Robin Cook - Terminal

“Gloria?” Janet called.

Gloria didn’t respond.

Propping the door open with its rubber foot, Janet approached the bed. Off to the side was a slop bucket with a mop, but Janet didn’t see it because as she got closer she noted with alarm that Gloria’s face was a deep cyanotic blue!

“Code, room 409!” Janet shouted at the operator after snatching the phone from its cradle. She tossed the envelope with the glass shards on the bedside table.

Pulling Gloria’s head back and after making certain her mouth was clear, Janet started mouth-to-mouth resuscitation. With her right hand pinching Gloria’s nostrils, Janet forcibly inflated Gloria’s lungs several times. Noting the ease with which she was able to do this, she became confident there was no blockage. With her left hand she felt for a pulse. She found one, but it was weak.

Janet blew several more times as people began to arrive. Marjorie was there first, but soon others followed. By the time Janet was relieved from her resuscitative efforts by one of the other nurses, there were at least ten people in the room trying to help. Janet was impressed by the quick response: even the housekeeper was there.

Gloria’s color responded quickly, to everyone’s relief. Within three minutes several doctors including an anesthesiologist arrived from the second floor. By then a monitor had been set up showing a slow but otherwise normal heartbeat. The anesthesiologist deftly inserted an endotracheal tube and used an Ambu bag to inflate Gloria’s lungs. This was more efficient than mouth-to-mouth, and Gloria’s color improved even more.

But there were bad signs as well. When the anesthesiologist shone a penlight into Gloria’s eyes her widely dilated pupils did not react. When another doctor tried to elicit reflexes, she was unable to do so.

After twenty minutes Gloria started to make efforts to breathe. Minutes later, she was breathing on her own. Reflexes also returned but in a fashion that did not bode well. Her arms and legs extended while her hands and feet flexed.

“Uh oh,” the anesthesiologist said. “Looks like some signs of decerebrate rigidity. That’s bad.”

Janet did not want to hear this.

The anesthesiologist shook his head. “Too long without oxygen to the brain.”

“I’m surprised,” one of the other doctors said. She tilted the IV bottle to see what was running in. “I didn’t think respiratory failure was a complication of this regimen.”

“Chemo can do unexpected things,” the anesthesiologist said. “It could have started with a cerebral vascular incident. I think Randolph better hear about this.”

After rescuing her envelope, Janet stumbled out of the room. She knew scenes like this came with the territory, but knowing that hard fact didn’t make them any easier to bear.

Marjorie came out of Gloria’s room, saw Janet, and came over. She shook her head. “We’re not having much luck with these advanced breast cancer patients,” she said. “I think the powers that be better start questioning the treatment protocol.”

Janet nodded but didn’t speak.

“Being the first one on the scene is always tough,” she said. “You did all you could.”

Janet nodded again. “Thanks,” she said.

“Now get that medicine for Helen Cabot before we have more trouble,” Marjorie said. She gave Janet a sisterly pat on the shoulder.

Janet nodded. She took the stairs to get to the second floor, then crossed to the research building. She took an elevator to the seventh floor and, after asking for Ms. Richmond, was directed to her office.

The nursing director was expecting her and reached for the envelope. Opening it she poured the contents onto her desk blotter. With her index finger she pushed the shards around until she could read the labels.

Janet remained standing. Ms. Richmond’s silence made her fear that somehow the woman knew exactly what Janet had done. Janet began to perspire.

“Did this cause a problem?” Ms. Richmond asked finally in her surprisingly soft voice.

“What do you mean?” Janet asked.

“When you broke these vials,” Ms. Richmond said. “Did the glass cut you?”

“No,” Janet said with relief. “I dropped them on the floor. I wasn’t injured.”

“Well, it’s not the first time or the last,” Ms. Richmond said. “I’m glad you didn’t hurt yourself.”

With surprising agility for her size, Ms. Richmond sprang up from behind her desk and went to a floor-to-ceiling cabinet that concealed a large, locked refrigerator. Unlocking and opening the refrigerator door, she took out two vials similar to the ones Janet had broken. The refrigerator was almost filled with such vials.

Ms. Richmond returned to her desk. Searching in a box in a side drawer, she took out printed labels identical to those on the shards on her desk. Licking the backs, she began applying the appropriate label to each vial. Before she was finished her phone rang.

Ms. Richmond answered and continued to work, holding the phone against her ear with a raised shoulder. But almost immediately the call took her full attention.

“What?” she cried. Her soft voice turned querulous. Her face reddened.

“Where?” Ms. Richmond demanded. “Fourth floor!” she said after a pause. “That’s almost worse! Damnation!”

Ms. Richmond slammed the phone down and for a moment stared ahead without blinking. Then, noting Janet’s presence with a start, she got up and handed over the vials. “I’ve got to go,” she said urgently. “Be careful with that medicine.”

Janet nodded and started to respond, but Ms. Richmond was already on her way out the door.

Janet paused at the threshold of Ms. Richmond’s office and watched her walk rapidly away. Looking over her shoulder, she gazed at the cabinet which concealed the locked refrigerator. Something wasn’t right about all this, but she wasn’t sure what it was. Too much was happening.

Randolph Mason marveled at Sterling Rombauer. He had some idea of Sterling’s personal wealth as well as of his legendary business acumen, but he had no idea what motivated the man. Chasing around the country at other people’s bidding would not be the life Mason would lead if he had command of the assets Sterling did. Nonetheless, Mason was grateful for Sterling’s chosen occupation. Every time he hired the man, he got results.

“I don’t think you have anything to worry about until the Sushita plane shows up here in Miami,” Sterling was saying. “It had been waiting for Tanaka in Boston and was scheduled to go to Miami, but then it went to New York and on to Washington without him. Tanaka had to fly down here on a commercial flight.”

“And you will know if and when the plane comes?” Dr. Mason asked.

Sterling nodded.

Dr. Mason’s intercom crackled on. “Sorry to disturb you, Dr. Mason,” Patty, his secretary, said. “But you told me to warn you about Ms. Richmond. She’s on her way in and she seems upset.”

Dr. Mason swallowed hard. There was only one thing that could set Margaret off. He excused himself from Sterling and left his office to intercept his director of nursing. He caught her near Patty’s desk and drew her aside.

“It’s happened again,” Ms. Richmond snapped. “Another breast cancer patient with a cyanotic respiratory arrest. Randolph, you have to do something!”

“Another death?” Dr. Mason asked.

“Not a death yet,” Ms. Richmond said. “But almost worse, especially if the media gets involved. The patient is in a vegetative state with obvious brain damage.”

“Good Lord,” Dr. Mason exclaimed. “You’re right; it could be worse if the family starts asking questions.”

“Of course they will ask questions,” Ms. Richmond said. “Once again, I must remind you that this could ruin everything we’ve worked for.”