Michael Crichton - A Case of Need

That stopped them cold. They froze, thinking what I was thinking, that skull films were so hard to interpret and required a trained eye. They also didn’t understand how I knew to ask such a question.

“No, the radiologist is not here right now.”

“Well, where is he?”

“He just stepped out for coffee.”

“Get him back,” I said. My mouth was dry and stiff; my jaw hurt. I touched my cheek and felt a large swelling, very painful. No wonder they had been worried about a fracture.

“What’s my crit?” I said.

“Pardon, sir?”

It was hard for them to hear me, my tongue was thick and my speech unclear.

“I said, what’s my hematocrit?”

They glanced at each other, then one said, “Forty, sir.”

“Get me some water.”

One of them went off to get water. The other looked at me oddly, as if he had just discovered I was a human being. “Are you a doctor, sir?”

“No,” I said, “I’m a well-informed Pygmy.”

He was confused. He took out his notebook and said, “Have you ever been admitted to this hospital before, sir?”

“No,” I said. “And I’m not being admitted now.”

“Sir, you came in with a laceration—”

“Screw the laceration. Get me a mirror.”

“A mirror?”

I sighed. “I want to see how good your sewing is,” I said.

“Sir, if you’re a doctor—”

“Get the mirror.”

With remarkable speed, a mirror and a glass of water were produced. I drank the water first, quickly; it tasted marvelous.

“Better go easy on that, sir.”

“A crit of forty isn’t bad,” I said. “And you know it.” I held up the mirror and examined the cut on my forehead. I was angry with the interns, and it helped me forget the pain and soreness in my body. I looked at the cut, which was clean and curved, sloping down from above one eyebrow toward my ear.

They had put about twenty stitches in.

“How long since I came in?” I said.

“An hour, sir.”

“Stop calling me sir,” I said, “and do another hematocrit. I want to know if I’m bleeding internally.”

“Your pulse is only seventy-five, sir, and your skin color—”

“Do it,” I said.

They took another sample. The intern drew five cc’s into a syringe. “Jesus,” I said, “it’s only a hematocrit.”

He gave me a funny apologetic look and quickly left. Guys on the EW get sloppy. They need only a fraction of a cc to do a crit; they could get it from a drop of blood on a finger.

I said to the other intern, “My name is John Berry. I am a pathologist at the Lincoln.”

“Yes, sir.”

“Stop writing it down.”

“Yes, sir.” He put his notebook aside. “This isn’t an admission and it isn’t going to be officially recorded.”

“Sir, if you were attacked and robbed—”

“I wasn’t,” I said. “I stumbled and fell. Nothing else. It was just a stupid mistake.”

“Sir, the pattern of contusions on your body would indicate—”

“I don’t care if I’m not a textbook case. I’m telling you what happened and that’s it.”

“Sir—”

“No,” I said. “No arguments.” I looked at him. He was dressed in whites and he had some spatterings of blood on him; I guessed it was my blood.

“You’re not wearing your name tag,” I said.

“No.”

“Well, wear it. We patients like to know who we’re talking to.”

He took a deep breath, then said, “Sir, I’m a fourth-year student.”

“Jesus Christ.”

“Sir—”

“Look, son. You’d better get some things straight.” I was grateful for the anger, the fury, which gave me energy. “This may be a kick for you to spend one month of your rotation in the EW, but it’s no kicks at all for me. Call Dr. Hammond.”

“Who, sir?”

“Dr. Hammond. The resident in charge.”

“Yes, sir.”

He started to go, and I decided I had been too hard on him. He was, after all, just a student, and he seemed a nice enough kid.

“By the way,” I said, “did you do the suturing?”

There was a long, guilty pause. “Yes, I did.”

“You did a good job,” I said.

He grinned. “Thanks, sir.”

“Stop calling me sir. Did you examine the incision before you sutured it up?”

“Yes, s—. Yes.”

“What was your impression?”

“It was a remarkably clean incision. It looked like a razor cut to me.”

I smiled. “Or a scalpel?”

“I don’t understand.”

“I think you’re in for an interesting night,” I said. “Call Hammond.”

ALONE, I had nothing to think about but the pain. My stomach was the worst; it ached as if I had swallowed a bowling ball. I rolled over onto my side, and it was better. After a while, Hammond showed up, with the fourth-year student trailing along behind.

Hammond said, “Hi, John.”

“Hello, Norton. How’s business?”

“I didn’t see you come in,” Norton said, “otherwise—”

“Doesn’t matter. Your boys did a good job.”

“What happened to you?”

“I had an accident.”

“You were lucky,” Norton said, bending over the wound and looking at it. “Cut your superficial temporal. You were spurting like hell. But your crit doesn’t show it.”

“I have a big spleen,” I said.

“Maybe so. How do you feel?”

“Like a piece of shit.”

“Headache?”

“A little. Getting better.”

“Feel sleepy? Nauseated?”

“Come on, Norton—”

“Just lie there,” Hammond said. He took out his penlight and checked my pupils, then looked into the fundi with an ophthalmoscope. Then he checked my reflexes, arms and legs, both sides.

“You see?” I said. “Nothing.”

“You still might have a hematoma.”

“Nope.”

“We want you to stay under observation for twenty-four hours,” Hammond said.

“Not a chance.” I sat up in bed, wincing. My stomach was sore. “Help me get up.”

“I’m afraid your clothes—”

“Have been cut to shreds. I know. Get me some whites, will you?”

“Whites? Why?”

“I want to be around when they bring the others in,” I said.

“What others?”

“Wait and see,” I said.

The fourth-year student asked me what size whites I wore, and I told him. He started to get them when Hammond caught his arm.

“Just a minute.” He turned to me. “You can have them on one condition.”

“Norton, for Christ’s sake, I don’t have a hematoma. If it’s subdural, it may not show up for weeks or months anyway. You know that.”

“It might be epidural,” he said.

“No fractures on the skull films,” I said. An epidural hematoma was a collection of blood inside the skull from a torn artery, secondary to skull fracture. The blood collected in the skull and could kill you from the compression of the brain.

“You said yourself, they haven’t been read by a radiologist yet.”

“Norton, for Christ’s sake. You’re not talking to an eighty-year old lady. I—”

“You can have the whites,” he said calmly, “if you agree to stay here overnight.”

“I won’t be admitted.”

“O.K. Just so you stay here in the EW.”

I frowned. “All right,” I said finally, “I’ll stay.”

The fourth-year student left to get me the clothes. Hammond stood there and shook his head at me.

“Who beat you up?”

“Wait and see.”

“You scared hell out of the intern and that student.”

“I didn’t mean to. But they were being kind of casual about things.”

“The radiologist for the night is Harrison. He’s a fuck-off.”

“You think that matters to me?”

“You know how it is,” he said.