Fatal Complications

by John Benedict

  Shirley gave him a puzzled look. “Nope, not a thing.”

  “Good. Knife.” The scrub nurse handed Seidle the scalpel back.

  Luke tensed—he had one more hurdle to clear. There was no such thing as a guaranteed perfect spinal, especially in an obese patient. The spinal block could sometimes range high or low. Luke stared over the drape as Seidle prepared to make the incision. This was the moment of truth. If the spinal was good, Shirley would be unaware of the incision. If not, she would scream.

  CHAPTER TWO

  FRIDAY, SEPTEMBER 1, 6:00 P.M.

  Bart Hinkle adjusted his cummerbund for the fourth time in what he was beginning to realize was a futile attempt to rein in his gut. He took another swallow of his scotch, ice clinking, and grimaced. His head was pounding and his back ached—he couldn’t tell which was worse. Another fundraiser at the Forum in Harrisburg for Senator Pierce’s re-election campaign. Another fucking waste of time.

  Bart stifled a yawn and surveyed the large banquet hall. Tables were situated all about the room, but few were occupied during the cocktail hour, when everyone stood talking and boozing it up in small groups. Jazz music came from the far end of the room, where a four-man band played somewhere beyond the haze of smoke. The music was decent enough, and some other evening he might have enjoyed it. But tonight he found it loud and tinny. And he felt as if the bass drum was screwed into his skull.

  All the city’s high rollers were here, decked out in their tuxes and evening gowns—this included representatives from each major law firm. Lots of younger in-crowd women, staffers, and young trophy wives were strutting their stuff. Maybe the night wouldn’t be a total waste.

  A young hostess in a black French maid getup walked up carrying a silver platter of hors d’oeuvres. “Would you care for some?” she asked in a high, nasal voice.

  Bart was famished; he despised the long wait for dinner at these affairs. He grabbed three chicken-wrapped-in-bacon gizmos and almost spilled his scotch in the process. “Thank you, my dear,” he mumbled as he ogled the hostess. She was nice and slim and sort of cute, in a rough, slutty way. He took special note of her black fishnet stockings as she walked away. He imagined her wrapping those long legs around him in some nook in the kitchen.

  Mimi tugged on his arm and demanded in a screeching voice, “Bart, are you listening to me?” He had almost forgotten that his wife was standing next to him. The way she spewed smoke and alcohol fumes everywhere reminded him of a diesel bus belching exhaust. She waved her hand holding the glowing cigarette after the waitress and almost burned the gentleman standing beside her. “I guess you were too busy drooling over Little Miss Muffet there.” Bart could already detect the slur in her speech—an increasingly common occurrence these days.

  Bart took a step backwards. “Mimi, keep it down,” he said in a low voice, lifting both hands in a shushing gesture.

  “Keep what down?” she bellowed.

  “I mean it, Mimi. Don’t you embarrass me here.” He looked at her closely for the first time that evening and shuddered. Her red lipstick was smudged. And her expensive plaid dress failed to hide a bulging midsection that no amount of liposuction seemed to touch. He made a mental note to withhold the next payment to her plastic surgeon—the joker certainly charged enough money to entitle his clients to results.

  Before he and Mimi could escalate things into a full-blown shouting match, Kyle Schmidt, senior partner at Bart’s law firm, approached. He slapped Bart on the shoulder and grabbed his hand, pumping it vigorously. “Bart, you old fox—good to see you!”

  “Kyle, glad you could make it.” Bart disengaged his hand from the older man’s crushing grip. Although Kyle was in his late fifties, he was one of those guys who clearly didn’t miss many sessions at the gym. Bart was about to say more when a stunning woman appeared at Kyle’s shoulder. She had long blond hair, and wore a tight evening gown that displayed an unbelievable amount of cleavage. Bart stared.

  “Bart, you’ve met my wife, Bunny,” Kyle said, smiling.

  “Of course I have.” Bart held out his hand, using any excuse to continue staring. He vaguely felt Mimi elbowing him. He had met Kyle’s new, thirty-something wife once before, but it had been at some outdoor function and she had had a coat on, for God’s sake. Bart reluctantly dropped her hand and forced himself to turn away from those beautiful breasts toward Kyle.

  “Sorry we’re late,” Kyle said. “Bunny and I had some—uh—things to take care of.” He wrapped his arm around Bunny’s slim waist and pulled her tight. He pecked her on the cheek and a syrupy grin spread across his face.

  “I’ll bet,” Bart mumbled as Bunny’s pretty face blushed pink and she giggled easily. Bart took another swallow of his scotch.

  “Mimi, are you enjoying the gala so far?” Kyle asked, dropping the teenage grin.

  “Well,” Mimi said, “the drinks are always watered down at these things. You’d think they could afford better.” She pinched her perpetual look of irritation into one of exasperation. She also belted down her third drink with a fierce determination as if, by God, she’d overcome any silly watered-down effect.

  “So Bart, what do you think of our Senator Pierce?” Kyle asked.

  “I think he’s got a lock on this election,” Bart said. “They say he’s got the biggest war chest in the history of the state.”

  “That’s true. He is, after all, the distinguished president pro tem of the Senate. And of course Schmidt, Evans and Knobe contributed heavily to that war chest.” Kyle flashed his bleached-white teeth in another smile.

  “Don’t I know it. But why are we even here tonight, Kyle? At a damn fundraiser? Barring some major fuckup, Pierce should win in a landslide.”

  “You know how these things work. Election results are never guaranteed. Polls can be dreadfully wrong—remember the New Hampshire primary? The party doesn’t want to take anything for granted.”

  “I guess so.”

  “After all,” Kyle said, “the Dems have a real chance of taking back control of Congress this year. The stakes could not be higher. The very balance of power in the US Senate might hinge on Pierce’s re-election.”

  “You really think so?” Bart rubbed his temple and considered making another trip to the bar. The first scotch had done squat to erase his headache.

  “Of course I do.” Kyle studied him for a moment. “What’s bugging you, Bart?”

  “It’s just—I’m not a huge fan of Pierce. I’ve met him several times. The guy’s a first-rate asshole.”

  Kyle raised his eyebrows and took a sip of his red wine.

  “I can’t take his goddamn sanctimonious style,” Bart said.

  “What do you mean?”

  “He kills me with all his environmental crap.”

  “He does own the green position and is crushing his Republican opponent, is he not?” Kyle said.

  “Yes, he is,” Bart admitted. “But Kyle, I’m telling you, Pierce would support child molesters if he thought it would help him get elected.”

  Kyle chuckled. “Look, maybe you’re right, Bart. He is a piece of work, but he does have a knack for reinventing himself. Could it be you’re just a bit jealous of his success?”

  “Maybe,” Bart conceded.

  Mimi yawned. “Bunny, let’s go to the bar and get you a drink. We can leave these old farts to talk politics.” Politics came out powitix.

  “Sounds good, Mimi,” Bunny said, breaking into a new fit of giggles. The two headed for the bar. Bunny glided across the floor in her high heels, her silky evening gown hugging her figure, the thigh-high slits revealing titillating glimpses. Half the men in the room watched her, undoubtedly hoping she would lean toward them or, better still, suffer some wardrobe malfunction. Mimi waddled along beside her, looking a little unsteady on her feet.

  Bart also followed Bunny’s departure with interest. “God almighty, Kyle, you’re a lucky man!”

  “Bunny, you mean. Yep—she’s a real peach. She’s teaching me stuff I’ve never
dreamt of.” He was all smiles. “How are you and Mimi doing?”

  “Funny you should ask,” Bart said, shaking his head. “Not so well.”

  “Is it that bad?”

  “Horrible.”

  “She’s a good mother to your son.”

  “Yeah, if you want an alcoholic for a role model. Perfect for a teenager.”

  Kyle didn’t say anything.

  “Listen, Kyle, I need to talk to you.”

  “So talk.”

  “Not here.” Bart glanced nervously about the room. “Walk with me.”

  “The wives will be back any minute.”

  “I know.” Bart took Kyle’s elbow, almost spilling his wine, and guided him out of the banquet hall and down a deserted hallway, finally stopping at what appeared to be an abandoned cloakroom. The dense carpeting and wainscoting in the corridor seemed to absorb all sound. The air was still and slightly musty, but no longer reeked of smoke.

  “What in the world’s gotten into you?” Kyle asked. “And why all the cloak and dagger stuff? Is this about the Abercromie account?”

  Bart glanced around again and lowered his voice. “No, it has nothing to do with work.”

  “Okay, good.”

  Bart took a deep breath, let it out. “Sometimes I wish Mimi were dead.”

  Kyle laughed and looked relieved. “Yeah, I used to feel the same way about my ex. I don’t think you’re the first one to have such thoughts.”

  Bart remained silent.

  Kyle’s smile dissolved, leaving behind a look of appraisal. “Bart, we’ve been friends for how long?”

  “Twenty years or so, give or take.”

  “And in all that time, I don’t remember you ever mentioning such insurmountable marital problems. What’s the big problem?”

  “I can’t stand her anymore—she’s revolting. I’m serious about this, Kyle.”

  Kyle studied him. “You really are, aren’t you? Listen, just have an affair, for chrissakes. Get it out of your system.”

  “Are you kidding? If Mimi found out, she’d take me to the cleaners. She’s got plenty of lawyer friends who’d love to nail my ass.” Bart drained his scotch. “Besides, I’m no good at all that sneaking around stuff.”

  “Well, there’s always divorce.”

  “I can’t believe you’re saying that after all you went through.”

  “Okay, you’re right.” Kyle took another sip of his wine. “You’re in a hopeless fuckin’ jam. Welcome to the human race.”

  “I’ve been thinking about this for months.”

  “And…”

  “That’s just it, Kyle. I can’t come up with a plan that’s safe. The news is full of hit men bungling the job or ratting out their employer.”

  “Whoa—hold on. Did you say plan?”

  “Yes.”

  “Are you talking about having her killed?”

  “I know it sounds drastic.”

  “Drastic? Are you fuckin’ nuts?” Kyle turned to leave. “I don’t want to hear any more of this crazy talk.”

  Bart reached out and grabbed hold of his arm. “Wait, Kyle, I’m serious about taking care of business. I need your help.”

  “Don’t be a fool, Bart. You’re way out of your league here—you’d get caught and spend the rest of your life in jail. These things have to be handled professionally.”

  “That’s the point. I know you know people, Kyle.”

  “Those are just old wives’ tales.”

  “Remember last year when I helped your son beat his cocaine rap?”

  “Yeah…”

  “And you said if I ever needed anything…”

  Kyle looked off into space. Finally he turned and looked Bart squarely in the eye. “I might be able to help you, after all.” He set his wine glass down and pulled a business card out of his wallet. “This just might be the professional help you’re looking for.” He handed the card to Bart.

  Bart took the card gingerly, rubbing it gently between his thumb and index finger, as if searching the paper for clues. The card was blank except for a handwritten phone number: 566-3031. “Thanks, Kyle.” Bart tucked the card into his wallet and for the first time that evening forgot about his headache.

  CHAPTER THREE

  FRIDAY, SEPTEMBER 1, 4:00 P.M.

  Mark Seidle sliced a foot-long incision horizontally across Shirley’s lower abdomen in one quick, uninterrupted motion. Shirley stared off into space, a tranquil expression on her face, completely oblivious to the surgery—the spinal was working well. Luke resumed breathing. Teri gave him a thumbs-up sign and he nodded in response.

  The BP monitor chirped, announcing its latest reading—88/58.

  “Hang another bag,” Luke said to Teri. “I’ll give some more ephedrine.” Luke turned and bent down to the level of his patient. “Shirley, how do your hands feel?”

  “They feel like they’re asleep.”

  “You mean tingly?”

  “No, numb.” She looked up at him, worry creeping into her eyes. “Aren’t they supposed to be?”

  “They can be,” Luke said, his voice trailing off. The thought of a total spinal—a spinal block that goes way too high—blazed across his mind. Please, not a total spinal! It was unlikely, but numb hands were the first sign. If she was developing a fullblown total spinal, her breathing would be next to go, as her respiratory muscles became blocked. He turned to Teri and said in a low voice, “Tube.”

  Teri raised her eyebrows. Luke nodded and she proceeded to get an endotracheal tube and laryngoscope ready in case general anesthesia would be necessary.

  Shirley’s husband appeared, led into the room by an OB nurse. He looked like Hulk Hogan’s bigger brother. The XXL scrub top looked ridiculously small on him; his chest jutted out and the sleeves looked uncomfortably tight on his upper arms. He was ushered to the head of the OR table and sat down on a little metal stool that looked rather precarious beneath him.

  “Hey, Shirl,” he said and patted her arm. “I’m here.”

  “Hi, Bear.”

  “You okay?”

  “I think so,” she said uncertainly.

  “Are they hurting you, babe?” He threw a threatening look at Luke.

  “No.” She shook her head.

  Luke glanced at Bear’s massive, tattooed biceps before turning to Shirley. “The baby should be out in a couple of minutes.” It was always a good idea to focus the mother’s attention on her baby and distract her from her immediate predicament. “Doing okay?” Luke put forth the question tentatively, afraid of what her response would be. But he had to know.

  “Seems kinda hard to breathe.”

  Shit! There it is in black and white. Unbelievable. Total fricking spinal! First C-section. Difficult OB man. Big, mean, son-of-a-bitch husband and morbidly obese patient.

  “She okay, Doc?” Bear asked. His eyes were bulging and the veins popped out on his neck.

  Luke ignored him and put the mask from his breathing circuit tightly on her face. “Take a big breath, Shirley,” he said, trying to keep his voice steady.

  Shirley attempted to suck in some air. “I can’t,” she said weakly, her voice muffled by the mask. Luke stared at the volumeter on his circuit. Shit, only 300 cc. Not enough.

  “She can’t breathe, Doc.” Bear was on his feet, fists tightening and biceps threatening to rip apart his scrub top. “What’s going on?”

  Teri stood up and said, “Maybe you should wait outside, Mr. Karas.”

  “I ain’t leaving, honey—and from the looks of it, neither of you two twits is gonna make me.” Bear puffed his chest out even more and widened his stance, glaring at Teri and Luke.

  Seidle looked over the drapes. “Daulton, what seems to be the problem up there now?”

  “She’s having a little difficulty breathing,” Luke said. “I’m working on it.”

  “Deal with it, okay? I’m kinda busy here.”

  Luke turned to Bear. “Sometimes this happens with a spinal.” He hoped that would pacify th
e man for the moment, because he needed to concentrate on getting Shirley through this. “Shirley, I’m going to help you breathe some. You’re gonna be fine.” Luke began to assist her respirations with the bag and mask. He glanced up at her oxygen saturation monitor, which remained at 100 percent. Maybe, she’ll make it. “How’s that, Shirley?”

  “Better,” she answered, but her voice was barely a whisper.

  Suddenly the suction apparatus gushed as the amniotic fluid was sucked out following uterine incision. A minute later, Seidle extricated the baby from the muscular uterus and the sound of a crying newborn filled the room. Everyone paused in wonder, and the tension ratcheted down a notch.

  “Shirl, it’s a baby boy!” shouted Bear. He sat back down and began to stroke her arm.

  Shirley didn’t respond. Luke watched with horror as her eyes rolled up into her head.

  Bear turned to Luke and demanded, “Did you put her to sleep?”

  Luke ignored him and checked her respirations. She was making no effort. He was still ventilating her, but now he was doing all the work. He cycled the BP monitor, then shot a look at the suction canister behind him. Moments ago it had been empty, but now it was filled to the top with a mixture of blood and amniotic fluid—hard to tell just how much blood she had lost.

  Seidle handed off the large, slimy Bear Jr. to the waiting neonatal nurse and turned back to the abdomen. “Losing some blood up here, Daulton. Hurry and run the Pit.”

  BP: 60/35.

  Shit! Blood loss on top of a total spinal—not good!

  Then Seidle added something that froze the blood in Luke’s veins. “Looks like we’re dealing with an abruption here.” This was truly catastrophic. Luke could barely hear him above the roar of the suction as Shirley’s blood was rapidly being sucked out of her body.

  “Get some blood!” Seidle practically screamed. “Nurse, see if Dr. Gentry’s in house.” Seidle’s hands were shaking badly now.

  Luke figured it was time for action. He had an extremely critical situation on his hands and this lady’s life hung in the balance. Dad was right—sometimes the only one you can rely on is yourself. The pressure of this situation might have paralyzed him, but he actually calmed down somewhat as he entered his emergency zone. No more thinking, worrying, denying, or indecision.