URBAN SUBWAYS AND BACK ALLYS of drinking establishments smell of the same odor that has hit Ian’s olfactory channel. He leaves the door open longer than he had dared to before, airing out the space where Gray has finally lost control of his bladder and giving him the ambient light he needs to remove the light bulb and screw into the electrical socket the plug adaptor and then screw the bulb into the adaptor. The tungsten element burns again and Ian rolls the door closed. He steps in front of Gray and places at this feet a plastic grocery bag and a backpack from which he pulls a cordless drill with a three-eighths drill bit. This is duly frightening to Gray.
“Pissed yourself. I could smell it outside.” Ian pulls the trigger on the drill and it responds and stops with a ferocity of a freshly charged battery. “I’ll be right back.” Ian steps back to the door, lifts it quickly, steps outside and brings it back down to rest. He looks around to see that he is still alone, then sizes up the door, running his hand along its steel to a spot at eye level. He lifts the drill and places the tip of the bit on that spot and drills. It doesn’t take long to produce the hole. Were he inside he would have heard the Gray’s muffled scream during the drilling. Ian scuffs away the shavings from the door with his foot, re-enters the unit and with the door down back in place puts his eye up to the hole and looks. He turns his head from one side to the other checking what little peripheral he has through this new peephole. He needs this, a way to check if the coast is clear, a sixteenth century idiom that Ian knows to actually be a misquote. It originally meant that a vessel had cleared the coastline, though its true insinuation stems from smuggling contraband with an indication that officials are out of the way making it possible to proceed.
Back in front of Gray, Ian removes the bit from the drill and stows the tools in the backpack. Gray abates his earlier panic and breathes a bit easier now, as easy as he can with his mouth sealed with duct tape and an NG tube up his nose. Ian sits on the folding chair and lifts a box of latex exam gloves from the backpack. He pulls out a pair and stretches them onto his hands. They are powdered making their installation a bit easier. Looking at Gray he sees his soiled trousers, his wet crotch, and he touches the wet spot with the back of his hand, letting it linger there for a moment.
“Lost it a while ago. You been sitting in your piss for a while now, Doctor Reagan?” He can say nothing with the tape still in place, but the rasping in his upper airway is tell tale of his increasing respiratory rate. Ian reaches into the backpack again and pulls out utility scissors and cuts up Gray’s left pant leg from the cuff, stopping at his knee. Gray’s breathing is becoming more rapid and more junky.
“Lift your leg.” Gray does not respond. “Lift your leg.” And again, nothing. Ian thumps Gray’s knee with the handle of the scissors and there is no response. He wiggles both legs and they wag like bags of gelatin. “Are they asleep?” Gray just looks at them. “Of course they are, shit. I’m sorry, I didn’t think about that.” Ian produces his Leatherman pocket knife and cuts the duct tape securing Gray’s legs to the adirondack. Ian straddles the sleeping legs and lifts Gray’s left one, placing its foot on the rung of the folding chair between his own. Ian vigorously massages it and slaps it and eventually sees the ankle rotate in relief, that moment just before the sensation of long dormant nerves becoming electrified. Ian repeats the process with the right leg. With the reverie complete, Ian finishes cutting away Gray’s soaked pants and then his boxers, his breathing slowing down, his wheezing increasing in depth and intensity.
“Arch your back so I can pull these out from under you.” Gray lifts as much as is possible and Ian pulls the soiled clothes out and lets them drop to the floor. Gray sits naked from the waist down. Ian retrieves the diaper wipes from the bag, opens the canister and pulls out a couple of wipes from the top and throws them onto Gray’s bare lap. He then cuts the tape securing Gray’s right hand to the armrest of the adirondack. “Clean yourself.”
While Gray makes the attempt, Ian pulls an adult diaper out of the bag. “When you’re done put this under your ass,” and he tosses it on his lap. Any indignation in the action would have been warranted had Doctor Reagan not done the same thing a thousand times to women in his care, certainly without the abruptness, but with the same nonchalance and indifference, not with diapers, but with paper gowns and lubricating jelly. Ian checks his watch and regards Gray as he struggles to get the diaper underneath himself. It’s askew, but under him nonetheless. Ian reaches around Gray’s putrid smelling body, rights the butterfly of the diaper and fastens its tabs. One need down.
With his ears in proximity to Gray’s chest it’s clear his breathing is strained, upper and lower. Fluid has settled in his lungs and given the duskiness around his lips, his oxygen level is desaturating, probably in the mid eighties.
Ian peels the gloves off, snapping the first off his hand while still retaining it in the thumb and index finger of his gloved hand, then with the bare hand he pulls the second glove off enveloping the first, something he has done a thousand times. He tapes Gray’s hand back to the chair, checks the coast through his new peephole and exits the storage unit, bringing its rolling door to a careful, quiet close.
The pay phone at the entrance to the storage facility rings and Ian trots through the opening gate, reaches the phone and picks up the receiver.
“What do you have?” he says, no phone etiquette here and the assumption it was Elaine was pretty safe. It is eight on-the-nose.
“I want to get those from you. Now. Tonight.”
Her next question has Ian looking down the street. “There’s a 7-Eleven on Corby Avenue.” Elaine tries to orient herself to where he is referring. “Now. Right now,” he says and ends the call. He replaces the receiver and darts back to unit to retrieve the backpack.
THIS IS A BUSY 7-ELEVEN. Ian waits inside the store and watches the lot and the pump islands. He has a clear view up and down Corby and has tagged any vehicle that has arrived in proximity to the convenience store and, so far, it appears to be safe. He has the backpack slung over one shoulder. After a few more moments the red sedan, a Toyota Camry, from the Silverado neighborhood pulls into a parking stall in front of the store. Elaine is behind the wheel. Ian reaches her door before she has a chance to get out. She rolls the window down and Ian takes the pack off his shoulder and hands it to her. He sees a thick manila envelope on the passenger seat.
“Put that into the bag, please.” Elaine complies, struggling a bit to get it in along with the stuffed FedEx pouches.
“What are you going to do with those?” The anxiety in her voice is unmistakable.
“Are Linda’s in here?”
I told you we don’t have records on site that are over ten years-old.”
“Do you have the cell phone?”
Elaine pulls it out of the center console. It illuminates as she does.
“Turn it off.” She flips it open and powers it down. “Have you received any calls on it?” and Elaine shakes her head. “No one’s called?” He has to be certain.
“No,” says Elaine.
“And you placed the call to me on that phone?” She looks at him. He looks at his watch. “I think you’d better get out of here,” he says.
“What are you going to do with those?”
“That’s Gray’s cell phone,” He encroaches on her, his face almost through the car window. “…and if I were looking for Doctor Reagan I’d be following his phone. Wouldn’t you?”
“How did you get it?”
Ian warns one last time. “I’d get out of here,” and with that he stands and walks away. Elaine backs out of the stall and drives out of the lot onto Corby and speeds away.
A POWER CORD HAS BEEN PLUGGED into the outlet adaptor just above the light bulb. The hum of a small compressor strains against a load of pressure against the suction it provides and as it does Gray violently coughs. The cord leads to a suction machine, a small, whirring compressor connected to a clear container via a small hose that evacuates the air from the container creating suction. The container is filling with a cocktail of mucous and blood. Feeding that to the container is another hose that reaches up from the suction machine to a suction catheter, the base of which is in Ian’s gloved hand. At the junction of the tube and the catheter is a plastic piece that attaches to the tube. It has a shallow oval tube that rises about a half inch at a right angle to the suction part of the catheter. With the hole uncovered, there is no suction at the catheter’s tip. When Ian covers the hole with his thumb, it creates vacuum at the tip, sucking away any fluid with which it comes into contact, like Gray’s previous expectorate.
The tip of the catheter is up Gray’s nose and Ian is trying to get is past Gray’s gag reflex again to just the top of his trachea where a bothersome rattle is still coming from his upper airway. As soon as Ian gets the tip past the reflex, he covers the oval hole with his thumb and the tip of the catheter pulls in any surrounding fluid. Gray heaves and produces plenty for it to suck up, straining the compressor under the load of vacuum a second time.
Ian withdraws the tube from the nostril, about five inches worth and he switches off the compressor and places the catheter and hose on top it. Gray’s mouth is free from tape. He breathes through it, quieter, less effort than it took before Ian’s respiratory treatment. When he breathes in deeper to speak, though, a deep raspiness is still low in his chest.
“Are you going to tell me what this is all about?” asks Gray.
Ian lights on the folding chair in front of him. He opens the backpack and pulls the manilla envelope from within.
“Yes,” says Ian, “I think I’m going to do just that.”
He opens the little brass clasp that threads through the hole of the flap and pulls the contents out, drawing from it a number of file folders. “But, I have to do some reading first so we’ll have something to talk about.”
Gray is as confused as ever. The two are in tight proximity, knees alternating as they face each other, an intimacy that makes everyone in the room uncomfortable except for Ian.
He puts the manilla envelope on Gray’s bare lap covering his cool sweaty blanched thighs. In Ian’s hands are four file folders each with a name handwritten on the tabs, alphabetized: BARRETT, CHAMBERLAIN, ESPOSITO, JACOBSEN. Ian takes the top file and places the other three on the envelope on Gray’s lap. Gray cranes down for a look, the duct tape stretching his brow, opening his eyes wider than natural, and tries to make out the names.
Ian opens the folder, a dozen pages or so with a cover, a patient intake sheet.
PATIENT: BARRETT, LEIGH
DELIVERING OB: Doctor GRAY REAGAN
BABY BARRETT-CNS DYSGENESIS
Ian thumbs through the copies of the fetal monitor strip, consultation narratives, discharge summary. He closes the folder and exchanges it with another.
PATIENT: ESPOSITO, SERENA
DELIVERING OB: Doctor GRAY REAGAN
He closes the folder and picks up another.
PATIENT: CHAMBERLAIN, KAREN
DELIVERING OB: Doctor GRAY REAGAN
BABY CHAMBERLAIN-DECEASED POSTNATAL
And the next.
PATIENT: JACOBSEN, LAURA
DELIVERING OB: Doctor GRAY REAGAN
BABY JACOBSEN-CNS ABNORMALITIES
He finds the discharge sheet that bears Gray’s signature.
“That your signature?” he says, as he holds it up to his face. Gray remains silent. Ian stands and stretches his back, his hands behind him pressing his hips forward. “You want to stretch? Bet those hips of your are burning in their sockets.” He rubs his eyes and then points to the file folders on Gray’s lap. “That’s what this is all about.” He plants back into his seat in front of Gray and picks up the folders. “Esposito, fetal death. Barrett, CNS dysgenesis. Chamberlain, died after delivery. Jacobsen, CNS abnormalities.”
“Where did you get those?”
“Doctor Reagan, that is the wrong fucking question.”
Gray knows these names. He has seen them on subpoenas, on law office letterhead, on court dockets. “If I were an obstetrician, and if my mortality rates were as shitty as yours, I’d be asking different questions.”
“Those aren’t my patients.”
“That’s right. It’s the mothers, they’re your patients. Their babies are just some kind of collateral damage in the wake of your practice of medicine.”
“As soon as the baby is born-”
“The pediatrician is the physician of record, and that would be Doctor Bryant, the same pediatrician you referred in all of those cases.” Ian is clarifying where he is going with this. The emotion that drove Gray’s abduction is growing more cognitive, while Gray’s emotion is retreating to something more primitive.
“Is that what this is about?” Gray is escalating. “You’ve kidnapped me here, you’ve assaulted me because I had complications with some deliveries?” He’s incredulous, indignant, as if every litigating little shit should know that attrition is part of the game.
Ian does all he can to retain his control. He thinks, he considers this context he’s created, the power he has within it for the time being.
“Her name was Linda.” Ian says, stone cold. “McDaniel.”
“I told you, I don’t rememb-”
“December, nineteen ninety. Full term. Breech presentation so you did an external cephalic version, you turned her the day before you delivered.
Gray defends his procedure. “Turning breech babies is not uncommon.”
“Yes, but not monitoring them after is. Doing an external cephalic version in your exam room at your office is. It’s very uncommon,” says Ian as he goes close to Gray’s face, “and so is a fucking blunt head trauma.” Ian lifts, gathers himself back in. “But you didn’t stop there. She goes into pre-labor, mild contractions. We’re admitted to the Women’s Center. She doesn’t dilate, so we wait. I can hear three other deliveries being prepped out in the hallway. A few hours go by and you put her on Pitocin and walk away.”
“It’s common protocol.”
“Helps you manage your deliveries. I believe it’s also common to monitor IV medication.”
“That wasn’t my fault,” Gray growls back in his defense.
He does remember.
Ian shakes his head. In a previous life this guy would have rattled him to a point of something more severe in working with sociopaths who have no connection between conscience and behavior. “No, that goes back to your nurse. But you saw it. You looked at it. You overlooked it. She overdosed.”
IT WAS A NEWER DELIVERY SUITE. Patient load was growing beyond any expectations with the population growth of the area. Young families, couples attracted there to the tech industries and the university, insured, healthy, middle class. The Center kept up with additions, the latest in birthing comfort and ergonomics, with hardwood floors and quilts and sleigh bed headboards. None of this dulled the panic that unfolded on that December afternoon fifteen years previous.
The fetal monitor was alarming. The baby’s heart rate was way out of parameters. A nurse had come in to check the data and alerted the delivering physician and staff. Ian just had his video camera to his eye and was slow to realize the gravity of what was unfolding before him. Another nurse and PA burst into the room, the nurse disconnected the telemetry and the three rolled Linda out of the suite and into the corridor. Ian was in tow trying to keep up, his camera still rolling. He was intercepted by someone and pulled into another small waiting room. “You’ll have to wait here. They’re going to get her prepped and when she’s ready we’ll take you in.” Linda is rolled away. “We need to get you ready, too,” she said as if there was any notion of joy left in this delivery.
Ian was brought into the surgical arena where he found Linda prepped and draped with a curtain blind at her collarbones, naked from the waist down. At the bare end were two OBs, one between her legs and the other at her side, sanitizing the incision site for a Caesarean section. Ian was brought to a position at Linda’s head, joining an anesthesiologist who was monitoring her oxygen and sedation. Her arms were at right angles to her sides, bound to supports and inundated with IVs and telemetry. Linda was agitated, panicking through her groggy state.
“Ian?! Ian, what are they doing to me?”
He was there trying to reassure her, comfort her.
“What are they doing to me?!”
This was not in the plan, a C-section. She had this carefully and painstakingly thought out and suddenly none of those thoughts had meaning.
From the other side of the blind Doctor Reagan matter-of-factly described to Linda what they were doing. “We’re going to do a C-section to deliver your baby, Mrs. McDaniel.”
She was getting groggier. “A C-section?” she slurred.
“You haven’t responded well to starting your labor and we feel we need to take your baby now. We don’t want to risk anything,” said Doctor Gray Reagan.
“You’re cutting me open!” she cried out through the onset of the sedative.
The two OBs looked up, Doctor Reagan was incising longitudinally across Linda’s abdomen with a long scalpel.
“You can feel that?” he said as he shot a look at the anesthesiologist.
The assisting OB urged Gray. “You’ve started, we’ve got to go.” Fetal and maternal heart monitors were beeping faster. Doctor Reagan continued the incision.
“I can feel that!”
And then the uterine incision. The sack was broken and the water evacuated. Doctor Reagan’s gloved hand reached in through the incision and Linda’s whole body moved with his force. Linda was terrified.
“What are you doing to me?!”
“They’re delivering right now.” Ian said, “Your water is broken and they’re pulling the baby out.” Linda’s head and shoulders almost disappeared through the drape as she was pulled. The baby’s head crested through the incision and a nurse with a bulb syringe cleared her airway, but the baby was not breathing. The rest of the baby’s body was cleared from the incision. The cord was cut and the quiet and still infant was handed off to an attending PA. He rushed to a heated exam table and placed the silent tiny girl on the surface, her legs straight at the knees and displaced at her hips, her arms folded up tight to her chest, and she still wasn’t breathing. She was blue.
Telemetry patches were placed on her body, and a bulb syringe invaded her mouth and tiny nose again. Ian was as close to her as he could be without being in the way. He looked back at Linda. She was out. Her uterus rested on top her abdomen just above the incision and the other OB was wrapping up the procedure, while Doctor Gray Reagan was backing out the door to the arena, and for a moment made eye contact with Ian.
The baby began to breathe with very shallow respirations. There was no lung clearing cry into living, just the hiss from the blow-by oxygen tube near her nose and mouth.
A pediatrician entered the arena, Doctor Bryant, and that was when Ian broke the silence of his daughter’s attending care. “Can someone tell me what’s going on?”
“Not just yet,” said the pediatrician and as if Ian had suddenly become incapable to speak on his own behalf, Doctor Bryant turned to the PA and asked, “Is this the father?” And he gestured to have Ian removed from the arena.
“Mr. McDaniel,” said the nurse who got him prepped for the delivery, “come with me into the next room. You can watch through this window and I’ll tell you what we know as soon as we can determine it.”
He stood outside that window for three hours, watching the gradual peeling off of personnel, of Apgar testing happening every five minutes change to every fifteen. He watched an intravenous line placed into his daughter’s tiny arm, and a clear plastic dome put over her head to concentrate the oxygen around her mouth and nose. He saw a respiratory therapist do the most gentle percussive therapy on her chest. Her color had improved but she was still a shade of dusky, a term with which Ian would become too familiar over the next nine years and ten months.