Fatal Trauma Read online

  ***

  Kelly saw Mark when he came in and wanted badly to talk with him, but before she had that chance the EMTs brought in an elderly man who coded almost as soon as he came through the doors.

  She saw the situation developing at the same time that the lead EMT, Mason, did. “Put him in there,” she called.

  Mason started external cardiac massage while his partner pushed the gurney into the curtained cubicle to which Kelly pointed.

  As she followed the patient, Kelly caught Mark’s eye. “Code,” she mouthed and saw Mark speak softly into the ear of the nursing assistant who was holding out a clipboard toward him. The assistant nodded and hurried to a phone.

  “What do we have?” Mark asked as he parted the curtains and edged in beside Kelly.

  Mason didn’t interrupt his external cardiac compressions, giving the salient facts without missing a beat. “Eighty-eight year old man, lives with his daughter, who found him unresponsive in the living room this afternoon. History of two prior infarctions, both managed with a stent. Moderate hypertension, controlled with a beta blocker and diuretic. Daughter was calling his internist as we left. EKG in the ambulance showed a large, evolving anterior infarction.”

  “Stop a second and let’s see what his vital signs are.”

  Kelly bent over the patient and in a moment said, “No pressure. No pulse.”

  “Resume compressions,” Mark said.

  Another nurse had joined the group and was fitting an oxygen mask to the old man’s face. “You going to intubate him?” she asked.

  “Not yet,” Mark said. “See if you can get an IV going.”

  “Switch?” the second EMT said.

  Mason nodded, and the second man took over chest compressions.

  Kelly finished applying the leads for the cardiogram. “Mark, the EKG is ready,” she said.

  “Stop chest compressions,” he said. Everyone stared at the screen as though by their efforts alone they could produce a normal set of complexes. Instead, when the compressions stopped, the tracing became a flat line.

  Kelly moved on automatic pilot, preparing and handing Mark the necessary drugs: epinephrine, vasopressin, amiodarone.

  When there was no response, everyone in the room knew that the outlook was bleak, but they moved through the whole sequence. “We’ll shock,” Mark said.

  Kelly moved the machine forward, and Mark applied conductive gel to the paddles. “Set to three hundred joules,” he said. “Clear!”

  Everyone stepped back. He pushed the button on the paddle, the patient jumped like a marionette whose strings had been jerked, then settled back.

  Finally, after all measures had been exhausted, Mark stepped away and looked at the clock. “Time of death is 1600 hours.”

  Kelly began removing the IV and EKG electrodes. “I’ll get the body ready.”

  “And I’ll see if the family is in the waiting room,” Mark said.

  Their eyes met, but only for a second. Kelly knew that Mark was as anxious as she to talk, but that wasn’t going to happen for a while. Right now, both of them had something to do—something that wasn’t pleasant, but was part of their profession. How long either would be able to continue practicing that profession, of course, remained to be seen.

  ***

  It was almost ten p.m. before things were slow enough for Mark to snatch a moment to speak with Kelly. “How are you doing?” he asked.

  “If you mean after we lost that man with the heart attack, I’ve learned to live with things like that. If you mean with the thought of a malpractice suit hanging over my head, I guess I’ve learned to accept that as part of the practice of my profession.”

  “But how about—”

  She continued as though he hadn’t spoken. “If you mean how do I feel, knowing that at any minute someone may make an attempt on my life? Well, let’s just say that tonight every time someone dropped something, every time the outer door burst open, every time there was a raised voice here in the ER—my heart almost jumped out of my chest.”

  “We need to talk,” Mark said. “I don’t think the malpractice suit—”

  “Please, Mark.” She looked over her shoulder. “Let’s find someplace quieter and more private for our conversation.”

  “Can you meet me in the food court after our shift ends?”

  Kelly shrugged her shoulders. “I agreed to meet my ride there, but . . . sure. I’ll see you then.”

  Things had quieted down by the time Mark did a handoff to the colleague relieving him. “Any questions, Gary?”

  “No, I’m good.” Gary Matthews grinned and pushed his brown waves back up onto his forehead in what Mark had observed was a perpetual battle. “I presume you didn’t leave me any gunmen, threatening to shoot everyone in the ER.”

  Mark realized Gary was trying to lighten the moment, but he still had to take a couple of deep breaths before answering. “No, other than the man we lost with a heart attack earlier, it’s been pretty quiet.”

  His scrubs covered with a fresh white coat, Mark slung his backpack over one shoulder and hurried to the food court. He’d seen Kelly giving her report and figured she’d be along soon. Mark sought out a table in a quiet corner, as far away as possible from the corridor along which a stream of hospital personnel flowed, some coming to work, others leaving.

  Mark closed his eyes and took deep breaths. He tried a calming yoga exercise, but found himself drifting off to sleep as soon as he closed his eyes. The third time it happened, he surrendered and leaned back in his chair.

  “Shall I let you sleep, or do you want to talk?”

  Mark looked up and saw Kelly standing over him. Her neutral expression gave him no clue as to whether she was serious or playful. Given the circumstances, he decided that playful was unlikely. “Sorry. I was trying to relax. As you know, it was a busy night.”

  Kelly lowered herself into the chair across from Mark. “You wanted to talk.”

  “I didn’t want you worrying about the threat of a malpractice suit by the Garcia family.”

  “Is there more to this than what you told me earlier?” Kelly asked.

  “No, except that I talked with Eric after I left Goodrich’s office. Eric doesn’t think there’s anything to it, and now that I think about it, neither do I.” Mark stretched and heard the bones in his neck crack. “I’m going to call my malpractice insurance carrier in the morning and bring them up to date on this latest development, but I didn’t want you worrying about it.”

  Kelly shook her head. “I’ll try not to. Both you and I did what we could to save our own lives and those of the people around us. I’m at peace about everything.”

  “I wish I could feel that way—”

  Despite her hurt feelings, Kelly decided to give it one more try. “You mean peace? We could talk about that if you’d like.” Kelly’s voice softened. “Just say the word.”

  “I don’t think I’m ready quite yet,” Mark said. He paused. “But thank you.”

  “Let me know if you change your mind,” Kelly said.

  “Ready to go?” Tracy Orton detached herself from the stream of people going by and approached the table where Mark and Kelly sat.

  Mark stood, an automatic gesture from his early years, thanks to his mother. “Tracy,” he said, and inclined his head.

  “Am I interrupting something?” Tracy asked.

  Kelly shook her head. “No, I think Mark and I were through talking.”

  A middle-aged Hispanic man wearing scrubs trailed Tracy to the table. She nodded toward him and said, “Carl, these are my two friends, Dr. Mark Baker and Kelly Atkinson.” Turning back to Mark and Kelly, she said, “Carl is our new scrub tech. He’s been working with me on the three to eleven shift.”

  Carl shook first Mark’s hand and then Kelly’s.

  Kelly smiled. “Carl, I’m glad we’ve finally met. Tracy said I might be able to ride to the hospital with you sometime if our schedules don’t mesh.”

  “It would be my pleasure,
” Carl said, with only a trace of accent in his words. “I’ve wanted to meet you—actually, to meet you both—since the episode in the ER Saturday night. I’ve heard so much about what you did.”

  Mark frowned. There was something about Carl, something that made the hairs on the back of Mark’s neck prickle and come to attention.

  Tracy consulted her watch. “Well, we should go.”

  Carl fixed Mark with a look that wasn’t quite a stare. “I’ll look forward to seeing you again, Dr. Baker.” He started away, then halfway to the door, glanced back over his shoulder. The look on his face was fleeting, but it still made Mark shiver. He thought he knew what that look meant . . . and he didn’t like it.

  9

  Mark pondered what he’d just seen and heard as he watched Kelly, Tracy, and Carl exit the food court. He rose and was about to head for his car when he decided to check his cell phone for messages. He frowned when he thumbed the button and saw that he had one missed call and one voice-mail message . . . from Anna King.

  Had something changed since his lunch with Anna only a few hours ago? The proof she’d furnished that she was sober during the operation on Ed Purvis would undoubtedly clear her in any action Purvis’s family brought, although in so doing she made it more likely that Mark’s inexperience as a surgical assistant could be called into question in a lawsuit.

  Mark listened to the message. It was brief and to the point: “Mark, I guess you’re at work with your phone turned off. It’s important that I speak with you. Please call me.”

  The tone of voice, Anna’s inflection, the words themselves gave no clue about her reason for wanting to talk with him. He checked the time the call came in: nine p.m. It was approaching midnight now. Surely Anna didn’t want a call back this late. Tomorrow was Tuesday, one of Anna’s scheduled days to operate, so calling her office in the morning was out. Maybe if he tried the OR he could make contact with her between cases. In the meantime, he’d try not to worry—something he was having no success with thus far.

  He knew he wasn’t going to drink—the death of Joe, Jr. at the hands of a drunk driver had seen to that more effectively than a lifetime of AA meetings. Mark’s yoga meditation exercises hadn’t been successful thus far. Nothing was working for him, and he felt sometimes as though he was going to jump out of his skin. Maybe he should take Kelly up on her offer. She’d mentioned being at peace. He certainly wasn’t having any success finding peace on his own. Maybe that was another call he’d make tomorrow. First, he needed to think about it some more.

  ***

  Tracy’s red Hyundai hummed along through the quiet streets, moving from dark to light to dark again as it passed by streetlights and an occasional lit billboard. Kelly listened with one ear and murmured responses as Tracy rattled on about her evening’s work. Normally, she’d be engaged in a spirited dialogue with her friend, trading stories and making comments, but tonight her mind was elsewhere.

  It was unfair for the family of the man she’d wheeled into the emergency room to consider a malpractice suit because Mark failed to save his life. There was no question in her mind that the man was essentially DOA when his brother brought him through the doors. And for the hospital administrator to try to suspend Mark until the incident blew over? Absolute madness.

  “What did you think of Carl?” Tracy asked.

  Kelly roused long enough to consider her answer. “He seemed nice,” she said.

  “Carl’s only worked in the OR for a short time, but he’s trying to fit in. I mean, he’s doing a good job learning procedures, but that’s not all. He’s always asking about the people who work in the operating room. And he was interested in the incident in the ER on Saturday night. That’s why I was glad he got to meet both you and Mark tonight.”

  Kelly thought back to the brief encounter. Frankly, Carl hadn’t made much of an impression, either positive or negative, but she was willing to accept her friend’s judgment. “You know, until I’m sure I’m no longer at risk from the Zetas, I’m afraid to be in the car alone. I’d ask to ride with you again, but I worry about putting you at risk.”

  “Don’t give it another thought,” Tracy said. “Since I started working this shift, driving home late at night, I’ve made it a habit to watch my rearview mirror and drive with the doors locked. Actually, it’s kind of nice to have someone I can talk to. So, no problem.”

  “Then can I ride with you tomorrow night?”

  Tracy thought for a moment. “You know, I think I’m supposed to be off tomorrow night. I guess it was fortuitous, your getting to meet Carl tonight. When I get home, I’ll give him a call. I’m sure he’ll be happy to let you ride with him.”

  “I appreciate your doing that,” Kelly said. “But you’ve never told me where he lives. Maybe it would be too much out of his way for Carl to pick me up.”

  “Don’t you worry about that. He’s a nice guy. I’m sure he’ll be happy to swing by and get you. I’ll just need to give him your address. Everything else will take care of itself.”

  ***

  The driver of the black SUV looked straight ahead as the red Hyundai stopped at the curb and the nurse exited. She’d ridden with a friend tonight, which might make it more difficult to eliminate her. It would be better to catch her alone, possibly in her own car. To encounter a situation where she was with the doctor and they could both be targets would be too much to ask for, but sometimes things change. It would require a bit more observation before it was time for action. But that was all right. Orders had been given—eliminate them—but there was no time constraint. And as the saying goes, “La venganza es un plato que se sirve frío.” Revenge is a dish best served cold.

  ***

  Mark wasn’t really hungry, but he decided he should eat something before going to bed. He heated a Lean Cuisine dinner in the microwave and ate it standing at the kitchen sink, accompanied by the last few sips of a quart of milk consumed directly from the carton. The package he tossed in the trash told him he’d just consumed “Five Cheese Rigatoni.” Frankly, it could have been powdered sawdust sprinkled with catsup for all he could recall tasting—not that the dinner was bad, but he was eating only because he knew he needed to fuel his inner engine. Ever since the shooting, his appetite had dropped to zero.

  He stood under the shower, hoping the spray would clear his head, but found his thoughts returning again and again to the two malpractice suits with which he’d been threatened. When he tried to force himself away from that subject, his feelings for Kelly Atkinson and Anna King took center stage. He’d dated them both—Kelly because she was fun and genuinely seemed to enjoy their time together, Anna because . . . well, because she was interested in him and was available. Matter of fact, as he recalled, Anna had been the one who’d asked him out the first time, not vice versa.

  He dried himself, climbed into the fresh scrub suit he favored over pajamas, and crawled into bed. Maybe he should follow Kelly’s lead and read the Bible tonight before turning off the light. He knew sleep wasn’t going to come easily anyway. Didn’t he have a Bible around here somewhere?

  Mark tumbled out of bed and looked through his bookshelves, scanning the titles of medical texts and paperback novels before pulling out a large volume bound in black imitation leather. When he and Joe had left for medical school and college respectively, their parents had presented each of them with a Bible. The books weren’t expensive, although they probably were as nice as Joe Sr. and Erma Baker could afford. Mark pulled the purple ribbon that served as a bookmark, and when the Bible opened his eyes fell on the first words of Psalm 27. “The Lord is my light and my salvation—so why should I be afraid? The Lord is my fortress, protecting me from danger, so why should I tremble?”

  Why should I be afraid? Mark decided he was afraid of everyone and everything: of revenge by the Zetas, of malpractice claims against him, of being alone instead of in a relationship. Maybe this promise was part of the peace Kelly mentioned.

  Was it too late to call her? She’d only b
een off work . . . he looked at his watch and discovered it was after one a.m. If Kelly had gone straight to bed, she’d be asleep by now. No, he’d phone her in the morning. He’d make it his first call.

  ***

  The shooter had dressed carefully—black jeans, black long-sleeved tee shirt, black driving gloves, black athletic shoes. A black ski mask completed the outfit, both providing anonymity and allowing the shooter to blend into the shadows. There was no moon tonight—not simply by happenstance. No, the date had been carefully chosen. There was no light from the sky, and since a well placed shot from an air rifle had taken out the street lamps on either side of the subject’s house, none from ground level either.

  All the houses around were dark. The shooter’s car rolled to a stop half a block from the target’s house. When the door opened, no light illuminated the interior of the car, since the bulb from that lamp was stowed safely in the glove compartment. The shooter placed the car keys above the sun visor. Everything was in place for a quick exit.

  Do it. Sprint to the car. Drive away slowly and quietly. Leave the headlights off for a block or two, then turn on the lights, pull off the ski mask, and blend into the stream of traffic that would be present on the nearby freeway even at three a.m. Ten minutes, start to finish. Meticulous planning, leading to proper execution . . . in more ways than one.

  ***

  Mark’s dream was a montage of images and scenes involving the emergency room and men with guns. As police streamed through the double doors, they set off an alarm, producing a strident noise, a noise that eventually cut through Matt’s sleep-deprived brain and woke him. It took a moment for him to realize what he heard was his cell phone. He rolled onto his side and reached for the bedside lamp.