She'd no idea what he meant, but the larger worm advanced vertically until the loop in its end was directly before the tip of the smaller horizontal line. Lockman said something about Hamlin threading the needle, and sure enough, the thin dark filament went forward, appearing to pass through the ring.
"Inflate the balloon," said Hamlin, his tone impatient.
Lockman fiddled with his end of the catheter in her thigh. Where the two catheters intersected, a tiny round sphere grew into the white dye like a small dark bubble. "That ought to trap it," he said.
"Gently pull down as I feed you some slack."
She watched in horrified fascination as the thicker line tugged the thinner filament lower, dragging it toward where the artery branched into what looked like a spatter of white dye. Was that where she'd bled?
"Jesus Christ! Will you get the tip at the opening of the pontine artery the way you're suppose to," said Hamlin.
"Goddamn it, you can be an asshole."
"Then hold it steady, until the flow carries it in."
The free end of the tinier line continued to weave around while the two men, cursing and swearing at each other, struggled to get it where they wanted. After what seemed like minutes, it swept sideways into the branch leading toward the white splotch.
"Take a little pressure off the balloon," said Hamlin, bringing up a glass syringe containing a clear liquid and roughly plunging it through a side portal on the catheter in her neck. Where the dye had made the interior of her head grow warm, this infusion had an icy quality to it, leaving her with what felt like an ice-cream headache.
Oh, God, what were they giving her now? Kathleen felt as if this nightmare would never end. Lockman had said they faced homicide charges. Were they deliberately murdering people? Doing away with others as they were about to do with her? But why?
Grisly stories about serial killers who worked in hospitals raced through her thoughts. No, that was impossible, she reassured herself, trying to dismiss the idea that these two could be such monsters and nobody know about it.
But the idea crawled back. Lockman in particular seemed dangerous. How could she not fear the worst about him? Hadn't he just threatened Richard?
Reflexively she thrashed and struck out at her tormentors. In reality she only blinked and shot her eyes up and down, all in a futile show of outrage. Lockman kept taking wary glances at her over his shoulder. "You know, you're right in the way you describe her," he said.
Hamlin didn't reply, obviously still annoyed with the man.
"I mean that quote you told the residents. Where was it from?" persisted Lockman.
Hamlin emptied the syringe, let out a big sigh. "You mean Dumas's description of Nortier from The Count of Monte Crista?" he said, disposing of the needle and snapping off his gloves with a flourish. His suave manner of speaking had returned.
"Yeah," said Lockman, seeming relieved to get things between them back to a more civil level. "She really is like 'a corpse with living eyes.' "
Chapter 2
At fourteen Chet had already spurted to within eye level of Richard's own six-foot frame, and his voice had settled into the lower registers. But his curls, dark like his mother's, remained as unruly as when he'd been a child. His gaze, never failing to show exactly what he felt, held the same wide-eyed blackness that Richard had seen at the time of Luana's death, and something else. A determination that hadn't been there before. It suggested a newfound strength since the tragedy that had almost destroyed them both.
"Dad, I want the truth this time. Is Kathleen going to die?"
This time. As opposed to all the times he'd lied to him about his mother. "I don't know, Chet," he answered. "Kathleen's in real trouble, but there's a chance she'll make it."
Chet stared at him with eyes that were identical to Luana's. After her death when Chet looked at him, Richard had felt as though Luana stared from the grave, reproaching him as he fled the agony of his own grief by running from their son. Over the last year with Kathleen in their lives that same gaze had come to comfort him. Now was no exception, even mixed as it was with the needs of a man-child trying to be brave. The boy swallowed. "You're pretty matter-of-fact about it," he said, his tone sounding an alarm.
Did Chet mean that if he could pull away from Kathleen, he might desert his son again? Richard wanted to reach forward and ruffle the boy's permanently tousled hair, then pull him into a hug the way he had before he'd made such a mess of things and the awkwardness of the teen years banished such open displays of affection. Instead, he said, "I love her as much as you do, Chet, and feel every bit as scared. It's just that in ER we're practiced at being matter-of-fact when frightening stuff happens. It doesn't ever mean I don't care." He left it at that, because as much as he wanted to assuage his son's fear, having wounded him once, he knew no amount of promises, pledges, or talk would ever convince either of them it couldn't happen again. Just as all the good intentions in the world couldn't make a coward brave. He nevertheless waited in silence, allowing Chet the choice of challenging him further or letting it be.
They were sitting alone in their living room, a place bright with paintings, lush with plants, and filled with family photographs, the legacy of Luana's instinct for creating a nest that was both beautiful and homey. She'd practiced her own art here, teaching music and playing at her prize possession, a magnificent grand piano that sat invitingly by the window. Occasionally one of her former students would drop by and perform a piece they'd worked on together, filling the house with her spirit. "I like the woman who did this," Kathleen had told him during one of her early visits. "She obviously had style and sophistication, yet it's all about family."
Chet let out a long breath, stood, and started to pace. "So do we tell Lisa outright how critical her mother is?" he said, lowering his voice and gesturing with his eyes toward the next room. She was holed up there, busily phoning everyone who had to be told what had happened— the staff at her mother's lab, close friends, the people who published her books and produced her television programs. It was a long list. "I know she already understands it's bad," he continued practically in a whisper, "but if she asks outright, the way I did, do we spell it out for her?"
Richard studied him. "I'd like to know what you think would be best," he said, going with an instinct that there might be another way to settle the wrong between them. "After all, I didn't handle this sort of thing so well with you when your mother was ill."
The boy started at the admission. At first he looked puzzled, as if trying to decipher if his father was being sincere. Then he swallowed a few more times, and seemed to stand a little more erect. "We're straight with her, from start to finish. Otherwise she won't trust us."
His voice had trembled, but there was a determination in his eyes that made Richard's heart leap. It was the same look his mother had summoned when she'd first been diagnosed with cancer of the pancreas and tackled the fight of her life. God, Richard thought, Chet had had her courage all along, and he'd never given him a chance to use it. Thursday, June 14, 7:10 a.m.
He should have been in ER ten minutes ago. But he'd only just woken up, not having fallen asleep until five A.M.
"She's as stable as can be expected, Dr. Steele," the nurses had told him each time he called to inquire, their tone making it clear they thought him a nuisance.
He'd finally dropped off in front of the TV during a rerun of Sea Hunt. After two hours of fitful sleep and with his mind incapable of focusing on anything else but Kathleen, he headed directly for ICU figuring it better if he stayed clear of Emergency anyway.
Bypassing the usual morning congestion in front of the elevators, he used the staircase, taking the steps two at a time. He slowed for the strings of men and women in white who trailed like loose threads on the coat of the staff doctor leading them through rounds today. In the corridors he encountered similar processions, except they had been joined by nurses busily emptying bedpans and handing out food trays, the aromas of both hanging in the air. He
noted a hush around one particular doorway through which the ward supervisor led a red-eyed, elderly woman to a motionless, sheeted figure lying on the bed. The nurses, on their final round before the day shift arrived, must have found a corpse, some poor soul who had died during the hours before dawn. He shuddered at his knowledge of how patients slipped away unnoticed even in a hospital.
In ICU there were no smells of eggs, bacon, or anything else to do with food, breakfast here served mostly through tubes. That left the scent of excretia pretty well unchecked.
From twenty feet away he could see Kathleen's eyes flicking, like joke eyeballs on a spring. "How long has she been doing this?" he demanded of the nurse as he strode to Kathleen's side.
"According to the report, all through the night, Dr. Steele," the nurse said. She looked odd to Richard with her spiked blond hair and a silver ring through her left nostril. He recognized her as being among the ones he'd made a point of speaking with yesterday to ensure Kathleen got the best care, but her laconic / don't give a damn tone suggested he'd wasted his time. Anger coiled his intestines into a knot.
"At first they thought it might be some kind of seizure," the nurse continued, not bothering to look at him, "yet she blinks appropriately when asked for a yes or no response to a question. Then Dr. Hamlin ordered an increase in the morphine, and that knocked her out for a few hours. According to the med-sheet, the evening shift hadn't exactly done all they could to keep her topped off enough. I made sure that's not the problem now."
Controlling his temper, he leaned over and asked, "Kathleen, are you in pain?"
She blinked once for no, the convention established between her and Jo O'Brien in ER.
"Is something else wrong?"
Her lids closed and opened twice, indicating yes.
"Are you feeling dizzy?"
No response.
"Yes or no?" he asked.
Nothing, except she raised her eyes upward and held them there. Even in her helpless state, they retained a sparkle, and their magnificent green color flashed under the overhead lights. If he didn't know better, he would have thought she was signaling her exasperation with him.
"Do you need more morphine?"
A definite no.
"Are you anxious?"
Her eyes shot toward the ceiling again.
She was getting impatient with him, he thought. Obviously he wasn't asking the right question. He leaned closer to her ear and whispered, "Is what you need a bedpan?"
This time he got a sharp blink and an elevated gaze. A cluster of monitors at the head of the bed flashed their warning lights to show a rise in her blood pressure, and her pulse ticked up to one-twenty.
"You're upsetting her with all your questions, Dr. Steele," said the nurse. "You have to let her rest. As you perfectly well know, any increase in her vitals could start a rebleed."
The pulse and pressure instantly rocketed higher.
No, Kathleen blinked over and over, a pause between each movement so there was no mistaking her. No to what? His being sent away, or the prospect of a second stroke? He instinctively held her hand. It felt clammy and as flaccid as death, but he clasped it to his lips and gently kissed her fingers. He also placed a palm on her brow, then stroked her auburn-gold hair, all the while watching his touch coax her readings back to normal. "I'll be staying with her," he told the nurse, appalled by her cold insensitivity and finding it a stretch to speak calmly.
"No problem," she snapped, "except it's on your shoulders if anything bad happens."
Richard cringed at the woman's belligerence, but said nothing, continuing to soothe Kathleen with his hands. "Is that better?" he asked.
Yes, she blinked.
Her forehead was warm with fever, his clinical self noted. Probably from the usual effects of a pontine hemorrhage on the nearby thermoregulatory centers. Later he'd check and make sure they were giving her acetaminophen to control it. But it was as her lover that he must act now, he reminded himself, and went on caressing her.
When the nurse left, huffily drawing the white curtains behind her, Richard, asked, "Is she bothering you?"
No.
"It's something else?"
Yes.
"About your stroke?"
She blinked twice, waited a second, then once more.
"Yes, no?" He thought an instant. "You mean yes and no?"
Yes.
"But what?"
She kept directing her gaze downwards.
"You mean some other part of you hurts?"
No.
Jesus, this was getting them nowhere, he thought. He began to worry that despite her insisting nothing hurt, something else could be wrong with her. Any number of potentially serious symptoms— shortness of breath, numbness, even nausea and vertigo— might indicate a significant problem that didn't necessarily involve pain. The possibilities clicked through his head. Congestion in her lungs. Unrelieved pressure on a peripheral nerve from lying too long in one position. Maybe the nurses hadn't even turned her— bed sores were a real danger in paralyzed patients. Worse, it could be an extension of her bleed involving the pathways that control balance. Such an event could set off a new round of dizziness, foreshadowing a second major hemorrhage. She could be lying there, the stroke growing worse, but if he didn't ask the right question, she wouldn't be able to tell him.
Fighting his own panic, he rapidly queried her about each of the telltale sensations, yet she mostly answered no, except for dizziness and nausea, to which she gave both the single and double blink, a response he now took to mean yes and no. And when he demanded if that was what she had been trying to tell him, she gave him a clear-cut no and shot her eyes toward the ceiling again.
"Is there something wrong in a particular part of you?" he said, going back to square one, and trying another approach. "Besides the stroke."
Yes and no.
They were going in circles. "This 'something wrong with you,' is it what you want me to understand?"
Yes.
He had an idea, remembering a way he sometimes got patients in ER to tell him where they had a problem when they couldn't communicate. "I'll be right back," he said.
No, she repeatedly blinked.
"I'm just going to get some paper," he reassured her, and left the curtain open, so she could see him make his way to the nursing station where he picked up a prescription pad. Back in the confines of the cubicle, the curtain once more drawn, he quickly drew the outline of a human figure. "Now when I point to the body part where something is wrong, blink yes."
Again she looked at the ceiling, her eyes flaring.
"Please, Kathleen, humor me." He pointed to the drawing's head.
Yes.
"You mean the stroke?"
Yes and no. Here they went again. "Is there anywhere else I need to know about that has something wrong?"
She hesitated a good five seconds, then blinked twice, slowly, as if unsure of her answer.
"Okay, then let's see. Chest?" he said, holding up the drawing and tapping the appropriate section with his pen.
No.
"Abdomen?"
No.
"Right arm?"
No.
"Left arm?"
No. "Legs?" No. No. No.
What had he missed? "Face?" he said.
She hesitated, then blinked no, but slowly.
"Am I close?" he said, feeling a flush of excitement.
Yes.
He looked at his crude picture. "A particular organ on the face? Nose, eyes, ears?"
No.
Then what the hell have I overlooked? he thought, once more studying his sketch.
Then he saw what he'd skipped. "The neck?"
Yes, snapped her lids.
He immediately leaned over her, his fingers instinctively palpating under her jaw and down the sides of the throat feeling for some abnormality. A small Band-Aid on the right, about midway down, caught his attention. Until now, looking so innocuous, it had escaped his notice. He lifted
it off and saw a tiny clean puncture wound over her jugular and carotid vessels. She'd had a needle inserted in her neck. "Is this what you wanted me to see?"
Yes.
"They put a needle in here?"
Yes.
"Do you know why?"
No.
"Excuse me a minute. I'm going to check this out with the nurses."
As he turned to walk away, she started to bat no repeatedly.
"Kathleen, I'm not going anywhere," he said, then immediately regretted how curt he sounded. "I'll be right back," he added, making an effort to speak gently and giving her his best professional everything's fine smile. On his way to where the unit supervisor sat sticking bobby pins into her bun of gray hair as she stared at the central console, he chastised himself. He shouldn't have allowed his own fear and lack of sleep to make him testy, especially this early in the game. The real trials, he knew, lay ahead. If he couldn't keep a grip now, she would start to wonder if he would fold on her— just the way Chet doubted him. He swallowed hard, as if that could get rid of his own self-doubts.
"Nurse," he said, abruptly coming to a standstill at the console, "when did Dr. Sullivan have a neck puncture?"
The matronly woman perused Kathleen's chart. "It says here that she came back from her angiogram last night with the puncture site bandaged." She sounded pissed at having to take the trouble.
"But they usually go through the groin for an angiogram."
She'd already gone back to watching two dozen video screens reduce the latest progress of the souls in her charge to digital readouts and fluorescent squiggles.
Her sigh at being interrupted could have stripped paint. "According to Dr. Hamlin's note, her pressure fell during the procedure. Thinking she might be having an allergic reaction to the dye, he put in a central line, in case he needed to monitor her wedge pressure with a Swan-Gantz and give her fluids. But nothing happened, so he took it out." She spoke in the slow measured cadence nurses use when they want to make it clear they think the doctor's an idiot, and her face had Now don't bother me anymore! written all over it, just in case he didn't get the first message.
Critical Condition Page 3
