Unclean Spirit (9 page)

CHAPTER TWENTY-EIGHT

              "Someone pushed you down the stairs?"

              "Not someone, Dr. Gomez, something."

              Oh, brother, thought Javier, like daughter, like father!              

              "Mr. Forsythe, I don't..."

              "Please, just hear me out before you form any conclusions about my mental status. Okay?"

              Javier supposed that was the least he could do.

              "Go ahead."

              "I was so shaky that I dropped my hand sander, it was at that point that I lost the urge to continue working. It was as though whatever had been coercing me to finish the job I had started had suddenly vanished. All I could think about was getting upstairs and lying down. I was halfway up the staircase when something struck me square in the chest and sent me hurdling down to the cellar floor. When next I opened my eyes, I was here."

              Javier could tell that Paul was sincere in the telling of his story, but he couldn't buy into its other-worldly aspects.

              "Mr. Forsythe, I can appreciate how you might feel inclined to attribute what happened to some unseen force, as it were. But let's look at the events of that night a bit more realistically: The compulsive behavior, the nausea, the smell, the stifling atmosphere...those could all be indicators of an impending seizure or some other type of brain abnormality; the labored breathing and the perceived blow to the chest are pretty indicative of a cardiac event. I'm just speculating here but it's entirely possible that you had a myocardial infarction, a heart attack."

              Paul wasn't buying it and he was pissed that the doctor had such a pat answer for what had been such an unusual event.

              "So, what was it? A heart attack or a seizure or both? Or, am I just some nutcase?"

              "Mr. Forsythe, you're angry with me and I regret that, but I'm only attempting to ascertain the cause of your injury. True, at first I suspected that your remembrances were a sign of some sort of psychological dysfunction but now I don't think that's the case. From what you've told me, it's very likely that your initial symptoms were the result of reduced cerebral blood flow secondary to a clot in one or more of your coronary arteries. The effort you then exerted in climbing the stairs was all it took to overtax your heart and cause you to pass out and fall down the steps. That would go a long way toward also explaining why your heart stopped during surgery and why your pulse rate was so rapid the other night."

              "But you said that my heart was okay."

              "Yes," said Javier, "I did. But given this new information, I'm going to talk to Dr. Barker about doing a cardiac catheterization on you. I also want to get an MRI of your brain. That's..."

              Paul was not a happy camper. "I know what an MRI is!"                                         

              Javier was getting pretty frustrated himself. He was only trying to help Paul Forsythe, he didn't have to bite his head off! He reminded himself, however, that this had to be a very trying time for his patient. "Okay, sorry."

              "No, Dr. Gomez, I'm sorry. I don't mean to behave like an ingrate. It's just that I'm, well, I'm scared."

              Javier was touched by Paul's apology and his admission of fear.

              "Of course you are and I can understand that. We'll just take it one step at a time and we'll start by getting you out of ICU. I still want you watched closely though so I'm going to transfer you to telemetry where your heart can be monitored around the clock. I'll also get in touch with Dr. Barker as soon as possible. The MRI will have to wait until I remove your cranial staples, but I'm going to have an electroencephalogram, an EEG, done in a couple of days.

              "I expect that your wife and daughter will have plenty of questions for me. Do I have your permission to be open with them?"

              "Yes, certainly. But let me talk to them first. Starr has a unique perspective on things."

              That's a fact! thought Javier.

CHAPTER TWENTY-NINE

              Paul had already been transferred to Telemetry by the time Tamara, Starr, Patsy, and Marybeth arrived at the hospital. Paul was thrilled to see them all and had absolutely no recall of his prior negative reactions to his daughter.

              "Hey, guy, that's a lovely turban you're wearing!" quipped Patsy, referring to Paul's cranial bandaging.

              Paul patted his dressing.

              "What? This old thing?"

              After kisses all around and the requisite small talk, Paul told his family, in toto, about his most recent conversation with Dr. Gomez. The words "heart attack" came as a shock to everyone.                            "No, I don't believe that. The cardiologist said your heart was perfectly fine. Dr. Gomez has to be mistaken." Tamara sounded more calm than she felt.

              "I don't know, Tam. I've been thinking about it and Dr. Gomez' reasoning sure makes a lot more sense than my original hypothesis."

              Starr inquired, "And what was that hypothesis, Dad?"

              Paul hesitated briefly before speaking.

              "My initial take on the events of that night was that I had been in the company of some sort of supernatural presence, one with enough malevolence and power to push me down the stairs." Paul took note of the fact that Starr's face was the only one that didn't register incredulity. "I realize now how ridiculous that sounds and how much more rational Dr. Gomez' explanation is. I'm not thrilled about the possibility of having had a heart attack but I suppose it's preferable to being pursued by evil spirits!"

              Paul's lame attempt at humor didn't fool or relax anyone and the room went silent as each person pondered what Paul had said. There was practically a collective jump when Starr finally spoke.

              "Dad, I've been having some pretty eerie visions since the night of your accident, including one of you in the plane with me while you were physically in surgery. Just this morning I saw a black cat sitting on the showerhead; I think we all know the stigma attached to black cats. I don't know what these manifestations mean, but they certainly seem to jibe with your first impression of what happened in the basement that night."

              "But, Starr," asked Marybeth, "couldn't they also be prophetic of a serious change in Paul's health status?"

              "Yes, I suppose they could." But Starr didn't sound convinced of that. She started to say more, but was interrupted  by the entrance into the room of a petite, forty-something brunette.

              "Mr. Forsythe? Good morning. I'm Dr. Barker. We've met before, only you were unconscious at the time.

              "I believe Dr. Gomez told you I would be dropping by?"

              Once the introductions and ice-breaking chit-chat were out of the way, Dr. Barker initiated her cardiac assessment. Tamara stayed with her husband; Starr, Marybeth, and Patsy left the room in order to afford Paul some privacy. As Starr turned in the doorway to mouth "good luck" to her parents, she saw, ever so briefly, a halo of black hovering just above her father's head.

CHAPTER
THIRTY

              Charlie had gone into town for his next dose of intravenous antibiotic.

              Cooter had finally completed his ritual ball-licking and was contentedly snuggled into his newly acquired blanket.

              The elaborately decorated horses on Marybeth's carousel music box, the one that sat on her bedside table, moved counterclockwise on their base as the notes that comprised
Midnight
, from the musical
CATS
,
played backwards.

CHAPTER THIRTY-ONE

              "Wanda... Wanda, are you there?" Saul had been attempting to contact his receptionist via the intercom for several seconds now and he was growing increasingly irritated. "Damnation, Wanda, stop filing your nails or whatever absurd thing it is you're doing and answer me!"

              "DON'T YOU CURSE AT ME!" came Wanda's typically thunderous voice. "WHAT'S SO ALL-FIRED IMPORTANT?"

              Charlie snickered to himself and couldn't help but admire Wanda's gutsy response to her employer.

              "Well, if it's not too much trouble, would you be kind enough to call the lab and see if Charlie's culture report is ready?"

              Charlie knew that Doc Feener's sarcastic tone would not sit well with Wanda--he was right.

              "WELL, IT WASN'T TOO MUCH TROUBLE WHEN I CALLED THEM JUST BEFORE YOU STARTED CATERWAULING AT ME. THE PRELIMINARY REPORT IS NEGATIVE." And with that, Wanda broke the electronic connection between herself and Saul.

              "Well, Charlie, that's the good news. Bad news is, Wanda will take a two-hour lunch today and leave work an hour early just to punish me."

              The smile on Saul's face indicated to Charlie that the intercom-tiff carried no real significance.

              "So," asked Charlie, " negative means my nose is okay?"             

              "Negative means that so far at least the lab hasn't been able to identify any microorganisms--'bugs'--in the fluid we sent them. That's surprising, considering what that fluid looked and smelled like. I should have the final report back by late tomorrow. Maybe it will show something. At any rate, the antibiotics seem to be working; I can't believe how quickly your nose has healed. Just to be on the safe side, though, I'm going to give you one more dose of the intravenous antibiotic and then start you on the pill form."

              As Saul initiated the anti-infective drug, he asked Charlie if he had heard anything new about Paul. Although Charlie told him about his telephone conversation with Starr, Saul gleaned no new information about Paul so he made a mental note to call Dr. Gomez later in the day. 

              "Ya know, Doc, Miz Lillie--ran into her over at Welsh's supermarket--says Preachur Duncan's been tryin' to call the hospital fer three days now and cain't never git through. The mizzus says he's plannin' to drive over to El Paso and pay Mr. F. a visit. Reckon that's a good idea?"

              Saul tried not to let his rancor toward Lukas color his answer, but he wasn't totally successful in that endeavor.

              "I really don't know, Charlie. I suppose that Pastor Duncan feels it's his 'Christian Duty' to at least make an appearance at Paul's bedside."

              Charlie caught a hint of contempt in the doctor's remark, but he chose to let it pass. He knew that there was bad blood between Doc Feener and Preachur Duncan; he also knew enough to let sleeping dogs lie.

              "Any more problems at the ranch, Charlie?"

              "Nope. No smells, no black cats, no nothing. Maybe things is back to normal."

              Saul wasn't so sure that was the case; he feared that things were far from normal. He hoped to hell he was mistaken.

CHAPTER THIRTY
-
TWO

              It had been a hectic morning for both Javier Gomez and Elizabeth Barker, but they made time for a working lunch in order to discuss Paul Forsythe's case.

              "Javier, my examination of Mr. Forsythe didn't yield any data that leads me to believe he suffered a major cardiac event on the night of his accident. His heart sounds perfectly normal and his EKGs show no evidence of myocardial damage. But, just for the sake of argument, let's say he did have an MI. His heart could not have withstood that bout of tachycardia he experienced in ICU."

              "But, Liz, what about his symptoms? The shortness-of-breath, the nausea, the perceived blow to his chest? And, more importantly, what about his cardiac arrest in the O.R.? How can we know with any certainty at this point that Paul didn't suffer an infarct?"

              Dr. Barker could sense Javier's frustration with this case and she wanted to be able to give him a definitive diagnosis that would explain Mr. Forsythe's fall and its sequelae. The problem was, she simply could not put her finger on what had happened to the man.

              "You're right. We can't be certain right now that Mr. Forsythe didn't experience a myocardial infarction. My years of experience, however, lead me to believe that it's a very remote possibility. I'm more inclined to believe that he experienced an episode of paroxysmal atrial tachycardia. That would certainly explain the sudden onset of tachycardia in ICU and it could even have caused him to pass out and fall down his cellar steps.

              "At any rate, I know you spoke to Mr. Forsythe about a cardiac cath, but I would much rather run some less invasive diagnostics first. I'm way out of my league when it comes to neurosurgery, but I can't imagine that doing a cath this close to an evacuation of a subdural hematoma is desirable, especially since we do use low-dose heparin during the procedure."

              A more insecure physician might have taken offense at having his proposed plan of care questioned, but Javier welcomed Dr. Barker's opinion.

              "Damn! I forgot all about the heparin! You're right, Liz, no way do I want Mr. Forsythe to get any anticoagulants just now.  What other procedures do you have in mind?"

              "For a start, an echocardiogram and thallium imaging. The cardiac isoenyzmes we ran post-op were okay, but I'll probably repeat the myocardial LDH since it generally peaks two to five days post-infarct. If everything comes out negative, I see no reason to even do a cath."

              "Okay by me. Have you spoken to Mr. Forsythe about these exams?"                           

              "No. I wanted to get your approval first. I'll stop by and see him again this evening.

              "I'm hesitant to bring this up, Javier, but after what you and Mr. Forsythe have told me about his remembrances relative to the fall, I can't help but wonder if there is something other than an organic explanation for what happened that night."

              "I've had the same thought myself, Liz. But we have to do what we were taught--first rule out the organic, then look to the functional.

              "From what I gather, Paul Forsythe was the picture of health before this happened; no diabetes, hypertension, hypo- or hyperthyroidism--nada. The best we can do is work him up. You take the heart, I'll take the brain, and I'll be at the neck afore ye."

              "Cute, Javier, real cute."

              "So the ladies tell me!"

              While his physicians were discussing his fate, Paul was taking a post-prandial nap. Tamara remained at his bedside, nodding off a bit herself; Starr had left to take Marybeth and Patsy back to the motel. Paul's hospital room suddenly turned ice-cold and, though no one was awake to see it, the dark nimbus that had wavered over Paul's head earlier began to take on a shape.