MAYA HOPE, a medical thriller - The Dr. Nicklaus Hart series 1

by Timothy Browne, MD

  He turned back to Ali. “And your plan of attack?”

  “When I explored the wound in the ER, the patella was split. We’ll do the amputations, wash the heck out of everything, put the ex-fix on the upper right arm, and place wound-vacs on everything. Of course, we’ll be coming back to the OR every day for a while until it’s all clean, and then we can fix the patella and humerus,” Ali said.

  Nick squeezed his Fellow’s shoulder. “You did well, Ali.” He couldn’t help but notice the large scar that ran from the corner of Ali’s mouth to his ear. Ali had told him it was from a tree branch, but when he wouldn’t make eye contact, he figured there was more to the story. He shrugged it off. Probably none of his business anyways.

  Jasmine interrupted the doctors and thrust a clipboard of papers to be signed in front of Ali. He smiled warmly at her and accepted his assignment gracefully. Jasmine frowned at Nick causing his eyes to move from her shapely figure, back to his Fellow.

  Nick liked the man. With the stress and bedlam of the MED it was easy to be unkind, but he rarely saw Ali get rattled. Ali was only a few years younger than himself, and he often felt conflicted as to whether he should consider him an equal or a surgeon-in-training. He was becoming confident in Ali’s ability to make good decisions and leaned toward the former, but it was his responsibility to remain the teacher.

  Ali had completed his orthopedic residency in Seattle, at Harborview, Nick’s alma mater. Ali interviewed at many medical centers for a trauma fellowship, but when he didn’t secure a spot, one of his professors, who happened to be a close friend and colleague of Nick’s, called and asked for a personal favor to pick him up as a Fellow for the MED. The professor told Nick that Ali was a bit older than most candidates because he had done a five-year general surgery residency before changing to orthopedics and that was possibly why other programs had overlooked him. It was unusual to have someone trained in both specialties, but Nick had a growing sense of gratefulness to have him as his Trauma Fellow for the year. Ali had been at the MED for two months and was adjusting well. He was competent, but not overly so, and he understood his limitations; this was something Nick appreciated.

  Ali handed the clipboard back to Jasmine and smiled at Nick.

  “Sounds like you saved this young man,” he complimented Ali.

  “Thanks, Dr. Hart, but it was really the EMTs and the folks in the ER who did that. I just hate seeing what that propeller did to this kid. It’s going to be difficult for him to wipe his own nose.” Ali shook his head.

  “Hey, Turk, you mind helping out here?” One of the Residents washing the mangled arms with betadine called to Ali.

  Ali looked at Nick inquisitively, waiting to be excused from his mentor. Nick thought the other Residents called him Turk because he was originally from Turkey, but wondered if the nickname bugged him. He looked into Ali’s dark eyes for a clue. If it did, it didn’t register in his face. Ali was consistently polite and friendly to the entire staff.

  He speculated that the other reason Ali might have been turned down for a fellowship at the other medical centers was because of his religion. But being a Muslim in a predominantly Christian area like Memphis did not seem difficult for Ali.

  Nick nodded toward the OR table. “I need to go scrub,” he said to Ali. “Good job, man!”

  As he exited Trauma 2, he glanced at the clock on the wall. Midnight.

  James Taylor was still belting out about fire and rain and lonely times. It seemed so fitting.

  It’s gonna be a long night.

  * * *

  Beep, beep, beep. That sound. What is it? Beep, beep, beep. Where am I? Beep, beep, beep. Nick took a swipe in the direction of the annoyance and sent the contents of the nightstand crashing to the floor. The breaking of glass was enough to arouse his consciousness from a fretful slumber.

  He peered over the bed and the nightlight revealed a broken lamp. He rolled back on the small twin bed, rubbed his head, and wondered what time it was. Beep, beep, beep, his pager rang out again.

  His head cleared enough to remember where he was. Crap. Oh, yeah, the call room.

  The beeping wouldn’t stop on its own and he reached over the side of the bed and searched for the scourge of his life—the umbilical cord to the Residents and the ER. He pushed the button by feel and the message lit up. It was the ER and it was 4:45 in the morning, only two hours after they had finished with the boy from the speedboat accident.

  Two hours of restless sleep. The worst part was he had a packed day of patients in the clinic ahead of him. He pushed on his chest and sighed, remembering his nightmare, one that he often had. He was in the operating room; the case was going horribly wrong and when he looked down, he discovered he had forgotten to put on his surgical gloves. The medical staff would crucify him.

  Nick startled when the house phone buzzed, indicating that it had been knocked off its receiver and onto the floor. He fished for the phone and dialed the ER.

  “Emergency Department,” an unfamiliar voice on the other end declared.

  “Hart,” was all he could croak out. He thought it strange that Conner, the informal, always chipper, front-desk clerk, hadn’t answered the call.

  “Hold one,” the voice said.

  Nick waited until the phone clicked. “Dr. Hart. Sorry to wake you. This is Ali. I’m afraid there has been a most unfortunate incident in the Emergency Department. A meth-head came in and shot up the place. Connor, the front desk worker, and Riley, one of the triage nurses, have been killed. Security was able to stop the man before he got any further.”

  “What? Seriously? Riley…and Connor?” He asked trying to clear the fog in his head. He sat up on the side of the bed and rubbed his face. He hated the ER, but his co-workers made it more tolerable. Riley was one of his favorites. She always worked nights, always quick with a smile, and always kind, even to the worst of humanity that came through the doors after midnight. His friends in the Emergency Department were the closest thing to family that he had in Memphis.

  “I’m sorry, Dr. Hart, to break the news to you.”

  “What a screwed-up world,” he said, glancing at his bloodied scrubs on the floor. “I’ll head down.”

  “You should wait. The ER is on lock down and it’s a real zoo down here. Besides, the shooter was shot multiple times by security and he is still alive. We are on our way to the OR with him.”

  His heart sank. What a perfect way to spend the rest of the night. Treat a guy that is most likely wacked out on meth, HIV positive, and has absolutely no resources to pay his bills. The jerk would probably sue him or the hospital for whatever reason and walk away with a few million dollars in his pocket.

  Nick thumped his chest trying to beat the sarcasm from his heart. “What’s he have?” he asked.

  “Gunshot wounds to the left shoulder and left arm, and one through and through to the leg that just needs to be washed out. The bullet to the arm shattered his humerus. We’ll irrigate and debride the wounds and put an ex-fix on the arm to stabilize it temporarily,” Ali said and added, “We’ve got this, Dr. Hart. I only wanted to give you a heads up.”

  Nick thought for a moment. He was critical of the Attendings that didn’t get their butts out of bed to help the Residents, but he was exhausted and laid his head back on his pillow. “All right, but call me if you need me,” he said. “Or let him die for all I care.”

  CHAPTER 2

  * * *

  Attack

  Friday

  Nick walked into the clinic wearing his white coat over his scrubs, but when he caught his reflection in the window, he saw that nothing could camouflage the dark circles under his eyes and his pale, unshaven face. He headed straight for the coffee machine. The older he got, the more his body ached like the flu after a night of call.

  He thought he’d fallen back to sleep after the early morning page and conversation with Ali, but his head didn’t feel like it. He woke up wondering how the case had gone. He intended to walk through the ER, but af
ter hitting the snooze on his phone alarm a few extra times, he didn’t have time before his morning clinic started. He would go check on the crew during his lunch hour. The ER personnel were well acquainted with tragedy, but this was different. It was unbelievable that Connor and Riley were dead. Guilt hit him that he knew little about their personal lives. He thought they were both unmarried, but wasn’t sure.

  He stirred three packets of sugar into his coffee and took a sip.

  “Dr. Hart.”

  He turned to see Antonio Scott standing behind him, wearing a crisply pressed white coat over an expensive looking blue shirt and gold tie. Antonio was a hand surgeon and, like many he knew, was fastidious and wound tight to the point of being prissy.

  “Hey, Antonio,” Nick said trying to sound chipper. Because Scott was a colleague, he had tried considering him a friend, but ended up holding him at arm’s length. Nick had witnessed the man almost getting into a fist fight with another surgeon who dared park in his parking spot. But Scott was the top moneymaker for the group and the newly elected Chief of Staff for the MED. Most likely, the money and the promotion went hand in hand.

  “You get your rest?” Antonio said sharply.

  “Uh…” Nick looked at the man, whose face was already turning crimson, highlighting his ginger hair. He was of Irish descent and stood a full foot shorter than Nick. His sharp attire couldn’t hide his barrel stature. “Call…you know,” Nick shrugged, sensing a brewing storm and sipped more coffee.

  “Well, I sure in the hell didn’t. You hear about your patient?”

  Which patient? Nick’s mind searched his files. The kid from the boating accident last night or one of the twenty or so patients he currently had in the hospital? His brow furled trying to understand the man’s cryptic anger.

  “I’ve been up since six a.m. dealing with your crap. You know about the shooting early this morning in the Emergency Department?”

  Nick was not surprised that they had called the Chief of Staff about the incident. “Yes, I heard. What a…”

  “Then the OR called me and told me that your patient was dead. I asked to speak to you, but they said you weren’t there…that you were sleeping.”

  “The meth-head? I thought the guys…”

  “That meth-head happens to be the mayor’s son,” Scott cut him off again. “I just got off the phone with their attorney. Crap, Hart, why weren’t you in there?”

  Nick’s mind raced. He thought of all sorts of things to say to his accuser. Scott was one of the worst Resident abusers and rarely left his multi-million-dollar home in the middle of the night to get in his three-hundred-thousand-dollar Bentley to come help the team. The Residents told Nick that the first thing Scott would ask about a patient was their insurance status. Scott probably thought call was easy, but only because the Residents stopped calling him if the injured was uninsured.

  Nick’s cell phone rang, and he pulled it out of his pocket. He saw it was Ali. He had already missed three calls from him. He must have knocked the phone to silent or missed them as he tried reviving himself in the shower.

  “Ali?” He answered the phone.

  “Dr. Hart, thank goodness. I have been trying to reach you. I’m afraid I have bad news about the shooter from this morning. We got him to surgery and when the anesthesiologist induced him, he went into full code. I guess he had so much meth on board that the anesthesia made his pressure drop out and they couldn’t ever get him back. I wanted you to know before anyone else told you the news,” Ali said.

  Nick looked at Scott whose face was nearly turning purple. He wasn’t sure why the man seemed to dislike him so much. He suspected it was jealousy, especially after the attention that he had received after his service in Guatemala. Scott was one of those people that thrived in the spotlight and wanted it all for himself.

  “I’ll call you back Ali, thanks.”

  “The mayor’s attorney is already accusing us of letting his kid die for shooting up the ER.”

  “And?” he asked sarcastically.

  “Hart, you know how these things work,” Scott said flashing his anger. “Someone is going to have to take the bullet, and it’s not going to be me.”

  “That’s an appropriate metaphor,” he said. He was in no mood to take any grief from the man.

  “These are the kinds of stupid antics with which you seem to like to acquaint yourself.” Scott raised his voice and stepped closer to Nick who didn’t budge. “They’re also the sort of thing that can bring a stain on your reputation, let alone mine.”

  “I’m sure you are very concerned about that,” he challenged.

  “Look, Hart…I know who you are. I am the head elder of my church and we deal with your kind all the time.”

  “My kind?” Their voices were echoing down the hallway.

  The man shot daggers from his eyes. “I’ve heard about your philandering…your…sin.” His anger made him stumble over his words. “And you call yourself a Christian?” His spittle hit his scrub top.

  One of the clinic nurses stood in the doorway and cleared her throat. She put her hands on her hips, gave them both a disgusted look, and pulled the door to the breakroom shut.

  “I’m suspending your hospital privileges for the day. You need to go home.” Scott said.

  “You can’t do that.”

  “You bet your ass I can. You want to leave on your own, or shall I call security?”

  “I have full day of clinic.”

  “We have that covered,” Scott said. “You have today and tomorrow to get yourself together. You’re back on the call rotation on Sunday.” He turned on his heels and left the room.

  * * *

  Nick slept hard and woke with a stiff neck and raw attitude after being sent home by the Chief of Staff. He rarely had an opportunity to sleep during the day, so he woke up feeling drugged. He was angry at Scott for judging him and acting like a pious buffoon. He knew many of Antonio’s secrets as well. He was not going to stand by and let the guy throw him or Ali under the bus. He had done nothing wrong; the Residents perform surgeries all the time under the watchful eye of the Fellow or fifth-year Resident, with or without the Attending’s supervision. It is part of the training to help grow their confidence to be out on their own. He did regret joking with Ali about letting the patient die. Unfortunate words. But he hoped that Ali understood that he was joking.

  Nick pulled up to the front of the Madison Hotel in downtown Memphis. If he was forced to have the night off, he was going to make the most of it. After a long, hot shower, he had donned his pressed white shirt, blue jeans, favorite pair of cowboy boots, and a layer of Axe cologne. He didn’t bother to shave.

  “Be careful with her,” he said when he handed the keys to the young valet, who licked his lips at his shiny new, aqua-blue Porsche 911 Carrera.

  “Yes, sir,” the boy said and enthusiastically jumped behind the wheel.

  “You do have your driver’s license, right?”

  The boy gave him a sideways glance and sped off.

  He watched his car turn a corner. The car was extravagant, but it was the one perk he enjoyed. Even the short drives from his apartment to the hospital seemed more joyful. He could have even walked from his apartment to the Madison, but with the gun and knife club in full swing after sunset, it was just another good reason to enjoy his expensive toy.

  Nick strolled through the posh lobby and into the elevator. He was headed up to the Twilight Sky Bar on the roof of the Madison.

  He stepped off the elevator and into the festive night air. The music and social scene were already hopping as he made his way to the bar. “Tito’s and tonic.” He nodded to the bartender and leaned on one arm against the stainless-steel bar top, surveying the crowd. It was too early for people to be dancing, but the lubrication was well underway.

  Nick pushed back a wave of his sandy-blond hair, tossed by a breeze off the Mississippi. Two women in tight-fitting miniskirts put some extra swing into their steps as they passed him and smile
d. The beauties, balancing on high heels and showing off their assets, left a trace of sweet perfume.

  The taller of the pair slowed, raised her hands, wiggled her hips and sang, “It’s all about the bass, about the bass…”

  Her friend joined in, flashing Nick a mischievous smile and finishing the song, “…no treble.” The pair giggled and continued trolling the bar.

  He looked back at the bartender who was smiling at him.

  * * *

  Nick lost track of how many Tito’s Sonics he drank—enough to numb his run-in with Scott and too many to drive himself home. The girls invited him to continue the party at their place and were annoying the Uber driver with their boisterous laughter after Nick told them a joke.

  He sat sandwiched between the pair in the back seat when his phone rang.

  He pulled it from his front pocket and looked at the caller ID…it was Maggie. The phone was already on its third ring. He wanted to talk with her, more than anything. But he would sound stupid drunk…and there were the girls.

  Fourth ring.

  God, how I miss her.

  Fifth ring.

  I just can’t. Nick let her call go to voice mail and hated himself for it.

  “Maggie?” one of the girls said, looking at his phone. She must have read the conflict in his body language.

  He nodded and put the phone back in his pocket.

  “If I find you sneaking around on me I’m gonna whoop your butt,” she said highlighting her threat with a wagging finger. She broke out in a boisterous laugh that jiggled her large breasts.

  Author’s Note

  * * *

  Redemption

  I have written Maya Hope out of obedience and a spirit of prophecy. As every author will tell you, truth is mixed with fiction. This is a novel; however, it is important to know that the historical, geographic, and political issues are based on truth. Likewise, the stories of the children of Central America are based on truth. Their names have been changed, but I want you to meet the real Isabella, and I have included some photos on the next page.