by Barbara Ebel
Table of Contents
DEAD STILL
Copyright © 2016 by Barbara Ebel, M.D.
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
Epilogue
From the Author
DEAD STILL
by Barbara Ebel, M.D.
Book One of the Dr. Annabel Tilson Novels
Book Two: Deadly Delusions
Book Three: Desperate to Die
Book Four: Death Grip
Book Five: Downright Dead
Book Six: Dangerous Doctor
Copyright © 2016 by Barbara Ebel, M.D.
All rights reserved. No part of this book may be reproduced, stored, or transmitted by any means – whether auditory, graphic, mechanical, or electronic – without written permission of both publisher and author, except in the case of brief excerpts used in critical articles and reviews. Unauthorized reproduction of any part of this work is illegal and is punishable by law.
Paperback ISBN-13: 978-0-9911589-9-7
eBook ISBN-13: 978-0-9977225-0-5
This book is a work of fiction. Names, characters, places and events are the product of the author’s imagination or are used fictitiously. Any resemblance to actual events, persons, or locations is coincidental.
In celebration of Chester, Putt-Putt, Buck,
and Kittie who surround me while I work and who tolerate my picture-taking for their children’s books.
Chapter 1
She had started the surgery rotation the day before so Annabel Tilson barely knew her patients from the list of names that had been shoved into her hands. As a third-year medical student, the day had been hectic; therefore, a short introduction to them and a quick listen to their chests with her first shiny Littmann stethoscope had sufficed. But this morning as she squeezed in close to the bed and looked down at a dead corpse, she remembered the sixty-five-year-old woman, Mrs. Hardy, with clarity from visiting her in her room and watching her surgery in awe.
During the first surgery that Annabel had witnessed on her clinical rotation, the chief resident performed a minimally-invasive gallbladder removal - or laparoscopic cholecystectomy - causing the long mechanical instruments to protrude from her patient’s belly like the squirming arms of a squid. No one indicated at the time or postoperatively that anything had been complicated about the case, so why was her patient dead? She admonished herself for missing the resuscitative attempt before she’d walked into the room; medical supplies, carts, and equipment were scattered about the bed and floor but personnel paid no attention as they began exiting through the doorway.
“Most likely a heart attack,” Marlin Mack said, waving an EKG and signaling her to follow him out of the room. Excluding the chief resident, he was one of the two residents on the team, an unkempt-looking fellow with a ridiculous mustache for his age and a lab coat that needed ironing.
Annabel lagged, taking a last impressionable stare at the deceased woman: mucus smudged her cheeks, urine soaked the bed, and the smell of bowels having opened up was pervasive. A nurse moved the patient’s stocky legs closer together and covered them with a sheet, hiding the unnatural way they seemed to lay. Someone else jammed a pillow under her head before housekeeping came in and started removing the black bags from the trash cans.
As she peeled her eyes away, Annabel tried to shake off her conflicting thoughts of sadness, unsettled nerves, and nausea before rushing out like a puppy after the resident. This was her second day out from the two first years of course work during medical school and the second day on clinical rotation in hospitals. She shuddered. Already this was emotionally difficult.
Outside, Dr. Mack waved her over to a desk in a small cubbyhole. “You’re going to deal with life and death,” he said. “It’s not all a bed of roses. Do you know that blood pools at the bottom of a dead body, whatever area is most gravity dependent?”
Was that something she needed or wanted to know? She didn’t see the relevance of him telling her that and she shook her head.
“Furthermore, since there’s no more circulation and no more heat, the muscles harden, thrusting a corpse into rigor mortis which sets in after about four hours. Then you better do something with it because if it’s left for a day it’ll start to bloat and blacken. And I won’t even mention the smell.”
Annabel gulped. She was beginning to regret that she’d been assigned to surgery right off the bat. Were all the residents as blatant and cold as he was?
Marlin glanced her way. “Oh, sorry. My dad owns a funeral home. It’s natural for me to know about cadavers. Anyway, now comes the second part. I have to go talk to the deceased’s sister. The patient wasn’t married, no kids, not much of anybody in her life it seems.” He got up and brushed past her.
“What’s the matter, Annabel? You look like you’ve seen a ghost.” The other female medical student on her team, Ginny Young, sat on the edge of the main desk’s counter and gave Annabel a warm smile. She was thirty years old compared to Annabel’s twenty-three and had sought admission to medical school after reconsideration of her first career in biological research.
Annabel leaned over. “Mrs. Hardy, one of my few patients passed away,” she said in a low voice so no one overheard her. “She went from being a living, breathing person with whatever past and with whatever ties to family and friends, to not leaving the hospital. Dr. Mack makes it sound like she’s a lifeless disposable sack of flesh.”
“Sorry to hear about your patient,” she agreed. “That’s too soon after we just started. She frowned and, in a few minutes, settled her eyes on Marlin Mack as he walked towards them.
“Good morning, Dr. Young,” he said. “Annabel’s gone and lost her first patient before official rounds with our attending doctor. Anyway, the sibling of the deceased doesn’t want to see her sister but wants to wait until she’s beautified by the funeral home. She’s pretty much in shock.”
While Marlin grabbed the patient’s chart, Annabel and Ginny stole a glance.
“Come on, don’t just stand there,” Marlin said. “Let’s assemble the team in the office and be ready for Dr. Burk.”
They filed out and, as they passed the dead patient’s room, stopped so Marlin could talk to the transporters waiting in the hallway. A nurse in the room put a blouse on Mrs. Hardy, holding her forearms with a tennis-racquet grip; the body fell quickly back on the mattress when she let go.
Two male transporters filed into the room while Annabel dawdled in the hallway. They lifted the dead woman and her head, arms, and legs fell away as they put her in a big black bag. Annabel closed her eyes for a moment. In the last few years, her physician father had been a role model with his religious overtones. She thought of him and then gave a little blessing for her patient to rest in peace.
-----
The other resident and two medical students were in the surgery team’s office when they arrived. Annabel trailed in last and, with no more places to sit, she stood next to Ginny against the wall.
“I’m sorry I missed yesterday’s late rounds after surgeries,” the chief resident said to the group; his name was Robby Burk, a man around Ginny’s age with
the same long lab coat that the two residents wore. “Formal introductions for everyone in a moment. But first, how did it go with the family, Dr. Mack?”
“After letting the bad news sink in,” Marlin said, “the sister said she didn’t want to see the body because, in her words, it didn’t seem right to see her that way. Based on her previous experience with a dead husband, she only wants to remember her sister the way she was.” Dr. Mack turned to the blackboard and erased the patient’s name.
“I can understand her viewpoint. What did she say about an autopsy?”
“She doesn’t want one even if we were thinking about it. She said if it was a heart attack she wasn’t surprised. Her sister had high cholesterol and although not morbidly obese, she ate greasy fast-food like they were giving her lottery tickets as a reward to do it.” He turned his attention to all four medical students. “And remember this dead patient’s case for exams. Your typical patient presenting with gallbladder disease is female, fat, and forty. The three f’s.”
Annabel glanced at Dr. Burk, waiting for his response. She hadn’t seen him yesterday without his OR mask and hat so now she could appreciate his features; she also recognized his voice. He stood about six-feet, four inches taller than her. When he took off his coat and draped it over his arm, his trim yet muscular physique was obvious. His sleeves were rolled up to the elbows and his arms were firm like those of a lightweight lifter.
A small muscle next to Robby’s eye twitched as he narrowed his eyes toward Marlin. “Dr. Mack, we’ll go over Mrs. Hardy’s details later,” he said and walked over to the window and turned around. “I haven’t met all of you students. I’m Dr. Burk or Robby to friends and family and I’m your chief resident for the next six weeks. Our attending doctor in practice that we all report to, particularly me, is Jacob Pittman. To reiterate, our two residents here are Marlin Mack and Brandy Wallace.”
He slid a piece of paper out of his shirt pocket and glanced at it while Annabel admired his milk-chocolate eyes which matched his hair color and the slight upper pout of his lips.
“You’re Annabel Tilson,” Robby said nodding towards her, “from surgery yesterday. I’ll have Dr. Mack present Mrs. Hardy’s case this morning.” He winked at her and she felt her cheeks blush. “You’re off the hook.”
Robby pointed to the other female student. “And you’re Ginny Young,” he said and then his gaze fell on the two male students. “And Bob Palmer and Da’wan Roth? Who is who?” He leaned forward to read their plastic name tags.
“I’m Da’wan,” said the closest student. “I want to be a surgeon and I can’t wait for this entire experience. I don’t know of many African-American surgeons and my goal is to serve in heavily-black poor cities where I can do the most good.”
Robby laughed. “You do know what you want. Thanks for sharing and I hope you still feel that way after the rotation.” He eyed Da’wan another few seconds. The young man wore a modern professional look with rounded rectangular glasses and hair professionally stranded in twists.
“And so, you’re Bob Palmer,” Robby said, turning to his right.
The sandy-haired male with a round face smiled. “Yes, sir. My common name makes me unforgettable.” His eyes averted for a second towards Annabel.
“I bet that made you an easy target to blame for trouble in school,” Robby said.
“Yup, just blame it on Bob.”
“We’ll remember that.”
Bob grinned. During the first two years of classes, it was apparent to other students that he came from a wealthy family and he always wore a stylish look. Although his hair was tapered on the sides, the top layer was long and cut at an angle and his looks were worthy enough for a young man’s magazine.
“And I’m Ginny Young,” said the other student. “I’m fascinated with surgery but I may go into pediatrics. I have a three-year-old at home and I love youngsters.”
“You all have plenty of time to decide,” Robby said. “During these six weeks, you’ll get your feet wet in the OR. But the four of you can’t forget that, besides your new clinical duties, you must continue studying. Exams continue. As a matter of fact, they’ll persist in residency and when you’re an attending doctor in practice. There are competency exams and specialty recertifications as far down the road of your career path as you can see.” A look of disappointment surfaced on the students’ faces.
“Dr. Wallace,” Robby said to the other resident besides Marlin Mack, “we didn’t work together yesterday in surgery. One of your patients is on the schedule for today, so you’ll be by my side. Anything you’d like to say as far as joint introductory remarks?”
Brandy Wallace was the quietest of the group. Her attention focused on her hands, either rubbing the flesh beneath her thumbs as if she had arthritis or focusing on her nails. She carried an extra forty pounds, evenly distributed, helping her to have a more commanding presence since she wasn’t a big talker.
“Not so much,” Brandy said. “But since it’s my second year as a surgery resident, I’ll help the students out as much as possible. I love general surgery and I plan on going back to my home town to practice.”
“Okay, then,” Robby said. “You will all meet Dr. Pittman in two hours when we have official rounds. His mood depends on how he woke up in the morning. He also has a lot on his plate both academically and clinically so we may not see him that often. However, he and I discuss patients as often as needed; behind the scenes our team will have back-up guidance. Any questions?”
Annabel couldn’t think of any. Plus, it was difficult to peel her eyes off of him.
-----
The students began scattering in different directions to check on patient updates before rounding with the attending. Annabel knew she had to hustle. She’d gotten delayed due to the earlier circumstances and still had patient chart notes to write.
“Annabel, not so fast,” Dr. Mack said. She stopped and turned around.
“Your work due to Mrs. Hardy dying is not totally over. Think what a problem the hospital and the team would have if any of her recent tests weren’t looked at or got sidetracked between labs and didn’t make it to her chart, particularly if there was an abnormality that needed to be addressed. There are litigious lawyers lurking everywhere.” He rubbed his hand over his lopsided mustache and stared at her.
Annabel waited impatiently. She suspected where he was going with this but the more he kept her from doing her duties, the more behind she would fall.
“Being a medical student is no fun,” he said. “Just like I did, you carry a hell of a load and the trickiest part is passing all those damn exams so you can keep moving forward to the next rotation’s scut work.”
Annabel’s eyes widened at his frankness and an audible sigh escaped her lips. She had only yesterday learned the popular yet demeaning term for the errands that students performed. In essence, they were the bottom dwellers of a patient management team at a university-affiliated medical training facility.
He noticed her flinch. “Don’t worry. Two years of being a scut monkey will fly faster than you think.” He condescendingly patted her shoulder.
Anger welled up inside her making her think that not so many years ago she qualified as a tomboy. It seemed like those days she was quicker at coming up with clever, taunting remarks to people like him. However, she couldn’t risk making an enemy out of him; starting at the bottom of a ladder was a sad and unfortunate reality of many career or job changes. It was a ritual like being indoctrinated into a sorority.
So she held her tongue and asked, “What is it I can do, Dr. Mack?”
“I’ll go to the desk and thoroughly check the chart and computer results. However, it’s possible something wasn’t posted in either place yet, so go to the lab and make sure you bring back every single result for Mrs. Hardy in the last thirty-six hours.”
Annabel nodded, turned on her heels, and headed to the hospital directory as she didn’t even know where the lab was.
Chapter 2
Marlin and Brandy sat at the semi-circular desk and Ginny, Bob and Da’wan huddled together looking like it was the first day of school. On the other side of the counter, Robby talked privately with a very tall doctor whom Annabel assumed to be their attending.
“I was worried you were late,” Ginny said when Annabel joined them.
“Dr. Mack sent me on a mission where I was given low priority,” Annabel said after catching her breath. “To fulfill my request, I had to practically promise the male technician free medical care when I finish residency.”
“That’s a long time from now,” Ginny said. “He’ll forget you by then.”
Bob leaned in. “If he was a smart, selective young male with a healthy pulse,” he said, “he’s not going to forget her.”
Annabel looked at him and shook her head. “I doubt it,” she said.
“Shh,” Ginny warned, “here they come.”
The team congregated in a close circle and the doctor they hadn’t seen before spoke up.
“I’m Dr. Pittman, the attending physician. I have a list of all your names from Dr. Burk and I’ll be intermittently doing rounds with the team as well as showing up in the OR. We hope to teach you more than a few things.”
Dr. Pittman’s attention went to the first ICU room and he started walking that way. They all stepped inside the doorway where a middle-aged male was not moving except for the rise and fall of his chest from the ventilator. Annabel ended up the closest to his bedside. His one arm splayed out from his side with thick bandages, partly saturated with a serum-like fluid. Half of his face had the dressings aside while a nurse prepared new ones. Her stomach did a somersault as she gazed at his burned flesh.