Critical (23 page)

Laurie was about to leave when she remembered to ask Chet about his MRSA case.

“Right,” Chet responded. “Jack had mentioned you were interested in it, so I got it out.” He pulled himself along his desk with his chair's casters squeaking shrilly enough to make Laurie wince. He grabbed a case file from the top of his file cabinet and handed it to her. “The name was Julia Francova.”

“Terrific,” Laurie exclaimed. “I'm glad you still had it.” She slid out the contents to make certain it was another Angels Healthcare case.

“What's the big interest?”

“I had a similar case this morning,” Laurie explained. “There have been quite a few over the last three months or so: twenty-four, to be exact. It hadn't appeared on anyone's radar screen, since the cases have been widely distributed among the staff, including cases in Queens and Brooklyn.”

“I didn't know about any others,” Chet admitted.

“Nor did anyone else. I'm looking into it, and I'm psyched. There is something weird about these cases, and I'm going to figure it out if it kills me. I've already managed to provoke our fearless leader.”

“Let me know if I can help. The reason I still have the case is that I've been waiting for the CDC to get back to me before signing it out.”

“Don't tell me you sent an isolate for subtyping,” Laurie questioned while trying to keep her excitement in check.

“I did. I sent a sample to a Dr. Ralph Percy. I got him through the CDC's central switchboard.”

“That's more than terrific. I'll call Dr. Percy for you, and I'll put the results in the case file. It will save you a step.”

Eager to add yet another name to her matrix, Laurie again tried to leave. This time, Chet called her back.

“I took your advice you gave me this morning and called my new lady friend this afternoon,” Chet said.

“And? What happened?”

“I was shot out of the sky, and I was as direct as you suggested I be. I put my ego out there on the table, but she blew me off. I had even sent some flowers to soften her up, but no luck.”

“Was she rude?”

“No. Actually, I'm exaggerating. She was pretty nice about it, even though I stuck my foot in my mouth with my opening ploy. She had confided to me the evening before that she was desperately trying to raise a couple of hundred thousand dollars for the company she works for. I started the conversation by saying I'd found the money in my bedside table, and I wanted to invest.”

“Bad strategy.”

“Obviously. She said she felt I was mocking her.”

“I think I would have felt the same,” Laurie agreed. “How did you leave things?”

“Open-ended. I gave her my cell phone number.”

“She's not going to call,” Laurie said with a wry chuckle. “That's asking too much. You'd be making her feel like the aggressor. You have to call her back and apologize for your supposed joke.”

“You mean I should call her back after she shot me down twice.”

“If you want to go out with her, you have to call. If she didn't want you to call she would have said so.”

“When do you think I should do it?”

“Whenever you'd like to see her. It's up to you.”

“Do you think I should call her back again today? I mean, isn't that a little too pushy?”

“I wasn't a party to your conversation,” Laurie said. “But you said you left things open-ended. There's a slight risk she might be perturbed, but I think the chances are better than even she'll be flattered. Call her! Take a chance,” Laurie said as she backed out into the hall. “Obviously, you want to see her. What do you have to lose?”

“The rest of my self-esteem.”

“Oh, baloney!” Laurie said, heading toward her office.

Chet put his hands behind his head and leaned back, staring up at the ceiling. He felt indecisive, yet he trusted Laurie's counsel. She was smart, intuitive, and, above all, female. With sudden resolve, he tipped forward, got out the Post-it note on which he'd written the number of Angels Healthcare, and placed the call. He wanted to do it quickly, before he lost his nerve.

As on the previous call, he had to go through the operator to get Angela's secretary. Then, after identifying himself appropriately, he was put on hold. While he waited, he debated whether to be humorous or serious, but ultimately decided to be merely straightforward. When Angela finally came on the line, he simply told her that he'd been thinking of her and had just had another conversation with his colleague, who'd again urged him to call.

When Angela didn't immediately respond, Chet quickly added, “I hope I'm not annoying you. I was reassured that wouldn't be the case. She said there was always a small risk but that in all likelihood you'd be flattered. When I told her I had given you my cell number, she laughed and said you wouldn't call.”

“It sounds to me that your colleague is socially astute.”

“I'm counting on it,” Chet said. “Anyway, I'm calling for two reasons: The first is to apologize for my earlier insensitive attempt at humor.”

“Thank you, but an apology is not necessary. Actually, I overreacted because I am a bit desperate and preoccupied. Your apology is accepted. What's the second reason for your call?”

“I thought I'd ask you out to dinner again. I promise it will be the last time, but you have to eat, and perhaps a break from your routine will give you some fresh insight to where you can find the capital you need.”

“Your persistence is indeed flattering,” Angela said with a chuckle. “But I really am wickedly busy. But I appreciate the call, especially since I imagine as a doctor you still have a waiting room full of patients.”

“That might be true,” Chet said, slipping into his defensive humor, “but they are all dead.”

“Really?” Angela questioned. She assumed there was humor involved but didn't get it. “I don't understand.”

“I'm a medical examiner,” Chet answered. “It was supposed to be funny. Actually, I'm free anytime this evening, starting now. What I have left to do, I could always come back later to finish.”

“Do you work here in Manhattan?”

“I do. I've been here for twelve years. I know it's not as sexy as being a brain surgeon, but in my book it's intellectually more challenging. Every day we learn something and see something we've never seen before. Neurosurgeons pretty much do the same thing every day. Truthfully, doing craniotomies day in and day out would drive me batty. I suppose the company you work for employs clinical pathologists….” Chet trailed off, unsure how Angela was responding to his line of work. In his experience, women were either fascinated or turned off. There was little middle ground. Unfortunately, Angela didn't respond to his last sentence, which was purposefully a half question. For a moment there was a pause, which progressively made Chet uncomfortable. He worried he'd made a faux pas by bringing up his medical specialty.

“Are you there, Angela?” Chet questioned.

“Yes, I'm here,” Angela responded. “So you work at the OCME under Dr. Harold Bingham?”

“That's correct. Do you know him?”

“To a degree. Do you also work with a Dr. Laurie Montgomery?”

“I do. In fact, she just left my office. It's funny you should ask. She happens also to be my social adviser.”

“You know, I just remembered something,” Angela said to change the subject. “Just a few minutes before you called, I'd had a call from my daughter. She called from her best friend's house. She'd been invited to stay for dinner and was asking if she could. I said yes.”

“Does that mean that you might be rethinking your evening plans?” Chet questioned, trying not to get his hopes up.

“It does,” Angela said. “Maybe you are right about a change in routine, and you are certainly right about the need to eat. Today I only managed a sandwich on the run.”

“Does that mean you'll join me for dinner?”

“Why not,” Angela said, as a declarative statement, not as a question.

For the next few minutes, they discussed a time and place. At Angela's suggestion, they decided on the San Pietro on 54th Street between Madison and Fifth. Chet had never heard of it, but Angela told him it was one of those best-kept New York secrets. She said she'd make a reservation for seven-fifteen, and Chet agreed with alacrity.

I
t had not been a good day for Ramona Torres, age thirty-seven, mother of three children ranging in age from five to eleven. Her husband had awakened her at the first blush of dawn in order to drive her to the Angels Cosmetic Surgery and Eye Hospital for her surgery. It was so early that she had to wake the children to say good-bye. Once at the hospital, he had had to drop her off at the posh entrance, where the doorman had relieved her of her overnight bag. She had waved as he pulled away to return home to the Bronx and see that the children had their breakfast before school. She really would have preferred that he'd come in with her to lend moral support.

Ramona had always had a general fear of hospitals, but her fears had been significantly magnified during her last hospitalization by the difficult delivery of her youngest child. The rocky, postpartum course during which she had almost died had required emergency surgery. Although it had been carefully explained to her after the fact that the venous embolism she'd suffered had not been anyone's fault and that everything had been done to avoid such a complication, Ramona had still blamed the hospital. Even Ramona's husband, an attorney, had been unable to change her opinion, such that when Ramona had entered the hospital that morning, her heart had been beating faster than usual and the perspiration dotting her forehead had not been from being too warm.

As Ramona had changed out of her clothes and donned the traditional hospital garb in the same-day-surgery area, she had been tense and had tried to hide her trembling from the nurses and nurse's aides. If someone had asked her what she was afraid of, she wouldn't have been able to tell them, although suffering another venous embolism would have been high on the list. Also on the list was undergoing anesthesia. The idea of another person, no matter how well trained, being in control of whether she lived or died was enormously unsettling. Mistakes happened, and Ramona did not want to be another mistake. As a medical secretary, she had had more than enough knowledge of all that could go wrong.

With such a mind-set, Ramona had almost changed her mind about having the surgery while she had waited on the gurney in the admitting area. But then her vanity had intervened. With her last child, she'd experienced a significant weight gain, which had never melted away as it was supposed to; in fact, it had substantially worsened to the point that Ramona herself admitted she was obese. Although Ricardo, her husband, had never said anything about being disenchanted, she knew he didn't like it. She didn't like it herself, especially when her oldest, Javier, said it embarrassed him. Since Ramona had struggled to restrict her caloric intake, she had reluctantly decided on liposuction, which a friend had had with great success. Hoping for a similar result, Ramona had visited her friend's plastic surgeon, and she'd been scheduled.

After a three-and-a-half-hour operation, Ramona had awakened vomiting, and as unpleasant as that had been, things got progressively worse. The only high point had been a quick visit with Ricardo, who'd taken time off from the office to visit when Ramona had been moved from the post-anesthesia unit to her luxurious room. He'd not been able to stay long, which Ramona did not regret because she'd been remarkably uncomfortable. She'd not been able to find a position that didn't aggravate her pain, and her painkillers, which she could self-administer, seemed to have no discernable effect whatsoever.

Then, a half-hour after Ricardo left, she'd suffered a shaking chill, the likes of which she'd never experienced. It started in the core of her body and then spread out to the very tips of her fingers. Alarmed at such a development and with her teeth chattering, she'd immediately called the nurse, who had responded quickly with a blanket. The nurse also had taken Ramona's temperature and recorded it as 101.8 degrees, a respectable fever.

“It's not uncommon,” the nurse had said. “With an extensive liposuction like yours, it's as if you have a very large wound, even when all you can see are the small incisions on your skin.”

Ramona had been content with that explanation until the moment when more disturbing symptoms emerged. All at once, she was aware of a vague feeling of pressure in her chest, an urge to cough, and a sense that she couldn't quite get a full breath of air. If Ramona had not had the experience with venous embolism after her last delivery, she might not have panicked as she did. She reached for her call button and pressed it repeatedly.

“Mrs. Torres, you only have to ring once,” the nurse admonished, as she quickly came into the room and arrived at Ramona's bedside.

Ramona explained her symptoms and her fear of having a pulmonary embolism. The nurse rapidly retook her temperature, which had climbed only a tenth of a degree, and retook her blood pressure, which was mildly lower.

“Am I having an embolism?” Ramona anxiously asked.

“I don't think so,” the nurse said. “But I'm going to call your surgeon just the same.”

At that moment Ramona coughed, which she had been trying to avoid, because any movement aggravated the postoperative pain. When she coughed and expectorated into a tissue, she saw something that alarmed her even more. It alarmed the nurse as well. The considerable mucus was bloody through and through, and not merely streaked.