The Second Opinion, page 10
“Goodness.”
“Someone said it might be the same pervert who molested that woman on Bladd Five, but I don’t know what sort of business he thought he could get done in an all-glass ICU. Not exactly fertile grounds for a molester.”
“I agree,” Thea said, sensing strongly that a laugh of some sort was called for, and complying with one that sounded totally unnatural to her.
Bladd Five . . . Blaylock Three . . . the Clark Pavilion . . . the Eisenstein ER . . .
It seemed as if every conference room, auditorium, and building, and even many of the patient rooms in the Beaumont, were named for a donor. Thea entered the Rebecca and James Kinchley Intensive Care Unit wondering in passing how much of a donation it had taken from the Kinchleys to have their names connected to it. A million? More? Much more? She had so little feel for amounts of money that it was impossible to guess.
Raising those funds was, she knew, the primary responsibility of Dr. Scott Hartnett. Now, Hartnett and Nurse Tracy Gibbons were on a very short list of those who knew that Thea believed her father might be awake and alert, and in the terrible grip of locked-in syndrome. Of course, she realized as she entered his room, either of them could have said something about it to anyone else, including the twins, Sharon Karsten, Amy Musgrave, and almost anyone else. So maybe the list wasn’t so short at that. From now on, until matters were resolved, she would be more careful to whom she spoke.
Meanwhile, she and her father had business to work out.
Thea approached the bed. Petros, eyes taped shut, looked as he always had: motionless, serene, being monitored in every way, fed intravenously, and breathed for through a ventilator. It was horrifying and hard to believe that he could hear every sound, feel every touch, and absorb every ache, but almost certainly, he could. Thea took his hand in hers and glanced about to ensure that no one was taking any particular interest in them. His nurse passed by once, glanced in, but didn’t stop. Thea carefully removed the paper tape and instilled a drop of lubricant in each eye to protect the Lion’s corneas.
“Dad, it’s me, Thea. Can you blink or look up?”
This time Petros’s response seemed marginally more brisk than it had been—a definite upward flick of his left globe accompanied by a wisp of movement of the lid. Now for the difficult part. She had considered trying the obvious, one blink for yes and two for no, but Petros seemed so slow that she felt certain his answers would end up being ambiguous and confusing.
“Dad, I love you and I need to communicate with you. I know it’s hard, but I beg you to try. I’ve been thinking about what might be easiest for us. . . . I will ask you questions. If the answer is yes, move your eye. If it is no, do nothing until I have counted to ten. Does that make sense to you?”
Thea held her breath, then began to count softly. She was at six when her father’s lid moved.
“Thank you. I know this is hard. I know you’re having trouble concentrating, but just do your best. With time things might get better.” She realized almost immediately that the rather hopeless statement wasn’t something a neurotypical would say, and corrected herself immediately. “No, Dad. Things will get better. Now, let’s try a question. Are you purposely not letting anyone except me know that you are awake and alert? One . . . two . . . three . . .”
This time, Petros’s response came at eight. Thea warned herself to be patient. She remembered being told that the French editor with locked-in syndrome was able to watch and focus as his assistant pointed through the alphabet a letter at a time until hitting on the proper one. Thousands and thousands of repetitions. That wasn’t going to happen here—at least not yet.
Her father was awake, but he was still foggy. She imagined the debris and neuronal swelling still present in his brain, doing battle against the incredibly complex and precise processes of thought, memory, reasoning, movement, emotions, and so many others. She would have to formulate her questions to make them as clear and unambiguous as possible.
“Do you believe that the driver of the car did this on purpose?”
Seven.
Thea felt ill. Her father believed, as did her brother, that someone had purposely tried to kill him. Now, it appeared, a second attempt had been made on his life. What next?
A woman from house keeping knocked on the glass and was beckoned in by her. Five minutes passed as the woman, who looked too old for her job, straightened the room, ran a mop over the floor, and left. Finally, Thea was ready for another question.
“Dad, do you know who did this to you?”
Again the count began. This time there was no movement through ten. Was the answer no, or was he too worn out to respond? Had he drifted off into coma again? As she had suspected, the system she had devised was an awkward one at best. If Dimitri and their father were correct, then the logical assumption was that Petros saw or learned something that would be damaging to whoever had twice tried to kill him.
“Can I keep going?” she asked after a minute had passed. “Can I try some more questions?”
Petros’s response came at eight, a definite upward gaze, but Thea was at a loss as to where to go from here. There was no telling how much the man had left in him. What yes or no question was there left to ask him?
“Do you have something you want to tell me?” she asked finally.
The positive response came at four. She believed that she could actually sense her father was excited.
His nurse tapped on the glass and let herself into the cubicle. The woman had passed by and peered in several times before finally knocking. Thea wondered what the woman was thinking about her, about what she might be doing hunched over among the machines and tubes, speaking to a man who had been in an irretrievable coma for almost two weeks.
“Everything all right?” the nurse asked.
“Fine. I just want to be certain my father gets stimulation. You never know what’s getting in and what isn’t.”
“Yes, of course,” the woman said, her tone patronizing. “Perhaps we could put a pair of earphones on him—play some nice music.”
“Medical journals would be better,” Thea replied. “He likes to keep up. Any new information about the man who tried to get in here?”
“Nothing yet. We think he might be the ex-husband of the woman in three. Apparently she’s taken a restraining order out against him. That’s my guess.”
Not mine, Thea was thinking. By the time the nurse had completed her work and left the cubicle, close to an hour and a half had elapsed since Thea’s arrival. Dan had probably been sutured and sent home. Despite the stressful circumstances, she felt her feelings for the man growing. He was at once vulnerable, frustrated, embarrassed, and angry. Thea knew that if she could read such abstract emotions in any person, they must be quite genuine and ill- disguised. Dan Cotton was much more comfortable playing the tough than he was the guy kneeling by the boy in the cafeteria, but his macho veneer was thin.
The image of him scowling on the ER stretcher made her smile. If he contacted her, and she thought he would, she would try and set up a meeting with Dimitri. It would be amusing to watch the two of them trying to figure one another out. Before that, though, she wanted to see if the library had the book dictated a letter at a time by the French magazine editor, as well as any other information on his life.
She also desperately wanted to get a look at Hayley Long’s hospital record without having Scott Hartnett or Hayley’s oncologist feel that she was in any way checking up on them. Hayley was a remarkable, remarkable woman, and anything she could do to help her through the ordeal of her cancer and treatment, she would do.
Thea turned her attention back to her father, desperately searching for a way to get at what ever it was that he wanted to tell her. Her back was beginning to ache from bending over, and she felt as if the muscles around her jaws were going into spasm from having been clenched too tightly. Finally, stimulated by the image of the editor picking his way through the alphabet again and again, she put her lips close to Petros’s ear.
“Can you hear me okay? . . . Dad, can you hear me?”
It seemed like a consummate effort, but Petros looked upward a millimeter or so. With time, it was possible that the function and strength around his eye might improve, but Thea felt there was no time to wait. As far as she was concerned, there had just been a second attempt on his life, this one quite possibly brought on by her claim to Tracy Gibbons, and also to Scott Hartnett, that she had seen evidence he was awake.
Petros knew something—something deathly important. The problem she faced was getting at precisely what it was. If she understood things so far, he didn’t know who had done this to him, but perhaps he wanted to tell her why.
“Dad, I want you to think of one word—one word that will point me in the direction you want me to go. Then I’m going to go through the alphabet starting with A. As soon as you hear the right letter, move your eye. I’ll go slowly. I’ll count to ten between each letter. Do you understand? One . . . two . . . three . . . four . . . five . . .”
At five there was movement. Thea added another drop of lubricant to each eye from the small vial on the bedside table.
“Here we go. A . . . One . . . two . . .”
As a schoolgirl, Thea had once been diagnosed as having another condition other than Asperger syndrome—ADHD, attention deficit hyperactivity disorder. It turned out that she didn’t have an attention deficit at all—only a lack of focus and patience for things that didn’t interest her. She learned to embroider before she was ten, and to knit at a time when, in many of her classrooms, she spent entire days staring out the window or pacing back and forth across the back of the room. And of course, she could read for hours on end without even changing position.
Now, a letter at a time, ten seconds per letter, she was totally immersed in the connection with the man who had never once told her that he loved her and that he was proud of who and what she had become.
At K Petros blinked.
“Yes, Dad, yes,” Thea whispered excitedly. “Stay with me. Let’s try the next letter.”
She sensed even before her father confirmed it that the letter was going to be an A. K-A. . . . A name of some sort, she thought. Or a place. It’s going to be a person’s name or some sort of place.
The L came hard, Petros signaling at the last possible instant. The next letter, an I, was the same way. K-A-L-I. Thea waited for several minutes before taxing her father again. When she did, he seemed to have regained a bit of energy. S . . . H . . . A . . .
“Dad, listen to me,” she said excitedly. “Is it Kalishar? Is it the owner of all those department stores? Blink if that’s who it is. One . . . two . . .”
Almost gratefully, it seemed, the left lid closed, then opened, then closed again. Jack or John Kalishar, Thea couldn’t remember which. Or perhaps the mogul used both. Kalishar’s was the name he used for his worldwide chain of upscale department stores and products.
Kalishar’s.
“One more question. Just one and we’re done for now. John Kalishar—was or is he a patient here? One . . . two . . . come on, Dad, come on . . . three . . . four . . .”
Petros’s globe turned upward ever so slightly. Each response had been like Sisyphus at his rock. But this time, at least for the moment, the Lion was done, and Thea knew what her next move had to be.
She sank back in the Danish modern visitor’s chair and called Sharon Karsten. It took just seconds after Thea was announced to the hospital CEO before the woman was on the line.
“Thea, hi. Is everything all right?”
“No change in my father, if that’s what you mean. At least not that I can see. But I’ve had a change of heart.”
“A change of heart?”
“Yes. How soon can you get me staff privileges to take over my father’s practice?”
“You mean that? . . . Why . . . why, that’s wonderful.”
“How soon?” Thea asked again.
“Well, I do have some clout around here. Let me talk to Herb Lesley, the head of credentialing. Since a number of us have known you since you were a child, and since you rotated through here and know a lot of the staff, I suppose we could move the process through quite rapidly and at least get you some sort of temporary credentials.”
“Like by tomorrow?”
“Possibly. Possibly by then.”
“Excellent.”
“May I ask why the change of heart?”
“Of course. I believe my father is going to be around for a long while, and I want to be here with him.”
“Have you told the twins yet?”
“Not yet, but I will.”
“I’m sure they will be very pleased.”
“Yes. I agree. Oh, one more thing.”
“Anything, Thea.”
“How soon can I get oriented to your electronic medical records system—Thor, yes?”
There was a prolonged pause.
“Yes, it’s Thor,” the CEO said. “I . . . I can’t take any action in that direction until the credentials committee has its say. This place is positively paranoid when it comes to its medical records.”
The hesitation and tone of Karsten’s response made Thea wish she hadn’t brought the subject up.
“That’s fine,” she said. “What ever you say.”
CHAPTER 18
The Stuart Drummond Memorial Medical Library occupied three refurbished stories of the Coldwater Building, one of the oldest on the campus. On her way to the expansive research center, Thea called Niko to report the ICU intruder and to formulate a strategy for protecting their father. Given her decision not to mention Petros’s locked-in syndrome, she knew convincing her cynical brother to do anything of the sort would not be easy. It wasn’t.
“Tell me again why you think this man was after Petros?” Niko asked.
“Dimitri is convinced that the hit-and- run was no accident.”
Niko groaned.
“You mean that animation of his? The damn thing looks like some sort of cave drawing.”
“The way he presented it made sense to me. Niko, call him anything you want, but don’t call him dumb.”
“Oh, please. Nothing about Dimitri should make sense to anyone. He’s one of those cases where he would have been better off without so much intelligence. Thea, I believe that you are grasping at straws. Petros was hit by a drunk driver or someone reaching for their cell phone, and has sustained massive, irreversible brain damage and a prognosis that is worse than hopeless. At the moment of impact he crossed the bridge of no return.”
“That’s cruel.”
“No it’s not, it’s realistic. Thea, Scott Hartnett told me you tried to demonstrate to him that Dad was awake and alert.”
So much for limiting those who knew about that to Hartnett and Tracy Gibbons, Thea thought. It wouldn’t be the first time she had been entangled in a hospital grapevine. It seemed as if she spent half of her residency there. One tells two, two tell four. Rumor at the speed of sound. Word of her behavior at her father’s bedside, based on hopelessly naïve wishes, was making its way across the vast hospital like ripples on a pond.
“That was a mistake,” she said.
“Now we’re getting somewhere.”
“So I take it you don’t think he needs a guard.”
“What he needs is benign neglect.”
“Are you coming by the ICU later today?”
“Petey has a soccer game. I missed the last two.”
“I hope I get to see him play.”
“We’ll have you over for dinner next week on an evening when he’s playing. I’ll speak to Marie.”
“That would be great.”
“Thea, I know you think I’m being harsh about this, but we’ve both been doctors long enough to appreciate that Dad’s situation is as hopeless as it is degrading. Deep down inside you must know that I’m right.”
Deep down inside I know that you’re not, Thea barely kept herself from saying.
A number of the oak tables, carrels, and computer stations of the Drummond Library were occupied. Thea and the reference librarian, a lanky, bespectacled brunette named Rachel, were pleased to find a copy of Jean-Dominique Bauby’s powerful memoir of his locked-in syndrome, The Diving Bell and the Butterfly.
Thea took only forty minutes to read the 132 pages. It wasn’t easy for her to comprehend why the once-powerful magazine editor would have chosen to write such a positive, life-affirming book when his condition was so abysmal and painful, but she dutifully took notes, and promised herself that she would spend more time thinking about what Bauby was trying to tell the world. Perhaps it was something she and Hayley could talk about.
She next moved to an available computer for more in-depth research and note-taking on the syndrome that only she and her father knew was holding his body hostage. According to Petros’s longtime lover, Niko stood to inherit millions. Did Niko himself know that? If so, he would certainly have reason over and above his philosophical and medical beliefs to want the tragedy in the ICU to be over quickly.
As she worked, Thea’s thoughts mulled over and over the questions raised by the Lion’s refusal—not reluctance, refusal—to share with anyone else the fact that his mind was keen and totally alert to what was transpiring around him. Was it a manifestation of his well-established need to be in control? Was it fear? Pure petulance? It didn’t really matter, she decided. At that moment, as helpless as he was, Petros was in control—unless, of course, someone other than Thea believed he had locked-in syndrome and was capable of communication. In that case he was not only not in control, he was in serious danger.
An hour of work on the Internet brought a mix of encouraging and frightening news. Locked-in syndrome, LIS, whether caused by hemorrhage, clot, or trauma, was rare, but common enough to have a number of outcome studies reported in the literature. One such study published in the British Medical Journal, hard for Thea to believe, alluded to an 80 percent ten-year survival. Another estimated the four-month mortality of LIS at 60 percent.
