Life Support Page 5

  She sighed and started up the Mercedes. At last it was time to go home, time to leave behind the night’s disasters.

  But as she drove away from Springer Hospital, she was unable to shake off her gloom. Within the span of a single hour, she had lost two patients. She felt certain that the woman’s death had been unavoidable, that there was nothing she could have done to save her.

  Harry Slotkin was a different matter. Toby had left a confused patient unattended for nearly an hour. She was the last person to lay eyes on Harry, and try as she might, she could not remember whether she had restrained his wrists before she left the room. I must have left him untied. It’s the only way he could have escaped. It’s my fault. Harry was my fault.

  Even if it hadn’t been her fault, she was still the captain of the team, the person ultimately responsible. Now somewhere, an old man was wandering, naked and confused.

  She slowed the car. Though she knew the police had already searched this area, she scanned the streets, hoping for a glimpse of her fugitive patient. Newton was a relatively safe suburb of Boston, and the neighborhood she was now driving through had the look of wealth. She turned onto a tree-lined residential street and saw well-kept houses, trimmed hedges, driveways fronted by iron gates. Not the sort of neighborhood where an old man would be assaulted. Perhaps someone had taken him in. Perhaps, right at this moment, Harry was sitting in a cozy kitchen, being fed breakfast.

  Where are you, Harry?

  She circled the neighborhood, trying to picture these streets from Harry’s point of view. It would have been dark, confusing, cold without his clothes. Where did he think he was going?

  Home. He would try to find his way home to Brant Hill.

  Twice she had to stop and ask for directions. When at last she came to the turnoff for Brant Hill Road, she almost drove right past it. There were no signs; the road was marked only by two stone pillars flanking the entrance. Between them, the gate hung open. She pulled to a stop between the pillars and saw that two letters were scrolled into the gate’s cast iron design, an elegantly baroque B and H. Beyond the pillars, the road twisted away and vanished behind deciduous trees. So this is Harry’s neighborhood, she thought.

  She drove through the open gate, onto Brant Hill Road.

  Though the road was newly paved, the maple and oak trees flanking it were fully mature. Some of the leaves were tinged with the first blazing hues of fall. Already September, she thought; when had the summer gone by? She followed the curving road, glancing at the trees on either side, noting the heavy undergrowth and all the shadowy places that might conceal a body. Had the police searched that shrubbery? If Harry had wandered this way in the dark, he might have gotten lost in those bushes. She would call the Newton police, suggest they take a closer look at this road.

  Up ahead, the trees suddenly thinned, giving way to a panorama that was so unexpected Toby braked to a sudden stop. At the side of the road was a sign in green and gold.

  BRANT HILL

  RESIDENTS AND GUESTS ONLY

  Beyond the sign stretched a landscape that might have been lifted from a lush painting of English countryside. She saw gently rolling fields of manicured grass, a topiary garden with fanciful animals, and autumn-tinged stands of birch and maple. Glistening like a jewel was a pond with wild irises. A pair of swans glided serenely among water lilies. Beyond the pond was a “village,” an elegant cluster of homes, each with its own picket-fenced garden. The primary mode of transportation seemed to be golf carts with green and white awnings. The carts were everywhere, parked in driveways or gliding along village paths. Toby also spotted a few rolling about on the golf course, shuttling players from green to green.

  She focused on the pond, suddenly wondering how deep the water was, and whether a man could drown in it. At night, in the dark, a confused man might walk straight into that water.

  She continued driving down the road, toward the village. Fifty yards later, she saw a turnoff to the right, and another sign.

  BRANT HILL CLINIC

  AND RESIDENTIAL CARE FACILITY

  She took the turnoff.

  The road twisted through evergreen forest, to emerge suddenly and unexpectedly into a parking lot. A three-story building loomed ahead. To one side of it, construction on a new wing was about to start. Through the mesh fence ringing the side, she saw the foundation pit had already been dug. At the edge of the pit, a circle of men in hardhats stood conferring over blueprints.

  Toby parked in the visitors’ lot and walked into the clinic building.

  The whisper of classical music greeted her. Toby paused, impressed by her surroundings. This was not your usual waiting room. The couches were buttery leather, and original oil paintings hung on the walls. She looked down at the array of magazines. Architectural Digest. Town & Country. No Popular Mechanics on this coffee table.

  “May I help you?” A woman in a pink nurse’s uniform smiled from behind the reception window.

  Toby approached her. “I’m Dr. Harper from Springer Hospital. I examined one of your patients in the ER last night. I’ve been trying to contact the patient’s physician for more medical history, but I can’t seem to reach him.”

  “Which doctor?”

  “Dr. Carl Wallenberg.”

  “Oh, he’s away at a medical conference. He’ll be back in clinic on Monday.”

  “May I look at the patient’s record? It might clear up a few medical questions for me.”

  “I’m sorry, but we can’t release records without authorization from the patient.”

  “The patient’s unable to give consent. Couldn’t I talk to one of your other clinic doctors?”

  “Let me pull the chart first.” The nurse crossed to a filing cabinet. “The last name?”

  “Slotkin.”

  The nurse slid out a drawer and flicked through the folders. “Harold or Agnes Slotkin?”

  Toby paused. “There’s an Agnes Slotkin? Is she related to Harry?”

  The nurse glanced at the chart. “She’s his wife.”

  Why didn’t Harry’s son tell me there was a wife? she wondered. She reached in her purse and found a pen. “Could you give me the wife’s phone number? I really need to speak to her about Harry.”

  “There’s no phone in her room. You can just take that elevator there.”

  “Where?”

  “Agnes Slotkin is right upstairs in the skilled nursing facility. Room three four one.”

  Toby knocked at the door. “Mrs. Slotkin?” she called. There was no answer. She stepped into the room.

  Inside a radio was playing softly, its station tuned to a classical program. White curtains hung at the window, and through the gauzy fabric, the morning sunlight shone in with a softly diffuse glow. On the nightstand roses in a vase shed pink petals. The woman in the bed lay unaware of any of this. Not the flowers nor the sunlight nor the presence of a visitor in her room.

  Toby approached the bed. “Agnes?”

  The woman didn’t stir. She was lying on her left side, facing the door. Her eyes were half-open but unfocused, her body positioned by pillows propped behind her back. Her arms were curled into a fetal self-embrace. Above the bed, a bag of creamy white liquid dripped into a feeding tube that snaked into the woman’s nostril. Though the linens looked clean, an odor hung in the air, undisguised by the scent of roses. It was the smell of the stroke ward, of talcum powder and urine and Ensure. The smell of a body slowly involuting.

  Toby reached for the woman’s hand. Gently she tugged the arm straight. The elbow extended with only slight resistance. No permanent contractures had set in; the nursing staff had been diligent with the passive range-of-motion exercises. Toby lay the hand down, noting the plumpness of the flesh. Despite her comatose state, the patient had been kept well nourished, well hydrated.

  Toby focused on the slack face and wondered if those eyes were looking at her. Could the woman see anything, comprehend anything?

  “Hello, Mrs. Slotkin,” she murmured. “My name i
s Toby.”

  “Agnes can’t answer you,” a voice said behind her. “But I do believe she can hear you.”

  Startled, Toby turned to face the man who’d just spoken. He was standing in the doorway—in truth, he filled the doorway, a giant of a man with a broad black face and a gleaming wedge of a nose. It was a nice face, she thought, because he had kind eyes. He was wearing a white doctor’s coat, and he held a medical chart.

  Smiling, he extended his hand. His arm was so long the wrist poked out beyond the sleeve’s edge. Did they make lab coats large enough for a man this size? she wondered.

  “Dr. Robbie Brace,” he said. “I’m Mrs. Slotkin’s doc. Are you a relative?”

  “No.” Toby shook the man’s hand, felt it engulf hers like a warm brown glove. “I’m an ER doc at Springer Hospital, down the road. Toby Harper.”

  “Professional call?”

  “In a way. I was hoping Mrs. Slotkin could tell me about her husband’s medical history.”

  “Is something wrong with Mr. Slotkin?”

  “He was brought into the ER last night, confused and disoriented. Before I could finish my workup, Harry left the hospital. Now we can’t find him, and I have no idea what was wrong with him. Would you know his history?”

  “I just take care of nursing home inpatients. You might check with the doctors in the outpatient clinic downstairs.”

  “Harry’s a patient of Dr. Wallenberg’s. But Wallenberg’s out of town. And the clinic won’t release records to me without his approval.”

  Robbie Brace shrugged. “That’s the standing policy here.”

  “Do you know Harry? Is there some medical problem I should be aware of?”

  “I only know Mr. Slotkin in passing. I see him when he comes to visit Agnes.”

  “So you have spoken to Harry.”

  “Yeah, we’d say hello, that’s all. I’ve only been working here a month, and I’m still trying to put names to faces.”

  “Do you have the authority to release Harry’s records to me?”

  He shook his head. “Only Dr. Wallenberg can, and he requires a patient’s written consent before he’ll release any information.”

  “But this could affect his patient’s medical care.”

  He frowned. “Didn’t you say Harry walked out of your ER?”

  “Well yes, he did—”

  “So he’s not really your patient anymore, is he?”

  Toby paused, unable to contradict that statement. Harry had walked out of her ER. He had left her care. She had no pressing reason to demand his records.

  She looked down at the woman in the bed. “I guess Mrs. Slotkin can’t tell me anything, either.”

  “I’m afraid Agnes doesn’t talk at all.”

  “Was it a stroke?”

  “Subarachnoid hemorrhage. According to her chart, she’s been here a year. Seems to remain in a vegetative state. But every so often, she’ll sort of look at me. Don’t you, Agnes?” he said. “Don’t you look at me, honey?”

  The woman in the bed didn’t stir, didn’t even flutter an eyelash.

  He moved to the bedside and began to examine his patient, his black hands a startling contrast against the woman’s pallor. With his stethoscope he listened to her heart and lungs, and checked her abdomen for bowel sounds. He shone a light in her pupils. He extended her limbs, checking for resistance to range of motion. Finally he rolled her toward him and examined the skin on her back and buttocks. No bedsores. Gently he repositioned her against the pillows and folded the sheet over her chest.

  “Lookin’ good, Agnes,” he murmured, patting her on the shoulder. “You have yourself a nice day.”

  Toby followed him out of the room, feeling like a midget tagging at a giant’s heels. “She’s in good condition for someone who’s been vegetative for a year.”

  He opened the chart and scribbled his progress note. “Well, of course. We give genuine Rolls-Royce care.”

  “At Rolls-Royce prices?”

  Brace glanced up from the chart, the first hint of a grin on his lips. “Let’s just say, we don’t have any Medicaid patients.”

  “They’re all private pay?”

  “They can afford it. We’ve got some pretty wealthy residents.”

  “Is this place exclusively for retirees?”

  “No, we have a few active professionals who’ve bought into Brant Hill just to guarantee that their future needs are taken care of. We provide housing, meals, medical care. Long-term care, if it becomes necessary. You probably saw we’re already expanding the nursing home.”

  “I also noticed a very nice golf course.”

  “Along with tennis courts, a movie theater, and an indoor pool.” He closed the chart and grinned at her. “Sorta makes you want to retire early, doesn’t it?”

  “I don’t think I could afford to retire here.”

  “I’ll let you in on a secret: neither one of us could.” He glanced at his watch. “It was nice meeting you, Dr. Harper. If you’ll excuse me, I’ve got a lot of patients to see.”

  “Is there any way I could find out more about Harry?”

  “Dr. Wallenberg’s back on Monday. You can talk to him then.”

  “I’d like to know now what I was dealing with. It’s really bothering me. Couldn’t you review the outpatient record? Call me if you find anything relevant?” She scribbled her home phone number on a business card and handed it to him.

  Reluctantly, he took the card. “I’ll see what I can do,” was all he said. Then he turned and walked into a patient’s room, leaving Toby standing alone in the hallway.

  She turned from the closed door and sighed. She’d done her best to track down the information, but Brant Hill wasn’t cooperating. Now hunger and fatigue were dragging her down, and she could feel her body issuing demands. Food. Sleep. Now. In slow motion, legs sluggish, she began to walk toward the elevators. Halfway there, she halted.

  Someone was screaming.

  It came from one of the patient rooms at the end of the hall—not a cry of pain, but of fear.

  As Toby ran toward the screams, she heard other voices spilling into the hallway behind her, heard footsteps following at a run. Toby reached the room ahead of everyone else and shoved open the door.

  At first all she saw was the elderly man crouching on hands and knees on the bed. He was naked below the waist, and his wrinkled buttocks were bobbing up and down in a doglike mating dance.

  Then Toby saw the trapped woman underneath him, her frail body almost hidden among the tangle of blankets and sheets.

  “Get him off me! Please get him off me!” the woman cried.

  Toby grabbed the man’s arm and tried to drag him away. He responded with a shove so powerful it sent Toby sprawling backward to the floor. A nurse ran into the room.

  “Mr. Hackett, stop it! Stop it!” The nurse tried to pull the man away, but she too was flung aside.

  Toby scrambled back to her feet. “You grab one arm, I’ll get the other!” she said, circling around to the far side of the bed. Together, she and the nurse took hold of the man’s arms. Even as he was dragged off the woman, he kept thrusting like a grotesque sexual robot without an off switch. The woman on the bed curled up into a fetal position and began to cry as she hugged herself among the blankets.

  Suddenly the man twisted, elbowing Toby under the chin. The jab slammed her jaw shut, ramming a bolt of pain straight through her skull, She saw a burst of white and almost released him, but sheer rage kept her holding on. He lashed out at her again. They were grappling like animals now, and she could smell his sweat, could feel every muscle in his body straining against her. The nurse lost her footing and stumbled, releasing her grip. The old man reached behind Toby’s head and grabbed a fistful of her hair. He was thrusting at her now, his erect penis stabbing at her hip. Disgust and fury boiled up in her throat. She tensed her thigh, preparing to knee him in the groin.

  Then her target was gone. The man was lifted away by a pair of huge black hands. Robbie Bra
ce hauled the man halfway across the room and barked to the nurse: “Get me some Haldol! Five milligrams IM STAT!”

  The nurse ran from the room. She came back a moment later, syringe in hand.

  “C’mon, I can’t hold him forever,” said Brace.

  “Let me get at his butt—”

  “Do it, do it!”

  “But he keeps squirming away—”

  “Man, this guy’s strong. What’ve you been feeding him?”

  “He’s a protocol patient—plus he’s got Alzheimer’s—I can’t get at him!”

  Brace shifted his grip, turning the man’s rear end toward the nurse. She pinched a fold of bare buttock and stabbed it with the needle. The old man shrieked. Bucking, he yanked away from Brace. In a blur of motion, he grabbed a water glass from the nightstand and swung it at the doctor’s face.

  The glass shattered against Brace’s temple.

  Toby lunged, catching the old man’s wrist before he could swing again. Viciously she twisted his hand and the broken shard tumbled from his grasp.

  Brace wrapped giant arms around the man’s shoulders and yelled, “Give him the rest of the Haldol!”

  Again the nurse jabbed the needle into the man’s buttock and squeezed the plunger. “It’s all in! God, I hope this works better than the Mellaril.”

  “This guy’s on Mellaril?”

  “Around the clock. I told Dr. Wallenberg it wasn’t holding him. These Alzheimer’s patients need to be watched every second or they—” The nurse took in a sharp breath. “Dr. Brace, you’re bleeding!”

  Toby glanced up and was alarmed to see blood trickling down Brace’s cheek and splattering his white coat. The broken glass had sliced open the skin on his temple.

  “We have to stop that bleeding,” said Toby. “It’s obvious you’ll need stitches.”

  “First let me get this guy into a nice tight Posey restraint. Come on, sir. Let’s get you back to your room.”

  The old man let fly a glob of spit. “Nigger! Let me go!”

  “Oh man,” said Brace. “You’re trying to get on my good side, aren’t you?”