“Name’s Will.”
“John. John Cooper.”
“I haven’t seen you here before.”
“Haven’t been.”
“Well, you picked a good night to start. Beef stew is about the best thing we do.”
“It’s very tasty.”
“Listen, John, I don’t go around advertising the fact, but I’m a doctor. I work at the hospital. Stop me if you think I’m out of line, but I’m concerned about those lumps on the side of your neck.”
Cooper didn’t bother reaching up to touch them.
“What about ’em?”
The lumps, markedly swollen lymph glands, were trouble. Will’s quick differential diagnosis included several types of cancer, as well as scrofula-a form of tuberculosis.
“Has any doctor checked them out?”
“Can’t afford no doctor.”
“You have Mass Health? Any kind of insurance?”
Cooper shook his head.
“Will you come see me and let me check those over, maybe run a few tests? It won’t cost you a thing.”
“Maybe.”
“I promise I’ll take good care of you.”
“That’s nice of you.”
Seldom more than a couple of tables behind, Will could see enough from where he stood to know he would be hard-pressed now to catch up with the influx.
“Listen, John,” he said, “I’m going to send Ben Beane over to talk with you. He runs this place. He’ll help you fill out the forms to get some state insurance, okay?”
“You mean welfare?”
“Insurance-the sort everyone in this country deserves to have. I don’t like to put labels on things, but what I’m talking about isn’t welfare. Wait here. I’ll get Ben. He’ll explain everything, and he’ll also give you my address. Okay?”
“If you say so.”
On the way over to find Beane, Will paused briefly to wipe down two tables. Most of the patrons of the Open Hearth Kitchen were respectful of the place and quick to do whatever they could to keep the tables ready for others. But some weren’t.
“Beano, I need your help with a new guy.”
“The one you were talking to?”
“He needs to come see me about some big lumps in his neck. Can you give him my address and have your people start him on the bumpy road to Mass Health coverage so we can get some tests done?”
“I would,” Beane said, “but the dude just got up and left.”
Will raced to the front door. A mean wind was sweeping through the blackness. There were a few patrons shambling toward him, but John Cooper was gone. Impotent with the situation and peeved at himself for possibly frightening the man off, Will was still on the staircase, peering down the street, when his cell phone went off. The display showed an ER number.
“Damn.”
“Will, it’s Lydia,” the surgical resident said. “Rescue just called from an alley downtown. They’re working on a guy a couple of kids found there, beaten up pretty bad. Mid-forties, robbery probably. No ID, no BP to speak of. He’s frozen, but they assure me he’s still alive.”
“ETA?”
“Ten minutes.”
There was no sense in trying to find out the location of the alley, even though it might have been nearby. In the field, the paramedics and EMTs were better and faster than he could ever be.
“I’ll be there,” he said, sensing the familiar adrenaline rush and accelerated thinking that accompanied a possible surgical emergency. “Have the CT scan people ready to do his head. Call someone in if there’s no one there right now. Two lines in, large bore, cath his bladder, get bloods off including a
“Got it.”
“Oh, and, Lydia, if he’s as cold as the rescue people say he is, please have the nurses get a warming blanket ready and heat up some Ringer’s lactate solution.”
Of all the Tuesdays he had taken call while volunteering at the Hearth, this was the first time he was faced with an emergency that demanded his immediate return to the hospital, ready to race up to the OR. He went back inside, looked over at the kids, and, as he was doing for the emergency at FGH, sorted through a dozen different courses of action at the same time. Finally, knowing there was no other way, he swallowed his pride and frustration, and called Maxine.
Lydia Goldman spotted Will and the twins approaching down the hallway and raced to meet them. A third- year resident, she had never handled emergencies calmly, and Will was pleased to have learned some weeks ago that she had been accepted into a plastic-surgery program in Kansas.
“This is real trouble, Dr. Grant. His core temperature is fifty-two. He’s been beaten to a pulp. BP isn’t readable. I’m getting set to put in an arterial line.”
“Deep breath,” Will said, “now slow exhale. Kids, this is Lydia. Lydia, Dan and Jessica. The guy’s alive, right?”
“Yes, but-”
“Hold it for a second. Jess and Dan, I’m really sorry about having to cut off the night so early. Mom will meet you over there in the waiting room. I’ve got to get to work helping Lydia with her patient.”
“Can we watch?” Jess asked.
“Yuck,” Dan said.
“Another time, I promise. I’ll see you both on Saturday. I love youse guys.”
“Da-ad.”
“I know, I know.”
Will kissed each of them on the forehead, then followed Lydia into the ER. The unconscious, middle-aged man had been stripped and placed on a large warming pad. Two nurses were adjusting his IV lines and monitoring equipment. He had been beaten badly about the head, face, and chest, with some fresh bruising on his abdomen as well.
“Order some neck films, Lydia, just in case.”
“Oh, my, I’m really sorry I didn’t do that.”
The woman, a knowledgeable-enough resident in spite of her lack of cool, flushed at having made an oversight. Will paused to settle her down.
“Lydia, we do this as a team so that together we might think of everything, okay? Self-flagellation does nothing to improve our focus.”
“O-okay. I’ll be right back.”
She raced off to get spine X-rays ordered.
“Arterial line,” Will called after her, already examining the patient as he approached the bedside.
“Julie,” he called to one of the nurses, “please call anesthesia down here to put a tube in this man.”
Will set his hands on either side of the man’s abdominal wall and felt the muscles beneath them tighten. Even comatose there was some reaction from John Doe. Light pressure had caused enough pain to break through his depressed consciousness.
“It’s in here,” he said to no one in particular. “I’d bet the ranch on it. Listen, everyone, as soon as we have
