“Grabbed it?” Dr. Nawaz yelled. “What necessitated her having to grab the frame?”
There was an uncomfortable pause as Paul and Carl exchanged glances.
“What is this, a conspiracy?” Dr. Nawaz demanded. “Somebody answer me!”
“There was kind of a whiplash effect,” Carl said. “I was in a hurry to get the patient back on the monitor, so we were pushing the table rather quickly. Unfortunately, it wasn’t aligned with the OR doorway. After the bump occurred, Constance came over to support the frame. She was still gowned and gloved. At that point, we were concerned about contamination, since the patient had awakened and his hands weren’t restrained. But there wasn’t any contamination.”
“Why didn’t you tell me all this when it happened?” Dr. Nawaz snapped.
“We did tell you,” Paul said.
“You told me the table brushed the door frame. That is a far cry from hitting it hard enough to cause whiplash.”
“Well, whiplash might be an exaggeration,” Carl said, correcting himself. “The patient’s head fell forward. It didn’t snap back or anything like that.”
“Good God!” Dr. Nawaz mumbled with discouragement. He sat down heavily in a desk chair. He pulled off his surgical hat with one hand and gripped his scalp with the other while he shook his head in frustration. He couldn’t believe he’d allowed himself to get caught up in such a burlesque affair. It was now clear to him that the stereotaxic frame had to have slightly rotated as well as tipped down, either on impact or when the scrub nurse grasped it.
“We’ve got to do something!” Daniel said. It had taken him a moment to recover from the revelation about the OR table’s collision with the doorframe and its possible tragic consequences.
“And what do you suggest?” Dr. Nawaz questioned derisively. “We’ve mistakenly implanted a host of rogue, dopamine-producing cells in the man’s temporal lobe. It’s not like we can go back in there and suck them out.”
“No, but we can destroy them before they arborize,” Daniel said, with a flicker of hope beginning to crackle like a fire in his imagination. “We have the monoclonal antibody to the cell’s unique surface antigen. Instead of attaching the antibody to a heavy metal like we did for X-ray visualization, we bind it to a cytotoxic agent. Once we inject this combination into the cerebrospinal fluid, bam! The misplaced neurons are annihilated. Then we merely do another implantation on the patient’s left side, and we’re home free.”
Dr. Nawaz smoothed back his shiny black hair and gave Daniel’s idea a moment of thought. On the one hand, the idea of potentially rectifying a disaster for which he shared a significant responsibility was enticing, even if the method was unorthodox, but on the other hand, his intuition told him he shouldn’t allow himself to be dragged in any further by doing yet another highly experimental procedure.
“Do you have this cytotoxic antibody combination on hand?” Dr. Nawaz asked. There was no harm in asking.
“No,” Daniel admitted. “But I’m certain we could get it concocted on a rush basis by the same firm that supplied us with the antibody heavy-metal combination, and then have it overnighted.”
“Well, you let me know if and when you get it,” Dr. Nawaz railed as he stood up. “I said a second ago that we couldn’t go back in and suck out the misplaced treatment cells. The unfortunate irony is that if nothing is done and the patient ends up with the kind of temporal lobe epilepsy he most likely will, he’ll probably have to undergo something along those lines in the future. But it would be serious, ablative neurosurgery, requiring the removal of a lot of brain tissue with high attendant risk.”
“That strengthens the rationale for doing what I have proposed,” Daniel said, progressively warming to the idea.
Stephanie abruptly pushed away from the countertop and headed for the door. Her fragile emotions and fear of calling attention to herself notwithstanding, she couldn’t bear to hear another word of this exchange. It was as if the conversation involved an inanimate object rather than an iatrogenically stricken fellow human being. She was particularly appalled at Daniel, because she could tell that despite the dreadful complication, he was still maneuvering like a modern medical Machiavelli, in blind pursuit of his own entrepreneurial interests despite the moral consequences.
“Stephanie!” Daniel called, seeing her heading for the door. “Stephanie, why don’t you call Peter up in Cambridge and have him…”
The door closed behind Stephanie, cutting Daniel’s voice off. She began to run down the hall. She fled toward the ladies’ room, where she hoped she could cry in peace. She was upset about a lot of things, but mainly because she knew that she was as responsible as anyone for what had happened.
twenty-seven
7:42 P.M., Sunday, March 24, 2002
“Now, I do not mean to be a bother to you talented folks,” Ashley said, drawing out the words in his prototypal drawl. “And I do not mean to seem unappreciative of all your efforts. I apologize from the bottom of my heart if it distresses you, but there is no way I can stay here tonight.”
Ashley was sitting up in a hospital bed with the back cranked up as high as it would go. Gone was the hospital johnny, and in its place was his wacky tourist outfit. The only evidence of his recent surgery was a double-wide bandage on his forehead.
The room was one of the Wingate’s inpatient rooms, and it appeared more like a hotel than a hospital. The colors were all bright tropical hues, particularly the walls, which were peach, and the drapes, which were a combination of seafoam green and hot pink. Daniel was standing to Ashley’s immediate right in his efforts to dissuade the senator from leaving the clinic. Stephanie was standing at the foot of the bed. Carol Manning was ensconced in a purple club chair near the window with her shoes on the floor and her feet tucked in underneath her.
After the CAT scan, Ashley had been brought to the room and put in the bed to sleep off his sedation. Both Dr. Nawaz and Dr. Newhouse had left after they were certain Ashley was stable. Both had given Daniel cell phone numbers to be called if and when there was a problem, particularly a seizure recurrence. Dr. Newhouse had also left a vial of the fentanyl and diazepam combination that had been so effective, with the instructions that two cc’s should be given either intramuscularly or intravenously if the need arose.
Technically, Ashley was under the care of an impeccably groomed nurse by the name of Myron Hanna, who had been the Wingate Clinic’s recovery room nurse back in Massachusetts. But Daniel and Stephanie had stayed at the bedside, along with Carol Manning, for the four hours it had taken Ashley to wake up. Paul Saunders and Spencer Wingate had stayed for a while as well, but they had left after an hour with assurances that they too could be reached if needed.
“Senator, you are forgetting what I told you,” Daniel said with as much patience as he could muster. At times, it seemed that dealing with the senator was like dealing with a three-year-old.
“No, I understand there was a little problem during the procedure,” Ashley said, quieting Daniel by laying his hand on Daniel’s folded arms. “But I feel fine now. In fact, I feel like the spring chicken that I know I’m not, which is a tribute to your Aesculapian powers. You told me before the implantation that I might not notice much change for a few days, and even then it might be gradual, but that is clearly not the case. In comparison to how I felt this morning, I’m already cured. My tremor is almost gone, and I am moving with considerably more ease.”
“I’m glad you feel that way,” Daniel said with a shake of his head. “But it’s probably due more to your positive attitude or to the strong sedatives you were given than anything else. Senator, we believe you need more treatment, as I told you, and it is safer to remain here in the clinic, with all the medical resources at our fingertips. Remember, you had a seizure during the procedure, and while you were having the seizure, you acted like a completely different person.”