Code 15

by Gary Birken

  Fortunately, he didn’t strike his head, and within a few seconds, Michael opened his eyes. The pain tore at him as if somebody had buried a pair of axes deep into his thighs. Hot blood from his shattered pelvic bones and mangled soft tissues gushed out, soaking his pants. Forcing himself to take the pain, he slowly picked up his chin and looked up the hill.

  The car had pulled over about twenty yards away. Straining to focus, he saw nobody, but he could hear the engine running. A few seconds passed, and the car door slowly swung open. Its interior light cast a shadowy glow that was sufficient for Michael to see the silhouette of a hulking man emerge from the car. His relief was instantaneous but fleeting. Instead of running toward him, the man stood beside his car, gazing up the hill.

  Assuming the man didn’t see him, Michael yelled out, “I’m in the ditch. Help me.” The man didn’t move, but Michael knew he heard his cries for help.

  “Please help me,” he screamed again between labored breaths.

  But the man didn’t take a single step. In stead, he climbed back into his car and slowly pulled away. Michael closed his eyes and allowed his head to drop to the soggy muck. He knew the man would not return. After a few deep breaths, he reached down to see if by a miracle his cell phone case was still clipped to his sweatpants. It was gone.

  The mounting terror of not being found consumed him.

  About two minutes passed before the first car approached. It was heading down the hill and Michael waited until the last possible moment before waving and calling out to it. He screamed as loud as he ever had but the car never slowed. A half dozen other vehicles passed by in the next twenty minutes, but none heard his pleas for help. Fearing for his life, he closed his eyes and prayed.

  Just when he thought he would lose consciousness, he heard the first bark of the dog. His eyes snapped open. The sound of distant footsteps became steadily louder. On the ground in front of him, the bright beam of a flashlight appeared.

  Two coeds walking a golden retriever climbed down into the ditch.

  “My God,” the one holding the leash said.

  “We’re calling nine-one-one,” the other one told him. “We’re nursing students. We’re going to stay with you until the ambulance comes.”

  In a pained, shaking voice, he said, “Somebody hit me. He stopped, but then he took off.”

  “Don’t worry about that now,” she said, kneeling down next to him. She then reached for his hand and felt for his pulse.

  “Thank you,” was all he could manage.

  Five minutes later the air was filled with the wailing siren of an approaching ambulance. Seconds later, with its orange-and-red strobe lights flashing, the rescue van came into view at the top of the hill. The girls jumped up, moved to the shoulder of the road, and flagged it down. Two paramedics jumped out, opened the back doors of the vehicle, and wheeled over a collapsible stretcher. The more senior one took Michael’s vital signs and then started an IV. As soon as it was securely taped into place and his legs were splinted, the two men carefully transferred him onto the stretcher and loaded him into the ambulance. As they were trained, their time on scene was as brief as possible.

  Ten minutes later, they rolled Michael Allenby into the main receiving bay at the Shands Hospital Trauma Center.

  CHAPTER 59

  DAY TWENTY-NINE

  After a twenty-minute drive from the hospital, Ben and Morgan pulled into the parking of the Broward County offices of the Agency for Health Care Administration.

  “The most important thing is to keep your cool,” he told her as they got out of his car and headed for the entrance. “I know a couple of doctors who have gone through this. Just explain to the investigator in a calm and logical manner exactly what happened. Be careful not to come across as an arrogant doctor with a God complex. The last thing you want him to think is that you view yourself as someone incapable of making a mistake.”

  “I got it, Ben. You’ve told me all of this ten times. Have a little confidence,” she said, getting the feeling he was more nervous than she was.

  “You’ll be fine. Just as long as you remember to—”

  “To leave my attitude at the door. I know.”

  “I think you’re ready. I’ll wait for you right here,” he said, pointing to the only couch in the lobby.

  Ben gave her a quick hug, kissed her, and gave her the thumbs-up. “It’s just like the first time you soloed.”

  Morgan rode the elevator up to the fourth floor. After identifying herself to an indifferent receptionist, she was escorted into a small office. Devoid of any windows, the unadorned room contained only a metal desk, two straight-backed chairs, and an empty bookcase. Except for a few haphazardly placed color photographs of minor Florida officials, the walls were bare.

  Using the time to bolster her confidence, Morgan went over her plan. As Ben had suggested, she would confidently but calmly defend her care of Faith Russo. Irrespective of how the interview progressed, she would not allow herself to become unglued. A few more minutes passed and Morgan was left with nothing to do except look at the photographs on the wall. Finally, after what seemed like hours, the door opened and a middle-aged man in dire need of a haircut strolled into the office. As if he were the only one in the room, he settled in behind the desk, took out a handkerchief and wiped his nose. He then reached into his briefcase and pulled out a large manila file.

  “My name’s Matthew Cochran,” he announced as if he were running for office and then handed her one of his business cards. Before saying anything more, he arranged the contents of the folder into two neat stacks. “The purpose of this meeting is to offer you the opportunity to respond to the complaint made against you regarding your treatment of Faith Russo. After our meeting, I’ll prepare a report and submit it to the board of medicine. Let me make it perfectly clear that I have no role in their deliberations or decisions.” He wiped his nose for a second time. “Do you have any questions before we begin?”

  Morgan found his dispassionate monotone reminiscent of a tired waiter’s recital of the Saturday-night dinner specials for the twentieth time. She was tempted to tell him that although he might find these proceedings to be a matter of routine, they were humiliating and disconcerting to her. But with Ben’s advice still echoing in her mind, she said instead, “I have no questions.”

  He picked the top paper from the first stack.

  “I have a brief description of the Code Fifteen along with the complaint, which I’m sure you know was anonymous. I’d like to get your side of things from the first moment you met Miss Russo.” He then raised his eyes to meet hers for the first time since he had paraded into the office.

  Anxious to plead her case, Morgan moved to the front of her chair and laid her forearms on the armrests. For the next twenty minutes she went through every aspect of Faith’s treatment in methodical detail. Ever careful to avoid sounding like a defensive physician struggling to explain away a poor patient outcome, she conducted herself in a professional manner and confined her comments to the medical facts of the case.

  When she finished, Cochran took a minute or so to complete his notes.

  “I want to make sure I’m clear on something. Is it your opinion that Miss Russo did not have a ruptured spleen the first time you saw her?”

  “That’s correct.”

  “Would you please explain to me again how you reached that conclusion?”

  “There was absolutely no physical or laboratory evidence that any of her abdominal organs had been injured in any way. As you can see from the medical record, I carefully documented my findings before discharging her.”

  Morgan watched while he again pored over the ER record.

  He asked, “Would I be fair in reporting to the board that you reviewed the triage nurse’s note before examining Miss Russo?”

  “I reviewed it in detail.” Morgan knew he was referring to the nurse’s notation that Faith had complained of vague abdominal pain. Before Cochran could question her on the point, she wen
t on to add, “In fact, it was because of the admitting nurse’s entry that I repeated Miss Russo’s abdominal examination. When I found nothing abnormal, I again asked her if she had sustained an injury to any part of her abdomen. She told me she hadn’t.”

  Cochran slid his reading glasses off and set them down on the desk. He appeared puzzled. It was the first hint Morgan had that tucked away in some small fissure of his robotic brain, he was listening to her.

  “I’d like to include something in my report that indicates why you believe Miss Russo was hurt after she left the emergency room. Is there anything in the police or paramedic’s reports that would substantiate your theory?”

  “I’m afraid not,” Morgan answered with a sudden loss of resolve.

  Cochran replaced his glasses, interlaced his fingers, and set his hands on the desk.

  “Dr. Connolly, I’ve been an AHCA investigator for twenty years. If I’ve learned anything it’s that these cases rarely come down to what a physician thinks or theorizes. The only thing that matters is what he or she can prove.”

  “I wasn’t with Miss Russo when she left the emergency room, so there’s no way I can prove that’s when her injury occurred. All I can tell you is that it’s the only explanation that makes sense.”

  “Is there anything else you would like me to include in my report?”

  She shook her head. “Not that I can think of at the moment.”

  Cochran returned Morgan’s file to his briefcase.

  “I’m truly sorry this happened to you. I’m a registered nurse by training. I worked in a busy emergency room for five years, so I have a pretty good idea of the crazy things that can go wrong.” He paused for a few seconds while he checked to make sure his briefcase was locked. “I’m not supposed to say this, but I hope things go your way.”

  With a note of desperation in her voice, Morgan asked, “Is there anything else I can do?”

  “The board meets in two weeks. Your case is one of the last ones on their agenda. From what I see here, all they’ll have to base a decision on is your statement and the medical records. You’re going to have to convince them that Faith Russo was injured after you saw her the first time.”

  Morgan looked squarely at him. “I’m not a police officer, Mr. Cochran, and two weeks doesn’t give me much time.”

  “I understand, but anything that would refute Dr. Canfield’s autopsy report and his . . . his editorial comments would greatly help your case.”

  “Editorial comments?”

  “He included a letter that accused you of being under great personal stress. He suggested that it might be the cause of your faulty medical judgment.”

  Morgan wanted to scream.

  “Can he do that?”

  “It may not be considered proper procedure, but there’s no law against it.”

  “I thought his job was to offer an objective opinion regarding Faith Russo’s cause of death. He’s a pathologist, not a psychiatrist. He has no right to make unfounded and unqualified statements regarding my emotional state.”

  “You’re preaching to the choir, Dr. Connolly.”

  “Why would the board even look at such a letter?”

  “Normally they wouldn’t. But coming from Dr. Canfield . . . well, they probably will. He’s one of the board’s most respected consultants. They’ve asked him to offer opinions on several cases over the years. They hold him in very high regard.”

  “Great,” Morgan said, crossing her arms and pushing back in her chair. “What’s the point in even defending myself?”

  “As I mentioned before, it’s impossible to predict what the board will do. In addition to being the key caregiver in a particularly bad Code Fifteen case, you have a highly respected pathologist who’s claiming you’re responsible for it. If you want to help yourself, find something of substance in your defense that the board won’t be able to ignore.”

  “What I need is more time. Will they give me a postponement if I request one?”

  “Not without a compelling reason,” he said, coming to his feet. Morgan remained seated.

  “You have my card. If you should have any questions, please call me.”

  “Thank you,” Morgan told him with a polite but faint smile.

  After Cochran left, Morgan sat in the office pondering her ever-worsening predicament. Entangled in a Gordian knot of uncertainty, one fact seemed clear: she had to find Mason Kaine. Ben was right. For all she knew Kaine could have moved out of Florida a year ago. It would be pointless to try to enlist the help of the police department, but based on her conversation with Adele Kaine, she didn’t think she needed to.

  After another minute or so, Morgan stood up and left the room. She was not a woman prone to paranoid ideations. But as she made her way down the hall, she’d swear the entire machinery of Florida’s medical authority was conspiring against her.

  CHAPTER 60

  DAY THIRTY

  Gideon knelt down on the shallow incline of his multitiered rock garden.

  Scrutinizing his work, he was at last satisfied that the spacing and alignment of the purple and white impatiens were perfect. Pushing himself to his feet, he brushed the crusted dirt from his jeans. He then made his way down an azalea-lined gravel trail until he arrived back at his house. He climbed the four steps leading to a wooden deck and then walked over to the railing.

  From the middle of his shoulder blades, a razor-sharp pain climbed upward and then over his neck before sinking into the depths of the base of his skull. Determined to ignore the stress-induced pain, he gazed out over his beautifully landscaped property.

  Subconsciously, his grip on the railing tightened until the last drop of blood was squeezed from his hands. The news that AHCA had failed to impose any significant sanctions on Dade Presbyterian had quickly disseminated through the hospital. When word reached him, he was infuriated. At a minimum, he had expected the inspection team to require the hospital to pay a substantial fine and to order a temporary suspension of the cardiac program pending an in-depth review of its safety record.

  The flames of Gideon’s anger were further fanned by the knowledge that, in the absence of significant penalties from AHCA, the Code 15s wouldn’t receive any media attention. From the beginning, he had counted heavily upon television and the newspapers crucifying Dade Presbyterian hospital for their unsafe practices.

  Irrespective of what had happened to this point, he couldn’t allow AHCA’s spineless dereliction of duty to weaken his resolve. Righteousness would always be on his side. This time, he vowed to himself, he would leave nothing to chance. He would create a Code 15 of such staggering proportions that the media would have a field day with it. A public outcry would result that would echo all the way to Tallahassee. AHCA would have no choice but to return to Dade Presbyterian and do what they should have done the first time.

  His determination renewed, Gideon released his grip on the railing and went into his house. Entering the sunroom through a set of white French doors, he strolled over to a wicker love seat that overlooked his garden. A large ceiling fan cast a welcomed stream of cool air across his face and neck. He closed his eyes. His breathing slowed and soon became deeper.

  His last thought before falling asleep was that he would not allow Morgan Connolly to do anything more to interfere with his plans. To his dismay, he would have to change his tactics. He could no longer afford to indulge himself by tormenting her. It was time to arrange for her death. He owed at least that much to his sons.

  CHAPTER 61

  DAY THIRTY-ONE

  Morgan’s second session with Will Johnson was even more free-flowing and productive than the first.

  They spent most of the time discussing her interview with AHCA, her conversation with Adele Kaine, and the other events that had transpired since they had last spoken. At no time was Will judgmental or did he make her feel as if her concerns were irrational or groundless. Most important, she was confident that nothing they talked about would leave his office.


  “We still have a few minutes left,” he told Morgan, flipping his notepad back to the first page. “Is there anything else you’d like to talk about?”

  Having a captive expert in human behavior sitting directly across from her was an opportunity too appealing for Morgan to pass up.

  “Anything?”

  He nodded.

  “I know you spend most of your day trying to talk people off of the ledge. I’d like to discuss something a little different.”

  “I’ll try and shift gears,” he said, sporting a cautious grin.

  “I’d like to know what type of person might become irrational as the result of a severe grief reaction?”

  He picked up his container of coffee and took the last swallow.

  “What you’re asking for is a personality profile of an individual who might be predisposed to such a psychotic breakdown.”

  “Exactly.”

  He flipped a few pages back in his notes.

  “This wouldn’t have anything to do with Mason Kaine, would it?”

  “Let’s just say we’re two physicians discussing an interesting psychiatric case.”

  “Fine. Any standard psychiatric textbook would say that the type of breakdown you’re describing is rare. On the other hand, there are numerous case reports in our scientific journals suggesting it’s a more common phenomenon than we once believed, and that it doesn’t necessarily mean the individual is psychotic.”

  “Is there a particular personality type that would be more prone to an extreme grief reaction?” she asked.