by Robin Cook
The room was about thirty feet square, with windows that looked out onto the same courtyard as the staff cafeteria did. Two opposing doors led into the locker rooms. The furniture consisted of a couple of gray vinyl couches, a smattering of chairs, and several dictating desks. A central coffee table was littered with newspapers, outdated magazines, and an open box of pizza. A corner TV was tuned to CNN, but no one was watching. In another corner was a small refrigerator with a communal coffee pot on top.
Ten people were sitting in the room, all dressed in the same unisex scrubs. Some had hats or hoods, and some didn’t. Although the OR appeared egalitarian, Roger knew otherwise. It was the most hierarchical domain of the hospital. Most of the people in the room were reading and munching on various snacks while sipping coffee, while others chatted.
Roger went over to the coffee machine. He debated having more, not to keep awake, but more as a social ploy, as well as an ostensible reason to be there. He hadn’t recognized anyone in the room. Believing he was adequately wired, he opened the refrigerator and opted for a small orange juice.
With his drink in hand, Roger swept his eyes around to look more closely at the various people. No one had paid him any heed when he’d come in, but now a woman made eye contact and smiled. Roger walked over to her and introduced himself.
“I know you,” the woman said. “We met at the Christmas party. My name is Cindy Delgada. I’m one of the nurses. We don’t get admin visitors very often. What brings you up here in the middle of the night?”
Roger shrugged. “I was working late, and I thought I’d wander around a bit for some human contact and see the hospital in action.”
A wry smile appeared on Cindy’s face. “Not much excitement with this somnolent group. If you’re looking for entertainment, I suggest the ER.”
Roger laughed to be polite. “No cases tonight?”
“Oh, yeah,” Cindy said. “We’ve done two, there’s one going on right now in room six, and we have another coming up from the ER within the hour.”
“Do you know Dr. José Cabreo?”
“Of course,” Cindy said while pointing to a pale, heavyset man in a chair by the window. “Dr. Cabreo is right over there.”
Hearing his name, José lowered his paper and looked over at Roger. He had a bushy mustache that hid most of his mouth. His eyebrows rose expectantly under the edge of his surgical cap.
Roger felt obligated to walk over. He hadn’t necessarily planned to talk with the two anesthesiologists directly; his informal game plan had been to engage the OR staff in casual conversation about the men to see if he could get a feel for their personalities. Roger wasn’t fooling himself. He was no psychiatrist and had no delusions that he’d be able to recognize a serial killer unless the person out-and-out told him, yet he had a vague idea that he would be able to sense if either man could be a potential suspect.
“Hi,” Roger said self-consciously, since he didn’t know what to say. He berated himself for not anticipating the possibility of such a confrontation.
“What can I do for you?” José questioned.
“Well,” Roger said, trying not to sound as confused as he was. “I’m chief of the medical staff.”
“I know who you are,” José said. His voice had an edge, as if he was wary of what Roger wanted.
“You do? How is that?” José was one of many on staff he’d not met, which included just about everybody on the night shift.
José pointed to Roger’s nametag.
“Oh, of course,” Roger responded, bouncing the heel of his hand off his forehead. “I forget it’s there.”
There was an awkward pause. The rest of the room was quiet except for the TV whose volume was turned way down. Roger had the sense the other people in the room were listening.
“What is it you want?” José asked.
“I just wanted to make sure that you are content, and there are no problems.”
“What do you mean, ‘problems’?” José demanded. “I don’t like your implication.”
“There’s no reason to get upset,” Roger said soothingly. “My intention is merely to be proactive and meet the staff. We’ve not had the pleasure.” Roger stuck out his hand toward José, whose face had flushed.
José eyed Roger’s hand but made no attempt to shake it. Nor did he get to his feet. Slowly, his eyes rose and reengaged Roger’s. “You’ve got a lot of nerve coming up here out of the blue and talking to me about problems,” he said heatedly. He poked his finger threateningly toward Roger. “This better not have anything to do with ancient history, like dredging up the painkillers I needed for my back or my closed malpractice cases, because if it does, you and the rest of the administration will be hearing from my lawyer.”
“Calm down,” Roger urged softly. “I had absolutely no intention of talking about any such thing.” He was taken aback at José’s belligerence and defensiveness, yet he forced himself to remain cool and collected. If the man could get this wound up with such little provocation, maybe he was a loose cannon capable of the unthinkable. To defuse the situation, Roger quickly added, “My real goal in stopping by was to ask how things were working out with Dr. Motilal Najah. You’ve been here a long time, and Dr. Najah is a relative newcomer. As the senior man, I was interested in your opinion.”
Some of the hostility and tenseness drained out of José’s face, and he motioned for Roger to take a seat next to him. As soon as Roger was seated, José leaned forward and lowered his voice. “Why didn’t you say that straight off? Motilal is the one you should be talking with, if you’re concerned about problems.”
“How so?” Roger asked. José’s eyes now had a conspiratorial glint. Roger found himself thinking that even if José wasn’t a serial killer, he might be the last person Roger would want giving him anesthesia.
“The man is a loner. I mean, like, we’re kind of a tight team on the night shift. Let me tell you, he doesn’t interact with anyone except in a professional capacity. He eats by himself and never comes in here to socialize. And when I say never, I mean never!”
“He seemed personable enough when I interviewed him,” Roger said. Roger could distinctly remember being impressed by Motilal’s easy candor and gentle manner. He seemed friendly enough, yet what he was hearing from José suggested that Motilal had some antisocial traits, and if that was true, he’d have to be considered a suspect.
“He fooled you then,” José said. He sat back and then gestured around the room. “Ask anybody if you don’t believe me.”
Roger’s eyes scanned the room. The people had gone back to their reading or conversation. Roger looked back at José. Roger was beginning to feel pessimistic about winnowing down his potential suspect list with what he was hearing about Motilal and the way José was acting.
“What about his professional skills?” Roger asked. “Is he a good anesthesiologist?”
“I suppose,” José said. “But one of the nurse anesthetists would be better at evaluating that, since they have to work directly with the lazy bum. The problem that I have with him is that he is never here. He’s always out wandering around the hospital.”
“What’s he doing when he’s wandering around?”
“How should I know? All I know is I end up doing all the work. Like ten minutes ago, I had to page him to get his ass up here, since it was his turn to do a case. Hell, I had already done two tonight.”
“Where was he when you paged him?”
“Down on the OB-GYN floor. At least, that’s what he said when I asked him. But he could have been in one of the local bars, for all I know.”
“So he’s doing a case at the moment?”
“He better be, or our chief, Ronald Havermeyer, is going to hear about it. I’m tired of covering for that guy.”
“Tell me something,” Roger said, settling back into his seat. “Have you been aware that in the last couple of months there have been seven unexpected and unexplained deaths of healthy, relatively young people in our hospital within
twenty-four hours of surgery?”
“No,” José said—a bit too quickly, in Roger’s estimation. José held his hand out toward Roger as if to quiet him. A wall speaker had crackled to life.
“Code red in 703,” a disembodied voice announced. “Code red in 703.”
José heaved himself to his feet, tossing his newspaper aside. “Wouldn’t you know it? The second I get a chance to sit down, there’s a cardiac code. Sorry to break this off so abruptly, but when we’re not on a case, we’re supposed to show up for a code. I urge you to talk with Motilal. If you’re trying to head off problems, he’s your man.”
José rushed from the room with his stethoscope clasped in his hand. From out in the hall, Roger could hear the double doors leading to the elevator lobby bang open and noisily swing shut. Roger exhaled uneasily and glanced around the room. No one had reacted to their strange conversation, to the code announcement, or José’s sudden departure, until his eyes reconnected with Cindy Delgada’s. She smiled again and made a questioning gesture with her shoulders. Roger got up and walked back to her.
“Don’t mind Dr. Cabreo,” she said with a laugh. “He’s a hopeless pessimist and our resident prophet of doom.”
“He seemed a bit defensive.”
“Ha! That’s the understatement of the year. He’s out-and-out paranoid, with a touch of misanthropy, but you know something? We give him some slack because he’s a damn good anesthesiologist, and I should know, since I work with him almost every night.”
“That’s reassuring,” Roger said, although he was hardly convinced. “Did you happen to hear what he said about Dr. Najah?”
“I got the gist.”
“Is that the general feeling up here in the OR?”
“I suppose,” Cindy said with a shrug. “It’s true Dr. Najah doesn’t socialize and hang around with us, but no one minds except José. I mean, this is the graveyard shift, after all.”
“What does that mean?”
“We all have our quirks, which is why we work this shift. Maybe we’re all a little misanthropic in our own ways. I know I like the fact that there’s less supervision and a lot less bureaucratic crap. Why Motilal prefers this shift, I don’t know. Maybe it’s as simple as just being shy. He’s hard to read since he’s so quiet, but I’ll tell you, he’s definitely a good anesthesiologist, and don’t get me wrong because I said it about José, because I don’t say that about everybody.”
“So you wouldn’t say Dr. Najah is antisocial.”
“Certainly not in the psychiatric sense. At least, I don’t think so, but to be honest, I really don’t know. I’ve probably only spoken ten words to him.”
“José complained about him wandering around in the hospital. Do you have any idea where he goes?”
“I believe so. I think he visits all the in-house preops scheduled for morning. Why I think so is because he’s always carrying around the next day’s surgery schedule.”
Roger nodded while silently reaffirming his opinion about his deficiencies as a detective. After chatting with José, hearing a little about the loner Motilal, and learning about the night shift in general, he wasn’t eliminating anyone as a suspect, but he pressed on. “Did you hear what José said when I asked him if he was aware of the seven deaths we’ve seen over the last couple of months?”
“Yeah, I heard,” Cindy said with a derisive chuckle and a dismissive wave of her hand. “I don’t know what was going on in his mind, because he knows about them. We all know about them, particularly the anesthesiologists. I mean, we haven’t exactly been dwelling on the issue, but it’s been the topic of conversation on occasion, especially as the cases mount.”
“Why would he tell me he was unaware of them?”
“Beats me. Maybe you should ask him when he comes back. The anesthesiologists never stay long on codes. They just pop in if they happen to be available to intubate the patient or, if the patient was already intubated, to make sure the patient was intubated properly.”
“Thanks for chatting with me,” Roger said. He then glanced around the room a final time. “I have to say, no one else seems particularly friendly.”
“As I said, we have our quirks, but if you came up here on a regular basis, you’d find people friendly enough.”
With a final wave and appreciative smile, Roger walked out to the elevator. His finger went toward the call button, but stalled in midair. His visit to the OR hadn’t been particularly helpful. He had two anesthesiologists who were potential suspects before he arrived, and he still had two after he left.
The choices were simple. He could stay on the third floor and visit the pharmacy and try to find out something about Herman Epstein, who’d transferred from the night shift at St. Francis to the night shift at the General. He could go down to the second floor and visit the lab to find out what he could about the two lab technicians who were on the same list. He could go back down to the first floor and visit security or even to the basement to visit housekeeping and maintenance, where there were two more similar transferees. Yet something told him he wasn’t going to learn anything, thanks to his total lack of investigative experience. His little chat with José had made it clear that he didn’t even know what questions to ask, short of “Are you a serial killer who’s been knocking off patients during the night shift?” Laurie’s idea was good in theory, but in reality, there were just too many potential suspects. All the transferees had access to the hospital in general by virtue of their respective job descriptions.
The thought of directly asking people if they were a serial killer brought a smile to Roger’s face. It wasn’t hard to guess what would happen to his reputation and job if he started asking such a question. Roger sighed and looked at his watch. It was now after three A.M. Although some of the caffeine euphoria was wearing off, the feeling of being wired hadn’t. There was no way he would fall asleep if he went back to his apartment.
Impulsively, Roger pressed the up button on the elevator. He decided he’d pay a visit to the surgical floor, whose charge nurse had been mugged and killed and where four of the seven unexpected deaths had taken place. He also decided to take a quick tour through the fifth floor, which housed orthopedics and neurosurgery, where there had been two deaths. He reasoned that he’d never been in the hospital during the night shift, particularly on the patient floors, and having a sense of the ambience and locale might be helpful in his thinking.
Although he had assumed as much, the atmosphere of the surgical floor was completely different than it was during the day. Instead of controlled chaos, an unexpected and deceptive serenity reigned. Even the lighting was different, dimmed from its daytime starkness. As Roger walked from the elevator lobby toward the nurses’ station, he saw no one. It was as if there had been a fire drill and everybody had run out of the building.
Reaching the nurses’ station Roger looked at the bank of monitors displaying the EKGs and pulses of all the patients. With modern wireless technology, such telemetry was now easily available on regular hospital floors. The problem, of course, was that no one was there watching it.
Roger looked down the lengthy corridor in both directions. The composite floor gleamed in the half-light. At that moment, Roger heard the telltale squeak of a desk chair. Wondering where the sound had come from, he rounded the end of the nurses’ station and walked over to an open doorway. It led into a utility room with a long built-in desk/countertop, under and over cabinets, and a refrigerator. Sitting at the desk with her feet propped up and reading a magazine was an arresting-appearing nurse. Her features reflected a hint of Asian exotic, which Roger had come to appreciate in his years in the Far East. Her eyes were appropriately dark, as was her cropped hair. Beneath her scrubs was the hint of a shapely, hard body.
“Evening,” Roger said before introducing himself. He noticed that the nurse was reading a firearms magazine, which seemed mildly inappropriate.
“What’s up?” the nurse inquired without removing her feet from the edge of the countertop.
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Roger smiled inwardly. He remembered a time in the not-so-distant past when nurses were deferential to doctors to the point of acting intimidated, even in the United States. This one clearly wasn’t.
“I’m just checking to see how things are going,” Roger said. “I know you tragically lost your charge nurse yesterday morning. I’m sorry.”
“Not a problem. Actually, she wasn’t all that good as a charge nurse.”
“Really?” Roger questioned. It seemed a curiously unsympathetic response. Such candor with a stranger was hardly the norm, whether what she said was true or not. He read her nametag: Jasmine Rakoczi. He remembered that she was on the transferee list.
“I’m not pulling your leg. She was a weird one, and nobody liked her much.”
“I’m sorry to hear that, Ms. Rakoczi,” Roger said. He leaned back against the countertop and crossed his arms. “Has Clarice Hamilton assigned a new charge nurse for the shift?”
“Not yet. We got a temp to tide us over, but just as another grunt. I kind of took charge and assigned the patients. Somebody had to do it, and the others were just sitting around, wringing their hands. Anyway, things are going just fine.”
“I’m glad to hear it,” Roger said. “Ms. Rakoczi, I’d like to ask you a question.”
“Call me Jazz. I don’t respond to Ms. Rakoczi.”
“I assume you have been aware of the four deaths of relatively young, ostensibly healthy, postop patients that have occurred on this floor over the last six or seven weeks or so, with the last one just last night.”
“Of course. It would be hard not to be aware.”
“True,” Roger agreed. “Have they bothered you?”
“How do you mean?”
Roger shrugged. The question seemed so self-evident. “Have they disturbed you psychologically?”
“No, not really. This is a big, busy hospital. People die. You can’t get attached, because if you do, you’ll go crazy and your other patients will suffer. You brass sitting in your fancy offices don’t remember what it’s like out here in the trenches, you know what I’m saying?”
