“He’s right. You’re wasting time, and you aren’t even a doctor.”
I turned toward her.
“Who told you that?”
Her expression changed.
“Julian said you did consulting work from home.”
“Julian lied.”
I removed my hospital identification card from my wallet. It carried my maiden name, Dr. Elena Vance, and my specialty: Cardiac Electrophysiology.
Valerie stared at it.
“I specialize in heart-rhythm disorders,” I said. “Julian’s potassium is critically low. That can cause muscle weakness, confusion, and dangerous arrhythmias. His sodium and kidney results indicate severe dehydration. Those problems need immediate treatment.”
Dr. Lin reviewed the numbers again.
“We’ve started controlled potassium replacement,” he said. “I’ll add magnesium testing, repeat his metabolic panel, and order toxicology.”
“Please check for medications and supplements,” I said.
Valerie’s hand moved toward her coat pocket.
A nurse arrived with the sealed bag containing Julian’s belongings.
“Did you find any medication?” I asked.
She checked the inventory.
“There’s an unlabeled container with several red and silver capsules.”
Valerie went pale.
“What are they?” I asked her.
“I don’t know.”
“Then why did you react?”
“I didn’t.”
“The hospital can test them. If they contributed to Julian’s condition, the doctors need to know where they came from.”
“They’re ordinary supplements.”
Barbara turned toward her.
“How do you know?”
Valerie froze. She had identified them without seeing them.
“They’re natural weight-loss capsules,” she finally admitted.
“Did you give them to Julian?”
“He asked me about them.”
“That wasn’t my question.”
Her eyes moved toward the exit.
“Valerie, his potassium is low enough to stop his heart. Did you give him those capsules?”
“Yes,” she whispered. “A few weeks ago.”
“How many did he take tonight?”
“He said he’d taken two that morning. At my apartment, he complained that they weren’t working anymore, so I gave him two more.”
“Had he eaten?”
“No.”
“Did he drink alcohol?”
“We shared some wine.”
Julian had taken four unregulated capsules while fasting, then combined them with alcohol, dehydration, and weeks of poor sleep.
“What did you do during the 23 minutes before calling 911?” I asked.
“I tried to wake him.”
“Did you hide the packaging?”
“No.”
“Then give the doctors the original box and the website where you bought it.”
“I threw it away.”
Arthur stepped toward her.
“You gave my son dangerous pills and then waited while he was unconscious?”
“They were advertised as natural!” she cried. “I didn’t know this would happen.”
Before anyone could respond, a senior cardiologist approached with the repeat ultrasound.
Dr. Marcus Cole had supervised part of my fellowship in Boston.
“The second scan shows only a small, harmless amount of fluid,” he said. “There’s no cardiac compression and no need for a drainage procedure. The first image mistook surrounding tissue for a larger collection.”
Barbara covered her mouth.
“The immediate danger is his unstable rhythm caused by severe electrolyte depletion,” Dr. Cole continued. “We’re transferring him to intensive care while we replace his potassium and fluids.”
Arthur sank into a chair.
“Will he survive?”
“We expect him to recover, but he isn’t safe yet.”
