The Robler Clinic is getting a reputation for too many deaths during routine operations. A gorgeous female administrator, Ms. Kathy Hahl, is discovering a profitable little racket, and her tame anesthetist, Dan Demmet, is playing along nicely.
When timid mother-dominated Nathan David Wilberforce -- a subject of special interest to CURE -- comes to a premature death at the clinic, Remo and Chiun decide it is time to infiltrate... And it is Remo who books in as the "patient" -- exposing him to the rare and deadly aging drug.
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December 01, 2002
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Excerpt from The Destroyer #15: Murder Ward by Warren Murphy
Dr. Daniel Demmet was a true professional. When he decided it was time to kill his patient, he first made sure that the critical body functions were doing well. He checked the electrocardiogram screen, as he had been checking it since the patient had been wheeled into the operating room of the Robler Clinic, one of the finer hospitals just outside of Baltimore. Dr. Demmet sat on a stool behind the patient's head, from which point, as a modern anesthesiologist, he could best supervise and protect the patient's hold on life. The surgeon, working a few feet from him, was too busy rearranging the body with instruments to worry about his life. The surgeon worked on the appendix; the anesthesiologist worked on the patient.
The screen showed normal sinus rhythm, a sharp beeping line across the screen, which caught the electrical impulses from the heart. At the first sign of trouble, the wave would become ectopic, indicating cardiac malfunction.
On the screen, death was a smooth flowing line, with little hills; life was sharp and discordant. What Dr. Demmet continuously looked at was the line that guaranteed life. Perfect. A perfect sinus rhythm. The low hill, the deep valley, the high peak, another valley, and then the pattern all over again. All this in a beep. Life.
Perfect. But then, why shouldn't it be? The patient was healthy, and Dr. Demmet had done his job well, in the best tradition of modern, balanced anesthesia. Gone were the days when good doctors would knock out a patient with a single massive dose of a potentially lethal chemical, with the inevitable residual toxicity that left the recovering patient nauseated, uncomfortable, and, sometimes, in pain.
Now, anesthesia is a symphony. Demmet had given the patient, a healthy, forty-five-year-old male, an initial injection of sodium pentothal, which put him quickly to sleep. The opening note.
Then oxygen through the anesthesia machine to assure good breathing. Intravenously, the succinylcholine, which relaxed the body muscles and made way for the endotracheal intubation, affording Dr. Demmet greater control over the patient's breathing. Then, through the anesthesia machine, nitrous oxide, a further nerve depressant. And finally halothane. Very carefully with the halothane, for this was the basic anesthetic of the operation.
It was also what was going to kill the patient.
Intravenously, Dr. Demmet administered a small amount of curare to relax the stomach muscles, making the appendectomy that much easier for the surgeon to perform. The electrodes of the electrocardiograph were attached to both arms and a leg. There was a constant intravenous flow of 5 percent dextrose. Dr. Demmet felt for the pulse, checked the blood pressure, listened to the heartbeat through a stethoscope, which was not of course as accurate as the electrocardiogram but still a good backup check. Then he proceeded to kill the patient.
He also did something that never appears in television dramas or great romances about hospitals but that is not at all uncommon in real operating rooms.
He passed gas. Sitting on high stools for several hours, under great tension and with great need for concentration, anesthesiologists help make operating rooms smell more like lavatories than like Marcus Welby's office. This is reality. No one ever comments, because everyone is too busy to notice.