Except that this wasn"t an air raid. And rather than warning of a possible mult.i.tude of deaths, this had to do with only one possible demise. But even one was one too many.
She didn"t want to have another on the books if she could help it.
Nika instantly abandoned the chart, setting it down on a side counter.
"What is that awful noise?" Ericka asked as she put her hands over her ears and tried to press out the sound.
"I"ll put down you have good hearing when I get back," Nika promised, trying to divert the woman"s curiosity from the reason that the alarm was going off. She didn"t want the woman frightened-and she definitely didn"t want her to start wondering if perhaps that alarm would ever go off for her.
"What"s going on?" Ericka demanded, shouting in order to be heard.
"It"s a code blue," was all Nika said before she ran out into the hall-making sure she closed the door to Ericka"s room behind her.
The sound that signaled the very real possibility of someone"s life ebbing away filled the hallway, making it momentarily impossible for her to ascertain from which direction the alarm was coming. The next moment, Nika had her answer. Alerted by the monitor at the nurses" station, the two responding nurses and an orderly were all running toward one room.
A quick scrutiny told Nika that so far, no doctor was coming to the patient"s aid. They were still incredibly shorthanded.
"Crash cart," she yelled out to the other three. "We"re going to need a crash cart."
The orderly, Gerald Mayfield, a powerful-looking man who was almost as wide as he was tall and had helped get her out of the elevator earlier, fell back to fetch the lifesaving device.
She knew who the room belonged to a second before she entered. John Kelly. She"d paused to talk to the man this morning just before she"d gone down to the cafeteria. And subsequently gotten stuck in the elevator on her way back, she thought ruefully. Maybe if she"d taken the stairs, she would have gotten back sooner and somehow could have prevented this.
G.o.d knew how, she thought now, looking at the painfully thin man whose heart had abruptly stopped beating.
The monitor attached to him, tracking his vital signs, had nothing to show for its efforts but very thin, straight lines. They were accompanied by an eerie, flat note that mournfully announced the end of a life.
"There"s no pulse, Doctor," Katie O"Connor, one of the two nurses who"d made it to the patient"s room first, told her. The nurse"s long fingers were still pressed against the elderly man"s throat, as if that would somehow make his vital signs magically reappear once again.
But they didn"t. The straight lines on the monitor continued going nowhere.
It couldn"t end this quickly, Nika silently argued in her head.
"He was just talking to me," she said out loud, addressing her words to Katie. "Telling me how much he was looking forward to going back to the nursing home because he"d figured out a chess move that would confound his roommate. He was positively gleeful about it. He didn"t sound or behave like a man who was about to die," she added, saying the words more to herself than to the other two women.
Katie, who"d been a nurse more years than she"d willingly admit, looked at her with sympathy. "Can"t always tell by the way they look, Doctor."
She knew that. And yet...
Behind her, Gerald was coming in, pushing the crash cart before him.
"Charge "em," Nika ordered, grabbing the defibrillator paddles. She held them up while Gerald quickly covered both surfaces with a gel. Rubbing them together, Nika called out, "Clear!" before applying both paddles to Kelly"s chest.
His body convulsed in response, clearing the mattress in some places, but ultimately the former police sergeant didn"t awaken from what appeared to be his now permanent sleep.
Nika didn"t want to let him go.
"C"mon, Mr. Kelly, you"ve got a chess game to finish, remember? You wanted to show Don that he couldn"t just come in and be the center of attention, remember? Don"t wimp out on me now," she pleaded. Glancing over her shoulder, she looked at the nurse who was now at the controls of the defibrillator. "Again!" The next moment, with the amps raised, Nika cried "Clear!" and tried to revive the man again.
With the same results.
Twice more she made the retired police sergeant"s body go through its macabre, lifeless dance and had the exact same results each time.
Holding the paddles, she saw the two nurses and the orderly looking at her, waiting. Silently telling her to do what she knew she had to do.
Call it.
She released the sigh that was rattling around in her chest. "Time of death-eleven twenty-three," Nika p.r.o.nounced quietly and then returned the paddles to the cart.
"You did everything you could do, Doctor," Katie told her sympathetically. "It was just his time to go," the grandmother of five added softly.
"Besides," the other nurse, Jenna, chimed in, "where he"s going is a lot better than where he would have gone if you"d brought him back from the brink," she a.s.sured Nika with the confidence of the very young who never doubted themselves. "Have you seen that nursing home he was living in?" Jenna, all of twentysomething, shivered to make her point. "If that"s the way I"m going to end up, shoot me now."
"Hey, a little respect for the dead," Gerald chided sharply. Jenna frowned and fell into a brooding silence as she slowly stripped the deceased man of the various tubes and wires that had been connected to him. Gerald spared Nika a compa.s.sionate look. "Death"s all part of it, Dr. Pulaski," he told her philosophically. "You shouldn"t take it so hard."
The orderly was right. After all, what did she expect, Nika asked herself. She was working in the Geriatrics Unit, for heaven"s sake. These were old people. A lot of them had overtaxed their immune systems and were susceptible to so many different things, things that could fell them without a moment"s notice.
That was why they were running understaffed in this unit, because of the threat of someone unwittingly bringing in the flu. They couldn"t control the visitors who came in-although, sadly, a lot of these patients had no one to visit them-but they could at least control the staff"s interactions with the patients.
Nika nodded in response to what the orderly said. She forced herself to focus on the steps she had to take next, not on what had just happened.
"I guess it just seems like a lot of these old people have been dying lately," she murmured. And death was not something she would ever get used to.
"That"s because they have," Katie told her. She went about tidying the man up so that he had a little dignity left, even in death. "They"re old people," she emphasized, just as Nika had in her mind. "It goes with the territory and is to be expected. It"s a lot harder to handle when you lose a patient in the pediatrics ward," she pointed out. "At least these people have had relatively full lives."
Nika nodded, then squared her shoulders, silently telling herself to get over it, to straighten up and fly right. She"d do none of her remaining patients any good if she allowed herself to break down and cry.
"You"re right," she told Katie.
The woman grinned broadly. "Of course I"m right. It"s in my contract," Katie told her with a wink. "Go help your living patients. There"s nothing more you can do for Mr. Kelly. We"ll do what needs to be done for him now," the nurse a.s.sured her, taking charge.
"I should notify the next of kin," Nika said, more to herself than to Katie. The very idea filled her with a sense of dread. This was the ultimate in bad news, no matter how prepared a loved one might think that they were.
"There isn"t any," Jenna told her, practically chirping out the information. "n.o.body to notify. Except for maybe the nursing home," she added as an afterthought. "They"ll want to know so that they can get his room ready for someone else."
That sounded so cold. So detached. Business as usual, nothing more. d.a.m.n, she hated this part of her world.
Out loud, Nika said nothing. She looked at the two nurses and the orderly. They were all doing their part, unfazed, preparing the old man for his last exit. Would she ever get to that state? Would she get to the point where death rolled right off her back, and it didn"t feel as if the specter had taken a large chunk out of her heart when she lost a patient?
As if reading her mind, Katie leaned in as she moved past her. "You let it get to you, you"re no help to the rest of them-the ones who still need you to make a difference in their lives. Remember that."
Nika nodded and whispered, "Thank you," before she left the room.
It took her a few minutes to get the tears under control.
"You look terrible," Sasha declared, almost walking into her cousin. She was on her way in and Nika appeared to be on her way out. "Who died?" she asked.
Nika paused and followed her cousin back inside for a second. "Mr. Kelly," she told Sasha quietly.
Sasha"s eyes widened with surprise-and distress. "Oh G.o.d, Nika, I"m sorry. It was just an expression. I didn"t realize someone had actually died," she apologized, chagrined. "Was he a patient of yours?"
"Right now, they"re all patients of mine on that floor. The Geriatrics Unit," she said in case Sasha wasn"t aware of where her rotation had taken her. Something had been gnawing at her since she"d put it into words earlier. "Since I"ve come to work in the unit, it feels like a lot more people have died."
There was nothing but sympathy on Sasha"s face. "And that means you"re what, the angel of death? Things happen, honey. Old people do die. What do you mean by "more," exactly?"
"More than the average expected number," Nika answered. She saw the skeptical look on her cousin"s face. "I minored in math," she explained.
"Good to know. Next time I"m in a jam, I"ll bring my checkbook to you. I can"t count higher than ten without taking off my shoes." She slipped a comforting arm around her cousin"s shoulders despite the fact that Nika was several inches taller than she was. "Honey, again, they"re old people. They"re in the hospital, which means they"re sick. A lot of them are worn out. The odds are against them and those odds get worse every day." She saw that Nika wasn"t completely at ease. "Look, if you"re really worried that something isn"t quite right, why don"t you run this past Dad? Or Tony?" Sasha suggested, referring to her husband, who was a detective in the homicide division of the NYPD. She reached into her pocket to take out her cell. "I could call Tony for you-"
Nika put her hand over her cousin"s phone. Gently, she pushed it back into the pocket it had come from. "That"s okay, maybe I"m just being overly sensitive."
"FYI, patients think that"s a good quality in a doctor," Sasha told her. She was about to say something more, but her pager went off. She angled the device that was clipped onto her belt. "After five false alarms, it looks like Mrs. Davis"s water finally broke. Thank G.o.d!" she declared happily. "Gotta run, Nika." And yet, she still paused long enough to give her cousin"s face another once-over. "You"ll be all right?" she asked, concerned.
"I"ll be fine." She waved Sasha on. "Go, do what you do best. Bring another little taxpayer into the world," she urged with a smile.
The moment her cousin was out of sight, the smile on Nika"s face vanished, replaced by a weary expression. She wasn"t being overly sensitive. That was just an excuse she"d given Sasha. And she also didn"t believe that the way she was feeling was the product of an overactive imagination. Older patients on her floor were expiring at a rate that she was definitely uncomfortable about.
Okay, it wasn"t in droves, but still...
Granted, there had been more admissions to the unit of late than there used to be. She"d checked into that via a comparison between last year"s admissions at this time and now. More people meant that the number of patients dying increased. But so had the percentages and that part was odd.
She"s lost five patients in two months. Okay, so three of them were diagnosed with terminal diseases and death was an almost merciful release-but getting cured would have been even better.
Was it just a coincidence, or was there something else going on? Something that she was missing?
She hadn"t a clue, but her gut warned her of some kind of pattern. Still, she didn"t want to mention her suspicion to her family. She didn"t know them all that well yet and the last thing she wanted was for them to think that she was the kind of person who went around seeing ghosts when there weren"t any or stirring up trouble as she went along. She wasn"t a rabble-rouser, just a concerned doctor.
What she needed was an impartial outsider who, by the way, was also acquainted with police procedure and could figure out if something not quite aboveboard was going on.
Frustrated, she shoved her hands into her pockets, pensively reviewing her options. Her fingers came in contact with card stock.
Nika realized what it was before she had a chance to pull it out all the way and look at it.
Cole Baker"s business card.
Detective Cole Baker"s business card, she amended, her mind going from zero to sixty-five in just under a racing heartbeat. She had no idea if he"d be open to look ing into this for her, but there was nothing to be lost by asking him. He couldn"t hold that against her, she reasoned as his frowning, disapproving face rose up in her mind"s eye. She was just being a concerned citizen, that was all.
She lost no time in dialing his cell phone number.
The line went active on the second ring. The detective surprised her with his prompt response. She could hear street noise in the background. They all but drowned him out.
"This is Baker."
Did he ever sound anything but impatient, she wondered. "Detective Baker, this is Dr. Pulaski calling-"
Impatience turned to gruffness instantly. "What"s happened to my grandmother?" he demanded.
A voice in her head told her her meddling was an all-round bad idea. If she had concerns, there were proper channels to go through. She could-and should-go to the hospital administrator and talk to Ella about what was on her mind. She owed the woman that, rather than going over her head and calling in the police. What if she was completely off the mark? She didn"t want to embarra.s.s the hospital, and that would be exactly what she"d be doing-not to mention committing medical suicide with her career.
"Nothing happened to your grandmother," she a.s.sured him.
"Then why are you calling?" he asked. It was obvious he didn"t believe her.
The level of background noise increased, making it hard for her to hear. But she pressed on. She had to give him some kind of reason for calling, otherwise he would think that his grandmother"s fate was in the hands of a lunatic. "Do you have any idea if she"s always had high blood pressure?"
"I didn"t know it was high at all," he confessed. d.a.m.n it, why hadn"t his grandmother told him? Why were all the surprises attached to her case bad? "Why, is that a problem?"
"It might be," she acknowledged, treading cautiously. She didn"t want to alarm him. "I"ll confess that I"d like to see it significantly lower before we go ahead with the procedure."
"What about her other tests?" he asked. "What do they say?"
She"d forgotten about them. "Nothing yet. We haven"t gotten back any of the results. They should be in first thing in the morning," she promised him, then, because she had a feeling he was expecting it, she added, "I"ll be in touch with you the minute they turn up. Thanks for the information," she told him and then, with that, she terminated the call.
With a deep sigh, she put her cell phone back on vibrate and pocketed it. She debated the wisdom of her next move for approximately two minutes, decided that she couldn"t live with herself if she said nothing and her instincts ultimately turned out to be right-that something more than natural progression caused these people to die.
Squaring her shoulders, she forgot about taking a late lunch and went to talk to the person she should have discussed this with in the first place, the hospital administrator.
While her office was being renovated, the administrator had temporarily relocated to the second floor. Nika took the stairs.
Chapter 5.
"And your contention is what exactly?" Ella Silverman asked, looking at Nika over the top of her reading gla.s.ses. They had slipped down again and the woman had left them there, temporarily suspending the ongoing battle with gravity that required her to push them up the bridge of her nose every few minutes.
As quickly and succinctly as she could, Nika had told the tall, imposing, frowning hospital administrator that she was uneasy about the number of recent deaths in the Geriatrics Unit. The moment the words had left her mouth, she could have sworn that Ella Silverman had instantly looked like someone who"d gone on the defensive.
Nika chose her words carefully as she repeated her concern.
"Just that the patients in the Geratrics Unit are dying at almost twice the national average for their age group."
The woman"s back literally went up. Ella narrowed her eyes. "And you know this how?"
Nika wasn"t about to back off now. "Research."
"I see." Ella tossed her head. Since her shoe-polish-black hair was frozen in place with a third of a can of hair spray, not a single hair moved out of place. Despite the administrator"s caricaturelike appearance, Nika knew through word of mouth that the woman was actually very good at her job, but she was a bit overly chauvinistic when it came to protecting the hospital"s reputation.
"Are you insinuating that the patients are dying because the quality of the care they are receiving here is poor? Or are you saying that the hospital is in some way failing to provide as clean and germfree an environment for these patients as possible?" She held up her hand before Nika could begin to answer, warning her. "And before you answer, I would think very carefully about the next words I say if I were you."
"No, no," Nika denied the two suggestions Ella had offered with enthusiasm. "I"m not saying it"s either of those reasons."
Ella sighed, exasperation echoing in the sound. "So exactly what is it that you are saying, Dr. Pulaski? That the hospital is having some kind of run of bad luck, having these people come here to be treated in our Geriatrics Unit only to die?" the woman asked sharply. She pretended to frame a public service announcement. ""People, keep your parents and beloved Uncle Oscar out of Patience Memorial if you don"t want them to die on you." Is that what you"re implying, Dr. Pulaski?" she asked, leaning over her desk and somehow managing to fill the s.p.a.ce around Nika with her presence.