Perry instantly sprang to his feet.
"Della?" he called out, leaning over her and putting a hand on her shoulder.
As he feared, she did not wake.
He could try no other interventions of his own, for a group of medical professionals swarmed around the bed, unceremoniously sweeping him aside.
Stepping back, reminding himself over and over to let the nurses and orderlies do their jobs without interruption, Perry watched in wide-eyed horror as organized chaos began.
"We're going to need another IV line in her other arm!" Annette cried out.
"I'll put one in," a different nurse said, tying a tourniquet around Della's right arm so quickly that her fingers were almost a blur.
"Someone get the emergency medications cart!"
"I can't get the IV line in, her veins are too small!"
"Here, let me try," an older nurse said, nudging her colleague out of the way. She was successful, but Perry winced as the large needle was driven into Della's arm.
Then there was the sound of pounding footsteps, and for the first time in their long acquaintance, Perry Mason saw Bill Hawley literally running. The physician sprinted into the room, dashed towards Della and felt her carotid pulse for himself, and began to call out orders.
"Call Dr. Jeremy Liao, immediately! And get the electrocardiograph machine." He looked at Annette. "Did anything precipitate this?"
"Not that I know of. She seemed perfectly well when she went to sleep about two hours ago. I discovered her low heart rate during a routine vital sign check."
A huge machine was wheeled into the room, and Dr. Hawley started to connect Della to it by way of adhesive pads and wires.
It was then that the charge nurse noticed Perry in the corner of the room, and approached him.
"Sir, you cannot be in here right now. Please go to the waiting room."
"No." Perry answered, rather shortly, gazing over her head at the scene taking place around Della's bed.
"Sir, according to hospital policy-"
"I'm her lawyer, and her close friend, and she has given her physician permission to disclose everything about her medical condition to me. I am staying right here."
Clearly unaware that she was attempting to win an argument with one of the best debaters in California, the nurse opened her lips to protest further when Dr. Hawley, who had overheard the exchange, tersely interrupted.
"Kellie, let him be, and go and find out if Dr. Liao is on his way." He then turned back to his patient, not even catching the grateful look which Perry Mason sent his way.
The nurse turned away in a huff and went out into the hall.
Perry's victory was a hollow one, for the next words he heard Bill Hawley mutter were,
"Twenty-five beats per minute. It's dropping."
O, God, no, no! Please don't take her! was the attorney's silent, wild prayer. Perry felt crushed by his own helplessness. There was nothing else that he could do, except stand by, and petition the One who had the ultimate say over life and death.
Dr. Liao ran into the room a minute later.
"What happened?" he asked breathlessly. Dr. Hawley gave him an abbreviated report, and the cardiologist bent over Della and pressed his stethoscope to her chest. Straightening up, he said slowly, "I know that you said that the stimulant you gave her yesterday during such a spell provoked an arrhythmia, but I think the best course of action would be to give her another, gentler stimulant and start it at a very, very low dose. We simply have to bring her heart rate up."
"But what if the arrhythmia recurs?"
"That is a chance we are going to have to take," Dr. Liao said. He then added, "She's dying anyway, Bill."
Dr. Hawley considered, and nodded. Perry's face was ashen. Della, dying!
The cardiologist asked one of the nurses to draw up a syringe of the desired medication, and then, glancing at one of the orderlies, murmured:
"In case we can't get her out of this alive, I think it would be prudent if you were to call the hospital chaplain to bedside."
The staff member nodded and disappeared to make the phone call. Perry grasped the wall, trying to steady himself. Three hours ago he had been laughing with her and trying to convince her to stay a few more days in the hospital for observation, and now Della was a candidate for the Last Rites!
The syringe was handed to Dr. Hawley, and Perry looked at the small amount of clear liquid in it with dread. It could help Della…or it could kill her.
Lord, please let her live. I beg You!
Dr. Liao bent down again and practically plastered his stethoscope to Della's chest.
"All right, Bill, push it in, very slowly." His colleague connected the syringe to one of the IV lines, and almost imperceptibly, began to push the plunger downwards.
After sixty seconds, Dr. Liao suddenly called out,
"STOP!"
Bill Hawley relaxed his grip on the syringe and looked at the cardiologist. Jeremy Liao shook his head. "Her heart just skipped a beat. The medication is about to cause another arrhythmia." The two physicians stared at the paper which was slowly coming out of the electrocardiograph machine. Dr. Hawley pointed to a particular section of it.
"I see the irregularity," he acknowledged. "And the machine is reading her heart rate at twenty beats per minute."
"And unfortunately, it is accurate." Dr. Liao said, straightening up. He took another look at the print-out, and stared at it expectantly for an additional thirty seconds. "At least her heart is not skipping any more beats. It seems like we stopped the medication quickly enough to avoid a full-blown arrhythmia."
Perry felt a sliver of gratitude upon hearing this.
"But what should we do about the bradycardia?"
"If we cannot reverse it, then all we can do is to try to keep her brain and vital organs as oxygenated and perfused as possible. Let's give her a bolus of IV fluids, prop up her legs, and get her some oxygen."
A large black oxygen mask was forced over Della's nose and mouth. The nurses opened the IV lines and let copious amounts of liquid run into her veins. And in the meantime, a priest arrived, deftly wove his way through the throng of medical professionals, and began to anoint Della's forehead and hands with holy oil.
Perry stood shaking like a leaf.
…..
An hour later, the nurses and orderlies began to slip out of the room, one by one. A few remained behind for a few more minutes. They moved around quietly and tidied the room, picking up the medical supplies and blankets which had been hurriedly cast aside during the crisis. The relative lack of hustle and bustle made the hissing sounds of the oxygen mask all the more prominent.
Looking very weary, Dr. Liao and Dr. Hawley approached the pale defense attorney who was somehow still standing on his own two feet. Before the physicians could begin the conversation, the lawyer blurted out,
"Is she stable now?"
Dr. Hawley carefully answered him.
"That is not the word I would use. 'Stable' implies that you expect nothing bad to happen in the near future. All we can tell you is that, at this moment, her heart rate has slightly risen and plateaued at thirty beats per minute. As far as we know, ten minutes from now, it could be forty, seventy, or zero."
Perry stared fixedly at the unconscious woman lying in the hospital bed.
"Is there truly nothing else that could be done? If there is any treatment, anywhere – even across the country or abroad, which could possibly help her – please send her there to try it! Expense is of no importance."
"No, Perry, there is not," Dr. Hawley rejoined. "I would move heaven and earth to save her, you know that. But as it is, I can only advise you to keep praying for a miracle, and to prepare yourself for the worst."
"It may be the 1950s," Dr. Liao gently chimed in, "but we can scarcely diagnose or cure all diseases. In the interests of full disclosure, some of my cardiology colleagues in the east are working on a device called a 'pacemaker', which can send electrical impulses to the heart and speed it up in cases such as these. However, it will still take several years for them to perfect the device and start using it, even experimentally, in humans. And from the looks of it, Ms. Street likely does not have years – or weeks, even."
"So we just sit here and wait – wait for her to - " Perry's voice broke.
"She improved once, she may or may not improve after this spell…but now, we know that her condition is a repetitive one. Even if she appears to recover fully in the next few days, I cannot promise you that she will remain well." Dr. Liao sighed. "In the meantime, we are doing everything to increase her blood's volume and oxygen content, in the hopes of ameliorating the effects of the slow heart rate on the rest of her body. Even so, some brain damage might already have been done. If she lives through the night, I will send a neurologist in the morning to assess her, but right now, I would say that is a pretty big 'if'."
Perry swallowed the lump in his very, very dry throat. He faintly felt Dr. Hawley's comforting grip on his arm, but it felt as if it were miles away.
"Can I touch her hand?" he asked.
"Yes, but be careful. Any sudden jolt might very well kill her. We will stay very close by for the rest of the night. And we will leave the electrocardiograph machine connected to her for now. We usually do not monitor patients with it for a very long time, but in this case, the more information that we can accumulate, the better."
The physicians filed out of the room, leaving Perry alone with the woman he loved.
Gingerly, he crept nearer to the bed. He noted that the figure in it resembled a corpse more than his vivacious secretary. Only the slight rise and fall of her chest and the tracings on the electrocardiograph's print-out indicated that she still lived. And yet, he loved her more fiercely than ever.
He sank down into a bedside chair and tenderly wrapped his fingers around her cold ones. Leaning towards her white face, which was half-covered with the oxygen mask, he whispered:
"Hold on, Della. My darling…hold on!"
It seems that the mob boss was right...Perry might have a mental breakdown if he ever goes through THAT again.
The electrocardiograph machine is basically an EKG. It turns the heart's electrical impulses into tracings on a piece of paper. Doctors use it to diagnose arrhythmias, etc. Despite my research, I am not sure exactly how EKG machines worked in the 1950s or whether they had continuous print-outs of their results like they can now, but bear with me!
Pacemakers, according to my research, were first used in 1960. Since this story is set in the 1950s, they can't be used to help Della, as Dr. Liao said.
I know you are all wondering how exactly the mob has managed to harm Della – I promise there will be a BIG development on this topic in the next chapter.
I'll try to get the rest of this story written up and posted as quickly as possible, but I am moving in a few weeks, so please do have some patience with me if I don't post as often as I usually do. I really appreciate your interest and reviews, so I will try to prioritize it as much as I can!
As always, please review!