He was just about to ask for more adrenaline and add some sodium bicarbonate and calcium gluconate, when the lab tech tapped Matt on the shoulder. Still pumping on her chest, he turned to read the lab values over his shoulder. The hemoglobin was two, hematocrit seven, which meant she had lost over ninety percent of her blood. Matt sighed and stepped back, eyes on the monitor. The girl’s heart did not quiver again. She had bled to death. Somehow.
Matt glanced at the staff standing around the body. “Code’s over. I’m calling it at nine-fifteen.”
Three
As the trauma team left the room one by one, Matt stripped his bloodstained gloves off and dropped them in a red plastic-lined wastebasket where blood products and infectious waste were stored. He stood there, shirt soaked with sweat, goose bumps covering his arms, staring at the body. He had the irrational feeling that if he turned his back to leave, her eyes would open and she would watch him walk out on her, silently blaming him for not saving her.
Finally, he headed for the coffee room, using every bit of his willpower not to glance back to see if her eyes had opened.
“Those that can, do; those that can’t, teach.” The words rang up the hallway behind Matt. He hesitated, sighed, then kept on walking toward the coffee, knowing the speaker would catch up with him. He knew the voice all too well.
A man stuck his head in the door just as Matt was tipping a cup to his lips. “Hey, pal. You don’t look so good. What’s goin’ on?” he asked.
After Matt drained the cup, he leaned over the sink and washed his face, rubbing harder than he had to. He didn’t know if it was the sense of defeat, or the stench of fear he was trying to wash off. He reached for a towel off the rack, looked at its stained, grimy condition, and put it back. After drying his face on his shirt, he said, “Hey, Shooter. What brings the local pigs out? Did I double-park?”
Shooter grinned as he sauntered into the room, looking around just in case there was a pretty nurse he could come on to. Steve “Shooter” Kowolski was a detective sergeant in the Houston Police Department and probably the closest friend Matt had in the world. He was just under six feet tall, slim waisted with wide shoulders, and had blue eyes and thick, curly hair that always looked as if he forgot to comb it. Women thought he looked like a young Tony Curtis, a fact Shooter took advantage of at every opportunity. He was unmarried, like Matt, and intended to keep it that way.
It was Matt who’d given Steve his nickname. Two years ago, Steve and his partner had been on routine patrol when they got a call to respond to a liquor store burglary. As they approached the building, a young black man wielding a shotgun stormed out the door. In his haste to draw his weapon, Steve pulled the trigger on his .38 and shot off his right little toe.
After Matt operated on it, he arranged for a banner to be hung in Steve’s room reading SHOOTER Kowolski. The name had stuck.
“How about some coffee?” Shooter asked, grabbing for a cup without waiting for Matt’s reply.
“Sure,” Matt said, “with any luck, you’ll drop some on that coat and do us all a favor.” Shooter was wearing his usual unlikely combination of colors and patterns: a garish plaid sport coat and blue jeans over black western boots. Matt shook his head, grinning as he sat wearily in a chair.
“You take care of the Jane Doe brought in around nine o’clock?” Shooter asked.
“Yeah.” Matt’s heart, which had slowed to normal, gave a lurch and began to speed up again when he heard the question.
“DOA?”
“Not quite, but very close. Had a heartbeat for about three minutes, but not enough blood left in her body to keep her alive.”
“Cause of death?”
With some effort Matt raised his head and looked at his friend. “Shooter, even a dumb flatfoot like you knows the cause of death is determined by the ME, not the ER doc.”
“Off the record, Matt. I need to know something before tomorrow when the medical examiner’ll look at her.” He took a drink of coffee, then hacked and coughed. “Jesus, what is this? I didn’t think anybody made worse coffee than cops.”
Puzzled, Matt asked, “Why do you need to know the COD tonight? Won’t make any difference to her.”
He shook his head, taking a small leather notebook out of his breast pocket. He flipped it open, looking at Matt over the top of it. “I kinda need to know what killed this young lady so I’ll know how hard to push the investigation. Your dad was a cop, Matt, so you know the majority of homicides are solved in the first twenty-four hours. After that, the ratio goes way down.” He shrugged. “I need a little help here, partner.”
“Well, I hate to tell you this, but I don’t know.”
“What do you mean you don’t know? Weren’t you working on her when she died?”
Realizing he wasn’t going to let it go, Matt took a deep breath. “Come on,” he said, getting up and motioning for Shooter to follow him. They went back into the treatment room, where the body still lay covered with a sheet. Matt took another deep breath and pulled the sheet back, praying her eyes were still shut. Her face was white and pale, with a peaceful look, as if she had been relieved to give up the burden of life. “Take a look.” Matt noted that her look of horror had faded; she was finally at rest.
Matt admired Shooter’s self-control. The cop didn’t even blink when he leaned down and examined her body up close, from her neck to her vagina. He probably knew as much as Matt did at that point.
“Uh-huh,” he said, and began writing in his notebook.
Matt attempted a smile, failed, and said, “What do you think killed her?”
“That’s easy, loss of blood.” Shooter wrote for another moment, then added, “Probably from the throat, since that appears to be her carotid artery sticking out of the wound.”
Matt glanced around the room, wondering what it was that had spooked him before. Everything seemed normal enough now. “You can’t tell from looking, but her entire vagina has been ripped open, all the way up into her abdomen.”
Shooter raised his eyebrows. “Rape?”
“Not with a penis,” Matt said. “The wound’s too deep, too extensive. Maybe with a foreign object, but the ME’ll have to determine that with microscopic sections of vaginal tissue.”
“Okay, Matt, thanks. Oh, by the way, she say anything before she died? Give any clue to the identity of her assailant?”
“Yeah, she said he was a demon, a monster,” Matt answered, goose bumps again rising on his arms.
Shooter grinned. “Well”—he glanced at her torn and rendered body—“I guess I’d have to agree with her on that.” He turned to leave, then looked back at Matt with serious eyes. “You okay, compadre?”
“No, I’m not okay, but I’ll get over it. I always do.” He sighed, looking at the floor. “Death comes with the territory in my profession, just as it does in yours, pal.”
Shooter hesitated. He too dealt with death on a daily basis, but he was usually there after the fact and had no personal interest in the victims. That didn’t make it easy, but it sure as hell was better than having them die in front of you as they did with Matt. “You want to call me when you get off duty? We can grab a cup a coffee.” Shooter inclined his head toward the staff lounge. “Real coffee, not that varnish you guys drink, and maybe some pie to go along with it.”
Matt smiled, knowing Shooter was trying to keep him from going home, brooding about losing the girl. “No, thanks anyway. Shooter. Quit being a mother hen. I’ll be all right.”
As Shooter left through the double doors at the end of the hall, he shrugged and asked, “See you at the poker game?”
Matt waved, nodding his head. “Yeah. I’ve got my eye on that Shelby and need some extra cash.” Buying and restoring classic muscle cars of the ’60s was an expensive hobby. So far, he had a ’65 Vette and a ’66 Mustang convertible. A man in South Dakota was advertising a ’68 Shelby King of the Road convertible, and Matt hoped to win enough money playing poker to put a down payment on it.
Mat
t ambled back toward Room Two to see how the second trauma team was doing with their gunshot victims. It looked to be a long, busy night at the Taub, which was good. It kept Matt from thinking too much about young girls who wore too much makeup and bled to death in his emergency room.
Four
Since it was Saturday morning, Matt slept in. He had stayed at the Taub until about four, observing the two surgical residents who took over after Strickland and Mathis went off duty.
At three in the morning, Matt called one of the residents into the coffee room and shut the door. He had seen something in the way the young doctor treated his team, and his patients, that he didn’t care for. He was developing something Matt called “staff patient syndrome.” Staff patient was the name given to people who utilized the charity hospitals for their medical care. They were usually poor, minority, and somewhat overwhelmed by both life and the system. Residents spent a great deal of their time working on staff patients who couldn’t afford their own private doctors. Unfortunately, some of the residents began to treat those patients as a lower form of life, put on earth mainly to help train them in their specialty. They became derogatory and condescending to the patients and dismissive of their relatives and their feelings.
Matt gave his “compassionate doctor” speech, followed by his “the nurses and other technicians will save your ass more than once so be nice to them” speech. The resident seemed to listen, but Matt had seen too many young surgeons fail to get over the arrogance and egotism they learned in their training.
By the time he left the hospital to walk across the darkness of the medical center to the parking garage, he had almost forgotten the strange feeling that had affected him while working on the woman who had died. He shuffled through the night without so much as looking over his shoulder, dead tired after a full night’s work. Once home, he tumbled into bed and fell immediately into a deep, dreamless sleep.
The next morning, Matt called the morgue to find out when the Jane Doe from last night was going to be autopsied. They were stacked up and running behind as usual so it was going to be close to noon before they got to her. He told the autopsy assistant he intended to be there, thinking perhaps he would find some answers to the questions her death had raised, not the least of which was why she had affected him in the way she had. In all his years of practicing medicine, he had never felt such horror, such unrelenting terror as he had in the young patient the previous night. Maybe the autopsy would shed some light on the puzzle.
He poured himself some coffee as he thought about his schedule for the day, then went into the garage and fired up his Stingray. Unlike the night before, there were no rain clouds to soften the August heat and it lay on the city like a malevolent fog. Matt put the top up on the ’Vette and turned on the air conditioner. This made the engine overheat, the short-block 327s being notorious for that. Classic cars look good, but lack the comforts of new technology. Finally, to keep the engine from exploding, he turned off the air conditioner and sweated like a warthog on the way to the Taub, wondering, as he did every summer, if the thrill of driving a muscle car was worth the trade-off in comfort.
After crawling through the terrible early-morning Houston traffic to the medical center, Matt parked his ’Vette and again walked to the Taub. While waiting for the elevator to take him to the basement morgue, he saw an old friend walking down the hall. Dr. Sheldon Silver was, as usual, making rounds in white jeans and a red-flowered Hawaiian shirt. His only concession to hospital protocol was a rather wrinkled white clinic jacket. In spite of the heat and his size, he managed to look crisp and cool.
Dr. Silver—Shelly to friend and foe alike—was a rotund six feet tall, solid and muscular. He had a springy, quick walk and, like so many big men, he moved with no wasted motion. His hair was dark, shot through with gray, and he had blue eyes that students swore twinkled when he caught them in a mistake.
“Hi, Shelly,” Matt called, waving.
Shelly looked up, saw Matt, and broke out in a smile. That’s one of the things Matt liked best about Shelly. His smile was frequent and open and his face held no secrets. If he liked you, you knew it. He had no patience for hypocrisy, so if he didn’t like you, you knew that too. Everyone knew where they stood with Shelly.
“Hey, Matt. What are you doing here on a Saturday?” He took a handkerchief out of his pocket and wiped his forehead. “Especially on a day as hot as this one.”
Matt grinned. Shelly had a well-known aversion to heat, which everyone teased him about. His secretaries had been known to show up for work in the summer with coats on to protest the coldness of his office. “I’m here to watch an autopsy on one of the patients I had in the ER last night. How about you? You’re a little out of your territory, aren’t you?” Matt asked.
Shelly was chief of pathology at Methodist Hospital, and Matt couldn’t imagine why he would be at the Taub.
Shelly shrugged. “Just doing a favor for a friend. Dr. Chow, the medical examiner, had a heart attack. . .”
Matt interrupted, “Oh no. I hadn’t heard. Is he going to be all right?”
“Yes, fortunately it was a mild one with very little damage. They did an angioplasty Friday and say he’ll be good as new in three or four weeks. Meanwhile, I’ve taken a leave of absence from Methodist to cover his job.”
It was just like Shelly to take time off his job to help a friend. Rumor had it he began his career in internal medicine, but was too honest for his patients. He finally became cross-trained in pathology, where the patients didn’t care what you thought about them.
Suddenly what he said dawned on Matt. “Are you doing the postmortem on the Jane Doe from last night?”
“Yep. Looks like I’m finally gonna get you in one of my lectures.”
He was teasing Matt, who had often told him he needed to come and listen to Shelly lecture to see how to maintain students’ interest. Shelly was an enormously popular lecturer, and his monthly clinical-pathological conferences were always well attended by students, nurses, and staff doctors.
“I’m looking forward to it,” Matt said.
As the two doctors stood there, waiting for the elevator, they looked out the window at the smog, which managed to dim even the white-hot heat of the summer day. Shelly frowned, saying, “You know, Matt, I remember how Houston used to be before the smog came to irritate our eyes and noses and make breathing a chore.” He smirked and turned as the elevator dinged. “You realize how old that makes me?”
Just before the door opened, Shelly said, “Hold the door for me, Matt. I see somebody I need to talk to.” He walked rapidly toward a tall man, calling, “Roger, hey, Roger, wait up a minute, will ya?”
A moment later, Shelly brought the man over to the elevator and introduced him. “Matt Carter, this is Roger Niemann, hematologist.”
Matt sized the doctor up. It was a game he often played with himself. He had a theory that a lot could be deduced about people the first time you met them by the way they dressed, their mannerisms, and their handshakes. Niemann was nearly six feet tall, wore a three-piece suit, had graying hair and gold-rimmed glasses. He was as distinguished looking as Shelly was casual.
Niemann stuck out his hand and grinned. “Glad to meet you, Dr. Carter. I’ve heard about you from some of my students that you made their rotations in the ER fun. Quite an accomplishment considering the hours you made them put in.”
Matt smiled back, liking the man immediately. “Thanks, Dr. Niemann.”
“Call me Roger,” Niemann said easily. “Only my patients call me Dr. Niemann.”
Shelly put his hand on Niemann’s back and ushered him into the elevator, along with Matt. “Roger,” he said, “a case came in last night that I thought you might be able to give us a hand with.”
Niemann took off his glasses and began to clean them on a spotless linen handkerchief. “Shelly,” he said without looking up, “you know I’ll do anything I can to help the chief of pathology, but what kind of case could cause you to ask me for hel
p?” He slipped the glasses back on, hooking the earpieces around his ears. “Hell, I’ve never known you to admit there was anything you didn’t know.”
Shelly took it in stride. “Now, Roger, you know I’m not that bad. Why, just two years ago we had that case of African Hemorrhagic fever and I admitted there was one man at Harvard who might know as much about it as me.”
Matt noticed again how cool and crisp Niemann looked, in spite of the heat. He pulled his sticky shirt away from his skin and fanned himself with his hand, thinking the man probably drove to work in an air-conditioned luxury car, as he would if he had any sense.
The doors closed and Niemann leaned back against the wall, arms folded. “Now, tell me about this case.”
Shelly began to fan his face with a manila folder. “I’m having a little trouble with the COD on this case.”
Niemann held up his hands. “Whoa, wait a minute. Just what is a COD?”
Matt broke in, “COD means cause of death.” He grinned at his new friend. “You know how pathologists hate to say anything in plain English.”
Niemann looked at Matt and nodded his agreement. “My patients tell me all doctors are guilty of that, Matt.” He glanced back at Shelly. “Go on, Shelly.”
Shelly held up his folder and said, “Anyway, last night a young woman was found in a vacant lot with part of her throat ripped out . . .”
Before Shelly had time to say more, the elevator doors slid open. Shelly and Matt stepped out and walked a few feet down the hall before they realized Niemann hadn’t moved. They turned to find him standing there, holding the doors open.
Night Blood Page 4
