The Inquisitor by Peter Clement Page B

blinds were closed, so he could barely make out her form on the bed. But he could smell the acrid, sour aroma of her sweat.
    Swallowing, he drew closer, and his eyes adjusted to the dark. She lay on her side clutching her knees, curled around the point where the tumor, grown from what had once been the source of her seed, would have maximally eaten through the contents of her lower abdomen and into her pelvis. She rocked back and forth, as if her belly were a cradle to the malignancy and her hideous keening could lull its ravages to sleep.
    "Mrs. Matthews?"
    The piercing sound from her throat never wavered.
    A movement in the corner of the room startled him. "Doctor?" a man's voice said.
    Earl turned to see a tall, asthenic figure rise from a lounge chair set well back from the bed.
    "I'm Elizabeth's husband." He held out his hand. "Thank you for coming."
    Earl took it, touched by the simple dignity of the gesture. Either the man had nerves of steel to remain so composed in the face of his wife's suffering, or witnessing it had left him numb. "Mr. Matthews, I'm so sorry."
    "Nothing's helped, Doctor. She's been this way for the last two days. The residents tell me they're giving her the maximum amounts of morphine possible…"
    As he talked, Earl flipped to the medication sheet and looked at the orders.
    Morphine sulfate, 5 mg sc q 4 hrs prn.
    Maximum, his ass. A medical student must have written it, copying word for word from the Physicians' Desk Reference, the bible of medications and their standard dosages. But Elizabeth Matthews didn't have standard pain.
    He immediately felt back on his turf. "Get me ten milligrams of midazolam," he said to Yablonsky. This kind of suffering he could dispatch in seconds.
    "But-"
    "Now!"
    One of her younger assistants darted out the door.
    "When did she get her last dose of morphine?" he asked, walking over to check that Elizabeth Matthews's IV line remained functional. He opened the valve full, and it ran fine.
    Yablonsky flipped to the nurses' notes. "At three this afternoon," she said, "during our usual medication rounds."
    "And it's now nearly eight, five hours later. Her order says every four hours, as needed. I think we agree she needs it."
    "Well, yes…"
    "And you gave her only five milligrams?"
    "Subcutaneous, as prescribed."
    "You didn't request her doctor raise the dose, even though you could easily see she required more?"
    "More is not what's on the chart, Doctor. Besides, we don't want her to get used to it so the drug no longer has an effect-"
    "You call this an effect, Mrs. Yablonsky?" He gestured to the crumpled shape on the bed.
    She fidgeted with the chart, fuming at being confronted. "No, but I-"
    "What do you say we give her ten, then? And if that doesn't work, make it fifteen." He grabbed the file out of her hand and wrote the order, scrawling his signature with an angry flourish. "And once we find out how much is enough, we'll make it an IV infusion. Even street junkies know that popping narcotics under the skin doesn't hold a candle to mainlining."
    Yablonsky turned scarlet all the way to the tips of her ears. "Really, Dr. Garnet, her oncologist says she could linger like this for months. She wi//grow tolerant to morphine, and-"
    "Then we'll sedate her, just as I'm about to do now."
    As if on cue, the young nurse who'd gone to fetch the midazolam returned and handed him a syringeful of the fast-acting sedative. He swiped the rubber portal at the side of Elizabeth's IV line with an alcohol swab, jabbed in the needle, and slowly pushed on the plunger. "Whatever it takes to make her comfortable," he continued, "especially if she's got months. My God, is that your policy, the longer a patient has, the longer they don't get sufficient morphine?"
    Yablonsky's younger colleagues, standing behind her back, nodded tellingly.
    Yablonsky snapped her head high and threw back her ample shoulders. "Of course not."
    Earl wondered if she had once been an army nurse.
    Elizabeth's cries