Fuel the Fire

by Jamie Garrett

  To his surprise, the woman nodded. “She’s in the med room,” she said, gesturing down the hall. “Or she was a few minutes ago.”

  He needed to see her. Now. He headed for the end of the hallway where he knew the medication room was located. Rachel had become increasingly important to him. Over the past months, he grown to respect and admire her, but now, it was more than that.

  He felt a surge of excitement, a thrill, and a nervousness all at the same time. He wanted to take their relationship to the next level. Especially now, when nature’s fury was just outside those doors. Life was too short, too short to waste any time. He knew how he felt, and he would act on it.

  He just needed to find Rachel.

  18

  Rachel

  Rachel stood in front of one of the med carts in the room, where all the medications for patients on the halls, along with a loaded, portable medical cart for each hall in the hospital were stored under lock and key. While she couldn’t access the drawers without another key, she did know where they were kept, in a locked cupboard just next door to the small, windowless room in which he now stood. She also had a key to that door, inside which was a master set of keys for every office and door in the building, from the med cart keys to the administrator’s office, the housekeeping department, and the door behind which they kept their cleaning chemicals. She didn’t need those right now. For now, she was just checking on her suspicions.

  Any medications given to the first responders who had passed away would now be removed from the med carts, so it wasn’t necessary for her to go snooping around in those. If she were caught in those drawers, it would be pretty much like being nabbed with your hand in the cookie jar. Accusations of drug theft would just be the beginning. She instead turned her attention to the medication administration records, or MAR sheets, clipped to clipboards on each carts. Usually, and in hospitals with larger budgets, the MAR was located in the electronic medical records or EMR system, but as with medical records downstairs, the hospital hadn’t yet caught up to the latest in technology for some departments, and didn’t yet have the computerized system set up for every hall in the hospital for med passes. They were essentially working in a half-paper, half-electronic charting system until everything was done. In the meantime, all records of patients, procedures, and medication logs were still recorded the “old-fashioned” way—on paper. Every patient had a MAR, and each patient’s MAR was stacked along with others onto a clipboard on the med cart; every patient, along with medications, dosages, frequency, and so forth.

  Because of the chaos of the past couple of days, she wasn’t particularly surprised to find that the medication charts for patients who had passed away had not yet been removed. Quickly, she scanned the clipboards, finding Brian’s first, then George McPherson’s, David Kincade’s, and the burned police officer, Michael Bascom’s charts. She would take them down to Medical Records in just a few minutes, explaining to anyone who manned the desk down there that she’d been helping out with filing issues since the employee who usually took care of that had not been able to get into work yet. It was a lame explanation, but hopefully it would fly. Thus, she could avoid trouble if she were caught with them on her person.

  Knowing that she took a huge risk, she quickly removed the pages associated with those patients. Any nurse who passed meds might note that the pages of the deceased patients were missing, but that wasn’t unusual; such records were culled from the stack by medical records personnel and taken down to the Medical Records department to be scanned and inserted into the patient’s permanent EMR. Folding the pages and quickly stuffing them into the side pocket of her scrub pants, she left the med room and headed for her desk in the Physical Therapy department.

  The moment she stepped out of the room, she sensed something was wrong. Nurses rushed down the hallway, their attention focused, their steps hurried yet not quite running. Excited voices filtered through the corridors and paused. They came from the lobby. Curious, she followed one of the nurses down the hall, then glanced out the large bank of windows at the end. Her eyes widened in surprise. It looked almost dark outside, the wind gusting, causing what windows that remained to shake in their mountings. The plywood sheets that had been nailed over previously broken windows bulged as the wind buffeted them. Another tornado? The lights flickered and went off, accompanied by screams, and then kicked back on.

  She was torn. Where to go? What to do? Dr. Moeller didn’t want her in his department, and because she was under investigation—and she knew how fast gossip traveled in a hospital environment, like anywhere else—it was doubtful that the charge nurses on the other floors would want her working with their patients, either. She groaned in frustration, and she quickly turned toward the Physical Therapy department. For now, she’d go there, quickly check out what she’d found, and then try to find a way to help—if anyone would let her. She could make herself useful wherever she was needed, whether it was pushing wheelchairs or mopping floors. She didn’t care.

  Her heart racing, knowing that she might not have much time, she quickly made her way down the corridor, then turned and strode down the short hallway that led to the Physical Therapy department. She pushed open the double wide doors and headed immediately for her office, passing through the empty, semidark room, trying to ignore the sound of the howling wind, resisting the intense desire to rush toward the Emergency Department to offer a helping hand that would be refused. Her hands balled into fists of frustration, she talked herself down onto her chair in front of her desk, tapped on her keyboard, and woke up her computer.

  She quickly pulled the MARs from her pocket and quickly glanced at them, then pulled up each of the patient’s EMRs on her computer, quickly scanning them as well. It only took a few minutes for her to grow frustrated. She didn’t see anything. She shut down the software and sat back in her chair, idly watching the hospital’s icon dance around the now otherwise black screen.

  “You’re an idiot.” Her voice echoed softly in the empty, dark room. If somebody was killing the patients, they certainly wouldn’t mention it in the patient’s MAR. They wouldn’t have signed in or out of the EMR, the med book’s sign-out sheet, nor, in a separate book, the narcotic removal records. For several seconds, self-doubt assailed her. Had she made a mistake? Had she made a deadly mistake with one of David’s medications?

  No. She was sure of that. She had purposely worked slowly and carefully, double-checked every medication, every dose, against every patient. She had to go back, check the locked glass cabinet above the carts along one wall of the small space. She wasn’t in the med room often, but she knew what was generally kept there—drug vials that didn’t need to be refrigerated, along with two mobile defibrillators. Every floor had a defibrillator and a supply of certain medications that were not typically found in the med carts themselves. Then again, so did the Emergency Room. Drugs like morphine, and succinylcholine, a paralytic commonly known as SUX that was often given to a patient during incubation to prevent the throat from closing up in an automatic gagging and survival response.

  Something tickled her memory and she double-checked on the burned cop’s medical record. She wasn’t imagining it. There was something there, on Michael Bascom’s MAR on her second review. She quickly logged into his EMR and scanned it. He had an allergy to Betasept, commonly used as a topical antimicrobial for burn patients. Michael’s EMR chart noted that he was sensitive to the drug. He had probably suffered a burn before at work, been treated, and developed a negative reaction to the drug. She checked and didn’t notice the use of Betasept in his MAR, but if you wanted to kill someone and hide it, using an everyday drug on a patient who was sensitive or allergic to it would get the job done.

  Her shoulders tensed as her mouth set in a firm line. First things first. She had to narrow down her suspicions still more. She knew now, deep in her gut, that something was wrong, that the deaths of the first responders were not merely coincidences.

  Ignoring the growing sound of vo
ices out in the halls, the wind, the rain and hail pounding down outside, the clouds still gathering, bunching, and the wind gusting against windows and plywood, Rachel quickly left her office and hurried back to the med room. She passed nurses and support personnel, no one paying any attention to her, focused on their own tasks. She unlocked the med room and slipped inside, this time closing and locking the door behind her. She peered into the double-locked glass-front cabinet above the counter behind the med carts, finding a myriad of drugs, but oddly enough, no morphine. She didn’t see any Betasept or SUX nor . . . her heart skipped a beat. They should be there. There’d been at least one vial of morphine the day she’d passed meds. She didn’t see the carbamazepine suspension, either, though she remembered it from yesterday because one of the patients on the floor required the anti-epileptic. She had been especially careful with that, knowing that an error in dosage could lead to immediate and negative reactions, including the suppression of sinus nodal automaticity and AV conduction. In other words, with a high enough dose, you could stress the heart out to the point the patient went into cardiac arrest. Now that her brain traveled in that direction, she didn’t see Flecainide either, an anti-arrhythmic that she had given another patient.

  Rachel froze, her stomach a tight ball of anxiety, her mind spinning. It was one thing to have suspicions, but to have her suspicions confirmed . . . what now? She’d been so caught up in proving something was going on, she hadn’t thought past the next step. Whom should she go to for help? Whom could she even trust?

  Taking a deep breath, heart pounding, she left the med room, locked the door behind her, and headed down the hallway, first toward the Emergency Room, then paused. Dr. Moeller wasn’t the best person to approach with this. The nursing director or the administrator? What if—

  It was only then that she noticed the hospital had grown darker, the interior lights barely dispelling the growing gloom. One of the hallway lights still flickered as a loud whining sounded. She thought for a second that the First Flight rescue helicopter had landed on the roof, but then, with a glance toward the window toward the lobby, Rachel’s heart leapt to her throat. It wasn’t a helicopter. A piece of green metal road sign blew by and disappeared into the parking lot, followed by a cushion from a chaise lounge. She frowned, momentarily confused. They didn’t have any chaise lounge chairs in front of the hospital.

  She gaped as she stared out the window, mesmerized by the sight of greenish-purplish clouds moving as if in slow motion, from left to right across the window. Hail the size of quarters pounded down, bouncing against the window. Even through the double thickness of glass, if it kept up for long, the remaining windows would crack or shatter. A gust of wind buffeted the window. She stood frozen, mesmerized by the storm, not sure what to do first, and then, all of a sudden, the hailstorm pounding against the windows stopped, as if the faucet had been turned off.

  Rachel found her breath and her feet. She had to tell someone what she’d found, before any more first responders were targeted. She turned, preparing to head to the Emergency Room, but slammed into someone. “Oh, I’m so sorry, I didn’t mean—” She looked up to find Dr. Moeller staring down at her, hands on her shoulders as he kept her from falling. “Dr. Moeller, I found—”

  “You’re needed upstairs on the third floor. They’re evacuating patients to the basement.”

  “What about the patients in ICU?” Wouldn’t a triage approach work better? “What if—”

  “They’ve already been taken care of,” he snapped. “Now please do as you’re told. We’re expecting the tornado to hit any minute.”

  With that, he rushed off, and so did Rachel, her heart pumping with dread. Another tornado. While the first one had caused only minor damage to the hospital, was the oncoming tornado bigger? Stronger? What would—

  Jeremy! Oh God, Jeremy was out there! And the other guys . . . panic nearly engulfed her. She fought the urge to rush out into the lobby, out the front doors of the hospital to find a way to Jeremy. She had no car, nor any way of knowing where he was. She pulled her cell phone from her pocket and swore. No signal. It fucking figured.

  She quickly headed toward the door to the stairwell leading up to the third floor, leaving the elevators to others. She’d make it up there faster taking the stairs anyway. Her suspicions about the first responders were forced to wait a moment longer, at least until the danger of a tornado strike had passed and the patients had been protected.

  As she entered the stairwell and took the steps up two a time, she quickly reached the landing to the second floor, turning on the small landing, ready to take the stairs up to the third when the door opened. She barely avoided slamming into another nurse entering the stairwell from the second floor. Both of them stumbled, and with a startled cry, the nurse went down on one knee, hand clutching the handrail, as did Rachel, barely preventing herself from toppling backward down the stairs.

  “Dalisay!” she gasped, hand over her heart. “Are you alright? I’m so sorry—” She paused as she gazed at her coworker, at the look on her face, brows lowered in anger, lips thinned and jaw tight with a grimace. “Are you alright?”

  Dalisay suddenly recognized her, gathered herself, and lifted her hand to brush her long hair away from her face. “Yes, and you?”

  “I’m okay. I’m headed upstairs to help evacuate the patients into the basement. Where are you going?”

  “The med room,” she mumbled.

  Rachel caught her arm. “Dalisay . . . be careful. There’s something going on around here. There are medications missing.”

  Dalisay frowned. “Missing? What do you mean, missing?”

  “I think . . . I think someone’s been—”

  Her words were interrupted as another nurse pushed through the door, nearly ran into two of them, muttered a quick apology, and then quickly headed downstairs.

  “Follow me,” Dalisay said, returning through the doorway she had just come through and heading toward the bank of elevators at the end of the hallway. Rachel followed. “You’re taking the elevator down a floor?”

  “No, to the third. I’ll help you evacuate patients and you can tell me what’s going on around here.”

  The elevator door opened. To Rachel’s relief, no one else was inside. She didn’t want it getting around that she was accusing someone of being an angel of death, not in this hospital, and not until she had absolute proof. It was out there. She just had to find it.

  The two of them stepped into the elevator, and after the doors swished shut, Dalisay reached for the panel. Her finger paused over the button to the third floor, but then quickly moved. She pulled out the red emergency stop button. Rachel frowned. “What are you doing?”

  “A conversation like this should be private, don’t you think?”

  Rachel nodded, though she thought when the elevator stopped, an emergency alert would be sent out, a buzzing sound. But all was quiet, the cacophony of the building tension of patients, family members, and staff outside in the halls dimmed, as was the sound of the roaring wind. She wasn’t sure she wanted to be in an elevator if the electricity went out. “Dalisay, I think we’d better stick to the stairs. If the electricity goes out—”

  “So why do you think there are medications missing from the med room?”

  She pushed her fear of getting stuck behind her need to tell someone what was going right under their noses. “Because I checked! I looked at their EMRs and noticed that there were some drugs missing from the cabinet above the carts. And that firefighter. He was sensitive to Betasept, and I know I saw some in there before I started passing meds after the day before yesterday with the tornado, and there’s other vials missing too—”

  “You should just mind your own business, Rachel,” Dalisay said, hands tucked into the pockets of her scrub top.

  “What?” Rachel stared at her, puzzled by her tone.

  “Have you told anybody about your suspicions?”

  “Well, I tried to tell Doctor Moeller, but he’ll never b
elieve me. He wants me upstairs to—” She watched in confusion as Dalisay extracted a syringe from her scrub pocket. Dalisay glanced down at it, calmly removed the cap, then looked to Rachel. “Dalisay, what are you—”

  “Now you’re going to pay for being so nosy.”

  “Dalisay! What are you doing?” Though she knew. The hair on the back of her neck rose, and she stiffened. “What are you talking about?” Rachel automatically took a step back but ended up cornering herself against the walls of the elevator. “Dalisay, don’t—”

  Faster than she could have imagined, Dalisay jabbed the needle into Rachel’s neck and pushed the plunger. At the last second before the drug surged into Rachel’s system, she lashed out with her hand and scratched Dalisay’s cheek, down near her jaw. Fight! She fought against growing panic that wanted her to freeze. Flight or fight response. Fight!

  Rachel stared at her, heart pounding, mouth open to scream, while Dalisay, her expression blank, watched as the drug took quick effect. In a matter of seconds, Rachel felt her body go numb, and she collapsed to the floor, unable to move, barely able to breathe. Her eyes wide and staring, she watched Dalisay kneel beside her, pushing her face close to hers.

  “They’re going to pay,” she sneered. “All of them are going to pay!”

  Pay? Pay for what? What was she talking about? Why had Dalisay done this? Questions raced through her mind, but she couldn’t voice any of them, couldn’t make her lips work, couldn’t move her fingers, her hands, her body a leaden weight. Sux! Dalisay had injected sux into her! Confusion turned into realization. It was Dalisay! She was the one who . . .

  “Nobody tried to save my parents. Nobody!”

  Rachel tried to speak, to reply, but all she could hear was the terrifying gasps of her own strangled breaths.