> She became increasingly alarmed when she saw, from her seat three rows back, that the veins in Brown's neck were bulging. The bulging neck veins here would h

> She became increasingly alarmed when she saw, from her seat three rows back, that the veins in Brown's neck were bulging. The bulging neck veins here would have been concerning for jugular venous distension, which occurs when the right side of the heart can’t empty properly (so blood backs up in the venous circulation), in this case because of an increased pressure in the pulmonary circulation caused by the pulmonary embolism.