Robin Cook - Critical

Agnes's comment about the CDC reminded Laurie that she had meant to call Dr. Ralph Percy about Chet's case, but a glance at her watch suggested she might be too late. After quickly thanking Agnes for everything she was doing, Laurie dashed up a flight to save time. Since she'd not gotten the number from Chet, she had to call directory assistance for the main CDC switchboard. When the CDC operator connected her to the doctor's line, Laurie got voice mail.

"Damn!" she murmured before Dr. Percy's outgoing message had terminated. The doctor had already left for the day, and Laurie was irritated at herself for not having called the moment she'd returned from Chet's. After the beep, Laurie gave her name, her direct-dial number, the patient's name, and the fact that she was interested in the MRSA typing he'd done for Dr. Chet McGovern. Then, as an afterthought, she mentioned she was a medical examiner and a colleague of Dr. McGovern.

"What's going on?" Riva asked. She'd returned to the office while Laurie had retrieved her printed documents and had overheard Laurie's voice-mail message.

"It's been one busy day," Laurie complained. "I wanted to talk to someone at the CDC, but he's left for the day."

"There's always tomorrow," Riva said.

"I hope you are not trying to aggravate me," Laurie said. Such a patronizing comment reminded Laurie of her mother.

"Oh, no. If anything, I was trying to calm you down. You look frazzled. I know you've been preoccupied most of the day."

"That's an understatement," Laurie said. She then told Riva what she'd been up to all day and why she wanted to talk with the doctor from the CDC.

"What about the woman at the CDC I dealt with?" Riva suggested. "Did you call her?"

"I did. She was helpful and said she'd get back to me."

"Why not try her? I'm certain she'd have access to Chet's case."

"Good idea," Laurie said. She had Silvia Salerno's number on a Post-it stuck to the edge of her monitor. As the direct-dial connection went through, she glanced at her watch. It was now significantly after five. Once again, she got voice mail. On this occasion, she didn't leave a message since the woman had already agreed to call her back. Laurie hung up the phone and shook her head.

"Two for two!" Riva said lightly. "They must have a curfew at the CDC!"

Laurie laughed. Riva's comment about the world-renowned CDC amused her, as unlikely as it was, and laughing for possibly the first time all day made her realize how tense she was.

Riva stood up and took her coat from behind the door. "I think I will follow the CDC's example and head home. Working with Bingham this morning on the police custody case exhausted me."

"Oh, yeah!" Laurie said. "As preoccupied as I've been, I forgot to ask you what the outcome was."

"Not good for the police or the city," Riva said, "although it could turn out to be a windfall for the family. The hyoid bone was fractured in several places, so there was obviously excessive force."

"The only good part is that Bingham will take over the inevitable political and legal fallout."

"That's true," Riva said. "We pathologists can only say it was a homicide. Whether justified will be up to a jury."

With her coat on, Riva said good-bye, but before she left Laurie asked, "If there are any more MRSA cases over the next week while you're assigning cases, would you give them to me?"

"I certainly will," Riva said before leaving.

Laurie turned back to her desk with the three stacks of case files from the three Angels Healthcare hospitals and the stack of printed hospital records. Over the next three minutes, she combined the case files with their hospital records. There were still a few hospital records missing, as Cheryl had indicated.

Putting her matrix in front of her, Laurie picked up David Jeffries's hospital record and began reading. As she read, she filled in the boxes that she'd not been able to do without the hospital record. Since she still felt the operating room had to be where he was infected, she read through the anesthesia record, paying attention to the detail. When she did so she came up with some additional categories that she had not thought of earlier, namely the OR room number, how long the operation took, duration of time spent in the PACU, and which drugs were given in the PACU. Reading through the nurses' notes, she found the names of the scrub nurse and the circulating nurse. With a ruler, she made more vertical lines to create boxes for this additional information.

When she finished with David Jeffries's hospital record, she reached for another. It happened to be one of Paul Plodget's patients: a forty-eight-year-old man named Gordon Stanek. Like Jeffries, he was a patient of Angels Orthopedic Hospital. And as she'd done with Jeffries, she used the hospital record to fill in the boxes of her matrix. As she'd noticed earlier with Riva's two cases, the anesthesiologists were different. Unsurprisingly, she recorded that the other people involved with the patient, including the surgeon and the nurses, were also different, as was the operating room itself. Even the anesthesia was different. Although both patients had general anesthesia, the agents employed were different. There was also a difference in the way the anesthesia was administered. Jeffries had had an endotracheal tube, while Stanek had had a laryngeal mask airway.

Laurie sat back and glanced first at her matrix, then at all the case files and hospital records. It was going to be a long process. In the end, what she hoped to find was some kind of commonality they all shared.

Laurie was about to pick up another hospital record when a rhythmic thumping coming from the hallway caught her attention. It was low in pitch and distant, and had the building not been as quiet as it was, since it was after five, Laurie might not have heard it. Straightening up in her chair, Laurie cocked her head to try to hear better. Although the beat stayed the same, it was becoming progressively louder. It was as if someone was beating on the floor with a rubber mallet and coming closer and closer.

Irrational fear spread through Laurie like a jolt of electricity. The thought of jumping up and slamming and locking her door flashed through her mind, yet she was frozen in place.

"Hey, sweetie," Jack said as he appeared in the doorway and proceeded into Laurie's office on his crutches. Leaning over, he gave her forehead a kiss. "You'll never guess what I've been up to." He leaned his crutches up against Riva's file cabinet and sat down in her chair. "I've been having a ball," he added and started to explain but then stopped in mid-sentence when he looked closer at Laurie's expression. He leaned forward and waved his hand in front of her face. "Hey! Hello! Anybody home?"

Laurie batted his hand away. "As quiet as it is around here, you and your crutches scared me," she said, not sure for the moment if she was more relieved or miffed.

"How did I do that?" Jack asked with confusion.

"Because…" Laurie started to say, but then realized with some embarrassment how ridiculous it was for her to have been frightened by the sound of Jack's crutches on the corridor's vinyl floor. She guessed it was a symptom of how overwrought she was.

"I'm sorry," Jack said.

Laurie reached out and gave his knee a pat. "You don't have to apologize. If anybody is to blame, I am. I've had one hell of a day."

"No matter," Jack said, regaining the excitement with which he had arrived. "I wanted to tell you what I've been doing for the last couple of hours."

"I'd like to hear," Laurie said. "But you see all these case files and these printouts of hospital records on my desk?"

"Of course I see them," Jack interrupted. "It's hard to see your desk underneath them. But first let me tell you about the case you passed up."