Code Blue With Intent

by Marilyn Esper Kelsey

  “You can count on it,” Kate assured her. “Do you still have Mrs. Banks’s chart on the unit? I need to call her insurance company.”

  “Yes, it’s over at the far end of the desk. Dr. Timmers asked me to put it aside for him to chart later. Thanks again, Kate. I hope to see you at Dr. Fenelli’s Saturday night.”

  Rita Jenkins, an RN in ICU, had overheard Kate and Julie’s conversation about Julie’s mother. It triggered painful memories about her own family and tumultuous past.

  ***

  When Rita was fourteen, her mother had a stroke and shattered the otherwise normal family into a downward spiral. The stroke affected her mother’s right side, leaving the right arm and leg paralyzed. At the time of the stroke, Rita’s mother, Janet, was thirty-five years old. She hated using a cane or walker—even though it was the only way she could ambulate—and refused physical therapy. All she wanted to do was to lie in bed all day and feel sorry for herself. She was deeply depressed and crying all the time but did not want any help. Essentially, she gave up on life.

  Rita’s father was devastated and unable to accept his wife’s disability. He worked all day and cruised the bars at night, drinking to forget his problems. He usually came home drunk in the middle of the night and plopped into bed.

  Over the next year, Rita’s life changed drastically. She went from being a carefree teenager to cooking, cleaning, laundering, and taking care of her two sisters—thirteen-year-old Alena and six-year-old Jenny—in addition to caring for her mother. It was a heavy burden for a fourteen-year-old to carry.

  Rita rose at six o’clock every morning, made breakfast for her sisters, packed their lunches, and made sure Jenny, who was in first grade, made it to the bus stop. Then she prepared a tray of breakfast and brought it to her mother’s bedroom before heading to school. Rita was a freshman in high school. It should have been a fun time in her life, but she had way too much responsibility to indulge in fun.

  After school, Rita would forego all her usual after school activities and rush home to be there when Jenny came home. She soon quit the cheerleading squad and all the sports teams she loved to participate in. Her life as she had known it was over.

  Rita helped Jenny with her homework, did the laundry, and started dinner. She always fixed her mother a tray, cut up her food, and sometimes fed her when she was too weak or too frustrated to try. She tried to get her mother to come out and eat at the table with them, but she refused, saying she was too tired. Janet would instead put her headphones on and listen to music to shut out her children and the world.

  After dinner, Rita would wash the dishes, clean the kitchen, and play with Jenny. She bathed her little sister, put out her school clothes, read her a bedtime story, kissed her, and tucked her into bed. Jenny had cried for several months after her mom’s stroke, wanting her mother to put her into bed at night like she used to. But Janet did not want to partake in any of her old routines; she just stayed in bed wasting away. Jenny finally stopped asking for her mother, stopped crying, and began clinging to her sister Rita instead.

  When Jenny went to bed, Rita would encourage her mother to take a bath or to just sit and chat with her like they used to, but Janet said no, she didn’t care and she had nothing to bathe for now. So Rita would do her homework, shower, and go to bed exhausted.

  Alena, who was in eighth grade and once a cheerful, bright teenager, was now angry at the world. She resented her mother for not snapping out of her depression after the stroke despite her children’s need for her. She hated her father for giving up on his family and staying out late drinking. She even resented her older sister Rita for being so calm and helpful, even though she knew someone had to step up and take care of the family. Alena’s grades dropped, she skipped school, and she started hanging out with a rough crowd, using drugs and alcohol. She changed from being sweet and caring to belligerent and defiant.

  Rita tried her best to talk to her sister, telling her that she was ruining her life, but Alena would explode in anger, saying things like, “What the hell do you know? You’re not my mother, although you certainly think you are, but you’re only a year older than me. You understand nothing. Squat. Nada!”

  Exasperated, Rita tried to make Alena understand that she was making a big mistake. “I just don’t want you to get hurt or in trouble. Those people you’re hanging out with are bad news.”

  “You can’t tell me what to do. I’ll live my live as I please,” Alena glared at her sister. “I’m not staying in this hellhole. Our so-called mother won’t come out of her room. She cries all day, drools all over herself. God, she won’t even bathe; she stinks! Our father could give two shits about us. And you, dear sister, think you are our mother now, and poor Jenny is stupid enough to believe it, but I’m not!”

  Rita lost her patience. “Alena, stop it! How can you be so mean and uncaring? Jenny is only six years old. She needs us. You can help me take care of Jenny, you know, instead of acting like a selfish brat.”

  Alena knew her sister was right but wouldn’t admit it. “I hate this family! I hate you! You can all go to hell, for all I care!”

  Rita slapped her sister across the face, and Alena stood there in shock. Had her sister really hit her? Rita also stood in shock at her own unbidden action. Such primal behavior was unacceptable in her book.

  “I’m out of here!” Alena turned and tore out of the house.

  “Wait, Alena. I’m so sorry! I didn’t mean to slap you. Come back; we’ll talk about it. Please don’t go!” Rita pleaded.

  Alena turned around, shot daggers of sheer hatred at her sister, and slammed the door.

  Rita sat down at the kitchen table and sobbed. She wished she had someone to talk to. She longed for her mother to come out to her, put her arms around her, and tell her everything would return to normal.

  Alena never came home that night, and when she did come home a couple weeks later, she had shaved off her beautiful, long black hair. She wore a short, cropped, off-the-shoulder, skintight tee shirt and low-slung cutoff jeans barely covering her backside. Alena used three tattoos on her tawny, brown skin as a billboard of rebellion: a skull and cross perched on her left shoulder, a pair of rub-red lips said “KISS IT” on her right hip, and an evil-looking snake wound between her ample breasts.

  Rita stared at her in disbelief. “Alena, what have you done to yourself?”

  Alena snickered at her sister’s shocked expression. It was just the reaction she’d been aiming for. “I’ve come for my things. I’ve moved in with my boyfriend, Jimmy.”

  “Jimmy? He’s a bum and too old for you.”

  “He’s only twenty-six, and he’s my man now,” Alena argued. “Don’t interfere, Rita. I’ve made up my mind.”

  “Please don’t do this, Alena!” Rita pleaded. “You’re going to regret this. Go talk to Mom.”

  Alena threw her head back and roared, “You’ve got to be kidding me! She doesn’t give a damn about us anymore. She’s an empty shell now. A freakin’ zombie! I’m out of here!” She hoisted a paper bag of belongings into her arms, strode out of the room, and slammed the front door behind her.

  Rita wept in sadness for her sister. Her mother had heard the yelling and some of the conversation and started to get up out of bed. Then she changed her mind, put her earphones back on, and turned the music up loud enough to drown out the screaming. Tears streamed down her face.

  Rita decided to stay up and talk to her dad, thinking that maybe, just maybe, he would listen to her and help her figure out what to do about Alena. At four o’clock in the morning, the front door opened and Rita’s father staggered in. He reeked of alcohol, stale cigars, and cheap cologne. Rita jumped off the couch and called to him, “Dad, you have to listen to me. Alena is in trouble. We need to help her.”

  Her father weaved into the living room, bumped into the coffee table, and knocked off the lamp. He swore and plopped onto the couch.
“Damn girl. Don’t bother me with this shit.”

  “But Dad, she left the house and has gone with that lowlife Jimmy, a punk on drugs.”

  Rita’s father peered out from behind glazed eyes and belched loudly. “Good for her. Someone in this house needs to have some action. Lord knows, I’m not getting any with your mother anymore.”

  Rita stared in disgust. “Come on, Dad. Get serious. What are we going to do about Alena?”

  “Forget about her now, girl, and come over here and give your old man some loving.” He patted the couch and let out a loud boisterous laugh at her shocked expression. “You’re the mother of the house now. You might as well take over every role.”

  “You pig!” Rita yelled and turned and bolted out of the room crying. She locked her bedroom door, curled up in a ball, and pulled the blanket over her head, feeling alone and frightened. She had no one. She couldn’t break down or leave the house like Alena had, which is exactly what she wanted to do. She couldn’t because of Jenny. Who would take care of her?

  Rita woke up an hour later to her parents arguing, which was unusual given that they never spoke to each other anymore.

  Janet had heard Rita and her husband yelling, gotten out of bed, grabbed her walker, and dragged herself to the hallway just in time to hear her husband’s comment suggesting that their teenage daughter take over the role of wife. She was appalled. How could he speak to his daughter that way! Carl had always been a sweet, mild-mannered gentleman, not the rowdy drunken fool she had just heard. What was he thinking talking to his daughter in that foul manner? Oh God, what had she done to her girls? Realization sank in—she was a terrible mother. She hobbled back to her room, planning to change her ways. It was time the girls got their mother back.

  Janet waited for Carl to come into bed. Then she stood up, stared at him in disgust, and shouted, “For God’s sake, Carl, what the hell’s the matter with you, speaking to your daughter with such a filthy mouth? Are you freakin’ crazy?”

  “Ah, she speaks,” he spat sarcastically. “If you’d snap out of it and start acting like my wife, I wouldn’t have to talk that way. Besides, she knows I didn’t mean it.”

  “She knows no such thing, you idiot. She’s just a little girl.”

  “She’s fourteen years old, and it’s time for her to be a woman. Crap, you and I were getting laid under the bleachers in high school at her age. Why don’t you just shut up and go back to la-la land, like you usually do, unless you want to get it on.” He looked at her with an evil grin, stood up, and staggered around the bed toward Janet. “On second thought, I think I’ll go see our baby girl and see what she’s got.” He shot his wife a menacing look and turned to leave the room.

  “Oh no, you don’t, you sick bastard! You’re not going anywhere near our daughter!” Janet snapped. She opened the bedside table drawer, grabbed the gun they kept there for protection, and aimed at her husband. With hands shaking, she fired three shots in rapid succession into his back. Gasping, she dropped the gun and clutched her chest; the intense pain sent her tumbling to the floor. She’d had a massive stroke.

  Rita heard the shouting, then the gunshots. Leaping from her bed, she ran into her parents’ bedroom and saw her mother spread out on the floor, with the right side of her face grossly distorted, sputtering garbled, unintelligible words. Her father was lying facedown on the floor in a pool of blood.

  Rita screamed and ran over to her mother, shaking her. “Mom, Mom, get up . . . please get up!” Her mother just stared at her in panic trying to say she was sorry, but no words fell out.

  Then from the doorway came a shrill, high-pitched wail. Jenny stood there wide-eyed, clutching her teddy bear in terror.

  “Go back to your room, Jenny! I’ll be there in a minute … Go!” Rita commanded her little sister. Jenny gasped, turned, and ran to her room. She flew into the closet, slammed the door shut, and grabbed her teddy bear. Staring into space and moaning incoherently, she rocked back and forth, hugging her bear.

  The next hour was a blur to Rita. She called 911, and the police and EMS arrived at the house. They transported her father to the morgue and her mother to the hospital. After several attempts by the police and EMS to remove Jenny from the closet, Rita was the one who convinced her little sister to come out. Jenny crawled into Rita’s arms, squeezed the bear close, and stared straight ahead, not uttering a sound.

  Rita’s mother and sister were admitted to the hospital, leaving Rita all alone in her grief. The police questioned her thoroughly and called social services. She just wanted to go home, but was placed in a foster home that night. Alone in the dark in a strange home and a strange bed, Rita buried her face in a pillow and sobbed all night. In an instant, she had gone from being a happy daughter with two loving parents and two fun-loving sisters to no parents, one sister living somewhere doing God-knows-what, and one sister in the hospital, speechless and in shock. She had no home, no family.

  The next few years, Rita waded through a thick fog as she moved from foster home to foster home. She went to school, worked at odd jobs, came home, stayed in her room, studied, and kept to herself. The only time she perked up was when she visited Jenny in the sanitarium. Her sister remained in a trance, communicating with no one; she hadn’t uttered a single word in years. The doctors said she was so traumatized that she withdrew to a safe place within to cope. Rita would pull Jenny onto her lap and hug her without avail—there was no response. Rita also rocked her and read her favorite stories over and over again.

  After her visits with Jenny, Rita would go see her mother in the nursing home. There she would sit and talk to her mother, tell her about school and Jenny, and try to be upbeat and cheerful, even though inside she was screaming in despair.

  Rita tried to find her sister, Alena, but no luck. One of the gang members told her that Jimmy and Alena had moved out west. Rita prayed every night that her sister was safe and happy—not sick, wasted, or worse, dead.

  When Rita turned eighteen and graduated from high school, she had no birthday party or family to celebrate with her. Released from the foster care system, she was on her own now and moved into a tiny rented room. She didn’t care how small it was, just that she finally had a place of her own.

  As she sat in her cramped room, she wondered what she was going to do next; she had worked odd jobs the last few years and had saved every penny she could. The decision was soon made for her by the perky, blonde girl in the next rented room—Becky Kent. When Becky introduced herself to Rita, they became friends, talking about anything and everything. As they compared their lives, Becky said, “Wow, I thought my life was screwed up, but you win, hands down.”

  It was the first time since childhood that Rita had a friend. It was so nice to have a cheerful, fun person to talk to. Becky talked Rita into enrolling in a nurse’s aid program course at the hospital with her. They finished the course, and Rita felt she had found her niche. She loved taking care of the patients. Helping people made her feel she was doing something good. She did well in school, and her instructor talked her into going to nursing school. Two years later she graduated with an associate degree in Applied Science and passed her boards and became a registered nurse.

  It had now been three years since she began working Northwest General Hospital. Her hope was to save enough money to buy a house so she could bring her mother and her sister, Jenny, home to take care of them. She also planned to hire a private investigator to find her sister, Alena. She knew she would need money and was determined to find a way, any way, to bring her family back together again and possessed a fierce determination to get her family back at any cost.

  Chapter 4

  “Hi, this is Linda McCarthy, nurse reviewer at Premier Regional Insurance Company.”

  “Hi Linda, this is Kate Ross from Northwest General. How are you today?”

  “Hey Kate, I’m swamped with reviews. How’s it going with you? Hospital busy?”


  Linda McCarthy had been employed at Premier Regional Insurance Company since it opened five years ago. One of the hospitals she reviewed was Northwest General. Kate called frequently with clinical reviews, so they felt like old friends, even though they had never met face-to-face.

  “The hospital has been extremely busy. We have patients waiting in the ER for beds. I called to give you an update on Sara Banks, auth. number three-six-five-nine, but she expired this afternoon.”

  “No kidding. I thought you’d be calling to tell me she was being transferred out of ICU. What happened?” Linda asked.

  “I don’t know. She was ready for transfer to the step-down unit, coded, and never came around.”

  “The powers-that-be around here will be happy to close this case,” Linda said.

  “Excuse me!” Kate was clearly taken aback. “They will be happy she died?”

  “Oh, no. I didn’t mean it that way. That sure came out wrong,” Linda said. “What I meant was during our weekly meetings this past week we were discussing our multiple-admissions patients. We were trying to figure out a way to cut down on frequent hospital admissions by coming up with alternative plans.”

  Kate couldn’t resist saying, “One way being to knock off all your multiple-admissions patients?”

  “Very funny.” Linda decided to play along with Kate. “Yes. We rush right over to the hospital and cast a spell on our frequently admitted patients. Ha! What I was saying about alternative solutions was that we were trying to avoid hospitalization by maybe suggesting home health, outpatient testing, and so on. We were just discussing Mrs. Banks in our weekly conference.”

  “Because of her many admissions?” Kate asked.

  “Yes. Our company is having some financial difficulty. We started out five years ago with very low rates to attract policyholders. We succeeded in attracting new clientele, but, in the process, we also received a lot of multiple-admissions policyholders. Now the company is paying out more money than it’s taking in. Word around here is that Eastern National, a huge insurance conglomerate, is looking to buy our company if the numbers are right. So our company wants to show that they can make a good profit to impress Eastern National, but you didn’t hear that from me, Kate. I shouldn’t even be discussing this on the phone. I must be crazy!” Linda said, wondering if she had told Kate too much. This merger was supposed to be kept quiet.