by Kay Hadashi
Ainslie shrugged and went to put the dressing on the patient.
“This is Doctor Kato.”
“Melanie, Bob Brown here in the ER. I have something you need to see. How soon can you get here?”
“Five minutes.” She hung up the phone, sped through writing orders for her patient, and struggled into her white lab coat that no longer spanned her waist. “Harm, get the patient tucked into the ICU and then come find me in the ER. Ainslie, hold off on setting up for the next patient. We might have an emergency to do.”
Pregnant women were nothing new on Maui, long known as the ‘bedroom community island’ of Hawaii. But when six foot tall, nine months pregnant Melanie hurried down the hall to the Emergency room, people stepped aside to let her pass. By the time she got there, the bouncing in her belly had turned the ache in her back into a strain. When she pushed through the double doors into the large department, she glanced around. It was always easy to find the most critical patient in any emergency room by locating the biggest gathering of nurses and doctors. This time, it wasn’t particularly busy, only a pair of nurses leaving where a privacy curtain was drawn in an area typically reserved for children.
“What’s going on?” Melanie asked them. “Is there an emergency or not?”
“You’re about a day too late, Doctor Kato.”
Confused as to what that meant, she ducked behind the curtain and found Bobby doing an examination on a man quite obviously dead.
“Bobby, why am I here?” she asked, keeping a full step back from the stretcher. As a clinician, Melanie knew death by trauma wasn’t contagious, but as a mother, she was too superstitious to take any chances. “Or better yet, why is he here and not in the morgue?”
“Melanie, hi. I’m having every drowning victim brought to the ER for the next few months for an article I’m working on.”
“Good for you. It’s pretty obvious at first glance this victim didn’t die by drowning.”
Bobby continued to examine the corpse. “My hamster could’ve told me that.”
Between spasms shooting down one leg, the never-ending headache due to lack of caffeine, and her aching feet, Melanie had a hard time keeping a civil tongue. “Why am I involved?”
“Well, I suppose you’re not. But there’s something about this one I thought you’d like to see.”
“Bobby, after six years of Search and Rescue and a dozen years of surgery, I’ve seen pretty much of everything there is to see in a dead body. Maybe you haven’t noticed, but I’m about to produce a new kid at any moment, and I’m way too superstitious to be bringing my unborn around a dead body if I don’t have to. What’s so fascinating about this one that you called me?”
“It wasn’t a simple drowning. According to police and paramedic reports, his body was found by other surfers just off Lahaina. His board leash was tangled in coral, which they figured was why he drowned, that maybe he’d been dunked a little too hard and hit his head, the leash holding his unconscious body below the surface of the water.”
Melanie took half a step closer to the stretcher. “I can see that happening. But the trauma he suffered wasn’t from just hitting his head on coral. All surfers worth their stuff have done that a time or two, and I have the scars to prove it. His injuries were different. He suffered high-energy impacts.”
“Obviously. Crushed skull to the point of being unrecognizable, flail chest with nearly every rib on one side snapped into pieces. Any of his injuries would’ve been enough to kill him outright, but it was his broken neck that did him in, not drowning.”
“How do you know that?”
“I tapped his lungs and there was little water in them. That means he died suddenly. He never struggled to take a breath after the impact. The theory about the leash holding him underwater just doesn’t work. I think his leash got tangled in the coral long after he died.”
“You’re playing coroner now?” she asked. “Why not leave the post-mortem to be done in the morgue by the coroner? His body is evidence of a possible crime, Bobby.”
He seemed to ignore her. “Look at his chest on this side. All the ribs are crushed, which is consistent with the type of lateral cervical fracture he sustained, and his head injury. There was a sudden and massive impact with something, or something with him.”
“And once again, that’s quite obvious. It’s also best left to the coroner to determine what.”
“But look here.” Bobby uncovered the rest of the chest, making Melanie wince at the sight of the mangled and twisted body. “On the other side of his chest is a bruise, along with one on his jaw.”
Melanie finally stepped up to the stretcher, standing sideways to it because of the size of her belly. “And he wouldn’t have bruises if these were a part of his accident.”
“From the color of them, they look like they were several hours old, but less than a day. I got X-rays, and found that his jaw had a non-displaced hairline fracture on the opposite side of his body as the impact. His lethal impact was on the left, but the jaw fracture and bruise on his chest are on the right.”
“Sounds like he got beat up by a southpaw and then went surfing.”
“That’s why I called you. I know you’re an avid surfer, and have been through the ringer a time or two. I imagine you’ve had a broken rib along the way. Would someone go surfing right after they’d had their butt handed to them like this?”
“Surfing takes a fair amount of core strength, and he would’ve felt that in his ribs. He was pretty dedicated to go surfing after getting punched hard enough to break a jaw. It sounds like he was in a bar fight late yesterday afternoon. The swell along Lahaina yesterday was the best it’s been in months.”
“You keep track of surf reports?” he asked, as he picked up the man’s hands to examine the skin on his knuckles.
“I have an app on my phone that gives daily surf reports for the island.”
“His hands are okay. He didn’t fight back.”
“Or he was held by someone. But I don’t see why being beat up right before going surfing is so interesting? Unless you’re thinking he killed himself? He got in trouble, got beat up for it, and thinking there was no way out, he paddled out to the shipping channels to wait for something to run him over? That doesn’t make sense. Better bet would’ve been to wait for a shark to find him. Of all the ways for someone to kill himself, that seems least likely. Seriously, who wants to be eaten by a shark?”
“See? Not so simple as you thought.”
“If I was on a little island out in the middle of the ocean and I was in enough trouble to get beat up for it, I’d go to the airport. No reason to risk trouble a second time in the same place.”
“I just don’t think he committed suicide,” Bobby said.
“First, you need to figure out how he got the massive blunt trauma,” she said. “And once again, that’s the job of the coroner, not an ER doc.”
“I’m still trying to figure that out. Look at the shape of this bruise on his chest. Does that look like anything in particular to you?”
She leaned down to look closely at the side of his chest that was relatively uninjured. The dark mark had a well-defined edge, a half circle about the size of a baseball. “Toe of a work boot?”
“That’s exactly what I thought,” he said. “And the bruise on his jaw is consistent with a fist.”
“Bar fight, plain and simple.” Melanie stood up straight again, trying to keep the look of impatience from her face. “Did you draw labs for blood alcohol or a tox screen?”
“Can’t really generate lab charges on a victim brought in DOA. I’d have to pay out of my own pocket.”
“Why are you spending so much time on this, Bobby? You said your paper is on drowning, but this is massive trauma. I say, give it a rest and find something better to do with your time, such as curing the common sunburn.”
“Aloe.”
Melanie sighed. “And again, what does this have to do with me?”
“I thought since you’re
our chest and vascular surgeon here at West Maui Med, you’d be interested. And since you’re mayor of the island, you’d probably get involved in this, no matter how it shakes out.”
She flung open the curtain to leave. “I’m missing lunch to look at a dead guy, Bobby. Thanks for that.”
“Wait for a sec. I need to talk to his family, but I hate making those calls.”
“And you expect me to? Leave it for the police or the coroner. As it is, they’ve probably already gone to his home.”
“Apparently the police haven’t positively ID’d him yet. Something about his prints not being in the usual database, whatever that means.”
Melanie made a quick call to Ainslie to get the next case started. “Still not our problem, Bobby. Let the police take care of figuring out who he was and contacting the next of kin. Getting involved in something like this when it doesn’t concern us is asking for trouble. I’d be glad for your company while eating lunch, as long as you don’t talk about dead people.”
Being a bachelor, he didn’t have much to offer when it came to talking about the only real news in Melanie’s life right then, that of her due date in a week. After poking at a salad and picking apart a muffin, she got a call from Ainslie just as she was finishing her meal.
“If you hear any more about your new friend, let me know.” Melanie pushed her empty food tray onto a cart. “Bobby, you’re new here and right out of training. I know you want to get involved, but I strongly suggest leaving it alone. Just let the coroner manage things with the police. That’s one thing they don’t like, having hospital docs interfere with their investigations.”
***
Melanie got her headlight tightened to her head and put on her loupes, along with a surgical mask. She did her scrub-up for her last surgery before going on maternity leave. All she had left were rounds and half a day in the clinic the next day. Then it would be a week of sitting on the couch at home waiting for the baby to come. Somehow, she knew it wouldn’t be as simple as that. As Maui’s mayor, she had those duties to content with, along with an energetic daughter and a nervous husband.
The last case went more quickly than expected. She was tossing down the last few knots in the slender blue suture that she had used to repair the patient’s aorta when Harmon brought up the call.
“What was in the ER?” he asked.
“Nothing. One of our new ER docs is working on a paper about drowning victims and wanted to show me something unusual on a corpse.”
“Why isn’t the coroner handling it?” Harmon asked.
“That what I asked. The injuries aren’t consistent with drowning, though. From what I saw, he had the crap beat out of him, and then got clobbered by a boat while out surfing. Probably rammed by a container ship that never even saw him. Just left him behind without knowing they’d run someone over in the water.”
“Eww,” muttered Ainslie.
“No kidding,” Melanie said. “But the odd thing was there were two different sets of injuries. Harm, you remember back in San Francisco, when you were still working as a paramedic and I was in my residency, you guys brought in the scab worker who’d been kicked and beat up by those union dock workers?”
“I remember him. Black eyes, split lip, half a dozen broken ribs. Happened on Christmas Eve, right? What a way to spend the holiday.”
“I doubt you saw the bruises on his chest where he’d been kicked. They were all half circles, the size and shape of half a baseball, matching the toe of a steel-toe work boot perfectly. Well, this guy today had the exact same mark on his chest, right over a broken rib. Plus, the classic fist print on his jaw.”
“And you think that had something to do with his death?” Harmon asked.
“Bobby does, and I hope he leaves it alone.”
As the nurses began a final count of sponges, Melanie started closing the patient’s abdomen.
“You know, you look miserable,” Harmon said. “Let me close while you write orders. You can meet us in the ICU in a few minutes.”
She handed over the suture driver and forceps to him. “Right now, a trip to the bathroom would be like sitting on Cloud Nine.”
She broke scrub, tossing the surgical gown and gloves away. After returning from a mad dash to the OR locker room, she sat on a stool and let her long legs sprawl while writing orders. “Harm, once I’m done in the clinic tomorrow, Doctor Wellman will follow my patients.”
“I’ll lend him a hand whenever I can.”
“I know. I doubt he’ll need anything. These patients today have been pretty straightforward.”
“Only taking a month off to be with the baby?” Ainslie asked.
“Not much choice. Anyway, my mother-in-law is coming to help. Again,” Melanie said with a sigh.
“Supposed to be another girl, right?”
“Yep, and the last one. If Josh wants another kid, he’ll have to form one out of dust from the Garden of Eden.”
“Well, once you’re done in the ICU, you have to come back here to the OR,” Ainslie said.
Melanie thought all day something was at play, and could tell by the sparkle in the nurses’ eyes something was cooking. “Why?”
“We have something for you.”
“For the baby,” the scrub nurse added.
“You guys already gave me a baby shower.”
“We were sworn to secrecy but we have something cute for the baby.”
“Swearing nurses to secrecy is futile,” Harmon said, laughing.
“I’ll try to act surprised,” Melanie said. “What is it?”
“A little onesie with pictures of tropical flowers all over it and a package of diapers.”
“Onesies and diapers I can use. The giant box of stuff I got from my in-laws the other day I’m not so sure about.” Before she could go on, her phone rang with a call from Josh, her husband. She went out in the hall to take it. “Where have you guys been? I’ve been sending texts all day.”
“Been all over. Mostly at the beach. There was a big deal at Lahaina today. There were cops, and…”
“The death at the beach? Already heard about it. Saw the guy, as a matter of fact. No news there. What’s for dinner, anyway?”
“Can we go out?”
“To?” She had a pretty good idea of where he wanted to go.
“The Island Breeze?”
“Our own restaurant?” she asked. “The place we bought from Aki, who bought it from my mom, the same place I worked at while in high school? You can’t think of anywhere more interesting than that?”
“We like it there!”
“But once a week?”
“We need to keep an eye on things, Melanie. Otherwise, the cooks and waitresses will start to slack off.”
“Buddy, you keep your eyes off the waitresses, and that new hostess you insisted on hiring. Seriously, it is a physical impossibility for anyone to get any perkier than her.”
“And looking at the numbers for last month, that perkiness is bringing in more business.”
“We’re running a restaurant, not a brothel, Josh.” A pang of something hit her, maybe latent pregnancy nausea, maybe hunger over the idea of having a fresh meal. “How’s Tay? You’ve been putting sunscreen on her?”
“And her hat, and she’s been drinking water faster than she can whiz it out. I’ve never met a kid who has to go potty so much as her.”
Melanie hurried to the locker room. “Another topic besides peeing, please.”
Just as she was sitting in a bathroom stall, her daughter came on the phone. “Hi Momma! Having fun today?”
“Fantastically great fun, as always, Sweetie. I’ll tell you all about it at dinner tonight. Put your daddy back on the phone again.”
“When will you be out from work?” he asked.
“Give me two hours to tuck someone into the ICU and then waddle through rounds before you pick me up outside the ER entrance.”
Two hours later, at least according to her way of telling time while pregnant, Melanie b
reezed through the ER. Bobby was still there, tapping a pencil on the desk at the nurses’ station.
“Would you rather have it busy?” she asked him.
“An appendectomy patient every two hours would be nice. Or a sprained ankle. Even a mild heart attack, something easily managed, just to make the time pass. Sitting around like this makes me nervous.”
Melanie chuckled. “And to think you left behind gangster drive-bys and freeway trauma on the mainland to work with us here at West Maui! The most exciting thing the rest of us want is an uncomplicated gall bladder or a coral gash.”
“Even looking at some kid’s tonsils would be more fun than this. Hey, I heard a little more from the police about that vic you saw earlier.”
As a doctor, there was nothing she could do about the poor man that had perished in the ocean just down the road from them. As a superstitious woman pregnant from one end of her body to the other, she tried hard to not have interest. But as mayor, she knew she would have to deal with the unusual death of a newcomer to the island. She looked at her watch and noticed the two hours she’d promised Josh had turned into a pregnant three hours. “And?”
“They ID’d him and called next of kin. His mother is flying in from Arizona later tonight. She wants to see him before they do the autopsy.”
Somehow, Melanie knew she was going to be involved. “I suppose she’s bringing a lawyer with her, ready to sue the county for negligence?”
“All I know is she gets here first thing in the morning and is insisting on seeing him then.”
Melanie rubbed her forehead. She had a clear line of sight out the double door entrance and saw Josh’s car parked in the second row back. “Thanks for the heads-up. But once again…”
“Don’t get involved,” he said.
“Right.”
Chapter Three
Thérèse skipped along next to Melanie, who waddled down the walkway to the restaurant while holding Josh’s hand. At least until the girl caught a toe and took a fall. Scrambling to her feet rear end first, she kept going as though nothing happened.
“You okay, little one?” Melanie asked, checking the girl’s hands for scratches.