Dark moon rising, p.7
Dark Moon Rising, page 7
Minutes later, he went into the postictal phase and fell into a deep asleep. She laid his head down on the floor and grabbed his phone off the bedside table and called 911 for an ambulance.
As soon as she hung up from emergency services, she dialed Methodist Hospital and told the receptionist who she was and asked her to call Dr. Daniel Lim and have him meet them at the emergency room. When the receptionist told her that Dr. Lim was not on call this weekend, Syd snapped at her to track him down anyway and to give him her cell phone number.
Once she was off the phone, Syd stripped Jim’s pants off along with his underwear. Like most seizure victims, he’d lost control of his bladder while in the seizure and had wet himself. Syd didn’t want a staff doctor showing up in the ER with stained pants—he was going to be embarrassed enough as it was.
She’d just finished cleaning him up and gotten fresh pants on when the ambulance pulled up out front.
She ran to open the door and showed the two paramedics back to his bathroom and watched, feeling more helpless than she ever had in her life as they loaded him on the stretcher and wheeled him toward the waiting ambulance.
Her cell phone rang on the way to the hospital. She flipped it open with her left hand, her right hand being busy holding Jim’s hand tightly. “Hello,” she said, having a little trouble hearing over the wailing of the siren.
“Syd, this is Dan Lim.”
“Hey, Dan. I know you’re not on call today, but I’m in an ambulance with Jim Wilcox. He’s just had a grand mal seizure and we’re on the way to Methodist.”
“Jim? A seizure?” he asked.
“It’s a long story, Dan, but we just found out last night that he’s got a midcerebral tumor.”
“You think the seizure is from the tumor or from a bleed?” Dan asked.
“I don’t know. Maybe you could call and have radiology ready to do a stat MRI when we get there.”
Dan sighed. “Syd, I know you’re upset, but you know as well as I do that the MRI won’t show a bleed this early. I’ll meet you there and do an LP and see if there’s any blood in his spinal fluid.”
“Thanks, Dan,” she said and flipped the phone shut.
Just then, Jim blinked and opened his eyes, still looking a little dazed and confused. He glanced around the ambulance and then his eyes centered on Syd’s. It hurt her to the quick to see the fear lurking beyond his eyes.
“Uh-oh,” he said, attempting a grin. “Did you do this to me, Syd? Did I have a heart attack in bed?”
The paramedic sitting on the other side of the stretcher grinned and turned his head away, trying not to eavesdrop on their conversation.
Syd laughed, her eyes again filling with tears at his bravery and sense of humor in the face of his tragedy and at how he’d forced his fear down where it couldn’t hurt him. “No, but it’d serve you right if I had done it.” She sobered and leaned down close so he could hear her. “You had a seizure, Jim. We’re on the way to Methodist and I’ve asked Dan Lim to meet us there.”
He nodded weakly as if he was getting used to hearing bad news. “Good. He’s a fine neurologist . . . none better . . .” And then his eyes closed and he drifted back off asleep.
As his eyes closed, Syd whispered a silent prayer that he hadn’t had a major bleed inside his brain. If the tumor was already eroding into blood vessels as small as it was, his chance of survival was nonexistent.
As a third-year resident in a specialty that promised few miracles and more than a few horrible outcomes, she wasn’t sure if she still believed in the God of her childhood. Still, she reasoned, as the words of prayer formed in her mind, nothing ventured, nothing gained.
Chapter 9
Senator Jerome O’Donnel, known to everyone except his mother as Jerry, slammed his hand down on his desk, making the aide standing in front of him jump.
“Goddamnit, Tommy! Why the hell won’t the judge authorize a wiretap? Did you make it clear this was a senatorial inquiry that has intelligence and foreign policy ramifications?”
Thomas Oliphant had been O’Donnel’s aide-de-camp and best friend since they were both assistant district attorneys in New Orleans back before he ran O’Donnel’s campaign for senator, and he wasn’t in the least surprised or intimidated by O’Donnel’s display of temper. He knew the man hated to lose, and unless something broke soon in their current inquiry into General Titus Blackwood’s research program, the Senate was going to shut them down—and they both felt deep in their gut that the general was not only dirty but was also going against a direct presidential order.
Oliphant shook his head and frowned. “She said, quote, she will not authorize a wiretap on a distinguished military hero with a chestful of medals strictly on the say-so of some freaked-out wino, end quote.”
“Did you tell her this freaked-out wino said the doctors working for the general gave him some sort of cocktail that made him grow hair on his palms and start to bay at the moon like a lovesick coyote?”
Oliphant smiled and nodded. “Yeah, and she said a snootful of MD 20/20 would probably do the same thing. Evidently the good judge has to step over a cadre of homeless men on her way to the court every day and does not have a high regard for the species.”
O’Donnel cursed under his breath, saying some very politically incorrect things about feminist judges who had their heads up their asses, and he whirled around in his chair so he could look out of his Senate office building window at the teaming city of Washington below. For some reason, the sight of the chaotic traffic and hordes of pedestrians rushing down the street as if their lives depended on getting somewhere very soon calmed him down.
O’Donnel was young for a senator, still in his early forties, with dark hair worn slightly longer than was fashionable. He was slim built with wide bony shoulders, and preferred the term wiry to the adjectives thin or skinny. Handsome in a JFK sort of way with a pleasant boyish expression unless you happened to cross him, he was an old-fashioned Democrat who still believed the government knew best and that most of the people who served did so out of a patriotic calling as he had, not because they were lazy or wanted a secure job from which almost no one was ever fired.
His aide, Tommy Oliphant, knew better but was wise enough not to say so to his boss and best friend.
O’Donnel asked over his shoulder without looking at him, “Did you give her any of the other evidence we have that Blackwood is up to some very nasty business over at the fort?”
“Uh-uh,” Oliphant answered. “The only way I could do that would be to reveal the existence of Janus.”
Janus was their code name for a person who’d contacted O’Donnel by sending him information that General Blackwood was running a black-ops mission at Fort Detrick involving illegal medical experimentation on U.S. troops. A few days after O’Donnel had read the material, the person contacted him again and offered to continue to try and find out more and also warned O’Donnel to be very careful, for the general was not known to hesitate to eliminate anyone that he felt was a threat to his ambitions.
So far, their spy had been only able to provide them with generalities of the general’s programs and very few specifics and nothing they could act on, but they both had hope the spy would come through for them eventually, preferably without getting caught and executed.
O’Donnel thought the possibility of their plant getting killed was remote, but Oliphant knew better. He’d read all of the general’s records that weren’t sealed or marked TOP SECRET and he knew the man was capable of anything to advance his career or to make the military stronger. He knew the man was a fanatic of the worst sort, the kind of man who cloaks himself in the flag of patriotism and thinks his ends justify any means whatsoever. He was a dangerous adversary, and one Oliphant almost wished they hadn’t gone after. Still, when Jerry had gotten hints that Blackwood was working on some sort of chemical treatment that would turn ordinary men into killing machines and that he was testing this poison on elite members of the armed forces, what else could they have done?
An ex-football player in college who’d used his scholarship to get his prelaw degree, Oliphant was no longer buff but still weighed in at over two hundred and fifty pounds. At five feet ten inches tall, that made him look square rather than oblong, and accounted for his nickname—Bull—among his friends. Though his once firm muscles were slowly going to fat under the influence of fifty-hour workweeks and too much fast food grabbed on the run, he was still strong as an ox.
“By the way,” Oliphant added, putting his hip on the corner of O’Donnel’s desk and making the wood groan. “Why did you give our spy the code name Janus? I looked it up in the dictionary and all it said was that Janus was the Roman god of gates and doors, and that don’t make a whole lot of sense.”
O’Donnel slowly turned back around to look into his friend’s eyes. “In the first place, I didn’t pick the code name for our spy—he or she did. And in the second place, you must’ve used a cheap dictionary, Bull, because Janus is much more than that. He’s also the god of beginnings and endings, and that’s why he’s always portrayed with two faces. He also represents the transition between things, like peace and war, and once when the city of Rome was attacked by the Sabines, Janus made a hot spring erupt on the hill they were climbing and made them flee in fear.”
Oliphant nodded. “Okay, two-faced, peace and war, protecting the state—now I get it.”
O’Donnel smiled grimly. “You do know, Bull, that our asses are hanging out a mile here. If Janus, whoever he or she might be, is caught, there is no telling what the general might do.”
Oliphant gave a short laugh. “You mean your ass is hanging out, boss. Remember, I just work here and follow my leader’s orders.”
O’Donnel grinned. “That ‘following orders’ defense rarely ever works anytime, and never in politics, big guy.”
Oliphant spread his hands. “Hey, there’s always ambulance chasing if we lose this gig.” He didn’t add what he was thinking—that if they lost against the general they’d most probably be in the ambulances instead of chasing them.
* * *
Syd had the ambulance crew take Jim into the first vacant examining room in the Methodist Emergency Department and waved away the on-call ED doc who moved to take over. “I’ll check him out, Bill,” she said as she bent over to look deep into Jim’s eyes with an ophthalmoscope, hoping against hope she wouldn’t see any signs indicating an intracerebral bleed or skyrocketing intracerebral pressure.
Good news, she thought, finding his pupils equal in size and equally reactive to light stimulus and his retinal vessels normal sized, not pinched or dilated. That argued against any acute major brain pathology.
Glancing up, she raised her eyebrows at the nurse who was taking his vital signs. “His BP’s 135 over 78, and his temp’s normal,” the nurse said as she unwrapped the blood pressure cuff from around his arm and took the thermometer out of his mouth.
Looking back down at Jim, Syd asked, “You feel any weakness or numbness anywhere? Any localizing symptoms at all?”
Jim smiled and shook his head. “No, Doctor.”
Syd made a face and punched his shoulder. “Don’t you call me doctor after all we’ve been through, you putz.”
He looked around and motioned her down close to whisper in her ear, “I thought darling might be a tad inappropriate, considering the circumstances.”
She chuckled and looked up just as Dr. Daniel Lim walked into the room. His lips smiled when he saw Jim but his eyes remained concerned. He was tall and lanky, with black hair and unlike most Orientals in middle age, did not wear glasses. He had an excellent sense of humor and was known throughout the medical center for his quick wit and teasing manner and for the way he dressed. Today he was in Armani, a charcoal-gray ensemble with a solid black tie and a blue and gray pinstriped shirt. As usual, he looked as if he just stepped off the pages of GQ magazine.
“Hey, Dan,” Jim said.
“What’s this I hear about you growing some new brain cells?” Lim said as he too took an ophthalmoscope out of his coat pocket and leaned over to stare into Jim’s eyes.
“Yeah, ain’t it a bitch?” Jim replied. “And the worst part is, I don’t think they’re working, ’cause I don’t feel a bit smarter.”
Dan glanced up at Syd and then back down at Jim, sizing up the situation. “I don’t know about that, Jimmy. It looks like you got smart enough to pick a very nice lady to hang around with on your weekends.”
“Hey, guys,” Syd said, making a face. “Let’s not discuss the lady in question like she’s not here, okay?” She laughed, low in her throat. “Time enough for that in the locker room when I’m not around.”
Dan laughed. “Oh, Syd, us men are much too grownup to discuss our dates in locker rooms anymore. We use bars or the Internet now.”
“Oh, great,” she replied, shaking her head. “That makes me feel a whole lot better.”
Dan eased his hip onto the stretcher Jim was lying on and crossed his arms in front of his chest. Loosely, so he wouldn’t wrinkle his suit. “Now, let’s get serious for a while. When did you first start having symptoms and what were they?”
Jim told him the same story he’d told Syd, and then she filled him in on the MRI results and her negative physical exam of the night before.
“I’ll want to see those films,” Dan said, “but from what you’re telling me, it looks like this baby is in a hell of an inconvenient area for surgery.”
Both Syd and Jim nodded. “It can be gotten to,” Jim said, “but not without doing significant damage along the way.”
“What about radiation?” Syd asked, though she knew the answer already.
Dan shrugged. “With the new stereoscopic aiming computers, we can target tumors down to millimeters in diameter with very little residual effects, but as you know, tumors in this area are not very often amenable to radiation therapy. At best it’ll buy us a little time, but a total cure is probably unrealistic to expect.”
“Anything new in the pipeline?” Jim asked, meaning had Dan read about any new treatments being used experimentally that he might be a candidate for.
“Nothing comes to mind, but it’s been a while since I did an exhaustive search of the literature. Let me take a look at the MRI films, do an LP, and then we’ll talk again.”
He glanced at the nurse standing near the head of the stretcher. “Would you get me a lumbar puncture set please and prep him for the test?”
* * *
Lim was smiling as he entered the examination room where Jim was still lying on a stretcher. “Good news, guys. There’s nothing abnormal in the spinal fluid, so the seizure wasn’t caused by a bleed.”
Syd squeezed Jim’s hand where she was holding it and smiled gratefully at Lim, as if the good news were all on account of him.
“So, Doc,” Jim said, parodying the expression a lot of patients used with him in similar circumstances, “what’s next on the agenda?”
Lim hopped nimbly up on a counter and crossed his legs as he looked at Syd and Jim. “Well, I think the first thing to do is to get a top-notch neurosurgeon involved in the case.” He held up his hands when he saw Syd start to bristle. “Hold on, Syd. I know you’re good, but you’re still in residency training and from what I remember that ties up about ninety percent of your time. Am I right?”
She reluctantly nodded.
“Of course, due to your . . . um . . . special relationship with Jim you’ll remain fully involved in his case, but we need someone who’s familiar with the very latest in new techniques—even like Jim said earlier, experimental ones.”
“How about Tony Frank?” Jim asked.
“The head of the neurosurgical department here at Baylor?” Lim asked, jokingly. “Good choice, and since he’s teaching more now than operating, he’ll have plenty of time to call all of his contacts around the country and see if there’s anything new being worked on for cases like yours, where the tumor is small but the path to get to it is complicated.”
When both Syd and Jim nodded, Lim cleared his throat and looked uncomfortable. “Now, I’ve got to recommend that you do no more surgery or procedures until this is taken care of,” he said, frowning as if he feared he might get an argument from Jim.
“He’s already taken care of that,” Syd said. “He called Tony yesterday and had himself taken out of the surgical rotation.”
“And tomorrow, I’ll have my nurse and secretary call all of my patients and get them transferred to someone else’s care until I’m back in the saddle,” Jim added.
Lim looked relieved. It wasn’t often that doctors gave up the reins of their practice so easily. Usually they had to be dragged kicking and screaming out of their offices or the surgical suites. “What about your income? How will you live without being able to practice?” he asked, knowing the overhead of a surgical practice like Jim’s was staggering.
Jim smiled sadly. “Disability insurance,” he said shortly. “Though I never thought I’d ever need it, I even got insurance that covers my office overhead for up to two years.”
Lim smiled and nodded. “For once you’ll get your money’s worth from an insurance company. Get the forms over to my office and I’ll fill out all the paperwork needed to get your checks in the mail. Most of the policies have at least a thirty-day waiting period, so the sooner we get them turned in the sooner you’ll have money to pay the bills.” He sobered. “You know, pal, this is going to be a long road, no matter what we find out about new surgical techniques. Even if we get the tumor out relatively soon with little side effects, it’ll probably be at least six months to a year before you’re able to practice again.” He took a breath and added, “And, to be brutally honest, unless we’re very lucky indeed, you might be impaired enough that you won’t be able to do surgery anymore.”
Jim’s face fell, and Syd patted his shoulder. “You can treat it like a vacation, which if you’re like most of us you haven’t ever taken.”
“Sure,” Jim said sarcastically, “maybe I can take up needlepoint or something equally fascinating.”
