Night Rounds

Chapter 1

THE NIGHT NURSE, Siv Persson, had just stepped into the hallway when the lights went out. The street lamps outside spread a weak glow through the tall windows, but not enough to light up the hall. It appeared that only the hospital had lost power.

The nurse stopped short and spoke aloud into the darkness. “My flashlight!”

Hesitantly, she returned to the nurses’ station. With help from the streetlamps, she fumbled for the desk chair and sank down into it. She jumped, startled, when the respirator alarm went off in the small intensive-care unit. The sound was dampened by the solid double doors that isolated the unit, but the alarm still pierced the silence.

From her station she cast a practiced glance along the hallway and screamed. A dark shadow loomed in the door.

“It’s only me,” came the doctor’s exasperated voice. Nurse Persson jumped up from her chair. Without another word, the doctor rushed down the hallway to the ICU; the nurse followed him, using his fluttering white coat like a beacon in the dark.

Inside the ICU the sound was deafening.

“Marianne! Turn off the alarm!” the doctor shouted.

There was no answer from the ICU nurse who was supposed to be on duty.

“Siv. Find a flashlight.”

Nurse Siv said weakly, “I … forgot my flashlight when I was here helping Marianne turn Mr. Peterzén. It must be underneath the examination cart.”

“Go get it!”

She fumbled her way back toward the door. Her fingers rooted around in the darkness until they knocked against a hard plastic case. She pulled the case out and headed back in the direction of the doctor.

“Where are you?” she asked.

His hand on her arm made her jump. He grabbed the case from her.

“What’s this? The emergency kit? How can we use that when we can’t see?”

“Look inside. The bag-valve mask and a laryngoscope are in there,” she answered. “The laryngoscope is powered up, and you can use its light.”

The doctor muttered to himself as he opened the case. After some searching he found the lamp for guiding a breathing tube into the pharynx of anesthetized or unconscious patients. He clicked it open and shone the narrow beam of bright light toward the old man lying in the bed.

Now that they could orient themselves, Nurse Siv stepped toward the respirator by the bed and shut off the alarm. The silence echoed in their heads. They heard the sound of their own breathing.

“His heart’s stopped. Where is Marianne? Marianne!” the doctor shouted. He placed the ventilator mask over the patient’s nose and mouth. “Take care of his breathing while I do CPR,” he hissed through tight lips.

Siv began to pump air into the unmoving lungs. The doctor pressed down on the man’s breastbone, his palms rhythmically trying to stimulate the silent heart. They did not speak while they worked. The doctor took a minute to inject epinephrine directly into the heart muscle. It was no use. The heart would not resume beating. Finally they were forced to give up.

“It didn’t work, damn it. Where is Marianne? And why hasn’t the backup generator turned on?”

When the doctor flashed the light of the laryngoscope around the room, Nurse Siv glimpsed the examination cart. She stepped carefully toward it, her arm out stiffly, hip high. She moved her right hand along the top of the cart, over the examination instruments and plastic gloves. Finally she found the barrel of her flashlight and turned it on.

The beam of light struck the doctor right between the eyes, and he threw up his hands with a muffled curse.

“Uh … sorry,” Siv stammered. “I didn’t realize where you were.”

“Okay, okay. I’m just glad you found a working flashlight. Check out the floor. See if she’s here. Maybe she’s fainted.”

But the ICU nurse was not to be found anywhere in the small ICU.

The beam of the flashlight caught a phone, and the doctor strode to it and lifted the receiver. “Dead as a doornail.” After thinking a moment, he said, “My cell phone is in the on-call apartment. Let me take the flashlight up there to call emergency services. Then I’ll start searching for Marianne. You didn’t see her go past your station, did you?”

“No. I haven’t seen her since eleven this evening, when we were in here turning Mr. Peterzén.”

“So she must have gone out the back door. I’ll go that way to the on-call apartment and walk upstairs through the operating rooms. That’s the closest.”

The doctor swung the beam toward the door. Beyond it were the stairs and the elevator to surgery, one floor up. One floor down, on the ground floor, were the polyclinic and physical therapy rooms; one floor below that was the basement, where the X-ray suite, employee changing rooms, and building machinery were located. The hospital was a large area to search, but Surgical Chief of Medicine Dr. Löwander was the person who knew its layout the best.

Nurse Siv was left alone in the dark. Her legs trembled slightly as she made her way back down the hall to the nurses’ station. Out of habit she glanced through the ward door’s window. A bone-white moon augmented the mild glow from the street lamps outside. In the cold light from the windows, she could see a woman moving in the stairwell, her back to the nurses’ station. The woman’s white collar glowed against the dark fabric of her calf-length dress. Her blond hair was pinned back severely, and above it she wore a starched nurse’s cap.