Dr. Knox (17 page)

“I wondered why your car was parked in the same spot for so long,” Ben Sutter said, and he blew a long plume of cigar smoke into the night sky. We were drinking beer on the roof of my building, and I'd just finished telling him about the earlier part of my evening. Sutter was sprawled on a mesh-and-metal lounge chair, and I was perched on the coping of the low wall that ran around the rooftop. Two bottles of Populist IPA had begun to leach some of the fear and adrenaline from me. The night was warm, and there was a breeze that carried off Sutter's smoke.

I squinted at him. “How'd you know how long my car was parked?”

“The tracker I put on,” he said.

I thought for a moment about being angry with this, but decided I was touched instead. I nodded at Sutter and drank some beer. “Were you ever going to check out why?”

“I was curious, but then you called. Speaking of which, let me see your phone.”

I dug my phone out of my pocket and tossed it to Sutter. “Why?”

Sutter took the cover off my phone and examined the edges. Then he took out his key ring, and selected a slim tool from it. He slipped it into the phone casing, twisted, and lifted the back off. Then he pulled a penlight from his cargo shorts.

“I'm checking for spare parts,” he said. “Like trackers.”

“Shit.”

“No worries there,” he said as he slid the phone case back on and tossed the phone back to me. “How about your backpack?”

“Under your chair.”

After ten minutes searching through the pack, Sutter held up what looked like a gray pen cap. He looked at it for a moment, then crushed it under his heel. “Tracker,” he said.

“Shit,” I repeated, and let out a long, shaky breath.

Sutter smiled ruefully. “That Kyle guy sounds like a dick.”

I nodded. “Without a doubt. Too much money, everybody around him saying yes all the time…”

“Always a healthy mix. The cousin seems like fun, though. She cute?”

“If you like naughty elves.”

“My favorite kind. She smarter than Kyle?”

“Smarter; more manipulative. She had a nice way of offering the carrot, but she never let me forget about the stick.”

“You buy her story?”

I shrugged. “It explains why the Brays are after Alex.”

“And that business about why they haven't called the cops or the feds, or the National Guard?”

“That makes less sense. I know the Brays are private people—that's what everything I've read about them says, anyway. And, given what they've got with PRP—their own little army—they clearly have no problem cutting the authorities out of things when it suits them. But bypassing the cops seems like a damn big risk to take when your son or your grandson is missing. And then there's Elena.”

Sutter shifted in his lounge chair and tilted the back down farther. “Is she or isn't she the kid's mom?”

“That's the question. When Alex's airway was closing up, Elena was freaked in the way that only parents get. But Lydia's had her doubts from the start—how she left her kid with total strangers, et cetera. I chalked that up to fear and desperation—being chased, wanting to protect Alex—but now I'm wondering.”

“You're not going to have an answer until you find her.”

“No shit. But I'm still waiting for a brilliant idea of how to do that. Mandy said she'd give me a little time to think things over, but that's measured in days. Or less.”

Sutter smiled. “
Mandy
—that's nice. She have a pet name for you?”

“Not that she mentioned.”

“Probably waiting for the second date.”

“Which I'd prefer to pass on. She may be cute, but she's also scary, and I take her threats seriously.”

Sutter nodded slowly. “Yep. These folks haven't been the slickest operators so far, but it's not for lack of trying. Eventually, they'll get lucky.”

By Friday morning, no ideas—brilliant or otherwise—of how to find Elena had announced themselves, though a headache, as gray and dispiriting as the marine layer that squatted over the city, had. Advil did a little something to cut the pain, and coffee did a little more. I poured a third cup and drank it, and thought about Amanda Danzig and Kyle Bray and carrots and sticks. Then Lucho called from downstairs to tell me the waiting room was filling up, and I turned on the shower.

It was another busy day, with more norovirus cases in the morning, and in the afternoon the principals in a pickup-versus-SUV collision a block away, who very nearly came to blows at the reception desk. Lucho was threatening violence to the pickup driver, and I was ushering an SUV passenger into the exam room, when Mia came in. She was wearing jeans and a halter top, and she crossed the waiting room to catch my sleeve.

“I need to see you, doc,” she whispered.

I looked her over quickly, and saw nothing beyond pallor and nervousness.

“Check in with Lucho, Mia—it's crazy today.”

She was pacing by the front door next time I passed through the waiting room, looking paler and jumpier.

“What's Mia in for?” I asked Lydia.

She shrugged. “She wants to talk to you.”

“About what? The cut on her leg bothering her?”

“She just said she needed to talk.”

I looked across the waiting room. Mia was buried in her cell, worrying her lower lip. “Okay,” I said. “After the UTI in Exam Two.”

The urinary tract infection was barely out of the door when Mia swept into the exam room, her usual flirty cool nowhere in sight. I motioned her to the exam table, but she didn't sit. Her sandaled foot tapped nervously.

“What's up, Mia? The leg okay?”

“It's fine, doc. You need to come with me.”

“What?”

“You need to come with me, like on a house call. Like now.”

“A house call? I've got patients out there.” She pressed fingers to her temples and sighed. “What's the matter?” I asked.

“It's…it's Jerome, doc—he's not doing good.”

“What's wrong with him?”

“I…I'm not sure. That's why you need to look at him.”

“He can't find another doctor?”

“He needs to see somebody
now.
”

“If it's an emergency, he should call
911
.”

“He…he can't, doc. He just needs…”

She rubbed her temples again. She was paler and more frightened than I'd ever seen her. I checked my watch. “Let me see if I can get away.” Relief crossed Mia's face like the sun coming out.

Lydia said she could cover the rest of the day's patients, and I grabbed my backpack. “Let's go,” I said to Mia.

She smiled and nodded. “Let's use the back door. I got my car in the alley.” I nodded and led her down the hall.

Mia's car was a Golf that was once red, with a soft top that was once not mostly duct tape. Inside, the Golf was surprisingly tidy, and Mia played electronic dance music at a deafening volume as she angled expertly west and then north. We were nearly in Little Tokyo when she pulled into a spot in front of a shuttered store that used to sell soccer equipment.

“This is where Jerome lives?”

Mia locked the car. “On the second floor.”

We went through a metal door and up a dim staircase. There was a short hallway at the top, with flimsy-looking doors at either end. Mia paused.

“Which way?” I asked.

She shrugged her broad shoulders and looked down at the mildewed carpet. When she looked up, her face was red. “I…I'm really sorry.”

My pulse spiked, and sweat prickled across my forehead. “Sorry for what?”

“I owed, doc, and I had to pay off.”

“You…Mia, what did you do?”

She shook her head and turned and ran down the stairs. I started to follow but froze when the door to my left opened. “Don't blame her,” a voice said from the darkened doorway. “She didn't want to lie to you. I made her do it.”

It was a small, tired voice, and it came from a small figure with bleached-blond hair streaked blue in front. Her left arm was folded across her chest, and her left hand pressed to her right shoulder, where her shirt was crusted with dry blood.

She stepped into the hall and I caught her as she sagged against the wall. “Jesus, Shelly, what happened to you?”

“It hurts like a bastard,” she said, “but she's in deeper shit.” She pointed into the apartment, and I looked past her, to a spavined daybed and Elena upon it, beneath a thin and bloody blanket.

Shelly had a contusion, purple and swollen, under her left eye, and a flap of skin like the sole of a shoe hanging from her right deltoid—painful, ugly, and possibly infected, but, with cleaning, stitching, and meds, not life-threatening. She was conscious, coherent, and ambulatory. She was the lucky one.

“Call
911
,” I said, and left her in the hall. I crossed the room, knelt at the daybed, and pulled back the blanket. Elena lay on her left side, hunched around her pain. She was white—almost gray—and her breathing was fast, shallow, and desperate. I snapped on my gloves.

Elena's eyelids fluttered when I touched her neck, and she shrank from my hand. She tried to roll away, but pain or weakness stopped her. I found her carotid and felt her pulse careening beneath my fingers—120 at least.

“It's all right, Elena,” I said softly, “I'm going to help you. Remember me from the clinic—Dr. Knox? I took care of Alex.” Her eyes opened wide at the mention of his name, and darted about. She tried to speak but had no breath.

“I need to check you out,” I said, and turned her onto her back. Her jeans were dark and damp with blood at the beltline, and so was her Little Mermaid tee shirt—darkest and dampest around the long slash on its left side. I tore the shirt open from hem to collar.

Elena's breasts were small and blue-veined, her nipples like dark-red beans. The skin of her torso was paper white, and painted all over with tea-colored daubs—blood from a laceration across the lower left quadrant of her abdomen, from above her hip to her navel, and from a smaller wound—a puncture—on her right flank, just below the sixth rib. I slipped on my stethoscope, and placed the chest piece above Elena's left breast. I heard breath sounds—fast and labored. I moved it to the right side and heard…nothing.

Shit.

I pulled the stethoscope off, splayed my left hand on Elena's chest, just above her left breast, and rapped my middle finger with the middle finger of my right hand. There was a dull
thock.
I moved to her right side and percussed her chest again. It sounded like a hollow gourd.

Shit.

Elena had a tension pneumothorax—an air bubble in her chest cavity, between the chest wall and the lung, that was pushing against her right lung, squeezing it and starving her of oxygen. Killing her, if I didn't pop her chest. I rummaged in my pack. In another world, I felt Shelly behind me.

“Last ten minutes, she's been panting like a dog,” Shelly said. “She gonna be…okay?”

I found Betadine, tape, and packs of sterile gauze. Where was the needle? “What happened to her?”

“Motherfucking Russians happened. One of them had a knife like you clean fish with, and went at her like she was a tuna, the fucking prick.”

“When was this?” Where was the needle?

“This morning, around seven, maybe. Is…is she gonna be okay?”

Seven a.m.—more than enough time for pressure to build, and for a simple pneumo to become a tension pneumo.
Shit.

“The knife probably nicked her lung, and now it's collapsed,” I said. Shelly gasped. I dug deeper into my pack and found it—a syringe with a fourteen-gauge needle.

I looked at Elena's chest. Her ribs were plain beneath her white skin. I touched her clavicle on the right side, slid my finger to the midline, and counted down to the second intercostal space. I squirted Betadine over her second and third ribs, and wiped the area with a gauze pad. Then I sprayed lidocaine on the same spot. I tore open the syringe and tossed the plunger away.

Elena stared at the needle. “Close your eyes,” I told her. She nodded and closed them.

“You want to take a step back,” I said to Shelly. “There may be spray.” Then I pushed the needle slowly into Elena's chest, at a ninety-degree angle, in the space just above her third rib.

Push, push, push, and there it was: a pink mist in the barrel of the syringe, and a hiss, strong and steady. Almost immediately, Elena's breathing deepened and slowed. I slipped on the stethoscope and heard breath sounds from both sides of her chest now. Her color began to return. I checked her pulse again: ninety-five and slowing. I released a long-held breath of my own, and taped the needle in place.

“Better?” I asked, and she nodded, panic fading from her eyes.

“Alex,” she said in a hoarse whisper.

“He's fine,” I said. “Let me look at those cuts.”

I took a squeeze bottle from my pack, ran sterile saline over her wounds, and wiped away dried blood. The puncture wound had closed. The belly cut was thin and clean-edged—almost surgical—a single curving stroke made with a very sharp blade. A film of clotting blood had begun to form over the seam. I had no idea how deep the cut went, or if there were bleeders inside, or if—worse still—her abdominal cavity had been punctured and her gut was leaking. I pressed my fingertips into her belly to check for rebound tenderness. There was none, and that was a good sign, though the folks in the ER could tell for sure. They could also see to the fresh cut on her lip, and the new bruises on her head, her arms, and God only knew where else. A shiver ran through Elena's pale body. I pulled the thin blanket over her, careful not to cover the syringe. She sighed deeply and closed her eyes again. I sighed too, and looked at Shelly.

She'd retreated to a corner—to one of the folding chairs set around a card table. Her gaze flicked between the dusty screen of a television perched on a plastic crate, and a bar of greenish light that came through a window. I carried my pack to the table and knelt at her side.

“Is she okay now?” Shelly asked.

“She can breathe again,” I said softly. “The rest of her problems will keep till she gets to the ER.” Shelly stared at the floor. “Let me see the shoulder.”

I pulled on fresh gloves, and Shelly turned in her seat. She slowly took her hand from her shoulder. Unlike the surgical wound on Elena's belly, this was a butcher's cut, through layers of skin and muscle, nearly to bone—a hack with a thick blade and a heavy hand.

“Can you move your arm?” I asked, and Shelly showed me that she could, though with pain. “How about your hand and fingers?” She demonstrated those too. “Lucky,” I said, and squeezed some normal saline over the wound. Shelly winced, and cursed when I started cleaning. “Tell me what happened,” I said.

“I told you already.
Fuck
—that hurts!”

“Tell me more. It'll take your mind off the pain.”

“We were on San Pedro, by Fourth Street, headed over here, and those Russian pricks showed up from nowhere. One grabbed me by the throat, started shaking me, and—boom—my girl Ellie goes up on his head with a tire iron. Don't know where she was keeping that. Then this other asshole gets on her. She fought—whacked him good a couple of times—but then he pulls a knife and I hear her yell. I'm not too sure what happened after that, 'cause the first guy got up, screamin' bloody murder and wavin' a goddamn meat cleaver around. Caught me in the arm with it, and then I was runnin', draggin' Ellie down the street, and a cop car came up San Pedro, and the Russians took off the other way.
Ow!
”

“How do you know they were Russians?”

Shelly grimaced at me. “C'mon, doc, I'm not stupid. Those assholes work for Siggy Rostov. They're at the Horney twice a week, when they come around to collect. And lately I see 'em every day—following you all over the place, and asking anybody who can breathe if they've seen Ellie.”

“Elena's been with you the past week?” Shelly nodded. “I've been looking for her too, you know.”

“I know—and you're like the one person she hasn't been hiding from. She wanted to get in touch; she's worried sick about the kid. But between the Russians and the other guys looking for her—those big-neck creeps you drove off with last night—she was, like, crazy paranoid. She didn't want to be on the street; she didn't even want to call you. She thinks your phones are bugged or something. I tried to get word to you for her, but every time I saw you or went by your place you had company.”

I finished cleaning the wound, and taped a loose dressing over it. I pulled off my gloves and checked my watch. “There are pieces of your shirt in there that need to come out, and you need a tetanus shot, but that should hold you till the ambulance gets here. Which should've been twenty minutes ago.”

Shelly looked down at her sandals. “About that,” she said. Her voice was small and choked.

“About what?”

“About the ambulance. I…I didn't exactly call for one.”

“What?”
I stood, dug in my pocket, and found my cell. “What the hell's the matter with you, Shelly? Elena's been knifed, you've almost had your arm hacked off—it's only sheer luck you're both still breathing. Why're you fucking around?”

Shelly's small, blood-blotched hand closed around my wrist. Her eyes were wide and pleading. “You can't, doc! She made me promise—no cops, no
911
. She made me swear to it!”

“You're not calling them—I am.”

“Please! She said the hospital meant cops, and cops meant the end for her. She said if they got her then Siggy would get her, and if not Siggy, then Immigration, and either way she'd never see the kid again.”

I pulled free of her grip. “She's in a bad way, and you are too. I can't—”

“You fixed her up—she can breathe now—and you patched my shoulder too. Just give me some pain meds and I'm good to go.”

“Neither of you is good to go anywhere except a hospital. All I did was stabilize you; you need more than that.”

“Can't you do it here?”

“You've barely got running water here, Shelly.”

“Then how about at your place?” she said, and took hold of my wrist again. “Please, doc. Ellie's serious. She said if they take the kid then she hopes Siggy gets her, 'cause she'd rather be dead.” Shelly's face was pale and glazed with sweat, and I could feel the fever in her hand.

I shook my head. “You're killing me, Shelly,” I whispered, and touched a number from my phone book. I put the cell to my ear. “Lucho, it's me,” I said. “Did you drive your van to work today?”