Where There's Smoke (44 page)

"Quite all right.
 
How is your mother?"

"Not too well.
 
That's what I came to talk to you about."

Lara indicated the hallway that led to the rear of the building.

With Janellen behind her, she moved out of the clinic and into her private living quarters.

"I was having a glass of wine.
 
Will you join me?"

They entered a cozy den where magazines were scattered over table tops and scented candles flickered in votives.
 
The TV was tuned to a cable station that broadcast classic movies.
 
The one currently being shown was in black and white.

"I'm a fan of old movies," Lara said with a self-deprecating smile.

"Maybe because they usually have happy endings."
 
She used the remote control to turn off the set.
 
"Chablis is all I have.
 
Is that all right?"

"I'd rather have a soft drink."

"Diet Coke?"

"Fine."

While Lara was getting her drink from the kitchen, Janellen stood as though rooted to the floor in the center of the room.
 
She had invaded the enemy camp, but it was certainly a comfortable place.

Two walls of the room were lined with bookshelves.
 
Most of the reading material was related to medicine, but there was also a collection of hardcover and paperback fiction.
 
Over the fireplace, where once had hung the stuffed head of a ten-point buck, there was now an Andrew Wyeth print.
 
On the sofa table stood a silver-framed photograph of a baby girl.

"My daughter."

Janellen jumped at the sound of Lara's voice as she reentered the room carrying an icy glass of soda.
 
"Her name was Ashley.
 
She was killed in Montesangre."

"Yes, I know.
 
I'm sorry.
 
She was a beautiful child."

Lara nodded.
 
"I have only two photographs of her.
 
That one and another in my office.
 
I have those because I reclaimed them from my parents.
 
None of our personal effects were ever recovered from Montesangre.
 
I wish I had something of Ashley's.
 
Her teething ring.

Her teddy bear.
 
Her christening gown.
 
Something."
 
She shook her head slightly.
 
"Please, sit down, Miss Tackett."

Janellen gingerly lowered herself onto the sofa.
 
Lara sat in the easy chair she'd obviously been occupying when her doorbell rang.

There was a crocheted afghan bunched up on the hassock in front of the chair and a glass of white wine stood on the end table.

"Is your mother in the hospital?"

Janellen shook her head.

"No?"
 
That was obviously not the answer she had expected.
 
"I thought for certain her condition would require at least one night in the hospital."

216 SanOra Bro'n "She should be hospitalized."
 
Janellen felt herself on the verge of tears.
 
She picked at the cocktail napkin wrapped around the glass of soda.
 
"I came because .
 
. . because I wanted to hear what you had to say.
 
You were there during my mother's seizure.

I'd like to know your professional opinion of it."

"Your mother certainly didn't."

"I'm sorry about the way she behaved toward you, Dr. Mallory," janellen said earnestly.
 
"And if you ask me to leave, I'll understand."

"Why would I do that?
 
I don't hold you responsible for what your mother said and did."

"Then please give me your opinion of her illness."

"It's unethical for me to second-guess another doctor's diagnosis when I haven't even examined the patient."

"Please.
 
I need to talk to somebody about this, and there's no one.

"What about your brother?"

"He's upset."

"So are you."

"Yes, but when Key gets upset or worried, he .
 
. ."
 
She lowered her eyes to the glass in her hand.
 
"Let's just say he's currently unavailable.
 
Please, Dr.
 
Mallory, give me your opinion."

"Based strictly on what I saw?"
 
janellen nodded.

"With the full understanding that I could be incorrect?"

Again janellen nodded.

Lara took a sip of wine.
 
Looking toward the portrait of her daughter, she pulled in a deep breath, then released it slowly.
 
Her eyes moved back to janellen.
 
"What treatment did your mother receive at the county hospital?"

"They examined her in the emergency room, but she refused to be admitted."

"That was foolish of her.
 
Were you given a diagnosis?"

"The doctor said she'd had a mild stroke."

"I concur.
 
Did they do a complete blood work?"

"Yes.
 
She was prescribed medication that's supposed to thin her blood.

Is that what you would recommend?"

"Along with extensive tests and observation.
 
Did they do an EKO?"

"The heart thing?"
 
Lara nodded.
 
"No.
 
They recommended it, but she wouldn't stay that long."

"Was a brain scan done?"

"Yes, but only after Key threatened to tie her down if she didn't consent.
 
The doctor said he didn't find any significant cerebral infarction."
 
She tried to quote him precisely.
 
"I'm not certain what that means.

"It means that your mother has no significant amount of dead brain tissue due to a loss of blood supply.
 
Which is good.
 
However, that doesn't mean that the blood to her brain isn't being interrupted or completely blocked.
 
Did he suggest doing sound wave tests on the carotid artery?
 
They're called DopIer studies."

"I'm not sure."
 
Janellen rubbed her temple.
 
"He was talking so fast, and Mama was complaining so loudly, and "These tests would determine if there's an obstruction in the artery.
 
If there is, and the blockage isn't eliminated, there's a very good possibility for infarction, resulting in permanent disability or even death."

"That's what they said, too," Janellen said hoarsely.
 
"Something like that."

"No angiogram to see where the blockage might be?"

"Mama refused that.
 
She ranted and raved and said she'd had a dizzy spell and that's all there was to it.
 
Said she only needed to go home and rest."

"Did the impairment to her speech and muscle control last very long?"

"By the time we got her home, you couldn't tell anything had happened."

"That quick recovery fools patients into believing they've suffered only a dizzy spell."
 
Lara leaned forward.
 
"Does your mother frequently forget things?
 
Does she sometimes have blurred vision?"

She told the doctor what she had shared with Key a few weeks earlier.

"She never admits to any of this, but the spells have gotten noticeable.
 
I tried persuading her to see a doctor, but she refused.

I think she's afraid of what she'll hear."

"I can't be certain without examining her," Lara said, "but I think she's experiencing what we call TIAs, which stands for transient ischemic attacks.
 
Ischemia' refers to insufficient blood circulation."

"I'm following you so far."

"When one of these occurs, it interrupts the blood supply to the brain.

It's like an electrical blackout.
 
The part of the brain that's affected is turned off.
 
The dementia you described, blurred vision, slurred speech, and the dizziness are all symptoms, warning signals.

If they're not heeded, the patient can suffer a major stroke.
 
Today was probably the strongest warning yet.
 
Has she complained of numbness in her extremities?"

"Not to me, but she wouldn't."

"Does she have high blood pressure?"

"Very.
 
She takes medication to control it."

"Does she smoke?"

"Three packs a day."

"She should stop immediately."

Janellen smiled wanly.
 
"Never in a million years.

"Urge her to eat properly and monitor her cholesterol intake.
 
She should do moderate exercise.
 
See that she takes her medication.

Those precautions will help prevent a life-threatening stroke, but there are no guarantees."

"There's no complete cure?"

"For selected patients the arterial blockage can be removed surgically.

It's a fairly routine procedure.
 
Unfortunately, without the proper tests and your mother's full cooperation, that's not an option."

Sensing Janellen's despair, she leaned forward and pressed her hand.

"I'm sorry.
 
And remember, I could be wrong."

"I doubt you are, Dr. Mallory.
 
You've said essentially what the emergency room doctor told us.
 
Thank you for discussing it with me.

And for the soda."
 
She set the untouched drink on the coffee table and stood to go.

"Under the circumstances, I doubt we can be friends, but I'd like us to be cordial.
 
Please call me Lara."

Janellen smiled but remained noncommittal.
 
When they reached the front door, both were surprised to see that it was raining.
 
It was much easier to talk about something as banal as the weather.
 
Finally, Janellen shook the doctor's hand.

"You had every right to be rude to me.
 
Thank you for inviting me in."

"Thank you for giving my opinion credibility.
 
The next time you visit, let's hope the reason for it won't be so serious.

"Next time?
 
Are you asking me to come back?"

"Of course.
 
Feel free to drop in anytime."

"You're very nice, Dr. . Lara.
 
I can understand why my brother was so attracted to you."

Lara shook back laughed mirthlessly. me.

Janellen was stunned. was referring to Clark."
 
her hair and, looking up at the rainy skies,

"You're wrong.
 
Key isn't the least attracted to "Key?"
 
she repeated with puzzlement.
 
"I chapter eleven. owie flipped up the collar of his denim jacket and huddled closer to the exterior wall of the house.
 
The eaves provided scant protection from the blowing rain.
 
He was getting soaked.

He really couldn't say why he was at the Tacketts' place at this time of night, standing outside in the rain.
 
He should be stretched out in front of his secondhand TV set.
 
His rented trailer had few amenities, but at least it was dry.

Whatever the weather, he had no business being here.
 
jody Tackett's health was a private family matter.
 
They'd hardly want an outsider butting in.
 
None of that had affected his decision to come; he had felt compelled.
 
When he arrived, he noticed that Key's Lincoln was gone and so was janellen's car.
 
He parked the company truck out of sight behind the detached garage.
 
The only car in the driveway belonged to the housekeeper.