Ardyth responded with negative answers to questions about drugs, alcohol, allergies, blows to the head. A careful physical examination ruled out appendicitis, inflamed ovaries, gallbladder problems. Each successive test was normal, until Jordan examined Ardyth’s eyes with the ophthalmoscope. There was a slight papillidema, a swelling of the optic nerve.
By now Jordan was beginning to feel really concerned, wondering if this was a brain tumor, but there were a few questions she still needed to ask.
“Ardyth, has there been any change in your diet recently?”
The girl shook her head. “I’m a vegetarian. I’m very health-conscious and careful about what I put in my body.” Her expression was virtuous. “I take tons of vitamins and I don’t eat sugar or saturated fat. Oww! Oh my God, do something! It hurts.” Bent double, she cradled her stomach, moaning.
A warning bell went off in Jordan’s brain. Taking iron tablets on an empty stomach could lead to excruciating cramps.
“Exactly what vitamins do you take, and how many?”
As the pain eased, the girl rattled off a dozen or more names, adding that she swallowed massive quantities.
“Have you taken any new ones recently?”
“Only more vitamin A.”
“How much more?”
“Seven extra pills. My skin’s been breaking out—vitamin A cures acne.”
“How long have you been taking that dose?”
Ardyth shrugged. “A couple of months now, I guess.”
“How many international units per pill?”
“Five thousand.”
“And when did you take your last mega dose?”
“A few hours ago.”
Thirty-five thousand units of A, ten to twenty times a normal dose, taken daily for sixty days. Jordan was pretty sure she had the answer to Ardyth’s symptoms, and it gave her a feeling of satisfaction. At least her personal problems weren’t interfering with her diagnostic ability. Yet.
“My guess is you have acute vitamin A intoxication, Ardyth,” she said gently. “I think if you stop taking it, your symptoms will disappear. We’ll run some tests, though, just to be absolutely certain we’re not missing anything here.”
Jordan was jotting down orders for a CAT scan and an upper GI series when Lola stuck her head into the cubicle.
“Jordan, a guy’s just been dumped outside Emerg. He’s unconscious—whoever brought him sped off in a car. They’re bringing him in now. Billy says he’s got track marks, so it’s probably an overdose. Can you come?”
“Be right there.” Jordan handed orders to an aide and then sprinted after Lola. There’d been a series of drug overdoses in the past two weeks, a result of exceptionally strong heroin having hit the downtown Vancouver streets. Usually the Emergency Response Team brought the victims in, but sometimes bodies were dumped at the door by people who didn’t want to get involved.
Orderlies and nurses were lifting the limp male figure onto a stretcher when Jordan arrived. The patient’s face was obscured by a nurse’s arm, but Jordan saw at a glance that this wasn’t the usual skid-row addict.
Caucasian, well-dressed, charcoal sports jacket, black trousers, blue silk shirt—
She struggled to get her breath as a wave of dizziness swept over her. She recognized that shirt. Reaching past the nurse, Jordan took hold of the man’s jaw and turned his slack face toward her, and her worst fears were confirmed.
Garry. It was her husband. She’d bought him the shirt for Christmas.
Someone on the medical team was calling out his vitals, but Jordan barely heard it. One of the nurses was holding Garry’s wallet, going through it to determine his identity.
“Hughes, Garry M., DOB 1968, March 13.” As the woman read out the information on his driver’s license, for one shameful instant Jordan was relieved she’d retained her maiden name.
“I’ll see if he’s listed in the book,” the nurse said. “We may need next of kin.”
The number was listed, but Jordan knew there was no one home in their Kitsilano apartment. The nurse would get the message Garry had recorded for the answering service.
“Jordan? Hey, Jordan, what’s up? You okay?”
She suddenly realized everyone was waiting for her, looking at her—puzzled, impatient.
She should tell them about Garry and have someone else take over. It was against policy to treat a relative. Instead, like an automaton, she began the necessary assessment, even though she knew beyond a doubt what was wrong. Of course he’d taken an overdose. Her husband was a junkie.
“Pulse forty, respiration down to eight,” Lola reported. “We’re not getting a BP, Jordan. This guy’s on his way out…. He’s flat! Now we’re not getting much of a pulse at all.”
“Establish a line. Let’s give him Narcan.” She felt cold and detached and far away as she picked up the syringe with numb fingers and inserted naloxone hydrochloride into the IV valve.
In cases of overdose, the drug’s effect was miraculous. It instantly reversed the action of narcotics, and a patient who’d been on the verge of death only seconds before suddenly became awake and alert, just as if nothing had happened. In the E.R., they called it the Lazarus Effect. Except Lazarus had probably been grateful.
Everybody watched and waited. It only took a few seconds.
“Brace yourself, boys and girls,” someone murmured.
The instant the powerful drug reached Garry’s bloodstream, his sky-blue eyes flew open. A frown flickered across his smooth forehead as he stared up at the faces of the medical team grouped around the stretcher.
Inevitably his gaze came to rest on Jordan. As recognition dawned, his features contorted with rage. He grasped the sides of the gurney and pulled himself up as staff members struggled to control him. He was a big man, and it looked as if they were going to lose the battle.
“Call a code white,” someone yelled. “He’s freaking on us.”
Code white was an emergency call to security.
“Jordan?” Garry spat her name out. “What the hell have you done to me?”
Her mouth felt numb, her throat dry. She cleared it, amazed that her voice still worked. “You overdosed. I used Narcan to bring you out of it.”
It took a moment for Garry to react to that, and when he did Jordan wanted to turn her back and run from the room.
“You bitch!” he screamed at her. “You filthy bitch, you ruined my high, what the hell’s wrong with you? Do you have any idea what you’ve done, you stupid fool?” He tried to shake off the hands restraining him so he could climb off the table.
Jordan couldn’t move. She saw shock on the faces of her co-workers. They were staring at her, some of them open mouthed.
She was surprised when her voice burst out loud and strong. “Call a code white and get him out of here,” she ordered.
“You know this guy, Jordan?”
“Yes.” Her voice was unnaturally calm now. It seemed to come from a long distance away and belong to someone else. “I know him. Of course I know him. He’s my—he’s my husband. Get the equipment off him, I’m discharging him.”
She saw the glances that passed among the staff. They knew she