"What's wrong with Mr. Cain here?" Vanadium asked. "He suffered an unusually strong episode of hematemesis." "Vomiting blood. One of the paramedics used the word. But what's the cause?" "Well, the blood wasn't dark and acidic, so it didn't come from his stomach. It was bright and alkaline. It could have arisen in the esophagus, but most likely it's pharyngeal in origin." "From his throat." Junior's throat felt torn inside, as though he'd been snacking on cactus. "That's correct," Parkhurst said. "Probably one or more small blood vessels ruptured from the extreme violence of the emesis." "Emesis?" "Vomiting. I'm told it was an exceptionally violent emetic episode." "He spewed like a fire hose," Vanadium said matter-of-factly. "How colorfully put." In a monotone that gave new meaning to deadpan, the detective added: "I'm the only one who was there who doesn't have a dry-cleaning bill." Their voices remained soft, and neither man approached the bed. Junior was glad for the chance to eavesdrop, not only because he hoped to learn the nature and depth of Vanadium's suspicions, but also because he was curious-and concerned-about the cause of the disgusting and embarrassing episode that had landed him here. "Is the bleeding serious?" Vanadium inquired. "No. It's, stopped. The thing now is to prevent a recurrence of the emesis, which could trigger more bleeding. He's getting antinausea medication and replacement electrolytes intravenously, and we've applied ice bags to his midsection to reduce the chance of further abdominal-muscle spasms and to help control inflammation." bags Not dead Naomi. Just ice. ice bags. I almost laughed at his tendency to morbidness and self dramatization. The living dead had not come to get him: just some rubber ice bags. "So the vomiting caused the bleeding," Vanadium said. "But what the vomiting?" do further testing, of course, but not until he's been stabilized at least twelve hours. Personally, I don't think we'll find any physical cause. Most likely, this was psychological-acute nervous emesis, caused by severe anxiety, the shock of losing his wife, seeing her die.' Exactly. The shock. The devastating loss. Junior felt it now, anew, and was afraid he might betray himself with tears, although he seemed to be done with vomiting. He had learned many things about himself on this momentous day--that he was more spontaneous than he had ever before realized, that he was willing to make grievous short-term sacrifices for long-term gain, that he was bold and daring-but perhaps the most important lesson was that he was a more sensitive person than he'd previously perceived himself to be and that this sensitivity, while admirable, was liable to undo him unexpectedly and at inconvenient times. To Dr. Parkhurst, Vanadium said, "In my work, I see lots of people who've just lost loved ones. None of them has ever puked like Vesuvius." "It's an uncommon reaction," the physician acknowledged, "but not so uncommon as to be rare." "Could he have taken something to make himself vomit?" Parkhurst sounded genuinely perplexed. "Why on earth would he do that?" "To fake acute nervous emesis." Still pretending sleep, Junior delighted in the realization that the detective himself had dragged a red herring across the trail and was now busily following this distracting scent. Vanadium continued in his characteristic drone, a tone at odds with the colorful content of his speech: "A man takes one look at his wife's body, starts to sweat harder than a copulating hog, spews like a frat boy at the end of a long beer-chugging contest, and chucks till he chucks up blood-that's not the response of your average murderer." "Murder? They say the railing was rotten." "It was. But maybe that's not the whole story. Anyway, we know the usual poses these guys strike, the attitudes they think are deceptive and clever. Most of them are so obvious, they might as well just stick their willy in a light socket and save us a lot of trouble. This, however, is a new approach. Tends to make you want to believe in the poor guy." "Hasn't the sheriff's department already reached a determination of accidental death?" Parkhurst asked. "They're good men, good cops, every last one of them," said Vanadiuin, "and if they've got more pity in them than I do, that's a virtue, not a shortcoming. What could Mr. Cain have taken to make himself vomit?" Listening to you long enough would do it, Junior thought. Parkhurst protested: "But if the sheriffs department thinks it's an accident" "You know how we operate in this state, Doctor. We don't waste 'A energy fighting over jurisdiction. We cooperate. The sheriff can de not to put a lot of his limited resources into this, and no one will blame him. He can call it an accident and close the case, and he won't get his hackles up if we, at the state level, still want to poke around a little. Even though the detective was on the wrong track, Junior was beginning to feel aggrieved. As any good citizen, he was willing, even eager to cooperate with responsible policemen who conducted their investigation by the book. This Thomas Vanadium, however, in spite of his monotonous voice and drab appearance, gave off the vibes of a fanatic. Any reasonable person would agree that the line between legitimate and harassment was hair-thin. Vanadium asked Jim Parkhurst, "Isn't there something called ipecac?" "Yes. The dried root of a Brazilian plant, the ipecacuanha. It induces vomiting with great effectiveness. The active ingredient is a powdered white alkaloid called emetine." This is an over-the-counter drug, isn't it?" "Yes. In syrup form. It's a good item for your home medicine chest, in case your child ever swallows poison and you need to purge it from him quickly." Could have used a bottle of that myself last November." "You were poisoned?" In that slow, flat delivery with which Junior was becoming increasingly impatient, Detective Vanadium said, "We all were, Doctor. It was another election year, remember? More than once during that campaign, I could've chugged ipecac. What else would work if I wanted to have a good vomit?" "Well ... apomorphine hydrochloride."
"Harder to get than ipecac." "Yes. Sodium chloride will work, too. Common salt. Mix enough of it with water, and it's generally effective." "Harder to detect than ipecac or apomorphine hydrochloride." "Detect?" Parkhurst asked. "In the spew." "In the vomitus, you mean?" "Sorry. I forgot we're in polite company. Yes, I mean in the vomitus. "Well, the lab could detect abnormally high salt levels, but that wouldn't matter in court. He could say he ate a lot of salty foods." "Salt water would be too cumbersome anyway. He'd have to drink a lot of it shortly before he heaved, but he was surrounded by cops with good reason to keep an eye on him. Does ipecac come in capsule form?" "I suppose anyone could fill some empty gelatin capsules with the syrup," said Parkhurst. "But-" "Roll your own, so to speak. Then he could palm a few of them, swallow 'em without water, and the reaction would be delayed maybe long enough, until the capsules dissolved in his stomach." The affable physician sounded as though he was at last beginning to find the detective's unlikely theory and persistent questioning to be tedious. "I seriously doubt that a dose of ipecac would produce such a violent response as in this case-not pharyngeal hemorrhage, for God's sake. Ipecac is a safe product." "If he took triple or quadruple the usual dose-" "Wouldn't matter," Parkhurst insisted. "A lot has pretty much the same effect as a little. You can't overdose, because what it does is make you throw up, and when you throw up, you purge yourself of the ipecac along with everything else." "Then, whether a little or a lot, it'll be in his spew. Excuse me, his vomitus." "If you're expecting the hospital to provide a sample of the ejecta, I'm afraid-" "Ejecta?" "The vomitus." Vanadium said, "I'm an easily confused layman, Doctor. If we can't stick to one word for it, I'm just going to go back to spew." "The paramedics will have disposed of the contents of the emesis basin if they used one. And if there were soiled towels or sheeting, they might already have been laundered." "That's all right," Vanadium said. "I bagged some at the scene." "Bagged?" "As evidence." Junior felt unspeakably violated. This was outrageous: the inarguably personal, very private contents of his stomach, scooped into a plastic evidence bag, without his permission, without even his knowledge. What next, a stool sample pried out of him while he was knocked unconscious by morphine? This barf gathering surely was in violation of the Constitution of the United States, a clear contravention of the guarantee against self-incrimination, a slap in the face of justice, a violation of the rights of man. He had not, of course, taken ipecac or any other emetic, so they would find no evidence to use against him. He was angry, nonetheless
, as a matter of principle. Perhaps Dr. Parkhurst, too, was disturbed by this fascistic and fanatical spew sampling, because he became brusque. "I have a few appointments to keep. By the time I make evening rounds, I expect Mr. Cain to be conscious, but I'd rather you didn't disturb him until tomorrow." Instead of responding to the physician's request, Vanadium said, "One more question, Doctor. If it was acute nervous emesis, as you suggest, wouldn't there have been another cause besides his anguish over the traumatic loss of his wife?" "I can't imagine any more-obvious source of extreme anxiety." "Guilt," said the detective. "If he killed her, wouldn't an overwhelming sense of guilt be as likely as anguish to cause acute nervous emesis?" "I couldn't say with any confidence. None of my degrees is in psychology." "Humor me with an educated guess, Doctor." "I'm a healer, not a prosecutor. I'm not in the habit of making accusations, especially not against my own patients." "Wouldn't dream of asking you to make it a habit. Just this one time. If anguish, why not guilt?" A Dr. Parkhurst considered the question, which he ought to have dismissed out of hand. "Well ... yes, I suppose so." Spineless, unethical quack bastard, Junior thought bitterly. "I believe I'll just wait here until Mr. Cain wakes," Vanadium said. "I've nothing more pressing to do." An authoritative note came into Parkhurst's voice, that emperor-of- tone that probably was taught in a special medical-school course on intimidation, though he was striking this attitude a little too late to be entirely effective. "My patient is in a fragile state. He mustn't be agitated, Detective. I really don't want you questioning him until tomorrow at the earliest." "All right, of course. I won't question him. I'll just ... observe." Judging by the sounds Vanadium made, Junior figured that the cop had settled once more into the armchair. Junior hoped that Parkhurst was more skilled at the practice of medicine than he was at browbeating. After a long hesitation, the physician said, "You could switch on that lamp." "I'll be fine." "It won't disturb the patient." "I like the dark," Vanadium replied. "This is most irregular." "Isn't it, though," Vanadium agreed. Finally wimping out completely, Parkhurst left the room. The heavy door sighed softly shut, silencing the squeak of rubber-soled shoes, the swish of starched uniforms, and other noises made by the busy nurses in the corridor. Mrs. Cain's little boy felt small, weak, sorry for himself, and terribly alone. The detective was still here, but his presence only aggravated Junior's sense of isolation. He missed Naomi. She'd always known exactly the right thing to say or do, improving his mood with a few words or with just her touch, when he was feeling down.
Chapter 12 THUNDER RATTLED like hoofbeats, and dapple-gray clouds drove eastward in the slow-motion gallop of horses in a dream. Bright Beach was blurred and distorted by rain as full of tricks as funhouse mirrors. While sliding toward twilight, the January afternoon seemed also to have slipped out of the familiar world and into a strange dimension. With Joey dead beside her and the baby possibly dying in her womb, trapped in the Pontiac because the doors were torqued in their frames and wedged shut, racked by pain from the battering she had Agnes refused to indulge in either fear or tears. She gave herself to prayer instead, asking for the wisdom to understand why this was happening to her and for the strength to cope with her pain and with her loss. Witnesses first to the scene, unable to open either door of the coupe, spoke encouragingly to her through the broken-out windows. She knew some of them, not others. They were all well-meaning and concerned, some without rain gear and getting soaked, but their natural curiosity lent a special shine to their eyes that made Agnes feel as though she were an animal on exhibit, without dignity, her most private agony exposed for the entertainment of strangers. When the first police arrived, followed closely by an ambulance, they discussed the possibility of taking Agnes out of the car through the Missing windshield. Considering that the space was pinched by the crumpled roof, however, and in light of Agnes's pregnancy and imminent second-stage labor, the severe contortions involved in this extraction would be too dangerous. Rescuers appeared with hydraulic pry bars and metal cutting saws. Civilians were shepherded back to the sidewalks.
Thunder less distant now. Around her-the crackle of police radios, the clang of tools being readied, the skirl of a stiffening wind. Dizzying, these sounds. She couldn't shut her ears against them, and when she closed her eyes, she felt as though she were spinning. No scent of gasoline fouled the air. Apparently, the tank had not burst. Sudden immolation seemed unlikely-but only an hour ago so had Joey's untimely death. Rescuers encouraged her to move safely away from the passenger's door, as far as possible, to avoid being inadvertently injured as they tried to break in to her. She could go nowhere but to her dead husband. Huddling against Joey's body, his head lolling against her shoulder, Agnes thought crazily of their early dates and the first years of their marriage. They had occasionally gone to the drive-in, sitting close, holding hands as they watched John Wayne in The Searchers, David Niven in Around the World in 80 Days. They were so young then, sure they would live forever, and they were still young now, but for one of them, forever had arrived. A rescuer instructed her to close her eyes and turn her face away from the passenger's door. He shoved a quilted mover's blanket through the window and arranged this protective padding along her right side. Clutching the blanket, she thought of the funerary lap robes that red the legs of the deceased in their caskets, for she felt sometimes cove half dead. Both feet in this world-yet walking beside Joey on a strange road Beyond. The hum, the buzz, the rattle, the grinding of machinery, power tools. Sheet steel and tougher structural steel snarling against the teeth of a metal-cutting saw. Beside her, the passenger's door barked and shrieked as though alive as though suffering, and these sounds were uncannily like the cries of torment that only Agnes could hear in the haunted chambers of her heart. The car shuddered, wrenched steel screamed, and a cry of triumph rose from the rescuers. A man with beautiful celadon eyes, his face beaded with jewels of rain, reached through the cut-away door and removed the blanket from Agnes. "You're all right, we've got you now." His soft yet reverberant voice was so unearthly that his words seemed to convey an assurance more profound and more comforting than their surface meaning. This saving spirit retreated, and in his place came a young paramedic in a black-and-yellow rain slicker over hospital whites. "Just want to be sure there's no spinal injury before we move you. Can you squeeze my hands?" Squeezing as instructed, she said, "My baby might be ... hurt." As though giving voice to her worst fear had made it come true, Agnes was seized by a contraction so painful that she cried out and clutched the paramedic's hands tightly enough to make him wince. She felt a peculiar swelling within, then an awful looseness, pressure followed at once by release. The gray pants of her jogging suit, speckled with rain that had blown in through the shattered windshield, were suddenly soaked. Her water had broken. Darker than water, another stain spread across the lap and down the legs of the pants. It was the color of port wine when filtered through the gray fabric of the jogging suit, but even in her semi-delirious state, she knew that she was not the vessel for a miracle birth, was not bringing forth a baby in a flush of wine, but in a gush of blood. From her reading, she knew that amniotic fluid should be clear. A few traces of blood in it should not necessarily be alarming, but here were more than traces. Here were thick red-black streams. "My baby," she pleaded. Already another contraction racked her, so intense that the pain was not limited to her lower back and abdomen, but seared the length of her sphic, like an electric current leaping vertebra to vertebra. Her breath pinched in her chest as though her lungs had collapsed. Second-stage labor was supposed to last about fifty minutes in a woman bearing her first child, as little as twenty if the birth was not the first, but she sensed that Bartholomew was not going to come into the world by the book. Urgency gripped the paramedics. The rescuers' equipment and the pieces of the car door were dragged out of the way to make a path for a gurney, its wheels clattering across pavement littered with debris. Agnes was not fully aware of how she was lifted from the car, but she remembered looking back and seeing Joey's body huddled in the tangled shadow
s of the wreckage, remembered reaching toward him, desperate for the anchorage that he had always given her, and then she was on the gurney and moving. Dusk had arrived, strangling the day, and the throttled sky hung low, as blue-black as bruises. The streetlights had come on. Gouts of red light from pulsing emergency beacons alchemized the rain from teardrops into showers of blood. The rain was colder than it had been earlier, almost as icy as sleet. Or perhaps she was far hotter than before and felt the chill more keenly on her fevered skin. Each droplet seemed to hiss against her face, to sizzle against her hands, with which she tightly gripped her swollen abdomen as if she could deny Death the baby that it had come to collect. As one of the two paramedics hurried to the ambulance van and scrambled into the driver's seat, Agnes suffered another contraction so severe that for a tremulous moment, at the peak of the agony, she almost lost consciousness. The second medic wheeled the gurney to the rear of the van, calling for one of the policemen to accompany him to the hospital. Apparently, he needed help if he was to deliver the baby and also stabilize Apes while en route. She only half understood their frantic conversation, partly because the ability to concentrate was draining from h er along with her lifeblood, but also because she was distracted by Joey. He was no longer in the wreck, but standing at the open rear door of the ambulance. He wasn't torn and broken any longer. His clothes weren't bloodstained. Indeed, the winter storm had dampened neither his hair nor his clothes. The rain appeared to slide away from him a millimeter before contact, as though the water and the man were composed of matter and antimatter that must either repel each other or, on contact, trigger a cataclysmic blast that would shatter the very foundation of the universe. Joey was in his Worry Bear mode, brows furrowed, eyes pinched at the comers. Agnes wanted to reach out and touch him, but she found that she didn't have the strength to raise her arm. She was no longer holding her belly, either. Both hands lay at her sides, palms up, and even the simple act of curling her fingers required surprising effort and concentration. When she tried to speak to him, she could no more easily raise her voice than she could extend a hand to him. A policeman scrambled into the back of the van. As the paramedic shoved the gurney across the step-notched bumper, its collapsible legs scissored down. Agnes was rolled headfirst into the ambulance. Click-click. The wheeled stretcher locked in place. Either operating on first-aid knowledge of his own or responding to an instruction from the medic, the cop slipped a foam pillow under Agnes's head. Without the pillow, she wouldn't have been able to lift her head to look toward the back of the ambulance. Joey was standing just outside, gazing in at her. His blue eyes were seas where sorrow sailed. Or perhaps the sorrow was less sadness than yearning. He had to move on, but he was loath to begin this strange journey without her. As the storm failed to dampen Joey, so the rotating red-and-white beacons on the surrounding police vehicles did not touch him. The falling raindrops were diamonds and then rubies, diamonds and then rubies. Joey was not illuminated by the light of this world. Agnes realized that he was translucent, his skin like fine milk glass through which shone a light from elsewhere. The paramedic pulled shut the door, leaving Joey outside in the night, in the storm, in the wind between worlds. With a jolt, the ambulance shifted gears, and they were rolling. Great hobnailed wheels of pain turned through Agnes, driving her into darkness for a moment. When pale light came to her eyes again, she heard the paramedic and the cop talking anxiously as they worked on her, but she couldn't understand their words. They seemed to be speaking not just a foreign tongue but an ancient language unheard on earth for a thousand years. Embarrassment flushed her when she realized that the paramedic had cut away the pants of her jogging suit. She was naked from the waist down. Into her fevered mind came an image of a milk-glass infant, as translucent as Joey at the back door of the ambulance. Fearing that this vision meant her child would be stillborn, she said, My baby, but no sound escaped her. Pain again, but not a mere contraction. Such an excruciation, unendurable. The hobnailed wheels ground through her once more, as though she were being broken on a medieval torture device.
Dean Koontz - (2000) Page 5
