manageable. Once we got the bleeding controlled, we irrigated everything like crazy. There’s bound to be infection, but that’s what we have antibiotics and infectious-disease specialists for. Plus you just don’t look like someone with a lot of devil germs on his face. What on earth do you think happened?”
“Well, don’t use up your energy writing. We can talk after that tube comes out. Who’s takin’ care of you?”
“Good man, Millstein. A little scrawny by my standards, but sharp. Well, lad, I’m going to head on over to the recovery room to check on our boy.”
“Just don’t ever do that again. My poor knickers had to be permanently retired.”
Donna Lee appeared and pulled Cameron aside, beyond Will’s field of vision.
“I don’t believe it!” Will heard Cameron say. “I don’t-”
Will envisioned the nurse stopping Cameron short with a finger to her lips. He banged on the bed rail to get her attention.
“Nothing.” Donna’s tone was icy. “Dr. Millstein will be up to speak with you.”
“He’ll be here before long. Just close your eyes and relax until he gets here. And don’t touch that tube.”
The woman was gone before Will could write anything further. What could she have said that Gordo didn’t believe? Why was she refusing even a small amount of medication to help him deal with the tube? Why the sudden coldness? He shifted his position in bed and tried as best he could to ignore the discomfort in his throat and bladder.
For a time he lay there, trying to divert himself with thoughts of Kurt Goshtigian. He had a decent enough patient-physician relationship with the man, but their history was not a long one. Even if Goshtigian fully recovered from his Whipple procedure, a lawyer could certainly make a good case for Will having caused the need for additional surgery and powerful, potentially life-threatening antibiotics, as well as prolonged time under anesthesia. Still, no judge or jury could find him negligent when clearly some medical problem beyond his control or knowledge had caused the incident in the OR. Will took pride in the fact that despite a high-risk specialty, he had never yet been sued, but he hardly took the fact for granted. As a surgeon, the specter of a malpractice action was always hovering not far away.
Even without medication, Will began to drift off. Images of the OR floated about for a time, then gave way to a comforting darkness. Everything was going to be okay, he told himself. The diagnostic tests he would undergo over the days and weeks ahead would show no brain tumor, no vascular anomaly within his skull, no hemorrhage, and no irregular cardiac rhythm. The incident would be written off as a simple faint, caused by a virus, fatigue, dehydration, or factors never to be determined. Such a faint was known technically as vasovagal syncope, the sort of physiologic reaction that commonly accompanied stresses such as horrible news or a grisly sight. In such instances a sudden, powerful discharge of electricity along the large vagus nerve caused rapid dilation of the veins in the abdomen and legs and marked pooling of blood in those vessels. The resultant drop in blood pressure produced an instantaneous loss of consciousness. Fainting was the brain’s effort to protect its critical circulation by “insisting” that the body lie down.
“Will?”
Ken Millstein stood by Will’s left hand. Standing beside Millstein, Anne Hajjar looked down at Will with the stony impassivity of a sphinx. On the right side of the bed was anesthesiologist Ramon Bustamante, also looking grim.
Will opened his eyes and managed a weak thumbs-up, to which neither the nurse nor the physicians reacted.
“Will, Dr. Bustamante’s here to remove the tube; after that we’ll talk.”
The Philippine anesthesiologist moved forward and used a syringe to deflate the balloon cuff that held the tube in place below Will’s vocal cords. The inflated cuff also prevented him from aspirating his stomach contents into his lungs.
“Mrs. Hajjar, you have the backup tube ready?” Bustamante asked.
“Right here.”
“You tested the balloon?”
“Yes.”
“Suction?”
“Ready.”
“Okay, then, Doctor,” the anesthesiologist ordered unemotionally. “Cough when I say so. . and. . now!”
Will coughed feebly and the redwood tree instantly vanished from his throat. He sputtered and gagged as the nurse suctioned his mouth and throat with a hard plastic tube. Then, eyes tearing, he sagged back against the pillow, sucking in drafts of sweet air. Bustamante listened to his chest, assured himself that neither lung had collapsed, then turned and left without a word. Anne Hajjar slipped oxygen prongs into Will’s nostrils, did a blood- pressure check, nodded to Millstein that it was satisfactory, and quickly followed the anesthesiologist out of the cubicle.
For fifteen seconds, Millstein just stood there looking down at Will.
“Feel able to talk?” he asked.
Will cleared his throat as forcefully as he could manage.
“Sure,” he rasped, nearly overcome now by apprehension.
“Okay. I’ve gotten most of the lab work back, including a comprehensive panel I requested for drugs of abuse.”
“That would be negative.”
“Well, you can say so, Will, but it wasn’t.”
Will felt his heart sink.
“That’s impossible.”
“You lit up for fentanyl, Will. Big time.”
Fentanyl-one of the most powerful of all narcotics. It was used as a painkiller via a time-release patch and in an IV to put patients to sleep in the OR before they were intubated. It was highly addictive and too often an instrument of death in those anesthesiologists who chose to experiment with it by sequentially pushing up the dose they injected into themselves.
“I tell you, that’s impossible. I’ve never taken any painkillers stronger than Tylenol.”
“Two different samples,” Millstein said. “Fentanyl confirmed in both of them by emergency gas chromatography and mass spectrophotometry. Large amounts were in your blood when you passed out, Will. There is absolutely no doubt in anyone’s mind about that.”
Will found the bed control and raised himself upright.
“This is absolutely insane! I didn’t take anything.”
“I don’t see how that can be true,” Millstein said evenly. “I can try and help you, Will, but only if you tell the truth.”
The chilliness of the nurses and the anesthesiologist was certainly explained. Fear and anger tightened the muscles at the base of Will’s skull. A jet of bile rose in his throat.
“You’ve known me for years, Ken. You’ve got to believe me.”
Millstein shook his head slowly.
“I don’t know what to make of this, Will. I’ve learned to repeat abnormal tests that don’t fit, and that’s just what I did here. But if I don’t trust our lab when a test is repeated with the same results, I might as well pack up and find another profession.”
“It wasn’t my blood,” Will said desperately.
Again Millstein shook his head. Will could see now the deep sadness in his eyes.
