Robin Cook - Marker

"Where am I going?" Laurie asked, trying to find a ray of hope. "To ob-gyn?"

The orderly consulted his piece of paper. "No! They're full in OB-GYN. You're going to room 609 on the general surgical floor."

Laurie closed her eyes as she felt a shudder pass through her.

"Dr. Stapleton! Hey, Dr. Stapleton!"

Hearing his voice over the buzz of conversation and the sound of crying infants, Jack looked back at the emergency-room desk. With all the caffeine on board, he'd been pacing back and forth from the desk to the front doors, intermittently staring outside at the rain falling on the cement of the wheelchair ramp. As the time had passed, he had begun to think of switching to plan B, which was to give up on the Post-it quest, run back to the OCME, grab the material in Laurie's desk, and beat it back to the Manhattan General. It was two-thirty in the morning and he'd already been away for an hour and a half.

Jack could see Salvador waving for Jack to come back to the desk. Next to him was a girl who looked as if she were fifteen. She had straight, shoulder-length, light brown hair, parted in the middle and swept back on either side behind conveniently large ears. Her eyes were huge and separated by a narrow, upturned nose.

"This is Dr. Shirley Mayrand," Salvador said, motioning toward the cardiology resident as Jack quickly returned to the counter.

Jack was momentarily mesmerized by the woman's youthfulness. For the first time in his life, he felt old. Although he was pushing fifty, playing basketball with kids half his age made him forget how old he really was. As the cardiology resident on call, this woman in front of him had to have been through college, medical school, and a significant number of years as a resident.

"What can I do for you?" Shirley asked. To Jack, even her voice sounded prepubescent.

After Jack introduced himself, he fumbled with the page from Sobczyk's chart, placed it on the countertop, and folded out the electrocardiograph tracing.

"I'll leave you two," Salvador said and walked away.

"I know this is not much," Jack said, pointing to the strip of EKG, "but I was wondering if you could comment on it."

"It's awfully short," Shirley complained while bending over the tracing.

"Yeah, well, it's all we have," Jack said. He noticed that the part in Shirley's hair meandered around as it made its way from her forehead over the crown of her head.

"What lead is it?"

"Good question. I have no idea. It was a strip taken at the outset of an unsuccessful cardiac resuscitation."

"Probably one of the standard leads," Shirley remarked.

"Maybe so," Jack said.

The resident looked up. Jack realized one of the reasons her eyes appeared so big was that he could see the whites all the way around her corneas. It gave her the look of continuous, innocent surprise.

"I don't know what I can say," Shirley said. "You'd really have to show me more for me to be able to comment with any confidence."

"I assumed as much," Jack said. "But this tracing is from a patient who unfortunately is already dead, which you know since I said it was taken at an unsuccessful resuscitation attempt. My point is, it's not going to be to the patient's detriment if you take a wild guess, say, if you were forced to come up with some opinion. Anything."

Shirley looked back at the tracing. "Well, as you certainly have already noticed, it does suggest a widening of both the PR interval and the QRS complex, while the QTRS seems to have been fused with the T wave."

Jack gritted his teeth. Somehow, it seemed unfair that this petite, youthful woman made him feel both old and stupid. "Maybe," Jack suggested, "it would be best if you could limit your comments to something that I can understand. I mean, you could tell me your impression without telling me how you came to it."

"Well, it does suggest something to me," Shirley said, looking up at Jack. "But I have an idea."

"Okay! What is it?"

"Dr. Henry Wo, one of my attendings, happens to be here in the ER at the moment. He'd been called in to do an angiogram on a suspected acute myocardial infarction. Why don't we show it to him."

Jack was pleased. The possibility of getting an attending's opinion in the wee hours of the morning hadn't even occurred to him.

"Come on around into the ER proper!" Shirley said while leaning over the counter to point out the route Jack would have to take. "I'll meet you and take you back to the cath room, where he is working."

The elevator doors opened, and with a grunt, the orderly got Laurie's bed to roll out into the lobby on the sixth floor. Since there was a slight discrepancy between the level of the floor of the elevator and the lobby floor, there was a jolt, and Laurie grimaced from the pain it caused. It was apparent that whatever she'd been given for pain had all but worn off.

Although Laurie felt just as panicky as she had when she'd first left the PACU, she'd at least reconciled herself to the reality that there was little she could do until she got to use a phone. She'd asked the orderly where her belongings were, with the idea of getting a hold of her cell phone. Unfortunately, he'd said he had no idea.

The orderly pushed her down the short corridor from the elevator lobby toward the nurse's station, which loomed like a beacon of bright light in the dimmed and mostly sleeping hospital. The recessed nightlights with frosted glass were spaced at intervals along the walls, about two feet off the floor.

After getting the bed up to the speed of a brisk walk, the orderly had to struggle to get it to stop abreast of the nurse's station. Once he did, he engaged the foot brake before leaving Laurie and approaching the counter over the nurses' station desk. Laurie could see the tops of two female heads-one with cropped hair, the other with a ponytail. Both women looked up when the orderly plopped Laurie's metal-covered hospital chart on the countertop.

"Got a patient for you people," the orderly said.

Laurie saw the woman with the cropped hair take the chart and read the name emblazoned on the front. She immediately stood up. "Well, well, Miss Montgomery. I must say, we have been wondering where you were."

The two nurses came around from behind the desk while the orderly walked back toward the elevators.

Laurie watched as the women approached her bed, each going to a separate side. Both were dressed in hospital scrubs. The one with the cropped hair had dark skin, almond-shaped eyes, and a narrow, aquiline nose. The other's complexion was paler, with broader features that gave a hint of an Asian mix. Since both faces were illuminated from below by the nightlights, only the bony prominences were clearly visible. The rest of their faces was lost in relative shadow. To Laurie, who was already anxious, they looked decidedly creepy.

"I need to use a phone," Laurie said, looking from one to the other, unsure if one was more senior than the other.

"Jazz, I'll take her down to the room and get her settled," the Asian-appearing woman said, ignoring Laurie's comment.

"That's good of you, Elizabeth," Jazz said, "but I think I'll take care of Miss Montgomery personally."

"Really?" Elizabeth questioned. She was obviously surprised.

"Hello!" Laurie said with some annoyance. "I need to use a phone!"

"Suit yourself," Elizabeth said to her colleague and walked back toward the nurses' station.

Jazz tossed Laurie's chart onto the foot of Laurie's bed and went behind to start pushing.

"Excuse me!" Laurie said, rolling her head back to keep Jazz in view. "It is very important for me to use the phone." She grimaced as the bed's brake was released, and again when the bed lurched forward down the long, dark hall.

"I heard you the first time," Jazz said. Her voice reflected the strain of pushing the bed. "I think I should remind you it's two-thirty in the morning."