Free Toxin by Robin Cook

was apparent from some of the entries that Mrs. Arnold was bothering the nursing staff as much as she bothered him. It was also apparent Mr. Arnold was doing fine. This impression was confirmed by the grafts of his vital signs, the input and output sheet, and the previous day’s laboratory values. Satisfied, Kim slipped the loose-leaf chart back into its slot and walked down to his patient’s room.
    Mr. Arnold was sitting up in his bed, eating his breakfast and watching TV. Kim silently marveled at the progress cardiac surgery had made over the last couple ofdecades as evidenced by this individual. Here was a seventy-year-old man who less than forty-eight hours previously had been gravely ill and had had open-heart surgery. His heart had literally been stopped, opened, and repaired, and yet he was already relatively happy, mostly pain-free, and enjoying a significant improvement in the quality of his life. Kim couldn’t help but feel a keen disappointment that such a miracle was being devalued in the current economic environment.
    â€œHow are you feeling, Mr. Arnold?” Kim asked.
    â€œPretty good,” Mr. Arnold said. He wiped his chin with his napkin. When he was by himself, Mr. Arnold was a pleasant gentleman. It was when the husband and wife were together that the sparks began to fly.
    Kim interrupted his patient’s breakfast long enough to check on the dressing and the amount of drainage. Everything was progressing on schedule.
    â€œAre you sure I’ll be able to play golf?” Mr. Arnold asked.
    â€œAbsolutely,” Kim said. “You’ll be able to do whatever you want.”
    After a few more minutes of banter, Kim took his leave. Unfortunately he ran into Gertrude Arnold on her way in.
    â€œThere you are, doctor,” Mrs. Arnold said. “I’m glad I caught you. I want a private-duty nurse in here around the clock, you hear?”
    â€œWhat’s the problem?” Kim asked.
    â€œThe problem?” Mrs. Arnold echoed. “I’ll tell you what the problem is. The nurses on this floor are never available. Sometimes hours go by before we see one. And when Harvey rings his call button they take their sweet time.”
    â€œI imagine that’s because they believe Mr. Arnold isdoing well,” Kim explained. “And that they are devoting their time to patients who are not doing quite so well.”
    â€œNow, don’t you start making excuses for them,” Mrs. Arnold said. “I want a nurse in here all the time.”
    â€œI’ll have someone come to talk to you about it,” Kim said.
    Momentarily mollified, Mrs. Arnold nodded. “Don’t make me wait too long.”
    â€œI’ll see what I can do,” Kim said.
    Back at the nurses’ station Kim told the ward clerk to page the AmeriCare administrator and have him come up to talk to Mrs. Arnold. Kim couldn’t help smiling as he waited for the elevator. He would have loved to hear the conversation that would ensue. The idea of causing the AmeriCare administrators a little grief was enormously entertaining.
    The elevator arrived and Kim squeezed on. It was remarkably crowded for a Sunday morning. Kim found himself pressed up against a tall, bony resident dressed in the typical “whites” and whose name tag read: JOHN MARKHAM , M . D ., PEDIATRICS .
    â€œExcuse me,” Kim said. “Are there any enteric viruses making the rounds these days in school-age kids?”
    â€œNot that I’m aware of,” John said. “We’ve been seeing a pretty nasty strain of the flu, but it’s all respiratory. Why do you ask?”
    â€œMy daughter’s got a GI upset,” Kim said.
    â€œWhat are the symptoms?” John asked.
    â€œIt started with cramps yesterday morning,” Kim said. “Then diarrhea. I’ve treated her with some over-the-counter antidiarrheal agents.”
    â€œHas it helped?” John asked.
    â€œI thought so at