Miss Eight Seventeen
As long as I’ve been around hospitals I’ve never heard of a blue injection. “Blue?”
“Blue,” Terri said. “And clear. Like some kind of Kool Aid. A good twenty c.c’s. He brings it with him.” She pushed a pen down into her breast pocket and stood up. The starched white cotton above the pocket was streaked with ball-point ink. Near time to change that uniform but I’d never say it. Not to Terri.
“Well,” I said. “I guess Doctor Sims knows what he’s doing. Who am I to question his procedures? Maybe it’s a study.”
“Sure. And my Aunt Ethel is a Rockette.” Terri walked around the end of the nurses’ station, squeezing between me and an empty gurney.
“Look, Terri . . . .”
“So if it’s a study tell me why my floor nurses weren’t told about it? Who do you think is supposed to administer the meds around this place?” She poked me in the ribs with her elbow and started down the hallway.
I stood there leaning on the counter making progress notes in my charts. Half way down the hallway Terri pushed a door open and disappeared into one of the rooms.
A moment later she appeared at the doorway.
“Doctor Trainer? Could you come down here a minute?” She held the door open for me.
“Good Lord!” I said. Lying on the bed with not even a sheet to cover her was a naked girl with an I.V. in her arm. She couldn’t have been more than sixteen. Her body was covered with some kind of scaly skin lesions. All except her breasts, her face, and her neck. The lesions were dry and silvery-gray, like ichthyosis but some were weeping a little blood-tinged serum around the base. Her eyes were closed and she was breathing heavily.
“This is the one.” Terri said.
I put my finger to my lips and pulled her outside.
“The blue injection?”
“Yes. But you don’t have to worry that she’ll hear us. She’s been unresponsive ever since they brought her up.”
“You already said that.”
“She looks terrible! Why isn’t she in isolation?”
“I asked Doctor Sims about it and he says ‘No’. According to him, she’s not contagious.”
“What’s he calling it?”
“The diagnosis? There isn’t any. An off-duty cop and his wife found her wandering along the beach out by Breezy Point. She was talking to herself, soaking wet and half-naked. They brought her straight to the E R.”
“Why is she lying there with no gown? Or covers?”
“Doctor Sims says her skin is so sensitive that she wakes up and screams when you so much as touch her. Now he’s started low-dose Demerol in the I.V.”
“And the Kool Aid.” I said.
“The blue stuff. He insists on doing it himself. Pushes it into the IV tube BID.”
“When was she admitted, Terri?”
Terri looked at her watch.
“This is her fourth day. Your next question’s going to be, ‘Is she improving?’ The short answer is ‘no’. But Doctor Sims is hopeful.”
“No, my next question was going to be, ‘How did Sims, of all people, wind up getting this case?’ But I’ll settle for yours.”
“One, I don’t know how these things are decided, and two, Sims says that right now she’s holding her own. If he doesn’t see some improvement by the weekend, she goes to ICU.”
“Oh, so he does talk to you. Did you ask him about the Kool Aid?”
“He says it’s something new. And that’s all he says.”
That night around eight, my phone rang. It was Terri.
“Doctor Sims just called, Thought he’d find you here. He says he wants to see you tomorrow. He’ll be in his office all morning.”
“Ours is not to question why, Tommy. And don’t shoot the messenger but he sounded upset. Of course with Sims that doesn’t necessarily mean anything. It’s just his way.”
“If you’d added, ‘His bark is worse than his bite,’ I could have had three clichés for the price of one. Are you coming over?”
“Not tonight, Tommy. I’ve had a rough day.”
Early the next morning before rounds I went across to the research annex and took the freight elevator to the twelfth floor. Sims’s office is in the back hallway next to his lab - a big gray room full of monkeys and albino rats, all squealing and chattering, day and night. It’s not that he loves animals. They’re for research. To be fair, he has a gigantic aquarium in his office full of tropical fish, some of them six inches long, and he practically prays over them. So despite the rumors, I guess he cares for something, however un-mammalian.
“The door’s open. Come on in, Doctor Trainer.” I turned the knob and pushed the door.
“How’d you know it was me?”
“Who else?” he said. “I know that you got my message. I saw Nurse Barr this morning.”
I threw myself into a chair and pulled out a fresh pack of Camels.
“Please don’t,” he said.
Sims threw a sheet of paper across the desk. “Read that,” he said. “It will answer all your questions.”
“Who told you I had any?”
Sims does a thing with his head. Cocks it to one side and lifts one eyebrow. “Your name is Thomas Trainer, isn’t it?”
The single sheet had a name at the top. ‘Jane Doe, Room 817’ followed by a description of the girl’s condition. All the signs and symptoms were listed in neat order including her hypersensitivity to touch and apparent unconscious state, in ordinary circumstances two mutually exclusive conditions. After that, the lab work. I could see at once what Sims’s problem was. Every lab test was within normal limits, even the cultures. At the bottom he had written a summary.
‘Unidentified teen-aged female admitted through emergency room with fever of undetermined origin. Ten-millimeter disciform lesions covering torso, upper and lower extremities. Neck, upper chest, and head uninvolved. Lesions are scaly and productive of blood-tinged serum. Serum sample negative for bacterial growth after 48 hours in broth and agar. Compound A-246 started, with questionable improvement. Clinical reason for dermal hypersensitivity undetermined. Possible drug reaction?’
And that was all. I flipped it over. Oscar Sims was the only doctor on the staff who would write out “fever of undetermined origin” and “emergency room” instead of FUO and ER.
He was also the only doctor I knew who wrote on both sides of the paper. The back side was filled with case-related statistics and a list of vital signs by date. She was now five days into treatment.
“What’s compound three forty six?”
“Two-four-six,” he said. “It’s compound A-two-forty-six. It’s something new.”
“I know, that’s what you told the floor supervisor, Oscar. But what is it? If you tell me it’s just possible that I might understand.” I reached for my Camels again but Oscar wagged a finger.
“And don’t you think that it would be a good idea to have a couple other members of the attending staff weigh in on a decision to use an experimental drug? I mean, if only for safety’s sake? Not to mention the malpractice risk, Oscar.”
“I was going to. That’s why I asked you to come over this morning.” Sims took off his rimless glasses with both hands and ran a hand through what hair he still had.
“There’s another problem,” he said. “Truth is, I don’t know what the compound is myself.”
I slapped my pack of Camels on the desk.
“You what? What the hell does that mean? Are you telling me that you’re giving a patient an IV med twice a day and you don’t know what it is?”
I was about two seconds away from bolting out of there. I was in enough hot water, the last thing I needed was to be affiliated with a stunt like this.
“Look,” I said. “If you’re looking for an associate for this case, I’m not your man. With all due respect Oscar, I’m in no position. Tell you what. From my brief glance it looked infectious to me. Call Doctor Regord. He’s the tropical disease man. Rego would be the one to help you on this.” I got up to leave.
“It’s aquarium water.”
I almost fell back into my chair. “What’s aquarium water?”
“I just had to adjust the pH.” Sims said.
He pointed at his aquarium, a forty-gallon affair which sat on a water-stained credenza across from his desk.
“My fishes had the same exact lesions. All eighty-two of them, from the smallest guppy to the giant trigger fish, and nothing I did helped. It was going on for weeks and one by one they started to die. Every day I had to scoop out more dead ones. Very distressing, you know.”
He did that little thing with his eyebrow.
“Then, when I arrived one morning about a week ago the water in the tank looked blue. Something in it, you see. I thought the janitorial staff maybe accidentally dropped something in the tank . . . . and well, I thought they would all be dead in a day or two anyway so I didn’t do anything. Figured I’d just scrub it out and start over.”
He put his glasses back on.
“But over the next couple of days I’ll be damned if they didn’t get better. Every one. Their scales became reflective again and they got their appetites back. Every one. Swimming around like Esther Williams.
“And then they brought this girl in. What little clothes she had on were saturated with salt water. She must have been in the ocean, you see. As soon as I saw her I thought, if that blue water cured the fishes. . . . So I sterilized a batch and adjusted the pH a little . . .” He came to a stop.
I must be in some kind of a dream, I thought. This can’t be real. This is what happens when you fool around with girls and don’t say your prayers.
“Oscar, please don’t tell me things like that, even as a joke. I’ve been working too hard and I need some sleep. Now tell me what you’re giving that girl down in eight-seventeen. What exactly is compound seven-eighteen?”
“Two-four-six,” he said. “Letter A, dash, two, four, six. You know that I am not a joking man, Thomas. It is exactly what I told you it is.”
“But Jesus, Oscar, you can’t go around treating patients like they’re your goddam lab animals! It’s malpractice, for chrissakes! To say nothing of insane. You’ll be sued, blued, and tattooed, and spend the rest of your life in Ossining.”
With me in the next cell, I thought, if I’m crazy enough to get mixed up in this thing.
“Look,” Oscar said. “I think the infusions are beginning to help. Did you happen to look in on her this morning?”
“She’s not my patient, Oscar. I only saw her that once because Terri Barr called me into the room. I thought it might be an emergency.”
“Well go on down there and examine her. You have my permission. I’ll give it to you in writing, I’ll put your name on the cover sheet with mine.”
“Never mind!” I said. “Please don’t do me any favors, Oscar. Leave my name off it and out of it.”
But I did examine her. That very morning. After what I’d seen the day before I just had to get another peek. To find out if Oscar Sims was as crazy as I thought he was. Besides, I had the weird feeling that the girl needed me.
Just in case, I took a nurse’s aid into the room as a witness. I got the surprise of my life. Miss Eight-seventeen was sitting up in bed under a blanket, wearing a hospital gown. She was spooning yogurt out of a plastic container.
“Good morning!” I said. I was about to say, “I’m Doctor Trainer,” or “Doctor Sims asked me to look in on you,” but at the last moment I thought better of it and just walked over to the bed with her chart in my hand. That and the white coat are usually enough. The aid, a short, stout Island lady with a moustache, stationed herself just inside the door. Out of the corner of my eye I saw her make the Sign of the Cross.
Then I realized why. I got a look at the girl’s hands, something I hadn’t noticed when I glanced at her the day before. She was holding the plastic spoon in her fist, because except for her thumb, all of her fingers were joined together by a web of flesh. Doctors call it syndactyly. Of course it would affect both hands, and the one holding the cup was the same.
“Mind if I have a look at your skin problem?” I asked, taking the edge of the bed cover in my hand.
Up to now she hadn’t said a word. Hadn’t even looked up from her yogurt in fact, which she was shoveling in like it was her last meal. When she finished and was scraping the plastic spoon around in the empty container she turned and looked at me. I should say, “looked me over,” because that’s exactly what she was doing. Looking me up and down like I might have been something else to eat.
She smiled. Whether in greeting or not I couldn’t tell. Her teeth were tiny and pearly-white and it was probably my imagination but I could have sworn that they were pointed. I got the feeling that she wanted nothing more than to take a bite out of my neck. Behind me, the nurse’s aid had started to pray in a low, droning voice.
I tugged at the blanket. “Okay?” I said.
Suddenly, she threw back the covers and swung her legs over the side of the bed. Like most patients left to their own devices she had put her hospital gown on backwards and it fell open. Behind me, the aid said, “Madre de Dios!”
The door opened and closed. There goes my witness, I thought.
Although the scaly stuff on her upper body had cleared, Miss 817’s abdomen and legs were covered in the same discoid lesions. They extended over her hips, both legs, and down over the tops of her feet. Gray and smooth and no longer bleeding, but arranged into a sort of shingle-like covering. Now I saw the thing that had scared the wits out of the nurse’s aid. When she wiggled her toes, she didn’t have any. The syndactyly was complete. Fingers and toes.
The thing of it was, she appeared to have just that instant discovered it for herself, because she kept glancing up and down, first at her feet and then at me, and instead of fright or dismay she looked delighted. The “toe” wiggling in fact, was accompanied by an even broader grin.
But then something changed. A membrane seemed to flick across her eyes and I saw hunger there, like when she was eating the yogurt. I suddenly felt like - well, there’s no other word for it. Food.
She still hadn’t said a word so now I did, hoping it was all a dream but knowing very well that it wasn’t. Suddenly, I couldn’t get out of that room fast enough.
“Goodbye,” I said. “I have to go now.”
There’s one thing about me. I have this smooth bedside manner. Without saying a word she had completely intimidated me, I felt like a kid caught behind the woodshed. When the door closed behind me I leaned against the wall perspiring like hell, pulse racing. Unaccountably, I looked at my watch: 10:33. Somehow, I made it over to the nurses’ station.
“Is Terri Barr on duty?”
“She’s in the back, Doctor Trainer. I’ll get her for you.”
Terri told me that the girl had come out of her coma early that morning, waking up hungry and asking for food.
“We’re all absolutely stunned at her progress. I don’t know what’s in that blue juice that Doctor Sims is pumping into her twice a day, but I think I could use a little myself.”
“No you couldn’t.” I said.
“Did you go over to Sims’s office this morning?”
“Yeah, I went. That guy’s as crazy as a bedbug, Terri.”
“Did you find out what he’s giving her?”
“You don’t want to know what it is, Terri. Don’t make me tell you.”
“What do you mean, I don’t . . . .”
Just then a hallway door opened and a wedge of light splashed across the wall. I almost jumped out of my skin. There was Miss Eight-seventeen walking down the hallway toward us, hospital gown open in the front and billowing out behind. Terri saw my eyes and turned to look.
“Modesty, thy name is woman.” she said, and took off down the hall, grabbing a gown off a pile of linens as she went. When she reached her, Terri pushed the sleeves over the girl’s arms and tied the gown in the back. The girl looked at her greedily.
Suddenly, taking us all by surprise, she spoke. I can’t begin to describe how it made me feel. Her voice was like harps. It was beyond beautiful. I found myself wanting nothing more than to . . . No! I thought. I shook my head.
I knew I was past understanding any of it because I found myself thinking, oh, what the hell - she’s got no toes, she’s walking around the halls naked, she’s covered in fish scales. Why shouldn’t she be talking?
“Where can I find doctor Sims?” she said. I felt a pang of longing.
“I’ll call him and he’ll come to your room,” Terri told her. “Now go back and get in bed, please. You’re not supposed to be ambulatory. Doctor Sims will tell us when you’re allowed to get up. And what happened to your intravenous?”
Without protest and smiling that greedy little smile the girl turned on her heel and returned to her room, Terri Barr following. Miss Eight-seventeen’s bare, toeless feet padded silently along the floor, her curvaceous legs covered in those greenish-gray scales disappeared up under her gown. I couldn’t help myself. I watched her all the way.
Now Terri Barr is as tough a floor nurse as any I’ve ever met. And I’ve seen some heavyweight champs. Emergency room nurses who can wrestle coked-up street fighters to a draw and silence a waiting-room full of bawling casualties. But when Terri came out of room 817 she was shaking.
“What the hell happened in there?” I said.
Terri held her right hand out. It was bleeding. “She bit me. The little bitch bit me!”
“Bit you? How the hell did that happen?” I took her hand in mine and examined it. On the back of her hand there were tiny teeth marks in a near-perfect half-circle. There was a small flap of skin lifting away.
“I was just tucking her in . . .”
“Come with me." I said. "Now!”
I took Terri to the procedure room on the sixth floor, not even waiting for an elevator. We just ran down the fire stairs. On the way, Terri told me that when the patient had swung her legs up on to the bed the girl’s thighs seemed to be joined together part way down, just like her fingers.
“I just don’t understand it,” Terri said. “I got the distinct impression that it pleased her.”
“You’re all upset, Terri. There isn’t any such deformity.”
In five minutes’ time I had cleansed Terri’s wound and dressed it over antibiotic ointment. I also gave her a tetanus booster. But I was still worried, unreasonably I guessed, but I asked Terri if she would mind taking a penicillin analog by mouth for a few days.
“You afraid that I’ll bite you?” She was laughing but I could tell that Terri was scared. Frankly, I was too. There’s always something new in medicine but this was beyond medical practice, beyond anything I’d ever seen in fact. Frankly, I was beginning to wonder if Miss Eight-seventeen wasn’t sick as much as she was metamorphosing. Into what, God only knew. And what the hell was that about? I made a mental note to call Mike Regord, the tropical disease man.
“I don’t know about that,” I said. “But think about it, Terri. Nobody’s even taken a history on this girl, if we can even call her a girl. At this point we don’t know who she is, where she came from, who her family is, or for that matter what the hell she is. And as usual, despite best access Sims is clueless. I read his progress notes. It’s starting to look as though she might belong in one of his cages with the rest of the animals.”
Terri shook her head. “That’s cruel,” she said.
“Yeah, the truth hurts,” I said, holding up her bandaged hand.
By the time we got back up to the nurses’ station the eighth floor was in an uproar. Doors were flung open all along the hall, and slippered patients were shuffling around in confusion, clutching at their gowns and bathrobes, and chattering and waving their arms. A nurse appeared from behind the counter.
“Oh, Miss Barr! It’s that patient in eight-seventeen. Doctor Sims came to see her and then he took her away. She was opening all the doors, going into the rooms and scaring the other patients all along the hall. She even . . . .” Her voice gave out and she just stood there trembling.
Terri said, “Pull yourself together, Caroline. Did Doctor Sims say where he was taking her?”
“What’s that?” Caroline said, pointing at Terri’s hand.
“When I took her back to her room, she bit me.” Terri said.
Caroline said, “You’re not the only one! That’s what I’ve been trying to tell you.” The kid held up her hand. There were deep scratches along her wrist and up her forearm.
“I managed to pull myself free.” She was just short of hysteria.
“That will have to be cleansed and dressed,” I said. “Let’s do it right away. Like now.”
“Where did Doctor Sims take her?” Terri said.
As I dragged her toward the stair Caroline shouted back, “To his office!”
“Wait here!” I ordered and ran back to where Terri was.
“Terri! Don’t do anything foolish,” I said. “Stay here on the floor. Just call security and tell them everything. And tell them if they go over there to be careful! Promise me you won’t try to be a hero!”
“Wounded right hand up to God,” she said.
Dressing Caroline’s arm took longer than I thought. By the time I finished Terri was standing at my side.
“Do you think you can return to floor duty, Caroline?” she said. “I’m only asking. But it would mean a lot if you could. The excitement is over and Doctor Trainer and I have to see to something important.”
I turned. “What?” I said.
“We have to go over there.” Terri said. “Security has the floor sealed off.”
When the Annex elevator stopped on the twelfth floor there was a uniformed security man standing by the door. He put his hand out. “No one is permitted down there, Doctor T.”
“It’s all right,” I said. “We’re expected.”
As we headed down the hall, Terri said, “I’m going to wash your mouth out with soap.”
There was another guard at Sims’s office door talking on his intercom.
“It’s all right,” he said, waving us through. “You’re expected.” I was beginning to believe it myself.
Sims’s office was in shambles. Two men in suits and ties were poking around the wreckage. One of them looked up and said, “No one’s allowed in here. Who the hell are you, anyway? Somebody get these people out of here!” The guard outside the door leaned in and said,
“It’s all right Lieutenant. They’re expected.”
“Expected? Expected by . . . .”
“I’m Doctor Trainer and this is Nurse Barr, administrative supervisor on this case.”
“Oh, yeah, right.” the detective said. “Trainer. I saw your name on the hospital chart.” Son of a bitch! I thought. He did it anyway!
“Where is Doctor Sims?” I asked. The detective looked at me with what can only be described as pity.
“He’s in there,” he said, jerking his thumb towards Sims’s lab.
When I walked through the door two men were zipping up a body bag.
“Where’s Doctor Sims?” One of the men nodded toward the body bag.
“Do you know if he was married?” he said. “Did he have any living relatives? Wife? Kids? Mother, father?”
I shook my head. “No,” I said, still not believing what I was seeing with my own eyes. “No living relatives that I know of. If you don’t mind, I want to see him.” I squatted by the body bag.
“No you don’t,” he said. “Not this one. Maybe you can come downtown later on and identify the remains, if they can clean him up good enough.”
The other man said something about Heaven needing some soprano voices in the choir anyway and snickered in a funny way, but the first man gave him a dirty look. The two men lifted the bag onto a gurney and wheeled it out the doorway.
I looked around the big room. Usually raucous, it was strangely quiet now. A couple of monkeys sat in their cages huddled in a corner, just staring. The rat cages, thrown helter-skelter, were all empty.
It was Terri, in Sim’s office. “Come in here and look at this!”
Sims’s big aquarium, about half-full of silvery blue water, was tipped against the wall. There wasn’t a single fish in it.
“Look there!” she said. She pointed with the toe of her white oxford.
“It looks like a . . . .” I bent down.
“Better not touch it!” she said. It was a fish head, one of the bigger ones.
“It must have been one of the six-inchers,” I said. The entire body had been bitten away. You could see the teeth marks. A perfect semi-circle.
“Exactly the same as yours,” I said.
“Yeah, but cleaner,” Terri said. “She chomped straight through those fish bones like they might have been a stalk of celery.”
“I guess she’s a grown-up now.” I said. Terri hugged herself.
“Let’s get out of here.” she said.
During the ensuing investigation the blue-colored infusion fluid was analyzed and found to be ordinary aquarium salt-water with Windex in it.
“So old Oscar was just spinning his wheels,” I said. “Giving her that stuff. I guess the night cleaning staff thought they had to clean the inside of the aquarium glass same as the outside. Maybe they just poured some in and rubbed the sponge around.”
“Only in New York.” Terri said.
Miss Eight-seventeen was never found. Two weeks later I showed Terri a newspaper clipping. Two miles off the Jersey coast a commercial fisherman fell off his boat and was attacked by a small shark. He was nearly dead before they pulled him to safety. The article went on to say that although he would survive he suffered the loss of a hand and his “genitalia in their entirety”. Newspapers can be so delicate.
The reason they knew it was a small shark was because of the semi-circular bite marks.
“I thought mermaids were supposed to help swimmers.” I said.
"Mermaids are supposed to help swimmers,” Terri said. “They’re always sweet and kind. Don’t you remember the movie with Tom Hanks?”
“Maybe Eight-seventeen is not a mermaid,” I said. “Maybe she’s a siren. If I remember my Ulysses, those gals were anything but sweet and kind, luring men to their deaths on the rocks and all that. His children were lucky he had himself tied to the mast.”
“Mermaid, siren,” Terri said. “I’m glad she’s off my floor. She gave me the creeps. I feel itchy all over. That reminds me, take a look at my back, will you Tommy? Just near my bra strap.” She shucked her blouse down.
All I could see was a little dermatitis, with a few crusts forming wherever the bra strap touched.
“That’s where it itches the most,” she said.
“Why didn’t you tell me about this sooner?” The phone was ringing so I didn’t get what she said. She handed me the receiver.
“It’s Caroline. She’s asking for you.”
“Your memory is as bad as mine,” Terri said. “How could you not remember? She’s one of my nurses. You treated her for a lacerated arm when Miss Eight-seventeen tried to bite her.”
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