Robin Cook: Crisis

"The pain is in a different location."

"Okay, that's a start," Craig said. He shrugged for Leona's benefit and motioned for her to hurry. If the current problem was what he thought, he wanted to take Leona along on the house call. "How is the pain different?"

"The pain this morning was in her rectum and the lower part of her belly."

"I remember!" Craig said. How could he forget? Bloating, gas, and problems with elimination described in disgustingly exquisite detail were the usual complaints. "Where is it now?"

"She says it's in her chest. She's never complained of pain in her chest before."

"That's not quite true, Jordan. Last month there were several episodes of chest pain. That's why I gave her a stress test."

"You're right! I forgot about that. I can't keep up with all her symptoms."

You and me both, Craig wanted to say, but he held his tongue.

"I think she should go to the hospital," Jordan repeated. "I believe she's having some difficulty breathing and even talking. Earlier, she managed to tell me she had a headache and was sick to her stomach."

"Nausea is one of her common afflictions," Craig interjected. "So is the headache."

"But this time she threw up a little. She also said she felt like she was floating in the air and kind of numb."

"Those are new ones!"

"I'm telling you, this is altogether different."

"Is the pain visceral and crushing, or is it sharp and intermittent like a cramp? "I can't say."

"Could you ask her? It may be important."

"Okay, hold the line!"

Craig could hear Jordan drop the receiver. Leona came out of the bathroom. She was ready. To Craig, she looked like she belonged on the cover of a magazine. He indicated as much by giving her a thumbs-up. She smiled and mouthed: "What's happening?"

Craig shrugged, keeping the cell phone pressed to his ear but twisting it away from his mouth. "Looks like I'm going to have to make a house call."

Leona nodded, then questioned: "Are you having trouble with your tie?"

Craig reluctantly nodded.

"Let's see what I can do," Leona suggested.

Craig raised his chin to give her more room to work as Jordan came back on the line. "She says the pain is terrible. She says it's all of those words you used."

Craig nodded. That sounded like the Patience he was all too familiar with. No help there. "Does the pain radiate anywhere, like to her arm or neck or any other place?"

"Oh my word! I don't know. Should I ask her?"

"Please," Craig replied.

After a few deft maneuvers, Leona pulled on the looped ends of the bow tie and tightened the knot she had made. After a minor adjustment, she stepped back. "Not bad, even if I say so myself," she declared.

Craig looked at himself in the mirror and had to agree. She had made it look easy.

Jordan 's voice came over the phone. "She says it's just in her chest. Are you thinking she's experiencing a heart attack, doctor?"

"It has to be ruled out, Jordan," Craig said. "Remember, I told you she had some mild changes on her stress test, which is why I advised more investigation of her cardiac status, even though she was not inclined."

"I do remember now that you mention it. But whatever the current affliction, I believe it's progressing. I believe she even appears rather blue."

"Okay, Jordan, I'll be right there. But one other quick question: Did she take any of those antidepressant pills I left this morning?"

"Is that important?"

"It could be. Although it doesn't sound like she is having a drug reaction, we have to keep it in mind. It was a new medication for her. That's why I told her not to start until tonight when she went to bed, just in case they made her dizzy or anything."

"I have no idea if she did or not. She has a lot of medication she got from Dr. Cohen."

Craig nodded. He knew very well that Patience's medicine cabinet looked like a miniature pharmacy. Dr. Ethan Cohen was a much more liberal prescriber of medication than Craig, and he had originally been Patience's physician. It had been Dr. Cohen who had offered Craig the opportunity to join his practice, but he was currently Craig's partner more in theory than in fact. The man was having his own health issues and was on an extended leave that might end up being permanent. Craig had inherited his entire current roster of problem patients from his absent partner. To Craig's delight, none of his problem patients from his previous practice had decided to pay the required fee to switch to the new practice.

" Listen, Jordan," Craig said. "I'm on my way, but make an effort to find the small vial of sample pills I gave Patience this morning so we can count them."

"I will give it my best effort," Jordan said.

Craig flipped his phone shut. He looked at Leona. "I've definitely got to make a house call. Do you mind coming with me? If it turns out to be a false alarm, we can go directly to the concert and still make the entree. Their house is not that far from Symphony Hall."

"Fine by me," Leona said cheerfully.

While pulling on his tuxedo jacket, Craig went quickly to his front closet. From the top shelf, he got his black bag and snapped it open. It had been a gift from his mother when he'd graduated from medical school. At the time it had meant a mountain to Craig because he had an idea of how long his mom had to have squirreled money away without his father knowing to afford it. It was a sizable, old-fashioned doctor's bag made of black leather with brass hardware. In his former practice, Craig had never used it since he didn't make house calls. But over the last year he'd used it a lot.

Craig tossed a bunch of supplies he thought he might need into the bag, including a bedside assay kit for myocardial infarction or heart attack biomarkers. Science had advanced since he'd been a resident. Back then it could take days to get the results back from the lab. Now he could do it at the bedside. The assay wasn't quantitative, but that didn't matter. It was proof of the diagnosis that was important. Also from the top shelf he pulled down his portable ECG machine, which he handed to Leona.

When Craig had formally separated from Alexis, he had found an apartment on Beacon Hill in the center of Boston. It was a fourth-floor walk-up duplex on Revere Street with good sunlight, a deck, and a view over the Charles River to Cambridge. The Hill was central to the city and fulfilled Craig's needs superbly, especially since he could walk to several good restaurants and the theater district. The only minor inconvenience was the parking problem. He had to rent a space in a garage on Charles Street, a five-minute walk away.

"What are the chances we can get away in time for the concert?" Leona asked when they were on their way in Craig's new Porsche, speeding westward on Storrow Drive.

Craig had to raise his voice against the whine of the engine. " Jordan seems to think this might be legit. That's what scares me. Living with Patience, he knows her better than anybody."

"How can he live with her? She's such a pain in the ass, and he seems like quite a refined gentleman." Leona had observed the Stanhopes in the office on a couple of occasions.

"I imagine there are benefits. I have a sense she is the one with the money, but who knows. People's private lives are never what they seem, including my own, until recently." He gave Leona's thigh a squeeze.

"I don't know how you have such patience with such people," Leona marveled. "No pun intended."

"It's a struggle, and between you and me, I can't stand them. Luckily, they are a distinct minority. I was trained to take care of sick people. Hypochondriacs to me are the same as malingerers. If I had wanted to be a psychiatrist, I would have studied psychiatry."

"When we get there, should I wait in the car?"