Eye Sleuth (5 page)

“That’s the emergency response team from the fire station, they’re right outside. I’ll bring them up,” Val said. He was back almost immediately, followed by four firemen, who swung into swift, efficient action, their only comment a terse, “We got to get her down before there’s a full collapse.”

Calmly, they positioned two ladders under Lanny. A metal platform was slotted across the rungs near the top of the ladders. One of the firemen, a muscular wedge of a man, went up the rungs with lithe speed, stepping carefully onto the scaffolding and reaching cautiously for Lanny, who lay motionless. She hadn’t made a sound since the mutter that told me she was alive.

“Slowly, move slowly,” Aldon breathed, pushing his signature horn rims higher on the bridge of his nose. Tensely, we watched as the fireman gently lifted Lanny off the metal struts. Their burden removed, the supports groaned and shifted, releasing a stinging shower of glass slivers but the man didn’t flinch.

A subdued cheer went up when he stepped off the ladder and there was a rush to help him put Lanny on one of the sofas in the main clubroom. Blood was smeared down the side of her face but no cuts were visible. Hidden by her hair, I thought, noting that my panic had gone, replaced with impartial focus. My optometric training was taking hold. Not a moment too soon. Clinical work at the college has exposed me to a wide range of trauma, from metal slivers to pencils stuck in eyes. None of it means I’m licensed to practice medicine but optometrists study anatomy as well as pathology, even psychology, all of which is helpful in learning your way around the human system and psyche and extracting debris from eyes.

“The doctor will be here any moment,” one of the fireman said.

Before anyone could stop me, I knelt by Lanny and felt the pulse in her throat. It was a rapid thread of movement. Her breathing was shallow. A fifteen-second interruption of blood flow to the brain means you lose consciousness. God forbid the lag increases to four minutes; that spells serious damage to the brain. How many minutes had passed since I’d heard her speak? It was hard to think of real time. Had Lanny hit her head when she fell? If your head is brought to a sudden stop, your brain bounces off the skull and the consequences are severe. Half the cerebral cortex is devoted to visual processing and I was acutely aware how profoundly brain trauma affects visual function. I put my hands over Lanny’s. They felt clammy.

Someone with a black bag was standing over me. Behind the doctor were two orderlies with a stretcher. Scrambling to my feet, I moved out of the way but stayed close enough to watch as the doctor lifted Lanny’s eyelids, one by one. Bending even nearer, I saw that the pupil of Lanny’s eye was dilated. Emotion or pain causes large pupils. This had to be pain, the parasympathetic system was in control. Lanny was in deep shock.

Checking Lanny rapidly but thoroughly, the doctor nodded to the orderlies. They handed her an orthopedic support collar and the doctor expertly fitted it round Lanny’s neck. Gently, the orderlies lifted Lanny onto the stretcher.

“Let’s get her to the hospital,” the doctor said, stripping off rubber gloves and snapping her bag shut. The orderlies were maneuvering the stretcher into the hall when two men came into the lounge. One raised a pudgy hand to stop the orderlies.

“Detectives from the police station,” Val murmured behind me.

The doctor and the newcomers exchanged brief words and the orderlies moved off. “Statements from everyone,” the older man wheezed, nowhere close to catching his breath from the climb up the club’s grand staircase.

“I must go with her, she can’t go alone,” I insisted, hearing the urgency in my voice and not in the least embarrassed by it. Aldon joined in before the police could object and smoothly explained why I was the best candidate to go to the hospital. I caught phrases here and there. “She’s family,” and, “Swedish consulate.” The older detective nodded permission for me to leave and I rushed after the orderlies. They were slotting the stretcher into place in the ambulance when Val hurried out and steered me to the front of the vehicle.

Made sense. Erik, Lanny’s husband, had been deputy consular general there for twenty years. Since his death, Lanny continued to help with the peacekeeping trips the Scandinavian ombudsmen and negotiators made to hot spots around the globe. They’d been busy before 9/11. These days, they were even more active.

“Val, please call them back. Either speak to Lars Oldenburg or get a message to him, say it’s urgent,” I said as I ran to the ambulance’s passenger door. “I know, I know,” when Val protested he’d done just that. “Tell Lars it’s vital he find out if there’s a neurosurgeon on staff at the hospital who knows the work of Dr. Ghajar.”

“Dr. Ghajar,” Val repeated and hurried back into the club.

I squished myself next to the ambulance crew in the front seat, breathing a sigh of relief that I’d remembered what I’d read about head trauma victims. Anyone in a medical emergency needs an advocate but it was more than that, correct treatment as early as possible is vital for victims of head trauma. After her savage beating in 1996, the correct treatment had saved the life of the woman the newspapers called the Central Park Jogger.

What New Yorker could forget the hideous attack on the jogger, Trish Meili? Not expected to live, reports of her incredible recovery stressed that the miracle was due to a radical new way of treatment developed by a Dr. Ghajar. Despite the documented success of this treatment, it was taking time to percolate through the hierarchy of the medical ranks. I hoped desperately that the hospital had a neurosurgeon who knew about Dr. Ghajar’s innovations. I sat staring blankly at the streets as we drove, siren blasting. For years, I’d beefed about the ear-rending sound, now it was comforting.

At the hospital, I was detoured to Admissions to help the woman at the computer fill out Lanny’s name, address, age, the minutiae of implacable routine. Val had found Lanny’s purse and pushed it into my hand as we left the club so I had all the details.

Eventually, I was allowed into the cubicle where Lanny lay, still unconscious. The neck collar had been removed and she was strapped to a rigid spine support to keep her immobile. I sat holding her hand, speaking to her now and then in what I hoped was a reassuring voice. People who are unconscious can hear what’s said to them, I’d read enough firsthand reports testifying to that. I stuffed my anxiety deep in my gut where it surfed uneasily over hunger pangs. It was almost two PM. Barely one terrifying hour since I’d dashed into the club for lunch with Lanny but it felt like a month ago.

Why had my godmother been attacked? What was going on? Was it something to do with the club? It was true the place was in discreet turmoil. Members’ unhappy rumblings at the club had skyrocketed way beyond disgruntled some time back and percolated at roiling boil ever since. Matters had been outed nationally with a New York Times article. “Records Seized in Investigation at National Arts Club.” The New York Post wasn’t as restrained. “City raids posh Gramercy club over ‘tax dodge.’” The coverage by the New York Observer, Newsday and the Daily News fell somewhere in between the sober Times and the strident Post. Headlines sizzled, club members seethed. Lanny, I was certain, would not be involved with any of the groups. Where was the connection?

Early one chilly January morning, twenty-four detectives and agents from the New York City Department of Finance arrived at the club with a search warrant. They were on a mission to investigate possible larceny and tax evasion by the club. The club founders had to be twirling in their graves. Mark Twain and Teddy Roosevelt were among the members whose vision had been for a national arts club that would be educational, not juicy media fodder. Articles in the Gramercy weekly newspaper, Town & Village, alerted local readers that there might be trouble. “State Slams Arts Club” ran one heading. Another pointed out that the club’s bylaws protected the board and the president from responsibility and legal fees.

One headline aimed straight for the viscera, “Aldon James labeled racist, liar by Harlem Opera director.” The bottom line was that the club was allegedly guilty of tax evasion. The newspaper then took the usual step of mailing their articles to the city’s finance department for investigation. But Lanny wasn’t a tax lawyer or an accountant, so that surely wasn’t any reason for her to be embroiled in that particular mess.

Then there was a group of members agitated about the club’s financial activities. Aldon James labeled the group of “Concerned Artists” pure dissidents. The group retaliated, claiming their queries about finances had gone unanswered for years. While the charges, counter-charges and investigations were ongoing, people strained to hold on to their tempers and stay civil. Had someone from the Concerned Artists group or any one of the other factions had too much to drink and lost control, attacking Lanny in a rage because he thought she didn’t agree with them?

It didn’t make any sense. Nothing made sense.

I sat holding Lanny’s hand and mulled over the little that I knew about the lawsuits spawned by the club’s dissenting members. Was Lanny ever involved in one? She’d never mentioned anything to me. Had she been legally bound to silence? Surely Lanny wouldn’t have concealed something like that from me, she knows I’m not a blabbermouth. Perhaps it was nothing to do with the club but fallout from one of her peace-keeping missions. I shivered as I visualized the fury of Lanny’s attacker. And I considered one more nasty fact: was this the danger I’d been warned about yesterday?

A nurse hurried in. “People from the consulate are here,” she said. “The doctor says they can come in but we’ll be taking the patient for a C.A.T. scan soon.”

Lars Oldenburg, the Swedish consulate’s UN delegate, arrived on the nurse’s heels. Erik’s brother, he was Lanny’s dearest friend. After she’d been widowed, Lanny had made a living will giving Lars durable power of attorney for health care, a sign of their closeness. Impeccably groomed as always, the intensity of his slate blue eyes and the faint flush on his fair skin were the only outward indications of his concern. He had two men in tow. To my immense relief, Lars told me that one was a neurosurgeon on staff who knew about Dr. Ghajar’s work. The other was introduced simply as Dag, an attaché from the consulate, a Nordic diplomatic type, useful whether he was at a party or a panic station.

Lars and the neurosurgeon moved over to Lanny. Tears pricked my eyes as Lars bent over Lanny, kissing her cheek gently, stroking her face and murmuring her name. She didn’t respond, didn’t move, and he straightened up, a stunned look on his face. The neurosurgeon reached for Lanny’s chart and conferred quietly with the nurse.

Someone else hurried in and identified himself as the staff doctor and rapidly explained what they knew so far.

“Slight cuts, all in the hairline, above the left temple. Minimal bleeding. Preliminary tests indicate the aftermath of what was possibly a small stroke, perhaps the shock of the fall. It’s hard to evaluate the combined effects of the trauma at this stage.” He hesitated, reluctant to pile dire news on top of bad. “It could be there’s damage to the brain stem. It’s a question of time, of wait and see. We’ll have a C.A.T. scan and that will give us more information.”

I didn’t add that I was dreading the complete evaluation. I didn’t have to. Lanny was deeply unconscious. If that lasted for more than a few hours it was likely to cause permanent brain damage. Would she be identified as traumatic brain injured, TBI? Even mild TBI has lasting consequences. Every year, over two million in the U.S. are left TBI after sports, industrial and auto accidents, an incomplete estimate because only hospitalized patients are counted. Add a new category I thought angrily: vicious attack.

The doctors turned their attention to Lars. The neurosurgeon, a tall, balding man, didn’t sugarcoat his words.

“Now is a critical intervention point, so soon after the accident. We need to monitor pressure on the brain, try to avoid causing any more insult to the body, which would be like a second injury––the first injury, of course, was the accident. It’s possible that part of the brain was bruised during the accident.”

“What must you do?” asked Lars. His self-control was complete but he was deathly pale, the faint flush on his face gone.

“We monitor brain pressure by putting a tube into the middle of the brain. That gives us a number to tell us how swollen the brain is. Then we try and prevent the brain from swelling more and causing a second injury.”

“How do you do that?”

“We’ll talk later,” the neurosurgeon said firmly. “At the moment, the patient is not breathing adequately so we’ll monitor her carefully.” As if on cue, I heard Lanny struggle for breath and heard her ragged, short breaths.

“Surely she needs a respirator?” Lars, skilled at diplomacy, couldn’t keep the agitation out of his voice.

“No, we would not use a respirator. It can cause the individual to breathe so rapidly that blood pressure drops and not enough blood gets to the brain. The standard response has been to give steroids but these have no effect on head injury in terms of outcome. The drugs cause you to lose so much fluid that eventually blood pressure drops. Then you die.”

Lars nodded his understanding of the terse explanation.

Orderlies arrived to take Lanny for the scan. The doctors huddled in intense discussion. Lars only had to look once at Dag, the diplomatic type, and the man immediately fell into place behind Lanny’s gurney, following it out of the cubicle. The doctors started to follow and the staff doctor paused to speak to Lars.