Monica Yablonsky stiffened as he approached her desk, and she started to fidget with her glasses again.
"Mrs. Yablonsky, I want to see that list you were to prepare for me, the one Dr. Deloram used when he came here to interview patients who'd reported-"
"I know the one you mean, Dr. Garnet." She drew herself into a parade square stance, erect, as if ready for inspection. "Except I'm afraid it won't do you much good."
"Why?"
Her eyes avoided his. "There were only five names to begin with."
"Then I'll talk to those five."
"But you can't."
"And why not?"
"Three of them already died. The other two are comatose."
4:25 p.m.
Medical Records hadn't picked up the files of the deceased to store them in the archives yet, so he'd looked at them on the spot.
Two of the dead had been DNRs, not expected to survive much longer. The third had rallied last week and had been slated to go home for a few days. A code had been called for her. None of the clinical notes for any of them indicated a thing out of the ordinary in their deaths, except that all three had been discovered pulseless and not breathing just before dawn.
As for the two people in a coma, it took little more than a cursory glance at their recent lab results to see they'd been in bad shape to begin with, both having started the slide toward metabolic meltdown that often accompanies cancer patients in decline. Nobody found it unusual that they couldn't be roused as the nurses passed out breakfast trays that morning.
He returned the dossiers to Yablonsky's care without comment. She'd hovered about him as he'd glanced through them, appearing as uneasy about him going over the five cases as she had with his questioning her about Elizabeth Matthews's death. Let her sweat, he thought, figuring it might trip her up if she had something to hide. Because if his instincts and math were right, somebody sure did.
"The nurses who reported the near-death experiences- I'd like a list of their names," he told her.
She swallowed. "That might take a few days."
"I want it in twenty-four hours."
He rode to the ground floor at the back of the elevator, scowling. No physician liked coincidences, especially when it came to explaining matters of life and death. People died when and where they did for specific reasons. Failure to know those reasons meant he'd missed something until proven otherwise. Yet here he had five patients able to talk with Stewart Deloram on Friday who were unable to talk to anyone by Monday.
Unusual? Maybe not, he tried to tell himself, all at once following a talent he'd honed to a fine edge over the years: to play devil's advocate with his instincts. People died every day on a terminal ward. And those expected to pass on soon might have slipped into comas last night. Certainly the outcome for any of the five patients in question, taken individually, wouldn't raise suspicions. Natural causes could explain each one. Hell, if he tried to make a case otherwise, Wyatt could accuse him of dreaming up conspiracy theories to divert attention away from the Matthews inquiry. Still…
He went directly to his office and sat down at his computer. Using his newfound powers as VP, medical, he entered the codes that let him access the records of all departments. He pulled up Palliative Care, intending to see how many other people had died up there overnight and whether the three deaths were part of a larger than usual number. Not that that would mean much in itself. Some days were simply bloodier than others. Nevertheless, it would be interesting to know.
As a quick way to find out, he looked up discharges for Palliative Care this morning. There were six.
Was that a lot? He had no idea. He clicked up the average number for other mornings over the last few months and got 2.7.
"So there were three-point-four more bodies than usual," he muttered, impatient with how absurd statistics could seem at times. He also bet there were other days when the count would be just as high, and sure enough, when he requested a tally, he found that at least a dozen times in the last twelve weeks the morning dead had numbered six or more.
Yet three deaths and two patients slipping into a coma continued to disturb him because of the odds.
If he'd done the multiplication right, out of the hundred patients in palliative care, the chances that this would happen to the five Stewart talked to, all other things being equal, were one in nine trillion.
Which meant someone must have had a hand in their outcome.
But of course all things were never equal with a ward full of cancer patients. These five might have been closer to death than Wyatt thought, and maybe Stewart, in his perpetual readiness to take affront, had been wrong about their near-death accounts being bogus. They could have actually experienced what they reported because each of them really was about to die, and their deterioration was only nature taking its course.
In terms of probability that made far more sense than scenarios suggesting foul Play-He began to feel sheepish about his initial reaction. Perhaps he'd let his imagination get the better of him. Having arrived on the floor convinced that Stewart had been hiding something, and unclear what Wyatt might be up to, if anything, he'd failed to coolly consider all the possibilities. What a dumb-ass medical-student move. He didn't usually jump to conclusions like that. Of course, his already being suspicious of Yablonsky didn't help matters any, having primed him to think the worst.
But he damn well would insist that Stewart level with him about what exactly he'd thought was bogus when he talked with the five patients. And if even a hint turned up that Wyatt had tried to undermine Stewart's or any other researcher's credibility, he'd nail his hide. Whoa, there he went, leaping ahead of himself again. Better yank his urge to be in everybody's business back under control. Otherwise there'd be no end to the nastiness he might find. He'd taken the position of VP, medical to make his job of running ER easier, not to replace it with chasing down hospital shenanigans full-time.
He sat in the stillness of his office and felt the place weigh on him. Eight hundred beds, eight hundred souls, and if he weren't careful, every one of them would land a problem in his lap. And to think that just two days ago Jimmy had accused him of being too little involved with the rest of St. Paul's. Earl wondered if the real danger wasn't that he might get too entangled and be sucked dry. Because when he sensed something wrong, he couldn't let it slide.
But it was one thing to let the workings of an ER consume him. The tenacity that drove him not to quit on a patient took hold when trouble hit. His reflex as an ER physician was to leap on a problem the way he would a bleeder, well before it got out of hand. Yet he took the challenges in stride and inevitably, one way or another, found solutions. It all happened on a scale that never threatened to overpower him.
He leaned back in his chair and regarded the spartan furnishings- a steel-gray standard hospital-issue desk, two simple chrome chairs covered in black Naugahyde for visitors, a solitary potted plant that somehow survived the closed space and poor light from a grime-coated window the size of a cafeteria tray- and chuckled. The hospital CEO had offered him surroundings "much more suitable" to his new position, but he'd declined the upgrade, having always found it an advantage to demand sacrifice and best efforts from people if he himself worked out of an austere setting. The trick now would be to keep his perception of what needed fixing just as free of clutter.
He'd have to compartmentalize like never before, carefully choose his causes, and forget about charging off on wild hunches.
Keep everything at scale.
As for Yablonsky, well, he'd deal with her at death rounds.
Except something about her bothered him. She had definitely been edgy as he looked through those five files. Of course, just being around him could make her nervous, especially if his double-dose theory regarding Matthews was true. Yet..