Terminal (24 page)

The bustling atmosphere of the floor turned out to be a godsend for Janet’s troubled mind. Within minutes of her arrival, she was swept up in the tumult of the hospital. Nursing report gave the oncoming day shift a hint of the work ahead of them. Between diagnostic tests, treatments, and complicated medication protocols, all the nurses knew they would have little free time. The most disturbing news was that Helen Cabot had not improved overnight as the doctors had hoped. In fact, the night nurse taking care of her felt she’d actually lost ground, having had a small seizure around four
A.M.
Janet listened carefully to this part of the briefing since she’d arranged to be assigned to Helen Cabot for the day.

Regarding the controlled medicines, Janet had concocted a plan. Having seen the type of vials they came in, she’d made it a point to obtain similar vials that were empty. Now all she needed was some time alone with the medicine.

After report had concluded, Janet launched into work. The first order of business was to start an IV line for Gloria D’Amataglio. It was Gloria’s last day of IV medication on her current chemotherapy cycle. Having shown an early facility with venipuncture, Janet was in demand for the procedure. During report she’d offered to start Gloria’s IV since there had been some problems doing so in the past. The nurse scheduled to care for Gloria for the day had readily agreed.

Armed with all the necessary paraphernalia, Janet went into Gloria’s room. Gloria was sitting on the bed, leaning against a bank of pillows, obviously feeling better than she had the day before. While they chatted nostalgically about the beauty of the pond on the Wellesley campus and how romantic it had
been on party weekends, Janet got the IV going.

“I hardly felt that,” Gloria said in admiration.

“Glad to help,” Janet said.

Leaving Gloria’s room, Janet felt her stomach tighten as she prepared herself for her next task: getting to the controlled medication. She had to dodge several gurneys, then did a kind of sidestep dance to get around the housekeeper and his bucket.

Reaching the nurses’ station, Janet got out Helen Cabot’s chart and turned to the order sheet. It indicated that Helen was to get her MB300C and MB303C starting at eight
A.M.
First Janet got the IV bottle and syringes; she then got the empty containers which she’d put aside. Finally she went to Marjorie and asked for Helen’s medication.

“Just a sec,” Marjorie said. She ran down the corridor to the elevators to give a completed X-ray form to an orderly taking a patient down to X-ray.

“That guy never remembers the requisition,” Tim commented with a shake of his head.

Marjorie returned to the nurses’ station at a jog. As she rounded the counter, she was already removing the key from around her neck for the special medication locker.

“What a day!” she said to Janet. “And to think it’s just starting!” She was obviously preoccupied with the welter of activity hospital wards faced at the beginning of each workday. Opening the small but stoutly built refrigerator, she reached in and brought out the two vials of Helen Cabot’s medicine. Consulting a ledger that was also stored in the refrigerator, she told Janet she should take 2 ccs of the larger vial and a half cc of the smaller. She showed Janet where to initial after she administered the medication and where Marjorie would initial when Janet was finished.

“Marjorie, I have Dr. Larsen on the line,” Tim said, interrupting them.

With the vials of clear fluid safely in hand, Janet retreated to the pharmacy closet. First she turned on the hot water in the small sink. After making sure no one was watching, she held the two MB vials under the hot water. When the gummed
labels came loose, Janet pulled them off and placed them on the empty vials. She tucked the now unlabeled vials into the utility drawer back behind an assortment of plastic dosage cups, pencils, pads, and rubber bands.

After another precautionary glance into the busy nurses’ station, Janet held the two empty vials over her head and let them fall to the tile floor. Both smashed into tiny shards. After pouring a small amount of water onto the glass pieces, Janet turned and left the pharmacy closet.

Marjorie was still on the phone, and Janet had to wait for her to disconnect. As soon as she did, Janet put a hand on her arm.

“There’s been an accident,” Janet said. She tried to sound upset, which wasn’t difficult considering her nervousness.

“What happened?” Marjorie asked. Her eyes widened.

“I dropped the two vials,” Janet said. “They slipped out of my hand and broke on the floor.”

“Okay, okay!” Marjorie said, reassuring herself as well as Janet. “Let’s not get too excited. Accidents happen, especially when we’re busy and rushing about. Just show me.”

Janet led her back to the pharmacy closet and pointed at the remains of the two vials. Marjorie squatted down and, using her thumb and forefinger, gingerly pulled out the shards attached to the labels.

“I’m terribly sorry,” Janet said.

“It’s okay,” Marjorie said. She stood up and shrugged. “As I said, accidents happen. Let’s call Ms. Richmond.”

Janet followed Marjorie back to the nurses’ station where Marjorie placed a call to the director of nursing. After she explained what had happened, she had to get out the ledger from the medicine refrigerator. Janet could see the vials for the other two patients as she did so.

“There was 6cc in the larger and 4cc in the smaller,” Marjorie said into the phone. She listened, agreed several times, then hung up.

“No problem,” Marjorie said. She made an entry into the ledger, then handed the pen to Janet. “Just initial where I indicated what was lost,” she said.

Janet wrote her initials.

“Now head over to Ms. Richmond’s office in the research building, seventh floor,” Marjorie said. “Bring these labels with you.” She put the broken glass fragments with their attached labels in an envelope and handed them to Janet. “She’ll give you several new vials, okay?”

Janet nodded and apologized again.

“It’s all right,” Marjorie assured her. “It could have happened to anyone.” Then she asked Tim to page Tom Widdicomb to get him to mop up the pharmacy closet.

With her heart pounding and knowing her face was flushed, Janet walked toward the elevators as calmly as she could. Her ruse had worked, but she didn’t feel good about it. She felt like she was taking advantage of Marjorie’s trust and good nature. She was also concerned that someone might stumble across the unlabeled vials in the utility drawer. Janet would have liked to have removed them, but she felt she couldn’t risk it until later when she could give them directly to Sean.

Despite her preoccupation with Helen’s drugs, as Janet came abreast of Gloria’s door she noticed it was closed. Having just started her IV, this disturbed her. Except for the one incident when Marjorie had introduced Janet to Gloria, Gloria’s door was always ajar. Gloria had even commented that she liked to have it open so she could stay in touch with life on the ward.

Perplexed, Janet stopped and stared at the door, debating with herself what she should do. She was already behind with her work so she should get over to Ms. Richmond’s office. Yet Gloria’s door bothered her. Fearing Gloria might be feeling poorly, Janet stepped over to the door and knocked. When there was no response, she knocked again louder. When there was still no answer, Janet pushed the door open and peered inside. Gloria was flat on the bed. One of her legs was dangling over the side of the mattress. It seemed an unnatural position for a nap.

“Gloria?” Janet called.

Gloria didn’t respond.

Propping the door open with its rubber foot, Janet approached
the bed. Off to the side was a slop bucket with a mop, but Janet didn’t see it because as she got closer she noted with alarm that Gloria’s face was a deep cyanotic blue!

“Code, room 409!” Janet shouted at the operator after snatching the phone from its cradle. She tossed the envelope with the glass shards on the bedside table.

Pulling Gloria’s head back and after making certain her mouth was clear, Janet started mouth-to-mouth resuscitation. With her right hand pinching Gloria’s nostrils, Janet forcibly inflated Gloria’s lungs several times. Noting the ease with which she was able to do this, she became confident there was no blockage. With her left hand she felt for a pulse. She found one, but it was weak.

Janet blew several more times as people began to arrive. Marjorie was there first, but soon others followed. By the time Janet was relieved from her resuscitative efforts by one of the other nurses, there were at least ten people in the room trying to help. Janet was impressed by the quick response: even the housekeeper was there.

Gloria’s color responded quickly, to everyone’s relief. Within three minutes several doctors including an anesthesiologist arrived from the second floor. By then a monitor had been set up showing a slow but otherwise normal heartbeat. The anesthesiologist deftly inserted an endotracheal tube and used an Ambu bag to inflate Gloria’s lungs. This was more efficient than mouth-to-mouth, and Gloria’s color improved even more.

But there were bad signs as well. When the anesthesiologist shone a penlight into Gloria’s eyes her widely dilated pupils did not react. When another doctor tried to elicit reflexes, she was unable to do so.

After twenty minutes Gloria started to make efforts to breathe. Minutes later, she was breathing on her own. Reflexes also returned but in a fashion that did not bode well. Her arms and legs extended while her hands and feet flexed.

“Uh oh,” the anesthesiologist said. “Looks like some signs of decerebrate rigidity. That’s bad.”

Janet did not want to hear this.

The anesthesiologist shook his head. “Too long without oxygen to the brain.”

“I’m surprised,” one of the other doctors said. She tilted the IV bottle to see what was running in. “I didn’t think respiratory failure was a complication of this regimen.”

“Chemo can do unexpected things,” the anesthesiologist said. “It could have started with a cerebral vascular incident. I think Randolph better hear about this.”

After rescuing her envelope, Janet stumbled out of the room. She knew scenes like this came with the territory, but knowing that hard fact didn’t make them any easier to bear.

Marjorie came out of Gloria’s room, saw Janet, and came over. She shook her head. “We’re not having much luck with these advanced breast cancer patients,” she said. “I think the powers that be better start questioning the treatment protocol.”

Janet nodded but didn’t speak.

“Being the first one on the scene is always tough,” she said. “You did all you could.”

Janet nodded again. “Thanks,” she said.

“Now get that medicine for Helen Cabot before we have more trouble,” Marjorie said. She gave Janet a sisterly pat on the shoulder.

Janet nodded. She took the stairs to get to the second floor, then crossed to the research building. She took an elevator to the seventh floor and, after asking for Ms. Richmond, was directed to her office.

The nursing director was expecting her and reached for the envelope. Opening it she poured the contents onto her desk blotter. With her index finger she pushed the shards around until she could read the labels.

Janet remained standing. Ms. Richmond’s silence made her fear that somehow the woman knew exactly what Janet had done. Janet began to perspire.

“Did this cause a problem?” Ms. Richmond asked finally in her surprisingly soft voice.

“What do you mean?” Janet asked.

“When you broke these vials,” Ms. Richmond said. “Did the glass cut you?”

“No,” Janet said with relief. “I dropped them on the floor. I wasn’t injured.”

“Well, it’s not the first time or the last,” Ms. Richmond said. “I’m glad you didn’t hurt yourself.”

With surprising agility for her size, Ms. Richmond sprang up from behind her desk and went to a floor-to-ceiling cabinet that concealed a large, locked refrigerator. Unlocking and opening the refrigerator door, she took out two vials similar to the ones Janet had broken. The refrigerator was almost filled with such vials.

Ms. Richmond returned to her desk. Searching in a box in a side drawer, she took out printed labels identical to those on the shards on her desk. Licking the backs, she began applying the appropriate label to each vial. Before she was finished her phone rang.

Ms. Richmond answered and continued to work, holding the phone against her ear with a raised shoulder. But almost immediately the call took her full attention.

“What?” she cried. Her soft voice turned querulous. Her face reddened.

“Where?” Ms. Richmond demanded. “Fourth floor!” she said after a pause. “That’s almost worse! Damnation!”

Ms. Richmond slammed the phone down and for a moment stared ahead without blinking. Then, noting Janet’s presence with a start, she got up and handed over the vials. “I’ve got to go,” she said urgently. “Be careful with that medicine.”

Janet nodded and started to respond, but Ms. Richmond was already on her way out the door.

Janet paused at the threshold of Ms. Richmond’s office and watched her walk rapidly away. Looking over her shoulder, she gazed at the cabinet which concealed the locked refrigerator. Something wasn’t right about all this, but she wasn’t sure what it was. Too much was happening.

R
ANDOLPH
M
ASON
marveled at Sterling Rombauer. He had some idea of Sterling’s personal wealth as well as of his legendary business acumen, but he had no idea what motivated
the man. Chasing around the country at other people’s bidding would not be the life Mason would lead if he had command of the assets Sterling did. Nonetheless, Mason was grateful for Sterling’s chosen occupation. Every time he hired the man, he got results.

“I don’t think you have anything to worry about until the Sushita plane shows up here in Miami,” Sterling was saying. “It had been waiting for Tanaka in Boston and was scheduled to go to Miami, but then it went to New York and on to Washington without him. Tanaka had to fly down here on a commercial flight.”

“And you will know if and when the plane comes?” Dr. Mason asked.