"Not . . . at . . . the . . . moment . . . it . . . ain't."
"I'll give you some time to think it over, okay?" Ruth said, writing on the chart. "Talk it over with your wife. Let me know in a day or two."
Fred Walsh nodded and closed his eyes. Ruth replaced the chart at the foot of the bed and went on with her rounds.
An hour later it was blessed relief to put her feet up and relax with a cup of strong black coffee in the staff room. She'd take ten and then finish off the wards. No pathology lab tonight, unfortunately. Her duty didn't end till midnight and by then she'd be dog-tired.
The door swung open and Dr. Grant McGowan breezed in and helped himself to iced tea. McGowan was head of surgery, in his forties, and happily married with three children. He had a sympathetic ear for Ruth's grouses against Valentine, the chief pathologist, and the hospital at large.
"You still here?" she said, surprised.
McGowan scowled up at the clock. "I was on my way out when they caught me. Why do people choose such inconsiderate times to have cardiac arrest? I was all set to watch the fights on TV and I get paged at the damn door."
"Couldn't agree more'," Ruth said fervently. "All sickness and disease should stop at six p.m. on the dot. Germs and viruses knock off for the day and come back tomorrow."
MeGowan sat down in the armchair opposite and eyed her critically. "You look beat, Ruth. What is it? Too much work, not enough sleep, or both?"
"Old age."
"Are you still working in the path lab after hours?" At her nod he shook his head and sighed. "You know you're asking for trouble, don't you? Being a resident on the wards is a full-time job without waging a one-woman crusade in the name of medical science. We don't have the staff, the resources, or the backup for that."
"You sound like Valentine," Ruth replied testily.
"Christ, I hope not," said MeGowan with feeling. "Look, Ruth, I know the work is important and that somebody ought to be doing it, but why you? It isn't as if you were getting paid to do it."
"It isn't a question of money; it's what I want to do. What I must do."
"I didn't mean to imply--"
"You didn't imply anything, Grant." Ruth smiled at him. "I'm just thankful--really and truly--that you're around to talk to. Valentine thinks the diagnostic work I did in Denver isn't worth shit. At least you recognize it's worthwhile."
She arched back in the chair, massaging the nape of her neck with her fingertips. Pale and tired as she was, MeGowan couldn't bring to mind many women as sexually attractive and good-looking. Short, dark, naturally curly hair framed an oval face in which her full lips and vibrant dark eyes would have inspired a Goya. Gypsy eyes. There was something of the same passion and intensity in her personality, too. . . .
With a guilty start he swiveled around to look at the clock, then hurriedly finished off his tea. "Better get along before they start without me. See you tomorrow." He strode to the door and paused there. "And listen, Dr. Patton, get a good night's rest. Forget Manhattan Emergency even exists."
"Yes, sir, Dr. MeGowan." Ruth wrinkled her nose at him as he went out. Easier to forget you had a raging toothache.
She got up and went to the window and gazed down into the tunnel of smog that was East Sixty-eighth Street. She recalled her first visit to New York as a teen-ager, the thrill and excitement of the electric city. Just to stroll down Fifth Avenue was in itself a magical experience. The tall buildings gleaming in the sunlight, the haute couture shops and bustling department stores, the vendors on every street corner assailing the senses with mouth-watering smells--all the crazy mad whirl of big-city life that was like a shot of pure adrenaline into the bloodstream.
And the people!
Elegant women who had stepped straight out of a Vogue fashion plate, slender-hipped black dudes in soft wide hats and dazzling striped suits lounging behind the tinted windows of long limousines; old bags in threadbare fur wraps; goggled-eyed tourists trying not to look battered and bewildered; poets, prophets and cretins addressing the passing parade from the gutters.
The smile of fond remembrance faded. Nobody strolled down Fifth Avenue anymore. If you tried it without a respirator you could manage maybe fifty paces before collapsing facedown on the sidewalk and coughing up shreds of pink lung tissue. She'd seen that happen, and more than once. From the safety of a sealed car she'd observed a couple of down-and-outs, a man and a woman, slumped against the granite base of Rockefeller Center. Gray exhausted faces. Eyes blood-red and streaming from the photochemical irritants in the air. Lips drawn back in a ghastly snarl of abortive inhalation.
That had been during her first week in New York, almost three years ago.
Her friends and colleagues back in the wide clear spaces and mountains of Colorado had thought her deranged. What in heaven's name had possessed her to exchange a responsible well-paid research job in a decent part of the country for a thankless and disgusting last-ditch stand in the foul canyons of New York City? She wasn't cut out to be a Florence Nightingale. What a criminal waste of talent and brains. Stay in Denver, they had urged her, where you can live a decent life and make a real contribution.
Sometimes she thought they were right and wished she had. What exactly did she think she was achieving here? Saving one old guy because he happened to remind her of her grandfather? When hundreds --thousands--were rotting outside? And she wasn't even saving Fred Walsh, Ruth reminded herself brutally. Only passing him on to a special clinic where they would test another new batch of drugs on him in the hope that one of them would work a minor miracle.
Every day now, several times a day, she searched her thirty-five-year-old face in the mirror for a hint of the ravages to come. Inevitably they would. Everyone who' stayed in the city was affected, sooner or later.
Emphysema. Anoxia. Pollution.
Together they were a lethal combination. But that was only the start of the story. What now seemed to be happening was that a new range of viral infections and diseases was taking over from the age-old diseases such as polio, smallpox, malaria, typhoid, and yellow fever, which medical science had conquered. Medical theory said that environmental changes over the past quarter century had triggered off a new and mysterious strain of illnesses. There was Reye syndrome, which attacked children between the ages of five and eleven, and killed nearly a third of all those who contracted the disease. Cause unknown. There was Lyme disease, in which patients suffered skin lesions and painfully swollen joints caused by bites from the tiny parasite Ixodes dammini, which until recent years had been a harmless pest. There was infant botulism, where a highly toxic bacterium in the form of spores found in the dust on fruit and vegetables produced a nerve poison in the intestines of babies up to a year old. There were hemorrhagic fevers, the generic term for a group of virus-related illnesses from which up to 90 percent of the victims died.
Somehow, in a way not yet properly understood, chemical changes in the environment had created the conditions that were ripe and ready for new plagues to replace the old.
Ruth's experience with the Diagnostic Research Unit in Denver had hardly been adequate to cope with this. And so far she'd received scant support in setting up a clinical investigative facility here in New "lork.
Although quite a lot was known about emphysema--the fusing together of the air sacs in the lungs, which reduces the total area of efficient oxygen-carbon dioxide interchange--anoxia had never until now been thought of as a chronic condition. The only people known to suffer from it in the past were airmen, mountaineers and deep-sea divers. Ruth had read up on the subject, combed through textbooks and medical journals, and talked with air force doctors and physiologists in an effort to understand the nature of the condition.