Heart Stop

by Radclyffe

  She read journals in bed until she was tired enough to sleep. When she woke at twenty to five, her eyes were still scratchy from a restless night. A quick shower helped revive her, and after an even quicker cup of coffee, she walked the half block to the narrow lot squeezed between two town houses on Twenty-Fifth Street where she rented a parking space. Ten minutes later she pulled in to her customary spot behind the ME’s office.

  Hasim was just opening his food truck when she reached him.

  “Morning, Doctor,” Hasim said with his usual energetic good humor as he arranged cardboard trays of pastries on the shelf below the service window.

  “Morning, Hasim. An extra-large this morning when you can.”

  “Sure thing.” He entered the four-by-six-foot truck where he spent fifteen hours a day and poured a steaming cup of coffee into a large cardboard container with a generic blue logo on the side and placed a lid on top. “Something to eat to go with it?”

  Olivia glanced at the apple fritters, thought of Jay, and firmly glanced away. “I’ll have one of the plain bagels and a container of cream cheese. Thanks.”

  She handed him the money, he passed her the food, and she walked back to the medical examiner’s office through mostly empty streets. She was looking for Jay, and when she realized it, berated herself for the lapse. They didn’t have a meeting scheduled, and there was no reason for Jay to show up before morning review. Most of the residents and staff came rushing in a minute before the meeting started unless they had cases to present. She didn’t blame the residents for taking every spare moment for themselves they could. Once their training was over, they would have years of long demanding days, nights on call when their social and family lives would be disrupted at a moment’s notice. They’d all chosen to do it, as had she, but that didn’t mean the work was without sacrifice. As she expected, the halls were empty and still. Jay was not waiting by her door, and she hadn’t realized how much she’d hoped she would be until the spurt of disappointment washed over her. Foolish, as she’d been saying.

  She unlocked her office, hung her raincoat in the small closet inside, and sat behind her desk. She spread the cream cheese on the bagel and sipped her coffee, all the while staring at the empty chair Jay had occupied the day before. Since she couldn’t stop thinking about her, maybe if she actually analyzed her feelings she could impose a little reason on her irrational reactions. She’d simply approach the problem as she would any other clinical challenge.

  Jay was remarkable, true, but no more so than many other women she’d met. Supremely confident, accomplished, intelligent. Capable. The university was full of women just like her. Some who might even be as attractive and intriguing and…

  Olivia shook her head, unwilling to be party to her own ridiculous self-delusion. Yes, Jay was all those things, but what made her truly exceptional, what intrigued and captivated Olivia as no woman ever had, was Jay’s refusal to be broken by devastating loss or physical injury even as she struggled with her anger and frustration. Jay probably thought she hid that, or that only her stubborn resolve showed through, but Olivia knew something about loss and how difficult the pain was to hide. She admired Jay for her determination to recover, no matter the cost. Jay was a warrior in the classic sense of the word—unwilling to surrender despite fearsome odds. Olivia could see her at the head of a tribe of Amazons, her ferocious charisma compelling all to follow.

  “Mother would be proud,” Olivia muttered, pressing her fingertips to her eyes. She’d finally learned to see the present as a mere reconfiguration of the past. “But not just yet. I still have some willpower left.”

  No matter how she felt about Jay, she didn’t intend for it to show. She wouldn’t make excuses for her or treat her any differently than she would have if she had been an ordinary trainee. She wasn’t grading her, for which she was thankful. That wasn’t her job. Her job was to teach, to share her knowledge, and to ensure Jay met the basic standards of their training program. When Jay’s fellowship was over, she would have to pass her boards in order to practice, and that wasn’t Olivia’s decision. In that sense, Olivia had no power over Jay’s future. This wasn’t college, or anything even close to it. Postgraduate medical training was like no other training in the world—an apprenticeship of sorts, some would argue, more akin to indentured servitude.

  Archaic, perhaps. Yes, Mother, I hear you. History again. Well, she wouldn’t be letting her history repeat itself. One disastrous love affair was quite enough. As if that were even a possibility. Her world was right here in this building. She had made the life she wanted already.

  With a relieved sigh, Olivia turned on the computer and scanned her email. One message halfway down the screen caught her eye, the header indicating the lab report on her unidentified female. She clicked to open the file and skimmed it. Frowning, she scrolled down to the mass spectrographic results of the blood chemistry. A large spike appeared labeled unidentified substance. The computer-generated summary below that indicated the compound matched nothing in the database, which contained literally hundreds of thousands of drugs. She went on to read the analysis.

  This substance most closely resembles synthetic opioid compounds such as fentanyl in chemical composition, but matches no registered pharmaceutical compounds presently available in the United States.

  An unregistered synthetic opioid. Olivia sat back. Well, Sandy Sullivan had said there was a possibility they were dealing with a new street drug. That would explain this kind of result. Olivia pulled out the top drawer of her desk, checked the phone list of commonly called numbers she kept inside, and dialed Police Plaza.

  “Can you connect me to the CSU, please,” Olivia asked when the operator picked up.

  “Normal working hours are seven a.m. to five p.m.,” the operator helpfully informed her.

  “Thank you,” Olivia said. “If you connect me, please, I’ll leave a message.”

  “Certainly.”

  Olivia continued to read her mail, waiting for the computerized menu to come on.

  “Flanagan,” a woman with a determined Irish accent said after the third ring.

  “This is Dr. Olivia Price, assistant chief medical examiner for the county. Good morning. I didn’t expect to reach anyone.”

  “Dee Flanagan here, Doctor. How can I help you?”

  “I’m following up on an open case, female victim, possible OD.” Olivia read off the case number. “Officer Sandy Sullivan informed me you would be analyzing the evidence.”

  “We’re working that case, but I don’t know we have much of anything for you. It’s been a busy week. Let me pull it up.”

  “Thanks. I was wondering if you’ve identified the drug in question. Sandy thought there might’ve been some remnants in the packages found at the scene.”

  “Hold on for a second. Yeah, we’ve got something,” Flanagan said, “but I’ll be damned if I know what it is.”

  “Unknown spike on the mass spec?”

  Flanagan laughed. “I guess you got the same thing. I was rather hoping you’d have something more specific on your end.”

  “It looks like a synthetic opioid, but not a registered legal pharmaceutical.”

  “That fits with what we’re seeing too.”

  “What does that mean, exactly? From a practical point of view?” Olivia asked.

  “You mean as pertaining to cause of death?”

  Olivia smiled. Flanagan was sharp. “That and what I might be seeing more of.”

  “How much time do you have?”

  “About a cup of coffee’s worth?”

  “That makes two of us. Give me another second,” Flanagan said and Olivia could hear her pouring something in the background. “So back in the seventies and eighties, Upjohn and a couple of other pharmaceutical biggies were in a race to find the perfect analgesic, one that alleviated pain but didn’t cause addiction. And they wanted high potency as a side benefit.”

  “Sounds like a devil’s bargain to me,” Olivia said, making a quick
note to dig out the references.

  “Yep,” Flanagan said. “The Holy Grail of opioids. The perfect heroin without the poppies or the side effects. So anyhow they started cranking out drugs and systematically altering them in an attempt to defang them, for want of a better analogy.”

  “I take it that didn’t work?”

  “Oh, they made some mighty fine drugs,” Flanagan said sarcastically. “The only problem was they were so potent they tended to be lethal to just about every animal tested. No clinical trials ever got started because all the lab animals were dying.”

  “So they were never released?” Olivia stared at the spike on the mass spec.

  “No, most of them were patented but never marketed in any way.”

  “Okay,” Olivia said, nibbling on the bagel. “So there’s precedent for this kind of lab research. I’m not sure—”

  “See, the thing is, the patents had the chemical formulations and, in a lot of instances, fairly specific instructions on how to manufacture them.”

  “Ah. And now all those filings are available on the internet if you know how to look for them.”

  “Exactly.”

  “Does anyone know who’s making the current versions?”

  Flanagan grunted. “China for one, and in large quantities for the last year at least, but it hasn’t been a major problem here in the States. Some sporadic outbreaks, but the outbreaks are becoming more common and closer together.”

  “What about narcotic antagonists? How effective are they?”

  “Not at all. Unlike with standard heroin compounds, if an EMT is standing by while someone snorts one of these drugs and goes into cardiac arrest, there’s nothing they can give them to counteract the drug.”

  Olivia’s chest tightened. Flanagan had just described what could be an epidemic if this drug showed up in quantity. “I hope very much this is an isolated instance. For now, the case will remain open until we identify her and know more about the circumstances of her death.”

  “I’m going to call around to some of my counterparts in New York and DC and see if they’re seeing any of this,” Flanagan said. “If I get anything further, I’ll let you know.”

  “Thanks, I appreciate it.”

  “Have a good one,” Flanagan said.

  “You too.” Olivia disconnected. The victim still needed to be identified, and she needed to know a lot more about the agent that killed her in case she wasn’t the last.

  *

  “Morning,” Tasha called as Jay arrived at the pit a little after seven. Tasha wore pale blue scrubs and had her running shoes propped up on the coffee table, a half-eaten sandwich balanced on the arm of a dark green vinyl chair. She sipped from a mug with an image of the Statue of Liberty and looked surprisingly rested after a night on call.

  “How was your night?” Jay rinsed out a mug from the communal stash on the counter and poured some coffee. Tasha had left Smokey Joe’s right after dinner while Archie and Jay stayed for another beer.

  “Quiet. A couple death reports from the hospital, but no callouts. I got about six hours.”

  “That is nice.” Jay tried to remember a night on call when she’d actually been able to sleep and couldn’t think of one. She’d learned to get by on an hour or two in between cases or floor emergencies. Even now, when she had the opportunity to sleep straight through the night, she rarely could. Last night hadn’t been any different. After she’d gotten home, she’d read a book until almost midnight and still only catnapped until six. “So what’s on the agenda?”

  “The rotation list is over there on the bulletin board,” Tasha said. “Basically, we take calls in the order posted up there as they come in, unless we all get busy at once, and then we pretty much try to back up as needed. You’re on phone duty today.”

  “Okay, what’s that? Since I’m the new guy, I’m assuming it sucks.”

  “Not so much. Okay, maybe it’s really boring.” Tasha grinned. “You get to triage the calls that come in to us from the hospitals and emergency services. You’ll decide if a body needs to come here or can be released to family.”

  “Okay.” Jay sipped her coffee. “I don’t have any idea how to do that.”

  “I didn’t figure you did. Archie and I will give you a hand. We both have posts to do, but we’ll be around if you need us.”

  “Thanks, but I don’t want to interrupt you if you’re in the middle of a post—”

  Tasha waved her off. “Hey, it’s no problem. They’re not going anywhere.”

  Remember, to call for help is a sign of weakness.

  Jay shook her head. She sure as hell wasn’t in Kansas anymore. “All right, you want to give me a quick rundown of how I’ll know what I don’t know?”

  “Absolutely. When the police call, it’s usually straightforward—they’ve got a DB and you need to determine if it’s a scene we need to roll out on. Violent deaths—suspected homicides or suicides, ODs, accidents—they’re all rollouts for the investigators and one of us. Pretty much anything they get, we roll on it unless it’s somebody who dies at home after a long illness. Then the body will need to come here, but we don’t need to go out on it.”

  “Okay, so if it’s anything other than clear natural causes, we go.”

  “Yup. The hospital calls are almost always the opposite. They’re calling to tell you they’ve lost the patient.”

  “Yeah, been there a few times.”

  “The thing is, most docs don’t actually understand how to distinguish between cause of death and the final event. They all want to say—”

  “Cardiac arrest.”

  Tasha laughed. “You got it. So you’ll have to take a history to figure out what the presenting symptoms were, what the underlying disease process was, and kind of walk them through it until you come to the appropriate cause of death. Then if you’re comfortable with the course of events, you can call it natural causes and release the body to the family.”

  “Wow, I really don’t want to fuck that up.”

  “You won’t. You’ve got plenty of clinical experience, so you’ll recognize the red flags. But like I said, just give one of us a yell.”

  “Okay, sure. Thanks.”

  “No problem.” Tasha stretched, her breasts straining against her scrub shirt as she arched her back. “I’m not complaining about getting a full night’s sleep, but I sure as hell wish the beds here were a little more comfortable.”

  Jay had spent so many nights sleeping on sofas in the OR lounge or worse than that, anything that resembled an actual bed was a bonus for her, but she made agreeable noises.

  Tasha rolled her shoulders, sat up straight, and glanced over at Jay. “So are you seeing anyone?”

  Jay was good at not showing her feelings, and she managed to keep her mouth from dropping open. “Uh, not at the moment.”

  “Am I reading you wrong or would I be out of line asking you out to dinner or something?”

  “Your radar’s good,” Jay said slowly. “I’ve been out of commission for a while, though.”

  “Is that a no or a maybe?”

  “That’s thanks and can I think about it?”

  Tasha grinned. “Sure. You let me know. And if it makes any difference to you, I’m bi.”

  “Nope. It doesn’t.”

  Tasha bounced up. “Good, I’m going to take a shower. Want to come?”

  “Uh—”

  “Just kidding.” Tasha’s smile was infectious and Jay relaxed, grinning back.

  “All right, thanks anyhow,” Jay said.

  “See you later.”

  Jay leaned back against the counter and watched her go. She hadn’t had a date in over nine months, and she sure as hell hadn’t been thinking about one. She’d been thinking about a woman, though, and one she probably shouldn’t be. Olivia Price was complicated and interesting as hell, and anything with her would be intense. For a minute the image of Tasha in the shower teased at her senses. Tasha was attractive and easygoing and obviously not shy. Maybe something
light and easy was a much better idea.

  When her phone buzzed, she jumped. She’d gotten out of the habit of taking calls since the accident. The only calls she’d gotten before were about patients or emergencies, and she didn’t do that any longer. Well, maybe now she did. “Reynolds.”

  “It’s Olivia.”

  “Hi.” Jay’s heart rate spiked and she forgot all about naked women in showers.

  “Can you drop by my office before morning review?”

  “I’m on my way.”

  Chapter Fifteen

  Jay arrived at Olivia’s door, breathless, and took a second to catch her wind before knocking. She didn’t want to look like she’d just raced through the building, or at least her facsimile of racing considering her gimpy leg, which she had. Fortunately she hadn’t run into anyone who might have noticed her rush. Too early still for most people. She glanced at her watch. Forty-five minutes until morning review. That was good. Forty-five minutes with Olivia if she was lucky. She rapped on the door and concentrated on getting her game face on in the next second. “It’s Jay.”

  “Come in,” Olivia called, and Jay figured her game, such as it was, was a losing proposition. Just the sound of Olivia’s voice made her grin. She opened the door and stepped inside.

  “I wasn’t sure you’d be here this early.” Olivia smiled at her from across the desk.

  “I would have been waiting outside your door, but you know, stalkerish.”

  Olivia laughed. “That would not have occurred to me.”