Sleight of Hand (5 page)

Even abusive parents did not enjoy their children's sufferings.  Most of the abuse Cassie had seen occurred from a lack of impulse control rather than a lack of caring.  She thought upon her own experiences with Richard.  He'd been violent only when drunk or high on drugs.  And she was certain in some warped fashion that he had loved her–loved her still despite everything that had happened.

She was just tired.  Looking for demons to fight because she couldn't confront Drake.  

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Virginia Ulrich slid her hand out from under Charlie's head and shook the blood back into it.  He was finally asleep, thank goodness.  She stood, stretched and kneaded the sore muscles in her lower back.  The baby was kicking a lot lately.  Maybe little Samantha was worried about her big brother.  She headed over to the nurses' station.  There, her nurse, Emily, sat charting.

"He's asleep," Virginia told her.  "I'm going to go call his father.  Will you keep an eye on him?"

Emily looked up at that, a small frown creasing her brow.  She was new, had never cared for Charlie or George before him.

"I never leave him alone," Virginia explained.  "He's been through so much.  And accidents do happen.  His brother, George–" She cleared her throat, watched as Emily made a small noise of sympathy.  The other nurses or Dr. Sterling must have filled her in on what happened to George, saving Virginia the need to re-open those wounds.  "George was here a lot, too.  He almost died when a nurse gave him too much potassium."

Emily nodded her understanding.  "Of course.  I'll sit by him while I catch up on this paperwork."

"Thanks, Emily."  Virginia reached out and squeezed the nurse's shoulder in gratitude.  She always appreciated it when she found a healthcare professional willing to go the extra mile to protect one of her children.

She took a long look back at her son, then left the Pediatric ICU.  People didn't understand how stressful it was to have a child as sick as Charlie, especially if you had to protect him from the doctors and nurses who were supposed to be making him better.  It forced her to maintain a constant state of vigilance, but she wasn't going to take any chances.

She went into the parents' lounge across the hall from the PICU.  There she found fresh coffee and a quiet corner to sit and call Paul from.  She knew all the books said to drink decaf when you were pregnant, but she couldn't stand the taste.  Besides, she'd drunk coffee and the occasional glass of wine during her previous pregnancies without any problems.

Virginia eased herself down into the low-slung vinyl chair.  She cradled the phone on her stomach and leaned back, lifting her feet onto the coffee table.  Her feet were swollen and the veins on her legs looked like ugly blue worms crawling under her skin.  She hated this part of being pregnant.  She couldn't wait until the baby was delivered and she could go back to being a person instead of an incubator.  But it was nice the way they spoiled you after a baby came–the steak and champagne dinner at the hospital, all the flowers and visits to see how the new mother was doing.  

As she dialed, she looked out over the familiar landscape.  This side of the hospital faced the old cemetery.  Behind wrought iron gates and between the silhouette of still-leafless maple trees, white marble memorials shimmered in the sunlight.  Virginia quickly found the large angel she considered her guardian.  How many times before had she and that angel sat vigil?

Paul answered the phone after four rings.  "Yes?"

"It's me.  They admitted Charlie to the Pediatric ICU."

"Why?  What happened?  I thought you said he was fine and you were just taking him in as a precaution."

"I know, but when I got to the ER the doctor said he'd gone into seizures and shock.  They kept sticking him over and over for an IV. They couldn't get one, so they had to put one into his bone.  It was awful!"  She finally allowed herself to cry, remembering the sound of Charlie's bone breaking.

"Why couldn't they get the IV?" Paul demanded.  "They've never had trouble before."

"I don't know.  The doctor in the ER didn't seem to know what she was doing."

"Did they call Sterling?"

"I begged them to.  They finally did, and he got Charlie up to the ICU.  He's all right now.  They pulled the IV out of his leg and put one in through his femoral vein.  He's finally asleep."

"Jesus, Virginia.  It's Georgie all over again."  George, their first son–they'd been in the hospital with him almost a dozen times before he finally died. 

"I know, I know.  But Dr. Sterling is working on it.  He's doing everything he can."

There was silence for a moment.  Virginia knew how frustrated Paul was.  He was a man unaccustomed to feeling helpless.  As an attorney, he preferred to take control of a situation, not sit by and watch helplessly.  Especially when his son's life was at stake.  But she also understood his fear of hospitals.  It seemed that every time he visited George or Charlie they would take a turn for the worse. That was why he relied on her, with her medical knowledge, to deal with the medical professionals.

"You want me to come in?" he finally offered.

"No.  One of us should get some rest tonight."  They'd developed their own system over the years, first with Georgie, now with Charlie.  "Just bring me some clothes in the morning, okay?"

"I'll see you then.  And Virginia–"

"Yes?"

"Get me the name of that ER doctor.  I think Sterling should speak to her or her department head."

"It was Hart.  Cassandra Hart."

There was a long pause.  "Did you say Cassandra Hart?  She's Alan King's ex-sister in law.  You know, the one involved with those drug thefts in February."

"The woman who almost got Richard King killed?" Virginia asked.  

Suddenly the doctor's antipathy toward her made sense, despite their never meeting in person before.  She'd probably recognized Virginia's name.  

"Paul," she hated to voice her fears, "what if she did something wrong, something to hurt Charlie?  She'd know that you're partners with Alan and that we're friends of Richard.  What if..."  Her voice trailed off.  It was too terrible to even imagine anyone intentionally harming her beautiful little boy.  

"Don't worry about it," he reassured her.  "I'll talk to Sterling, make certain that everything is taken care of."

"Okay, honey.  Love you."

Virginia thought about the dark-haired ER doctor.  She hadn't liked Dr. Hart, the way she questioned everything Virginia told her about Charlie.  She understood now.  Cassandra Hart was covering up her own incompetence by questioning Virginia's.  The newspapers had made Hart out to be some kind of hero, a brilliant doctor who helped the police solve a big drug investigation.  But Virginia was a friend of Richard King, had visited him while he was in a coma, suffering from a drug overdose that Cassandra Hart had claimed was accidental. 

Richard had almost died.  Even now, almost two months later, he was a warped shadow of the vibrant man he'd once been.  

She'd seen Dr. Hart's handiwork firsthand.  Somehow Virginia had to make certain Cassandra Hart never had a chance to treat her son again. 

CHAPTER 4

Before going home, Cassie decided to join Adeena upstairs in the Pediatric ICU.  She needed to quiet this niggling feeling that there was something more going on with Charlie, maybe something she'd missed.  And she wanted to get another look at his mother.  After watching the video several more times, she couldn't decide what the fleeting expression on Virginia Ulrich's face meant.

The PICU was quieter than the other units.  A perpetual twilight surrounded its small patients who balanced between life and death.  Everything in here seemed muted, surreal, as if to avoid jarring patients and their loved ones into the harsh reality of their existence.  

Like the ER, it was a place where battles were waged.  But, unlike Cassie's territory, there was no atmosphere of chaos and frenzy.  Rather an anxious undercurrent of urgency evident in the quick footsteps of nurses and the strained faces of parents keeping vigil over their children.

The laughter at Charlie Ulrich's bedside was a garish contrast.  

Cassie looked over, surprised to see that it was Karl Sterling laughing as he held Virginia's hand and patted it.

"No worries now.  I'll have Charlie good as new in no time," he promised the mother.  Around him beaming and nodding residents clustered, a flock of white geese surrounding their gander.  

Charlie must be doing better, Cassie thought as she grabbed his chart and sat down at the nurses' station with it.

According to the progress notes, he was.  There had been no further seizure activity, and Charlie was now awake and acting appropriately.   She turned to the history section of the chart.

Virginia Ulrich's story had changed somewhat.  She'd told the pediatric residents and Sterling that the seizure began a few minutes before she arrived in the ER and that everything had started with an episode of abnormal breathing.  The only consistent fact was the delay before bringing him into the ER.  Virginia explained this was because an ER doctor, Ed Castro, did "nothing" when Charlie had a similar episode last week and had berated her for coming in when he wasn't sick enough.

Cassie tapped her finger against her lips.  Everyone lied when they came to the ER.  In fact, the first rule of emergency medicine she taught her residents was to trust no one, assume nothing.  

Had Virginia been so intimidated by Ed Castro during her visit last week that she waited at home for almost an hour before bringing Charlie in today and then lied to Cassie about the timing of his seizure?  She doubted it.  Ed had six kids of his own and was much more sympathetic with over-anxious parents than any of the other Emergency Department attendings.  

"Can I help you, Dr. Hart?"

Cassie looked up, startled by Virginia's voice.  She sounded so comfortable, as if Cassie was the outsider here, the stranger who needed guidance.  

"A bit far from the ER, aren't we?" Karl Sterling asked as he joined Charlie's mother at the nursing station.  Both of them looked down at Cassie. 

"Just checking on my patient."  She wasn't sure why, but she felt as if she needed to straighten her posture, that she was being judged.  She closed Charlie's chart, then stood, leveling the playing field.

"You mean
my
patient," Sterling corrected her, increasing her irritation.  His tone was friendly, jocular even, but Cassie found herself frowning.  "Did anything in particular interest you?  I've been following Charlie since he was a newborn.  And of course, his brother before him."

Sterling obviously had no concerns about Virginia's history.   Cassie glanced past them to Charlie's bedside.  The small boy was surrounded by white-coated figures.  "I was interested in the discrepancies in the history I received from Mrs. Ulrich."   

"Surely you aren't implying–" Sterling started, but Virginia Ulrich interrupted him.

"Now, Karl.  I'm sure Dr. Hart isn't accusing me of anything but being a distraught and overwhelmed mother."  She smiled at Cassie.  "You'll excuse me if I was confused.  It's just that Charlie had been doing so well lately, I dared to hope–anyway, I apologize."

Cassie was taken aback by the mother's gracious concession.  She had no choice but to accept it.  "Of course.  I just wanted to be certain that I hadn't missed anything important."

"No," Virginia Ulrich continued, her smile unchanging, still wide, exposing perfectly aligned white teeth but without wrinkling or marring her makeup.  "You were concerned about my son and wanted to be certain that I hadn't misled you."

"Virginia, you don't have to explain yourself.  We all understand what a strain you've been under."  Sterling placed an arm around Virginia to steer her away.

"It's all right, Karl."  With a regal shake of her perfectly coifed hair, Virginia straightened to her full height and looked down, meeting Cassie's eyes.  "You see, Dr. Hart, it's happened before.  Charlie had a brother, George, who died.  Early in the course of his illness a well-meaning but misguided nurse reported me to Children and Youth.  They investigated fully, we even spent time in Room 303 on Peds–you know, the room with the video surveillance.  

"I was of course upset at the allegations that I could be capable of doing anything to harm my child.  But I knew they were just trying to do what was best for my son.  I even volunteered to go away and leave George in the hands of you people here at the hospital."

"Do you have children, Dr. Hart?" Sterling asked Cassie.

"No."  She focused on the pediatrician.  What did that have to do with anything?

"Then you can't begin to understand the sacrifice Virginia was prepared to make for her son.  Trusting him to the care of strangers.  I'm just thankful it never came to that."  He patted Virginia's hand.

"I would do anything in my power to help my son," she went on.  "I would have left.  But then that same nurse gave George the wrong medication, and he almost died."

"Thank God you were there for him," Sterling said.

"So you can understand why I might seem hyper-vigilant about my son's care," Virginia finished.  "I'm sorry if my anxiety caused you concern.  But I appreciate your efforts on my son's behalf."  

Cassie noted that a small crowd of residents and nurses had gathered around them.  If Sterling was the King of the PICU, then Virginia Ulrich was the current Queen of the realm.

She looked past the flock of white coats to the little boy lying in the bed across from the nurses' station.  He met her glance and smiled faintly.  

"If you'd excuse me, I'd like to return to my son."  Virginia Ulrich moved to join Charlie.  

Sterling tapped his pen on the desktop, pulling Cassie's attention away from the little boy and his mother.  He gestured for her to join him in the dictation alcove behind the nurses' station.

"I know we've never worked together before," Sterling started, his voice mellow but with that same hint of condescension that had irritated Cassie earlier.  "But I hope you've learned something today, young lady.  About a mother's love for her child and," he straightened, snapped his brilliantly white lab coat shut, "about pediatrics in general.  Our patients aren't just small adults.  They need special care."