They'd stripped ten million dollars' worth of pending grants from him in less than two hours, and he knew he'd never get that kind of cash again. His fall had been extra steep because so many wanted to punish- no, make that eviscerate him.
Tocco wandered out of the kitchen, spiraled three times before plopping down, and contentedly gave herself a bath, as if her master sprawled in the middle of the foyer floor were no big thing.
Grateful for the one living creature that hadn't judged him today, he reached over and rubbed the ear he'd ignored earlier.
She immediately tried to give his hand a kiss.
He thought of the men and women who'd dissed him today. He remembered their goofy, want-to-be-around-a-winner expressions when they threw endowments at him and felt it a privilege to do so, not the sour faces that he had imagined went with the cold, dismissive tones they'd subjected him to over the last twelve hours. It reminded him of the discrepancy between how the eternal whines of disappointment from his ex-wives differed from the eagerness with which they'd once said "I do."
But the loss of control over his domain at work panicked him the most. His ability to command respect and make others do his bidding had slipped through his fingers like water.
He got up and glanced to the coatrack where Tocco's leash usually hung. It wasn't there.
He wandered down to the basement, to check the hook where the housekeeper sometimes left it.
Tocco followed, wagging her tail in anticipation of a walk.
He eyed the water pipes and saw the face that had haunted him since 1989.
Purple, swollen, and twisted, the image of it lurked at the core of his memory, always ready to intrude without warning, triggered by the slightest of associations. It could happen while he presented a paper, listened to accolades from younger colleagues, even appeared once in the middle of an interview on Oprah. Like an avenging ghost, it haunted him, particularly the bulging eyes. Their black scrutiny bored through his pupils and, like probes, activated what no anatomist could find- the convoluted cerebral coils of gray and white matter that housed conscience. Because that cold lifeless stare forced him to relive his treachery, admit to the innuendos and whispered lies that had been the ruin of the phantom who looked on him so accusingly. His only sure respite from the curse? When a case consumed him in ICU.
He ran back upstairs, Tocco whining at his heels. When he went out the front door without her, she barked her disappointment.
He rocketed his car out of the driveway and sped toward the hospital.
ICU, he thought. He'd be okay there.
Wednesday, July 16, 2:33 a.m.
Jane Simmons awoke in her bed with a cry on her lips, pain ripping through her abdomen.
"Christ!" she moaned, grabbing her stomach and curling into a ball. "Thomas!"
Then she remembered. He'd gone back to ER to relieve the resident who'd replaced him for a few hours. Since the Sunday revelation, much to her pleasure, he'd adjusted his schedule so that they could have dinner together the last three evenings.
Another cramp hit, twisting her intestines as if they were caught in a wringer. "Jesus!" she groaned, curling tighter. Must be something they'd eaten.Tonight she had picked up fresh snapper. It had looked fine, and she'd cooked it thoroughly. But she'd also made potato salad, so it could have been the mayonnaise. Nothing else would have done it. They'd drunk only fresh fruit punch- no alcohol, of course. He'd brought back lemons and grapefruit this time, enough for a pitcherful.
"A toast," she'd said, insisting the third supper in a row on using the champagne glasses kept for special occasions.
"Shucks, here's how we do it in Tennessee," he'd joked, and took a big swig directly from the jug as he usually did, just to tease her.
"Grand Forks too, but only behind the barn," she'd tossed back, and she chugged it with him, slug for slug, determined not to be outdone, but then insisted they fill the glasses to the brim and toast each other in proper style, raising them to each other, to the baby-
"Oh, my God!" she screamed.
Another surge, this one stronger than the others, gripped her like giant hands tearing her in two. Between her thighs she felt slippery, warm, and sticky. Her hand instinctively flew to her groin, and a flow of hot fluid coursed between her fingers.
"God, no," she whimpered, reaching for the light switch and bracing for what she'd see.
Nothing could have prepared her.
A circular red stain between her legs kept spreading, from beneath her hips to below her knees. With each surge of pain another swell of blood gushed from her vagina. In the middle of it all lay the crimson detritus of what had been her baby.
She let out a cry, reached toward it, then restrained herself.
More waves of pain jackknifed her into the fetal position again, and the periphery of her vision grew dark.
Head reeling, she uncoiled enough to reach the phone and tried to punch in 911. Her fingers slid off the keys from all the blood.
Michael Popovitch stepped outside the ER's exit door and loosened his mask. The cool night, still moist from rain an hour earlier, s me I led sweet. He stayed near the changing area-"limbo," as the residents called it, the zone between the safety of the outside world and the infected realm of the hospital. He always figured that this was where the battle would be won or lost. Sooner or later, despite all the precautions, someone would carry the virus into the street, take it home, spread it to family, to friends, to everyone.
He drew a deep breath and, freed from the stuffy confines of his mask, enjoyed the heady freshness of inhaling air unencumbered as much as he'd once savored the rush of nicotine from his smoking days. A faint sound like a wheeze rose and fell in the distance, then repeated itself, rising and falling as regular as breathing.
An ambulance on its way in.
Five minutes out, he judged, sound carrying far through the city when it slept.
He leaned against the wall and looked up at the stars. Patches of twinkling silver had opened amidst traces of clouds that still lingered overhead. Probably would be clear tomorrow. Rather than sleep off his shift, he'd take Terry and Donna to the beach.
It might be a good break for the three of them.
The quarrels between himself and Donna couldn't be good for the kid. They didn't throw things or physically hurt each other, but tension filled the house, thick and as smothering as a pillow to the face.
He remembered those kinds of times between his own parents. Hadn't scarred him, he figured. But they'd made him unhappy. The big difference was that his mom and dad had known how to end them. Unless he quit ER, the trouble between him and Donna would go on for as long as SARS lasted, which could be forever.
Sometimes she wouldn't even sleep with him. She cringed every time he picked up Terry, and found every excuse she could to take the kid to her mother's. And each time news broke of another nurse or doctor coming down with it, she looked at him as if he were a murderer.
He could leave St. Paul's, go to a place that hadn't been infected yet. But it wouldn't be that simple. SARS could pop up anywhere. Probably would. And besides, if whoever replaced him here got involved with his files, they'd see what he'd been doing-
The door bashed open, startling him out of his thoughts.
"Dr. Popovitch!" Thomas Biggs said, breathless as he leaned out the opening. "We just got a heads-up from an ambulance. They're bringing us a woman in shock, big time, from a miscarriage."
Michael pushed off from the wall. The wail sounded much louder now, approaching faster than he estimated. They must be really gunning it. "You got everything ready inside?"
Thomas nodded.
Michael felt his heart quicken, the way it did from the first day he stepped into ER and the sirens drew closer. The only thing that had changed was that he'd learned to channel the adrenaline, stream it through his head to clear his thoughts and sharpen his reflexes. He entered a zone where he would react without doubts, second-guessing, or hesitation, a purity of moment he
found only in the pit. As that telltale wail swelled louder, the stiller he grew.
Thomas, like all rookies, fidgeted with increasing restlessness but stayed outside.
As they stood waiting, a familiar dark Mercedes pulled into the doctors' parking lot, and Stewart Deloram got out.
"What's he doing here?" Thomas muttered. "Anyone who took the pasting he did should be at home hiding under his bed."
"Then you don't know Stewart," Michael replied, and waved at him.
Stewart saw them, then looked over his shoulder in the direction of the howling siren, so close now the shriek had set up a slight vibration in Michael's ear.
"Waiting for something special?" Stewart called, heading toward the other side of the ambulance bay and the door designated for people entering the hospital.
"Woman in shock," Michael said, "from a possible miscarriage."
Stewart used his card to open the lock. "Mind if I help?" He reached inside the entranceway and pulled a clean gown off a cart stacked with protective wear.
"It's an OB case," Thomas said, fixing his eyes on the oil-stained asphalt that separated them. His tone of voice hinted that Stewart should mind his own business.
Needless to say, the resident had already passed judgment on the man.
"Posse justice, Thomas?" Michael murmured. "Nobody innocent until proven guilty anymore?"
At first Thomas said nothing. Then he murmured, "I want him to be just what he's always seemed. But I don't know if I can trust that anymore."
"Understandable," Michael said in as low a voice as possible without it becoming a whisper, "but you learned a lot from him. Doesn't he at least deserve the benefit of a doubt?"
"You think he's innocent?"
"I think he's worked too many years at my side saving lives for me to turn on him now." Besides, Michael thought, he'd have at least one friend at St. Paul's when his own moment of reckoning arrived. "Glad to have you, Stewart," he called out loudly, all the while looking directly at Thomas. "After all, shock is shock, right?" he added in a loud voice.
The young resident lifted his eyebrows in a show of disapproval but kept silent as the ambulance roared into the hospital driveway, its siren dying to a deep-throated growl.
Jane lay shivering on the stretcher while faces bobbed above her like windblown balloons.
"Femorals in!"
"Type and cross six units- no, ten!"
"Two units, type O, up and running."
The voices came at her from the other end of a long tunnel. They sounded frantic. Always did, when one of their own came in, she thought.
"Still pouring blood."
"Systolic's down to eighty."
"Where's OB?"
Cold flowed through her.
The IV lines they'd jabbed into her arms, legs, and neck stung.
The catheter someone had rammed up her bladder filled her with a phantom urge to pee that she couldn't relieve.
And the pain in her belly pummeled her with the brute force of fists.
Not even Popovitch and Deloram had a moment to comfort her as they yelled orders and spoke excitedly to one another. That really made her afraid.
It also pissed her off. How dare they reduce her to a slew of pressure readings, blood counts, and chemistry parameters? And why should Deloram be here anyway? "Looking for a few words from the near-dead, Stewart?" she murmured, feeling strangely uninhibited and defiant enough to use his first name.
He started, his dark brows curling in amazement.
"Just kidding," she said. "At least now you noticed me."
"You sure you want me working on you?"
"Damn right, but don't you be thinking of your own problems. And quit staring at me as if I were already a ghost."
A muffled chuckle came from behind his mask. "You're something, Jane."
"How bad?"
"Hey, don't worry. I'm not about to let one of the few people around here who's still talking to me slip away."
Michael Popovitch appeared above her, a lab report in his hand. "You sure you don't take aspirin or blood thinners?" he asked.
"No." Her reply sounded like a moan.
"Bleeding problems?"
"None."
The pain returned. All at once she wanted Dr. G.
And Thomas. He continued to dart here and there, anxiety blazing out of his eyes. "Hang on, Jane," he whispered each time he came close enough to say anything. She thought of how they'd made love only hours earlier, and suddenly she'd never felt more naked.
Talk to me, damn it! Leave the numbers, tests, and needles to the others. Just hold my hand.
She started to spiral downward, her head lurching in a nauseating, off-center spin.
Oh, God, I'm going.
"Beta subunit's positive," a female voice called out, echoing through the room as if on a loudspeaker.
She didn't recognize it.
"Definitely got herself pregnant."
Bitch! Jane wanted to scream.
"Why's she still bleeding so much?" one of the residents asked.
"Retained placenta," Thomas said with the forced coolness he used when trying to sound calm and professorial. "We have to do a D and C, clean out her womb…"
Another flash of anger slowed her plunge into darkness, even buoyed her up. She wanted to grab him by what got her pregnant in the first place, and twist. Then she heard a woman's voice from out in the hallway that sounded as welcome as a distant bugle cry heralding the cavalry riding to the rescue.
"Okay, what have you got for me on my last night of call- my God, J.S."
Dr. Graceton came into view above her and leaned in close, grabbing her hand with a reassuring squeeze. "Okay, I need straight talk here," she whispered. "How long since the start of your last cycle?"
"Nearly two months." Her mouth felt full of cotton and didn't let her enunciate properly.
"Are you on any meds?"
"No."
Dr. Graceton leaned closer
"Did you try and abort yourself? Take something like RU-486 from Europe?"
"No, nothing-" She broke off with a cry as her uterus seized into another contraction.
Dr. Graceton frowned. "Sorry, J.S., but I have to ask."
"No, we decided to keep the baby."
"Oh, I see." Her frown deepened. "Then did you take anything by accident?"
"I don't think so."
"Do you use anti-inflammatories?n
"Sometimes, but-"
"Arthrotec or Cytotec?"
She shook her head, recognizing the names of drugs containing misoprostol, an analog of prostaglandin intended to block the ulcer-producing effect of arthritis medication. It also caused the cervix to open. She'd seen a number of women in ER who'd miscarried because they'd made the mistake of taking the pills Janet had just referred to. "No, nothing like that."
Dr. Graceton glanced over at Popovitch. "Any other lab results back?"
He'd just cranked up the bottom of the bed to auto-transfuse her with blood from her legs. The strain around his eyes drained the skin of color and made it seem as if he should lie down and do the same for himself. "Hey, Dr. Popovitch, lighten the mood," Jane told him with as much firmness as she could muster. "You're scaring me."
He looked down at her and must have tried to smile, because the lines at the corners of his eyes shifted slightly. "Sorry, Jane. Hey, I guess I always rely on you for that." He glanced back over to Dr. Graceton. "Biochem's okay. But even without the rest of the results, I can tell you right now her coagulation's off. She's hardly forming any clots."
"Then let's give her fresh frozen plasma," Janet said with an impatient flip of the hand, implying a no-brainer. She referred to blood that had not been separated yet into its individual components and would boost clotting factor as well as red cells.
He fired J.S. a wink. "Already thawing in the microwave, my dear."
His W. C. Fields imitation made her smile. It had always gotten a few chuckles and relaxed everyone as they worked. "That's
better," she told him.
Stewart raced up to the table with a printout in his hand. "I got the other results," he said.
They huddled around it as if sharing a newspaper, and threw out the alphabet soup of acronyms used to describe bleeding disorders.
"DIC?" Thomas said.
Oh, God! Jane recognized that one. DIC was a dreaded complication in hemorrhagic shock- the acronym stood for disseminated intravascular coagulopathy and meant that she'd used up all her clotting factors with excessive coagulation throughout her blood vessels, even where she didn't need it. Bottom line, her chance of survival would be fifty-fifty. Plus the treatment had always struck her as desperately insane. They'd give her heparin to slow her clotting even more, in the hope this would spare the few factors she had left and allow them to work at the site of the hemorrhage. Not many of her patients with the same problem had survived. "I'm going to die," she murmured, or had she just thought it?
No one seemed to hear.
Dr. Graceton grabbed the report. "What are you talking about, Thomas? Of course it's not DIC. Only her INR is elevated. Platelets and PTT are fine."
More alphabet soup.
"Yeah, watch what you're saying," Michael added. "You'll frighten our J.S. to death."
"I taught you better than that, Thomas," Stewart piped in, his frizzy eyebrows lifting in indignation.
Thomas acted stunned. "Oh, right," he said. "Stupid call."
They're lying to protect me.
The bing of the microwave sounded, and in seconds the nurses added more maroon IV bags to the ones flowing into her, except these felt warm in her veins from the recent thawing. The rest of her remained cold to the core. She started to slip away again. "I'm going," she cried.
"No, you're not," Janet told her in a firm voice.
But she plummeted into free fall, and her womb seized in another contraction.
The other three moved out of earshot, where they continued to chatter and gesticulate.
"Pressure's down to sixty-five," someone yelled.
Thomas appeared at her side and grabbed her hand. "Hang on, Jane. I love you," he whispered in her ear.
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