The Children's Ward (10 page)

Forty

“You poor little thing.” Tiffany White patted her daughter’s hand.

“I don’t know,” David White said, winking. “I’ve heard that Phenobarbital is some pretty good stuff.”

Courtney did not answer.

“Floating a little?” He leaned over and attempted to lift her eyelids. When she moved her head, he laughed. “I think Courtney’s wasted.”

“David…”

“Think if I threw a fit they’d give me some of the good stuff?”

“David…”

“She knows I’m only joking.”

“It isn’t funny…the poor little thing.”

Forty-one

The house was quiet.

Tiffany White shifted in bed, listening for a repeat of the sound that had woken her up. Beside her, smelling strongly of alcohol, her husband slept undisturbed.

It had sounded very much like a door being closed.

Coming in or going out?

She looked at David’s face, debating whether or not to wake him up. He could be very unpleasant when he’d had a lot to drink.

The dinner party had ended at ten in deference to those who had to work the next day. She had taken refuge in the bathroom when they got home so that David would go to sleep without making a drunken attempt at seduction. Waking him now might result in such an attempt.

There was always a chance that the sound was just her imagination, part of her dream.

Courtney. She’d been dreaming of Courtney.

Bringing her home from the hospital and into the house…

The house was so cold, a thin coat of ice covering the walls, frost, like lace, blanketing the furniture…

The ice crunching under their feet as they made their way up the frozen staircase…

A horrible dream.

She looked at the clock: just past midnight. She hadn’t gotten in bed until eleven-thirty, could only have been asleep for minutes…it must have been part of the dream.

Just as her eyes closed, another sound…not a door…caught her by surprise. Not as identifiable, not as clearly heard.

“Damn.”

With one more look at David, she slipped quietly from the bed.

The thick carpet on the landing cushioned her steps and she moved silently toward the staircase. When she reached the banister she looked over into the darkness below.

All was still.

She had probably left the French doors in the dining room open. Since they opened into an enclosed patio, it was unlikely that anyone could have gotten in. It was probably just the wind.

Still, she tightened her grip on the four-shot derringer before she started down the stairs.

The French doors were closed and locked.

Tiffany hesitated, no longer certain of how to proceed. She hadn’t heard any other noises and now she questioned whether it all wasn’t her imagination. She was tired, perhaps still half-asleep.

Pulling her robe around her, she turned away from the window, suddenly anxious to be out of the room.

As she neared the door she sensed movement behind her and she whirled, bringing the gun up as adrenaline pulsed through her veins.

She was alone in the room. The doors were glowing, a pale light that increased in intensity as she watched.

Confused, she took a step toward them, stopping short as drops of light—like rain—fell to the floor, skittering across the polished wood in all directions.

She blinked and looked back up at the windows where tendrils of light had begun to extend from the glass onto the walls. In seconds the far wall was covered with liquid light. It was spreading to the other walls…

A smell, like damp wood smoldering, filled the room.

Burning?

She had to get out…

Turning she saw that at least a dozen of the writhing coils had passed beyond the door.

“No,” she whimpered, “please, no.”

The red lights of the fire trucks were reflected in the windows of the house.

Tiffany watched, standing in the driveway, as the firemen tracked through the front door and into the house. David, eyes still heavy with sleep and seemingly struck speechless, stood at her side.

Tiffany was numb. There was something dreamlike about standing in the dark of night, helpless. There was nothing she could do. No control she could exert, no matter how desperately she wanted, that would make it any different.

It began to rain.

“No smoke damage,” the fire captain said, taking off his helmet and running a slightly grimy hand through his hair. “Just the walls charred and we…contained it on the first floor.”

“What the hell happened?” David was as subdued as Tiffany had ever seen him.

“Ah…” the captain looked at Tiffany. “You had a very intense fire which was not fully involved…the damage was limited to the structure and the…contents were not…”

“Wait a minute.” David shifted from one foot to the other. “How could it burn the walls and not the furniture?”

“I don’t know. It…the drapes weren’t damaged either. And, as I said, there was no smoke.”

“How is that even poss—”

“It doesn’t matter,” Tiffany interrupted, for the first time feeling the cold. “It doesn’t matter how it happened; it just happened.”

THURSDAY

Forty-two

“Russell.” Mary Aguilar got to her feet as the orderly wheeled the boy through the door. “I’m glad you’re back with us.” To her practiced eye he looked pale and wan.

He smiled faintly. “Thanks.”

She nodded at the orderly and stood aside as they passed, then followed them into the ward.

Abigail was the only one awake and Mary smiled in her direction before pulling the curtain around Russell’s bed. She pulled back the covers and watched as the orderly lifted the frail youth from the wheelchair and onto the bed.

“There,” she said, pulling the covers back up. “Breakfast should be arriving any minute; is there anything I can get you before then? Juice? Milk?”

“No thanks.”

“Do you want the curtain open or drawn?” she asked, preparing to leave.

“Closed for now…I didn’t get much sleep last night.”

“Oh.” She nodded her understanding. “ICU can be upsetting.” She waited, sensing that he wanted to talk.

“I was there before, right after the accident, but I didn’t remember…all of it.”

She nodded again. “I’ve worked in ICU, I know what you mean.”

“Those people.” He looked at her with eyes that were somehow old. “They brought a man up from the emergency room in the middle of the night. He’d been in a car accident. He was all bloody.”

Mary took his hand between both of hers, rubbing warmth into his slender fingers.

“His head…had gone through the windshield and he was almost scalped…” He swallowed. “His face was so cut up it didn’t look like a face anymore.”

“Oh Russell.”

“They were taking him to surgery this morning just as I was being brought back here. I heard the nurses talking…they’re going to amputate his legs…”

She squeezed his hand.

“My Dad…is a long-haul truck driver. He’s always on the road.”

“That doesn’t mean he’ll be in an accident,” she said firmly.

“I couldn’t stand it if anything happened to my Dad.”

“I know.”

His eyes were glistening but his voice was amazingly steady. “I would never let them do that to him…”

“Do what?”

“I’d never let them take his legs…”

Mary pulled the curtain closed behind her. The best thing for Russell was sleep. Everything else could wait.

Abigail was gesturing to her to come nearer and she complied, careful not to wake the other girls as she crossed the ward.

“How is he?” Abigail whispered.

“He’ll be fine,” Mary assured her, touched at the child’s concern.

“No one would tell me last night…what happened to him?”

Seeing nothing but honest distress at Russell’s absence, Mary replied: “He passed out while he was in physical therapy. The doctors thought it best that he spend the night in ICU.”

“Passed out?”

“Yes, he was in the whirlpool. The water may have been too warm for him, or…well, it doesn’t matter. He’s fine now.” Something flickered in the girl’s eyes. “Don’t worry, Abigail.”

“I’m not worried,” Abigail said softly.

Behind her, Mary could hear the outer doors open and then the smell of bacon filtered in.

“Breakfast is here,” she announced and turned to go back to the nurse’s station.

“Not at all,” Abigail was saying as she left.

Forty-three

Anne unlocked the door to physical therapy. At seven-thirty, she was half an hour late but the first patient wasn’t scheduled until eight if she remembered correctly. Thirty minutes was plenty of time to get set up.

She almost hadn’t come to work today. If there had been anyone available to work her shift she would have stayed home and tried to forget about Russell Delano.

But she knew, without asking, that none of the other therapists would be interested in working for her. This close to Christmas—twelve days away—no one wanted extra hours. The holiday parties had begun in earnest and the day shift started too early in the morning for serious party-goers.

Sighing, she hung her purse in her locker and slammed it shut with a little more force than necessary.

Well, she was here now and she’d make the best of it.

The whirlpool. She walked toward it, determined not to think of anything other than the routine.

Water on to bring the water level up, a quick temperature check (had the water been too hot?), and verification that all of the air jets were operational.

She stood gazing at the water as she waited for the tank to fill. With the jets turned off the water was still and she could see her reflection. The water was not kind to her; she looked haggard and drawn.

She had spent a sleepless night, unable to stop herself from thoughts of Russell Delano.

He could have died while under her care.

A few minutes more of daydreaming and he could have died. It could have happened so easily.

Over and over as the night wore on she’d relived the incident. His face haunted her.

Then her second mistake: not calling for assistance. She had managed to get him breathing again but it could have easily gone the other way. If it had, her failure to call for help might well have been a fatal error. There was no excuse for it, either. The code button was only across the room. Seconds away.

She had called ICU at six a.m. and was told that the boy was about to be transferred back to the ward. He’d spent an uneventful night. There were no indications of aspiration pneumonia.

Even with that reassurance, she was uneasy.

The water level was high enough and she turned the handle, shutting off the flow and wishing she
could stop her thoughts as easily.

Maybe at lunch she would walk over to the children’s ward and say hello. See for herself that he was okay. Replace the image in her mind— face slack and mouth cyanotic—with one that she could live with.

She turned, thinking that she’d heard the door open, but it was shut and no one was in sight.

Nerves.

Crossing to the windows, she opened the louvered blinds, letting what little light there was—it was still raining—into the room.

Time to start the morning paperwork, but she stood, eyes fixed on the horizon. Dark clouds hung in the air, somehow malevolent.

Around her, the room grew still.

She began to breathe through her mouth, not able to get enough oxygen through her nose. The air was thick, stagnant and she gasped as it seared her throat.

She put a hand to the wall to steady herself.

Something was…

The code button. She took a faltering step toward it. Her legs threatened to give way beneath her.

She clawed at her throat struggling to breathe.

The department door opened and an orderly backed through, pulling a wheelchair with her eight a.m. appointment.

Cool air filled her lungs.

Forty-four

The surgical scrub nurse glanced at the clock: 8:05 a.m. and one hour, fifteen minutes into the procedure.

As was her practice, she had reviewed the patient’s chart meticulously while the anesthesiologist had been putting the patient under. After ascertaining that the preoperative check list had been correctly completed, she turned to the emergency department record.

The face sheet listed the complaint as auto versus auto. The patient, Thomas Foster, was one of the drivers, and had not been wearing a seat belt. He had been trapped in his car, having sustained crush injuries to both legs, a fractured pelvis, and internal injuries. He had multiple lacerations, including a severe scalp wound.

He was, she noted, twenty-five years old.

Upon arrival in the emergency department his blood pressure was eighty over sixty, pulse one hundred, respirations thirty-two. They had established an intravenous line of 1000 cc’s of Ringer’s lactate; drawn blood for a blood count, chemistry, and type and crossmatch; obtained portable x-rays of chest, abdomen, pelvis, legs, and skull. Catheterization elicited 300 cc’s of blood-tinged urine.

The patient was negative for pneumothorax and was put on a respirator.

He had been transferred to ICU since the only available anesthesiologist was in the middle of an emergency surgery at another hospital some thirty miles away. The anesthesiologist had arrived at 6:30 and at 6:40 the patient was brought to surgery.

The surgeons had been working thus far to stop the abdominal bleeding and had removed the patient’s spleen. Another doctor was standing by to assist in the bilateral amputation of both legs at mid-thigh. The patient’s scalp wounds and other lacerations would be tended to afterward.

The green surgical drapes which bordered the abdominal incision were dark with blood and she noted that the glass suction bottle was nearly full of blood aspirated from the surgical site.

They were preparing to close and she assisted in the instrument count to make sure that none of the needles or clamps or even surgical sponges were left inside the patient. Then she watched the surgeon suture the incision, marveling at the speed at which he completed the intricate stitches.

For a minute they stood waiting as the anesthesiologist took the vitals readings to determine whether the patient was stable enough to remain under anesthesia for the amputations. With the intra-abdominal bleeding stopped and on his second unit of packed cells being transfused, his blood pressure was steady if still a little low.

The anesthesiologist nodded and they prepared to continue.

They removed the sterile drape from the legs which were badly mangled, reminding her of those cartoons where a steamroller would flatten the villain. She had seen the x-rays; there was not enough bone left intact for any type of reconstruction. The skin was badly avulsed.

The surgeons were trying to decide how far up the thigh to cut, discussing future prostheses and the patient’s potential for rehabilitation. The third surgeon, a self-professed “leg man,” ended the discussion by taking a scalpel and slicing into the skin.

As he did, she heard a loud crack and felt something wet strike her in the face. She instinctively closed her eyes.

“God damn, I’m cut,” someone said.

Opening her eyes she saw the surgeon holding out his hand. A piece of glass had cut through the glove and was embedded in the back of his hand which was bleeding profusely.

There was blood all over, though. Blood and glass, and after a moment it dawned on her; the suction bottle had somehow exploded, showering the operating room in blood and glass splinters.