No Cure for Murder (24 page)
“My God, Jacob! What happened?”
“Something happened with his anticoagulant...I don’t know what. His blood couldn’t clot. He’s bleeding everywhere, including, I’m afraid, into his brain.”
“His brain?”
“We just looked at the brain scan. Thank God it’s a small bleed. I think he’ll recover, but it’s going to be iffy for a while.”
Carol turned to Jacob. “I thought he needed the blood thinner to prevent another clot to his lung.”
“He does,” said, Jacob, “but I see no way we can give him a blood thinner now. It might make the bleeding in his brain worse.”
“What are you going to do, Jacob?” asked Phyllis. “You must do something.”
“I’ll talk with Sharon Brickman about putting a filter inside the large vein in the lower part of his abdomen ( the inferior vena cava ). That way, if more clots break off, we can catch them before they reach Harry’s lungs.”
“Whatever you think best, Jacob,” said Phyllis. “We trust you. We’ve come this far with you. We might as well go all the way.”
“I’ll never have that kind of loyalty...that kind of respect,” murmured Zoe. “The best of medicine will die with the departure of men like Jacob Weizman.”
Jacob turned to leave. Carol caught him by the arm. “You don’t know how this happened?”
“No,” said Jacob, “but I’ll find out!”
Chapter Forty-One
When Mary Oakes, the charge nurse on the fifth floor medical unit, looked at the skeletal Angelina Cass, she felt her eyes moisten then she flushed with anger.
This is a total waste of our time, she thought. We’ll never get to her.
This was the sixth admission for this thirty-year-old woman in the last six months, each time for the same sequence of problems: anorexia nervosa, a severe anxiety disorder, with malnutrition and dehydration leading to multiple electrolyte abnormalities, often life threatening.
Mary pushed aside the standard blood pressure cuff at the bedside, too large for Angelina’s twig-like arm, and grabbed the pediatric one. After she completed her assessment of the brooding, angry young woman, she saw Joanna Cass, Angelina’s mother, in the hallway talking with Arnie Roth, her daughter’s physician.
“What more can we do, Doctor? Angelina’s seen dozens of shrinks, psychiatric social workers, and participated in three eating disorder inpatient programs. Nothing worked.”
Arnie shook his head. “I don’t know. Let’s first get her out of trouble.”
“I’m so sick of this,” said Joanna. “I have a life too, you know.”
“I’m sorry,” Arnie replied. “I’ll try to find another program after she’s stable.”
“I don’t want her to have any visitors. Her friends are nearly as bad as she, and her son-of-a-bitch husband Milo, he’ll only upset her more.”
“I’ll write the orders for no visitors.”
When Arnie entered Angelina’s room the next morning, her eyes bored into him. “It’s you again, damn it. I told you I don’t want your help.”
“I don’t think you’re competent to make that decision, Angelina. You almost succeeded this time in killing yourself.”
“It’s my life,” she snarled, pulling on her restraints. “I can do what the fuck I like with it. I want you to remove this stomach tube and IV. And get these damned restraints off me.”
“Not a chance.”
Angelina’s eyes bulged as she strained to sit upright. “You fucking bastard! You can’t do this to me. I’ll sue the shit out of you and this damn hospital.”
Arnie had the foresight to step back from Angelina’s bed as a large wad of mucoid spit flew across the room landing on the wall.
He watched the thick saliva sliding downward. “I’ll have the nurse give you something to calm you down. Maybe sometime soon we can talk about a future for you.”
Arnie left the room. When the closed door muffled her profanity, he sighed with relief.
I’m getting too old for this crap!
The intruder ignored the large ‘No Visitors’ sign and entered Angelina’s room.
Even in sleep, her mouth formed into a smirk.
Grabbing the end of the feeding tube, the intruder attached a large syringe and pushed in the thick, green fluid. After the third syringe-full, the intruder smiled, caressed Angelina’s cheek.
Maybe this will end your smirk, the intruder thought, then departed.
At 4 a.m., the voice of Angelina Cass boomed through the intercom. “You got to help, my stomach is killing me.”
“I’ll send your nurse right in,” said the ward clerk.
When Patti Sax, the night nurse, entered the room, Angelina was bent over clutching her stomach and retching. “I never felt this bad before...these cramps are killing me.”
Patti wiped off the vomit, and then checked Angelina’s vital signs. Except for a racing pulse, they were stable. She felt Angelina’s abdomen which felt soft and wasn’t tender.
“I’ll call Dr. Roth.”
Arnie listened to Patti’s description. “It might be an ulcer or possibly pancreatitis. Give her a shot of Compazine and have the lab draw her morning bloods right now. Ask them to add an amylase and lipase to rule out pancreatitis. I’ll be at Brier in a couple of hours. Call me if she gets worse.”
When Arnie arrived for rounds, the morning nurse raced to meet him. “She won’t wake up, Dr. Roth.”
Angelina groaned when Arnie examined her, but except for deep breathing, he noted no other abnormalities. Back at the nursing station, Arnie turned to the ward clerk. “Where’s today’s lab?”
The ward clerk handed him the printout. “It just came up.”
Arnie stared. He’d rarely seen so many abnormalities of a patient’s chemistries with a pattern of too much acid in her blood.
Now I know why she’s breathing that way.
“Transfer her to ICU stat. I want a set of blood gasses, a chest x-ray, a new set of electrolytes, and get Jack Byrnes to consult.”
Two hours later, Arnie sat with Jack looking over Angelina’s laboratory tests.
Jack stood. “Come with me, Arnie.”
They walked to Angelina’s bedside.
Jack looked at Arnie. “Turn off the lights.”
“What’s going on?” asked Arnie.
“Just turn them off.” Jack grabbed a peculiar shaped lamp. When the room became dark, he shined the purple light on the bag of urine collected from the catheter in Angelina’s bladder. At once, the urine glowed green.
“What the hell?” said Arnie.
“Somebody poisoned her,” said Jack. “The chemistries, the pattern of electrolytes, the severity of the acid in her blood, and the green glow, says one word to me: antifreeze.”
Arnie stared at Jack. “Antifreeze!”
“I sent out a sample to our reference lab, but we can’t wait for the results. I think we need to pull out all the stops.”
“Whatever,” said Arnie.
“Where’s her husband? I’d prefer him to sign the permit for dialysis.”
“We called their home, but nobody answered.”
“I’m starting an intravenous alcohol infusion, until I get the dialysis machine ready. The alcohol competes with antifreeze for its metabolism. That should help until we remove it.”
“I have a few alcoholics who’ll line up for that IV anytime,” said Arnie.
“Once they get the whole picture, I don’t think they will.”
After four hours of dialysis and with the continued alcohol infusion, Angelina was in a cheery mood. With speech slurred, she giggled, “I really like you, Dr. Roth...you’re my favorite doctor.”
So that’s what it takes, Arnie thought.
Chapter Forty-Two
It was noon with the sun lighting the cloud margins with shiny lace trim. When Marilyn and Sarah Hughes approached Brier Hospital in their Toyota Minivan, the police barricade surprised them. Marilyn rolled down her window.
“I’m sorry, ma’am, you’ll need to turn around. The street’s closed.”
“What happened?”
“I’m sorry, ma’am, just move on.”
Marilyn turned then pulled into a waiting area one block away. She dialed Bob’s cell phone. “We’re a block away. What’s going on?”
“Somebody tried to kill one of our patients.”
“Who? What?”
“I’ll tell you about it later.”
“Is it still okay if Sarah joins you for lunch?”
“Of course. Just let her off. She can walk in. I’ll meet her in the ER.”
Marilyn kissed Sarah. “Have a good time.”
Sarah suddenly embraced her mother, holding on tight for thirty seconds. “I love you, Mom. I’m so sorry...”
Marilyn flushed with affection and felt the tears streak over her cheeks. “I love you too. Nothing can ever change that.”
Sarah walked down the sunny street toward Brier. Media vans with their microwave dishes elevated were double-parked. Onlookers filled the streets and the plaza before the hospital. When Sarah approached the north ER entrance ramp, Carleton Dix stood smoking a cigarette.
Shit!
She altered her course to the opposite end of the ER ramp.
In an instant, their eyes locked. He hurled the cigarette to the pavement, crushed it with his heel, and moved to intercept her. Sarah increased her pace, but he crossed diagonally to stand in her path. She moved to pass by. Her heart pounded. “Excuse me, Padre.”
He shifted, and again placed himself in her way. “I’d like a word with you, Sarah.”
“I have nothing to say to you, now get out of my way.”
“Don’t you owe me an apology? You knew very well what you did, and how it would affect me. How could you do it?”
Sarah trembled as he came closer. Being in the same room would have been too much for her, but this...
She raised her hand in a stop gesture, and then took two steps back. “This is your own doing, Padre. I told you to leave me alone. I told you never to touch me, yet you did it anyway.”
He looked toward the sky. “I was just trying to help you, Sarah. Your parents asked me to help.”
“I don’t need your help. I don’t want your help. Do you finally get it?”
“Don’t do this, Sarah. You’re anything but naïve. You knew what the word ‘touch’ implies, yet you used it.”
“You’re right, Padre. I may be young and inexperienced, but I understand exactly what your looks and your touch meant. Don’t deny it now that you’ve been busted.”
The reverend’s eyes narrowed and his lips tightened. “You’re asking for trouble, Sarah. All of us have something to hide.”
“I don’t know what you’re talking about.”
“Oh, I think you do. Don’t forget, Sarah, that you’re placing your immortal soul in danger. Remember the Ninth Commandment: Though shalt not bear false witness.”
“Not to worry, Padre. The truth is my best defense.”
Jacob Weizman’s office was particularly busy this afternoon.
Margaret Cohen called Zoe over the intercom. “I have Peggy Weiss on the phone. She’s asking for her lab results.”
“Bring me her chart and tell her I’ll speak with her later this afternoon when I get a break.”
“I can bring the chart right in.”
“No, that’s okay. I’ll call her later.”
“It’ll only take a second.”
Zoe stared at Margaret. “Aren’t you a little tired of the way Jacob indulges patients like Peggy Weiss? I am.”
Margaret stared back at Zoe. “Indulgence is pejorative. I assure you that Jacob doesn’t think that way about his patients. His attitude is what makes Jacob so beloved.”
Zoe smiled, and then shook her head. “Of course you’re right. Tell Peggy I’ll call her back for sure.”
“Yes, Doctor.”
At three in the afternoon, Margaret knocked on Zoe’s door. “Peggy called again. Please speak with her, Zoe. She’s a wreck.”
“I will.”
Margaret hesitated a moment. “It’s important. A few words is all it takes.”
Zoe stared cold-eyed at Margaret. “I said I’ll call.”
Jacob and Margaret were getting ready to close up for the day when the answering service line to the office rang. Margaret looked at Jacob. “Should I take it?”
“Go ahead.”
“Sorry to bother you, Margaret,” said the operator, “but we have Peggy Weiss on the line. She’s really upset. Can you talk to her?”
“Sure. Put her through.”
“What’s wrong with me?” cried Peggy. “It must be bad or Dr. Spelling wouldn’t be avoiding me.”
“Wait a sec, Peggy,” Margaret said, putting the call on hold. She grabbed Peggy’s chart and handed it to Jacob. “Please talk with Peggy Weiss, Zoe’s patient. She’s upset.”
Jacob flipped through the chart, read the most recent note, and reviewed her new lab tests. He picked up the phone. “Dr. Weizman. Can I help you?”
“What’s wrong with me, Doctor? How bad are they?”
“How bad are what?”
“My tests. It’s cancer. I knew it. It’s cancer,” Peggy cried.