Sisterhood (37 page)

“I think … yes, of course I do. A lovely girl. What’s wrong?”

“She’s had an accident. Automobile. We’re at Kensington Community Hospital now, but I’m on my way with her to the Doctors Hospital E.R. Could you meet us there and take over her care? She’s got a fractured arm, a basilar skull fracture, and some chest trauma, so
you’ll probably end up being traffic cop for a three-ring circus of consultants. Will you do it?”

“Of course I’ll do it,” Dr. Armstrong said. “Are you sure she can handle the trip?”

“Sure enough to try. Any risk is worth taking to get her out of here. Especially with you there waiting for her. I have a lot to talk to you about, but all of it can wait until you get Christine taken care of. We’ll be there within an hour.”

“That will be fine,” Dr. Armstrong said softly. “I’ll be waiting.”

A
t David’s instructions the ambulance ride was made at a steady fifty. No lights, no sirens. The fifty-five-minute drive seemed interminable, but what little time they might save by a dramatic dash to the city was hardly worth the catastrophe of an accident.

Throughout the trip Christine slipped in and out of consciousness. David, seated at her right hand, systematically checked her pulse, respiration, blood pressure, and pupil size, looking for changes that might indicate a sudden rise in the pressure against her brain. Any significant increase, either from bleeding or swelling, and he would have only minutes to reverse the process before permanent damage began.

The tension inside him was suffocating. He had acted decisively in dealing with St. Onge, but had he been too hasty? The thought ate away at him. Any crisis in the moving ambulance would be immeasurably more difficult to handle than in the hospital. It was the sort of decision he had spent years in training to be able to make—the sort of decision he had unflinchingly made many times over the years. But this was different.

“Christine?” He squeezed her hand. There was no
response. “Let’s go over the equipment again,” he said to the paramedic riding alongside him. Out of David’s field of vision, the man, a former corpsman in Vietnam, shook his head in exasperation. Granted it was the first time he had ever carried instruments for drilling cranial burr holes, but this was the third check David had asked him to make.

On an off chance Christine could hear, David turned his back to her and whispered the list of instruments and medications. The paramedic held each, one up or signaled that he knew exactly where it was. Scalpels, drill bits, anesthetic, laryngoscope, tubes, breathing bag, Adrenalin, cortisone, suction catheters, intracardiac needle—they were prepared for the worst.

Reluctant to take his eyes off Christine again, David began asking their location fifteen miles from the hospital without even trying to digest the information.

“Pulse: one ten and firm; respiration: twenty; B.P.: one sixty over sixty; pupils: four millimeters, equal and reactive.” The words became a litany, every two minutes. Dutifully, the paramedic repeated then charted them. There was no banter between the two men. No communication at all, in fact, other than the numbers, every two minutes. Pulse … respiration … B.P.… pupils.

As they entered the outskirts of Boston, the tension grew. David, constantly moving, checking, rechecking, rousing Christine. The paramedic, nervous in spite of himself, fingering the instruments of crisis. The driver, a burly young man with thick brown curls, growled a few words into the two-way radio and toyed with the control switches for the lights and siren. They were close enough now. Any sign of trouble in back and he would make a run for it, doctor’s order or not.

Suddenly the trip was over. The ambulance swung a sharp U-turn and backed up to the raised receiving platform. The rear doors flew open. A nurse burst into
the ambulance and, with a glance at Christine, went straight for the intravenous bag. Right behind her, an orderly grabbed one side of the collapsible litter. A quick nod from the paramedic and they were gone, the nurse, running to keep up, holding the I.V. bag aloft.

David moved to follow, then sank back on the seat. He caught a brief glimpse of Margaret Armstrong as she met the team halfway across the cement platform and began her examination even before they reached the entrance. Her white clinic coat, unbuttoned, swung behind her like a queen’s cape. Her every movement, every expression exuded control and competence.

They had made it. They were home. The decision to move, however hasty, had held up. As relief swept through him, David began to shake.

He weaved his way across the busy receiving and triage area and headed straight for the trauma wing. Real or imagined, it felt as if everyone—staff and patients—was staring at him. Phoenix, rising from the ashes; Lazarus from the dead.

Pausing outside Trauma Room 12, he glanced inside. The room was empty. He shuddered at the memory of Leonard Vincent’s knife gliding across his throat. Then he thought about Rosetti. As soon as Christine was out of immediate danger and he had finished speaking with Dr. Armstrong, he would go see Terry.

As David approached Trauma 1, Armstrong emerged and beckoned him inside. Christine was awake. Through a sea of white coats—residents, technicians, and nurses—her eyes—sunken shadows—met his. For a moment all he saw was pain. Then, as he drew closer, he saw the sparkle—the flicker of strength. Her swollen, discolored lips pulled tightly as she tried to smile.

“We made it,” she whispered. David nodded. “Now you won’t have to do burr holes on me.”

David’s eyes widened. “You were awake during the trip?”

“Awake enough,” she managed. “I … I’m glad we’re here.”

Her eyes closed. A reed-thin surgical resident moved in, swabbed russet antiseptic over her right upper chest, and prepared to insert a subclavian intravenous line. As the man slipped the needle beneath Christine’s collarbone, David grimaced and turned away. He came face to face with Margaret Armstrong, who was standing several feet behind him, watching quietly.

“David, I’m so relieved to see that you’re all right,” she said. “The stories that followed your brief visit here the other night were quite frightening.’

“There’s some trouble in this hospital—in a lot of hospitals, in fact. I have a great deal to talk about with you, Dr. Armstrong,” David said. He glanced over his shoulder at the resident, who was calmly suturing the plastic intravenous catheter in place with a stitch through the skin of Christine’s chest. “What about Christine?”

“Well,” said Dr. Armstrong, leading him out of the room, “I’ll examine her more carefully as soon as the crowd in there has finished. My initial impressions add little to yours. She has a definite skull fracture and some blood behind that drum, but so far she seems neurologically stable. I have both a neurosurgeon and an orthopedic man waiting in the house, but I think we’ll hold off on the wrist until we’ve had a chance to watch her. Ivan Rudnick is the neurosurgeon. Do you know him?” David nodded. Rudnick was the best on the staff, if not in the city. “Well, Ivan will see her and do a CAT scan as soon as possible. If there’s no evidence of active bleeding, we’ll wait and hope.”

“What about her chest trauma?” David asked.

“No problem as far as I can see. EKG shows no cardiac injury pattern. My more extensive exam should help confirm it.”

“Dr. Armstrong, I’m really grateful to you for handling this.”

“Nonsense,” she said. “I can’t tell you how flattered—and pleased—I am that you would ask me. By the way,” she added, “there is one small problem.”

“Oh?” David’s eyes narrowed.

“Nothing critical, David, but there are no ICU beds. Not a one. We’re checking on one postop patient now, but he’s been very unstable and I doubt we’ll be able to move him. I’ve decided we’ll be all right putting Christine on a floor. There’s a private room available on Four South. I know the girls up there will give hier closer attention than she would ever get anywhere else, including the ICU. She’ll be moved up there as soon as possible.”

“That sounds fine,” David said. “If the nurses don’t mind, I’ll hang around and do what I can to help monitor her. That is, after you and I have had our discussion.”

“Yes,” said Dr. Armstrong distantly.

“Well, you go ahead and finish. I’ll wait in the doctors’ lounge until you’re free to talk. By the way, which room will she be going to?”

“Excuse me?”

“The room,” David said. “What room is she going to?”

“Oh, ah, I have it right here. It’s Four twelve. Four South Room Four twelve.” The cardiologist smiled, then disappeared into Trauma 1.

Four twelve! David swallowed against the sudden fullness in his throat. Charlotte Thomas’s room! Step one on the bloody brick road that had led through one land of madness after another. He fought his sense of superstition and tried instead to focus on the irony. Room 412 would serve as the first command post in their battle to bring The Sisterhood of Life to an end. The exercise worked well enough, at least, to keep him from racing back to Dr. Armstrong to demand a room change. He wandered across the triage area to the
doctors’ lounge and stretched out with a copy of the monthly periodical
Medical Economics
. The lead article was entitled “Ten Tax Shelters Even Your Accountant May Not Know.” Before he had settled into shelter number one, David was asleep.

An hour later, the phone above his head jangled him free of a frightening series of dreams—Charlotte’s cardiac arrest and the bizarre events that followed, replayed with all of the characters interchanged—all, that is, except Christine, who died again and again in one grisly manner after another.

His clothes were uncomfortably damp and the sandpaper in his mouth made it difficult to speak.

“On-call room. Shelton here,” he said thickly.

“David? It’s Margaret Armstrong. Did I wake you?”

“No, I mean yes. I mean I wasn’t exactly …”

“Well,” she cut in, “our Christine is safely in her room. Nothing new for me to add to what we already know. I think she’ll be all right.”

“Wonderful.”

“Yes … it is.” Armstrong paused. “You said you wanted to talk with me?”

“Oh, yes, I certainly do. That is, if you …”

“This would be an excellent time,” she interrupted again. “I’m in my office—not the one in the office tower, the one on North Two.”

“I know where it is,” said David, at last fully awake. “I can be there in five minutes.”

    The cardiac exercise laboratory doubled as Margaret Armstrong’s “in house” office.

David knocked once on the door marked
STRESS AND EXERCISE TESTING
, then walked in. The small, comfortable waiting room was empty. He hesitated, then called, “Dr. Armstrong? It’s me, David.”

“David, come in.” Armstrong appeared at the door. “I was just making some coffee.”

As he passed where she had been standing, David breathed in the distinctive odor of liquor.

Instinctively he checked his watch. It was not yet one. He ran through a number of explanations as to why the chief of cardiology might be drinking under such circumstances, especially at such an hour. None were totally acceptable. Still, the woman seemed quite in control. For the moment, at least, he forced the concern to the back of his mind.

The lab was spacious and well equipped. Several treadmills and Exercycles, each with a set of monitoring instruments, were lined up across the room. The required emergency equipment and defibrillator unit were placed inconspicuously to one side—an effort, David knew, to avoid additional apprehension in patients already nervous over their cardiac testing.

One end of the suite had been set aside as a conference area, with a maple love seat and several hard-backed chairs encircling a low, round coffee table. Armstrong motioned David to the love seat, then brought a percolator and two cups. She seemed more subdued than David could ever remember.

“You seem tired,” he said. “If it would be better for us to talk later, I could …”

“No, no. This is fine,” she said too sharply. “Hospital politics, you know. But for a change I get to sit back and listen. Let me pour us some coffee, then you can fill me in on what has been going on.”

She pushed a carton of cream toward him, but he shook his head. “Where to start,” he said, using a few sips to sort out his words.

“The beginning?” She encouraged him with a comfortable smile.

“The beginning. Yes. Well, I guess the beginning is that I didn’t give the morphine to Charlotte Thomas, Christine did.” He sipped some more. “Dr. Armstrong, what I’ve got to tell you is incredible, potentially explosive
stuff. Christine and I have decided to share it with you because … well, because we hoped you might use your position and influence to help us.”

“David, you know that I’ll put myself and whatever influence I have at your disposal.” She leaned forward to give him a closer view of the reassurance in her eyes.

In minutes he was totally immersed in the story of Charlotte Thomas and The Sisterhood of Life.

Initially Armstrong encouraged his narrative with a series of nods, gestures, and smiles, interrupting occasionally to clarify a point. Soon, though, her posture grew more rigid, her gaze more impassive. Gradually, subtly, the warm blue invitation in her eyes turned cold. Still, David talked on, relieved at unburdening himself of the awesome secrets that, until now, he was the only outsider to hold. Nearly half an hour passed before he first sensed the change in her.

“Is … is something the matter?” he asked.

Without responding, Armstrong rose and walked unsteadily to a telephone resting on a small desk at the opposite end of the lab. After a brief, hushed conversation, she worked her way back and settled heavily into a chair across the table from him. All at once, she seemed frail, and very much older.

“David,” she said gravely, “have you discussed all this with anyone other than me?”

“Why, no. I told you that earlier. We were hoping you could help us without involving—”

“I’d like you to start over. There are some points you must clarify for me.”

    “Chris, are you awake? Can you hear me?”

The voice seemed to be echoing from a great distance. Christine opened her eyes, then blinked several times, straining to focus. She recognized the woman as a nurse, though her features remained uncomfortably blurred. She tried to turn toward the side. Pulses of
nausea and an excruciating pressure in her head made it impossible. The room was dark, but even the light from the hallway was unbearable. “I’m awake,” she said. “The light hurts my eyes.” Slowly she closed them.