Michael Palmer - Fatal

"And your statistics say?"

Rudy pressed an imaginary buzzer, adding the sound effect.

"Once again the numbers say that something's wrong. And need I remind you that these are my numbers, and my numbers never lie. From what I can tell, in the months of May, June, and July, you have a much greater chance of catching Lassa fever by flying to the U.S. than you do by staying in Africa."

"What do we do with this information?"

"We try and turn it into a working hypothesis," he replied, "a scenario that fits and explains the data. We need to come up with some facts."

"Starting where?"

"I would say starting at the Sierra Leone embassy in D.C. A friend of mine in the State Department tells me they have access to a passenger manifest of every flight out of their country. Plus, I'd be interested in how many Americans got Lassa fever in Africa as opposed to after they came home. I believe you could get that information from the Sierra Leoneans as well. Data! I crave data!"

Ellen jumped up and threw her arms around Rudy's neck.

"I knew you'd come through. Rudy, you've been just the best friend in the world to me."

"That's not exactly the hardest thing I've ever had to do," he said, looking away.

Code Blue, ICU… Code Blue, ICU… Matt was on Med/Surg 2, writing orders regarding Nikki's transfer to a private room, when the code call sounded. There was little doubt in his mind that the subject of the code was the sixty-something woodsman who had taken her bed. Matt had passed him in the corridor as he was being brought into the unit, and had noticed the pallor around his mouth and slight mottling of his skin, suggesting that his heart was not pumping effectively.

Matt raced to the unit, arriving simultaneously with two nurses and the respiratory therapist. Although he didn't regret the decision to switch from the one-patient-after-another approach in the ER to the more intense, in-depth relationships of primary care, he remained something of a hybrid, and the intense action surrounding a code blue or multiple trauma still brought a welcome rush.

He was in the room before he realized that the cardiologist at the man's bedside was Robert Crook. Matt hadn't seen his nemesis at all since the ill-fated meeting at BC amp;C. Crook greeted his arrival with a scowl and a derisive shake of his head.

"Need help?" Matt asked with accentuated cheeriness.

"I think I have enough," Crook grumbled.

From behind him, nurse Julie Bellet vehemently shook her head and mouthed the word "Stay!"

"Why don't I hang around just in case."

"Suit yourself. Get ready to shock at four hundred joules, please."

One twenty-five should \)e enough, Matt was thinking. Bellet looked over at him imploringly, but all he could do was shrug. The 400 was definitely overkill, but not a serious enough breach to go to war with Crook over.

The cardiologist plowed ahead, setting the defibrillator paddles against the man's chest.

"Clear!.. Ready, shock!"

Julie Bellet depressed the button delivering 400 joules of electricity through the woodsman's chest. Almost immediately, the chaotic spikes of fibrillation were replaced by a rapid, regular rhythm.

"Okay," Crook said in a purposefully matter-of-fact tone, "he's now in a nice, supraventricular tachycardia. Let's give him a milligram of propranolol IV."

No! Matt's mind screamed. Wrong diagnosis, wrong treatment. He moved forward next to Crook.

"Robert," he said, softly enough so that most of those in the room weren't even aware he was speaking, "that's V tach. I'm certain of it. Xylocaine, not propranolol."

Crook glared at him.

"A milligram of propranolol IV," he ordered again. "Make that two. Give it slowly."

Damn! Matt thought, unsuccessfully trying to avoid Julie Bellet's desperate gaze as she and another nurse responded slowly, clearly stalling. War was about to break out.

"Robert," he whispered again, "get some Xylocaine in him and you might be able to keep him from fibrillating."

Crook's sideways look was, if anything, more piercing than before.

"I'll thank you to — "

At that instant, with a flurry of ineffective beats, the woodsman's unstable ventricular tachycardia rhythm degenerated into immediately life-threatening ventricular fibrillation.

"Four hundred joules," Crook ordered, pointedly looking away from Matt. "Get a hundred of Xylocaine into him also. Let's hold off on the propranolol for now."

At that moment, the resuscitation, which should have been straightforward and successful, could easily have gone either way. Fortunately, a power greater than any in the room decided it simply wasn't the old woodsman's time. The electrical countershock was followed by the Xylocaine he should have gotten in the first place, which was then followed by another shock, and suddenly there they were — a decent monitor pattern and a functional blood pressure.

"Nicely done," Matt said.

There was no response from Robert Crook.

In minutes, the patient's cardiac situation had stabilized. His color had improved and his pressure rose and remained constant. Crook motioned Matt to one side of the cubicle, where he could whisper without being overheard.

"Take a word to the wise," he said harshly, "and think about finding another place to practice. Someplace far away from here."

"But I like it here," Matt said. "I grew up here. I always thought I'd grow old here."

"Well, you can damn well grow old someplace else. That is, if you want to grow old. You've stepped over the line, Rutledge."

"I don't know what you're talking about."

"People are going to get hurt, and I won't be a bit surprised if you're one of them."

"Are you threatening m — "

"Dr. Crook?"

Julie Bellet was pointing to the monitor screen, where some irregular beats had appeared.

"Another fifty of Xylocaine IV," Crook blustered. He turned back to Matt. "You didn't fool anyone," he said.

Matt suddenly reached out and grabbed the man by his tie and shirt in such a way that Crook's back screened the move from view of the nurses.

"Neither do you," he rasped. "Don't ever threaten me again."

Stunned, his cheeks flushed with crimson, Crook pulled away and, adjusting his shirt and tie, returned to the bedside.

Matt couldn't remember physically assaulting anyone in his adult life. Stupid! Absolutely stupid! It was dumb luck that no one saw what he did. Fists clenched, he whirled and, without so much as a glance backward, left the ICU. Crook clearly knew about their penetration of the toxic dump, Matt was thinking. But was the warning from Armand Stevenson, or was the cardiologist overstepping the bounds of his position with BC amp;C? And exactly what did he mean by "People are going to get hurt"? What people?

The Slocumbs!

Matt hurried to Nikki's room to see if the police guard had shown up. He had been away from Lewis Slocumb and his brothers way too long already. He arrived at the room just as Officer Tarvis Lyons came lumbering down the hall. Lyons had been Matt's classmate at Montgomery Regional High School. Tarvis's unofficial nickname, Tar Pits, referred to the speed with which he did just about everything. Matt's surprise that Tarvis had made it to graduation at all, let alone without a police record, was nothing compared to his shock when he returned home after his residency to find Lyons was on the force. It was hard to believe anyone would entrust the man with a pair of handcuffs, let alone a service revolver.

"Hey, Ledge, wazzapnin'," Lyons said, using Matt's high school nickname. His voice was an octave higher than one would have expected from his bulk.

"Grimes sent you?"

Matt hoped he hadn't emphasized the "you" as much as he feared he had.

"I was off today. That means I'm available for overtime. The big O.T. The chief says there's a babe that needs watchin'."