Tess Gerritsen - Bloodstream

“And what medicines do you take?”

“I gave them up years ago. Weren’t doing me any good, all those pills.”

She gave an exasperated sigh. “Mr. Emerson, you can’t just stop taking medications.”

“But I don’t need them anymore. I’m ready to die now.” He said it quietly without fear, without the faintest note of self-pity It was merely a statement of fact. I am going to die soon, and there’s nothing to be done about it.

She had heard other patients make such predictions. They would enter the hospital in far-from-terminal condition, yet they’d say to Claire, with quiet conviction, “I am not going home this time.” She would try to reassure them, but would already be feeling that premonitory chill of death. Patients always seem to know. When they say there are going to die, they do.

Looking into Warren Emerson’s calm eyes, she felt that chill. She shook it off, and proceeded to do the physical exam.

“I have to look in your eyes,” she said, reaching for the ophthahnoscope.

He sighed in resignation and allowed her to examine his retinas.

“Have you ever seen a neurologist about your seizures? A brain specialist?”

“I saw one way back. When I was seventeen.”

She straightened in surprise and flipped off the ophthalmoscope light. “That’s almost fifty years ago.”

“He said I had epilepsy. That I’d have it for the rest of my life.”

“Have you seen a neurologist since then?”

“No, ma’am. Dr. Pomeroy, he took care of me after I moved back to Tranquility.”

She continued her exam, finding no neurologic abnormalities. His heart and lungs were normal, his abdomen without masses.

“Did Dr. Pomeroy ever do a brain scan on you?”

“He did an X-ray, few years ago, after I fell down and hit my head. He thought maybe I’d cracked my skull, but I didn’t. Got too hard a head, I guess.”

“Have you been to any other hospital?”

“No, Ma’am. Been in Tranquility most all my life. Never had call to go anywhere else.” He sounded regretful. “Now it’s too late.”

“Too late for what, Mr. Emerson?”

“God doesn’t give us a second chance.”

She had found nothing abnormal. Still, she felt uneasy about letting him go home to an empty house.

Also, what he’d said still bothered her: I’m ready to die now “Mr. Emerson," she said, “I want to keep you in the hospital overnight and run a few tests. Just to make sure there’s nothing new causing these seizures.”

“I been having them most of my life.”

“But you haven’t been checked out in years. I want to start you on medication again, and get some pictures of your brain. If everything looks fine, I’ll let you go home tomorrow.”

“Mona doesn’t like to go hungry.”

“Your cat will be line. Right now you have to think about yourself. Your own health.”

“Haven’t fed her since last night. She’ll be yowling-”

“I’ll make sure your cat’s fed, if that’ll keep you here. How about it?” He studied her for a moment, trying to decide whether he could entrust the welfare of his best, perhaps only, friend to a woman he scarcely knew.

“The tuna,” he said finally. “Today, she’ll expect the tuna.”

Claire nodded. “The tuna it is.”

Back in the nurses’ station, the first call she made was to the X-ray department. “I’m admitting a patient named Warren Emerson, and I want to order a CT scan of his head.”

“Diagnosis?”

“Seizures. Rule out brain tumor.”

She was writing Warren’s history and physical when Adam DelRay strolled into the ER, shaking his head. “I just saw them wheel Warren Emerson out of the elevator,” he said to one of the nurses. “Who on earth admitted him?”

Claire looked up, her feelings of dislike for him stronger than ever. “I did,” she said coolly. “He had a seizure today”

He snorted. “Emerson’s had seizures for years. He’s a lifelong epileptic.”

“One can always grow a new brain tumor.”

“Hey, if you want to take him on, you get the halo. Pomeroy complained about him for years.”

“Why?”

“Never took his meds. That’s why he keeps seizing. Plus he’s on Medicaid, so good luck getting paid. But I guess there are worse ways to spend our tax dollars than serving old Emerson breakfast in bed.” He laughed and walked away.

She signed her name so hard the tip of her pen almost sliced through the paper.

All these tests she’d ordered, plus a night’s stay in the hospital, added up to an expensive hunch on her part. Perhaps Emerson’s memory was faulty; perhaps Dr.

Pomeroy had performed a recent diagnostic workup, though she doubted it. From what she’d seen of his charts, Pomeroy had been a lackadaisical clinician, more likely to write a prescription for some new pill than to painstakingly investigate the reasons for a patient’s symptoms.

She left the hospital and drove back to Tranquility. By the time she reached her office, she was focused on only one thing: reviewing Emerson’s outpatient chart and proving to herself that her decision to admit him was justified.

Vera was on the telephone when Claire walked in. Waving the phone, Vera said, “You’ve got a call from a Max Tutwiler.”

“I’ll take it in my office. Could you get Warren Emerson’s file for me?”

“Warren Emerson?”

“Yes, I’ve just admitted him for seizures.”

“Why?”

Claire halted in her office doorway and turned to glare at Vera. “Why does everyone in this town question my judgment?”

“Well, I was just wondering,” said Vera.

Claire shut the door and sank behind her desk. Now she’d have to apologize to Vera. Add it to her ever-growing list of mea culpas. She was in no mood to talk to anyone right now; reluctantly she picked up the telephone.

“Hello, Max?”

“Good time to call?”

“Don’t even ask.”

“Oh. I’ll keep it short, then. I thought you’d want to know they’ve confirmed the identity of that blue mushroom. I sent it to a mycologist, and he agreed it’s Clitocybe odora, the anise funnel cap.”

“How toxic is it?”

“Only mildly so. The small amounts of muscarine wouldn’t cause much beyond some mild gastrointestinal upset.”

She sighed. “So that’s a dead end.”

“It would appear so.”

“What about those lake water samples? Are the results back?”

“Yes, I have some of the preliminary findings here. Let me get the printout..

Vera knocked on the door and came in with Warren Emerson’s chart. She didn’t say a word, just dropped the folder on the desk and walked out again. While waiting for Max to come back on the line, Claire opened the chart and glanced at the first page. It was dated 1932, the year of Emerson’s birth. It described the uncomplicated labor and delivery of a healthy boy to a Mrs. Agnes Emerson. The doctor's name was Higgins. The next few pages were devoted to well-baby checks and routine childhood visits.

She turned to a new page in the chart and frowned at the date:

1956. There had been a ten-year gap between the previous entry and this one. For the first time, Dr. Pomeroy’s signature appeared in the chart. She started to read Pomeroy’s entry, but was interrupted by Max’s voice on the line.

“Bacterial cultures are still pending,” he said. “So far I see that dioxin, lead, and mercury levels are all within safe limits..

Claire’s attention was suddenly riveted on the chart. On what Pomeroy had written in the last paragraph: “Has committed no other violent acts since his arrest in 1946”

“…by next week, we should know more,” Max said. “But so far, the water quality seems pretty good. No evidence of any chemical contamination.”