Deadly Diversion: A Medical Thriller (18 page)

“Unless they find something,” BJ added.

“Like what?”

“Well, they’ll try to get the results of her urine test from the hospital, and maybe try to get her to give some blood, too. See if she’s on anything.”

“I doubt the hospital would release her results without a court order. Judyth’s too worried about our reputation. And with the accreditors coming back...”

“Her lawyer wouldn’t let her give blood anyway without a warrant. She have one? A lawyer?”

I told her about Tim’s brother agreeing to represent her.

“Good,” she said. “Too many perps say too much before they get a lawyer and then it’s too late. Of course, most of the time we’re glad about that.” She smiled.

“Look, we don’t even know that Huey didn’t die naturally,” I told her. “It’s only the ME’s office that decided to label it a suspicious death. We were expecting him to die. And Laura had only arrived a half hour or so before he coded.”

“You said she was his nurse. Had she done anything yet? Given him anything?” BJ leaned back and looked me in the eye.

“She’d given him morphine. But he was due for it.”

“Could that have killed him?”

“The flow is controlled. It’s on a pump and the patient pushes a button to release the drug.”

“What happens if he keeps pushing it? Wouldn’t he get too much?”

“There’s a mechanism that prevents it from releasing more that a set amount in a specified time, although it can be set for a continuous flow. Huey’s wasn’t like that because he also had a fentanyl patch.” I dumped out the crumbs from the bottom of my bag of chips, popped them into my mouth, and took a drink of beer. An off-road vehicle navigated a sand dune on the silent TV. “Laura hung a bag, too, but I don’t know why.”

“What do you mean?”

“He had a central line—the IV was inserted into his jugular vein.”

“Yikes! Didn’t that hurt?”

“I suppose, but he needed TPN—total parental nutrition— because he was so debilitated and he couldn’t eat much because of the stomach cancer. Anyway, those bags are changed once every twenty-four hours, usually on nights, so the night nurse, Bart, should have changed it.”

“But you say this Laura did it instead?”

“That’s what she charted.”

“Why would she do that?”

I shrugged. “It happens. The night nurse is usually pretty busy. He’s there with only a temporary-agency nurse or two. This guy is somewhat careless anyway. He’s more interested in grad school. He probably ran out at the end of his shift, Laura saw the bag lying there and hung it.”

“So could something have been in the IV bag?” BJ asked. “No, the bags come up premixed and labeled with the patient’s name. And they’re calibrated, too. They drip at a specified rate depending on the patient and the solution.”

I hadn’t thought too much about the bag before telling BJ about it. I’d meant to ask Bart why he hadn’t hung it, but I’d forgotten about it the past few times I’d seen him.

The bartender checked to see if we were ready for another beer but we waved him off.

“What makes Harding or McNeil think Huey’s death was murder?” I asked BJ. “What evidence do they have? Or motive. What reason do they think Laura might have for killing him? So far all we know is that Huey had a respiratory arrest and we don’t know exactly why, not for sure. Why is everyone making such a big deal about it?”

She shook her head. “Once the ME rules it suspicious, the cops don’t have any choice. They’ve got to follow up.”

“And arrest someone, anyone, just so they get an arrest?” She kept her eyes on the silent television screen, not answering my question. Then she turned to me. “There’s something else. They had a tip, Don told me. From that guy Dog, the one you know. Something about how Huey was afraid of someone at the hospital. It does seem weird that Huey was just getting ready to talk to the cops and then suddenly he’s dead.”

“What if Laura gave him what was ordered and it was too much? His liver was shot, so the drugs might accumulate,” I said, thinking. “That wouldn’t be her fault.”

“Maybe the doctor who ordered the drugs would be blamed,’ she said. “Shouldn’t he have known about his patient’s condition and not ordered too much?”

“It’s hard to judge exactly. And Huey kept clamoring for more I’m not saying that’s what happened. I’m just conjecturing.” Someone turned the sound up on the TV hanging from the wall. The Southside candidate was leading in his own neighborhood. The announcers went on to rehash the campaign issues: the sad state of the city’s public schools, another proposed increase in cigarette taxes and regulation of the gambling industry. The sound went back down.

“What about those tests they did on the nurses? Did they find anything?” BJ asked.

“One nurse was high. I saw her. She was fired. I heard that a couple more tested positive, and they’re running more tests on those samples. That’s all I know now.”

“Could this Laura have been on drugs when she took care of the guy? And wouldn’t the tests show that if she was?”

I thought for a minute before I said, “Huey died Friday. They tested everyone on Monday. I’ll have to find out, but I think most narcotics have a pretty short half-life.”

“Half-life?”

“That’s how long they stay in the body. That’s why we give them to patients every three or four hours. I doubt it would’ve shown up after three days.”

“So she could have been high, done something wrong that killed him, and still show up clean for drugs a few days later.” BJ signaled the bartender, pointing at our empty bottles.

“What could happen to her?” I asked.

“I don’t know. If they think she accidentally overdosed him on something, then it could be manslaughter—involuntary—or it could be a homicide, even first degree if they thought it was premeditated. Not accidental or spur of the moment, that is. First-degree murder carries the death penalty, you know,” she added.

“Oh, God, BJ. Don’t talk that way. I can’t even think about something that horrible.”

“Don’t worry, Missouri’s never executed a woman.” She patted my hand. “I’m sorry I mentioned it.”

I pointed to the TV screen. “If this breaks on the news right now and the accreditors arrive...”

The television sound came back up, and an announcer said the vote for mayor was too close to call.

“Don’t worry, the reporters are too busy with this election, especially after the brouhaha over announcers calling Florida for Gore back in 2000. They’re way too busy to go hunting through the arrest records for something to write about.”

After the bartender had deposited two more beers in front of us, BJ asked, “You ever talk to that priest? The one who brought Harding in?”

“I tried, but he’s on retreat until Thursday. I’ll catch him then.”

“Maybe he’ll know something that will help.”

“Unless it was a confession.”

“Then it went to the grave with him.”

I HIKED MYSELF UP on a barstool at the second tavern I’d been in that night and ordered a Busch Lite. The bartender was a large woman with too-blond hair who smiled at me as she popped the top and sat the bottle down on a stained coaster.

I smiled back and took a swallow.

“Is Mavis here?” I asked, looking around. A man with long, gray hair pulled back with a rubber band was counting bottles at the end of the bar. I was the only customer at the bar although some men were playing the 25-holer in the back. The machine was illegal unless they had a gambling license, which was unlikely.

“You a friend of hers?” the woman, whose name tag said “Bella,” asked. She leaned against the cabinet behind her and lit a cigarette. The man counting bottles glanced my way.

Driving home from Hauptmann’s I’d thought about Huey and who might have wanted him dead. I knew Laura wasn’t on that list but I didn’t know anyone who was. “I knew Huey better,” I answered.

Bella nodded. “Sad,” she said with a sigh. “Nice guy.”

I took another swallow of beer.

“We all liked him.” She nodded toward her coworker, who seemed to be counting the same group of bottles over.

“Everyone did,” I agreed.

She picked up a towel beside her and began to wipe the already-shiny bar. “Hell, that little guy could get more with his smile and one arm than most men twice his height and both arms.”

“Here’s to Huey,” I said, raising my bottle.

She waved her cigarette in my direction. “One hell of a guy”

A fiftyish guy ambled up from the back and pulled himself up on a barstool at the end. Bella told him we were toasting Huey. He picked up the half-empty bottle in front of him and joined us. “To Huey,” he said, “who never met a chance he didn’t take.”

“You knew him?” I asked.

“I knew this much.” He took another swig of beer. “If you had anything Huey wanted, watch out. He’d find some way or ’nother to get it away from you. Never saw nothing like it.” He shook his head in amazement. “And you’d end up thinking you had wanted to give it to him.”

“Aw, shut up, Harry,” Bella said, crushing her cigarette in an ashtray on the counter behind her. “You liked him, you know that.”

“That’s ’cause I never had nothing. He couldn’t charm me out of what I didn’t have.” He tapped his empty bottle on the bar and Bella pulled another bottle out of the cooler. “That gal he got down at the boat,” the man went on. “Wouldn’t do for nothing till she’d go out with him. Told her he was separated.”

“Was he?” I asked.

“Humph! Mavis would’ve separated him, that’s for sure.”

I took another drink and looked around. The man counting bottles had left. The two men in back were motioning for Bella to bring them more beers.

“When’s she coming back?”

Bella looked as if she didn’t know who I meant.

“Mavis, Huey’s wife.”

“She’s not.” She nodded toward the men in back and slung the towel over her shoulder.

“Oh?”

“She quit,” she said, pulling two Budweisers out of the cooler. “Said she didn’t need to work anymore.”

FOURTEEN

Wednesday, 15 August, 0932 Hours

I KNEW WHO THEY WERE the minute they came through the door. They were dressed alike in dark suits and white shirts, buttoned up tight. I was coming out of Mr. Dougherty’s room carrying the dirty sheets that he had soiled when I tripped over a wheelchair someone had parked in front of the curtain. The place looked a mess, but it was too late to do anything about it.

The doors banged open again. “Coming through,” the ponytailed attendant ordered as he pushed a gurney strung with IV poles and loaded with an elderly man covered in blankets. The man moaned as the gurney rattled through the door. The three surveyors scooted out of the way. Tim grabbed the gurney and pulled it into an empty room.

“Dr. Hendricks,” said the older visitor. “Lead surveyor. Joint Commission. And this is Ms. Holcomb, CEO of Hadley Hospital in Pennsylvania.” He nodded to the woman. “And Mr. Lawrence, RN.”

I shook hands with each in turn as I introduced myself.

Then all hell broke loose.

Tim yelled that our newest patient had arrested. Jessie grabbed a crash cart, banging it into a bedside commode left in the way. Just then an alarm screamed and Mr. Swenson emerged stark naked, his monitor leads trailing behind him. He was yelling that someone had stolen his clothes.

And the fire alarm went off.

Our three visitors left with a backward wave, saying they’d be back later.

Ruby found out the fire bell was a false alarm, and I got Swenson back into his gown and into bed. I told Serena to restart his IV and that I’d call Jake to see if he would order some kind of restraint for him, either chemical or physical. Tim would have to put in a new catheter; Mr. Swenson had pulled that out, too.

Tim and Jessie were still in with the code, joined now by an anesthesiologist. A lab tech had been in to draw a stat blood. I stepped into the room as the anesthesiologist said, “We’re calling the code.”

“Calling the code,” Tim intoned. “Time, 1012.”

“SHE’S OUT,” TIM SAID as I came through the door after a practice-review committee meeting. “Laura.”

“I ain’t heard that,” Ruby said.

“Believe it,” Tim said. “They didn’t have enough to charge her.”

“Thank goodness,” I said.

“She’s ready to come back to work, my brother said. Get this behind her.”

“She’s on administrative leave, according to Judyth. But maybe since she’s not charged with a crime, Judyth will let her come back,” I said, feeling a little bit guilty because I was more worried about having enough staff than I was about Laura.

“You gonna eat both of those?” Ruby asked, pointing to the Hershey bars I’d tossed on the desk the day before. “I can’t eat the nuts,” she said, picking them up. “But I like this one.” She gave me a grin. “You don’t need both, might make you fat.” She laughed, her chins bobbing.

“Take it,” I said, sorting through the phone messages Ruby had handed me. Mrs. Bauer’s daughter had called again. She and her sister had been arguing about where their mother would go once she recovered enough from her stroke to leave the hospital. Apparently neither daughter wanted her mother nor did they want her to go to a nursing home. Another call was from the sister of a patient who had died a couple of weeks ago who wanted to know if she could come by with a gift for the nurses. Human resources had called as well to remind me to bring my renewed nursing license in to be copied for the file.

“You heard about what happened?”

“Huh?”

“You better pay attention.” Ruby tore the wrapper off the top of the candy and took a bite.

I tried to remember if my new license had arrived in the mail yet.

“You see those guys hanging around the lobby?” she asked, her mouth full of chocolate. She took another bite.

“Those hulks? What about them?” I asked her.

She crooked a finger and leaned toward me. “They the mob,” she said and bit another chunk out of the candy bar.

“What makes you think that?”

“That Judyth—” she lowered her voice to a stage whisper “—she brung them here from Chi-ca-go,” Ruby added, smacking her lips. “And that’s not all.”

Were they involved with the Guardinos?