Lie Still (43 page)

LIE STILL

323

May said, “Before you go, though, a couple more things: a set of fingerprints and a blood sample.”

I said, “Absolutely.”

I found Mary Ellen at the nurses’ station on the Pediatrics ward, bent over a chart, writing furiously, looking tired. And beautiful.

“What have you been up to?” I asked.

She turned to me and grinned. “Digging in the Biomed Library.”

“Did I leave a trail?”

“Did you know your phone number is on the wall in the women’s room?”

“It’s your number, too.”

“Yeah, I noticed that.”

“Did it say I was a good time?” I said.

“No. I added that.”

“You’re a true friend. What were you doing at the library?

Besides checking for phone numbers?”

“A literature search.”

“Some really exciting form of diarrhea show up in clinic?”

“No, that was just plain old kid poop. No, after we talked I remembered something I’d seen on TV about nurses caus-ing intentional harm.”

“Do they do that?”

“It seems they do. At least in Indiana and Texas.”

She handed me copies of two journal articles. The first report was from
The Journal of Southern Medicine,
titled

“A Series of In-Clinic Seizures Found to Be Intentionally Induced with Lidocaine.” It described an office nurse in Texas who apparently so enjoyed the titillation of emergency resuscitations, screaming sirens, and paramedics in jumpsuits that she repeatedly loaded children with intra-venous lidocaine until they did what anyone does with sufficient lidocaine, they seized. There were seven such incidents before they figured her out. It said she was pros-ecuted for felony battery. Her name was withheld.

324

DAVID FARRIS

The second, from
The Journal of the American Medical
Association,
was titled “A Nurse-Associated Cluster of Cardiac Arrests in a Medical ICU.” It reported from an Indiana ICU a run of cardiac arrests, always associated with toxic potassium levels. The last two deaths also showed toxin digoxin levels. In-depth analysis showed they occurred only when two specific nurses were on shift together. The paper implied they were indiscrimi-nate killers. Nothing had been proven, though, and both RNs had subsequently moved out of state.

I looked at my friend. She smiled and nodded. “Years ago on TV, I saw a piece about that same case from Texas.

Only their version was it had more to do with her wanting to play the hero. I remember the idiot newsman pronounc-ing it ‘lidd-o-kane,’ and by the end of the piece it had become ‘
deadly
lidd-o-kane.’ He said the kids were ‘on the
brink
of death.’ ”

I half-laughed. I looked again at the second report. Something in it had caught my attention, as something at the edge of one’s vision, moving.

“So anyway, I thought if you had something like this, to show the board in Glory, it’s not exactly geometric proof, but it will paint a suggestive picture when you need it most.”

I reached over and hugged her. “Can I buy you dinner?” I said.

“Maybe. We got two admissions supposedly getting here before five o’clock, and the nursery is suddenly overflow-ing. If we get things under control I’ll page you.”

“Is your team shaping up? Is Michelle taking form?”

She nodded at me. “She’s coming along.”

As Monty went off to her multiple charges I read through the articles again. It was a long shot to think Robin could have been an itinerant child-hurter, but I was living well outside the area of usual and customary occurrences.

I went to see Cynthia Blachly, my former Mom-away-from-Mom. When I poked my head in her door she said,

“Oh my God, look who’s back.”

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325

“Not really,” I said. “Just passing through.”

“Causing trouble?”

“Something like that. I do have a small favor to ask.” She cocked her head at me. “You know anybody over at the Nursing Board?”

She chewed her lip. “No. I guess I don’t. But Monica would.”

“Who’s Monica?”

“Monica Rouse. Across the hall in Human Resources. She talks to them all the time. C’mon.”

The door across the hall said “Nursing Staff Services.”

Cynthia introduced me. She added, “Dr. Ishmail is—was—

one of my ‘boys.’ He slipped in a little mess last year and he’s on a break, but we’re trying to get him back. He wanted to know if we knew anybody at the Nursing Board.”

Monica gave a short laugh. “We got a regular
hot line
. We got nurses coming and going so fast around here I’m trying to get the board to just open up a branch office down the hall. Make my job a heck of a lot easier.”

We all smiled. “Well, if you could . . . ,” I said, looking from one to the other, “if you could call whoever you know best over there and ask them to peek at a file. Find out if this nurse ever worked in Indiana or Texas.” I wrote out “Robin Benoit” on a notepad.

Monica keyed a number by memory. “Hey, Charlene.

Monica. Can you pull a file real quick? On a Robin Benoit? . . . No, just a quick question. Look and see if there’s any work history from Indiana or Texas. . . . Yeah. . . . No, I’ll just hold.” Monica covered the mouthpiece and said to Cynthia, “Charlene used to work with me over at the Arizona Medical Society. We both left when it got so crazy with that Medicare rules thing. . . .” A pause, then, into the receiver, “Okay. . . . Good. . . . You sure? . . . Okay. Thanks.”

She hung up.

Monica said, “Charlene says his record had nothing but New York and Arizona.”

I blinked. “His?” I said.

“Uh-huh.”

326

DAVID FARRIS

“You sure she said ‘his’?”

“That’s what she said.”

My mind was at escape velocity: I tried not to look too shocked. As they watched me I listened to my brain arguing the possibilities: “I had sex with a man.” “Not possible—not like that.” “A former man.” “Boy, that anatomy seemed God-given to me.” “Where would that spermicide have gone?”

“Transsexuals don’t need contraception.”

I said, “‘His.’ Did she have the right Robin Benoit?”

Monica gave me look. “Well, how many you got?”

That’s the question,
I thought. To her: “Did you . . . Did she . . . Is there a description? In the file?”

“Yeah. Usually a picture, too.”

“I hate to be a pain, but is there any way you could call her back? Get the description? I mean, something is
really
haywire here.”

She called Charlene again and got the details: Male. Six foot two, 195 pounds. Blonde, green eyes. Born 1966 in Bath, England. Et cetera.

Charlene added that this seemed to be a hot file—“A couple of cops were in here yesterday looking it over, too.”

I forced a smile like I’d won a booby prize. I thanked them both. I promised Cynthia I’d come see her soon.

Maybe bring her a bottle of wine. Maybe, with a lot of luck, be able to explain what was going on.

From a phone at a charting desk on the Orthopedics ward I called Will Borden, getting the same rasping “Homicide”

solicitation and, “The detective is not in.”

“Is Ken May there?”

“No, honey. They go everywhere together. They’re both out.”

“Could I leave a message?”

“Sure, honey.”

“I’m hoping to find out what they really know about—”

“Who is this again?”

“Dr. Ishmail. I was just there a couple hours ago. They’re looking for a nurse named—”

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327

“Can you leave a number?”

“Sure.” I gave her my pager number. I said, “They’ve been to the Nursing Board, I guess, so I’m hoping they can tell me what’s next.”

“You’re at the Nursing Board?”

“Sure. Close enough. Tell them I called.”

21

H E N RY RO J E L I O , DAY S I X ( C O N T I N U E D )
Figuring I’d try to clear my head with a workout before dinner, I headed down a back stairway in the ’Copa. There I ran into Gene Woods, my friend from Surgery. He said, “Eh-hey, it’s the Prodigal again! Twice in one week. What are you up to, sneaking around here? You got something going with somebody around here I don’t know about?”

“Geno, I’m pretty sure you know about every female within twenty miles of here.”

“Yeah. That’s the problem.”

“What are you up to?”

“Going over to The Longhorn. Gordon Erickson has a new lady he wants me to drool over. Why don’t you come along? Maybe she’s got some
seesters
.”

“He’s bringing a date to The Longhorn?”

“Why not? It’s better than a zoo. Doctors in their native habitat.”

“I was hoping to hook up with Mary Ellen when she’s free.”

“You just keep hoping. For now, c’mon with me. You can call her from the bar. Tell her to join us. Even super-doctors have to eat.”

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329

The Longhorn was, as usual, smoky, noisy, dark, and beery. I paged Mary Ellen from the pay phone near the rest-rooms. A minute later it rang back. It was Michelle saying,

“Dr. Montgomery can’t come to the phone right now. She’s doing a procedure.” I knew this to mean Michelle had failed at the procedure and Monty had taken over. I said only, “Tell her we’re at The Longhorn. Join us when she can.”

Around the Oval Table and spilling into the nearby booths were interns and residents, inhaling chips and enchiladas, still talking with their mouths full about their patients’ problems. Though entirely familiar, it was painful: I felt again like an interloper.

Worse, on that night I felt impotent. Henry’s Care Conference, with all the major forces of society convened, had given a finality to his case. What I had wanted to say had been rendered irrelevant by my bad timing. Impotence makes me testy.

I rejoined Gene in one of the booths. He was sharing chips with Glenn Baba, a senior surgery resident, and a couple who looked like they were joined at the shoulder. I knew the male half of the couple: Gordon Erickson, an anesthesiology resident. Gordon introduced me to his date, a petite ball of
fuego Latino
named Angela. She was a PR specialist he’d met when she was interviewing around the OR for a promotional piece for the hospital.

The guys wanted to hear about life beyond the sleepless nights and near-constant call obligations of residency. I reminded them that, despite the immediate appeal of having a practice, even a half-assed one, I was working to get back
in
.

Glenn offered to trade on the spot.

“Sounds good to me,” I said, “let’s just see what Hebert and Goodbout and the GME Committee have to say about it.”

“Shit, Hebert would take you back in a second,” Gene said. “He told me he wants to fire my ass just to make room for you, and I think he means it.”

I smiled. I told them I was appealing my dismissal, but didn’t expect a fair hearing.

Gene nodded at me and said to Glenn, “The dumb bastard 330

DAVID FARRIS

managed to get his butt canned despite being the Old Man’s favorite. Now that’s talent.” When I was “not renewed” I’d shared some of my distress with Gene over a few beers.

Glenn stared at me for an explanation. “I was accused—

falsely—of stealing drugs from the hospital. That and the crime of trying too hard to improve patient care,” I said.

“Shit. Your only crime was being criminally honest,”

Gene said.

I smiled. Thinking more of my Mimi issues than the drug accusations, I said, “Hard to figure honesty as a fault.”

“Except about drugs. Half of all Americans use some kind of contraband, but none of them would admit to it.”

“They’d get crucified,” Glenn said.

“Precisely my point,” Gene said. “Bucko here did just that. The Powers asked, he told the truth, they showed him the door.”

“There was a lot more to it than that,” I said. “For one thing, I never did cop to it.”

“Yeah, but you danced around it. Didn’t say no. What I’m saying is, there is no rationality about drugs. Always, always, always say no! Just say no. If they ask you if you have ever seen a marijuana cigarette, just say no.”

“And how do you justify that?” I asked.

“Rationalize it, man, like everybody else. If you dance around drugs you’re basically challenging them to fuck you.

And they will. It’s pure self-defense. They’re looking for an excuse to kill you. Defend yourself.”

I sighed. “I’ve always been a shitty liar.”

He took a pull of his beer. He said, “It’s an important life skill. Practice up.”

We ordered dinner. They talked about the personal quirks of some of their Attendings. I was preoccupied. I stared at the various initials carved into the table. I didn’t add much to the conversation.

Apropos of nothing, I said to Gordon, the nascent anesthesiologist, “You poison people professionally. If you wanted to . . . had some hideous reason, how would you kill an asthmatic?”

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331

They all looked at me. Gordon said flatly, “Sux.”

“Sux?”

“Succinylcholine.”

“Depolarizing muscle relaxant,” I recited. Miguel had refreshed me about it in the lab.

“Yeah.”

“Why sux?”

“Works IM—” he turned to Angela, “intramuscular. A regular shot in the butt.” She nodded.

“And in—what?—one, two minutes?—completely paralyzes the person?” I asked.

“About that. Dose dependent, of course.”

“But it’s short acting,” Glenn said.

“Dose dependent,” Gordie repeated. “A usual dose works in thirty to maybe a hundred and twenty seconds, lasts maybe ten to twenty minutes. Plenty long enough to get to a state of no brain oxygen, unconsciousness . . . death. Assuming the person—I almost said ‘patient’—is only breathing ambient air, no supplemental O-two, he would probably die. With a larger dose you could almost guarantee it.”

“How would you know if somebody got it?”

“With sux you get twitches all over, so-called ‘fasicula-tions,’ as they’re paralyzed,” he said. “It’s a reliable sign.

They jerk and jump.”

“But I mean afterward. How could you test for it?”

“That’s the beauty of it,” he said. “You can’t. A normal enzyme in blood breaks it down. Pseudo-cholinesterase.