by Jaime Maddox
“Absolutely. Your place or mine?”
“We need privacy. Should I come up?”
Sixty seconds later, after telling the smirking ER clerk she’d be in Abby’s office, Ward walked through the door.
“He’s murdering people, Ab. I know it. There was another venous air embolus,” she said as she paced the room.
“Where? When?” Abby asked, breathing deeply and folding her hands that seemed to be shaking. Her skin seemed to pale before Ward’s eyes.
Ward gave her the details.
“And there’s no chance this is coincidence?”
Ward shook her head. She stopped wearing out Abby’s carpet, but instead of sitting, she stood, leaning against the bathroom door and closing her eyes against the light.
“He was here in January, too.”
“Huh?” Ward asked as she opened her eyes and stared at Abby.
“Hawk. He was the emergency replacement for Dick when he got sick. He was only here for three weeks, but do you know there were six deaths in January? It was a little high, but nothing that raised suspicions. Not at the time, anyway.”
“Can we look at those charts?”
Abby nodded. “Of course, they were already reviewed, but in light of current events, I thought another look was warranted. I had the list pulled this morning and e-mailed it to medical records. Someone’s going to get me the causes of death and attending docs.”
“When will you have it?”
Without replying, Abby turned her attention to the screen on her laptop, perched on her desk. Her fingers flew across the keys and Ward saw her smile. “It’s ready,” she said as she typed away. An instant later, the printer beside Ward came to life and spit out a sheet of paper.
Abby stayed seated as Ward reached for the paper and scanned the document.
“January ER summary of causes of death by attending physician. Number one—January first, Marion Jones, MI, Dr. Rove. Number two—January fifth, John Fitzgerald, CHF, Dr. Litzi. January fifteenth, Stella Miles, MI, Dr Farley. January twenty-first, James Dutton, heroine overdose, Dr. Hawk. January twenty-fourth, Valerie Vincent, MI, Dr. Farley. January twenty-ninth.” Ward stopped speaking, looked at Abby, and closed her eyes again. It was hard to breathe. She was dizzy. This was really happening.
“What?”
“Benjamin Moss. Dr. Hawk.”
She felt Abby’s hand on hers pulling the paper from her shaking fingers. She opened her eyes just as Abby began scanning the document. “Venous air embolus,” Ward said softly.
Abby was silent as she walked to the leather couch against the wall adjacent to her desk. Ward followed and sat beside her, numb.
“So what should we do?”
When their eyes met, Abby’s looked confused. Ward could understand that. Abby’s parents were both physicians, healers. She’d grown up at this hospital, knew all the great men and a few women who’d practiced medicine here since her childhood. Most of them did an outstanding job, and even the ones who weren’t stellar clinicians at least had their hearts in the right place. Ward had spent more time in the city than Abby had, and she knew that careless, reckless, even malicious physicians existed, but she’d never known anyone like this. She’d never even heard of anyone like Hawk. She thought for a moment, pushing the numbness from her neurons, and remembered what the state board’s Web site had said.
“The state board suggests calling the police. And obviously reporting him to the state board.” She laughed halfheartedly and frowned.
“Ward, I’m going to ask you again. Are you sure about this? Because once I call the police, I can’t take these accusations back. If we’re wrong, I’m setting the hospital up for the slander claim of the millennium.”
“Well, I wouldn’t want you to go out on a limb here, Ab. Just because people are dying.”
Abby turned her head and glared at her. “I don’t believe that attitude is necessary. I’m just trying to come up with a solution, the same as you.”
Ward closed her eyes again and pinched the bridge of her nose. Abby was right, of course. They were in this together, and in their solidarity they’d find the solution.
“Abby, I know he murdered those people. I know it. But can I prove it? No, I can’t. There’s just a tremendous amount of circumstantial evidence pointing at Hawk. From an ethical standpoint, we have no choice but to report him. As long as we stay professional and keep this to ourselves, perhaps we can spare the hospital a lawsuit. We just hand over our information to the police and let them investigate. Ditto for the state board. What else can we do?”
Abby bit her lip. “I guess we can do that. But how long will it take the police? If he’s murdering people, shouldn’t we do something more to stop him?”
Ward stared out the window. Abby really had a magnificent view. The sun was out today, shining in a bright-blue sky over the Endless Mountains beyond the town. It was picture perfect, this scene. How could she look upon such beauty while discussing murder?
“I don’t know what else to do, Ab—”
Someone knocked at the door, and Ward turned in that direction. Abby’s secretary stood in the doorway, her hand poised to knock again.
“I’m sorry to interrupt you, Ms. Rosen. Dr. Thrasher is needed in the ER.”
“Thanks,” Abby said.
“Thank you,” Ward added.
Their eyes met and Abby’s seemed to pierce hers. Her voice was soft when she spoke. “I’ll call the police. The chief is a friend of mine. He should be able to give me some guidance.” Abby stood and pulled Ward to her feet, into her arms. She hugged her tightly. Nothing had ever felt so good as Abby did right now. She wished she could take her home, crawl into bed again, and wake up to find she’d dreamt all this nonsense. She knew better, though. “What about the state board?” Ward asked.
“I’ll call them, too. The least they can do is evaluate his competence. Perhaps they can prohibit Dr. Hawk from inserting central lines.”
Abby’s tone was teasing, and Ward felt a welcome sense of relief, as if this was going to be all right. How, she hadn’t a clue. But Abby just made her feel that way.
A minute later she was back on solid ground, in the comfortable chaos of the ER. A motor-vehicle accident had summoned her, and seven victims from two cars were being escorted through the department on stretchers and in wheelchairs. It was an hour before Ward even had an opportunity to think of Edward Hawk again.
Everyone’s injuries had been minor, but one patient had suffered a significant laceration to the thigh, and as soon as all the paperwork was complete to release the other six, she went about the business of stitching.
Within moments she felt calm, the concentration needed to sort out the planes of tissue and plan the repair essentially shutting everything else from her mind. Once she knew where layers of fascia, fat, and skin were supposed to go, she inserted the needle into its holder and drove it home. One well-placed stitch told her the wound would close easily, and after a few more passes of suture through flesh, the actions became so routine her mind began to wander.
Abby’s words came back to her. Could they do something else to stop Hawk? She had virtually no knowledge of police work, but investigations seemed to be time-eating monsters that often disappeared back into the forest before any real progress was made. That happened when real, certain homicide victims existed. In this case, murder was just speculation. How hard would the police pursue this case when they weren’t even sure there was one?
In the meantime, Hawk would keep killing. Where was he now? Wherever he was practicing, patients were going to die, from bizarre diagnoses that should never be written on death certificates. It was so frustrating to think she had no proof, no weapon with which to stop him.
Or did she? The medical community in the mountains was relatively small, and while she might not know the ER directors at every hospital, she knew enough of them to be able to talk about this. People like Erin, nurses who worked with Hawk, suspected him of wrongdoing. Paramedics w
ere uneasy around him. How much would it take to cause an ER director to show Hawk the door? Especially if they’d developed their own suspicions. She would have to work quietly, of course. If Hawk got wind of it, she would be signing over the house, the car, and the kayaks before his lawyers were done with her. But if she could keep the campaign very informal, off the record, perhaps she could convince someone to put Hawk out of work until the state board and the local police had a chance to investigate. Perhaps it would only take a week or two for them to complete their investigations, and then Hawk might be grounded for good.
Hopefully, he was still somewhere in the mountains. Ward felt pretty confident she could reach out to one of the small, local directors. If he’d headed to a big city, where no one knew her, or Erin, or Abby, they’d likely just dismiss her for lunacy.
How to find out? She’d met Hawk only once, even though she’d been following him for nearly five months. Did he keep in touch with the nurses? She doubted it. Nothing was endearing about the man. The nurses were happy to see him go and not likely to take his number when he did. Would Abby have it? Was he required to leave contact information in the event a chart needed a signature or something? No. Abby would just contact the…of course! The locum tenens company would know his present location. Just how would she convince them to share that information with her?
With the task of suturing nearly complete, she returned her full attention to her patient. Other than a coating of blood that seemed baked onto his skin, the leg looked great. She gave him verbal instructions and told him she’d write them down as well, pulled off her surgical gown and gloves, and headed back to the nurses’ station.
“You’re only seven patients behind, Dr. Thrasher. It could be worse.”
Ward chuckled. “It could always be worse, so don’t jinx me.”
After completing the instructions, Ward chose the most critically ill patient and got busy. After another three hours, sans lunch, she had a break in the action. As she sat at her computer, hastily consuming a hospital-grade turkey sandwich, the unit clerk told her Abby was on hold for her. “You certainly earn your paycheck, Dr. Thrasher. What’s that, fifteen patients and you’re only halfway through the day?”
Abby could track the ER and OR schedules from her computer, and although it might have seemed like spying to some, Ward understood it was just another way for Abby to keep a handle on everything happening in the hospital. It was her job.
“I think it’s seventeen, but who’s counting?”
“Well, I know you must have a dozen charts calling your name, so I won’t hold you up. I just wanted to update you. I called the state and they will review the cases. And the police chief just stopped in. He’ll look into it.”
“Humph.”
Abby whistled out her sigh. “Our hands are tied, Ward. We have to let these people do their jobs. We’ve done ours—you’ve done great work, far beyond what anyone could have expected. You’re responsible for bringing this guy to the attention of the police and the state board. You. But now you have to be patient.”
“While he kills someone else?”
Abby didn’t answer for a moment. “What would you like to do? ’Cuz if you have a brilliant idea, I’m all ears.”
“Maybe I do.”
Ward shared her thoughts about contacting the local hospitals to warn them about Hawk.
“I’ll call the locums agency right now,” Abby said.
“Don’t you think I should call? After all, I work for them. They’d probably be more forthcoming with me.”
“Hmm. I don’t know. I can always say something like I need him for a peer review or to sign incomplete charts. I can ask if he’s close by, so he can come back to the hospital, rather than having to mail confidential documents. What would your approach be?”
“I didn’t get that far,” she admitted.
“Well, then let me call them. But you should start working on Plan B.”
“’Kay. Keep me posted.”
“Will do.”
Ward kept busy with charts and patients while Abby conducted her inquiry. She hurried to the phone an hour later when the clerk told her Abby was on the line. “That was fast,” she said by way of greeting.
“And I have good news. I found him.”
Ward was surprised. In the era of patient confidentiality, she would have hoped the locums company would have guarded employee privacy a little more carefully. “You’re amazing. What’d you say to them?”
“I just said I needed for him to sign some confidential papers and asked if he was in the vicinity.”
Ward couldn’t help smiling. What a relief. Hopefully they could warn their friends and colleagues about their suspicions. The authorities might not be able to stop him, but maybe she and Abby could.
“So where is he?” she asked when Abby stopped talking.
“Close, actually. He’s about forty-five minutes away, at a little hospital in Garden.”
Chapter Twenty-six
Post Mortem
“C’mon, Jess, answer the phone.”
It was the third time Ward had made that request in the ten minutes since she’d disconnected her call to Abby. First, she’d dialed the ER. It seemed Jess spent most of her time there. The clerk had told her Jess wasn’t working but had been kind enough to tell Ward she was expected at seven. It was nearly four, and if she was working the night shift, she would be waking soon. She hadn’t answered her cell, though, and Ward didn’t have time to sit there pressing redial all day. A patient had been waiting when she’d left the ER for the privacy of the physicians’ lounge, and at four in the afternoon, more like him would soon be piling in. If she didn’t get to talk to Jess now, she might not have a chance until midnight, when the ER in Garden slowed down. She didn’t want to wait that long.
“Hello.”
Ward nearly collapsed in relief. “Hey, can you talk?”
“Sure, just give me a minute. I just got out of the shower. I work tonight.”
Ward paced the lounge while awaiting Jess’s return.
“I’m back,” she said after an eternity.
“Jess, you have a huge problem. Edward Hawk.”
“What about Hawk?”
Ward detected the edge to Jess’s voice that she’d noticed so often lately. It seemed so long ago that she could have made the same statement and a receptive Jess would have been concerned. The defensive Jess just sounded…defensive.
“He’s murdering people. His patients.”
The laughter preceding Jess’s response was a response in itself. “Are you drinking?”
The barb stung, mostly because Jess knew how much it would. Ward swallowed a retort that might further the argument. She needed Jess on her side, and she couldn’t risk alienating her.
“Plenty of water, Jess. I’m totally serious about Hawk. A little kid here with a femur fracture died of a venous air embolus after Hawk put in a central line. The chances of that are slim to none. Another patient—”
“That should be on the consent form. One of the complications of central lines is venous air embolus. It’s expected.”
Ward chuckled. “Sure, Jess. We tell people all that stuff so they don’t sue us when there’s a complication, but have you ever seen it?”
“That doesn’t mean the guy’s a murderer. I’ve been watching him for the past few weeks and he seems quite capable.”
“I’m not arguing his abilities, Jess. But have you asked the staff about him? He’s creepy. And his patients die, for no reason. Stable patients just crash and die when he’s around.”
“I’m sure there’s an explanation. I mean, femur fractures bleed. The kid probably lost a lot of blood.”
“They did an autopsy and found air in the girl’s heart. Her hemoglobin was low, but not deadly low. It wasn’t blood loss.”
“Well, that doesn’t mean it was intentional. As I said, air embolus is an accepted complication of the procedure.”
“You have to put in twelve thousand li
nes to have a fatal complication. What are the chances of it happening three times?”
“Three?”
“Yeah. There was one in January, and another one, in March.”
“You didn’t say there were three.”
“You interrupted me.”
Ward heard Jess sigh into the phone. “It doesn’t matter. One, two, three, who cares? It doesn’t mean the guy is murdering people. Maybe he just sucks at lines.”
“Seriously? If one of your patients died after you inserted a line, would you let that happen again? I mean, you have to ask yourself, why and how and what I should do differently next time. You don’t let something that happens once every thousand years happen three times in six months.”
“Maybe. But maybe he didn’t know the cause of death. I don’t know, Ward. It’s just a completely illogical conclusion to jump to.”
“There’s more. Two other patients, both of them diabetic, mysteriously died in the ER. Both were ready for discharge, waiting for rides, when they were found dead in their exam rooms. Both were Hawk’s patients. And another one was found dead, but had no autopsy to say why. Hawk had more deaths in two months at the hospital than the others had in an entire year.” That was an exaggeration, but it was close enough to the truth that Ward didn’t regret the words.
“Are you listening to yourself? You sound paranoid, like one of the patients from the hood we used to treat in Philly.”
She heard Jess’s tone and wanted to scream. Jess was quiet and calm, as if she were talking to someone irrational. On the other hand, Ward was loud. The psychology was infuriating.
“I’m not paranoid, Jess, and I’m not the only one who’s concerned about Hawk. I just thought since I know you, I’d call. I thought I might get further than with a complete stranger, but I guess I was wrong.”
“Is this an attempt to get me back? If you can get Hawk into some trouble maybe I’ll think you’re a hero or something?” If Jess’s words weren’t enough to push Ward over the edge, the condescending tone certainly was.
“Fuck you, Jess. Just. Fuck. You.”