Seizure (46 page)

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Authors: Robin Cook

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“I want the films developed before we move him back,” Dr. Nawaz told the technician, when she came in to retrieve the exposed plates. “I want to be absolutely certain they are adequate.”

“I'll have them back in a jiffy,” the technician said brightly.

Dr. Newhouse returned inside the X-ray room to check Ashley's vital signs. Paul and Spencer accompanied the X-ray technician to await the emergence of the X-ray film from the developer. Daniel and Stephanie found themselves momentarily alone.

“This is like a comedy of errors that's not at all funny,” Stephanie whispered, with a disgusted shake of her head.

“That's not fair,” Daniel whispered back. “The X-ray
misunderstanding was nobody's fault. I can see both sides, and it's already water under the bridge. The X rays have been taken, so the implantation is back on track.”

“It doesn't matter if it's anyone's fault or not,” Stephanie retorted with a
pshaw.
“It's still a screw-up, and it's been one thing after another from that fateful, rainy night in Washington until now. I keep asking myself what else can go wrong.”

“Let's try to be a bit more optimistic,” Daniel snapped. “The end is in sight.”

Paul and Spencer emerged from the processing room with the technician a few steps behind. Paul clutched the X rays in his hands. “They look good to me,” he remarked, as he passed Daniel and Stephanie and went into the X-ray room. The others followed. Paul snapped the films up on the viewing box, switched on the light, and stepped to the side. The images were of Ashley's skull surmounted by the opaque image of the stereotaxic frame.

Dr. Nawaz moved over, and with his nose close to the films, he carefully examined each in turn, orienting himself mostly by the indistinct shadows of fluid-filled ventricles in Ashley's brain. For a moment, no one spoke. The only sound was Ashley's deep breathing briefly obscured by the noise of Dr. Newhouse inflating the blood-pressure cuff on Ashley's arm.

“Well?” Paul questioned.

Dr. Nawaz nodded reluctant approval. “They look okay. They should work.” He took out a marking pen, a protractor, and a precision metal ruler. With great care, he located a specific location on each film and marked it with a small X. “That is our target: the pars compacta of the substantia nigra on the right side of the midbrain. Now I have to figure out the x, y, and z coordinates.” He set to work drawing lines on the X rays and measuring angles.

“Are you going to do that here?” Paul asked.

“This is a good light box,” Dr. Nawaz said. He was preoccupied.

“We should get the patient back to the OR,” Dr. Newhouse said. “I'll feel more comfortable with him reattached to the cardiac monitor.”

“Good idea,” Paul said. He immediately went to the foot of
the OR table to lend a hand. Dr. Newhouse released the brake on the wheels.

Both Daniel and Stephanie peered over Dr. Nawaz's shoulder and watched in rapt attention as he plotted the coordinates for the implantation needle, the guide of which would be firmly affixed to the frame.

With Paul pulling and Dr. Newhouse pushing, they maneuvered the OR table out of the X-ray room. Dr. Newhouse kept one hand on Ashley's shoulder to help stabilize him as they moved. It probably wasn't necessary, since Dr. Newhouse had taped Ashley's chest to the cranked-up part of the OR table earlier, but he wanted to be certain.

Once in the hallway, Paul turned to face forward while holding on to the foot of the OR table behind his back. It was easier than trying to walk backward. He continued pulling, but his contribution was more for steering, since the OR table, with its four casters, had a tendency to yaw. Marjorie walked alongside, holding up the IV bottle but also ready to help support Ashley if need be. Spencer brought up the rear, giving occasional orders, which everyone ignored.

“His color is not great,” Dr. Newhouse complained in the bright fluorescent illumination of the hallway. “Let's move it!”

Everyone upped the pace.

“His color was pasty from the moment he entered the front door,” Spencer said. “I don't think it has changed.”

“I want him back on the monitor,” Dr. Newhouse said.

“We're here!” Paul announced, as he thrust open the OR door and entered without turning around to face the OR table. In his haste, he failed to align the table with the doorway, causing the table to come in at an angle. The result was that one of the front corners thumped into the metal doorjamb with enough force to cause Ashley's body to jolt against the tape that bound his chest to the table. The inertia of the stereotaxic frame caused a mild whiplash effect, snapping Ashley's head forward obliquely. Both Dr. Newhouse and Marjorie reacted swiftly and caught Ashley's arms, which had also flopped up from the impact.

“Good grief!” Dr. Newhouse blurted.

“Sorry,” Paul said guiltily. Since he was mostly responsible
for the steering, the collision was his fault more than anyone else's.

“Did the frame hit the doorjamb?” Dr. Newhouse questioned, as he patted Ashley's hand down into his lap.

“No, it missed,” said Marjorie, who was on the side of the collision and might have been able to avert it had she seen it coming. It just happened too quickly. She let go of Ashley's arm to push the front of the OR table away from the doorjamb.

“Thank goodness for small favors,” Dr. Newhouse said. “At least we didn't contaminate it. If we had, we would have had to start from the beginning.”

Constance hurried over from where she was standing at the scrub table. Since she had remained gowned and gloved while everyone had gone down to X ray, she was able to grasp the frame without threatening its sterility, straighten it up along with Ashley's head, and support it.

“Am I finished already?” Ashley asked, sounding inebriated. The collision had jarred him from his drugged repose. He tried to open his eyes, with little success. His lids were only able to struggle to less than halfway open. Sensing the strange weight on his head, he strained to reach up and feel what it was. Dr. Newhouse grabbed his raised arm; Marjorie restrained the other.

“Get the table into position,” Dr. Newhouse ordered.

Paul pulled the table to the center of the room. He helped Dr. Newhouse get the armboards in place. A moment later, Ashley's arms were appropriately restrained. Ashley helped by immediately falling back asleep. Dr. Newhouse handed the EKG leads to Marjorie, who connected them to the electronic unit. Soon the regular and reassuring beeping of the cardiac monitor replaced the tense silence in the room. Dr. Newhouse took the stethoscope from his ears after taking the blood pressure. “Everything is fine,” he announced.

“I should have been more careful,” Paul said.

“No harm done,” Dr. Newhouse responded. “The frame wasn't compromised. We'll let Dr. Nawaz know so he can check it. Does it feel stable, Constance?”

“Rock-solid,” said Constance, who was still supporting the frame.

“Good,” Dr. Newhouse said. “I think you can let go now. Thanks for your help.”

Constance released her grip tentatively. The frame's position did not change. She returned to stand by the scrub table.

“I guess you were right about the patient's color,” Dr. Newhouse called over to Spencer. “There's been no change in his cardiovascular status. At the same time, I think I'll set up a pulse oximeter. Marjorie, could you get one for me from the anesthesia room?”

“No problem,” Marjorie said, before disappearing through the door into the adjoining space.

A figure appeared at the window to the hallway and caught Paul's attention. Although the man was dressed in scrubs and was wearing a mask, Paul instantly recognized Kurt Hermann. Paul's pulse rate shot up again after having recovered from the collision with the OR table against the doorjamb. He was nervous, since it was highly unusual for Kurt Hermann to be seen in any building other than admin, where his office was located, and particularly unlikely in the OR suite. Something had to be seriously wrong, especially with the typically restrained Kurt waving for Paul to come out into the hall.

Paul made a beeline for the door and stepped out into the corridor. “What's up?” he asked anxiously.

“I need to talk with you and Dr. Wingate in private.”

“What about?”

“The patient's identity. He's not Mob-related.”

“Oh, really?” Paul voiced with relief. The last thing he expected was good news. “Who is he?”

“Why don't you get Dr. Wingate.”

“Okay! Just a moment!”

Paul returned to the OR and whispered into Spencer's ear. Spencer's eyebrows arched. He made a point to look out the window at Kurt, as if he didn't believe what Paul had just told him. With alacrity, he followed Paul back out into the hallway. Kurt motioned for them to follow him across the corridor and into the OR storeroom. Once there, he made sure the door was closed before turning to stare at his bosses. He didn't have a high regard for either one of them, especially since he was never quite sure who was in control.

“Well?” Spencer questioned. He didn't have the patience
with Kurt that Paul had. “Are you going to tell us or what? Who is he?”

“First, a bit of background,” Kurt said in his clipped military style. “I learned from the limo driver that he'd picked up the patient and his woman companion from the Atlantis resort. Through employee contacts at the resort that I'd been provided by the local police, I found out they are staying in the Poseidon Suite, registered to Carol Manning of Washington, D.C.”

“Carroll Manning?” Spencer questioned. “I never heard of him. Who the devil is he?”

“Carol Manning is a she,” Kurt said. “I had a friend run the name on the mainland. She's the chief of staff of Senator Ashley Butler. I checked with the Bahamian immigration authorities; Senator Butler arrived on the island yesterday. It is my belief the patient is the senator.”

“Senator Butler! Of course!” Spencer said, while slapping the top of his head. “You know, I thought I recognized him this morning, but I just couldn't put the face and the name together, at least not with him in that ridiculous tourist outfit.”

“Crap!” Paul swore. He jammed his hands onto his hips and paced in the small area the storeroom afforded. “All this trouble to find out who he is, and he turns out to be a freaking politician. There goes our big payoff.”

“Let's not be too hasty here,” Spencer said.

“And why the hell not?” Paul said. He stopped and looked at Spencer. “We were counting on the mystery man to be rich and famous. That meant a celebrity like a movie star, a rock star, or sports hero, or at the very least, a prominent CEO. Certainly not a politician!”

“There are politicians and there are politicians,” Spencer said. “What could be important to us is that there's been considerable talk of Butler running for the '04 Democratic nomination for President along with everyone else.”

“But politicians don't have any money,” Paul said. “At least, not any of their own.”

“But they have access to people with a lot of money,” Spencer said. “That's what's important, particularly with serious Presidential contenders. When the field of Democratic Presidential hopefuls gets whittled down, which it
undoubtedly will, there will be lots of money. If Butler runs, and if he does well in the early going, we could get that monetary windfall yet.”

“That's a number of big ifs,” Paul said with a wry, disbelieving expression. “But regardless, I'm happy with what we've got already. Windfall or not, I got great exposure to HTSR, which we'll profit from greatly, and that's in addition to the forty-five K, which isn't chicken feed. So I'm happy, especially getting Dr. Lowell to sign that statement. He's not going to be able to deny what he's done here, and I'm going to push for that article with the Shroud of Turin twist in the
NEJM.
Publicity will be our big long-term payoff, and for that, a politician is as good or better than any other celebrity.”

“I'll be getting back to my normal security duties,” Kurt said. He wasn't going to stand there and listen to the drivel of these two buffoons. He stepped to the door and pulled it open.

“Thanks for getting the name,” Paul said.

“Yeah, thanks,” Spencer added. “We'll try to forget it took you a month and you had to kill someone in the process.”

Kurt glared back at Spencer for a moment, then he was gone. The automatic closer pulled the door shut.

“That last comment wasn't fair,” Paul complained.

“I know,” Spencer said, with a wave of dismissal. “I'm trying to be funny.”

“You don't appreciate his contribution around here.”

“I guess I don't,” Spencer agreed.

“You will when we get up and running at full capacity. Security is going to be a big issue. Trust me!”

“Maybe so, but for now let's get back to the implantation, and let's hope it goes better than it has so far.” Spencer pulled open the door and started out.

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