Bloodstream (10 page)

“I’m doing what’s best for Taylor!”

“And that’s exactly why he ended up
here.”

Claire’s temper at last burst through. “Mr. Darnell,” she said, “this is
not
the time to be attacking your wife!”

He turned to Claire, and his contempt was clearly meant for her as well.
“Ex-wife,”
he corrected. And he turned and walked out of the chapel.

She found Adam DelRay sitting at the nurses’ station, writing in Taylor's chart. Although it was late in the evening, his white coat was starched and fresh, and Claire felt rumpled by comparison. Whatever embarrassment he’d suffered earlier that day during the crisis with Katie Youmans had been conveniently forgotten, and he regarded Claire with his usual irritating self-confidence.

“I was about to page you,” he said. “Paul Darnell just decided—”

“I’ve already spoken to him.”

“Oh. So you know.” He gave an apologetic shrug. “I hope you don’t take it personally.”

“It’s the parents’ decision. They have a right to make it,” she acknowledged grudgingly. “But since you’re taking over, I thought you should know the boy has an abnormal peak on gas chromatography. I suggest you order a comprehensive drug screen.”

“I don’t think that’s necessary.” He set the chart down and stood up. “The most likely drugs have been ruled out.”

“That peak needs to be identified.”

“Paul doesn’t want any more drug tests.”

She shook her head, puzzled. “I don’t understand his objections.”

“I believe he reached that decision after speaking with his attorney.” She waited for him to walk away before picking up the chart. She flipped to the progress notes and with growing dismay read DeiRay’s entry.

History and physical dictated.

Assessment.

1. Acute psychosis secondary to abrupt Ritalin withdrawal.

2. Attention Deficit Disorder.

Claire dropped into the nearest chair, her legs suddenly unsteady, her stomach queasy. So this was their criminal defense strategy. That the boy was not responsible for his actions. That Claire should be blamed, because she took him off the Ritalin, triggering a psychotic break. That she was the one who should be blamed.
I’m going to end up in court.

This was why Paul didn’t want to find any drug in the boy’s bloodstream. It would shift the blame away from Claire.

Agitated, she flipped to the front of the chart and read DelRay’s orders.

Cancel comprehensive drug/tox screen.

Refer all future questions and lab reports to me. Dr. Elliot is

no longer the attending physician.

She slapped the chart shut and felt her nausea intensify. Now it was no longer just Taylor’s life on the line; it was her practice, and her reputation as well.

She thought of the first rule of defensive medicine: cover your ass. You can’t get sued if you can prove you didn’t make a mistake. if you can back up your diagnosis with lab tests.

She had to get a sample of Taylor’s blood. This was her last chance to draw the specimen; by tomorrow, any drug would be cleared from his system, and there’d be nothing left to detect.

She crossed the nurses’ station to the supply room, pulled open a drawer, and collected a Vacutainer syringe, alcohol swabs, and three red-top blood tubes. Her heart was racing as she walked up the hall to Taylor’s room. The boy was no longer her patient, and she had no right

to be doing this, but she needed to know what drug, if any, was circulating in his bloodstream.

The state trooper gave her a nod of greeting as she approached.

“I need to draw blood,” she said. “Would you mind holding down his arm for me?”

He didn’t look happy about it, but he followed her into the room.

Draw it quick and get out of here.
With shaking hands she snapped on the tourniquet and twisted off the needle cap.
Get out of here before someone finds out what you’re doing.
She swabbed Taylor’s arm with alcohol and he gave a shout of rage, twisting against the trooper’s restraining grip. Claire’s pulse accelerated as she pierced the skin and felt that subtle and satisfying pop as the needle penetrated the vein.
Hurry. Hurry.
She filled one tube, slipped it into her lab coat pocket, then squeezed another into the Vacutainer. Dark blood streamed out.

“I can’t hold him still,” said the trooper, wrestling for control as the boy bucked and cursed.

“I’m almost done.”

“He’s trying to bite me!”

“Just keep him still!” she snapped, her ears ringing with the boy’s shrieks. She slipped the third tube into place and watched as a fresh stream of blood shot
out. Just one more. Come on, come on.

“What the hell is going on in here?”

Claire looked up, so startled she let the needle slip out of the vein. Blood dribbled from the puncture wound and dripped onto the sheets. Quickly she snapped off the tourniquet and applied gauze to the boy’s arm. Cheeks burning with shame, she turned to face Paul Darnell and Adam DeIRay, who were staring at her incredulously from the doorway. Two nurses peered over their shoulders.

The trooper said, “She was just drawing some blood. The boy got a little noisy.”

“Dr. Elliot isn’t supposed to be in here,” said Paul. “Didn’t you hear about the new orders?”

“What orders?”

“I’m the boy’s physician now,” snapped DelRay. “Dr. Elliot has no authority. She shouldn’t even be in here.”

The trooper stared at Claire, and his anger was unmistakable.
You used me.

Paul thrust out his hand. “Give me the blood tubes, Dr. Elliot.”

She shook her head. “I’m following up an abnormal test. It could affect your son’s treatment.”

“You’re no longer his doctor! Give me the tubes.”

She swallowed hard. “I’m sorry, Mr. Darnell. But I can’t.”

“This is assault!” Paul turned to the others in the room, and his face was florid with outrage. “That’s what this is, you know! She assaulted my son with that needle, and she knows she has no authority!” He looked at Claire. “You’ll be hearing from my attorney.”

“Paul,” interjected DelRay, playing the role of diplomat to the hilt. “I’m sure Dr. Elliot doesn’t want this kind of complication in her life?’ He turned to her and spoke with the smug voice of reason. “Come on, Claire. This is turning into a circus. Just give me the tubes.”

She looked down at the two tubes she was holding, weighing their value against a charge of assault. Against the probable loss of her hospital privileges. She felt the gaze of everyone in the room watching, even enjoying, her humiliation.

In silence she handed over the blood tubes.

DelRay took them with a look of triumph. Then he turned to the Maine state trooper. “The boy is my patient. Is that clear?”

“Perfectly clear, Dr. DelRay.”

No one said a word to Claire as she walked out of the ward, but she knew they were staring at her. She kept her gaze focused straight ahead as she turned the corner and punched the down button. Only when she’d stepped into the elevator and the door slid shut did she finally allow her hand to slip into her coat pocket.

The third blood tube was still there.

She rode the elevator to the basement lab and found Anthony sitting at his lab bench, surrounded by racks of test tubes.

“I’ve got a sample of the boy’s blood,” she told him.

“For the drug screen?”

“Yes. I’ll fill out the requisition myself.”

“The forms are on that shelf over there

She took one off the stack and frowned at the letterhead, Anson Biologicals. “Are we using a new reference lab? I’ve never seen one of these forms before.”

He glanced up from a whirring centrifuge. “We just switched over to Anson a few weeks ago. The hospital signed a new contract with them for our complex chem and radioimmunoassay work.”

“Why?”

“I think it was a cost issue.”

She scanned the form, then checked off the box for gas
chromatography/mass spectrometry; comprehensive drug and tox screen.
in the space for comments at the bottom of the page, she wrote: “Fourteen-year-old boy with apparent drug-induced psychosis and aggression. This lab test is for my personal research only. Report results directly to me.” And she signed her name.

Noah answered the knock on his front door and found Amelia standing outside in the dark. She was wearing a bandage, a bright slash of white across her temple, and he could tell it hurt her to smile. In her discomfort, the best she could muster was a crooked lifting of one side of her mouth.

He was so surprised by her unexpected visit, he couldn’t think of a single intelligent thing to say, so he just gaped at her, as dazzled as a peasant who suddenly finds himself in the presence of royalty

“This is for you,” she said, and she held out a small brown package. “I’m sorry I couldn’t find anything nice to wrap it in.”

He took the package, but his gaze remained on her face. “Are you all right?”

“I’m okay. I guess you heard that Mrs. Horatio She paused, swallowing back tears.

He nodded. “My mom told me.”

Amelia touched the bandage on her face. Again he saw a flash of tears in her eyes. “I met your mom. In the emergency room. She was really nice to me.
. .“
She turned and glanced over her shoulder at the darkness, as though expecting to see someone watching her. “I’ve got to go now—”

“Did someone drive you here?”

“I walked.”

“You walked? In the dark?”

“It’s not so far. I live just the other side of the lake, right past the boat ramp.” She backed away from the door, blond hair swaying. “I’ll see you in school.”

“Wait. Amelia!” He held up the gift. “What’s this for?”

“To thank you. For what you did today.” She took another retreating step, and was almost swallowed up in darkness.

“Amelia!”

“Yes?”

Noah paused, not knowing what to say. The silence was broken only by the rustle of dead leaves scattering across the lawn. Amelia stood on the farthest edge of the light spilling from the open doorway, her face a pale oval eclipsing into night.

“You want to come inside?” he asked.

To his surprise she seemed to consider the invitation. For a moment she lingered between darkness and light, advance and retreat. She looked over her shoulder again, as though seeking permission. Then she nodded.

Noah found himself panicking over the disorder in the front parlor. His mom had been home for only a few hours that afternoon, to comfort him and cook dinner. Then she’d driven back to the hospital to see Taylor. No one had tidied up the parlor, and everything was still lying where Noah had dropped it that afternoon—backpack on the couch, sweatshirt on the coffee table, dirty tennis shoes in front of the fireplace. He decided to bypass the parlor and led Amelia into the kitchen instead.

They sat down, not looking at each other, two foreign species struggling to find a common language.

She glanced up as the phone rang. “Aren’t you going to answer that?”

“Naw. It’s another one of those reporters. They’ve been calling all afternoon, ever since I got home.”

The answering machine picked up, and as he’d predicted, a woman’s voice came on: “This is Damaris Home of the
Weekly Informer.
I’d really, really like to talk to Noah Elliot, if I could, about

that amazing act of heroism today in the classroom. The whole country wants to hear about it, Noah. I’ll be staying at the Lakeside B and B, and I could offer some financial compensation for your time, if that would make it more worth your while.
.

“She’s offering to pay you just to talk?” asked Amelia.

“Crazy, isn’t it? My mom says it’s a sure sign I
shouldn’t
talk to that lady.”

“But people do want to hear about it. About what you did.”

What I did.

He gave a shrug, feeling unworthy of all the praise, of Amelia’s praise, most of all. He sat listening as the call ended. The silence returned, interrupted only by the soft beep of the message reminder.

“You can open it now. If you want,” said Amelia.

He looked down at the gift. Though the wrapping was plain brown paper, he took great effort not to tear it, because it seemed uncouth to go ripping it open in front of her. Gingerly he peeled off the tape and folded back the wrapping.

The pocket knife was neither large nor impressive. He saw scratches on the handle, and realized it was not even new. She’d given him a used knife.

“Wow,” he managed to say with some measure of enthusiasm. “This is a nice one.”

“It belonged to my dad.” She added, quietly: “My real dad.” He looked up as the implication of those words sank in. “Jack is my stepfather.” She uttered that last word as though it were an object of disgust.

“Then J.D. and Eddie.
.

“They’re not my real brothers. They’re Jack’s boys.”

“I guess I wondered about it. They don’t look like you.”

“Thank god.”

Noah laughed. “Yeah, that’s not a family resemblance I’d want to have, either.”

“I’m not even allowed to talk about my real dad, because it makes Jack mad. He hates to be reminded there was someone else before him. But I want people to know. I want them to know Jack has nothing to do with who I am.”

Gently he placed the knife back in her hand. “I can’t take this, Amelia.”

“I want you to.”

“But it’s got to mean a lot to you, if it belonged to him.”

“That’s why I want you to have it.” She touched the bandage on her temple, as though pointing to the evidence of her debt to him. “You were the only one who did anything. The only one who didn’t run.”

He didn’t confess the humiliating truth:
I wanted to run, but I was so terrified I couldn’t move my legs.

She looked up at the kitchen clock. With a start of panic, she abruptly stood up. “I didn’t know it was so late.”

He followed her to the front door. Amelia had just stepped out when headlights suddenly cut through the trees. She spun around to face them, and then seemed to freeze as the pickup truck roared up the driveway.