Baby Girl Doe (Stephanie Chalice Thrillers Book 5)

Everyone deserves a well-earned vacation, don’t they? Guess again!

Plans have been made and the bags are packed but Detective Stephanie Chalice is having about as much fun as Michael Vick at an ASPCA fundraiser.

The new story finds Chalice and Lido on the East End of Long Island, vacationing with Max, their new arrival. Things go wrong from the very start. Their vacation rental burns to the ground, bodies pile up, and just to make things interesting, Lido . . . All I’ll say is that you’ll never believe it.

Chalice may be out of her jurisdiction but she's never out of questions or determination and soon connects two unsolved homicides. As always, the whole is greater than the sum of its parts, and her initial findings plunge her deeper and deeper into the most extraordinary investigation of her career.

Baby Girl Doe

Stephanie Chalice Mystery #5

By

Lawrence Kelter

Baby Girl Doe Copyright © 2014 by Lawrence Kelter

All rights reserved.

No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by information storage and retrieval system, without written permission of the Publisher, except where permitted by law.

This book is a work of fiction. Names, places, characters, and incidents are the product of the author’s imagination or are used fictitiously. Any resemblance to events, locales, or persons living or dead, is coincidental.

Editing by

Jan Green of thewordverve.inc

Interior book design by

Bob Houston eBook Formatting

For

Dawn and Chris

The author gratefully acknowledges the following special person for her contributions to this book.

As always for my wife Isabella for nurturing each and every new book as if it were a newborn child, and for her love and support.

Baby Girl Doe

Stephanie Chalice Mystery #5

Lawrence Kelter

“Words have no power to impress the mind without the exquisite horror of their reality.”

~~Edgar Allan Poe~~

April 18, 1985

Dr. Simon Van Zandt approached the nurse’s station and picked up the telephone.
Perspiration trickled from his temple while he waited for the head of obstetrics to answer his call. The phone rang eight times before transferring his call to the answering service. Van Zandt clicked the receiver without leaving a message and paged Dr. Mark Finkel.

“I don’t like her color,” Nurse Hastings said as she rushed to Van Zandt’s side. Her BP is dropping.”

“How low?” he asked.

“Sixty-two over fifty-one.”

“It’s down since the last time I checked it.”

The elevator clanged. Van Zandt whipped his head in the direction of the elevator and waited for the doors to part.

Mark Finkel was no more than five-and-a-half-feet tall, a mere tea sandwich of a man but he bounded out of the elevator with the confidence of a giant. “You paged me?” he asked making no attempt at pleasantries as he encountered Van Zandt at the nurse’s station. “What’s going on?”

“Thirty-three weeks pregnant with twins,” Van Zandt began. “The patient arrived with prematurely torn membranes. BP is sixty-two over fifty-one and falling. She’s been in active labor since she arrived, but the pregnancy hasn’t progressed.

“And the babies?”

“One heartbeat is strong, the other is slower and weak,” Van Zandt said. “I’m thinking possible anaphylactoid syndrome.”

“Rare,” Finkel commented after a moment of thought. “But I’m glad you called me. Is she on oxygen?”

“Yes. She’s showing some signs of dyspnea but I’m not sure it’s abnormal.”

“Labored breathing? History?”

“This is her first pregnancy.”

“Is her husband in the delivery room?” Finkel asked.

“No.” Nurse Hastings replied. “We’ve been trying to reach him, but we haven’t had any luck. She got here on her own.”

“Christ,” Finkel swore. “All right, let’s have a look.” They walked briskly to the delivery room. He took one look at the patient, turned to Hastings, and whispered, “Prepare for an emergency C-section. What’s the patient’s name?”

“Caitlin Alden,” Hastings replied.

Finkel leaned over the hospital bed and put his hand on the patient’s forehead as he began to speak. “Caitlin, I’m Dr. Mark Finkel, chief of obstetrics. How are you feeling?”

“Nervous and weak,” she replied. “I can’t control my breathing. Are my babies all right?”

“Yes, your babies are fine,” Finkel said, “But your pregnancy is not advancing as quickly as we would like, and it might be a good idea to consider a C-section. Are you all right with that?”

Caitlin thought for a moment and then nodded. “Please, Doctor. I’m worried about my babies.” She began to cough and cry at the same time. “Do what you think is best,” she said weakly.

“Pitocin didn’t strengthen your labor, so I agree with Dr. Finkel,” Van Zandt reassured her. “Cesarean is our best option.”

Caitlin’s coughing increased in frequency. Van Zandt turned to Finkel with a knowing look in his eyes.

“I don’t think there’s any point in waiting,” Finkel said. “I’ll scrub and assist Dr. Van Zandt.” He smiled encouragingly. “Let’s deliver those twins right now.”

Nurse Hastings replaced Finkel at the patient’s bedside. “We’re going to give you a little Versed in your IV to make you more comfortable and then the anesthesiologist will administer an epidural. Do you know what that is?”

Caitlin nodded nervously and continued to cough. Everything was moving so quickly. “Do what you need to do,” she said.

Van Zandt assisted the nurses in preparing Caitlin for surgery. “One of the heartbeats is strong,” he said to the patient as he helped prepare her for transport to the OR. “The other is a little weak. I want to get the twins out as soon as possible.”

“Did you reach my husband yet?” she asked with urgency.

“We’ll keep trying, Caitlin.” Hastings checked her watch. “It’s almost six. I’m sure he’ll be getting home from work soon. One of my nurses will keep calling your home.”

“Thank you,” Caitlin said gratefully. She looked up toward the ceiling and took a deep breath. She suddenly grabbed Hastings’ hand and began to cry. “I’m really nervous.”

A courageous smile was part of Hastings’ everyday repertoire. “Your babies need you to be brave. Can you be brave, Caitlin?”

She nodded as the syringe of Versed was pushed into her IV. Her eyelids fluttered and fell. They were barely open as she was rolled to the OR.

“Have we heard from her husband yet?”
Finkel watched as the OR nurse cleansed Caitlin’s abdominal area and covered it with a sterile dressing.

“Not yet,” Van Zandt responded. He was checking the instruments on the surgical tray when he noticed a tremor in her arm. He got Finkel’s attention and motioned toward her shaking arm. “Did you see that?” he whispered.

“Yeah,” Finkel said unhappily. “Involuntary tremor—you made the right call. This is looking more and more like an amniotic fluid embolism.” He tapped his finger on one of the monitors. “Her blood gasses are deteriorating. We’d better hurry.”

Van Zandt looked at his patient’s face. Her eyelids flitted for a moment and then closed. “She’s practically unconscious. She shouldn’t be that relaxed from the Versed alone.”

“Heart rate just fell below fifty, Doc,” the anesthesiologist warned.

“Push one milligram of atropine,” Van Zandt ordered. He picked up a scalpel and looked at Finkel. “Ready?”

“How are the babies?” Finkel asked.

“One heartbeat is a steady 150. The other one is only at 85,” the obstetrics nurse said with concern.

“Making the incision now,” Van Zandt said as he cut through the flesh on Caitlin’s lower abdomen just above the pubic hairline. “I’ll use a transverse incision to open the uterus. Suction ready?” he asked as he glanced at the nurse from the corner of his eye.

“Ready, Doctor,” she replied.

Van Zandt’s hands moved deftly. “Okay, I’m in.
Suction,
” he said firmly.

Finkel reached in and removed the first child. Fluid was suctioned from the baby’s mouth and the newborn began to cry immediately. “It’s a girl,” he said enthusiastically, hoping that Caitlin would hear him and react to the good news. “A healthy baby girl. He clipped the umbilical cord and handed the baby to the nurse. “Here comes number two.” He reached in. “Scissors,” he shouted. “The umbilical cord is wrapped around the baby’s neck.” He reached in, snipped, and unwound the cord. He lifted the baby out and handed it to a second nurse. “It’s a boy,” he boomed. He turned aside to the nurse, “I don’t like the baby’s color. Get him on oxygen right away.” The tremors in Caitlin’s arms became more intense and frequent as the second baby began to cry in the background. Her head twitched and then began to shake uncontrollably.

“Push another milligram of atropine, STAT!” Van Zandt barked as he removed the placenta.

“Heart rate is forty bps. She’s in bradycardia,” the anesthesiologist said. “The atropine isn’t helping.”

“One milligram of epinephrine,” Finkel said quickly. “Ready the crash cart.”

The anesthesiologist had his eyes glued to the heart monitor. “Heart rate is still dropping. I’ve lost her pulse.”

“Shit! How are you doing?” Finkel asked Van Zandt. “Get her closed up.” His eyes darted back and forth between the heart monitor and the incision site. “Begin CPR.” He looked up at the anesthesiologist. “I need external left jugular access and a right femoral triple lumen catheter. Finkel’s hands moved quickly and delicately. The catheter was readied and inserted. “I—”

“Getting worse,” the anesthesiologist announced. He held his breath for a moment. “Damn! She’s in V-fib.”

“I’ve got her closed up, but she’s still bleeding from the incision site,” Van Zandt said.

“Charge paddles to 200 joules. Clear!” Finkel applied the paddles to Caitlin’s chest.

“No change,” the anesthesiologist warned.

“Charge to 300,” Finkel shouted. “Come on, lady. Come on.” He readied the paddles. “Clear!”

Bill Alden burst through the doors into the hospital emergency room and rushed to the reception counter.
“Caitlin Alden,” he cried. “I got a call; my wife was admitted with pregnancy complications,” he explained, panting and out of breath. “How is she?”

“Let’s have a look,” the receptionist said as she pecked at the computer keyboard. She picked up the telephone. “I have Bill Alden here in emergency . . . Okay. Thank you.” She put down the telephone. “We’re trying to locate Dr. Van Zandt. He’ll come down to speak with you as soon as he can. Why don’t you have a seat over there?” She pointed to a row of chairs. “I’ll call you as soon as he arrives.”

“Can’t you tell me anything?” Alden protested. “I’m half out of my mind.”

“I just came on duty, sir, and the only information I see on the system is to contact Dr. Van Zandt. I’m sorry.”

Alden sighed. He looked over at the unoccupied chairs and reluctantly walked toward them. He plopped down and buried his face in his hands. He checked the wall clock and noted the time, half past eight, several hours since the first message had been left on their home phone.
Christ, I blew it this time. I really blew it. God, I hope she’s okay.
His stomach growled.
What the hell did I do?

He glanced at the clock again hoping that he could will the doctor to his side. A deep ache developed in his jaw from clenching his teeth.

How long was I out?
All he could remember was awakening from a stupor to see the sun setting over the Atlantic.
I can’t do this anymore, not now, not with children. I just can’t.

“Mr. Alden.”

He looked up and saw that the receptionist was beckoning to him to approach the reception counter. “Yes?” he asked before reaching her.

“Dr. Van Zandt is waiting for you on the fourth floor. You can take the elevators just down the corridor,” she said as she pointed out the direction. “He’ll meet you at the nurse’s station.”

“Fourth floor. Got it. Thank you. What’s the doctor’s name again?”

“Van Zandt. Dr. Simon Van Zandt.”

“Great. Thanks,” he said as he hustled down the corridor. He squeezed into the elevator with a hospital attendant who was wheeling an empty bed, and pressed the button for the fourth floor. He smiled quaintly and received an equivalent smile in return from the man who had the word
Morgue
embroidered on his hospital jacket. His heart began to thump within his chest.

He tried to think about his babies to mask his guilt and worry. He pictured his son as a little leaguer deep in the outfield tracking down a fly ball. It helped to ease the tension. The intense ache he felt in his jaw lessened. The doors parted, and he sprang toward the nurse’s station. “I’m here for Caitlin Alden. I’m her husband.”

“I’ll page Dr. Van Zandt,” the nurse said intentionally avoiding eye contact.

“How are they?” Alden asked. “My wife and the babies?”

The nurse had her eyes glued to a clipboard, making an entry on a patient’s chart. “Dr. Van Zandt will be here in a minute.”

“Is something wrong?” he asked with alarm.

“I really don’t know,” the nurse continued. “Like I said, Dr. Van Zandt will be here in a—”

“Mr. Alden?” Bill Alden turned to see a doctor calling to him as he approached. “I’m Dr. Simon Van Zandt. I attended to your wife’s delivery. Can you come with me, please?”

Alden followed as Van Zandt turned and walked through a set of swinging doors at a pace that would allow Alden to catch up with him.

“What’s going on, Doctor? How’s my wife?”

Van Zandt was silent for a second. “I’m afraid there were some complications with your wife’s delivery, Mr. Alden.” He pushed on the door that led to a consultation room. He gestured to Alden with an open hand. “After you.”

A woman sitting at a circular table jumped to her feet. “Mr. Alden,” she began with a pleasant expression and a controlled voice. “I’m Gladys Hirsch, head of social work services. Won’t you sit down?”

“What’s going on here?” Alden asked angrily, his eyes cutting back and forth between Hirsch and Van Zandt. “Where’s my wife?”

“Please, Mr. Alden,” Van Zandt said. “Please sit down.”

Alden reluctantly took a seat. “What’s going on?”

Van Zandt placed a medical chart on the table as he sat down. “As I said, there were complications with your wife’s delivery. She arrived at the hospital in pain. As you know she’s a full month shy of delivering full term. She was in active labor with premature rupturing of the membranes. We waited as long as we felt prudent, but her labor didn’t advance. We were worried about the wellbeing of the babies, so we performed an emergency C-section.”

Alden frowned. He covered his mouth and fought back tears. “Did she lose the babies?”

Van Zandt glanced at Hirsch, prompting her to interject. “Please, Mr. Alden, let Dr. Van Zandt explain.”

“One of the twins is fine, Mr. Alden,” he began, “but I’m afraid that your son was with limited oxygen for a very long time. I’m very sorry, we’re not sure about his condition yet. We’re going to need more tests. The umbilical cord was wrapped around his neck . . . but you have a beautiful healthy daughter.”

Alden began to cry. Hirsch grabbed a wad of tissues and pushed them into his hand. “How’s my wife?” he sobbed. “Does she know?”

Hirsch sighed and looked at Van Zandt, her eyes showing that she didn’t envy his task. “Your wife is unconscious, Mr. Alden. She developed a condition known as amniotic fluid embolism. In effect, your wife had a toxic reaction to the amniotic fluid and fetal cells that sometimes enter the mother’s bloodstream prior to and during delivery.”

“Oh dear God. What happened?”

“Your wife’s reaction was very intense. She manifested with hypotension and bradycardia.”

“English, Doctor. Plain English!” Alden demanded angrily.

“Her blood pressure dropped, and her breathing became erratic. We gave her medication to counteract her symptoms, but they continued to worsen . . . ultimately her pulse stopped and her heart went into ventricular fibrillation. We shocked her a couple of times to bring her back, but her brain was oxygen-deprived for a long time.” Van Zandt’s head dropped. It took a moment for him to continue. “She’s in a coma, Mr. Alden. I’m afraid her prognosis is not very good.”

“But people come out of comas all the time. She can wake up, can’t she?” Alden asked beseechingly.

“I’m sorry to say that’s doubtful,” Van Zandt explained. “Because of the severe brain insult, she may never awaken. Her life expectancy is very short. If she does hang on . . . I’m afraid it will be in a vegetative state. I’m truly sorry. I wish there was more we could do.”

Alden covered his eyes. “But how could this . . .”

“We’re here to help you through this,” Hirsch said in a motherly voice. She reached out and took Alden’s hand in hers “I know it won’t be easy but with time . . .”

“What’s time going to do?” Alden said as he wept. “My wife is gone and my son . . .”

“I know it’s terrible news, Mr. Alden but look at the positive. You have a beautiful daughter to take home and to love. Try to focus on that.” Hirsch smiled bravely despite the fact that Alden’s eyes were awash with tears.

“What am I going to do?” he cried.

“You’ll just have to take one day at a time,” Hirsch said. “
One foot in front of the other, one step at a time
. After a while it will get easier.” She looked up at Van Zandt, cuing him to stand. “We’ll leave you alone for a few minutes and then when you’re ready I’ll take you to see your wife and children.”

Van Zandt put a comforting hand on Alden’s shoulder. “I’m very sorry, Mr. Alden. We did everything we could.” He lowered his head and walked out the door without looking back.

“I’ll be right outside when you’re ready,” Hirsch said. “Take all the time you need.” Hirsch left Alden to think about the future he would live without his wife.