Lie Still (40 page)

The double stitch is pretty slow and this princess, being
fairly exhausted, fell asleep before I was done. They often
do. I’m never so proud of being boring.

The dress looked like a total write-off. Still, the folks
looked grateful.

I think the clinic nurse thought I’d put the princess under
some kind of spell.

H E N RY RO J E L I O , DAY S I X ( C O N T I N U E D )
Henry, Day Six, was not shaping up as planned.

I had mixed feelings about the epinephrine syringe containing epinephrine. A big part of me still would have professed to the world that Robin was incapable of trying to hurt Henry. Maybe that was the part of me that had wanted to date her. But clearly some other part of me doubted that.

Perhaps the part of me that wanted exoneration and maybe a job. I did not want to give up scientific and professional detachment, though. Such weakness is only acceptable after it’s proven correct.

I thanked Miguel for his help.

“Did you get what you needed, Doc?”

“Yeah, Miguel, I guess I did.”

“ ’Cuz you don’t look too happy about it.”

I gave him a thin smile. “There’s adrenaline in that syringe, eh?”

“No doubt about that,” he said.

Dr. Emmerick came in, waving a newspaper. “Ah, Dr. Ishmail. You’re apparently famous.” He handed me the “Regional” section of the morning’s
Republic.
On the front page was a story about Henry Rojelio. There was a photograph of Henry’s mother, a tear on each cheek, clutching the baby son and glancing ruefully over her shoulder toward Maricopa Hospital. The cutline said she had been praying for her eld-est son, who was in critical condition in the Children’s ICU.

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The article was labeled as the first of a three-part series on emergency care in small towns. There was a nasty push going on in the medico-political circles to try to organize and consol-idate emergencies and trauma care. The big specialty centers were arguing for improved survival, the smaller decentralized hospitals were touting local access to care. It is a common co-nundrum in health care: specialization versus immediacy. All of us had heard all the arguments a hundred times before.

The tale of Henry, at least what the reporter had been told about it, provided a convenient lead-in to the larger issues.

He described an “unexpected” cardiac arrest in an adolescent with an asthma attack and a “complex seizure disorder.”

The hospital spokesperson said they were looking into the possibility of an allergic reaction.

The reporter noted that the attending physician on the case, “a Dr. Malcolm Ishmail,” had not completed a residency, was neither a pediatrician nor an emergency physician, and could not be reached for comment.

The implication of the report, of course, was that the arrest might not have happened in the hands of a “real” doctor in a specialty center, or at least it was a good example of the type of case the arguing parties liked to chew on. To illustrate the counterargument, the reporter had added that the patient and his family were well known and “liked” by the local nursing staff. Poetic license has its place in investigative reporting.

If the reporter had tried to reach me at all, it had been halfhearted. I was never paged.

I asked Alphonse if I could use a phone to call Maricopa.

He nodded to Miguel, who took me back to the lab, dialed the intercampus code, and handed me the phone. “It’s ringing the operator,” he said. I asked the operator to page Dr.

Montgomery.

“Seen the paper?” I asked her.

“Not yet.”

“Your patient and mine, Henry Rojelio, is the star subject of some creative reporting.” I described the article to her.

“Any messages at home from any reporters?”

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DAVID FARRIS

“None that I’ve gotten.”

“It’s got his name here. Maybe I’ll give him a call. I would like to comment on a couple of things,” I said.

“Malcolm, be serious. Do you think they’d use it in the next installment to make you look better? Or maybe just leave it hanging out there like a lame defense from the hopeless?”

“I could explain some physiology.”

“Yeah, that will get some big headlines.”

We kicked around what he would have asked: What was my background? Why had I not finished a residency? What had happened to the poor boy? My smartest response to just about any question would have been “No comment.” I realized there was a gulf between what I would have wanted to say and what would have been prudent to say.

“I suppose it was a good thing to have been ‘unavailable,’ ” I said.

“Probably. Where are you?”

“Doing research.” She probably took that to mean I’d been getting laid.

“You sound far away.”

“I’m on a beach on a desert island.”

“You’re not the kind to run and hide.”

“I’m thinking about getting drunk. I’ve been reading Hemingway. My new idol. I don’t think he was sober all that often.”

“You know, not everything he wrote was autobiographical.”

“I suppose. But he does refer to lovemaking as ‘We had a fine time.’ I bet that was autobiographical.”

“At least for him.”

“Yeah. That’s what I meant. Anyway I’m thinking of becoming dissolute.”

“Never happen. You’re not wired that way.”

“Hey, I can change. I’m finished in Glory, anyway.”

“What do you mean?”

“I mean they’re going to hang me out to dry over Henry’s debacle.”

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“Malcolm! Surely they don’t think this was all your fault.”

“They’re going to give me a hearing. I’ll get to tell them they’re wrong.”

“Then you’ve got a shot.”

“Yeah. Pigs could fly. How’s Henry?”

“Malcolm, you can still have a little faith in the system.

You can’t just quit.”

“Mary Ellen, I had faith in the system. It’s gotten pretty thin. But I’m not quitting. There are things going . . .” I sighed. “How’s Henry?”

There was a pause. “You’re not telling me what’s going on.”

“Mary Ellen, I will. I promise. I’ll buy you a nice dinner.

But for now, just tell me about Henry.”

A pause. “You’ve seen it before. You could probably phone in my daily chart notes. Normal physiologic functions. No signs of significant life.”

“What did the EEG show?”

“The usual. More slowing. Not flat, not human. But the day nurse today said he was twitching when she called his name. None of us could get him to do it, though.”

“She a Right-to-Lifer?”

“Malcolm!” Mary Ellen and I did not always agree on the value of religion in health-care decisions.

“I know, I know. But they see things, sometimes,” I said.

“Some pray for visions.”

“Apparently effectively. He’s starting to sound like that trauma kid we saw together when we were fourth years.

What was his name?”

“Uhh, you got to give me a little more to work with.”

“Head trauma. Vietnamese kid.” Silence. “They were from Chula Vista. . . . You were on some elective—Infectious Diseases. I was on the Trauma elective. We consulted you guys when he spiked his hundred forty-seventh fever and we already had him on every gorilla-cillin in the place.”

Another silence. “Vu. Wasn’t it Vu?”

“Nathaniel Vu. That’s it.”

“Twenty-year-old, horrid brain conk,” I recited. “Crashed 304

DAVID FARRIS

his little Chevy into an abutment at midnight. Probably a suicide. Only slightly unfinished. Neurosurgeon cut out half his upper skull to decompress the brain, cortex mushroomed out enough to strangle off its own blood supply against the edges of the bone, then it died back.”

“But this isn’t the same,” she said. “He was a trauma.”

“But it’s going to be. It’s the final common pathway: Twitching. He’d lie in a knot, eyes always open. Blinking a lot. No response to stimuli,” I said.

“Well, now that I remember it, that was the debate.”

“Yeah. His family thought he was in there. They thought he knew them. Every day, three, five, ten of them slogging in to sit and talk to him. Bringing cards and drawings and balloons and all that shit. It was terrible. They’d jabber away at him and he’d twitch and blink and they were convinced—

convinced!—he knew they were there. Shit, they’d talk about all the relatives back in the old country, how things were where he used to work, who was dating his sister. His sister would cry and his mother would cry more. They’d finally leave and he’d blink and twitch still. And the therapists would come in twice a day and try to stretch him out straight, and they’d leave and he’d go
sproing
back into his knot. The family—shit, they were wasting their own lives on a man with no brain.”

“Malcolm, people do that all the time. Besides, Henry is not as hopelessly chronic as Nathaniel Vu.”

“Not yet. He hasn’t cleared the edema yet. Started breathing on his own and blinking a lot.”

“We’ll have to see how he is when the time comes.” Her tone was icy.

“So how is his family doing?”

“I don’t know that they’re any worse than average for this sort of thing, but they are louder than most. Lots of yelling in Spanish.”

“Little kids still in tears?”

“I don’t know, Malcolm.”

“Bruises and broken bones?”

“Malcolm!” She took a deep breath. “The little brothers LIE STILL

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were acting out this morning. And Stepdad wants to challenge everything we say and do.”

“Sounds lovely.”

“Yeah, it’s great. Their lawyer asked if he could read the chart. I said no. An hour later the stepdad had me paged wondering why not. He wants him to see it, it’s his son’s record, et cetera. So what could I do? We’re going to have a big Care Conference at noon. Parents, priest, lawyer, nurses, social worker. Maybe a doctor or two. You should be there.”

“Mmm. Sounds exciting. Maybe I should be there, you know, to keep you from salivating over the priest.”

“Not possible.” A pause. “What are you doing this afternoon?”

“I’m gonna go buy a cheap camera and work on my artistic vision. It’s been in a coma, you know.”

She said, “I know what you’re going to do. You’re going to go to the library. Do some real research.”

“What library?”

“The Maricopa Biomed Library. I’m sure you still know where it is.”

“And what would I be looking up? Assuming they let me in.”

“Malcolm, pretend it’s a school project. Look up all the pathophysiology you can think of. Do a differential diagnosis. Like in school, Malcolm. Make a list of the possible causes for what happened to Henry, look them all up, expand the list, look them up. You’ve done it all before.”

I said, “Mm-mm. And it wasn’t any fun any of the other times, either.”

“Malcolm, do some homework for your hearing in Glory.

Look up the drugs in the pharmacy texts. Sometimes they list all the weird stuff that’s been reported. You know, the references. Pull the journals. Look for case reports.”

She was right. Since my epinephrine syringe contained—

as advertised—epinephrine, I was going to have to build my defense on dull science. “Well, the beach is all covered in sand, anyway. I suppose the library could fill a few hours.”

*

*

*

306

DAVID FARRIS

Just outside Tucson, I hit a highway construction snag. The heavy posture of the woman leaning on the stop-sign-on-a-stick, a hardtack bottle-blonde sucking on a cigarette, was all I needed to know we would be sitting for a while. I shut off my motor and got out of the car to stretch. I walked up the embankment, found a spot that afforded a view of the activities up ahead, and sat on a rock, hoping I could enter a desert trance. Instead I got agitated. The sun hurt my eyes. I had trouble remembering what I was still fighting and why.

Back in football country we used to say “When in doubt, go long.” I could make a U-turn over the median and head back to Tucson, then west out of town, maybe way out into the desert, see if the saguaros had been shot up out there, too. Maybe make LA or San Diego by nightfall; dull my brain with the So-Cal lotus leaves—days on the beach ogling a different species of bottle-blonde; then and only then start thinking about another job.

I pictured my Datsun skittering west across the desert; even with the cheery winter sun heating up the moving tin can, with the promise of Southern California, the home of instant gratification, even with the mindless babble of the radio at high volumes, it would be insufficient opium. I couldn’t do it. I knew when the sun set, the gloaming would be painful: The primitive parts of the brain know night as the time of lions and tigers and bears.

I wanted a home. Running away wouldn’t get me one.

I got back in my car, still parked on the freeway. The

“Henry” section of the newspaper was on the passenger seat.

I reread the article but found it no better reading the third time than the first two. But then, on one of the middle pages, right next to the story about Henry, a little one-column story caught my eye: “Police Seeking ID of Woman’s Body.”

Someone had found the body of a young Caucasian brunette of medium height, floating in a culvert in the canal along Indian School Road. Her face was “distorted.”

I sat and stared at nothing. The possibility of Robin’s body lying on a slab in the morgue would explain Detectives Borden and May making early house calls. They no doubt LIE STILL

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would have heard all about my confronting her in the Glory ER. I couldn’t remember exactly what I’d said, but I was sure it was enough.

Their lie detector suddenly seemed like a great idea. I pulled Will Borden’s card from my pocket. When traffic got going again I found a pay phone and called the Mesa PD. A raspy, tobacco-infused female voice dragged out the greeting,

“Homicide,” making it sound like an offer.

“Hello. I’m looking for Detective Borden.”

“The detective,” she rasped, “is on another call. Would you care to wait?”

“I’d like to leave a message, if I may. I’m short on pocket change.”

“Just a minute . . . okay.”