by Ray Flynt
“Be my guest,” Dubei said, sarcastically. Alan pulled off his facemask, lifted the receiver, and punched in a four digit extension. After a few seconds he announced in a crisp professional tone, “This is Dr. Fenimore.”
“When did this happen?” he said, clearly agitated. “Was she in a private room?” Alan fidgeted with the phone cord. “Good Lord! I’ll be right up.”
Alan turned around and his face flushed as he announced. “That was the duty nurse on 7-West. Another transplant patient just died.”
Chapter Two
3:23 p.m., Wednesday, January 10th
Brad and Alan Fenimore stepped off the elevator directly in front of the 7th floor nurses’ station. A man with curly black hair and wearing aqua scrubs absently glanced up from his work, but became more attentive when he spotted the doctor. His name badge read P. Paez.
“Oh, Dr. Fenimore,” the nurse said, “Crystal asked me to tell you she’ll be right back.”
The doctor nodded. “Thanks, Pedro. We’ll wait over here.”
Brad followed Alan into a glass enclosed sun porch adjacent to the nurses’ station where they joined a patient and her visitor staring out at a howling blizzard. Brad overheard the visitor suggesting that he should head home before the storm got much worse. Giant flakes of snow came hurtling toward them, melting as they hit the glass but almost immediately re-freezing as the cold wind swirled outside the window. The room felt frigid, and Brad remembered that he’d left his overcoat hanging in a closet in the autopsy suite. He peered down through the frosted glass and noticed an idle excavation site covered in fresh snow.
“It looks like it’s coming down at about two inches an hour,” Alan said.
“A classic nor’easter,” Brad responded, but Alan had already begun pacing between the sun porch and the chest-high counter of the nurses’ station.
Brad realized that it had been almost ninety minutes since he’d called Sharon Porter to join him, and un-holstered his phone to check on her progress. When the call went into her voice mail, he worried about whether he should have asked her to make the trip.
The man Alan had called Pedro, tapped on the counter with his pen. “Doctor! Crystal just called and said to meet her in 723-West.”
Alan beat a path to his left, and gave a quick wave for Brad to follow. Halfway down the hall the doctor pushed back the extra-wide wooden door and entered the patient’s room. Brad took mental notes on what could be a crime scene. There were two beds. The one closest to the door was elevated, its sheets and blankets haphazardly arranged, as if the occupant had hurriedly left. But the bed on the far side was flat and held an immobile body. The curtains used to provide privacy between the two beds were pulled back against the wall. TVs stared down from the wall, high above the foot of each bed. One screen was blank, while the other carried a muted image of the latest stock market report on CNN.
A woman in a yellow nurse’s uniform standing near the window pointed in Brad’s direction. “Sir, please close the door.” He eased the door shut.
Alan made the introduction. “This is Crystal Himes. She’s the charge nurse this afternoon.”
Crystal looked about Sharon’s age and height, but was at least twice as wide. Her chin-length blonde hair was cut in bangs across her forehead and curled under at her neck, accentuating her round face. Her ample breasts hung so heavily it conjured a vision of one very tired, overworked bra. Crystal’s makeup seemed overdone for the hospital setting, especially the apricot-colored lip gloss that shined in the fluorescent lit room. Did she moonlight in a retail sales job?
The lighting didn’t do much for the complexion of the body in the bed either. The dead woman, probably in her fifties judging from her graying hair, wrinkles and general appearance, had a yellowish pallor. Her mouth gaped, though not as wide as the dead man Brad had just seen in the autopsy room. She had a slight build, and wore a hospital gown over which two blankets were pulled halfway up her chest. Her head was cocked to the right, toward the window, while her right hand, balled into a fist, lay directly over her heart. Had chest pain caused her to clutch at her heart? A hospital table tray hovered over her feet holding a box of Kleenex, a Styrofoam cup with a straw, and a closed metal clipboard.
Alan pinched the bridge of his nose before loosening his tie. “Mr. Frame is a private detective, Crystal. He was with me at Mr. Severns’ autopsy. He may have some questions.”
Brad was surprised that Alan told her he was a private detective. From the wide-eyed I-know-something-you-don’t look on her face, he figured it wouldn’t be long until the entire hospital knew of his presence. So much for surreptitious inquiries.
“Tell us what happened here this afternoon,” Alan said, before reaching for his phone and appearing to check for messages.
Crystal stood on the side of the room with the dead woman, and Brad was anxious to move her and prevent any further contamination of the scene. When the room’s heating fan kicked into high gear, Brad seized the opportunity. “Could you come a little closer Crystal, it’s hard for me to hear you with that fan.” Brad punctuated the request by pointing toward the vent directly above him.
Crystal moved cautiously in Brad’s direction. “There’s not much to tell,” she began. “I saw Ms. McCullough when I did rounds at two o’clock. She was running a slight temperature, but she had eaten her first solid food since her surgery. And her need for pain medication had decreased. Barbara’s been hooked up to an intravenous infusion pump that dispenses measured doses of pain medication, but also allowed her to self-medicate when she had too much pain.”
In another impatient display, Alan Fenimore rocked on his heals as Crystal spoke. When she stopped talking, Alan smiled and nodded in her direction to urge her to continue.
“At 2:45 Barbara buzzed our station. Pedro responded, but she said he wasn’t needed. Then her roommate called us about 3:20 to say that she thought something was wrong with Ms. McCullough. That’s when we found her.”
Alan turned to Brad. “I’m sure you have questions.”
“Is that her chart?” Brad asked, pointing at the metal clipboard.
“Yes,” the nurse said.
Brad walked over and grabbed it from the tray table. “May I?”
Crystal opened her mouth to speak, and then glanced nervously in Dr. Fenimore’s direction. “Of course,” he said, just as his phone sounded.
Brad took the chart, opened it, and began scanning its contents. The patient’s full name was Barbara Clare McCullough. He glanced at the orders and saw that the last entry had been made around eight-thirty that morning. Morning rounds? “Why is the chart in her room?”
“We’ll be sending the chart to the medical examiner.”
Behind him Brad could hear Alan using his cell phone in an eddy of buzzes, beeps and muffled voices as he apparently retrieved voice-mail.
“This woman had a transplant?” Brad asked as Crystal’s head bobbed. “And when was her surgery?”
“Monday. It began at 11 a.m. and finished around 6:30 p.m. She didn’t return here from the recovery room until almost 11 p.m. Monday night. I was working the evening shift.”
Brad laid the chart back on the tray table and worked his way along the window ledge looking at the gift cards on five baskets of flowers and two potted plants. He also picked up each of the get well cards, and inspected the inscriptions. Beyond the window the winter storm still blew furiously, and he wished that he’d never asked Sharon to make the trip into the city. The storm clouds had already darkened the late afternoon sky, and soon the January sun would set and leave the city in cold blackness.
Crystal remained safely on the opposite side of the room, and Alan seemed distracted with his cell phone, so Brad decided to take a closer look at the deceased woman. “It sounds like a long and complicated operation,” Brad observed as he began inspecting the woman’s hands.
“Liver transplants take a while, even when there are no complications.” Crystal glanced nervously in the doctor’s direction
.
“Were there complications in Ms. McCullough’s case?”
“None during surgery, although she’d had some post-operative problems.”
“What kind of problems?” Brad asked matter-of-factly.
Crystal’s eyes fluttered toward the ceiling for a few seconds. “Her liver function tests weren’t where we would have liked them—she had elevated albumen levels. I know her surgeons were concerned, although her transplanted liver was functioning better than the one they removed.”
“Is that the reason for her jaundiced appearance?” Brad asked.
“Damn,” Alan muttered, “Now I can’t get a signal.” He disappeared into the hallway, and slammed the door shut behind him.
Crystal stared at the door. “He’s had a tough couple of months, Mr. Frame. You’ll have to forgive him.”
He tried to reassure her with a smile. “Tell me about the jaundice?”
“Ms. McCullough has… had a five-year history of liver problems. Her body wasn’t going to bounce back overnight. She faced a long period of recovery.”
Brad studied the position of the patient’s call button before turning his attention to the items on the tray table. “When you entered this room after 3:20 p.m., were the room-divider curtains drawn back the way they are now?”
Crystal rolled her eyes slightly and the tip of her tongue showed between her lips. “No. Iola and I did that, after we got Ms. Jackson, the other patient, out of the room.”
“Iola is another RN on this floor?”
“Yes.”
Brad moved to the side of the bed and inspected the IV line that led from the patient’s arm to two bags of fluid hanging from a portable metal “tree.” One of the bags was connected to a machine he recognized that would automatically dispense pain medication. The other contained a dextrose solution still half-full. Brad studied the Y-shaped connection where liquid from the two bags dripped into the single plastic tube connected to the patient’s arm. Brad stepped back when he noticed a wet spot on the floor. He knew he would have to make a closer inspection, but didn’t want to immediately raise an alarm with Crystal.
“In what position were the curtains when you entered the room at around 3:20 p.m.?”
Crystal pointed toward the space between the two hospital beds. “This curtain was drawn down the middle of the room, and Ms. Jackson’s curtain was closed across the foot of her bed for privacy.”
Brad studied the aluminum track mechanism on the ceiling where the privacy curtains were suspended by chains. The top two feet of the curtains were nylon mesh, which facilitated air circulation but little privacy for conversations.
The door opened, Alan stuck his head in, and barked, “Crystal, how much longer?”
Brad realized that Alan really wanted to ask him that question, but knew better than to rush his interview. He seized that moment and knelt to inspect a dime-sized wet spot on the floor below the IV drip bags. Under her bed, he spotted an errant Cheerio.
Brad stood up and saw Alan craning his neck to see what Brad was up to. “Excuse me, Alan would you please bring me sterile gauze pads or cotton balls and a storage bag?”
“I’ll have Pedro bring some,” he replied quickly, and started to reach for the call button on the empty bed.
Brad shook his head. “No. We don’t need any more people in here. Can you go get it?”
“Sure.” Alan quietly exited. Brad had expected an argument.
“Did Ms. McCullough have any visitors?”
“I’m trying to remember.” Crystal once more raised her eyes to the heavens, or at least the room’s ceiling. She didn’t strike Brad as trying to hide anything, just extra careful in her choice of words. “I think her roommate, Ms. Jackson, may have had visitors right after lunch, but Barbara didn’t have any today. Her family is from Lancaster. Her sister was here constantly until last night, but no one was around today.”
“You mentioned her sister. Did Barbara have a husband?”
The nurse shook her head. “No. I don’t think so. I studied her chart earlier. Her sister had her power of attorney. She witnessed all the consent forms. I don’t think Barbara was ever married.”
“Has the family been notified about the death?”
“Hmmm.” Crystal held the hum for a few seconds. “I’m sure they have. Dr. Peterson said he would handle it. The doctors usually work with the social work staff in death notifications.”
“What is Ms. Jackson’s first name, and when can we interview her?”
Crystal stretched her arms over her head with her palms together, a move that looked like an exotic exercise. “It’s Vesta,” she said, chuckling. “It’s an odd name isn’t it? Not too many parents nowadays are naming their girls Vesta. We moved her down to 708-North. You can talk with her any time, but she is eighty-two years old and according to her son she’s in the early stages of Alzheimer’s.”
“What kind of transplant did she get?”
“None. She’s here for exploratory surgery. The doctors want to look at a suspicious mass they spotted when they X-rayed her gall bladder.”
“But I thought this was the floor for transplant patients?”
“Oh, it is. But we don’t only have transplant patients.”
A deep feminine voice resonated from the patient’s intercom. “Crystal are you still in twenty-three?”
Crystal shouted, “Yeah, Iola. We’re still here, but I think we’ll be done shortly.” The nurse looked at Brad hopefully, but he didn’t respond.
“There’s no rush,” Iola said. “We’re now officially on Code White. A lot of people are calling in to say that they can’t get to work due to the storm. The way it’s coming down, we could be stuck here until spring.”
“That’s okay,” Crystal said, “I’m up for the overtime. Thanks, girl, for the good news.”
Iola chuckled. “You’re welcome. Say Crystal … have you seen Keith?”
“About two hours ago. He took Mrs. Stein in 17 down for her MRI. He’s not back yet?”
“Nope. I almost forgot he was workin’ today until Pedro asked about him.”
“I’ll be there shortly,” Crystal said, “and we’ll track down his hiding place.”
“Oh, Crystal, one more thing,” Iola’s voice crackled through the intercom.
“Yes.”
“Engineer’s office just called. It’s going down to minus-30 wind-chill tonight. They recommend we keep patient room doors closed to help keep the heat in.”
“Thanks,” Crystal shouted back to the intercom. “Maybe I should close the window drapes.”
“Not right now,” Brad said, not wanting her to invade that side of the room until he had retrieved the sample from the floor.
After two light taps on the door, followed by the sound of the latch turning, Dr. Fenimore entered. Brad noted that his personal care physician used the same procedure before entering an exam room.
“I brought you two-by-two sterile gauze pads, Brad, and a plastic zipper bag like we use to ship vials of blood to the lab,” he said. “Tell me what you’ve found.”
Brad took the package of gauze pads from Dr. Fenimore. “I’m not sure what it is, but there are a few drops of liquid here on the floor directly below this IV line.”
Fenimore let out a puff of air and shook his head. “I’m glad you’re not on the hospital accreditation team, Brad. We’d never manage to keep our top-thirty national rating.”
Brad decided against mentioning the runaway Cheerio. “It may be nothing, but I’d like to get it analyzed.”
“Crystal, I need a pair of gloves, please,” Brad said, with the most authoritative voice he could muster.
She moved quickly. “There should be a box here in the restroom,” she said, emerging moments later and handing Brad a pair of blue elastic gloves.
Brad slipped on the gloves, opened the new box of gauze pads, and dabbed at the liquid on the floor. He placed the specimen in the plastic bag and sniffed before zippering it shut.
�
��And I’d like to get a look at this IV tubing under a microscope, Alan. Do you think you can arrange that?”
Dr. Fenimore spoke to the duty nurse. “Crystal, have Ms. McCullough’s body taken to the pathologist’s office for a post-mortem.” The doctor turned to Brad. “Anything we have is yours, Brad. I’m not sure what we can do for you tonight. I’m afraid you’ll have to work with the Medical Examiner’s office on any microscopic examination. They’ll probably want to see it first. When I went to get the supplies you asked for, I found out that because of the snow emergency they’ve asked me to work in the ER tonight.”
Brad stood up and slipped off his gloves. “We can wait until tomorrow for the microscope, but I’d like to get this sample to the lab and have it tested as soon as possible.” Brad handed the zippered bag to Dr. Fenimore.
“What are you looking for?” the doctor asked, apprehensively.
Brad didn’t look at Alan. He didn’t want to say it, but he wouldn’t deceive his friend. “Poison!”
Dr. Fenimore’s phone chirped. He tugged on it twice before it came loose from his belt, and then gazed at the number. A grimace crossed his face as he spat out, “Damn it!” He took in a deep breath, and said, “I guess I better call her.”
Chapter Three
3:48 p.m., Wednesday, January 10th
Brad stood to the side of the wide corridor on the 7th floor, and watched a lone gray-haired food service worker as she pushed a metal cart along the shiny gray Terrazzo floor imbedded with flecks of pink and green. The woman paused occasionally to inspect her list, then retrieved a meal from one compartment and added a beverage from another bin to complete the tray. She entered a patient’s room, exiting moments later only to roll the cart a little further and repeat the procedure. When her cart ground to a halt as it scraped against the wide plastic bumper lining the walls, Brad scurried past her, while the odor of steamed vegetables and baked mystery meat followed him down the hall.
