Peter Clement - Mortal Remains

“Call me Charles. I’d like that. Gives me the illusion of being closer to your generation than my own.” He finished with a jovial chuckle.

“Give me a break,” Lucy muttered, her eyes shooting skyward in disbelief.

Mark nudged her to keep quiet. “So what can I do for you, Charles?”

“You know how word travels fast in our little community. I hear you’ve got a very attractive houseguest staying with you. Why not drop around for drinks tomorrow night, and bring her along. This sad business with Kelly has reminded me how out of touch we’ve grown. Your father was a regular guest in our home.”

Lucy rolled her eyes again.

“Yes, sir, I mean, Charles. Those were certainly memorable parts of my boyhood.” He had to avoid looking at Lucy for fear he’d burst out laughing. “I’d love to drop over.”

“Excellent. Shall we say around five?”

“Perfect.”

They hung up, and Mark whistled.

“Talk about being invited into the lion’s den,” Lucy said, walking out of the kitchen.

“Where are you going?”

“Into Saratoga, to buy a dress.”

“Do you want me to go with you?”

She turned back, her mouth cocked in a sly grin. “There are some things, my dear Mark, that a woman does alone.” Pulling on her coat and shouldering her purse, she disappeared out the front door.

Mark stood looking after her. Whatever Lucy had been on the verge of saying before the phone call, she obviously thought it could wait.

Thursday, November 22, 3:30 A.M.

The Plaza Hotel, New York City

At first Earl wasn’t sure what woke him.

Then the pain cut across his abdomen and doubled him in two.

“Jesus Christ!” He moaned, writhing in a ball.

His insides had been churning all evening. Once in bed, he’d tossed for a few more hours trying to fall asleep.

No way this could be from stress.

The cramps came in waves, hitting him like body blows. They were so closely spaced together that the pain from one hadn’t released its grip before the next struck.

He got off the bed and tried to make it to the bathroom, but fell to the floor.

Again and again and again the spasms struck, leaving him drenched in cold sweat and biting his lips to keep from screaming.

He’d had his share of “tourista,” especially during conferences to faraway places, but never experienced anything like this. Must have picked it up at one of the fast-food joints he’d been eating at these last few days. The most likely cause would be Campylobacter from undercooked chicken or beef, he reasoned during a few seconds pause in his symptoms. If he could just buy some Cipro – damn! It was Thanksgiving, and most pharmacies would be closed. No matter. He’d get Melanie to get him some from the hospital, providing he could reach her. Then maybe he could still make the trip home, though the idea of being stuck on the can for the whole flight – “Oh, my God!” he muttered, a new onslaught sending him rolling on the floor again.

This time it felt as if someone were twist-tying his intestines and dragging them through hot coals.

By 5:00 A.M. he relented and called 911, requesting they take him to ER at New York City Hospital.

The ambulance attendants tried strapping him down to the stretcher for the trip. He ended up breaking free and taking the ride coiled in a ball on the floor of the vehicle, threatening lawsuits, decertification, and free vasectomies with a dull scalpel on any man who touched him.

In ER his ordeal got worse.

“We can’t give you anything for pain until the surgical resident examines your abdomen,” said a young trainee in a short white coat who had to be the most junior student on the ER food chain. Christ, peach fuzz covered his cheeks.

“I’m Earl Garnet, Chief of Emergency Medicine at St. Paul’s Hospital in Buffalo. Get me your staff person, or give me Demerol, damm it! And for your future edification, a surgical abdomen doesn’t present as cramps.”

The boy looked unimpressed. “Does this hurt?” he asked, palpating deep into his lower right side, then abruptly lifting off.

Nurses started IVs.

A clerk wrote down his mother’s maiden name.

Someone took custody of his wallet; someone else drained a dozen tubes of blood from his arm.

“You haven’t got a fever, and your pressure’s fine,” a nurse reassured him.

The surgical resident came, prodded his stomach a few times, then went off to consult with his staffman.

Still no one gave him Demerol.

“Not before the surgeon himself sees you.” It became a reoccurring chorus.

“And where’s the surgeon?”

“In the OR.”

Where else?

He flagged another passing nurse, easily catching her attention as they’d parked him in the middle of a busy main corridor. Sporting tousled brown hair and covered in freckles, she could have been the kid sister of the lowly resident who checked him in, until she turned and he saw the triple silver rings piercing her eyebrow. He thought of J.C. in his own department, and felt oddly reassured. “I want to speak with the doctor in charge,” he demanded for the second time since his arrival.

“He’s managing victims from a bus accident,” she called without breaking stride.

“Then phone Melanie Collins.”

This got her to pause. “The Chief of Internal Medicine? I don’t think so.”

The fiery vengeance in his stomach shot to a new level, and he let out a loud groan, curling into a ball again. “Call her, please!” he managed to gasp between clenched teeth a few seconds later, his skin once more soaked with perspiration. “I’m a friend. Say that I need her help now!”

Whether his appearance, his use of “please,” or his claim of being a personal acquaintance to an important doctor convinced her, he couldn’t tell. She nevertheless walked to the nearest phone and made a call. She spoke a few words into the receiver, then stopped, a dumbfounded expression slowly spreading across her face like a connect-the-dot drawing.

“Dr. Collins will be right in,” she told him with newfound respect.

“Thank you,” he said, and forced a grin that must have made him resemble the grim reaper.

Twenty minutes later Melanie arrived at his bedside flanked by peach-fuzz and the ring-wraith. An additional bevy of students, interns, and residents formed a semicircle around them.

“Earl, I’m so sorry,” she said, patting his shoulder.

“Me too. I didn’t mean to haul you in here-”

“Don’t think anything of it.” She gave a thousand-watt smile and turned to her following. “Now, gang, let’s give our distinguished guest a show of how to do it right. What’s the presentation here?”

“Abdominal pain, crampy, generalized, and acute onset,” peach-fuzz called out.

“Any vomiting or diarrhea?”

“No, ma’am.”

“Vitals?”

“No fever, normal BP, but pulse is 120.”

“Yours would be fast too, if you had the kind of pain that I know it would take to bring this man into ER. Any abdominal findings on exam?”

“Abdomen’s soft, no rebound, no masses, no bruit, but increased bowel sounds.”

“Urine?”

“Normal.”

“Rectal?”

“Negative.”

“You checked for occult blood?”

“None.”

“So what’s your thinking?”

“Well, first off I’d consider this to be pain from a hollow organ rather than a solid structure, given its colicky nature-”

“I don’t want to reread the entire text on abdominal pain, so let’s bypass the general stuff and pinpoint the most likely possibilities. Yes it’s colicky, and originates from something hollow. But the lack of nausea and there being no focal, right-upper-quadrant tenderness means we don’t even have to think gallbladder, and with a normal urine, it isn’t renal. Any history of hypertension, Earl?”