Dead Certain (8 page)

I dialed 911 from my car phone, weaving wildly through the late-night traffic, struggling to make myself understood to the police dispatcher through my agitation. Passing Soldier Field, I caught sight of flashing lihts in my rearview mirror and slammed my hands Against the steering wheel in frustration, thinking the ponce meant to pull me over. It took me a couple of seconds and the dispatcher’s reassurance to realize that the patrol Car was there to hasten, not hinder, our progress to the trauma center.

When I pulled up beneath the bright lights of the emergency room entrance, the trauma team was already assembled and waiting like the pit crew at an Indy race. Even before I came to a stop, they swarmed the passenger side and had Delius out of the car and onto a gurney. I got out of the car and watched the rapid grace and military precision with which every person went about their job. The whole transition—from car to gurney to hospital-* happened so fast that it wasn’t until the automatic doors had closed behind them that I realized that it was my roommate, Claudia, who was on the other end of the stethoscope pressed against Bill Delius’s chest.

On the street, Prescott Memorial Hospital is called the Knife and Gun Club—something I hadn’t known until Claudia told me. It wasn’t the kind of thing they put in the glossy brochures they send out when they’re looking for donations. It’s also a piece of information that I’ve never felt the need to pass along to my mother. Her vision of Prescott Memorial was of a sunlit clinic where crippled children learned to walk again. While I understood that it was in no one’s best interest to disillusion her, passing through the double doors to the emergency room I found myself wondering how she’d managed to believe the fiction all these years.

Tonight the waiting room was filled with the usual bad-news ER crowd. Babies cried, drunks complained, and the air was filled with clashing odors characteristic to all hospitals: the salt smell of blood and the acid stench of vomit mingled with cleaning solution and the unmistakable scent of fear. A young woman in black fishnet stockings and a miniskirt so short it seemed to come up to her throat leaned against the wall holding a clump of bloody gauze to a laceration on her head. In an adjacent hallway a couple of drunks were sleeping it off on gurneys. I looked around to get my bearings and realized that compared to my office at Callahan Ross, my roommate went off to work every day into the Black Hole of Calcutta.

I felt at loose ends and wasn’t quite sure what to do. I knew that I should probably try to call the Icon suite at the Four Seasons, but I couldn’t bring myself to do it. I was still trying to convince myself to pick up the phone when the mechanical doors to the business end of the ER whooshed open and a young man in the short white coat of an intern hurried over to me. He looked barely old enough to shave.

“Were you the one who brought in the coronary arrest?” he demanded without preamble.

“Mr. Delius? Yes. I brought him in,” I stammered, alarmed by the raw urgency in his manner.

“Then you’d better come with me,” he instructed. “The doctor has some questions.”

I opened my mouth to say that I hoped that I would be able to answer them, but by the time my mouth began to form the words I was already looking at his back, retreating through the doors that separated the waiting area from the treatment rooms. I hurried up and followed him into the first room—trauma one—a bad sign. This was Claudia’s kingdom, the room they held open for the most serious injuries, the place where they kept all the heavy-duty equipment pumped and primed and ready to go.

Nothing had prepared me for the tumult—the bleeps of monitors, the scrape of gurney wheels, and the shouts of the medical personnel that formed an indecipherable cacophony. Through the open doorway I could see that the small room was jammed with people, all focused with a terrifying sense of urgency on the inert form of Bill Delius.

“Does he have a history of heart disease?” demanded the intern who’d come to fetch me.

“I don’t know.”

“Diabetes?”

“I don’t know, I don’t think so,” I stammered.

“What medications is he currently taking?”

From over his shoulder I could hear Claudia asking for the defibrillator paddles as matter-of-factly as if she were asking a dinner companion to pass the salt. Even though we’ve all seen it reenacted so many times on television, that it’s practically become a cliché, there’s nothing hackneyed about the actual drama of watching somebody try to jump-start the human heart. Even the intern paused in his questions at the sound of my roommate’s voice, suddenly commanding and adrenalized, warning everyone to clear.

Bill Delius went asystole after the second attempt. His heart no longer had enough electrical life in it to even squiggle uselessly. The face that stared up at the ceilings was that of a dead man. Claudia straightened up and took a step back from the gurney, her eye catching mine for the first time.

“A friend?” she demanded.

“A client,” I answered, feeling ridiculous.

Claudia blinked and then turned to the nurse standing at her side. “Thoracotomy tray, please,” she said. “I’m going to open his chest, perform internal cardiac massage, compress his aorta, and see if we can’t get some blood going to his head until cardiac surgery gets here.”

“Sounds good to me,” replied the nurse calmly.

“I’m afraid you’re going to have to leave now,” announced the intern, taking me by the arm as Claudia; picked up the scalpel.

“She can stay,” said my roommate, never taking her eyes off Delius. “Just make sure you stay out of the way.” She turned to the intern. “Come here and give me a hand. I’m going to crack his chest. I’ll intubate, seven-point-five tube. Call respiratory therapy. Six units, type and cross match. Convert that eighteen-gauge to an eight French. Fluid wide open. Begin with O-negative blood as soon as it arrives.”

Claudia bent over my client’s lifeless face and opened his mouth with her gloved hand. She began snaking the bright light of the laryngoscope down his throat. Once she had the breathing tube in place, she stepped back and listened with her stethoscope for a moment.

“Two minutes,” announced the nurse who’d been with Delius from the minute we arrived at the emergency entrance. It felt as if I’d already been there a year. I wondered how long it had been since the heart attack first hit. How long had I stood on the sidewalk debating with myself what to do? How long had the drive to the hospital taken? Two minutes? Ten?

I reminded myself that the heart is a resilient muscle, but I thought of Mrs. Lapinsky and how that in itself is a double-edged sword. Even if Claudia managed to get it restarted, how much time was left before brain damage turned Bill Delius into a lump of flesh, stripped of the feelings, insights, and ambitions that made him who he is?

“Two minutes, fifteen seconds,” exhorted the CPR nurse.

Claudia reached for the scalpel, and I turned my head away, worried that Delius would feel the incision and Pondering what kind of person could just cut through sonieone’s flesh like that. Any moment I expected Bill Delius to buck from the table, to scream, to protest. But some part of me knew that Claudia wouldn’t even be trying this if he weren’t for all intents and purposes dead already. By the time I got up the nerve to look, Claudia had already cut through the skin.

“Spreader, please,” she said. Despite the stakes her manner was not just calm, but unfailingly polite. I watched fascinated, like a secret onlooker at a satanic tea party. The spreader resembled a reverse vise, which she turned and pushed until she’d managed to open a small space in the wall of Bill Delius’s chest, just wide enough for her to slip her hand through.

I stared, transfixed, as she eased her gloved hand into the opening.

“What was he doing when he collapsed?” my roommate asked. It took several seconds to register that she was talking to me.

“He was walking to my car. He’d just come from some kind of business banquet,” I added idiotically. My voice sounded artificial from the strain.

“Three minutes, thirty seconds,” the CPR nurse bleated.

“Pupils?” asked my roommate, her eyes closed in concentration.

“Still fixed and dilated,” responded the respiratory therapist.

For a moment the whole room seemed to hold its breath, all eyes fixed on Claudia. Then, on my roommate’s face, through the armor of her concentration, I saw the faintest glimmer of a smile.

“We have a rhythm,” the nurse declared without emotion as the heart monitor began to chirp.

“Pupils?” inquired Claudia again.

“Responsive,” the respiratory therapist reported. “Equal and responsive to light.”

“Cardiac surgery is ready and waiting, Dr. Stein,” some-one called.

Suddenly Claudia looked down, as if surprised to find that her hand was still inside the patient’s chest. She pulled it out and quickly arranged moist towels over the wound. Then she stood back and watched as the nurses wheeled Bill Delius down the corridor to the operating room.

It wasn’t until after they were already gone that I found myself worrying that Gavin McDermott might be the surgeon standing by, ready to receive him.

CHAPTER 6

“Thank you,” Claudia called to no one in particular as the room emptied out. In a matter of seconds we were alone, but everywhere we looked, there was the detritus of calamity. The floor was littered with blood-soaked gauze and discarded packages from which tubes and needles had been ripped. I couldn’t help but wonder, just for a second, how it could be possible to figure out the cost of what I’d just witnessed.

I turned and looked with new eyes at the petite figure of my roommate. I used to think that the demands of my profession—the endless workweeks and demanding travel schedule—set me apart from other people. But now I realized that my situation was nothing compared to Claudia’s. How did you go to work knowing that your job was to look death in the face and stare it down? How did you put your hand inside another person’s chest and hold their heart and then go home and have anything that resembled a normal life?

I knew eventually I would have to ask her, but not today. Instead I said, “Is he going to be okay?”

“We’ll know better when we get him upstairs and open up his chest,” she replied, automatically stripping off her bloody gloves. “A lot depends on where the clot is and how much damage was already done to the heart muscle. All we can do down here is try to give him a chance in the operating room.” She picked up her stethoscope from the top of an adjacent rolling cart and slung it automatically around her neck. “So you say this guy’s one of your clients?”

“You know the computer thing I’m working on?” I replied somewhat incoherently. “He’s the engineer who invented the new input engine. Delirium is his company. I had just picked him up at McCormack Place. We were supposed to be going to a meeting,” I said, feeling like I was relating events that had happened in another lifetime.

“Well, it’s a good thing you were in the neighborhood,” said Claudia. “With a massive MI like that, normally you’d give the patient a fifty-fifty chance at best.”

I was about to ask her if she still thought those were Bill Delius’s chances, when the nurse I recognized as having done CPR popped her head in the doorway.

“They just called down from OR three,” she told Claudia. “Dr. Laffer wants to know if you’re available to assist or if they should page Dr. Jacobs.”

“Tell them I’m on my way,” replied Claudia.

“It was cool to watch you work,” I said, knowing that she was in a hurry, but not wanting to let the moment Pass without saying it. “Thanks for letting me stay.“

“Even you have to admit it,” she grinned as she headed for the door. “I have the coolest job in the world.”

I wandered back out into the waiting room and dug through my purse for my cell phone and asked the mobile operator to connect me to the Four Seasons. While I waited for her to find the number I checked my watch. I had no idea what time it was and was surprised to hnd that it was nearly ten o’clock. I remembered Claudia talking about how time stood still in the trauma room, and now I understood.

The operator at the Four Seasons regretted to inform me that she was under strict instructions to put no calls through to Mr. Hurt or any of the other Icon people’s rooms. Apparently they were having some sort of party and did not wish to be disturbed. I did everything I could think of to persuade her to make an exception, short of bursting into tears—though at this point I probably could have managed that without too much trouble— but to no avail. The closest I was going to get to Gabriel Hurt that night was the hotel’s voice mail.

I left a message that was long on apologies and short on detail. I had no idea if Bill Delius was going to survive the night, and even though it was my job, I couldn’t begin to think about what impact this turn of events might have on any possible deal. Instead I dug through my Day Runner for Mark Millman’s home number and tried to figure out what I was going to say.

I was so wrapped up in what I was doing that I didn’t notice Claudia’s ex-boyfriend, Carlos, until he’d plopped down into the seat beside me.

“Hi, Kate, how’re ya doin’?” he asked, throwing his arm around my shoulder, the very picture of fraternal concern. Instinctively, I got to my feet, anxious to put some distance between us.

Carlos was an attractive, well-put-together man with a shock of thick black hair, a little boy’s smile, and just enough mischief in his eyes to let you know that he knew just how much fun you could have being bad. With his chest muscles rippling through the dark fabric of the Chicago Fire Department T-shirt that the paramedics all wore, I had no trouble understanding what Claudia had found so attractive about him. She certainly wasn’t the first woman who’d been fooled by him, and she surely wasn’t going to be the last.