Code 15 (2 page)

Morgan pulled off her gloves and noted the time.

“We’re done here,” she announced in a monotone. “Make the time of death ten past nine.”

Morgan stepped away from the bedside and pulled off her sterile gown and mask. She tried, but she couldn’t shift her eyes from Andy’s lifeless face. Over the past ten years she had seen death come in many forms. But the loss of Andy Kaine and what was soon to follow would remain rooted in her memory for many years to come.

In a hush that inevitably follows the unexpected death of a young, healthy person, the nurses and other health-care providers steadily made their way out of the room.

Morgan stayed for a time, eventually finding a seat on a scuffed-up plastic chair. The fact that Andy’s fate was almost surely sealed before the ambulance ever arrived was of little consolation.

Pam pulled up another chair and sat down beside her. “His girlfriend told the paramedics he was fine this morning. She saw him in the library studying for a marine biology exam.”

“Dr. Connolly,” came a hesitant voice from the doorway. “I know this is a lousy time but North Miami Rescue’s on the phone. They’re on scene of a bad car accident and want to speak with you stat about two injured kids.”

Morgan filled her lungs and then let the breath slowly escape.

“What now?” she muttered before turning around and heading out of the room. When she reached the nursing station, the unit secretary handed her the red phone, which was used exclusively to communicate with the paramedics in the field.

“This is Dr. Connolly.”

“This is North Miami Rescue, Doctor. We’re on scene of a motor vehicle accident. We have two pediatric patients who were unrestrained backseat passengers. Their vehicle was broadsided on the driver’s side. It took us twenty minutes to extricate them. We have them on backboards and would like to transport them to your facility.”

“What are their vital signs?”

“Pulse and blood pressure both within normal limits.”

“What’s their neurological status?”

“The younger one’s a little groggy. The older one seems okay. They’re both able to respond to my questions.”

“What are their ages?”

“Nine and seven.”

“Are they having any trouble breathing?” she asked.

“Negative, but the nine-year-old is complaining of some chest pain.”

“Anything else?”

“The seven-year-old is a little pale.”

“Can you identify any major injuries?” she asked.

“Not at this time.”

Knowing that paramedics tend to overreact when assessing injured children, Morgan said, “Both victims have normal vital signs and are breathing without difficulty. Is that correct?”

“That’s affirmative.”

“And both are alert and responding to your questions?” she asked.

“Yes, but we’d like to save some time by transporting them to Dade Presbyterian. We’re less than ten minutes from your facility.”

“Negative. We are not a state-designated pediatric trauma center. Both of your patients are stable. Transport them directly to Ryder Trauma Center per Dade County protocol.”

“Will do. Thank you, Dr. Connolly.”

Morgan replaced the phone and pushed back in her chair. She was just about to dictate a note documenting the events of Andy Kaine’s death when Pam approached.

“You’re not going to believe this,” she said in a hurried voice. “The paramedics are bringing in Andy Kaine’s roommate. He’s already got the rash.”

“How bad is he?”

“They said he’s still breathing on his own but his vital signs were borderline.”

“What’s their ETA?”

“About five minutes.”

“Are the parents here yet?”

“Patient Relations said that the mother is in the Far East on business. I’ll check with them to see if the father got here yet.”

“Let’s use the trauma room,” Morgan suggested.

“It’s already set up.” Pam turned and started to walk away. After a few steps, she stopped and turned around. “There’s something else you should know. This kid’s not just Andy Kaine’s roommate. He’s his brother.”

Well aware of what she would soon be faced with, Morgan came to her feet. Fearing the worst, but seeking no explanations for the injustice or making any pleas for divine intervention, she simply walked toward the trauma room, ready to do her job.

Waiting for any news regarding the condition of his sons, Mason Kaine, a muscular man with a jutting forehead that overhung narrowly spaced eyes, paced in front of the registration desk.

His apprehension mounting, he finally decided to find a seat among the countless others waiting restlessly for either medical attention or some news of their loved ones. Loosening his tie, he wondered why the hospital felt compelled to keep the emergency room’s waiting room so oppressively hot. Normally he wasn’t particularly sensitive to temperature, but the heat mingling with the foul scent of illness left his stomach in turmoil.

Ten minutes passed. His patience exhausted, he stood up and walked over to the same desk that he had already visited twice. He waited for the triage nurse, a frazzled-looking woman with washed-out and thinning silvery hair, to look up and acknowledge his presence.

“Excuse me,” he began in a measured voice, trying to put aside the irritation on her face, “I’m still waiting for information regarding my sons.”

“As I told you before, Dr. Connolly is very busy. She’ll be out to speak to you as soon as she can. Now, if you’ll just have a seat.” Without waiting for a response, the nurse looked back down at the chart that she had been working on.

Kaine looked down at his watch. “But you told me that the doctor would be out to see me at least—”

She raised her eyes slowly. Stopping after every word, she said, “It’s been a very busy night. We’re asking all family members to bear with us and be as patient as possible.” He watched as she craned her neck to see past him. He didn’t have to turn around to know there was somebody behind him. The nurse, now wearing a scripted smile, said, “Dr. Connolly will be out as soon as she gets a free minute.”

Before stepping aside, he looked over his shoulder. A pregnant woman seated in a wheelchair covered her abdomen with both hands. She tried, but the pain in her eyes was impossible for her to conceal. Begrudgingly, he moved aside. Seeing no other alternative, he returned to the long row of attached plastic chairs, sat down and placed his forearms flush on the armrests. He sighed in a way that betrayed his irritation. In addition to the dozens of people waiting to be seen, there were at least ten stretchers pushed against the wall holding patients who by all appearances had been abandoned. Directly across from him, a young mother with a fretful face pushed a blood-soaked hand towel against her screaming toddler’s forehead. Next to her, a man with pasty skin wearing a tattered white T-shirt hacked uncontrollably.

A civil, spit-and-polish man by nature, Kaine was not one to become easily unglued. Looking around at the despair and hopelessness that surrounded him evoked little, if any, sympathy. He had always believed that when mankind crawled out of the caves, they were equal. What happened after that depended solely on the individual’s skill and determination. Society was neither responsible nor made any guarantees. Compassion for the great unwashed, as he liked to call the less fortunate, was not an emotion he possessed.

Seeking any form of distraction, he turned and looked up at the fuzzy picture displayed on an undersized, wall-mounted television. After a minute or so he gazed back in the direction of the registration desk. He saw a young Asian man wearing green scrubs whispering to the nurse. When the man strolled back into the triage area, the nurse stood up and walked over.

“If you’ll follow me to the consultation room, the doctor will be right out to see you.”

Kaine stood up in silence. He followed directly behind the nurse, who escorted him to the small consultation room. The converted office was bare-walled and adorned only with a potted plant, a small upholstered couch and a wooden end table.

“Just have a seat,” she suggested. “It shouldn’t be too long.”

The nurse then stepped outside. He watched her walk back to the registration area where she motioned to a woman in a thigh-length white coat with a stethoscope draped around her neck. When the woman approached the information desk, the nurse pointed in his direction. He was too far away to read her identification badge but he assumed it was Dr. Connolly.

She started toward him. He studied her carefully through the open door as she crossed the waiting area. It wasn’t until she stood in the doorway that he could see the unmistakable look of doom in her eyes.

“Mr. Kaine, my name is Dr. Connolly.” Morgan noticed the skin covering his forehead roll into fine parallel troughs.

“How are my sons doing?”

Morgan took a few steps closer before continuing, “Jason and Andy arrived about forty-five minutes apart. They were both suffering from advanced meningitis. Their vital signs were critically unstable.” Kaine said nothing. He folded his arms and took a broad-based stance squarely in front of Morgan. She could feel his slate gray eyes transfixed on her like a powerful beacon. “The infection was far advanced and overwhelming. We began full cardiopulmonary resuscitation immediately. Unfortunately we were unable to—”

“Cardiopulmonary resuscitation? Excuse me, Doctor. Are you trying to tell me both my sons died?”

With no intention of doing so, Morgan averted her eyes for an instant. “I’m . . . I’m afraid so. I’m very sorry, Mr. Kaine. We did everything possible, but we were too late. Perhaps if they had gotten here sooner, we—”

“I’m confused, Dr. Connolly. When Andrew and Jason arrived in the emergency room, were they or were they not alive?” Morgan was instantly taken back by the lack of shock or disbelief in his voice.

“They were alive, but as I said they were in profound and irreversible septic shock.”

“I understand, but I thought meningitis is curable with antibiotics.”

“In most cases it is. But sometimes the disease has progressed too far and there’s simply nothing we—”

“Did my sons receive antibiotics?”

“Of course,” she answered.

“Were you aware that both Andrew and Jason received the meningitis vaccine?”

“I wasn’t, but the present vaccine doesn’t cover every possible strain of bacteria that can cause meningitis,” she explained.

“And you’re quite certain you gave every medication possible to reverse the shock?”

Morgan was accustomed to denial in family members who had lost a loved one, but Mason Kaine’s behavior took on an odd and inappropriate note of resentment and antagonism she had never seen before.

“I assure you, Mr. Kaine. We—”

“My sons were perfect specimens. They were accomplished athletes. Neither of them was ever sick for more than a day or two in their entire lives. Now you tell me they’re dead? With all due respect, Doctor, this makes no sense.”

“Mr. Kaine, we’re familiar with treating meningitis. Most of the time we’re successful, but from time to time we run into a strain that . . .”

Kaine shook his head. His businesslike expression never changed. “I don’t believe you,” he announced one word at a time.

“I beg your pardon,” she said with total exasperation.

“I’m an educated man, Doctor. My sons were alive when they arrived in your emergency room. With expert medical attention, they should have survived. I don’t believe you’re being truthful with me.”

“I’m not sure I understand the implication of what you’re saying, Mr. Kaine.”

“There is no implication. I’m saying categorically that with proper medical care Jason and Andy should have survived.” He pressed his palms together, pulling his fingertips to his chin and then sending them out again until he was pointing directly at Morgan. “I’m saying you screwed up.”

“With all due respect, I’m not sure you have the medical expertise or . . .” Morgan stopped in mid-sentence and said nothing further.

Kaine said, “I’m well aware that fatal hospital errors are an epidemic in this country.”

Morgan took a few seconds to regroup. She quickly decided the last thing she was going to do was dignify his preposterous accusations by denying them or enter into a debate on medical mistakes.

“I understand how upset you must be, but I promise you, your sons received expert medical care.”

“My sons are dead, Dr. Connolly, so I guess we’ll never know the answer to that question.” Kaine’s stony glare never shifted from Morgan’s eyes. She didn’t feel physically threatened, but his intimidating demeanor made her uneasy. It was obvious her words were falling on deaf ears. Kaine dropped his hands to his sides. His voice never became louder but its added intensity left no possibility of misinterpretation. “I don’t believe you did everything possible. Absent your excuses, the obvious conclusion is that you failed to save the lives of two healthy boys.” Without waiting for a response, Kaine walked past Morgan. When he got to the doorway he stopped. “If you think this is over, you’re sadly mistaken. You have no idea who you’re dealing with, and if I have anything to say about things, you and this hospital are going down.”

Morgan had the presence of mind to realize that it would be an exercise in futility to say anything further. Maintaining her silence, she watched Kaine thunder out of the emergency room. Finding herself somewhere between rattled and appalled, she fell into a small love seat. In view of Mr. Kaine’s behavior, she had only one option available to her. She would report the matter to Arlen McMinn, the administrator on call. She had known Arlen long enough to know that his response would be to give Mr. Kaine some time to cool off and let Patient Relations handle the problem.

Trying her best not to think any further about Mason Kaine, Morgan closed her eyes and let her head fall back against the cushion.