The Doctor and the Dead Man's Chest (20 page)

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Authors: Robin Hathaway

BOOK: The Doctor and the Dead Man's Chest
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“What's up?” Horatio appeared at her side.
For some reason, she was incredibly glad to see him. “She fainted,” she said.
As the siren grew louder, the telephone rang. The doctor returning her call? she wondered. But she couldn't leave Mrs. Ashley, even for a minute. “Answer it, Rat.” (She rarely used his nickname.) “If it's the doctor, tell him what happened and to meet me in the ER at the Salem Hospital.”
He took off.
As Mrs. Doyle continued watching over her patient, she tried to scan the faces of the guests. This was a time when people might give themselves away—by a word, a look, or a gesture. But it was hard to observe while being observed. And every eye was fixed on herself and Mrs. Ashley.
The siren reached an earsplitting crescendo, and stopped. The silence was shocking. Two paramedics strode into the room. Seeing at once that Mrs. Doyle was in charge, they directed their questions to her. They placed Mrs. Ashley on the gurney, as they had placed her granddaughter a few weeks before. Susan insisted on accompanying her grandmother in the ambulance. She begged Mrs. Doyle to come too. Mrs. Doyle wondered if that call had been from Dr. Fenimore. She would have liked to talk to him before she left. She glanced down at Mrs. Ashley's still form. Impossible. Speed was of the essence. She could only hope and pray the phone call had been from the doctor and that Horatio had given him the message.
Susan got into the ambulance first. Before getting in, Mrs. Doyle took one last look at the guests gathered outside. Miss Cunningham looked on with curiosity mixed with relish; the Reverend with deep concern; Tom Winston with his perennial scowl;
Peter Jordon with detached interest; Agatha blinked back tears; Fred Jenks, who had come on the run from the barn when he heard the sirens, stared open-mouthed. Mr. Barnes was nowhere in sight. Oh, there he was, up front, telling the ambulance driver about a short cut and without realizing it, delaying their departure. Mrs. Doyle was about to intervene when the driver started up. She got in the back and someone slammed the doors. The last thing she saw through the back window, before she sat down, was Horatio—holding up two fingers, in the victory sign.
W
hen Fenimore's pager went off, he was at Veteran's stadium with Detective Rafferty, deeply engrossed in a baseball game. The Phils vs. the Pirates. Eighth inning. Game tied. Phils up. Two men on.
Fenimore had spent a grueling morning with Rafferty. Together they had gone over the lab reports that had come back on the warning note that had sailed through his office window. Despite access to the most sophisticated electronic equipment, all they were able to determine was that it had been typed on a computer and printed out by a laser printer. Gone were the days when a chipped typewriter key revealed all. Reluctant to report another dead end, Fenimore postponed calling Jennifer. To relieve his frustrations, he coerced his policeman friend to attend a baseball game. Convincing himself that gangland activity only occurred after dark, Rafferty agreed, and off they went.
Seeing the Ashley number flashing on his pager screen, Fenimore hastily excused himself and went to look for a pay phone. The phone rang seven times. He was about to hang up, when a familiar voice answered. Horatio gave him Doyle's message.
When Fenimore returned to his seat, Rafferty was so absorbed in the game, he didn't even look up.
“We have to go,” Fenimore said.
Rafferty glanced up in disbelief.
“Come on, Raff. It's an emergency. I have to go to south Jersey.”
When the policeman's attention shifted back to the game, Fenimore grabbed his arm. He yielded with bad grace. As Fenimore hustled him out of the row and down the steps, a cheer rose all around them.
“This better be good, Fenimore,” Rafferty growled. Without slowing his pace, he tried to look back at the field to find the cause of the cheer.
“It is,” Fenimore reassured him over his shoulder.
When they reached the car they were both out of breath. In his haste to unlock the door, Fenimore dropped his keys. Rafferty handed them to him with a glare. “You know, this is the first time I've ever left a game when the Phils were winning.”
Probably because they so seldom do, Fenimore thought, but said diplomatically, “You can catch the reruns tonight.”
Rafferty doubled up his long legs to squeeze them into the small front seat, and slammed the door.
Fenimore began careening through the lanes of tightly parked cars.
“Watch it!” Rafferty gripped the door handle. “This isn't a TV thriller.”
“That's what you think.” Fenimore spurted onto Pattison Avenue and sought out 1–95. When they had settled into the fast lane, Rafferty switched on the radio. While he concentrated on the end of the game, Fenimore mulled over Lydia's medical history.
Torsade de pointes
was the danger. He prayed he would be in time.
W
hen the ambulance pulled up to the emergency room entrance, Susan was the first on her feet. The paramedic who had silently ridden with them stepped to one end of the gurney. The driver got out, came around and opened the back doors. As the two men moved her, Mrs. Ashley sighed and her eyelids fluttered. Carefully the medics rolled her out of the ambulance and through the doors marked EMERGENCY ROOM. Susan followed. Mrs. Doyle hung back to make sure they hadn't left anything behind. As she turned to step out, the doors slammed in her face. She looked out to see who was responsible. She caught sight of a medic. A new one. Not one of the two who had brought them there. He was heading toward the front of the ambulance.
She banged on the back window. He didn't turn. She banged again—this time with both fists. The driver disappeared around the side of the vehicle. She shouted. A moment later she heard the motor start up. This is ridiculous! She stared out the back window at the rapidly receding hospital. Suddenly, directly overhead, the siren began its pulsing whine. She covered her ears. It must be answering an emergency call, and they were completely unaware she was on board. When they arrived at the scene of the
accident, they would throw open the doors and find her there. How humiliating.
She turned to look at the front end of the ambulance. Most city ambulances had a walk-through that connected the van to the cab where the driver was seated. This must be an older model. Resigned, Mrs. Doyle sat down on the side bench. She thought about Dr. Fenimore. Now she wouldn't be there to explain what had happened to Mrs. Ashley. To tell him how his patient had forgotten to take her morning medicine and doubled her dose. And about the missing bottle of blood pressure pills. Mrs. Doyle felt like adding her wail to the deafening wail of the siren.
Suddenly the siren stopped. Mrs. Doyle expected the ambulance to stop too, as it had at the Ashley house. She moved toward the back doors, ready to get out. But it didn't stop. On the contrary, it seemed to be picking up speed. And they were riding over rougher terrain. The van gave a sudden lurch, throwing her against the wall. Cautiously, pressing her hand against the wall for support, she made her way to the back window again.
A dirt road wound off behind them, through scruffy underbrush and clumps of weeds. Not a house or a human being in sight. Where could this accident be? As she watched, they passed an abandoned trailer camp. Trailers stood in various stages of disrepair. A door hung loose by a single hinge, like a tooth about to fall out. Awnings were faded and torn. Barbecue grills, orange with rust, stood like armed guards. There was a clothesline bearing a few weathered pins, but no clothes. From a wire, stretched between two poles, a chain dangled—the dog long since gone.
After the camp, there was nothing but the road, which had become a muddy track through a field. Mrs. Doyle moved to the front of the ambulance. She began to bang on the metal dividing wall that separated her from the driver. She yelled, straining her lungs. Surely he could hear her. Did she imagine it, or were they picking up speed again? The van was rocking from side to side. She had trouble keeping her balance. They hit a rut. She went down on one knee. The ambulance came to a jolting halt. At last
they had arrived. Now she could get out and explain this whole ridiculous situation and they would take her back to the hospital. Automatically she reached up to pat her hair into place.
She heard the doors open behind her. Still facing the front of the van, she started to rise and turn. She felt a searing pain behind her left ear. A shower of light. Then darkness.
T
he Phils brought in their two runs and won the game. Rafferty switched off the radio. “Now what's this all about?”
“Mrs. Ashley lost consciousness and was taken to Salem hospital.”
“So, the first afternoon I've taken off in twenty years I'm going to spend cooling my heels in a hospital waiting room?”
“Sorry, Raff.”
“Why
did
you hijack me?”
“I thought your expertise might come in handy.”
“You think there's something fishy about this Ashley woman's illness?”
“Could be.”
Resigned, Rafferty settled back. A few minutes and several miles later, he remarked. “You know what this reminds me of?” He indicated the flat, open fields with a sweep of his hand.
Fenimore, absorbed in his own thoughts, didn't answer.
“Holland.”
Fenimore roused himself. “Holland?”
“Yeah, without the tulips and the windmills.”
Fenimore scanned the landscape and grunted, “The Dutch
must have agreed with you,” he said. “They settled here before the British. And before the Dutch, there were the Swedes. And before the Swedes, the Lenape Indians …”
“And before the Lenapes—the dinosaurs. You didn't ask why I was in Holland.” He was disappointed.
“Vacation?”
“Nope. The Supe sent me. The Amsterdam police force had a unique program for handling kids on drugs.”
“Your specialty.”
“I thought so—at the time.”
“What was their technique?”
“Movies—or ‘films,' as they call them over there. They would take a kid, detox him, and then saturate him with movies about all the horrible things drugs can do to you.”
“Did it cure them?”
“About as well as a mustard plaster cures lung cancer.” He sighed. “Speaking of teenagers, how's Horatio?”
“Fine. Doyle tells me he's taken to the country like a duck to water.”
“I wish I could send more kids down here,” he said. “How would you like to start a summer camp for gang members, Doc?”
Fenimore stored that idea for future reference. He would like to put his newly acquired marshland to some use.
When they came in, there were only a few people scattered around the admissions area of the emergency room. Fenimore's eyes swept over them. Not finding Mrs. Doyle, he went up to the desk. “I'm here to see Mrs. Lydia Ashley. I believe she was just admitted.”
The woman looked at him suspiciously. “You a relative?”
“No. Her physician.”
“I don't recognize you.”
“Not on your staff. From Philadelphia.” He showed her his hospital I.D. tag.
She still hesitated.
“He's OK.” Rafferty gave her his steely police stare, the one he
reserved for hardened criminals, and flipped out his more convincing ID.
“Oh—I guess it's all right then. A Lydia Ashley was admitted about forty-five minutes ago. You may go in, doctor.” She pushed a buzzer under her desk, and the thick steel doors to the emergency room slid open. Fenimore disappeared inside.
Rafferty took a seat in the waiting room. Over a tattered magazine, he surveyed the other occupants. A young mother trying to keep her restless toddler entertained, and two young men seated at opposite ends of a row of empty chairs pretending to read magazines. Rafferty caught the two men casting surreptitious glances at each other, filled with hate. Curious, he thought. Did they know each other? Such situations fascinated him—one of the reasons he was a good policeman. He could detect the softest ticking of a time bomb and often defuse it before it went off.
Rafferty drew a lollipop from deep in his pocket. Although his five children were now in their teens, he had never given up the habit of carrying candy and tissues for emergencies. He unwrapped the lollipop, and with a glance at the mother for her consent, offered it to the whining child. His reward was silence and the mother's grateful smile. For the next half-hour, although seemingly absorbed in the coin tricks he was showing the little boy, most of Rafferty's senses were tuned to the two young men on the other side of the room.
Behind the steel doors, an efficient young nurse led Fenimore to the curtained cubicle in which Mrs. Ashley lay. Susan was sitting beside her. When she caught sight of Dr. Fenimore, her expression was worth missing all the baseball games that had ever been played. He glanced at the monitor above Lydia's head. It was recording her heartbeat.
Torsade de pointes.
He recognized the alarming electrocardiographic pattern.
Taking his patient's hand, he spoke her name. She opened her eyes, smiled faintly and closed them again.
“Who are you?” A brusque voice spoke behind him.
He turned to see an angry young man in a white coat. “Dr. Fenimore. Mrs. Ashley's physician—from Philadelphia.” He held out his hand.
The young man's manner changed instantly. Drawing Fenimore outside the cubicle, he began to explain his diagnosis and treatment. He had also recognized the
torsade
pattern. Fenimore heard the undercurrent of the younger doctor's excitement at seeing an interesting case. In a small community hospital, such cases were a rare commodity.
“When they brought her in,” said the intern, “the runs of
torsade
were occurring about once every five minutes and lasted about twenty to thirty seconds before her normal sinus rhythm took over. The runs have become shorter and less frequent. Now they last only ten to fifteen seconds, and come on about every fifteen minutes. Since she seemed to be recovering, I haven't treated the
torsade
Could she have inadvertently taken a drug that precipitated this attack and it's subsiding of its own accord as the effect of the drug wears off?”
Fenimore realized he was dealing with a very bright intern. This was exactly the way he, himself, would have managed the case. “A few years ago,” he replied, “a doctor in Baltimore, unfamiliar with her case, gave her quinidine and precipitated a bad attack of
torsade.”
Fenimore said. But he did not confide his suspicion that this time his patient might have been given the same drug—on purpose. Although he knew that
torsade
could occur spontaneously, in view of Lydia's history, he asked the intern to analyze her blood for drugs that might have precipitated the
torsade
.
The intern agreed, and told Fenimore he was waiting for a report of Mrs. Ashley's last
torsade de pointes
electrocardiogram on admission to the hospital in Philadelphia. Since her doctor was now here, the wait was over.
Fenimore was satisfied. His patient and friend was in excellent hands. He summarized Lydia's clinical history for the intern, and warned him again not to give her quinidine under any circumstances.
When he returned to the cubicle, Lydia was still improving. Since he had arrived, the runs of
torsade
on the monitor had become even shorter and farther apart. He and the intern were gambling that the condition would rectify itself—and they seemed to be winning. He turned to Susan and explained to her in layman's terms her grandmother's condition and how she was progressing. In passing, he mentioned that quinidine could cause
torsade
in her grandmother.
Susan concentrated on every word. When he had finished, she picked up on the quinidine, asking “But why would Grandmother take such a medicine, if she knew its side effects would make her ill?”
“She wouldn't. If she took it, she would have taken it without knowing it.”
“But where would she get it?”
“Someone would have given it to her.”
“But who?” She stopped, realizing where her questions were leading.
“I don't know the answer to that.” Fenimore took her arm. “Susan, I think you should go home. Your grandmother's condition is stable and she's in very good hands.” Fenimore heard himself repeating all the reassuring clichés. Fortunately, this time they happened to be true. He spoke a few more words to the intern while Susan bid her grandmother goodnight. Then he guided her out of the emergency room. As they emerged in the waiting room, Fenimore looked vainly around for his nurse. He turned to Susan. “Didn't Mrs. Doyle come with you?”
“Yes. I thought she was right behind me when I got out of the ambulance.”
“I'll take a look around the hospital.” After hastily introducing Susan to Rafferty, Fenimore followed the arrow to the main lobby.
Fenimore searched the lobby, the gift shop, and the snack bar. No Doyle. He even coerced some poor woman to go into the rest room and check every toilet booth. At one point Susan and
Rafferty heard Mrs. Doyle's name called over the hospital intercom. The speaker asked her to come to the emergency room. This was followed by an announcement that a hospital ambulance was missing. The license number was given and a request made to report it to the hospital if anyone saw it. Rafferty jotted the number down.
Returning to the emergency room, Fenimore saw no sign of his nurse. A minor worry was becoming a major concern. Rafferty decided it was time to place a call to the local police department, and ask for Missing Persons. He gave the phone to Fenimore to provide a physical description. Fenimore passed it on to Susan, who provided details about what Mrs. Doyle had been wearing that day. After that, there was nothing to do but wait. They decided to do that back at the farmhouse. As Fenimore and Rafferty started to usher Susan out the door, the two men seated across the room jumped up simultaneously and converged on either side of the young woman.
“I'll take you home, Susan,” Tom said.
“My car's right outside, Sue,” Peter said.
She looked from one to the other, bewildered.
“Her name is Susan,” said Tom.
Peter raised an eyebrow. “Maybe we're on more intimate terms.”
Detective Rafferty hadn't spent the last hour observing the two young men for nothing. When Tom swung, the policeman was ready. He grabbed his arm and prevented it from connecting with Peter's jaw. He then held it pinned behind Tom's back until Fenimore had led Susan safely out into the parking lot. Peter left hurriedly by another exit.
A few minutes later, Rafferty joined them at the car. He stuck his head in the window. “I think I'll ride back with Tom. I'd like to get to know that hothead a little better.”
“Don't be too hard on him,” Susan said. “He once saved my life.”
“That's right,” agreed Fenimore. “Maybe you should hitch a ride with the Jordan boy instead.”
Rafferty looked over his shoulder. A red Porsche was sailing out of the lot with Peter at the wheel. Tom, on the other hand, was having trouble starting his old, mudspattered Jeep. “It would have been a smoother ride,” Rafferty sighed.

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