The fifth vial

CHAPTER 19

Natalie wasn't going to make it through the session and she knew it. It was stupid to have agreed to get back into physical and pulmonary therapy so soon after the ordeal of the fire. She checked the elapsed time on the treadmill clock and then glanced up at the one on the wall just in case the electronics had failed. Seventeen minutes at zero incline. This is bullshit, she thought. There was no sense in prolonging the charade. Her lung wasn't working well. It was as simple as that. Rachel French could talk all she wanted to about healing burns and recovery of function, but it just wasn't going to happen.

Oh sure, Lefty, you're going to be pitching real good again before you know it — just as soon as that ol' missing arm of yours regenerates.

"Come on, Nat," her therapist urged. "Five more minutes. You're doing great."

"I'm doing sucky, and you know it."

"You're wrong. The pulmonary people tell me that your function tests have largely stabilized, and that there should be steady improvement in them for some time to come."

"Nobody in medicine ever predicts improvement," Natalie snapped, pausing to get an extra breath. "In fact they usually go…out of their way to predict no improvement. That way they'll either look smart and tuned in…or they'll look like heroes when things do get better."

"You know, you're not going to help yourself very much thinking negatively all the time."

"Correction," Natalie said, flicking off the power. "I'm not going to help myself at all…Thanks for your time…I'll call when I feel ready to come back."

She snatched up her warm-up towel and stormed from the unit, sensing the woman might actually be coming after her. She knew she was acting like a jerk, but in truth, she really didn't care. She had accepted the tragic loss of her lung with grace and spirit, and a positive philosophy. But at the moment, even though her mother and niece were alive because of her, and cards were continuing to flood in, and testimonials were being planned, there simply didn't seem to be enough grace or spirit remaining to undo what had been done.

She sped home, half hoping that a cop would have the temerity and bad fortune to try to ticket her. Perhaps with time, her feelings of despair and self-pity would yield to a renewed sense of purpose and perspective. Meanwhile, somewhere, some mathematician who probably couldn't get a job teaching in junior high was preparing to pull out his calculator to determine her lung allocation score.

Let's see, plus twenty two and she limps along indefinitely, stopping every few feet to catch her breath. Plus twenty-eight and she gets to wait on tenterhooks for the privilege of taking poison that will blot out her immune system, and make riding in a public elevator a potentially lethal off air…

Hermina, with two plastic bags of cleaning supplies at her feet, was writing a note to her at the dining table.

"Hi, baby," she said. "I didn't expect you home so soon."

"Jenny here?"

"She's in the car. I was just getting set to drive her over to the new digs. I think we might sleep there tonight."

"That's great, Mom."

"Honey, I'm really sorry for all this. I know you're furious with me, and you have every right to be."

"Things happen. I'm just grateful you and Jenny are okay. If you're feeling bad about what happened to me, you know what to do about it."

"I know, and so far I'm doing it."

"I hope so."

"You want to come over?"

"Maybe tomorrow."

"The rehab therapy go all right?"

"Terrific."

"Pardon me for saying it, but you don't sound so terrific.

"I'm fine.

"Believe me, if I could turn back the clock and either stop smoking a year ago or just crawl into a closet during that fire and get burned up, I would."

"That's nonsense. You've stopped smoking. That's what matters. And now, I want you to stop saying you wish you had burned up. That doesn't help anything."

"Nat, please, come help me fix up the new place."

"Mom, I'm fine. Really."

"Did they say you're getting better?"

"Yes, they did. Steady improvement, that's what they said."

Clearly sensing the truth, Hermina put her arms around her daughter, and Natalie made some pretext of responding.

"Baby, I'm sorry. I really am."

"I know you are, Mom."

"You sure there's not anything — ?"

"I'm positive. I need to get some rest, that's all."

"Well…I don't want to leave Jenny sitting in the car too long. Do you think maybe you could come over later for dinner?"

"No, no. I have some studying to catch up on after I nap."

"Thanks for the loan you gave us to get set up in the apartment. I'll pay you back as soon as the insurance comes through."

"That's okay."

"No, I really want to."

"Okay, Mom. Pay me back whenever you want."

Natalie stood for a time in the dining area even after the front door had closed. At some point she would surely end up in the shower, but she really hadn't even broken a sweat in rehab. Finally, she pulled off her tee, threw it onto the floor, thought about putting on some music, then just sank heavily into the deep recliner in her living room. Across from her, just above the ornate marble mantel of her small gas fireplace, was a large, framed color photograph, remarkable for its composition, clarity, and detail. It had been taken by a professional at the Pan Am Games in Mexico City seven years ago, just as Natalie was breaking the tape at the finish of the 1,500 finals. Her arms, fists clenched, were extended skyward, and a true description of the sublime exhilaration on her face would have defied words.

Never again. Not on the track. Not in the operating room. Probably not even in the bedroom, for chrissakes…Never again.

She reached across with her left hand and massaged the still-sensitive scar on the side of her chest. What did that song from M*A*S*H say? Suicide is simple? Suicide is painless? Maybe it was suicide is easy. Simple…painless…easy. Hardly words anyone would ever apply to pulmonary rehabilitation after burning up your only lung.

If she could just get up the nerve, how would she do it? This wasn't the first time she had actually considered the possibility of ending her own life, but it had been many years. Living as a pulmonary cripple simply would not compute. Nor would the debility of immunosuppressive therapy following a lung transplant. And worst of all would probably be waiting around, watching her lung allocation score rise and fall like the Dow Jones average.

It was hard to believe that a life with such promise had come to this.

The walls were closing in on her, and there seemed to be no way, no way at all, to stop them.

Pills, probably, she decided. It had to be pills. She remembered hearing someplace that the Hemlock Society recommended enough sedatives and painkillers to go into a coma, in conjunction with a plastic bag over the head just before consciousness vanished altogether. That didn't sound all that pleasant, or even all that possible. Perhaps it was worth going online. If one could learn to make a thermonuclear device there, one could certainly learn the most efficient, pain-free way to commit suicide.

Staring across at the Pan Am Games photo, and almost in spite of herself, Natalie began mentally ticking through how she would go about obtaining enough Oxycontin or Valium to induce coma. The phone on the end table beside her had rung several times before she became aware of it. Caller ID listed only the words "New Jersey" and a number.

Probably a telemarketer, she thought, smiling tightly at the notion of something so trivial interrupting something so profound. Bemused at the irony, she answered the call.

"Hello?"

"This is June Harvey of Northeast Colonial Health calling for Miss Natalie Reyes."

Northeast Colonial — her medical insurance carrier. What now?

"This is Natalie Reyes."

"Miss Reyes, I've been assigned the claim for all charges connected with your recent operation in Rio de Janeiro, Brazil, and your medevac flight back to the United States."

"Yes?"

"First of all, I hope you are doing well."

"Thank you for asking. I don't think I've ever had someone from my health insurance company actually inquire about my health. The truth is, I've had some recent setbacks."

"I'm sorry to hear that. Well, I'm calling with the good news that Northeast Colonial has reviewed your case and has committed itself to reimbursing you in full for your flight back to Boston."

Reimbursing. Until this moment, Natalie hadn't considered at all how her flight back had been paid for. Now, she realized, Doug Berenger had taken care of it. Not that he would have gone under financially without being reimbursed, but such a flight had to have been a good-sized nut. Typical of the man, he had never mentioned that he had paid for it out-of-pocket.

"Well, thank you," she said. "Thank you very much."

"There's just one thing."

"Yes?"

"Our records state that you had a lung removal performed at the Santa Teresa Hospital in Rio de Janeiro."

"That's right."

"Well, we have received no medical records from the hospital validating that fact, and in fact, although you are fully covered, no claim has been filed for your surgical procedure or hospitalization."

"Well, I was unconscious for a while, but after I woke up I called home and got my insurance number and gave it to the people at the hospital. I don't remember a lot of things from that hospitalization, but I do remember very clearly doing that."

"Well," June Harvey said, "perhaps you could write or call Santa Teresa Hospital. We need copies of your medical records, plus a claim. If you wish, I'll send you the appropriate forms."

"Yes, yes. Do that, please."

June Harvey wished her well with her setback, confirmed her mailing address, and then ended the conversation. Natalie remained in the recliner for a few more minutes, aware that, for whatever reason, the call had defused some of the urgency of her self-destructive impulses. There will still be time, she thought now, plenty of time.

She pushed herself up, boiled some water, and brewed a cup of Constant Comment tea, which she then took into the tiny study off her bedroom. Instead of doing a Google search for the Hemlock Society, she did one for Santa Teresa Hospital. There were 10,504 entries, the vast majority of them in Portuguese. The search engine found them all in 0.07 seconds.

Who would want to leave a world where this is possible? she asked herself. A backpack-sized mechanical lung might be just around the corner.

It took half an hour, but finally Natalie had an address for the hospital in the Botafogo section of Rio, and a phone number.

After considering, then rejecting, the notion of enlisting her mother's help in making the calls, Natalie looked up the country code for Brazil and the city code for Rio, and began dialing. Initially, her conversations were limited by lost connections while being transferred, as well as by her awkward Cape Verdean Portuguese. Little by little, though, her navigational skills improved. She made it to patient information, then to billing, to records, and even to security. An hour and fifteen minutes after she set the receiver down from her conversation with June Harvey, she finished an animated discussion with the director of the Santa Teresa record room, a woman named DaSoto, who actually spoke English — probably about as well as Natalie did Portuguese.

"I am sorry, Miss Reyes," she said, "but Santa Teresa is one of the fine hospital in all Brazil. Our electronic record system is be very good. You were not admit to our hospital on July eighteenth. You never did received an operation on in any of our operating rooms. And you were not certainly a patient in here for twelve days, or even one day. You ask if I am positive of which I say. I tell you that I would hang my career on it. No, I would hang my life."

"Thank you, Senhora DaSoto," Natalie said, aware of her heart beginning to beat heavily, but still unwilling to fully believe that the woman, however certain she was, hadn't overlooked something. "I know it was a hard decision for you to talk with me about this without proof of who I am."

"You are welcome."

"I have one last request."

"Yes?"

"Could you give me the number of the police station that would have been most likely involved with my shooting?"