Cal explained. “He’s got a perfect patient scheduled for surgery in the morning.”

  Samira turned to him. He was a handsome man. In the evenings he wore his tie shirts a size too small to emphasize his impressive physique. “Don’t worry. You’ll do fine,” Samira assured him. “The succinylcholine works literally in seconds.”

  “Veena said her patient’s face twitched all over the place,” Raj commented with a concerned expression. “She said it was horrid.”

  “There were some fasciculations, but they were over practically before they began.”

  “Veena said her patient turned purple.”

  “That did happen, but you shouldn’t be standing around admiring your handiwork.”

  Some of the nurses laughed. Cal, Petra, and Santana stayed serious.

  “What about Benfatti’s computerized medical record?” Santana asked. Since Samira hadn’t yet mentioned it, Santana was afraid she’d forgotten. She needed the history to make the story more personal for TV.

  By leaning back against the couch and straightening her body out, Samira was able to reach into her pocket and pull out the USB storage device, similar to the one Veena had provided Cal with the evening before. She then flipped it in Santana’s direction.

  Santana snatched the storage device out of the air like a hockey goalie, hefted it as if she could tell whether or not it contained the data, then stood up. “I want to get this story filed with CNN. I’ve already given them a teaser about it, and they are waiting anxiously. My contact assures me it’s going right out on the air.” While the people who had been sitting next to her on the couch raised their legs, Santana worked her way from behind the coffee table and started for her office.

  “I do have one suggestion,” Samira offered after Santana had departed. “I think we should get our own succinylcholine. Sneaking into the OR is the weakest link in the plan. It’s the only place in the hospital where we don’t belong, and if any of us were to be discovered, there would be no way for us to explain.”

  “How easy would it be for us to get the drug?” Durell asked.

  “With money, it’s easy to get any drug in India,” Samira said.

  “It sounds like a no-brainer to me,” Petra said to Cal.

  Cal nodded in agreement and looked over at Durell. “See what you can do!”

  “No problem,” Durell said.

  Cal couldn’t have been more pleased. The new strategy was working, and everyone was on board, even offering suggestions. He couldn’t help thinking that starting the scheme with Veena had been brilliant, despite the suicide scare. Just a few days before, he’d been afraid to talk with Raymond Housman, but now Cal couldn’t wait. Nurses International was beginning to pay off, which he couldn’t have been more pleased about, even if it wasn’t in the way he’d expected. But who cared, Cal thought. It was the results that counted, not the method.

  “Hey, who wants to see more of the movie?” Cal called out, waving the remote above his head.

  Chapter 9

  OCTOBER 16, 2007

  TUESDAY, 11:02 P.M.

  NEW DELHI, INDIA

  The wheels of the wide-body jet hit hard as they touched down on the tarmac of the Indira Gandhi International Airport and jolted Jennifer awake. She’d been awakened twenty minutes earlier by one of the cabin attendants to raise the back of her seat as the plane had started its initial descent, but she’d fallen back asleep. The cruel irony was that during most of the final leg, she’d not been able to sleep until the last hour.

  Pressing her nose against the window, Jennifer tried to appreciate her first images of India. She could see little more than the runway lights streaking by as the powerful engines reversed. What surprised her was what looked like fog obscuring the view toward the terminal. All she could see were hazy, individually illuminated airplane tails rising up out of a general gloom. The terminal itself was a mere smudge of light. Raising her eyes, she saw a nearly full moon in the apex of a dark gray sky with no stars.

  Jennifer started arranging her things. Lucky for her, the neighboring seat had been vacant, and she’d taken full advantage with the surgery book, the India guidebook, and the novel she’d brought for the flight—or, more accurately, the three flights. Her itinerary required two stops, which she’d actually appreciated as an opportunity to stretch her legs and walk, but only one change of aircraft.

  By the time the big plane had nosed into the gate, and the seat-belt sign had gone off, Jennifer had her carry-on items packed away in her roll-on but then had to wait while others closer to the exit slowly filed out. Everyone looked as she felt: exhausted, yet having landed in a strange and exotic country, she could feel herself enjoying a second, or maybe a th
ird or fourth, wind. Despite the fact that she was coming to deal with her beloved grandmother’s death, she couldn’t help but feel a certain excitement as well as nervousness.

  The flights themselves, although remarkably long, had been endurable. And contrary to her initial worry that their duration might give her too much free time to obsess about the loss of her closest friend, it seemed to have been the opposite. To some degree, the forced solitary time had allowed her to come to terms with the loss by tapping into one of the lessons she’d learned from studying medicine: that death was very much a part of life, and its existence was one of the things that makes life so special. Jennifer wasn’t going to miss her grandmother any less, but her loss wasn’t going to paralyze her.

  Once off the plane, Jennifer walked through the mildly dilapidated and dingy terminal building, finally appreciating that she was truly in India. On the plane everyone had been in Western clothes. Now she started to see bright-colored saris and equally bright-colored outfits on women she would later learn were called salwar-kameezes. On men she saw long tunics called dhotis over either voluminous lungis or pajamas, which were loose pants snugged at the ankles.

  With some concern that she might face a problem, Jennifer approached her first potential hurdle: passport control. She couldn’t help but notice that the lines were long and moving slowly for the few booths occupied by border agents both for citizens and for tourists. On the other hand, the line in front of the diplomatic booth was completely free. Its occupants were either chatting or reading newspapers. With little confidence in bureaucracy in general, and India’s in particular, thanks to what she’d recently read in the guidebook, Jennifer fully expected to have a problem because she was not carrying a visa, even though the airline had been so apprised. It all depended on Mrs. Kashmira Varini and whether she’d made the call she promised and whether she had spoken to the right people.

  “Excuse me,” Jennifer had to call out at the booth’s window to get attention. Conversations stopped and newspapers were lowered. The rather large group manning the diplomatic line, in sharp contrast to the other booths, which were occupied by single agents, all stared blankly at Jennifer as if shocked that they had business. All the agents were wearing saggy brown uniforms, and although the clothes were not obviously soiled, everybody appeared mildly disheveled.