Toxin Read online

  “She looks good to me,” Kelly said. “Who is she?”

  “Her name is Becky Reggis.” Having given up trying to yank off her skate, Caroline was back to loosening the laces. “She was the junior state champion last year.”

  As if sensing she was being watched, the girl then executed two double axels in a row before arcing around the end of the rink, heel to heel. A number of the shoppers broke out in spontaneous applause.

  “She’s fantastic,” Kelly said.

  “Yeah, well, she’s been invited to the Nationals this year,” Caroline reluctantly added.

  “Hmmm,” Kelly murmured. She looked at Brian. “There could be a story there.”

  Brian shrugged. “Maybe for the six o’clock. Certainly not for the eleven.”

  Kelly redirected her attention to the skater. “Her last name is Reggis, huh?”

  “Yup,” Caroline said. She had both skates off now and was looking in her knapsack for her shoes.

  “Could that be Dr. Kim Reggis’s daughter?” Kelly asked.

  “I know her father’s a doctor,” Caroline said.

  “How do you know?” Kelly asked.

  “She goes to my school,” Caroline said. “She’s a year ahead of me.”

  “Well, bingo!” Kelly murmured. “This must be serendipity calling.”

  “I recognize that beady look in your eye,” Brian said. “You’re like a cat ready to pounce. You’re plotting something.”

  “I can’t find my shoes,” Caroline complained.

  “I just had a brainstorm,” Kelly said. She picked up Caroline’s shoes from the bench and put them in her daughter’s lap. “Dr. Kim Reggis would be perfect for this merger story. He was chief of cardiac surgery at the Samaritan before the merger and then, bang, he became one of the Indians. I’d bet he’d have something saucy and sexy to say.”

  “No doubt,” Brian said. “But would he talk to you? He didn’t come off too good in that ‘Poor Little Rich Kids’ piece you did.”

  “Oh, that’s water over the dam,” Kelly said with a wave of dismissal.

  “That might be the way you feel,” Brian said, “but I doubt he’d feel the same way.”

  “He had it coming,” Kelly said. “I’m sure he’s figured that out. For the life of me I can’t understand why cardiac surgeons like him don’t realize their moaning about Medicare reimbursement rates strikes a hollow chord with the public when they’re earning six-figure incomes. You’d think they’d be more street-smart.”

  “Deserved or not, I can’t imagine he wasn’t pissed,” Brian said. “I doubt if he’d talk to you.”

  “You’re forgetting that surgeons like Kim Reggis love publicity,” Kelly said. “Anyway, I think it’s worth the risk. What do we have to lose?”

  “Time,” Brian said.

  “Which we don’t have much of,” Kelly said. Bending down to Caroline, she added: “Sweetie, would you know if Becky’s mother were here?”

  “Sure,” Caroline said. She pointed. “She’s over there in the red sweater.”

  “How convenient,” Kelly said, as she straightened up to peer across the ice. “This truly is serendipitous. Listen, Chicken, finish getting your shoes on. I’ll be right back.” Kelly turned to Brian. “Hold the fort.”

  “Go for it, girl,” Brian said with a smile.

  Kelly walked around the end of the skating rink and approached Becky’s mother. The woman appeared to be about her own age. She was attractive and well groomed, although her clothes were conservative. Kelly hadn’t seen a crew-neck sweater over a white collared shirt on a woman since she’d been in college. Becky’s mother was deeply absorbed in a book that couldn’t have been best-seller fiction. She was carefully underlining with a yellow felt-tipped pen.

  “Excuse me,” Kelly said. “I hope I’m not disturbing you too much.”

  Becky’s mother looked up. She was a dark brunette with auburn highlights. Her features were chiseled but her demeanor was gentle and her spirit immediately empathetic.

  “It’s quite all right,” the woman said. “Can I help you?”

  “Are you Mrs. Reggis?” Kelly asked.

  “Please call me Tracy.”

  “Thanks,” Kelly said. “That looks like serious reading for the skating rink.”

  “I have to take advantage of every moment I get,” Tracy replied.

  “It looks like a textbook,” Kelly said.

  “I’m afraid it is,” Tracy said. “I’ve gone back to school in my early middle age.”

  “That’s commendable,” Kelly said.

  “It’s challenging,” Tracy said.

  “What’s the title?”

  Tracy flipped the book over to show its cover. “The Assessment of Child and Adolescent Personality.”

  “Whoa! That sounds heavy,” Kelly said.

  “It’s not too bad,” Tracy said. “In fact it’s interesting.”

  “I’ve got a nine-year-old daughter,” Kelly said. “I probably should read something about teenage behavior before all hell breaks loose.”

  “It can’t hurt,” Tracy said. “Parents need all the help they can get. Adolescence can be a tough time, and it’s been my experience that when difficulties are anticipated, they happen.”

  “Sounds like something you know a bit about,” Kelly said.

  “Some,” Tracy admitted. “But you can never be complacent. Before going back to school last semester, I was involved with therapy, mostly with children, including adolescents.”

  “Psychologist?” Kelly asked.

  “Social worker,” Tracy said.

  “Interesting,” Kelly said to change the subject. “Actually, the reason I came over here was to introduce myself. I’m Kelly Anderson of WENE News.”

  “I know who you are,” Tracy said with a touch of scorn.

  “Uh-oh!” Kelly said. “I have the uncomfortable feeling that my reputation precedes me. I hope you don’t hold it against me that I did that segment on cardiac surgeons and Medicare.”

  “I felt it was underhanded,” Tracy said. “Kim was under the impression that you were sympathetic when he agreed to do the interview.”

  “I was to an extent,” Kelly said. “After all, I did present both sides of the issue.”

  “Only in regard to falling professional incomes,” Tracy said. “Which you made the focus. In reality that’s only one of the issues that concern cardiac surgeons.”

  A pink blur raced past Kelly and Tracy and drew their attention to the rink. Becky had increased her speed and was now tensing as she streaked backward. Then, to the delight of the impromptu audience of shoppers, she executed a perfect triple axel. More applause erupted.

  Kelly let out a faint whistle. “Your daughter is a phenomenal skater.”

  “Thank you,” Tracy said. “We think she is a phenomenal person.”

  Kelly regarded Tracy in an attempt to interpret her comment. Kelly couldn’t quite decide if it were meant to be disdainful or merely informative. But Tracy’s face gave little hint. She stared back at Kelly with a soulful but undecipherable expression.

  “Did she get her skating talent from you?” Kelly asked.

  Tracy laughed freely, letting her head fall back in true amusement. “Hardly,” she said. “I’ve never had a pair of skates on my clumsy feet. We don’t know where she got her talent. One day she just said she wanted to skate, and the rest is history.”

  “My daughter says Becky’s going to the Nationals this year,” Kelly said. “That might make a good story for WENE.”

  “I don’t think so,” Tracy said. “Becky was invited, but she’s decided not to go.”

  “I’m sorry,” Kelly said. “Gosh, you and the good doctor must be crushed.”

  “Her father’s not terribly happy,” Tracy said. “But to be honest, I’m relieved.”

  “Why is that?” Kelly asked.

  “That level of competition extracts a high price from anyone, much less a prepubescent child. It’s not always mentally healthy. It’s
a lot of risk without a lot of payoff.”

  “Hmmm,” Kelly said. “I’ll have to give that some thought. But, meanwhile, I’ve got a more pressing problem. I’m trying to do a piece for tonight’s eleven o’clock news since today’s the sixth-month anniversary of AmeriCare’s merger of the Samaritan with the University Med Center. What I wanted was the community’s reaction, but I’ve run into a lot of apathy. So I’d love to get your husband’s feelings on the issue since I know he’d have an opinion. By any chance is he coming here to the rink this afternoon?”

  “No,” Tracy said with a giggle, as if Kelly had suggested an absurdity. “He never leaves the hospital until six or seven on weekdays. Never!”

  “Too bad,” Kelly commented, while her mind rapidly processed various contingencies. “Tell me, do you think your husband would be willing to talk with me?”

  “I really have no idea,” Tracy said. “You see, we’ve been divorced for a number of months, so I couldn’t guess how he feels about you at the moment.”

  “I’m sorry,” Kelly said with sincerity. “I didn’t have any idea.”

  “No need to be sorry. It was best for everyone, I’m afraid. A casualty of the times and a clash of personalities.”

  “Well, I can imagine being married to a surgeon, particularly a cardiac surgeon, is no picnic. I mean, they think that everything pales in importance compared to what they do.”

  “Hmmm,” Tracy responded noncommittedly.

  “I know I couldn’t stand it,” Kelly said. “Egotistical, self-centered personalities like your former husband and I don’t mix.”

  “Maybe that’s saying something about you,” Tracy suggested.

  “You think so?” Kelly said. She paused for a moment, recognizing she was dealing with a gentle but quick wit. “Maybe you’re right. Anyway, let me ask you this: Would you have any idea where I might find your former husband right now? I’d really like to talk with him.”

  “I can guess where he is,” Tracy said. “He’s probably in surgery. With all the fighting for OR time at the med center, he’s had to do all three of his weekly cases on Friday.”

  “Thank you. I think I’ll head right over there and see if I can catch him.”

  “You’re welcome,” Tracy said. She returned Kelly’s wave and then watched the woman walk swiftly back around the rink. “Good luck,” Tracy murmured to herself.

  TWO

  Friday, January 16th

  All twenty-five of the University Medical Center’s operating rooms were identical. Having been recently renovated and re-equipped, they were up-to-the-minute in every way. The floors were a white composite that gave the impression of granite. The walls were gray tile. The lights and fittings were either stainless steel or gleaming nickel.

  OR twenty was one of two rooms used for open-heart surgery and at four-fifteen it was still in full operation. Between the perfusionists, anesthesiologists, circulating and scrub nurses, the surgeons and all the necessary high-tech equipment, the room was quite crowded. At that moment the patient’s still heart was in full view, surrounded by a profusion of bloodstained tapes, trailing sutures, metal retractors, and pale green drapes.

  “Okay, that’s it,” Dr. Kim Reggis said, as he handed his needle holder to the scrub nurse and straightened up to relieve the stiffness in his back. He’d been operating since seven-thirty that morning. This was his third and final case. “Let’s stop the cardioplegia solution and get this ticker going.”

  Kim’s command resulted in a minor flurry of activity at the console of the bypass machine. Switches were flipped. “Warming up,” the profusionist announced to no one in particular.

  The anesthesiologist stood and looked over the ether screen. “How much longer do you estimate?” she asked.

  “We’ll be closing here in five minutes,” Kim said. “Provided the heart cooperates, which looks promising.”

  After a few erratic beats, the heart picked up its normal rhythm.

  “Okay,” Kim said. “Let’s go off bypass.”

  For the next twenty minutes there was no talk. Everyone on the team knew his job, so communication wasn’t necessary. After the split sternum had been wired together, Kim and Dr. Tom Bridges stepped back from the heavily draped patient and began removing their sterile gowns, gloves, and plastic face shields. At the same time the thoracic residents moved into the vacated positions.

  “I want a plastic repair on that incision,” Kim called to the residents. “Is that understood?”

  “You got it, Dr. Reggis,” Tom Harkly said. Tom was the Chief Thoracic resident.

  “But don’t make it your life’s work,” Kim teased. “The patient has been under long enough.”

  Kim and Tom emerged from the OR into the operating-room corridor. Both used the scrub sink to wash the talc off their hands. Dr. Tom Bridges was a cardiac surgeon like Kim. They had been assisting each other for years and had become friends although their relationship remained essentially professional. They frequently covered for each other, especially on weekends.

  “That was a slick job,” Tom commented. “I don’t know how you manage to get those valves in so perfectly and make it look so easy.”

  Kim’s practice over the years had evolved into mostly valve replacement. Tom had gravitated more toward bypass procedures.

  “Just like I don’t know how you can sew those tiny coronary arteries the way you do,” Kim answered.

  Leaving the sink, Kim interlocked his fingers and stretched them high over his six-foot-three-inch frame. Then he bent down and put his palms on the floor, keeping his legs straight to stretch out his lower back. Kim was an athletic, trim, sinewy type who’d played football, basketball, and baseball for Dartmouth as an undergraduate. Because of the demands of time his current exercise had been reduced to infrequent tennis and lots of hours on a home exercise bike.

  Tom, on the other hand, had given up. He, too, had played football in college, but after years of no exercise, the muscle bulk that he’d not lost had turned mostly to fat. In contrast to Kim, he had a beer belly despite the fact that he rarely drank beer.

  The two men started down the tiled corridor, which at that time of day was relatively peaceful. Only nine of the OR’s were in use, with two more available for emergencies. It was about standard for the three-to-eleven shift.

  Kim rubbed his stubbled, angular face. Following his normal routine, he’d shaved that morning at five-thirty, and now, twelve hours later, he had the proverbial five-o’clock shadow. He ran a hand through his long, dark brown hair. As a teenager in the early seventies he’d let his hair grow beyond shoulder length. Now, at forty-three, it was still on the long side for someone in his position, though it was nowhere near as long as it had been.

  Kim looked at his watch pinned to his scrub pants. “Damn, it’s five-thirty already, and I haven’t even made rounds. I wish I didn’t have to operate on Friday. Invariably it cuts into any weekend plans.”

  “At least you get to have your cases run consecutively,” Tom said. “It’s sure not like it used to be when you ran the department over at the Samaritan.”

  “Tell me about it,” Kim said. “With AmeriCare calling the shots and with the current status of the profession, I wonder if I’d even go into medicine if I had it all to do over again.”

  “You and me both,” Tom said. “Especially with these new Medicare rates. Last night I stayed up and did some figuring. I’m afraid I’m not going to have any money left after I pay my office overhead. I mean, what kind of a situation is that? It’s gotten so bad Nancy and I are thinking of putting our house on the market.”

  “Good luck,” Kim said. “Mine’s been on the market for five months, and I haven’t even had a serious offer.”

  “I already had to pull my kids out of private school,” Tom said. “But hell, I went to public school myself.”

  “How are you and Nancy getting along?” Kim asked.

  “To be honest: not great,” Tom said. “There’ve been a lot of bad feelin
gs.”

  “I’m sorry to hear that,” Kim said. “I sympathize since I’ve been through it. It’s a stressful time.”

  “This is not how I expected things to be at this stage in my life,” Tom said with a sigh.

  “Me neither,” Kim said.

  The two men stopped just beyond the OR desk at the entrance to the recovery room.

  “Hey, are you going to be around for the weekend?” Tom asked.

  “Yeah, sure,” Kim said. “Why? What’s up?”

  “I might have to go back in on that case you helped me with Tuesday,” Tom said. “There’s been some residual bleeding and unless it stops, my hand is forced. If that happens, I could use your assistance.”

  “Just page me,” Kim said. “I’ll be available. My ex wanted the whole weekend. I think she’s seeing someone. Anyway, Becky and I will be hanging out together.”

  “How is Becky doing after the divorce?” Tom asked.

  “She’s doing fantastic,” Kim said. “Certainly better than I am. At this point she’s the only bright light in my life.”

  “I guess kids are more resilient than we give them credit for,” Tom said.

  “Apparently so,” Kim agreed. “Hey, thanks for helping today. Sorry that second case took so long.”

  “No problem,” Tom said. “You handled it like a virtuoso. It was a learning experience. See you in the surgical locker room.”

  Kim stepped into the recovery room. Hesitating just beyond the threshold, he scanned the beds for his patients. The first one he saw was Sheila Donlon. She’d been his immediately preceding case and had been particularly difficult. She’d needed two valves instead of only one.

  Kim walked over to the bed. One of the recovery-room nurses was busy changing an almost empty IV bottle. Kim’s experienced eye first checked the patient’s color and then glanced at the monitors. The cardiac rhythm was normal, as was the blood pressure and arterial oxygenation.

  “Everything okay?” Kim asked as he lifted the recovery-room chart to glance at the grafts.

  “No problems,” the nurse said without interrupting her efforts. “Everything’s stable and the patient’s content.”