I remember everything like yesterday.
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As she told and retold the story, she recalled seeing everything as if from the wrong end of a telescope, feeling desperate for air despite wearing an oxygen mask, and being about to pass out. A nurse had brought the syringe of digoxin up to the rubber injection port on a small intravenous bag. Then that lone clear voice. This is dig toxicity. The rest of the team had immediately turned to give her their attention.
Yes, yes, yes, the doctor in Bessie McDonald had thought, her hearing intact enough to pick up sufficient snatches of the quick-fire explanation to know it was correct even as her vision narrowed to mere pinpoints of light. The trick? To recognize it from the other arrhythmias where the atria and ventricles raced ahead at the same speed and the drug of choice was more digoxin.
Had the chief resident succeeded in giving an additional dose to Bessie, however, he would have entrenched the problem, rendering her myocardium twice as resistant to treatment, and she could have died.
Melanie had come through for her on that count as well. Despite the sensation of being kicked by a horse, the jolt of direct current, she knew, would stun the atria, render their conduction pathways refractory to the fast impulses, and allow her own natural pacemaker time to reassert itself. Within minutes she began to feel better, opened her eyes, and saw Melanie smiling at her. Makes it easier to stuff them with knowledge. But to what do I owe this trip down memory lane? I remember her. She was so pretty and pleasant around patients. And if you recall, Chaz Braden had been my cardiologist.
Come to think of it, he kept ignoring my complaints of being nauseated.
That should have tipped him off my digoxin level was rising. I nearly died. As for the time when Kelly McShane disappeared, I figure just about everyone remembers that, at least where they were. That was the night Nixon resigned. He gave a TV speech at nineP. I was glued to my TV at home.
And in my office, Friday, the patients and I watched his departure from the White House. I remember it happening, but not where I was. Must have been busy days on the floors. Bessie immediately felt excited. The mere mention of what lay ahead brought her to life again. Me on the Big Sur. Fred Junior and his wife have built their dream house, including a cottage for me, plus arranged for private nurses, all thanks to the dot-coms. That would be the dream team, having you in charge. You saved my life twice. Why not a third time? I might take you up on it. Is that you?
Bessie flashed an annoyed look at Tanya for interrupting them. Sorry it took me so long to stop by, yet better late than never, eh? Contemplating the striking woman Melanie had become in middle age, Bessie reached for her hand and took it in hers. How come such a good-looking woman had never married? Low molecular weight heparin was another anticoagulant, this one used in small injected doses to prevent blood clots from forming in the limbs of patients who were bedridden. Which was fine with Bessie. No way did she intend to be waylaid again and miss the Big Sur, she thought, watching Tanya, who stood with her back turned as she drew up the injection.
Her annoyance with the girl vanished. Just leave the syringe on my nightstand. She rolled over and reached for the syringe and swab. She wiped the skin with an alcohol swab, then managed to bunch up a roll of flesh using the limited movements of her right forearm. With a quick thrust, she sank the needle in to its hilt, and slowly pushed in the plunger. Chapter 4 That same evening, Tuesday, November 6, P. Hampton Junction Mark brushed aside a cobweb and sent a nest of spiders scurrying for cover. He was in the basement of his house, the home where he grew up and now lived and worked, rummaging in the inactive files that his father, Dr.
Cam Roper, had stored here for as long as he could recall. The voice of his mother complaining about it ran as clear as a recording through his head. Why clutter us up with this junk? We could make a workshop down here. Mark smiled at the resonance those words could still evoke.
Then she fell sick and died in a matter of days. To a five-year-old boy it sounded like something out of a fairy tale, an evil spell cast by a wicked dwarf involving a spinning wheel. But no magic kiss brought her back. Two years later his father died, killed in a freak explosion.
But when Margaret died, he moved in here, practice and all. Just until he had time to dispose of the estate, he told himself. That was two years ago. Outside the wind had come up, moaning and whistling against the wooden slat door that led to the yard. The beams above his head creaked and groaned as if the whole structure threatened to lift off the stone foundation, but it never had and, Mark guessed, never would. He easily ignored the sounds, having snuggled under blankets and fallen asleep to them throughout his life. Instead he concentrated on going through theMc s. Lucky you to have him all the time.
The summer she disappeared, he lost his father in the autumn. Funny about sound memories. It was as if the dead spoke to him. He moved on to checking theB s. As a little boy Mark assumed it was to play with him, especially since she had been his baby-sitter for most summers up until medical school kept her in the city.
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She always made such a big deal out of seeing him, scooping him up in her arms for a hug and a big smooch. He smiled, remembering how her skin smelled like cinnamon.
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She made him feel important, the first adult outside his mom and dad or aunt to do so, and he loved the way she fussed over him on account of she liked him, not simply because they were related. Kelly might have told his father about her troubles. His own youthful recollections of that time came to him filtered through love.
When his mother died, Kelly became so much more to him, even though she was in medical school by then, and her visits were less frequent. For a year he felt safe only when she hugged him, said everything would be all right, and softly sang to him. He flicked over voluminous sets of labeled manila tabs beforeBraden-McShane, Kelly popped up. Looks promising, he thought. Pulling it out of the box, he carried it over to a workbench, snapped on a lightbulb that dangled from the ceiling, and opened the front cover.
The first page contained a faded clinical entry datedJuly 13, He began to read. Kelly is six years old.
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Complaints, according to her mother, range from intermittent abdominal pain, nausea, loss of appetite, irregular bowel movements, and diarrhea alternating with constipation. The problem has been episodic since infancy. No history of fevers.