"How are you, Donald?" David asked as he arrived at the bedside.
Donald was on his back. His bed was raised so that he was reclining at a forty-five-degree angle. When David spoke he slowly rolled his head to the side, but he didn't answer.
"How are you?" David said, raising his voice.
Donald mumbled something David couldn't understand. David tried again to talk with him, but quickly realized that the man was disoriented.
David examined him carefully. He listened intently to his lungs, but there were no adventitious sounds, indicating that his lungs were clear. Walking out to the nurses' station he ordered a stat blood sugar.
While the blood sugar was being processed, David saw his other patients. Everyone else was doing well, including Sandra. Although she'd been on antibiotics for less than twelve hours, she insisted the pain in her jaw was better. When David examined her, his impression was that the abscess was the same size, but the symptomatic improvement was encouraging. He did not change her treatment. Two other patients were doing so well he told them they could go home the following day.
As he was finishing his entry in the chart of his last patient, the floor secretary slipped the result of Donald's blood sugar under David's nose. It was normal. David picked up the scrap of paper and studied it. He didn't want it to be normal. He wanted it to explain the change in Donald's mental status.
David slowly walked back to Donald's room, puzzling over his condition. The only explanation that David could think of was that Donald's blood sugar had had a wild swing either up or down and had then corrected itself. The problem with that line of reasoning was that the patient's sensorium usually returned to normal simultaneous with the blood sugar.
David was still mulling over the possibilities when he reentered Donald's room. When he first saw Donald, David stared in utter disbelief. Donald's face was dusky blue and his head was thrust back in hyper-extension. Dark blood oozed from a half-open mouth. His body was only partially covered; the bedcovers were in total disarray.
David's initial shock quickly turned into motion. He alerted the nurses that there had been an arrest and started cardiopulmonary resuscitation. The resuscitation team arrived and followed their familiar routine. Even Donald's surgeon, Dr. Albert Hillson, came in. He'd been making round's when he'd heard the commotion.
The resuscitation attempt was soon called off. It was apparent that Donald had suffered a seizure and respiratory arrest somewhere between fifteen and twenty minutes prior to David finding him. With that amount of time having passed with no oxygen getting to the brain, there was no hope. David declared Donald dead at five-fifteen.
David was devastated at having lost yet another patient, but he forced himself not to show it. Dr. Hillson was saddened but expansive. He said that it had been a tribute to good medical care that Donald had lived as long as he had. When Shirley Anderson came in with her two young boys, she voiced the same sentiment.
"Thank you for being so kind to him," Shirley said to David as she blotted her eyes. "You had become his favorite doctor."
After David had done all he could, he headed toward Caroline's room to get Nikki. He felt numb. It had all happened so quickly.
"At least you know why this patient died," Angela said after David had described what had happened to Donald Anderson. They were sitting in the family room. Dinner was long since over; Nikki was up in her room doing her homework.
"But I don't," David complained. "It all happened so fast."
"Now, wait a minute," Angela said. "With the other patients I could understand your confusion. But not with this one. Donald Anderson had had most of his abdominal organs rearranged if not removed. He was in and out of your office and the hospital. You can't possibly blame yourself for his death."
"I don't know what to think anymore," David said. "It's true; he was always teetering on the edge with his frequent infections and his brittle diabetes. But why a seizure?"
"His blood sugar was wandering all over the map," Angela said. "What about a stroke? I mean the possibilities are legion."
The phone startled them both. David reached for it by reflex. He was afraid it was the hospital with more bad news. When the caller asked for Angela, he was relieved.
Angela immediately recognized the voice: it was Phil Calhoun.
"Sorry I haven't been in touch," Calhoun said. "I've been busy, but now I'd like to have a chat."
"When?" Angela asked.
"Well, I'm sitting here in the Iron Horse Inn," Calhoun said. "It's only a stone's throw away. Why don't I come over?"
Angela covered the phone with her hand. "It's the private investigator, Phil Calhoun," she said. "He wants to come over."
"I thought you were letting the Hodges affair go," David said.
"I have," Angela said. "I haven't spoken to anyone."
"Then what about Phil Calhoun?" David asked.
"I haven't spoken to him either," Angela said. "Not since Saturday. But I've already paid him. I think we should at least hear what he's learned."
David sighed with resignation. "Whatever," he said.
A quarter of an hour later when Phil Calhoun came through their door, David wondered what could have possessed Angela to describe him as professional. To David he appeared anything but professional, with a red baseball cap on backwards and a flannel shirt. The sorrels on his feet didn't even have laces.
"Pleasure," Calhoun said when he shook hands with David.
They sat in the living room on the shabby old furniture that they'd brought from Boston. The huge room had a cheap dance-hall feel with such meager, pitiful furnishing. The plastic bag taped to the window didn't help.
"Nice house," Calhoun said as he looked around.
"We're still in the process of furnishing it," Angela said. She asked if she could get Calhoun something to drink. He said he'd appreciate a beer if she didn't mind.
While Angela was off getting the beer, David continued to eye their visitor. Calhoun was older than David had expected. A shock of gray hair bristled' from beneath the red cap, which Calhoun made no attempt to remove.
"Mind if I smoke?" Calhoun asked as he brandished his Antonio y Cleopatras.
"I'm sorry, but we do," Angela said, coming back into the room and handing Calhoun his beer. "Our daughter has respiratory problems."
"No problem," Calhoun said agreeably. "I wanted to give you folks an update on my investigations. It's proceeding well, although not without effort. Dr. Dennis Hodges was not the most popular man in town. In fact, half the population seems to have hated him for one reason or another."
"We're already aware of that," David said. "I hope that you have more specific details to add to justify your hourly wage."
"David, please!" Angela said. She was surprised at David's rudeness.
"It's my opinion," Calhoun continued, ignoring David's comment, "that Dr. Hodges either didn't care what other people thought of him or he was socially handicapped. As a purebred New Englander, it was probably a combination of the two." Calhoun chuckled, then took a drink of his beer.
"I've made up a list of potential suspects," Calhoun continued, "but I haven't interviewed them all yet. But it's getting interesting. Something strange is going on here. I can feel it in my bones."
"Who have you spoken with?" David asked. There was still a rudeness to his voice that bothered Angela, but she didn't say anything.
"Just a couple so far," Calhoun said. He let out a belch. He made no attempt to excuse himself or even cover his mouth. David glanced at Angela. Angela pretended not to have noticed.
"I've talked to a few of the higher-ups with the hospital," Calhoun continued. "The chairman of the board, Traynor, and the vice chairman, Sherwood. Both had reasons to hold a grudge against Hodges."