Peter Clement - Mortal Remains

“Tanya, don’t get carried away-”

“Dr. Garnet, for God’s sake, he got to Bessie. He could get to you the same way, or have someone sabotage you for him.”

That gave him pause. Still, such talk had to stop. “No way,” he said, even as he began to wonder about whom Braden might have hired to poison him. “There hasn’t been anyone near me, and if we go around making unsubstantiated allegations, no one will ever believe us once we do get evidence-”

“Dr. Collins has got you on morphine, for Christ’s sake. A squad of Marines could march in here, and there’d be times you wouldn’t know.” As she leaned in to speak with him, the illumination from the lamp caught her face from the side, exaggerating the shadows around her mouth and eyes. “So tell me, how do you feel?”

“Crappy.” He grinned at his choice of word.

Her worried expression continued to hover over him like an overwrought half-moon. “But are your symptoms what they should be, or has he done something else to you?”

Let’s see, he thought. Excruciating pain, nausea, a bellyful of writhing snakes, and soon to come, promising more delights. Maybe vomiting, most certainly the runs. Yeah, Tanya, that seemed exactly right. What a relief. I’ve only got one thing wrong with me, with or without any help from Chaz Braden. Clenching his jaw even tighter against a new volley of cramps, he muttered, “Of course they are.” Now go away, so I can twist and squirm in peace.

“What’s in here?” She turned to read the label of his IV bag.

“Normal saline, with extra potassium, exactly as it should be.”

“And who prepared it?”

“Dr. Collins herself. She did it to save the nurses – Oh, God.” All at once he felt scalded inside, as if something were shredding the walls of his intestines.

“What is it?”

“Just please leave. I’ve got to call the nurse.”

“For more morphine?”

“Whatever.”

“Why not Demerol-”

At the moment he didn’t care. “I’ll ask for it. Now, please get out of here.”

“Who gives you your shots? Always the same person?”

“Yes! She looks like Santa Claus in drag. Now dammit, Tanya, I’m ringing my buzzer.” He flayed at it with one hand, cradling his stomach with the other.

“Okay,” she said, pressing it for him, then heading to the door, “but I’m keeping an eye on you.”

He let out a long moan, and twisted himself into a pretzel.

Two hours later he fell and cut his head making a rush for the toilet as the remainder of his symptoms, long expected, kicked in.

That put an end to the morphine.

It also earned him a tube down his stomach.

His life became sandwiched between basins at one end, bedpans at the other, and the unremitting agony of a gut on fire in between.

They started giving him Demerol, but it barely muted the pain. A second dose didn’t work much better, other than to make him sleepy. He knew not to request a third. It’d have the same effect as morphine as far as suppressing his gag reflex, and he’d be choking on vomit.

“How about we ask Dr. Collins about a tube in your trachea to protect your airway? Then we could knock you right out,” the nurse with red cheeks suggested.

He declined. Then he thought, “Wait a minute. Weren’t you on the day shift?” he asked, fearing he’d let himself get disoriented.

“Dr. Collins asked that I switch to nights, just so you got the best of care.”

Oh, great!

By dawn he felt like an empty husk. “I’m dehydrating,” he told Santa, trying to prop himself up on one elbow. He flopped back, unable to bear the weight. “The IVs aren’t keeping up with the fluid I’ve lost. And better check my potassium. My muscles are so weak I can hardly move.”

“This isn’t a service station, Dr. Garnet.” Her icy tone sounded as cold as the North Pole and just as hostile, making it clear he wouldn’t be breaching the divide between patient and staff on her watch. But she sped up the IV.

By the end of her shift he could barely hold an emesis basin.

“And how are we today?” Melanie asked, disgustingly chipper as she swept in at 7:00 A.M. on the wings of a crisp lab coat, obviously giving him the honor of being her first case for morning rounds. A semicircle of sleepy residents sporting more wrinkled wear shuffled in after her and formed a small white amphitheater at the foot of his bed.

“As you recall,” she began, addressing her entourage without giving him a chance to answer, “Dr. Garnet came into ER over twenty-four hours ago with symptoms of bacterial enteritis characterized by inordinate pain, yet a relatively delayed onset of diarrhea. With this subtle discrepancy, I suspected this might be E. coli 0157:H7 , rather than the more typical organisms we might expect. Of course I withheld antibiotics pending cultures. As I passed through bacteriology this morning, I picked up the preliminary results. All sorts of normal E. coli are being grown as would be the norm, but no salmonella, no shigella, and no Campylobacter . That means, I think it’s reasonable to assume that hidden amongst these noninfectious E. coli , we’ll find the infectious strain, or a serotype close to it, that I initially suspected. Of course we’ll have to wait a full forty-eight hours…”

As Melanie went on and on, Earl felt like a specimen laid out in front of her and began to resent the gleeful way she talked about her probable diagnostic coup, oblivious to the agony he was in. It’s not all about you, Melanie, he wanted to yell at her, figuring she must have used the word I over two dozen times. He remembered when no one, including her, thought she’d make it through medical school. Well, she might have gotten smarter, but her bedside manner remained the pits.

He curled up on his side again, as red-hot spasms did laps from one end of his gut to the other.

She finished her spiel, told him she’d be back, and was out the door with her posse before he could stop her.

But she had to increase his IVs. Check his potassium. Listen to him lie about not being Kelly’s lover. “Melanie!”

No reply.

Son of a bitch!

Minutes later she whisked back into the room, all smiles and shaking a new IV bag with a big sticker on it indicating she’d added a twenty milliequivalents dose of potassium. In seconds she’d replaced the old with the new and had it running into him at a good clip. Turning to his other arm, she produced a rubber tourniquet from her pocket and tied it snugly around his biceps, then gave his veins a swipe with a cold alcohol swab. They bulged, glistening blue, and he shivered, thinking of the toxins coursing through them.

“You always draw bloods and start IVs on your own patients?” he said, trying to make small talk in the face of knowing too damn well the assault that his intestines, kidneys, pancreas, and brain were under. Even if he didn’t die, he could still end up with seizures or diabetes or be on dialysis.

“Yeah, I’m known for it,” Melanie said, taking yet another tube of his blood. “What the hell, nurses being busy as they are. Treat ‘em right by giving them one less thing to do, and they’re on your side for life, right, Earl?”

He tried to grin at her in agreement, but it felt more like a grimace. Flippant banter between physicians was how they normally coped with the life-and-death tensions that went with the job – a kind of whistling past the graveyard. But when that grave might be his, the schtick grew a little thin.

She leaned closer. “And in your case, given your suspicions about the cause of Bessie McDonald’s coma, I think it best I handle as many procedures on you as is humanly possible. I mean, after our drink the other night, I started to think. Do you know how many ways a doctor could secretly do away with a hospitalized patient, yet never get caught? It’s unreal.”