The nurses at the desk looked up as he went by. They had never seen Dr. Kingsley so depressed and anxious.
Twelve
Cassi became conscious of her surroundings around five o’clock in the morning. She could see the large wall clock over the nurses’ station and thought she was in the recovery room. She had an awful headache, which she attributed to the eye surgery. Indeed, when she tried to look from side to side she got a sharp pain in her left eye. Gingerly she felt the bandage over the operative site.
“Well, Dr. Cassidy!” said a voice on her left. She slowly turned her head and looked into the smiling face of one of the nurses. “Welcome back to the land of the living. You gave us quite a scare.”
Bewildered, Cassi returned the smile. She stared at the nurse’s name tag. Miss Stevens, Medical ICU. That confused Cassi further.
“How do you feel?” asked Miss Stevens.
“Hungry,” said Cassi.
“Could be your blood sugar is a bit low again. It’s been bouncing up and down like a rubber ball.”
Cassi moved slightly and felt an uncomfortable burning sensation between her legs. She realized she’d been catheterized.
“Was there a problem with my diabetes during surgery?”
“Not during surgery,” said Miss Stevens with a smile.
“The night after. As I understand it, you gave yourself a little extra insulin.”
“I did?” said Cassi. “What day is it?”
“Five A.M., Friday morning.”
Cassi felt very confused. Somehow she’d lost an entire day.
“Where am I?” she asked. “Isn’t this the recovery room?”
“No, this is the ICU. You’re here because of your insulin reaction. Don’t you remember yesterday at all?”
“I don’t think so,” said Cassi vaguely. Somewhere in the back of her mind she began to remember a sensation of terror.
“You had your operation yesterday morning and were sent back to your room. Apparently you’d been doing fine. You don’t remember any of that?”
“No,” said Cassi without conviction. Images were beginning to emerge from the haze. She could recall the horrid sensation of being enclosed within her own world, feeling acutely vulnerable. Vulnerable and terrified. But terrified of what?
“Listen,” said Miss Stevens. “I’ll get you some milk. Then you try to go back to sleep.”
The next time Cassi looked at the clock it was after seven. Thomas was standing by the side of her bed, his blue eyes puffy and red.
“She woke up about two hours ago,” said Miss Stevens, standing on the other side. “Her blood sugar is slightly low but seems stable.”
“I’m so glad you’re better,” said Thomas, noticing Cassi had awakened. “I’d visited you in the middle of the night, but you were not completely lucid. How do you feel?”
“Pretty good,” said Cassi. Thomas’s cologne was having a peculiar effect on her. It was as if the smell of Yves St. Laurent had been part of her devastating nightmare. Cassi knew that whenever she’d been unlucky enough to have an insulin reaction, she’d always had wild dreams. But this time she had the sensation that the nightmare wasn’t over.
Cassi’s heart beat faster, accentuating her pounding headache. She could not tell the difference between dream or reality. She was relieved a few minutes later when Thomas left, saying, “I’ve got surgery. I’ll be back as soon as I’m done.”
By noon, Cassi had been visited by Dr. Obermeyer and her internist, and released from the unit. She was taken back to her private room at the end of the corridor, but she raised such a fuss about being alone that they finally moved her to a multibed unit across from the nurse’s station. She had three roommates. Two had had multiple broken bones and were in traction; the other, a mountain of a woman, had had gallbladder surgery and was not doing too well.
Cassi had had one other insistent request. She wanted her IV out. Dr. McInery tried to reason with her, arguing that she’d just had a severe insulin reaction. He told her that had she not had the IV originally and gotten the sugar when she had, she might have slipped into irreversible coma. Cassi had listened politely but remained adamant. The IV was removed.
In the middle of the afternoon Cassi felt significantly better. Her headache had settled down to a tolerable level. She was listening to her roommates describe their ordeals when Joan Widiker walked in. “I just heard what happened,” she said with concern. “How are you?”
“I’m fine,” said Cassi, happy to see Joan.
“Thank God! Cassi, I heard that you’d given yourself an insulin overdose.”
“If I did, I can’t remember it,” said Cassi.
“You’re sure?” asked Joan. “I know you were very upset about Robert…” Her voice trailed off.
“What about Robert?” asked Cassi anxiously. Before Joan could respond, something clicked in Cassi’s mind. It was as if some missing block fell into place. Cassi remembered that Robert had died the night after his surgery.
“You don’t remember?” asked Joan.
Cassi let her body go limp, sliding down into her bed. “I remember now. Robert died.” Cassi looked up into Joan’s face, pleading that it wasn’t true, that it was part of the insulin-induced nightmare.
“Robert died,” agreed Joan solemnly. “Cassi, have you been dealing with your sorrow by trying to deny the fact?”
“I don’t think so,” said Cassi, “but I don’t know.” It seemed doubly cruel to have to learn such news twice. Could she have suppressed it or did the insulin reaction just remove it from her disturbed memory?
“Tell me,” said Joan, pulling over a chair so she could talk privately. The other three women pretended not to be listening. “If you didn’t give yourself the extra insulin, how did it get in your bloodstream?”
Cassi shook her head. “I’m not suicidal, if that’s what you’re implying.”
“It’s important you tell me the truth,” said Joan.
“I am,” snapped Cassi. “I don’t think I gave myself the extra insulin even in my sleep. I think it was given to me.”
“By accident? An accidental overdose?”
“No. I think it was deliberate.”
Joan regarded her friend with clinical detachment. Thinking that someone in the hospital was trying to do you harm was a delusion that Joan had heard before. But she had not expected it from Cassi. “Are you sure?” Joan asked finally.
Cassi shook her head. “After what I’ve been through it’s hard to be sure about anything.”
“Who do you think could have done it?” asked Joan.
Cupping her hand over her mouth, Cassi whispered. “I think it might have been Thomas.”
Joan was shocked. She was not a fan of Thomas’s, but this statement smacked of pure paranoia. She wasn’t sure how to react. It was becoming obvious that Cassi needed professional help, not just advice from a friend. “What makes you think it was Thomas?” Joan finally asked.
“I awoke in the middle of the night and smelled his cologne.”
If Joan had had the slightest concern that Cassi was schizophrenic, she would not have challenged her. But she knew Cassi was an essentially normal person who’d been placed under extreme stress. Joan felt it was advisable not to let Cassi build on her delusional thought patterns. “I think, Cassi, that smelling Thomas’s cologne in the middle of the night is awfully weak evidence.”
Cassi tried to interrupt, but Joan told her to let her finish.
“I think that under the circumstances, you are confusing a dream state with reality.”
“Joan, I’ve already considered that.”
“Furthermore,” said Joan, ignoring Cassi, “insulin reactions include nighmares. I’m sure you know that better than I. I think you experienced an acute delusional psychosis. After all, you’ve been under enormous stress, what with your own surgery and Robert’s unfortunate death. I think in that state it’s entirely possible you gave yourself the injection and then afterward suffered all sorts of nightmares you now think may be real.”