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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Fools, I thought. Cut off all sense of day or night, and a patient could become confused, perhaps psychotic. The observation came as a reflex, my training completely at odds with what I intended to do. The incongruity set my stomach churning, and bilious hot juices rose to the back of my tongue. I swallowed repeatedly and managed to send the acidic mix down the way it'd come up.

The ragged breathing of the woman I'd come for filled my ears. Sometimes the sound caught in her throat and ceased altogether, only to restart seconds later, when she would gasp, then exhale with a soft moan.

I tiptoed over to the blinds and opened them a sliver, just enough to admit an orange glow reflected from sodium lamps in the parking lot below. It cast her thin face in garish pumpkin shades, as if she'd applied too much makeup, and I could see that her mask had slipped down to her chest like a bib. She continued to breathe fitfully, yet remained asleep, completely unaware of my presence. But she could be roused awake. I'd made sure of that before picking her.

A cold loathing seeped through me.

I stepped over to the IV line that kept her hydrated and got to work. Even though she might die as a result of the drugs I would give her, I held with techniques instilled by years of practice and sterilized the side port with an alcohol swab so as not to risk infection. The maneuver also allowed me to think I'd given the subjects their best chance should they survive. Somehow that indulgence made it easier to get through what I did to them.

I pulled out the first of the two syringes I'd brought, removed the cap, and jabbed it in.

Slowly I began to empty half the contents, fifty milligrams of esmolol, a potent, short-acting drug that doctors used to lower pulse and pressure. It would bring her into a state of near shock. With my free hand I gently reached for her wrist and monitored her pulse with my fingers. The skin already felt clammy. She gave no reaction to my touch.

The beat slowed and grew weaker, then disappeared altogether, as it usually did once the systolic pressure fell below 90. Shifting my hand to her neck, I palpated for the carotid artery.

She stirred in protest and made little cries that sounded like mewing.

Ignoring her, I picked up the throb of the larger vessel, then continued the injection until that impulse nearly disappeared as well, which meant her pressure had fallen to just above 60.

I quickly switched syringes, and slowly gave the second ingredient, a hundred milligrams of ketamine. Normally used to induce awake anesthesia, this agent would also offset the fall in pulse and blood pressure, though not enough to reverse the near shock state. But what I really used it for had to do with a unique side effect: the blockade of certain neuroreceptors in the brain.

I finished delivering the dose, capped and pocketed both syringes so there'd be no accidents if she struggled- I'd taken that precaution ever since the Algreave woman- and waited a minute by my watch, giving time for the ketamine to have its full effect.

It felt like an hour.

The woman's breathing seemed to grow deafening as sputum rattled deep in her airway. In a treatment situation I would have suctioned her out to prevent her from choking on her own spit, an act of basic nursing. Instead I switched on the microcassette, shook her, and whispered, "Can you hear me?"

She moaned.

"Can you hear me?" I repeated.

Her reply was little more than a breath. But I could make it out.

"Yes," she said.

Show time.

I took the microcassette out of my pocket, brought it close to her mouth, and began to coax her along with the usual questions, following my format in the same methodical way a doctor would take a medical history.

"Any more pain?"

"No…"

"Do you see anything?"

"No…"

"Look harder."

Her gravelly, faint voice seemed to exhale from a corpse.

After a few minutes more she abruptly released a shrill cry, and her limbs thrashed about under the bedclothes.

"There're worms…"

"What?"

"They're all over me…"

"What are?"

"Oh, God, help me…"

"Take it easy."

"They're under my skin…"

"No, they're not."

"In my mouth… my nose…"

"You're imagining-"

"… behind my eyes… coming in through my ears…"

"Stop it!"

"They're eating me…" Her voice became a high-pitched shriek, piercing the dark like the cry of a hawk.

I snatched the syringe of ketamine from my pocket, plunged it into her IV, and pushed the plunger, giving her another twenty milligrams.

The scream died in her throat.

When they talked of heaven, it all sounded the same. But each one had a unique vision of hell.

I listened for the approach of running feet.

None came.

Would she remember? Most didn't. But some did, and that could be trouble. Already the nurses were starting to talk.

Anyway, I had enough material from her.

Snapping off the microcassette and retrieving the syringe, I closed the blinds, once more plunging myself into complete darkness. I felt my way to the door, stood there a moment, and, steadying my own breathing, listened for any sounds in the corridor.

Only the usual cries.

Behind me the old woman's respirations reverted to the fragmentary volleys of before, tapering out or choking off abruptly, then starting again. The gurgling noises made my skin crawl.

I opened the door a crack.

Nobody.

But I could still hear the nurses' voices from the far end of the hallway. No surprise there. They'd be sitting on their asses drinking coffee all night. I got ready to slip out of the room and make for the back staircase. I swung the door open another foot and carefully glanced in both directions.

The linoleum gleamed in the half-light, completely empty.

Toward the stairwell, there was only welcoming darkness.

I went to step out, and froze.

Something had moved down there, along the far wall. It had been little more than a dark shape gliding through black.

Then nothing.

Had I imagined it?

No, there it went again.

A figure emerged from the murk, tall and amorphous. It crept slowly from door to door on the opposite side of the hallway, pausing now and then, the way I had done coming in.

What the hell?

I stayed absolutely motionless and remained inside the room, watching, not moving the door, hoping the shadows would shield me as much as they did the form in the corridor. Except as the person drew closer, compared to the darker shroud of protective clothing, the white mask and upper face emanated as a pale smudge and appeared to float along by itself, like a bodiless head. Which meant I might become visible too. And behind me the noises from the old woman grew louder, certainly enough to attract attention.

My mouth went dry, and in a flash of panic I nearly leapt back into the room.

But no. This had to be done slowly.

The figure, paying no attention to the doorways on my side, continued to hug the opposite wall, focused only on the end of the passageway where the nurses' voices kept up a steady patter.

Apparently it was someone who didn't want to get caught either. It might be a man or woman. Everybody looked androgynous these days. I tried to see the eyes well enough to make an ID but couldn't with the distance and semidarkness.

The figure stopped and glanced back toward the stairs, as if making sure no one followed.

Definitely up to no good.

Nevertheless, I couldn't afford to be caught by whoever it might be, creep or not.

The person disappeared into a room twenty feet away.

I couldn't believe my luck.

But neither did I dare risk making a break now.

Whoever it had been might come back out.

I slowly closed my door, leaving a crack wide enough to see when he, or she, left.

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