“Okay, boss,” Carlos called after him.
12
EMERGENCY DEPARTMENT
L.A. UNIVERSITY MEDICAL CENTER
WESTWOOD, LOS ANGELES, CALIFORNIA
TUESDAY, JULY 1, 2014, 10:17 A.M.
George leaned back and stretched in his chair. Carlos did likewise in unconscious imitation. George glanced at him, making sure Carlos wasn’t messing with him. Apparently not. They were in the ER’s radiology reading room, where most of the light came from the viewing monitors. They had just finished going over all the X-rays taken the night before in preparation for their conference with the ER staff. George had found three X-ray cases that had been misread by the emergency medicine residents in the current batch.
“Would you like to present the details?” George asked.
“No!” Carlos replied, shocked. “It’s my first day. I’d make a fool of myself.”
“You would do fine. But I’ll leave that up to you. If you change your mind, let me know,” George said, remembering his own reluctance to speak when he was a first-year resident.
The door opened and a shaft of daylight pierced the reading room.
“Dr. Wilson?” one of the ER secretaries called out. “Dr. Hanson is at the main ER desk and wants to see you.”
George rolled his eyes and pushed himself out of his chair. “Start going through this morning’s X-rays,” he said to Carlos.
George stood outside the reading room, waiting for his eyes to adjust to the sunlight streaming through the floor-to-ceiling windows. The place was packed with patients who had not been deemed true emergencies, illustrating the chronic problem caused when the general public used the ER as primary care.
George spotted Clayton chatting up Debbie Waters, the charge nurse known for being a no-nonsense taskmaster and for her excellent work keeping the ER running smoothly. On seeing George, Clayton immediately broke off and walked over to him.
“Did you meet that first-year ER babe yet?” he asked, seemingly unconcerned about being overheard. “You know, the one I mentioned earlier, from Stanford.”
“That’s why you pulled me out of the reading room?” George’s tone of mild admonishment had no effect on Clayton.
“Someone has to look out for you, my friend,” Clayton said. “It’s time you left the past behind you, where it belongs. Tell me! Have you at least laid eyes on her?”
“No, I don’t believe I have. It was a busy night last night. Lots of films.”
Extending a hand, Clayton motioned for George to be quiet and nodded toward a young woman who had just come out of one of the enclosed cubicles. She was fashion-model tall and seriously attractive in a healthy, vibrant way. Even in scrubs it was obvious to George that she had a rocking-hot body. She walked past them, tapping away on her tablet.
“Now you have,” Clayton whispered. “What a sight. Agreed?”
George turned away from Clayton and rolled his eyes. Dutifully he watched the first-year ER resident approach the main desk to drop off paperwork before taking the next clipboard from the to-be-seen rack.
“They don’t get much better than that,” Clayton said.
“She’s definitely attractive,” George admitted, although at this point he was watching Clayton, not Kelley. The man was shameless.
Clayton watched as she stopped to go over a chart. “You better get busy before some surgical resident gets all up in that. But if it doesn’t work out, I can put in a good word for you with Debbie Waters.”
“The Queen of Mean?” George was shocked. He could feel his face redden as he briefly glanced over at Debbie.
“Hey, she said she was interested in getting together with you,” Clayton protested. “And you need to get out more. I’m worried about you. You have to have some balance in your life. You work too hard. Seriously. Invite her to have a drink at the W Hotel! She likes it there. I happen to know.”
George stole another glance at her. Luckily Waters’s attention was directed elsewhere. He had always admired how well she kept the ER on an even keel even when all hell was breaking loose.
“She’s a lot of fun, even though she can be a bit bossy,” Clayton said. “She’s very entertaining when she is taken out of her element here in the ER trenches. Believe me! Work is work. Fun is fun. She’s a pistol. Don’t judge a book by its cover!”
George knew everybody was intimidated by Debbie Waters. He had seen her give more than one tongue-lashing to unprepared surgeons all the way down to janitors. She didn’t discriminate.
“Debbie would be perfect for you,” Clayton persisted. “Hell, you don’t have to marry her. Come on! I’ll break the ice.”
“No way. It’s not that I don’t find her attractive. It’s just that she’s so damn . . . domineering.” He realized Clayton wasn’t about to drop the subject. George added, “I’ll talk to her when she isn’t quite so busy.”
Clayton shrugged. “It’s your call.” He glanced down at his watch. “I have to get back to work. I hope to hear you made some progress on one of these young fillies soon. You need to be entertained to pull you out of your funk.”
George shook his head in disbelief as Clayton walked off. In a way it was touching that Clayton was concerned about him. He had also heard rumors that Clayton and Debbie had been more than good friends.
Despite his misgivings George was intrigued. If Debbie Waters really had said she’d like to get together, he’d be a fool to not follow up. When you worked in the ER it was best to have her in your corner.
Reaching the main desk, George pretended to look through the to-be-seen charts while watching Debbie out of the corner of his eye. As usual she was juggling about ten different tasks. As George waited to see if she would even acknowledge him, one of the orderlies dropped a sheaf of paperwork on the countertop in front of him.
“The patient in Trauma Room Six is dead on arrival,” the orderly stated.
“And do you have a name, or are you going to make me weed through all of this to find out?” Debbie demanded. She aimed her pen toward the clipboard in front of her.
“Tarkington,” the orderly replied.
George’s head shot up.
“Thank you. That wasn’t so hard, was it?” Debbie said dismissively as she crossed out a name on the master sheet in front of her.
George edged along the countertop, angling for a look at the paperwork, though he wasn’t sure he wanted to know that his patient had died. He glimpsed the given name Gregory before Debbie snatched away the chart. As her eyes met his there wasn’t an ounce of recognition.
So much for Clayton’s good word, George thought. He turned and headed down to Trauma Room 6. The dead patient was lying on a gurney, his clothes torn open, revealing a bare chest. An ER doctor was off to the side typing on a tablet. A male nurse was busy detaching the EKG leads from the individual’s chest. A crash cart with a defibrillator stood off to the side.
George looked at the dead man’s face. He just wanted to be sure it was the Tarkington whose MRI George had supervised the day before.
“What was the cause of death?” George asked the ER doctor.
The resident glanced up and shrugged. “Don’t know. If I had to guess, probably a heart attack. Whatever it was, he was long gone by the time he got here. He was as cold as an ice cube.”
“Was there a resuscitation attempt?” George asked, looking over at the defibrillator.
“No. Like I said, the guy was already cold.” He gave George a look of “what can you do” and left.
“Are you okay, Doctor?” one of the orderlies asked as he came in to retrieve the crash cart.
“Yeah, I’m fine. Thanks,” George mumbled. Yesterday he had assumed Tarkington was in for a rough time, but he didn’t think the man would be dead within twenty-four hours! George couldn’t shake the feeling that the episode was directed at him to remind him yet a
gain that life was fragile, unpredictable, and unfair, and that he better squeeze what he could out of it while he was able. Worse yet, he felt a strange and irrational complicity, as if he were somehow responsible. Had it not been for him, the lesions in the man’s liver might have been overlooked, and had they been overlooked, the man might be alive, happy, and unsuspecting while enjoying life with his family.
George wondered again if medicine had been an appropriate career choice. Maybe he didn’t have the emotional strength necessary.
Just then an orderly poked his head into the trauma room. “Excuse me? Are you Dr. Wilson?”
“Yes?”
“Dr. Sanchez asks that you return to the image-reading room to view a possible hip fracture.”
“Okay, thanks,” George said. He looked back at Tarkington’s lifeless body, then began walking back to Carlos. Passing the central desk, he paused to take another look at Debbie Waters. She was still at it, barking out orders. It might be interesting to find out what made her tick. And he did need to get out of his rut.
13
WESTWOOD, LOS ANGELES, CALIFORNIA
TUESDAY, JULY 1, 2014, 10:41 A.M.
Sal DeAngelis glanced up at the clouds scudding across the sky. What a great day, he thought. He was dressed in a red T-shirt that had I LOVE MY OLDSMOBILE emblazoned across the front in white lettering. It was a gift from his oldest sister, Barbara, and happened to be his favorite piece of clothing. It was the same red as the exterior of his ride, and the off-white lettering matched the upholstery.
Sal carried a can of car wax in one hand and a toolbox in the other in case he came across something that needed repair. He had washed the car, and now it was time for a wax. He had only a vague sense of when it had last been waxed and couldn’t pin the exact date down. The reality was it had been the day before and the day before that.
He started on the grillwork, intending to proceed to the hood and front fenders. But he would never make it that far. All of a sudden an unpleasant feeling spread through his body. It was a sensation he used to experience frequently before iDoc entered the picture, when he would forget to eat on a regular basis. Since iDoc, such episodes had been a thing of the past. But now the sensation was back, and back with a vengeance.
He put down the can of car wax, tossed the polishing rag onto the hood of the car, and made a beeline for his apartment. Inside he went directly to the refrigerator and grabbed the half-gallon container of orange juice he had just bought. With shaking hands, he filled a glass and gulped it down. He stood still, waiting for the dizziness to recede.
Unfortunately he didn’t feel any better. With some difficulty he poured another glass of OJ. When that had no effect, he panicked, especially since he had begun to sweat profusely.
Dashing into the bathroom, he stared at his reflection. Perspiration was now literally drenching his face, and he could feel his pulse in his temples thumping rapidly. This was bad.
He dashed back out to the car, where he had foolishly left his phone. Even before he got to the car he heard his phone’s honk. Relieved at having his doctor available, he held the phone in front of his face. His hands were so sweaty that iDoc couldn’t make a biometric read of his fingerprints, so it automatically switched to visual verification. Finally, his iDoc doctor avatar appeared on-screen.
“Sal, we’re on speakerphone again,” Dr. Wilson said. “Can I speak openly?”
“Yes!” Sal shouted at the phone.
“I can tell you’re very anxious. I suggest you lie down.”
“Something’s wrong! My blood sugar is out of whack.”
“Nothing is wrong,” Dr. Wilson answered in his calm, reassuring voice. “You’re agitated. You need to lie down.”
“I need sugar,” Sal shouted back at the phone.
“Your sugar levels are normal,” iDoc stated soothingly. “Please, Sal. Go inside, lie down, and close your eyes.”
“Screw that!” Sal blurted. He knew he was getting worse, despite the orange juice. Dang it all, iDoc wasn’t working right. Damn computer glitches! Maybe he even screwed it all up himself. He might have broken that thing they put in him when he was bending over waxing the car. Sal pulled his T-shirt up to inspect the small, narrow pink scar on the left side of his lower abdomen. His anxiety growing, he tossed his phone onto the front seat of the Oldsmobile and massaged the pink scar with his fingertips. He’d always been afraid to touch the area, but now he pinched it, feeling the square, waferlike object implanted under his skin.
With sudden resolve, he bent down and opened his toolbox, rifling through his collection and sending screwdrivers and wrenches clattering to the concrete floor of the carport. There it was! His utility knife. He extended the razor-sharp blade, then looked back down at the thin scar, evaluating it. Abruptly changing his mind, he turned and ran. George!
Sal pounded hard on George’s front door, nearly shaking it off its hinges. There was no response. Sal’s anxiety level shot off the scale. He gasped for breath. On top of everything else, his COPD was acting up, causing him to wheeze.
“George! George! Open up, it’s an emergency!” George’s door didn’t open but the door to the adjacent apartment did.
“What the fuck, dude!” An angry, sleepy Joe stood in his doorway, sporting a pair of paisley boxers and nothing else. He looked at Sal: wild-eyed and clutching an open utility knife. “Whoa!” Joe immediately took a step back into his apartment, pulling the door halfway closed. “I’m trying to sleep, you crazy old fart!”
Unlike George, Joe had never found Sal worthy of sympathy and, having been awakened after a night of wild sex, he regarded Sal with irritation and disgust.
A naked tattooed young woman had come up and was peeking over Joe’s shoulder.
“What the hell are you doing disturbing everybody!” she yelled at Sal.
Sal didn’t respond. Instead he sprinted away, tearing down the path to his Olds. He yanked open the driver’s-side door. For a moment the world spun. He was forced to wait until the vertigo passed. As the sensation subsided, he climbed behind the steering wheel, still clutching the knife in his right hand. Securing the lap belt he’d retrofitted in the vintage vehicle didn’t cross his mind. He turned the key and the engine roared to life. At least the Olds wasn’t going to let him down. He was vaguely aware of the muffled voice of iDoc Dr. Wilson, still trying to get him to go into the house and relax.
Sal threw the car into reverse and backed up too fast, colliding with the trash cans lined up opposite his parking space. Unconcerned, he put the car in drive and careened down the street. His mental capacity was deteriorating quickly as he tried to get to the L.A. University Medical Center. They had an ER and would help him. George would be there, too. Without thinking about what he was doing, Sal hiked up his T-shirt and used the utility knife to try to cut open the scar on his left side. He had to get the damn device out!
Sal had been told what they were embedding in the fatty tissue just under the skin of his abdomen, but he didn’t really understand. He was leery of all things high-tech but had trusted that the doctors knew what they were doing. Now something had gone wrong. What he sensed on an intuitive level was that the damn thing in his belly was killing him, and he wanted it out. He felt no pain as he cut into his tissue.
Irrational as it was, a part of his compromised brain was horrified by the narrow jets of blood spurting onto the Oldsmobile’s white leather upholstery. But he had no choice. Gritting his teeth, Sal pushed the blade in as far as it would go and then drew it laterally. He could feel the tip scrape across plastic or metal.
Sal knew the route to the medical center by heart. He sped up. Suddenly there was a sickening sound of metal against metal, and he felt the shudder of his car as it ricocheted off a vehicle parked along the street. Jesus! He used the back of his right hand to try to wipe the sweat from his eyes while still holding the utility knife. Suddenly he was bounc
ing along the sidewalk without knowing how he got there. He wrenched the steering wheel to the left, sending the Olds careening back onto the street, clipping the back end of a parked Mercedes. Now he was driving into oncoming traffic; horns blasted as Sal yanked the car back into his own lane.
Sal thrust his index finger inside the four-inch gaping wound, feeling for the implant. Just as the tip of his finger touched the edge of the object he glimpsed the red blur of a traffic light. Its message no longer registered in his brain, and he sailed through the light and onto Wilshire Boulevard. He was totally oblivious to the cacophony of metal slamming into metal.
“Hey! Watch out!”
The loud yell came from less than a foot away. Sal jerked his head up. He had arrived at the hospital. A man on crutches, crossing the street, whom he had almost hit, had just screamed at him. Sal slumped his weight to the right. At that point it was all he could manage to do, using his body weight to turn the wheel in that direction. The car swerved and jumped the curb, crashing through a privet hedge, still moving at over forty miles per hour.
Sal’s foot no longer responded to the feeble messages sent from his brain and remained heavy on the accelerator. Shocked parking valets dived out of the way as the Oldsmobile plowed across a patch of grass on a direct path toward them. Their abandoned valet stand exploded into a mass of flying wooden shrapnel as the car-turned-ballistic-missile blasted through it on its way toward the floor-to-ceiling windows of the contemporary-designed ER.
The Olds knifed through the plate-glass wall and bounced across the ER’s marbled foyer, barely missing the department’s stunned concierge greeter, frozen in her tracks, digital tablet in hand. The car zipped by Debbie Waters’s command post and smashed into a massive LED screen displaying a slide show of the medical center. The vehicle crashed into the screen’s supporting concrete, its back end rearing up in the air before slamming back down onto the marble floor.