than usual, theservice slow enough to be irritating. He ordered an extra-thick chocolate malt.Then, wondering if Maura Hughes might be lured out of orbit, he ordered asecond one. If she couldn't handle it, he would make the sacrifice.
It was nine-thirty by the time he left theice-cream parlor, and close to ten when he reentered the hospital. Aftervisitors' hours, only the main entrance was open. Harry crossed the desertedlobby and flashed his plastic ID at the security guard, whose desk blocked themain corridor to the hospital.
'I've got to have you sign in, Doc,' theman said. 'After nine.'
Harry scribbled his name and destination.The guard glanced at it.
'Alexander Nine,' he said. 'You going upthere for the Code Ninety-nine?'
At that instant, the overhead page beganurgently summoning Dr. Richard Cohen to Alexander 928.
Harry hurried toward the elevators.Something had happened to Maura Hughes, he was thinking. She hadn't looked thatgreat when he left, but she certainly hadn't seemed in imminent danger. Thensuddenly he remembered that Richard Cohen was a member of the sameneurosurgical group as Ben Dunleavy, Evie's neurosurgeon. Cohen was undoubtedlycovering for the night. Gripped by an intense foreboding, Harry kept jabbing atthe elevator call button until one of the doors slid open. The ride up toAlexander 9 took an eternity.
Room 928 was halfway down the far arm ofthe 'L.' The nurse's station and near corridor were deserted. Harry set downthe bag from Alphano's and sprinted down the hallway, his heart pounding in histhroat. It took only a moment after he rounded the corner to have his worstfears confirmed. There were half a dozen nurses and med students standing outsideroom 928, craning to catch a glimpse of the action. Maura Hughes, stillrestrained in her bed, had been pulled to the far side of the corridor.Standing beside her, stroking her hand, was a young, uniformed policeman.
Harry raced past them all and into theroom.
The scene was one he had witnessed orparticipated in hundreds of times over the years. The monitors, the lines, thecrash cart, the defibrillator, the nurses, physicians, and technicians movinggrimly from equipment to bedside and back like a platoon of army ants. Onlythis time, at the center of the controlled chaos, intubated through her noseand being ventilated by a rubber bag, was his wife. The cardiac monitor showeda regular rhythm. Every ten seconds or so, though, her arms extended to the maximumand rotated inward, turning her palms away from her body in an eerily unnaturalposition.
'When did this happen?' he asked.
The neurosurgical resident who was runningthe resuscitation looked up.
'This is Dr. Corbett, her husband,' thenurse explained.
'Oh, sorry,' the resident said. 'Heraneurysm appears to have ruptured. Dr. Cohen is covering for Dr. Dunleavy. Ijust got word that he's on the way up.'
'What happened?' Harry asked. 'I left herjust a little over an hour ago and she was fine.'
Sue Jilson shook her head.
'About half an hour after you left I wentin to medicate Maura. I heard a moan from behind the curtain. When I looked,your wife had vomited and was barely conscious. The initial blood pressurereading I got was three hundred over one-fifty. One pupil was already largerthan the other.'
Harry stared down at Evie, his mindunwilling to connect what he was seeing with what he knew of cerebralhemorrhaging. He reached down and gently lifted her eyelids. Both of her pupilswere so wide that almost no iris color could be seen. He felt numb, dreamlike.It was already over.
Dr. Richard Cohen rushed into the room. Healready knew the patient's history, he breathlessly told the resident. Theresident gave him a capsule summary of the past thirty-eight minutes.
'You've done everything right,' Cohen saidas he examined the inside of Evie's eyes with an ophthalmoscope.
He quickly checked her reflexes andresponse to pain. Then he used the end of his reflex hammer to firmly stroke anarc along the soles of her feet from heel to great toe. The Babinski reflex — the great toe pulling up instead of curling down — was a grave, grave sign thather cerebral cortex, the thinking part of her brain, was no longer influencingthe movements of her body. Harry watched, stunned.
'We'll get a CT scan,' Cohen said grimly,'but in all honesty, I don't think we can get her to the OR. The brain swellingis enormous. Both of her optic discs are showing severe papilledema.'
'She. . she doesn't want any heroicmeasures,' Harry heard himself saying.
'Arterial line's in,' another residentcalled out. 'Her systolic is still two-ninety.'
'That's very strange,' Cohen said. 'We'vegiven her a huge amount of antihypertensives already, but her pressure hasn'tbudged.'
'But wouldn't you expect her pressure tobe up like this with a large hemorrhage?' Harry asked.
Temporarily, maybe. Most CNS bleeds dohave a period of marked rise. But they almost always respond to conventionaltreatment, and the residents have already gone well beyond that.'
'Oh, God,' Harry whispered, still feelingdetached and unreal.
'We'll keep trying to get her pressuredown,' the neurosurgeon said. 'And we'll get a CT to document what we alreadyknow. Meanwhile, Harry, difficult as it is under these circumstances, there'ssomething you should be thinking about.'
'I understand,' Harry murmured.
Evie was a young, completely healthywoman, whose only organic problem was her aneurysm. At the moment, she was thesort of prize coveted by every organ transplant specialist — a source of lifeor sight for any number of people.
'Let's get the scan and then I'll let youknow,' Harry said. 'Meanwhile, go ahead and begin tissue typing.'
Chapter7
After half an hour, the battle to controlEvie's astronomical blood pressure was finally won. But everyone involved inthe case knew that the war had already been lost. Harry stood helplessly by thedoor as the respiratory technician adjusted the controls on the ventilator thatwas now Evie's only link to life. There were IVs in both her arms and tubesinto her stomach, bladder, and lungs. Every minute or two, in response tonothing in particular, her entire body would tighten and extend into a decerebrateposture. This nightmarish scene was one he had witnessed many times in hisprofessional life and in Nam. But emotionally he had never become very adept atdealing with it.
There was inevitably a part of himunwilling to accept the simple truth that it was over.
'No, thank you,' he replied to a nurse whooffered him coffee. 'I … I've got to call Evie's folks.'
He glanced at the corridor behind him.Maura Hughes seemed calmer. Her brother, a carrottop with a face too youthfulfor the uniform he wore, continued stroking her hand as he watched theunfolding horror in room 928. It was quarter of eleven. The CT scanner would befree in five minutes. Blood samples had been sent off to the lab for tissuetyping. On the way back from the CT scan, assuming nothing had come up thatwould send her to the operating room; Evie would get the first of what would probablybe a series of electroencephalograms. Two flat or near flat EEGs twelve hoursapart were considered to be the electro-physiologic equivalent of death. Harryreached up unaware and brushed aside a tear that had worked its way to the topof one cheek.
'Corbett, what in the hell is going onhere?'
Still half-dazed, Harry turned toward thevoice. Caspar Sidonis stood several feet away, hands on hips, his expressionpinched and angry.
'I don't know what you're talking about,'Harry managed. 'But right now I'm a little busy. You see, my —
