Extreme Measures

by Michael Palmer

  It was as if a spell had been cast over him.

  There was still time, he thought. Time to get to the hospital.

  Time, somehow, to let Caduceus know that he wanted in, that he was willing to do whatever they asked. He leaped out of bed, toweled off, and was frantically dressing when the phone began ringing.

  Thank you, he thought. Whoever you are, thank you for calling back, for giving me a second chance.

  He snatched up the receiver. "Hello?"

  "Good morning," Laura said. "I hope I didn't wake you." Eric felt instantly deflated.

  "No, no," he said, "I've been up for a while."

  He sank to the edge of his bed and rubbed at what remained of the sleep in his eyes. He felt dizzy, disoriented.

  "I'm sorry I ran away last night," she said. "I really didn't want to leave you, but I was getting so upset thinking about Scott, and I was caught completely off guard by what happened between us."

  "I understand."

  "But in spite of everything, I did have a wonderful night.

  "Me too."

  "You sound a little distracted. Are you okay?"

  "I'm fine," Eric said, sensing the ungodly tension in his body beginning to lessen. "There's been a lot going on in my life, that's all. I'll explain when I see you.

  "Then we're still on for breakfast?"

  Eric glanced over at his clinic coat, hanging on his bedroom door.

  The pin was gone, and so, in all likelihood, was the future he had so carefully laid out for himself. But in that moment he sensed relief sweep over him. He had done what he had done, and now, as advertised, his life was already moving on a new, irrevocable path.

  "We're still on," he said with sudden enthusiasm.

  "Terrific," she said. "They don't have room service in this place, but if you want to come over, I'll pick up some coffee and croissants or something."

  "I'll be there," Eric said. "You can count on it."

  Najarian not working today. He has revoked his commitment to us, and will be dealt with.

  Until a suitable- replacement can be found, you must handle things just as you did with numbers 105, 106, and 107. The enclosed is our way of thanking you for your continued efforts.

  C.

  The note was in a sealed envelope on Norma Cullinet's desk when she arrived for work at seven.

  Included were ten $100 bills. The nursing supervisor read the note once, and then again. Then she shredded it angrily and threw it into her wastebasket. As much as she loved her involvement with Caduceus, as much as she delighted in living on the edge, she detested taking unnecessary chances. And now, for the fourth time since the firing and subsequent disappearance of Craig Worrell, ghe was being asked to take a fairly big one.

  Actually, she acknowledged, two of the three cases she had been forced to handle hadn't really been that risky. The retarded teen on the ward on Men-iman 7 had been pronounced dead by his resident and turned over to her without so much as an attempt at resuscitation; and pitiful Gary Kaiser had been so flustered and incompetent in trying to revive the drift diver that he had no inkling the man was receiving ten times the adrenaline dose Kaiser was ordering.

  Norma's performance that day had been flawless. still, the arrival at the hospital of Laura Enders and her posters pointed out that the system devised by Caduceus was not. Although it made little sense, given the description of Scott Enders as a computer expert, Norma was almost certain that the derelict and the woman's brother were one and the same. And if that was so, then clearly the patient had lied in every piece of information he had told her about himself. Given that, surely no one in Caduceus could criticize her for the break in protocol. And now the whole business seemed to have blown over.

  Cullinet slipped the bills into her wallet. A thousand dollars for less than an hour's work. She smiled.

  At least someone was willing to pay her what she was worth. She checked to be sure her office door was locked, and then from her desk withdrew the Xerox copy of an emergency-room admission sheet. The patient, a woman, had been treated at White Memorial forty-eight hours before. Two items on the sheet were marked with a

  yellow highlighter: AGE, and NEXT OF KIN-NONE.

  Nlorrna drew a circle around the woman's phone number. Her pulse began to quicken as she dialed and then listened. two… three… four… five..

  She counted each ring out loud.

  "… seven… eight… nine… ten..

  Four cases, four thousand dollars, she thought.

  And that was just a token of what was in store for her if the work of Caduceus proved as profitable as she had been assured it would be. fourteen… fifteen… sixteen… the twentieth ring Norma hung up. Loretta Leone was not going to answer her phone… not now, not ever. She checked the Boston directory, took a deep, carring breath, and dialed the police.

  "Hello, police?" she said, affecting the halting, cracked voice of a much older woman. "I've been expecting a call from a friend of mine, Miss Loretta Leone. That's L-e-o-n-e. I was supposed to take her to her doctor's appointment later this morning, but she hasn't called and I can't get an answer at her apartment. She never misses an appointment, but she's not well, you know, and I'm afraid something might have happened to… No, no I haven't gone over there myself. Her appointment's not uptil eleven, and I have a terrible back condition that… Oh, it's Three-fifteen East Harcourt Street, apartment six." … Thank you, young man. You're very nice. Thank you very much."

  Norma set the receiver down just as the police officer was asking for her name. She then straightened her desk and carefully destroyed the Xerox.

  Finally, she unlocked the bottom drawer of the desk and brought out a small metal box, secured by a combination lock. Inside the box were some vials, small jars of powder, and a number of already-loaded syringes. They were labeled NORMAL SALINE, but that was hardly what they contained.

  Norma slid one of the syringes into her uniform pocket. If Eric Najarian wasn't on duty in the E.R then almost certainly Reed Marshall was. And although Najarian was more flamboyant, and probably the better all-around physician of the two, Marshall was damn good, and certainly more meticulous. She would have to be exceedingly careful to keep everything looking smooth and steady for as long as he wanted to continue the resuscitation.

  She replaced the strongbox and made a final check to be sure she had put everything away. Then she left the office to begin morning rounds. It would be close to an

  hour before the police checked on her call, the rescue squad did their thing, and the Priority One was called into the E.R.

  Her attention turned to Reed Marshall and the way he handled Code 99 resuscitations. liked to direct things from near the E.K.G machine and to leave the actual CPR to the nurses and other residents who were assisting him. She would have to maneuver herself into position to handle the med cart. It would probably be worthwhile checking on the nursing personnel on duty that morning. With luck, the E.R. would be busy, or at least shorthanded.

  Lost in thought, studying the staff listing left for her by the night supervisor, Norma wandered past the man from housekeeping and the low sandwich-board sign proclaiming CAUTION: WET FLOOR. She had taken one step onto the.glistening surface when her foot slipped from beneath her.

  She fell heavily, first striking her shoulder against the wall, and then pitching forward over the edge of a flight of stairs.

  Helplessly, she tumbled down, over and over again. Midway through the fall she heard a horrible snap and felt a searing pain shoot up from her elbow. She landed heavily at the base of the stairs, air exploding from her lungs at the moment her head snapped back against the linoleum floor. Instantly, there was nothing.

  The man from housekeeping rushed down the stairs to her. But already, Norma Cullinet was arched and stiffened in the grip of a grand mal seizure.

  Apartment 6 at 315 East Harcourt Street was a cluttered one-room space below street level. Even at midday the narrow, barred windows by the ceiling let in little light, and thro
ughout the winter a damp chill pervaded the place. Still, for nearly twenty years Loretta Leone had been happy to call the room home; happy in large measure because for most of the prior thirty-five years, she had lived in a variety of institutions and often-hostile group houses.

  When Loretta first moved into 315 East Harcourt Street, her rent was $50 a month. And despite three changes in ownership of the building, $50 it remained. She paid the rent and bought her food by collecting bottles and cans, many of them saved for her by regular customers. In fact, she had been doing so well of late that she had plastic bags with three weeks'worth of cans stacked against the back wall of her apartment.

  She had a telephone, a radio, and a small black and-white TV. She had a table with four chairs, and the bed that the workers at her last group home had given her. She had a braided rug and a bulky chair that rifted up when she leaned back. She had stacks of magazines that she picked up while making her bottle rounds. And although she couldn't read them, she liked looking at the photos. She liked Oprah and The Price Is Right, and on warm days, she liked walking up and down the streets of the North End, waving to the children and the people in the shops.

  And every day she loved to call the weather machine and listen to the forecast.

  But now, Loretta Leone could do none of those things. She lay face up on her rug, unable to move, totally exhausted from trying to breathe.

  For a time she could see-trace the cracks in the ceiling with her eyes.

  But now everything was black. Her arms, especially the one with the new cast, had gone from heavy to numb. And now she couldn't lift them at all.

  She could feel and hear the fluid gurgling up in her mouth, choking her.

  For a while she could cough the fluid away, but now she no longer tried.

  The phone began ringing, again and again. She tried to move to — answer it, but nothing happened.

  Then, through the darkness, Loretta heard a pounding on her door.

  She heard men calling out her name.

  "I'm here," she wanted to cry out. "I'm here and I'm frightened.

  Please help me. I can't breathe."

  The pounding grew-louder. Suddenly there was a loud crash.

  Loretta knew that her door was being broken down.

  Hurry, Loretta thought. Hurry and help me.

  "Okay, okay. Reach in and open it," she heard a man say.

  "There she is. Jesus, look at this place. No wonder the North End's so clean. All the junk's in here."

  There were footsteps. Then Loretta sensed a hand touching her on the side of her neck.

  "Nothing," one man said. The hand probed again, and then pulled away.

  "She's gone. See that fluid?

  Looks like a heart attack." it took several seconds before Loretta understood.

  No, wait, her mind screamed. I'm alive! I can hear you! I can hear you!

  "Do you want to mouth-to-mouth her?"

  "Hell, no. Do you want to put your mouth over that? Just call the rescue squad. Let them do it if they want. Then call the station and report what's going on." One man made a phone call while the other continued feeling along Loretta's neck. Then he put his ear to her chest.

  "You know, every once in a while, I swear I can feel a pulse," he said.

  "That's just the pulsing in your own fingers. It happens like that all the time. Jesus, this place.

  "Billy, check her neck. tell me what you think."

  Loretta sensed the other man kneeling beside her and felt his hand on her neck. His fingers were colder than the first one's.

  "Nada," he said.

  The two men continued to alternate touching her neck, all the while talking about her place. Loretta heard them and felt them through a paralyzing darkness.

  Soon there were more voices, other hands.

  Have you done any CPR?" a woman's voice asked.

  "A little. Well, not much."

  "Dammit, Billy, you know the protocol. Full resuscitation on everyone except in cases of obvious traumatic death."

  "You mean like a beheading?"

  "That's exactly what I mean. The only one who can pronounce a patient is a doctor. Come on, Ray, jimmy, let's get moving."

  Suddenly Loretta sensed a great deal of commotion around her.

  Heavy hands began to press on her chest, again and again. Her head was tilted back and something was shoved into her mouth, then deeper and deeper into her throat.

  "Tube's in," a man said. "Give me some oh-two."

  "Okay, now an IV"

  "This cast looks new."

  "Get the monitor on her. Here, Billy. You know CPR. TAe over this pumping. Sixty a minute. That's it. Steve, ventilate her. Once every few seconds."

  "Monitor's on."

  "What have you-got?"

  "Something. Wait a second. Yes, she's in a very slow, regular rhythm.

  Eight, ten a minute. Complexes very wide."

  "Billy, you should have been doing CPR on this woman."

  "I'm sorry. I'm sorry. She looked dead."

  "She probably is, but that's not your decision to make."

  "Check her pupils, win you?"

  Loretta felt hands on her eyes. For an instant she experienced a painful flash of bright white light.

  "Dilated and fixed."

  "I told you she was dead."

  "Just keep pumping. Ray, get White Memorial on the radio. Tell them we've got a Monty One."

  "Any pressure?"

  "None."

  "No pressure, no pulse, dilated pupils. Jesus, what in the hell was I supposed to think."

  "You weren't. You were just supposed to start CPR and call us."

  "I'm sorry. I'm sorry."

  "Get some epi in that line."

  "White Memorial, this is Boston Rescue, paramedic Driscoll speaking. We have Priority One traffic.

  Repeat, this is Priority One…

  Voices began to blend with one another in Loretta's mind. And although she understood almost nothing of what they were saying, just the sound of them made her feel better. The hands pumping on her chest hurt her, but they, too, were reassuring.

  "Do you want to shock her?"

  "What's her rhythm?"

  "The same. Eight a minute. Very wide complexes.

  "Just end-of-the-line beating. She needs drugs, not current."

  "What she needs is a goddam priest."

  "Cool it, Billy, will you?"

  "The people at White Memorial say just proceed according to protocol and transfer as soon as possible."

  "move the stretcher over here. Over here!"

  "Stand back there, ma'am. Someone will be with you to explain everything in just a bit. It looks like heart failure… I don't know if she's going to be all right. Right now it doesn't look good."

  "Okay, get set to transfer. You two keep pumping and bagging her.

  Ready, Ray? Jimmy? Okay. One, two, three, lift!"

  Loretta felt herself being lifted and then set down.

  For a moment the comforting hands stopped pumping on her. Then they started again.

  "All right. Move back, everyone. We're coming through. Coming through."

  Within the heavy blackness, Loretta Leone sensed more than felt the movement out of her apartment and down the hall to the stairs.

  Help me, she thought. Just help me. I don't want to die.

  The bell announcing wake-up in Charity sounded at just after six.

  Garrett Pike rolled off his cot and dressed. He could tell the day was going to be another scorcher. He studied the playmate on his calendar and decided, as he crossed off April 13, that the photo was a keeper.

  Once, just once before he died, he would like to spend the night with a woman like that.

  He left his room, which was on the floor above the men's barracks, took his clipboard off the wall, and began making his rounds, checking off each patient's name as he roused him and sent him toward the dining hall. One of the men, Dick, was clearly getting ill. He had been bathed in a feverish swe
at the previous evening, but Dr. Barber had merely examined him and sent him back to bed. Now, his condition seemed worse.

  Pike walked the man to the clinic and turned him over to Dr. Barber.

  Then he returned to the barracks.

  He was used to illness among the patients and expected that the man would be shipped out before long.

  It was not until the last of the male patients had been sent to the dining hall that Pike realized his count was off. In nearly two years, this was the first time.

  Feeling the first twinges of panic, he searched the barracks and then hurried to the dining hall. A quick recount told him his survey was correct. The man called Bob was missing.

  Dr. Barber at first took the news calmly. But as he, Pike, and John Fairweather began a systematic search, Barber's concern grew. He hurried back to the clinic to ensure that the security network of photoelectric cells and cameras encircling the town-was working properly. The system was-at least so he had told Pike-foolproof. And in fact, following an adjustment made after the Colsons' surprise visit, he had seen animals as small as jackrabbits set it off.

  "He's here someplace," Barber exclaimed, ordering a repeat swing through the buildings. "There's no way he's not."

  But minutes later John Fairweather called them to a shallow arroyo on the west 'end of town.

  "He left through here," the Indian said, pointing at some gouges in the dry earth.

  "That's impossible."

  "Not impossible," Fairweather said. "Happened."

  To prove his point, he flattened out on the ground and worked his way serpentlike along the narrow gully, just beneath the intersecting photoelectric beams. The alarm, keyed to the loudspeaker system, remained silent.

  "Go through again," Barber ordered. "Go higher this time, on your hands and knees."

  Fairweather did as he was asked. Instantly the alarm began wailing.

  "I don't believe this. I just don't believe this," Barber exclaimed, his composure all but gone.

  He raced to the clinic and shut down the siren.

  Then he brought out a detailed topographical map of the area and set it out for Pike and Fairweather to study.

  "Who is he?" Pike asked.