by CJ Lyons
Most of the recent records were computerized, but there still existed hard copy backups. Cassie liked being able to look at the complete chart instead of one page at a time on the computer. Especially at times like this when she had no idea what she was actually looking for.
She stumbled as she crossed the entrance, her coordination hampered by a lack of sleep. A perpetual problem ever since what happened two months ago. Last night Cassie had almost been tempted to take a few of the Percocet her orthopod had prescribed and which still sat un-opened in her medicine cabinet.
Every time she did fall asleep, each groan and creak of her old house transformed into a killer's footsteps. A killer waiting to pounce on her, beat her unconscious, drug her, leaving her helpless to warn Drake as he walked into an ambush.
Ed and Adeena had hired a cleaning company that specialized in crime scenes to deal with the mess left in the wake of the killer's attack. It had taken days to scrub her oak floors clean of the dried blood, to clear the air of its stench, to vacuum and erase all the fingerprint dust and Luminol.
The worst had been finding the blackened, wilted and crushed remains of the roses Drake had brought her that night–only to confront a killer in her living room instead.
She yawned, covering it with the back of her hand. Last night had been particularly bad, the now-familiar scenes of that night six weeks ago mingled with Charlie's resuscitation yesterday. In the end it had been Drake staring up at her from the gurney, his blood covering Cassie's hands as his life slipped away.
There was only one clerk this early in the morning, and he seemed less than thrilled to be working, favoring her with a glare designed to send lesser beings skittering away to seek comfort above ground. Cassie met his gaze, undaunted. After the hell she'd been through, the dour-faced, pasty-skinned denizens of medical records failed to intimidate.
She wrote down George Ulrich's name and date of birth on the request slip and handed it to the clerk. The paper crackled between his fingers as if his touch might set it on fire.
"No medical record number?" the clerk asked in an annoyed tone as dry as the paper he handled.
"I don't have it."
He sighed, rolled his eyes, and punched the information into the computer. "Why didn't you tell me the patient was expired?" he snapped. "It'll be a minute. Wait here." He rose and left the desk, disappearing into the shadowy stacks of musty medical charts.
He returned in a few minutes and dumped three thick volumes onto the counter, releasing a small wave of dust. Cassie took them over to one of the dictation cubicles that lined the room.
The manila covers were printed with Charlie's older brother's name, date of birth, medical record number and the Three Rivers logo as well as a confidentiality disclosure. Overtop of all the printing was stamped in large red letters the word "Expired".
Expired. Medical records term for dead. Cassie hated it. It made the often messy process of death seem sterile and uncomplicated. What was wrong with good old-fashioned dying? Why was everyone so frightened by the word? After all, it was something that happened to them all, no avoiding it.
If anyone knew that, it was Cassie. She closed her eyes briefly, willing the image of Drake, covered in his own blood, away from her mind. It was painfully obvious that something she'd done was keeping him at a distance. If she just knew what it was, she could fix it...
She pulled her attention back to the chart before her and the lost child whose story it told.
George's chart was thick for someone who died at such a young age. Cassie thumbed through the indexed tabs and counted nine admissions and at least twice as many ER visits interspersed with clinic notes.
She grabbed a piece of the ubiquitous hospital notepaper and started on the first volume. George's birth was unremarkable. Full-term, no complications. But things quickly changed. His first ER visit was at three weeks of age for a blue spell. He was admitted and evaluated for possible sepsis as well as cardiac problems, but no cause was ever found.
It was then that Karl Sterling got involved. He invited the Ulrichs to participate in a study of children with "near miss SIDS" or Apparent Life Threatening Events. He would provide free care and a monitor for George. The parents were both in trained in CPR as well as the monitor use, and George went home after a week in the hospital.
The very next day Virginia Ulrich brought him back into the ER for another blue spell. She reported giving the baby CPR for several minutes before he responded. He was admitted again.
And so it went.
By the time he was a year old, George had spent more time in the hospital than out of it. Nursing assessments and social work notes described Virginia as a devoted, concerned, intelligent mother who would do anything to make her baby healthy.
George stopped growing and a feeding tube was placed. Then he developed an intolerance to his feeds and experienced such profuse diarrhea that a central line was inserted near his heart so that he could receive nutrition intravenously. The IV became infected, he was treated, it again became infected, he was treated a second time and evaluated for an immunodeficiency.
It was during this admission that a nurse named Sheila Kaminsky documented that she'd found Virginia Ulrich holding George with his IV line open, dripping blood.
Virginia claimed that it had come loose when her husband had placed George into her arms, but Kaminsky reported her suspicions to Children and Youth.
Notes from the correspondence section of the chart documented Karl Sterling's rabid defense of Virginia. Then came a notation that Children and Youth, after an exhaustive investigation, had found no evidence of abuse or neglect.
Cassie skimmed through George's next admission, this time for breathing problems, and found a medication mishap form. George had apparently received more than ten times the dose of potassium in his IV fluids. A nurse who prepared the bag of fluid was blamed. She raised her eyebrows when she noted the nurse's name: Sheila Kaminsky. Coincidence?
Dr. Sterling's notes detailed more and more exotic possible causes for George's illness, each hypothesis tested for and rejected in turn. Cassie could detect his growing frustration as he documented consultations with colleagues throughout the country, each with more ideas but no one with an answer. She sympathized with Sterling as he investigated every possible avenue, trying to find a cure for his patient. She would have done the same thing.
Sterling's spidery handwriting blurred before her as her eyelids drooped.
"When's the last time you slept?" Adeena's voice jerked her back to attention.
Cassie rubbed her eyes, swallowed a yawn as Adeena pulled a chair up beside her. "What? You mean like all night?" She tried to joke away Adeena's look of concern.
Adeena's frown deepened until parallel furrows divided her forehead. "I can't believe you're going to treat patients in this condition. Cassie, you have to take care of yourself." Then her gaze dropped to the chart in front of Cassie. "George Ulrich. I had a feeling you wouldn't let go so easily."
Cassie shrugged, looked away. "I couldn't stop thinking about Charlie."
"Is that what kept you awake all night?" Cassie was silent. "Let me guess," Adeena continued. "You're dreaming about the shooting. What to tell me about it?"
Cassie touched her lips with her finger and looked away. No, she didn't want to talk about it, let her fears control her waking hours as they did her dreams. Not dreams, not nightmares–night terrors. Filled with images of blood and death. The man she'd killed with her own hands. Drake, lying still as death, staring at her with unblinking eyes.
Then came the worst part. Drake would morph into her father. She'd hear her father's voice, his last words. "Be strong, Cassie. I need you to be strong."
Some nights history would rewind itself and Cassie's twelve-year-old self would trudge through the snow, scrambling to find help in time to save her father. Sometimes the entire car accident would play itself out, the lurching sensation as they bounced off the mountain, the sickening wrenching feeling when they
'd become airborne, plummeting through the air.
The deafening crash of pain when they'd finally hit the ground.
She'd see her father hopelessly pinned in the wreckage. Hear his words. Feel the snow slipping over the tops of her boots, the cold biting the bare flesh of her hands as she climbed back up the mountain.
When she returned with help, she'd tasted the salt of swallowed tears, the bitter knowledge that she'd failed her father choking her into a strangled silence.
These dreams were familiar ghosts, haunting her sporadically in the eighteen years since the crash. But now as she floundered through the snow to the wreckage, it was Drake staring out at her, his eyes dull with death. She would flee her dreams, heart slamming against her ribs with the certain knowledge that she'd killed Drake.
She'd reach out for him, the empty bed beside her opening up like a dark, bottomless abyss and he wouldn't be there.
Cassie hunched her shoulders, still not meeting Adeena's gaze. "It's not so bad," she lied. "Getting better. I'm fine."
Her voice was leaden and she knew she fooled no one, much less her best friend.
"Right," Adeena said. "That's why you're spending your free time digging up the ghost of a dead little boy. Beause your life is just so very fine."
Cassie turned to Adeena, her palms flat on George's chart as if daring her friend to take it from her. "There's something going on here. I can feel it."
"I'm surprised you can feel anything right now. You're a walking zombie." Cassie was silent. Adeena shrugged one shoulder, setting her braids jangling. "All right, then. You want to know what happened to Georgie, I'll tell you."
She pursed her lips, blew her breath out and started. "He was twenty-two months old. But he weighed less than what an average twelve month old should. He didn't crawl or walk, could barely sit up and his only words were 'mama' and 'no' which he'd cry anytime one of us got close to him. He couldn't go anywhere without a special stroller equipped with IV pump, cardiac monitor, and a bag for his medications.
"It was a beautiful fall day–bright sun, not too cold yet. Virginia was taking him outside to the children's area in the ground floor atrium. It was change of shift, no one was there but her and Georgie. She was pushing him in his stroller, round and round the tiny space that was the entire outside world to him.
"He was smiling, actually reaching for the bright leaves that she plucked off the trees to show him. His monitor lead became dislodged, but she didn't want to undress him to replace it–he was having so much fun, it was the first time she'd seen him laugh in weeks, so she didn't take him back inside.
"There are wind chimes scattered on the tree limbs, but there was no wind that day. Virginia left his side to run from tree to tree, setting them singing for Georgie. At first he clapped his hands and cooed. So she kept racing, keeping the magic music flowing."
Adeena grew silent, her gaze fixed on the shadows hiding below the desk. "Then she realized he'd stopped laughing. She ran back to him. He wasn't breathing. She started CPR, called for help, but by the time anyone got there, it was too late.
"He died in her arms. Sterling had to sedate her, she was hysterical, wouldn't let anyone take the body from her, crying that it was her fault. We all knew that he'd been going down hill–Sterling was surprised that he'd lived as long as he had–but Virginia had actually been planning for his second birthday. She never gave up hope, never. Not until then. And once Georgie was gone, it was as if part of Virginia died with him. She was admitted to the hospital, placed on suicide watch. If it wasn't for Charlie, I'm not sure she would have ever snapped out of it."
Cassie closed her eyes, wincing at the pain in Adeena's voice. How awful, to have your child die in your arms. She chewed on her lower lip, imagining herself in the mother's place. Virginia Ulrich had gone through so much–how could Cassie suspect her of harming her own child?
"Satisfied?" Adeena asked, swiping her tears. "Get what you came for? Are those really wounds you want to reopen? You think it's going to help Charlie by dragging this up again?"
Cassie clutched the top volume of the chart to her chest, hugging it as if she could still feel the heartbeat of the little boy whose life it chronicled.
Adeena sniffed and then laid a hand on Cassie's shoulder. "You need to talk to someone, Cassie. Get some help. Before it's too late. You can't keep on like this. You know damn well it has nothing to do with Virginia or Charlie."
Cassie bowed her head, was silent. What was wrong with her? Why was she here reading the chart of a dead baby? Adeena was right, she had come back to work too soon. Maybe she was the sick one, not Virginia Ulrich.
"I'm here if you need me," Adeena said as she scraped her chair back and stood. "Think about what I said." Then with one final squeeze of Cassie's shoulder, she was gone, leaving Cassie alone with the ghost of George Ulrich.
Cassie shook her head. She took a deep breath and began to stack the charts back together. This was dangerous, she wasn't going to go any further with this delusion. She would end it now, start her shift and forget about the Ulrichs.
She returned the volumes of charts to the clerk. She had a stack of notes written in her cramped printing. She slid them into the wastebasket, then added the copies of Charlie's ER visits that she'd retrieved from the computer.
She watched the sheets of paper swirl down to the bottom of the black metal basket. Instead of feeling better, she felt worse.
She took a step away from the basket, heading for the exit, but stopped. She turned, scooping up all of the papers. Cassie spread them out on the counter, ignoring the jaundiced stare of the clerk, and examined them once more.
That was it. She traced a finger over the date of George's death with one hand and the date of Charlie's birth with the other. Charlie had been born only five days after George died.
CHAPTER 6
Cassie's vision darkened. She gripped the counter's edge with sweaty palms.
"Hey, if you're sick, the ER's one flight up," the clerk said, his voice sounding more annoyed than concerned.
"I'm okay," she mumbled, rolling her papers into a cylinder and shoving it into her coat pocket.
She stumbled out of medical records, her vision clear–too clear. The thoughts that rushed through her mind disgusted her, but now she understood.
Virginia had no need to keep George alive when she had Charlie coming in a few days. And it would be a burden to care for both infants at the same time.
Cassie wanted to scream, to cry–she didn't want to understand this madness.
But somehow, it all made sense, in some twisted, grotesque way. She pictured George and his mother out on that empty playground. She could see Virginia look at George, and it wasn't a mother's love that she imagined in Virginia's face. Then a hand reaching down to the little boy, so defenseless as the hand slowly pressed over his nose and mouth.
No! Cassie forced the image from her mind. She found herself in the stairwell. She sat down on the grey concrete steps and tried to still the surge of anger that overwhelmed her. Pounding her fist against the rough cinder block wall was the only thing that kept her from racing up the steps to the PICU and confronting Virginia Ulrich.
They'd think Cassie was the madwoman. She looked down on her scraped and reddened hand. Who would blame them? She still had no tangible evidence. Just an intuition, a feeling that twisted her gut with the force of a knife blade. If experts like Sterling and Adeena believed Virginia, what could Cassie do?
<><><>
"Why'd you wait so long to tell me about these cases?" Drake asked Jimmy as the older man drove them to the next scene in Highland Park.
Jimmy cleared his throat. "Truth is, after Sophia and Cleary went unsolved, your dad got kind of obsessed. Threatened to leak it to the media that there was a serial killer loose in Pittsburgh. Then Eades was found, and he was certain it was the same actor. Wanted to work the case himself."
"Who caught it?"
"Miller. When she got promoted it just sat collecting
dust." Jimmy grunted. Commander Sarah Miller had leapfrogged through the ranks with a speed that put her on track to becoming the first woman police chief in Pittsburgh history. "Right before he died, your father thought he'd found a connection between the cases. Not a suspect, but maybe something to get them reopened."
"What kind of connection?"
"Dunno. He never said, never wrote anything down. A lot like you that way."
Drake smiled. He never made any notes until he was certain of their importance to his case. He loved it when defense attorneys invoked Rosario and subpoenaed his notebooks. All they ever got for their trouble were pages of doodles and a few cryptic words left as reminders.
"Think he told Miller about it?"
"He was campaigning to get the case reopened, even sent to Quantico for the Feds to look at it. That's why she was riding with him–" Jimmy stopped, cutting his eyes over to his partner.
"The day he died," Drake finished slowly. He forced himself to relax his clenched hands. He'd wanted to ask Miller about those last few hours his father spent alive but never found the courage.
He'd always assumed that his father had died needlessly, racing on foot after a suspect merely to impress his female supervisor. But maybe it was this case that had killed Drake Sr. This case had driven him to the heart attack. He wished his father had talked to him about it. But Drake's father never talked about his work. At least not with his son.
"Miller never said anything?"
"No." Jimmy pulled off Washington Boulevard and into Highland Park. He followed the curving road past the zoo and up to the reservoir. "Sophia Frantz and Tanya Kent were both found here. Both killed right away but dumped forty-eight to seventy-two hours after death. Like the others, strangled. No signs of sexual activity or any other wounds."
"Still, it's about sex," Drake muttered. Weren't they all? Just had to figure out what fed this particular bastard's sick fantasies, gave him the illusion he was in control.