Fatal Complications

by John Benedict

  Katz whirled. “You’re too late, Daulton.”

  Luke launched himself at Katz, knocking him backward across the room, like a football player hitting the sled. The older man’s head smacked against the wall. “You sick bastard! What did you do?”

  Katz didn’t reply; he was dazed but still conscious.

  Two bodies were on the floor against the wall—Nikolai lying in a pool of blood with a knife in his hand and next to him was Jenna, who looked ashen in death. What the hell had happened?

  Katz started to move, his hands rubbing his head. He focused on Luke. “I injected her with air,” he croaked. “She’ll die of a massive air embolus. A common complication following a bloody C-section.”

  “I’ll kill you, you son of a bitch!” Luke wrapped his hands around Katz’s thick neck and began to throttle him. Katz struggled to free himself, but was too weak to offer much resistance. As Luke continued to squeeze the life out of him, he noticed the bullet wound in Katz’s left shoulder, now bleeding freely.

  Kim’s monitor shrieked a piercing alarm. Luke looked over to see her EKG go flatline. He let go of Katz, who sagged to the floor, gasping, and rushed to Kim’s side.

  Cardiac arrest! Damn, I never should have left her. What should he do? Call a code and get help? Give epinephrine? Start CPR?

  Luke ran over to the crash cart in the corner, over by Nikolai’s body. He flung open the drawers, looking for epi. He also turned the defibrillator on and charged the paddles—even though there was no rhythm to shock. All the while, he knew it was hopeless—no matter what he did. There was no treatment for a massive air embolus, short of immediate cardiopulmonary bypass in the OR, for which they had no time.

  Luke ripped open a box of epi and injected it into her IV port and ensured the IV was running wide open. He glanced at the monitor again, hoping for any sign of life—now, even her pulse ox failed to register. Was she dead already?

  Luke felt the tears well up in his eyes as he injected a second syringe of epi. It seemed like he was standing in the living room twelve years ago, with his dad sprawled out on the floor. He could hear his dad’s voice: “Luke, what happens in life is up to you. There is no ghost world to rely on to do your work. Work hard and you will succeed. Misplace your belief in someone other than yourself and you will fail.” He always knew he was to blame for his father’s death. And now he was responsible for Kim’s death as well. What kind of God would let Kim die now? Surely not one he wanted to place his faith in.

  He heard Katz stir behind him, but didn’t care. Katz made his way to the door and said in a hoarse voice, “And to think I was worried about you and your wife. You’re both pathetic and no match for me.” He heard Katz stagger out of the room and down the hallway.

  Luke began to weep as he put his hands on Kim’s chest and prepared to do compressions. He stopped short when he noticed the bedsheet covering her arm was wet. There was a large wet spot, and it was growing—and it was blood-tinged. He quickly peeled the sheet back and realized with a shock that her IV catheter was lying loose in the bed. It was no longer in a vein and blood oozed from the site in her arm where it had been. Surely Katz hadn’t pulled out the IV?

  Luke was confused, but also couldn’t stifle a ray of hope. He noticed the pulse ox probe was not on her finger. But that didn’t explain the EKG flatline. He pulled the sheet entirely off her, exposing her whole upper body, and what he saw froze him. He saw one crumpled EKG pad with the lead wire still attached, clutched in her hand. No wonder the EKG had gone flat. He didn’t dare to hope any further, but couldn’t help himself.

  “Please God,” he whispered to the air. He was terrified to ask, but did so anyway. “Kim, can you hear me?”

  No response.

  He stroked her hand. “Kim, Kim, I love you. I’m sorry I wasn’t there for you.” Finally, after summoning additional courage, he bent down and put his face up to her ear. He could make out her unique fragrance, a tiny beacon almost lost in the overwhelming sea of harsh SICU smells. “Kim, are you there?” he asked.

  Did her hand move in his?

  “Kim,” he said louder, his voice breaking. He squeezed her hand tightly.

  She opened her eyes and looked up at him.

  A rush of emotion swelled up in Luke. Thank God, he thought in utter amazement. Unbelievable! Thank God. “Are you okay?”

  She nodded.

  He kissed her on the cheek several times and squeezed her hand, his own hands trembling badly. He fought to control his breathing and settle his heart down.

  Kim’s eyes darted about the room, fearful.

  “He’s gone. Katz is gone.”

  She settled down and gazed up at him.

  “You pulled the IV out, didn’t you?” he asked, filled with admiration.

  She nodded again, more vigorously this time.

  “You got my message?”

  More nodding.

  Tears flowed from Luke’s eyes. “Oh, I love you so much.” He bent down and hugged her in spite of the ventilator hoses and kissed her again, smiling through his tears. “You’re so smart.” She had obviously decoded his message; 604 in Roman numerals was DCIV—medical shorthand for “discontinue intravenous line.” She had also improvised and pulled off the EKG patch and the pulse ox probe.

  Kim stared up at him, tears streaming out of her eyes.

  He saw the question in her eyes and understood. “Abi’s fine. The delivery was a little rough, but she’s fine.” He paused as Abi’s angelic face floated across his mind. “I delivered her myself,” he added with pride.

  Again she smiled and managed to look beautiful in spite of the endotracheal tube.

  “I’ll explain it all later. Let’s just work on getting you well. You need to rest, sweetheart.”

  Suddenly Kim’s eyes opened wide, flashed a look of terror, then closed and her hand went limp.

  “Kim, come back!” Luke cried. What was happening? Maybe she hadn’t pulled the IV out in time and enough air had been injected to kill her? He snapped his head up to the monitor, but it was still disconnected and useless. “Oh, God, please, no.”

  A deep voice behind him startled him. “God’s got nothing to do with it.”

  Luke whipped around to see Dr. Katz standing behind him, wielding a large pipe wrench. Luke barely managed to put his hand up in time before the wrench came down hard on his head and everything swirled to black.

  CHAPTER FORTY-SIX

  TUESDAY, NOVEMBER 23, 12:58 A.M.

  Rob shut the water off, toweled off, and climbed out of the shower stall, his feet leaving water on the tile floor. He checked his phone on the counter—no messages. He dialed Gwen’s number again and got her voicemail.

  He checked his beeper out of habit—he wasn’t on call tonight. He was surprised to see 2126 911. This was the SICU number and the 911 meant stat. The time of the page was twelve minutes ago. Shit! Kim was in the SICU. He quickly wrapped the towel around his waist and dialed the SICU.

  “Hello, SICU,” came a breathless, shrill voice.

  “This is Dr. Gentry. I was stat paged.”

  “Dr. Gentry—all hell’s breaking loose down here. Didn’t you hear the red alert?”

  “I must’ve missed it. What’s going on?”

  “Somebody was shooting in Mrs. Daulton’s room.”

  “Shooting?” Rob blurted. “Yes.”

  “Is she okay?”

  “I think so. The police are here now. You’d better get down here.”

  “I’ll be right there.”

  Bad shit was going down out there and he still didn’t know where Gwen was. Rob hopped into fresh scrubs, almost slipping on the wet tile floor. He put his sneakers on, not bothering with socks, and made for the door, then paused. He scribbled a note and left it on the nightstand: Gwen, went to SICU. Call me if you get this note. I love you!!!

  Rob raced out of the call room so fast he bumped his elbow on the doorframe. As he ran toward SICU, he couldn’t shake the eerie feeling that the gun of fate w
as preparing to mete out its judgment tonight.

  There was a Derry Township police officer outside Kim’s door, stringing yellow crime scene tape. Curtains were drawn across the door, partially blocking the view inside. Rob could just make out Kim lying in the bed in the center of the room—she looked unharmed.

  “What happened here?” Rob asked the police officer. “I heard there were gunshots fired.”

  The bleary-eyed cop, whose badge identified him as Sergeant Markel, stared back at Rob without saying anything. He pulled a small dog-eared notebook from his back pocket and readied a pen. He cleared his throat. “And just who might you be, sir?” he inquired.

  “I’m Dr. Gentry.” Rob pointed at Kim. “This woman’s obstetrician. Here’s my ID.”

  The sergeant took Rob’s ID and studied it for what seemed like a long time. He then looked up to inspect Rob. Not impressed, he showed no sign of moving aside.

  “I need to examine her,” Rob said, not hiding his irritation. He started to walk around Markel; politeness and civility be damned.

  “Not so fast, Dr. Gentry.” Markel blocked Rob. “My orders are to let no one in this room—not even Jesus Christ. The room is a crime scene.” He pointed to the yellow tape for emphasis.

  Rob looked past the man and saw blood on the floor—lots of it. There were footprints in it and scuffle marks indicating a struggle. Kim looked to be asleep with the ventilator breathing for her. Her vital signs on the overhead monitor appeared normal.

  Rob sidestepped to see further around the rotund sergeant and gasped. Against the far wall, Nikolai, the hospital orderly, lay crumpled in a heap with what looked to be two gunshot wounds to his chest. On the floor in the corner of the room lay Jenna, the FBI agent/OB nurse. He couldn’t make out an obvious injury, but she was clearly dead. And she had this haunting look on her face.

  Rob reeled backward. What the hell was going on here? “What happened here? Where is Dr. Daulton, her husband?”

  “We have several officers combing the building, looking for the perp,” Markel said.

  “The perp?”

  “Husbands are always the number-one suspect,” he added, with a knowing, almost smug expression. “We just missed them.”

  “Them?”

  “Yeah, another fellow named Doctor…uh—” Markel consulted his notebook. “Katz. Katz was seen here with him. Perhaps the two are working together—you know, in cahoots.”

  So Katz was involved in this mess! Rob thought furiously while Markel droned on.

  “We responded as soon as we got the call about shots being fired in Obstetrics. More officers are on the way. The Derry Township SWAT team is mobilizing—you know, long arm of the law and all that. Don’t worry, we’ll catch ’em.”

  Rob had a sickening feeling that this thing would be over long before Derry Township’s finest got their act together. Homicides in sleepy little Hershey were rare. The urgent situation demanded action, but he wasn’t sure which way to turn. If Kim were conscious, she might have a clue what happened here. “I need to talk to my patient,” Rob insisted.

  One of the SICU nurses hovering nearby came to Markel’s defense. “She can’t talk right now. She became agitated and I had to sedate her.”

  “What happened?” Rob asked.

  “She was thrashing about violently when we came in—she even managed to pull her IV out,” she said. “I was afraid she might hurt herself, so I had no choice but to sedate her.”

  “Fine.” Rob tried to piece together the events of the evening, make some sense of it all. First, Seidle tries to murder Kim. Then an undercover FBI agent shoots him dead. Now the FBI agent’s dead and so is an OR orderly. Plus, he learned that Katz was involved. This thing stank to high heaven.

  Which brought him back to Luke. Where was Luke? He said he had to go to the OR to check on the senator. But instead, he showed up in the SICU. What was it Luke had said? Something about a puzzle and a crazy plot to kill the senator. Maybe it wasn’t so crazy. Rob recalled a story he had read in last year’s paper—about an anesthesiologist at Our Lady of Mercy Hospital in Lancaster getting mixed up in a murder plot in the OR. A couple of people were killed. His name was Landry, or something like that.

  But for Rob, the bigger question remained—where was Gwen? He needed to find her. Something had prevented her from coming to the call room. She had said she would be right up. Could she be mixed up in this craziness? What else had she said? She mentioned she had some weird story to tell him about the incinerator—whatever that meant. Rob ran his fingers through his wet hair. This much was clear—he couldn’t just stand here with Gwen and Luke unaccounted for, and a murderer running loose in the hospital. Things were happening quickly and he felt certain the local police would never sort them out fast enough. Time for action.

  CHAPTER FORTY-SEVEN

  TUESDAY, NOVEMBER 23, 1:10 A.M.

  FBI Special Agent Jared Smith walked silently up to the office door, gun drawn. His nerves were wired. What was it his boss had said? “Don’t let the small-town setting fool you—some bad shit’s going down at this hospital. Figure it out, okay? And Smith—don’t fuck up and get yourself killed.” Thanks for the pep talk, boss.

  Jared had been dispatched from the Harrisburg branch office just after midnight when Special Agent Jenna Steele had failed to call in. He hadn’t been thrilled to take the call, but he knew Jenna and this made it personal. They had started working at the Bureau at about the same time—Jared after fifteen years in the army, Jenna right out of nursing school. He didn’t think she graduated, but somehow had grown disenchanted and made a career change. She was young and bright—not bad looking, either. A bit too in your face for his tastes, but what the hell. The brass liked her and that’s what counted. She was headed for a promising career—her nursing skillset a bonus for the Bureau. He didn’t know the other agent, Benjamin Harris, but the word was, he was a complete computer geek.

  Unfortunately, Jenna’s cell phone had gone dark and so had Harris’s, making it difficult to pinpoint their locations. So the boys down at IT had triangulated on the cell phone signal that was the origin of Harris’s computer distress call. This led Jared to the Anesthesia billing office, which was deserted. So Jared proceeded to the next logical place.

  The sign on the door read Chief of Anesthesia: Dr. Jason Katz. Jared tried the handle—it was unlocked. He took a deep breath, flung open the door, and burst into the room, finger poised on the trigger.

  Holy shit! A woman lay crumpled on the floor in a pool of blood.

  After checking to make sure the room was clear, he rushed to her. At first he thought she was dead, but up close, he saw she was breathing very shallowly. He checked her pulse—weak. He rolled her onto her back and ripped open her blouse. He recoiled at the jagged abdominal wound, probably knife-inflicted. The woman had lost a lot of blood—a whole lot of blood!

  Jared had been a corpsman in the Gulf War so was familiar with battlefield trauma. The fact that she was still alive after receiving no treatment was a good sign. It meant she was unlikely to have suffered a penetrating heart or lung wound, or major blood vessel transection, as these would have killed her in minutes. He believed they could save her, but they needed to get her to an OR immediately. Jared radioed for help.

  The woman was moving her lips. Although her eyes remained shut and she was probably delusional with shock, she was trying to say something. Jared bent down close to her face. She was very beautiful, even under these circumstances. He also caught a whiff of her perfume. She was whispering something—repeating something over and over: “Rob, I love you.”

  CHAPTER FORTY-EIGHT

  TUESDAY, NOVEMBER 23, 1:12 A.M.

  Tucked in a little-used hallway between the SICU and the OR was the freight elevator. As far as he knew, this elevator was the most direct route to the basement. Rob hopped on the dingy car, which smelled musty and was clearly not intended for public use. Hoping the thing was still functional, Rob pushed B. The old elevator lurched and groun
d noisily into its descent.

  Rob noticed droplets of fluid on the cracked linoleum floor of the elevator. He crouched down to take a closer look. Was it blood? It was hard to tell in the dim yellow light thrown off by the single bulb recessed in the ceiling. The elevator reached the bottom with an alarming jolt, and the door opened hesitantly amidst more loud grinding noises. He was glad to get off the thing.

  Out in the better-lit hallway, he saw more red droplets on the floor. No question about it now, it was blood. Not a lot of blood, just enough to leave a few drops every few feet. His heartbeat accelerated as he followed the blood trail. The hallway cut through the center of the laundry complex. The air was warmer here and more humid. Laundry carts were parked along the wall and the smell of institutional detergent and bleach hung heavily in the close air. The trail of blood led Rob through the laundry to a door at the end of the hall. An orange glow emanated from its small window. The incinerator room.

  Rob’s heart began to pound and his throat went dry, as a deep sense of foreboding gripped him. He approached the door and peered through the grime-streaked window. What he saw made his blood run cold. Dr. Katz was pushing a wheeled cart toward the furnace—and there was a body on the cart. And the large grated door to the furnace was wide open.

  Rob ripped open the heavy door and screamed at Katz, “What are you doing? Are you crazy?” He wasn’t even sure Katz could hear him above the roar of the furnace.

  Katz spun to face Rob. “Get away! You can’t stop me!”

  “The hell I can’t!” Rob shouted back. He ran over and jumped between the cart and the furnace, glancing down at the body on the cart—Luke. He had a wicked gash and a large goose egg on the side of his head. Rob immediately bent over and shook him, hoping for any sign of life. Luke moaned.

  Katz rammed him from the side, knocking him away from the cart—both men went down hard. The two men grappled on the dirty floor, all the while moving closer to the grated door of the furnace.