At that point the evening house doctor, Dr. Sarla Dayal, arrived at a run. She crowded in at the head of the bed, and Dr. Krishna gave her a rapid summary of what had happened.

“When I got here he was definitely cyanotic,” Dr. Krishna said, “and the cardiac monitor looked reasonable, but it’s only one lead. The problem was, he’d stopped breathing.”

“You think it was a stroke?” Dr. Dayal questioned. “Maybe a heart attack precipitated a stroke of some sort. The patient has a history of occlusive cardiovascular disease.”

“Could be,” Dr. Krishna agreed. “It does look now like the cardiac monitor is telling us something. The rhythm is certainly slowing.”

Dr. Dayal placed a hand on the patient’s chest. “The heart rate is slowing and feels rather faint.”

“It’s probably the patient’s obesity.”

“The patient also feels really hot. Take a feel. I’ll breathe for a while.”

Dr. Krishna turned the ambu bag over to the house doctor and felt David Lucas’s chest. “I agree with you.” He looked over to one of the floor nurses. “Let’s get a temperature!” The nurse nodded and got the patient’s thermometer.

“Do we have a cardiologist on call?” Dr. Krishna asked.

“We certainly do,” Dr. Dayal said. She called over to the other floor nurse to give Dr. Ashok Mishra a call and ask him to come in immediately. “Tell him it’s an emergency,” she added.

“I don’t like that the heart rate keeps slowing,” Dr. Krishna said, watching the monitor. “Let’s get a stat potassium level.”

The floor nurse who was not on the phone drew some blood and rushed it off to the lab herself.

To stay out of the way, Raj had slowly backed away until he’d hit up against the wall. He was thankful that people were so involved in the resuscitation activity that he was being virtually ignored. He again began to think about slipping out, although the specter of drawing attention to himself made him stay put.

“Dr. Mishra will be in as soon as he can,” the nurse yelled out while hanging up the phone. “He’s finishing up with another emergency.”

“That’s not good,” Dr. Krishna said. “I have a bad feeling. With this progressive bradycardia, it might be over by then. This heart is definitely having trouble. It looks to my untrained eye as if the QRS interval is widening.”

“The patient definitely has a fever,” the nurse blurted, staring at the thermometer in disbelief.

“What is it?” Dr. Krishna demanded.

“It’s over one hundred and nine.”

“Shit!” Dr. Krishna shouted. “That’s hyperpyrexia. Get ice!”

The floor nurse ran out of the room.

“You must be right, Dr. Dayal,” Dr. Krishna moaned. “We must be dealing with a heart attack and a stroke.”