Code 15 (11 page)

By no means ready to kill Morgan Connolly, he now had a very simple way of causing her an untold amount of personal terror. He kneeled down and stuck the homing device in place. Still grinning, he stood up, took one final look around, and then walked away.

With the crucifix clenched firmly in her fist, Morgan exited the elevator on the tenth floor.

Directly across from where she stood was the cardiac electrophysiology lab and the office of its director, Dr. Mira Ramon. Morgan walked through the registration area and then into the lab. In spite of its expansive size, the facility was still crowded with monitors, examination tables, and a multitude of sophisticated diagnostic instruments. Morgan looked toward the back of the lab. Seeing that Mira’s door was wide open, she marched straight back to her office. Before she could tap on the door, Mira looked up, smiled, and waved her in. Morgan had known Mira since coming to Dade Presbyterian and they had always gotten along well.

Mira’s office was hardly a showplace. Except for a painting of Victoria Falls, the walls were bare. There was one short bookcase behind her aging wooden desk but most of its shelves had nothing more on them than a skinny layer of dust. If there was a saving grace, it was the perfectly arranged bunch of bright yellow daisies in a crystal vase that she had placed on her credenza.

Mira closed the patient file she was reviewing. She slid her tiny reading glasses down her nose until they sat perched on the tip.

“It’s so nice to see you, Morgan,” she said with a sympathetic smile, coming out from behind her desk. She took Morgan’s hands in hers. “How are you doing?”

“I’m doing okay.”

“It was a beautiful service. Your father was certainly beloved.”

“Thank you.”

Mira sat down on the corner of her desk. She pointed to two empty mugs. “I’m making some tea. Would you like some?”

“No, thank you.”

When Morgan didn’t say anything further, Mira folded her arms across her chest and said, “If you don’t mind me saying so, you look like a lady with something on her mind.”

“I need a favor.”

“How can I help you?”

“I could really use a quick education on pacemakers.”

“Why the sudden interest in pacemakers?” Mira asked.

“It involves a recent Code Fifteen that the Patient Safety Committee is reviewing.”

“I assume you mean the one involving the pacemaker insertion—not the open-heart case.”

“How much do you know about the case?”

Mira stirred her tea, the spoon tapping against the inside of the mug. “I know the basics. Her death was hardly a secret.”

“I spoke to the physician who represents the pacemaker company. He assured me that it couldn’t have been a pacemaker problem.”

Mira snickered and then took another bite of her Danish. “Now there’s an objective opinion if I’ve ever heard one.”

“You obviously disagree.”

“The woman underwent placement of a pacemaker and died several hours later. I don’t think you can make a categorical statement that it’s impossible there could have been something wrong with the device. There’s always a reason why patients go into V-tach. Who ran the code?”

“Will Balbuenas,” Morgan answered. “He and I have been over the chart so many times we could probably recite it by heart.”

“What were the patient’s potassium and other electrolyte levels?” Mira asked.

“All normal.”

“What about her medication doses? Did you check them?”

“Ten times,” Morgan answered. “Everything was right on the money.”

“Did she have a heart attack? That can cause cardiac irritability and lead to V-tach.”

“We ruled that out. Her EKG and cardiac enzymes were normal.”

“Did her blood oxygen level drop right before the V-tach started?” Mira inquired.

“Not according to the nurse who took care of her.”

Mira tapped her fingertips together. “I haven’t reviewed the chart but it sounds to me like you’ve eliminated all the usual causes of V-tach.”

Morgan reached into the pocket of her white coat, pulled out the cross, and held it up.

A puzzled grin fell upon Mira’s face. “I appreciate the gesture, but I was hoping to help you without resorting to divine guidance.”

They shared a quick laugh.

“Miss Greene was wearing this when she arrested,” Morgan said.

“Are you suggesting that being religious might make one more likely to develop a fatal arrhythmia?”

“Not as a rule, but maybe in this case it did.” Morgan placed the cross on the base of Mira’s desk lamp. “The cross is a strong magnet. I remember reading somewhere that magnets are used to adjust pacemaker settings.”

“A pacemaker can be programmed in a few different ways,” Mira explained. “Normally, it’s set in what’s called an EP mode, which means it only fires when it senses a problem with the patient’s heart rate.”

“What kind of a problem?” Morgan asked.

“If the person’s heartbeat falls below a preset rate, the pacemaker kicks in and speeds it back up.”

“So the pacemaker would be kind of a backup.”

“In a manner of a speaking.”

“So why would you ever have to change the settings?” Morgan asked.

“If the patient’s cardiac condition changes, we might have to reprogram the pacemaker. You have to remember that these things are surgically implanted. Altering the settings would mean we’d have to reoperate on all these people. That’s why the manufacturers and bioengineers came up with the idea of using magnets to change the settings.”

Morgan pointed at the cross. “Is it possible that if a magnet was close enough to Alison Greene’s pacemaker, it could have changed the settings?”

“It’s possible,” Mira answered.

“Could that lead to a problem?”

“Absolutely. If this woman’s heart was beating normally, and for some reason the pacemaker started firing, it could have drastically upset the normal electrical currents of her heart. The heart’s wired very efficiently, but it’s also exquisitely sensitive. If a pacemaker was improperly set and fired at the wrong time of the cardiac cycle, it could upset the conduction system and cause a type of V-tach that would have been extremely difficult to reverse.”

“So it is possible,” Morgan whispered.

“In the absence of another plausible explanation, I would say it’s quite possible.”

“This is unbelievable,” Morgan muttered to herself as she slid the cross from the lamp. “I wonder how somebody would have gone about magnetizing it?”

“I doubt anybody magnetized it,” Mira informed her.

“I beg your pardon.”

“It was probably manufactured that way.” Mira reached for the cross and held it up. “I’ve seen these before in alternative health catalogues. They’re made by companies that sell products related to magnetic therapy.”

“What in God’s name is magnetic therapy?” Morgan asked.

“The theory is that a magnet creates an electrical field that has profound healing properties. Supposedly, it’s a very safe way to treat a myriad of aches and pains.”

“You can’t be serious,” Morgan said.

“I’m very serious. In fact, one of their hottest-selling products is a magnetic mattress. I guess it’s kind of a heal-while-you-sleep approach to perpetual wellness. It may all be a bunch of bologna, but it’s probably harmless.”

After a short sigh, Morgan said, “Not in Alison Greene’s case. Thanks, you’ve been a huge help.”

“Anytime. Good luck.”

Instead of returning to her office, Morgan took the elevator down to the first floor. Stepping out into the lobby, she couldn’t shake the lingering feeling that she was overlooking something that was so obvious a child would see it. She stopped at the information desk and smiled at a high school volunteer who was helping with visitor identification passes. Morgan reached for the physician’s phone and tapped in Ben’s number.

Much to her surprise, she didn’t get his voice mail.

“Are we still on for tomorrow?” she asked.

“Absolutely. I’ll meet you at your hangar at three.” After a momentary pause, he asked, “Are you okay?”

“Sure. Why do you ask?”

“Because you already called me this morning to confirm.”

Realizing Ben was right and having no reasonable explanation for the repeat call, Morgan simply said, “I guess I forgot. I’ll see you out there.”

Morgan hung up the phone and turned around. Leaning back against the information desk, she quickly became lost in thought about her conversation with Mira. It was only the husky voice of a man inquiring about visiting hours that brought her back from her dreamlike state. Morgan smiled to herself and then started for the exit. A few feet from the revolving glass doors, she noticed a fine but readily apparent tremor of her hands. Trying to ignore the outward sign of anxiety, she continued through the doors and out onto the sidewalk.

Walking through a mist-like sprinkle from a single rain cloud, Morgan made her way toward the parking garage. Although she never questioned her ability or determination to remain emotionally functional, she couldn’t deny her level of anxiety was starting to soar. Not knowing how the events of the next few weeks would play out was nerve-racking. She never held herself up to be a spiritual person, but if she didn’t know better, she would swear that some higher authority was determined to test her resolve.

She looked up to see the cloud floating off to the east. She thought about her father and how much she missed him. Thinking about their inviolate ritual of going out for Sunday morning breakfast and talking about everything from hospital politics to professional basketball brought a smile to her face. There were many things that saddened her about his death. But more than anything, the realization that he wouldn’t be there to share in the joy of her baby’s birth was the most painful.

DAY SIX

 

 

Staring at the monitor, Dr. Jenny Silverman passed the rectangular-shaped ultrasound probe across Morgan’s lower abdomen for a final time before concluding her examination. When she was finished studying the last image, she picked up a folded white towel from the countertop and wiped the ultrasound jelly from Morgan’s tummy. Jenny had one of the busiest obstetrical practices in the county but had never allowed her demanding schedule to damper her boundless enthusiasm and devotion to her patients.

“You were pretty accurate with your estimation,” Jenny said, helping Morgan to a sitting position. “I’d say you’re about two and a half months pregnant.”

Morgan dangled her legs over the side of the table. “Did everything look okay on the ultrasound?”

“Perfect,” Jenny answered. Morgan nodded briefly and then tossed her a flicker of a smile. She said nothing as Jenny rolled the ultrasound machine to the other side of the room.

“What’s going on with you and Kevin? Has anything changed since the last time we talked?”

“I’ve decided to file for divorce. I guess it finally sunk into my thick skull that Kevin’s never going to change.”

“This is not the same Morgan Connolly I spoke to last month. You sound a lot different.”

“I feel a lot different.”

“What about a social life?” Jenny asked.

“I’m not worried about that right now.”

A coy smile came to her face. “Really? I heard you went out with Ben Docherty.”

“How did you find out about that?”

“You guys shouldn’t have picked such a popular Italian restaurant,” she said with a wink.

“It was just dinner.”

“Who have you been talking to about all this?” Jenny inquired.

“I’ve interviewed a few attorneys but—”

“I wasn’t talking about a lawyer. I was asking if you’ve seen a therapist.”

Morgan shook her head.

Jenny continued, “I know you have a lot of friends, but sometimes it’s better to get the input of a professional.”

“I guess I haven’t thought seriously about . . . about talking—”

“If you need the name of somebody, just let me know.”

“Thanks.”

“What do your mom and brothers think about all this?”

“My mother’s been supportive, but she’s got her own life. It’s kind of the same with my brothers. We’re close when it comes to certain things, but not about our personal lives. Anyway, they both live overseas and we don’t get to see each other that often.”

“Let’s go out for dinner this week.”

“I’d love that.”

“I’ll check my on-call schedule and give you a call,” she said, shutting down the ultrasound machine. “We have a GNO scheduled this month. It’s been a while since you’ve been to one. You should come.”

GNO, as Jenny always refered to it, was an acronym for girls’ night out. She had organized the group of young professional women about two years ago. Every few months they got together for dinner. Most of the early evening was spent trying new wines, complaining about their jobs, and bemoaning their relationships. But as the night progressed and the wine took hold, the conversation generally shifted to the more humorous side of their lives.

“Why don’t you e-mail me the information,” Morgan suggested. “I’ll do my best to make it.”

Jenny took her by the arm and escorted her out of the examination room and then down a broad, royal blue-carpeted corridor. When they reached the door that led to the waiting room, she gave Morgan a hug.

“Make sure you stop on your way out to make an appointment. I want to see you in four weeks.”

“I’ll do it,” Morgan promised.

“Good . . . and don’t forget about girls’ night out. I’m not taking no for an answer. Call me if you have any cramps, bleeding, or any other problems.”

After thanking Jenny again, Morgan left the office and rode the elevator to the lobby. She checked the time. She was running late for a meeting with the blood bank and she was still planning on going flying with Ben in the afternoon. Oblivious to her surroundings, she quick-walked toward the exit.