"Jesus. Okay, I'm going in," Eric said. "Someone page the cardiac people. Stat."
"Wait!" June Feldman was staring down at her fingertips. "Wait… Yes, I've got a pulse. I've got a pulse." At virtually the same instant, the central venous pressure level began to drop. The arterial pressure monitor kicked in at 70 over 30. Seconds later' it read 90.
Subarsky, cool as snow, nodded as if the wholeaffair were routine, but two of the nurses began to applaud.
"I've never seen anything like that in my life," one of them exclaimed.
"Never."
"Neither have I," Eric muttered, softly enough for no one to hear.
Russell Cowley's coloring improved almost as dramatically as had his blood pressure and CVP. His breathing grew strong and steady. And within two minutes, his eyes fluttered open.
NO One spoke- Eric studied the faces around him.
Their expressions were a wonderful mix of awe and jubilation, It was the prolonged silence of a concert audience who had just experienced the music of a master.
And Eric relished every bit of it.
Through the open doorway, he saw Tern Dillard approaching.
No, not yet, dammit, his thoughts hollered. This is my moment.
Not yet.
':Everything okay?" Tern asked.
'Look for yourself."
He motioned toward Cowley.
"Nice going. Eric, the cardiac people are on their way down.
You've really got to come in and help Kaiser."
"Lord. Any change in the diver?"
"No."
"So what's to help?"
"Eric, please."
"Okay, okay. June, have the cardiac service admit this guy to them with ortho as consult. I'll be back in a few minutes." He glanced over at Tern. "Maybe sooner.
Gary Kaiser annoyed Eric more than any resident he had ever known.
He was immature, indecisive, and nervous as hell in all but the most routine situations.
It was no surprise to see him running a full Code 99 on a derelict who looked as if he had been dead for hours.
"Gary, what gives?" Eric asked.
The scene was subdued, in sharp contrast to the action and energy surrounding Russell Cowley. A nurse was doing CPR while a respiratory therapist was ventilating the man through an endotracheal tube.
Nursing supervisor Norma Cullinet was assisting another nurse in keeping notes on the code and administering meds.
Kaiser, a rosy-cheeked enlargement of the Pillsbury Doughboy, glanced down at the E.K.G machine.
"Nothing," he said.
"Nothing? Do you think this is the result of a coronary.
"I… I imagine so." The E.K.G pattern showed a straight line with an ineffectual electrical pulse every ten or fifteen seconds. It was the sort of complex that often persisted for hours after a patient was clinically dead.
"Who is this man?"
Reflexively, Eric motioned the nurse to stop her CPR while he checked the man's groin and neck for pulses. There were none. He motioned her to start up again.
"A John Doe," Kaiser said. "We've been working on him for almost fifteen minutes."
"Why?"
"Why?" Kaiser shifted nervously. "Well, he had those beats on his E.K.G."
"Those beats mean nothing more than a dead heart."
"And… and his temp was only ninety-six. I…
I thought we should try to warm him up a bit before calling off the code."
As usual, Kaiser was performing mindless, cookbook medicine. it was a maxim in most hypothermic situations to warm the patient before calling off a resuscitation. But ninety-six was hardly hypothermia, and this man was clearly beyond help.
"So," Eric said, "what do you want to do?"
He checked the man's pupils, which were wide and lifeless.
"Do? no, I.- I was sort of hoping you'd take over here so I could get back to the walk-ins."
"Kaiser, what branch of medicine are you going into?"
"Well, I… I've just been accepted in dermatology residency for next year."
"Excellent. I think that's a perfect spot for you. you are excused."
"What?"
"I said, leave. Go back to your walk-ins. I'll take over here."
"You sure it's okay?"
"It's more than okay, Gary. It's an order."
His moon face flushed with crimson, Gary Kaiser backed from the room.
"Dermatology," Eric muttered as he turned his attention to the derelict.
"Thank God for dermatology." The man, unshaven and unkempt, smelled of the alleys. He was dressed in soiled long johns, a frayed checked hunting Jacket, and tattered pants, all of which had been — cut away during his attempted resuscitation. He had a scar on his abdomen-possibly from an old exploratory. There was a tattoo on one hip and a bruise and healing abrasion on his forehead. Eric flashed on the corporation president lying two rooms away, and wondered what the cardiac team was saying about the remarkable save.
"Eric, do you want me to keep pumping?" the nurse asked.
"Huh? Oh, keep at it for a few moments more while I get oriented.
Thanks. You're doing a great job.
Did Kaiser give him anything?" Eric asked the second nurse.
"The usual. Epinephrine, atropine. There's an Isuprel drip running now."
"Right by the ol' cookbook."
"Pardon?"
"Nothing. Norma, do we know who this man is?"
"John Doe. That's all we have."
"well, for my money this is an exercise in futility.
Any objections if I call it off, and we all go about trying to save the living? Good."
Eric studied the end-stage cardiac activity for a few more moments. With the most vigorous efforts, and a great deal of luck, they might be able to reestablish some sort of more effective heartbeat. But with no blood pressure and fixed, dilated pupils, what then?
The time for battle had passed, probably well before the rescue squad had even arrived. He sighed and then reached up and flipped off the monitor.
"That's it," he said. "Thank you all. Norma, i want to get back in with that other Priority One. Can you take over and call the medical examiner about this guy?"
"No problem," the supervisor said.
"Also see what you can do about finding a next of kin. I'll talk to whoever it is, if you want."
Eric turned and hurried from the room without waiting for a reply.
He wanted to be with his save for as long as possible before the cardiac team took the man away.
Norma Culfinet assisted one of the nurses in removing the derelict's IV and endotracheal tube.
Then she wheeled the sheet-covered body out of the room.
You needn't worry about a next of kin, Dr. Najarian, she was thinking. You see, I know for a fact that there isn't any.
Entering the crosswind leg of its landing sequence, the Delta 727 banked sharply, giving Laura Enders an expansive view of Washington, D.C. She had been there once as a ten-year-old, on the only trip she and Scott had ever taken with their parents, and had returned to their Missouri farm determined to become someone of importance.
Now, she pressed her forehead against the Plexiglas window and tried to remember exactly what it was she had wanted to be.
Her flight from Little Cayman Island via Grand Cayman and Miami had been uneventful, but the few days preceding it-the phone calls, the trips to the bank on the main island, the search for someone to replace her at work-had ranged from hectic to frantic. For nearly three years she had been the scuba diving instructor and guide at the Charles Ray Club, the only resort on the tiny Caribbean paradise. It was an experience that had transformed her. But now-at least until she found Scott-it was over.
When she had first arrived at the club as a guest, she was pale, hollow-eyed, emotionally drained, and physically flabby. It took just ten days of vacation there for her to decide not to return for her fifth year of teaching special education at Montgomery High School.