Lethal Practice (10 page)

The boundary was marked by a line of well-spaced evergreen trees and shrubs. Entering the property was a simple matter of stepping between the branches and ignoring the Strictly No Trespassing! signs. I stopped at the edge of the fairway and looked around. Even at night, there was enough city light reflected off the underside of the clouds to make it possible to see. Muffy could hardly contain herself.

Off to my right and down a gentle slope the open grass stretched at least three hundred yards to a distant green backed by a ring of dark trees. I could see the black shapes of surrounding sand traps. The only sound was the noise of the city in the background. We were alone. I reached down and set Muffy free.

She took off like a bullet, charging over the dew-soaked ground with the happy abandon she always showed in a wide-open space. I strolled along behind her while she ran in ever-expanding circles, my shoes quickly becoming soaked in the wet grass.

I tried not to dwell on Bufort and Hurst but found myself worrying about ER coverage and Jones instead. Would she use her research as an excuse not to come in to work again tomorrow, to punish me for ... for what? Hanging up on her this morning? Ignoring her at this evening’s meeting? For having hired Kradic in the first place? I was finding it increasingly hard to cope with her tantrums.

Before coming to St. Paul’s, she’d moonlighted working nights in a variety of hospitals. She’d been competent but insecure and lacking in the confidence I would have expected from a physician of her experience. The cardiac research with Zak, however, seemed to give her a self-assurance in the ER that I hadn’t seen before. In addition to providing some very respectable work for the study, she appeared to have parlayed all those obscure night shifts and years of experience on the road into the self-assurance I looked for in an ER veteran. Of course, her added exposure to cardiac arrests had quickly made her our most skilled resuscitator.

Unfortunately, her success had also made her rather aggressive. She’d lorded her new level of skill over the rest of the department as though we deserved punishment for having made her feel inferior somehow in the past.

And work. She’d craved it. I couldn’t give her enough shifts. It seemed her new prominence in the department was like a drug to her, and she needed to show off her skills as often as possible to maintain me fix. Then I’d hired Kradic, and she’d had to share the spotlight.

My shoes started to squish, and the bottoms of my trousers were wet and dragging in the grass. Muffy continued her joyous gallop by heading down the fairway in great sweeping curves. I was about to call her back when she stopped dead in her tracks and stared intently toward the distant green, still several hundred yards away.

A lone figure was standing there, completely motionless. But around its feet two black shapes swirled in small circles, then scurried back and forth, moving incessantly, like shadows on the ground. The stillness of the figure was eerie. It seemed to be looking back up at us.

Without warning or a sound, the two shadows began hurtling up the fairway toward us. I had to blink to be sure they were real—their speed made them almost translucent in the dim light. But they were real, speeding at us like a pair of dark torpedoes. Muffy growled, then barked. I heard a returning snarl.

Dogs!

Muffy was twenty yards ahead of me, perfectly still but ears up, and poised to charge.

“No, Muffy!” I screamed, but it was too late. She raced away toward the oncoming animals.

I started to run after her, yelling her name and hollering, “Stop! Come back! No!” but in seconds she was way ahead of me, becoming little more than a shadow herself. With mounting panic I watched the three shapes hurtle toward each other, separated by less than a hundred yards and closing.

I kept running after her, frantically waving my arms at the figure on the green. “Stop them! For God’s sake, stop them!” I implored at the top of my lungs. “Call off your dogs!”

Whoever it was continued to watch, and didn’t respond. Now I could see the dogs: Dobermans. They could tear Muffy to pieces.

Fifty yards.

Shit! I had to break Muffy’s rush.

My throat burned from yelling and I was breathing hard as much with fear as from exertion. They were almost at each other.

Twenty-five yards.

I stopped running, took a deep breath, and let out a roar as loud and fierce and full of rage as my poor vocal cords could muster.

Muffy whirled around to see what beast was coming at her from behind. The two dogs, still ten yards away from her, also stopped, but as their heads went down and I heard their low growls continue, I suspected they’d been more surprised than frightened.

“Get back here, you dumb dog,” I screamed at Muffy, trying to shock her into obedience. It worked. Her tail, head, and ears drooped, and she slunk toward me, looking nervously at the growling animals behind her.

They didn’t run off, but they didn’t approach either. They started circling us, keeping their heads toward us, showing their teeth, snarling.

When Muffy got close enough, I grabbed her collar and pulled her to my side. Being careful not to hit her, I began twirling her leash over my head like a whip, the metal clasp on the free end.

“Get away! Get back!” I screamed at the circling Dobermans. I accelerated the circling of the leash over our heads until I could hear the metal tip whistling through the air. Muffy stopped cowering and began lunging and barking at the dogs. It was all I could do to hold her with one hand and circle the leash with the other.

Suddenly one of the dogs skirted around behind us. Muffy tried to turn and face the attack, but her collar twisted in my hand, choking her and knocking me off balance. I managed to direct the twirling leash down and behind and felt it connect. The incoming animal screamed in rage and pain and continued to yelp as it pulled back and joined its partner. I was getting ready for them to come at us again, but above the growling and barking, I heard the sound of a whistle—like a policeman’s or a referee’s—come from way up the green.

The Dobermans immediately broke off their attack, spun around, and raced away toward their master as fast as they had come.

I held Muffy tightly. She was trembling as she barked, straining to give chase.

“No, Muff, good girl, they’re gone. It’s okay,” I reassured her, though I was by no means certain we were out of danger. Trying to calm my own shaking, I watched the two distant shapes run up to the figure and begin their previous pattern of prancing around its feet.

I wanted to scream, “You fucking idiot!” but I was terrified the dogs would be sent after us again. I quickly connected Muffy’s leash and started back up the slope from where we’d come. She resisted, whined, and stood on her hind legs to get a final look before we left. When I next glanced back, the green was deserted.

All the way home I kept checking over my shoulder and listening for the padded sound of galloping dogs on pavement. Muffy, on the other hand, trotted along beside me, happily sniffing out the bushes as usual, our ordeal apparently forgotten. I was not so sanguine.

Once we were safe in our kitchen, Muffy raced on upstairs to get the best spot in bed. I began to feel anger more than fear, and wanted to report the incident to the police. That idiot had nearly let his dogs kill us.

I was about to dial 911 when I had second thoughts. What was I going to complain about? I’d been illegally on a private golf course with my dog unleashed and had been chased off. The creep on the green might even have been a night watchman. I knew I wasn’t the only person in the neighborhood to use the fairways as a dog run, despite the property being posted. There even had been flyers distributed door-to-door requesting we keep our animals away. Maybe the owners of the club had finally gotten fed up with warning us and had resorted to letting their security staff scare us a little. It was dangerous and stupid, and the idiot who’d been there tonight ought to be charged with reckless behavior, but I put down the phone.

I certainly wouldn’t be taking Muffy there anymore, I thought, still angry, but beginning to feel a little foolish as well.

* * * *

I awoke to heaven. My head was being stroked, and I could smell coffee on my bedside table. I opened my eyes and sleepily smiled up at Janet, who had one hand on my forehead and one hand holding her own cup of coffee. The light was dim outside the window and invited dozing off again, just for a few moments.

I slid into a rush of last-minute dreams denied by too much missed sleep. A large ambulance was driving toward me, bringing Kingsly back, rotted, all in parts. His fluids seeped out the side panels and blew into liquid plumes. Yet I could hear his screams. Piercing screams that overwhelmed the noise of the siren. Screams that kept coming from the yellow bulk looming up over me, a shadowy figure at the wheel.

I woke to my own scream. Janet was long gone, and the telephone was shrieking in my ear. I fumbled the receiver and managed a dry “Hello.”

“Nice hours, Doc. Wish
I
could sleep in.” It was Susanne, fresh and saucy as ever.

“Oh, God, what time is it?” I’d obviously slept more than a few minutes.

“Eight-thirty, and we’re fighting World War Three here while our fearless leader sleeps.”

“Bad?”

“Real bad.”

“I’ll be there in thirty minutes.”

I’d barely hung up and was halfway to the shower when the phone rang again.

“Hello!” I answered impatiently, expecting it was the ER.

I heard only static, the kind of noise produced by a car phone.

“Hello,” I repeated, more politely this time.

The noise seemed to change. At first I thought it was more interference on the line. But it became a whisper, barely audible.

“Hello! Who is this?” I demanded. “Speak up. I can’t hear you.”

The raspy voice became louder. “I know. Doc. I know it’s you. You’ve had your warning. Back off!” Then I was listening to a dial tone.

The noise level in the ER matched my frazzled state of mind. Stretchers were end to end in every corridor. Susanne rushed by and muttered, “We’re not doing well,” keeping her reputation for understatement intact.

All around me nurses and doctors yelled orders and patients cried for help. Ventilation bags, oxygen masks, and IV sets were tossed to residents waiting alongside still-untreated cases. At first I thought there had been a disaster, a train crash or a downed plane. I tried to huddle with the clerk; she was besieged with calls for ECGs, X rays, the lab, and beds, always for beds. While still listening to someone on the phone, she mouthed my answer.

“We’re getting ambulances again.”

Zak! Shit! I’m not sure if I said it or thought it.

I was down the hall and in my office in seconds, but there I found more unpleasant surprises, two to be exact.

The first was a foot-high stack of computer printouts, which meant added hours of work going over them.

The second surprise was embarrassed to be caught going through the first.

Jones jumped back from my desk. “A lot of paperwork,” she sputtered nervously.

Annoyed, I let silence work her over. It took ten seconds until she caved in.

“I brought you the latest numbers on my magnesium sulfate resuscitation study.” She added a thin folder to the pile she’d been sneaking a peek at.

“Find anything interesting?” I knew I sounded cold and sarcastic.

She looked startled.

I wanted her to see she was over the line. I brushed by her to get behind my desk and let her stand there looking uncomfortable while I called Zak and wheedled another ambulance ban.

He demanded payment. “Any news on the murder front?”

“I can’t talk now.” I whispered, hoping I could still imply goodies to come. Apparently it worked. After we’d exchanged a few sentences, Zak said he’d direct his ambulances to other ERs until noon. I hung up before he could change his mind
.

“I meant your study. Valerie,” I said, turning swiftly back to her, hoping to get her even more off balance.

Her thin shoulders lowered a notch. I felt pressed to get back outside, but I knew how important the work was to her. Maybe if I gave it a moment’s attention now, I’d get her on my side, at least for the rest of the morning. I was dangerously distracted as it was and needed to avoid another fight with her.

“We finished the first phase last month,” she said, “and the initial...”

I tried to focus on what she was saying and ignore the feeling in my stomach of a fist that kept tightening. I was aware they’d gotten ambiguous results so far. Magnesium sulfate, cheaper than other cardiac agents, had shown initial promise, but hadn’t panned out as the wonder drug some earlier California studies had suggested it was. As she spoke, her disappointment showed. Still, to give her credit, negative finds in medicine were important, and the material was timely and fascinating. Even talking about it, her voice reverberated with a quiet authority that I hadn’t heard much in our recent exchanges, and her prickly defensiveness was momentarily gone.

“Fabulous for torsade de pointes,” she concluded. “Compared to the old magnesium sulfate protocol, our new version improved survival rates by twenty percent. Not much advantage for V. tach. or V. fib. though.” She shrugged, then added, “It’s too bad.”

I agreed. Torsade de pointes was a lethal but rare form of abnormal heart rhythm. I’d only read about it and in twenty years had never seen a case. The usual killers were ventricular tachycardia and ventricular fibrillation.

“But for unstable angina or MIs it might be promising,” she continued, sounding enthusiastic. “The study’s going to be extended into a second phase, and we’re going to see if magnesium sulfate protects these patients against going into V. tach. or V. fib.”

Trying to keep myself from glancing at my watch, I responded, “Hope so.” I meant it, especially for patients with unstable angina, a condition preceding a heart attack where the blood supply to the heart is increasingly shut off by clogged arteries, but the heart muscle isn’t yet permanently damaged. To reverse the process and prevent the impending heart attack, or MI, we use oxygen, nitroglycerine, bed rest, blood thinners, and sometimes surgery, but the patients often die anyway from the deadly rhythms Jones had mentioned. If magnesium sulfate could protect these patients against V. tach. and V. fib., it might improve survival rates and prevent this. In some cases its use would avoid the need to use thrombolytic agents costing three hundred to three thousand dollars a dose. Magnesium sulfate cost thirty cents a dose. It was a lot safer too.