Mercy

by Rada Jones

  Emma nodded.

  She returned to her office to check the chart. Somebody knocked at the half open door.

  “Come in.”

  Sal came in.

  “Have a seat. Problem?”

  “I found this in Room 10,” he said, showing her a vial.

  Emma reached for it. He pulled it back.

  “Gloves.”

  She gloved. “Propofol. 200 mg. Empty.”

  “Yes. I was wasting the meds in the RSI kit when I found this on the counter. It wasn’t in the kit. That one was still there. Untouched.”

  “Dr. Crump didn’t order anything for this patient.”

  “Correct.”

  “Could it be left in the room from the previous patient?”

  “Unlikely. The room had just been through a terminal clean after an infectious patient.”

  “Weird.”

  “It gets worse. The serial number identifies this vial as part of an RSI kit Carlos took out last week. He recorded wasting it.”

  Carlos.

  “That’s enough to kill that tiny old woman.”

  “If she got it.”

  “Yes, if she got it.”

  “The labs will tell. Either way, Carlos is in trouble.”

  “Major trouble.”

  “What next?”

  “I’ll tell Mike and the pharmacy director. They’ll take it from there. I just thought you’d want to know.”

  “Thanks, Sal.”

  Carlos? Killing all these people? Not likely.

  She went back to her cases.

  The door opened wide. Kurt stepped in looking like he’d slept in his clothes, his usual spunk gone. Emma offered him a chair and chocolate.

  “I wish it was wine.”

  “Me too. Who the hell is doing this? Why? And how?”

  “Kurt, you’re sure you didn’t give her anything?”

  “Come on, Emma!”

  “Sorry, I have to ask.”

  “Not even Tylenol.”

  “Sal found an empty vial of propofol in the room.”

  “I didn’t order propofol. I didn’t order anything, for fuck’s sake!”

  “OK. I guess we’ll find out.”

  “Sorry, Emma. I’m just tired and frustrated. I’m sure you are too.” He cleared his voice.

  “Your daughter…I didn’t know she was pregnant.”

  “Yep. The joys of parenthood.”

  “How old is she?”

  “Eighteen.”

  “Is she…what is she going to do with the baby?”

  “Good question. I don’t think she knows. It’s been a rocky ride.”

  Kurt stood. “I’d better head home; I’m late already. Sheila won’t like it.” He stopped with his hand on the doorknob. “You know, Emma...” He shifted his weight from one leg to the other. “Sheila and I, we’re looking at adopting. In case…if Taylor is considering it, we’d welcome not only the baby but Taylor too. Sheila would be overjoyed.”

  “I’ll tell Taylor. I’ll tell her to speak to you if she thinks that’s something she may consider.”

  “Thanks, Emma.”

  Should I tell him that the baby’s father is… No. That’s up to Taylor.

  62

  Mike’s office was packed the next morning. They held an emergency meeting. Nobody was happy. The voices were high, the tempers short, and the oxygen mostly gone. Emma squeezed a seat between Sal and Brenda.

  “The latest event was yesterday. Another patient, MR 0897654454, here for a syncope, waiting for her workup to be completed, arrested suddenly and with no explanation and was unable to be resuscitated.” Mike glanced around to make sure they were all paying attention.

  Emma uncrossed her legs and crossed them the other way. I hate medicalese! Why can’t we speak like normal people? “Wasn’t able to be resuscitated.” We weren’t able to resuscitate her. That’s just like “the patient failed the treatment” bullshit. It’s the treatment that failed the patient.

  “This has to stop. We have lost more patients in the last few weeks than in a whole quarter of last year. The Quality team started an investigation. The state will come after us, sooner rather than later, to look into this increased mortality. We can’t afford to wait and see what happens. We have to be proactive. We have to stop this.”

  Proactive my ass! Proactive meant stopping it before it started. If anything, this is post-active.

  “I agree,” Gus said. “We should have done something long ago.”

  “What are you saying, Mike?” Judy asked.

  “I think we should put Carlos on a leave of absence while we’re looking into things.”

  “Carlos? Why Carlos?”

  “Carlos was involved with a bunch of these deaths. He was the primary nurse of four of them. He was also involved with the care of a few of the others,” Mike said.

  “That in itself doesn’t mean anything,” Emma said. “So was I. So was Sal.”

  Sal frowned.

  “Come on, Sal, you know what I mean. There’s no evidence against Carlos.”

  “Actually, there is. He was the one who gave the meds to that back-pain patient of yours who died. Then he said he didn’t. But it’s in the computer. He signed for them.”

  “That’s exactly what worries me. I know he didn’t. He was with me in another room. We were working on an arrhythmia. He couldn’t be in two places at the same time.”

  Mike shrugged. “It only takes a minute to leave the room and give the meds. Nobody would even notice.”

  “And log into the computer to sign that you did? Then deny it? It makes no sense.”

  “It may not make sense to you, but it’s going to make a lot of sense to the police. Then there’s the RSI kit.”

  “What RSI kit?” Gus asked.

  “Sal, can you explain?”

  “One of Carlos’s patients got intubated a few days ago. Carlos took out an RSI kit. They used a couple of meds, not all of them. Carlos recorded discarding the rest. There was no witness. Then, yesterday, a patient coded. The empty vial of propofol found at her bedside belonged to that discarded RSI kit.

  “That’s bad,” Gus said. “That’s awful.”

  “Still, it doesn’t explain everything. Some of the incidents didn’t involve Carlos.”

  “That we know of,” Mike said. “Not yet. By the way, remember that patient with the agitated daughter, the pneumonia in Room 15? Your patient?”

  “Yes.”

  “George was your nurse.”

  “Yes.”

  “George went on break. Carlos covered for him. When George came back, she was dead.”

  “George and Carlos room together,” Judy said.

  “What are you saying?” Emma asked.

  “Nothing. Just thinking out loud.”

  “Then this last patient. The one with the propofol vial. It was Faith’s patient, but Carlos went to draw blood. When Faith went back, she was dead.”

  “Death seems to be following Carlos,” Gus said. “If he’s not guilty, he sure is unlucky.”

  “What if somebody is framing Carlos?” Emma asked. “Some cases he’s not involved with. Some things make no sense. First, why would he do this?”

  “Why would anybody do this?” Judy asked.

  “Because they’re nuts,” Mike answered.

  “But why sign that you gave meds to a patient you’re trying to kill? Shouldn’t he pretend he never did? That makes no sense.”

  “Maybe he forgot and did it by reflex,” Mike said.

  “This is complicated. It doesn’t look like we can clarify it today,” Gus said, “We’ll work on it. But in the meantime, we have to do everything we can to protect our patients. I say Carlos is out.”

  “What if it’s not him? What if this continues?” Emma said.

  Gus glowered at her.

  “What do you want to do, Emma?”

  “We should call the police. Have them look into things.”

  “Absolutely not! If somebody leaks the ne
ws, we’re cooked! Nobody will come here any longer for fear of being killed! We’ll go bankrupt. We have to clarify this first.”

  “We’ll be even more cooked if we watch people dying and don’t do anything,” Emma said.

  “That’s precisely why we are putting Carlos on a leave of absence,” Gus said.

  “What if it’s not him? What if it’s somebody framing him? And they’re still here?”

  Mike shrugged. “If they’re framing him and he’s gone, maybe they’ll stop the killings.”

  Emma’s jaw fell. “Really? Is this the best we can do?”

  “I’m afraid so. In the circumstances,” Gus said. He stood. “I’m sorry, but I have another meeting. We’ll put Carlos on a leave of absence and we’ll see how this goes.”

  Emma opened her mouth to say something, but Sal touched her elbow.

  “They’ve made up their minds,” he whispered. “There’s no point in pushing it. You’ll just make enemies.”

  He’s right. I guess I’ll have to continue to work on it myself. At least now I know what I’m looking for.

  Emma ran into Faith on her way to her car. Faith smiled. Emma wanted to stop, but she couldn’t. Something inside her said no. She felt Faith’s eyes burning into her back. Something stirred in the pit of her stomach. She shivered.

  63

  Angel

  It worked. I can’t believe it! It was less than twelve bucks on Amazon. It doesn’t look like much. A piece of green plastic, looking like a luggage scale. It fits in my scrubs pocket.

  I wait until she goes to sew a laceration. She always leaves her coat on the chair, so she doesn’t get blood on it. Her ID hangs from the chest pocket.

  I snatch it as I pass by, and I head to the bathroom.

  I get my RFID reader, and aim it at her ID. I press READ.

  It beeps.

  I get a blank card and aim the RFID reader at it. I press WRITE.

  It beeps. It worked.

  That’s it!

  I return her ID. She’ll never know I took it.

  I wave my new card over the sign-in reader to make sure it works.

  It asks for the PIN.

  I have it. I got it last week. She was too preoccupied with that sick patient to see me staring at her hands.

  I type it in. It works.

  I’m Dr. Steele now. I can look up charts, put in orders, document, whatever. Under her signature.

  Dr. Angel Steele. Sounds good!

  64

  When she got home that evening, Emma checked out the wine rack. She looked for something to warm her inside, to clean her from the day’s misery, sadness, and fear. Something unusual caught her eye: Renmano Chairman Selection Shiraz 2017. The bottle was dark green, the label white with a galloping golden horse. That gave her pause. What does the horse have to do with anything? I hope it’s not the flavor! I thought oak and leather were bad. She shrugged, opened it, poured a glass, and sat on the sofa.

  Dark as ink, the wine had a nose of blackberries and plum, with a touch of honey and a hint of pepper. No horse. She took a sip. The wine was full bodied, “corposo” as Italians say, and sensual. She felt its warmth spreading through her. She sighed.

  Guinness laid her head on Emma’s knees. She rolled belly up, demanding to be scratched.

  “I thought you Germans were aloof and dignified.” Emma set down her glass to scratch her armpit. Guinness moaned with pleasure.

  “What do you think about all this? I think somebody is framing Carlos. He isn’t stupid. He wouldn’t leave that kind of trail. Somebody’s trying to sink him. But why?”

  Guinness rolled, offering the other armpit.

  “The obvious answer is Faith. They were together, they fell apart, she hates him. But she’s a great girl. I’m biased, of course. How could I not be? She saved my life. But she really is patient and caring, especially to the elderly. She’d never do something like this! Carlos has other enemies. Ben got demoted because of Carlos. He almost got fired. Faith said that’s just the tail end of the story. There’s a lot of bad blood between them. Ben said Carlos is stealing drugs. Was that the propofol vial Sal found? Is there more coming? And what happened to the rest of the RSI kit that vial came from?”

  Guinness had no suggestions. She rolled back on her other side.

  Emma shook her head. “I’m getting nowhere. I need to speak to him. Let’s go.”

  The red car swallowed the empty roads. George’s windows glowed orange in the night.

  Emma rang the doorbell. George opened the door, holding a beer.

  “Long time no see, stranger. Come in. Beer?”

  “No, thanks.” Emma shivered looking at the can in his hand. “I’m a wine person.”

  “Sorry, but I don’t…”

  “Good. I’m driving anyhow. Is Carlos home?”

  “Nope. He came back from work and said they put him on leave. He drove out like a bat out of hell. Said he’s going back to New Hampshire to clear his head.”

  “I see.”

  “They think he’s got something to do with all these deaths, but I don’t think so. He’s not a killer.”

  “I agree. But then who is?” Emma asked.

  “His girlfriend?”

  “I don’t think so. She’s a nice girl.”

  “She’s not nice. She’s disturbed. There’s something seriously wrong with her.”

  “What makes you say that?”

  “I’ve seen her. She’s dark inside. Those glass-blue eyes are creepy. They give me the chills.”

  “I don’t think so, George. Just because Carlos is your friend…”

  “Listen, Emma. You know me better than that. That girl is trouble.”

  Emma shrugged. “I’ll go now.”

  “Emma, watch your back. I have a bad feeling.”

  “What feeling?”

  “Something’s about to happen.”

  “Bad things happened already. Too many.”

  “I know. I have a feeling something bad is going to happen to you.”

  Emma shuddered. She turned up the heat in the car. She was still shivering when she got home.

  Boris was waiting in the driveway.

  “I couldn’t wait until next week.”

  Her heart sang.

  65

  Carlos drove for hours and hours that night. He put mile after mile of dark wet road behind him. His shoulders hurt and his neck was stiff from leaning forward, trying to see beyond his lights. His tired eyes burned from the glare. He was far enough to stop and take a break, but there was nothing. Nothing but the never-ending wet road, the rain, and the forest.

  Drunk with rage, he had left on a whim. He couldn’t think about anything else to do. He was humiliated and angry.

  And guilty.

  They called him for an urgent meeting in Mike’s office. They were all there: Mike, the VPM, the union representative, the hospital lawyer. They ganged up on him.

  They asked about the meds for the back pain.

  “I left them on the counter.”

  “You gave them. There’s your signature,” Mike said.

  “I didn’t.”

  “You signed that you did.”

  “I didn’t.”

  They didn’t believe him.

  They asked about the woman in Room 15.

  “You covered George’s break. How was she?”

  That’s when Brenda came to me. I never made it there.

  “She was fine,” he lied.

  They asked about Taylor’s patient in Room 10.

  “Yes, I got the blood.”

  “What did you give her?”

  “Nothing. She wasn’t my patient.”

  “Then why did you get the blood?”

  “Taylor needed help.”

  “How about the propofol?” Mike asked.

  What?

  “You left the empty vial in the room.”

  “I didn’t leave any vial in the room.”

  “You did. We checked. It’s the propofol from
the intubation kit you charted as discarded.”

  Carlos heard his blood boil, and his brain darkened with fury. Mike was Ben’s friend. That’s why he hates me. That’s why he blames me.

  But Carlos had indeed charted that stolen RSI kit as discarded. He’d hoped it was gone for good. It wasn’t. The propofol had come back to haunt him. I’m fucked.

  “Don’t answer any questions you’re not sure about,” the union rep intervened. “Even better, don’t answer any more questions at all. You need a lawyer.”

  “I’m here,” the hospital lawyer said.

  “You’re not his lawyer. He needs his own.”

  Carlos agreed. He didn’t need to dig himself any deeper. Security escorted him out, just as Ben was coming in to work. Ben grinned like he’d won the lottery. Carlos ached to punch him in the face. It took all his self-control to refrain.

  The smirk on his face! He couldn’t wait to go and tell them. As if the whole ER didn’t already know.

  A burning flash of lightning split the sky. A deafening roll of thunder followed a second later, bringing him back to the present. The rain, falling like a wall of water. The car, skidding on the slick road. A truck’s high beams blinded him. He slowed down.

  I wish I hadn’t left.

  Faith and Ben were going to laugh at him. All the others—Brenda, Mike, even Dr. Steele—they’d think he was guilty. And he was. He was guilty of one thing. He had lied about discarding the kit. He had nothing else to be ashamed of. He didn’t kill people. He didn’t steal drugs. He only tried to do his job and save lives.

  Now he was on the run. Ben was laughing. With Faith. His anger made him sick. He opened the window to spit his bile. The rain caressed him with cool fingers. It soothed his forehead and relieved the burn in his eyes.

  He couldn’t let that happen. He couldn’t run away and let them laugh. He had struggled his whole life to become somebody. He couldn’t let them steal that. He turned around. I’m going back. I’ll show them. I’ll put things right. I’ll prove that I’m innocent.

  He drove and drove and drove.

  Hours later, he was getting close but he was hurting. He was running out of gas. Another hour or so to go. He rubbed his burning eyes. He saw the lights on the left side of the road. I almost missed it.