Angels on the Night Shift (14 page)

“What did you do with her?” I asked Ted.

“Well, we put her in observation for a couple of hours,” he explained. “And one of our techs watched Adelle. Then when Charlene could walk straight, we called a cab. I had a word of prayer with her and told her that if she ever came in again asking for chloral hydrate, we would call the police, or something worse. She seemed to understand, though. And before she left, we gave her some information about where she could get some help for her addiction. I was going to call DSS, but she was gone before I could. But I don’t think we’ll be seeing her again.”

“We need to call DSS anyway,” I suggested. “Adelle doesn’t need to spend the rest of her life like this.”

Less than a week later, we learned that she wouldn’t. Adelle was dead. We didn’t find out about it until the afternoon Charlene was brought to the ER by EMS. She had called 9-1-1, hysterical and totally out of control. A day or so earlier, her daughter had had a seizure and apparently aspirated. Charlene blamed herself and was inconsolable.

“When we got to her apartment building,” Denton Roberts told us, “she was walking up and down the sidewalk, waving her arms in the air and screaming. The neighbors couldn’t get her calmed down, and we were barely able to get her to lie down on the stretcher.”

Ted Nivens had been on duty when she came in. It took him a while to get her to the point where he could talk with her. She had no family in the area and no friends, but she didn’t want to be admitted to the hospital.

“I’ll be okay,” she had tried to convince him. “It will take a while, without Adelle, but…”

And then she broke down all over again. Ted was worried she might try to hurt herself. After all, she hadn’t proven herself to be the most dependable and upright of people. But in the end, she calmed down and he was able to send her home. He gave her something to help her rest, but it wouldn’t be chloral hydrate this time.

A week later, I was finishing up a night shift when Ted Nivens walked through the ambulance entrance doors.

I told him about the patient in room 5 who was over in radiology getting a chest X-ray for a possible collapsed lung. And I told him that Charlene Saunders had come in during the middle of the night.

“She told me she was doing okay, but that every once in a while, she just lost it,” I told him. “I refilled the Valium you gave her and told her she needed to follow up with somebody at the mental-health clinic.”

I thought Ted was going to explode. His face turned red and steam started pouring out of his ears.

“You gave her more Valium?” he exclaimed. “Why that…”

He sputtered for a minute, searching for the right words. Then he took a deep breath and said, “I’ve been off for a couple of days and haven’t had a chance to talk with you. I guess I should have called, but I’ve been busy.”

“Call me about what?” I asked, curious about his reaction and now this last statement.

“Well, Robert, let me just tell you about our Charlene Saunders,” he began. “About a week ago, I was out at Wal-Mart picking up a couple of things and just looking around. I think I was in the sporting goods department when I turned a corner and started down an aisle. I wasn’t paying much attention and almost ran into the back of a woman who had stopped in front of some fishing tackle. I said, ‘Excuse me,’ and when she turned around, doggone if it wasn’t Charlene. Her eyes got real big and she looked like she had seen a ghost or something. She started backing away, pulling her cart, and that’s when I looked down.”

He stopped talking and his face got red again.

“What happened?” I asked him, confused. “Why did she—”

“Robert,” he interrupted me. “I looked down in that cart, and there sat Adelle, big as life. She was smiling and looking around, and… and…”

My mouth dropped open and I was speechless.

“I just stood there and stared at the two of them,” he told me, calmer now. “I couldn’t say anything, and Charlene just kept backing down that aisle, then turned a corner and disappeared. She never said a word.”

Hoodooed—all the way around.

I
t was several days after our meeting with Walter Stevens before I had a chance to talk with Lori Davidson. It was a little after seven in the morning, and I was washing my hands in the medicine room when she walked in.

“Lori, have you got a second?” I asked her, drying my hands on some paper towels.

“Sure. Just getting some Rocephin for the child in room 2,” she answered. She put down the chart in her hand, took a key chain out of her pocket, and unlocked one of the drug cabinets. We kept our injectable medicines, such as antibiotics and nausea drugs, locked up in a floor-to-ceiling cabinet. Beside that cabinet was the narcotic storage container. It was double-locked, requiring two different keys to open.

“You’re the one who found the missing Vistaril,” I began. “And I’m sure you know about the unaccounted-for narcotics.”

She stopped and looked at me, her key still in the cabinet lock.

“Yes, I do,” she answered, her voice serious and subdued. There was a frown on her face, something unusual for Lori.

“Does any of this make sense to you?” I asked her. “I mean, I don’t know who in this department would be messing with the narcotics. It would have to be someone with access to the keys, and even then… they’d have to be pretty brazen to be getting stuff out of the cabinet in plain sight, don’t you think?”

She sighed and shook her head. “I’ve been thinking a lot about this, Dr. Lesslie. And I’ve started watching different people, and wondering…I just can’t imagine any of our staff doing this.”

“You know about the Demerol vials,” I continued. “I’ve never seen anything like that. Walter Stevens showed me that box the other day, and I couldn’t believe it.”

“Walter Stevens,” Lori muttered, in a tone as close to disgust as I had ever heard from her. “He’s on some kind of a crusade, it seems. And if I hear about his
bus
one more time, I think I’ll explode.”

“His ‘bus’?” I asked her, confused. “What are you talking about?”

“I’ve been in a few meetings with him, and he always talks about
‘the bus.’
He compares the hospital to a big bus, and he talks about making sure the right people are on the bus and in the right seats. And if they don’t need to be on the bus, or shouldn’t be on it—well, he’s going to make sure they get off. I’m sure he just wants the hospital to be the best it can be, but sometimes he seems a little obsessive.”

It sounded like some kind of management style he had learned in business school, but I had never heard him mention it.

“He’s determined to solve this problem and have someone prosecuted,” Lori added. “I hope it’s not all about making himself look good, because somebody out there is in trouble and needs our help.”

I thought about this for a moment, realizing Lori’s perspective had been lost on me. Like Stevens, I wanted this figured out, and quickly. And I hadn’t considered this point of view, that whoever was doing this might have a real problem and need our assistance. Lori was right, but the first thing was to find out who this person was—maybe
persons.
Whoa—that was something else I hadn’t considered.

“And this idea of Mr. Stevens that someone is
selling
these drugs,” she continued, shaking her head. “That’s crazy. I think someone is stealing the stuff and using it themselves, as bad as that sounds.”

“I think you’re right,” I said. “I tried to tell Stevens that the small amount of missing drugs wouldn’t add up to very much on the street, certainly not enough to be worth the risk of losing your job. He just wouldn’t listen. But you know, before that meeting with Virginia and him, I was hoping this was all some mistake, some counting or documentation error. And then there was that box of Demerol. That’s no counting error.”

I tossed the paper towels in the trash can and was about to say something else, when Lori glanced at the door and quietly said, “I need to show you something.”

She took the key out of the antibiotic cabinet, sorted through the chain for another pair of keys, and opened the narcotics cabinet. There were several boxes of medication, just like the Demerol container, and she reached for one in the back of one of the shelves.

“I found this when I first came in,” she said, handing it to me. “Darren Adler worked last night, and he did the drug count with me. I didn’t say anything to him, because I don’t know who all knows about this. I was going to bring Ms. Granger in here just as soon as I took care of the child in room 2.”

I knew where to look this time, and I turned the box upside down. The plastic wrapper was still in place, but once again, there were several small holes in the bottom. I counted five, evenly spaced, just like before.

Shaking my head, I handed the Demerol back to Lori.

“I wonder if this could be dusted for prints,” I thought aloud.

“I was thinking the same thing,” she agreed. “But then I thought about how many people have handled this. There’s whoever delivered it to the hospital, and the people in the pharmacy—and every time we count the narcotics somebody picks it up. And now there’s you,” she added, smiling.

“Hmm…” I murmured, looking down at my hands. “Well, I guess that’s not going to help. But I agree, you need to let Virginia know. This is worse than I thought. Maybe the three of us can talk about it later.”

“What about Walter Stevens?” she asked, her frown returning. “Do you think he needs to know about this?”

“
I
wouldn’t tell him, Lori,” I said. “He’s got enough information to run with, it seems. But I’d let Virginia make that call.”

“You’re right,” she agreed, putting the Demerol back in the cabinet and double-locking the doors.

“Do you have any idea who might be doing this?” I pursued. “Any unusual behavior or strange activity? ’Cause I haven’t.”

“I haven’t either,” she spoke quietly, slowly shaking her head and studying the floor. Then she looked up at me and said, “But I’m paying more attention now. And if someone is using this stuff, it’s only a matter of time before they slip up, or do something stupid, or worse.”

Again she was right, And I was worried about the “or worse” part.

“I will be too,” I told her, stepping toward the doorway. “And if you see something, or find more punctured boxes of Demerol, let me know.”

I left her in the medicine room with the chart of room 2 and walked over to the nurses’ station, deep in thought and a little confused—and very troubled.

8:30 a.m.
I didn’t know if Lori had had a chance to talk with Virginia, but I hadn’t. A few minutes after I walked out of the medicine room the floodgates had opened. There was a minor school bus accident out on highway 21, and EMS had brought in a dozen or so kids to be examined. Fortunately no one was really injured, but they all needed to be checked over.

And then we had a construction worker who fell off some scaffolding at his work site. He ended up being diagnosed with fractures of both heels. That wasn’t a life threatening injury, but it was a life-changing one. He would never walk the same and would probably always have pain in those feet. It happens so fast.

“Here, Amy,” I said, sliding the chart of this patient across the counter. “We need to get in touch with ortho and make sure they see him as soon as possible.”

“Sure,” she answered, picking up the chart and putting it on top of the pile beside her. “Just as soon as I get some of these schoolkids straightened out.”

The ambulance doors burst open and a man who looked about thirty ran into the department.

“Help me!” he yelled. “Somebody help me!”

He was carrying a little girl in his arms, and as he looked around the ER for assistance, her arms and legs flopped lifelessly. She didn’t appear to be breathing.

He was panicking, twisting from side to side, taking a step in one direction and then another. I hurried over to him and took the child from his arms.

“Follow me,” I directed him, heading to the cardiac room. Jeff Ryan was a couple of steps ahead of me and I called to him, “We need an airway tray!” He didn’t need to respond, but I saw his head nod as he disappeared into the room.

“Amy, call radiology,” I ordered over my shoulder. “And get the lab down here. And respiratory therapy,” I added.

I took a look down at the little girl. She couldn’t have been older than three, and her color was terrible. She was a dark blue and hung like a wet towel in my arms. It was then I noticed the mucus coming out of her nose and a foamy substance coming from her mouth. And I was right—she wasn’t breathing.

“We’ll need suction,” I told Jeff as I carefully placed her on our stretcher.

“Right here,” he said, handing me the suction catheter, then turning to flip its switch on the wall behind him.

I cleared as much of the mucus from her nose and mouth as I could, and within another thirty seconds we had her airway secured with an endotracheal tube.

One of our respiratory therapists had just walked into the room and over to where I stood.

“Here, let me do that,” he said, taking the ambu bag and beginning to rhythmically inflate the girl’s chest.

“Thanks,” I told him, leaning down and placing my stethoscope on her chest, first on one side and then the other.

“That’s good,” I said. “She sounds wet, but we’re getting good breath sounds on both sides.”

Jeff had attached cardiac electrodes to her chest and now flipped on the monitor. At first there was just some chaotic activity, nothing that looked like any purposeful electrical impulses. But after a few seconds, we began to see some narrow, regular complexes—about thirty or forty a minute. That was slow and wouldn’t sustain her for very long. I hoped that providing oxygen to her lungs would fix that, and that her heart rate would quickly come up to where it should be—some place over 100.

The man who had brought the little girl had been standing quietly in a corner of the room. I assumed he was her father, and I turned to him and asked, “Is this your daughter?”

“Yes, it is,” he answered, barely audible. “Trish. Her name is Trish.” He was wringing his hands and I noticed how flushed he was. He was sweating, and his soiled T-shirt was plastered to his chest. I looked down and saw his blue jeans and grass-stained sneakers. He must have been working outside earlier this morning, maybe mowing grass.