Michael Crichton - A Case of Need

I was certain the girl had heard me, but she did not react.

“How much?”

“Ten milligrams,” I said. “A good dose.”

Angela gave a slight shiver, but said nothing.

“Is that all right with you, Angela?”

She looked up at me and her eyes were filled with anger and something else, almost hope. She knew what it meant, all right.

“What did you say?” she asked.

“I said, is it all right if we give you ten milligrams of nalorphine.”

“Sure,” she said. “Anything. I don’t care.”

Nalorphine was an antagonist of morphine. [52] Actually a partial agonist, meaning that in low doses it has a morphine-like effect, but in high doses in an addict, it induces withdrawal symptoms. If this girl was an addict, it would bring her down with brutal swiftness—possibly fatal swiftness, if we used enough.

A nurse came in. She blinked when she did not recognize me, but recovered quickly. “Doctor, Mrs. Harding is here. The police called her.”

“All right. I’ll see her.”

I went out into the corridor. A woman and man were standing there nervously. The man was tall, wearing clothes he had obviously put on hurriedly—his socks didn’t match. The woman was handsome and concerned. Looking at her face, I had the strange feeling I had met her before, though I was certain I had not. There was something very, almost hauntingly, familiar about her features.

“I’m Dr. Berry.”

“Tom Harding.” The man held out his hand and shook mine quickly, as if he were wringing it. “And Mrs. Harding.”

“How do you do.”

I looked at them both. They seemed like nice fifty-year-old people, very surprised to find themselves in a hospital EW at four in the morning with a daughter who’d just slashed her wrists.

Mr. Harding cleared his throat and said, “The, uh, nurse told us what happened. To Angela.”

“She’s going to be all right,” I said.

“Can we see her?” Mrs. Harding said.

“Not right now. We’re still conducting some tests.”

“Then it isn’t—”

“No,” I said, “these are routine tests.”

Tom Harding nodded. “I told my wife it’d be all right. Angela’s a nurse in this hospital, and I told her they’d take good care of her.”

“Yes,” I said. “We’re doing our best.”

“Is she really all right?” Mrs. Harding said.

“Yes, she’s going to be fine.”

Mrs. Harding said to Tom, “Better call Leland and tell him he doesn’t have to come over.”

“He’s probably already on his way.”

“Well, try,” Mrs. Harding said.

“There’s a phone at the admitting desk,” I said.

Tom Harding left to call. I said to Mrs. Harding, “Are you calling your family doctor?”

“No,” she said, “my brother. He’s a doctor, and he was always very fond of Angela, ever since she was a little girl. He—”

“Leland Weston,” I said, recognizing her face.

“Yes,” she said. “Do you know him?”

“He’s an old friend.”

Before she could answer, Hammond returned with the nalorphine and syringe. He said, “Do you really think we should—”

“Dr. Hammond, this is Mrs. Harding,” I said quickly. “This is Dr. Hammond, the chief medical resident.”

“Doctor.” Mrs. Harding nodded slightly, but her eyes were suddenly watchful.

“Your daughter’s going to be fine,” Hammond said.

“I’m glad to hear that,” she said. But her tone was cool.

We excused ourselves and went back to Angela.

“I HOPE TO HELL you know what you’re doing,” Hammond said as we walked down the hall.

“I do.” I paused at a water fountain and filled a cup with water. I drank it down, then filled it again. My headache was now very bad, and my sleepiness was terrible. I wanted to lie down, to forget everything, to sleep.…

But I didn’t say anything. I knew what Hammond would do if he found out.

“I know what I’m doing,” I said.

“I hope so,” he said, “because if anything goes wrong, I’m responsible. I’m the resident in charge.”

“I know. Don’t worry.”

“Worry, hell. Ten milligrams of this stuff will shove her into cold turkey so fast—”

“Don’t worry.”

“It could kill her. We ought to be doing graded doses. Start with two, and if there’s no effect in twenty minutes, go to five, and so on.”

“Yes,” I said. “But graded doses won’t kill her.”

Hammond looked at me and said, “John, are you out of your mind?”

“No,” I said.

We entered Angela’s room. She was turned away from us, rolled over on her side. I took the ampoule of nalorphine from Hammond and set it with the syringe on the table just alongside her bed; I wanted to be sure she read the label.

Then I walked around to the other side of the bed, so her back was to me.

I reached across her and picked up the ampoule and syringe. Then I quickly filled the syringe with water from the cup.

“Would you turn around, Angela, please?”

She rolled onto her back and held out her arm. Hammond was too astonished to move; I put the tourniquet on her arm and rubbed the veins in the crook of her elbow until they stood out. Then I slipped the needle in and squeezed out the contents. She watched me in silence.

When it was done, I stood back and said, “There now.”

She looked at me, then at Hammond, then back to me.

“It won’t be long,” I said.

“How much did you give me?”

“Enough.”

“Was it ten? Did you give me ten?”

She was becoming agitated. I patted her arm reassuringly. “There’s nothing to worry about.”

“Was it twenty?”

“Well, no,” I said. “It was only two. Two milligrams.”

“Two!”

“It won’t kill you,” I said mildly.

She groaned and rolled away from us.

“Disappointed?” I said.

“What are you trying to prove?” she said.

“You know the answer to that, Angela.”

“But two milligrams. That’s—”

“Just enough to give you symptoms. Just the cold sweats and the cramps and the pain. Just the beginnings of withdrawal.”

“Jesus.”

“It won’t kill you,” I said again. “And you know it.”

“You bastards. I didn’t ask to come here, I didn’t ask to be—”

“But you are here, Angela. And you have nalorphine in your veins. Not much, but enough.”

She began to break out into a sweat. “Stop it,” she said.

“We can use morphine.”

“Stop it. Please. I don’t want it.”

“Tell us,” I said. “About Karen.”

“First stop it.”

“No.”

Hammond was bothered by all this. He started forward toward the bed. I pushed him back.

“Tell us, Angela.”

“I don’t know anything.”

“Then we’ll wait until the symptoms start. And you’ll have to tell us while you scream from the pain.”

Her pillow was soaked with sweat. “I don’t know, I don’t know.”

“Tell us.”

“I don’t know anything.”

She began to shiver, slightly at first, and then more uncontrollably, until her whole body shook.

“It’s starting, Angela.”

She gritted her teeth. “I don’t care.”

“It will get worse, Angela.”

“No…no…no….”

I produced an ampoule of morphine and set it on the table in front of her.

“Tell us.”

Her shivering got worse, until her whole body was wracked with spasms. The bed shook violently. I would have felt pity if I had not known that she was causing the reaction herself, that I had not injected any nalorphine at all.

“Angela.”

“All right,” she said, gasping. “I did it. I had to.”