Deficiency

FOURTEEN

"Hey," Steve Battie called to Terri as she was going through the corridor and the emergency room. He was in an examination room. "You've got to stop and see this."

"What do you have?" she asked stepping into the room. The sight before her stopped her cold. Her first thought was it looked like a patient who had overdosed on Coumadin, an anticoagulant drug to help prevent the formation of blood clots in the blood vessels or dissolve them by decreasing the blood's ability to clump together. Because they prevent clotting, they can, if poorly managed, cause severe bleeding.

Terri had never seen a case like this, even in her textbooks. Two lines of blood trickled out of the young woman's eyes like red tears. The trauma appeared all over her body. It looked like an explosion of arteries and veins. There was no question she had intracranial bleeding as well.

"She expired about ten minutes ago."

"Was she a hemophiliac?" Terri asked.

"Don't know yet. She has been in the hospital before, so we're tracking down her medical history, but if ever I saw an example of a congenital or Acquired Factor II deficiency, this is it," Battie replied.

Terri nodded. She knew, of course, that normal blood coagulation was a complex process involving as many as twenty different plasma proteins, or blood coagulation factors. The complex chemical reactions using these factors took place rapidly in a healthy person to form an insoluble protein called fibrin that stops bleeding. To be congenital, the woman would have inherited it from both parents. What triggered alarms in her mind, however, was that acquired Factor II deficiency resulted from one of three possibilities: a severe liver disease, the mismanagement of the anticoagulant drug, or a vitamin K

deficiency.

A nurse came into the room and handed Battie a file.

"Hold on," he said to Terri. She watched him read. He flipped a page. "She was brought in here for an appendectomy. No history of bleeding, a normal blood workup. She wasn't put on any anticoagulant for any reason here."

"How long ago?"

He looked up again.

"Just three months."

"My God," she whispered. "I've got to get to a phone." She went out to the desk and called Will Dennis.

"Sorry," she said, "neither of us are getting any sleep tonight," she began, and then told him what she feared.

"No, you go get some sleep, Doctor," he told her. "I'll call you at your office tomorrow, or should I say, today, as soon as I have anything definitive." She agreed. There really wasn't anything more she could do here anyway. She debated going to her own home, but the memories of Curt collapsed at her door were still too vivid. Why the police impersonator would be coming for her, she did not know. In his madness, he was convinced perhaps that she wasn't telling him something she knew. The chances of a so-called normal villain returning to her home after having a confrontation with someone like Curt were probably very slim, but they weren't dealing with anything like a normal villain here, so when the cross streets came up at which a right turn would take her back home or a left would take her to Curt's, she turned left. The key was under the flowerpot to the right of the front door as usual. She let herself in and then paused. Being here now with Curt hurt and in a hospital room suddenly brought tears to her eyes. Maybe if she had been more forthcoming at the hospital parking lot, they wouldn't have argued and he wouldn't have felt it necessary to come to her house to patch things up. She should have been less the doctor, and more the fiancee, she concluded. Curling up in his bed gave her a sense of security and contentment, however. The scent of his cologne and hair dressing was there and it was something she welcomed. She had crawled in naked too. Pretending they had just made love, she turned over and closed her eyes. She hadn't realized just how exhausted she was until that moment. It took only seconds, it seemed, for her to fall asleep. Sometime before morning, she woke with a start. Whether it was a nightmare or what, she wasn't sure, but the echo of what sounded like someone at a window remained in her ears. She shuddered and then slowly sat up and listened hard. If he found her home, why wouldn't he be able to find Curt's, knowing he was her fiance?

Why didn't she consider this and go to a motel?

She reached for the phone. Call the police to her aid again? She was feeling so stupid. I'm behaving like a hysterical person, she thought.

She knew where Curt kept his pistol and went to the drawer. It was there and it was loaded. He had insisted they take target practice together.

"I'm sworn to do all I can to save lives," she told him. "How can I fire a pistol at someone?"

"If that someone is going to take your life, you're going to let it happen because of your Hippocratic oath? What will you be able to do for your patients when you're dead?" he reasoned.

"All I'm saying is I can practice with you, but I don't know if I can ever fire the gun at someone."

"You'll know," he said with a smile of cold confidence. "If the occasion should ever arise, you'll know."

She grasped the pistol and, after taking a deep breath, walked slowly out of the bedroom and listened again in the hallway. A squeak at a window in the den sent a hot chill down her spine. Heart pounding, she walked to the door of the den and peered in.

The window was up. She couldn't move. Had Curt left it up? Can't call him to find out now, she thought.

Instead, she backed up, returned to the bedroom and closed the door. As much as she hated to do it, she called the sheriff's office again and related her message to the dispatcher. The woman of course knew exactly who she was. Then she got into bed, sat up with the pistol in her hand, and waited for either the door to open or the patrolman to arrive.

He was well on his way to somewhere when he suddenly slowed down. What am I doing? he wondered. Why do I have to run off like this? I'm starting to act like them.

Them?

Funny, he thought, he rarely differentiated between himself and the women he mined for nutrition and life-giving compounds, except to remind himself how superior to them he really was, and especially superior to their men. He had a big night, too, and where was he going? A nice fatigue was setting in him, nice as compared to the fatigues he felt when he was in need. Nothing ached. There was just this sense of deep relaxation settling in his body. The prospect of lying in a bed and lowering his head to the pillow was looking better and better. In the morning he could reconsider everything and make decisions. Morning wasn't all that far off anyway.

The flicking bulb on a motel sign ahead seemed to be beckoning him. He smiled, slowed down, and pulled into the lot and parked by the office. This late in the evening, there was no one visible, but the door was open and there was a bell on the counter to summon someone.

The night manager was actually asleep in an oversized easy chair. He was dressed in a thin, yellowing T-shirt and a pair of jeans held up with suspenders. Under the weakened neon ceiling fixture's illumination, his face looked as if it consisted of old wax. The sick pallor of his complexion was emphasized by his obviously unprofessionally colored black thinning hair. He looked like someone who had dumped a bottle of ink on his head.

For a moment he stood there watching the manager breathe. He reminded him of a fish. His large nostrils moving in and out like gills. His face spotted with patches of reddened skin and a mole on the right side of his nearly indistinguishable chin.

The man is ugly enough to kill, he thought and for a moment actually considered doing just that. He grunted with the thought.

The manager's large round eyes opened as if they had two tiny springs on the lids. He looked up with an expression of utter astonishment at the sight of someone staring at him so intensely.

"Whaaa..." he said and scrubbed his face vigorously with his dry palms to bring some blood into it and maybe into his brain. He sat up, realized he had a customer, and immediately stood. His potbelly seemed to roll down and settle itself just under his waist as he rose to his feet. He actually looked like a pregnant woman in her ninth month.

"Sorry," he said. "We rarely get any customers this time of night."

"Why? It's on the road. Doesn't anyone travel on this road?" he asked with an unexpectedly aggressive tone.

"Oh, sure, sure. It's just not a main highway anymore," the manager said defensively. "Since they built the bypass. My parents left me the place just about the time it all went to pot." He shrugged to indicate there was nothing he could do about his fate. "I don't need much. I'm by myself here. So, you want a room for the night?"

"Maybe two nights," he said and the motel owner's eyebrows went up as if he had won the lottery.

"Oh, sure. Well, as I said we have lots of rooms available."

"Give me one as far from the highway as possible. I want it to be as quiet as possible," he said.

"Gotcha." He turned the sign-in book to him and stepped back to choose a room key.

Who am I tonight? he wondered as he lifted the pen to sign. He decided he would be Rip Winkleman. After all, he was going to sleep and he felt confident this excuse for a man wouldn't get the irony and humor. He was paying with cash so there was no name to check on a credit card.

"Thirty-eight fifty a night," the motel owner told him, and he gave him a hundred-dollar bill.

The owner went under the counter to get a cash box out and the change, which he gave him with the key.

"It's the last room on the end, as far from the entrance as I have."

"Perfect."

He spun around and started for the door.

"Where you headed?"

He turned to him, at first annoyed at his curiosity and then realizing that wasn't the best reaction to have, smiled.

"I've got to make my way to a business meeting in Newark eventually. Just taking my time. Enjoying the trip. Stopping to smell the roses, know what I mean?"

"Sure," the motel owner said, although it was clear from the look in his face that he had no idea what "smell the roses" meant. "If you need anything, just pick up the phone. It rings automatically in here."

"Thank you."

He went out to the car and looked back to see the ugly, overweight man settling himself in the chair, looking as if he was sinking into his own body. He couldn't help wondering if this sort of man had any sexual energy whatsoever. His sex seemed to have dissolved into his fat. Who could be attracted to such a creature anyway? He looked like a personified wart. Who would mourn its death?

And then he thought, who would mourn mine? Did that matter? Should it matter? When you're dead, how do you know you've been mourned at all? Or in what spirit and with what pomp and circumstance?

These sorts of philosophical concerns only complicated life, he decided. They distract, depress, disturb. The only thing that was important was the moment, now. The past was the past. It couldn't be changed. And the future was unknown except for one thing. There was an end out there, a place where it all stopped, where the light inside you went dark. It seemed to him there was only one thing to concentrate on, one thing to have as your priority therefore, and that was to do everything possible to keep the light burning for as long as possible. Everything else was just a distraction.

It occurred to him that he was very much like any other creature out there. Like any of them, he spent his day working on keeping himself alive. There was a time, he thought, however, when he had more time for the distractions, when they weren't as detrimental or harmful to that effort. Vaguely at first, but suddenly getting more vivid in his mind, was the realization that the periods of time he could afford for such things was diminishing to the point where they were almost gone entirely.

He had no doubt, for example, that when he woke in the morning, he would feel the early signs of an oncoming need to hunt, and this, after just doing so the night before. Again, he concluded. This wasn't good.

The imagery of that rabbit's warren returned. What he might have to do, he thought, was find a central location and stock it with prey, gather up a half dozen or so and have them there for harvesting when he required and as he required. Not a bad idea, he thought and now regretted having set fire to the rooming house. It might have served him in that purpose. On the other hand, someone like that minister, was bound to come by and make things difficult. He'd have to go somewhere else.

After he brought his suitcase into the room and prepared for bed, he rested his head on the pillow and gazed into the darkness, still thinking about this great idea. What a wonderful fantasy. It would be like a fish with an endless supply of worms at the bottom of the bowl. Hungry? Just dip down and pluck one. It brought a smile to his lips.

Gather them, keep them in one place, and stop this endless traveling, he told himself. It was a real project to consider, a purpose, something with a beneficial objective, a new reason to be. How wonderful. He closed his eyes, turned in the bed, and snuggled comfortably under the blanket and against the pillow. I might live forever yet, he thought, and fell asleep on the fluffy cloud of that enormous possibility.