The Queen of Hearts(84)

“Time of death, nine eighteen a.m.,” she said, her voice flat.

She showed me how to ascertain he was really dead: we checked his gag reflex, checked for pupillary constriction, breath sounds, a pulse; nothing. Then Dr. McMann closed his eyelids and said to the nurse, “Where’s the family?”

The family consisted of a wife named Ellen Anne Dubois, the nurse reported, and she was in the family room. We went in, the nurse and I trailing silently behind Dr. McMann. Mrs. Dubois was attractive: midforties, smooth ebony skin, thick hair in a ponytail, a slender form encased in exercise clothes. She glanced up with equal parts relief and anxiety when we introduced ourselves, repeating our names with a tenuous smile.

“What has Richie gone and done to himself?” she asked, hugging her arms around herself.

“Mrs. Dubois,” said Dr. McMann in a considerably quieter voice than her norm. “Has your husband been feeling unwell lately?”

“No, no, he’s been fine,” Mrs. Dubois answered.

“Does he have any medical problems? Who is his primary care doctor?”

It was dawning on Mrs. Dubois that these were questions to which Mr. Dubois should have already provided the answers.

“He . . . he has high cholesterol,” she ventured nervously. “Is he okay?”

There was a little pause. Dr. McMann spoke: “His colleagues called EMS because he collapsed at work. When the medics got there, they found he was not breathing. They pumped oxygen into him and began measures—CPR and medications—to try to restart his heart. When he got here, we inserted a breathing tube and gave him more medications.” She paused again. “Mrs. Dubois, I am so very sorry to tell you we were unsuccessful, despite trying for a very long time, and your husband died a little after nine o’clock.”

“What?” said Mrs. Dubois in a tiny voice.

I had a sudden mental image of Mrs. Dubois as a very old woman, sitting alone, hunched in the same posture she inhabited now, her little arms wrapped around herself, mourning and bewildered.

“I am so sorry.” Dr. McMann spoke gently. “We tried everything to save him.”

Very slowly, Mrs. Dubois lowered her head to her knees. She rocked back and forth a little.

“We have a hospital chaplain,” said Dr. McMann. “She’ll call someone to be here with you.”

“Oh,” said Mrs. Dubois.

“That should be her,” said Dr. McMann, as a quiet knock on the door sounded. She stood. “You may want to talk to me later, or you might have questions. Just ask for me; I’ll come back. We are all here for whatever you need. And Megan will stay with you.” Megan, the nurse, nodded.

We swung open the door, but stopped as Mrs. Dubois raised her bewildered face toward us.

“I’m grateful you tried,” she said, and her face broke as she tried to smile.

—

“Okay,” said Dr. McMann, as soon as we were clear of the room. She had resumed her motorized gait and was churning through the ER like a rocket-propelled grenade. “What killed him?”

“Uh. Heart attack?” I offered, wondering what it was about Dr. McMann that so unnerved me.

“We call it a myocardial infarction, yes. MIs are one cause of sudden death. What else makes you suddenly keel over?”

“Strok— Cerebrovascular accident?”

“Okay. Yep. CVAs, subarachnoid hemorrhages, brain stuff; good. Let’s have one more.”

Oh hell. Something about Dr. McMann always wiped my hard drive. How long was it academically acceptable to stand openmouthed in a desperate search for data retrieval? Let’s see, let’s see. A malfunction in the heart or brain could kill you instantly . . . What else? Lungs!

“Pulmonary embolism!” I said triumphantly. Then I deflated. “What do you think happened to him?” I asked.

“He’ll be a coroner’s case for sure,” said Dr. McMann. “You should follow up to find out. Okay. I know we’re behind now, but why don’t you take ten minutes to grab us a couple good coffees?”

“I will,” I agreed gratefully. I headed briskly for the elevator, turning when Dr. McMann called out.

“Medical student?” she hollered.

“Yes?” I answered.

“What did we talk about during the code?” She cocked her finger into a gun shape and fired at me. “Don’t forget arrhythmias.”

—

The elevator was crowded when I got on. I wedged into the corner, next to two chatting girls in pink scrubs, still thinking about Mr. Dubois. He was clean-shaven, handsome; he looked tall and fit. He’d been wearing a business suit. How could someone like that die without warning? What would his wife do now?

“. . . Nick Xenokostas, you know, the fifth-year surgery guy?” said an unfamiliar man’s voice somewhere behind me.

I immediately forgot about Mr. Dubois. I arched my neck and slowly half turned, trying to look as if I were not paying attention. The speaker was enormous; he and his companion were both extremely tall, extremely strong-looking men in their late twenties, wearing long white coats and scrubs. Probably orthopedic surgery residents.

“. . . told a nurse he’d forgotten his wife’s birthday. He said he needed to send her flowers.” The ortho guy laughed.

“More like he forgot he has a wife,” said the other guy. “Isn’t he always banging a nurse?”