Deadly Diversion: A Medical Thriller (22 page)

“I wish I could be more helpful, Serena,” I said as I scanned Kleinfeldt’s latest lab results, “but I can’t. Why don’t you ask one of your instructors?” Another EEG had been ordered on Kleinfeldt for today; maybe the brain scan would confirm the inevitable.

“I can’t talk to them.”

I shut Kleinfeldt’s chart. “Why not? That’s what they’re there for, isn’t it?”

Tears clouded her eyes.

I took her arm and gently led her into the conference room. “Now. What’s this all about?” I asked after shutting the door.

“Do you have to tell the truth?” she asked, wiping her eyes with stubby fingers.

I didn’t know what questions were on the application these days. All I remembered from mine was that it asked if you’d ever been convicted of a felony. We’d had one student who’d asked if a speeding ticket counted. It hadn’t.

“Could you go to jail if you didn’t tell them everything?” Serena asked.

“You need to answer the questions honestly. I don’t think you have to volunteer anything that’s not on the application. Does that help?” After she didn’t respond I asked, “Are you in trouble, Serena?” I asked.

She pushed back her chair. “Right. Thanks.” She gave me a quick smile as she scooted out the door.

Quirky though she was, Serena had the natural talent for nursing. She caught on quickly, seemed to enjoy learning, and had a genuine warmth for patients that I’d seen too seldom lately. How she’d do when she had to carry a full patient load after she graduated, I didn’t know. But she had a good start. And I hoped she didn’t have something in her short life that would prevent her from getting a license to practice nursing.

“SLOW DAY?” I asked Wanda, stopping by her office on my way back from lunch. She had a large textbook open on her desk and was eating a cheese sandwich.

“Trying to get a little studying done while it’s quiet. Pull up a chair and take a break.”

“I’ve got a question for you. An anesthesia question.”

“I’ll try. It’s my first year, though.”

“Succinylcholine. What do you know about it?”

“It’s a neuroblocker we use routinely in surgery. We give it along with the anesthesia to put them to sleep. It paralyzes the muscles.”

“All of them?”

“Well, sure. You don’t want someone’s arm to snap up and punch the surgeon in the eye, do you?” she added, chuckling.

“Is that what would happen?”

“I’m exaggerating. But they’re not specific to any one muscle group. It’s all or none. Why?”

“I’m trying to figure out how it works.”

“That’s why we have to intubate them and ventilate them mechanically. The respiratory muscles are paralyzed, too.”

“What happens when the surgery’s over?”

“We reverse it—using an antagonist—and the patient has his muscles back.”

“Like we give Narcan for an overdose of narcotics.”

“Exactly.”

“And if you didn’t give the antagonist? The patient wouldn’t be able to breathe, right?”

“Right, again,” she said. “Do you remember that advanced critical care course we took? Remember the guy with a heart transplant?”

“Oh, yes, the one with the hole in his chest.”

“They had to leave the chest cavity open until the swelling went down so they paralyzed him with pavulon, I think, that’s another paralytic agent used sometimes. He was on a vent to keep him breathing. Didn’t you think it was really strange to look into his chest and see the heart pumping?”

“And keeping out infection was a challenge, I remember.”

“Yes and that should remind you how neuroblockers work.”

“Is succinylcholine controlled?” Controlled substances, also called scheduled drugs, are those under the jurisdiction of the Drug Enforcement Agency.

“It doesn’t need to be. No one would use it to get high.”

“So where is it kept? Is it at least locked up somewhere?”

“Sure. It’s in the med room behind the supply room on the second floor. Right outside surgery. All the anesthesia meds are locked up in there.” She tossed her sandwich wrapper in the trash can. “Why do you want to know all this, Monika? You thinking about anesthesia school? I’ll tell you, it’s the way up. Lots more money. Better hours. And...” she stopped and smiled, “the patients don’t argue with you.”

I hesitated. Wanda was a vital cog, I imagined, in the gossip machine. Finally, I explained. “Just that a patient had a respiratory arrest and they can’t seem to find out why he died. Someone suggested succinylcholine, but I can’t imagine how he could have received any.”

“Who was the patient?”

“You wouldn’t know him.”

“You know, Monika, sometimes we just don’t know why someone dies. Especially when they’re terminal. Maybe they just give up.”

“I know. I’ve seen people die who shouldn’t have. And some live who we didn’t expect to make it. We all know patients who struggle to stay alive until that something they are waiting to happen, happens.”

“Like a son graduates or a grandchild is born.”

“Exactly.”

“Monika, let it go. Don’t you have enough to do without getting all worked up about someone who’s not your patient anymore?”

“I just can’t, Wanda. I have to find out how it happened.”

“Suit yourself.” She turned back to her book.

TWO MEN WERE POSITIONING a large vending machine against the wall when I entered the supply room. They grunted as first one, then the other, shoved his side a fraction farther. Finally, they stepped back.

The machine held a stack of scrubs—pants on the bottom, tops up above. A panel on the right indicated the choice of sizes. Color wasn’t a choice. They were all puke green.

“Want to try it out?” the heavier of the two men asked me.

I came closer. Four dollars each. “Sorry. No money.”

The men began moving the scrubs from a linen cart into the cabinet.

A surgical tech came in and grabbed a scrub top off the shelf the men were emptying.

“That’s the last one you get for free,” the hefty man told her.

“What?”

“See that.” He pointed to the newly installed machine. “From now on, you gotta buy them.”

She glanced at the machine and then looked at me. “Can you believe this? Charging us for scrubs now!”

“Too many of them walked out of here,” the man told her.

She stood there a moment, then reached over and grabbed a handful of tops and pants and hurried away.

The men shook their heads.

I went through the connecting door to the medication room Wanda had told me about. A floor-to-ceiling cabinet ran the length of the opposite wall. Rows of medications, in packets, jars and vials, were visible through the glass doors. It was under lock and key all right. The key protruded from the lock.

EIGHTEEN

Thursday, 16 August, 1432 Hours

“I’M HERE TO TALK about Huey Castle,” I began, settling myself in Father Rudolf’s small office next to the chapel.

“I wish he could have seen those detectives. I think it would have put his mind at ease.” Rudolf fingered the multicolored paperweight on his desk, rubbing its polished finish as I went on.

“That’s what I want to know about. What was it he was going to tell them? He told you, didn’t he?”

Rudolf jiggled around in his seat. “I don’t know if I should say.”

I stayed quiet. I wasn’t under any illusion that he’d just blurt it out.

“It wasn’t a confession, if that’s what you’re thinking. But it was confidential,” he said finally.

“And now he’s dead.”

“He was worried about that.”

“About dying?”

“He said he was afraid he’d stop breathing and you wouldn’t resuscitate him.”

“He told us that, too, but I assured him that we would do everything to keep him alive although I did try to talk him into signing an advance directive.”

“So you tried everything you possibly could to save him?”

“We did it all.”

“Perhaps it was his fear of dying that made him so anxious that you might not revive him.”

“Be that as it may, I’m here to ask you about what he wanted to tell Harding.”

“I don’t understand, Monika. How could what he wanted to talk to the police about have anything to do with his dying?”

“That’s what I’m trying to find out.”

“Did someone slip him some booze? That might mix with the drugs, couldn’t it?”

“His blood alcohol was negative and narcotics high but not lethal. But now the medical examiner has labeled his death suspicious and one of my nurses is under suspicion.”

“Oh, my,” he said, his hands flying to his face. “I’ve been away. I didn’t know.”

I shifted forward. “What he was going say to the police? You know, don’t you?”

“I promised, Monika.”

“Let me ask you this. What do you think Huey would want you to do? Help find out how he died, or keep quiet because you’d promised not to tell anyone?” I’d said everything I could think of to convince Rudolf to tell me. Now it was up to him.

He shined the paperweight with the back of his sleeve. “All right,” he said at last. “It won’t make that much difference because he told me very little.” He shifted in his seat. “And I can’t imagine it having anything to do with his death. No one would bother killing him. They didn’t need to. All they had to do was wait a little while. They wouldn’t take the risk.”

“So what’d he tell you?” I asked, getting antsy as he digressed.

“He knew something about a murder twenty years ago.”

“Knew something? Like who did it?”

Rudolf shook his head. “He didn’t say.”

“Did you ask him?”

“He said that the less I knew, the better. I told him I knew a police detective and I’d bring him to see Huey. I knew we didn’t have much time.” He leaned back and his chair creaked. “Life wasn’t easy for him. You know how he lost his arm, don’t you?”

“I assumed it was a war injury.”

“He threw himself on top of a land mine to save his buddies.”

I caught my breath.

“He got a Purple Heart for it. But when he got home from Vietnam it was the time of the protests. There were no war heroes, then. Here he was, permanently wounded, and they couldn’t even fit him for a normal-looking prosthesis because too much of his arm was gone. That’s why he had that hook. He couldn’t get a job—no rights for the disabled then. He got into drinking pretty heavy, did some gambling, and then he ran afoul of the law, as they say.”

“He told us he was a pickpocket, by profession.”

“That was Huey. Everything was a joke to him.”

HER PLACE WASN’T EASY to find in the dwindling light. I’d gone home for supper and to feed Cat and by the time I’d changed into shorts and a T-shirt and figured out what I wanted to do, the light was fading. The temperature was still in the nineties and we could expect more of the same tomorrow, the weather station had predicted.

I found a parking spot in front of her building. As I stepped out of the car I noticed the red glow of a cigarette near the porch.

“Uh, am I taking your parking spot?” I asked the shadow seated on the top step.

“That’s okay,” she answered with a heavy European accent.

“I won’t be long, I promise,” I told her.

She scooted over so I could pass her on the steps, and she resumed her contemplation.

Inside, the building smelled like grease, onions and cabbage but it wasn’t unpleasant, just strange. I found CASTLE printed on a tag on the mailbox. Number 2A.

Mavis let me in with a sigh and waved toward a worn sofa under the front window. Paperback novels—their telltale covers displaying ripped bodices and long gazes—covered end tables and a coffee table and spilled into piles on the floor. A film of fine gray dust coated the tops.

Mavis’s hair had been cut and sported the telltale brown of a home color kit. She wore a man’s shirt—originally white but now a dishwater gray—with the sleeves rolled up and the top button missing, blue-and-white polka-dot boxer shorts and neon-pink flip-flops. She sat down in an overstuffed chair at right angles to the sofa, pushed on the arms and fell back to a reclining position. She asked me what I wanted.

“It’s about Huey.”

“That sonofabitch!” The recliner popped back up. “That asshole! He cheated me. All those years I worked when he couldn’t. Or didn’t. And now this.” She pulled a pack of cigarettes out of her pocket and lit one with a kitchen match. She blew out the smoke with force. “I hope he rots in hell.”

When I didn’t say anything, she went on. “That bastard cashed in his life insurance, that’s what he did. A long time ago. And I went right on supporting him, thinking at least someday I’d have enough to quit working.” She stubbed the newly lit cigarette out on a paper plate dribbled with watermelon juice and seeds. The cigarette sizzled for a moment and went out.

“I’m sorry to hear that.”

“You’re sorry! I hope that little twerp...” She choked back a sob. “Oh, what am I saying? I loved the little bastard. He just couldn’t stay away from the casinos. Or the women.” She sniffed. “I just don’t know what I’m going to do now.”

She pulled a tissue out of her pocket and blew her nose. “At least I’ve got this building,” she said, looking around. “It was my grandparents. I grew up here in the apartment right below this one. ’Course it’s changed now. Lots of foreigners. They don’t bother me none. Gotta live somewheres, don’t they? Better than where they came from. Bosnia, you know.”

“I’m here to ask you about something.”

She wiped her face and stowed the tissue between her leg and the chair arm. “What do you want to know?”

“It’s about what Huey wanted to tell the police.”

She studied me but didn’t say anything.

“He knew something about a.. .a death.” I let the words hang in the air.

“Why do you want to know? You think someone killed him? I thought the cancer got him, the little twerp.”

“That was probably it,” I said. “I’m just following up. I’m curious is all.” If she thought there was something strange about a nurse following up about what a dead patient knew about a long-ago death, she didn’t say it.

“I guess it couldn’t hurt now. He can’t testify against anyone, and they can’t hurt him.” A sheen of tears clouded her eyes, and she pulled the used tissue back out and blew her nose, looking at the results before stuffing it back into the crack in the chair.