Declared Dead - Couverture souple

Proulx, Suzanne

Couverture souple

ISBN 10 : 0449007081 ISBN 13 : 9780449007082

Editeur : Fawcett Books, 2002

Synopsis

Book by Proulx Suzanne

A propos du livre

Extrait :

Monitor

The number three cardiac catheter monitor had nearly killed somebody, for the third time in as many weeks, and I'd had enough. I clamped my phone between my head and my shoulder and, while a lab equipment tech babbled something about checking out subroutines, scrabbled through my top drawer seeking tools. I found various pens, an eyeglass repair set, and a stubby Phillips screwdriver, none of which seemed up to the task. I had a Swiss army knife, which I pocketed even though it didn't seem up to the task either.

About the time the lab tech finished his spiel I located a pair of vise grips in my bottom drawer. I grabbed them, hung up the phone, and headed for the cath lab. The long walk did nothing to calm me down.

Cardiac catheterizations, or angiograms, are fairly routine, at least for the folks who perform them. Our cardiology unit does nearly a thousand a year, sometimes in conjunction with surgery and sometimes simply as a diagnostic tool. Out of that thousand we'd had only twenty bad incidents in the last year, and eighteen of those were linked to this monitor, one of three. I couldn't believe nobody had made the connection except me.

The cardiology unit was quiet. I slipped into the cath lab without being seen, not that I tried for stealth. The monitor, about the size of a refrigerator, with a keyboard and printer in the front, sat in the dimly lit room with its colored lights blinking malevolently. It should have been in the hall with an Out of Service sign on it.

Yesterday a patient suffered a heart attack right after being hooked up to the monitor, but before the procedure had begun. A week ago the monitor screen went blank as the cardiologist threaded the catheter through the artery, and then blasted out an alarm causing the doctor, who was already edgy, to nick the artery, necessitating emergency surgery. Two weeks ago, a patient's heart stopped just as the catheter entered the left ventricle, and while the cardio team observed the cessation of pumping action on the fluoroscope, the monitor happily spit out evidence indicating things were just fine.

I considered this a direct assault on patients. Nobody knew what was wrong with this monitor, hence nobody could fix the problem. Therefore, the equipment techs went into denial, whining that it wasn't the monitor's fault the patient had a heart attack. Couldn't be.

I didn't care. The first thing I did was unplug it, so it wouldn't kill me before I killed it. Not that this would be really helpful, since it had a powerful backup battery pack.

Then I studied the best way to do it in. Smashing the vise grips into various parts might be effective but lacked finesse. Still, since I didn't know how the thing worked, or rather, failed to work, I needed to do some obvious damage. I also realized that, even though it was unplugged, I should still avoid places that contained high-voltage warning signs.

The only warning sign I saw at all, a black-on-orange sticker on the front, read caution. refer to manual before connecting patient. I wondered if anyone had tried that.

I ripped off a couple of dials and bent the metal edge of the printer. The vise grips were a waste, so far. I could have done this with my bare hands, although I probably would have broken my nails. I wondered what the incident report would say, when it came through my office. Maybe somebody would think that a maintenance person, changing the light bulb, dropped some kind of tool on it. Yeah, that sounded good.

I didn't quite have the nerve to smash out the video screen, although that would have disabled the monitor for sure. With some effort I shoved it a little farther from the wall and went for the back, where all the connections were. Now here was something I could sink my hand tools into. I pulled out cables, twisted wires, bent some pieces of metal and crushed others, all the while waiting for the telltale Szzzt! that would mean I was fried. Instead I heard:

"What the fuck?"

I glanced over my shoulder. A guy with fuzzy hair, wearing a white coat that could mean he was a doctor, but could also mean he was a lab tech, stared at me over his spectacles.

"This machine." I looked for an M.D. tag on his jacket and didn't see one. I could feel myself glowing with effort and possibly, hatred. "How come nobody can figure out what's wrong with this thing and either fix it or take it out of service?"

"Who the hell are you?"

I smashed idly at some connectors on the back of the monitor. "I'm the risk manager." I did not add that I was also acting general counsel, because I was sensitive about it. Acting general counsel.

"Can I ask why you're doing this?"

"Sure," I said. "This machine wants to kill people."

"The patient experienced an aortic infarction before we had even made an incision," he said. "Not the machine's fault. The patient had a known heart defect. He was lucky he was here when it manifested."

So this guy was familiar with the last case, at least. "I understood that he had the problem before you made the incision but after he was hooked up to the monitor," I said. "So you can't be sure the monitor is blameless, can you?" I wished I knew enough to throw around the language the tech had used, subroutines and such.

"Correct, he was connected to the monitor; otherwise we might not have realized he was in trouble."

"Otherwise he might not have been in trouble." I used the vise grips as pliers to mash some connectors together. The monitor didn't strike me dead, although the doctor looked as if he'd like to.

He spoke with obvious restraint. "It's ridiculous to believe the monitor had something to do with the situation. The electrical impulses go from the electrodes on the subject's skin into the monitor, not vice versa, and in any case the electrical impulses are slight."

I bit my lip. I knew that. But something about this monitor was way off.

"To believe otherwise," he said, "is like--I don't know--like believing in astrology."

"You know it wasn't just the one patient," I said.

"It's been checked out," he said. "The techs just left."

"Hah," I said. "They told me they couldn't find a problem. Therefore it was okay. But it's not okay." And with any luck it would never be okay again.

"We need this monitor," he said. "It provides the most sophisticated functions of any of them."

"We need it like we need a recession," I said, "or several more lawsuits. This monitor is not right. It's a lemon. It has deep, unresolved problems, okay? It must be stopped."

"It isn't rational to personify a piece of equipment." He stepped closer to read the hospital ID that identified me as Vicky Lucci, Risk Manager. I held it toward him, meanwhile reading his own. Richard O'Grady, M.D. And rationalist. His stubborn jaw was accented by one of those annoying little jawline beards.

"It's a murderous inhuman piece of metal," I said. "It's--that is, it was--dangerous." I pushed my bangs out of my eyes. I figured I'd done enough damage. I flipped my vise grips up over the keyboard, then caught them by the handle before they hit--a little grandstanding that could have been dangerous, but only to my image, if I'd missed.

Okay, I would have felt better performing an all-out assault, with pieces of flying metal and lots of noise. Can't have everything. At any rate it would be a few days before anyone else was hooked up to that cardiac cath monitor.

"You're insane," O'Grady said calmly. "This is a hundred-thousand-dollar piece of equipment you've vandalized."

"A sixty-thousand-dollar piece of equipment," I corrected as I walked out. "And it's insured."

When I got back to my office, my ten o'clock appointment was waiting in the reception area. Jenna McLaren. Some months before, apparently, the hospital had somehow killed her sister. I'd forgotten all about her, and I was late.

I shifted the vise grip to my left hand to shake hands, and she performed a similar shift with a large manila envelope. My secretary had made the appointment yesterday and hadn't gotten the sister's name, so I hadn't pulled the chart to figure out what the problem might have been. I asked her if she wanted coffee--she didn't--then led her back to my office.

I couldn't remember if I'd met her at the time of the incident. I meet a lot of people, particularly grieving family members, and Jenna McLaren was not somebody who would have stood out. But I didn't even remember an incident, so I assumed there had been no question about the circumstances of her sister's death.

She had light brown hair pulled back in a clip, revealing a widow's peak, a heart-shaped face, delicate coloring, and one-carat diamond studs in each ear along with a second, dangling earring in her right ear. She sat down in one of the chairs in front of my desk and I sat in the other, instead of behind the desk.

"I'm very sorry about your sister," I said, and waited for her to tell me what Montmorency Medical Center could do to make her feel better about a young woman's untimely death.

"Oh," she said. "Thanks. Um . . ."

She fingered the envelope and didn't meet my eyes. I let the silence settle around us--not that it was really silence, since the whine of a drill from construction workers outside made my windows rattle, pretty much continuously. After a minute I asked, "How can we help you?"

She sighed. "I don't know that you can, really. Really, this is just something I . . . thought you should know about." She held the envelope toward me, and just as I reached for it she pulled it back.

Uh oh. A real tease.

She opened it herself, slowly, peered inside the envelope, then pulled out a one-page document, which she glanced at before, finally, handing it to me. A death certificate. I scanned it. Cause of death: (1) cardiopulmonary arrest, (2) myocarditis. Other significant symptoms: (1) Pleural effusions. Signed by Dr. Jeremy Fitzhugh. Apparently, no autopsy had been performed. Place of death: here. Date: August 29 of this year. I didn't spot anything obviously wrong.

Jenna watched me intently.

Okay. It was a test. I looked back at the document.

Then I caught it. The name of the deceased was Jenna Louise McLaren. I was meeting with a ghost.

2

Certificate

A death certificate is a very intimate document. Reading it, I learned that Jenna Louise McLaren had been born in New Jersey forty-one years ago--she didn't look it--to Jolena Arendt, who was born in Hungary in 1917, and Mason Menlo McLaren, who was born in Arkansas in 1925. Jenna was single, at the time of her death living in Wheat Ridge, Colorado. Her usual profession was homemaker.

Of course the fact that Jenna McLaren was alive and sitting in front of me cast a certain amount of doubt on all other information on the death certificate.

I confirmed it again. "You're Jenna."

"You want to see my driver's license?"

It seemed like a good idea. While she fumbled with her purse, I asked, "What's your sister's name?"

"Ohh." She pulled her billfold out of her purse. "It's, it was, Marnie. Marnie Jolene. McLaren."

Sometimes I think better with paper in front of me. I rolled my chair behind my desk, flipped open a notebook, and wrote the name down. Jenna jiggled her foot.

"Or sometimes she used Edmonds. She's, she was married to Dash Edmonds--the dancer--but she didn't necessarily use his name."

She spoke as though I ought to have heard of Dash Edmonds the dancer. Had he been Dash Edmonds the quarterback I'm sure I would have.

She handed the driver's license to me. "This is a real mess," she said.

The real Jenna McLaren was still forty-one years old, with shorter, blonder hair. But then, the license had been issued three years ago. Same address in Wheat Ridge. Stability.

I stared at my notebook and decided I wanted copies of both the death certificate and her driver's license. My mind ran through possibilities of how the wrong name had gotten on the death certificate, and the only thing I could think of was that somebody had given false information. Because that was the only way it could have happened. But who had done it?

"I notice your mother was the informant," I said. "You and your sister had the same parents?"

"Oh," Jenna said, and bit her lip. "My mother. Yeah, that might be the problem. Because she never did English real well, and she's gotten kind of, um, forgotten things. Recent things. Like the English language. And also she's kind of deaf. So when people talk to her and she doesn't understand, she pretends she does. She smiles and nods."

I noted that--Mom a space cadet, and Hungarian to boot--while wondering how well Jenna did English. She hadn't answered my question. I guess that meant they had the same parents.

"Would your sister have listed her as next of kin?"

Jenna's foot started jiggling again, as if it were on a string attached to my questions. Her hand went to her ear and she twirled one of her diamond studs. "She might have, or she might have listed me, or she might have listed Dash," she shut her eyes and frowned, "depending on who would have been easiest to get hold of. Dash was on a, he had a, um . . ." She bent her head down and tapped her forehead. "Brain freeze. When you take your show on the road. A tour, that's it. So, probably--it probably would have been me." She stared into her lap.

I hated to ask the next question but it had to be done. "Is the date of death correct?"

Jenna nodded. "He left the tour and came home but then she improved so he went back to join his company, and she died. It all seemed so quick. But she was in the hospital a couple of days beforehand." Jenna exhaled quickly after each sentence.

"So the only thing wrong on the death certificate is the name."

"I guess the medical stuff is right; I don't know." Jenna leaned back a little but kept her foot in motion. "It didn't mention that she had lupus. Every now and then she would just pass out, but she didn't usually seem all that sick, just sometimes. I mean, who knows?" I wrote down "not that sick?" and waited for Jenna to suggest that the hospital had killed her sister and should pay.

Présentation de l'éditeur :

DEATHLESS IN DENVER

The reports of Jenna McLaren’s demise were premature. Because Jenna–nervous, well-appointed, and very much alive–was sitting in risk manager Vicky Lucci’s office, with a copy of her own death certificate. Now Vicky has to find out how her Denver hospital pronounced Jenna dead . . . and why.

For Vicky, the answers come fast and furious–along with a rising tide of mystery, suspicious behavior, and unexplained deaths. With a lucrative job offer dangling in front of her eyes, Vicky may be leaving the medical center just in the nick of time. On the other hand, with lies, secrets, and the promise of an unproven miracle drug swirling all around her, Vicky may be doing just what a killer ordered: leaving the heat–for the fire. . . .

DECLARED DEAD

À propos de cette édition

• Éditeur: Fawcett Books
• Date d'édition: 2002
• ISBN 10: 0449007081
• ISBN 13: 9780449007082
• Reliure: Broché
• Nombre de pages: 352