Code Triage (11 page)

There was a small, answering bray from two gates down.

+++

Leigh leaned across the McNealys’ quilt-covered bed to adjust the oxygen prongs, aware that Nick was watching her. She shouldn’t be surprised that Antoinette would call him. “You were going to trim the privet hedge. Weren’t you, Harry?”

“Of . . . course,” her neighbor replied, his voice breathless and reedy but emphatic. There was a lipstick print on his forehead. “A man can’t . . . expect his bride . . . to do that sort of work.” Harry’s watery eyes shifted to gaze at Nick. He waggled a finger in the air. “Right, son?”

“That’s right, sir,” Nick said quickly. “And I agree that the hedge needs pruning. Our . . .” He hesitated. “Our side is overgrown too. I’ll get it done. Don’t you worry.”

“Thank you.” Harry sighed and swept a tremulous hand over his snowy hair. “A little . . . at a time. That’s how you do it . . . keep at it. Keep . . .” He yawned, and his lids fluttered, then closed. Leigh waited for a few moments before grasping his slender wrist very gently, checking his pulse. Much stronger now, and the rate had settled down with the two-liter flow of oxygen. No more bluish tinge to his lips. And his breathing rate . . . She nodded at his gentle snore. Far better.

She stepped away from the bedside, out of hearing range. “Poor, sweet man.”

“Did you have to give him something?” Nick asked in a low whisper.

“No. The home health nurse keeps sedatives here for emergencies, but Harry settled down after Caro and I got him away from the garden shed and convinced him to put down those gigantic shears.” She winced. “He could have just as easily wandered into traffic, Nick. Or set the house on fire. It could have been a horrible tragedy for both of them. I know how much Antoinette wants him here, but . . .” Her words faded at sounds in the distance. Caro and Antoinette, rattling teacups. Followed by a familiar whistle and Cha Cha’s throaty call. “Forever and ever. Forever and ever.”

“He’s mimicking Harry,” Nick said, glancing at the dresser beside the bed—dark mahogany topped with a tatted lace runner, a vintage silver hairbrush set, and at least a dozen framed photos of the couple. Including one of them dancing at their wedding. “It’s what he’s told Antoinette every day they’ve been married: ‘I’ll love you forever and ever.’” His eyes met Leigh’s.

“Still,” she said, glancing away. “These wandering episodes—nighttime agitation, ‘sundowning’—tend to escalate with dementia patients. It’s worsened by his emphysema; his oxygenation isn’t what it should be. I should talk with Antoinette about finding a care home.”

“Don’t. Not yet.” Nick scraped his fingers across his mouth. “Antoinette told me that their wedding anniversary is coming up. Sixty years.” He met Leigh’s gaze again. “They should have that. It’s only a few days.”

A few days.
Leigh nodded, her heart hitching. “I won’t say anything.”

“And I’ll check on them,” Nick assured her. “I’ll trim that hedge, too. When you’re not home. I won’t bother you; don’t worry.”

“I won’t,” she said, knowing it wasn’t true. She would worry. About Harry and Antoinette. And she was bothered . . . about the irrational way she’d been acting lately. She’d hoped that with the divorce in its final countdown and her sister getting back on her feet after treatment, things would finally feel better. And life would move steadily toward normal. Or at least toward merciful numbness. Numb was so much better than what she’d had. But if yesterday—a miserable day that left her racing from the physicians’ library to clutch a toilet bowl—was any indication, this final week was going to seem like—

“Forever,” Cha Cha crooned in the distance. “Forever and ever.”

+++

Kurt told himself to get out of there. He shouldn’t have come back to Golden Gate Mercy so soon. There were fewer staff on evening shift, and though people had assumed he was new or that he was passing through on his way somewhere else, eventually someone might get suspicious and question him. He hunkered against the wall near the pediatrics utility room and laughed out loud. But this was so easy; some housekeeper had even offered him a piece of banana nut bread. Good thing, since he couldn’t remember the last time he ate. Yesterday maybe. But then he never felt hungry or sleepy or bugged by anything when he’d scored some great crystal meth. He had done that and now he was energized. No—he
was
energy. He was pure, powerful electric current. Like one of those stinkin’ heart defibrillators you saw on TV medical shows.
Yeah. Zap, zap—whoa! Look out!

He laughed again, then clamped his hand over his mouth, fingers trembling against his dry lips like a high-tension wire. It was funny, though. To be able to jam right in here in Kristi’s scrubs and keep a watch over his kids. Keep that investigator away, and dodge the old crippled security guard. Kurt laughed again, clutched at his stomach, and felt his jacket pocket sag with the cold weight of what he’d stuffed into it when he got out of the car. He shook his head, a new jolt of energy making him shiver, making him taller and smarter and completely invincible.

A heart defibrillator was nothing compared to the blast of a gun.

Chapter Eight

“I’m not sure you’re being honest with me, sir. How did you get these wounds?”

“Just like I said. Lost my balance and fell. Yes, ma’am . . . Dr. Stathos.” Freddie Barber, a wiry sixty-four-year-old, blinked as blood trickled into his eye from one of several small, perfectly round punctures on his forehead. Exactly the same shape as the dozen or more wounds that peppered his upper chest and shoulders. He looked down at his hands. “Fell down. That’s the plain truth.” He sighed, exuding stale alcohol fumes. “Gettin’ clumsy in my old age, I guess.”

“Hmm.” Leigh glanced across the gurney at Riley. The chaplain wasn’t buying it either. And the respite Leigh had hoped for this Sunday shift wasn’t happening. In the past two days she’d dealt with Nick and Sam Gordon, then moved right on to the turmoil at the McNealys’. A roller coaster of emotion. Last night she’d been wrung out, sleepless long into the night. She wanted today to be far more routine. But most of the patients who’d streamed in since 7 a.m. had been “full moon” cases—people with needy psychological issues, complicating everything she’d tried to do. And now this guy . . .

“Maybe you want to blame this on clumsiness, Mr. Barber, but unless you fell onto a very large porcupine, I don’t see how you could end up with all of these—” she grimaced—“holes.” She tugged at the top of his patient gown, lifted his heavy link necklace aside, and noted the wounds there. She touched a gloved fingertip to his graying chest hair and exposed the deepest divot. Only a few needed sutures. “We’ll get back to your story in a few minutes. But first, when was your last tetanus shot?”

“December. Christmas Day. Hard to forget. Had myself a little accident that day, too.” Freddie smiled sheepishly, exposing gold bridgework. “So I’m good with the tetanus situation.” He took a deep breath, following Leigh’s instructions as she pressed her stethoscope to his chest. “Ah, man. That hurts like a . . .” He cursed, then bit his lip. “Sorry, ladies.”

“Another deep breath, Mr. Barber,” Leigh instructed, listening for breath sounds. Not easy with the sudden explosion of noise from the corridor: raised voices, yelling, cursing. She closed her eyes, concentrating as she pressed the disc flat against the man’s chest. A wheeze. And were those breath sounds diminished? Were there crackles? Leigh pulled her stethoscope earpieces aside as Riley tapped her arm.

“I’m sorry. But his oxygen saturation’s dropping and—” she pointed to the monitor, raising her voice over the continuing disturbance in the outer hallway—“his pulse is faster.”

Leigh frowned. Riley was right. Oxygen 93 percent on room air, heart rate 112, BP 100 over 70. Respirations faster, skin a bit pale. She’d barely begun the man’s exam, and these wounds seemed superficial, but still . . . “Mr. Barber, are you having trouble breathing?”

“Yes . . . I can’t seem . . . to get . . . my breath.” His eyes widened as medics stopped a stretcher outside his room. “Uh . . . oh. Oh, brother.”

Leigh turned, catching sight of a plump, middle-aged woman in shorts and patterned stockings lying on the transport gurney. Her wig, berry red and shiny, rode too high on her head, and the side of her face was dotted with several puncture wounds exactly like Freddie Barber’s.

The woman struggled to a sitting position on the gurney and jabbed a finger in the air, pointing into the exam room. “There you are, you lying snake! Look what she did to me. That trashy wife that you never bothered to mention!” She glared murderously and batted her hand at the paramedic trying to calm her. “No one takes a high heel to me and gets away with it. And you, you lousy . . .” The paramedics hustled the stretcher toward the next room, but the woman managed one last string of curses and a final taunt. “I hope she poked something vital with that steak knife, Freddie Barber. I hope you bleed to death!”

Knife?
Leigh met Riley’s eyes for a split second, checked the vital signs display, then leaned over the gurney. “You were stabbed?”

“Uh . . . I . . . My back.” Perspiration glistened on his forehead.

Leigh gestured to a nurse in the hallway. “Give me a hand, would you? Help me sit him up.” She dropped his gown to his waist and together they leaned him forward.

“There,” Riley said, pointing below his shoulder blade. It was a narrow wound, about a half inch long and oozing blood. Leigh palpated it gently with her fingers; the skin surrounding the stab wound felt crunchy like bubble wrap.
Air escaping into the tissues. From a lung puncture?
She pressed her stethoscope to his back, high and low, listening as he breathed in and out. Unequal sounds, likely evidence of some collapse.

“Let’s get him on high-flow oxygen,” Leigh told the nurse as they laid him back down. “Start an IV, normal saline. Pull labs, including a blood alcohol and a type and hold. I’ll order a stat portable X-ray. And set me up for a chest tube insertion. Meanwhile . . .” She lifted the sheet from her patient. “I’m going to need to look you over stem to stern, Mr. Barber. To see if we have any more surprises here. That was quite a ‘fall’ you took.”

Guilt flickered across his face as the nurse fitted the oxygen mask. “My wife has a troublesome temper. I knew that—” his breath fogged the green plastic—“when I married her. She’s a good woman in most ways, but . . .”

Riley stepped closer as the nurse went to get the IV supplies. “She attacked you because of that woman we just saw?”

He nodded, shifting his legs to accommodate Leigh’s exam. “Found us together and wouldn’t listen to reason. Not even for a minute. No sir. Never does. Just goes for my throat.”

“Your wife’s assaulted you before?” Riley asked.

“Yeah.” Freddie grasped Leigh’s sleeve. “I’m sorry I lied, Doctor. But even if I’ve deserved it—and I’m not saying I haven’t over the years—it’s hard for a man to admit to being beat up by a woman, you know?”

Leigh didn’t want to know. The very last thing she needed was another example of messy relationships. More lies, more excuses. “All I know right now is that I need to check you over,” she said, her tone brittle even to her own ears. “And attend to that chest injury. I’m concerned about your lung. First things first.”

“Will the police be called?”

“I would think they’ve already been notified, Mr. Barber. I’ll check for sure.” Riley looked toward the doorway. “I imagine your lady friend wouldn’t be as protective as you were. I’ll stay with you when the officers come, if you like.”

Leigh glanced at Riley, wondering if her nonjudgmental kindness came from her training as a chaplain, her faith, or simply because she was naive. She was young and from a tight-knit family. Maybe she’d never been on the receiving end of betrayal.

“You’re the chaplain, right?” Freddie asked Riley, extending his arm so the nurse could start his IV.

“Assistant chaplain.”

“Just as good.” He grimaced at the needle stick. “We used to go to church. The wife and I. But it’s been a while. Almost a year. Christmas was the last time. I lied about having an accident that day, too. The truth is, she walloped me with another shoe—high heel with holly berries. Because I got drunk and stayed out all night. Christmas Eve. What was I thinking?” The mask fogged, and sudden tears shimmered in his eyes. “A year from Social Security and I’m still making a mess of my life. It’s probably too late, but I’ve been hoping to find a way to start getting it right. Maybe I could talk with you about that.”

“I’ll be glad to listen,” Riley said softly. “It’s never too late for hope, Mr. Barber.”

“Never too late”—she is naive.
Leigh finished her exam quickly, checked the monitor, and left the exam room, fighting the beginning of a headache. She’d see what the X-ray showed and make a decision on the chest tube. And meanwhile, she’d have the joy of examining the other half of the shoe massacre.

She pulled up a chair at the nurses’ station and sighed. The way her day was going, she’d probably end up with the knife-wielding wife on a gurney as well. She wanted to find some humor in it—even imagined for an instant threatening Nick with a riding spur—but the sad fact was that there was nothing funny about it. Somehow, without her consent, she’d joined a pathetic sisterhood. Here she was in a white coat, expected to know all the answers, but she was no different from the woman whose stomach she’d pumped on Friday or the wife who’d yanked off her holiday shoe and clobbered her husband under the mistletoe. Leigh had no answers. Except that the assistant chaplain was wrong. It did get too late for hope. She had reached that point months ago. At least she hadn’t resorted to brandishing a weapon.