Peter Clement - The Inquisitor

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Several patients die each day at St. Paul 's Hospital, a sprawling complex in Buffalo, N.Y., that takes on the most high-risk cases, including victims of the SARS virus. A few more deaths a week would hardly even be noticed. But hospital vice-president Dr. Earl Garnet, star of Clement's enjoyable line of medical thrillers, perks up when he hears about a strange circumstance in the hospital's cancer wing: a few days before they died, many of the patients reported out-of-body near-death experiences. Someone, Garnet determines, has been taking cancer patients to the brink of death and tape-recording their observations before briefly bringing them back to life. Suspects include the hospital's chaplain, Jimmy Fitzpatrick, who has been lobbying for years to get St. Paul's to relax its policy on withholding pain medication to terminal patients; Monica Yablonsky, the head nurse on the cancer ward whose prickly, unhelpful demeanor makes Garnet wary; and Dr. Steward Deloram, St. Paul's critical care expert who has also done extensive research into near-death experiences. The action in Clement's sixth hospital-based thriller (Mortal Remains, etc.) moves briskly and without an overload of medical jargon. Despite several indistinguishable characters and a few dead-end plot lines-Clement does little with the SARS element after an initial buildup-this entry keeps the author on an ascending trajectory in the genre.

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Carriers.

The possibility set his stomach churning in high gear.

7:25 a.m.

Intensive care swarmed with its usual rush of morning activities. Patients here were an eclectic enough group with such a variety of multiple problems that they attracted consults from just about every type of specialist in existence. Cardiologists, neurologists, immunologists, oncologists, internists- they all huddled in small groups at the end of one bed after another and took turns pronouncing on the state of the particular system where their expertise lay. Mercifully many recipients of this attention were too sedated to hear or care. But the sentient ones wore puzzled expressions as sage-looking professors introduced themselves, then proceeded to discuss hearts, brains, white cell responses, tumors, and metabolic abnormalities as if these were entities to be considered on their own, objects of interest that happened to be located in the body of whoever occupied the cubicle. True professionals, they at least attempted to mask their glee at each discovery, managing to be no more noisy than excited shoppers at a mall.

Earl ignored them all and walked directly to the nursing station. He came up behind Stewart Deloram, who sat rummaging through a lost-and-found drawer. "Anybody see my goddamned keys? I seem to have lost them again."

Every nurse within hearing distance rolled her eyes toward the ceiling. Earl heard at least three of them mutter something about the need for idiot strings. The guy could keep track of every molecule in a patient's biochemistry, but personal belongings were another matter.

Stewart turned, caught sight of him, and jumped to his feet. "Earl! I intended to come and see you." He blurted out the words with an urgent sincerity that sounded odd coming from him.

"Pardon?" Earl had half expected a fight.

"I wanted to say I'm sorry for not realizing what Janet must have been thinking and feeling. I can be such a dolt about that sort of thing."

Well, well, Earl thought.

"I'll go to the case room and apologize to her in person, as soon as I get the ward settled-"

"She's at home, Stewart."

The thick black eyebrows arched like warring caterpillars. "What?"

"She decided to take it easy today."

"Oh."

"I think she's okay physically. Luckily, the blood levels for chloroform came back virtually negative, so we doubt the baby had a significant exposure. But the deliberateness of what happened really upset her."

"Shit, I hope I didn't add to that."

"No, no, I'm sure that's forgotten. I'm here to discuss something else with you.

Let's find a quiet corner."

They moved to an area behind a large curved console of monitors. The quantified parameters of life- blood pressures, pulses, the forces of cardiac contractions, oxygen saturations, respiratory rates- squiggled and jiggled in a dance of fluorescent green readouts.

"I went to interview the patients you spoke with on Peter Wyatt's ward, the ones who reported the near-death experiences that you called bogus."

"What?" His eyes widened, the way an animal's would if it were taken by surprise.

"Down, boy. If Wyatt had started a vendetta against you, I wanted to know, so as to put an end to it before anything got out of hand."

Stewart remained unappeased, his expression suspended between incredulity and fury.

"But since you visited with them last Friday, they have all either died or slipped into a coma."

Incredulity won.

"They what?"

"You heard me. Dead, or near dead."

"My God."

"Did they strike you as being that ill when you saw them?"

"Well, I don't know. I wasn't evaluating them medically…"

He seemed genuinely stunned by the news, but also to be fishing around for answers.

"Come on, Stewart, you don't need a full workup to sense people are near the end. It looked to me they were in bad shape on their charts, but of course nothing beats seeing them firsthand. Would you have guessed these people were about to die or go unconscious?"

"You mean you didn't talk to a single one of them?"

Earl felt Stewart hadn't heard the question. "No, I didn't. Now answer what I asked."

"Yes, they were ill," he said decisively, his puzzled expression unwinding to neutral. "None of them was going to survive more than a few days."

"Really?"

"Yeah, really."

An icy cold began to gnaw at the pit of Earl's stomach. "So it doesn't surprise you, three dead, two comatose."

"Not at all." Stewart's expression grew suspicious again. "What are you getting at?"

"You seemed pretty astounded at first."

He sat up straighter, threw his shoulders back, and raised his chin a notch. "Only that you went to question them yourself. But I guess I should thank you for that, considering you appear to be looking out for my interests against Wyatt's."

"St. Paul's interests, actually."

"I don't understand."

"I think you do." Earl turned to leave, in no mood to be stonewalled- he had other ways to find out what he wanted- when inadvertently he glanced toward the isolation chambers at the end of the room. Three were ablaze with light, the nurses busily attending to the patients within. But the one where Teddy Burns had struggled to breathe yesterday loomed dark and empty.

Stewart saw him staring at the glass cubicle. "Yeah, it sucks," he said and gestured helplessly at the heavens with both hands. Whatever else he'd been pretending about, his voice resonated with a blend of anger and remorse that couldn't be faked. "He arrested last night. I couldn't save him."

Earl slumped against the wall of the elevator all the way up to the eighth floor. As VP, medical, he would be the one to arrange a memorial for Teddy. He tried out what he would say.

/ recall all the times we struggled side by side to restore the breath of life to the already dead…

He couldn't finish. The disgust on the man's face as he'd struggled to breathe when no one could help him overwhelmed such treacle.

Earl stopped by the nursing station in Palliative Care and asked the woman in charge, a tiny person with big Elton John glasses, if Monica Yablonsky had left him a list of all her colleagues who'd reported a patient having a near-death experience.

She hadn't.

"Then would you do it, please?" he asked.

She looked at him curiously, shrugged, and made a note of the request.

It was probably better not to deal with Monica Yablonsky anyway, he thought, pressing the button to summon the elevator back. The less he had to confront her, the better his chance to quietly discover what had transpired up here without setting off alarm bells. However much Hurst had infuriated him, what the manipulative old bastard had said about how distractions could be lethal still made sense. And this morning's headlines underlined that everyone must stay focused on the minutest detail of how to protect against the infection. Worst of all, even that might not be enough. Teddy Burns had never been able to tell the SARS control committee what slip cost him his life.

The elevator arrived.

He didn't get in, wanting a quiet place to clear his head.

The roof garden. It ought to be deserted on a day like this.

Minutes later, stepping out into the fog, he might have been on a mountain ledge. Buffalo itself lay completely obscured, and the sounds of the city came to him as if out of a gray dream. Only the potted trees defined his floating world. As he walked their perimeter, droplets of moisture in the air felt cool on his forehead.

But nothing could soothe his churning gut.

Stewart had seemed relieved those patients couldn't repeat what they'd said about their near-death experiences. And it wouldn't be an exaggeration to say that, for a few seconds at least, he'd also acted genuinely surprised to hear they had ended up dead or comatose.

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