Royal Pains : Sick Rich (9781101559536)

by Lyle, D. P.

  “Anyone else?”

  “Not that I know.”

  “Any disease in your family? Diabetes or anything like that?”

  “My dad does have sickle cell, but it doesn’t really bother him. As far as I know. I don’t see him very often either.”

  “Sickle cell?” Divya said. “Has Patrick ever been tested for that?”

  She shook her head. “You heard him. He don’t like doctors. I’m amazed he agreed to come see you.”

  “Dr. Hank is cool,” Patrick said. “And funny.”

  Coming from Patrick that was quite an endorsement. I was glad Evan wasn’t here. He’d try to turn it into an ad campaign.

  “I want to draw some blood,” I said. “Then Divya will do an X-ray and ultrasound of your abdomen.”

  “I’m not going to no hospital,” Patrick said.

  “You don’t have to. We can do them right here. Just take a minute to set it up.”

  “Cool.”

  I drew the blood and while Divya took the X-rays, I carried the blood sample out to the van, where I made slides, stained them, and looked at them through our digital microscope.

  Bingo. The diagnosis jumped right out at me.

  Sickle-cell anemia is an odd disease. It’s genetic and tends to run in families of African origin. The defect is with the hemoglobin, the oxygen-carrying molecule in the red blood cells. It’s abnormal in this disease and the abnormality causes the red blood cells to take on a sickle appearance. They look like little half-moons. That’s exactly what I saw on Patrick’s blood smear.

  These abnormal cells might look like innocent little smiley faces under the microscope, but they can be extremely treacherous. Their shape causes them to snag and clump and pile up in small blood vessels, slowing or blocking blood flow. This can lead to joint and muscle pain. Red blood cells, as part of their normal life cycle, are filtered through the spleen. Sickle cells can sludge in the spleen’s intricate network of blood vessels and cause damage, even a rupture, of this delicate organ.

  That was what was going on with Patrick.

  By the time I returned to the booth, Divya had completed the X-rays and the ultrasound and loaded the digital images onto her laptop. I examined them. Everything appeared normal except that the spleen was slightly enlarged.

  I told Patrick and his mother what I had found on his blood smear.

  “What does this mean?”

  “That your grandfather, through your mother, and maybe your father, passed this along to you. That you inherited the same disease they have.”

  “That’s what’s causing all this pain?” Rochelle asked.

  “Absolutely.” I went on to explain what was happening inside Patrick’s body. “The major problem here is the pain in your abdomen. The spleen is involved and that’s a potentially dangerous situation.”

  “I don’t like the sound of that,” Patrick said.

  “Remember earlier when I said you didn’t have to go to the hospital?”

  “Yeah.”

  “I lied.”

  His eyes widened.

  “Not exactly lied, since I didn’t know what we were dealing with then. Now I do. I’m afraid you’ll have to get over to Hamptons Heritage.”

  “No way.” Patrick looked at his mother. “Tell him I’m a quick healer. I can fix this at home.”

  “You sure the hospital is necessary?” Rochelle asked.

  “I’m afraid so. The treatment for this is bed rest, IV fluids, and pain medications while we evaluate his spleen more thoroughly. It’s possible that it might have to be removed.”

  “Are you talking about an operation?” Patrick said. “No way. I’m not going to have anyone cut on me.”

  “You might not have a choice. But let’s not go too far down that road until we get you over to Hamptons Heritage and see how everything goes.”

  “Come on, dude. Do I really have to?”

  “Afraid so. Trust me, you don’t want to deal with a ruptured spleen. If you think it hurts now wait until that happens. Not to mention it could kill you.”

  Patrick rolled his huge eyes. “I’m starting not to like you so much.”

  “Now my feelings are hurt.”

  “Not as much as my spleen, or whatever you call that thing in there.”

  Chapter 23

  Divya and I watched the medics pull away and disappear through the exit gate.

  “That young man is something else,” Divya said.

  “Twelve going on thirty-five. I get the feeling his mother is overmatched.”

  “True. But they seem to have a good relationship.”

  “Not to mention that Patrick seems focused on school and sports and not drugs like the other kids we’ve seen.”

  You know the old admonition that if you think something or, worse, say it out loud, it will happen? It’s hocus-pocus to me, but some people believe it. Sort of like the movie Beetlejuice. If you said his name three times, he would appear and chaos would follow. Same thing here except that I mentioned kids and drugs once and three showed up.

  Just like that.

  As if I had summoned them or something.

  The three teens—one boy, two girls—were hammered. No doubt. A diagnosis anyone could make from across the room. One, a girl with short black hair and glassy eyes, severely so. The other two were helping her into the booth.

  “Are you the doctor?” the boy asked.

  “I’m Dr. Lawson,” I said as I helped the girl onto the exam table. “What’s the matter?”

  “I don’t know,” the other girl said. She had red hair, pale freckled skin, the beginnings of a sunburn on her exposed shoulders, and glazed blue eyes.

  “What’s your name?” I asked the girl sitting before me.

  She stared back.

  “It’s Alaina,” the boy said. “I’m Cory and this is my sister, Carrie,” he said, indicating the redhead.

  “What’s the problem?” Divya asked. She began wrapping the blood pressure cuff around Alaina’s arm. The girl sat quietly but watched Divya’s every move as if she couldn’t quite grasp what was happening.

  “I don’t know,” Carrie said. “She’s acting all weird.”

  “Weird?”

  “You know. Like out of it. I mean like I’m not sure she knows who we are.”

  “What did she take?”

  Carrie’s gaze left mine and jumped to her brother as if hoping he had an answer. He obviously didn’t.

  “Nothing,” Carrie said.

  “BP is one-fifty over one hundred. Pulse one-thirty-five,” Divya said.

  My exam showed that Alaina had dilated pupils that were poorly reactive and hyperactive reflexes. Just like the other kids we had seen.

  I turned to the brother and sister team. “‘Nothing’ isn’t going to work here. What did you guys take?”

  They looked at each other but said nothing.

  “Alaina is intoxicated. We’re going to send her over to Hamptons Heritage.”

  “No—,” Carrie began.

  I stopped her by extending my palm toward her. “Yes. And once she’s there they’ll draw some blood, test it, and we’ll know what she took. But the sooner we know, the quicker we can help her. She could be in danger. Her blood pressure is high and her heart is galloping. So, what did you guys take?”

  Both stared at the floor.

  “Do you want something really bad to happen to her?”

  Now they looked at me and then each other, but neither said a word.

  What is with these kids? Not just these three, but the ones we had seen over the past two days. Even Kevin Moxley. Okay, I understand not confessing your sins, but these two were worried enough to drag Alaina in here, fear etched on their faces, yet they refused to
talk.

  “Really? That’s it? You bring her here and then refuse to tell me what’s going on?”

  Cory shoved his hands into the pockets of his shorts and rolled one sneaker up on its side, but that’s all I got.

  “She’s your friend. Right?”

  Nothing. I did notice Carrie’s lower lip tremble.

  “I’ll ask again . . .”

  From the edge of my visual field I saw Alaina sway. I turned just as her eyes rolled back and she went limp, falling forward. I managed to grab her, her head lolling against my shoulder. I laid her back on the exam table and checked her carotid pulses. Very fast, very faint.

  “Alaina?” I shook her shoulders.

  No response. Divya began hooking up our portable cardiac monitor while I listened to her lungs. At least she was still breathing, even if in a shallow and erratic manner.

  The monitor popped to life as Divya fastened the final lead into place.

  “V-tach,” I said. “One hundred milligrams of Lidocaine.”

  While Divya drew the Lido into a syringe, I started an IV, frequently monitoring Alaina’s wrist pulse in the process. If she lost her pulse or stopped breathing, we’d have to begin CPR.

  As I taped the IV into place, I looked at Cory. He and his sister were wide-eyed and openmouthed as they watched.

  “See the medics over there?” I asked Cory.

  He stared at Alaina, unmoving, as if he hadn’t heard me.

  “Cory, look at me.” He did. “The medics are directly across from us. Run over there and tell them to get over here.” He stood as if embedded in the ground. “Cory, do it now.”

  That seemed to snap him back to reality. He turned and ran a straight line toward the medic station.

  “Here you go,” Divya said, handing me the syringe.

  I injected the Lido and waited a minute, watching the monitor. No change in her rhythm.

  “Let’s hook up the defibrillator.”

  While Divya attached the defib patches, I drew up another hundred milligrams of Lido and gave it. Her V-tach ignored it and stubbornly remained at a rate of around one-ninety.

  “Okay,” I said, “let’s zap her. We’ll start with two hundred watt-seconds.”

  Divya hit the CHARGE button and the defibrillator whined as its capacitor charged. Once it finished, Divya said, “Ready.”

  “Do it.”

  “Clear,” Divya said and then pressed the red button, delivering the charge.

  Alaina twitched, recoiled, and moaned. The charge spiked the EKG monitor for a second and then her rhythm reappeared. “Sinus tachycardia about one-ten.”

  “Good. It worked.”

  Alaina began to come around, trying to talk and sit up. This confused state after a period of very low blood pressure and after an electric shock is not unusual. I held her down.

  “Alaina?” I said.

  Her eyes fluttered open but didn’t focus.

  “Alaina?” I repeated.

  Her gaze landed on me and her eyes fought to focus. She appeared confused and disoriented.

  “Don’t move. You’re okay.”

  The medic van pulled up, followed by Cory, who was gasping from his run back and forth across the field. Two medics climbed out.

  It took a few minutes for me to explain to them what had happened, after which they loaded Alaina into the back and drove away, lights flashing, siren attracting attention and moving people out of the way.

  I returned my attention to Cory and Carrie. Both appeared pale, eyes still wide.

  “Do you know Alaina’s home number?”

  “I do,” Carrie said. She rattled off the number.

  Divya flipped open her cell and dialed the number. While she told Alaina’s mother what had happened and that her daughter was on the way to Hamptons Heritage, I leaned on Cory and Carrie.

  “See what I mean by something bad happening?”

  “What was that?” Cory asked. “What happened to her?”

  “The drug she took made her heart go haywire. Nearly killed her. If she hadn’t been here it probably would have.”

  I saw tears collect in Carrie’s eyes.

  “So, I’ll ask again . . . where did you get the drugs?”

  “They’re not drugs,” Carrie said. “Not really. They’re just harmless natural pills.”

  “Did what just happened with Alaina seem harmless or natural to you?”

  “No.”

  “Let me take a wild guess,” I said. “Someone here sold you some pretty pink pills. You each took one and at first it seemed cool. Fun. But then Alaina got freaky and you freaked out. Close?”

  Cory nodded.

  “See, that was easy.”

  “She actually took three of them,” Cory said and then glanced at his sister. “We only took one, but Alaina took three. We told her not to.”

  “Who’d you buy them from?”

  “Some random dude,” Cory said.

  “Someone you don’t know? Never seen before?”

  “That’s right. Some guy we don’t know.”

  He would have been convincing except that his gaze kept dropping toward the ground and a small twitch appeared at the corner of his left eye.

  “Hank?”

  I looked up. It was Jill. Behind her stood McCutcheon, Hyatt, and a guy who I assumed was Billy Presley. A thin, wiry kid with shaggy hair, blue shorts, an oversized white T-shirt, and eyes dilated with fear. And maybe drugs. Probably the stuff he was selling.

  Cory’s entire demeanor changed. His eyes widened and then he began looking around as if searching for an escape route.

  Bingo.

  “Is that the guy you don’t know?” I said. “The random dude?”

  McCutcheon stepped forward. “What’s going on?”

  “Three more customers, I think. Unfortunately one of them nearly died and is now on the way to Hamptons Heritage.”

  Billy’s eyes jerked wide open and he started to say something, but McCutcheon rested a hand on his shoulder and gave it a squeeze. Billy got the hint and fell silent. McCutcheon then looked down at Cory. “I’m Sergeant McCutcheon. Did you buy drugs from Billy here?” Cory hesitated. “You do understand that lying to a police officer is serious business, don’t you?”

  Cory nodded.

  “Yes,” Carrie said. “We got them from Billy.”

  All eyes turned toward Billy, who now had that deer-in-the-headlights look.

  McCutcheon nodded. “Seems Billy’s been selling for our mysterious couple. That’s why we haven’t seen them around.”

  “Actually,” I said, “Evan saw them a little while ago. Over among the booths on the other side. He tried to follow them, but they slipped away.”

  “So they’re still here somewhere,” McCutcheon said, more a statement than a question.

  “They were then. Who knows about now. Evan might have spooked them.”

  “Their van is in the lot. They aren’t,” McCutcheon said. “I’ve got a couple of guys watching it.”

  “Maybe they’ll return to it,” I said.

  “Maybe. We were thinking they might have abandoned it. Maybe found out we were here undercover and split. Afraid to go back to the van. But if Evan saw them maybe they’re still around. Maybe they’ll get stupid and we’ll get lucky.”

  “Is that where you picked up the pills?” I asked Billy. “At the van?”

  He nodded.

  “When?”

  “A couple of hours ago.”

  “Do you know them?” I asked.

  “Not really.”

  “Just enough to do their dirty work? Is that it?”

  He shrugged.

  “Names? Do you know their names?”

 
“All I know is Pete and Erin.” He glanced up at McCutcheon. “I swear that’s all I know.”

  “Have you sold for them before?” I asked.

  He shook his head.

  “Just today?”

  He nodded.

  “How’d they pick you?”

  He stared at me.

  “I mean, there are a lot of high school kids around here. Why’d they pick you?”

  “I bought some stuff from them. Earlier today. I gave some to a friend of mine.”

  “That would be Jessica Michaels,” McCutcheon said.

  I nodded. “She’s pretty messed up. And she’s in the hospital.”

  “What?” Billy said. “The hospital? Her, too?”

  “You see, Billy,” I said, “that makes two people this stuff you’re passing around has harmed enough that they require a visit to the hospital.”

  Tears gathered in Billy’s eyes. “They said it was safe. Just fun.”

  “It’s not. So again, why did they pick you?”

  “When I went back to their van and asked for some more they jacked the price. From five dollars a pill to ten. I told them I couldn’t pay that, so they said there was a way I could earn some for free.”

  “Sell it to your friends?”

  He nodded. “I didn’t know.”

  “How many did you sell?”

  “A couple of dozen.”

  “Pills or people?” I asked.

  “People. Maybe twice or three times that many pills. Most wanted two or three.”

  “And when you ran low you what? Went back by the van and got some more?”

  “And gave them the money.”

  “And they paid you?”

  “With pills. For every five I sold they gave me one to sell or use myself.” He kicked at the ground. “I sold them all.”

  “When did you see them at the van last?”

  “An hour or more ago. The last time I went by it was locked up and they weren’t there.”

  “Van’s registered to a Peter Anders,” McCutcheon said. “We got the word out. Already had someone knock on his door. Not home. But we know who we’re looking for now, so it’s just a matter of time.”