Fever Dream

By J.J. DiBenedetto

Dr. Sara Alderson isn’t used to her patients dying for no reason. When a young boy succumbs to a mysterious illness that defies all her efforts to treat it, she refuses to accept defeat.

After two months of questions, Sara has attracted the attention of powerful people who don’t want their secrets uncovered, and will go to any lengths to make sure they stay hidden.

Now, time is running out for Sara to unravel the mystery before anyone else falls victim to the illness. And before her career, her family and her freedom are taken from her by enemies she doesn’t even know she has.

Fever Dream is the eighth book of the Dream Doctor Mysteries.

Other Books By JJ Dibenedetto:
The Dream Doctor Mysteries (all ten books!)

Betty and Howard's Excellent Adventure

The Jane Barnaby Adventures (all three books to date!)

Mr. Smith and the Roach (coming soon!)

Finding Dori (Welcome to Romance)

• Language: English
• Publisher: J.J. DiBenedetto
• Release date: May 22, 2015
• ISBN: 9781311334831

Book preview

Sudden Death

(December 5, 2006)

This shouldn’t be happening. I don’t understand it. I haven’t had a patient like this in years—not since my first months of residency. Connie Marchetti brought her son to me three days ago because he couldn’t shake a cold, and now I’m fighting to keep him alive.

And I’m losing.

Two days ago, I sent out a full panel of blood tests, including several things that I would never normally check on an eight-year-old boy. He must have some sort of auto-immune disorder, but he’s been my patient for three years, and there’s never been the slightest sign of it. And, anyway, boys are far less prone to most auto-immune diseases than girls are. There was never any reason to suspect it.

There is now, though. I’m fighting to save him, but his own body is fighting against me. I haven’t been able to get his temperature below a hundred and one, I haven’t been able to get his breathing anywhere close to normal and he hasn’t eaten solid food in close to a week.

Damnit, Michael, I didn’t save you three years ago just so you could die on me now! Yelling at him isn’t going to help, but I don’t know what else I can do at this point, except to admit defeat and send him to a bigger hospital. Someplace with more resources to, hopefully, figure out what’s going on with him and treat it in time.

Three years ago, Michael Marchetti and his sister Celia were trapped in a basement during that awful winter storm. I went into Celia’s dream and figured out where they were, so that they could be rescued before they froze to death. But dreams aren’t going to help now. The answer, if there is one, is in his bloodwork, or, far more likely, in the mind of another doctor who can see whatever it is I’m missing.

I don’t want to do it. But the patient has to come first. I stand over Michael’s bed for a couple of minutes, watching him sleep, seeing his troubled breathing and his almost complete lack of color. I really don’t have a choice.

I leave the room, and the person I want to see is passing right by me in the hallway. Shelly, can you get hold of Connie Marchetti? I need her to come back in right away. Either Connie or her husband have been here pretty much non-stop since Michael was admitted, but she had a meeting at school with his teacher this afternoon. And her husband David works at the Indian Point nuclear power plant, twenty minutes south of here. He had a safety drill today, and obviously he couldn’t get out of that. But I need to speak to at least one of them in person, and right away. I want to send Michael to Mount Sinai. It’s the best children’s hospital in New York; there’s nowhere better to try and figure out what’s wrong with him.

My head nurse stares at me. Are you serious? I hold her stare, which is all the answer she needs. You think it’s that bad?

I don’t know. He could recover by dinnertime tonight. He might be home tomorrow, trying to sneak a peek into the closet and see what Christmas presents are waiting for him. I’ve had it happen before—patients suddenly turning the corner, all on their own. But could and might aren’t good enough. I can’t bet his life on them. I’m afraid it might be.

Shelly nods, a little nervously. She’s worked with me long enough to know I don’t give up easily, so the fact that I’m doing it now has her rattled. I’ll call her, she says, no longer able to meet my eyes.

Thanks. I’ll get in touch with Mount Sinai. I’d like to get him there tonight, if we can. The sooner, the better. I head up to my office and immediately begin going through my rolodex. If I were in better spirits, I’d laugh—my brother has been trying to get me to put all my contacts on the computer for a while. According to him, I’m stuck in the twentieth century.

But I liked the twentieth century! And I’m comfortable with my rolodex; it works for me. I’ve got the card for Mount Sinai, and my hand is on the phone when I hear the alarm. It’s faint, coming from downstairs and halfway down the corridor, but my ears are well trained. It’s Michael’s room. I’m out of my chair and halfway to the door in one heartbeat, and back downstairs in maybe twenty seconds.

Shelly is already there, and she’s getting a mask on Michael. I glance at his monitors, and I see why—he’s not breathing at all now. His blood pressure is crashing, too. He was stable—not good, but stable—just five minutes ago! His heart rate is slowing, flattening out. The alarms are blaring, but I hardly notice them. If we—I—don’t do something soon, we’re going to lose him.

I forget about getting him to Mount Sinai, or why he’s not getting better. Right now, I need to focus on keeping him alive minute to minute. But nothing is working. He’s not responding, not at all. The heart monitor shows a flat green line. CPR doesn’t help. I handle the chest compressions while Shelly adjusts his oxygen, but there’s no response to any of it.

He’s got no pulse at all. Adrenaline. Now! Shelly knows what I mean, even though I’ve never actually had to do this, and I don’t think she has, either. It only takes her seconds to find the kit, take out the needle and hand it to me. I know exactly what to do; rare as this is these days, I was taught how to do it back in medical school. The needle slides right into the fourth intercostal space, between Michael’s ribs and into his heart. And—nothing. I withdraw the needle, watching, waiting—still nothing. No reaction at all.

I hear clattering behind me; I don’t have to turn around to know that it’s Monica Hampton—the only other nurse on duty at the moment—with the defibrillator cart. There’s too much noise for one person, though; Dr. Bates must be with her.

He doesn’t need to ask what’s going on, and I don’t have the time to tell him anyway. All he says is, Charging now. The cart is pushed in front of me, and Dr. Bates is applying gel to the paddles now. Ready, he says, handing the paddles to me. I could do this in my sleep; I slam them down onto Michael’s chest.

Clear! Michael’s body shudders—but no heartbeat. Again! I hear the whine of the defibrillator as it charges, and I don’t need to be told when it’s ready. Clear! Another jolt, another shudder. And still no other reaction. I do it a third time, and a fourth, and still nothing.

After the sixth attempt, I have to admit the truth to myself. At 4:17 PM, I remove the paddles from Michael’s chest and call the time of death.

There’s nothing more you could have done, Dr. Bates says, patting me on the back. Shelly can’t look at either of us, or at Michael’s body, lying there motionless, the way it will be forever. She runs out of the room, and it’s only now that I recall her relationship to the Marchettis. Michael’s sister, Celia, is her goddaughter.

Celia is also Ben’s best friend. All my kids know her, and Michael. He’s slept over at our house, and the twins have slept over at his. I don’t know how I’m going to tell them that they’ve lost a good friend today. And I certainly don’t know how I’m going to tell Connie and David Marchetti that they’ve lost a child.

I’ve been standing here in Michael’s room for the last half hour. I’ve been alone, except for Dr. Bates poking his head in two minutes ago to inform me that Connie and David are on their way. I’m sure that they haven’t been told; even if Shelly or Dr. Bates had it in them to take that responsibility from me, it’s not the kind of news you deliver over the phone. If it had happened even a few hours ago, one of them would have been in the room with him and they’d have seen it firsthand. I’m not sure whether to be grateful that they weren’t here to go through it in person, or sorry for them that they didn’t have a chance to say goodbye.

I’ve been going over and over my actions, every choice I made for the last three days, everything I did and didn’t do for Michael. That’s the only way I’ve been able to keep all my feelings about this at bay. They are going to come out, though, and—no. I can’t think about that now. I have to keep myself calm, keep my mind clear. I can’t let my emotions take over when I tell the Marchettis. Once I open that door, and let my own grief, and anger and everything else out, I won’t be any use to anyone. Not that I was any use to Michael.

But even that doesn’t matter now. My feelings are irrelevant. I don’t have the right to cry, or be angry or anything else. That’s for Connie and David and Celia and everyone who loves them. And, when I get home, that right belongs mainly to the twins, who knew Michael best.

I have to tell them, calmly and directly, and let them react however they will. I have to give them the truth: that I did everything I could think of, everything in my power, and it just wasn’t enough. And it is the truth. Maybe I could have tried to transfer Michael earlier today, but even if I’d started the process first thing this morning, even if we’d gotten him there before everything went wrong, it wouldn’t have made any difference. There wouldn’t have been enough time to get a specialist in to see him, and to run a whole new battery of tests and all the rest of it. He’d have died there just as surely as he did here.

And I didn’t make any other mistakes. I know that I’ll be replaying my memories of Michael’s death over the next few days, the next few weeks. But I don’t think it’s going to reveal anything to me. There’s not going to be an a-ha moment. I almost wish there would be, though. I almost wish I had made a mistake, that I was responsible. At least that would make sense. It would be a reason, an explanation. His death wouldn’t have been random and cruel and pointless. And Connie and David would have someone to blame, someone to hate, something to focus on besides the loss of their son.

The first patient I ever lost, back in residency, was just the same. In the end, there wasn’t anything I could have done—not me, and not anyone else, either. It was—I don’t know what else to call it—bad luck. Still, when I’m home, when I’m alone, I’ll dwell on Michael, on every detail of his treatment, on every second of his final day, just like I did back then.

I hear a knock on the door, and as I turn, it opens to reveal Shelly. They’re here, she whispers. I follow her out the door, down the hall, and up the stairs. She’s leading me back to my own office. They must know—if I were in their place, and I were summoned to the hospital and I wasn’t brought directly to my child’s room…

No, I won’t go there. I won’t put myself in their place. I’m a doctor, and I have to act like one. I open the door to my office, and they turn in unison. David’s blue eyes, maybe a tiny shade lighter than his son’s, or maybe not even that, lock onto mine. Connie, whose red hair is almost identical to her daughter’s, focuses on Shelly.

They’re sitting in the wooden armchairs in front of my desk. I walk around to my own chair, and Shelly follows, standing behind me, her hand on my shoulder. David is the first to speak. He asks, Doctor? in a tone with very little hope in it. They have to know already.

And there’s no easy way, no kind way, to confirm it. Just the hollow words I was taught years ago in medical school. David, Connie, I—we did everything in our power, but…

Shelly begins sobbing before I can finish. She pulls her hand away from me, comes around the desk and throws herself onto Connie. For a while—I have no idea how long—no one speaks. The only sound is the deep, ragged breaths of Connie and Shelly, in between their sobs. And the whole time, David just holds my eyes.

Finally, in a low, lifeless voice, he says, I knew. I knew this day would come.

For an instant, I’m puzzled, and then it hits me. I might be wrong, but I think I know what he means, what he thinks. What he’s probably been thinking for the last three years, ever since the night of the storm, the night Ben and I saved his children. I hope I’m wrong, but I don’t think I am.

He thinks—I’m sure I’m right about this—his children have been living on borrowed time since that night. He thinks they were destined to die, that what Ben and I gave them was only a temporary reprieve, one that would be revoked. And now, today, it has been.

Or maybe he hasn’t been thinking it all this time. It could have come to him in the last day or two, as his son failed to recover. Or even just now, in the last few minutes. A coping mechanism. A way to make the loss of his son bearable, by convincing himself it ought to have happened three years ago, that every day since then was a gift.

That’s wrong, and in the long run it’s dangerous—not just to David, but to his whole family. And I’ll have to do something to try and help, because I doubt anyone else will figure it out, and even if they do, who’s going to tell a grieving father that he’s grieving the wrong way?

Nobody—including me—is going to say it today.

Connie and David spend nearly an hour with me. It’s almost six o’clock when they leave, stumbling out of my office, if not in actual shock then in a state close to it. Shelly tells them that she’ll drive them home. It’s a command, not an offer, and I’m glad. Neither of them is fit to be behind the wheel. Neither am I, honestly—and when I lock up my office and make my way down to the lobby, I see I’m not going to be.

My eldest daughter is waiting there, and she throws herself at me, almost suffocating me with a tight hug. I’m so sorry, Mom, she says. I shouldn’t be surprised that she knows. Stephanie heard it from Jake Bates. She told Grandma Betty. And my mother sent Grace here to drive me home, because she knew how I would be feeling.

What about Ben? Does he know yet?

Grace pulls back from me, lets me breathe. No, she answers. Lizzie’s over helping out at Candy Ralston’s shop, and Grandma Betty thought that Ben and Matty should hear the news from you.

She was—is—absolutely right. It’s my responsibility—not my mother’s, and certainly not Grace’s or Stephanie’s. We may as well go home. Waiting isn’t going to make it any easier. And, yes, you can drive. I know that’s why Mom sent you. Grace got her junior driver’s license over the summer, and she’s done everything right since then. She’s given us no reason to doubt her—really, she hasn’t put a toe out of line in any respect since her ordeal in Paris a year and a half ago.

Still, it feels strange to get in on the passenger side, and I make a point of watching everything she does. It’s not even a matter of trust, really. It’s more that I want her to develop good driving habits—if she does that now, she’ll have them for the rest of her life. Watching her also has the benefit of taking my mind off the news I’m going to have to deliver to my sons. It’s going to hit Ben especially hard—not only is he the closest to the Marchettis, but he’s also, by far, the most sensitive of my children.

I’m going to have to break my son’s heart, and there’s not a thing in the world I can do to ease his pain. Or Connie and David and Celia’s. Or my own.

Casino Royale

(February 17-18, 2007)

The dealer pulls the next card out of the shoe, and before he even starts to turn it over, I know what it’s going to be. He flips it over, and I groan right along with everyone else at the table when I see the five of diamonds.

It’s unbelievable. I’ve been losing steadily for the last half hour, and now here’s $2,000 more gone, just like that. I did everything right! The dealer had a three showing, and I had—could you ask for anything better?—two aces. So I split them. And I doubled down on both. I got an eight on one, and a nine for the other. Nineteen and twenty. With the dealer showing a three.

The dealer turned over his second card. Another three. Then came a four, a two and another four. Sixteen. And then the five. Twenty-one. Everyone loses, including me. I had $8,000 just a little while ago, and I’m down to $1,000 or so now.

I feel a hand on my back, and I turn to see my husband standing behind me. I leave you alone for five minutes, he says, shaking his head. The sight of him in his tuxedo, martini in hand, almost manages to distract me from my losses, but not quite.

This whole thing was your idea, remember? When I mentioned to him, back in September, that I wanted to have an annual fundraiser for the hospital, he immediately suggested a casino night.

I hope you’d be more careful if it was real money, he answers, laughing. He’s right, of course. I just got so caught up in the game that I forgot the stakes aren’t real—and they’re less real for me than anyone else here. Whoever winds up with the most chips at the end of the night wins a prize, but as the hostess of the evening, I’m obviously not eligible to win. I still hate losing, though. Especially in such a ridiculous way.

You saw what happened just now! The odds…

Now he gives me a grin. Never tell me the odds, sweetheart. He’s having far too much fun tonight. I take my pitifully small stack of chips and let Brian lead me away, towards a quiet corner. He really does look—I don’t even know the words for how good he looks. We actually match; black and white, him in his tux and me in a long white sleeveless dress that he helped me pick out a couple of weeks ago.

I know he’s imagining himself as James Bond—that’s why he thought of a casino night in the first place. The last movie just came out back in November, Casino Royale, and they were running commercials for it even before that, so it was stuck in his mind. Not that I’ve seen it—I was never a huge fan of those movies, and, anyway, Brian’s far more handsome than Sean Connery or Roger Moore or the new guy. I can’t even remember his name, but it doesn’t matter—Brian blows all of them out of the water.

Especially when he’s got me in his arms and we’re dancing. The band is playing a jazzy tune, something that Joshua Skinner would probably recognize. We pass by him, and he gives me a thumbs-up. He doesn’t look too bad in a tuxedo himself, especially for being eighty-four years old. He did everything in his power to make tonight possible. We certainly wouldn’t be having it here, in the ballroom of the Hudson Inn, the best hotel in town. To be fair, there are only two proper hotels in town, but this is by far the nicer of them. Anyway, I have no idea what he said to Mark Hines, the hotel’s general manager, but whatever it was, it worked. Not only did Mark rent us the ballroom, but he gave us a huge discount, so that the money we raise can actually go to the intended purpose.

With a lot of effort, I’m able to pull my eyes away from Brian occasionally as we dance. It looks like everyone is enjoying themselves, and by everyone I mean nearly the entire adult population of Aisling, New York. I’m pretty sure we’re in violation of the fire code for having too many people in this room. Luckily, our fire chief is also running our roulette wheel, so I’m not worried about being cited.

About the only person who doesn’t appear to be having a grand time is one of our out-of-town guests, Tom Santos, who’s here representing the Consolidated Chemical Corporation of America. In a way, he—or at least his company—is the reason I wanted to have a fundraiser in the first place. It was quite the surprise for me last April when we received the check from them…

There’s nobody else in the office, so I may as well go through the mail myself. There’s not likely to be anything here for me to deal with personally, but I like to at least have an idea what’s going on. I am Chief of Staff, after all; I’m ultimately responsible for everything that happens here at Phillipstown General Hospital.

One item catches my eye; it’s from the Consolidated Chemical Corporation of America, and it has the distinctive look of a check in payment of an invoice. But why would they be sending us a check for—what?—$200,000? I hold the check up to the light, looking for—I have no idea what. Some sign that it’s a fake, a forgery? A joke? It is April first.

Good, it came, I hear Megan Carter, our newly promoted Director of Business Operations. She’d been doing the job, in addition to her duties as HR Manager, for years; it was well past time to acknowledge it officially, with a title and a nice raise.

I turn to look at her. It’s real?

It always comes on April first. Start of the fiscal year, and they’re never late. I’m still confused, and it must show on my face. Consolidated Chemical is our biggest donor. They took over from Hudson Valley Plastics when they bought them out last year. Dr. Harrington talked the CEO of Hudson Valley into it years ago, and I guess it was written into the deal that Consolidated has to honor it.

I’ve been Chief of Staff for six months now, ever since Dr. Harrington retired, and this is the first I’m hearing about it. I start to ask Megan why he never mentioned it, but I know the answer. There was so much he never mentioned, in the five months between him offering me the position, and my officially stepping into it. That sounds like a lot of time, but it wasn’t, and there were a thousand things I’ve had to discover for myself. A thousand and one, now…

What? Brian’s shaking my shoulder. Why? Oh, I take a deep breath, remember where I am and what I’m doing. Sorry. I went back for a minute, I was just remembering something. Before he has a chance to answer, I head over to Mr. Santos. I didn’t have the chance to talk with him when he arrived a couple of hours ago. He got an urgent call before I could properly introduce myself, but there’s no time like the present.

I sit at his table, and Brian follows suit. Our guest is, at a guess, around fifty years old. If he’s not, he isn’t far from it, definitely not more than a couple of years to one side or the other. He’s not wearing a tuxedo, but his suit is very expensive all the same. He’s also not wearing a smile, but the same bored expression he’s had every time I’ve seen him tonight. When he takes notice of us, it turns into a momentary frown, before he catches himself and plasters an extremely fake smile on his face.

I’m not sure whether the frown is because he suspects the truth—that I want to wean the hospital off his employer’s charity—or if he’s simply annoyed at having to spend an evening with a room full of small town hicks playing dress-up, which I heard him whispering into his cell phone an hour ago.

I can’t imagine why he wouldn’t be glad that we want to replace Consolidated Chemical’s annual gift with money we raise ourselves, not that it’s going to happen anytime soon. Megan’s best guess was that, if everything goes as well as we could possibly hope, we’ll bring in $10,000 tonight. That’s just a drop in the bucket. Honestly, the biggest benefit for me from this event is that it’s given me something to focus on besides the death of Michael Marchetti two months ago. I haven’t let it go, because after all this time, it still makes no sense. I don’t know why he died, even after getting all the bloodwork back, after poring through hundreds of increasingly obscure journal articles and reaching out to colleagues all across the country.

I managed to spare some