She sighed to herself. After the euphoria died down, she’d remembered his promise not to make decisions for her. He’d broken it, but he’d been right, so maybe she was wrong, at least about this one thing. She was inclined to be lenient, as long as he didn’t do it again. He’d lavished compliments upon her, and apologized, and she hadn’t seen him that happy in months. She smiled to herself and turned her attention to her job.
It was her first shift back at work after Phyllis’ death and among the things she’d found in her e-mail box was a note from Detective Tran, giving contact information to use if the police station number was busy. Network security had automatically sent a copy to the ICU Head Nurse, Ginny’s boss, and to Human Resources. Ginny made a note of the alternate number, then moved on. Her concentration was broken by a muted squeal of feminine delight.
“Oh! They’re so cute!”
Someone had brought in a box of puppies.
“Look at them! Aren’t they adorable?” Four nurses surrounded the box, each cuddling a puppy. Ginny’s mouth twitched at the sight.
Grace called to her. “Come on, Ginny. Don’t you want to hold one?”
Ginny found she did. She rose, walked over, and looked down at the remaining three pups. Grace rescued pit bulls and these were typical of the breed, modified by an unspecified male parent. “How did you come to have puppies?”
“The usual way. The last bitch I adopted turned out to be pregnant. Come on. Hold one and tell me you don’t want to take it home.” Grace scooped up a puppy and handed it to Ginny, who tucked it up against her cheek. It squirmed in her hands, turning to lick her ear.
She played with the pup for a few minutes, then put it back in the box. “Sorry. Can’t take on an animal at the moment. And you’d better get them out of here before you get caught.”
Grace nodded. “They’re going to the shelter tomorrow, but I was hoping to find homes for some of them before that.”
“Have you been down to the ER?”
“That’s my next stop.” Three of the other nurses put the puppies back in the box, but the fourth followed Grace to the elevator, making arrangements for transfer of ownership of the chosen animal. Ginny washed her hands of the dog hair and the incident, reflecting that Grace had a habit of thinking rules were made to be bent—in a worthy cause, of course.
The first few hours of the shift were easy. There was so much to do she didn’t have time to think about the murder, but as the clock moved toward midnight and the night settled in, Ginny found herself looking at the other staff, rather than the patients.
Peter was new. African-American with a buzz cut, Marine tattoos, and one diamond stud in his left earlobe. He’d been employed at Hillcrest for four months and was one of the Respiratory Therapists acquired when the latest hurricane had driven refugees from their homes on the coast to the north Texas prairie. She didn’t know him at all.
Dee, also African-American and also a Respiratory Therapist, had been here longer than Ginny. She didn’t look old enough to have three grandchildren, but she’d started young so maybe that explained it. Solid, reliable, an open book. She would talk to anyone about anything, if they would only stand still long enough.
Both of them had been busy with the Code Blues. There was no chance either of them could have slipped away while those were going on. Ginny corrected herself. It was possible, of course, just not likely.
Ginny felt her skin crawl. She turned her eyes back to her work, trying to shake the memory of how many times she’d been told to butt out last time.
But this time is different, the little voice in her head argued. Detective Tran has asked for your help. You have a duty to try. And—let’s be honest here—you are the nosiest person I know, never satisfied until you find out what’s behind everything.
Ginny squirmed, admitting the truth of that accusation, then sighed. She could put together a time line. They’d gotten slammed just before two a.m. and the fun didn’t ease off until close to six. Ginny didn’t know which Respiratory Therapist had been assigned to which Code, but it would be in the logs.
She rose and checked on her patients, making sure they were safe and comfortable, which kept her busy until one-thirty, at which point she found herself with twenty free minutes. She let her mind drift back to the night of the murder.
They’d started the Thursday night/Friday morning shift with four of the twelve beds empty. Ginny’d had a patient in resolving Diabetic Ketoacidosis, and the first admission.
Phyllis had had two relatively stable patients; one renal failure on continuous dialysis, the other a multiple trauma, four days out, on a vent, with TPN and wound care with Contact precautions. Ginny glanced around the Unit, as if expecting to see the dead woman emerge from one of the patient rooms.
It had been hard not to hate Phyllis in nursing school. She learned easily and was the sort of leggy blonde who looked good in everything, which meant she could have her pick of male companions. But her laid-back Texas upbringing defused any real animosity. She and Ginny had been in the same study group and both had benefitted from the partnership. After graduation, they both applied to Hillcrest and both ended up in the Medical ICU. Ginny had been glad of that, too. Phyllis was calm and competent and night shifts were always quieter when she was on duty.
Ginny looked up as Alice flew by on her way to the med room. Alice was the opposite of Phyllis, a bombastic brunette with a penchant for noise. She had one of those laughs that could be heard over the alarms and an aggressive style of interaction that included the newly-minted wedding band set with diamonds that she flashed like a red flag at a bull.
On Thursday night Alice had drawn what turned out to be an expanding subarachnoid hematoma, who Coded, then had to be shipped off to surgery and transferred to the Neuro ICU. Ginny had stepped in to cover her respiratory failure patient until the first admission arrived. At which point Susan had taken over Alice’s second patient, and lent a hand to help Ginny get her myocardial infarction settled in.
Susan was a plump fawn of a person, doe-eyed and mousey brown. She and Ginny had gone through orientation together, sharing lunches and tidbits of personal information. She saw everything, understood everyone, and had a wicked sense of humor she shared with very few.
Susan’s admission that night, a motor vehicle collision from the ER with orders to prep for orthopedic surgery, but not until he cleared the cocaine from his system, turned out to be uncooperative, so she’d had to stay with him and was no longer available to help Alice, which meant the charge nurse had to take over.
The charge nurse was usually one of the night people, but Margot had called in with some sort of family emergency. So the Head Nurse, Marjorie Hawkins, had been forced to come in on her day off and fill in.
Physically, Ms. Hawkins was unremarkable. You could look right at her and not be able to describe her the minute you looked away. Medium height, medium build, medium age, medium brown hair and eyes. But she was good at her job, with a flair for the bureaucratic tasks required of a department head.
She’d been holed up in the office doing paperwork for the first part of the shift, but had to come out and play when her own admission arrived, also from the ER and also a motor vehicle collision, this one also an asthmatic. That put extra strain on the Respiratory Therapy department as they kept having to do breathing treatments, as well as cover the ventilators and assist with the Codes.
Ginny looked up as Margot approached.
“Have you seen Grace? She’s MIA.”
Ginny shook her head. Best not to mention the puppies. “She’s here, though. I saw her earlier.”
“Well, she’d better show up soon. I’ve got other work to do.” She stalked off.
An alarm called Ginny to one of her patient’s side. She dealt with the issue, collected the two a.m. data, administered the scheduled medications, charted, and ended up an hour later back at her table, watching the monitors, thinking about last Friday.
Grace had the last two patients t
hat night, a vented lung cancer with metastasis awaiting a bed on hospice, and a patient with pneumocystis (immunocompromised and in Protective Isolation).
Grace lived up to her name. She was tall and willowy, with almond-shaped eyes and satin skin. She had been a model and had been married, but both of those endeavors had ended badly. She usually displayed a sang-froid that allowed stressors to roll right off her back, but Ginny had seen a darker side on the one occasion when Grace had completely lost her cool.
The fourth admission was the second MI and should have gone to the nurse with only one patient, Ms. Hawkins, but she was busy with charge nurse tasks and helping Alice and Susan. So the fourth admission (and a third patient) fell to Ginny, which put her over the top and racing to finish all her work on schedule. By which time it was four-thirty a.m. and that was when the cocaine abuser decided to rip out all his lines, trash his room, and die on them.
And—at some point during that chaotic night—Phyllis had been murdered.
Murdered! Ginny rose and went about her tasks with the word floating in the air just out of sight. Someone had followed Phyllis into the restroom, wrapped a wire around her neck, and clamped it in place.
The police were leaning toward premeditation, the wire and clamp brought to work with murder in mind. But Ginny couldn’t help thinking that, if you wanted to kill someone in an ICU, all you had to do was look around.
“Did you hear the news?”
Ginny turned to find Lisa leaning over the back of the monitor desk, speaking to June.
“What news?”
“The police came Saturday afternoon and broke into Phyllis’ locker and you’ll never guess what they found!”
“Tampons?” June had a dry sense of humor that was lost on Lisa, but made Ginny’s mouth twitch.
“No! Well, yes. They found her purse, but they also found drugs.”
“Drugs? What kind of drugs?”
“Cocaine!”
June frowned. “Why would she have cocaine in her locker?”
“Well, isn’t it obvious? She was using on the job! If she wasn’t dead already, they would have to fire her.”
June raised a skeptical eyebrow. “You really think Phyllis was snorting cocaine on the job and not one of us noticed?”
“Well, all right. Maybe she was just stashing it here until she could take it home.”
“Where would she get cocaine? From our stock?”
“No. These were street drugs.”
“How do you know?”
“Had to be. We don’t stock cocaine in our medication dispenser. That’s a surgical, or maybe an ER drug, not ICU.”
June nodded. “But it still doesn’t make sense. If she wasn’t stealing it from here and stashing it until the end of shift, why would it be in her locker? If she bought it on the street, she should either have taken it home or left it in her car.”
“It was in her purse. Maybe she forgot to take it out.”
June seemed unconvinced. “How did you find out about all this?”
Lisa pulled back, then lifted her chin. “I have my sources.”
“Really?” June’s voice was even drier than usual.
“Yes, really. What’s more, someone called in an anonymous tip last Thursday. The Director of Nurses was already investigating.”
“And your point is?”
“Well, maybe that’s what got her killed. Something to do with the drugs. It’s a good thing she’s gone. If the media found out, Hillcrest would be in big trouble. Maybe someone wanted to hush up the investigation.”
“By killing her? That’s not going to stop an investigation. Besides, the autopsy will tell us whether or not she had drugs in her system.”
“Well, all I’ve got to say is, if one of us had to be killed, it’s a good thing it was someone who needed killing.” And with that remark, Lisa stalked off in the direction of her assigned rooms.
Ginny smiled when June rolled her eyes toward the ceiling. Lisa could be a lot to deal with. Still, it was a disturbing thought. Who among them had decided Phyllis needing killing? Because someone certainly had. Ginny looked around.
It wasn’t the same ICU crew tonight; Margot was back and Susan was off. Some the patients (and their families) had gone and new ones taken their place. The Code Team members, the physicians, and the night supervisor all rotated duty. It could have been any one of them and it would take some doing to eliminate them from the investigation. As of this moment, the only person she knew was innocent was herself.
Ginny pulled her phone out of her pocket and scrolled to the audio recording software. What she had in mind was a memorial collection, the kind where everyone contributed a memory of the dearly departed. If she could pull it off, it might even be a nice gesture, something to give John Kyle. But what she hoped to do was find someone who might say something in an unguarded moment. A clue that could be handed over to Detective Tran.
She made sure her patients were stable, then made the rounds of the nurses on duty. With each one, she explained the memorial idea, recorded the responses (or accepted a promise of an e-mail when the interviewee had more leisure), then asked if he or she had heard about the cocaine.
Ginny was no psychiatrist, but not one of them (other than Lisa, of course) seemed to be hiding anything. They were all interested and willing to help. She was kept busy the rest of the night recording tidbits those on duty the night of the murder had forgotten to tell the police, and rumors those who had not been there had come across since.
Several had heard about the drug seizure, but none had been in the Unit at the time. Ginny would have to ask the day shift about that.
They had questions for her, too. Did the police have a favorite suspect? Was there any forensic evidence? A man or a woman, for instance? No? Not even that? So it could be anyone. There were a number of worried expressions.
Ginny documented carefully, making notes of her own thoughts alongside the accounts. It was just as interesting to hear what the others were asking her as their answers to what she was asking them.
Her mother had been right. The innocent among them wanted this mystery solved, and quickly. They didn’t like the idea that there was a murderer among them. No one said it, but everyone seemed to be wondering if the murderer would strike again and—if so—who would be next?
* * *
Chapter 11
Day 5 – Tuesday midmorning
Jim’s apartment
Jim had his feet up on the bed, pen in hand, writing his latest medical journal article. He was the sort who could concentrate, ignoring distractions, but even he had limits.
He swore mildly, finished his sentence, then rose to investigate the incessant knocking that was interrupting his work. He found the Laird on his doorstep. He stepped back, opening the door to a swirl of heavy wool and cold air.
“Are ye deaf, lad? I’ve been knockin’ fer fifteen minutes.”
“The doorbell works.”
The Laird snorted. “It dinna th’ time afore.”
Jim smothered a smile. “I’ve had it fixed and you could have called.”
“’Tis better ye see this fer yerself.” The Laird flipped his cloak off and sat down on the edge of the couch.
Jim sat down facing him. “All right. What do you have to show me?”
He watched as his grandfather pulled a small plastic bag out of his sporran and extended it toward him. “This.”
Jim peered at the contents of the bag, frowning. “Where did you get these?”
“Rose found them stuck on Luis this mornin’, when she stripped him tae gi’e him a bath.”
Jim looked up in alarm. “Is he dead?”
“Nae, th’ wee nyaff’s unharmed.”
Jim pulled on a pair of disposable gloves, then opened the bag and drew out one of the wafers, inspecting it closely. It appeared to be a transdermal patch containing a potent narcotic painkiller, the kind used with terminally ill cancer patients. “He was wearing these?” Jim counted the patches, esti
mating the delivery dose.
“Aye. He told Rose he found the stickers and was playin’ wi’ them, but he’s no sure how they got on tae his skin.” Himself lifted an eyebrow. “I’ve a notion the lad knows a bit more than that, but he’s no sayin’.”
“Give me a minute.” Jim moved to his computer and pulled up a reference site used to help identify medications. “Well, it certainly looks like fentanyl.” He swung around in his chair. “Was he sick? Any symptoms?”
“Nary a one. Perfectly normal wean, and I’ll eat my hat if he dinnae ken he shouldna hae been playin’ wi’ them.”
“You spoke to him?”
“Aye. Rose found them, and recognized them. Her mither, I think, uses something like. She tells me it gave her quite a turn, but the bairn was fine so she called me instead o’ takin’ him tae th’ emergency room.”
Jim frowned. “If these are used, then the amount of narcotic in them might be significantly diminished, but he could still have absorbed some of the drug. Where did he get them?”
“Ah, weel, that he hasna said.”
Jim picked up the patch again and examined it closely. “There’s an expiration date, but no lot number. We might be able to trace the manufacturer, but we’d need the box it came from, or someone with more experience than I have.”
“Wha’ aboot th’ pharmacy at th’ hospital?”
Jim nodded. “We can try.” He set the patch down and looked at his grandfather. “He wouldn’t talk to you? Or Rose?”
The Laird shook his head.
“Then he won’t talk to me, either. What we need is Ginny.”
“Aye, but she’s asleep.”
Jim nodded. “With your permission, I’ll take these in with me when I go to work tonight and see what I can find out.” His brow furrowed. “It’s interesting that it’s fentanyl.”
“Why is that, lad?”
Jim looked up and met his grandfather’s eyes. “Because it’s fentanyl that brought the DEA to Dallas.”
The Swick and the Dead Page 8
