Read Online Critical by Robin Cook - Free Book Online Page B

exquisite detail. Jack felt that too much attention to detail initially prejudiced his ability to keep an open mind, while Laurie felt that not going over the history increased the chances she'd miss something. They'd argued over the issue but had finally agreed to disagree.
    "I think you should read this," Laurie said in a serious tone, extending a case toward Jack. "I think you will find it personally disturbing."
    "Oh?" Jack questioned. He read the victim's name, David Jeffries, which he did not recognize. His brows knitted in confusion over Laurie's comment and tone as he slid out the contents of the envelope. "What do you mean, 'personally disturbing'?"
    "Just read the PA's investigator's note," Laurie suggested. PAs were physician assistants who worked as forensic investigators. It was the OCME's policy that PAs visited the scenes when indicated rather than forensic pathologists. The Chief Medical Examiner, Dr. Harold Bingham, felt strongly that it wasn't an efficient use of the M.D.'s time, despite his recognition that in some cases a site visit was crucial to determine the mechanism and manner of death.
    It took only a few sentences for Jack to understand. David Jeffries had died of a fulminant postoperative staphylococcus infection following an anterior cruciate ligament repair, due to a particularly nasty type of staph called methicillin-resistant staphylococcus aureus, or MRSA. Considering the argument he and Laurie were having over Jack's upcoming surgery, it seemed coincidentally relevant, even if it involved another hospital. "I know what is going through your mind," Jack said, "but it ain't going to change my mind. I've already taken into consideration the risk of postoperative infection. Fearmongering is not going to work."
    "But this coincidence has to give you pause," Laurie said. She knew it would certainly give her more than pause if the situation were reversed and she was slated to have the surgery.
    "Frankly, it doesn't," Jack said. "First, I'm not superstitious, and second, I specifically asked Dr. Anderson what his postsurgical infection rate was. He told me that the only postoperative infections he'd had over his entire career involved compound-fracture repairs, which are a totally different situation. Besides, this case you're showing me involved University Hospital." Jack tried to return the file to Laurie, but she wouldn't take it.
    "If you'd read further, you'd see that's not the case."
    "What do you mean?" Jack asked. He felt himself getting irritated about the surgery issue all over again. Laurie could be like a dog with a bone, which he found frustrating at times, although he knew people often accused him of having the same trait.
    "The patient had had his surgery eleven hours earlier at Angels Orthopedic Hospital, not University Hospital. The reason he ended up at the University Hospital was to treat his septic shock and fulminant staphylococcal pneumonia."
    "Really?" Jack's eyes went back to the PA's note. Although he trusted that Laurie would never make such a thing up he had to read it himself.
    "This has to worry you," Laurie said. "The fact that they had to transfer a critically ill patient at all doesn't speak very highly for the Angels Orthopedic Hospital. What kind of hospital outsources its dirty laundry? The patient apparently died in the ambulance. That's crazy!"
    "New treatments for septic shock require specialized personnel," Jack said. He was distracted by what he was reading. The rapidity with which the patient's infection progressed was shocking. Jack, as the OCME's putative infectious-disease guru, from having made several -- what he called lucky -- diagnoses on cases of infectious disease ten years ago, couldn't help but be impressed. In fact, he started to wonder if Mr. Jeffries had had a more truly infectious disease like Rocky Mountain spotted fever.
    "Was the infectious agent unequivocally proved to be staph aureus?" Jack asked. He tried to remember what other known