Foreign Body

Chapter 8

October 16, 2007

Tuesday, 7:45 p.m.

New Delhi, India

By reflex Samira Patel smiled coyly at the two tall Sikh doormen at the Queen Victoria Hospital’s front entrance. She was dressed in her nurse’s uniform, just as Veena had been the night before. They did not return her flirtatiousness. But there was no doubt they recognized her. Each silently reached out and pulled open his respective door and, with a bow, allowed her to enter.

Durell had coached her for several hours that afternoon before Samira had set out on her mission, which had included what to do once she was inside the hospital. Despite her excitement, she followed the suggestions to the letter. She marched across the lobby, avoiding eye contact with anyone. Instead of the elevator, she took the stairs up to the second floor, where the library was located. After turning on the lights, she got down from the shelves several orthopedic books and spread them out on one of the tables, even opening one to the section on knee replacement, which was the procedure her patient, Herbert Benfatti, had had that morning. All this was Durell’s idea. He wanted her to have a clear, confirmable explanation for being at the hospital after hours if one of the more senior nurses questioned it.

Once the library was prepared to her liking and she’d downloaded Benfatti’s chart from the library’s workstation onto a USB storage device, she returned to the stairwell and climbed up to the fifth floor, where the OR suite was located. By now her excitement had built to the point of true anxiety, even more than she had expected, and it caused her to question why she’d been so eager to volunteer. At the same time, she knew exactly why she’d volunteered. Although Veena Chandra had been her best friend since they’d met each other in the third grade, Samira had always felt inferior. The problem was that Samira envied Veena’s beauty, which Samira knew she could not compete against, ergo her wish to compete in every other way. Samira was convinced Veena’s hair was darker and shinier than hers, and Veena’s skin more golden, her nose smaller and shapelier.

Yet despite this competitiveness, about which Veena was totally unaware, the girls had developed a keen friendship based on the shared dream of someday emigrating to America. Like their other friends at school, both had had early access to the Internet, which Samira had availed herself of much more than Veena but which had provided both girls an oculus to the West and an introduction to the idea of personal freedom. By the time they’d reached their teenage years, they’d become inseparable and shared their secrets, which for Veena included abuse by her father, something she’d never shared with anyone else for fear of bringing shame to her family. Samira’s secret, sharply contrasting with Veena’s, was that she was fascinated by pornographic websites, and consequently sex, finding it hard to think of anything else by its denial. She was dying to experience sex herself and felt like a caged animal, especially because of her strict Muslim upbringing. Ultimately, what cemented the relationship between the two young women was their willingness to cover for each other. Each would tell her parents she was sleeping at the other’s home, enabling them to go to Western-style clubs and stay out all night. Instead of embracing the traditional Indian karmic values of passivity, obedience, and acceptance of life’s difficulties based on expectations of reward in the next life, both Samira and Veena progressively wanted the rewards in this life, not the next.

Yesterday, when Samira heard that Veena had been selected as the first of the nurses to carry out the new strategy, she’d been immediately jealous. That was why she’d acted as she had, volunteering for the next task with the claim she’d do it better and without hesitation. The reason she felt so confident was that there was one arena in which she had made more progress than her friend, and that was in the degree to which she’d abandoned the old culture of India and embraced the new culture of the West. Her affair with Durell was clear evidence.

With a trembling hand, Samira pushed open the stairwell door on the fifth floor. It was relatively dark. For a few seconds, Samira merely listened. She heard no sounds except the constant omnipresent low hum of the HVAC machinery. She stepped out into the hallway and allowed the door to close behind her.

Confident she was alone, Samira walked in the direction of the operating suite while trying to keep the sound of her heels striking the composite floor to a minimum. The lighting was dim but adequate. Passing through the outer double doors, she made certain the surgical lounge was empty. She knew that it was occasionally used during the evening, and that the night-shift staff used it to take breaks and catch some TV, even though officially it was off-limits. She moved on to the double doors to the OR suite itself and cracked them. Unfortunately, the hinges complained with a screeching noise, making Samira cringe. She could feel her heart throbbing in her chest and could hear it in her ears. After pausing for a few seconds to check for any kind of response to the sound of the doors, Samira stepped into the operating suite itself. When the same screech occurred as the door closed, she cringed again. But the earlier tomblike silence immediately descended like a heavy blanket.

Samira was eager to get this portion of the task over with. She could now feel perspiration on her face despite the OR’s being over-air-conditioned. She was not fond of feeling anxious, and because of the long-term duplicitous life she’d led as a teenager with her parents, she’d felt it all too often.

Once in the OR and confident she was alone, Samira made quick work of getting the syringe full of succinylcholine. The only potential problem was that in her haste she nearly dropped the glass bottle containing the paralyzing drug. If it had broken, hitting against the hard floor, it would have been a calamity, since she would have hesitated cleaning it up. Each sliver of glass would have been the equivalent of a curare poison dart in the jungles of Peru. It wasn’t lost on her how ironic it would be if she’d end up being found dead in the OR in the morning.

It was with great relief that Samira retraced her steps back to the stairwell. With this portion of the assignment out of the way, she thought she was home free, but little did she know.

Descending two floors, she checked the time. It was a tad past eight. Her only concern at that point was Mrs. Benfatti, whom she had met that afternoon. Would she still be visiting? On the positive side, it was the night of Herbert Benfatti’s surgery, and the chances were he was still feeling the results of the anesthesia, meaning he’d probably be seriously sleepy or sleeping. The only way to find out was to check.

Opening the third-floor stairway door, Samira glanced up and down the corridor. Two nurses could be seen in the brightly lit nurses’ station, which meant the other two were either off in patient rooms or taking a break. There was no way Samira could know.

With her anxieties again mounting, she told herself it was now or never. Taking a deep breath, she stepped out into the hall and headed toward Mr. Benfatti’s room. All went well until she arrived at the man’s door, which was open about six inches. Eager at that point to get the whole thing over with, Samira raised her hand to knock when she found her hand poised in midair. To her utter shock, the door had been pulled away the instant Samira had expected to make contact with its surface. Reflexively, Samira let out a yelp of surprise as she was unexpectedly confronted by one of the evening nurses, whom Samira knew only by her first name. It was the remarkably obese and brusque Charu, and she completely filled the doorway.

In contrast to Samira’s reaction of surprise, Charu acted irritated that someone was in her way. She looked Samira up and down as if evaluating her and said, in not too friendly a manner, “What are you doing here? You work days.”

Charu and Samira knew each other only from nurses’ report during the shift change when the day nurses communicated to the evening nurses each patient’s status and specific needs.

“I just wanted to check on my patient,” Samira said, her voice more hesitant than she would have preferred. “I’ve been in the library studying up on knee-replacement surgery.”

“Really?” Charu questioned, with a tone that suggested doubt.

“Really,” Samira echoed, trying to sound forceful.

Charu eyed Samira with a look of disbelief but didn’t voice it. Instead, she added, “Mrs. Benfatti is visiting.”

“Will she be leaving soon? I wanted to ask Mr. Benfatti a few questions about symptoms.”

Charu merely shrugged before pushing past Samira.

Samira watched her as she headed in the direction of the desk. Samira was in a quandary about what to do. She couldn’t hang around the floor waiting for Mrs. Benfatti to leave, yet if she returned to the library, she wouldn’t know when the wife departed. On top of that, she wondered if running into Charu meant she should abort the effort altogether. Of course, the trouble with doing that was that it might be a week before she had another American patient with some kind of history of heart trouble who would make an appropriate target. By then the benefits of competing with Veena probably wouldn’t accrue.

Samira was still debating the issue when she was surprised yet again. This time it was Mrs. Lucinda Benfatti, who was a moderately tall, heavyset woman in her mid-fifties with tightly permed hair. Having met Samira that day, she recognized her immediately. “My word, you do put in a long day.”

“Sometimes,” Samira stammered. Her mission during which she was to avoid being seen was devolving into a bad joke.

“What time do you work until?”

“It varies,” Samira lied. “But I’ll be heading home shortly. How is the patient doing? I wanted to stop by and check.”

“Well, aren’t you a dear! He’s doing reasonably well, but he’s not good with pain, and he’s having a lot of pain. The nurse who was just in here gave him an additional pain shot. I hope it works. Why don’t you go in and say hello. I’m sure he’d be glad to see you.”

“I’m not sure that’s appropriate, since he just had a pain shot. I don’t want to bother him.”

“It’ll be no bother. Come on!” Mrs. Benfatti took Samira by the elbow and walked her into her husband’s room. The lights had been dimmed, but the overall level of illumination was reasonably bright, since the large, flat-screen TV was on and tuned to the BBC. Mr. Benfatti was propped up in a semi-recumbent position. His left leg was encased in a device that was slowly but constantly flexing the knee joint thirty degrees several times a minute.

“Herbert, dear,” Mrs. Benfatti called out over the sound of the TV. “Look who’s here.”

Mr. Benfatti lowered the TV’s volume with the remote and looked over at Samira. He recognized her and, like his wife, commented on the impressive length of Samira’s workday.

Before Samira could comment, Mrs. Benfatti intervened. “I don’t know about the rest of you people, but I’m exhausted. I’m going back to the hotel and collapse. Good night again, dear,” she said, kissing Herbert’s broad forehead. “Hope you sleep well.”

Mr. Benfatti’s right hand waved weakly. His left hand, with the IV going into his arm remained perfectly still. Mrs. Benfatti said good-bye to Samira and departed.

Samira found herself in an awkward predicament. She wasn’t interested in getting into a conversation with the man if she was going to go through with her plan, yet she couldn’t just stand there. Plus, having run into Mrs. Benfatti, was there more reason to cancel? The only thing that was for certain was what she’d thought was going to be so simple was turning out to be anything but. Unable to make up her mind, Samira just dumbly remained rooted to her spot.

Mr. Benfatti waited for a moment before inquiring: “Is there something I can do for you, like run down to the kitchen and rustle you up a snack?” He chucked briefly at his own attempt at humor.

“How is your knee feeling?” Samira questioned, while she tried to organize her thoughts.

“Oh, great,” Mr. Benfatti scoffed. “I’m ready to go for a jog.”

Unconsciously, Samira’s hand slipped into her pocket, and her fingers encountered the full syringe. With a start, she was reminded why she was there.

While Mr. Benfatti carried on about the details of the pain he’d been suffering, Samira struggled with what to do. Recognizing there was no rational way to make a decision short of the crystal ball she didn’t have, she opted for the more simple choice of acknowledging her impetuosity and just proceeding as planned. The deciding factor was the realization that Mr. Benfatti would not be discovered for hours maybe, since his wife had just left and the nurse had just given him a shot. What that meant was that Samira would have lots of time to be far from the scene when he was discovered. She pulled the syringe from its hiding place. Using her teeth to remove the needle cap, she reached for the IV port below the millepore filter.

Mr. Benfatti had seen Samira suddenly approach the bed, had caught sight of the syringe, and had stopped his diatribe about pain. “What’s this?” he questioned. When Samira ignored him and raised the needle up to the IV port to inject, he reached out with his right hand and grasped Samira’s right wrist. In the next instant, their eyes locked. “What am I getting?”

“It’s something for your pain,” Samira nervously improvised. The fact that Mr. Benfatti was holding her terrorized her. For a second, she irrationally worried that what she was about to give Mr. Benfatti would pass into her from the contact.

“I just got a pain shot two seconds ago. Isn’t this overdoing it?”

“The doctor ordered another. This is more, to get you to sleep longer.”

“Really?”

“Really,” Samira repeated, reminding her of the unpleasant conversation she’d just had with Charu. She looked down at Mr. Benfatti tightly gripping her wrist. The man was strong, and although she wasn’t yet experiencing pain, it was close. He was restricting her blood flow.

“Is the doctor here?”

“No, he’s gone for the day. He called this in.”

Mr. Benfatti maintained his grip for several more seconds and then suddenly released it.

Samira let out a silent sigh of relief. The very tips of her fingers had begun to tingle. Without wasting another moment, she struggled to get the needle inside the port, being especially careful in her haste not to prick herself. With succinylcholine, even a small amount could create problems. Without delay, Samira emptied the syringe. A second later a cry began to issue from Mr. Benfatti’s lips, causing Samira to clamp a free hand over the man’s mouth.

Mr. Benfatti responded by reaching for the nurses’ call button clasped to the edge of his pillow, but Samira was able to yank it out of reach with the hand holding the syringe. Almost immediately, she felt the resistance she’d had against her hand cupped over the man’s mouth melt away. Taking her hand away, Samira noticed a kind of wriggling under the man’s skin, as if suddenly his face had been infiltrated by worms. At the same time, his arms and even his free leg began to briefly and uncontrollably jerk. The next second, the twitching stopped. In its place was a darkening of his skin that was particularly apparent due to the white light from the TV. It had started slowly, then picked up speed until all of Mr. Benfatti’s exposed skin was an ominous dark purple.

Although Samira had purposely avoided looking into the man’s eyes while he’d gone through his rapid death throes, she did now. The lids were only half open and the pupils blank. Backing up toward the door, Samira collided with a chair and grabbed it to keep it from falling over. The last thing she wanted was for someone to appear, questioning a crashing noise. Taking one last look at Benfatti from the doorway, Samira was momentarily hypnotized by the fact that the man’s leg was still rhythmically being mechanically flexed and extended as if he were still alive.

Turning around, Samira fled from the room but then forced herself to slow to a walk by sheer will to keep from attracting attention. Maintaining her eye on the nurses’ station, where she could see all four nurses, Samira made her way to the stairwell. Only when she was inside did she allow herself to breathe, surprised that she’d been holding her breath. She’d been totally unaware.

After picking up the books and turning out the light in the library, Samira descended to the lobby floor. She appreciated that the lobby was empty and appreciated even more that the doormen had gone off duty. Out on the street Samira caught an auto rickshaw, and as they pulled away, she glanced back at the Queen Victoria Hospital. It looked dark, shadowy, and, most important, quiet.

During the ride home, Samira felt progressively better at what she had accomplished, and the fear, anxiety, and indecision she had experienced rapidly faded into the background. As the auto rickshaw reached the bungalow’s driveway, it seemed to her that such problems were mere blips on the radar screen.

“I have to leave you here,” the driver said in Hindi, as he pulled to a halt.

“I don’t want to get out here. Take me up to the door!”

The driver’s eyes nervously flashed in the darkness as he looked back at Samira. He was clearly afraid. “But the owner of such a house will be angry, and he might call the police and the police will demand money.”

“I live here,” Samira snapped, followed by choice Internet-learned expletives. “If you don’t take me, you won’t be paid.”

“I chose not to be paid. The police will demand ten times as much.”

With a few more appropriate words, Samira climbed from the three-wheeled scooter, and without looking back started hiking down the drive. In the background she heard a burst of equivalent profanity before the auto rickshaw noisily powered off into the night. As she walked, Samira mulled over how she was going to describe her experience taking care of the American. It didn’t take her but a moment to decide to leave out the minor concerns and concentrate on the success: Mr. Benfatti had been taken care of. That was the important thing. She surely wasn’t going to complain like Veena had.

Entering the house, she found everyone, all four officers and all eleven other nurses, in the formal living room watching an old DVD called Animal House. The moment she walked into the room, Cal paused the movie. Everyone looked at her expectantly.

“Well?” Cal questioned. Samira was enjoying teasing the group. She’d taken an apple and sat down as if to watch the movie without providing a report.

“Well what?” Samira questioned, extending the ploy.

“Don’t make us beg!” Durell threatened.

“Oh, you must mean what happened to Mr. Benfatti.”

“Samira,” Durell playfully warned.

“Everything went fine, exactly as you all suggested it would, but then again, I didn’t expect anything different.”

“You weren’t scared?” Raj asked. “Veena said she was scared.” Raj was the only male nurse. Despite his bodybuilder appearance, his voice was soft, almost feminine.

“Not in the slightest,” Samira said, although while she spoke she remembered how she’d felt when Benfatti was gripping her arm hard enough to hinder the blood flow.

“Raj has volunteered for tomorrow night,” Cal explained. “He’s got a perfect patient scheduled for surgery in the morning.”

Samira turned to him. He was a handsome man. In the evenings he wore his tie shirts a size too small to emphasize his impressive physique. “Don’t worry. You’ll do fine,” Samira assured him. “The succinylcholine works literally in seconds.”

“Veena said her patient’s face twitched all over the place,” Raj commented with a concerned expression. “She said it was horrid.”

“There were some fasciculations, but they were over practically before they began.”

“Veena said her patient turned purple.”

“That did happen, but you shouldn’t be standing around admiring your handiwork.”

Some of the nurses laughed. Cal, Petra, and Santana stayed serious.

“What about Benfatti’s computerized medical record?” Santana asked. Since Samira hadn’t yet mentioned it, Santana was afraid she’d forgotten. She needed the history to make the story more personal for TV.

By leaning back against the couch and straightening her body out, Samira was able to reach into her pocket and pull out the USB storage device, similar to the one Veena had provided Cal with the evening before. She then flipped it in Santana’s direction.

Santana snatched the storage device out of the air like a hockey goalie, hefted it as if she could tell whether or not it contained the data, then stood up. “I want to get this story filed with CNN. I’ve already given them a teaser about it, and they are waiting anxiously. My contact assures me it’s going right out on the air.” While the people who had been sitting next to her on the couch raised their legs, Santana worked her way from behind the coffee table and started for her office.

“I do have one suggestion,” Samira offered after Santana had departed. “I think we should get our own succinylcholine. Sneaking into the OR is the weakest link in the plan. It’s the only place in the hospital where we don’t belong, and if any of us were to be discovered, there would be no way for us to explain.”

“How easy would it be for us to get the drug?” Durell asked.

“With money, it’s easy to get any drug in India,” Samira said.

“It sounds like a no-brainer to me,” Petra said to Cal.

Cal nodded in agreement and looked over at Durell. “See what you can do!”

“No problem,” Durell said.

Cal couldn’t have been more pleased. The new strategy was working, and everyone was on board, even offering suggestions. He couldn’t help thinking that starting the scheme with Veena had been brilliant, despite the suicide scare. Just a few days before, he’d been afraid to talk with Raymond Housman, but now Cal couldn’t wait. Nurses International was beginning to pay off, which he couldn’t have been more pleased about, even if it wasn’t in the way he’d expected. But who cared, Cal thought. It was the results that counted, not the method.

“Hey, who wants to see more of the movie?” Cal called out, waving the remote above his head.