Mortal Remains

Chapter 13

Later that same afternoon, Wednesday, November, 21,

2:15 P.M.

The Plaza Hotel

Earl slammed back in the leather seat as Tommy accelerated away from the snarled traffic of Madison Avenue and headed east on Sixty-second Street. He caught the green at Park, only to hit the brakes for a red at Lexington. “I know what you’re thinking, Earl. Kind of a waste, my driving a Jag in New York. All that power, and I only get to make like it’s a drag strip a block at a time.”

“Uh-huh,” Earl said. He wasn’t one to get carsick, but neither did he appreciate having his stomach sloshed against his spine, then slung forward against the lap strap of his seat belt. “If you don’t want me to upchuck on your calfskin interiors or polished mahogany dash, you better slow down.” He tried looking at the horizon, but had to settle on a restricted view of the elevated FDR Drive and a glimpse of the East River beyond. It didn’t help much. And the brilliance of the sky, a bleached polar blue, made his eyes hurt.

Tommy looked at him askance. “You’re, kidding right?”

“Uh-huh.”

He looked relieved. “But don’t you just love the sound of that motor?”

Insecure Tommy, still needing everyone’s approval. Earl swallowed hard to keep his lunch down.

The last thing he wanted was to go beer drinking with Leannis. It wasn’t just the prospect of listening to the man’s bravado and usual litany of worries that deterred him. After having worked the phones for the past few hours talking to more of the former students, interns, and residents who were involved with the digoxin toxicity cases, yet finding zilch, he’d nearly run out of reasons to remain in New York at all. Maybe he should go up to Hampton Junction and help out with the legwork. Unfortunately, the locals there probably wouldn’t talk any more frankly to an outsider than the physicians here would have opened up to Mark.

The idea of squeezing out of this whole grungy mess for a few days to spend Thanksgiving with Janet and Brendan instantly became irresistible. He’d try to get a reservation as soon as he got free of Tommy, then tell Mark he could be back in a heartbeat, if needed.

He wouldn’t even have had to be stuck with Tommy if he’d been quick enough when the call came through.

“Hey, Earl. Can I buy you a beer?” Leannis had said as soon as Earl picked up the phone.

He’d sounded pretty happy for the prince of worry. “Tommy?”

“Yeah, I know an Irish joint that’s about a five-minute drive from those pretentious digs you’re in. I’ll pick you up outside the hotel.”

“Hey, no! I’m waiting for a callback-”

He’d already hung up.

Tommy had never once initiated the two of them going out for a beer together their whole time in med school. Nor had he looked up Earl since then. The guy was after something. Stuck at an unseemly long traffic light, Earl decided he might as well make him get to the point.

“So what did you want to talk about?”

“I figure I needed to warn you.”

“About what.”

Another sprint start sent them roaring toward Second Avenue. “A strange conversation I had with Melanie this morning. She got me in her office, all worried about you and Kelly.”

Something that had nothing to do with Tommy’s driving tightened in Earl’s gut.

“Oh?”

“Yeah. Apparently you two had a conversation last night. She found it suspicious that you never asked who she thought Kelly’s lover was.”

Earl’s every instinct went on alert. “Kelly’s lover?” He tried to sound curious, but not overly so.

Tommy gave him a sideways look as he rocketed through the next intersection. “Hey, Earl, come on. Don’t play dumb. Melanie said she already told that snoop Roper that Kelly had the look of a woman in love. Naturally, she found it strange you never asked about it, since Roper must have made it part of the investigation you’re helping him with. So now she’s thinking maybe the lover was you.”

Shit! Earl felt a cold sweat percolate on his back. He could kick himself for having made such an obvious omission. The only response he could think of was to act incredulous. “What? You’re kidding me.”

“Nope, and I figured you ought to know she’s already making noises about reporting you.”

“Oh, my God, that’s ridiculous. I didn’t ask what she knew about Kelly’s love life because I figured Melanie would have told me anything of importance without me having to dig for it.”

“Hey, buddy, you don’t have to convince me. One way or the other, my lips are sealed. As I said, I figured forewarned is forearmed.”

Earl’s mind raced. Every emotion he could come up with that seemed appropriate for a guy wrongfully accused – astonishment, indignation, disbelief – he threw into his performance. “I’m calling her right now, and putting an end to this nonsense. Why, if a rumor like that got started…” He trailed off, digging out his cell phone, checking for her number in its memory, and punching ENTER. Let Tommy believe him, he prayed. And for Christ’s sake, let Melanie believe him.

“Hey! She’ll know I told you,” Tommy protested.

“I can’t just let her think-” Her answering machine interrupted, ordering him to leave a message at the sound of the beep. “Melanie, it’s Earl. We got to talk. There’s been a terrible misunderstanding, and I might have given you a very wrong impression. Please call me as soon as possible. It’s urgent.”

Tommy lurched the car left onto York Avenue.

Earl’s stomach seemed to keep on going toward the river. “Jesus, Tommy, do you have to beat every car at every light-”

“Don’t you be tellin’ Melanie I warned you. But if you explain to her like you did to me – it sounded pretty good, that part how you thought she’d tell you anything important about Kelly’s love life without your asking – she just might buy it.”

Damn, Tommy doesn’t believe me either. “Look, there’s nothing to buy, Tommy. Kelly and I were just friends.”

“Well, then, all’s the more the pity, because our dear Kelly deserved a good man to love her before she died.”

Earl snapped another sideways glance at the well-coiffed man, to see if he was being serious.

His lips were pressed into a thin red line.

“She had it rough all right,” Earl said, the only admission he felt ready to make.

When they hit Tommy’s watering hole, the patrons greeted him by name and the staff gave them attentive service. Earl nursed a nice Irish red ale and made small talk, all the time willing Melanie to call. His drink, cool and pleasant to the taste, seemed to rile his stomach and set it churning again. Nerves, he thought.

3:30 P.M.

Hampton Junction

“They fired you?”

Victor Feldt nodded, face crimson and lips trembling under his magnificent mustache. He sat on the edge of the chair across the desk from Mark, his huge frame hunched over, his beefy hands clasped together and working each other with the steadiness of a beating heart.

“But that’s outrageous!” Mark got out of his usual chair and took the one beside Victor. “Why?” he asked.

Victor shook his head, pulled his mouth into a grimace, and swallowed a few times. His eyes glistened.

Mark let him compose himself.

“The reason they gave was that I showed unauthorized people around the lab,” he said eventually.

“What?”

The big man shook his head again. “I’ve taken visitors on tours since day one. ‘Good PR,’ my director always said. To pull this now, I don’t get it.”

“But they can’t do that. We’ll get you a lawyer, sue them for unlawful dismissal-”

“It’s no good. The rules are clear. They just never enforced them before.”

“So why now? Who’d you show the place to that got them so upset?”

“Do you really want to know?”

“Of course.”

“Try you and Lucy O’Connor.”

He couldn’t have heard right. “Pardon?”

But Victor grimaced, held his palms skyward, and gave a huge shrug.

“You’re not serious.”

“I’m afraid I am.”

“Jesus Christ!”

“That’s what my director said. He’s as flabbergasted as I am.”

“There’s got to be some mistake.”

“Oh, there’s no mistake. They stipulated my alleged violation of lab security occurred between the hours of six and seven last night.”

“Wait a minute. Let me go to your boss. I’ll explain to him-”

“Won’t do any good. My own boss was apologetic as hell. The order to can me came from the head office in New York.”

“But how did anyone there even know about our visit?”

“That’s what I can’t figure out. I mean, security’s extra tight these days. But this doesn’t figure. It’s overkill.”

“Did the people in New York know you were showing two doctors through the lab?”

“I don’t know. But my director did. When he got the order, he looked at the surveillance tapes and saw it was you, then figured the woman was one of your students. He even called New York on my behalf, arguing that you were the local GP and no more a security threat than he was. They weren’t interested, and told him that unauthorized personnel were unauthorized personnel.”

“But orders from New York to fire you because you showed me around. Why would somebody in the head office of a high-powered lab be so skittish?”

“Beats me.”

Still dismayed, Mark began to think the worst. “Who owns Nucleus Laboratories?”

“A numbered company. You know how it works these days – nameless corporations within corporations.”

“Could you find out who’s at the top?”

“With all I know about their records? Give me a day. But what good will it do?”

“Just get me a name. I might be wrong, but this may have more to do with me than you. If that’s the case, and I can prove it, we could get your job back.”

Victor frowned “What do you mean?”

“Sorry, I can’t tell you any more right now. But do this for me, and if a hunch I have plays out, chances are Nucleus Laboratories won’t be causing either of us any more trouble.”

“Us?”

“Yeah! Us. Hey, without you managing the place, how am I going to get my blood tests done?”

Victor studied him a few seconds, then the apprehension in his expression dissipated. “It’s a deal, Doc. And thanks.”

“As I said, you’ve done me and everyone in my practice a big favor for years. It’s I who thanks you.”

For a few seconds the rest of the man’s flushed expression gave way to a hint of a smile, but couldn’t quite deliver all of it. “Just don’t tell anyone I’m doing it for you,” he said, getting to his feet and shaking Mark’s hand. “Not anyone. They find out I’m hacking into their business files, I’ll be blackballed from working in the industry ever again-”

A knock on the door interrupted him, and Lucy poked her head in. “Oh, hi, Victor, I thought I heard your voice. Wondered if you wanted to drop over for dinner later.”

“Oh, I couldn’t-”

“Come on. I’ve had a fresh vegetable soup on a low heat all day that’s a stew by now, so join us.”

Victor looked at Mark as if for permission to cross the line that separates patients from doctors.

“Absolutely, Victor,” Mark said, unable to think of any better medicine for the man than good company and a fine meal. “Please come.”

“Why, thank you.”

“Shall we say seven?” she asked.

“Yes, seven would be perfect.”

Mark saw the hint of a smile beneath the mustache.

“Lucy, you gave that guy exactly what the doctor ordered,” he told her, after Victor had left.

“What?”

“I’ll explain later.”

4:30 P.M.

Mark and Lucy finished early with the afternoon’s patients and took a short run together.

“You’re in as good shape as I am,” he said to her, as they started the uphill portion of his route.

She sprinted ahead and grinned at him over her shoulder. “The question is, are you in as good shape as me?”

Afterward they shared a pot of tea in his kitchen.

She sat curled up in a large rocking chair, holding her cup with both hands. “You could be right,” she said, having listened to him explain his theory why Victor might have been fired.

Behind her the large cast-iron woodstove that had been the centerpiece of the room in both his mother’s and aunt Margaret’s day crackled with burning maple. It filled the room with a warmth that was far cozier than the baseboard heaters could provide, but Mark had hardly ever bothered to fire it up. Lucy, however, as soon as she learned it was functional, had sent him out to retrieve an armload of logs off the woodpile while she chopped up some kindling.

The sounds transported Mark back to a time when his home was a happy place, but the memories also carried the dull aching reminder of parents and childhood prematurely lost. Which was why he’d shunned stove fires in the past.

Yet this evening was different. Lucy’s company mollified his usual discomfort with remembrance. How pleasant it felt at the end of the day to have someone with whom he could discuss the little victories. And the problems.

“Obviously I’m making someone nervous,” Mark said, “Nucleus Laboratories must be a business interest connected to Chaz Braden. Why else would our visit bring down such a heavy-handed response?”

She scrunched up her face into a show of skepticism, making her look as if she were staring into a harsh light. “But how could your investigation of a murder twenty-seven years ago have any connection with a lab built in 1996?”

He shrugged, unable to give her an answer. “I just feel it in my bones. Chaz’s name will be among the business interests running the place, I’m sure of it. What the tie-in might be to Kelly, I’ll have to figure that out later.”

“What if you’re wrong, and there is no evidence that Chaz is involved? Or even if his name does appear somewhere in the hierarchy of the place, it doesn’t prove anything is wrong. Lots of doctors have business interests in private labs.”

“Then Victor’s getting fired would be one big coincidence. Don’t tell me you believe that.”

“No, not really. I’m saying there may be another reason.”

“Such as?” he asked, waiting for her to continue. Then he figured he knew what she must be going to say. Earlier he’d told her of Earl’s astonishing revelation about Samantha and Walter McShane. “Okay, I have to admit, if the McShanes turned out to own a piece of Nucleus Laboratories – and they do have extensive business interests, if the Wall Street Journal’s to be believed – it might be her we’re after. But why our visit would make either of them fire Victor is even more unimaginable than it is for Chaz. Besides, there’s something that doesn’t fit about the idea of Samantha killing Kelly. There should have been a different dynamic involved.”

“How do you mean?”

“It didn’t sit right when Dr. Garnet suggested it, and now I remember why.” Earl’s testiness when Mark hadn’t embraced the idea outright also didn’t sit well, but he kept that irritation to himself. Someday soon, however, he intended to point out that as coroner on the case, he outranked chiefs of ER from Buffalo. “During my psychiatry rotation at NYCH, we saw court tapes of women on trial for killing their children in what were believed to be Munchausen by proxy syndromes. Now Samantha didn’t really fit that profile, but as Earl said, the dynamic of her playing a noble, self-sacrificing victim was similar. Well, here’s something else she might be kindred in. Each one of those women had accepted her sentence with eerie equanimity, all the while protesting her innocence, as if her incarceration were simply another hardship to endure as part of being a long-suffering mother. If we’re right about Samantha, she could have reacted that way, too, might even have reveled in standing accused by her daughter. It would have given her a chance at an ultimate performance, in court, before the cameras, playing the victim role of a lifetime – mother unjustly charged of terrible wrongdoings by the very child she’d so self-sacrificingly nursed through one mysterious illness after another. It’s unlikely that she would have given up such an opportunity, let alone killed to avoid it.”

Lucy took a sip of tea and stared across the top of her mug, appearing to digest what he’d said. After a few seconds she looked over at him. “Interesting, but did you ever think it might not be your investigation of Kelly’s murder that’s got whoever runs that lab so upset, but something else?”

That surprised him. “Something else?” Her open expression and glittering brown eyes were so lovely and vulnerable, he found them distracting. “Okay, what am I missing?”

She swallowed, seeming uncertain whether to speak, and curled her legs more tightly under her.

“Lucy?”

Her gaze drifted off him and wandered the room. “Something I’ve been mulling over, but didn’t want to tell you until I could be sure what it meant. I can’t even say now how it fits in with either Kelly or the lab.” She again fell silent.

For the two days he’d known her, this self-assured young woman hadn’t betrayed the slightest trace of indecision in her work. Yet here she was, hesitant to speak up. “Go on,” he said, his curiosity growing about what could fluster her so.

“Well, it’s personal, so bear with me-”

Mark’s home phone began to ring, interrupting her.

He took the call on a wall-mounted extension near the back door of the kitchen. “Roper.”

“Mark, this is Charles Braden calling.”

He felt as if a bomb had exploded in his ear. “Ah, yes, Dr. Braden.”

Lucy’s eyes widened into a you’ve-got-to-be-kidding-me look.

He gestured her to join him in listening. “What can I do for you, sir?”

She huddled at his side, their ears sharing the receiver

“Well, you can not call me ‘sir’ for starters. Makes me feel ancient.”

“Of course, sir – Dr. Braden.”

“Call me Charles. I’d like that. Gives me the illusion of being closer to your generation than my own.” He finished with a jovial chuckle.

“Give me a break,” Lucy muttered, her eyes shooting skyward in disbelief.

Mark nudged her to keep quiet. “So what can I do for you, Charles?”

“You know how word travels fast in our little community. I hear you’ve got a very attractive houseguest staying with you. Why not drop around for drinks tomorrow night, and bring her along. This sad business with Kelly has reminded me how out of touch we’ve grown. Your father was a regular guest in our home.”

Lucy rolled her eyes again.

“Yes, sir, I mean, Charles. Those were certainly memorable parts of my boyhood.” He had to avoid looking at Lucy for fear he’d burst out laughing. “I’d love to drop over.”

“Excellent. Shall we say around five?”

“Perfect.”

They hung up, and Mark whistled.

“Talk about being invited into the lion’s den,” Lucy said, walking out of the kitchen.

“Where are you going?”

“Into Saratoga, to buy a dress.”

“Do you want me to go with you?”

She turned back, her mouth cocked in a sly grin. “There are some things, my dear Mark, that a woman does alone.” Pulling on her coat and shouldering her purse, she disappeared out the front door.

Mark stood looking after her. Whatever Lucy had been on the verge of saying before the phone call, she obviously thought it could wait.

Thursday, November 22, 3:30 A.M.

The Plaza Hotel, New York City

At first Earl wasn’t sure what woke him.

Then the pain cut across his abdomen and doubled him in two.

“Jesus Christ!” He moaned, writhing in a ball.

His insides had been churning all evening. Once in bed, he’d tossed for a few more hours trying to fall asleep.

No way this could be from stress.

The cramps came in waves, hitting him like body blows. They were so closely spaced together that the pain from one hadn’t released its grip before the next struck.

He got off the bed and tried to make it to the bathroom, but fell to the floor.

Again and again and again the spasms struck, leaving him drenched in cold sweat and biting his lips to keep from screaming.

He’d had his share of “tourista,” especially during conferences to faraway places, but never experienced anything like this. Must have picked it up at one of the fast-food joints he’d been eating at these last few days. The most likely cause would be Campylobacter from undercooked chicken or beef, he reasoned during a few seconds pause in his symptoms. If he could just buy some Cipro – damn! It was Thanksgiving, and most pharmacies would be closed. No matter. He’d get Melanie to get him some from the hospital, providing he could reach her. Then maybe he could still make the trip home, though the idea of being stuck on the can for the whole flight – “Oh, my God!” he muttered, a new onslaught sending him rolling on the floor again.

This time it felt as if someone were twist-tying his intestines and dragging them through hot coals.

By 5:00 A.M. he relented and called 911, requesting they take him to ER at New York City Hospital.

The ambulance attendants tried strapping him down to the stretcher for the trip. He ended up breaking free and taking the ride coiled in a ball on the floor of the vehicle, threatening lawsuits, decertification, and free vasectomies with a dull scalpel on any man who touched him.

In ER his ordeal got worse.

“We can’t give you anything for pain until the surgical resident examines your abdomen,” said a young trainee in a short white coat who had to be the most junior student on the ER food chain. Christ, peach fuzz covered his cheeks.

“I’m Earl Garnet, Chief of Emergency Medicine at St. Paul’s Hospital in Buffalo. Get me your staff person, or give me Demerol, damm it! And for your future edification, a surgical abdomen doesn’t present as cramps.”

The boy looked unimpressed. “Does this hurt?” he asked, palpating deep into his lower right side, then abruptly lifting off.

Nurses started IVs.

A clerk wrote down his mother’s maiden name.

Someone took custody of his wallet; someone else drained a dozen tubes of blood from his arm.

“You haven’t got a fever, and your pressure’s fine,” a nurse reassured him.

The surgical resident came, prodded his stomach a few times, then went off to consult with his staffman.

Still no one gave him Demerol.

“Not before the surgeon himself sees you.” It became a reoccurring chorus.

“And where’s the surgeon?”

“In the OR.”

Where else?

He flagged another passing nurse, easily catching her attention as they’d parked him in the middle of a busy main corridor. Sporting tousled brown hair and covered in freckles, she could have been the kid sister of the lowly resident who checked him in, until she turned and he saw the triple silver rings piercing her eyebrow. He thought of J.C. in his own department, and felt oddly reassured. “I want to speak with the doctor in charge,” he demanded for the second time since his arrival.

“He’s managing victims from a bus accident,” she called without breaking stride.

“Then phone Melanie Collins.”

This got her to pause. “The Chief of Internal Medicine? I don’t think so.”

The fiery vengeance in his stomach shot to a new level, and he let out a loud groan, curling into a ball again. “Call her, please!” he managed to gasp between clenched teeth a few seconds later, his skin once more soaked with perspiration. “I’m a friend. Say that I need her help now!”

Whether his appearance, his use of “please,” or his claim of being a personal acquaintance to an important doctor convinced her, he couldn’t tell. She nevertheless walked to the nearest phone and made a call. She spoke a few words into the receiver, then stopped, a dumbfounded expression slowly spreading across her face like a connect-the-dot drawing.

“Dr. Collins will be right in,” she told him with newfound respect.

“Thank you,” he said, and forced a grin that must have made him resemble the grim reaper.

Twenty minutes later Melanie arrived at his bedside flanked by peach-fuzz and the ring-wraith. An additional bevy of students, interns, and residents formed a semicircle around them.

“Earl, I’m so sorry,” she said, patting his shoulder.

“Me too. I didn’t mean to haul you in here-”

“Don’t think anything of it.” She gave a thousand-watt smile and turned to her following. “Now, gang, let’s give our distinguished guest a show of how to do it right. What’s the presentation here?”

“Abdominal pain, crampy, generalized, and acute onset,” peach-fuzz called out.

“Any vomiting or diarrhea?”

“No, ma’am.”

“Vitals?”

“No fever, normal BP, but pulse is 120.”

“Yours would be fast too, if you had the kind of pain that I know it would take to bring this man into ER. Any abdominal findings on exam?”

“Abdomen’s soft, no rebound, no masses, no bruit, but increased bowel sounds.”

“Urine?”

“Normal.”

“Rectal?”

“Negative.”

“You checked for occult blood?”

“None.”

“So what’s your thinking?”

“Well, first off I’d consider this to be pain from a hollow organ rather than a solid structure, given its colicky nature-”

“I don’t want to reread the entire text on abdominal pain, so let’s bypass the general stuff and pinpoint the most likely possibilities. Yes it’s colicky, and originates from something hollow. But the lack of nausea and there being no focal, right-upper-quadrant tenderness means we don’t even have to think gallbladder, and with a normal urine, it isn’t renal. Any history of hypertension, Earl?”

He shook his head no, wishing she hadn’t chosen him to grandstand on. But he was imminently grateful to her for coming in and getting things going, and if he had to endure a few minutes of being a teaching specimen, so be it. Besides, it wasn’t entirely a waste. The latest rage in teaching hospitals was for the teachers to take a turn on the other side of the white coat. He’d let the residents know he’d had his, thank you very much, when he got back to Buffalo.

“So, his lack of risk factors, along with the absence of a pulsatile mass, means an aortic aneurysm is unlikely,” she continued. “The patient being male, what’s left that’s hollow?”

“GI!” responded a bearded man at the back.

“Sold!” Earl said, figuring it was time to wrap up the bidding on his diagnosis.

But Melanie hadn’t finished putting on her show. “Right. And since there’s no vomiting, we can assume the problem doesn’t lie in the upper gastrointestinal tract, which leaves us with?”

“Lower,” her audience said in unison.

Get on with it, Earl nearly told her, his innards clamping down on themselves again.

“Now I know this thought process sounds oversimplistic, but it’s what should have zipped through your heads in the first few seconds you saw this patient, and everyone’s focus ought to have been on the lower GI for a nonsurgical problem from the get-go. Okay, what’s the differential? But this time start with the most probable. Don’t bother me with stuff about tumors, obstruction, ischemia, or chronic things like inflammatory bowel disease. And for God’s sake don’t begin with rare genetic disorders like porphyria. I hate having to look up those damn metabolic pathways.”

A collective chuckle came from the group.

“Enteritis, colitis, or both,” one of the young men said.

“Very good. The probable cause?”

“Viral or bacterial contamination from food,” he replied.

“Which bacteria?”

“Campylobacter jejuni, salmonella, shigella.”

“Treatment?”

“Hydration, electrolyte management, particularly potassium replacement, Cipro, and painkillers!” He spoke with the certainty of someone on a roll.

Yes! Earl wanted to yell out. You can replace peach-fuzz as my doctor.

“Not so fast,” Melanie said. “Is there any danger in giving ciprofloxacin at this point?”

Oh, Melanie, he wanted to shout, surely old Earl Garnet didn’t have to be treated by the book. Come on, give the Cipro. As physician to physician. Cut corners.

The bearded resident seemed at a loss for words.

“Any reason to wait for stool culture results before treating?” Melanie prompted.

The man stroked his chin as if contemplating a chess move, then shrugged.

Melanie searched the crowd for any other takers. There were none. “Okay, here’s the teaching nugget of this case. The severity of Dr. Garnet’s pain plus an apparent delay in the onset of the inevitable diarrhea makes me think this might be an organism other than the more common ones you listed. With them, the diarrhea usually follows closely on the heels of the pain. But with some of the enterohemorrhagic E. coli, where toxins are the culprit, they need time to work, and there can be the sort of delay we see here. In other words, the agent infecting Dr. Garnet may be none other than E. coli 0157:H7, which can not only cause a hemorrhagic colitis, but in 10 percent of cases, introduce toxins which attack the kidneys to produce a hemolytic uremic syndrome. The latest evidence suggests antibiotics may actually increase the risk of complications, so we hold the Cipro.”

There wasn’t a round of applause, but the appreciative nods as her audience dispersed and returned to their various duties were as good a stamp of approval as a teacher could get for first-rate bedside teaching. Earl had to admit he’d not heard of the subtle nuance she was making, but it made sense, and her zeroing in on it impressed him,

“Hope you didn’t mind me putting you through that,” she said, while checking the IV bag flowing into his arm – normal saline with an added dose of potassium – “but I wanted to set them straight after the inexcusable delay they put you through.”

Be gracious, he told himself. “Hey, our residents are the same until we whip them into shape. You’ve nothing to apologize for, and thank you again for getting out of bed.” And since he had her attention: “Melanie, I’ve also been trying to call you to clear up a misunderstanding-”

“Now you just stay quiet, and I’ll have you comfortable in minutes.” She pulled a syringe out of her lab pocket, stuck it in the side portal of his IV line, and began to push in the plunger. “No allergies I take it?”

“None. What are you giving me. Demerol?”

“You, my friend, get the big M.”

“Morphine?”

She nodded.

But morphine, powerful analgesic that it was, doctors seldom used for acute abdominal pain in ER. It could obtund consciousness to the point of suppressing respiration and cause serious drops in blood pressure. Neither of which was a good thing where issues such as staying awake enough to keep breathing or avoiding aspiration of vomit or fighting a low blood pressure from dehydration were concerned. Of course there were exceptional cases, but he didn’t want to be one of them. “Listen, Melanie, I’m not that bad. Don’t give me special treatment – Whoa!”

The potent opiate affected him immediately, taking away not only his abdominal spasms but every ache and pain he had, physical or emotional. He felt his brain slip into a warm puddle, where it floated without a care in the world.

“I’ll make sure the nurses keep you well topped off,” said a voice from the other side of the universe.

Must be God talking. Sounded like his kind of woman, one who knew her business.