An Open Heart (25 page)

Jace shook his head and looked around for the matatu responsible for hitting the pedestrian.

Gone.

Jace kept his concentration on the victim. “The vehicle that struck this man has fled.”

The angry man spoke again. “The van had to swerve because of your vehicle beside the road.” He closed his fist.

Jace scanned the crowd and the road. The other two youths who had accompanied the victim seemed to have disappeared. Along with the gun.

“This is your fault,” the man said, pushing Jace backward, out of contact with the victim.

Suddenly, Gabby was in the angry man’s face, screaming and motioning wildly. “This man is a doctor! He is the only thing keeping this victim alive. We need to move him to a hospital so he will have a chance. Now get out of the way!”

Surprisingly, the man backed away from the crazy white woman.

The pickup truck backed up so that the bed was a few feet from the victim. Gabby began shouting orders for the occupants to get out, like a sergeant ordering the evacuation of a bunker. “Now!”

Reluctantly, more than a dozen men began to hop out. When only one man remained, Jace looked at a few men standing quietly beside the road. “Help me move him,” he said. “We need to move him all at once. Head, chest, hips, and legs all together. Try not to bend the spine.”

The men seemed to understand. Jace supported the head and neck. Evan took one side of the chest, Gabby the feet. Three other men joined and followed orders. “On three,” Jace said. “One, two, three!”

When they had the victim in the back of the truck, Jace pulled his hand away from the man’s hair. Blood. Jelly-like and matted on the back of his head. He wiped his hands on his pants and wished for a pair of examining gloves, pushing a threatening thought aside.
HIV is everywhere.

“What’s this?” Evan said, picking up a paper that had fallen from the man’s front pocket during the transfer. He unfolded what appeared to be a photocopy of a newspaper picture.

Jace looked at the paper with his heart suddenly in his throat. The image was unmistakable. The man in the picture was Jace Rawlings.

26

As he approached the Rawlings home, Steve Brady thought,
Jace Rawlings must have been running from some pretty powerful demons to want to leave all of this.
Stone foundation, covered porch, tan siding, and a yard with dogwood and azaleas—the home could have graced the cover of
Architectural Digest
.

He rang the doorbell and waited.

Heather answered. Even in a jogging suit, she was attractive. Steve was pretty sure she had at least ten or twelve years on him, but she was aging well. He found himself thinking again that Jace Rawlings was either running or a fool.

Or both.

Heather’s face brightened. “Hi, Steve.”

He nodded and stood quietly for an awkward moment until she added, “Would you like to come in?”

He followed Heather into the formal living room and sat when she gestured toward the couch. She sat opposite him in a leather chair, with a large coffee table between them. “I’ve done a little snooping,” he said.

“And?” She waited.

Steve cleared his throat.

“Tell me it’s a fraud. Tell me I shouldn’t be doubting Jace—”

“The copy of Anita Franks’s autopsy is legitimate. It appears to be a photocopy of the original.”

“Okay, how does that help me?”

“That doesn’t. But what may help is tracing who had access to the document.”

She waited until he continued.

“Since it is officially a part of her medical record, it is protected. The only people with access are the next of kin and her doctors.”

“That doesn’t really help. There is no reason for the governor to send me the information.”

“So perhaps we need to think about Anita’s physicians.”

“Do you know who else the ME’s office sent the report to?”

“Only one doctor’s office.” He paused. “Your husband’s.”

“Jace? Why would his office request her records?”

“He must have had a file on her. Otherwise, the state wouldn’t have released the records.”

“This makes no sense. Jace was the governor’s doctor.”

“Would anyone at Jace’s office want you to know this information?”

Heather stood and began to pace. “Not that I know of.” She turned and faced the detective. “So what’s next?”

He held up his hands. “I know things don’t add up, Heather, but we really don’t have any evidence that Anita Franks was sexually assaulted. Maybe she was using ketamine as a recreational drug.”

“That’s crazy.”

“I’m sorry. But this is good news, in a way. Right now, we don’t exactly have solid evidence to indicate a crime.”

“If the governor’s wife was using ketamine illegally, that sounds like a crime to me.”

“Maybe it was,” he said slowly. “I want you to consider another possibility.” He took a deep breath. “Maybe Jace sent that autopsy report to you.”

“Jace? Why would he want me to know this?”

The detective shrugged. “Maybe it’s his way of coming clean,” he said. “Maybe it’s a confession.”

“Tell him to drive us to the new hospital in Karen,” Jace told Gabby, naming a Nairobi suburb.

The driver heard. “It’s too expensive.”

Jace sighed. “It’s the closest. Don’t worry about the money.” He looked at Gabby. “Ride up front with him. Evan and I will ride with the patient.”

They knelt beside the man as the driver sped away, leaving a thick trail of dust and Jace and Evan grabbing for the sides of the pickup.

Evan shouted, “Just keep his head from rolling around.”

When the driver slowed behind another truck, Jace addressed the elephant in the room. “So why does a man carrying a gun have my picture in his pocket?”

His friend kept his hand locked on the side as they swayed and bumped along. “Seems like you were just spared a bit of serious trouble of your own.”

“The guy was coming over to kill me.”

Evan squinted into the sun. “Evidently.”

“So was that whole thing set up? Was our driver in on it?”

“How else would the guy have known we’d be there?”

The thought sent a chill down Jace’s back. “Let’s just keep this guy alive so the police can question him.”

The pickup truck slammed through a series of potholes, then ran off the road onto the shoulder, since it appeared smoother than the road itself. Speeding, passing a matatu, and weaving back into the left lane again, the driver of their pickup kept up a brutal pace, knocking Jace and Evan side to side and prompting Jace to cry out. “Slow down!”

The driver ignored him. Or didn’t hear.

By the time they pulled into the hospital parking lot ten minutes later, their patient was gasping, with a thready pulse of 120.

Jace called to Gabby. “Go ask them for a stretcher. I don’t want to move him twice.”

She disappeared and came back a minute later with a nurse pushing a stretcher.

The nurse was a light-skinned Kenyan of about twenty-five. “I am Dr. Rawlings,” Jace said. “This is Dr. Martin. We were traveling from our home in Kijabe when we witnessed this pedestrian accident.”

She nodded soberly. “You are welcome to help.”

Wow,
Jace thought.
That was easy. No complicated application or a critique of my case log. Just a Good Samaritan agreement. Welcome.

They maneuvered the stretcher against the tailgate and moved the patient. As they were pushing the stretcher toward the casualty entrance, Jace looked over his shoulder to see Gabby laying shillings in the open palm of the driver. She made quick eye contact with Jace. Clearly, it was not her idea, but what could she do?

The emergency-room facility was better equipped than their department back in Kijabe. Jace asked for IV equipment as another nurse began cutting off the victim’s clothing with a large shears. Evan lowered a cushioned mask over the patient’s nose and mouth and began bag ventilation. “I’ll need a laryngoscope and an endotracheal tube,” he said.

A nurse responded by wheeling up an emergency cart. She quickly broke a seal and pulled open a drawer. Evan grabbed an Ambu bag and sealed the mask over the patient’s mouth. After another thirty seconds of ventilation, Evan inserted the tube. “I’m in,” he said.

“Here’s a sixteen-gauge IV,” Jace said, taping down the tubing to the canula just below the patient’s elbow. “Do we have blood available?”

A young nurse in a white coat scurried toward a desk. “I’ll call the lab to see.”

Jace connected a bag of saline. “Squeeze this in as fast as it will go.”

Evan placed a stethoscope on the chest. “The lung sounds are absent on the left,” he said. “And I can feel the crepitance of broken ribs here.”

“He’s going to need a chest tube.” Jace looked at the nurse. “Do you have a tray or some sort of kit for the placement of chest tubes?”

An older nurse, a heavy-set woman with white hair, shook her head and looked at the dial on a manual blood-pressure cuff. Her accent was distinctly Kenyan. “Blood pressure is sixty.”

Jace opened another sixteen-gauge IV needle. “Here,” he said, swiping the skin with an alcohol swab. He shoved the needle into the patient’s right chest. Air and blood sprayed through the needle, relieving the buildup of pressure.

In the minutes that followed, Jace made a small incision over the patient’s right chest and inserted a clear tube the size of his index finger. Immediately, the tube turned red, colored by a continuous flow of blood from the chest. Jace quickly attached the chest tube to a clear plastic collecting chamber to record the output.

A nurse returned holding a single unit of blood. “Our surgeons were up late last night operating. This is all we have in the blood bank.”

Jace looked around. “Anyone here have O negative blood?”

The chest tube collection system continued to fill. One thousand ccs. And rising.

Gabby touched the patient’s abdomen. “Look at this. It seems to be expanding.”

Jace ran his hand over the lower ribs. “Most of his injury seems to be on the right side. His liver is probably lacerated.”

Evan asked for a flashlight and looked in the patient’s eyes. “His pupils don’t respond.”

“What’s the pressure?”

“I can’t measure it.”

Jace made eye contact with Evan. “Could he be in cardiac tamponade?”

Evan examined the neck. “Neck veins are flat. That means he needs volume. If his neck veins were up, that would mean tamponade or pneumothorax.”

Jace looked at the chest-tube container, now containing almost two liters of blood. “We start CPR or we call it.”

Gabby frowned. “We can’t save him, Jace. Let him go.”

Jace nodded. “We have no more blood.”

Evan stepped away from the table. “Time of death, eleven thirty-two.”

Jace felt like cursing. If they’d had an emergency prehospital system, if they’d had more blood, if they’d had access to equipment in the field … He looked around the room as the nurses began cleaning up. There was no emotion, no tears, just the everyday let’s-get-the-work-done attitude.

In emergency rooms in Africa, death was a frequent visitor. There wasn’t time to mourn. Only time to prepare for the next victim transferring from life to somewhere beyond.

Jace needed air and space to think. He sighed deeply, frustrated by his inability to turn the tide against the enemy of death. As he walked toward the entrance, he heard the voice of the nurse. “Who is going to pay his bill?”

He felt an immediate stab of anger. How could they be thinking of money when a man’s life had just been lost?

He turned to see the face of the light-skinned nurse holding up a chart. “I’m going to need you to fill out a report.”

Jace nodded. “Maybe there’s some next of kin. Perhaps he has a family who can help with his bills.”

“Doubtful,” the white-haired nurse mumbled. She rifled through a discarded pile of bloodstained clothing, lifting a wallet from the man’s pants. “He has an ID,” she said. “His name is Kimathi.”

Jace froze.

“Kimathi,” the nurse repeated. “Anthony Kimathi.”

27

Jace and Evan split the six-thousand-shilling bill for the supplies they used in their resuscitation attempt of Anthony Kimathi and walked out into the parking lot.

Gabby followed, rubbing dirt from the front of her dress. “We need to talk to the police, Jace.”

He shook his head. “I’ve been rethinking this. I think we ought to keep this quiet.”

“Jace,” Evan said, “that guy, Anthony whoever, clearly had ideas about doing you harm. Don’t you think the police need to hear about that?”

“That might not be a smart move,” he said. “Think about it. How would that guy have known we would be at that exact spot? Obviously our driver told him where we would be stopped.”

“Unless they were following us,” Gabby said.

“They were on foot,” Jace answered. “So it all had to be planned. The driver had to know exactly where he would run into the spike strip to flatten a tire.”

Gabby frowned. “So you assume the police were in on this too?”

“I think so.”

“What if our driver just knew where the police were going to be setting up a roadblock?”