Read Natural Causes for Free Online Page B

ambulance, the question that had confounded
that
woman’s doctors burned in Sarah’s mind:
Why?

CHAPTER 4
    S IX OF THE NINE S UFFOLK S TATE H OSPITAL BUILDINGS originally purchased by the Medical Center of Boston were still in use. Two of the others had been razed and replaced with parking facilities. The third, a crumbling six-story brick structure with the name CHILTON etched in concrete over its entrance, had been abandoned and boarded up when Sarah began her training, and remained so—a mute reminder of the hospital’s ongoing financial difficulties.
    The Chilton Building and garages were separated from the rest of the hospital by a broad, circular drive. Enclosed within the loop was an expansive, grassy courtyard, dotted by some shrubbery and half a dozen molded plastic picnic tables. Vehicle access to “The Campus,” as Glenn Paris had named the area, was restricted to those administrators and department heads with parking slots, and to emergency room traffic.
    The ride from Knowlton Street to MCB, spearheaded by the sirens of the police cruiser and rescue squad, took fifteen minutes. Seated beside Lisa Summer in the back of the lurching ambulance, Sarah heard the driver radioahead that a Priority One patient was on the way. She pictured the guard, suddenly puffed with importance, scurrying to open the security gate and move all traffic aside.
    Lisa’s contractions, now occurring every four minutes or so, were forceful and prolonged. However, Sarah’s gentle exam had disclosed a cervix that was still only four centimeters dilated—far from being ready for delivery. The bleeding from her nose and mouth was, if anything, more brisk. And although her left hand and both feet still had some warmth and capillary blood flow, her right arm was now pallid and lifeless from the elbow down.
    “Hang on, Lisa,” Sarah urged. “We’re almost there.”
    As they turned onto the MCB access road, Sarah reviewed her knowledge of DIC. Having never encountered a severe case of it during her training, her understanding was essentially what she had gleaned from a lecture or two in med school, some reading, and an occasional conference. Rather than being a single, specific disease, the condition was an uncommon complication of many different sorts of injuries or illnesses. Surgery, shock, overwhelming infection, massive trauma, drug overdose, toxins, abrupt separation of the placenta—any of a number of insults to the human body could result in DIC. And in part because of the severity of the predisposing condition, full-blown DIC was, more often than not, fatal.
    But Lisa Summer was neither injured nor ill. She was a healthy young woman at the end of a totally uncomplicated pregnancy. Perhaps this wasn’t DIC after all, Sarah thought.
    The siren cut off as they neared the hospital. Sarah did a quick blood pressure check and exam and began mentally preparing the presentation she would give to Dr. Eli Blankenship. It was her job to present the facts in a totally unbiased manner, carefully avoiding her own diagnostic impression or any other leading statements.Until a diagnosis was proven, assuming one to the exclusion of others was foolish and potentially very dangerous.
Assume makes an ass of u and me
was the way one professor had stressed that principle.
    Eli Blankenship, perhaps the sharpest medical mind in the hospital, would combine her information with his observations. He would then come up with an approach to diagnosis and treatment. Meanwhile, if therapy could not be held off until a definite diagnosis could be made, they would simply have to say a quiet prayer and forge ahead with what measures seemed likeliest to help.
    In this case, with two lives already hanging by a thread, it was unlikely they could wait for any laboratory results before instituting treatment. And the treatment for DIC was, itself, life-threatening. All in all, Sarah knew, it was going to be one hellish day for Lisa Summer and the dozens of