Angels on the Night Shift (11 page)

That was enough. Now I knew what I had to do.

“Lucinda, this is very concerning,” I told her truthfully. “I’m going to make a few phone calls and we’re going to get you some help.”

Relieved at last, she leaned back on the stretcher and said, “Thank you, Dr. Lesslie. Thank you so much.”

When I got to the nurses’ station, I slumped into one of the chairs. Susan looked over at me, puzzled.

“Do we need to do anything for the woman in 4?” she asked.

“Would you call up to the behavioral med unit and see if one of the psych doctors is up there?” It was a long shot at this time of the morning, but we might get lucky.

A few minutes later, I was talking with Martin Childress, the on-call psychiatrist. He had happened to be upstairs handling a problem patient when Susan had called.

I told him about Lucinda Banks, hoping desperately that he might be willing to take a look at her.

When I finished describing her case, there was a long pause on the other end of the phone. I was trying to think of my next step, when Martin said, “Robert, that sounds fascinating. Let me finish up here with this patient, and I’ll be down and talk with Ms. Banks. Thirty minutes okay?”

“That would be great,” I said gratefully. “She’ll be right here in room 4.”

I hung up the phone, relieved and thankful for the help. And I was thankful that Lucinda Banks was going to get some help. She didn’t have lupus, or heart disease, or a blood clot in her lungs. She needed psychiatric help and not another lengthy and futile workup.

When Martin Childress came down the hallway a little while later, I picked up the chart for room 4 and handed it to him.

“Thanks again for seeing her,” I told him.

“No problem,” he responded, studying the front sheet of her record. “I’ll let you know what I find.”

He walked over to room 4, stepped in, and pulled the curtain closed behind him. I sat there, watching and listening for some explosion, some outburst from Lucinda. But the room remained quiet.

“Here,” Jeff said, sliding the chart of room 3 over to me. “Bobby Craddock. Eight-year-old with a sore throat and temp of 102.”

I picked up the chart, read his name, noted the complaint and the boy’s temp, and thought—
A sore throat. Thank you, Bobby Craddock.

Friday, 7:45 a.m.
Virginia Granger had been in her office with the door closed for the past half hour. That wasn’t anything unusual. What
was
unusual was that she had been meeting all this time with Walter Stevens, one of the hospital’s VP’s. I couldn’t remember what he was VP of, but I knew he was young and hadn’t been on the job for very long.

They must be discussing the department’s missing medication
. Nothing had turned up to explain the inconsistent narcotics count, and now the administration was involved. That certainly didn’t thrill Virginia.

Her door opened and she stepped partway out.

“Dr. Lesslie,” she called, getting my attention as I stepped out of the medication room. I had been washing my hands, looking out the window into the parking lot. I’d been watching a young mother herd her four young children toward the ER entrance and thinking that none of them seemed very ill. Maybe they were just visiting.

Virginia caught my eye, then motioned with her hand for me to join her.

I finished drying my hands, tossed the paper towel in the trash can at the nurses’ station, and walked over to her office.

She was just sitting down behind her desk when I entered. I closed the door behind me and walked over.

“Have a seat, Robert,” she said, motioning to the remaining chair in front of her desk. In the other chair sat Walter Stevens. He had on a long-sleeved white shirt and wore a bright-red bow-tie. In one of his hands was a legal pad filled with scribbled notes. When he noticed me looking down at it, he quickly flipped it over in his lap.

“Dr. Lesslie,” he intoned with an air of gravity. “It’s good to see you.”

He held out his hand and I shook it. I was struck once again by the damp weakness of his handshake. I had met the twenty-eight-year-old when he had first arrived at Rock Hill General. He had just finished his MBA program at some small school in eastern Kentucky and had struck me then as being a little too sure of himself, and a little too smug. Nothing seemed to have changed.

“Walter, good morning,” I told him, sitting down and turning to face Virginia. “What’s going on?” I asked the two of them.

The head nurse put her palms down on the desk in front of her and leaned toward the two of us.

“Walter and I have been discussing the matter of the missing narcotics,” she began. “And I think he may have some ideas.”

There was little enthusiasm in her face, and less in her eyes.

“What makes you sure they’re missing?” I asked. “I had hoped this was simply an oversight. Has there not been some simple explanation?”

“There is an explanation, to be sure,” Walter intoned. “But it is not simple.”

Virginia turned in her chair, reached behind her, and picked up a small box from the bookshelf behind her.

“Take a look at this,” she said, sliding the plastic-wrapped container over to me.

I recognized it immediately. It was a medication container—a two-and-a-half-inch cube shrink-wrapped in plastic. It contained 25 glass vials of some type of medication, arranged neatly in five rows of five vials each. The tops of the vials were all that was visible, the rest being surrounded by a paper box. Each vial was protected from the others by a thin, cross-hatched insert. One side of the container read
Demerol—100 mg
. I turned the box over in my hands, examining each side. It looked to be brand-new and unopened.

I thought Virginia might be testing me, and I thought of something. Looking down once more, I checked the expiration date. It was still current.

Putting the box down on her desk, I said, “Looks like a box of unopened Demerol to me, Virginia. Is there something important here?”

“You didn’t look quite closely enough, Dr. Lesslie,” Walter Stevens said, snatching up the box of medicine and holding it in front of me. He oriented the cube so that the bottom of it was right under my nose.

The guy was starting to get on my nerves, but when I glanced over at Virginia, she gave me a brief nod of her head.

Reluctantly, I looked once more at the Demerol, this time focusing more intently on the bottom of the box. Again, it looked fine to me, with the plastic perfectly in place. There didn’t seem to be any evidence of tampering, or of someone trying to open it.

Wait a minute.

“Let me hold that a second,” I said to Stevens, taking the box out of his hand and moving it around in the light.

There, just to the right of dead center. I looked closer, not wanting to believe this and needing to be sure.

But there it was—a small hole, almost invisible. And there was another one, about half an inch away. And another. I counted six holes in the bottom of the box. I flipped it over and examined the vials that were sitting above these holes, looking at them closely. Just what I was afraid of—they were empty.

I lowered my hand to the desk and looked up at Virginia. She was studying my eyes, waiting for my response, waiting for me to say something.

Looking down at the Demerol again, I said, “Very clever.”

Someone had taken a small needle and syringe and deftly sucked the Demerol out of six of the vials, spacing the punctures so the box still seemed balanced and full. And with a small enough needle, they wouldn’t have drawn any broken glass into their syringe.

“Very clever,” I mused again.

“Not clever, Dr. Lesslie,” Stevens said, once again taking the box from my hand and placing it on the table. “This is
criminal.
”

Cleverly criminal,
I wanted to say, having to bite my tongue to remain silent.

But he was right—this was serious business. We had a problem in the department, and it was bigger than I had thought.

“Have we checked the other medications?” I asked Virginia, fearing the worst.

“It seems this is the first one,” she answered quietly. “No other evidence of any tampering. But whoever did this has an intensity of purpose and will likely go to extremes to get what they’re after.”

“And we’ve narrowed our list of possible suspects to just a few people,” Walter added, leaning back in the chair and bridging his fingers, spiderlike. “Just a few,” he repeated for emphasis. He studied my eyes for some response, then looked up at the ceiling, apparently absorbed in a moment of obvious self-satisfaction.

I looked away and once more focused on the package of Demerol. It had to be someone with access to the narcotics cabinet, so that did narrow the number of possible suspects. But still, that would be a dozen or more nurses. The narcotics keys were handed off at the beginning and end of each shift, so there was an opportunity there for someone to put his or her hand on them. But the nurses were always careful with the keys, and they all understood how important this whole issue was. Their licenses and employment might depend on it.

“Let me tell you how this sort of thing works, Dr. Lesslie,” Walter began, assuming the tone of one of his MBA professors. “It’s very much like a case of embezzlement. The perpetrator has to fulfill three definite and specific criteria. First, they must have a need. This is almost always financial in nature. Secondly, they must have access—in this case, to the medication room and narcotics. And lastly, they must be able to rationalize their actions, overlooking the criminal nature of their activity and somehow justifying it. For some people, that’s the easy part.”

He paused, looking at me again, seeming satisfied with his fund of knowledge.

“Is it possible that the
perpetrator,
as you call them, might have a drug problem?” I asked him. “Maybe that’s the case rather than a financial need. After all, these are small quantities of drugs we’re missing, hardly a major deal on the streets of Rock Hill.”

Out of the corner of my eye, I could see Virginia slowly nodding her head. But she remained silent.

“No, that’s not the case here,” Stevens said emphatically. “Whoever is stealing drugs from the ER is doing so because of money. They are selling whatever they can get their hands on and will continue doing so until we catch them. And that’s what we’re going to do. In fact, we—”

He stopped short, pursed his lips, and looked away from me.

“You’re going to what?” I asked, curious where this last statement had been headed.

Walter slapped the armrests of his chair, stood up, and with an air of finality said, “Virginia, I’ll be back with you in a couple of days. And we need to be sure this stays quiet. Not a word to any of your staff.”

He glanced in my direction, and I thought there might be a hint of a warning in his eyes.

“Dr. Lesslie, good to see you as always.” And with that, he turned and walked out of the office.

Virginia looked up at me and shook her head.

“Where do they find these people?” she asked in frustration. “You heard just a few minutes of it, but I’ve been in here for half an hour.”

“What do you think he’s talking about?” I asked her. “Who has he narrowed this down to? He seems so certain, but nobody comes to my mind. I can’t imagine any of our people doing this. Yet…”

“Yet, it’s happening,” she finished my thought. “But he hasn’t given me any specific names, just that he’s got a good idea of who’s doing this. He says he only needs a little more time and that he’s ‘gathering more information,’ whatever that means. Anyway, it will be interesting to see what he comes up with. Maybe he knows something that we don’t. And if he can help solve this, I will be glad for his assistance. We need to put a stop to it.”

She was right about that. I stood up and walked to the door. Before opening it, I turned to her and said, “I might talk to Lori Davidson about this. She already knows about it, and she has a good read on people. Maybe she has an idea.”

Virginia nodded her head and then pulled a pile of papers over in front of her. Without saying another word, she adjusted her glasses and went back to work.

At the nurses’ station I was greeted with a “4-fer”—four patients for the price of one. The clipboard of room 5 held the charts of the four children I had seen heading into the ER. I guess they weren’t visiting after all, but were now my patients. I looked down at the complaint written on the top chart, and then quickly at the other three.

Pinworms.
Great.

I picked up the charts and was about to head to room 5, when the EMS radio came to life.

“Rock Hill ER, this is EMS 2.”

Lori Davidson was standing beside Amy and she reached over and pushed the speakerphone button.

“EMS 2, this is the ER. Go ahead.”

There was some painfully loud crackling, and Amy leaned over to adjust the volume.

“ER, we’re on the way in with a traumatic arrest—twenty-two-year-old woman,” the paramedic told us. It sounded like Denton Roberts, and he was out of breath or excited, or both.

I stopped where I was, put the charts back down on the counter, and glanced up at the clock—
9:15 a.m. It was early in the day for a traumatic arrest,
I thought.
Must be an auto accident.

Lori was writing on a pad of paper beside the radio, shaking her head.

“Did you say ‘twenty-two-year-old’?” she asked the paramedic.

“Yes,” he responded. “Twenty-two, and pregnant. About thirty-eight to thirty-nine weeks.”

Lori and I looked at each other. This last piece of information changed everything.

I leaned closer to the receiver and said, “Tell us what you have.”

“Doc, this is Denton Roberts,” he identified himself. “We’re out on Cherry Road, two or three minutes away. Open head injury with no responses at all. I don’t see any other obvious injuries. Blood pressure is 100 over 60 and her pulse is 110. Can’t tell anything about the baby—too much noise to hear fetal heart tones.”