Imperfect Contract (2 page)

2

I was hungry.  I glanced at my watch and knew why.  The cafeteria had closed ten minutes ago.  I grabbed Hutchinson's medical record, dropped it on the top of my computer cart, and pushed it to the nursing lounge where I poured a cup of old coffee.  Someone had brought in donuts, and there were a couple left.  I'd satisfy my curiosity and my hunger at the same time. 

I cleared an area on the table by brushing the remnants of someone else's lunch into the trash while thinking that health care workers can be such pigs.  I selected the strawberry jelly donut and sat. 

The surgeon's operative report made interesting reading.  The entry wounds into Hutchinson's body were on his left side.  More accurately, halfway between his left side and his back.  One bullet entered behind the left ear and exited over the right eye.  The newspaper account reported the slug went through the plate glass window and struck the adjacent wall.  A second one passed through his chest.  It entered behind his triceps and exited through the left lung.  He was lucky—maybe unlucky—it didn't get his heart.  The next bullet had a different angle and exited through his abdomen, ripping through the bowel on its path from the body, filling the peritoneal cavity with fecal material.  Consequently, Hutchinson had suffered a raging peritonitis.  He was unlucky enough to have survived the infection in his abdomen.

Lastly, it appeared he was shot several times in the left thigh, hence the amputation.  The orthopedic note and the x-rays confirmed there was no hope of saving the limb.  The bone splintered and shattered on impact.  Most of Hutchinson's blood loss was through his leg wounds.  Paramedics arrived on the scene and put a tourniquet on the leg before he exsanguinated.  I thought that bleeding to death would have relieved both the patient and his family of their suffering.

I sat, drinking my bitter coffee and nibbling on the donut.  Nurses can think about almost anything, blood and guts included, and still want to eat.  It goes with the territory.  I remember losing my appetite once.  It was four years ago, soon after I finished school.  I'd helped move a post-operative patient off a stretcher and onto his bed.  Blood stained the sheets, so I peeked underneath.  Much to my chagrin, his abdominal wound had opened and the contents of his abdomen spilled out.  When I got to the cafeteria, they were serving a stewed-beef concoction that looked like liver.  I lost it.  That was the only time.

I drew the bullet entry and exit sites on nurses' stationery—a paper towel—noting the measurements supplied by the surgeons.  I studied my array of colored lines, deducing there were several shooters or the shooter was moving at the time, perhaps with an automatic weapon.  This is South Florida where machine guns and gangland style slayings are common.  But why would someone want to shoot a respectable real estate broker? 

The critical care nurses noted Hutchinson's wife, Amelia, had spent every day of the last three weeks at his bedside.  From the comments about her comings and goings, I wondered if she was showing houses for the business.  For instance, during the day on Saturdays and Sundays, there was always a comment that no family was at the bedside.  The comment that the wife was present appeared in the evening charting.  I needed to ask Amelia who was running the agency.

Curious, I reread the nursing entries from critical care.  The staff commented on the son's visit twice, both times with his mother.  While he may have been there many times and no one bothered to make mention, I doubted it.  I thought he would have been more comfortable with the circumstances if he visited frequently.

Questions ran through my mind.  Ray would have answers for them by now.  He was an excellent detective even if he was a lousy fiancé.  What the heck, I could do a little poking around myself.  After all, Amelia did ask me to take an interest.

While eating the last bite of the pastry, I reached for the remaining one.  It was the firm cake variety.  I tapped the donut against the side of the box to remove the excess powdered sugar.  I'd have to diet for a week after this lunchtime menu. 

I hadn't had time to extract all of the clinical information from the record.  Pouring the last of the stale coffee, I resolved to spend a few more minutes reviewing the chart.  I didn't expect to get another chance to sit for the rest of my shift.  My right leg throbbed with little shooting pains radiating into my knee and hip socket.

When I finished, I cleared everyone's garbage off the white mica tabletop and wiped it with a damp paper towel.  The next time I wanted to use it, it would be dirty again. 

I checked on Hutchinson and my other patients.  Most had visitors and were doing fine.  Hutchinson was alone. 

I took advantage of the opportunity to bathe him and change his dressings.  The fetid odor was coming from his head wound.  I cleaned it with saline and redressed it, being careful to use good sterile technique.  Hospitals are full of pathogens, bacteria that make people sick, and I didn't want to add fuel to the already raging infection.  I hung his intravenous antibiotic, connected the short tubing to the IV pump, and keyed a detailed narrative into the chart.  As I saved my entry, Amelia reappeared.

"Hi, Amelia."  I nodded in her direction.  She smiled and settled into the chair.

"I see you've done his dressing.  How does it look?"

"Not good to me.  I'm writing about it now.  His neurosurgeon makes rounds before dinner so I'll talk to him about it then.  I think the wound is infected."

"That started a few days ago in the ICU."

I darkened the computer screen and perched on the edge of the straight-back chair next to Amelia.  "Amelia, are you trying to keep up with the realty business while he's here?"

"As best I can.  He kept the finances pretty much to himself, I'm afraid, though he did put my name on everything.  He just never gave me the details.  I'm figuring it out.  We have a secretary and another agent.  We're getting by."  She stared at her hands as she talked.  "And, customers are still coming in.  We're in a strip mall in the middle of several new housing developments.  We get a lot of walk-in traffic shopping for resales."

"How are you set for the future?"  I asked.

"It's not good.  I always thought the agency was doing well.  The escrow accounts are in order—thank God for that—but the checking account is almost empty.  We need to close some deals to make payroll."

"Is there anyone to help you?"  I felt sorry for her.  Her world was falling apart.

"I'm getting some help from a broker friend of Barry's, but he has limited time.  I'm going to have to close the agency and work for someone else.  I always thought I'd retire when I reached sixty—that was my plan.  Barry's friend Mike from Michael Wiley Realty offered me a job and offered to take over our outstanding contracts.  That's what I'll have to do."  She stared out the window, then her gaze shifted to her husband.  "The problem is Barry would disapprove if I sold out to Mike.  It's true they're friends, but they’re also fierce competitors.  Each one tried to get the upper hand.  Mike has been more successful over the last couple of years."

I let her talk for a few minutes before excusing myself.  I was behind with my other patients and needed to hurry to get off duty on time.  In my opinion, Hutchinson would never run the agency again.  I thought that Amelia should cut her losses, close the place, and get a job.  I wondered about life insurance, and I wondered about motives. 

Maybe I'd talk to Detective Ray Stone after all.

3

The next morning I pulled out of the quiet cul-de-sac where I live onto the main drive preoccupied with thoughts about Ray.  I'd done my best to remove him from my system and my mind, but I was ambivalent.  We had a history together that started when I was a police officer and continued in fits and starts over the years.  We'd gotten together to discuss one of his cases a few times since then, and the attraction remained. 

I sat at a traffic light, waiting for a left-hand turn arrow, and remembering.  A creep shot me during a routine traffic stop eight years ago.  During the several months in the hospital and rehab, I discovered a desire to be a nurse.  After I healed—all except for the problem with my right leg—I enrolled in nursing school. 

Since I worked at Coral Bay Medical Center, my friends on the force asked for information on a regular basis, and I stayed in touch with my former profession.  People's life problems, not just their physical ones, continued to energize me, and I welcomed the opportunity to stay involved. 

The result was my special talents were useful.  I had been a patrol officer most of the time and like other female cops in a small department, I did undercover work for Vice.  Being a nurse and a former sworn officer gave me special understanding of some situations and access to people and information not available to an officer who doesn't know the health care system—where to look or whom to ask.

When I arrived on the unit, my friends, Connie Kuhn and Vanessa Vanderbilt, met me in the nurses' lounge. 

Connie greeted me with a tight smile and said, "I'm glad you’re here.  I want to give report and get home before Darrell leaves for work.  I spent the night caring for Hutchinson, and I'm tired."  She fidgeted in her chair.

I grabbed a cup of fresh coffee and sat across the table from them.  The blend smelled rich and strong—Connie had brought it in from Starbucks.  It tasted winey and had a snap.  I savored my first sip.

"Sophia, you're assigned Hutchinson," Connie said.  "With him and the other patients, you're going to have a rough day."  Connie was middle-aged and matronly beyond her years.  She had two grown children, nurse Susan and college freshman Wayne.  Though she wasn't overweight, she seemed to have settled into her hips.  Her grown-out-perm hairdo hung in ragged curls around her ears and down her neck.  To top it off, she wore uniforms that looked like tents, or maybe like nun's habits without the overlay.  But I liked her—usually.

I sipped the coffee and looked at Connie and Vanessa over the rim of my cup.  "I had him yesterday.  I know about his problems."

"Seems to me he got what he deserved."  Vanessa picked her handheld computer off the crumb-covered table and tapped the small screen to open the ventilator settings.  Vanessa is the respiratory therapist on our unit and is responsible for managing the breathing treatments for all our patients.  She's had the same assignment for a long time, and we've become friends.  We shop together and sometimes take in dinner or a movie.

"My God, Vanessa, why would you say that?"  I felt my jaw drop.  My shock must have been apparent.

"I have a thing about realtors.  They seem to be such operators.  I don't know how they can live with themselves.  The way they jerk people around, I'm surprised more of them aren't shot."  Vanessa settled into her chair and glared at me. 

She was tall.  Anyone over five-six seems tall to me.  I estimated her at five-ten or five-eleven, and she was thin.  She carried herself with grace.  Shoulder length honey-blond hair and bright blue eyes set off her fine features.

"I hope Amelia doesn't notice your attitude.  She was a nurse.  You won't put anything over on her."

"Amelia and I get along.  I keep my feelings to myself.  If it were a problem, I'd call another therapist to come upstairs and take care of him.  But a patient is a patient, so why not?"  She held out her device so I could review the ventilator data.  She knew I liked to know everything about my patients.  "He's stable, and he's triggering the ventilator, though he can't breathe on his own for more than a few minutes."

"His doctors are trying to wean him?"  I was surprised.  The critical care nurse told me the pulmonologist believed Hutchinson would never get off the vent.

"No, I took him off for a few minutes yesterday.  I wanted to see how he would do."  She flipped to the next screen of the chart.

I raised an eyebrow and stared at her, but she avoided my gaze.  We'd been friends and co-workers a long time.  She'd managed to get rid of an abusive husband and was starting to get her life on track.  She lived in a shelter until her ex left town, then she rented a small apartment.  Over the years, she squirreled away enough money for a healthy down payment on a townhouse and was in the process of making a purchase.

"I don't think you should take Hutchinson as your patient again," I said.  "Play safe.  Don't aggravate yourself."  Her actions concerned me.  Typically, a patient was given trial periods off the ventilator under a physician's direct order.  If something happened when he was off the vent without an order, Vanessa would be responsible.

"You're right.  Of course, you're always right."  Vanessa's voice hardened.

She left the unit, and Connie finished giving report.  I dumped the rest of my morning coffee in the sink and went into Hutchinson's room.  Amelia sat at his bedside.

"Morning, Amelia.  Hope you had a restful night."

"Thanks.  I did.  I went home earlier than usual and slept most of the night.  It gives me peace that Barry has improved enough to be out of critical care."

Interesting, I thought.  She must have known we moved him because the doctors and the HMO didn't think he'd get better, and they didn't want to waste resources.  The plan was to get him discharged from the hospital and into long-term care, with or without his ventilator.

With Amelia watching, I assessed her husband and measured his vitals.  There was no change from the previous day.  I stood in the room while I made an entry in the record.  From her pensive expression, I assumed she wanted to talk.  When I finished charting, I pulled a chair next to her.

"What's on your mind, Amelia?"  I touched the older woman's hand.  It felt cool and dry. 

She was dressed in layers again, though today she was more casual in loose knit slacks and matching tunic and sweater.  There were embroidered appliqués of sailfish on all of the pieces.  You see the style on the early bird dinner crowd.

"I asked Barry for a divorce—before they shot him."

"I didn't know."  I studied her, trying to understand why she was telling me.  "You seem attentive to him."

"I had a change of heart.  We didn't get along at home for a long time, though we did okay working together.  I decided to be a realtor because I thought we'd see more of each other and maybe get along better.  He was one of those men who did whatever he wanted.  Sometimes he wouldn't come home until late.  He never called and told me he wasn't coming home, and he went drinking with his friends.  I sat and waited and cried and worried.  He'd get home, and I'd be glad he hadn't been killed in an accident or something.  I'd be mad at him for what he put me through, and I'd scream and yell at him."

"Doesn't sound wonderful." 

As pools of tears filled her lower lids, I tried to understand why a woman would tolerate that behavior.

"It wasn't good," she said.  "After I asked him to find another place to live, that I wanted a divorce, he stayed out even more.  At work, he ignored me or treated me like hired help.  I missed him, wished he were home.  I realized I loved him."

"Did you tell him?"

"Not at first.  A few days before he was hurt, I told him I loved him and asked him if we could try again."  She streaked her mascara as she rubbed at the tears.

"What did he say?"  I took a tissue from the tiny box on the overbed table and handed it to her.  She made a bigger mess of her face before putting the tissue in my outstretched hand.  I dabbed, cleaned, and repaired her makeup with some success.  Then I focused on her eyes, wanting her to answer the question.

"He didn't say anything.  He patted me on the head, as if to tell me to be a good little woman, and turned around and left.  When he did come home, he had been drinking.  As always, he denied it."

"And?"

"He repeated things that had been said before.  He knew someday I'd ask for a divorce, and he was ready.  He was tired of my screaming.  That was why he never came home.  I told him my yelling was because he wasn't around.  He had it backwards."

"Did anything get settled?"  In nursing school, we learned that patients and families confide the intimate details of their lives while they’re in the hospital.  It's true.  People tell nurses things they wouldn't tell their best friends.  Being in the hospital increases their vulnerability and their need to talk. 

"Not really, but he came home on time the next few nights.  Then he was shot."  She squirmed in her chair.  "I don't know why I'm telling you all this.  I guess I feel guilty.  Now, look at the position I'm in—no husband, no agency, and no money.  I don't know what I'm going to do."  Amelia continued talking.  She mentioned the business, her son, and her daughter who died at a young age. 

When she relaxed into her chair, I went about my work.  It stuck in my mind that the picture Amelia painted didn't seem complete.  Maybe she changed her mind because she was afraid to be alone, maybe because she didn't have money of her own, but I didn't think she loved him.  How could she after the years of neglect and emotional abuse?  I wondered if Hutchinson got himself a girlfriend.  If so, would she come to see him?  I'd keep my eye out for strangers.

I spent most of my day discharging patients, which is often the state of affairs on Fridays.  Near dinnertime, the charge nurse suggested I give report to another nurse and leave early.  I didn't argue.  I was off for the weekend. 

I hurried home, showered, pulled on a pair of stretch jeans that fit low on my hips and exposed my belly button ring, added a spaghetti-strapped tank top, and headed for the mall.  Being small-boned and nearly flat-chested, I can wear youthful styled clothes without having bra straps show.  Bras to me have always been optional equipment.