Beat the reaper_a novel

19
I’m standing by the curtained-off bed next to Squillante’s in the recovery room, rolling the two empty potassium vials around in one hand. I should be rounding on my patients, then getting the f*ck out of the hospital. Or else forgetting about my patients, and going straight to the getting-the-f*ck-out part.
What I should not be doing is standing here trying to figure out who killed Squillante. I mean, who cares, and what difference does it make? Is there some hitman still in the hospital who’s about to get a call saying “Wait up. While you’re there, would you mind whacking the Bearclaw, too?” Unlikely. I probably have about ninety minutes.
But no one’s ever whacked a patient of mine before, and I can’t get past it. It pisses me off in a whole new way.
I give myself one hundred seconds to think.
The obvious suspect is someone from Squillante’s family. Someone who was hoping Squillante would die in surgery so there could be a big malpractice suit, but was willing to take matters into his or her own hands when Squillante pulled through. So an insurance beneficiary.*
But it’s also someone who knew to use two whole vials of potassium. Any less than that might have allowed Squillante to live, or even helped him. Any more would have been pointless, and would have caused streaks in his aorta that would scream out on autopsy.
But if the person wanted to hide the fact that it was murder, why inject Squillante so quickly that his EKG spiked? The insurance company would love that. The money’s never coming out of probate.
Maybe the person did care, but didn’t have the time or training to do it right.
Again, though, who gives a shit? Enough time wasted. I’ll go see those of my patients who might die if I don’t, and leave the rest to Akfal.
Then get the f*ck out.
I know: Sterling. And f*ck the Pakistani, eh? But he might as well get used to it, since I doubt I’m coming back.
In the hallway outside the recovery room, though, I run into Stacey. She’s still in her scrubs, and she’s crying.
“What happened?” I ask her.
“Mr. Squillante died,” she says.
“Oh,” I say. Wondering how it’s possible to hang out with Dr. Friendly and still be surprised by the death of one of his patients. Then I remember Stacey’s new on the job. I put an arm around her.
“Hang in there, kid,” I say.
“I don’t know if I can deal with this job,” she says.
Something occurs to me. I say, “Yeah.” Then I count to five as she sniffles. Then I say, “Stacey, do you have any potassium chloride samples?”
She nods her head slowly, confused. “Yes...I don’t usually, but I’ve got two of them in my bag. Why?”
“Why do you have them now, if you don’t usually have them?”
“I don’t do the ordering. They just FedEx me the stuff and I bring it into the hospital.”
“They FedEx it to your office?”
“I don’t have an office. They FedEx it to me at my apartment.”
I’m amazed. “You work out of your home?”
She nods again. “So do my roommates.”
“Do all drug reps work out of their homes?”
“I think so. We’re only supposed to go in twice a year, for the Christmas and Labor Day parties.” She starts sobbing again.
Jesus, I think. Every day’s a lesson.
“You wouldn’t have any more Moxfane, would you?” I ask her.
“No,” she says through the tears, shaking her head. “I’m all out.”
“Go home and get some sleep, kid,” I tell her.
I’m doing respirator settings on a patient I haven’t mentioned and won’t mention again, dripping time like blood, when I get a page from Akfal. I call him back.
“Assman’s got jaundice,” he says.
Great. It means his liver is malfunctioning so badly that it’s stopped correctly processing dead blood cells. My own arm has started to feel a bit better. But he, at least, is f*cked.
I should skip it. Not so much because it can wait, which it sounds like maybe it can’t, but because I can’t think of what to do for him even if I take the time. I know if I called WITSEC and said “I really should run for my life, but I’ve got a patient who’s gone from ass pain to liver failure in less than eight hours due to an unknown, spreading pathogen,” and they knew what they were talking about, they’d say “Run for your life. You might as well save someone.”
Or maybe they wouldn’t. WITSEC is not the most sympathetic organization in the world. Their universal word for witness is “scumbag”—which is fine for actual criminals like myself, but gets a bit grating when they’re talking about a young widow with a baby who’s just testified against three gangsters who came into her store and shot her husband in front of her.
And most relocated witnesses are lucky to get a job at a Staples in Iowa. So you can imagine how the Feds feel about me, who as far as they’re concerned got placed in a gold-plated, tax-dollar Porsche en route to a golf course, with a license plate reading, “FUKUFBI.”
What actually happened is that I got placed into the two-year premed program at Bryn Mawr, which I paid for myself. But even that was only because I had Sam Freed backing me. Sam’s retired now. If I get relocated again, it’ll be to paint fire hydrants in Nebraska. It will never be to work as a doctor.
Of course, I could run without being relocated. Participation in WITSEC is strictly voluntary. In fact, if you do something they don’t like they kick you out, and half the time “accidentally” rat you out in the process. But to keep my name, and therefore my MD, I’d have to find some shithole so far away the mob couldn’t find me to mail me a bomb. And even those places have surprisingly strict licensing requirements. Like wanting to know who you are.
The fact is, once I leave this hospital I leave medicine, almost certainly forever.
The concept is dizzying. I race up to Assman’s room.
As I’m passing the nursing station, the Jamaican charge nurse calls out: “Doctair.”
“Yes, ma’am,” I say. The Irish crone is asleep on her computer keyboard, drooling into the AS/ZX region.
“There’s a woman keeps calling to talk to you. Leaving a number,” the Jamaican one says.
“How long’s she been calling?”
“Several hours.”
So it’s possibly legitimate. “Can I have the number?” I say.
She slips it across the counter to me, written on a prescription pad.
“Thanks,” I say. “Don’t let your friend electrocute herself.”
She scowls and holds up the unplugged cable from the computer keyboard. “This is a hospital,” she says.
I make the call. A woman says, “Hello?” There are traffic noises in the background.
“This is Dr. Peter Brown,” I say.
“You’re Paul Villanova’s doctor?”
“Yes, ma’am.”
“He was bitten by a flying rodent.”
“What do you mean?”
I hear the clunk you can only get these days by hanging up a payphone.
I enter Assman’s room.
“How you feeling?” I ask him.
“Up yours,” he says. I touch his forehead. He’s still burning up. I feel a bit guilty about the fact that my forearm barely hurts anymore, and that I have movement back in my fingers.
“You ever been bitten by a bat?” I ask. Not that a bat is a rodent—it’s a chiropteran. But sometimes you need to put yourself in the shoes of the common man to practice medicine correctly.
Plus, no one gets bitten by a flying squirrel.
“No,” Assman says.
I wait for him to equivocate, but he doesn’t. He just keeps his eyes closed and sweats.
“Never?”
At least it gets his eyes open. “What are you, a retard?” he says.
“Are you sure?”
“Yeah, I think I would probably remember that.”
“Why? You can’t even remember the last four presidents.”
He rattles them off.
“Or what day of the week it is.”
“It’s Thursday,” he says.
So at least his mind’s still working. Mine, meanwhile, is blurring.
“Are you married?” I say.
“No. I wear this ring to keep supermodels from rubbing up against me in the subway.”
“Where’s your wife?”
“How the f*ck should I know?”
“Is she in the hospital?”
“You mean as a patient?”
“Any time you want to stop being a smartass,” I say to him.
He closes his eyes and smiles through the pain. “She’s around here somewhere,” he says.
I pull the curtain and check on Mr. Mosby. He’s managed to undo his wrist restraints but has left the ankle ones on out of courtesy. He’s asleep. I check the pulses in his ankles and leave.
I scribble “R/O bat bite per wife” in Assman’s chart,* then finish the note with two horizontal lines and a diagonal one. I don’t even sign it.
Because right now I’m in a strange state of purity. One way or the other, “Dr. Peter Brown” will not exist long enough to be sued, or even to check lab results. There is nothing to do but actual medicine, and even then only what is strictly, imminently necessary.
Or what I feel like doing. I check the speed on a couple of chemotherapy drips, then spend all of thirty seconds fixing the dressing on the girl missing half her head.
Osteosarcoma Girl, in the next bed over, is ashen, staring at the ceiling. The bag on her knee is filled with blood and blood clots.
Her other knee’s propped up. I pull her gown down to cover her p-ssy, which still has a blue tampon string hanging out of it, and which anyone walking into the room can see.
“Who gives a shit?” she says. “No one’s going to ever want me again.”
“Bullshit,” I say. “Thousands of people will want you.”
“Yeah. Losers who think they can trade up by f*cking a gimp.”
Huh. Seems pretty astute to me. “Where’d you get a mouth like that?” I ask her.
“I’m sorry,” she says, sarcastically. “None of the boys are gonna want to take me dancing.”
“Sure they will,” I say. “Down at the hop.”
“You f*cker!” she says.
I wipe the tears off her cheeks. “I have to go.”
“Kiss me, you a*shole,” she says. I do.
I’m still doing it when there’s a throat clearing noise behind me. It’s two surgery techs come to wheel her away so she can get her leg cut off.
“Oh shit I’m scared,” she says when they lift her to the stretcher bed. She’s holding my hand, which is sweating.
“You’ll be okay,” I say.
“They’ll probably cut off the wrong leg.”
“That’s true. But the second time they operate it’ll be harder to f*ck up.”
“F*ck you.”
They wheel her away.
When I get beeped to the ER by a doctor I know who works there, I think: No problem.
It’s on my way out.
Just outside the ER I pass the f*ckhead who tried to mug me this morning. He still hasn’t been examined yet, since long wait times are how they discourage people without insurance from coming to the ER. His face is covered with blood, and he’s holding his broken arm. When he sees me he jumps off his stretcher and gets ready to run, but I just wink at him as I jog by.
Under less extreme circumstances, I love emergency rooms. People who work there are as slow and calm as houseplants. They have to be, or they f*ck up and burn out. And in the Manhattan Catholic ER you can always find the doctor who paged you, because it’s all been one open space since an incident you really don’t want to know about.*
The doctor is hosing out a low-back knife wound on a patient who’s writhing and screaming but being held in place by a couple of nurses.
“What’s up?” I ask her.
“The ER’s a f*cking nightmare,” she says, sedately.
“Sorry, I’m in a hurry. What can I do for you?”
“I’ve got a biker status post–motorcycle accident with heavily contused testicles.”
“Okay.”
“And he’s mute.”
“He’s mute?”
“That’s right.”
“Can he hear?”
“Yes.”
So he’s probably not mute.
I look at my watch, like it’s going to say, “Ten minutes to hitmen.”
“Show me,” I say.
She puts down the sprayer and takes me over.
The biker’s not some jackass with a weekend Harley. He’s an actual biker-gang biker, like from Gimme Shelter. He’s got green tattoos and is wearing sunglasses in the Emergency Room. There’s a bunch of ice packs on his groin, with his purple and black water-balloon scrotum showing through them.
“Can you hear me?” I ask him.
He nods.
I squeeze his nose shut. He looks surprised, but not as surprised as when he realizes he’s not strong enough to claw my hand off his face.
Eventually he opens his mouth to breathe, and I take the bag of heroin out.
I toss it to the doctor. “Okay?” I say to her.
“Thanks, Peter,” she says.
“Any time,” I say, wishing it were true.
I walk out through the ambulance entrance.




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