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Authors: Eileen Dreyer

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BOOK: Nothing Personal
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It was Tim’s turn to shuffle. “The cafeteria. Security has been warned not to let you past the front door. Said it’s bad for hospital PR.”

She shook her head. “No sense of humor. Would you mind swinging by the ER? I wanna say hi.”

“You wanna harass Phyl, and you know it.”

Kate flashed him a big grin. “I know it.”

Tim shook his head like a patient father. Kate could see he understood, though. It was what had gotten her through that first day upright: the promise of getting down to where the real heart of the hospital was for her. She’d been sitting in that damn chair all afternoon like a kid waiting for her mom to get home to take her to the park. Well, it was time to get her shoes on and go. Back home where the trauma code roamed. Noise, lights, action. It was just too damn quiet up here, where sick people thought silence would heal.

By the time Kate managed to straighten all the way back up into walking position, B.J. was at the door on his way out. B.J. was not the park and field-trip type. “Well, if you remember anything interesting, let me know.”

“Interesting?” Tim echoed, instinctively moving closer to help Kate along. “You talking about Warner?”

That brought Kate to a full stop. “God, I forgot. What did you find out?”

B.J. shot her quite a look. “Give away clues to the prime suspect? Don’t be absurd.”

“Thank you, Hercule Poirot. What did you find?”

“Carbamazepine in her coffee and a big bleed in her head.”

“Subarachnoid?”

He nodded. “She blew like a bad boiler on the
Titanic
.”

Kate had her crutches fitted. She was itching to visit her friends. She didn’t move. “From carbamazepine?”

B.J. shrugged. “From something. Maybe you just pissed her off one too many times.”

Kate offered a particularly charming grimace as Tim passed over Kate’s official Pig Nurse’s cap to cover the buzz. “Why not? I already have Attila on my head. I probably killed Warner too. While you’re at it, check and see if I was in Dallas in 1963.” She settled the cap so the pink snout pointed forward and the white nursing cap pointed backward, right between the pink pointy ears. It’s the small details that make a difference.

“So it wasn’t murder?” Tim asked, forehead puckered, hand at Kate’s elbow.

B.J. shook his head. “I didn’t say that, either.”

And that was that. Kate could see it in the set of his features.

Murder. Kate tried rolling the sound of that one on her tongue and found she didn’t like the taste at all. Even with Little Dick’s histrionics, she hadn’t really believed Mrs. Warner had been murdered. After all, everybody in the place talked about revenge. It was the favorite topic of conversation, after sex and bad shifts. But nobody would ever seriously think of doing it. Murder went against everything they’d been trained for, had dedicated themselves to.

Did she really believe that, though?

“Who’d do it?” she demanded, suddenly feeling a little more tired.

“Little Dick Trainor thinks
you
did,” B.J. said.

“He doesn’t count. Who’d really do it?”

For a moment there was silence as the three of them considered implications. The hospital went on around them, voices drifting in from the halls, the elevators dinging softly, an IVAC beeping on somebody’s IV. Familiar, comforting sounds to Kate, who had burrowed into hospitals like a mole uncomfortable in the light outside. But B.J.’s announcement took Kate’s sense of balance with it.

“Ridiculous,” she said, straightening, as if that would carry her conviction. “Check her insurance policies. I bet one of her family offed her to get money. Murder’s always committed by next of kin.”

B.J. just lifted an eyebrow.

“Well, all you have to do is watch
America’s Most Wanted
,” she protested lamely.


Code blue, Medical ICU, room five. Code blue, Medical ICU, room five
,” the intercom announced.

“Oh, shit!” Tim snapped by way of saying good-bye, and whirled out the door.

Kate slumped a little. “I’m hungry.”

B.J. grimaced. “So now I’m supposed to take you?”

Kate leveled quite a smile at him. “Well, Tim’s gonna be busy for a while. That was Mr. LaPlante that just went.”

Mr. LaPlante, who had had one too many cigarette-and-leisure-suit combinations, was a gomer of epic proportions whose family refused to give up, even though the only healthy thing about the man was his hospital bill. Kate felt for Tim. He’d be up there for an hour, stabilizing the poor bloated oblivious thing, and then end up having to do it all over again in no more than four hours. Maintenance had been known to set time clocks by Mr. LaPlante.

“If you’ll tell me one thing,” B.J. said, leaning back against the wall.

“Anything. I’m starved.”

She should have seen the bemusement in his expression sooner. “How long have you been living with Tim?”

“About six months. Why?”

“You two getting married?”

Kate hated lying to B.J.; she didn’t do it well. She tried anyway. “We’ve talked about it.”

“Kate.” B.J. looked disappointed. “Don’t insult my intelligence.”

Kate knew she was still short a good supply of blood, because when it drained from her face she almost passed out. B.J. had no idea what he was doing.

“How did you know?” Kate asked.

“That he’s gay?” B.J. shrugged. “Unlike most of the medical staff around here, I pay attention.”

“Don’t…you wouldn’t…you haven’t….”

“Said anything? Don’t be stupid. I’m not going to do anything to jeopardize the career of one of the only two surgeons I consider any good in this place. Tim’s business is his business. I’m wondering about you.”

Kate actually had to sit down in the chair for that one. Her ears were ringing. “Jesus, don’t scare me like that. Anybody found out…well, you know what this neck of the woods is like.”

“As enlightened as the Inquisition.” B.J. gave a crisp nod. “Especially when it comes to surgeons. But what’s in it for you? Last I heard, you hadn’t taken a vow of celibacy.”

Kate thought of life with Tim and smiled. Her version of safe sex, she guessed. Tim slept in gym shorts and made it a point to keep himself in top physical shape. He and Kate were comfortable together, friends without interfering agendas who could criticize and compliment with impunity. Tim didn’t mind that Kate found him distressingly beautiful, and Kate didn’t mind so very much that Tim didn’t want to get too close.

Besides, Tim was gentle and supportive and
caring and creative. He coordinated her wardrobe better than she did. Every time he’d come to visit her in the hospital, he’d brought new earrings to wear with very short hair. He was a brilliant doctor who was old-fashioned enough to be passionate about his work. A girl could live with a worse person. Kate had most certainly lived with worse.

“I guess he’s my beard, too,” she finally admitted. “He’s a good friend who doesn’t demand too much. And after Michael the Perfect, just what I need to keep any more real involvements at bay.”

“I told you that asshole was wrong for you.”

Kate glared at him. “You told me when your blood alcohol was four-hundredths of a percent away from dead. You think I’m going to take you seriously then?”

“I dispense some of my sagest advice at moments like that.”

“You also told me Elvis was alive and working in radiology.”

His grin was grudging and cute. “He was. He just slipped out before I could prove it. Now, let’s eat.”

 

They ate. In fact, they were fêted. It didn’t take a giant leap of logic to figure out that word had gotten around that Little Dick had been in to interview Kate, or that it was about the demise of Evelyn Warner, personal favorite for more than one lounge dart board. There wasn’t exactly any applause when Kate hobbled into the cafeteria. There was, however, a general raising of coffee
cups and more than one offer of compensation.

“Somewhere there’s a murderer who’s pissed you’re getting all his attention,” B.J. informed her dryly.

Kate took a small bow and maneuvered a crutch around so she could get her tray. “How do you know I didn’t do it after all?”

B.J. actually snorted. “Because you’d never have the patience to set her up. You’d just beat her to a pulp.”

Oddly enough, the rank humor and objectionable insinuations offered by a definite percentage of the staff members made Kate feel comforted. No one had ever stood up for her before. No one had ever thrown insults like bouquets of bright flowers. Kate smiled and kept on smiling until she reached the emergency room, all the while dreading the moment when they would turn against her. Because throughout her life, whenever there was a moment like this, there was a moment like that.

 

By the time she finally made it down to the ER, Kate was really getting tired. Not tired enough to give in to a wheelchair, as Parker suggested in less than moderate tones; a girl still had her pride. But her gait was decidedly slow and faltering, and her fondest thoughts focused on how the dizziness would fade once she was horizontal again. First things first. Kate had to soak herself in the ER for a while before giving in.

It was the first time she’d set foot in the place since the accident. She’d thought about it a lot as
she lay in her bed, listening to the hall noises, smelling the hall smells, anxious with the collected anxieties of every person who waited there for relief, for answers, for death. Even with other people around, people she knew, she felt afraid and restless in a place that sparkled but didn’t feel clean.

The emergency room was fresher. Crisper. The smells weren’t waste but flux: disinfectants, floor wax, exhaust from the ambulances; popcorn and coffee, the staples of a place where meals were at a premium. The outside air washed through every time a door sighed open so that no smell or sound permeated, and patients rotated through too quickly to mark the corners with their scents.

Kate was refreshed every time she smelled the place, basked in the babble of the radio, the distant moan of a siren, the beeping and trilling and clatter of the machinery that lived there. Like the first whiff of smoke to an old fire horse, the smell of alcohol and Betadine sent Kate’s adrenaline spilling, and she readied for the charge. It was a high like no other in life.

She came to a halt at the head of the ER hallway so she could watch the constant motion, staff bouncing in and out of rooms like random electrons in a charged ion. She listened to the voices, a chorus of dissonant distress, punctuated by bursts of laughter or tears. She slowly inhaled and sated herself on the fresh aroma of movement. She waited for the hit of adrenaline.

She waited.

And she only felt tired.

“Hey, killer, nice to see you.”

Kate hadn’t even realized Jules was working. The big woman ambled over from the central desk, stethoscope dangling, pockets bulging, lab coat already stained with the day’s detritus. For a minute Kate couldn’t answer. She was trying to get over a perfectly irrational hiccup of terror.

Nothing excited her like walking onto the hall of an ER. Better than sex, better than chocolate. Action in the fast lane.

But it wasn’t there. That clutch of anticipation, that brightening, that sudden shift into gear. She’d depended on it.

Suddenly she wondered just how long it had been since she had last felt it. Like the time she’d faced Michael and realized he had broken her faith one too many times.

“Kate?”

This time Jules was looking a little worried. Kate did her best to smile, wondering whether she could will the infatuation back. Wondering what she could possibly do if she couldn’t, since this was the only place in the world she belonged.

“I’m disappointed,” Kate managed, shifting a little so her ribs would stop protesting. For the first time since leaving the floor, she wondered when her next pain med was due. “The place hasn’t fallen around your heads without me.”

“Sure it has,” Jules assured her blithely, patting her on top of her pig-snout cap like a puppy. “We just can’t let it look that way.”

“Sure you could. Just till I get back upstairs.”

“When you comin’ back?” one of the secretaries asked, only her head visible behind the desk.

“She doesn’t want to come back here,” Parker said on his way by.

“Sure she does,” Jules argued. “Kate loves disasters, don’t you, Kate?”

“I love disasters,” Kate parroted instinctively.

“Then when do you think they’ll let you back?”

“I don’t know,” was all she could say. Because for the first time since she was twelve years old, suddenly she didn’t want to.


YOU KNOW HOW
you can tell a hospital in Saint Louis?” a surgeon had once asked Kate. “By the emergency sign in front and the crane in the back.”

Truer words, Kate thought, had never been spoken. St. Louis, for its size and population, had an abundance of hospitals. Even after growing up in the city and succumbing to the lure of the only growth industry in the area besides beer, Kate had never had a great desire to study the history of the system. She was, however, well acquainted with its present, having worked in two of the metropolitan area’s largest hospitals and knowing people who worked in several others.

All in all, there were over sixty-five hospitals, clinics, outpatient surgical centers, and various and sundry psychiatric and detox units. It was a booming business that tended to clump around the major arteries of the metropolitan area like bad cholesterol. A calling administered to by the charitable of several faiths until recently, when the religious rosters had dwindled and the money-
making possibilities had soared. Where once Sisters of Mercy, St. Joseph, and Charity had swept through hallways, men in three-piece suits now reigned. Where each unit had stood in splendid isolation, buyouts had followed the same trend as everywhere else in the eighties until there was Barnes West and Deaconess West and St. John’s in Washington, also lovingly known as St. John Boy’s, all satellites of the older, larger, more established institution of the same name closer to the city center.

As for Serious Money, it had begun life under the auspices of the farseeing Little Sisters of Good Grace for the care and treatment of indigent tuberculosis patients. Taking advantage of low land prices the nuns had situated themselves far from the teeming city so their patients could indulge in healthy country air. For a time, St. Simon’s had been nicknamed St. Send Us Anyone, and they’d lived up to the name.

Progress being what it was, the population caught up with the hospital not long after tuberculosis, in that incarnation, went the way of the leech. The nuns expanded their facility into a teaching institution with ties to Missouri University and fought off the inevitable drain of vocations to the convent until they could no longer deny the fact that they, like every other order in the neighborhood, would have to rely on lay help.

That was when Leo Gunn took over. That was when staffing dropped and profits rose. That was when, as Mr. Gunn liked to put it, charity was introduced to reality. Kate preferred to refer to it as the
GM revolution in hospital administration, when TLC went from Tender Loving Care to Totally Low Cost, when black ink and bottom line became the only acceptable goals.

Kate had fought the tide longer than most. She was, after all, an incurable optimist. Somewhere she’d gotten stuck back there where patient care meant just that and not client relations. Where one worked with a patient to restore health rather than negotiate with a consumer to protect the hospital from litigious problems.

Kate was a dinosaur, and damn proud of it.

But as she sat in her room with the dusk gathering outside and the chatter of the hospital much too distant and low to soothe her, Kate found herself wondering if this particular dinosaur had just met her meteorite.

She’d managed to get back upstairs from the emergency department under her own power. Then she’d refused her pain med. Not out of displaced heroism but out of misery. If she was going to feel bad, she might as well make an evening of it.

She’d stood down in the ER for a good hour, laughing at the dismal jokes, asking about the patients, sucking in the exhaust fumes like her last cigarette, fighting off the panic.

She felt like a woman who woke one morning to realize she no longer loved her husband. Who wondered just how long it had been since she had loved him. She still saw everything that had attracted her to him, endeared him to her. But what had once been exciting now inspired nothing but weariness. Weariness and fear for a suddenly uncertain future.

What the hell was she supposed to do now? That passion had been all she’d had. It had been the only thing strong enough to offset the disillusionment, the frustration, the dismay of modern medicine.

Without it, what was worth fighting for?

She was a nurse, Kate thought, her chest burning, her head throbbing, her sea legs suddenly missing. There were thousands of different jobs for 2 nurse. She could do them all. She just had to find the right one, the one that made her feel as if she belonged.

“Oh my dear, don’t you look well!”

Startled, Kate looked up. She hadn’t heard anyone enter. When the light flipped on, she realized why. It was Mary Polyester, clipboard in hand, smile on face, comprehension noticeably absent. Kate was not in the mood for platitudes and vague comfort.

“Hi, Sister.” Ungraciously, she didn’t move.

The little nun seemed not to notice. She just bobbed her head and checked her list. Kate wondered offhandedly whether it showed if a patient had been naughty or nice. Maybe the answer to her own question was on that list somewhere.

“Is there anything I can get for you, dear? A rosary, perhaps? It says here you’re Catholic.”

“No thanks, Sister. The sisters who were up in the unit gave me one.” She kept it under her pillow like a talisman. Not so much because she believed in its magic anymore as because she still held out hope that she was wrong.

Sister smiled and nodded. “Oh, yes. Yes. They
were here for a miracle, weren’t they? Not here, though. The good Blessed Octavia will have to find her power somewhere else, I imagine.”

Kate couldn’t figure a better answer than “Yes, Sister.”

The little woman kept nodding, her rheumy blue eyes directed to the darkened window, her free hand at her chest, as if keeping herself on the earthly plain by force. “A sweet child, Kate. A poor innocent. It shouldn’t have happened.”

For just a wild moment, Kate let herself wonder which shouldn’t have happened. The illness? The prayers? The determination for a miracle? Or all of it taking place under the roof of St. Simon’s? Once again, though, she reverted to training.

“Yes, Sister.”

For some reason, that brought the little woman back to earth. She smiled, her tiny features exploding into a web of wrinkles beneath the white habit. “But you,” she said with satisfaction. “You’re doing fine, aren’t you? Just fine. I knew you would. I knew it would make a difference.”

“Yes. Thank you.”

A nod, as brisk as a spring stroll. “And I think the baseball caps and earrings are quite charming. You tell them that, all right?”

Tell who?

“Oh, and here, I almost forgot.” Reaching into her habit pocket, she pulled out a little clear plastic pouch and plopped it into Kate’s hand. Inside, nestled like a sleeping snake, was one of those mass-market plastic brown rosaries that nuns the world over give good schoolchildren and worried
patients. Kate figured it wouldn’t hurt to double her mojo. She just shut up and accepted it.

“Thank you, Sister.”

But Polyester had already turned to leave. Kate ended up shaking her head, which made her latest set of earrings, dangly red rhinestones, dance against her neck.

“Yes, Sister.”

She closed her eyes and tipped her head back against the big chair….

 

“Kate?”

The voice was hesitant. Even so, Kate heard an edge of incipient panic that brought her upright and her eyes open.

The evening nurse was perched halfway in the door, body poised for flight.

“What’s wrong, Tracy?”

“Uh, I know this is…well, are you up to a little IV?”

“I have one, thanks.” Kate was already reaching for her crutches. She recognized that tone of voice. She imagined the announcer on the
Titanic
had sounded just as timorous when he first mentioned the little problem they were having with the ice.

“It’s Mr. Peabody in four-fifteen,” Tracy apologized, already moving aside to let Kate by. “His IV came out and we can’t get it restarted. I only have agency nurses on, the supervisor’s busy, and ER just got in an accident and can’t send anybody.”

“And?”

Tracy took a deep breath, which upped the ante. “And he’s been having chest pains.”

They headed down the hall, where remnants of families migrated toward the elevators at the end of visiting hours.

“What’s he here for?”

“Gallbladder. Fourth day post-op. He was doing fine. We’re trying to get Weiss now.”

Kate just grunted. Her buddy Weiss. No wonder Tracy was panicky. If Weiss was the resident on the case, God only knew what disaster was brewing—assuming that Weiss showed up in time to orchestrate it.

“Did you call EKG and X ray?”

Tracy looked positively aghast. “Without a doctor’s order?”

They’d reached the door to room 415. Kate only had to take one look inside to hear the shark music in her head. There was no mistaking that particular color of pasty gray. Mr. Peabody didn’t just need a new IV. He was getting ready for that big bus ride to the pearly gates, and there was no one on hand but Tracy and Kate and the agency nurse, who was already hovering at the bed to cancel his ticket.

“I’ll tell you what,” Kate suggested, her voice instinctively settling into that lilting, calming tone she used for very serious situations and mad animals. “I’ll do the calling. Get me an eighteen Cathlon and try and find the medical resident. I think Lisa Beller’s on, isn’t she? And call the unit. You’re gonna need a bed.”

“But Kate,” Tracy insisted, dead serious, “you can’t do this.”

Kate grinned. “What are they gonna do, shave my head and break my leg? Who’s the primary?”

“Doctor Fleischer. We’ve been trying to find him all afternoon.”

Kate fought a groan. The music amplified in her head. Oh, well, nothing she could do but jump in the water. Tracy couldn’t take the initiative, especially with Fleischer. He’d flay a floor nurse alive for acting like an adult behind his back. And it was a cinch no rent-a-nurse was going to rock the boat. One of the few perks of the ER was that you could get away with some major shit if you just shucked and jived in the right order. The difference between living in a land where disaster was a surprise and where it was the rule.

It took out the option of floor work in the future, though. Kate could only survive so many broken legs.

“I’m not in any shape to do CPR,” she told Tracy in that same tone, as she turned to head into the room. “Let’s get going.”

The other nurse, a handsome graduate named Paul Cantor, had his eye on the administrative suite. Right now he looked only fractionally more frantic than Mr. Peabody as he stood with one hand on the older man’s wrist and the other clutching his stethoscope as if it were an umbilical cord. Kate wasn’t at all sure who was having more trouble breathing. She didn’t blame either of them in the least. All Mr. Peabody needed to do was tell her he was going to die to complete the picture, because that was exactly what he was trying to do.

“Vitals?” Kate asked, smiling down at the sweaty, panting little man.

“Eighty over forty,” Paul answered, his voice a squeak. “Pulse one-ten and irregular.”

Kate nodded. “Hi, Mr. Peabody. Hear you’re not feeling well. Paul, get the cart.”

“Who are you?” Mr. Peabody demanded as Kate carefully reached up to rip the oxygen cannula from the wall where it was always kept at the outlet.

“I’m a nurse,” she acknowledged, seeing his attention on the earrings and the Malcolm X ball cap she’d been given by Parker down in the ER to go with the scrubs she’d adopted. “On light duty. Is the pain worse when you breathe in?”

“No…no, it’s just…heavy. I don’t…”

She didn’t let him finish that thought. It would just head in directions she didn’t want to take. Well, at least he wasn’t throwing an embolism. Heart attacks she could manage, at least until the cavalry arrived. “Are you allergic to anything?”

The little man shook his head as Kate fitted the oxygen under his nose and dialed it up.

“Paul, get me some MS too,” she said, as he headed out the door. If Kate was lucky, Tracy would find a medical resident quickly enough so they could give the morphine sulfate right away, or at least cover Kate’s butt when she did it. It was the only thing that was going to help. Kate spent valuable seconds getting rid of the crutches and testing her balance without them. Then, retying the tourniquet Tracy had just loosened around Mr. Peabody’s slick, pale arm, she began looking for a vein.

Kate heard Paul running down the hall as she palpated with one hand and phoned with the other. Overhead the intercom paged Dr. Weiss and Dr. Beller stat to four west. Kate bent to the IV, praying that Beller would beat Weiss in the door.


EKG to room four-fifteen stat. Respiratory therapy to room four-fifteen stat
,” the intercom announced.

“That for me?” Mr. Peabody asked, his face tightening up.

Kate slapped at his forearm with impatient fingers, trying to bully a vein into existence for her use. “So we can get rid of that pain,” she said. “That okay with you?”

“I’m dying, aren’t I?”

Now he’d done it.

“And have me be the last thing you see?” she demanded with a grin even as Tracy slid back into the room with the new IV cannula and the crash cart. “I’d never be that cruel.”

“What the fuck do you think you’re doing?”

Kate would have recognized those dulcet tones anywhere. Weiss was definitely in full cry. Kate didn’t bother to look up from Mr. Peabody’s wrist. The IV was more important than Weiss’s attitude, although something about it made Kate wish for some protection at her back. She did her best to pretend he was addressing Tracy, who had begun to shake like a wet poodle.

Weiss didn’t buy it. “I asked you a question. You got bored, did you, and decided you’d be a hot dog on somebody else’s division? Is that it, Manion?”

“Mr. Peabody has crushing substernal chest pain,” Kate announced calmly. “It does not increase on inspiration. His rate is irregularly irregular and his pressure’s eighty over forty. He’s four days post-op. Wanna listen to his chest, Martin? Tracy asked me to try and restart the IV for them.”

At least he couldn’t argue that much. If Kate had been in Tracy’s shoes, she would have done the same thing.

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