Matt paused before moving deeper into the alley. He took a few deep breaths, and each one brought a new wave of pain that threatened to immobilize him. He clutched his white coat around him against the early morning chill and, for a few moments, felt marginally warmer. Then he looked down and realized the coat was like a white beacon in the dim light.
Be warm or be a target for men trying to kill me? Not
much of a choice
.
With a sigh, he rolled the coat into a tight ball and shoved it behind one of the dozens of trash cans lining the alley. Now the wind that swirled around him seemed to go right through the thin material of his surgical scrub suit. His teeth chattered, from both cold and fright. He shivered, and each muscle twitch caused more pain.
He was in a narrow passageway between two industrial buildings. Ahead in the dark was a veritable obstacle course. He didn’t know if there was escape at the end of the alley. All Matt knew was that he had to keep moving.
Matt stretched his hands in front of him like a blind man entering a strange room. He moved close to the right-hand wall and worked his way into the darkness. As his eyes adjusted he could make out dim shapes. He circumnavigated garbage cans, empty crates, and piles of debris, following an irregular course along the wall, moving steadily deeper into the alley. He encountered metal doors at irregular intervals. He checked every one. Locked.
He mentally kicked himself—he could call for help. Matt felt at his waist for the cell phone usually clipped there. Gone, knocked loose at some point. Perversely, his pager was still at his waist on the
other side. He thumbed it to the off position and dropped it behind a pile of debris.
Matt’s heart sank as his dark-adjusted eyes showed him a wall a few feet ahead. This was a blind alley. He was trapped.
He heard a series of faint shuffling noises behind him.
They’re
here
. Matt stopped dead still and quickly compressed his six-foot frame into a doorway. He held his breath. He tensed his aching muscles, ready to run, then realized he had no place to go.
The sounds stopped. Matt peeped out of his hiding place and caught the faint outlines of two men, the smaller silhouetted against the entrance to the alley, the larger moving slowly toward him, one careful step at a time. He heard the rasp of a lighter, saw a brief flicker, then the flame died. Despite repeated sounds of flint on metal, with an overlay of profanity, the darkness remained unbroken. Good. Darkness was Matt’s friend right now.
Matt’s mind’s eye replayed the images from that momentary flash of light. Something had glinted in the big man’s hand—a gun. Probably the same one Matt had felt pressed against the base of his skull. Did the smaller man have one as well? No matter. A single bullet from one weapon would be enough to kill him.
Matt groped around him for a weapon of some kind, any kind. Nothing. He had nowhere to go, nothing with which he could fight. His only hope was to hide. But where? How?
When he was about to give up, his fingers touched rough wood. He squinted against the darkness and used both hands to explore further. Near the brick wall that blocked the end of the alley, a stack of wooden pallets had been shoved against the wall. Matt stretched as high as possible and was barely able to touch the top. Would the stack hold him? If it came tumbling down, the noise would certainly bring his captors. He held his breath and wedged his toe into an opening
in the stack. With infinite care, he scaled the rickety pile, wincing over every sound, praying the big man was still too far away to hear it. At the top he pulled himself up and stretched prone. He wiggled around to peer back over the edge, his legs hanging off either side of the improvised platform.
There was the sound of a step, a long pause, another step, another pause. Then, from the mouth of the alley, a metallic cacophony was followed by a spate of curse words erupting into the night. Apparently one of his pursuers had found the garbage cans Matt had so carefully avoided.
“Lou, I need help.” The loud whisper’s high pitch told Matt this was pursuer number two. “I cut my leg on this—”
“Shut up! A cut won’t kill you.” There was a guttural laugh. “But if I can find the doc, I’m going to kill
him
.”
Matt willed himself to be perfectly still. As the shuffling moved toward him, Matt peeped over the edge and could faintly see the dark bulk of the larger kidnapper creeping closer. The man’s hand traversed left, right, left, right in concert with the motion of his head. If he looked up, Matt was dead.
The kidnapper continued along the alley, trying doors along the way, moving on when he found them locked. He stopped at the wall that blocked the end of the passageway, turned, and retraced his steps along the opposite side of the alley. Matt hardly dared hope he would escape, but there was a chance . . .
Finally the man reached the entrance to the alley. Matt could see him, silhouetted by the faint light of the street, as he shook his head and dropped the pistol into his coat pocket. He ducked his head and whispered to his partner, who was bent at the waist, holding his right shin. In a moment, they disappeared from Matt’s view, the injured man limping and hopping, struggling to keep up.
After what seemed like an hour, Matt heard two car doors slam. There was quiet for a few seconds, then an engine revved and accelerated away. Matt couldn’t believe his good fortune. They’d missed him. They were gone. Or were they? Had one of them crept back to keep watch? He couldn’t take the chance.
Matt’s back muscles were in spasm. He forced his nails into the palms of his hands to keep from crying out as he kept his body pressed against the rough wood.
He decided to count to five hundred before he moved. By the time he reached a hundred and fifty, he thought he’d never be able to lie on his perch for another second. He swallowed hard, gritted his teeth, and continued his count.
At last Matt drew a deep breath and willed his muscles to relax. Like an old man getting out of a chair in which he’d sat too long, Matt hunched himself slowly into a crouch. He turned his back to the alley, intending to descend backward from his hiding place. Matt groped with his foot for purchase in the stack of pallets, but found only air. He teetered as he struggled to keep his balance, then threw his arms wide in a futile attempt to hold on to something, anything. Instead, gravity grabbed him and pulled him head-down into black oblivion.
Dr. Hank Truong placed the last careful stitch in the face of the teenage boy. “I’ve closed the wound the knife made. There’ll be a scar,” Hank said, “but only a small one. Now try to stay out of trouble. I don’t want to see you back here again.”
Odds were the teenager would be back—maybe even brought in DOA—but there was always hope. That was what made this duty in the Parkland Hospital Emergency Room tolerable for Hank: hope that what he did for some of his patients might help.
A nurse stuck her head into the room. “Patient in trauma room 2,” the nurse said. “Unidentified white male, early to mid-thirties, brought in unconscious. EMTs say the call came from a guy who owns a pawnshop down on Riverfront Boulevard. He went into the alley to throw some boxes into the Dumpster and found the man lying there. No ID.”
“Be right there,” Hank said.
As he strode past patients on gurneys, many with family members hovering around them, Hank’s mind clicked along as though
powered by a microchip as he sorted out the possibilities for the diagnosis and treatment of an unresponsive patient.
Someone found in an alley in that neighborhood was a likely candidate for head trauma—probably a mugging. But Hank had to consider alcohol, drugs, diabetic coma, epilepsy, stroke, and many other possibilities. He wasn’t worried. He was confident he’d come up with the right diagnosis. He generally did.
Hank tapped on the door of the trauma room and eased it open. The man on the treatment table was naked from the waist up, his skin as pale as the sheet over the lower half of his body. Dried blood covered his scalp and obscured his facial features like a Mardi Gras mask.
A surgical scrub shirt and pants, the stenciled name on them partially obscured by black splotches of dried blood, were crumpled on the shelf beneath the gurney. Hank wondered what a psychiatrist would make of the fact that the blots reminded him of a Rorschach test showing a hand holding a gun.
I’ve been in the ER too long
, he thought.
Was the scrub suit significant? If they washed out the blood, they could probably read the name of the hospital. But would that help? This could be a patient who’d grabbed the clothes to slip away without waiting for his discharge . . . or his bill. Or he might be a hospital worker—dietary, janitorial, laboratory, whatever. Lots of them wore scrub suits they “borrowed” from the hospital. But most likely this was just a bum who either found or stole the clothing. No, there wasn’t going to be any help there.
“What have you got?” Hank asked.
A nurse whose name Hank couldn’t remember stood at the patient’s side, scribbling on a clipboard. “Here’s what we have so far.” She passed the clipboard over, and when she did, Hank saw her name tag.
“Thanks, Allison.” Hank scanned the ER intake record. White male, estimated to be in his thirties. Unconscious, bleeding from a
scalp wound. No odor of alcohol. No Medic-Alert bracelet. Nothing that would help.
“Vital signs?” Hank asked.
Allison looked at the ballpoint scribbling on her palm. “Haven’t had time to chart them. One-ninety over sixty, fifty-four, ten.”
The information clicked into Hank’s brain as though he’d hit Enter on his well-worn laptop. Systolic blood pressure up, diastolic down, slow pulse. Cushing’s triad—evidence of increased pressure on the brain. “Could be developing a subdural hematoma, if he doesn’t already have one,” he said. “We need a stat CT of his head. I’ll go with him in case he goes south while he’s in radiology. And get a neurosurgeon down here.”
“Do you want to clean up that scalp laceration?”
Hank whirled and noticed the nursing student who stood in the corner. He swallowed the answer he had planned for the ER nurse—she’d know better, but this girl might not. “No, it’s barely oozing now. We don’t want to mess with it until we know there’s not a fracture. We’ll wrap some gauze around his head and get the CT first.”
For the next forty minutes, Hank functioned on automatic pilot. His actions were dictated by lessons initially learned through countless hours of textbook study and hammered home by involvement in the care of case after case of head trauma. Stabilize the airway, get an IV going, give Mannitol to decrease the pressure in the brain, administer Dilantin to ward off convulsions, confirm the diagnosis through CAT scans, keep a careful eye on the patient’s neurological status.
“What have you got?” The staff neurosurgeon, Ken Gordon, strode through the door and stopped next to Hank.
“John Doe with a head injury,” Hank said. “Thought it was an acute subdural, but it’s actually an epidural hemorrhage.”
Gordon had been a standout basketball player at SMU, a crackerjack
medical student and resident at Southwestern Medical Center, where he was now associate professor of neurosurgery. Gordon was the typical tall, dark, and handsome man—six-two, wavy brown hair—and all the nurses tended to follow him with their eyes when he walked by. Hank didn’t care about that. What he cared about was that Gordon, the best neurosurgeon at the medical center, was on call today for Parkland Hospital.
“Think he’s going to need burr holes?” Hank asked.
Gordon held up one finger in a “just a minute” gesture. He finished scanning the chart that Hank handed him, then began a rapid but thorough neurological exam of the still-unconscious man. Finally he stepped to the viewbox on the wall and spent a moment studying the CT scan of the patient’s head. “Yep,” Gordon finally said. “Acute epidural hematoma.” He pointed. “There’s the fracture line. Non-displaced, though. That’s good.”
“Glad you agree,” Hank said as he basked in the undeclared glory of having made a good pickup.
Gordon yawned and stretched. “Want me to let you know how he does?”
“Please,” Hank said. He didn’t ordinarily have time to keep up with the hundreds of patients who passed through his hands each month, but for some reason, he felt a special interest in this John Doe. He wondered why.