Bone of Contention: A Medical Thriller With Heart (The Gina Mazzio Series Book 4)

by Bette Golden Lamb

  “Get a gurney, Gina … and grab the portable oxygen tank on the way back.” Then the nurse was rattling off a litany of Carrie’s symptoms on the phone. “No! We can’t wait. We’ll bring her down.”

  As they raced down the hall with the gurney, Taneka was yelling, “Thelma! Thelma!”

  * * *

  Thelma Karsh hurried to respond. “I’m here,” she called out. She watched the lead nurse and the new staff nurse stuff the gurney and themselves into the elevator.

  “We’re going to the ER,” Taneka yelled at her.

  “What happened?”

  But the door slammed shut. Thelma couldn’t help but smile.

  Chapter 9

  Thelma Karsh could barely sit still – excitement was curling in her belly, pressing down on her; she almost peed her pants.

  Smart-mouth Carrie was on the way to the ER. And she, Thelma, was the reason.

  It had taken all of her self-control not to laugh at Taneka and that new nurse trying to maneuver the gurney into the elevator. They looked pretty funny, both of them huffing, their eyes wide with fear.

  Carrie? Her face was white as virgin snow.

  And that was the only virgin thing about her. Filthy whore! Murderer!

  Thelma had listened to, tolerated Taneka fire off orders, telling her what to do. And she had nodded like a good drone because she wouldn’t let on that she was way smarter than any of them thought.

  When she’d started here three years ago she’d done what they told her, signed all the orientation documents, because to work in Woman’s Health, she’d had to agree to assist with therapeutic abortions.

  She hated herself for doing it.

  If she hadn’t needed the money, she would have torn up the papers and thrown them back in their faces. But she’d finally agreed for only one reason: she would make those baby murderers pay with their lives.

  And now she had a big secret weapon.

  So, yes, she would continue to do as she was told, be mild mannered, and cause Taneka to give her excellent performance evaluations so she could make even more money. But she would still do her real work. The work of God.

  She fingered the gold cross that always hung around her neck – touching it made her feel strong, strong enough to be a good soldier.

  For a long time she’d hesitated to do what she and Marvin had planned – get rid of women who murdered their growing babies.

  “Do something real. Make a difference,” Marvin had yelled, no screamed, at her when she hesitated to take action. “Wasn’t that the reason you went to work for that killing machine?”

  Then he started pushing her around. He’d shoved her into a table, broke her leg. And he continued to call her a weak soldier, not worthy to be in the Lord’s army of the righteous.

  Thinking about it, the memory caused a sudden rush of pain to swell in her chest. She thought she would cry and she didn’t want to cry anymore. Not ever. Marvin hit her when she cried. Said she was weak. Thelma didn’t want to be weak.

  She bit down hard on her lip. She would be strong, worthy of the Lord’s blessing.

  Marvin’s opinion of her made her sad. Hadn’t she been a good wife? Hadn’t she brought four baby girls into the world? Why did he call her weak?

  I’ve always done what had to be done.

  Did he even consider all the time I’ve spent studying, observing, listening to doctors and nurses talk about infections? All those long meetings dedicated to the one thing they talked about endlessly: preventing infection.

  She might not be a real nurse, but she wasn’t stupid. The very thing they tried endlessly to prevent would bring them down – infection.

  Studying, learning about bacteria, buying the necessary materials − a small incubator, a microscope, and several culture Petri dishes − had been an intense ordeal. The streptococcus itself had been easy to get. She simply took a sterile swab and got the culture from her nephew’s throat – he was always getting strep. But, she could just have easily taken a swab off of a doorknob, her own nose, or even her skin. Strep was everywhere.

  She tried to tell Marvin about her plans, but he wouldn’t listen, didn’t care. All he talked about was God punishing bad women. He was impatient, wanted immediate results.

  When she was ready, everything fell right into place. She’d carefully swabbed some of the bacteria that she’d grown on the blood agar culture, just as the books instructed her, and transported it in special culture tubes that they kept on the Women’s Health unit.

  The rest was easy. Taneka tried to keep Carrie’s abortion hush-hush, but it was impossible to keep secrets in the compact unit. Then Taneka told her to fix the set-up in the OR, which gave Thelma plenty of time to pull everything together.

  And it really wasn’t complicated.

  Thelma introduced the organisms into the warmed KY Jelly that was squeezed out on the instrument tray for the procedure.

  That’s all it took.

  When the MD jellied her gloved fingers for a pre-exam, the bacteria was there, ready and waiting.

  When she dipped every cervical dilator into the jelly, before introducing it into the cervix, the bacteria was there.

  Every time she used the warmed lubricating jelly, the bacteria were there, waiting. All that fresh bacteria was finding a new home in every vessel in that killer’s uterus and bloodstream.

  And Carrie was only the first. The first because she’d always treated Thelma like a lesser person because she wasn’t an RN.

  I may only be a medical assistant, but I deserve respect. I’m not the unholy one here. You’re the ones who sin by helping destroy little babies; you suck out God’s gift and throw it away like garbage. You let the real killers walk away to fornicate again and again. Kill again and again.

  The law may not make them pay, but God will. And I will help Him.

  Chapter 10

  Harry Lucke’s first day back at Ridgewood was a quiet one. ICU had three stable patients and if everything went as planned, they would end up on a step-down unit later in the day ... or tomorrow.

  There was only one other nurse on the floor and Harry had encouraged her to take one of those rare cafeteria breaks ICU nurses get.

  When she left for the cafeteria, she called out, “You’re a doll, Harry.”

  Is it sexist to call a man a doll? I’ll have to see what Gina has to say about that.

  He laughed, poured a cup of coffee, and studied his nurse’s notes while he waited for it to cool.

  He and Gina had very different nursing goals. She treasured the close relationships that developed with the people under her care, the kind of nursing where she could get to the core of what made people tick.

  All of that was secondary to Harry. He loved doing critical care, with its massive doses of high-tech nursing; it not only made him feel needed, it left him with the primary goal of bringing his patients safely through a crisis.

  And he didn’t like being tied down to one hospital; it was why he'd become a travel nurse in the first place. It allowed him to move from one location to another, check out the different standards of care in different places across the country. It kept him alert and challenged.

  But he'd felt he couldn’t leave Gina right after the trauma of Nevada. Then her brother showed up, unsettled and troubled. Vinnie really needed all the help both he and Gina could give. And Gina, whom he loved and planned to marry, was scared and distracted now that her ex, Dominick, was out of prison; she was the one who’d put him in the slammer after he'd almost beat her to death. At least the gods were in their favor -- he was in New York, three thousand miles away.

  Since they’d come back from Nevada, she’d had almost continuous nightmares. Harry wanted to be with her, next to her, so when she reached out, he could take her in his arms and hold her until she felt safe again.

  So, instead of going on the road again, he'd made himself available to Ridgewood on an on-call basis. But they seemed to need him every day in the ICU; he was already a near-regular o
n the daily schedule. And being the ICU, the prospect of overtime piled on overtime was ever present.

  Harry was about to sip his coffee when the ER line buzzed.

  “We have a critical female on the way up,” said a hurried voice. “Real bad.”

  Before he could respond, the swinging doors from the corridor crashed open. Two ER nurses came barreling into the unit, pushing a gurney. Harry threw on a pair of gloves and helped shove the cart into a patient slot.

  The woman was out of it, moaning, shaking, even under the piled, warmed blankets.

  “Lay it on me,” Harry said. He hooked the patient’s oxygen tube into the wall outlet, hung her saline solution with a piggyback of Clindamycin onto the IV unit.

  “Patient is two days out from a routine TAB,” said one of the nurses. “Absolutely no problems during or post procedure, according to nurses’ and doctors’ notes in Women’s Health.”

  The other nurse chimed in. “Co-worker said she returned to work, but went through a rapid cascade of symptoms that started with complaints of flu-like symptoms that rapidly degraded to fever, abdominal pain, dizziness, disorientation.”

  Harry set up the leads for the EKG, respirations, and oximeter readings for the telemetry unit. “She’s going to need venting … and she’s pretty damn tachy. Look at that heart rhythm.”

  The B/P unit beeped. Everyone focused on the readings.

  “Blood pressure and temp are diving,” Harry said. “And zero urine output. Christ, this has to be multiple organ failure.”

  “That’s what our docs said before they transferred her up here,” said one of the ER nurses.

  Harry’s adrenalin raced. “Call the attending,” he ordered, pointing at the nearest nurse. “Did they scan her?”

  “Yeah!” said the other nurse. “CT was negative for all the usual suspects: retained tissue, obstructions, perforations, foreign bodies.”

  Back from calling the staff MD, the first nurse said, “Blood cultures are cooking.”

  “Shit! Her only hope is the antibiotics … they have to kick in right now,” Harry said.

  “She was hooked up with antibiotics pretty fast once the doc got the WBC and cultures going.”

  “Yesterday would have been fast. Let’s just hope it’s not too late.”

  One of the ER nurses’ grabbed fresh linen, pulled out blood-soaked pads, and shoved a clean sheet under the woman. “Je-esus, she’s gushing blood.”

  All the monitors suddenly went crazy.

  “She’s flat-lining.” Harry grabbed the defib paddles. “Turn it to two hundred. God damn it, girl, hang in there!”

  The other RNs slapped pads on the woman’s chest as he gelled up the defibrillator and yelled, “Clear!”

  Her body arched from the electrical shock, but her rhythm remained flat. He quickly repositioned the paddles. “Turn it up to three hundred … clear!”

  “Again! Clear!”

  “Again!”

  The attending raced up to the gurney, stopped in his tracks, eyed the monitor and the large puddle of blood splattered on the floor.

  “Call it!” he said to Harry.

  Chapter 11

  Gina and Harry sat on a bench in the staff garden just outside the cafeteria. It was their lunch break, yet neither had carried any food outside to eat. They sat in silence, off in their individual worlds.

  Harry was the first to speak. “I feel like I failed that nurse, Carrie.”

  Gina tucked an arm in his and hugged him close. “You did everything you could for her.”

  “Then why isn’t she here?”

  “Harry, we can only do so much for anyone. After that, it’s up to the gods.”

  “It really shakes my confidence, not only in medicine, but in me, when we lose a patient. “ Harry said. “That’s the whole purpose of ICU. We’re supposed to save people’s lives. It’s the only reason we’re there.” He swiped at a plant near the bench. “If only we’d gotten to her sooner, she might have had a fighting chance.”

  “Everyone in our department is in total shock. The way Carrie died … it’s like she had a back alley abortion.” Gina pressed her body against him, kissed him on the cheek, and rested her head on his shoulder. Then she sat up again. “Don’t you think it’s weird for her to develop septicemia so rapidly?”

  “I’ve been thinking about that myself,” Harry said. “Unless it was some kind of exotic bug she picked up.”

  “We should have a final culture result tomorrow,” Gina said. “At least that ought to give us something.” She laid her head on his shoulder again. “Anyway, they’ll probably do a post.”

  “Oh, yeah, but I know she died of sepsis … a classical case.”

  “I still think it’s strange.”

  “It’s kind of unusual to become septic in such a short time. I mean, she was a young, healthy woman … unless … she had intercourse right after the surgery … that could introduce some nasty bacteria directly into the uterus.”

  “I didn’t know Carrie, but she was a professional. She wouldn’t be that stupid.”

  “Everyone surprises you sooner or later.”

  “Man, our first day back.” Gina said. “What a mess.”

  “Most people don’t have to deal with this; they live in a bubble, thinking bad things or sudden death only happens to other people.” Harry’s eyes were very sad. “With us, each day is a reminder that life is short, very short sometimes.”

  He ran a knuckle across her chin. “What did you think of the department?”

  “I think I’ll like it. I’m more worried about Vinnie.”

  “Oh, my little pumpkin, I don’t think you have anything to worry about,” Harry said, smiling. “Before the shit hit the fan, I called Internal Meds.”

  “Really? That was so nice of you, Harry. I didn’t want to be forced into the big sister role.”

  “Well, I know the charge nurse there,” Harry said.

  “Uh huh! One of your exes?”

  He leaned over and gave her long, deep kiss. “There’s only you, baby.”

  Gina smiled. “An evasive answer, expertly given … but acceptable, nonetheless.”

  “Anyway, she said Vinnie was gentle, kind, and seemed to have a natural ability to work with frightened people, had a way of calming them.”

  “Wow, that’s pretty cool.”

  “She also said, you’d never know watching him that he hadn’t spent years working with people in trouble.”

  Gina broke out in a grin. “I just didn’t know how it would turn out. Vinnie’s usually a gruff, in-your-face kind of guy.”

  “Sometimes that’s what a patient needs. Anyway, the charge nurse said that by mid-morning their manager was talking about having to fight off other units that wanted to steal him away.”

  “Still, Vinnie has a real tough side… he can be like steel. After what my ex-husband did to me, Vinnie was out on the streets looking to kill him ... the same night. I still think he would squash Dominick today if he ever got his hands on him.”

  Harry squeezed her arm. “Maybe his military experience has stripped away that veneer of toughness you always talk about. Maybe now he’s more honest about being scared … about being vulnerable.”

  Gina’s eyes filled with tears. “Harry, I’m so afraid for my kid brother. He seems so done in. That’s the only way I can describe it.”

  “This job could be just what he needs − being with patients who rely on him. It could keep him from stepping off the edge … keep him from not caring ... keep him from taking his own life.”

  Gina shuddered at the thought. “We can’t let that happen, Harry.”

  “We won’t, doll.”

  Chapter 12

  After work, Vinnie and Helen walked aimlessly, both of them silent, yet strangely wrapped up in each other. Vinnie sensed words would never be important to either of them. What mattered more than anything was the strong current of connection that kept tugging at him. It was something fierce, something powerful that pulled a
nd drew them together. When she slipped her hand into his, he held onto it for dear life.

  They ate an early dinner at a little Chinese restaurant down the street from her apartment.

  “Do you want to stay at my place?” Helen blurted at some point between the hot and sour soup and the pot stickers.

  “We’ve just met today. Are you sure that’s what you really want?”

  “Vinnie, I haven’t been sure of anything for a long time. But I have to go with my gut when I meet someone really special.”

  “You think I’m special?”

  “Oh, yes, Vinnie. You’re very special.”

  He knew this woman would not be a one-night stand, and for the first time the idea of being with only one woman didn’t scare him. Strange, it was the only thing that didn’t scare him at this point in his life. Maybe it was because Helen seemed fearless, strong. Even though she was just a slip of a thing − couldn’t be much over five feet tall − he felt safe with her. He hadn’t felt safe with anyone, other than Gina, for a long time.

  “Remember, you can kick me out at any time.”

  “Oh, I will. Don’t you worry about that.”

  “Maybe we ought to stop at Gina and Harry’s so I can pick up some clothes.”

  She gave him a wide smile.

  * * *

  “So Vinnie isn’t eating with us?” Harry said, wrapping his arms around Gina as she stood at the kitchen sink.

  “I don’t think so.”

  “But are you sure?” Be buried his head into her black, curly hair, fingertips rode across her hips, slid under her tee shirt. “Hmmm. I really love it when you don’t wear a bra.”

  Gina gave him a wide smile that was lost when their lips met. It was a long moment before she could even remember his question. “It looks as though he came by and took some of his clothes while we were out shopping. He left a note saying he’s with Helen.”

  That caught Harry off guard. “Helen from Oncology? Your buddy?”

  “That’s the one.”