Resuscitation (48 page)

Cardoza slipped on her reading glasses and studied the file. “First off, he’s of English descent. He’s slightly over six feet tall. He’s forty-two years old and has dark hair and blue eyes.”

“That describes about twenty million men, just in California alone,” Al said. “Can you give us any distinguishing features or something more specific?”

“Well, all potential donors are required to take an IQ test and a Global 3 Personality Test. His IQ is 147 and his character pattern of behavior, thoughts, and feelings lean toward assertiveness, competitiveness, perfectionism, dedication, and altruism. What seems a bit out of the ordinary is the fact that rarely does a personality trait of altruism combine with these other traits.”

Sami and Al’s eyes met.

“I appreciate your efforts, Ms. Cardoza,” Sami said, “but this information doesn’t really help us. We’ve got nothing except a broad description.” Sami paused for a moment. “When is this donor scheduled to come in again?”

“Most clients just pop in without an appointment. I guess it has something to do with their mood on any particular day. I’m sure you understand.”

“Here’s my card,” Sami said. “Next time he wanders in, call me immediately. And find a way to detain him until we get here.”

Sami and Al stood. Sami offered her hand. “Thank you for your help.”

Just as Sami and Al reached the reception area, Maria Cardoza called Sami’s name.

“Something just occurred to me,” Cardoza said. “I’m not sure if this helps, but when I originally interviewed this guy, I couldn’t help but notice that he had a dimple on his left cheek—a very pronounced dimple.”

“Only on his left cheek?” Sami asked.

Cardoza nodded. “That’s correct.”

Sami and Al stood in the parking lot, both leaning against their cars.

“Any brilliant ideas?” Al asked.

“Well, you were right, Al. Bad judgment on my part. We have to speak with Doctor Hastings ASAP. It would also be a good idea to speak to the nurse who injected McKenzie with the sedative.”

“We could put out an APB for anyone with a left dimple on their cheek,” Al said.

“Good luck with that.”

“I’ll follow you to the hospital,” Al said. “If you lose me, call me on my cell and I’ll meet you in the main lobby.”

“The way you drive, I doubt that Mario Andretti could lose you.”

Odd, Sami thought. Their playful interactions almost seemed normal. Then a disturbing image of Al making love to the Brazilian tramp flashed through her mind and everything turned sour again.

As Sami had predicted, Al pulled into the hospital parking lot right behind her. In fact, he parked his car right next to hers. Under normal conditions, Al would grab her hand or drape his arm around her shoulders whenever they walked side by side. Now they walked together separately.

Neither of them spoke as they approached the main entrance. Al held the door for her, so at least one factor in their relationship hadn’t changed. Aside from his often vulgar mouth, he had always been a gentleman.

She pushed the up button for the elevator and the silence between them continued. A good number of people were scattered about the hallway. Some appeared healthy, others were in wheelchairs or pushing walkers. It seemed like a mix of visitors and patients. One woman in particular caught Sami’s eye. Obviously in pain, the woman’s face was a picture of misery. Hunched over in the wheelchair, her backbone looked severely deformed.

Is this what I have to look forward to in my golden years?

They waited for the less-healthy people to board the elevator, then they barely squeezed in. Sami pushed the button for the sixth floor. Of course, everyone else behind them wanted to get off the elevator before the two of them, so it was like a game of musical chairs.

Finally, the sixth floor.

“Where we headed?” Al asked.

“Before we find Doctor Hastings, let’s talk to the officer stationed at McKenzie’s room.”

“Do you remember where her room is?” Al asked.

Sami pointed. “Intensive care is down the hall and through the double doors on the right. I think it’s room six twenty-five.”

Double-timing their pace, they sailed down the hallway, passing nurses and doctors and an assortment of other people. When they turned right, Al pushed the saloon doors open and held one for Sami. She stopped dead in her tracks when she saw an empty chair in front of McKenzie’s room.

Where the hell is Officer Martinelli?

Sami and Al gawked at each other.

“Something ain’t right,” Al said. “Let’s check with the nurses’ station.”

“Excuse me,” Sami said to the tall blonde nurse. “Have you moved McKenzie O’Neill to another room?”

“Are you a relative?” the nurse asked.

While Sami dug through her purse, Al whipped out his badge from his back pocket. “We’re homicide detectives, miss. Can you tell us where Ms. O’Neill is?”

Sami had an eerie feeling that the answer to Al’s question would not be good news.

While the blonde nurse banged on her computer, Sami noticed that the nurses’ station looked like the control room for NASA. Modern medicine had truly evolved.

The blonde nurse stood and cocked her head to one side. “I’m afraid that Ms. O’Neill took a turn for the worse and was rushed into emergency surgery.”

“Can you tell me who’s operating?” Sami asked.

The nurse checked the computer again. “Doctor Hastings is leading the surgery, and Doctor Templeton will assist, but I’m not sure who else is on the surgical team. She deteriorated rather quickly, so they had to assemble a team stat.”

Sami tried to remember the name of the nurse who gave McKenzie the sedative. Olivia was the only name that rang a bell. “Is there a nurse here by the name of Olivia?”

“No Olivia here,” the blonde nurse said. “There is a Nurse Oliver.”

“That’s it!” Sami almost yelled. “Can I speak to her, please?”

“She just went on break, but she’s probably in the employee lounge just down the hall.”

When Julian had gotten the call from Doctor Hastings, he could hardly contain himself. Maybe he wouldn’t even have to take action. Doctor Fisher still wasn’t due in for a couple of hours so Julian and his colleagues were on their own. If she didn’t die on the table, which now seemed quite possible, it would be much easier for him to sabotage the heart pump surgery without Doctor Fisher standing next to him. Furthermore, this particular procedure required three cardiothoracic surgeons, each busy with their own responsibilities, so his actions would go unnoticed.

After a brief discussion, which had included feedback from Doctor Fisher by telephone, Julian and the other surgeons determined that the safest course of action was to install the heart pump
before
the valve replacement surgery. Julian hadn’t had a great deal of experience installing a left ventricular assist device, and he had no experience whatsoever with the unit they chose to install, the HealthMate II, the smallest, least cumbersome of all LVAD devices. Consequently, if he did make a fatal error, no one would ever suspect that it was anything more than an honest mistake.

The team of doctors, nurses, and surgical technicians stood at various stations in the operating room, each of them with a defined role. Doctor Hastings, who had more experience with the HealthMate II than the other surgeons, stood over McKenzie’s spread-open ribcage.

“Before we begin,” Doctor Hastings said. “This is how it’s going down. As usual, Doctor Mickelson will monitor the patient and adjust the anesthesia as necessary. He will also administer Heparin to prevent clotting. We need to make three incisions: one at the base of the left ventricle, one in the aorta, and one in the right side of the abdominal wall. Before we install the LVAD, we will reroute the blood to the heart-lung machine and it will pump and oxygenate the patient’s blood. We then must form a pocket for the LVAD in the abdominal wall as well. After that, we’ll insert a tube to channel blood from the ventricle to the LVAD. Another tube will be connected from the pump to the aorta. When the pump is adequately supporting the patient’s heart, and her vital signs are stable, we can move forward with the mitral and aortic valve replacement. Any questions?”

No one uttered a sound.

“Let’s proceed.”

Sami and Al found their way to the employee lounge, so crowded that Sami wondered who was running the hospital.

“Is there a Nurse Oliver in here?” Sami yelled over the buzz of the crowd.

A nurse standing at the counter, buttering a bagel, turned her head and waved the hand holding the knife. “That would be me.”

Sami and Al flashed their badges simultaneously, as if it were a coordinated plan.

“I’m Detective Rizzo and this is Detective Diaz. Can we talk privately?”

“Sure thing. Just let me check out with the charge nurse.”

When Nurse Oliver returned, she led the detectives to a small room used for patient consultation.

“This is about the O’Neill girl, isn’t it?” Nurse Oliver asked.

“What would make you ask that?” Sami said.

“First off, everybody in the free world has heard what happened to this poor girl, the news media revealed her name. Second, a police officer is posted at her door twenty-four hours a day.”

“The police officer posted at Ms. O’Neill’s door told us that you were in her room when she regained consciousness,” Sami said. “Is that right?”

She nodded vigorously. “I wouldn’t exactly call it consciousness. She mumbled a few words and seemed a little agitated, so the doctor asked me to give her an injection of diazepam, which is generic Valium.”

“Could you make out what she mumbled?” Al asked.

“Not really.”

“We understand that Doctor Hastings was the one who examined Ms. O’Neill and asked you to give her the sedative, correct?”

She shook her head. “It wasn’t Doctor Hastings.”

“Are you sure?” Sami asked.

“Absolutely positive. I
know
Doctor Hastings.”

“Then who was it?” Al asked.

“To be honest, I’m not sure what the doctor’s name is.”

Sami looked at the nurse in disbelief. “You work here and you don’t know the doctors’ names? Please understand that it’s absolutely crucial we speak to the doctor who examined her. He might have understood what she mumbled and that could be a significant piece of evidence.”

“I’m sorry, Detective. I’ve been a nurse for almost twenty-five years, but I’ve only worked at Saint Michael’s for about a month. And I was just transferred to the ICU a week ago. Do you have any idea how many doctors buzz in and out of this place day in and day out? I suspect it’s going to take me several months before I know everyone by name.”

“How can we find out who examined Ms. O’Neill?” Sami asked.

“Whoever it was must have signed her chart.”

“And how do we get our hands on that?” Sami asked.

“I’m still feeling my way through procedures. Give me a minute and I’ll ask one of the other nurses.”

Sami and Al waited in silence, and once again, everything seemed out of sync between them.

With guidance from Doctor Hastings, Julian made the first incision at the base of McKenzie’s left ventricle. Once cut, he proceeded to carefully insert a small plastic tube in the incision and secured it with a special clamp.

“Nice work,” Doctor Hastings said. “Make sure the clamp is tight enough to prevent leakage and loose enough to allow blood flow.”

Julian did his best not to grin. He knew
exactly
what had to be done. He checked the heart monitor and noticed that McKenzie’s heart rhythm was erratic.

Time to play good doctor
.

“Can you stabilizer her?” Julian asked Doctor Mickelson, the anesthesiologist.

“Doing my best, but I can’t give her narcotics. I don’t want to risk her heart rate elevating. She’s tracking at forty-eight beats per minute, and that’s right where she should be.”

Again Julian made an incision, this time in the aorta, approximately five centimeters above the heart. This was the clamp he had to compromise. But not quite yet. Once all of the procedures were completed—installation of the LVAD and valve replacements—they would remove her from the heart and lung machine, and turn on the heart pump to be sure it worked properly. Then, as was normal procedure, Julian would check the clamps one more time and make minor adjustments just before they closed her. And at that time, if he made the aortic clamp just loose enough, it would fail as soon as her blood pressure elevated slightly, and that would happen the moment she regained consciousness, or better yet, if she had a nightmare. Either way, she wouldn’t last through the day.

Julian couldn’t have written a more perfect script.

Nurse Oliver walked into the consultation room, let out a heavy sigh, grabbed the clipboard from under her arm, and dropped it on the table. “Well, Detectives, this is really embarrassing.”

Sami reached for the clipboard and flipped through the pages. “I don’t understand. Didn’t the doctor we’re trying to track down sign Ms. O’Neill’s chart?”