Trauma (21 page)

Unless …

An idea came to Carrie so ingenious her whole body tensed. The next shift was due to come on at eleven o'clock. Carrie could go home, call the duty nurse, and order a CAT scan using Dr. Navarro's hospital ID. It was pinned to the nurses' station for everyone to see.

It was a risky move, but asking for a scan was not like ordering narcotics. She could say that Navarro had personally asked her to call in the labs. Chances were nobody would question the order. If the nurse on the next shift was anything like Lee Taggart, it was almost a certainty. The scan could be done overnight or very early in the morning. Carrie would go by radiology first thing and have a look at the films herself. No one was likely to see her if she showed up early enough. Once she checked out the CAT scan and the EEG, she'd decide what to do from there. Carrie gently touched Fasciani's face. His skin felt spongy, no give. Her heart ached for him. Something had to be done.

It was not perfect, but at least it was a plan.

 

CHAPTER 28

A glance at the speedometer showed Carrie was going seventy. Her thoughts raced, and it was no surprise the surge of adrenaline had her driving so fast. Carrie checked the time on the dashboard clock. In thirty minutes she could make the call she had rehearsed into memory.

The radio was off, but Carrie's fingers drummed an erratic rhythm against the steering wheel as she exited the highway. Her thoughts returned to Fasciani, Abington, and this bizarre palinacousis. The implications of the discovery both exhilarated and bewildered her. DBS sat at the epicenter of a renaissance in psychosurgery, a groundswell that Carrie's discovery might disrupt. It was the last outcome Dr. Finley had imagined when he brought her on board.

Carrie kept to the speed limit and arrived home at quarter to eleven, leaving fifteen minutes until shift change and showtime. It was difficult not to project into the future. If DBS proved detrimental in the way she suspected, it would put an immediate halt to Dr. Finley's pilot program, and put her right out of a job. What she was about to do carried a burden of guilt, lots of it. Dr. Finley had given her a second chance, and here she was going behind his back, working covertly to dismantle what might be Nobel Prize–worthy work in the treatment of PTSD.

While the surgical community had embraced DBS as a neurosurgical treatment for a variety of ailments, the public would key in on the brain damage it caused, and would have a hard time not seeing the procedure as a harkening back to the days of rusty implements and drooling, mindless patients. Some side effects to experimental surgery would be tolerable, but palinacousis was not one of them. The extremely rare condition made it impossible for anyone to function, with bodiless voices constantly shouting in one ear. If it was not a fate worse than death, it sure was close.

Irene Bryant was in the living room working on a painting when Carrie arrived. Adam was stretched out on the sofa. Dressed in gray shorts and a loose-fitting T-shirt, he struck a Rubenesque pose as he munched on an apple. If only he were as plump and healthy-looking as those models. After hanging up her coat, Carrie came around to the front of the easel. She fully expected Adam would be part of her mother's creation, but Irene had painted only the bowl of fruit on the coffee table. It was so realistic-looking it tricked Carrie's mind into smelling citrus mixed in with the scent of fresh oil paint.

“It's beautiful, Mom,” Carrie said.

Standing beside Carrie, Irene appraised her work thoughtfully, body akimbo. “I'm thinking of calling it
Bowl of Fruit
.”

“Very clever title,” Carrie said. She pointed to an apple in the fruit bowl. “May I?” Carrie asked. She had eaten only a salad for dinner, and her belly was rumbling. She needed something to settle her stomach before making the call, and her mother's painting had given her a craving for fruit.

“My work here is done, so be my guest.”

Adam tossed Carrie an apple. She noticed the tips of her brother's fingers were blackened with engine grease, which he somehow managed to keep off the furniture but not her apple. Carrie tossed the apple back to her brother.

“I'll get my own. Thanks.”

“I almost got the beast running today,” Adam said.

The distant look in Adam's eyes and his downcast expression caused Irene's bright smile to retreat. It made Carrie sad, thinking how this must be for her mother. Adam's past was stunting his potential, his future, and the mental shackles he wore kept him in a seemingly inescapable limbo. Here was Carrie, at the helm of a major mental health breakthrough, in a position to help Adam and others like him, but she was about to do the exact opposite.

Irene turned her attention to Carrie and fixed her daughter with a worried stare. Irene's ability to see what others missed made her gifted at the canvas as well as a difficult parent to hide from. Carrie had learned that lesson the hard way in her rebellious middle school years, most notably the one and only time she came home a little tipsy from a friend's house. Her mother's powers of observation never failed to amaze. Perhaps Carrie had inherited some of that talent, and it allowed her to see in Abington and Fasciani what others at the VA had not.

“Is something wrong, sweetheart?” Irene asked.

I'm just about to blow my future up again,
Carrie thought.
Mine and Adam's.

“No. I'm fine,” was all Carrie managed.

“Good day?”

“Great. But I'm going to turn in. Big day tomorrow.”
Maybe the biggest, depending on what those tests show, or don't show.

“Yeah, me too,” Adam said, sounding sarcastic. “I'm going to do nothing, and then in the afternoon I have a big heap of nothing on my plate.”

Irene shot Adam a slightly disapproving look, only because the truth in his humor hurt. Adam had nothing to do except work on that car of his. He could not hold a job, see his friends, or concentrate on a task without his frustration and pent-up anger getting the better of him.

Carrie crossed the room, wrapped her arms around her brother, and gave him a kiss on the forehead. “I love you, brother,” Carrie said. “And we're going to get through this together.”

Adam returned a weak smile that seemed to contradict her conviction. “Maybe in my next life,” he said.

The guilt returned. The ache of betrayal, of secrets Carrie would have to keep, weighed heavy and would probably grow more burdensome over time. As she headed for the stairs, Carrie paused to apply a quick peck on her mother's cheek. The look Carrie got in response said her loving gesture hadn't lightened her mother's lingering concern.

Carrie bounded up the stairs and closed her bedroom door behind her.
Home again, home again.
But not home. No, no really. This was transient living; Carrie's life was in flux, much like Adam's.

Carrie sat on her bed with her smartphone in hand. She did not know the VA's phone number by memory, and after looking it up, wrote it down on the same scratch paper where she had earlier jotted Navarro's hospital ID and his user name/password combination. Navarro had posted those numbers as a personal convenience so he would not have to approve and enter every lab order from a resident. It was a bit lazy, but not at all an uncommon practice. Still, Carrie did not want to keep Navarro's login credentials on her smartphone, lest Goodwin employed hackers as spies. She could not be too cautious.

Carrie knew without checking that her pupils were slightly dilated and her heartbeat accelerated, all neurological responses to stress. Intellectually, she understood that her sympathetic nervous system was causing a biochemical imbalance, not that the knowledge reduced her anxiety any.

The phone rang. Her hands turned clammy.

The operator answered. “VA, can I help you?”

“Yes, neuro recovery ICU, please.”

“One moment.”

A beat of silence preceded the phone ringing once again. Carrie took a breath and exhaled slowly. She studied Navarro's ID number, committing the digits to memory.

You can do this. Just sound confident.

Another ring. Carrie tensed, gripping her phone even tighter. But the phone kept on ringing. No answer.
Where's the duty nurse?
Carrie considered the possibility that Fasciani had suffered a setback. Maybe he was being triaged at that moment, or he could have coded. Naturally, Carrie's mind went to the worst possible outcomes. Was it related to the DBS?

Carrie waited fifteen minutes, then called back. The operator connected her to the unit for a second time. By twelve thirty, after three attempts to reach the duty nurse, Carrie was an emotional wreck. Something horrible was happening to Eric Fasciani, she felt certain of it. She dialed the operator once more.

“This is Dr. Carrie Bryant,” she announced. “Could you please page the duty nurse on the neuro recovery ICU and have whoever it is call me back ASAP.”

Carrie gave the operator her number and waited anxiously for the call back. When her phone finally rang some seventeen minutes later, she was on the floor trying to stretch out a bit of tightness in her legs and back. Days after Abington's unprovoked assault, Carrie still felt a persistent ache. She should have gone downstairs and grabbed something to eat, but Adam was up watching television and Carrie was in no mood to confront her guilt again.

She staved off a bout of light-headedness from having stood too quickly, and answered the call. “This is Dr. Bryant,” Carrie said into the phone.

“Yeah, Dr. Bryant, this is Mandy, the operator here.”

“Mandy?” Carrie was confused.
Where's the duty nurse?

“Um, okay,” was all Carrie could think to say.

“There's nobody up on the ICU neuro recovery floor.”

The light-headedness Carrie had experienced returned with a vengeance. “What do you mean? That's impossible. I was just visiting a patient there not more than a few hours ago.”

Mandy made a bit of an exasperated sigh as if to imply the docs never knew what was really going on.

“That may very well be,” Mandy said. “But there ain't no patients up there now. Security checked it for me. The lights are out, the doors are locked, and nobody is home.”

 

CHAPTER 29

Carrie kept a light foot on the gas on her early-morning drive back to the VA. She had espresso for blood. The notion that Fasciani had somehow gotten up and walked away from neuro recovery simply did not compute. Could Fasciani have had a medical emergency like Abington's? Perhaps he coded, maybe an arrhythmia like Abington, and had been transferred to the med ICU—“turfed,” as Goodwin would call it. DBS-induced palinacousis and arrhythmia? Carrie could not dream up a more bizarre set of symptoms.

If Carrie could have called Lee Taggart or the duty nurse for the eleven o'clock shift from home, she would have. The problem was, Carrie did not have access to the scheduling application. She was Dr. Finley's employee and had no IT privileges. If she wanted to speak with the nursing staff, her only option was to return to the hospital. Not a problem. Carrie had reheated a burrito in the microwave, and a Red Bull would keep her alert for hours.

Besides, this would give her an excuse to go to the med ICU to look for Fasciani and personally check up on Abington, assuming he was still a patient there. It would be easy enough to walk the floor without raising too many eyebrows. Her goal was modest and obtainable. She would get to work hours before everyone else, find out what she needed to know, and maybe grab a few hours' sleep in a vacant on-call room.

A little past one thirty in the morning, Carrie arrived at the VA and parked in the same spot she had occupied hours ago. Then it was back through the rear entrance with a head nod and a flash of her badge, this time to a different security guard. She raced down the hallway, eager to confirm what she already knew to be true. The hospital, like most of the patients here, seemed fast asleep.

The elevator stopped on the third floor and Carrie hurried out. In no time she was back at the double doors to the neuro ICU. They were locked, but that was standard procedure. More unusual was the view through the windows built into the swinging doors. The hallway lights were off. The glow from various screen savers illuminated the nurses' station enough for Carrie to see it was unoccupied.

Unoccupied, but why? What had happened to her patient? Not her patient, but rather Navarro's and Goodwin's.

If Fasciani was still in the hospital—and where else would he be?—Carrie reasoned she would find him in the med ICU. He'd coded, or something. The arrhythmia. It was the only logical explanation.

Soon Carrie was standing outside the locked doors to the med ICU, looking through the glass into a well-lit, active unit. Carrie buzzed the intercom and announced herself as Dr. Bryant. The doors unlocked and Carrie strode over to the nurses' station. A black woman in her late twenties, hair pulled back, high cheekbones, pretty and slight, looked up from her monitor and gave Carrie a quiet smile.

“Morning, Doctor, what brings you here?”

“I just wanted to see if you had a patient by the name of Eric Fasciani brought here this evening?”

The woman, Dot according to her name badge, clicked at her keyboard and shook her head slightly.

“The name doesn't sound familiar. No, I'm sorry. He's not here.”

Carrie's brow furrowed and her eyes narrowed into slits. Where could he have gone? She asked, “Is Steve Abington still here?”

Dot executed more key taps than a ticket broker at an airline counter. That slight frown returned. “We don't have a Steve Abington here, either,” she said.

“Well, he was transferred to the floor the day before yesterday.”

Dot checked her screen again, thinking she might have missed something. “I'm sorry, we don't have his record, so I can't tell you where he went.”