There were the long, thin, pencil-like glass tubes with red-lettered labels saying MORPHINE SULPHATE GR ⅙ or GR ¼. Inside the tubes the tiny dead-white tablets were lined up in a row. A box marked DEMEROL (100 MG) contained a dozen or more clear glass ampules, heat-sealed at the top, with the drug name imprinted in blue ink on the outside of each ampule. Here the drug was already in solution, quite colorless, like a cc or two of water.
“I thought Demerol came in tablets,” Ned grunted.
“It does, for oral use. This is for injection.”
“Is this more of it?” He picked another ampule from the drawer. “I guess not. The name’s different.”
“You’re getting into the emergency box now. That’s Coramine, a heart stimulant. And here’s adrenalin, and nor-adrenalin, and Mecholyl. And those tabs in the narcotics tray are Dilaudid, and that’s Pantapon—”
He examined each tube carefully. “What do you do with the M.S. in tablets — dissolve it in a spoon?”
“Sometimes. Usually it’s a lot easier to pop the tablet into a clean syringe and draw up a cc of water on top of it. It dissolves pretty quickly.”
Ned nodded. “And suppose you were to give 50 mg. of Demerol instead of 100? You can’t leave half the dose in the ampule and use it again, can you?”
“No, of course not. The other half is discarded.”
Dr. Thompson raised his eyebrows.
“Oh, that’s perfectly legitimate. It’s just recorded as ‘wasted’.”
“Yeah, that’s nice. How much has been ‘wasted’ on Fourth in the past week or so?”
“Some — but very little. Certainly not enough to supply—” She glanced aside and shrugged.
“And you actually count all this stuff with the medications nurse at the end of a shift?”
“After every shift. Every tablet and tube, three times a day, including Christmas.”
“Supposing the nurse can’t account for some?”
Gibby shook her head grimly. “She can. If she can’t, we hunt for what’s missing until she can. If we just can’t find it anywhere, it’s reported to the nursing office, and a report is filed with the Federal Narcotics Bureau, and that medications nurse isn’t on medications any more. Period. We haven’t had any missing on the report since that idiot Lesswing got married.”
“Which just goes to prove that all that glitters is not gold,” said Ned Thompson.
“Wrong proverb, but right idea,” said Gibby. “Any luck at all yet?”
“Not a bit.”
“Well—” She snapped the drawer closed and locked it carefully. “I guess we just keep trying.”
By five o’clock he was weary enough to welcome the early hospital supper. He had the duty to look forward to, covering all medical patients in the house, so he strolled down to the intern’s quarters, waved Endicott off en route to a dinner date, and sprawled on the sofa in the lounge in hopes of catching an hour’s sleep before the evening rush began. After three calls about one patient and one call apiece about three others in the next half hour, he gave up in disgust. He rang the operator and “checked out” for ten minutes — his usual dodge to insure a few moments without interruption — and took a quick shower and shave. A clean shirt and a change of uniform cheered him somewhat. Ten minutes later he was stepping off the elevator on Fourth.
The floor seemed quiet. Miss Allison, the little gray-haired, bird like charge nurse, was churning with activity at the desk (“That woman,” Dr. Endicott had once said in his soft southern drawl, “can work harder to get less done than any other woman I ever knew”). She greeted him with her usual effusiveness. “Oh, Dr. Thompson, I’m so glad you came up. I was just about to page you—”
“I felt sure you were, Allison,” said Ned. “I could feel it in my bones. I said to myself, ‘You might just as well go up there now, because you’re going to be called in five minutes anyway—’ ”
Allison blinked at him for a moment. “Well, I think somebody ought to go see Mrs. Conway. She’s been lying there suffering since five o’clock, poor soul.”
“Oh? What’s on her order sheet?”
Allison handed him a chart, “You know, Dr. Morton was in and put her on half a grain every two hours if she needed it — but I think she needs more. Half a grain just doesn’t hold her—”
“Half a grain of what?” Ned broke in.
“M.S.”
“And that doesn’t hold her?”
“It certainly does not! She had a hypo not twenty minutes ago—”
Ned was already halfway down the hall. Mrs. Conway was a favorite of his — an old friend, in a way. He had seen her first during her initial admission for surgery months before; since then she had been back five times. This was her final admission to St. Christopher’s Hospital. She knew it, and Dr. Thompson knew it. She had been failing rapidly in recent weeks, still Ned was shocked when he saw her. She seemed to have grown more gaunt and shriveled in just the past day; her thin sallow face was a rigid grimace when she tried to smile at him, and she gripped his hand as he stopped by the bedside.
“Little trouble tonight, Margaret?”
She shook her head weakly. “I just don’t know what’s wrong with me. You know, I was doing so well yesterday. And now every time I move a muscle — Dr. Thompson, isn’t there anything you can do? I’ve tried to fight it, you know I have, but when it breaks loose like this—” She turned her face away. “I don’t think I can take it much longer.”
“Did that last hypo help?”
“It didn’t even touch it. It might as well have been water.”
Ned stared at her. “I see,” he said.
“If there were only something to give me an hour’s rest—”
“Yes, ma’am. There is something,” said Ned Thompson softly. “You just rest a minute and we’ll get you straightened out.”
His face was white when he reached the nursing station, but somehow he kept his voice under control. “Get her a half grain of M.S. right now,” he said to Allison, scribbling the order on the chart.
“All right. I’ll have to get Davis—”
“Well, get her.” He waited until the medications nurse came into the station.
“A half grain, Doctor?”
“That’s what it says on the order sheet.”
She opened the drawer, slowly, began to prepare the syringe. Ned watched her take out the two quarter-grain tablets, drop them into the syringe, draw in a cc of water. She took a small alcohol sponge in one hand, picked up the syringe.
He held his hand out. “I’ll give it,” he said tightly.
Her eyes widened for just an instant. Then: “If you wish.”
“I wish.” He took the syringe and turned to Allison. “After I give this I want you to check Mrs. Conway every fifteen minutes without fail until you go off duty... I mean you, not somebody else, okay? I want that woman kept out of pain tonight if you have to give her a half a grain every quarter hour until dawn. Got that now?”
“Check her every fifteen minutes,” said Allison, her eyes wide. “I’ll take care of it.”
“Fine,” said Ned Thompson. He glared at Davis, then turned on his heel and strode down the hall.