by Barbara Ebel
“For this surgery, I’d like to suggest an epidural. I would insert the catheter into your back through a needle and then medication would be infused which keeps you numb from the waist on down. We would also make you sleepy with IV drugs.”
“As long as I don’t stay numb forever, like the people who get paralyzed from spinals.”
“Spinal paralysis is like fiction, mostly a myth.”
“All right then, doc. Short term pain for long term gain. I agree, because I want my golf score to be as good as my age.” He settled his hand on the top of his head. Inching his fingers to the back and left, his hair moved with them.
Viktoria finished asking him questions and telling him what to expect. She paused and asked, “Your toupee may be safer left with your wife than wearing it back to the OR.”
“I guess so. The adhesive has come to the end of its lifespan and my hairpiece is due for maintenance. I shouldn’t have worn it.” He pulled it off carefully and handed it to his wife. “Do you mind?”
“No. I told you to take it off.”
“You were right, dear. Like always.”
Instead of parting the curtains, Viktoria thought it best to give Mr. Brady a touch of midazolam. She brought out the syringe from her pocket and gave him one cc. Closing his eyes as she left, she figured the sedative would do wonders for their marriage before they wheeled him back to the OR.
-----
Her other patient, Viktoria discovered, was late to arrive. “Go get a cup of coffee,” Jay told her. “The OR staff needs to resterilize a piece of equipment for Bobby Glade’s case, so both of your cases are delayed.”
“Holler if you need me.” But instead of going to the lounge, Viktoria had other plans. The convenience of a block of free time hastened her steps, and she soon boarded an empty elevator up to the medical ICU.
Exiting the elevator, she walked past the wall divider and the plastic ivy potted plants between the hallway and the waiting room and crossed her fingers that Fred had made medical progress overnight and maybe was off the ventilator. From what she’d heard, the internal medicine service in the hospital had a fine reputation and, hopefully, Fred was on the road to a full recovery.
The ICU doors slid open and she padded in. Heading towards the desk to inquire about Fred’s whereabouts and condition, she nevertheless glanced into the rooms to her right. Arriving at the next doorway, she stopped short. Two uniformed men stood inside, as well as a nurse, and Fred was in the bed, the endotracheal tube jutting from his mouth with the mechanical drone of the cycling ventilator, and his vitals prancing across the monitor above.
The man standing at the foot of the bed glanced her way and the man in front of her, facing the other way, turned around. Noticing that she wore scrubs and a white coat, he frowned.
“I was hoping you were some sort of family member, not a doctor,” he said. “Nothing personal.” He was a tiny man whose uniform would fit someone half her size, and he stepped to the side thinking she needed to be next to Fred’s bed. “Are you the doctor taking care of him? When can we talk to him?”
Thinking they were regular police officers, she discovered her supposition to be inaccurate. The emblems on both their uniforms said “DEA.”
“No, I’m not,” she said. “I’m an anesthesiologist. I happen to know him from the hotel I stay in while I work here as a locum tenens doctor—a doctor working for a service that provides temporary coverage to a health care facility.”
“We’ve contacted an out-of-town sibling half across the country and found out his father has dementia, so we’re striking out. Anything you can tell us about his job. Apparently, he was on a job site at the Stay Long Hotel when EMS brought him in. Is that where you know him from?”
“Yes, and I’ve talked to him a few times as well as his co-workers.”
“Co-workers?” The man at the bottom of the bed chimed in. He was the older of the two with a serious mustache and large hands, one of which stayed hooked to his belt. “Apparently they found him working by himself.”
“Nope, there are two other guys. One seems to be their senior, wears a black baseball cap, and the other one had a purposeful habit of wearing his pants too low. I can’t tell you much more than that, but I tell you who can. The manager in the front office, Mason, should know about them. Was your division called in for a particular reason? All I know is that he had a drug overdose.”
“That information should help because, yeah, we were just given the case and haven’t been over to the hotel yet. This guy’s drug screen was significant for 100% pure fentanyl, not like the doctored-up stuff we find on the street.”
The nurse emptying Fred’s Foley catheter bag nodded in agreement and said, “You’d think an anesthesiologist like you had given him the pure potent drugs that were swimming around his veins when he got here.”
CHAPTER 27
The little DEA officer glanced at Viktoria and the nurse. “Can either of you guess when he’s going to be able to answer our questions?”
“The internal medicine service will be doing rounds shortly,” the RN said. “I’d stake a bet it will be sometime today after he wakes up.”
Viktoria nodded. “If he has no medical complications, that’s a strong possibility.”
“Fine then,” the officer said. “By the way, I’m Buster, and he’s Patrick. And here’s my card.” He handed one off to both of them and faced the nurse. “Please call us, Miss, when he has that tube out or ask the doctor in charge to call us.”
They sauntered out and the RN grinned. “Buster?”
Viktoria chuckled. “Yeah, a big name for a tiny guy.”
“It must be a nickname that stuck.”
-----
Casey Johnston slapped an OR bonnet on his head and entered the anesthesia office where CRNAs and anesthesiologists were buzzing in and out. He went to his second locker outside of the male changing room and grabbed a fanny pack which he had recently started wearing. Small and unobtrusive, he slung it around his waist under his scrub jacket. It provided extra storage; another place besides the pockets in his jacket which needed the necessities of the day’s schedule, pens, hard candies, drug syringes, and drug vials. The fanny pack often secured the vials which he was confiscating out of the OR.
A few steps behind Casey, Jay Huff bounced into the office full of energy and made clear to the anesthesia staff that he was in charge of the schedule and was the doctor on call for the day. “Casey, you’re the floater today, the primary person in charge of breaks and lunches. If cases are delayed, etc. etc., I’ll have other free people help you out.” He turned and popped back out the door.
Jennie Shaw patted the top of the table for her husband to take a seat. Sipping black coffee from a foam cup, she slid another full cup to him. “Here you go, slow poke. How come we come in together and you’re always slower changing into scrubs than I am?”
Leaning in from the same table, Susan Rust eyeballed the two of them. “Now, now, leave the marital individuality alone. If you both do things the same way, your marriage will get stale.”
“Yes, Mom,” Jennie said.
A cell phone rang and Casey fumbled in his jacket. Pulling out his iPhone, he squinted at the number, and looked with concern at his wife. He leaned into her. “Ben is calling. He knows not to bother me at work.”
“It must be important.” She waved her hand below the table, signaling him to go take the call. He nodded and exited the OR.
In the hallway, Casey hurried and stopped between the doctor’s lounge and Jay Huff’s office. He leaned against the wall and slid his finger across his phone to accept the call.
“Ben, this better be important.”
“You want to know about this. First of all, Fred overdosed on narcotics late yesterday on the job. David and I got out of there, but had Mason immediately check on him, so he’d call 911. He’s at Masonville General Hospital. So, he’s out of commission as far as work.
“Secondly, David and I are in the Stay Long H
otel parking lot. We pretty much finished up the room we were working on yesterday, but came back this morning to sweep and tidy it up. See if we’d left anything. However, cops have yellow ribbons over the door. So where do you want us today?”
Casey felt his blood boil because Fred’s hospitalization was a significant problem. Would there be questions asked as to where he got the drugs to OD on? He thought about it quickly. Maybe health care workers would just treat his overdose and not dive into his personal drug use. However, if cops had been at the scene, that was the scary part.
“What a screw up.” Casey tried to keep his voice low, but it wasn’t easy. “Get out of there then. There are two units at the low-income housing project on the other side of town right now that need to be cleaned out— furniture, personal items etc. Both renters left without a trace. Glad I got a month’s security deposit out of them to cover the month’s rent. Anyway, you know what to do. Keep what you want or move what you don’t want to consignment or Good Will and keep any proceeds as part of your salary. Then, give me your input about what else needs to be done—carpet cleaning, walls painted etc. I’ll try to look them over in a day or two as well.
“And Ben, no more screw ups. Here’s a new rule. No drugs on the job. Shoot up at your own residences from now on.”
“I’ll pass it on. Sorry boss.”
Casey retraced his steps back to the anesthesia office. He made direct eye contact with Jennie when he entered and shook his head. Pulling out the chair in front of the computer, he sat and looked up Fred’s whereabouts in the hospital. His name didn’t come up on a regular floor, but popped up in the medical ICU. Casey lowered his head and cursed under his breath. He swiveled the chair and whispered to Jennie. “I have bad news. Horrible news. I’ll tell you later.”
Susan Rust sat across from Jennie and pushed back her chair. “See you later when I need an old woman’s bathroom break,” she said to Casey. “I think the OR is finally ready for my knee replacement case. I’m going back. It’ll be a nice day, I hope. Dr. Thorsdottir is my staff.”
“Okay, I’ll break you out first,” Casey responded.
Casey left after giving Jennie another concerned look. He had time before starting morning breaks, so he sneaked back out of the office. In the elevator, he hit the button for the ICU. He had to visit Fred and absolutely take a peek at his chart to find out how much was known about his overdose.
Passing the plastic plants and the waiting room to the automatic doors upstairs, the ICU doors opened before him. Two officers, like two mismatched tinhorns, swaggered out. He stepped straight past them, his heart taking a knocking against his chest when he saw “DEA” on their uniforms.
Could their presence have something to do with Fred? The possibility was highly likely, more than highly likely. He gulped the lump in his throat as he went straight in. At the nurses’ station, he glanced at the board for Fred’s room number and grabbed his chart.
Casey stepped around the counter, aiming for Room 3. The RN came out, and they smiled at each other, but without any forewarning, he almost bumped into Dr. Thorsdottir, who rounded the corner after her.
“Casey,” Viktoria said. “What are you doing up here?”
At a loss for words, he wanted to ask her the same thing. Why would she be visiting Fred? He was not a surgery patient from yesterday needing a postop anesthesia note. Her being in his room was disconcerting.
He thought fast. “Dr. Huff sent me to find you. Your knee replacement patient has gone back, and they’re almost ready for you.”
“Thanks,” she stammered. “I was on my way back down.” She hastened away, but she stayed perplexed the entire way to the OR. How did he know where to find her?
In the OR Jay Huff stared at the board, tapping his pen on top of the main desk, as Viktoria approached him. “Thanks for sending Casey to get me.”
Jay gave her a blank stare. “I didn’t send him anywhere. He must have done it on his own. Susan Rust is probably ready for you.”
Viktoria nodded. Casey clearly lied, but what provoked him to step into Fred’s ICU room? She had no answers, but ever since the beginning, she didn’t trust him or his wife, and now she was clearer with that fact. As she walked back to her case, however, it was strange that she suspected them of shorting patients of their intraoperative narcotics and the man Casey just visited came in with a drug overdose. She couldn’t make the connection, but it was strange nevertheless.
She pushed aside her concerns for the moment. It was time to insert Bobby Glade’s epidural for his knee replacement surgery.
-----
Buster and Patrick left the hospital and headed up Hospital Road to the Stay Long Hotel, but not without Patrick breaking down and veering into a drive-through fast food lane. The rest of the drive, he chewed on a takeout breakfast sandwich, and Buster sipped coffee from a go-cup.
Patrick’s cell phone, mounted on the air vent, buzzed, and he answered hands free. “I have your home search warrant for the drug overdose user,” someone on the other end said. “Swing by the office when you can.”
“Thanks,” Patrick said. “We’re stopping by the hotel, and we’ll be by next.” He made a left and eased their vehicle to a spot in front of the hotel’s front office. He crinkled his sandwich paper in a wad, placed it in the bag, and threw it in the back seat.
The two men entered Mason’s office where the middle-aged man was sitting in the back room, legs crossed on the stand in front of him. The DEA officers took in the view of his brown, old-fashioned laced shoes and Buster hit the ding button on the counter.
Mason’s shoes dropped to the floor, he hung up his call, and he came out. “Back again so soon?”
Buster jutted out his square chin and spoke before Patrick. “We came back to ask you what you know about the two other workers who work with Fred Stowe. Names, addresses, whatever.”
“I’ve got their names and phone numbers, but their boss, my boss, would have more details. He’s the same guy who owns the hotel. They call him “The Man.”
Buster yanked a notepad from his pocket and placed it on the counter. “I’m ready.”
“Ben West and David Bidwell.” He rattled off their cell phone numbers and paused. “And the owner is a guy named Casey Johnston. Actually, he owns it with his wife. A woman named Jennie. I heard they just got married.”
Patrick took his hands off his thick waist and tapped on Buster’s piece of paper. “You never know. Give us a number for this “Man” in case we need it.”
Mason added the number to Buster’s note and wrote down Casey’s name. “Anything to help. My boss is not going to be happy with what happened yesterday. I haven’t called him yet. I put that task on my back burner for this morning.”
“Thanks for your help,” Buster said. “We’ll be getting out of your hair. Mind if I fill up my go-cup with some of your coffee?”
“Help yourself.”
As the officers left, Mason slipped his hand under the counter, and pulled out his daily newspaper.
-----
After stopping at the office and picking up their search warrant, Patrick put the car into drive and the two DEA officers followed the GPS to a trailer park southwest of the city. Trash cans dotted the entrance where the smooth road turned into gravel and tree limbs arched over the lane in a lazy fashion. After trying to make sense of the addresses, Patrick came to a stop.
Buster tossed back the last few ounces of his coffee and both men scrambled out of the vehicle.
“This is so small-time,” Buster said. “It’s like we’re wasting our man-hours on an insignificant user, not a dealer.”
“On the contrary,” Patrick said, “our low-key little town is doing well after that meth facility entrapment two years ago. That’s what we want, isn’t it? And besides, sometimes a little drug bust leads to a bigger drug deal or more significant stash camouflaged behind it.”
Buster glanced sideways with a nod and Patrick knocked on the peeling trailer door. Since Fred was
in the hospital, the bigger agent figured no one else was about and, with little doing, he unlocked the flimsy lock.
For some light, they left the door open to see the narrow unit not as unkempt as they might have thought. At most, Fred was clearly behind on his dirty laundry pile thrown on the flimsy futon. Buster set out peering into the kitchen cabinets and Patrick headed to the bedroom.
The unmade bed housed more dirty clothes. He checked the side tables which were full of key chains, old wallets, and photographs, and then the narrow dresser. Most of the top drawer held a tidy shoe box. Patrick pulled it out and took off the top. The box had jostled, so some vials had tipped over, but the man’s neatness was apparent with his stash of drug vials.
There were 2 and 5 cc solutions for injection but, in addition, 20 cc vials. Patrick’s eyes widened. He had never seen the chunky fentanyl size before. Then he spotted the more potent narcotic than fentanyl. The drug hoarder had confiscated vials of sufentanil citrate injection, a potency of 50 mcg/cc, and they were stashed in 1, 2, and 5 cc glass ampules. The CRNA also had a neat pile of 5 cc vials in packages of ten.
Patrick whistled out loud, knowing the opioid analgesic was ten times more potent than fentanyl and should only be used by persons trained in their use, and only if an opioid antagonist, oxygen, and resuscitative and intubation equipment were readily available.
Buster showed up and glared inside the box as well.
“High grade stuff,” Patrick said. “This isn’t something he got off a street corner. This is some kind of a direct-access, inside job.”
CHAPTER 28
After Susan Rust gave Bobby Glade two ccs of midazolam and one cc of Fentanyl, he was barely bothered by the epidural Viktoria inserted in his back for his knee replacement. She taped down the catheter on his back, he lied back down, and the nurse began to prep his knee.
“My legs are starting to go numb,” the elderly golf player said. “That’s kind-of scary.”
“That’s because I’m injecting local anesthetic into that catheter,” Viktoria said. “You’re doing fine.”