“There’s been a death over at the hospital in the ER. EMS brought in an elderly gentleman with a cardiac history as a PNB.”
PNB is medical speak for a pulseless nonbreather, meaning the patient was already dead when EMS found him. And given that he’s now my patient, it’s safe to assume that the efforts to revive him were unsuccessful.
“It sounds like your basic coronary,” Izzy goes on, “but we still need to examine the patient, review the chart, and obtain a history. It should be pretty straightforward, and given your nursing background, I think it will be a good one for you to do for your first solo. Are you up for it?”
The delicious smells of garlic, mozzarella, and tomato sauce are making my stomach rumble, which makes me want to tell Izzy no. But I owe him on many levels, not the least of which is his giving me this job when I so desperately needed it.
“Sure,” I tell him.
“Fabulous,” Izzy says, and I can’t help but smile at his choice of words. Even though he is openly gay, Izzy doesn’t broadcast his proclivities much. But every once in a while he does or says something that screams gay to me. The way he says the word fabulous is one of those things. “How soon can you be there?”
“I’ll head over now,” I say, looking longingly first at the lasagna, then Hurley.
“Call me if you have any questions.”
“Will do.”
I end the call and give Hurley a woeful look. “I have to head over to the hospital to look into a death they had in the ER.”
I’m hoping he’ll look disappointed, or at the least, chagrined, but instead he looks contentedly resigned and says, “I understand. It’s part of the job. We can have dinner some other time.”
Easy for him to say. It seems like every time we try to get together in a nonwork-related way, somebody dies. I feel like I’m trying to date the Grim Reaper. And to make matters worse, I detect a distinct lack of conviction in Hurley’s voice that makes me nervous.
I scarf down two quick bites of the lasagna, which tastes utterly divine, and then take a bite of garlic bread. When I’ve swallowed I tell him, “This is heaven. You’re a very good cook.”
He beams at me. “Thanks. How about I fix you a little to-go container and you can take some of it with you?”
“That would be fabulous,” I tell him, echoing Izzy. I watch as he quickly packs up a meal of lasagna and garlic bread in a plastic container, giving it, some napkins, and a fork to me when he’s done. It’s a sweetly domestic scene and it’s easy for me to imagine a lifetime of such moments with him. It fortifies my faith in the future of our relationship . . . until I remember that he’s been implicated in a nasty murder and solicited my cooperation with a secret investigation.
“Thanks,” I say, carrying my food out to the foyer and setting it on the lowest step of the staircase. He retrieves my coat from the closet while I take off the shirt he gave me and drape it over the newel post. Then he holds the coat for me so I can slip it on. After he settles it onto my shoulders, he turns me around to face him. Our eyes lock for a pregnant pause and I brace myself for the kiss I hope is coming.
Except it doesn’t. All he does is smile and say, “Thanks for everything.”
He hands me my to-go container and steers me out the door. I stumble off the porch in a state of mind-numbing confusion, climb into the hearse, and pull away.
As I head for the hospital, my mind scrambles to make sense of this change in Hurley’s behavior. Damn men anyway! On the one hand they can be so easy to read. Speak to the small brain and they’ll say or do anything. But their big brains function so differently from women’s that it’s like dealing with someone from another planet, maybe even another whole solar system.
The hell with him, I decide. Screw him, David, and all the other men in the world who possess the ability to manipulate my hormones and complicate my life. I mean really, why do I need a man in my life anyway? To fix things around the house? Clearly not, since David is about as inept at those things as a man could be and I can always hire a handyman. For sex? Well, that part is nice but there are plenty of other ways to find satisfaction, maybe even the aforesaid handyman. Children? Thanks to sperm banks and recent advances in modern reproductive science, I don’t need a man for that either.
The more I think about it, the more convinced I become that I’m on to something. The whole idea of giving up men is oddly liberating; it makes me feel giddy and determined. By the time I reach the hospital, I’ve made up my mind. It’s time to reevaluate my life, reexamine my goals, and focus on myself without any men in the picture. I am Mattie renewed, version two-point-oh, the latest and greatest release.
After parking the hearse, I open my to-go container and chomp down on a slice of buttery garlic bread. The delicious mix of soft, yeasty, still-warm bread, tangy garlic, and fresh butter is enough to make my toes curl with delight.
Damn, but Hurley can cook! Maybe it’s too soon to give up on him altogether. I mean we have shared a few kisses that were hot enough to be a threat to global warming, and it was me he kept asking for when he was drugged up in the hospital. Surely all that meant something, didn’t it?
I realize how desperately I want to believe in Hurley—to believe in me and Hurley—and already I’m rethinking my antiman dogma.
Way to go, Mattie, I mumble aloud. It took you, what, all of two minutes to fall off your fanatical feminist pedestal?
But I can’t help myself. The more I think about it, the more convinced I become that Hurley feels something for me. The question is what? I’m pretty certain he feels some level of attraction, but is it enough? Did I scare him away? Given his current situation, is it possible he’s just leading me on? Stringing me along to make me a happy follower so he can further his own agenda?
It’s clear I’m not going to get any answers tonight so I shove the thoughts to the back of my mind and get out of the car, dragging my pedestal and the sad remnants of my membership card in the feminists’ club along with me. Fortunately I have a death to look into, something I find much easier to deal with than men.
Chapter 7
After popping a couple of Tic-Tacs to mask my garlic breath, I make my way into the ER at a little after six. The waiting room is fairly crowded and as I scan the occupants with a habitual eye toward triage, I don’t see anyone who looks critically ill, just miserable. Most of the folks are coughing, sneezing, and snotting all over the furniture and one another, ensuring the sharing and survival of whatever nasty little virus is dominating this year’s flu season.
The gal behind the registration desk recognizes me and buzzes me into the back patient care area, where things are hopping. Every bed is full. I hear some poor soul barfing up his toenails in one room, and the screams of a miserable child in another. The nurses are all running about in a carefully choreographed dance of controlled chaos. I know from my own years working here that the arrival of the PNB most likely turned what might have been a merely busy shift into one that is now a mad and desperate scramble to catch up.
I make my way to the nurse’s desk, where I see Ricky “Rickets” Masterson standing in front of a full rack of charts. ER nurses have a habit of referring to patients not by their name, but by their bed number and diagnosis. So instead of John Doe, Bob Jones, and Susan Smith you get the Pancreatitis in Room Four, the Bowel Obstruction in Room Two, and the Bitch-On-Wheels Hypochondriac in Room Six. Several years ago when I worked in the ER, a bunch of us decided to make up nicknames for ourselves that were both close to our real names and to a disease or disorder. As a result, Ricky became Rickets, faring a whole lot better than my good friend, Phyllis, who is now referred to as Syph for short.
“Hey, Rickets, are you the charge nurse tonight?”
He shakes his head. “Nope, Lupus is,” he says, referring to a nurse named Lucy. “But she’s tied up at the moment with a Five-Year-Old Head Lac in Room Four who is trying out for a role in the next Exorcist movie. You here for the PNB in Room Two?”
“I a
m.”
He hands me a clipboard containing the code sheets—a written summary of what happened during the attempts to resuscitate.
“Has the family been notified?” I ask.
“There’s a daughter who apparently found him and called it in. She was here when he first arrived but I don’t know if she’s still here or not. Check with Constance.” Constance, who was hired after the nicknaming session, has remained just Constance, probably a good thing since her last name is Pate and I’m pretty sure she’d be known as Constipation by now.
“Do you know where she is?”
Rickets gives me an apologetic look and shakes his head. “Sorry, it’s been a zoo here tonight.”
“Can you log me onto a computer so I can review the PNB’s chart?”
“Sure.” Rickets gets me into the computerized charting program and then leaves me to my own devices. After grabbing a notepad and pen, I glance at the data at the bottom of the code sheet and write down the man’s name—Harold Minniver—and his age, which is seventy-two. Next I look up his chart on the computer and start taking notes. A scan of his medication list shows that he was on several heart drugs as well as one for high blood pressure, and his medical history includes a three-vessel heart bypass surgery five years ago. So far so good, I think, since these facts make the likelihood his death is attributable to some type of cardiac event that much higher. I switch to the nurse’s narrative section but there is nothing entered there yet. This isn’t too surprising; charting sometimes takes a backseat to actual care when things get hectic. Stuff gets written down as it’s done, but sometimes the notes are scribbled on whatever’s handy—paper towels, the bedsheets, the palm of a hand—and then entered into the computer chart later. A quick scan of the code sheets tells me that Constance was the primary on the case, so I’ll have to wait to talk to her before I can get a thorough history of the night’s events.
I move into a section of the chart that contains documentation by Mr. Minniver’s primary physician. Here I see that the patient underwent a cardiac catheterization just two weeks ago following an episode of chest pain. Curious, I click on the tab that takes me to the cardiologist’s notes and feel my hopes for a quick resolution sink faster than the blood count on a hemorrhaging patient: the cath showed no blockage of any sort, meaning Minniver most likely died of something other than a heart attack.
Since the nurses are all still busy and I have yet to see Constance appear, I head for the room holding Mr. Minniver’s body. He is lying on a stretcher with a sheet across his pelvis and various tubes sticking out of his body. There is an IV in each arm, a breathing tube protruding from his mouth, and a urinary catheter snaking out from beneath the sheet. His chest is covered with little stickers from the cardiac monitors and the EKG machine, and there are also two large pads—one on his upper right chest area and one on the lower left—that are connected to the defibrillator. His skin is cold to the touch and reddish-blue in color, and I can see the edges of a darker purple hue indicative of lividity beginning to form along his back. His hair, which is sparse, white, and short, is sticking up in little tufts along the sides of his head. The top of his head is bald.
The door to the room opens and Constance comes in accompanied by another nurse I don’t recognize. “Hey, Mattie. Sorry to keep you waiting but the place has been crazy busy tonight.”
“No problem.”
“This is Karen Alcott,” Constance says, nodding toward the other nurse. “I’m orienting her and I can tell you it’s been a trial by fire tonight. Karen, this is Mattie Winston. She used to work here but these days she’s with the ME’s office.”
“Nice to meet you,” Karen says, looking thoughtful. Then she adds, “Are you the nurse I heard about who was involved with the nipple incident?”
I nod and quickly turn my attention back to Constance. “What can you tell me about Mr. Minniver?”
“Not a whole lot. The EMTs said his daughter found him slumped behind the wheel of his car in his garage. He was already pulseless when they found him and the daughter didn’t do any CPR. By the time he got here he was straight line on the monitor but we worked on him for about twenty minutes anyway, mainly for the daughter’s sake. We’re guessing he developed chest pain or some other serious symptom and tried to drive himself to the hospital but collapsed before he could. His daughter says he has a cardiac history so we’re guessing he had a heart attack.”
“Is his daughter still here?”
Constance nods. “Her name is Patricia Nottingham. I just left her upstairs outside the chapel. She’s making phone calls.”
“I’ll head up there to talk to her.”
“Can I disconnect this stuff and take him to the morgue?” Constance asks, nodding toward the dead man. “We could use the bed.”
“Not yet. There are some things I need to look into. Let me talk to the daughter first.”
Constance sighs. “Okay, let me know.”
I leave the room, grab my notepad and pen, and head for the second floor where the chapel is located. There is only one person outside in the hall, a fiftyish-looking woman who is pacing and talking on a cell phone. I hang back, watching her for a moment. Her face is drawn and tearstained, and her voice is hoarse, though I’m unsure if that’s its natural state or if it became that way from crying. She sees me and seems to sense that I’m waiting on her because she tells the person on the phone, “There’s someone here. Let me call you back.”
I put on my best sympathetic smile and approach her. “Ms. Nottingham? I’m Mattie Winston. I’m with the Medical Examiner’s office.”
“Oh?” she says, looking confused. Then I see dawning on her face and her expression turns grim. She repeats herself, but with a much more serious tone. “Oh.”
“I’m very sorry for your loss,” I tell her, reciting the standard, wholly inadequate line.
She nods.
“Can we sit down for a minute? I’d like to talk to you about your father.”
Again she nods and after looking around for a chair and finding none in the hallway, she heads toward the chapel. I follow her inside and we settle into the last of three pews on the left side of the room, leaving the two pews in front of us and the three on the right open.
“I understand you were the one who found your father?”
“Yes,” she says, wincing with the memory. “He was in his car, out in the garage.”
“Where in his car was he?”
“Behind the wheel, in the driver’s seat.”
“Were the keys in the ignition?”
“Yes.”
“Was the car running when you found him?”
“No.”
“Was the garage door open or closed?”
“Closed.”
I reach out and put a hand on her shoulder. “I know this isn’t easy for you, but can you describe what he looked like when you found him?”
She takes a deep breath and slowly lets it out. “He was slumped down in the seat. He looked . . . well . . .” Tears well in her eyes and she glances toward the ceiling, trying to regain her composure.
“Was he breathing?” I ask.
She shakes her head.
“Did you check for a pulse?”
“I did,” she says. “But I couldn’t feel one. I tried to shake him, thinking he might be asleep or something because he looked so pink.”
“Pink?”
“Yeah,” she says, sniffling. “His color was very pink, almost red. You know, ruddy looking.”
Ruddy coloring is unusual and it makes me wonder if Mr. Minniver might have tried to commit suicide. Carbon monoxide poisoning typically causes a cherry-red color in the skin and if he was in his car with the garage door closed, carbon monoxide poisoning seems like a possibility.
“Ms. Nottingham, I know you said your father had his keys in the ignition but did you happen to notice whether or not the ignition was turned on?”
Her brow furrows as she thinks about this. “I don’t think so,” s
he says finally, “because the engine wasn’t running.”
I realize the engine might have been running and the car simply ran out of gas before he was found, but I don’t say so. I’m pretty certain she has no idea what position the ignition was in. “Did you notice any unusual smells in the garage?” I ask. She furrows her forehead, looking confused, so I elaborate. “Like a strong odor of exhaust?”
She thinks a minute and then says, “No, I don’t think so.”
“I understand your dad had a history of heart problems?”
“He did, but he had that bypass surgery they do and he’s been doing pretty well since then. In fact, he was checked out by his cardiologist just two weeks ago and they said his heart looked great.”
This confirms what I read in his chart.
“What happened?” she asks, her voice hitching slightly. She dabs at the tears in her eyes with a worn-looking tissue she has crumpled in one hand. “Was it a stroke or something? I know he was pretty stressed out about some lawsuit he has going on with his neighbor. Could that have led to a stroke?”
“I don’t really know,” I tell her, unwilling to share my suicide theory yet. “We’ll need to do an autopsy.”
She pulls back from me. “You’re going to cut him open?” she says, looking horrified.
“It sounds much worse than it is. An autopsy is a professional, scientific, and dignified process. It’s not much different than having surgery at the hospital,” I say, knowing it’s a lie. While an autopsy is a professional and scientific process, there is nothing even remotely dignified about flaying someone open, removing all their organs, and turning their face inside out so you can saw part of their skull off and pop their brain out.
She shudders and hugs herself. “I suppose if you have to, you have to,” she says. “Is this going to delay the funeral arrangements?”
“It shouldn’t. We’ll do the autopsy tomorrow and hopefully we’ll have some answers by the afternoon. Most likely his body will be released the next day. Have you contacted a funeral home yet?”
Frozen Stiff Page 5
