Lethal Practice (37 page)

I must have been rolled onto my back, because I started to sense someone pushing, not unpleasantly, on the front of my chest. Next, bursting into my lungs, I felt a rush of air explode the vise of asphyxia. Again, again, and again. It was like sex, like coming, release.

More pushing, more volleys of relief.

The whiteout in my eyes began to clear. Shadows speckled with light moved above me. The ringing dimmed a notch; voices vibrated through the din.

More pushing, more relief. I could feel a mask applied to my face.

These creeps were resuscitating me. They were bagging air into my lungs, compressing my heart.

The voices organized to speech. I still saw only shadows dancing above me.

One of the shadows barked, “All clear!”

The other form withdrew. The precious puffs of air stopped, the vise in my chest clamped back down. They were stopping. I wanted seconds more. Don’t stop. Not yet!

I sank back into the airless pit. I still could see the remaining shadow lean over me. I felt more pressure on my chest.

Another ignition of white light exploded up my eyeballs, arched through me, and flopped me back on the floor.

My world stayed white, but the vise on my chest was lifting. This time I could even feel the press of the reapplied mask on my face and a delicious flow of air bagged into me. My ears were back to ringing. I couldn’t move, couldn’t twitch a muscle, but I knew my heart had been restarted. Hey, when you’ve been down to the last ticks of the second hand, you take what you can get, although even in my recently fried state, I figured I wasn’t exactly in the care of a concerned team of health professionals.

I tried taking inventory. Breathing on my own was slowly coming back, the mask assisting my still-feeble efforts. Talking was impossible. My tongue felt the size of a salami. I could only gurgle pathetically. My sense of smell was all too functional; I was lying in a pool of my own urine and feces. Everything hurt, nothing moved.
Anoxia, acidosis,
and
postresuscitation myalgia
were the medical terms. In reality, it was the wall of screaming muscle pain marathoners hit when their bodies run out of oxygen. I was powerless, effectively paralyzed. Their specimen. They had turned resuscitation into an instrument of torture. Any move by them could plummet me back to a slow and lingering horror, death.

The flashing lights subsided. The hooded shadows became silent ski masks. Behind the odd “0” eyes and mouth shapes, I looked for some shred of pity, doubt, or change of heart. Instead, the eyes above me revealed a cold indifference. In the one bagging me, the lips were thin, grimaced, neutral. The other, hunched over in front, leered at my increasing fear. The mouth was hideously familiar. I knew she would speak, would no longer take the trouble to hide. She would leisurely savor a running commentary on my death, or deaths even, repeated over and over, as long as the cruelty pleasured her.

“Go check his computer. See how far he’s got!” Jones’s voice was cool, matter-of-fact, the voice of a practiced clinician, familiar with the process. The other figure left without a word.

“So, who’d you tell. Doc? Or did you figure it out yet? Before you go, we have to know.” Her leer returned at her own accidental rhyme. My attempt to reply was still a gurgle.

“Fuckin’ Kingsly. Came up on me in the path lab that night. I think the slob went there to hump the corpses when he couldn’t find a stray woman to paw. He caught me with one of my subjects. Even stewed, he knew I was being a bad girl. He started loping off down the hall, hollering. I had to run after the dumb fuck. I grabbed my cardiac needle and caught up with him easy enough, but he was thrashing around like a cornered pig.”

I heard more gurgling. It was my breathing. I tried to turn my head to get rid of the drool and vomit, but I couldn’t move.

“Oh, airway trouble. Doc. You were always the stickler about teaching the importance of managing an airway.” With a vicious twist, she wrenched my head to the side. A sour goo ran out the corner of my mouth, and I stopped choking. But every part of me felt encased; I couldn’t seem to move at all. Even my eyes had trouble turning back toward my tormentor’s voice. I gave up trying to see her. If she was talking, she wanted me able to hear. That’s all I was reduced to—listening and gulping air, grasping a few more seconds.

Her voice dropped the clipped neutrality. “Did I do that good. Doc!” she exclaimed. I could feel her breath on my ear. “You hear me, Doc!” she shrieked, and snapped my head back around, grabbed my chin, and pinched hard, putting her face right up to mine. Her eyes, dead before, now seethed with fury, a ferocity I’d diagnosed and felled with Haldol many times. This was one sick cookie.

She switched back and donned her cool indifference like a gown. She studied me, her specimen, and continued her dissertation.

“So I had to settle him down, Doc, get him positioned, you know what I mean. So you know what I did? Hey, you’re going to love this one. I ripped open my shirt and showed him my titles!”

At this revelation, she snapped her head upright and waited, real delight on what I could see of her face, as though she expected a laugh from me. When none came, she shrugged and went on with her tale.

“Dumb fuck went for them, like a bull to a red flag, sucking and slobbering all over the place. I had to get my back up against the wall to support his weight. As he entertained himself, I got his shirt unbuttoned, slid in the needle tip, and did an underhand into the heart.” The recollected moment brought another smile. “Funny, he was so into my little titties, he didn’t realize at first he was dead. Kept sucking away.” The smile faded, the voice hardened. “Then he dropped; broke the needle. Sprayed blood everywhere and peed all over me as he went down.”

She seemed transfixed as she continued. “Stripped off his shirt and pants, cleaned up the blood, got him into a wheelchair, and bagged his clothes. I covered him with a sheet and had to switch into OR greens myself, in case a stray guard saw us, but they didn’t usually go to administration at night. I got him up the freight elevator to his office without being seen.”

She’d started out by taunting me but now was staring off into space as I’d seen her do so often at staff meetings. It was as though she’d repeated what happened many times before, compelled to reiterate her downfall, like a liturgy for her own undoing. “I dumped him on the carpet,” she continued, not even looking at me, “wiped off his chest again with alcohol swabs, and cranked up the heat to dry him off. By that time the blood had clotted and the puncture site was just a tiny scab. With what everybody knew about him, they’d still think he’d tried to have sex somewhere, stumbled back to his office in his underwear, got cold and turned up the heat, and then died from a heart attack. I slipped back to the morgue, cleaned off the wheelchair, called in my ambulance, and whipped the derelict I was working on, the bloody clothes, even the sheet, out the back door.” She stopped, seemed to see me again, and added, “Did you know you can move a body in a body bag in and out the back door of a hospital morgue at almost any time during the night and nobody questions it? Everybody assumes it’s a pickup for a funeral home.”

She looked proud, but seconds later the smug expression faded and her face took on a hardness again. “Who would’ve thought a stupid civilian would pump a corpse? Hell, no doctor would have. Even with the heat, Kingsly would have been stiffening up after five hours.” Her eyes were filling with rage. “And you,” she snarled, grabbing my hair and leaning toward me, “you homed in on the call, noticed the blood, and found the needle. Then you just kept pushing. Watts’s little pointer. When you called to ask Kradic about needle stabs and the DOA, I knew you were getting close to what was really happening and you had to die too. Even without Watts, it’d be only a matter of time before your damn ER data gave you my name. The rest, as they say, is history, and so are you, you pompous, self-righteous prick.” She slammed my head back on the tile floor.

I had at least started swallowing again, but the stench of her breath and the pain in my skull promised new vomit to choke on. I tried to pull my face away, but instead she gripped my chin again with her fingers. “How about you. Professor?” she whispered. “Do you want to suck my titties while you go?” She suddenly brought her head so close to mine, I could see only her eyes. “Don’t worry, I won’t tell your precious Janet.”

My fury snapped through me like a jolt of current. If I could have moved, I would have torn into her like an animal, with teeth, hands, fingernails—anything.

Just as abruptly, she moved back, and I was being eyed as a specimen once more. She returned to the defibrillator monitor on the floor beside us. Quickly she set the machine at ready and picked up the electrical paddles. She began slathering lubricating gel onto their surfaces. Over her shoulder she bellowed to her partner, still upstairs, supposedly with my computer records. “Did you find anything yet?”

The reply was muffled but satisfied her, something about “in a minute,” which was probably how long I had. I tested if I could move anything. I got a finger to twitch.

She kept circling one paddle on the other, languidly spreading the lubricant as if absently stirring a bowl of batter. I noticed she’d taken off her gloves.

“You know,” she said softly, “if mag sulfate had been the magic bullet to resuscitate arrests the early studies had hinted at, my trials would have discovered the standards for the most effective dose and administrative protocol long before the rest of the world. Other researchers in the study were tied to the tedium of double-blind randomization and limited by having to wait for natural arrests to occur.” She kept circling one paddle on the other and staring off into space. I tried to move my hands.

“And the delays, they always had the delay before they got to the subject. I had them fresh; time didn’t obscure my results. Sometimes I could run up to ten treatment protocols on a single specimen before they were gone for good.”

More silence, more circling. A faraway look glazed over her eyes. I knew her fever. It was like Fernandez’s, but on a much greater scale. Jones was after the adulation of
sensational
health research. The same forum of recognition and respect that so enthralled Fernandez, but multiplied tenfold. At this level there was the possibility of big bucks. The drug-company cash available for backing a winning record was phenomenal. Discovering a drug protocol that dramatically increased survival after heart attacks and cardiac arrests would be heralded everywhere and set its founder up with research funds for life. Jones had been after a breakthrough in resuscitation, a kind of Lazarus protocol, a new and better way to raise the dead that would catapult her to the head of the field.

I could hear her bitterness. “It wasn’t there. Mag sulfate, the cheap heart saver, didn’t work much better than the usual treatments.” Then she stopped circling the paddles and looked down at me. “But Doc, I couldn’t let all that risk, all that work go to waste. No, I grabbed one corner of resus protocol and made it mine forever.” She leaned forward. “Did you figure it out yet, Professor?”

It was a command, an order to see and acknowledge her genius. And I
had
figured it out. Torsade de pointes. An obscure, rare dysrhythmia, never frequent enough to give the opportunity for much definitive study, had started turning up unexpectedly as one of the dysrhythmias in patients on allergy medication, like terfenadine, in combination with antibiotics, like erythromycin. Those were the drugs found in our DOA. When the health warnings first came out, Jones had seized on the knowledge to salvage something from her failing murderous quest for recognition. Alcoholics had been injected, probably intracardiac, to produce torsade de pointes and give Jones enough cases to get the best protocol with magnesium sulfate. Then she buried her data in the Buffalo cardiac arrest study.

But the p value for her results, the probability of certainty over chance in scientific studies, was far too good for the small number of cases the Buffalo area should have had. That’s what twigged when she ran her study by me—her possibility of a result due to chance was below a probability of one in ten thousand times. She must have had nearly three hundred cases to have such certainty.

Of course, she’d never spelled out her study size. She never had to. She was sentenced to having her name confined to a minor find, just a footnote added to a larger investigation. A mention, a p value, nothing more. There were no detailed numbers or data. She couldn’t afford closer scrutiny. But the rarity of naturally occurring torsade de pointes wouldn’t invite much interest. Her study would be a little oddity in the literature of cardiac arrests. To end with so little; to have hungered after so much. To have caused so much evil.

I had to stop her.

She placed one of the paddles on my chest and languidly spread the gel, absently, almost tenderly, like greasing up a lover. Her eyes were far away again, as if locked on her failure.

I could still feel the cold slush from melted snow under my palms. I could move my hands enough now to press them against the wet tiles.

She stopped stroking my chest. The paddle had smeared itself dry. Sticking to my skin, it tugged her focus back on me. She troweled on some more gel, but roughly this time. “What the hell’s keeping you!” she screeched over her shoulder.

There was another distant murmur. I heard the floorboards above creak, followed by the heavy thud of returning steps.

The other figure loomed behind her.

“Anything?” She was curt, clinical now.

The figure stepped around in front, shook a masked head. My sight was clearer. I could see white stubble lining the silent mouth. Older; male.

“Good for you, Doc. No entry to the identity code logged. Got here just in time.” She turned to the dials. “You hadn’t gotten my name yet.” The click of the sync switch going off sounded like a cocked pistol.

“So now a little heart attack. All that paranoia, running around, and sneaking in through the snow. Too much stress. Popped your mind; blew your heart.”