A Case of Need: A Novel by Michael Crichton, Jeffery Hudson Page A

and how you could, in the small hours of the morning, make a mistake. I had nearly killed an old man with heart failure when I was an intern. With three hours of sleep during the last two days, you could do anything and not give a damn.
    “I know you’re tired,” I said. “I won’t stay long.”
    “No, no,” he said very earnestly. “Anything I can do to help. I mean, now …”
    The wife came in with two cups of coffee. She looked at me angrily. The coffee was weak.
    “My questions,” I said, “have to do with the girl when she first arrived. Were you in the ward?”
    “No. I was trying to sleep. They called me.”
    “What time was this?”
    “Almost exactly four.”
    “Describe what happened.”
    “I was sleeping in my clothes, in that little room just off the OPD. I wasn’t asleep long when they called me; I’d just gotten through putting another IV into a lady who pulls them out. She says she doesn’t, but she does.” He sighed. “Anyway, when they called me, I was bleary as hell. I got up and dunked my head in cold water, then toweled off. When I got to the ward, they were bringing the girl in on a stretcher.”
    “Was she conscious?”
    “Yes, but disoriented. She was pale, and she’d lost a lot of blood. She was feverish and delirious. We couldn’t get a good temperature because she kept gnashing her teeth, so we figured it was about 102 and got to work on the cross-matching.”
    “What else was done?”
    “The nurses got a blanket over her and propped her feet up with shock blocks. 1 Then I examined the lesion. It was very clearly vaginal hemorrhage and we diagnosed it as miscarriage.”
    “About the bleeding,” I said, “was there any discharge accompanying it?”
    He shook his head. “Just blood.”
    “No tissue? No signs of a placenta?”
    “No. But she’d been bleeding for a long time. Her clothes …” He looked across the room, seeing it again in his mind. “Her clothes were very heavy. The nurses had trouble getting them off.”
    “During this time, did the girl say anything coherent?”
    “Not really. She was mumbling every once in a while. Something about an old man, I think. Her old man, or an old man. But it wasn’t clear, and nobody was really paying any attention.”
    “Did she say anything else?”
    He shook his head. “Just when they were cutting her clothes off her. She would try to pull them back. Once she said ‘You can’t do this to me.’ And then later she said, ‘Where am I?’ But that was just delirious talk. She wasn’t really coherent.”
    “What did you do about the bleeding?”
    “I tried to localize it. It was hard, and things were pretty rushed. And we couldn’t angle the lights down properly. Finally I decided to pack it with gauze pads and concentrate on getting her blood volume back up.”
    “Where was Mrs. Randall during all this?”
    “She waited by the door. She seemed all right until we had to tell her what had happened. Then she went to pieces. Just went to pieces.”
    “What about Karen’s records? Had she ever been admitted to the hospital before?”
    “I didn’t see her chart,” he said, “until … later. They had to be pulled from the record room. But she had been in before. Papp smears every year since she was fifteen. Usual blood tests from her twice-yearly physicals. She was well looked after medically, as you might expect.”
    “Was there anything unusual in her past history? Besides the hypersensitivity, I mean.”
    He gave a sad smile. “Isn’t that enough?”
    For a fleeting moment I was angry with him. He was soaking in self-pity, despite his natural fright. But I wanted to tell him he’d better get used to the idea of people dying in front of him, lots of people. And he’d better get used to the idea that he could make a mistake, because they happened. Sometimes the mistakes were balder than others, but it was just degree. I wanted to tell him if he’d asked Mrs. Randall about Karen’s hypersensitivity,