by Kay Hadashi
“Mostly. Was wearing a Special Forces T-shirt meant to send me a power message of some sort?”
Melanie crossed her arms over her chest, and crossed one leg over the other, nervously bouncing a foot. “If I wanted to send you a power message, I’d wear something about me being the President’s daughter, one of the most popular Presidents in modern times. Or I’d just stencil my bank account balance on the front of it, quite possibly the largest bank account balance on Maui. Or maybe I’d just have my personal Secret Service agent sitting here with me. Or maybe I could show off my military record and commendations. Or flash around my diplomas and certificates. There are a lot of things I could do if I wanted to play some game with you, Detective, but have you ever known me to act that way?”
“No, I haven’t.” He killed off his can of beer and set it aside. “In fact, after visiting you at the hospital these last couple of days, I have a whole new appreciation for you and what you accomplish there.”
She stopped bouncing her foot and uncrossed her arms. “Does that mean I’m not going to one of your interrogation rooms tonight?”
“Not as far as I’m concerned, no.”
“Then why are you here? Why did you come to the hospital this morning? Just to test me? To see how I’d react about my fingerprint being found on something I have no knowledge of ever touching?”
“That’s exactly what it was and you passed with flying colors, by the way. I spent the rest of the day at the hospital, chasing down a few leads, most of which came to dead ends. I was able to watch Doctor Benson do his autopsy on both bodies, though.”
“The Taylors? Did he find anything?”
“Healthy organs, healthy brains, healthy bodies. No evidence of trauma, internal or external. No evidence of meth, narcotics, or the most common recreational drugs in their blood. No needle marks, nothing in their nasal passages, no residues in their windpipes, no pills in their stomachs. They just died.”
“Everybody dies of something, Detective. I’m sure Benson will keep looking.”
“He said the next step is to do a more in-depth toxicology screening on them, taking tissue and hair samples, along with more blood. He’s going to look for medications they might’ve been given, not for recreational drug use, but for conditions that might’ve needed treatment.”
“That would seem odd, that both would have the same condition at the same time, and get the same treatment,” Melanie said. “From all outward appearances, they looked healthy and spry to me. Benson is sure meth had nothing to do with their deaths? Not even as a triggering agent?”
“He said that’s something else he needed to look into. He has some colleagues on the mainland where meth is in much greater use and will see if they’re finding similar cases as ours.”
“The whole thing is so peculiar. We wouldn’t even be talking about meth if that teddy bear hadn’t been found with them in the rowboat.”
“And you never would have been insinuated in their deaths if you hadn’t found them,” he said.
“Or if I’d told you about how the bear had been ours only the day before. I still can’t figure out why someone would drop off a teddy bear at my office. Have you looked into the Moore family? I asked my receptionist about the delivery again. Apparently, the man who dropped off the bear was named Roger.”
“I talked to her, also. Then I talked to the Moore family, which by the way, talking to a patient and family during an official investigation is perfectly acceptable.”
“Not my problem,” Melanie said. “What did they have to say?”
“They knew nothing about any teddy bear, nor do they have any relatives named Roger. I checked their social media sites online and came to the same conclusion, that they have no near relatives named Roger. I also see no reason not to believe them when they say they know nothing about the teddy bear.”
“So, we’re back to insinuating me in the crime. I guess insinuate is an upgrade from implicate in the eyes of the police?” Melanie asked.
“The police and the DA. What I haven’t been able to do is check out island toy stores to see if the same type of teddy is sold here on Maui. I just don’t have the personnel and I can’t be in twelve different places at once.” He smiled at her. “Still stretched pretty thin at MPD, Mayor. Hint hint.”
“I know. I’ve been running recruitment advertising on the mainland, focusing on the Samoan and Filipino populations, hoping to find someone that would be more aware of island lifestyles. I may have to broaden my search.”
“Right about now, I’d take Boy Scouts with driver’s licenses and the good citizenship merit badge.”
“Tell me, did your evidence team find any traces of meth in my home?” she asked.
“Nothing. And very few of the products needed to make the stuff. Just an old bottle of brake fluid in the shed, a small bottle of ammonia in a kitchen cabinet, and the only bleach was non-chlorine. According to the crime scene techs, you have one of the most organically clean homes they’ve even been in.”
“I wish there was something more incriminating to make your day, Detective.”
“Believe it or not, I like eliminating suspects.”
“Did you talk to Andrew Carson?” she asked.
He referred to his little notepad. “He’s a piece of work. I can see why the two of you didn’t stay together. He said something about seeing you at the pool recently and you threatened him?”
“Right after he threatened me. It’s a game we play. He gets pumped up at the gym and acts like some badass trying to push me around, and I slap his hand off my chest and stretch one of his knuckles backward for him.”
“What happened at the pool?” Nakatani asked.
“Oh, he challenged me to a race, even placing a bet of some sort on it. When I mentioned my terms of the bet, he started to posture, asking if I was going to beat him up, or whatever.”
“What did you say?”
“The usual, that I could if I ever needed to but I didn’t want to, something like that.”
“He said you physically tried to intimidate him.”
“Yeah, he would.” Melanie chuckled. “He implied I wasn’t feminine, so I stood up straight. We were in shallow water and I was wearing a bikini that day. I’m not only taller than him, but in spite of being built athletically, I dare any man to tell me I’m not built like a woman.”
“Yes, I can see that.” He looked up quickly. “What I meant was…”
“I know what you meant, Detective. Did Andrew have anything else to say other than trying to dominate me?”
“He said he has received a total of five incident reports in the last twelve months. He got them out and showed them to me.”
“Only five? That seems like a very low number.”
“That’s what he showed me. I have no idea. How many more should there have been?”
“Gosh, at least in the hundreds, if not the thousands for all incident reports. Medication errors and issues should be the highest number of all.”
“Thousands? Is the hospital safe if there are that many?” he asked.
She nodded her head. “Let me explain. Those reports are generated even when there was a close call, not just when an error was made. Missing vial of medication, an outdated product in the patient care workplace, a med given a few minutes too early or late, any innocuous thing should generate an incident report. The point is QA improvement. Part of that is to help the employee or care team learn from the incident and understand how easy it is to make a mistake. The other half is for tracking purposes. If one employee is found to be the cause of too many incidents, or if a large number of incidents are occurring in one particular area of the hospital, or even with a procedure, the situation is given a close look to see what exactly the problem might be. A large number of incident reports doesn’t necessarily mean the workplace is bad, it may just mean the place is aware of potential problems and is taking steps to prevent them. On the other hand, if there are very few incident reports, it may mean the
re is a cover-up of some sort. Administrative denial, if you will. If that’s the case, you need to look for what’s being hidden, and that would most likely be malpractice of some sort.”
“When Carson waves around only five incident reports related to missing medications, I should be surprised there are so few instead of so many?”
“Right,” she said. “I know for a fact that at least two have come from my clinic, just from what we’ve talked about, that someone neglected to replace a med vial. That’s why we have a second vial of each med, for redundancy. The more critical it is, the more likely we’ll have greater redundancy. And before you think, ‘Gee, if it’s in the code cart, it should be too critical to let lapse’, the thing about those meds in that cart is that we have multiple vials of everything in our clinic stock, from cardiac critical drugs to the most mundane things like antacids.”
“You dispense all those meds?” he asked.
“No. Our patients get their prescriptions filled at pharmacies, just like everywhere else. We keep those meds on hand for use in the clinic, if a patient goes into a crisis, or just for basic treatments.”
“I see,” he said, taking more notes, as always. “But as a police officer without any medical training, I’d have no way of telling if those reports were reporting near accidents or something bad that happened to a patient, would I?”
“You’d probably pick up on a few cues after a while. But at first, much of it would sound like gibberish. Just the same as if I were to sit in a courtroom and listen to lawyers bicker over legal processes, trying to make sense of all the legalese.”
“Your father’s background was as a lawyer, right?”
“That doesn’t mean I know all the intricacies of it. I know more about legal proceedings from watching old Perry Mason TV shows than from anything I ever learned from my father.” Melanie gave Nakatani a hard look. “Wait. Are you going to try and talk me into helping with this investigation?”
“Would you? I need somebody reliable that can read those reports with a critical eye.”
“But aren’t I still insinuated as a possible culprit because of the fingerprint?”
“If you agreed to help, wouldn’t it give you’re the chance to clear your name?” he asked. “Anyway, who said it would be an official part of the investigation?”
“You’re very sneaky, Detective Nakatani.”
“That’s how I got promoted to detective grade.”
Melanie gave the idea some thought. “If Andrew was honest and kept all the incident reports that were generated at the hospital, all someone could do is scan them for specific terms, and even that would take hours, even days. I really do have better things to do with my time than read incident reports. That’s a QA department thing and I doubt they’d be interested in helping.”
“That’s exactly what he said about them. But I get the idea I’d turn up a clue or two if those reports were dug through.”
“You have nobody at the precinct that can go through them?” Melanie asked.
“We have an ex-nurse that now works in patrol, but Mister Carson mentioned patient privacy laws would prevent somebody from outside the hospital from looking at the reports.”
“Sorry, but that’s complete BS. Only the reports that had patient identifiers on them would be excluded. Those could easily be removed before an audit was performed. Audits are done on hospital paperwork all the time by outside people. That’s nothing unusual.”
“Carson wasn’t square with me?” Nakatani asked, his pencil tip poised on paper.
“I doubt he’s ever been square with anyone in his life.”
“Okay, keeping the editorial comments out, was he telling me the truth?”
“Not about doing an audit of incident reports. Like I said a moment ago, hospital QA is always going through things like incident reports and patient charts looking for problem areas. Also, every outside agency that certifies and licenses the hospital and individual clinics and departments also looks at related reports and elements of policy and procedures. It would take a staffer in his office all of an hour to pull out the patient care-related reports and provide you with what you want. He might have already done that for previous audits. What I’d be surprised about was if he hadn’t sent them all through the shredder, hiding what he believed to be liabilities.”
“You know…” he started.
“I know what you’re going to say. You’re going to try and guilt me into helping by saying since I’m already a part of this, I should want to see it through, if only to clear myself of any wrong doing. You’re also going to say that I would want to find something wrong with his office, just so I’d have something else to hang over his head, right?”
“Right, on the first part. The second part is between you and him and the boxing gloves. Will you help me?”
“When?” she asked.
“Tomorrow?”
“Busy day in surgery, just like today.”
“Friday?”
“Long day in the clinic. In fact, I’m overbooked that day.”
“Are you always so busy?” Nakatani asked.
“Exactly what Josh and my in-laws keep asking. Or at least why. And yes, my weeks are typically this busy. My surgery schedule has overflowed into weekends, when I average four cases every Saturday, even when I’m not on call.”
“Would you have time this weekend? I know it would cut into your private time with your family, but maybe a few hours?”
“You’re in luck, Detective. I’m on call all weekend and I’ll spend most of it at the hospital. But you’ll need to get those reports from Andrew’s office to mine by Friday afternoon. And please understand, he’ll be very reluctant to give them up, citing all manners of laws or regulations, so be prepared with whatever official request signed by a judge you might need.”
He finished jotting notes. “You got it. Anything else?”
“You’re asking me? I get a turn to ask questions?”
“Come on, Mayor. Cut me some slack.”
“Okay, whatever happened to the Gubler-Steinhoeflers? And how did the Taylors get their hands on the game show prize? Honestly, I don’t know how they could’ve checked in without proper identification at reception,” Melanie said.
“That’s something else we’re trying to figure out. These last couple of days, I’ve been dividing my time between sitting on the phone with police departments on the mainland, pressing the resort for help in understanding how the Taylors got checked in, and trucking up and down hospital corridors looking for answers to questions I haven’t discovered yet. It’s always at this point in an investigation that I discover I’m spending more time chasing my tail than chasing down leads. But this time, I’m chasing three tails, and none of them are particularly attractive.”
“Detective, as county mayor, I command you to go home and chase your wife around the bedroom for the rest of the evening, if for no other reason than to get tail off your mind.”
Chapter Nine
Melanie got a call from the inpatient radiologist just as she was finishing her second of six cases on Thursday morning. It had to be about Dottie and her special MRI.
“Is my father-in-law there?” she asked. “I’m swamped in the OR today and need to go see one of my ward patients that’s having some sort of crisis. I barely have five minutes to spare.”
“The husband is here but I haven’t talked with him yet,” Dr. Williams said. “I just finished with Mrs. Strong’s MRI and it isn’t good news. I’d like someone to be here while I talk to her husband.”
Melanie ground a knuckle into the corner of her eye that was twitching as she hurried down the hall. “My husband is at work, at least for the next two hours. Are you able to wait until then?”
“Mister Strong is pretty anxious to know what I found on the scan.”
“Which is?”
“She has a tumor. Not large, but well-defined, and fairly superficial.”
Melanie stopped in the middle of the hallway, others
going around her. “Is it cancerous?”
“At this point, I can’t tell. It could be a meningioma. We’ll have to wait for pathology results to know for sure.”
“If she agrees to surgery.” Melanie started walking again. “Have you talked to Dottie’s neurologist, Doctor Hennessey, yet?”
“He’s on his way. For this conference, I’d really like someone a little, I don’t know…”
“With a better bedside manner?” Melanie offered.
“Or at least more personable. When can you be here?”
Melanie checked the time just as she was walking into her patient’s room. What she saw going on wasn’t good. “I’ll give you a call.”
She slipped her phone into a pocket, pulled on a set of exam gloves, and crowded in where several nurses were gathered around the patient’s bed. It was someone she had done gall bladder surgery on the day before and was slated to go home the next day. What she saw was a bloody dressing pulled from the young man’s belly incision, the nurses trying to restrain his arms.
“What happened?”
“He just started freaking out,” one of the nurses said. She was disheveled, her uniform blouse torn.
Melanie felt the man’s wrist for his pulse, finding it racing too fast to count. His panting breaths were labored, almost gasps. “Obviously, but from what?”
“I don’t know. His friend just left and I found him like this.”
“Mister Egbert! Relax! You need to calm down,” Melanie commanded the patient, now in a battle with his free arm swinging wildly near her. When it caught her on the chin, she grabbed hold and pressed it down against his mattress.
“I think he’s stoned on meth,” one of the nurses said. “It smelled like someone had just smoked some when I came in.”
“Get the code cart in here,” Melanie said, trying to control her own emotions while struggling against the man’s nearly superhuman and drug-induced strength. They got a set of EKG leads on his chest while Melanie continued to try and talk the man down. When she saw the medication drawer get opened on the cart, she made her first order. “Give ten milligrams of Valium, IV.”