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Shadow of Death
By Patricia Gussin
Oceanview Publishing Copyright © 2006 Patricia Gussin
All rights reserved.
SEPTEMBER 1967, FOUR YEARS EARLIER, DETROIT
Laura Nelson let out a long breath, clutched her black bag, and headed toward the men's surgical ward. She didn't know that walking into that room would impact her life forever.
"I'm so nervous," she whispered to her fellow med student, Susan Reynolds.
"They are why we're here. Right? Real live patients." With a thumbs up, Susan crossed the hall to her assigned ward.
Laura and Susan were first year students at University Medical School and best friends. So far all their courses had been in the classroom or labs: anatomy, physiology, biochemistry, histology. But today they were in City Hospital to do a history and physical examination on their very first patient.
Laura was apprehensive, but also very excited. Until today, she had stepped inside a hospital only twice, for the birth of her two children — cheery semi-private rooms, happy memories. Now she stared into the men's ward at City Hospital, aghast at the medieval scene. Narrow cots lined all four walls and patients were crammed so close together they practically touched. A disinfectant odor mixed with foul human smells twisted her stomach. Groans, droning equipment, clanking bed rails, made her wonder how she'd be able to concentrate on her list of questions.
Squinting to locate her patient among a sea of mostly black faces, she realized that all eyes were on her as one of the patients let out a whistle. She blushed self-consciously. Ignore them, she said to herself. Holding her head high, Laura moved to the foot of bed 5 where her eyes settled on an emaciated young male with grayish dark skin. Distracted by a hissing noise coming from a machine connected to a hole in the boy's neck, she stood for a moment, gaping at it. The respirator synchronized the rise and fall of the chest with the wheezy sound. Other than that, her patient's body was perfectly still. Was he unconscious or just sleeping?
Unzipping her instrument bag, she considered how she'd proceed if her patient was unconscious. Her instructions were to take a complete medical history, to examine the patient, and report back for a debrief session in one hour. As she reached to awaken the boy, a plump woman, slumped in the metal chair by the head of the bed, stirred.
"Excuse me, Ma'am."
The woman jerked awake, her rough hands flying to straighten her navy polyester skirt. She looked up at Laura, one hand covering her throat.
"I'm Laura Nelson, one of the student doctors here." Laura reached for the notes in the pocket of her white coat. "Are you with this patient? Anthony Diggs?"
"Yes. He's my baby."
"What is his medical problem?" Laura asked, staring at a bulky dressing on the left side of the boy's head.
"They shot him. In the head. The police. The riots. They say he was looting, but there's no way he would do that." The woman's voice dwindled. "Look what they did to him." The mother leaned over and placed a worn hand gently on her son's cheek.
Laura hesitated a moment and swallowed. "What happened then?"
"Your people tried to take out the bullet," the mother responded, shaking her head back and forth. "Brain surgery. Major brain surgery. Isn't that on his chart?"
Laura glanced at the chart at the end of the bed, four inches of nearly illegible notes bulging out of the cardboard binder. She was only here to practice taking a history and to do a physical examination. She wasn't supposed to read the chart. "Of course," she improvised, rather than trying to explain that she was a mere first year student, that she hadn't yet touched her first patient.
"Anthony is a good boy," the woman whispered, rocking forward. "He's going off to college next month, Michigan State University."
Laura had to lean forward to hear the woman over the din of the other patients. As she did, she felt a tug at the hem of her white coat. Turning, she gasped as a scrawny man in the next bed looked her up and down with beady, lecherous eyes and a grin exposing broken teeth. Both of his legs and one arm were shackled to the bed. A prisoner! "Come work on me, pretty lady," he sneered.
Not knowing what to do, Laura ignored him, turning back to her patient's mother. "I'm sorry, Mrs. Diggs," she said. "What were you saying?"
"Diggs was my maiden name. I'm Lucy Jones," the woman corrected. "Anthony graduated from Cass Prep with a scholarship. Now they say he will never wake up." The woman looked at her with pleading brown eyes. "Can't you help him?"
Laura, forgetting that she should act like a doctor, stood at the patient's side and stroked the woman's rough hand, not daring to think of anything this horrible ever happening to her boys. Then she glanced across to the other two medical students assigned to the ward. Both male, both looking very competent, strategically moving stethoscopes across their patients' chests. Regaining her composure, she reached into her black bag and pulled out her instruments.
"Why does his throat get clogged up?" Lucy asked softly. "The nurses are always trying to fix it."
"I don't really know, I'm only a medical student," Laura said. "I have to ask you more questions, then examine your son."
On her way from the medical school to the hospital, Laura had imagined a "normal" patient, whatever that was. Not the thin chest, the bony ribs, the gurgling sounds that filled her stethoscope as she tried to hear the heartbeat. No way could she have imagined so many tubes coming out of one body: one connecting the crusted hole in his throat to the respirator; one in his nose draining greenish stomach juices; an intravenous line in his left wrist; another tube dripping amber liquid into his right arm. Laura gawked at the tube coming out of his penis, draining rusty-orange urine. According to her notes, she was supposed to check the whole body, but she decided against turning the body over. However, she did notice beet-red sores invading his dark brown skin, oozing pus onto the loose gauze dressing on his buttocks. That must be the putrid smell that almost made her gag. Get used to it, she thought, as she performed the series of tests she'd scribbled on a cheat sheet she'd stuffed into her lab coat pocket.
When she was done, she hastily covered Anthony's body with the white sheet and light blanket. It was after five o'clock. She was due back in the surgical conference room. After packing up her otoscope, stethoscope, reflex hammer, and jotting down a few notes, she opened the curtain and turned to the boy's mother.
"Thank you Mrs. Jones," she said, impulsively leaning over to give the poor woman a parting hug, murmuring words she hoped were reassuring.
"But Doctor, tell me —"
Laura left the bedside without further comment, unable to offer any hope, mentally rehearsing what she'd report about this patient.
Chief Complaint: Gunshot wound to the head.
History of Present Illness: She had nothing more from the mother, but the patient was obviously in a coma; that's all she could tell without reading the chart, which they were not supposed to do.
Review of Systems: What could she say? It wasn't like she could ask the patient?
Past Medical History: No health problems; didn't smoke; didn't use drugs or alcohol.
Family History: Diabetes on the mother's side; mother knew nothing of the boy's biological father's medical history.
Social History: One half-brother; four half-sisters; mother widowed, employed, but worried about hospital bills.
How to present all this in a clear, succinct way? This was Laura's focus as she exited the ward, scanning her notes. She hadn't seen the young man barging toward her until he brushed so close that she dropped her notebook. She jerked to avoid him, noticing his muscular build, such a contrast to her unfortunate patient, and his skin was several shades lighter. He was dressed all in black, including a baseball cap that obscured his face.
How rude, Laura thought. Or maybe it was her fault for blocking the entrance. Whatever, she had to concentrate on her report.
She took a couple of steps forward into the hall before coming to an abrupt halt when she heard shouting behind her.
"Mama, what you doin' talkin' to that yellow-hair bitch?" The voice was menacing, rising above the clamor.
With a start she realized that the "yellow-hair bitch" must be her. She'd been the only woman with blonde hair on the ward. So what was his problem? Could he be the half-brother Mrs. Jones reported in the family history?
Curious now, she inched back to the doorway of the ward. Sure enough, the angry kid hovered over Mrs. Jones, shaking a finger in her face. "Told you 'bout the one fucked up Anthony in the 'mergency room!"
What was that all about? She'd never been in an emergency room. That wouldn't be until her third year of med school.
"Johnny, quiet down. Please." She strained to hear the woman's response.
"What was that bitch doin' here?" he shouted as Laura turned to go.
"Stop it, Johnny. You're shouting. They'll throw you out of here."
"Who was she?" he demanded.
"She's just a student doctor, honey. I could tell she was trying to help."
What more could she overhear? Nothing, she decided. She'd be late if she didn't get going.
A few minutes past six Laura Nelson left the surgical conference room with Susan. Neither noticed the stocky young man lurking in the corridor by the stairwell.
"I got an alcoholic with massive esophageal bleeding," Susan explained. "Sure wish I could go to the library to look up cirrhosis of the liver, but Dad's picking me up. I told him to meet me in front of the hospital rather than the basic science building where we usually go out."
Anxious to tell Susan about her patient, Laura walked with her to the hospital exit. "I'd love to research head injuries," she commiserated, "but I need to get home to the kids." She missed her children, even more, after the time spent with the poor Diggs boy's mother. Before school had begun, Laura promised herself that her highest priority, whenever possible, would be to spend the hour before bedtime with her own boys, three-year-old Mikey and three-month-old Kevin. Tonight, she needed that hour with them. Yet she had to present her patient case in the morning too.
Worried about this conflict so inherent in her career choice, she said good night to Susan, waving as she got into a dark blue sedan under the glare of spotlights. Rather than turning back to leave by the basic science building where the school provided escorts to the student parking lot, Laura decided on an alternate route, directly out the main hospital exit, cutting through the doctor's parking lot, and walking the two blocks to her car.
Facing the block of deserted, burned-out tenements, she took a deep breath. Yes, she could still smell the smoldering ash. Or was it her imagination? The fires no longer burned, but there was a curfew. Detroit, still a tinderbox of hostility and tangible fear. With an involuntary shudder, Laura sped up her pace and tried to ignore the shifting shadows that seemed to follow her. She thought of her parents, how shocked they'd be if they knew what this neighborhood was like. Then there was Steve, her husband, who knew full well and who'd insisted that she carry a gun, which she did, but only to placate him. Where Steve grew up in northern Michigan, guns and knives and hunting were second nature.
"Just one more block," she whispered aloud, slowing a bit to avoid the debris littering the sidewalk. Thankful there were no passing cars. Thankful that there was enough light. Anxious to get home to her kids. Anxious to tackle her patient report for tomorrow.
Suddenly she lurched. Her neck snapped backward, jerking her head. A violent, painful jerk. Then she saw the glint of steel in the grayness of threatening rain as a switchblade snapped open just inches from her throat. She tried to scream. Only small, muffled sounds came out as a strong hand clamped over her mouth.
Too stunned to react, Laura felt herself being dragged through a rubble-strewn lot. The powerful hand sealed her mouth and the other arm wrapped around her body, restraining both of her arms. Where was the knife? She didn't know.
A mugging. "Just take my purse," she tried to scream, but the man's grip tightened, choking off her breath. Frantic, she tried to kick, but only stumbled as her assailant pulled her more deeply into the shadows of the burned-out buildings.
She closed her eyes for a second, hoping against hope that this was a nightmare. She opened them when she hit hard on what looked to be the foundation of an abandoned house. She could see crumbling concrete strewn with broken bottles and patches of dirt. Landing on her side, she scrambled to all fours, but the hand on her mouth did not relent. The ground beneath her was jagged and pieces of broken glass cut into her legs. She tried to crawl, but one muscular arm flipped her over and pinned her down on her back. The other clamped even more tightly against her mouth. She tried to bite the big hand, but the pressure intensified and she couldn't breathe. "Take my purse," she screamed silently. "Take my purse and leave me alone!"
Trying to get some leverage, she groped at the uneven ground with her feet, but her assailant had dropped to his knees and dug an elbow into her chest, spreading her legs with his other hand. He shoved up her skirt and ripped off her pantyhose, shredding them.
"I'm being raped!" screamed through Laura's mind the instant she felt a strong hand against her thighs. No, this couldn't be happening to her! This was not a mugging. He was not interested in her purse. He was going to rape her. For the first time Laura realized he was making sounds. Hisses, grunts and some words. "Fuck." "Pay." "Brother." They made no sense. She knew she should pay attention, but he was digging his fingers into her abdomen, groping for her white cotton panties. She flailed and twisted, but he yanked them down past her knees in one effortless move. Then he lowered himself onto her. His face so close to hers that she could feel each guttural breath. His bulk crushed her chest, making it hard to breathe. For the first time, she looked at his eyes, recoiling at what she saw: brown saucers, smoldering with hate.
Pinned to the hard ground, helpless against this man's immense strength, barely able to breathe, she urged herself to think, but how could she as he pushed his body onto hers? He kept spewing obscenities, more focused now. The words "fuck" and "kill" and "cut your throat" interspersed between incomprehensible grunts.
"Kill"? He was going to kill her? She had to get away! Repeatedly, she tried to scream, but the hand crushed her lips and nose. His other hand worked his pants down and he thrust his stiff penis between her thighs.
Her struggle seemed useless, but she wouldn't surrender. She thought of her husband, her children. Was she going to die right here? Her purse strap, wound around her right shoulder, impaired any motion on that side. Pulling her left hand free, she reached up and ripped off her attacker's baseball cap. She tried to tear at his hair, but the head was shaved smooth. She tried to scratch at his eyes, but her nails were filed too short to make an impact. He managed to pin her arm. Something lumpy was digging into her back and she realized that the bump underneath her must be her purse. Desperate now, she felt like an animal, a trapped animal with the powerful instinct of survival taking hold.
He groaned as he shoved his penis inside her back and forth. The cadence of crude obscenities assaulted her. "Fuck you, bitch doctors. Slit your fuckin' throats." Laura realized with horror that her attacker was acting out of hate, not lust. Hate so deep that he wanted to hurt her as much as he could. What was next? Death? Was he going to kill her with that knife? Her heart beat so fast that she thought it would explode in her chest. She had two small children. She wasn't ready to die!
Excerpted from Shadow of Death by Patricia Gussin. Copyright © 2006 Patricia Gussin. Excerpted by permission of Oceanview Publishing.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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