“Still nothing,” Davies said. “Team called every ER in L.A., and I sent Jiao down to look at a couple of suspicious patients, but they were false alarms.”
“Have them check again,” Stanton said. “Every twenty-four hours.”
They hung up, and Stanton hurried around the edge of the building. The press weren’t the only ones crowding the parking lot; a cavalcade of ambulances was outside the ER, lights blazing. Paramedics swarmed, and doctors and nurses barked orders as patients were unloaded on stretchers. There’d been a major car accident on the 101 freeway, and dozens of critically injured patients had been transported here.
Stanton made another quick call as he headed back for the front door of the building. “It’s me,” he said quietly when he got Nina’s voice mail again. He glanced around to make sure no one was listening. “Do me a favor and throw your milk and cheese overboard too.”
INSIDE THE ER, Stanton squeezed himself against the wall to make room for gurneys from the car accident flying by. An elderly man, with his arm wrapped in gauze and a tourniquet, screamed in pain. Surgeons were operating in the non-sterile ER on patients too critical to get to the ORs. He gave silent thanks that triage wasn’t his area of expertise.
Back on the sixth floor, Stanton found Chel Manu in the waiting area. Even in her heels she was tiny, and he again found his eyes drifting down to the nape of her neck,where her black hair fell. It wasn’t just that she was attractive—she was clearly sharp too. She’d already managed to get key information from Volcy, so he’d asked her to stay.
“You want coffee while we wait for the nurses to finish?” he asked, motioning toward the vending machine.
“No, but I could use a cigarette,” Chel said.
Stanton dropped quarters into the slot, filling a Styrofoam cup. It was hardly Groundwork, but it would have to do. “Probably won’t find many of those in here.”
She shrugged. “Promised myself I’d quit by the end of the year anyway.”
Stanton sipped the weak coffee. “Guess that means you don’t believe the Mayan apocalypse is coming.”
“No, I don’t.”
“Me neither.” He smiled, thinking they were just making easy banter, but didn’t get one in return. Maybe it wasn’t something she wanted to joke about.
“So what now?” she asked, deadpan.
“Soon as the nurses are done in there,” Stanton said, “we should try to get Volcy to tell us all the dairy items he might have had in the last month or so.”
“I’ll do my best,” she said, “but I’m not sure he completely trusts me.”
“Just keep doing what you’re doing.”
STANTON WAS SURPRISED to find no one standing outside Volcy’s room. Mariano, the security guard, was nowhere to be seen, and no replacement had arrived. Every guard in the building must have been called down to control the crowd from the freeway accident.
Inside, Stanton and Chel found nothing but an empty bed.
“Did they move him?” Chel asked.
Stanton flipped on the lights and scanned the room. Seconds later they heard a hissing coming from behind the bathroom door. He put his ear to it. “Volcy?” The hissing was high-pitched and sounded like a leak, but there was no answer.
Turning the doorknob, Stanton found it unlocked. Then he saw Volcy. The man was facedown on the ground as if he’d been cold-cocked. The room itself was destroyed: drywall everywhere, the basin of the sink detached from the base, copper pipes protruding from the wall and leaking water onto the floor.
“
Stanton dropped to the ground and touched the patient’s shoulder.
“Are you okay? Can you hear me?”
No answer.
He pulled the man’s arm around his neck to lift him up. Stanton could feel how distended Volcy’s body was; the man’s arms, legs, and torso all looked like they had been pumped too full of air. Like they were desperate to be punctured. The skin was cold.
“Get the care team!” Stanton yelled to Chel.
She seemed paralyzed.
“Go!”
Chel darted, and Stanton turned back to the patient. “I need you to hold on to me, Volcy.” Stanton tried to get him back to the bed, where they could put him on a ventilator. “
By the time the rest of the medical team got there, Volcy was barely breathing. He had ingested so much water that it was overloading his heart, and he was close to cardiac arrest. Two nurses and an anesthesiologist joined Stanton at the bedside, and they began to inject drugs. They covered Volcy’s face with an oxygen mask, but it was a losing battle. Three minutes later, Volcy’s heart stopped.
The anesthesiologist applied a series of electric pulses, each stronger than the last. The defi brillator paddles left scorch marks as the patient’s body arched up. Stanton began chest compressions, something he hadn’t done since his residency. He threw his weight down from his shoulders and delivered a series of rapid pulses to Volcy’s chest, just above the sternum. The body rose and fell with each,
Finally the anesthesiologist grabbed Stanton’s arm and urged him back from the bed. She said the words: “Time of death twelve twenty-six p.m.”
MORE AMBULANCES SCREAMED from the 101 freeway toward the ER. Stanton tried to block out the sounds while he and Thane watched the orderly team lifting Volcy’s corpse into the body bag.
“He’s been sweating for a week straight, right?” Thane said. “He must have been dehydrated.”
Stanton looked down at the blue, bloated corpse. “This didn’t come from his kidneys. It came from his brain.”
Thane looked confused. “You mean like a polydipsia?”
Stanton nodded. Patients with psychogenic polydipsia were driven to drink excessively: Sinks had to be disabled, toilets drained. In the worst cases, like this one, the heart failed due to fluid overload. Stanton had never seen an FFI patient do it before, but he was angry at himself for not considering the possibility.
“I thought that was a symptom of schizophrenia.” Thane was rummaging through the man’s chart, trying to grasp what had happened.
“After a week without sleep, he might as well have had schizophrenia.”
As the orderlies zipped the body bag, Stanton imagined Volcy’s horrific last minutes. Schizophrenia caused abnormalities in the perception of reality; FFI patients exhibited many of the same symptoms. Stanton had often wondered if sleep was all that kept healthy people out of insane asylums.
“What happened to Dr. Manu?” Thane asked.
“She was here a minute ago.”
“Guess you can’t blame her for freaking when she saw this.”
“She was the last person to talk to him,” Stanton said. “We need her to write down everything he said as precisely as possible. Track her down.”
The orderlies lifted Volcy’s body onto the gurney and wheeled it out. After the corpse was prepared, Stanton would meet the pathologists down in the morgue for the autopsy.
“I should’ve been here,” Thane said. “I got pulled down to the ER. They’re sending way too many critical patients here from that accident. It looks like an Afghan fucking field clinic down there now.”
“Nothing you could’ve done,” Stanton said, pulling off his glasses.
“Some asshole falls asleep in his SUV on the freeway, and the rest of our patients suffer,” Thane said.
He walked to the window, moved the curtain aside, and gazed down below. A siren blared as yet another
