has an oxygen line that has a valve in it at a funny place, rather well concealed.”
“Susan, look. You’re forgetting that some twenty-five percent of your supposed victims weren’t even near the OR, much less room No. 8. Now, even under the best of circumstances, I find your crusade ridiculous and threatening. And when I’m exhausted, I find it numbing. Can’t we talk about something soothing, like socialized medicine?”
“Mark, I’m sure about this.” Susan could sense the exasperation in Bellows’s voice.
“I’m sure you’re sure, but I’m also sure I’m unsure.”
“Mark, the man who attacked me this afternoon warned me, and then he returned tonight, and I don’t think he wanted to talk. I think he wanted to kill me. In fact, he tried to kill me. He shot at me!”
Bellows rubbed his eyes, then the sides of his head. “Susan, I don’t know what to even think about that, much less have something intelligent to say. Why don’t you go to the police if you’re so sure?”
Susan did not hear Bellows’s last comment; her mind was racing ahead.
She started to speak out loud. “It has to be from lack of oxygen. If they were given too much succinylcholine or curare, must enough so that the people would have a hypoxic episode ...” Susan trailed off, thinking. “That could be why respiratory arrest occurred. The one they autopsied, Crawford.” Susan took out her notebook. Bellows took another drink.
“Here it is, Crawford. He had severe glaucoma in one eye and was on phospholine iodide. That’s an anticholinesterase and that means that his ability to break down the succinylcholine would have been impaired and a sublethal dose could be lethal.”
“Susan, I’ve already told you that succinylcholine would not work in the OR, not with the surgeon and the anesthesiologist right there. Besides you cannot give succinylcholine by gas ... at least, I’ve never heard of it.
Maybe you could, but anyway, they’d just keep respiring the patient until it was gone; there wouldn’t be any hypoxia.”
Susan took another slow sip from the bourbon.
“What you’re saving is that the hypoxia in the OR has to occur without the color of the blood changing so the surgeon stays nice and happy. How could that be done? ... You’d have to block the use of oxygen by the brain somehow ... maybe at the cellular level ... or block the release of oxygen to the brain cells. It seems to me there is a drug that can block oxygen utilization, but I can’t think of it offhand. If the valve on the oxygen line were significant, it would have to be a drug that comes in a gas form. But there’s another way to do it. You could use a drug that blocks the uptake of oxygen on the hemoglobin and yet still keeps the color. ... Mark, I’ve got it!” Susan sat bolt upright, her eyes wide open, her mouth forming a half-smile.
“Sure you do, Susan; sure you do,” soothed Mark sarcastically.
“Carbon monoxide! Carefully bled-in carbon monoxide, by way of the T-valve, titrated to cause just the right amount of hypoxia. The blood color would stay the same. In fact it would get even brighter red, cherry red.
Even a very small amount would cause the oxygen to be displaced from the hemoglobin. The brain is starved of oxygen and—coma. In the OR
everything has seemed absolutely normal. Then the patient’s brain dies; there is not a trace of the cause.”
There was a silence as the two people looked at each other. Susan expectantly, Bellows with tired resignation.
“You want me to say something? OK, it’s possible. Ridiculous but possible. I mean it’s theoretically possible for the OR cases to be caused by carbon monoxide. It’s an awful idea, maybe it’s even ingenious, but at any rate, it’s possible. The trouble is there are still twenty-five percent of the coma victims who didn’t even get close to the OR.”
“They’re the easy ones to explain. That was never hard. It was the OR
cases that were hard. It was also hard for me to break away from the idea in the diagnosis of disease in medicine that one should search for single causes. But in this case we’re not dealing with a disease. The cases on the medical floors were given sublethal doses of succinylcholine.
Something like that happened in a V.A. hospital in the Midwest, and even in New Jersey.”
“Susan, you can hypothesize until you’re blue in the face,” said Bellows with a tinge of anger growing out of frustration. “What you’re suggesting is some fantastic organized plan—a criminal plan—with the sole purpose of making people comatose. Well, let me tell you this: you haven’t given an ounce of effort to the biggest question: the question of why. Why, Susan? Why? I mean, you’re spinning your mental wheels at ninety miles per hour, taking all sorts of risks with your career, and mine, I might add, to come, up with a potentially plausible although fantastic explanation for what is a series of unconnected, unfortunate incidences.
But at the same time, you’ve conveniently forgotten to ask why. Susan, there would have to be motive, for Christ’s sake. It’s ridiculous. I’m sorry, but it is ridiculous. And besides, I’ve got to go to sleep. Some of us work, you know. ... And there isn’t one bit of solid evidence. A valve on the oxygen line! God, Susan, that’s pretty weak. I mean you’ve got to come to your senses. I can’t take any more of this. Really. I’m finished.
I’m a surgical resident, not a part-time Sherlock Holmes.”
Bellows got up and finished his bourbon in one long drink.
Susan watched him intently, her paranoia awakening once again. Bellows was no longer on her side. Why indeed? The criminal aspect of the matter was horribly apparent to her at that point.
“What makes you so sure,” continued Bellows, “that all this has anything to do with Nancy Greenly or Berman? Susan, I think you’re jumping to conclusions. There’s an easier explanation for this character who seems so interested in getting hold of you.”
“I’m waiting.” Susan was angry now.
“The guy was probably looking for some action and you ...”
“Screw you, Bellows!” Susan went livid.
“Now she gets mad. God damn it, Susan, you take this whole affair as some sort of complicated game. I don’t want to argue with you.”
“Every time I tell you about some aggressive behavior from Harris to this fucker who tried to kill me, all you can come up with is some Goddamn sexist explanation.”
“Sex exists, my child. You’d better learn to face that.”
“I think it’s more your problem. You male doctors never do seem to grow up. I guess it’s too much fun being an adolescent.” Susan got up and put her coat back on.
“Where are you going at this hour?” said Bellows with an authoritarian air.
“I have a feeling I’m safer on the street than here in this apartment.”
“You’re not going out now,” said Bellows with determination.
“Ah, now the male chauvinist is displaying his true colors. The great protector! Bull crap. The egoist says I’m not going. Just watch.”
Susan left quickly, slamming the door.
Indecision kept Bellows immobile and silent as he watched the door. He was silent because he knew that she was right in a lot of ways. He was immobile because he really wanted to be rid of the whole mess. “Carbon monoxide, holy shit.” He walked back into his bedroom and got into bed once more. Looking at the clock, he realized morning was going to arrive very, very quickly.
D’Ambrosio began to panic. He had never liked confined spaces and the walls of the freezer began to move in on him. He began to breathe faster, gulping for air, and then he thought he might be going to suffocate. And the cold. The deathly cold wormed its way through his heavy Chicago overcoat, and despite constant motion, his feet and hands had gone numb.
But by far the most disturbing aspect of the whole miserable affair was the bodies and the acrid odor of formaldehyde. D’Ambrosio had seen a lot of grisly scenes in his life and had been through some gruesome experiences, but nothing could compare with being in the freezer with the stiffs. At first he had tried not to look at them, but involuntarily and out of mounting fear, his eyes had been drawn to the faces. After some time it had begun to look as if they were all smiling. Then they were laughing and even moving when he didn’t watch them
