Fatal Complications

by John Benedict

  “What are you talking about?”

  “I saw you throw that man into it. I saw you kill him!” She was definitely breathing fast now.

  Shit, unbelievable. Just when he thought he was free and clear. “I’m not sure what it is you think you saw, Gwen. Who have you told and why are you telling me this?” Katz took a deep breath and forced himself to slow down. Silence from the other end. He paused for another moment. “What is it that you want?” He understood full well how the human mind worked.

  “I need something—I need a favor.” Her voice sounded squeaky and she cleared her throat. “I need you to help me get rid of Mrs. Gentry.” He heard her take a big breath. “In exchange for my silence. You make her go away and I’ll never tell a soul what I saw down there in the basement. Okay? Do we have a deal?”

  “Hmm,” he said and paused. So that’s it. He got the whole picture now very clearly. People are so predictable, but this stretched irony to the limit. After all, he had seen fit to introduce Gwen to the good Dr. Gentry. Just spreading goodwill at the time. Everyone in the hospital knew they were an item now, but he hadn’t realized it had progressed this far. Amazing—plant a seed and watch it grow. “That’s asking a lot, Gwen. Let me think—”

  “Look, I saw you throw that poor man into the fire.” Her voice was stronger now, becoming strident. “I know you can do it. I need you to.”

  Katz’s mind was racing—she was threatening him, that was clear. No, blackmail was a better word. He couldn’t suppress a brief flicker of admiration for Gwen’s boldness—he approved of her technique. But it represented one more fucking loose end to deal with. How many more will there be before this thing is over? “Look, Gwen, we shouldn’t talk about this over the phone. Where are you? We should meet.”

  “I’m here at the hospital.”

  He thought he had recognized that number as a hospital extension. Unbelievable—here, now. Time for some more creativity. But he must be cautious—after all, patience was a virtue. Does her being here have anything to do with the senator? Does she know anything about that? “What are you doing here at this time of night?” he asked, trying hard to sound casual.

  “I came in to talk to Rob—uh, Dr. Gentry.”

  That sounded legit—but it could also complicate things. “Is Dr. Gentry there with you now?”

  “No,” she said, “he had to go help with an emergency C-section.”

  What! How could this be? What was going on up there in OB? He had left just a short time ago. Was Plan B being played out? He wouldn’t have thought that possible. “Listen, Gwen, I have some ideas. Meet me in my office in five minutes.” So much for things proceeding smoothly. He blew out the candles.

  He dialed Nikolai’s number again as he headed out the door, back to Obstetrics.

  CHAPTER THIRTY-SEVEN

  MONDAY, NOVEMBER 22, 11:55 P.M.

  “Mark, do something!” Luke implored. He watched helplessly as the suction canister filled up with his wife’s blood, making a horrible gurgling noise.

  “I’m trying, damn it!” Seidle poked the suction cannula around in Kim’s open belly and the level in the canister continued to rise.

  “Can’t you stop it?” Luke was beside himself with fear and dread, and couldn’t stand still. “Can’t you deliver the baby?”

  “I’m trying, Daulton.” Seidle turned to the scrub nurse and barked, “Hemostat!”

  “What’s the problem? Can you at least tell me that?”

  “Shut up, Daulton. Can’t you see I’m busy?” He suctioned some more and then said in a grave tone, “I think the uterus might have ruptured.”

  Luke realized he wasn’t helping the situation with his constant questions. Seidle needed to concentrate. Luke also remembered why he hated having family in the delivery room. When everything went smoothly, it was a wonderful, touch-feely, Kodak moment. But when the shit hit the fan, the docs responsible for life-and-death decisions didn’t have time to deal with the raw emotions of scared shitless loved ones.

  Luke needed to get a grip on his own emotions, even though he had never felt so helpless in all his life. He had just witnessed the horrifying spectacle of a total spinal on his wife. Luckily, he had recognized the symptoms quickly and had intervened. He and Diane had put Kim to sleep; he had intubated her himself. This had been bad enough, but now she was hemorrhaging profusely—maybe the result of the dreaded uterine rupture.

  He stared down at Kim’s face—her eyes were taped shut and an endotracheal tube disfigured her pretty mouth. Her lips looked so pale—she was bleeding to death right before his eyes. And Abigail’s chances were dwindling rapidly as well. He turned to Diane and asked, “How long until we get the blood?”

  “Ten minutes,” Diane said.

  Great, Luke thought. She needed the blood now. Luke paced some more but his mind kept returning to Dr. Katz. His suspicions of Katz were growing by the minute. After all, he had given Kim the total spinal. Could that possibly have been an accident? Luke strongly doubted it. But, what the hell was going on? And was Kim right about the puzzle? Was someone actually trying to kill the senator? Was Katz somehow involved in some bizarre plot? Or was it just a drug-induced hallucination? Who should he trust? It was hard to think straight while his wife bled to death in front of him.

  The roar of the suction canister interrupted his thoughts. It now had over 1,000 ccs of blood in it—Kim’s blood. He’d have to worry about Katz later. If the bleeding wasn’t controlled soon, she would go into irreversible shock and then nothing could save her. The blood pressure machine beeped 60/40.

  All of a sudden, a horrifying thought struck Luke—he stopped pacing as if he’d walked into a wall. What if Seidle’s mixed up with Katz? His knees threatened to buckle as the implications of this hit him, and he reached toward the anesthesia cart to steady himself. What if he’s in on some plot to murder the senator? And overheard Kim solve the puzzle? And is killing Kim now to silence her? Dear God, what should I do?

  Luke turned to the nurse anesthetist. “Diane, do you see her pressure? Give some more Ephedrine or Neo!”

  “I just gave a ton of it,” she said, her tone defensive but nevertheless laden with worry. “I’ll give some more. The blood should be here soon.”

  Soon? She’ll be dead soon. Luke resumed pacing, his footsteps becoming frantic as time slipped away. He had to know about Seidle. He had to figure things out. If Seidle was in on it, Kim didn’t stand a chance—he was busy butchering her. But if Luke was wrong about him, he just might destroy the only chance Kim had of survival.

  He banged his foot painfully into the wheeled base of the IV pole, making it rattle loudly. Suddenly, an idea blazed across Luke’s mind—a way to pin Seidle down, perhaps. It had “bluff” written all over it, but bluff was the only card he had left to play. Kim and Abi were out of time.

  “Mark!” he shouted across the drapes at Seidle. “Kim solved the Sudoku. It names you and Katz in the plot to kill Senator Pierce.” Luke stared at Seidle, looking for a sign—for anything.

  Seidle hesitated for the briefest of moments and his face reddened slightly, but then he quickly resumed his suctioning. “I don’t know what you’re talking about, Daulton. You’re craz—”

  But he didn’t finish his sentence. Luke had jumped around behind him and now wrapped his arm around his neck. “Get away from her, you bastard!” Luke shouted as he manhandled Seidle to the floor. Seidle flailed with the scalpel and sliced Luke across his forearm. Luke ignored the burning pain and grabbed Seidle’s arm. He smashed the hand clutching the knife on the floor over and over until the scalpel went flying across the room. Straddling Seidle, Luke punched him several times in the face. He could hear Diane screaming in the background.

  “You’re too late, Daulton,” Seidle spat out between bleeding, crushed lips. “She’ll bleed to death and you can’t stop it.”

  Luke had heard enough—no more bluffs needed now. He whacked Seidle’s head against the floor repeatedly until his eyes rolled back
in his head. He instantly abandoned Seidle and jumped back up to the operating table. What he saw filled him with dread. Blood was everywhere. The gaping wound in Kim’s belly was filled with blood. He couldn’t see a thing. “Oh, shit,” he mouthed. God help me.

  Luke didn’t know where to begin. Relying on himself only went so far—this was beyond him. He was out of his league. Anesthesia emergencies were one thing—he had been trained extensively for those. But obstetrical/surgical emergencies? He had no idea what to do. He had to rely on something bigger. I need help. God, please help me.

  With these words, something opened up inside his mind, a door he had seen before but had never cared to open. Calmness flowed in—but more, knowledge crept in. This all took place in a fraction of a second, but to Luke it felt as if time stood still as many things washed over and through him. Multiple staggering revelations shook him, forcing the breath from him.

  “Clamp,” he shouted.

  The scrub nurse just stood there looking at him, as if she had turned to stone. Her one hand twitched as if to do something, then stopped.

  Luke grabbed a large Kelly clamp from her tray. He worked the suction catheter, hoping to clear some of the blood away so he could glimpse something recognizable and get his bearings. As fast as he sucked, more blood rushed in. Shit, no good.

  “Pressure’s 50/20!” Diane shouted. “And I’m losing the pulse ox.”

  “Give her some epinephrine. I don’t know if I can stop the bleeding.”

  Luke reached in with his bare hands, searching for Kim’s aorta, the main artery coming directly from the heart. He knew he must clamp her aorta to stop the bleeding. It was her only hope. He searched inside her belly. He felt the swollen uterus and realized it had a large gash in it—probably where all the blood was coming from. He tried to push the intestines aside but they kept slithering back. Everything was so damned slippery. Shit, where’s the aorta?

  Finally, after what seemed like ten minutes, his right hand found a large, pulsing, garden hose-like object way toward Kim’s back. He slipped the Kelly around it and closed it tight. There, that had to be good!

  Now for the moment of truth. He suctioned her wound again. Her belly would either fill up with blood and she would die, or the god-awful pool would be drained and stay that way. He held his breath as he watched the suction canister fill up to 3,000 cc—over half her blood volume and probably past the point of no return.

  Time seemed to slow down further. He could see her uterus now. The large gash was vertical, parallel to the muscle fibers of the uterus—this was not the usual horizontal incision used to deliver a baby. Luke realized it was clearly a surgical wound designed, no doubt, to mimic a uterine rupture. Seidle had purposely tried to kill her. The incision would have been quite lethal within a matter of minutes. But the abdominal cavity was remaining dry. At first he wasn’t sure if this was just related to his altered time sense. He took a couple breaths to make sure time was passing. The blood was definitely not re-accumulating. The clamp was working. Thank God!

  “Blood’s here!” Diane said shrilly.

  “Give the blood now,” Luke yelled to her. “Skip the cross-match. Just give it.”

  “I’m spiking it now.”

  The scrub nurse spoke up. “What can I do to help?”

  “We’ve got to deliver the baby, fast,” Luke said, grateful for her help. Luke reached through the gaping hole in Kim’s uterus and grabbed the baby. It wasn’t moving. He maneuvered it out of the damaged uterus and then out of Kim’s belly. The baby’s skin was very dark, as though someone had rubbed charcoal all over it. This was a very bad sign—he wondered how long the baby’s blood supply and hence oxygen had been compromised.

  There was nothing more he could do.

  Again, Luke felt that he was not in control of this situation. It was beyond his power to affect the outcome. Self-reliance only goes so far, Dad. He shook his head slightly. Perhaps there were other powers at work here?

  Luke flipped the baby over and quickly clamped and cut the dangling umbilical cord. As he prepared to hand the limp body off to the neonatal nurse, something about the baby’s still face caught his attention and he hesitated. He looked down into the most beautiful, angelic face he had ever seen. Abigail. She had light hair and the resemblance to her mother was striking. Luke stood transfixed, staring at her little face as powerful emotions roiled through him. He felt additional connections opening up to the spiritual world and realized the spiritual world had always been around him, just sort of translucent and not plainly visible in the harsh light of the living.

  “Doctor!” the neonatal nurse shouted at Luke. She had her arms outstretched, motioning for the baby.

  The little creature in Luke’s hands startled at this noise and her eyes opened. She drew in a big, stuttering breath as if about to cry. A frown creased her forehead and her lips pursed together in a pout. Then she looked up at him. Her eyes spoke to him. She didn’t cry, but took several more breaths and began to pink up.

  Luke handed Abigail off with a renewed sense of wonder. As he turned to face the daunting task in front of him, he heard Abi gently whimpering in the background and he drew strength from her cries. Maybe he could pull this off after all.

  He refocused on Kim’s abdomen, but what he saw horrified him anew. The clamp had indeed worked to stop the bleeding, but at a fearful price—it also cut off the blood supply to the lower half of Kim’s body. Kim’s internal organs had blanched markedly, taking on a sickly white, mottled color. Clamping the aorta had only stalled the inevitable. Her internal organs would quickly die and she would sustain spinal cord injury from lack of blood, if he didn’t release the clamp soon. But before he could release the clamp, he needed to repair the damaged uterus—something he had no clue how to do.

  His calm evaporated. He heard the clock ticking as he debated what to do. He had brained Seidle, the only man in the room who could save Kim—he was now lying unconscious on the floor. Here he was for the third time in the space of minutes facing a challenge that was larger than he was—bigger than he could handle. His fledgling connection to the spiritual was being dealt a body blow, and he opened himself up to despair. God, what’s the point? Maybe Dad was right—if you rely on the void, you’re left with nothing. Kim would surely die at his hands and he would spend the rest of his life wondering what he should have done. And he would have to explain it to Abigail.

  The cold metal barrel of a gun being shoved against his left temple cut short Luke’s descent into despair. What the hell?

  “Step away from her, Daulton!” Seidle’s voice was gurgly.

  Out of the corner of his eye, Luke saw the bloodied face of Mark Seidle glaring at him. He looked a little unsteady on his feet, but he gripped the gun tightly enough with two hands, pressing it painfully against Luke’s head. “I said, get away from her!” Seidle screamed, and dug the barrel harder into Luke’s flesh.

  “She’ll bleed to death.” Luke tried to turn his head to get a better look at Seidle, but the gun barrel prevented him. “But I guess you know that.”

  “I’m gonna count to three and then pull the trigger,” Seidle said. He spread his feet to take on a more stable stance. “One.”

  Luke frantically tried to decide what to do. If he left Kim, she would die. If he stayed, they would both die. Should he try to hit Seidle?

  “Two!”

  Luke figured it was over. At least, he consoled himself, he had saved Abi. That must count for something on the eternal ledger. Pretty soon he’d have his answer about the existence of the spiritual world. Was his dad right or wrong? A sudden blur across the table caught his eye.

  “FBI! Freeze!” A pistol had materialized in the scrub nurse’s hand, and she had it leveled at Seidle’s head. “Drop the gun!” She sounded like she meant business.

  “What the fu—” Seidle danced on his feet to get behind Luke, but kept the gun barrel pressed against Luke’s temple. “I don’t think so, lady! You drop yours or I’ll blow his fu
ckin’ brains out!”

  “More agents are on the way,” she said and edged slightly to her right to get a better firing angle on him. “You can’t get away.”

  The delivery room door squeaked open. Seidle turned his head. Before Luke could comprehend what was going on, the room exploded with noise.

  Two gunshots were fired in rapid succession, the reports deafening in the confined room. Luke turned in time to see Seidle crumple to the floor, gun still clutched in his hand. The door closed and Luke couldn’t see who had opened it. The scrub nurse—make that FBI agent—stood with her smoking gun aimed at the door. What is she even doing here? Luke wondered. Does this have to do with the senator? Maybe the conspiracy theory wasn’t so far-fetched.

  Luke looked at Seidle. He wasn’t getting back up off the floor this time—he had a bullet hole in his forehead and another through his left eye. A pool of blood was spreading across the floor from his head. Blood had spattered from the back of his head to spray across the far wall.

  Luke’s mind was reeling with sensory overload and his ears were still ringing. The acrid smell of gunpowder assaulted his nostrils. He struggled to process it all. Then he remembered Kim. Her life was still in the balance.

  The door squeaked halfway open again. The FBI agent tensed and kept her gun aimed at the door. “Who’s there?” she shouted. “FBI—come in with your hands up!”

  “Don’t shoot!”

  Luke recognized the voice, shaky though it was, of Rob Gentry.

  Rob came in slowly with his hands held high. “I’m Dr. Gentry—I’m here to help.”

  She turned to look at Luke, still training the gun on Rob. “Do you want his help?” she asked.

  “Yes. Absolutely.”

  “Well, get in here, Dr. Gentry,” she said, lowering her weapon.

  “Holy Mother of God,” Rob said as he walked by the body of Seidle and up to the OR table where he quickly gowned and gloved.