The Pain Nurse - страница 18

The walls told him that Christine Lustig was a graduate of Tufts Medical School and a fellow in the American College of Surgeons. The desk had a computer and beside it, thick notebooks labeled Med-Interface and SoftChartZ. What was her job? Did she see patients? Will used a tissue to shield his hand as he opened desk drawers. Pens, pencils, more files with obscure names. There were no family photographs. He rolled around, seeing the office from the desk’s perspective. How could you sit with your back to that empty hallway late at night? The newspaper story said a nurse had discovered the doctor’s body, so the door might have been open. There was no sign of a broken lock. The Slasher never broke a lock, a door, or a window. Will pushed the drawer back in and by habit reached under it, sweeping the metal with his hand.

He felt duct tape and then the unmistakable outlines of a knife.

“Damn.”

The doorknob shook. Will started and drew back from his discovery. He backed the wheelchair against the wall, hoping it would be in the safe place when the door opened. But no key was inserted into the lock. The knob rattled again and the door snapped against the frame from sudden pressure. Slap! The door was again pushed hard and the lock was rattled impatiently. Even when the sounds stopped, it was a long time before Will turned off the lights and ventured into the corridor.

Cheryl Beth answered the phone and could hear screaming in the background. It was the sound of the newest consult. It was going to be a bad day.

She had hurried to recovery, to a patient with pancreatic cancer who had undergone a Whipple Procedure. It basically involves lopping off part of the pancreas and rebuilding the digestive tract. It’s difficult surgery, almost, but not quite, being made obsolete. The aftermath can be pain incarnate: evil, damnation, omnipotent. It reminded Cheryl Beth of the hell-fire Baptist sermons she had heard as a girl growing up in the little Kentucky railroad town of Corbin. This was pain as the Lake of Fire, and it was almost as hard to knock down as bargaining on judgment day.

It was engulfing a woman so small and eaten up that it seemed barely possible she had the organs remaining to destroy or the breath to scream so loudly.

“I didn’t know what to do. I was afraid to violate the orders.” A young nurse in purple scrubs spoke with a voice on the edge of panic.

“You’re not violating anything, Megan,” Cheryl Beth said, getting the woman’s name off her name badge. Barely under her breath, she said, “I don’t know why people want to cover their ass when a patient is suffering. And does the damned anesthesiologist care?” Megan stared at the floor.

Tamping down her fury, Cheryl Beth did a quick workup. The paperwork was a mess, as usual. It appeared that she had been undermedicated by one of the surgical residents. She touched the old woman, her skin like that covering a chicken wing after a week in the refrigerator. “I’m going to help you.”

“I just want to die,” she wailed.

Cheryl Beth’s brain and hands were on automatic now, a coordination born from years of training and experience.

“What are you doing?” the young nurse asked.

“Rescue dose,” Cheryl Beth said. She injected morphine and Ativan through a cap in the IV line. They rushed into the vein that would bear them like a liquid savior. She stroked the woman’s hand and the screaming subsided. Her pager vibrated again, even as she wrote out extensive orders for the pain meds to follow. She looked at it and decided it could wait. Around her, the general surgery recovery room looked like much of Cincinnati Memorial, a surreal combination of modern medical technology haphazardly fitted into rooms that had been built during the Great Depression and left to slowly rot ever since. She noticed more than usual the attendant fleeting odors of disinfectant, feces, vomit, and various medicines. They seemed colored with a brooding, claustrophobic tint in the aftermath of Christine’s murder.

She felt herself silently mouthing the word: Murder. She stopped when she was aware that Megan was hovering nearby. Cheryl Beth instructed her on monitoring and administering the morphine and the Ativan, an antianxiety drug, and regulating the PCA pump that would prevent an overdose.