“You were busy!” Mark said with a whistle, realizing she must have stayed up most of the nights he’d left her working on them at the kitchen table.
“As I said, I got used to reading mass records at the camps. Now here’s the point. The guy’s maternity center is short on congenital abnormalities.”
“Short?”
“Yeah. Remember obstetrical statistics. Three percent of all newborns have some defect at birth. Out of the six thousand deliveries documented in these records, he should have recorded about a hundred and eighty with some kind of problem. He had barely a dozen. Good prenatal care can accomplish a lot, but change the rate of defects that much, no way. He had to be fudging his numbers. At least, that’s what I thought initially, but couldn’t see how or why.”
“Well, I’ll be.”
“And I figured your dad couldn’t pin him down, or he’d have done something about the place.”
He never got the chance, Mark thought.
“Which begged the question,” she continued, “why Braden would care about anyone twigging to the discrepancy in his records at this late date, there being no obvious link with Kelly’s murder or anything else. At least it seemed that way, which is why I hesitated to even bring it up…”
As Lucy talked, the number 180 stuck in his mind. He’d found something of that amount when he reviewed the records himself. But what? He recalled it had to do with the home for unwed mothers, not the maternity center.
“… I did spot another connection, but it didn’t mean anything until just now, when you mentioned eugenics. Look at the total number of adoptions. Braden claimed to have made them directly out of the home for unwed mothers.” She flipped back a page and began to scan yet more lists of figures.
Mark reached over and laid his hand on her arm. He knew what the number would be. One hundred and eighty. His breathing slowed.
“Here it is,” she continued, obviously too charged up to heed his touch. “The number of private adoptions arranged from the home – 180! See what he might have been doing? Substituting healthy babies from the home for deformed ones at the maternity center. I mean, my God, can you imagine anything so hideous? It might actually have been legal if done on the up-and-up, couples from the maternity center putting their deformed kids up for immediate adoption, at the same time picking themselves up a healthy child from the home. Odious, but legal. The trouble is, there’s no records of the abnormal kids at either place. It’s as if they disappeared.”
Chapter 17
The same evening, Friday, November 23, 9:30 P.M.
New York City Hospital
“My potassium’s 2.1?” Earl felt a ripple of fear. At anything below 3.0, heart muscle became so twitchy the slightest stimulation could throw it into various sorts of fibrillation. Just like what happened to Bessie McDonald. Except hers had been limited to the upper chambers. His entire myocardium could end up squirming like a useless sack of worms, in other words, complete cardiac arrest. He broke out in a cold sweat that had nothing to do with his gut.
Instinctively he didn’t want to move. Any exertion at all could tip him over the edge. Already he could feel his pulse start to pound, the effect he’d expect from all the adrenaline that must be surging through his blood. Christ, slow the rate down, he thought, trying to calm himself, but that only made it tick up higher. His intestines kicked in with a snarl, and hinted at sending another wave of cramps his way. “Oh, great,” he muttered, pain being another surefire way to get his heart racing. “Tanya, I need IV potassium fast, maximal dose, sixty milliequivalents in a liter, run it in at ten to twenty milliequivalents an hour.” The rate had to be exact. Too much too fast could also stop a heart cold.
She grabbed two more vials of potassium from the medication bin, having already added one to the new bag of normal saline that she’d brought with her.
“And I’ll need to be on a cardiac monitor, plus you better give me a hundred milligrams of Demerol after all, to at least take the edge off the spasms-”
“Whoa, I’m not even supposed to be here, remember?” She shook up the intravenous solution to mix in the added vials. “What I suggest,” she added, her fingers flying as she got the new bag up and running, “is request the Demerol yourself as already ordered, and complain of palpitations or something so they put you on a monitor while they sort it all out. That ought to just about cover your needs for the moment. Just before shift change in the morning I’ll phone the result to the floor clerk here, pretending I’m a lab tech reporting an error. She’ll tell the nurses, and they’ll order a repeat themselves. That way you’ll know if more potassium’s required.”
He felt sheepish about his previous suspicions of her. “You’re a wonder, Tanya Wozcek. I don’t know how to thank you.”
Her weak smile couldn’t hide the worry in her eyes as she fine-tuned the intravenous rate. She knew as well as he did it would be very touch and go. “Does that burn?” she asked.
The concentrated solution she’d prepared could strip the lining of a vein, sclerosing it. It already felt like fire going up his arm. “I’ll live,” he muttered.
She slowed the rate by two-thirds.
What he wanted to know was how his potassium could have been brought so low so fast. The runs? Not this quickly. Something else had to be depleting it. But what?
He glanced toward the IV bag Tanya had discarded. “Did your friend run any other tests on me?”
“Sure. Your white count’s up, which is to be expected with the infection, but everything else was fine, except for a high CO2 which probably doesn’t matter.” She anchored the tubing to his skin with tape.
CO2 was an indicator of his naturally occurring bicarbonate level, the base that balances all naturally occurring acids circulating in the body. It also existed as a pharmaceutical preparation. Though rarely used anymore, it was part of the emergency protocol for dropping critically high serum potassium levels, and large vials of it were common in hospitals. The solution itself looked clear as water, and if someone did do a blood test checking the bicarb level, it would normally be to make sure the reading wasn’t too low. Nobody would make too much out of an unexplained elevation, just as Tanya hadn’t. In other words, it would be a perfect agent to mess up a patient’s potassium without raising suspicions, and anyone could have slipped a dose into his IV while he’d been sleeping. It also had another nasty little property, he remembered, a chill slowly creeping up his spine. It could precipitate digoxin toxicity in patients who were already on the medication. “Tanya, quick, please grab a urine dipstick and hand me the IV bag you just replaced.”
She frowned, but did as he asked.
He released a few drops of the remaining fluid on the test strip.
The portion measuring acid-base should have remained a neutral beige. Instead it turned blue as a sapphire, indicating extreme alkalinity.
Bingo!
A sickening cold sensation filled his chest.
“Who else would know how to play with potassium like that but a doctor?” she said, once Earl told her what had been done to him. “Chaz still has my vote, or someone he ordered to do it. Christ, forget our other plan. We’ve got to get you out of here. If they can get to your IV bottles without you knowing-”
“Not just yet.”