Deadly Medicine (31 page)

Abby could track the ER and OR schedules from her computer, and although it might have seemed like spying to some, Ward understood it was just another way for Abby to keep a handle on everything happening in the hospital. It was her job.

“I think it’s seventeen, but who’s counting?”

“Well, I know you must have a dozen charts calling your name, so I won’t hold you up. I just wanted to update you. I called the state and they will review the cases. And the police chief just stopped in. He’ll look into it.”

“Humph.”

Abby whistled out her sigh. “Our hands are tied, Ward. We have to let these people do their jobs. We’ve done ours—you’ve done great work, far beyond what anyone could have expected. You’re responsible for bringing this guy to the attention of the police and the state board. You. But now you have to be patient.”

“While he kills someone else?”

Abby didn’t answer for a moment. “What would you like to do? ’Cuz if you have a brilliant idea, I’m all ears.”

“Maybe I do.”

Ward shared her thoughts about contacting the local hospitals to warn them about Hawk.

“I’ll call the locums agency right now,” Abby said.

“Don’t you think I should call? After all, I work for them. They’d probably be more forthcoming with me.”

“Hmm. I don’t know. I can always say something like I need him for a peer review or to sign incomplete charts. I can ask if he’s close by, so he can come back to the hospital, rather than having to mail confidential documents. What would your approach be?”

“I didn’t get that far,” she admitted.

“Well, then let me call them. But you should start working on Plan B.”

“’Kay. Keep me posted.”

“Will do.”

Ward kept busy with charts and patients while Abby conducted her inquiry. She hurried to the phone an hour later when the clerk told her Abby was on the line. “That was fast,” she said by way of greeting.

“And I have good news. I found him.”

Ward was surprised. In the era of patient confidentiality, she would have hoped the locums company would have guarded
employee
privacy a little more carefully. “You’re amazing. What’d you say to them?”

“I just said I needed for him to sign some confidential papers and asked if he was in the vicinity.”

Ward couldn’t help smiling. What a relief. Hopefully they could warn their friends and colleagues about their suspicions. The authorities might not be able to stop him, but maybe she and Abby could.

“So where is he?” she asked when Abby stopped talking.

“Close, actually. He’s about forty-five minutes away, at a little hospital in Garden.”

Post Mortem

“C’mon, Jess, answer the phone.”

It was the third time Ward had made that request in the ten minutes since she’d disconnected her call to Abby. First, she’d dialed the ER. It seemed Jess spent most of her time there. The clerk had told her Jess wasn’t working but had been kind enough to tell Ward she was expected at seven. It was nearly four, and if she was working the night shift, she would be waking soon. She hadn’t answered her cell, though, and Ward didn’t have time to sit there pressing redial all day. A patient had been waiting when she’d left the ER for the privacy of the physicians’ lounge, and at four in the afternoon, more like him would soon be piling in. If she didn’t get to talk to Jess now, she might not have a chance until midnight, when the ER in Garden slowed down. She didn’t want to wait that long.

“Hello.”

Ward nearly collapsed in relief. “Hey, can you talk?”

“Sure, just give me a minute. I just got out of the shower. I work tonight.”

Ward paced the lounge while awaiting Jess’s return.

“I’m back,” she said after an eternity.

“Jess, you have a huge problem. Edward Hawk.”

“What about Hawk?”

Ward detected the edge to Jess’s voice that she’d noticed so often lately. It seemed so long ago that she could have made the same statement and a receptive Jess would have been concerned. The defensive Jess just sounded…defensive.

“He’s murdering people. His patients.”

The laughter preceding Jess’s response was a response in itself. “Are you drinking?”

The barb stung, mostly because Jess knew how much it would. Ward swallowed a retort that might further the argument. She needed Jess on her side, and she couldn’t risk alienating her.

“Plenty of water, Jess. I’m totally serious about Hawk. A little kid here with a femur fracture died of a venous air embolus after Hawk put in a central line. The chances of that are slim to none. Another patient—”

“That should be on the consent form. One of the complications of central lines is venous air embolus. It’s expected.”

Ward chuckled. “Sure, Jess. We tell people all that stuff so they don’t sue us when there’s a complication, but have you ever seen it?”

“That doesn’t mean the guy’s a murderer. I’ve been watching him for the past few weeks and he seems quite capable.”

“I’m not arguing his abilities, Jess. But have you asked the staff about him? He’s creepy. And his patients die, for no reason. Stable patients just crash and die when he’s around.”

“I’m sure there’s an explanation. I mean, femur fractures bleed. The kid probably lost a lot of blood.”

“They did an autopsy and found air in the girl’s heart. Her hemoglobin was low, but not deadly low. It wasn’t blood loss.”

“Well, that doesn’t mean it was intentional. As I said, air embolus is an accepted complication of the procedure.”

“You have to put in twelve thousand lines to have a fatal complication. What are the chances of it happening three times?”

“Three?”

“Yeah. There was one in January, and another one, in March.”

“You didn’t say there were three.”

“You interrupted me.”

Ward heard Jess sigh into the phone. “It doesn’t matter. One, two, three, who cares? It doesn’t mean the guy is murdering people. Maybe he just sucks at lines.”

“Seriously? If one of your patients died after you inserted a line, would you let that happen again? I mean, you have to ask yourself, why and how and what I should do differently next time. You don’t let something that happens once every thousand years happen three times in six months.”

“Maybe. But maybe he didn’t know the cause of death. I don’t know, Ward. It’s just a completely illogical conclusion to jump to.”

“There’s more. Two other patients, both of them diabetic, mysteriously died in the ER. Both were ready for discharge, waiting for rides, when they were found dead in their exam rooms. Both were Hawk’s patients. And another one was found dead, but had no autopsy to say why. Hawk had more deaths in two months at the hospital than the others had in an entire year.” That was an exaggeration, but it was close enough to the truth that Ward didn’t regret the words.

“Are you listening to yourself? You sound paranoid, like one of the patients from the hood we used to treat in Philly.”

She heard Jess’s tone and wanted to scream. Jess was quiet and calm, as if she were talking to someone irrational. On the other hand, Ward was loud. The psychology was infuriating.

“I’m not paranoid, Jess, and I’m not the only one who’s concerned about Hawk. I just thought since I know you, I’d call. I thought I might get further than with a complete stranger, but I guess I was wrong.”

“Is this an attempt to get me back? If you can get Hawk into some trouble maybe I’ll think you’re a hero or something?” If Jess’s words weren’t enough to push Ward over the edge, the condescending tone certainly was.

“Fuck you, Jess. Just. Fuck. You.”

“Well, that’s mature.”

She’d managed to calm her pulse and her voice by the time Jess started to speak again. She cut her off before she could say anything further.

“Don’t, Jess. I’ve heard enough. I’ve called the police, I’ve called the state medical board, and now I’ve called you. If Hawk kills again, it’s not on my conscience.”

*

Jess heard the click as Ward disconnected the call. Ward had gone off the cliff, and Jess was sorry for her part in it. She still thought of telling her about the drug in her system on the night she attacked Em and George, but each time she debated it, she decided against it. It might make Ward feel better, but it would make the situation worse for everyone else. And her own situation wasn’t great. Things weren’t going well with Wendy, and though she suspected they’d be great friends, she knew they wouldn’t make it as lovers. Her father was doing and saying things that concerned her, and she’d been trying to get him to the doctor for weeks. Dementia was a big concern. The ER was slammed with summer visitors, and she was working two or three hours extra every day to help the staff keep up. As the director, it was her job. Yet it all weighed heavily on her. It took all her strength to make it through her days, to keep it together, to get to work, and to not crack up. Being responsible for Ward, too, was just too much to ask.

Reaching into the bedside table, she pulled out her pill bottles. First, she opened the Xanax and swallowed two tabs with the water sitting there. Carefully, she closed the lid. She couldn’t afford to lose pills. Yes, she could still get them, but since leaving Philly, it was much harder. Next, she opened the bottle of Percocet. She’d managed to convince the pain-management specialist that she needed six of the tablets daily, and mostly, she did. She’d spent the last two years of her life as small segments of time passed between narcotics doses. Through sheer force of will she’d managed to wean herself down to six tablets a day, but at times like now she definitely needed more. She tapped the bottle against her palm until three tablets sat in her hand. For a moment, she debated putting one back but then threw back her head and swallowed them before she could change her mind.

She definitely needed a new source. For years she’d been able to find pills through her regular patients in the ER, mostly the guys with sickle-cell anemia, who made regular appearances in the ER for crises. After getting to know some of the faces, she’d developed the sort of relationship with one or two that allowed her to exchange money for the thirty extra oxycodone tabs she needed every week. The cost was a little higher when she used her patients, but she didn’t need to worry much about money. As long as she had her drugs, she could function, and she often needed as many as ten tablets a day to keep her that way. But then, the owner of the Happy and Healthy Pharmacies was arrested for distributing narcotics, and overnight the supply on the streets of Philadelphia ran dry.

Jess had been able to painfully wean herself down, and she would do well for weeks on end, then crash. Her needs would rebound and she’d need a dozen tabs to recharge. Now, she was mostly stabilized on this dose, and she’d found a reliable doctor to prescribe the pills. All she needed was a little insurance, for stressful times, like when her ex-girlfriend called to tell her one of the doctors on her staff was murdering patients.

Jess pulled on a pair of shorts and a T-shirt and sat on her bed. It had once been their bed, but the relationship had become too much for her. Her addiction to pain pills took all of her energy, and she just didn’t have enough to share with a partner. At times she’d contemplated telling Ward about her problem, but in the end, she’d decided against it.

Jess had always been the prude, criticizing Ward for drinking too much, when, really, she was just having fun. Then, when her wrist surgery didn’t go as planned, Ward had nursed her gently, cautioning her every day about the use of pain pills, until one day, Jess just went out and got another prescription from her family doctor so she could take them without Ward’s knowledge. Her dependence on the drugs happened so quickly she’d never seen it coming. As her wrist healed, she’d tried to cut back, but within hours of taking a tablet, she started to feel the misery of withdrawal—anxiety, muscle aches, diarrhea, profuse sweating. It was hell, and just a single Percocet could make her normal again.

For a moment, she wished she could have shared this trouble with Ward. But she was too good, too perfect. She would have insisted on something like rehab, or random urine drug screens before bed. It was much better for Jess to be alone with this problem than to deal with Ward. It took all she had to function as a doctor, and that was her first priority, her true love. Women were emotional and taxing, and medicine really wasn’t.

It was unpredictable at times—patients didn’t always respond the way they should have to treatment, but that made it challenging. Almost always, she could solve their riddles and diagnose their problems. Almost always she could make them feel better. And in the chaos of her life, that one little sliver of joy kept her alive. Ward couldn’t do it. Her career could. She’d had to let Ward go.

Jess didn’t know what to make of Ward’s accusations. Ever since learning Ward had been drugged on the night she attacked Emory and George, Jess tended to sympathize with her. Not enough to tell her the truth—what was the point? The lie gave Jess the perfect excuse to break up with her, and that had been just what she needed at the time.

What about now, though? Things with Wendy weren’t working out, and she could never be with a man. She’d been foolish to even entertain that idea, but her life was in the sort of state where foolish ideas seemed logical. Was her breakup with Ward another folly? Was it time to rethink Ward? She’d never find anyone kinder and better for her—better to her, either. Yet that was part of the problem. Ward enabled her, and Jess couldn’t help taking advantage. Ward was just an easy target.

What about Hawk? Could Ward be right? He was a little strange; the staff had mentioned that. What would make Ward label him a killer? It sounded like bad luck more than anything. Still, three fatal air emboli—that was a bit hard to comprehend. It was rare to see a doctor make a fatal mistake more than once. Doctors were healers—they buried their mistakes but learned from them.

I’ll have to keep an eye on him, she thought as she sat before her computer. She liked to scan her e-mail before work, just to know what was happening. After logging on, she scanned the list. Junk, junk, junk, Wendy.