Beyond the Pale (8 page)

“Who are you?” Grace asked. It was all she could think to say.

A pretty frown creased the girl’s forehead. “Who are
you
? That is a better question, I think.”

Grace shook her head, unsure how to answer. The world had fallen silent. She could hear no traffic, no sirens, no circling airplanes waiting to land. It was as if the city had vanished into the night. A crescent moon hung in the sky, although she could not remember seeing it earlier. The wind held its breath.

The girl’s eyes reflected the moonlight. “A darkness is coming,” she whispered.

Grace stared at the girl in incomprehension, then a shrill chime pierced the silence. After a confused second Grace realized what it was. Her beeper. She fumbled for the small device clipped to her belt, grabbed it in numb hands, and glanced at the glowing liquid crystal display.

“Damn it,” she said. “They want me back at the hospital.” She looked up. “I have to …”

Her words trailed off. The girl was gone. She spun around and scanned the deepening night, but she had no real hope of seeing the child, nor did she.

Fifteen minutes later, Grace dashed through the door of Denver Memorial’s Emergency Department. For a moment she leaned against a wall, eyes squeezed shut, mouth open, and panted for breath. She had half walked, half run the ten blocks from City Park, and now her lungs felt as if she had been the one caught in the smoke of the apartment fire earlier that day. The long hours of a resident left little time for
exercise, and although she was thin enough—maybe even too thin—Grace wasn’t in top physical shape. She took one last breath, then opened her eyes.

The ED was a madhouse.

In front of the receiving counter, a man argued with his wife even as he gripped the carving fork she had stuck in his side. Down one hall, a couple of gang members hurled expletives and death threats at each other while a frightened intern tried to bandage their knife wounds. A gray-faced man stumbled through the door, asked to see a doctor, then vomited in the middle of the floor. Every chair in the waiting room was occupied by someone clutching a broken limb, or sweating with fever, or wheezing for breath. Above it all, like a dissonant chorus of sick angels, rose the crying of children.

Grace gathered her will, pushed her way through the throng of injured toward one of the nurses’ stations, grabbed a pair of gloves, and put them on with an expert
snap
.

“Grace, where the hell have you been? I page you three times and it still takes you thirty minutes to show up?”

“Fifteen,” she murmured. She turned around and found herself gazing at the young, angry face of Chief Resident Morty Underwood. Grace disliked Underwood, but she never displayed her feelings. She refused to give him the satisfaction of knowing he had gotten to her. “It took me fifteen minutes, Morty. I came as soon as you paged me.”

This latter statement was not entirely true. For several minutes, after her beeper had first gone off, she had stood in the park and gazed into the gloom, looking for the child, but the girl in the old-fashioned dress had vanished like a ghost. Maybe, in a way, that was what she had been. Just before Grace had noticed the girl she had been thinking about the orphanage, and there were ghosts enough in those memories to haunt a hundred walks. Yet Grace didn’t quite believe that. The girl had seemed so real. Almost
too
real. As if everything else Grace had seen that day—the hospital, the city, her own apartment—had been the apparitions, and among them all only the girl in the archaic clothes had been solid and true. Besides, if the child had been a phantasm of memories, why had she spoken of what was to come?

Underwood lifted a hand to check the comb-over plastered
with large quantities of pomade to his prematurely balding head. “Take this long to show up again, and I’ll be reporting it, Grace.”

Just wanting to get away from Underwood and get to work, Grace feigned contrition. “Which one is mine?” she asked.

The doors of the ambulance entrance
whooshed
open. A stretcher hurtled through, propelled by a pair of emergency medical technicians in crisp white uniforms. One of the EMTs shouted for help. Behind them came two Denver police officers, hands on the guns at their hips. On the stretcher, torso smeared with blood, a man writhed in agony.

“I think that’s your ticket now, Grace,” Underwood said with a noxious smile. “Looks like a nice sucking chest wound. Enjoy.”

“Thanks,” was all Grace said. She turned her back on Underwood and moved to help with the stretcher.

“What have we got?” she asked one of the EMTs.

“Penetrating trauma from gunshot,” he said. “Two entrance wounds, no exits.”

Grace grabbed a passing intern. “Get me two units of O-negative and a portable X-ray, and meet me in Trauma Three.” The intern sprinted away, and she commandeered another resident and a pair of nurses.

“How did it happen?” Grace asked as they raced down the corridor.

One of the police officers, a woman with gray-flecked hair, answered. “The suspect was caught breaking and entering at an antique store on South Broadway. We arrived on scene to see the suspect assailing a woman, the owner. When the suspect wouldn’t desist, I brought him down with two shots.”

Grace looked up at the officer. “And the owner? Where is she?”

“There,” the other officer answered, his boyish face grim. Grace followed his gaze. Across the ED, she saw Leon Arlington push a gurney into an elevator. On it lay a sheet-draped form. Leon nodded in her direction as the elevator doors slid shut.

“The store owner was dead on the scene,” the young officer went on. “Her neck was broken, the suspect did it with his bare hands. He’s a strong bastard, I’ll give him that
much. Although why he was breaking into an antique shop, I don’t know. There was less cash on the premises than in a convenience store.”

“Maybe he’s a collector,” Grace said. She shook her head. “All right. We’ll take it from here.”

Moments later, wearing sterile gowns, Grace, resident, and nurses wheeled the stretcher into the trauma room. On her count they lifted the patient onto the table. Within seconds the nurses had taped electrical leads to his chest, started an IV drip, and had a catheter in him.

Grace took her first good look at the patient. He was a white male, late twenties, curiously groomed and affluent-looking for a typical break-in suspect. However, she didn’t care who he was. He was wounded, that was all that mattered now. With instinctual speed she assessed his condition. He was cyanotic, his flesh tinged blue. Pink froth bubbled from the holes in his chest. Probable pneumothorax. The intern rushed into the trauma room. Grace took the two units of blood from him, hung them, then glanced at the other resident. “Intubate him.”

He nodded and guided a plastic breathing tube down the patient’s trachea. Grace made an incision beneath the armpit, inserted a chest tube, and attached it to a vacuum bottle. Blood and fluid bubbled into the bottle. Grace and the others stepped back as the intern positioned the X-ray arm over the table, then moved in again after he swung the unit aside and continued their work to stabilize the patient.

“I’ve got the film,” one of the nurses said minutes later.

Grace straightened, and the nurse held up the X-ray for her. Grace’s own gloved hands were now smeared with blood. She glanced at the image on the film, then frowned. “What is
this
?”

The two slugs showed up on the X-ray as white dots. One was lodged next to the right lung. The other was situated dangerously close to the descending aorta, had perhaps nicked it. However, Grace noticed these only in passing. For just left of center in the patient’s chest was another white blot, except this one was huge, as big as a fist, and rough-edged. It lay directly in front of his heart.

“Your guess is as good as mine,” the nurse said. “But something tells me this isn’t his first chest wound.”

Grace pushed aside the X-ray and glanced back at the patient. The other nurse had cleaned away most of the blood. Now the two gunshot wounds stared upward like angry red eyes. In between them, down the center of his chest, ran a jagged line of pink scar tissue. The scar looked barely healed. Grace studied again the white blotch on the X-ray. Only metal would show up that clearly.

“It’s almost like he’s got some huge chunk of shrapnel in his thoracic cavity,” she said. She had seen a lot of strange things in the ED—an attempted suicide who drove himself to the hospital with a bullet lodged in his cerebral cortex, a woman complaining of heartburn who gave birth to twins, a girl with a piece of grass growing from a seed that had taken root in her eyeball—but this had to be the strangest. How could a man live with a piece of metal that big in his chest? And how did it get there in the first place?

A monitor beeped. “Pressure is fifty and dropping,” the other nurse called out. “I think we’re losing him.”

Grace called for a syringe of epinephrine and injected it into the IV tubing. A second later the patient’s eyes flew open. He screamed and arched his back off the table, hands clenched into claws.

“Get him down!” Grace shouted. “Get him down
now
!”

It took all of them to hold the man on the table. Convulsion after convulsion wracked his body, and he mumbled something in a ragged voice.

“… sin … have to find … 
Sinfath …
”

“What’s he saying?” the intern asked.

“I’ve lost his pulse!” a nurse shouted.

The patient stiffened, then his eyes fluttered shut, and he fell limp. The intern grabbed defibrillator paddles from the crash cart and handed them to Grace. She rubbed them together to spread the conductive gel, then placed them on the man’s chest. The defibrillator whined as the charge built up.

“Everyone clear!”

The patient’s body jerked as the electric charge surged through him, then went still. Grace glanced at the monitor. Only a few erratic spikes broke the flat green line. She shocked him again, and again. No response.

“All right, let’s crack him,” she ordered. “I’m going to massage his heart.”

Grace grabbed a scalpel and made a deep incision in the left side of the man’s chest. She took a stainless steel rib-spreader from the intern and in one deft motion opened him up. Without being told, a nurse positioned a suction tube and cleared away excess blood so Grace could see. Grace reminded herself to compliment her coworkers. They were top-notch and deserved to know it. She reached into the thoracic cavity, deftly moved aside the left lung, then plunged her hand deeper, toward the sac that contained the man’s heart.

Her fingers closed around something hard, rough, and bitterly cold. With a hiss of pain she snatched her hand back. It felt as if she had just touched a lump of dry ice.

“What is it?” the other resident asked.

Grace shook her head and cradled her hand. “I don’t … I don’t know.”

She shook her hand, then picked up a retractor and pulled back the left lung. The suction tube gurgled and drained away the blood in the patient’s chest so that all could see what lay within.

Grace stared in perfect shock.

“Oh, God …” one of the nurses breathed, while the other clamped a hand to her mouth to stifle a scream.

“Jesus, what is
that
?” the intern said, his eyes wide.

Grace worked her jaw, unable to form words. She could only gaze at the fist-shaped lump of metal that lay in the center of the man’s chest, exactly where his heart should have been. The monitor beeped frantically, then let out a piercing whine.

The suspect was dead.

It was getting late.

About an hour ago the tide in the ED had finally turned, and after that more patients were wheeled out the doors than were wheeled in. The throng of wounded dwindled to a scattering of people waiting to be seen for minor injuries, and the roar of anger and pain faded to a patient murmur. Somewhere,
far down a corridor, an infant cried. It was a weak and forlorn sound, and along with it drifted the weary music of a woman’s lullaby.

We are born to this. To life, and to hurt
. Grace sighed and gripped a chipped mug with both hands. Ripples shivered across the brown surface of the coffee within. Circles spreading to nowhere, containing nothing, vanishing when they struck the boundary that imprisoned them. Maybe that was all they were, ripples on a pond. Maybe she was foolish to try to fight.

“Dr. Beckett …?”

Grace jerked her head up. A police officer sat in the chair opposite her, a concerned expression on his face. “I was asking you a question about the suspect, Dr. Beckett.”

She blinked. “Yes, of course, I’m so sorry. Please go on.”

“Did the suspect say anything that might help us in learning his identity? Did he mention a name? Or a place he might have come from?”

Grace concentrated, thought back to the urgent chaos in the trauma room, then shook her head. “I’m afraid not. For a minute he did mumble something, but I couldn’t understand what it was. I’m not even certain it was English. It might have been something about
sin
or
sinning.
”

The officer nodded and scribbled on a notepad. “We’ll run his fingerprints through the system, but any additional information could help narrow down the search. Did he say anything else you could make out? Anything at all?”

Grace shook her head again. She watched as he jotted down a few more notes. Officer John Erwin, read the tag on his blue shirt. He was middle-aged, with kind brown eyes. He and several other police officers had arrived at the hospital not long after the happenings in Trauma Three, called in by the original two officers. Erwin had explained it was standard procedure to file a report on how the suspect had died, and—he had paused here—to describe any unusual circumstances associated with that death. At first Grace had been nervous, but Erwin had sat her down, pushed a mug of coffee into her hands, and with his considerate manner had put her at ease.

Earlier, Morty Underwood had done just the opposite.

Not long after she had sewn up the body of the John Doe
and had sent it down to the morgue, she had rounded a corner to find herself face-to-face with the Chief Resident. His comb-over flew above his head, and his expression was one of panic. He had just gotten out of a meeting with the chief of the ED. The hospital’s management had decided it was necessary to keep the
incident
with the police suspect quiet. Everyone remembered the
incident
at another hospital a few years back, when toxic fumes emitted by a woman’s blood had nearly asphyxiated a half-dozen hospital workers. Some people had gone so far as to suggest she had been an extraterrestrial alien. Denver Memorial Hospital did not want that kind of publicity. Things like that happened in tabloids, not here. A detailed autopsy would certainly reveal a more mundane explanation for the patient’s condition. Until then, no one—including Grace—was to say anything about the
incident
to anyone.