Chapter 4 4

The phone on the polished table in the clinic's waiting room vibrated against the glass. It was a continuous, angry buzz.

Ingram answered. His face went gray.

"Turn around," he barked at the driver over the phone. "New York Presbyterian. Now."

"What is it?" Elmira asked. The act was dropped.

"My grandmother," Ingram said, staring straight ahead. "Cardiac arrest."

The Rolls Royce tore through traffic, an invisible siren of pure wealth parting the cars. When they reached the hospital, they bypassed the waiting room and went straight to the VIP wing.

Chaos reigned in the hallway. Doctors were shouting. Nurses were running.

Elmira followed Ingram. A security guard stepped in her path.

"Let her through," Ingram commanded, his voice cracking like a whip. "She's with me."

They burst into the suite. The sound of the EKG was a flat, high-pitched whine.

Beeeeeeeeeeep.

A team of doctors hovered over the bed. They were charging the paddles.

"Clear!"

"No!" Elmira shouted.

Everyone froze. Eleanor Holmes, Ingram's mother, stood by the window, her face a mask of perfectly applied makeup and hysteria. "Get that trash out of here!"

Elmira ignored her. Her eyes scanned the room. The IV bag. The empty medication cup. And there, on the bedside table, a small glass bottle with a gold label. Herbal Supplements.

She saw the patient's chart at the foot of the bed. Digoxin.

Her brain snapped the pieces together. Digoxin and certain herbal stimulants caused a feedback loop. Electrical storm.

"Don't shock her," Elmira said, stepping forward. Her voice was low, deadly calm. "Her heart isn't stopped. It's in tetany. If you shock her, you'll rupture the ventricle."

"Who the hell are you?" the lead doctor demanded. "She's flatlining!"

"Look at the waveform," Elmira pointed. "It's not flat. It's oscillating at a frequency too high for your monitor's filter. It's ventricular fibrillation, not asystole."

She reached the bedside. A guard grabbed her shoulder.

Elmira didn't flinch. She turned her head slightly. "If you touch me, I will file a complaint for assault with the hospital board and the state medical licensing authority. Your name is David, badge number 743. Do you want that on your record?" He gasped and his arm went limp.

She turned to Ingram. "Give me three minutes. Or watch her die."

Ingram looked at the doctors, who were panicking. He looked at his mother, who was screaming. Then he looked at Elmira.

He saw something in her eyes. Absolute certainty.

"Let her try," Ingram said.

"Ingram!" Eleanor shrieked. "Are you insane?"

Elmira didn't wait. She spoke to the nearest nurse. "I need a 10cc syringe of magnesium sulfate and a vial of Digibind. Now. The magnesium will stabilize the cardiac membrane. The Digibind is the antidote for the digoxin toxicity you're witnessing."

The doctors gasped.

Elmira's voice was pure command. "Her potassium levels are likely through the roof from the supplement. The magnesium will counteract it. Move!"

The lead doctor, stunned into action by her confidence, nodded at the nurse. "Get it!"

"She's killing her!" Eleanor lunged forward.

Ingram stepped in front of his mother, blocking her path. "Wait."

Ten seconds. Twenty seconds. The nurse returned with the syringe and vial. Elmira didn't touch them. She pointed to the IV port.

"Administer the magnesium first, slow push over two minutes. Then the Digibind."

The doctor, his own authority usurped, hesitated for a second, then injected the medication himself.

The monitor screamed as the heart rhythm fluctuated wildly.

Beep.

Silence.

Beep... Beep... Beep.

The rhythm returned. Slow. Weak. But there.

The lead doctor stared at the monitor, his mouth open. "Sinus rhythm restored. BP is stabilizing."

Elmira took a half-step back, her hands clean, her involvement purely intellectual. She slipped back into the shadows, lowering her head, shrinking back into the role of the terrified girl.

"I... I read about it in a medical journal once," she whispered.