Chapter 1
The whole hospital's a madhouse, Pilar Ramirez fumed as she hurried through the corridors to the ER, her half-unbuttoned lab coat flapping and swishing about her like ruffled wings. Dodging pedestrians and gurneys, she thought, I shouldn't even have to come down here. As if I didn't have enough to do back in the lab!
A whole raft of alcohol and drug tests, for instance, and the antibody work-up on that old lady on the third floor who was having problems after her transfusion. To say nothing of that baby Pilar was probably going to have to draw herself, with all the extra work and aggravation that entailed, since there was only one phlebotomist on duty and half the time she couldn't even find him. She wasn't sure he was good enough to handle a baby yet, anyway.
They didn't tell you about holidays and midnight shifts in classes and internships. Those you found out about too late, when you were past all that and on the job. Her Aunt Juanita said it was worse in the old days, when everything had to be done in the hospital instead of via the telemetry most regular patients now used. But somebody still always had to be here for the walkins and carry-ins, especially on these odd shifts. And they were always like this: too many patients, because too many people had time to go out and get themselves in trouble; and too few staff, because nobody wanted to work those shifts so the bosses put on only as many as they absolutely had to.
Which, typically, meant too few to do it right. Everybody working a holiday grumbled about having too few hands on deck; but whenever they tried to put on more, everybody grumbled about that, too. Pilar used to think it was just Hudson Hospital, but she'd been to meetings and it seemed to be that way everywhere.
So here she was: up to her elbows in jobs that just had to be done right now, and nobody doing them because Pilar was hurrying down to the emergency room to draw blood stat because she couldn't find Link. And it was supposed to be almost the end of her shift, and she hadn't seen her relief yet, either.
She waded through the check-in area, past moaning and bleeding patients wanting to know when a doctor would see them and why they took somebody first who came in later, and relatives pacing and threatening to sue if they didn't get some action soon. With some relief she hustled through the door past the receptionist into the relative sanity of the treatment room.
Even that was pretty frantic this evening. There were two doctors on duty, the very young Thomson and the very old Schneider, and it was fairly obvious which one wanted her stat. The young woman on the left table, in front of Thomson, was clearly an accident victim. She'd obviously lost so much blood, and was still losing more, that she'd be needing a transfusion Real Soon Now. That fit the work order Pilar had ripped off the printer in the lab two minutes earlier: four tubes, CBC, biochem panel, coag, drugs and alcohol, type and screen, crossmatch four units.
Less than three years out of her internship, Pilar had already done it all so often she could do it with part of her mind on autopilot while the rest just as automatically observed what was going on around her. As she pulled on gloves, checked name and ID number, applied a tourniquet (at least they'd already cleaned up one arm fairly well), and whisked out an alcohol prep for Dr. Thomson's patient, she half-listened to the incoherent babbling coming from Dr. Schneider's table.
Schneider's patient was a man, maybe in his mid-sixties but with a wiry build and hair gone almost white, just starting to grope his way up from unconsciousness. Dressed in the one-piece gray pinstripes fashionable a few years ago, he looked about as distinguished as a guy could be expected to in his situation.
Pilar couldn't see his wrist tag or make much out of what he was saying, though an occasional word suggested it was English. A young couple in skimpy summersuits stood next to him, twentyish, college students maybe, the guy with green-flecked black curls and glasses, the woman's hair in peppermint waves, watching anxiously as the doctor checked vitals.
"You think it's an allergic reaction to the bug bite?" the girl asked as Pilar stuck her patient (Got her on the first try! she grinned inwardly). "Or sting, or whatever it is?"
"Too early to say," Schneider said with a frown. Pilar could see him thinking, I wish this guy'd start making sense on his own so I can send these two back out where they belong. "That's certainly one of the first things to check for. But anaphylactic shock would be my first concern there, and this doesn't look...right." His frown deepened, and Pilar realized with surprise that he looked puzzled. Even as she filled her first tube and switched to a second, she found herself listening more attentively to Schneider.
"Classic symptoms are itching, spasms, swelling, breathing difficulty, and a drastic drop in blood pressure." Still frowning, he watched the puzzlingly normal and unwavering readings on the digital BP monitor. "Usually all that's so obvious I'd give the poor guy an antihistamine and epinephrine before he hit the table. But I don't see any of it. Hell, I don't even see the usual swelling and pinkness a nonallergic person would get from a mosquito or a bee."
Pilar switched to her third tube. Schneider put down his rubber bulb and leaned back, looking at the young couple who had apparently brought the man in. "You're sure it was a bug bite or sting? And he collapsed suddenly?"
"Very," said the woman. "It stung him right between the eyes--though I'll admit I don't see anything there now. But I sure saw him trying to pull it off. The poor guy was obviously in agony." She looked at his right hand, clenched in a fist. "This sounds weird, but I think he's still holding the bug."
"Really? Let's see what it is." As Pilar switched to her last tube, Schneider gently tried to pry the guy's fist open. He seemed to be meeting quite a bit of resistance--not just stiffness, but as if the man were actively fighting the effort to uncurl his fingers. His gibberings became more animated, with more and more recognizable words among them. But he wasn't quite strong enough to keep Schneider from opening his hand.
The doctor stared at the thing in his patient's palm, frowning his deepest frown yet. "Ugly thing," he said, wrinkling his nose. "Either of you recognize it?"
The two shook their heads. Hurrying to finish up--last tube labelled and placed neatly on the tray, needle out, clean gauze and bandage on her patient's arm, blood bank ID on the wrist--Pilar strained to see what all the fuss was about.
She didn't recognize it, either. Admittedly she hadn't lived in this area, or even on the mainland, long enough to recognize everything that might be found here; but this thing looked wrong. It was dead and mangled, of course, the main body crushed and tiny pieces of it sprinkled like pepper and oregano over the white-haired gent's palm. But she could tell it was bigger than any bug and smaller than any bird she knew around here. It was much more buglike than birdlike, but even so it jarred at first sight and grew stranger with every detail she noticed: the eyes that were too angular, with too few facets; the prevalence of metallic colors on the body, rather like a greenbottle fly but more varied....
Picking up her tray, she routed herself past that table, trying to get a better look without being too obvious about it. It didn't work. Schneider looked up, right at her, and said, "Pilar, you ever see one of these before?" He picked up the main remnant with his gloved hand and held it out to her.
She stopped and looked, trying to anticipate his next question and also itching to know the answer. "No," she said, "and we don't do bugs here. But I'm on my way back to the lab now. If you'd like me to take it along, we could send it out--"
Suddenly Schneider's patient sat up, looking wildly around. "Where am I?" he demanded clearly. "This looks like a hospital. What am I doing here?"
Schneider blinked, patting the man's hand soothingly. "Easy, there. You're in Hudson Hospital, in Peekskill, and you're doing just fine. You collapsed and these folks here brought you in. Seems to have been something of a false alarm, though I'm a little afraid to dismiss it too casually..." He paused, looking his newly alert patient up and down. "I can't find anything wrong, at the moment. Yet you did collapse....Why don't we keep you here for observation for a while, just to make sure?"
"I don't want to stay for observation," the man stated emphatically. "I just want to get out of here. I was in the middle of something--"
"Excuse me," Pilar interrupted, as politely as possible, "but I've got a terrific backlog in the lab. Do you want me to take it back and send it out?"
Schneider hesitated, deliberating. As he did so, an uncharacteristically frantic voice came from his pager. "Dr. Schneider, how's it coming in there? We just got three burn cases you'll want to see as soon as possible--"
And, simultaneously, dozens of the specks of debris that had remained in his patient's hand suddenly took wing, exploding out in a multitude of directions with a chorus of mosquitolike whines. All at once everybody in the room was slapping at them.
Pilar swatted one on her forehead. A couple of people screamed; at first Pilar didn't understand why, but an instant later she felt an explosion of sensations and images from some point in the middle of her head and she screamed, too. The overload was like a crowd shrieking at the tops of their lungs in a boiler factory, but somewhere in the midst of it she could barely detect, like a child trying to be heard over all that, a small part of her mind telling her she ought to trap the bug that was still on her forehead.
But when she reached up, it was gone--and the dizzying sense of overload, that ultracentrifuge of a kaleidoscope in her head, was fading away. What seemed like an hour, but the clock said was less than a minute after it started, it was already beginning to feel like a bad dream. She still felt dizzy, but not too dazed to remember where she was.
Or to notice that the bug patient was sitting up and looking around, vaguely puzzled but otherwise calm. Apparently he was the only one in the room who had not been hit by one of the buglets. Everyone else, including Dr. Schneider, showed some combination of dizziness, disorientation, and anger. Patients were muttering things like, "What happened?" "What kind of place is this?" "Don't they ever get an exterminator in here?"
And a variety of dark imprecations including the words "lawyer" and "sue."
Over it all, Schneider's pager spoke urgently again. "Dr. Schneider, are you ready for these burn patients?"
That seemed to snap him back to reality. Time is everything in treating burns, and it would do neither the patients nor Schneider's reputation any good to delay them any longer. "OK," he snapped loudly. "Sorry about that little incident, but it's over now and everybody seems to be all right. I'm afraid I have to ask you all to clear out." He whipped his gaze around to his white-haired patient. "Except you. I'm going to have to insist that you stay a little longer. And yes, Pilar, take that bug out for analysis, stat!"
"Yes, doctor." She picked it up gingerly, noticing that his face was a poor match for his confident words, and dropped it into a vial. She wanted to stay and ask him privately what he really thought about what had just happened. But he was already turning his attention to the gurneys being wheeled into the room, and a nurse was herding everyone else toward the door.
Except Dr. Schneider's distinguished-looking patient, who tugged Pilar's sleeve as she was leaving and looked into her eyes with an odd mixture of pleading, bewilderment, and fear. "Please, miss," he half-whispered. "I want to know what it is, too. But when they're done with it, I have to get it back. OK?"
"I'll see what I can do," said Pilar. Then she turned away and hurried back to the lab.
Copyright © 2002 by Stanley Schmidt