Code Blue With Intent

by Marilyn Esper Kelsey

  “Don’t worry, Linda. Your secret is safe with me,” Kate laughed. “I won’t breathe a word to anyone that your company is killing off all its multiple-admission patients to make a profit.”

  “Oh God, wouldn’t it be funny if our conversation was recorded?” Linda sighed at the thought. It was common practice for insurance companies and other businesses to record phone conversations for teaching purposes as well as quality customer-service checks.

  “It certainly would, Linda! The other reason I called was to precert another admission this morning. And speaking of frequent admissions, Judith Adler was admitted with a bowel obstruction. She’s in the OR now.”

  “Oh, really? Judith Adler is another patient we were discussing at our conference last week. What’s going on with her?”

  Kate gave Linda a detailed clinical review. She went over vitals, symptoms on admission, blood work, x-ray results, and medications ordered. Then she repeated that Mrs. Adler was in the operating room.

  “Ok, Kate. I’ll give her two days to start, with an update in three days. Her precert number is three-seven-six-eight.”

  “Thanks, Linda. I’ll call you in three days with her update. If your company doesn’t knock her off before then, that is. Ha!” Kate teased.

  “Hilarious,” Linda said. Deciding to play along, she added, “Since you know our secret, we will have to wait for another admission to eliminate Mrs. Adler so you won’t suspect us! Goodbye, Kate. I’ll talk to you in three days, if not sooner.”

  “Bye, Linda.”

  Judith Adler had no idea how fortunate she was that Kate and Linda’s conversation had just postponed her demise. This admission, that is.

  Chapter 5

  “Change of plans with your assignment,” said the mysterious voice. “Forget Judith Adler for now; we’ve hit a snag. We’ll hold off on our plan to eliminate her for now.”

  “What happened?” the receiver of the call asked.

  “Nothing to concern yourself with. We’re going to change the assignment to a Mr. James Allen, admitted last night to ICU at Northwest General. Once you’ve completed your assignment, I’ll get back to you regarding your money drop-off.”

  “I’d like to speak with—” But the muffed voice had hung up.

  ***

  The caller turned off the electronic device from the phone and turned to the man sitting across from him. “I’m a little concerned about the new recruit at Northwest General. A lot of questions and anxiety. Do you think this person can be trusted?”

  “Yes, I do, for the money. Don’t worry. It takes awhile to get used to this. Medical personnel are trained to save patients, not kill them.”

  “What about you? You don’t seem to have a problem with it.”

  “It took me a long time to adjust, believe me. I just don’t think about what I’m doing. I think about relieving their pain and suffering.”

  “Yeah, right. A lot of money relieves your pain and suffering.”

  “It’s not like that.”

  “On another matter, after listening to the recorded message, what do you think we should do with the situation of the nurse from Northwest General, Kate Ross, and our nurse reviewer, Linda McCarthy?”

  “I really don’t think there’s anything to worry about. I think they were just kidding around with each other.”

  “If you’re sure. But their conversation was a little too close to home for my comfort. You better keep an eye out for Kate Ross. I will have someone talk to our nurse reviewer, Linda McCarthy.”

  “I know Kate, and she won’t cause any trouble. I’ve worked with her for years. She’s a great nurse.”

  “I don’t give a rat’s ass how great she is. She better not screw up our plans or she will have to be taken out.”

  “Trust me, she won’t interfere with your plan. She was only having some fun joking around with Linda. She has a terrific sense of humor.”

  “If you say so. Just feel her out about her dealings with our insurance company and our nurse reviewers, and let me know what she says. I don’t want anything to ruin this merger with Eastern National Insurance Company. This is a huge deal, and we stand to make a bundle of money. I’m talking big bucks!”

  Chapter 6

  Dr. Ben Lucien’s pager buzzed as he left a patient’s room on the third floor. Then it flashed “ICU 911.” Simultaneously, the overhead page blared, “Dr. Lucien, ICU STAT! Dr. Lucien, ICU STAT!” Ben headed to the stairs as the overhead page announced, “CODE BLUE ICU ROOM 220! CODE BLUE ICU ROOM 220!”

  Ben knew Room 220 was his patient, James Allen. Sixty-seven-year-old Mr. Allen had been admitted yesterday in a diabetic coma. Because of his noncompliance with his diabetes, Mr. Allen was frequently admitted to the hospital. He refused to adhere to his diet or take his insulin on time, if he felt like it at all. Dr. Lucien had held numerous counseling sessions with James and his wife, Emily. James would always shake his head and agree, then go home and do whatever he pleased. Emily Allen was at her wits end with her husband. She prepared all the proper meals for him, but he would push them aside and prepare a high-carbohydrate, high-sugar, high-fat diet instead. Over the past couple of weeks, he had been bringing home take-out meals from various fast-food restaurants as well as pastries from the local bakery. Emily had finally given up and told her husband that if he wanted to die, that was his choice; she was tired of arguing with him. James had already lost his right foot to diabetes and was now having problems with his eyesight—diabetic retinopathy—due to his diabetic noncompliance. Emily’s worst nightmare had come true yesterday when she arrived home from work to find her husband on the floor in a coma.

  As Dr. Lucien reached room 220, the code was in progress. Rita Jenkins was preforming chest compressions while Julie Summers, Maria Sanchez and Rachael Reynolds were drawing up medications from the crash cart and passing them to Dr. Larissa Markov, an internist, who happened to be in the ICU when the code was called. Dr. Timmers was at the head of the bed about to intubate the patient.

  “Julie, tell me what happened,” Dr. Lucien said as walked over to Larissa Markov. “I’ll take over, Larissa. Thanks for helping.”

  “No problem, Ben. I was in the ICU when they called the code. The patient has had one amp of Epi. No cardiac rhythm since we started. Sure you don’t want me to stay? I can be late for my office hours.”

  It didn’t go unnoticed that Dr. Larissa Markov had offered her assistance so readily, since that was uncommon for her.

  ***

  Larissa Markov had grown up in Russia with strict parents who tolerated no nonsense from their daughter. It was study hard, learn your lessons, and don’t talk back. When Larissa was just three years old, her parents decided their daughter would be a doctor, no questions asked. They gave her no choice in the matter.

  As a child, Larissa’s only pleasure was playing the piano. Her parents allowed her to take piano lessons but only after she completed her school work and five hours of study time every day. She practiced every chance she could to escape and get lost in her beloved music. She wanted to be a concert pianist, but there was no way she could convince her parents of the merits of such a plan. Her piano teacher even tried to intervene on Larissa’s behalf, but to no avail. Her parents did not want to hear about how brilliant their daughter was on the piano. They had made their choice.

  After Larissa finished college at Moscow State University, with high honors, her parents decided that Larissa would go to medical school in the United States. Larissa’s Aunt Diana lived in New York, so her parents enrolled her in New York University School of Medicine so she could live with her aunt. Her life would never be the same again.

  Diana, Larissa’s mother’s sister, appeared to be a New York socialite. She had blonde, coiffed hair, sported a model-thin body, dressed in designer clothes, and lived in a high-end 5th Avenue penthouse.

  Larissa’s impression of
her aunt this time around, who she had met as a child, was awe. The penthouse was huge and grandiose, and her aunt was sweet and inviting. Larissa thought this stay was going to be fun, that she could relax and even have some friends. The best part of her new living arrangement was the magnificent Steinway grand piano in the living room. The thought of being able to play that piano every day put her in heaven. This was going to be great, or so she thought.

  The first few months were indeed idealistic. Larissa went to med school, studied hard, and played the piano. She even managed to make a few friends. Her ties with her parents consisted of letter writing and emails. She dutifully gave them the impression that her time was all work and no play, as they always expected of her.

  Diana was impressed with Larissa’s musical ability, and she felt Larissa was wasting her time going to med school. So she tried to convince Larissa to further her musical endeavors. She could have connected her to a number of her associates who represented a wide range of well-known theater members and musicians. Larissa said she would have loved to pursue a musical career but that her parents wouldn’t approve. In fact, they would be furious with her and her aunt. Besides she was actually enjoying med school and her parents would only send her money if she stayed in school. Going back home was not an option. No way did she want to return to Russia.

  A few months into Larissa’s stay her aunt Diana had insisted that she get a makeover, including her hair and clothing. After Diana took her shopping for designer clothes, Larissa was shocked by what she saw in the mirror. She had been transformed from a plain, mousey-brown, straight-haired girl to a fashion model with long layers of rich, dark-brunette hair with light-auburn highlights. Her perfect makeup showcased huge, engaging, soft-brown almond shaped eyes and flawless, white creamy skin. Larissa had never thought she was pretty, but the mirror now told her otherwise.

  Next, Diana arranged for Larissa to go out on a date, much to Larissa’s resistance. She was terrified. What was she going to say? She had never gone out on a date. How was she suppose to react? I can’t do this!

  But Diana insisted that she go. She knew that man, and she would be fine, Diana said. It was time for Larissa to start going out.

  When the day arrived, Larissa was secretly excited, albeit very nervous. She had chosen a low-cut, short black cocktail dress along with four-inch Jimmy Choo heels and her aunt’s diamond necklace and earrings. She could have passed for royalty.

  A white stretch limo picked her up. She was to meet her date at the Stafford Hotel at the bar for drinks, but when she arrived at the hotel, the bartender told her to meet Mr. Cummings up in his suite instead. Larissa hesitated for a moment, then rode up the elevator to the fourteenth floor and knocked on room 1426. Oh God, please don’t answer, she thought, trembling. I want to go home.

  The door opened to a big man—six-foot-four, with a beer gut hanging over a huge, silver steer-horn belt buckle. An enormous cowboy hat topped off a wide, leering grin plastered on his face. “Hey little lady. Come on in.” His cold, steel-grey eyes glanced boldly up and down, checking out her body. “Diana said you were a peach . . . how right she was!”

  “Um, I . . . I’m not sure I have the right room . . .” Larissa said, feeling ill. This was her date? This man was her father’s age. This couldn’t be right! It must be a mistake.

  “You’re in the right place, sugar,” the man said in a Texas accent. He grabbed her arm and pulled her into the room, shutting the door behind her.

  “There’s been a mistake,” Larissa said, shrinking from his touch.

  “Come on, girl. Relax. Have a drink. We’re going to have a party”

  Larissa fidgeted and thought maybe it would be okay to have one drink, then leave. After all, her aunt knew this man, so it couldn’t be that bad. She sat on a chair far away from the bed, trying desperately to calm down.

  “I’m Denny. You’re Larissa, right?” He handled her a glass of wine.

  “No thank you, Denny. I don’t want a drink, I’m not feeling well. I think it’s best I go home.

  “Now, sweet little lady,” his voice dripped with sugar, “you’re going to drink your wine, and then we are going to party. Diana told me you were shy and to take real good care of you, and that’s exactly what I’m going to do. I had your aunt years ago, when she was younger. I like the young sweet ones.” He ran his beefy hand down her bare arm.

  Larissa asked naively, sipping the wine, “Oh, you dated my aunt?”

  “Yeah, right,” he snorted. “We dated all right.” Denny gave her a look of impatience. “Let’s get started, girl.” He removed his jacket, then started on his shirt.

  Larissa jumped up off the chair with a sense of urgency. “I have to go right now! My aunt is going to be very angry with you.” She ran to the door.

  Denny laughed as he reached the door and blocked her way out. “You are not going anywhere. We haven’t finished yet. You and I are going to have a good time.”

  Frightened behind belief, she backed away, crying. “Let me out!” Please, God, she thought, “let me get out of here. He has to realize this is a big mistake.”

  Denny grabbed her roughly, threw her on the bed, and groped her, ripping her dress off.

  “NO, NO, you can’t do this!” she screamed, thrashing and trying to kick him off of her.

  Denny slapped her face, pinned her down with his massive weight, and had his way with her. He got up after he was finished, put his clothes on, and tossed a wad of bills on the bed. “Let’s do this again when I’m back in town. I love the innocent act and the way you try to fight me off. I like it that way. I’m going down to the bar and have a drink. If you’re still here when I get back, we could go for round two.” He slammed the door as he left the room.

  Larissa lay on the bed in a trance, trying to figure out what had just happened. She pulled herself off the bed, stumbled into the bathroom, and peered into the mirror. Her mascara and lipstick were smeared all over her tear-streaked face. Her eyes were sunken in and staring back in fear. She cleaned up as best she could, pulled her wrap around her torn dress, rode the elevator down to the lobby, hailed a cab, and rode back to her aunt’s. She hurried into the apartment, ran to her bedroom, tore off her clothes, rushed to the shower, and turned on the hot water. Then she sat on the shower floor, sobbing.

  After what seemed like hours, she wrapped herself in her fleece robe and crawled into bed wishing she were dead. She waited for her aunt to come home so she could confront her. When the front door opened, she dragged herself down the stairs and unleashed upon her aunt.

  “Aunt Diana, that terrible man Denny hurt me!” Larissa wept as she wiped the tears that flowed down her face. “He laughed when I begged him to stop. I don’t understand why he did that to me?”

  After listening to Larissa’s nightmare, her aunt replied in a harsh tone that Larissa had never heard before. “Listen, girl. I did you a favor getting you away from your snobbish, tight-ass parents and giving you a new life here in New York. You owe me big time, and it’s payback time.” Diana’s face turned dark, ugly, and frightening.

  “Aunt Diana, what are you saying? Did you know what that man was going to do to me?” Fresh tears welled up into her shocked, disbelieving eyes.

  “You needed to grow up, girl, and start acting like a woman, not a baby. From now on, you can go to school, play your damn piano, and continue to screw who I tell you to. By the way, where’s the money Denny gave you? I want it, and I’ll give you a percentage.”

  Her words hit Larissa like a physical blow. Larissa froze, helpless. “You can’t be serious. Please tell me this is a joke.”

  “It’s no joke, baby-cakes. Rest tonight, for tomorrow I have two wealthy gentlemen coming to town who are looking for an innocent girl, and you will deliver or I will send you back home to Russia.”

  Larissa gasped. “You can’t make me, and I will tell my parents on you. You’ll be i
n trouble.”

  “If you breathe a word about this, I will tell your parents and the police you’ve stolen my jewelry and money, and you’ll go to jail. Then you’ll say goodbye to medical school and goodbye to life. My cop connections are a phone call away, and they can arrange for you to rot in jail for a long time.” The crazed look in her aunt’s eyes told Larissa she meant what she was saying.

  Larissa didn’t know what to do. This was all wrong. This was not supposed to happen. Her stomach churned as she fled upstairs to her bedroom. She packed her bag, thinking there was no way she could stay here, that she had to leave. As she passed the parlor, her aunt yelled out, “Go, but you will be back. It’s not such a bad life, and you would make a lot of money. Remember, I’ll call the police and have your ass in jail if you open your big mouth.”

  Larissa fled out the door and never looked back. She took a bus to NYU and put her stuff in the doctor’s lounge. She stayed in the on-call room that night thinking about how she was going to survive. In the morning, she showered in a depressed trance as she prepared for her shift.

  Later that day after much prodding, Larissa broke down and told Sonya, one of her fellow med students, that her aunt had kicked her out of her apartment. Sonya immediately invited Larissa to stay at her apartment till she figured things out. Besides, Sonya said, she needed help with her rent. Relieved, Larissa took Sonya up on the offer. She didn’t tell her what else had happened to her, because she was too scared and didn’t know if she could trust anyone.