“Is there a pulse?” the captain asked while keeping her eyes glued to the monitor.
“No, there’s no pulse,” one of the team said, feeling against Elena’s neck.
“Okay, that’s it,” the captain said, throwing up her hands. “We’re done. I think this should have been a DNR from the word ‘go’ with this amount of decerebrate symptomatology. But who’s to say? Let’s close up shop and get out of here in case we get another call.”
Almost the moment the woman finished her little speech, the cardiac alarm went off, indicating that Elena Aguilar had yet again fallen back into fibrillation. Several of the resuscitation team members reacted to the alarm, but the captain raised her hands to stop them. “Hold up! As I said, we’re done here.”
As the resuscitation team packed up their equipment, which mostly involved tending to the defibrillator and its paddles, the monitor alarm kept sounding until one of the ICU nurses turned it off. Not too long after the resuscitation team had pushed the crash cart out of the room and away down the hall, Mitt noticed that the monitor’s blip changed from its chicken scratch — like tracing to a perfectly flat line. Elena Aguilar was now dead by definition.
Mitt watched the straight-lined monitor for several beats until one of the ICU nurses turned it off along with the ventilator, which had mechanically continued respiring the patient despite her heart having stopped. Then everyone but Mitt left the room. He remained rooted to his spot, staring at his assigned patient’s motionless body.
Although he’d expected for a number of hours that Elena Aguilar was going to die, now that she had, it weighed on him anew that six out of his seven initially assigned patients had passed away. Once again, his mathematically oriented mind struggled to deal with the reality of such a statistic, especially now that he couldn’t get any potential traction out of the Dr. Geraldo Rodriguez connection since Latonya Walker and Elena Aguilar had been with Dr. Kevin Singleton. Now, as far as Mitt knew, he was the only person or circumstance that connected the deaths together, and he struggled to try to understand what, if anything, that could possibly mean. The only idea that came to his mind was rather preposterous: Maybe a medical serial killer was on the loose in Bellevue Hospital and was plotting for Mitt to take the fall if he or she were to be discovered.
Yet almost the moment Mitt entertained the implausible idea of a medical serial killer being somehow involved, he dismissed it out of hand. In his mind such an unlikely explanation was evidence of his desperation. There was no way the idea made sense, as the patients were too disparate, with no association other than being Bellevue patients. If these deaths were related, it had to be by something else. But what, he had absolutely no inkling whatsoever.
“Excuse me!” a voice said. “Can I help you?”
Mitt took a breath as if coming out of a trance and turned to see a nurse enter the room carrying a fresh bedsheet. He’d noticed her earlier during the resuscitation attempt and now assumed she’d been originally assigned as the night nurse for Elena Aguilar.
“No, I was just leaving,” Mitt said, finding his voice. But he didn’t leave. Instead, he watched the nurse cover the body with the sheet and otherwise prepare the room for the arrival of housekeeping. “I was the surgical resident assigned to Ms. Aguilar and assisted with her surgery,” Mitt added. “Tell me, do I need to fill out the death certificate or anything like that here in the ICU?” Since Critical Care had its own physicians and residents, Mitt wasn’t sure.
“No, I’m certain that’s being taken care of. I can assure you that everything is under control and you are free to go. Sorry about the outcome with your patient, but it had never looked good from the moment she arrived here in the ICU from the PACU.”
“She never was able to breathe on her own after her surgery,” Mitt said.
“So I heard,” the nurse said. She had now moved to the head of the bed and was detaching the intravenous line.
After a further brief conversation to be personable, Mitt set out back through the ICU on his way to his on-call room. As he walked, he felt numb, still mulling over the disturbing issue of trying to explain six out of seven patient deaths, but falling short. Yet by the time he’d passed through the swinging doors out into the empty elevator lobby, he’d come to accept that the situation had to have been chance despite its very low probability. After all, he reasoned, in the course of human history there’d been many unexpected and surprising events of extraordinarily low probability that had nonetheless happened. He also found himself thinking about his one remaining patient, Diego Ortiz. Mitt was briefly tempted to stop by the fifteenth floor just to make certain he was okay but then changed his mind. The patient would undoubtedly be asleep, and Mitt would be understandably reluctant to wake him. Besides, Mitt would have heard from the nurses if everything wasn’t copacetic.
As he pressed the elevator button his mind instantly switched from thinking about statistics to the horrid image of the ragtag surgerized people he’d been confronted by on his way to the ICU. He tried to prepare himself if there was a repeat, again wondering if he should or could ignore the apparitions as fanciful constructs and just pretend they weren’t there. Mitt couldn’t decide, nor did he have much chance because a moment later, the chime sounded at one of the elevator doors, indicating the car was about to arrive.
Quickly moving down to the appropriate spot, Mitt positioned himself about three feet back and tried to brace himself in case there was a repeat episode. As the door began to slide open, he tensed despite not having decided exactly what he was going to do if the hallucination of the disgusting crowd and rats returned. But then he let out a sigh of relief. The elevator was empty.
Within minutes, he was walking through the deserted on-call lounge area and, a moment later, keying his room. Once inside, he took off his jacket and draped it over the lone reading chair. Before collapsing on the bed, he needed to use the toilet.
Already fantasizing about what it was going to feel like to lie down and allow himself to fall asleep, he turned on his bathroom light with the wall switch, opened the bathroom door, and went to step inside. But then he froze with his foot suspended in the air and his hand still holding the doorknob. Inside the bathroom, hundreds of rats were emerging from the toilet and crawling all over one another, filling the entire floor, the shower, and even the sink with a seething mass of vermin.
With a shudder Mitt frantically yanked the door shut and reflexively stepped back, momentarily terrified that the rapidly expanding army of rats was about to break through and swarm the room. But then he quickly recovered. Remembering how his hallucinations had a tendency to disappear, he forced himself to step forward and regrasp the bathroom door handle.
After a brief hesitation to build up his courage, he cracked open the door. Seeing no vermin whatsoever, he pushed the door completely open. As he’d hoped, the room was free of the disgusting creatures. Allowing himself to enter, and despite significant unease, he quickly relieved himself. As he did so, it occurred to him that the more exhausted he became, the more frequently the hallucinations seemed to be appearing. They were now even invading his personal space. Whatever that meant, he had no idea, but he didn’t like it nor did it bode well for the future.
Chapter 22
Thursday, July 4, 2:02 a.m.
Like an exquisite torture, Mitt’s phone again rang seemingly the moment he’d fallen asleep. And on this occasion, it was particularly loud, as he’d put his phone on the bedside table instead of leaving it in his white jacket pocket. With the jacket draped over the reading chair and out of reach, he’d purposefully taken out the phone to have it within his reach. His hope was that if he was called yet again that night, he might be able to handle the issue remaining recumbent, without even getting to his feet. The downside was that it took a moment of frantic fumbling in the dark to find the damn thing and bring it up to his ear. By then his pulse was up over a hundred beats per minute.