To Obey
Page 21
Warning bells filled her mind; their encounter had clearly meant more to Kendall than to her.
The chime of Susan’s Vox startled her. She jumped so suddenly, she nearly jabbed a finger in her eye.
Kendall chuckled softly as Susan looked at the source of the call. It was a text from Dr. Mitchell Reefes. Even before she read the message, her heart sank, and the actual words flashing onto the screen only made things worse: “Come to my office stat!”
“What do you suppose he wants?” Apparently, Kendall had read the words upside down and from a distance, an impressive feat. “You don’t suppose Jessica’s dad already complained.”
Susan shook her head. “Too quick. He’s still reeling. Besides, if that were the reason, I think Reefes would call us both on the carpet.” She rose, prepared for the inevitable.
“Maybe he’s just concerned about you. I mean your father did just—”
Susan interrupted Kendall before he could use some humorous euphemism. She was not in the mood. “Impossible. Reefes has ice chips in his chest and sawdust in his skull.” She headed for the door.
Kendall looked longingly after her. She knew he wanted to go with her, but he had no reasonable excuse for doing so, nor did she have a right to ask him. “See you, SU-2,” he said, shorthandedly reminding her of her “can’t harm human beings” robotic status. Not that it did much good. Susan was not at all certain she could classify Dr. Mitchell Reefes as human.
Chapter 13
Susan entered the office of Dr. Mitchell Reefes, shut the door, and waited for him to look up from his palm-pross. It took inordinately long for him to do so, and when he finally did, it was with condescending slowness. He studied her with the same predatory expression she imagined a hyena might have after stealing a meal from a hungry cub.
Reefes gestured toward the chair in front of his desk.
Susan followed the motion with her eyes but made no move to act on it. If he wanted something from her, he would have to use something more than hand motions. They made her feel like an obedient dog.
After a moment in stalemate, Reefes said, “Sit.”
Susan accepted the chair, perching stiffly on its front edge. She regarded him with what she hoped was an emotionless expression. She had no intention of making this easier for him.
“So,” he said at length. “Jessica Aberdeen’s back.”
Susan continued to study her attending. As he had not asked anything, she felt no particular need to respond.
Mitchell Reefes cleared his throat. When Susan continued to stare at him impassively, he continued, “Susan, you’re making it difficult for me to help you.”
“Help me?” Susan repeated, having no idea what he meant.
Reefes purposefully closed his palm-pross. Apparently, he wanted to give the impression his focus was wholly on Susan. “You know I have to write your evaluation. Thus far, you’ve made some mistakes that can only be described as…well, dangerous.”
“Dangerous?” Susan had intended to answer only to direct questions, but the word was so unexpected it was startled from her lips.
Reefes ticked off the cases on his fingers. “First, you argue against transferring a man to Neurosurgery, despite a whopping spinal tumor on his MRI.”
Susan’s mouth fell open.
Reefes appeared not to notice. He thrust out a second finger. “Then you discharge a malnourished woman back into the care of her deluded father. Had he not returned her, she would probably have developed irreversible brain damage. She might even have died.”
Suddenly, Susan wished she were a robot, the kind with ten-foot-long, thrusting blades and no understanding of the Three Laws. “What are you talking about? I’m the one who sent Chuck Tripler to MRI, against your orders. You’re the one who ordered me to discharge Jessica Aberdeen.”
Mitchell Reefes muttered something under his breath. He shook his head, his entire face creased. “I’m sure you’d like to remember it that way, young lady. But that’s not what happened.”
Susan studied her attending’s face. She saw nothing suggesting deception, just a raw hint of anger. Either he really believed things had happened the way he said or he was a master liar. Which one did not really matter. He held all the power, and he clearly intended to use it against her.
Rage seethed through Susan like a living thing. She could imagine herself leaping from her chair, burying her fist in his holier-than-thou face. She could practically hear the crack of cartilage, feel the warm blood from his nose coursing between her fingers. Anything she did or said would only make the situation worse.
Dr. Reefes’ voice took on the phony tone of concern Susan heard from people who wanted to seem compassionate when they really did not care at all. “Susan, I know how difficult it must be to lose your father. My parents got divorced when I was six, and I never really got over—”
Susan could not bear to hear another word of it. “I didn’t lose my father; he didn’t wander away in a grocery store or fall out of a hole in my pocket. He was viciously murdered.” Her field of vision turned a spectacular scarlet, and her head buzzed so loudly the sound filled her ears, muffling her own words. She needed to explode like a volcano, violently thrashing out tons of molten rock, hurling irrevocable statements of fact and feeling, in an instant. She was on her feet before she realized it, fighting the compulsion to fling herself at him, instead turning on her heel and marching toward the door.
“Susan, sit!” Reefes called after her.
Susan ignored him until she reached the door, fingers tensing around the knob. There she paused, trying to dredge some reasonable thought from the swirl of homicidal noise pounding through her head.
Apparently assuming he had her attention, Reefes said, “If you leave, I’m going to fail you for this rotation.”
Susan suddenly realized that was the worst he could do. She could make up the extra time at the end of her residency, could chose a different elective, one that did not have her working with a madman. No matter what happened from this moment on, she had no chance to salvage a positive evaluation. Susan whirled suddenly to face him, her glare so intense it caused her actual, physical pain. For the first time in her life, she really wished looks could kill. Without another word, she whipped open the door, strode through it, and slammed it closed behind her.
Kendall was waiting in the hallway when she stormed past him, dimly wise enough to keep his mouth shut. He caught up to her in the residents’ area as she gathered up her palm-pross and miscellaneous belongings. “Calvin,” he said cautiously. “Go back to my apartment. I’ll cover here.”
Susan went utterly still, head low, struggling with rage. Her mood had nothing to do with Kendall, and he did not deserve to suffer for it. After what seemed like an hour in that position but was surely only a few moments, Susan regained enough control to look at another human being without tearing him into pieces. “I’m sorry to dump everything on you, but I’m not coming back.”
Kendall laced his fingers, clearly uncertain how to approach the situation. “Ever?”
“Ever,” Susan confirmed, then gradually realized Kendall worried more for whether she was giving up medicine than Winter Wine Dementia Facility. “Not the whole residency. Just here.”
Kendall visibly relaxed but remained silent. He knew better than to say something that might sound even remotely like “I told you so.” He had cautioned her to take some time off, that she was not ready to return to work, but she had chosen to ignore him.
Susan felt confident she would have done fine on any other rotation. She had even taken Reefes’ personality into account; she just had not expected him to flat-out lie. She clearly could not stay; yet, as her ire cooled, she suffered guilt at the knowledge that Kendall would have to work doubly hard and that she was essentially abandoning her patients, even into his capable hands. Susan reluctantly sat. Not only did she want to get out of the environment as soon as possible, but she knew if Mitchell Reefes attempted to speak to her again, she could not
account for her actions. “Before I leave, would you like me to go over my patients?”
Kendall shook his head vigorously. “I know them all well enough. Anything I don’t know, I can get from the chart.” He added helpfully. “And don’t worry about Jessica Aberdeen. I can handle her father.”
That being obvious, Susan tried to smile but found it impossible. “There is one other patient I’d like you to check on. His name’s Kado Matsuo.”
“That young Asian on Unit 2?”
Susan supposed “young” was appropriate for a man in his forties at a dementia facility. “Consider citrulinemia.”
“Citrulinemia?” Kendall’s features crinkled. “Isn’t that one of those weird baby diseases they test for at birth? Krebs cycle or citric acid cycle—something to do with ATP or NADH or some other alphabetical energy source we had to memorize in microbiology?”
Susan finally managed a slight smile. “Citrulinemia is a defect in the urea cycle. You need to draw plasma levels of ammonia, citrulline, arginine, threonine-to-serine ratio, and pancreatic secretory trypsin inhibitor. If you can get consent, you’ll want to send out some blood to the genetics lab to identify a possible biallelic mutation in the SLC25A13 gene.”
Kendall stared. “God bless you.”
Susan had no idea what he meant. “What?”
“Was that a long sneeze or did you just start speaking in tongues?”
“Speaking in…?” Susan was still in no mood for games. “What are you talking about? I was just telling you how to handle diagnosing a patient using basic medical terminology. What did I say you didn’t get?”
“I missed everything after ‘plasma levels of.’” Kendall gave her a suspicious look. “I’m sure I know what all those things are; I just wouldn’t remember them all at once and spout them off so easily. Are you sure you’re not really a robot, SU-2?”
Susan snagged a piece of paper and wrote out the necessary tests. “I’d suggest you type that into something or at least rewrite it in your own handwriting before you take it to”—it took all the restraint she could muster not to refer to Mitchell Reefes by an expletive. Even then, she could not force out his actual name—“our esteemed attending. If he thought it came from me, he’d kill it on the spot, along with the patient.” She handed the paper to Kendall, who shoved it into his pocket without bothering to read it. “After you’ve drawn the labs, I’d start him on arginine and sodium pyruvate, which should buy him some time before you can talk…you know who…into allowing a curative liver transplant.”
Susan heard footsteps in the hallway. Worried they might belong to Reefes, she snatched up her palm-pross again. “See you this afternoon.” She glanced furtively out the door, seeing only one of the nurse’s aides passing by. Relieved, she scuttled into the hallway and away from Winter Wine Dementia Facility. If she so much as glanced at her attending now, violence was almost a certainty.
The call, an innocuous buzzing of Susan’s Vox, came on the glide-bus. The display flashed a message from the police station, and Susan answered immediately. “Hello?”
“Dr. Susan Calvin, please.” The voice on the other end was youthful, male, and unfamiliar.
“This is Susan,” she acknowledged softly, directly into the Vox.
“This is Detective Jake Carson, NYPD. I’d like to talk to you about the investigation of your father’s death.”
Susan sat bolt upright. “Yes. What have you found out?”
“We’re closing the case, ma’am.”
Confused, Susan considered what to say next. “Closing it? You mean you’ve caught the murderer?”
“Not exactly, ma’am. We’ve determined there was no murder. Your father died of natural causes.”
No words could have surprised Susan more. “What?” She did not care that she positively screamed out the word, attracting the attention of the sparse passengers on the bus. “So…bullets are now considered natural?”
“Bullets? No, ma’am. No bullets.”
Susan was confused on so many levels, she did not know where to start. “They told me he was shot. Several times, in fact.”
“No, ma’am. The ME’s report was quite conclusive. Natural causes, ma’am.”
“But…but…” Realizing she was sputtering, Susan tried to regather her wits. Still seething from her encounter with Dr. Mitchell Reefes, she found it impossible to integrate information that seemed to make no sense at all. “The apartment was trashed. And there was blood”—she remembered thinking she had not seen as much as she should have in the apartment—“and a second victim in the hallway, Sammy Cottrell.”
“Her case is still open, Dr. Calvin.”
Susan grasped at the only bit of logic thus far. “She was shot, wasn’t she? What kind of absurd coincidence is that?”
The detective listened patiently until Susan paused to breathe. “I’m not at liberty to discuss that other case, I’m afraid. Not with anyone outside her family.”
Susan continued to piece together information that made his pronouncement implausible, if not wholly impossible. “Dad’s body disappeared from the morgue. How can you have a medical examiner’s report at all?”
Apparently stunned silent, Jake Carson said nothing for several seconds. If not for the faint sound of his breathing, Susan would have thought he silently disconnected. “I’m not sure where you got that information, ma’am, but it’s wrong. I have the ME’s report right here in my hand. Natural causes, it says. A brain tumor, apparently. It sent him into some kind of wild, uncontrollable convulsions, resulting in the tearing up of the apartment.”
Susan grasped for sense in a preposterous situation. She had seen the pathology log, had spoken with Hasbro’s chief resident in the morgue. She wanted to scream at Detective Carson, to call him a filthy, flaming liar, to demand the explanation of how a brain tumor could cause decapitation. But, wisely, she held her tongue. Accusations and hysterics would only drive him into worthless silence. Perhaps the pathology lab had misidentified the body or some innocent explanation existed for the discrepancy. Even if it did not, Susan would gain far more information by listening and pretending to go along than by confrontation, at least for the moment. Unlike those of Mitchell Reefes, Jake Carson’s errors, whether deliberate or incidental, did not immediately risk a human life.
Why would the cops lie? Building on the presumptive honesty of Detective Carson’s claim, Susan tried to think of a malady that could present in the manner he had described. If her father had been harboring a brain tumor, she should have seen at least a few soft signs prior to such a major event. Seizures did not cause the kind of complete and methodical destruction she had seen, nor sudden and instantaneous death. Fighting to hold accusation from her tone, Susan demanded, “Read me the ME’s report.”
That clearly caught the detective off guard. “It’s mostly medical jargon. I doubt I could even pronounce it.”
“The ‘doctor’ in my title is not decorative.” Susan kept her tone flat.
“I’m not trying to be evasive, Doctor,” Jake said in his most reassuring tone, which only served to reawaken memories of Reefes’ condescension. “It’s mostly a bunch of organs and their weights—that sort of thing. If you’d like to come down and read it yourself, I’m at the Ninth Precinct. Homicide division.”
Susan would not be deterred. “Read me the cause of death, Detective Carson.”
Jake cleared his throat. “I’ll do my best, ma’am. It says: ‘traumatic brain injury with internal bleeding, increased intract crynal pressure…’”
“Intracranial pressure,” Susan corrected.
“‘…and massive seribral eedeema…’”
“Cerebral edema.”
“‘…secondary to large gly-oh-blast-amah multiform…’”
“Glioblastoma multiforme.” Again, Susan provided the correct pronunciation.
“CK levels consistent with massive and sustained convulsions, status epilepsy-tykus.”
“Status epilepticus.”
&
nbsp; “Clearly, that means more to you than it does to me. As it was explained to me, he had an enormous brain tumor that caused wild seizures, and ultimately hit his head on something, or several somethings. Death was from massive head trauma.”
Susan had to admit, it did fit together neatly. Seizures were often the first sign of a brain tumor, at least in the general public, where people were not trained to notice subtle signs of abnormality. Perhaps the tearing up of their apartment had only seemed methodical because she had assumed it the work of a determined human hand; she had not considered the possibility of sudden, intense confusion and convulsions. That could certainly also cause intracranial injury extensive enough to kill someone, if not immediately, then after voluminous internal hemorrhaging.
Except that, in another way, none of it made sense at all. Susan could discount some of her findings as errors or misinterpretations, but certain facts remained and wholly contradicted the information she had just received. She knew people often found it difficult to accept that people beloved or of great stature died in the same direct and lowly fashion as the rest of humankind. Seventy-five years after the assassination of President Kennedy, people were still inventing and rehashing vast conspiracy theories to explain his death. Elvis Presley would be a century old had he survived his overdose, yet people continued to spot him, or obvious progeny, at various places around the country.
Maybe someone switched Dad’s living but injured self with a decapitated body to fool his would-be killers into thinking he was dead. Susan did not want to fall into the trap of believing only things that substantiated her hopes that her father might somehow, miraculously, still be alive. On the other hand, she had no intention of falling prey to trickery. Pinning people down by Vox was not working for her. She was trained to read people, their gestures, their expressions, their actions. None of these came through during a strictly verbal conversation.
“Dr. Calvin. Dr. Calvin?” Detective Jake Carson’s tone held an urgency suggesting he had repeated her name far more than just two times. He probably thought she had collapsed in some terrible or public place.