Paramedic Killer

by Patterson, Pat

  “Medic-seven on scene,” Evan said keying his mic.

  Jim pulled the stretcher from the back of the truck. Evan tossed the cardiac monitor and med-box aboard. Jim added the oxygen cylinder and airway kit. “C’mon, let’s get this over with.”

  “Jeez,” Evan exclaimed guiding the tail of the stretcher as Jim led them into the building. “This place smells like a pine forest after a hurricane.”

  “It used to be called The Greenery. That name always reminded me of the hospital in the book, Coma.”

  “Robin Cook? Yeah, Coma. Great book.”

  “You read, Evan?”

  “Everything I can get my hands on.”

  “Funny. You don’t seem the type.”

  “I have a lot of surprises in me.”

  Somehow Jim had expected that comment. He led the stretcher down the tiled hallway—past the nurses’ station to room 222—and stepped inside the room. The odor of urine all but turned his head. The elderly woman lying in the bed appeared to be unresponsive. Her bony chest moved like bellows. Her papery skin looked pasty and white. Jim pulled out a small tube of Vapor Rub, placed a dab under his nose, and offered it to Evan. Evan shook his head.

  “Who is she?” Jim asked the nurse.

  “This is Missus Overby.”

  “When did this start?”

  “I don’t know. I just came on shift.”

  Jim touched the old woman’s hand. It felt like refrigerated tuna. Her wrist had no apparent pulse, and her fingers had a pale bluish tint. “Do you know her code status?”

  “She’s a full code,” the nurse responded. “Family wishes.”

  Jim placed his stethoscope on the old woman’s chest. Her breathing sounded muted and wet. “She’s full,” he said turning to Evan. “I’ll call for backup and get a twelve lead. Can you get an IV and check her pressure?”

  “Roger that, doc.”

  Evan went to work. Jim did too. He called dispatch to request an engine company for assistance and then unbuttoned the old woman’s gown and placed the ECG electrodes on her chest. He was impressed with the way Evan moved, the fluidity with which he operated, like a well-oiled machine, much smoother than he had expected. Evan reached for the med-box—pausing for a moment and wincing with noticeable pain in his right shoulder—then opened the box and quickly gathered his supplies. After spiking an IV bag and flushing the line, he placed a tourniquet on the patient’s upper arm and tapped up a suitable vein. After prepping the site with Betadine, he plunged an 18-gauge IV catheter into the vein. The flash chamber filled with blood. A minute later, he had the IV taped down and the flow set to a slow drip. Next he placed the blood pressure cuff on the patient’s other arm and inflated the cuff.

  “Seventy-over-forty,” he reported pulling the stethoscope from his ears. “A very quiet seventy.”

  Jim printed out a copy of the ECG and folded it in half to hide the monitor’s interpretation. Here,” he said handing it to Evan. “Whatcha think?”

  “Testing me, doc?” Evan studied the strip for about five seconds and then handed it back. “Left bundle branch block with five mils of S-T elevation. If you’re using the Sgarbossa’s criteria, I’d say a presumed STEMI.”

  “Very good. Now what?”

  Evan pulled a silver IV bag from the med-box. “How about some dopamine?”

  Jim chuckled. “Just checking, partner.”

  “Oh, so I’m a partner now?”

  “What’s the drip rate?”

  Evan chuckled as he prepared the dopamine. He piggybacked it to the IV lifeline and then glanced at the ceiling. “Let’s see, based on her weight, about sixty kilograms? Hmm, I’d say about twenty-two drops per minute.”

  “Twenty-two point five to be exact.”

  “Thanks, mom. Do I pass?”

  “I’ll let you know. The day is still young.”

  CHAPTER

  29

  SUNDAY—07:36—REEDY CREEK CIRCLE (East Beach) Rico had grown accustomed to death. Drownings and hangings, car crashes and shootings, suicides and homicides—he had seen them all, some too horrible to describe, but as he leaned over the faceless corpse at the end of Reedy Creek Circle, a wave of nauseating grief churned his intestines to knots. The splattered red mush had once been a young woman’s face. A pretty young co-ed from what he could tell. A glossy pink lower lip remained intact, along with a couple of teeth and a pretty pierced ear. Her shoulder length blond hair lay fanned out on the ground as if laid out for a photo shoot. Rico stared at the gory remains trying to reconstruct her face—the curve of her nose, the color of her eyes. He removed the beach towel that covered her near-naked body. He glanced at her youthful figure. Her fresh tan lines and manicured nails. The bite mark on one breast. Her once beautiful legs now spattered with blood. He could feel his head pulsing. He heard footsteps and glanced over his shoulder. Corporal Annie Archer knelt beside him and shook her head. “What kind of sick twist would do this?”

  “An animal named Bobby Canaday.”

  “Did you ever see such beautiful hair?” Annie said with a shake of her head. “Her mother used to brush that hair.”

  Rico sighed and lowered the towel. “What have you found out?”

  “Rico, first … any news about Jimmy. Have they found him yet?”

  “Still missing. He was chasing the suspect near Harker’s Island when we lost contact. Greg Mulkhead has a team out there looking for him now. What’d you find out?”

  “A coed in one of the condos remembers hearing a gunshot. Said she looked out the window and saw a red car racing away from the scene.”

  “Ford Mustang?”

  “How’d you know?”

  “What time?”

  “About seven a.m.”

  Rico glanced at the condominiums. Beautiful brick homes with well- manicured lawns. He wondered if the victim lived there. If so, someone should know her. He turned and glanced about the cul-de-sac. A black Mercedes here, a silver Lexus there. A brutal rape and shooting. Someone had to have seen it. He envisioned the red Mustang parked beneath old lady Canaday’s shed. “Bobby was here,” he muttered glancing back at the corpse. “But why you?” he whispered glancing back at the corpse. “Who are you?”

  “Lieutenant?”

  “Find me another witness, Annie. Someone knows this girl.”

  “I’ll try.”

  Rico was barely cognizant of Annie’s parting words. Something nagged him. He couldn’t get past the spooky feeling the victim had something to say to him. “What is it?” he whispered. “Talk to me, sweetheart.”

  “Talking with the dead again, Lieutenant?”

  Rico turned. Detective Sean Murphy stood over him with his hands on his hips. Rico shook his head and cursed. “I’m getting tired of this, Sean.”

  “What happened to your nose, old sport?”

  “Lost in a shovel fight.”

  “I see.” Murphy knelt beside Rico, grunting as both his knees popped. Something resembling a chortle rattled from his throat. “This is bloody awful. Kid in the spring of her life? Frat boys on her mind?”

  “Thought I’d seen it all, but this is getting ridiculous.”

  “You’ll never see it all. In fact—” Murphy reached in his pocket, withdrew a monogrammed handkerchief, and wiped the beads of sweat from his face. “As hot as it’s been lately, I get the feeling we’ll be seeing more of this sort of thing. People can’t stand this humidity. It makes ’em bloody crazy.” He wiped his neck and refolded the sodden handkerchief. “Don’t dally, Rivetti. Tell me what you think.”

  “I think someone held a twelve-gauge shotgun in front of her face and pulled the trigger.”

  “Who?”

  “A born killer named Bobby Canaday.”

  “What’s that? Hold on, yank. I thought they caught Bobby Canaday last night out on Harker’s.”

  “They did. Escaped during the night. His gang busted him out during a routine transfer. Killed one officer and overpowered another one. Just received a call that he�
�s on the loose again.”

  “And you think he did this?”

  “This is his calling card—erase the face. Only this one looks more personal than the others. See those bruises on her neck? Inner thighs? Looks like he sanded ’em with number five grit.”

  “So he raped this one.”

  “Bastard raped her, Sean, then killed her.”

  Murphy sighed and pulled out a small digital camera. He snapped a series of photos—of the victim’s neck and breast, the abrasions on her thighs, the bloodstain on one foot and ankle. He snapped one last shot of what was left of her pitiful face and then paused and looked at his camera. “My wife gave me this thing for my birthday. If she only knew the pictures I’ve taken with it.” The detective shook his head and put the camera back in his pocket. “Has the coroner been notified?”

  “Yeah.”

  “Did you find an ID? Purse? Cell phone?”

  “Just that,” Rico said pointing at a small Carolina blue backpack in the grass on the other side of the cul-de-sac. “Don’t know if it’s hers. There’s no wallet. No identification of any kind. We have no idea who she is.”

  Rico stood and walked a tight circle around the body. “What’s next?”

  “Next? We look for eyewitnesses, scrape her nails, check for DNA samples. You know the routine.”

  Rico unscrewed the cap of bottled water he had been carrying around for the past hour and took a sip. “Some parent’s worst nightmare, huh?”

  “Keeps us in a job.” Murphy uttered a few vulgar words then jotted a note and walked away to join a group of cops standing nearby. Rico wasn’t sure if he should hug the little man or rip off his bulbous head. He turned back to the corpse and stared for several minutes, allowing the image of the young girl’s pulverized face to forever imprint itself upon his mind. He still had the feeling she had something to say to him, but whatever clue she might have had would remain a mystery. He just couldn’t make a connection. He pulled the towel up over her head until only her feet were exposed. He was taking a long drag from the bottle when something caught his eye. Something he hadn’t noticed at first. A small detail on her ankle. A tiny green mark half-hidden beneath the spattered blood.

  Rico poured some water over the victim’s foot and wiped away the congealed blood with his finger. Suddenly it felt as if a Mack truck hit him in the chest. He stood up and backed away stunned. A small tattoo adorned the victim’s right ankle … a tiny green shamrock no larger than a quarter.

  CHAPTER

  30

  SUNDAY—07:46—EAST BEACH EMS—MEDIC-7 (En Route to East Beach Regional ED) “East Beach Regional, this is medic-seven, we’re en route with an eighty-three-year-old female suffering from hypotensive pulmonary edema secondary to a probable STEMI. Twelve lead indicates a left bundle branch block with five millimeters of elevation. Be advised, the patient is intubated with an end-tidal CO2 of twenty-two—that’s up from an original fifteen prior to treatment. We have dopamine running, and at last check B-P had risen to 102/60, up from 70/40. Valium on board for sedation. Lung sounds have cleared slightly. We’re making great progress and do not anticipate complications en route. E-T-A approximately five minutes.”

  “Ten-four, medic-seven. Room one on arrival.”

  Evan glanced at Jim and shrugged. “Well, doc? Call-in suit you?”

  “Evan, you know it did. We’re only going through formalities here. I can see you know what you’re doing.”

  “Good. How’s compliance?”

  “Not perfect.” Jim squeezed the Ambu-bag. The patient’s chest rose, but the lungs felt heavy and stiff. “We’ve still got a long way to go.”

  “Okay, ventilate to keep end-tidal as close to thirty as possible.”

  Jim sat at the head of the stretcher and watched Evan to make sure he completed the call, reassessing blood pressure—which he did—administering nitro and Lasix—which he also did—and rechecking lung sounds, ETCO2, SpO2, 12-lead ECG, titrating the dopamine back, and rechecking blood pressure—all of which he did.

  Good medic.

  The siren died as the ambulance pulled into the driveway for East Beach Regional Emergency Department. Angus raced down the ramp, stopped the truck, and backed into an empty space between two other trucks. Jim heard the front door open and close. A few seconds later the rear doors opened and Angus reached in to help with the stretcher. “Thanks for the ride,” Evan said, patting his big friend on the back. “I didn’t feel a bump.” Jim managed the back of the stretcher and followed Evan inside. Two minutes later, they had the patient in the emergency room. A doctor and three nurses waited. All four were dressed in scrubs, gloved up and ready to go.

  “Who’s in charge?” Evan demanded, leading the stretcher into the room. “It’s my first day and I don’t know a soul.”

  Everyone in the room laughed, all except for Jim. He rolled his eyes and glanced at the charge nurse. Mindy Brown nodded her approval.

  “That would be me.” Dr. Andrew Young chuckled and raised his hand.

  “Howdy, Doc. Need you to confirm tube placement before we move her.”

  Young placed his stethoscope on the patient’s chest. Jim gave the Ambu-bag a series of quick squeezes as the doctor listened. Young’s right thumb went up. “Excellent tube,” he said, removing the stethoscope from his ears. “Lung sounds are almost clear, too. End-tidal?”

  “Thirty-two,” Evan responded. “She was close to death. We almost started CPR.”

  “Well, nice job, fellas. We’ll take it from here.”

  Someone nudged Jim from behind. “I’ll take that now.”

  Jim handed over the Ambu-bag and then moved into position to help with the move. As a team, the paramedics and nurses pulled the patient to the ER gurney. Jim glanced around hoping to spot Valerie. He noticed she wasn’t there. He waited until everything—stretcher straps, IV lines, monitor cables, sheets and blanket, and oxygen tubing—was untangled and cleared, and then pulled the stretcher aside. Evan handed Young the most recent 12-lead ECG and then proceeded with a detailed report. Jim saw the charge nurse wink at him. He walked over to her corner desk.

  “New medic?” Mindy Brown said, nodding at Evan.

  “First day.”

  “He looks good. How is he?”

  “A little annoying, but an outstanding medic.”

  “Good.” Mindy wrote down the patient’s name, age, meds, and history as Evan called them out. “Coffee sometime?” she managed between notes.

  “Sure. Seen Val?”

  “She was here a minute ago. Might wanna check her office.”

  Jim hurried down the hall and checked all of Valerie’s usual spots—the treatment and resuscitation rooms, the nurses’ station, her office. He finally found her sitting alone in the physician’s lounge drinking coffee and perusing a chart. He stood in the doorway for a moment watching her. She looked agitated, tapping her finger on a Styrofoam cup as she read what looked like a detailed patient report. Jim entered the room. “I was beginning to think I wouldn’t find you.”

  “What are you doing here?”

  “Evan and I brought in a pulmonary edema.”

  “That’s not what I mean. You’re not supposed to be in here, Jim. This is the physician’s lounge.”

  “Nice greeting.”

  “If you don’t like it, then leave.”

  “Val, what happened last night? You went crazy on me.”

  “I don’t feel like talking about it.”

  “You seem irritated.”

  “Irritated? Irritated! Jim, do you realize we were almost killed last night?”

  “Val, calm down.”

  “Calm down? My little sister could be dead right now! Don’t tell me to calm down!”

  A man stepped into the room, a tall, trim, straight-laced looking doctor, the kind who ate organic foods, ran marathons every weekend and every other month a triathlon. He wore blue scrubs, like Valerie’s, with a clean, white lab coat and a pair of Reebok sneakers. His hair was trimmed just ri
ght, slightly grayed around the temples. His nails were clean and neat, and his brow wore an obvious frown. Jim didn’t like him. “Doctor Vick,” the doctor said staring at Jim. “Is everything all right?”

  “Yes,” Jim responded with a matching scowl. “Everything is all right.”

  “I’m talking to Doctor Vick!”

  “So am I!”

  The physician took a step closer to the table where they were seated.

  Jim stood up and chuckled. “Really?”

  “All right!” Valerie said standing. “That’s enough! Jim, sit down.”

  “Valerie, should I call security?”

  “No, no, it’s all right, Dr. Rogers. I’m sorry. This will only take a moment. He’s leaving.” Rogers cast Jim a threatening leer, then shook his head and walked out. Valerie spun around and raised her hand at Jim as if to strike him. “What’s the matter with you?”

  “Me? You were the one shouting when that dweeb walked into the room. What’s wrong with you?”

  “Jim! I am so tired of…”

  “Tired of what?”

  “You! Do you have any idea how difficult it is trying to keep up with you? Your life is non-stop. You’re like an adrenaline junkie on a thrill ride. Always pushing the envelope. Always on the edge. Sometimes I get the feeling you’re trying to hurt yourself. Ever since you put this ring on my finger it’s been one thing after—”

  “Since I put the ring on your finger?”

  “We were almost killed, Jim. And have you forgotten last winter? Sharon and I were nearly raped. Since then we’ve lost Devon and Tom. Now you’ve got some crazed lunatics chasing you around in Halloween masks, and last night they planted a bomb in your house.”

  “You make it sound like I’m enjoying it.”

  “I think you are. In some sick, twisted kind of way you seem to get off on it. The danger. The rush. You’re addicted to your own dopamine, Jim. I can’t keep up with you anymore. I just can’t.”

  “Valerie, I don’t understand where all of this is coming from.”

  “And, Jim, I know what’s been going on between you and Sadie. I saw your phone last night. I know you’ve been texting her and staying up nights talking to her.”