Isolation Ward

by Joshua Spanogle

  The pathology lab was as dark as I’d left it. I didn’t need the lights to circle to the back side of the door, to snap off the plastic safety guard on the scalpel’s blade. And there, behind the door, arm raised and quivering, I waited. Though it was clear to me that standing fifteen feet from the door with my arms spread on the counter was the wrong thing to do, it was not clear that planning to attack a man with a ten-gram scalpel was the right thing.

  I listened and waited. I wanted to check my watch again, but didn’t dare let my arm fall. So, I stood there, frozen, while the seconds stretched to minutes.

  Then I heard footsteps, or, more exactly, shuffling and dragging sounds. The handle clicked and the door opened slowly. I stiffened my arm.

  CHAPTER 87

  Brooke stumbled into the room; she was backlit, two feet in front of me. The door opened wider, and I raised my arm, ready to stab down onto whoever was behind her.

  I never got the chance.

  Before I could react, the door swung open violently, knocking back my arm and crashing into my head and feet. Knocked off balance, I staggered backward. The scalpel was still in my hand, and I tried to orient myself toward the door. But then the lights were up and my vision flashed white. Next thing I knew, I was on the floor with someone’s weight on top of me. Someone cranked my right arm behind me; a knee drove into the small of my back. Brooke croaked, “God, Nathaniel. Oh, God.”

  “We obviously have a misunderstanding about distance, Dr. McCormick,” a man said. “This is not fifteen feet.”

  Across the floor, I saw the scalpel. I had no memory of its being knocked from my hand. I heard the ratchet of handcuffs and felt the metal bite into my wrists. The man—a man—pulled me roughly to my feet.

  In front of me, Brooke wept quietly. Her hands, too, were behind her back. A fresh bruise, red and purple, darkened her left cheek.

  From behind, hands fluttered over my body, emptying out my pockets. I felt the cell phone and my ID cards being pulled out. My car keys, my wallet. The folded papers with Janet Magulies’s termination threat on them.

  Powerful arms shoved me forward. Awkwardly, I stopped myself before knocking Brooke over. I turned and looked at my attacker, who, true to his word, scrolled down through the menus in my cell phone.

  “What is this call? Four-oh-four number.”

  I was silent.

  The man calmly walked toward me, put his hand between my shoulder and neck, and squeezed. A pain unlike anything I’d ever felt fired down my right side; my knees buckled.

  “Stop!” Brooke yelled.

  He did.

  “What’s the number, Dr. McCormick?”

  I was trying to regain my footing. “A lab at CDC. Look at the goddamned time stamp. I called before I talked to you.”

  “Why?”

  I didn’t answer, expecting his claw to come down on my shoulder again. It didn’t.

  “Well, no matter. It just means we’ll have to accelerate things on our end. Not good for you, I’m afraid.”

  Maybe he wasn’t the last person on the face of the planet I thought would be so fast or so strong, but he certainly wouldn’t be my top pick. The gent who’d slammed the door into me and disarmed me in less time than it took me to suck a breath was a good four inches taller than me, but probably outweighed me only by ten pounds or so. His shoulders caved slightly into his chest. He was balding, with dark, curly tufts sticking from the sides of his head. His eyes were sunken and tired looking, and fit in well with his pasty complexion. All in all, he looked like the attending doc on my surgery clerkship in med school. Maybe the guy was burped from the same ring of hell as Dr. Clement. Perhaps they shared the same rotten womb. If so, God help me. I hated Dr. Clement.

  “Shall we?” he asked.

  I looked at his hands and saw he held a small automatic pistol. He flicked the barrel toward the door. From just that motion, you could tell the man had spent a lot of quality time with guns.

  Brooke and I walked into the hall. “To the right,” the man whom I’d nicknamed the Surgeon said.

  I glanced at Brooke. Her hands were bound behind her with metal cuffs. Quietly, I asked her, “What happened?”

  She half-turned toward the Surgeon, but he didn’t seem to care if we talked.

  “He came to the apartment before I left. I don’t know how he got in. And then we were in the car, coming here. I don’t know what’s happening.”

  We pushed through the doors to the OR’s observation room. “Go through the doors,” the Surgeon said. We went through the doors to the scrub room. He led us through two more sets of doors to the OR itself.

  “All right, Doctors, you should be familiar with the surroundings. Sit.” With the gun, he motioned to Brooke to sit down.

  “Dr. McCormick, go over to the table and sit on the floor.” I did so. He holstered his gun and pulled a cable tie from his pocket, the kind police use to round up protesters. With it, he cinched my ankles together. “Okay, Doctor, no funny stuff.” He pulled me back against the table, undid the cuffs from one wrist, and reattached them around the leg of the table. Then he went around to all the wheels and made sure they were locked down.

  The Surgeon went to Brooke. “Legs together,” he said, which was marginally better than “Legs apart.” At least he wasn’t going to rape her. But no, not him. He was a professional.

  Brooke slid her legs together and the Surgeon reached for his cable ties. As he pulled the tie from his pocket, Brooke kicked toward his face. Her sneaker caught him on the tip of the chin. This seemed to piss him off, because even before his head had righted itself, his fist shot out like a rocket and smashed into her cheek. Brooke slumped backward and moaned; I yelled. The Surgeon didn’t say anything, just grabbed her feet and zipped the tie closed.

  “Why are you doing this?” I asked.

  Ignoring my question, the Surgeon finished with Brooke and stood, surveying both of us. “All tidy,” he said.

  I asked again, “Why are you doing this to us?”

  “Doctor, I think you don’t know what you’re doing.”

  “Of course I know what I’m doing,” I said, though, of course, I hadn’t a clue.

  “No. You think you’re doing a very good thing. But your actions would have hurt a lot of people.”

  “That’s bullshit.”

  “I tried to tell them not to let it get this far. We should have cleaned house much earlier. But in some ways, they’re just as blind as you are.”

  I didn’t ask him what “cleaning house” meant.

  “Now, unfortunately, you are the doctors who know too much.”

  “What do I know?”

  “Don’t be naïve. I don’t know all of what you’ve found here, but that doesn’t matter now. These”—he pulled out the papers with Margulies’s pregnancy test and termination request—“as you probably knew, are valuable.” He folded the papers tidily back into his pocket.

  “You killed them, didn’t you?”

  “Who?” the Surgeon asked flatly.

  “Of course he killed them,” Brooke said.

  “I didn’t. Your brilliant doctor friends killed them, because they couldn’t understand the situation. You see, I have experience in these matters. And they didn’t bring me in until it was too late. Unfortunately, people had to be dealt with.”

  “Gladys Thomas?”

  The Surgeon said nothing, just stared with drooping eyes.

  “Dr. Tobel?”

  “That was a tragedy.”

  I remembered the car speeding off that night at Dr. Tobel’s house, the license plate I couldn’t quite get. “You were at her house when I was there.”

  His silence told me he was.

  “Where is everyone else?”

  “They’re with their alibis, Dr. McCormick.”

  Brooke groaned.

  “Who the fuck are you?” I yelled. I saw what was coming and I was terrified.

  “Dr. McCormick, Dr. Michaels, I know this is going to sound hollow. But
I’m truly sorry for what’s happened. If others hadn’t made poor decisions—many, many poor decisions—we wouldn’t be here now, but they have and . . .” The Surgeon trailed off, his eyes fixed on a point behind me. “I am being paid a king’s ransom to fix their problems. At times I enjoy my . . . profession. For what it’s worth, I’m not enjoying this.”

  Brooke, scared and angry, blurted, “Well, that’s good to hear.”

  The Surgeon squatted on his haunches and looked at her sadly. “I can also see the big picture. I can see what your colleagues are trying to do, the people they want to help. It is one reason I chose to take this job.”

  “So you’re a fucking saint,” Brooke spat. The woman had guts.

  “Of course not. A saint would let you go.” The Surgeon stood. “The ends justify the means, Dr. Michaels. Don’t fool yourself into thinking that’s some trite sixteenth-century maxim. It’s the way the world works. It’s the way the world should work. It doesn’t make it easy.”

  It sure as hell doesn’t make it easy if you’re the means, or rather, if your being dead is the means.

  “You killed Kincaid Falk and Janet Margulies?”

  “Janet Margulies was gone before I was in the picture. Kincaid Falk should have been dealt with long ago. Instead, things got messy.” He stood. “Now, if you’ll excuse me. You’ll be happy to know you are in a very delicate situation. It’s not clear what will be done.”

  I wasn’t very happy to know that, but I was happy when he left the OR. A moment later, though, he was back.

  He opened the drawers and the cupboards in a stainless steel cabinet. From it, he pulled out a box of disposable scalpels, a box of hemostats, a bunch of scissors, anything else that could be used to cut a cable tie. He threw everything into a tray.

  “Almost forgot,” he said. “Wouldn’t want you to cut yourself on anything.” Then he left with the tray.

  I saw him through the glass in the observation room. He set the tray on a small table, then emptied his pockets of my belongings and pulled out a cell phone—his own, I assumed. I watched him as he hunted around the room, the phone in front of him like a divining rod. Maybe there was too much concrete in this part of the building for a signal. He looked at us through the glass, then disappeared through the door.

  CHAPTER 88

  So there we were. Me: feet bound, hands behind my back, cuffed to a metal table. Brooke: hands behind her back, feet bound together. All in all, not a real promising situation.

  “He’s gone,” I reported to Brooke, who couldn’t see the glass.

  “I can’t believe this, Nathaniel. I’m so sorry for pushing you into this. For getting both of us—”

  “I got us into this.” I yanked at the cuffs until my wrists felt like they were going to snap. I yanked again.

  “Stop it,” Brooke said. “You’re going to break something.”

  I struggled more, but the flesh was beginning to tear. Pain seared around my wrist.

  She said, “I can’t believe people would do this. Goddamned physicians, of all people.”

  “They think they’re saving humanity.”

  “They think they’re going to get rich.”

  “That, too.” I pulled at my wrists and yelped.

  “What?”

  “Nothing.”

  Brooke sighed and slumped against the wall.

  I could feel the blood trickling down my hand. I scanned the OR, past the monitors, to the ransacked metal cabinet.

  “Brooke,” I said. She seemed not to hear. “Brooke.” She looked up at me. “See if you can get to the cabinet and see what’s in there.”

  “He took everything, Nathaniel. This guy thinks of every—”

  “Do it. Now.”

  She glared at me a moment, then rolled to her side and wormed along the floor to the cabinet. With her hands still behind her back, she opened the door, then turned around so she could see. “Just chucks and Foleys in the bottom,” she said.

  “What’s in the drawers?”

  Brooke maneuvered herself to a sitting position. All those hours on her bike weren’t wasted, and she pushed herself upright. She grabbed the drawer and hopped forward to open it a little. Then she turned around, hopping.

  I wondered how many minutes had passed since the Surgeon had left us and how many minutes it would take to decide what to do about our delicate situation. “What’s there?” I asked.

  “Wait.” She balanced and looked into the drawer. “Just some syringes.”

  “What meds?”

  “I can’t see— Oh, yeah. Just some lidocaine. A lot of lidocaine.”

  “Grab a syringe and a bunch of vials. They have two percent?”

  “What? Yes.”

  “If you see any with epi, get it.”

  “What do you need lidocaine for?”

  The question wasn’t why I needed lidocaine, but why pigs needed it. But pigs feel pain, and the docs would probably use lido for any procedure, so as not to freak the hogs out too much. Also, they’d want lido on hand if there was any heart trouble—any arrhythmias—during the operation.

  “Just get as much as you can hold and get over here.”

  Brooke backed against the drawer and squatted a few inches to let her hands drop down. I heard the sound of glass vials rubbing against one another.

  “Hurry up, Brooke.”

  “Shut up, Nathaniel. What do you need this for?”

  “I need you to block my hand.”

  She looked at me for a few long seconds. “How tight are the cuffs?”

  “Tight.”

  “You can’t do it—”

  “Yes I can. Get over here.” Another beat. “Brooke—”

  “Okay, okay. Let me get a syringe filled.” She fidgeted around. “I need a big one.”

  After a few more seconds, I heard her crack the top of one of the lidocaine vials, a pause as she filled the syringe, then another crack, and another. “You don’t want to do this,” she said.

  “Of course I don’t. Come over here.”

  She gathered a few more vials and pitched forward at me. Her body hit the floor hard; her head landed in my lap, but she still held the syringe and the vials. I moved to the side so my wrists were near her hands. Our backs were toward each other. I was still sitting; she was on her side. “Go for the left,” I said.

  “This one?” Her fingers brushed my right hand.

  “No.”

  “Hold these.” She passed the lidocaine vials into my right hand. “I’m going to use a lot.”

  “Good,” I said.

  She touched the left hand, and I felt her fingers move along the wrist. It hurt like a bitch to have her going over the ragged flesh, but not for much longer. Her fingers stopped along the outside of my wrist. “I’ll hit the ulnar nerve first.”

  “Try to avoid the vessels.”

  “Thanks for the tip.”

  With the amount of lidocaine that Brooke was about to dump into my wrist, if she got a vein or an artery, there was a good chance that she could induce a fatal arrhythmia in my heart. Since our backs were to my hands, neither of us could see if she hit a vessel.

  “You’re sure?”

  “Goddamn it, Brooke, just remember your anatomy.”

  She jammed the needle in. Not only was the needle she used large gauge and painful, the lidocaine she squeezed in felt like she was dumping acid into my wrist. I cursed.

  She pulled out the needle. “Median nerve.” She sank the needle directly into the center of my wrist. Pulling it out a bit, reangling, injecting again. I swore again.

  “They let you graduate from med school?” I snarled.

  She ignored me. “Let me have the other vials.”

  She took the vials from my right hand and cracked them. I could already feel the hand beginning to go numb. “Hurry,” I said, glancing at the observation room door. Whatever discussion the Surgeon was having, thank God, seemed to be involved. Nearly five minutes must have passed since he’d left.

&nb
sp; The needle plunged into my wrist just behind the thumb. “Radial nerve,” she said. Again, I felt the in-and-out of the big needle. “I’m going to hit the ulnar again.” She did.

  I tried to work my fingers to move the lidocaine around. I felt pressure as the needle went again into the center of the wrist. “That’s enough,” I said.

  “You’re sure?”

  “Yeah. Move back.”

  She slid away, then rolled 180 degrees so she could see me. I took a deep breath, worked the fingers of my left hand again, and pulled as hard as I could.

  Even with the anesthetic, the pain lanced up my arm. A bone cracked as my hand compressed and pulled slowly through the small metal ring.

  “Nathaniel. God, Nathaniel.”

  I arched my back against the OR table. The hand slid, too slowly. There was the snap of another bone. And another and another. I shifted the hand back and forth, trying to work it through the cuffs. The epinephrine in the lidocaine acted to constrict the blood vessels in the hand. In spite of it, blood ran across the floor to the drain. I felt bile rising in my throat and choked it down. As I slid the hand up toward the knuckles, there were more dislocations, more breaks. The hand seemed to be sliding easier; I guessed the bones had cracked and the blood had begun to flow and was slicking the skin.

  I heaved once more against the hand. The OR table shifted, and, suddenly, I was free. My left hand popped from the cuffs, sending a spray of blood across the room.

  CHAPTER 89

  I looked at the appendage and vomited in my lap. Not only had many of the bones been broken and dislocated, but part of the hand had been what doctors call degloved, a particularly graphic and accurate description. The skin had been stripped from the wrist over the thumb and index finger, past the knuckles, and hung like, well, a half-removed glove, exposing the raw muscle beneath it. It bled, but because of the epi, it wasn’t as bad as would have been expected. It throbbed dully.

  There was pain in my shoulder, too. I must have torn a muscle as I pulled.

  Brooke gaped at the damage. “Oh my God, Nathaniel.”

  “It’s okay.”

  “Oh, honey . . .”

  With my right hand, I pulled the skin back up along the hand and wrist. Bits of skin and blood clung to the cuffs dangling from my good hand. It struck me that if I survived this, my right would always be called that: my good hand.