The engine turned over and over, but it would not start. She took out the key and closed her eyes. She was shivering violently. Why wouldn’t the car start! She tried again with the same result. Looking at the IV she realized the bottle was almost empty. Shaking, she removed the cover, from the second bottle. Even during the few minutes it took to make the exchange she could feel the effect. There was no doubt in her mind that when the glucose ran out, she’d most likely lose consciousness.
She decided her only chance now was Patricia’s phone. Emerging from the garage into the rain, Cassi rounded the building and ran to Patricia’s door. Still holding the IV bottle above her head, she rang the buzzer.
As on her previous visit, Cassi was able to see Patricia descend the stairs. She came slowly, warily peering out into the night. When she recognized Cassi and saw her holding aloft an IV bottle, she quickly fumbled with the door and threw it open.
“My God!” said Patricia, noticing Cassi’s pale, perspiring face. “What happened?”
“Insulin reaction,” managed Cassi. “I have to call an ambulance.”
Patricia’s face registered concern, but seemingly paralyzed with shock, she did not get out of the way. “Why didn’t you call from the main house?”
“I can’t. The phones are out of order. Please.”
Cassi blundered forward, pushing clumsily past Patricia. The movement caught Patricia by surprise and she stumbled back. Cassi didn’t have time to argue. She wanted a phone.
Patricia was incensed. Even if Cassi wasn’t well, she didn’t have to be rude. But Cassi had turned a deaf ear to her mother-in-law’s complaints and was already dialing 911 when Patricia caught up to her in the living room. To Cassi’s relief, this time she could be heard by the emergency operator. As calmly as she could, she gave her name and the address and said she needed an ambulance. The dispatcher assured her that one would be there immediately.
Cassi lowered the receiver with a trembling hand. She looked at Patricia, whose face reflected confusion more than anything else. Exhausted, Cassi sank to the couch. Patricia did the same, and the two women sat quietly until they heard the sirens coming down the drive. The years of unspoken antagonism made communication difficult, but Patricia helped Cassi, who was now nearly unconscious, down the stairs.
As Patricia watched the shrieking ambulance race back across the salt marsh, she had a moment’s real sympathy for her daughter-in-law. Slowly she went back upstairs and called Boston Memorial. She felt her son should try to meet his wife at the local hospital. But Thomas was in surgery. Patricia left word that he should call as soon as possible.
Thomas glanced down at the clock on the instrument panel. It was 12:34 A.M. The charge nurse had given him Patricia’s message the moment he came out of the OR at 11:15. When he’d spoken to his mother she’d been very upset, telling him what had happened. She chided him about having left Cassi alone and urged him to go to the local hospital as fast as he could.
Thomas had called Essex General, but the nurse hadn’t been able to say yet how Cassi was doing. She just told Thomas that she’d been admitted. Thomas didn’t need any urging to hurry. He was desperate to find out Cassi’s condition.
At the red light the block before the hospital, Thomas slowed but did not stop. When he reached the hospital grounds, he turned so sharply the wheels of his car squealed in protest.
The front desk of the hospital was deserted. A small sign said INQUIRIES GO TO EMERGENCY. Thomas sprinted down the hall.
There was a tiny waiting area and a glassed-in nurses’ station. A nurse was having coffee and watching a miniature TV set. Thomas pounded on the glass.
“Can I help you?” she asked with a strong Boston accent.
“I’m looking for my wife,” said Thomas nervously. “She was brought in here by ambulance.”
“Would you mind sitting down for a moment.”
“Is she here?” asked Thomas.
“If you’ll sit down, I’ll get the doctor. I think you’d better talk to him.”
Oh God, thought Thomas as he turned and obediently sat down. He had no idea what was coming. Luckily he didn’t have to wait long. An Oriental man in a crumpled scrub suit appeared, blinking in the bright fluorescent light.
“I’m sorry,” he said, introducing himself as Dr. Chang. “Your wife is no longer with us.”
For a moment Thomas thought the man was telling him Cassi was dead, but then the doctor went on to say Cassi had signed herself out.
“What?” shouted Thomas.
“She was a doctor herself,” apologized Dr. Chang.
“What are you trying to say?” Thomas tried to stifle his fury.
“She arrived suffering from an insulin overdose. We gave her sugar and she stabilized. Then she wanted to leave.”
“And you allowed her to.”
“I didn’t want her to leave,” said Dr. Change. “I advised against it. But she insisted. She checked out against medical advice. I have her signature. I can show you.”
Thomas grabbed the man’s arms. “How could you let her leave! She was in shock. She probably wasn’t thinking clearly.”
“She was lucid and signed a release form. There wasn’t much I could do. She said she wanted to go to the Boston Memorial. I knew she’d get better care there. I’m not a specialist in diabetes.”
“How did she go?” asked Thomas.
“She called a taxi,” said Dr. Chang.
Thomas ran back down the corridor and out through the front door. He had to find her!
Thomas drove recklessly. Luckily there was almost no traffic. After a brief stop at home, he headed back into Boston. When he pulled into the parking garage at the Memorial it was just before 2:00 A.M. He parked and ran into emergency.
In contrast to Essex General, the ER at the Memorial was flooded with patients. Thomas ran straight to the admitting office.
“Your wife hasn’t come into the ER,” one of the clerks told him.
The other clerk punched Cassi’s name into the computer. “She hasn’t been admitted either. It shows she was discharged this morning.”
Thomas felt a sinking feeling in the pit of his abdomen. Where could she be? He had only one other thought. Maybe she’d gone up to Clarkson Two.
Although he’d never stopped to wonder why, Thomas did not like to be on the psychiatry floor. It made him feel uncomfortable. He didn’t even like the sound the heavy fire door made when it closed behind him with its airtight seal.
As he walked down the dark corridor, his heels echoed loudly. He passed the common room where the TV was still on although no one was watching. At the desk a nurse who’d been reading a medical journal looked up at him as if he were one of the patients.
“I’m Dr. Kingsley,” said Thomas.
The nurse nodded.
“I’m looking for my wife, Dr. Cassidy. Have you seen her?”
“No, Dr. Kingsley. I thought she was on medical leave.”
“She is, but I thought she might have come in here.”
“Nope. But if I see her I’ll tell her you’re looking for her.”
Thomas thanked the woman and decided to go to his office while he tried to figure out what to do.
As soon as he opened the door he went to his desk to get several Talwin. He took them with a splash of Scotch, then sat down. He wondered if he were getting an ulcer. He had a boring pain just below his sternum that he also felt in his back. But the pain he could live with. What was worse than the pain was the pervasive anxiety. He felt as if he were about to shatter into a million pieces. He had to find Cassi. His life depended on it.
Thomas pulled over the phone. Despite the hour, he called Dr. Ballantine. Cassi had spoken to him before, and there was a chance she’d approach him again.
Dr. Ballantine, groggy with sleep, answered on the second ring. Thomas apologized and asked if he’d heard from Cassi.
“I haven’t,” said Dr. Ballantine, clearing his throat. “Is there some reason I should?”
“I don’t know,” admitted Thomas. “She was discharged today, but after I took her home I had to come back to the hospital for an emergency. When I got out of surgery there was a message to call my mother. She told me Cassi had apparently given herself another overdose of insulin. An ambulance took her to the local hospital but by the time I got there she’d signed herself out. I have no idea where she is or what state she’s in. I’m worried sick.”