Royal Pains : Sick Rich (9781101559536) (17 page)

Chapter 21

“Dr. Lawson?”

I finished wrapping a sprained ankle with an elastic bandage. A middle schooler who didn't exactly nail the landing on the long jump. I told the boy's father to keep his son's foot elevated and iced. Divya handed him a baggie filled with ice.

“Will do.” Then to his son I said, “Looks like no more running and jumping for you today.”

The boy frowned. “Why did this have to happen today? I was in second place.”

“That's pretty good,” I said.

“I'd win if it wasn't for Patrick. He won yesterday, too.”

“Patrick Knight?” Divya asked.

“Yeah. You know him?”

“We met him yesterday.”

“He's good,” the boy said.

“So I hear,” I said.

The boy hobbled over to his father. “I can't beat him in anything.”

“Stick with it,” the man said. “You will.” He nodded to me. “Thanks.”

As they left Evan and Danielle showed up.

“What mischief have Evan R. Lawson and Mata Hari, the superspies, been into?” Divya asked.

“We've been doing the fund-raising walk,” Danielle said.

“How many laps so far?” I asked.

“Thirty-two.”

“Eight miles? You got my brother to walk eight miles?”

“On those legs?” Divya nodded toward Evan.

Evan wore a pair of black athletic shorts and a white T-shirt. Danielle had on similar shorts with a light green tank top.

“What's wrong with my legs?”

“Nothing a few trips to Marcy's Bodyworks wouldn't help.”

“He's been doing great,” Danielle said. “In fact he can actually walk and schmooze at the same time.” She laughed.

“Evan can schmooze in his sleep,” I said.

“Are you guys finished?” Evan said.

“I was going to ask you the same thing.”

“We're shooting for fifty laps,” Danielle said.

“Don't overdo it,” I said.

“It is hot out there.” Evan looked around. “Do you have any more of Jonathan's magic water?”

“In the box there,” I said.

Evan grabbed a pair of the raspberry ones and handed one to Danielle.

After resting for twenty minutes and downing two bottles of Wiggins Water, Evan and Danielle returned to the track to complete their laps. A few laps later they hooked up with George and Betsy Shanahan. Evan introduced them to Danielle.

“You're the surfer I read about, aren't you?” George asked. “In the paper the other day?”

“Yes.”

“You were in the paper?” Evan asked. “It wasn't about me injuring your arm, was it?”

“No. They did an article on my career.”

“Why didn't you tell me? I want to read it.”

“It's no big deal,” Danielle said. “But Grandma does have a few copies.” She laughed. “Maybe a dozen or so.”

“That explains the sling,” Betsy said. “What did Evan do to you?”

“It was an accident,” Evan said.

Danielle laughed again. “Yes, it was. And it was partly my fault.”

“Were you surfing?” George asked.

“I was giving Evan a lesson.”

“Now it's even clearer,” Betsy said.

Evan flapped his arms. “It was an accident.”

Betsy nudged him with her elbow. “I'm just teasing you.”

“How far have you guys gotten?” Evan asked.

“Forty-six laps,” George said. “You?”

“We're on number thirty-eight.”

“I can't believe this many people are doing this,” Betsy said.

The track was filled with hundreds of people and passing slower walkers required a bit of weaving.

“Thanks to Evan,” George said. He clamped a hand on Evan's shoulder. “I should hire you to work for me. Maybe we could increase our customer base.”

“I don't think my brother would go for that. Besides, I could never leave HankMed.”

“Don't blame you. Must be easier than banking.”

“Plus,” Betsy said, nudging George in the ribs, “if you had more customers I'd see even less of you.”

“But think of the extra shopping you could do,” George said.

“Hmm. Maybe I should rethink this,” Betsy said.

Evan suddenly stopped.

“What is it?” Danielle asked.

“It's them,” he said, pointing toward the row of booths across the track.

“Them who?” George asked, his gaze turning in the direction Evan pointed.

“That couple. Who've been selling drugs to kids.” He grabbed Danielle's arm. “Let's go.”

He half dragged Danielle across the track and the infield, but by the time they reached the row of booths the couple had disappeared.

“Where are they?” Danielle asked.

Evan looked each way. “I don't know. They were right here.”

Then he saw them. A few booths down, walking away from them. “There.” He started after them.

The stringy-haired woman glanced over her shoulder at Evan. She nudged the guy and he looked Evan's way, too. Evan pushed through the crowd, Danielle following.

The couple veered right and disappeared between two booths. Evan picked up his pace. He and Danielle cut between the two booths. Now they stood looking along the back of the row of booths. The couple was nowhere to be seen.

“You go that way,” Evan said. “I'll go along the back.”

Evan circled the entire row of booths, finally catching up with Danielle again near the far goalposts.

“Anything?” Danielle asked.

“No.”

They made another lap around the booths but didn't see the couple. They gave up and rejoined the walk. Evan's head remained on a swivel, constantly checking the booths that flanked the track.

“They just disappeared,” Evan said. “How does that happen?”

“It's a crowded place. Easy to hide.”

“Not from Lawson, Evan R. Lawson.”

Danielle laughed. “Even Bond, James Bond, lost Blofeld's trail from time to time.”

“Bond was a hack compared to Evan R. Lawson.”

Danielle laughed and hooked an arm with his. “Then let's finish this walk so you can get back on the case.”

“I wish I had my spy cane with me.”

“Why? You don't have any high-tech tracking devices in the secret compartment yet.”

Evan shrugged. “Still, it would be cool.”

“It'll be cool when we finish and get out of this heat.”

They walked in silence for a couple of laps and then Evan noticed a man about a hundred feet ahead of them begin to stagger. To his left, his right, and then his knees buckled and he dropped to the track, facedown. Evan ran toward him. A crowd gathered as the walking procession came to a halt.

Evan knelt by the man, rolled him onto his back, and shook him. “Sir? Are you okay?”

The man groaned and took a deep breath.

Evan shook him again. “Can you hear me?”

“What?” The man's eyes were glassy and he didn't seem able to focus.

Evan looked up at Danielle. “Go get Hank.”

She disappeared through the thickening crowd.

“Need some help?” It was Peggy Whitmire, the high school PE instructor. She knelt on the opposite side of the man.

“I don't know what happened,” Evan said. “He was walking and then he collapsed.”

Peggy reached for the man's neck, pressing her fingers in. “His pulse is fast and a little weak.” Now she shook the man. “Can you hear me?”

The man's gaze finally found her. “What happened?”

“You fainted.”

The man tried to sit up, but Peggy placed a palm on his chest. “Just lie here a minute.”

Hank and Divya pushed their way through the crowd.

“Man, am I glad to see you,” Evan said.

“What happened?”

“He collapsed,” Evan said. “He was just in front of us. He sort of staggered and then fell.”

“I called the medics,” someone in the crowd said.

Evan watched as Hank gave him a quick exam, listening to his heart and lungs. Divya checked his blood pressure.

“One-ten over sixty. Pulse one hundred.”

“Let's get him into the shade.”

Just then the crowd parted to let the medic van roll up onto the track. Two medics jumped out.

“What have you got, Dr. Lawson?” one of them asked.

“Looks like he got a little overheated.”

“Been seeing a bunch of that.”

“Can you help us get him over to our booth?”

“Sure thing.” He looked at his partner. “Let's load him up.”

“Good job,” Hank said.

“We didn't really do anything,” Danielle said. “Except go get you.”

“That's all you needed to do. Once we get some fluids in him I suspect he'll be fine.”

Danielle laughed. “At least we were here instead of chasing that ghost couple.”

“What ghost couple?” Hank asked.

“That couple I saw at the beach,” Evan said. “The ones selling drugs.”

“You saw them?”

“Yes, but we couldn't catch up to them. This is twice they've given me the slip.”

“Ah, the life of a superspy,” Hank said.

“Not feeling so super right now.”

“Let's finish our laps, and then we'll go look for them again,” Danielle said.

“How many more?” Hank asked.

“Eight,” Danielle said. “Then we'll have reached our goal.”

Back at the HankMed booth, Divya placed an oxygen mask on Michael Tobin and then while I started an IV, she hooked up the EKG machine. As we did this I asked him a dozen questions and found out he was fifty-three and in good health except for mild hypertension. He took a single blood pressure med but nothing else. He had been walking for two hours and hadn't often stopped for water.

“Pretty stupid, huh?” he said.

I shrugged. “Glad you said it so I wouldn't have to.” I smiled.

“I know better.”

“You're not alone,” Divya said. “Most of what we've seen today has been problems with the heat.”

“Thanks to you guys I'm feeling a lot better. I'm thirsty. Can I have something to drink?”

The liter bag of IV fluids I had hung was almost empty and his last BP reading was up to one-twenty over eighty.

“Sure.”

While I helped him sit up, Divya grabbed a bottle of Wiggins lemon-lime and handed it to him. He gulped down half of it.

“Man, that's good.” He looked at the label. “I've never had this before.”

“Jonathan Wiggins makes it,” I said. “He's got a booth just down the way.”

Michael drained the bottle and Divya handed him another.

“I feel pretty good now,” Michael said. “When can I get out of here?”

The IV bag was nearing empty. “Let's run the rest of this in, and then I'll take the IV out and you'll be good to go.”

“Can I finish my walk?”

“Not sure I'd do that,” I said.

“But I promised all my donors I'd do sixty laps. They're counting on me.”

“Think of all the money you'll save them if you come up short,” Divya said.

“I never thought of that.” Michael laughed. “You could be right.”

“How far have you gotten?” I asked.

“Forty-eight. Just twelve more to go. Three miles. That's all I need.”

I shrugged.

“I'll go slow.”

“And drink lots of fluids?” Divya said.

“When I leave here I'm heading down to Wiggins's booth. I promise.”

“Okay, but take it slow and easy,” I said. “If you feel anything unusual, any fatigue or light-headedness, stop and get back over here.”

“Will do.”

Chapter 22

Almost as soon as Michael Tobin left the booth a teenage girl showed up. Obviously agitated, she rubbed her arms up and down. Her eyes were glazed, pupils dilated.

“What's the matter?” I asked.

“I don't know.” Her gaze flitted around, seemingly unable to lock on to anything. “I feel like . . . I don't know.”

“What's your name?”

She looked toward the ceiling, then out toward the infield, and then finally her gaze returned to me. “What?”

“Your name?”

“Uh . . . I . . . uh . . .” She looked panicked. She gave her head a shake as if trying to knock something loose. “Uh . . . Jessica. My name's Jessica Michaels.”

“Sit down,” I said.

I directed her to the exam table, where she sat on the edge, one foot doing a tap dance in the air. Her lips and fingers trembled.

She pushed her shoulder-length brown hair back with both hands and shook her head. “What's wrong with me? Everything in my head is doing cartwheels.”

“Cartwheels?” I asked.

Divya wrapped the blood pressure cuff around one arm and began inflating it.

She squeezed her head between her hands. “My thoughts. They seem to be tumbling all over each other. I can't stop them.”

“BP's one-ninety over one hundred,” Divya said as the BP cuffed hissed out its air.

“Lie down here,” I said.

“I can't,” Jessica said. “I have to move.” She stood.

“Jessica, look at me,” I said.

She tried.

“What did you take?”

“Nothing.” She looked toward the entrance and started to move that way.

I grabbed her arm. She tried to pull away, but I held on.

“Call McCutcheon and Hyatt,” I said to Divya and then to Jessica, “Listen to me. You need to stay here so we can help you.”

“Help me? Help me do what?” She shook her head back and forth. “What's wrong with me? Am I going crazy?”

“No.” I managed to get her settled on the exam table again. “You took something. What was it?”

“Nothing.”

“Jessica, you have to tell me the truth so I can help you.”

“Nothing. I didn't take anything.”

“Let me guess,” I said. “A harmless-looking little pink pill?”

“How'd you—” She caught herself. “I didn't take anything.”

“Do I look stupid?” I asked. She stared at me but didn't respond, so I went on. “I know you took something and I think I know what. It's called Strawberry Quick. It's dangerous. It's scrambled your brain and that's what you're feeling.”

McCutcheon showed up. “What's the problem?”

“I want you to meet Jessica,” I said. “Jessica, this is Sergeant McCutcheon.”

Jessica looked at him, her gaze traveling up and down, obviously taking in his tourist outfit. She looked even more confused than before.

“You called the cops?” she asked.

“You aren't the only one taking these drugs.”

“But I didn't—”

“Jessica, give it a rest,” I said. “When we get you over to the hospital and draw some blood we'll know what you took anyway.”

“Hospital? I'm not going to any hospital.” She jumped off the table but couldn't get by McCutcheon, who stood in her path, his massive arms crossed over his equally massive chest. “Let me by.”

McCutcheon shook his head. “Not going to happen.”

She whirled toward me. “You can't do this.” Her gaze bounced around as if she was looking for an escape route. With McCutcheon blocking the front and Divya the back, she had nowhere to go. She began to cry, burying her face in her hands.

I wrapped an arm around her shoulder and helped her back onto the exam table. I let her cry it out for a couple of minutes.

“Jessica, the drug you took is methamphetamine with some ecstasy in it. That combination has caused you to react this way. Your tumbling thoughts. Your excitement and agitation and elevated blood pressure. We need to give you some meds to bring you down, but you'll need to be monitored in the hospital while we do.”

She cried harder.

“Divya's going to give you something to settle this down and then we'll get the medics to take you over to Hamptons Heritage.” I turned to Divya. “Ten milligrams of Thorazine.”

Ten minutes later the injection began to take effect and Jessica settled back to earth. Her BP was down, her trembling had stopped, and she was much more coherent. She said the tumbling in her head was better. Not gone, but better.

Principal Hyatt arrived. Jill was with him. When I told them the story, Hyatt looked injured. As if he had personally failed.

“Jessica, you know better than this,” Hyatt said. “You're one of our best students. A class leader. I didn't know you were involved in anything like this.”

She sniffed back tears. “I'm not. I swear. I've never done anything like this before.”

“Why now?”

She shook her head, her gaze dropping to her lap. “I don't know. Just something to try.” She looked up at Hyatt. “All the other kids do, so I thought I'd see what the big deal was.”

“Where'd you buy it?”

“I didn't. Someone gave it to me.”

“Who?” McCutcheon asked.

She looked at him and then at Hyatt. “Just some dude.”

“Jessica?” Hyatt said. “I know you. You didn't get some pill from some stranger and swallow it. You got it from someone you know. Someone you trust.”

See what I mean? Doctors and high school principals get lied to all the time.

“He told me it was nothing.” Her voice was soft, almost a mumble.

“Who?” Hyatt said.

“Do I have to say?”

“That depends. Do you want another of your classmates to go through what you're going through?”

“No.” She sighed. “It was Billy. Billy Presley.”

“I see.”

“I take it you know this Billy?” McCutcheon asked.

“Yes. He's a junior. Like Jessica.”

“Let's go find him,” McCutcheon said. “If he's still here.”

“No,” Jessica said. “He'll know I told you.”

“We won't let him know,” Hyatt said.

“Where did you last see him?” Jill asked.

“Over by the refreshment stand. Maybe an hour ago. I don't know where he is now.”

McCutcheon and Hyatt left.

The medics pulled up behind the booth and we settled Jessica on a stretcher for her trip to Hamptons Heritage. I had called her parents and they were headed to the hospital. Not happy, but that's the way it was.

“Pretty stupid, huh?” Jessica asked.

“Yeah,” I said. “But the worst is behind you.”

“You don't know my parents.”

“Let me make a prediction. They'll be mad. Then they'll be scared, and then they'll be supportive. Just give it time.”

“I hope you're right.”

Things returned to normal after Jessica left. Divya and I saw a few bumps and scrapes and half a dozen dehydrated folks but nothing major. Until Patrick Knight and his mother, Rochelle, showed up again. Patrick was walking gingerly, one hand plastered to his left side.

Before I could ask what the problem was, Patrick said, “I won. Like I told you I would.”

“The long jump?” I asked.

“And three races. The hundred, the two-twenty, and the four hundred.”

“That's pretty good.”

“It was too much, you ask me,” Rochelle said. “I think he did some damage with that long jump.”

“Like what?” I asked.

Rochelle nodded to Patrick. “Tell him.”

“I think it's the flu,” Patrick said.

“It's no flu,” Rochelle said. “You did something to yourself with all that running around and jumping. Now you tell the doctor everything.”

“Why do you think it's the flu?” I asked.

“'Cause I ache all over.”

“Any cough or shortness of breath?”

“No. Just aching. But not like it usually is when I have a bug. My joints hurt. My belly, too.”

“Let's take a look.”

I had Patrick strip off his T-shirt and sit on the exam table. His lungs were clear, no palpable nodes in his neck, and his heart was normal. His abdomen was another story. I had him lie back and performed a complete abdominal examination. Very tender, particularly in the left upper quadrant. When I pressed my fingers into that area he withdrew and winced audibly.

“Sorry. How long has this been going on?”

“The joint pain began a couple of days ago and this whatever it is in my belly began yesterday.”

“But you didn't tell anyone?”

“I just did.”

I laughed. “But you didn't tell your mother, and you certainly didn't tell me yesterday.”

“Because I had jumping and running to do. I'm all done now.”

He tried to sit up, grunting in the process, but I held him back.

“Just lie there,” I said.

“Man, that hurts.” He pressed an open palm over his abdomen.

“Any nausea or vomiting or diarrhea?”

Patrick shook his head. “None of that.”

“Have you ever had anything like this before?”

“Not really.”

“Not really is not really no,” I said with a smile.

He laughed, which apparently caused discomfort, since he now placed both hands over his belly and said, “I've got to remember not to do that.”

“So you've had similar episodes in the past?”

“Not exactly. This is worse.”

“Tell me about them. The ones you've had in the past.”

“Sometimes when I get the flu or when I do too much running or other sports I'll get pains in my muscles and joints.”

“How often does that happen?” I glanced at Rochelle.

“Don't ask me. He don't tell me nothing.”

“If I did I'd never get to do anything.”

“So, how often?” I asked again.

“I don't know. Sometimes.”

“How long do the symptoms last when they happen?”

“A few hours. Sometimes a couple of days. They always go away.” He glanced at Divya and then back at me. “But I've never had anything this bad.”

“Did Patrick ever see a doctor about these other episodes?” Divya asked Rochelle.

Before she could answer, Patrick shook his head and his chin came up. “I'm not big on doctors.” He glanced at me. “Sorry.”

“That's okay. But we don't bite.” Then I asked Rochelle, “Anyone in the family with similar problems?”

“Patrick's daddy,” Rochelle said. “He complained of the same stuff sometimes. Aching joints and muscles. Mostly after he'd been drinking. 'Course I haven't seen or spoken with him for years. Maybe five years. Not since he took off to Miami.”

“Anyone else?”

“Not that I know.”

“Any disease in your family? Diabetes or anything like that?”

“My dad does have sickle cell, but it doesn't really bother him. As far as I know. I don't see him very often either.”

“Sickle cell?” Divya said. “Has Patrick ever been tested for that?”

She shook her head. “You heard him. He don't like doctors. I'm amazed he agreed to come see you.”

“Dr. Hank is cool,” Patrick said. “And funny.”

Coming from Patrick that was quite an endorsement. I was glad Evan wasn't here. He'd try to turn it into an ad campaign.

“I want to draw some blood,” I said. “Then Divya will do an X-ray and ultrasound of your abdomen.”

“I'm not going to no hospital,” Patrick said.

“You don't have to. We can do them right here. Just take a minute to set it up.”

“Cool.”

I drew the blood and while Divya took the X-rays, I carried the blood sample out to the van, where I made slides, stained them, and looked at them through our digital microscope.

Bingo. The diagnosis jumped right out at me.

Sickle-cell anemia is an odd disease. It's genetic and tends to run in families of African origin. The defect is with the hemoglobin, the oxygen-carrying molecule in the red blood cells. It's abnormal in this disease and the abnormality causes the red blood cells to take on a sickle appearance. They look like little half-moons. That's exactly what I saw on Patrick's blood smear.

These abnormal cells might look like innocent little smiley faces under the microscope, but they can be extremely treacherous. Their shape causes them to snag and clump and pile up in small blood vessels, slowing or blocking blood flow. This can lead to joint and muscle pain. Red blood cells, as part of their normal life cycle, are filtered through the spleen. Sickle cells can sludge in the spleen's intricate network of blood vessels and cause damage, even a rupture, of this delicate organ.

That was what was going on with Patrick.

By the time I returned to the booth, Divya had completed the X-rays and the ultrasound and loaded the digital images onto her laptop. I examined them. Everything appeared normal except that the spleen was slightly enlarged.

I told Patrick and his mother what I had found on his blood smear.

“What does this mean?”

“That your grandfather, through your mother, and maybe your father, passed this along to you. That you inherited the same disease they have.”

“That's what's causing all this pain?” Rochelle asked.

“Absolutely.” I went on to explain what was happening inside Patrick's body. “The major problem here is the pain in your abdomen. The spleen is involved and that's a potentially dangerous situation.”

“I don't like the sound of that,” Patrick said.

“Remember earlier when I said you didn't have to go to the hospital?”

“Yeah.”

“I lied.”

His eyes widened.

“Not exactly lied, since I didn't know what we were dealing with then. Now I do. I'm afraid you'll have to get over to Hamptons Heritage.”