Heart Failure (5 page)

Carrie was walking through the ER on her way back to her office when paramedic Rob Cole stopped her. “Dr. Markham, what’s the latest on the man we brought in with the digitalis toxicity?”

“He’s out of the woods,” Carrie responded. “Good pickup on the diagnosis, by the way. He’d also taken too much HCTZ, so his potassium was in the cellar.”

“Ouch. I noticed the atropine we gave him in the ambulance wasn’t enough to get him straightened out. Glad he’s doing better now.”

“Thank you for asking.”

Carrie turned away and had taken a step when Rob said, “Dr. Markham?”

She stopped and looked back at him. “Yes?”

He frowned and looked away. “Never mind. I’ll ask another time.”

As she traversed the enclosed breezeway that connected Centennial Hospital with the building that housed the Rushton Clinic, Carrie wondered what else Rob wanted to say. It seemed to her that, more and more, Rob went out of his way to run into her, sometimes in the ER when he and his partner
dropped off a patient, occasionally in the cafeteria, once or twice in the halls.

It was flattering that he seemed to want to be around her. Rob was a little younger than Carrie, possessed of good looks that had all the nurses talking—wavy black hair, deep brown eyes, sparkling white teeth. There was no question he was what some of the staff would call “a hunk.”

Get a grip
, she told herself.
Stop wondering if Rob is coming on to you. This isn’t junior high
. She looked at her bare finger and wondered if she’d acted hastily in giving back Adam’s ring. Until thirty-six hours ago, Carrie was sure she was in love with Adam Davidson. But what about this new Adam? And what about their future? With the old Adam, it seemed certain and secure. Now it was uncertain and dangerous.

It was obvious that Mrs. Berringer loved her husband. She was right beside him in the ER, putting into practice her vow to love him in sickness and in health. Carrie had been ready to make that vow and more to Adam, but now was she really prepared to be with him “for better or for worse”? Especially if “worse” meant running from someone trying to take his life . . . and hers along with it? That was the question she had to answer. She was hurt at his deception, but it ate at her that if she really loved him, she wouldn’t be running away when Adam needed her.

Carrie leaned against the wooden handrail that ran the length of the breezeway, pulled out her cell phone, then paused with her finger over the keys. She closed her eyes for a moment and tried to prepare for the call she was about to make. She at least needed to listen to his whole story. She’d set up another meeting with him. After that? She’d wait and see.

As hesitant as a child climbing onto a jungle gym for the first time, she pushed the speed-dial button.

When Adam felt the buzz of his cell phone in his pocket, he experienced the epitome of “mixed emotions.” The display showed that the call came from Carrie—and she’d be calling for one of two reasons: to give him a chance to explain, or tell him to get out of her life and stay out.

“I’m glad you called,” he said, hoping that her next words wouldn’t make him a liar.

“Adam, I don’t have long to talk. We need to finish our last conversation. But I want to meet somewhere safe. I don’t want to be a target again.”

Adam ran through the choices. He figured his apartment was out. If the gunman had found his car, he’d no doubt located where Adam lived as well. And there was no way he would lead a potential killer to Carrie’s home. “How about the law firm where I work? Everyone is out of there by five—five thirty at the latest unless something unusual is going on.”

“Is it safe?”

“I’m not sure any place is safe anymore, but this seems the best option. I’ll leave the building with everyone else and drive around a bit to lose anyone who might be following me. Then I’ll park a block away and come in the back door.”

“So what do I do?”

Adam thought for a bit. “Hopefully the shooter doesn’t know your car. The lot’s well lit. Park right by the entrance and call me on my cell as soon as you get there. Hurry inside, and I’ll double lock the doors behind you.”

Carrie hesitated. If she said no to that idea, he wasn’t sure what he’d do next. But finally he heard the rush of a long exhalation. “Fine. I’ll be there as soon after six as I can make it.”

“Thanks,” Adam said. “I appreciate—” He stopped talking when he heard a click. Carrie had already ended the call. He stared at the dead phone, his heart sinking. He prayed their relationship wasn’t broken beyond repair.

Outside the clinic exam room, Carrie scanned the information on her next patient. George Harris, age sixty-two, complaining of swollen feet and ankles. A number of diagnostic possibilities ran through her head, disorders like “congestive heart failure” and “deep vein thrombosis.” That was what she liked about her internal medicine practice. Every day there were new challenges. Well, time to tackle this one.

She tapped on the door and stepped inside. The older man perched on the edge of the exam table had silver hair combed straight back. Blue eyes twinkled behind steel-rimmed glasses. He was already wearing an exam gown—Lila had seen to that—but he wore it with the same dignity as though it were a white tie and tails.

“Mr. Harris, I’m Dr. Markham. How can we help you today?”

“Frankly, I think I’m fine. But my daughter seems to have a different idea.”

There was a distinct British accent there. Carrie checked the address on the man’s papers and confirmed that he was local. Then the younger woman sitting in the corner spoke up and solved the mystery. “My father-in-law recently came to the United States to live with us. He says nothing is wrong,
but we don’t believe it’s normal that his feet and ankles are so swollen.”

Carrie eased onto the rolling stool, positioned it midway between patient and daughter, and looked first to one and then the other. “Suppose we get a little more history. Mr. Harris, when did you first notice this?”

As the story unfolded, Carrie mentally laid aside several possible diagnoses until only one stood as the prime suspect. Mr. Harris worked in Great Britain for years in an electronics manufacturing plant. His job had been to solder and weld various components, and although provisions were made to avoid inhalation of the fumes from his work, he and many of his fellow workers had hated the respirators, disliked the noise of the exhaust fans, so they plied their trade without them at every opportunity. And as a result, he now presented to Carrie with the consequences of decades of inhaling cadmium-laced fumes: facial puffiness, swollen ankles and feet, protruding belly. Why? Because his kidneys were failing, causing the loss of a protein called albumin from the body, with resultant accumulation of tissue fluid in these areas.

“We’re going to start by checking some lab work,” Carrie said when she’d finished her exam. “Lila will help you with that. I’d like to see you back again tomorrow, when we can go over the results and talk about treatment.”

Carrie had just finished dictating her note when Lila appeared in the doorway of the cubicle. “Urinalysis and metabolic profile are cooking, but you don’t seem to have any doubt about the diagnosis.”

“No, I’m sure we’re dealing with nephrotic syndrome. That poor family is about to have its life turned upside down.”
Special diet, medications to control blood pressure, regular trips to the dialysis lab. Carrie closed her eyes and balled her fists.
God, why do You let these things happen?

Then again, why was God letting Adam break her heart? And why did God let good men like John die because a seemingly simple medical procedure went horribly wrong? As she headed for the next exam room, it was all Carrie could do to focus on the patient inside. She worked to put aside her situation with Adam. She struggled to stop thinking about the way her husband’s life had ended . . . and the role she played in that terrible event. Carrie thought she might pause and pray for help and guidance but quickly dismissed the idea. That avenue had been closed for quite a while.

As Carrie pulled into the law office parking lot, her heart thudded against her chest wall. It wasn’t only the potential danger that pushed her adrenaline level sky-high. It was the very real possibility that tonight Adam might tell her something that would fracture their relationship forever. She loved him—that was clear to her. But how much could that love withstand?

She was about to find out.

The law offices occupied a small, two-story building. Adam had told her that the bottom floor contained offices, the upper story a conference room and law library. She punched his speed-dial number on her phone.

“Carrie?”

“I’m here.”

“I’m unlocking the door now,” Adam said.

She hurried the few steps from her car to the front entrance
where Adam waited. They stepped into a reception area where a low-wattage light burned. The burgundy carpet was soft under her feet. Tasteful drapes of burgundy and tan framed the windows. Several upholstered chairs were situated along the walls. A cherry wood desk and chair faced outward from one corner, and behind it two lateral file cabinets of the same material flanked a door that probably led into a business office.

Adam pointed. “My office is back there.”

Carrie walked down a hall lit dimly by security lights. In Adam’s office, he flipped the light switch and gestured her to one of the two chairs across from his desk. He took the other and turned it sideways to face her. Adam seemed to have aged overnight. His face was haggard and his eyes were red-rimmed, accented by dark circles beneath them. Carrie almost felt sorry for him—almost. She recalled the love she’d felt for him—still felt. She wondered what her emotions would be after she learned more of his story.

Carrie nodded at Adam, as though to say, “It’s your turn.”

“Okay. Let’s hear the rest of it.”

Adam leaned toward her and she saw him struggle to keep his voice calm. Though they were alone in the building, he spoke in a quiet voice. “Thank you,” he said. “For meeting me . . . for giving me another chance.”

Carrie shook her head. “I should at least hear the whole story. I owe you that much.”

He moved as if to reach for her hand, then pulled back and let his own hands rest on the arms of his chair. “As I told you, I started life as Keith Branson. I went to law school at John Marshall in Chicago. While I was in school, I met a woman who worked in her father’s law office. She seemed perfect, and I
fell hard for her. After a relatively short engagement, Bella and I were married. When I graduated, her father, Charlie DeLuca, took me into his practice.”

Carrie nodded but said nothing. She didn’t want to stop the flow of his narrative.

Adam went on to tell about an idyllic first year of marriage. But soon he discovered his father-in-law’s practice had a shady side. Charlie not only defended some of the biggest criminals in Chicago, he played a key role in laundering huge sums of money, was a cut-out in several narcotics rings, and acted as an advisor, if not a partner, for a group that controlled most of the prostitution in that part of the state.

Beads of sweat dotted Adam’s brow. “I finally told Bella what I’d found out about her father’s law practice—that it was part of a criminal enterprise—and that I wanted no part in it. She laughed and said, in effect, ‘The money’s good. Keep your mouth shut.’”