CODE BLUE with INTENT
Marilyn Esper Kelsey
ISBN (Print Edition): 978-1-54398-771-3
ISBN (eBook Edition): 978-1-54398-772-0
© 2019. All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.
Contents
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Chapter 42
Chapter 43
Chapter 1
Sara Banks’s eyes flew open and darted wildly around the room. She tried desperately to sit up in her hospital bed, but she was too weak. Burning pain traveled up her arm, crushing her chest.
Oh God, am I having a heart attack? Her hand trembled as she searched for her call button.
Where the hell is it? “Help me,” she barely managed to whisper before slipping into darkness.
The monitor at the nurses’ station transitioned from a cardiac arrhythmia to a flat line. Julie Summers, an ICU nurse, leaped out of the chair and ran into Mrs. Banks’s room. Finding no pulse and no respirations, Julie cried out, “Call a code! Get the crash cart, Maria! Mrs. Banks has coded! Call Dr. Fenelli!”
The ICU nurses sprang into action. Maria Sanchez ran for the crash cart and rushed into room 216. Rita Jenkins followed and started CPR.
“CODE BLUE, ICU ROOM 216! CODE BLUE, ICU ROOM 216!”
Rachael Reynolds and Lydia Brooks, who were sitting in the hospital cafeteria when the overhead page sounded, sprang up from their seats, leaving their lunch behind, and ran up the stairs to the ICU.
“Damn!” Rachael grunted, sprinting up the stairs. “That’s my patient. What the hell happened? I just gave her twelve o’clock meds before we left for lunch, and she was fine.”
“I know. She was just recovering from her surgery. I looked in on her too before we left,” Lydia said.
Mrs. Banks had been rushed to the ER two days earlier with severe abdominal pain. A physical exam, blood tests and CT scan had showed a ruptured appendix, and Mrs. Banks had been hurried into the OR. When Dr. Jake Fenelli opened her up, he found her abdominal cavity filled with infection. He removed the purulent appendix and cleaned the infected area with repeated lavage.
After the surgery, because of Mrs. Banks’s complex medical history—which included two prior heart attacks, arrhythmias, diabetes, and hypertension—she’d been admitted to the ICU. Despite Mrs. Banks’s declining temperature over the past two days, Dr. Fenelli had been concerned about her elevated blood work. On the other hand, he’d been encouraged by her stable vital signs and normal cardiac rhythm.
When Rachael Reynolds and Lydia Brooks reached room 216, the code was in full swing. Dr. Richard Timmers, an anesthesiologist, intubated Mrs. Banks and attached the ventilator. Maria Sanchez performed chest compressions while Julie Summers and Rita Jenkins passed medication from the crash cart to Dr. Ben Lucien.
“Did anyone call Dr. Fenelli and tell him his patient coded?” Dr. Timmers asked.
“Yes. We paged him and called his office. He’s on his way,” Julie reported.
“Stop compressions,” Dr. Ben Lucien ordered five minutes into the code. He checked for a pulse and glanced at the monitor, which indicated no cardiac activity. “No pulse. Resume compressions. Give her another amp of Epi.”
After another minute, Dr. Lucien repeated, “Hold compressions. We have a rhythm.”
“V-tach,” Julie said, indicating that the monitor showed ventricular tachycardia, a life- threatening arrhythmia.
Dr.Lucien stepped back from the bedside,“Charge the defibrillator to 200.” Julie applied conductive gel to the defibrillator paddles. “Clear.” Everyone stepped back from the bed while Julie shocked Mrs. Banks’s heart.
“Still in V-tach! Charge to 400.” Dr. Lucien ordered. “Clear.” Julie called out and shocked Mrs. Banks’s heart again. Resuscitation continued for another forty minutes.
Dr.Fenelli charged into the room thirty minutes into the code and threw his jacket onto the chair. “What the hell happened? She was fine this morning.”
“Rachael went to lunch, but she couldn’t have been gone for more than a few minutes when the monitor showed an arrhythmia, then asystole,” Julie said. “Rita, you were in her room right before the code. Did you notice anything going on with Mrs. Banks at that point?”
“No,” Rita replied. “She was sleeping, and her monitor showed normal sinus rhythm.”
“How long has she been down?” Dr. Fenelli asked.
“Forty minutes,” Dr. Timmers said. “Her pupils are fixed and dilated now.”
“Damn!” Dr. Fenelli said. “How did this happen? She was doing so well. I was ready to transfer her out of ICU in the morning.”
“What do you want to do, Jake?” Dr. Timmers asked.
“Okay, let’s call it. Time of death 12:55 p.m.,” Dr. Fenelli said. “I’ll go talk to Sara’s husband.”
Chapter 2
“Good work on the Banks case.” The muffled voice on the phone was electronically distorted, not allowing the receiver of the call to tell if the voice was male or female. “My sources at the hospital said everything went smoothly.”
“I don’t think I can continue with this.”
“Sure, you can. The first one is the hardest. The rest will be easier for you.”
“I’m not so sure about that.”
“Listen up carefully. You have a contract with us now, and if you don’t follow through, there will be severe consequences.”
“What kind of consequences are you talking about?”
“We’ve discussed this. You know exactly what I’m talking about!”
“I want to talk to someone about my assignments. Someone with a human voice, not this Star Wars voice. I don’t have any numbers to contact you. Who’s in charge?”
“In due time,” the cryptic voice stated. “We need to know that we can trust you first. When we feel you’re ready, we’ll tell you more. I have wired your 100K to the designated bank you requested, under the name of A. J. Morgan. We’ll contact you with your next assignment.”
“Well, I … wait!” But it was too late. The altered vo
ice had hung up.
Chapter 3
Northwest General Hospital, a 400-bed hospital in Morristown, New Jersey, was well known throughout the whole Northeast area for its renowned surgeons and innovative surgical techniques and procedures. The hospital was also distinguished for its cardiac and neurology units. The cardiac and rehabilitation outpatient services encompassed two floors of the hospital and had a long list of patients waiting to enter their rehabilitation programs. Interns and residents who survived their rotations at Northwest General were among the best trained in the country.
Kate Ross, a Utilization Nurse Reviewer in the Case Management department, walked into the ICU shortly after the code. Kate had been an RN at Northwest General for the previous twenty years. Her nursing career included the emergency room, OR, medical/surgical floors, and the ICU, so she knew the hospital staff well. She had transferred to the Case Management department three years ago after the death of her husband, Nick. Kate needed to spend more time with her daughter, Megan, who was only ten years old when Nick died. She needed more flexible hours and weekends and holidays off. The RN nurse reviewer position for the hospital made this possible.
Kate’s job required her to review all hospital admissions for medical necessity and to make sure the patient and the hospital received the proper reimbursement from the patient’s insurance company.
Kate spotted Dr. Jake Fenelli charting at the ICU nurse’s station desk and said, “Hey, Jake. Sorry to hear about Mrs. Banks. I was just about to call her insurance company for an update and ask for a few more approved days for her stay in the hospital when I heard the news.”
“Thanks, Kate. I wish I knew what happened. I’ll have a better idea after the autopsy. What’s up in your life? I haven’t talked to you in a while. How’s your daughter doing?”
Kate Ross and Jake Fenelli had worked together in the OR and in the ICU for many years and had become friends. He had been there for her when her husband died, and she had been there for him when he divorced his wife years ago. They had numerous chats about their children. Jake had a sixteen-year-old daughter, Grace, and a nineteen-year-old son, Matthew. Kate and Jake also had shared their many humorous and disastrous dating stories throughout the years.
“Megan is thirteen going on twenty,” Kate replied. “She’s a cross between Dakota Fanning and Katy Perry. God help me, she’s getting more beautiful everyday. I would keep her locked in the house if I could!”
“I know what you mean,” Jake said. “Grace is sixteen now, and I can’t believe how grown up she is at times. Matt is a sophomore at Rutgers University and in no hurry to mature. And speaking of mature,” Jake, said as Maria Sanchez strolled past him, “who’s the hot new nurse?”
“Down boy,” Kate teased. “Maria is a new graduate nurse here, and she’s only like twenty years old.”
“A guy can dream, right?” Jake said.
“Don’t you have surgery or something to do?” Kate replied with a tilted smile.
“Yes, as a matter of fact, I need to get down to the OR. I’m doing a bowel resection on Mrs. Adler.”
“Do you mean Judith Adler?” Kate asked.
“Yes. She came into the ER with a bowel obstruction.”
“She’s been in the hospital many times. We call her a frequent flyer around here,” Kate said. “Maybe it’s you she keeps coming in to see!”
“Very funny. I’ll be sure to ask her when I see her downstairs,” Jake said. “By the way, I’m having a party Saturday night at my house. The OR and ICU staff are all invited. How about you come too, Kate?”
“Sure. I’d love to. Special occasion?”
“Good news for me! My ex-wife is getting married again. No more alimony for me!” Jake threw his arms up in the air as if he’d just scored a touchdown.
Kate smiled. “I’ll be there.”
“Oh, and make sure you bring J.Lo with you!” Jake said, referring to the new nurse, Maria Sanchez.
“Dog, or should I say grandpa dog?” Kate mocked.
Dr. Fenelli left the ICU sticking his tongue out at her.
Maria Sanchez walked toward Kate and said, “Hi. You’re Kate, right? I’m Maria Sanchez, a new nurse here. Who’s the gorgeous doctor you were just talking to?”
“Yes, I’m Kate, and welcome to Northwest General. That was Dr. Fenelli, a surgeon here.”
“Talk about a hottie! Are you two involved?” Maria asked.
“No. We’ve worked together now for twenty years. We’re good friends.”
“It looked like more than friends to me, but whatever. I wouldn’t mind having a piece of him. Is he married? Not that it matters to me,” she added.
Kate was taken aback by Maria’s brazen attitude. “No, he’s divorced. As a matter of fact, he’s having a get-together Saturday night. The OR and ICU staff are all invited.”
“Oh, that’s the party I’ve been hearing about all week. I’m sure to go now that I’ve seen the delicious Dr. Fenelli. Any other tasty docs going?” Maria asked.
“I’m sure there will be enough there to please everyone. Dr. Fenelli is well liked and throws great parties.”
“I’ll definitely be there!” Maria was already planning her wardrobe to rock the house. “See you later, Kate,” she said as she whisked off down the hall.
OMG, what a piece of work that one is, Kate thought. Maria Sanchez is on the prowl!
Kate was still shaking her head in disbelief over the encounter when Julie Summers said, “I see you met the notorious Miss Sanchez.”
“What a trip she is! I have a feeling the men here are in for it. She’s definitely a player.”
“Oh yes!” Julie said. “Rumor is she looking for a rich doctor.”
“Well, she certainly has the looks.”
Maria was beautiful in a sexy Latin-look way, even in her scrubs. She had smooth olive skin and thick dark eyelashes framing her huge, brown eyes, the color of dark roasted coffee beans with flecks of cinnamon swirls. Her long, thick, wavy brown hair hung down to the middle of her back. Even with her hair pulled up in a ponytail, she looked incredibly sensual.
***
Maria Sanchez would not be denied the best life had to offer. She had grown up in a small, rundown tenement apartment with three sisters and four brothers—Maria was the fifth of the eight children. Her mother worked at the local motel, and, truth be told, she did a lot more than the laundry. There were at least six different fathers (could be more—even Maria’s mother wasn’t sure), so there were always “uncles” hanging around the apartment. None of these so-called uncles stayed around long. They drifted in and out—lazy, poor, and constantly hitting on her and her sisters when their mom was at work. The girls would tell their mom, who would scoff at them and reply, “Get used to the attention while you can girls, ’cause when your looks go, they won’t come around anymore.”
Maria was determined that life was not for her. She would have the better things that life had to offer. She’d learned early on that she possessed a sexual power over men and could use that power to her great advantage. She matured into a sexy beauty with a body that drove men wild with desire. All through middle and high school the boys and men panted over her. She teased and tempted them with her body but went only so far; she was not about to end up like her mother, with a bunch of degenerate losers.
Maria had actually kept her virginity till her senior year of high school. One day, the father of Lisa Chandler, one of her girlfriends, picked them up after school in his silver convertible Porsche. He was decked out in an Armani suit, Louis Vuitton shoes, Gucci sunglasses, and a Patek Philippe watch. Charles Chandler was a physician at St. Peter’s Hospital in Livingston, New Jersey. He was suave, smart, show-off rich, and the proverbial playboy. Maria was instantly impressed and attracted to his stature and presence, thinking to herself, This is more like it. This is exactly what I want—fancy cars, clothes, and l
ots of money.
Dr. Chandler was interested in Maria’s incredible beauty and arrogant enough to know that the starstruck girl staring at him would be his before the night was over. Maria did indeed lose her virginity that very night. Dr. Chandler told her straight out that he would never leave his wife, but Maria had been naïve enough to think she would change his mind.
Their affair lasted five months, till Dr. Chandler moved on to new prey. Maria was devastated by his betrayal. Who the hell did he think he was? She made two decisions that day— one was to enroll in nursing school where she could find a rich doctor, and the second was that she would never give her body away for nothing again. She learned the art of seduction and tantalized her partners till they would do anything for her. She was clear in her own mind; she would be the one to break off the relationships. No one would break her heart again.
***
“Maria is definitely a threat to the nurses. They’re all green with envy already. She’s only been here for a couple of weeks and has gone through a good portion of the medical staff,” Julie noted sarcastically.
“It should be an interesting show Saturday night,” Kate said. “Are you going to Dr. Fenelli’s party?”
“I’m not sure yet. My mom has been getting weaker, and her dementia has gotten worse.
“I’m so sorry to hear that, Julie. I know you’ve had a tough time with your mom.”
Julie’s husband had left her after Julie’s mother had become ill and come to live with them. She’d refused to put her mom in a nursing home. Instead, she had hired private-duty nurses and sitters to stay with her mom when she was working. This included double shifts in the hospital when possible for the extra money. She had no relatives or siblings to help alleviate the financial burden.
“What are you going to do?” Julie sighed. “You have to play with the hand you’re dealt.”
“Yes, you do, but sometimes you’re dealt a lousy hand. I hope things look up for you,” Kate said. “And you know I’ll gladly help you in any way I can.”
“Thanks. I appreciate it, Kate. I’ll never forget all the times you stayed with my mom when I needed it. It’s comforting to know that if I get in a bind, you’ll step in for me.”
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