“You did everything you could do, Doctor,” Katie told her sympathetically. “It was just his time to go,” the grandmother of five added softly.
“Besides,” the other nurse, Jenna, chimed in, “where he’s going is a lot better than where he would have gone if you’d brought him back from the brink,” she assured Nika with the confidence of the very young who never doubted themselves. “Have you seen that nursing home he was living in?” Jenna, all of twentysomething, shivered to make her point. “If that’s the way I’m going to end up, shoot me now.”
“Hey, a little respect for the dead,” Gerald chided sharply. Jenna frowned and fell into a brooding silence as she slowly stripped the deceased man of the various tubes and wires that had been connected to him. Gerald spared Nika a compassionate look. “Death’s all part of it, Dr. Pulaski,” he told her philosophically. “You shouldn’t take it so hard.”
The orderly was right. After all, what did she expect, Nika asked herself. She was working in the Geriatrics Unit, for heaven’s sake. These were old people. A lot of them had overtaxed their immune systems and were susceptible to so many different things, things that could fell them without a moment’s notice.
That was why they were running understaffed in this unit, because of the threat of someone unwittingly bringing in the flu. They couldn’t control the visitors who came in—although, sadly, a lot of these patients had no one to visit them—but they could at least control the staff’s interactions with the patients.
Nika nodded in response to what the orderly said. She forced herself to focus on the steps she had to take next, not on what had just happened.
“I guess it just seems like a lot of these old people have been dying lately,” she murmured. And death was not something she would ever get used to.
“That’s because they have,” Katie told her. She went about tidying the man up so that he had a little dignity left, even in death. “They’re old people,” she emphasized, just as Nika had in her mind. “It goes with the territory and is to be expected. It’s a lot harder to handle when you lose a patient in the pediatrics ward,” she pointed out. “At least these people have had relatively full lives.”
Nika nodded, then squared her shoulders, silently telling herself to get over it, to straighten up and fly right. She’d do none of her remaining patients any good if she allowed herself to break down and cry.
“You’re right,” she told Katie.
The woman grinned broadly. “Of course I’m right. It’s in my contract,” Katie told her with a wink. “Go help your living patients. There’s nothing more you can do for Mr. Kelly. We’ll do what needs to be done for him now,” the nurse assured her, taking charge.
“I should notify the next of kin,” Nika said, more to herself than to Katie. The very idea filled her with a sense of dread. This was the ultimate in bad news, no matter how prepared a loved one might think that they were.
“There isn’t any,” Jenna told her, practically chirping out the information. “Nobody to notify. Except for maybe the nursing home,” she added as an afterthought. “They’ll want to know so that they can get his room ready for someone else.”
That sounded so cold. So detached. Business as usual, nothing more. Damn, she hated this part of her world.
Out loud, Nika said nothing. She looked at the two nurses and the orderly. They were all doing their part, unfazed, preparing the old man for his last exit. Would she ever get to that state? Would she get to the point where death rolled right off her back, and it didn’t feel as if the specter had taken a large chunk out of her heart when she lost a patient?
As if reading her mind, Katie leaned in as she moved past her. “You let it get to you, you’re no help to the rest of them—the ones who still need you to make a difference in their lives. Remember that.”
Nika nodded and whispered, “Thank you,” before she left the room.
It took her a few minutes to get the tears under control.
“You look terrible,” Sasha declared, almost walking into her cousin. She was on her way in and Nika appeared to be on her way out. “Who died?” she asked.
Nika paused and followed her cousin back inside for a second. “Mr. Kelly,” she told Sasha quietly.
Sasha’s eyes widened with surprise—and distress. “Oh God, Nika, I’m sorry. It was just an expression. I didn’t realize someone had actually died,” she apologized, chagrined. “Was he a patient of yours?”
“Right now, they’re all patients of mine on that floor. The Geriatrics Unit,” she said in case Sasha wasn’t aware of where her rotation had taken her. Something had been gnawing at her since she’d put it into words earlier. “Since I’ve come to work in the unit, it feels like a lot more people have died.”
There was nothing but sympathy on Sasha’s face. “And that means you’re what, the angel of death? Things happen, honey. Old people do die. What do you mean by ‘more,’ exactly?”
“More than the average expected number,” Nika answered. She saw the skeptical look on her cousin’s face. “I minored in math,” she explained.
“Good to know. Next time I’m in a jam, I’ll bring my checkbook to you. I can’t count higher than ten without taking off my shoes.” She slipped a comforting arm around her cousin’s shoulders despite the fact that Nika was several inches taller than she was. “Honey, again, they’re old people. They’re in the hospital, which means they’re sick. A lot of them are worn out. The odds are against them and those odds get worse every day.” She saw that Nika wasn’t completely at ease. “Look, if you’re really worried that something isn’t quite right, why don’t you run this past Dad? Or Tony?” Sasha suggested, referring to her husband, who was a detective in the homicide division of the NYPD. She reached into her pocket to take out her cell. “I could call Tony for you—”
Nika put her hand over her cousin’s phone. Gently, she pushed it back into the pocket it had come from. “That’s okay, maybe I’m just being overly sensitive.”
“FYI, patients think that’s a good quality in a doctor,” Sasha told her. She was about to say something more, but her pager went off. She angled the device that was clipped onto her belt. “After five false alarms, it looks like Mrs. Davis’s water finally broke. Thank God!” she declared happily. “Gotta run, Nika.” And yet, she still paused long enough to give her cousin’s face another once-over. “You’ll be all right?” she asked, concerned.
“I’ll be fine.” She waved Sasha on. “Go, do what you do best. Bring another little taxpayer into the world,” she urged with a smile.
The moment her cousin was out of sight, the smile on Nika’s face vanished, replaced by a weary expression. She wasn’t being overly sensitive. That was just an excuse she’d given Sasha. And she also didn’t believe that the way she was feeling was the product of an overactive imagination. Older patients on her floor were expiring at a rate that she was definitely uncomfortable about.
Okay, it wasn’t in droves, but still…
Granted, there had been more admissions to the unit of late than there used to be. She’d checked into that via a comparison between last year’s admissions at this time and now. More people meant that the number of patients dying increased. But so had the percentages and that part was odd.
She’s lost five patients in two months. Okay, so three of them were diagnosed with terminal diseases and death was an almost merciful release—but getting cured would have been even better.
Was it just a coincidence, or was there something else going on? Something that she was missing?
She hadn’t a clue, but her gut warned her of some kind of pattern. Still, she didn’t want to mention her suspicion to her family. She didn’t know them all that well yet and the last thing she wanted was for them to think that she was the kind of person who went around seeing ghosts when there weren’t any or stirring up trouble as she went along. She wasn’t a rabble-rouser, just a concerned doctor.
What she needed was an impartial outsider who, by the
way, was also acquainted with police procedure and could figure out if something not quite aboveboard was going on.
Frustrated, she shoved her hands into her pockets, pensively reviewing her options. Her fingers came in contact with card stock.
Nika realized what it was before she had a chance to pull it out all the way and look at it.
Cole Baker’s business card.
Detective Cole Baker’s business card, she amended, her mind going from zero to sixty-five in just under a racing heartbeat. She had no idea if he’d be open to look ing into this for her, but there was nothing to be lost by asking him. He couldn’t hold that against her, she reasoned as his frowning, disapproving face rose up in her mind’s eye. She was just being a concerned citizen, that was all.
She lost no time in dialing his cell phone number.
The line went active on the second ring. The detective surprised her with his prompt response. She could hear street noise in the background. They all but drowned him out.
“This is Baker.”
Did he ever sound anything but impatient, she wondered. “Detective Baker, this is Dr. Pulaski calling—”
Impatience turned to gruffness instantly. “What’s happened to my grandmother?” he demanded.
A voice in her head told her her meddling was an all-round bad idea. If she had concerns, there were proper channels to go through. She could—and should—go to the hospital administrator and talk to Ella about what was on her mind. She owed the woman that, rather than going over her head and calling in the police. What if she was completely off the mark? She didn’t want to embarrass the hospital, and that would be exactly what she’d be doing—not to mention committing medical suicide with her career.
“Nothing happened to your grandmother,” she assured him.
“Then why are you calling?” he asked. It was obvious he didn’t believe her.
The level of background noise increased, making it hard for her to hear. But she pressed on. She had to give him some kind of reason for calling, otherwise he would think that his grandmother’s fate was in the hands of a lunatic. “Do you have any idea if she’s always had high blood pressure?”
“I didn’t know it was high at all,” he confessed. Damn it, why hadn’t his grandmother told him? Why were all the surprises attached to her case bad? “Why, is that a problem?”
“It might be,” she acknowledged, treading cautiously. She didn’t want to alarm him. “I’ll confess that I’d like to see it significantly lower before we go ahead with the procedure.”
“What about her other tests?” he asked. “What do they say?”
She’d forgotten about them. “Nothing yet. We haven’t gotten back any of the results. They should be in first thing in the morning,” she promised him, then, because she had a feeling he was expecting it, she added, “I’ll be in touch with you the minute they turn up. Thanks for the information,” she told him and then, with that, she terminated the call.
With a deep sigh, she put her cell phone back on vibrate and pocketed it. She debated the wisdom of her next move for approximately two minutes, decided that she couldn’t live with herself if she said nothing and her instincts ultimately turned out to be right—that something more than natural progression caused these people to die.
Squaring her shoulders, she forgot about taking a late lunch and went to talk to the person she should have discussed this with in the first place, the hospital administrator.
While her office was being renovated, the administrator had temporarily relocated to the second floor. Nika took the stairs.
Chapter 5
“And your contention is what exactly?” Ella Silverman asked, looking at Nika over the top of her reading glasses. They had slipped down again and the woman had left them there, temporarily suspending the ongoing battle with gravity that required her to push them up the bridge of her nose every few minutes.
As quickly and succinctly as she could, Nika had told the tall, imposing, frowning hospital administrator that she was uneasy about the number of recent deaths in the Geriatrics Unit. The moment the words had left her mouth, she could have sworn that Ella Silverman had instantly looked like someone who’d gone on the defensive.
Nika chose her words carefully as she repeated her concern.
“Just that the patients in the Geratrics Unit are dying at almost twice the national average for their age group.”
The woman’s back literally went up. Ella narrowed her eyes. “And you know this how?”
Nika wasn’t about to back off now. “Research.”
“I see.” Ella tossed her head. Since her shoe-polish-black hair was frozen in place with a third of a can of hair spray, not a single hair moved out of place. Despite the administrator’s caricaturelike appearance, Nika knew through word of mouth that the woman was actually very good at her job, but she was a bit overly chauvinistic when it came to protecting the hospital’s reputation.
“Are you insinuating that the patients are dying because the quality of the care they are receiving here is poor? Or are you saying that the hospital is in some way failing to provide as clean and germfree an environment for these patients as possible?” She held up her hand before Nika could begin to answer, warning her. “And before you answer, I would think very carefully about the next words I say if I were you.”
“No, no,” Nika denied the two suggestions Ella had offered with enthusiasm. “I’m not saying it’s either of those reasons.”
Ella sighed, exasperation echoing in the sound. “So exactly what is it that you are saying, Dr. Pulaski? That the hospital is having some kind of run of bad luck, having these people come here to be treated in our Geriatrics Unit only to die?” the woman asked sharply. She pretended to frame a public service announcement. “‘People, keep your parents and beloved Uncle Oscar out of Patience Memorial if you don’t want them to die on you.’ Is that what you’re implying, Dr. Pulaski?” she asked, leaning over her desk and somehow managing to fill the space around Nika with her presence.
Maybe she should have gone to her uncle after all, Nika thought. At least Uncle Josef listened and let her finish when she spoke. He didn’t immediately go on the defensive the way Ms. Silverman was obviously doing.
“No, ma’am, I’m not implying that the hospital is at fault in any way.” And she really wasn’t. She supposed that her intention in coming here was to use the hospital administrator as a sounding board. She’d had better ideas, she now thought ruefully. “Then what are you saying?” the woman demanded irritably.
Nika tried to salvage the situation by falling back on a technical question. “Have any of these last few deaths been looked into?” She could see by the woman’s expression that she wasn’t making herself clear. “Have any of them had an autopsy performed?”
“An autopsy?” Ella cried. “No. None of their deaths were suspicious,” she retorted, enunciating each word slowly and carefully as if in doing so, she’d crush the argument. “There was no reason for an autopsy,” she said with finality, “not to mention that there’s no money to conduct one on a whim.”
Nika pressed her lips together. “This last patient who just died this morning, Mr. Kelly, they said he had no family. If no one steps forward to claim his body, maybe you could authorize—”
Ella’s glare was frosty and she succeeded in freezing what Nika was about to say in midsentence. “There’s no money for anything ‘extra.’ In case you don’t know this, the hospital’s budget is stretched to the very limit as it is.” Like a queen who’d grown tired of the conversation, Ella straightened, indicating that the audience was over. “Now, unless you have some hard and fast evidence to present—”
“Not without an autopsy,” Nika pointed out, still hoping that the hospital administrator would change her mind.
The exact opposite happened. Ella took that as a sign that the discussion was terminated. “Well, there you have it, then,” she announced with a wave of her hand. “The subject is closed, Doctor. Now, if you’
ll excuse me, I have work to do. Real work,” she underscored, looking back at the report she’d been reading before Nika had asked to speak with her.
“Sorry to have bothered you,” Nika muttered, withdrawing.
“No bother,” the woman replied without looking up. “My door is always open,” she added, repeating her very worn public mantra.
In contrast to your mind, Nika thought as she left the room.
Well, she’d tried, she told herself. And maybe Ms. Silverman was ultimately right. Maybe there was nothing more to it than a perverse kind of misfortune, an anomaly that just happened to have shown up at this hospital instead of another one.
Why didn’t that make her feel any better about the situation?
Nika went away troubled, vowing to pay more close attention to as many details as she could. And most likely to give up sleep for the next few months, she thought wearily.
“How is she doing?”
The voice, deep and resonant, seemed to come out of nowhere. And succeeded in scaring the hell out of her because Nika was so caught up in what she was reading in one of the reports she’d managed to get off the computer at the nurses’ station. The report was a history and physical of one of the deceased patients. An elderly woman with leukemia. A condition that had mysteriously and miraculously gone into remission. Just before she died.
Stifling a scream, Nika swung around to look behind her.
“Hey, sorry. Didn’t mean to scare you like that,” Cole apologized.
On his way to see his grandmother, he’d spotted the young doctor standing off to the side, reading. He’d decided to stop and ask about the tests that had been taken earlier today. He figured it was too soon for answers, but the way technology was moving forward these days, he took a shot at it. He hadn’t expected Nika Pulaski to almost jump out of her skin.
“Is everything all right?” he asked. “You seem a little jumpy.”
The Doctor's Guardian Page 5