by Gary Kinder
“Go ahead and take a closer look at him, anyhow,” said Wallace, “while I do the trache.”
The boy’s blood pressure was still zero. His skin was blue and clammy. He was making a hacking attempt to breathe. His left arm had risen from the table slightly, his hand turned to the outside and flexed open. Stiff-armed, it clawed the air.
The blood spurting from the boy’s endotracheal tube had begun to splatter, and Andy was hurriedly tying a gown around Wallace as the doctor prepared to open the boy’s throat.
“Jess, there’s nothing you can do for this boy,” Hauser said. “I don’t give him more than a few minutes.”
“Well, he’s not going to die in my emergency room,” said Wallace.
“This decerebrate posturing with the hand,” continued the neurosurgeon, “and the fixed pupils with this kind of head injury … I have never in my life seen this situation in a patient who survived.”
Wallace had children of his own not much younger than the boy. When the boy’s body had been pulled from the ambulance, Wallace had been struck first by his youth, then by his gasping for air.
“Maybe so,” he said to Hauser, “but the kid’s still trying to breathe, and we’re going to put this trache in and see if we can get him some air. I can’t just sit here and watch him die.”
“It’s your emergency room,” said Hauser, “you do what you want. But I’m advising against any heroics.”
Andy had prepared the Mayo stand with the tools for the tracheotomy. Wallace took a scalpel from the tray and neatly sliced the boy’s throat at the base of his neck. Andy pulled the skin back with hemostats to expose the underlying tissue. Vicky bagged and suctioned the boy through the tube still in his mouth. Dr. Wallace’s thick forearms were upraised, his eyes riveted on the slit in the boy’s throat. He carefully cut away at the tissue surrounding the trachea. Andy spread the incision wider. The boy’s gristly tracheal cartilage emerged. Andy wrenched a hook into it, twisted it slightly, and held it firm as Dr. Wallace cut a dime-size hole in it. Andy spread the cartilage. Wallace reached for the new five-inch plastic tube. As Andy yanked the endotracheal tube from the boy’s mouth, Wallace inserted the tracheostomy tube through the cartilage in his throat. Vicky fastened it with cotton ties, reattached the squeeze bag to the new tube, and continued bagging and suctioning the boy. A delicate operation that usually requires fifteen minutes had taken a little under three, and there were no bleeders to tie off. Andy attached a humidifier to the oxygen bag to warm and moisten air for the boy’s lungs, while Vicky tried to suction the bubbles flushing out of the new tracheostomy tube.
As soon as he had examined the boy, Dr. Hauser had been paged by the hospital switchboard for another emergency at the McKay-Dee Hospital. Before he left the trauma room, he took up the boy’s chart and under Physician’s Notes hurriedly wrote the following entry:
Young white male with gunshot wound of R occipit—has had trache thru which there are copious, pink, frothy secretions. Breathing vigorously but totally unresponsive. Pupils dilated & fixed.
Impression: terminal head injury.
Intensive Care had been alerted to prepare for the boy. With his tracheostomy tube now in place he was immediately rushed from the trauma room, down the hall, into the elevator, and up to Intensive Care on the third floor. The IV dangled from his arm as a nurse ran alongside the cart holding the bottle of dextrose. Vicky jogged on the other side, squeezing oxygen into the foam filling his new airway.
Dr. Wallace untied the gown from around his waist and watched the crowd attending to the boy.
“Andy,” he said, without turning around, “we’re sending that boy up there and he’s just going to die.” He wadded the bloodstained gown in his fist and threw it into a corner. “What the hell,” he said, “maybe Hauser was right.”
The cart and the nurses rounded the corner at the end of the hall and disappeared. For a few more seconds Dr. Wallace stared after them. “The whole thing was unreal,” he said later, “because I was looking at two people, one who was dead and one who was critically injured for no reason at all. You know, you see people hit in cars and even though it’s hard to justify, you can see how it happens. You see a child run into the street and he’s hit and killed, it’s disturbing and upsetting. There’s a certain aspect of Russian roulette to living. But just for somebody deliberately to set out and try, actually try, to kill these people … you couldn’t understand how anybody’s mind could be so depraved. That’s what was so unreal about it, to sit there and look and see the straits this kid was in and know that somebody had done it with no more feeling than if they’d crushed a bug.”
He turned back and said to Frances Heward, the nursing supervisor, “Fran, why don’t you and Andy take the woman on over to the morgue; we’ll need to keep her body preserved for the medical examiner.”
It had been almost a half hour since the unusual gunshot victims had arrived. Their identities still were unknown. The body of the petite blond-haired woman, listed as Mary Doe, was slipped into the top refrigeration unit in St. Benedict’s tiny morgue. Upstairs, in Intensive Care, the teen-age John Doe was spewing blood from his lungs nearly three feet into the air.
No one expected him to live. Even Dr. Wallace, when he sent the boy up to ICU, had listed him as a “no-code,” meaning that if the boy’s breathing stopped or his heart quit beating, no life-saving measures were to be taken. If the boy’s brain shut down to where it no longer was capable of the primitive function of asking for oxygen, there was nothing left of him to save anyhow.
His body remained on the gurney, not enough life in it to warrant transfer to a more permanent bed. They wheeled the gurney into ICU and straight ahead into unit #1, a cubicle with a broad glass front. The boy lay behind the glass, appearing to be a man, much older. His body was motded gray and white. His cheeks were sunken, and his eyes were dark and hollow-looking. His fingernails were blue-gray. The bloody foam gathered in his lungs, inched its way up the tube in his throat, rising and rising, until his gasping attempt to get oxygen would explode the foam like a small, pink geyser out the end of the tube. The watery pink foam splattered on the nurses and the technicians, until even the walls of the small room were stained with splashes of pink.
Chad Nielsen and John Smith, the respiratory technicians, set up a small pressure ventilator in the cubicle. Dr. Hauser also had left instructions for them to do nothing life-saving.
“Suction him if you want to,” he had said, “but if he stops breathing, don’t resuscitate him. I don’t want you pumping air into a body that’s not asking for it.”
They dialed the ventilator to Demand, so that it pumped air into the boy’s lungs, but only if he initiated each breath. Since the bubbles to be suctioned out would pop and merely reform around the suction tube, they nebulized ethyl alcohol and sprayed the mist into the boy’s trache. The mist was designed to break down the surface tension of the bubbles, reducing them to a liquid which then could be easily suctioned out.
As they were spraying the alcohol mist down the boy’s airway, John saw two police officers walk into the ICU and stand next to the nurses’ desk. He handed the suction tube to Chad and walked out of the cubicle to where the officers were standing. They were still calling the boy John Doe.
“You haven’t identified these people yet?” said John.
One of the officers said no, and John said that maybe he could help them eliminate some possibilities.
“A friend of mine in this respiratory therapy program is studying downstairs,” he said. “He used to date a girl whose cousin owns the Hi-Fi Shop.”
The police knew only that the bodies had been found in the basement of the popular stereo store in downtown Ogden; as yet they had no leads on the victims’ identification. They asked John to have his friend come up and take a look at the boy.
John stepped behind the desk and phoned Ray Moser.
“Ray, the police are up here in ICU. I told them about you dating Claire. They want you to come up an
d take a look at this boy.”
“I don’t think I’d be much help,” said Ray. “I was standing in the hall when you guys wheeled them by and I didn’t recognize either one of them.”
“Come on up anyway and tell them yourself,” said John. “They’re just trying to eliminate possibilities.”
Ray left his studies and ran up the stairs to the third floor. He entered Intensive Care, and through the broad plate-glass window he saw John and Chad nebulizing alcohol into the boy’s airway. The police stood just to the right of the entrance. Ray glanced at them and walked into the cubicle.
Dr. Wallace had treated a few more patients, then left Dr. Allred in charge of the emergency room. He hurried upstairs to see if the boy was still alive. As he walked in the door, Ray Moser was sliding in among John, Chad, and a covey of nurses to take a look at the boy. Wallace waited by the entrance with the officers. Ray was inside for only a few seconds. When he stepped out again, the casual expression on his face had turned to disbelief.
“It’s Cortney,” he mumbled, “Cortney Naisbitt.”
Wallace was incredulous. “You mean By Naisbitt’s boy?”
“Yes, sir. I used to date his sister, Claire.”
“Are you sure?”
“Yeah, I saw him go by a few minutes ago and I just thought, ‘Well, whoever he is, he won’t make it.’ But that’s Cortney.”
One of the officers pulled a small note pad from his pocket and jotted down the victim’s name. “Would you mind going downstairs with us to take a look at the woman?”
“No,” said Ray, “course not.”
Dr. Wallace had already rushed into the cubicle. John and Chad were still spraying a fine mist of ethyl alcohol into the boy’s airway, but the alcohol was being overpowered by the edema. The bloody foam gurgled out of the boy’s lungs, surged through the mist, and poured into the lines of the ventilator.
Wallace saw the pink froth oozing up the tubes. “What the hell are you doing!” he yelled. “He’s trying to breathe! Can’t you clear that stuff out?”
“Dr. Hauser told us just to maintain,” said John, “not to do anything but nebulize him and suction out what we could.”
“I’ll be damned! We’re not going to sit here and watch the kid die!”
“You want us to shoot straight alcohol down the tube?”
“Anything!” said Wallace. “Just get him more air with that ventilator. I’m going to call Rees, then see if I can get hold of Hauser again. If this kid has hung in here this long, he might have a chance.”
Chad and John began a rapid-fire routine. John squirted 20 cc of ethyl alcohol down the boy’s airway. Chad capped the ventilator hose back over the mouth of the tube. The alcohol worked on the bubbles. Chad removed the ventilator hose. John suctioned out a small amount of the fluid. Then they started over again.
While the effort to break up the boy’s edema continued in the cubicle, Dr. Wallace phoned Dr. Richard Rees, a thoracic surgeon skilled in the use of complicated life-support systems.
“Dick? Jess Wallace. Look, I’ve got By Naisbitt’s boy in ICU. He’s been shot in the head, his lungs are full, he may have suffered actual brain death. But he’s still alive. I stuck a tube in the kid. I need you to help resuscitate him.”
Next he called Dr. Hauser’s home, but Hauser had not yet returned from the emergency at McKay-Dee. Wallace left a message with Hauser’s wife.
“Tell Jim the kid he looked at before is still alive and trying to breathe. Rees is on his way, and I’d like Jim to come back and take another look at him too. And tell him we just found out it’s By Naisbitt’s boy.”
A quick call to the home of Byron Naisbitt was not answered. As Wallace hung up the phone, the nursing supervisor walked into ICU.
“Fran,” said Wallace, “that kid in there is By Naisbitt’s boy!”
“You’re kidding,” she said, “it can’t be.”
“A friend just identified him. I’ve tried to get in touch with By, but he’s not home. See if you can get hold of his brother Paul, or any of the rest of the family. I don’t know what the hell’s going on, but somebody ought to be down here with this kid!”
THE MURDERS
That afternoon, Cortney Naisbitt had hurried along the sidewalk in downtown Ogden, his reflection darting in and out of storefront windows. At sixteen Cortney was developing in the mold of his father and two older brothers, all exceedingly handsome men. Nearly six feet tall, he was thin and well-muscled. His hair was blond and hung in bangs angled across the forehead of his rather elfish face: a face with a slightly pointed chin, gray-green eyes, freckle-dotted nose, and an impish grin of straight, white teeth. As he moved, he seemed to bounce, his blond hair lifting and settling smoothly across his forehead, his face hardly concealing a rush of joy. As afternoons go, it had been the most exciting of his life.
A late-April sun cast square shadows of buildings across the city streets and blazed down on rush hour traffic entering the intersections along busy Washington Boulevard. As Cortney came abreast of Inkley’s, a variety store selling cameras and film, a tall, pretty girl with glossy lips and auburn hair crossed at the light and hurried toward him on the sidewalk. The girl was smiling and waving, and when she got closer she yelled, “Cortney!”
At first Cortney seemed not to recognize his old neighborhood playmate, Cora Beth Baggs. Cora was also sixteen, and Cortney hadn’t seen her since she had moved from the neighborhood in third grade. Now she stood in front of him only vaguely resembling the little girl he had known as a child.
Cortney’s forehead wrinkled. “Cora Beth?”
“Yes!” she beamed. “Gosh, Cort, how are things?” And before he could answer, she said: “Are you still living up on Mitchell Drive? I really miss that old neighborhood. I really liked it up there.”
“That’s right,” said Cortney, “you moved like in the third or fourth grade.”
“Third,” she said. Then she grabbed hold of his arm and laughed. “Remember the old Easter egg hunts?”
Celebrating Easter on Mitchell Drive had been a neighborhood occasion with hundreds of brightly colored eggs and dozens of children looking for them. Cora and Cortney reminisced about the egg hunts and argued over who had found the most eggs. Cora did most of the talking. She felt that she could have talked to Cortney about anything and he would have listened. “He was light and very pleasant that day. Very happy,” she later remembered.
Finally, she said to him, “Well, what have you been up to?”
“I just soloed,” said Cortney.
“In a plane?”
“Yeah, first time.”
“Cortney,” she said, “that is so exciting!”
But before Cortney could tell her how it felt to be alone at the controls of an airplane, Cora interrupted to ask him if he knew a friend of hers who was also taking flying lessons. When Cortney said no, Cora dropped the subject of flying.
“Are you going into Inkley’s?” she asked. “I’ve got to pick up some pictures.”
“I do, too,” said Cortney. “My mom and dad just got back from Hong Kong.”
In Inkley’s, Cortney charged the pictures to his parents’ account, and the clerk handed him a large sack of colored slides. With the sack in his hand Cortney then browsed along the camera counter until Cora came up behind him and poked him in the ribs. “Which way are you going now?”
“To the Hi-Fi Shop,” said Cortney. “Why don’t you walk down there with me?”
Cora had a schoolgirl crush on Cortney’s cousin, Brent Richardson, who owned the Hi-Fi Shop. She said, “Okay.”
They strolled toward the shop, Cora telling Cortney how her parents had been “getting on her case” the past few weeks about being home early with the car on weeknights. She said she shouldn’t really even be walking down to the Hi-Fi Shop with him. But when they arrived in front of the shop, she asked Cortney, “Do you know if Brent’s in there?”
“He’s out of town,” said Cortney. “I think Stan’s working.”
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“Yeah. Well,” said Cora, “I guess I really should be getting home then. I’ve got Mom’s car, and she said, you know, ‘Be home at six!’” She looked at her watch. “I’m already going to be a little late, it’s ten to six now.” Then she added: “You know where I live now, don’t you? I live right across from your grandmother.”
“That’s right,” said Cortney.
“Okay, now you know where I live, come on over anytime and visit me.”
“Yeah, I’d like that,” said Cortney, “I haven’t seen you for so long.”
“I’m going to hold you to it. I’ve got to go. Good seeing you, Cortney.”
“Good seeing you, Cora Beth. Bye,” said Cortney.
Cora had left her mother’s car in the parking alcove just behind House of Fabrics, a few doors down from the Hi-Fi Shop. She turned and waved good-bye again to Cortney, then disappeared into the store.
Cortney turned and strode between the stereo-filled display windows of the Hi-Fi Shop, stopping to reach for the door handle and swing it open. The glass door closed behind him with a metallic clack, and the quiet, cozy atmosphere of the shop suddenly muffled the noise from the street. The Hi-Fi Shop was a narrow store, stretching to the alley where Cortney had parked his car. As Cortney walked toward the back, the soft, speckled carpet hushed his quick footsteps. He was in a hurry, bouncing with his long stride past the record racks and glass counters, past shadowed alcoves of receivers and amplifiers spotlighted by small ceiling lamps. Save for the crinkling of the package in his hand, the store was silent.
Closing time on Mondays was six. The store clerks, Stan Walker and Michelle Ansley, should have been turning off the equipment, placing the records back in their jackets, ringing up the day’s receipts on the cash register. No one was even in the front of the store. The cash register sat quietly. Halfway through the shop, Cortney could see Stan in the sound room, the last room before the door to the alley. In the sound room, sets of speakers on the floor and mounted on the walls were wired to a master control panel so sound could be switched from one set to another for comparison. Stan was up against the wall on the right. He was still. Two steps beyond him was the landing for the steps leading around to the right and down into the basement. At the back edge of the landing was the door leading to the alley.