Time of Death

by Lucy Kerr

  “Thanks,” I said. “I’m Frankie, by the way.”

  Donna’s eyes crinkled with mischief. “Oh, I know who you are.”

  I groaned as I scrubbed beneath my nails. “Costello?”

  “He’s a piece of work,” she agreed, handing me a tissue-thin blue gown. “Who knows how long that man could have sat outside if you hadn’t noticed him? You saved his life.”

  “I hope so,” I said softly, remembering what I’d told Riley. No guarantees.

  Unlike the main nursery, where the bassinets were lined up at the window, the NICU was much more private. Curtains could be drawn across the main windows to prevent people from peeking at the isolettes. Each clear box was surrounded by monitors and supply carts, an upholstered rocking chair, and a second floor-length curtain that could be used for additional privacy. Classical music played softly in the background, and the few babies already inside rested beneath brightly colored signs bearing their names. It was clear that Donna and the rest of the NICU nurses worked hard to make the unit feel like home—probably because their tiny patients stayed for weeks on end.

  As much as I liked the variety of the ER, I wondered what it would be like to spend so much time with a patient. The longest I ever saw my cases was a single twelve-hour shift—by the time I returned to work, they’d moved on.

  A flurry of activity from the back of the room caught my attention. A moment later, another nurse wheeled in an isolette, a clear Plexiglass box with portholes lining the sides. Inside, obscured by wires and tubes, a tiny hand lifted and made a fist.

  “Told you she was doing great,” said Donna, helping maneuver the cart into place.

  “She’s perfect,” I breathed. It was true. Rowan was impossibly tiny, impossibly perfect. Despite all the tubes and wires, I could see a thatch of reddish-blonde peeking from beneath a knit cap. Her eyes were squeezed shut, shiny with antibacterial ointment. Donna gave me a pair of latex gloves, and I tugged them on before reaching through the porthole to touch Rowan’s hand.

  Her fingers closed on mine, surprisingly strong, but she didn’t cry.

  “She’s doing remarkably well,” said Dr. Solano.

  Donna placed a small plastic mask over Rowan’s mouth and nose, then attached it to a machine on the opposite side of the isolette.

  “She’ll need that CPAP machine for a few days; she can already breathe on her own, but it will prevent her from tiring herself out,” Dr. Solano said. He proceeded to rattle off a list of challenges and protocols, all the things the staff would do to help Rowan develop and stabilize enough to go home. The clinical part of my brain took in his words, asking the right questions, filing away the information so I could translate it for Charlie later. But another part was content to marvel at the delicate, helpless creature before me.

  Suddenly, Charlie’s panic didn’t seem so overblown. It was protectiveness, and I couldn’t blame her one bit. Five minutes with Rowan, and I was ready to move mountains for her.

  I stayed at her side, marveling at the impressive strength of her grip, until Charlie and Matt arrived a few hours later. They were both suited up in gowns and gloves, Rachel hovering behind them. My sister looked ghostly and anxious as Matt pushed the wheelchair closer. “Is that Rowan? How is she?”

  “What are you doing out of bed?” I asked, aghast. “You just had major surgery, Charlie. You shouldn’t be up yet.”

  Rachel drew me aside as Matt maneuvered Charlie directly in front of the isolette. “She was threatening to check herself out against medical advice if we wouldn’t bring her down here. Dr. K said it was okay, as long as she stays in the chair and I’m nearby.”

  I didn’t like it, but before I could speak, Charlie made a soft crooning noise, tears rolling down her cheeks as she reached inside the isolette. “Hello, sweet girl.”

  “She’s got my ears,” Matt said proudly.

  “Let’s hope she’s got your appetite,” Charlie replied.

  “She’s beautiful.” Somehow, I kept myself from ordering Charlie back to bed. “The neonatologist said she’s doing great.”

  She spared me a brief glance. “You’re sure? Why can’t I see her face? What’s the mask for?”

  “It’s to help her breathe—like a sleep apnea machine, but they’re using it so she doesn’t get overtired. It’ll come off in about a week, maybe less. Once she’s able to coordinate her swallowing, she’ll switch to oral feedings instead of the IV. Dr. Solano will explain all of this to you guys again soon.”

  “What else did he say?”

  I reviewed everything the neonatologist had told me: the various monitors and breathing treatments, the phototherapy for jaundice, other medications Rowan might need. The list sounded daunting, but I knew how lucky we were, and I emphasized that for Charlie. “She’ll have to stay for at least a few weeks, but she’s doing great.”

  Matt reached in through the second port to touch Rowan’s bare foot, his arm around Charlie’s shoulder. She tipped her head against him with a sigh, and it struck me how solid the two of them were.

  I was not solid, not with anyone. And it was nobody’s fault but my own.

  “I’ll go give Mom and Riley the scoop,” I said and left the three of them there, trying to ignore the jealousy scraping at my heart.

  * * *

  I found Garima near the nurse’s station.

  “Hey,” I said, “you let Charlie out of bed already? Are you nuts?”

  “Would you prefer she rip out her stitches sneaking down to the NICU?” she shot back, then softened. “She’ll be okay, Frankie. We would have wanted her up and moving in a few hours anyway, and Rachel’s keeping a close eye on her.”

  I quashed the urge to argue. This, after all, was why doctors and nurses weren’t supposed treat family members—their judgment was clouded. “If you say so. But I’m about to go get my mom and Riley. You might want to tell the staff to brace themselves.”

  She didn’t laugh, and her expression was a look I knew too well—furrowed brow, straight mouth, searching eyes. My hands went cold. That was a bad-news face, one I’d seen—and used—plenty of times in the emergency room.

  “You said Charlie was fine.”

  “Not Charlie. It’s your patient,” she said. “The heart attack.”

  “Clem?” The chill spread, and I folded my arms, trying to ward it off.

  “I’m so sorry, Frankie.” There was no mistaking her tone.

  “Clem’s dead? That doesn’t make sense. When?”

  She nudged at her glasses. “A couple of hours ago. Maybe less. Respiratory arrest, someone said.”

  “He was stable last night. He was snoring.”

  She touched my shoulder in sympathy. “You know how fast these things can turn.”

  “Yeah, you’re right.” But it didn’t feel right. I’d lost patients before—sometimes there was nothing to be done. This time, I had done something. I’d found Clem. I’d saved him, or thought I had.

  “World’s Best Grandpa,” his cap had read. I thought about CJ, the same age as Riley, the same age I’d been when my dad died, and suddenly I wasn’t satisfied with “nothing to be done.”

  “Make sure Charlie gets back to bed soon,” I said.

  “Of course.” Garima frowned. “Frankie, where—”

  I was already headed for the doors.

  FOUR

  The cardiac ward was bustling, and the air hummed with tension. Losing a patient was always tough on the staff, no matter how much we tried to compartmentalize. Marcus sat at the nurse’s station, scowling at a stack of paperwork. He looked up as I approached, his frown softening to sadness. “Frankie! You heard?”

  I nodded. “What happened?”

  “I don’t know,” Marcus said. “He was stable, and then . . . boom. Vitals dropped off a cliff, no warning. Happened during shift change.”

  That figured. Shift change—when one group of nurses went off duty and another came on—was a combination of the witching hour and Murphy’s Law. If a crisis was go
ing to hit, it almost always happened during shift change.

  “He looked good when I was in with him.” The protest sounded feeble, even to my own ears. “Maybe I should have stayed.”

  “Don’t beat yourself up,” he said. “You did more than most people would’ve. Maybe it was just his time, you know?”

  “Maybe,” I said, not bothering to hide my skepticism.

  “How’s your sister?”

  “She’s good, and so is the baby. C-section early this morning.” I tried not to think about the fact that Rowan’s life was beginning as Clem’s was ending. “Good thing you woke me, or I might have missed it.”

  “You fell asleep in there?” He sounded genuinely surprised, and then his face split in a broad grin. “You should be upstairs celebrating.”

  “I guess,” I said. “What are you still doing here? Shouldn’t you be off duty?”

  “My shift ended at eleven,” he said. “But I needed to finish up his chart, and the daughter’s on her way in. I wanted to stick around until she got here.”

  “Long night for you.”

  He shrugged. “My wife’s dad is the same age. Same kind of build. I’d want someone to talk to her, you know?”

  “I do,” I said, a smile breaking through. “Softie.”

  He chuckled. “Don’t tell anyone.”

  “I really thought he was on the mend,” I said. “Everything looked good last night, didn’t it?”

  “It did. But the man wasn’t exactly in his prime,” Marcus gestured to the chart. “He had more history than one of those PBS dramas.”

  He had a point. It wasn’t uncommon for patients to crash so suddenly, especially if they had prior heart issues. I leaned over the counter to get a better view of Clem’s chart, my vague uneasiness coming into sharper focus.

  “It’s like I said last night—he came in with elevated cardiac enzymes, but they shouldn’t have been so high if he was on benazepril. And how’d he throw the clot if he was taking warfarin?” I asked.

  “You know how those old guys are. The minute they start feeling better, they think they’re cured. He probably stopped taking his meds, or forgot to get a refill, and he was too ashamed to admit it. Happens to my father-in-law all the time—my wife is constantly checking to make sure he’s doing what he’s supposed to.” But Marcus looked troubled, which troubled me even more. “Besides, it wasn’t his heart, it was respiratory arrest. Didn’t matter what he was taking—once his lungs stopped working, his heart couldn’t handle it.”

  “I suppose. Have they taken him to the morgue?”

  “Not yet. The daughter wanted to say good-bye before they transported him.”

  It was such a small thing, but I knew how much it would mean to Clem’s family, to have that chance for closure. “Could I . . .”

  “Sure thing,” he said, eyes warm with understanding.

  Working in emergency medicine meant I was plenty familiar with dead bodies. Not comfortable, exactly—I didn’t ever want to get to the point that I was comfortable with death. But as I entered Clem’s room and spied his body, hidden beneath a sheet, I wasn’t afraid, or nervous.

  I was sad.

  The room was still and terribly silent, as if time itself was suspended. I drew the sheet down far enough to see Clem’s face. His eyes were closed, and his skin had the ashy pallor of the recently dead. His longish gray hair was thinning on top, but the bushy mustache, drooping over the corners of his mouth, more than made up for it. His “World’s Best Grandpa” hat was nowhere in sight.

  I swallowed hard and pulled the sheet up again.

  Everything was in order. I’d seen cases like this one thousands of times, with outcomes just as tragic. But Clem’s death felt personal. I hadn’t had time to put up my usual boundaries, and my emotions were already running high, thanks to Rowan’s arrival and the end of my engagement. Whatever the reason for our connection, I couldn’t shake the sorrow—or the sense of wrongness.

  The staff had done a quick cleanup of the room to prepare for Clem’s family. Someone, most likely Marcus, had bathed him, arranging his features in a peaceful expression. They’d had to leave his IVs in; by law, those would stay until the coroner signed off on the death certificate. Out of habit, I examined the bags still hanging, half-empty, tubing taken away. They’d run the usual: maintenance fluids, heparin to thin his blood, the standard assortment of cardiac drugs. I’d glanced at them last night, but now I scrutinized each bag, trying to make out the exact dosages. Trying, I realized, to find an explanation.

  I should have been satisfied, but I wasn’t.

  “I’m sorry, Clem,” I said softly. “I wish . . .”

  What? What did I wish? That I’d found him earlier, that I’d done more, that I’d stayed with him. I wished for all of it, to no avail.

  There was a noise at the door. A woman with red-rimmed eyes stood in the doorway. Her shoulders were hunched, thin arms wrapped around herself, as if she’d taken a blow to the stomach. In a way, she had. Marcus stood behind her, eyebrows raised in alarm.

  “Who are you?” the woman asked, stepping inside. Clem’s daughter, no doubt. Her dark-blonde hair was cut in a sensible bob, but it looked disheveled, her black cardigan crookedly buttoned.

  “Frankie Stapleton. I’m . . .” I trailed off uncertainly. Not Clem’s nurse, not his friend. A stranger, with a newly discovered sentimental streak.

  Marcus stepped in. “Laura, this is the lady that found your father. She was just leaving.”

  “I’m so sorry for your loss,” I said, the familiar words springing to my lips. I made for the door. “I’m sure you’d like some privacy.”

  Her hand brushed my sleeve. “Wait. You’re the one who helped him?”

  I halted. “I tried. Everyone did.”

  She pressed her fingertips to her eyes and took a breath. “Thank you. I . . . I’m still in shock. I was going to come last night, but the doctor said he was stable. He said we could wait until morning, and now it’s too . . .” She began to weep. “I haven’t even told my son.”

  “I’m sorry,” I said again. Marcus tipped his head toward the door. “I’ll let you say good-bye.”

  As I left, Marcus coaxed the woman toward Clem’s bedside. Her shoulders shook, and her sobs rang in my ears even after I’d left the floor.

  * * *

  “Aunt Frankie!” Riley bounced up and down in her seat as I entered the cafeteria. “Did you see Rowan?”

  “I did.” Exhaustion grabbed me by the throat, and I sank onto the hard plastic bench. “She’s small, but she’s doing great.”

  “You look terrible,” my mother said. “Have you eaten?”

  “Coffee,” I mumbled. “I’ve been busy.”

  She smoothed my hair, the gesture unexpectedly kind. “Let me get you some lunch.”

  I propped my chin in my hand and closed my eyes. “Awesome. Thank you.”

  “When can I hold the baby?” Riley asked around a mouthful of peanut butter sandwich.

  “Not for a while. They’ll probably let you into the NICU, if you’re superclean, but they won’t let you hold her until she’s ready to come home.”

  “I’m the big sister!” she said, outraged.

  “Sorry, kid. Rules are rules.”

  “Rules are stupid,” she said.

  “Some are,” I agreed, not opening my eyes. “This one’s not. Kids have germs, and germs are bad for Rowan right now.”

  “What’s bad for Rowan?” My mother had returned.

  “Aunt Frankie says rules are stupid.”

  I opened my eyes and met my mother’s frown. “That’s not what I said.”

  Wordlessly, she set coffee and a turkey sandwich in front of me.

  “I was explaining to Riley why she can’t hold Rowan yet. In a little while, we’ll go upstairs and ask if you can visit her.”

  Riley considered this, her scowl softening. I suspected, after eight years of being an only child, she was a little dictator at heart.

  �
��We saw some babies in the nursery,” she said. “They’re kind of ugly. Is Rowan ugly?”

  “Nah, she’s pretty cute. Not a knockout like you, obviously.”

  Riley nodded, satisfied. She chattered while I ate, carrying the conversation for all of us.

  My phone rang again, Peter’s picture flashing on the screen. I sent the call to voice mail and ignored my mother’s raised eyebrows.

  When I’d finished, my mother said, “You should come home and rest.”

  “I’ll crash in the family lounge upstairs. Charlie needs me.”

  “Charlie can manage without you for a few hours. You’ll be no good to anyone unless you get some sleep.”

  “I’ve gotten by with less.”

  “But you don’t need to,” my mother began, then looked up, directing her words over my shoulder. “May I help you?”

  “I . . . um . . . I was looking for Miss Stapleton. Frankie?”

  I twisted in my seat. Clem’s daughter stood in front of me, clutching a white plastic bag labeled “Patient Effects.”

  “Is this a bad time?” she asked.

  “No, no,” I assured her. “Mom, why don’t you two check on Charlie? Make sure she’s back in bed. I’ll be up soon.”

  My mother was as subtle as a bulldozer, but she could read a room. “Riley, let’s go see if we can spot your sister through the window.”

  Her tone didn’t allow room for argument. Once they’d gone, I gestured to the seat across from me. “Sorry about that. My sister had a baby this morning, and everybody’s frazzled. I didn’t catch your name.”

  “Laura Madigan.” She set her purse on the floor and extracted a fresh tissue. “I wanted to thank you for helping my father.”

  “You’re welcome,” I said. “I’m so sorry for everything you’re going through. I’ve been there.”

  “He’s my dad.” She dabbed at her eyes. “I thought he was invincible.”

  “Is there someone I can call for you?”

  She glanced up, gave a small wave to a group of nurses two tables over, and shook her head. “No. It’s just us—me and my dad and CJ. And my husband,” she added with a grimace. “I call him as little as I can. He’s not what you’d call supportive.”