Robin Cook - Marker

Patricia's room was a mess. The debris from the cardiac resuscitation attempt littered the floor. In the frenzy of the event, some of the wrappers, syringes, medication containers, and the like had been merely tossed aside. The bed had been cranked down flat, raised to help with the CPR, and the resuscitation board was still in place. A few telltale droplets of blood were sprinkled across the wrinkled, white sheet.

Unfortunately, what Roger was looking for was not in evidence. The IV pole was in its usual position at the head of the bed, but without the bottle or plastic container of fluid that had to have hung there. As a consequence of being on the scene, Roger had gotten the idea of having the IV contents checked. Since Laurie had told him that toxicology had come up short, maybe testing the IV fluid would yield something.

Roger turned around and went back to the nursing station. He got Meryl's attention and asked her about the missing bottle.

Meryl shrugged her shoulders. "I don't have any idea where it is." She then turned around and yelled to the medical resident who'd been in charge of the resuscitation, asking the same question. He shook his head, indicating that he didn't know, either, before getting back to his sidewalk mini-conference. He and the other residents were still loudly debating why they had been unsuccessful.

"I guess it went down with the patient," Meryl said. "We always at least leave the IVs in place, along with any other tubes."

"This might be a silly question, but I haven't been on staff that long. Where exactly did the patient go?"

"To the morgue, or what we use as the morgue. It's the old autopsy theater in the basement."

"Thanks," Roger said.

"Not at all," Meryl said.

Roger went back to the elevators. He pressed the down button but then eyed the sign for the stairs. He suddenly had it in his mind to ask Ms. Rakoczi why she went to the OB-GYN floor so often, and what it was that she needed that night. Since the elevator was taking its time arriving, Roger used the stairs. As he descended, he acknowledged that the caffeine was finally starting to wear off. His legs felt heavy. He decided that he'd have one more chat with Ms. Rakoczi, hunt briefly for the IV bottle, and then head for home.

The surgical floor was as quiet as it had been earlier. Roger surmised that the nurses were all attending to their patients. He saw some of them as he passed open doors into the patients' rooms. Rather than bother anyone, he thought he'd wait at the nurses' station for Ms. Rakoczi to return. To his surprise, he found her where he'd found her earlier, in the same position, reading the same magazine.

"I thought you said you had patients to see," Roger said. He knew he was being abrasively provocative with someone with a volatile temperament, but he couldn't help himself. This woman was obviously goldbricking.

"I saw them. Now I'm manning the nurses' station. Do you have a problem with that?"

"Luckily for both of us it's not my bailiwick," Roger said. "But I do have another question for you. I followed your suggestion and went upstairs to OB-GYN and spoke with Meryl Lanigan. She said you were a frequent visitor to her floor. In fact, she said you were up there earlier. I'd like to know why."

"For my continuing education," Jazz said. "OB-GYN interests me, but I didn't get much exposure to it with the Marines, for obvious reasons. So I frequently go up there on my breaks. Now that I've learned a bit about the field, I'm thinking of putting in for an opening in OB-GYN."

"So it was for continuing education that took you up there tonight?"

"Is that so hard to believe? Instead of going down to the cafeteria on my lunch hour with my half of the surgical-floor team and talking about drivel, I went up to OB-GYN to learn something. I don't know what it is about this place. Whenever you make an extra effort to improve yourself, you get nothing but grief."

"I don't want to add to your burden," Roger said, struggling to keep the sarcasm from his voice. "But there seems to be a discrepancy. Ms. Lanigan told me that when she confronted you earlier, you said you wanted to borrow something."

"Is that what she said?" Jazz questioned with a scornful laugh. "Well, she's right in one sense. I did need to borrow some infusion lines, thanks to central supply not restocking us, but that was an afterthought. What I was really doing up there was sucking up information from reading nursing notes. She probably doesn't want to admit that, because she's probably worried I'm gunning for her job."

"That wouldn't be my take," Roger said. "But what do I know? Thanks for your time, Ms. Rakoczi. I'll be back in touch if I have any more questions."

Roger walked out of the utility room and rounded the nurses' station countertop. He was now feeling genuinely fatigued. The caffeine had completely worn off. A few moments earlier, he'd entertained the idea after talking again with Ms. Rakoczi of returning to the OR to see if he could find Dr. Najah. As with Rakoczi, he wanted to ask him what he had been doing on the OB-GYN floor, but now he had second thoughts. He was exhausted. It was nearly four o'clock in the morning.

Roger resolved that the first thing he would do when he got into his office later that morning was call Rosalyn and beg for Jasmine Rakoczi's St. Francis record. He didn't care about the consequences. He found himself wondering how much the general nursing shortage had to do with the fact that Jasmine Rakoczi was employed. The overwhelming chances were that she was not a serial killer. That would be too easy. But the fact that she was employed as a nurse with her attitude was a travesty as far as he was concerned, and he intended to do something about it.

Roger pressed the elevator's down button and hazarded a glance back toward the surgical nurses' station. It was only for a split second, but he thought he caught a glimpse of Jazz eyeing him from around the edge of the door to the utility room. Roger wasn't so sure, and as tired as he suddenly felt, it could have been his imagination. The woman made him uneasy. He hated the thought of being a patient under her care.

The elevator came, and he boarded. Just before the doors closed, he looked back at the utility-room doorway. For the second time, he didn't know if it was his eyes or his brain that was tricking him, because he thought he saw her again.

He took the elevator down to the basement level, where he'd never been. In contrast with the rest of the hospital it was completely utilitarian. The walls were unadorned stained concrete, and myriad exposed pipes-some insulated, some not-ran along the ceiling. The lighting fixtures were simple porcelain sockets with wire cages. Just beyond the elevators, an old sign composed of peeling paint applied directly onto the concrete wall said "autopsy amphitheater," accompanied by a large red arrow.

The route was labyrinthine, but by following the red arrows, Roger eventually arrived at a set of double leather doors with oval windows set at eye-level height. The glass was covered with a greasy film. Although Roger could tell a light was shining in the room beyond, he couldn't make out any details. He pushed through, then propped the door open with an old brass doorstop.

Inside was an old-fashioned, semicircular two-story medical amphitheater, with rows of tiny seats that rose up on tiers into the shadows. Roger guessed it had been built a hundred years ago, when anatomy and pathology were kingpins in the academic medical curriculum. There was a lot of old, scraped, and pitted dark varnished wood, and the lighting came from a single, large, hooded lamp that hung on a long cord from the ceiling. The light was centered on an antiquated metal autopsy table that occupied the center of the pit. Against the back wall was a glass-fronted cabinet with a collection of stainless-steel autopsy tools. Roger wondered when they'd last been used. Outside the medical examiners' office, few autopsies were now done, particularly in managed-care hospitals like the Manhattan General.