Transplanted Death

by Ray Flynt

  Brad thought he saw a tear well in Alan’s eye.

  Alan cleared his throat. “My father died when I was four-years-old. I never knew him, and my mother seldom talked about him.” He spoke in even tones. “She remarried when I was five, and her new husband—a widower with twin seven-year-old sons—wanted no part of me. Fortunately, my real dad left me a trust fund. That’s how I was able to get a good education and be out on my own when I turned eighteen. Ken will be in good shape when I’m gone, he’ll inherit everything.”

  As Alan recounted his story, Brad recalled having heard it once before in their Princeton apartment after a few beers.

  Brad thought Ken’s emotional inheritance would be equally important. Apparently his message to Alan had missed the target. He pondered his own life. He too had benefited as an heir to his family’s fortune, but the memories that mattered most from his childhood had little to do with money. Brad’s cell phone vibrated again.

  “Think about what I said.” Brad took the cell phone from his pocket, but it had already stopped vibrating. “Pardon me while I check for messages.” Brad flipped open the phone and dialed the number for his voice mail, then entered his passcode. He heard Sharon’s beleaguered voice: “I need you on the seventh floor.”

  Brad downed the rest of his coffee, stood up and retrieved the balloon from the back of his chair. “That was Sharon; I need to go.”

  “How’s our patient doing?” Alan asked, sounding relieved to change the subject.

  “I think she’s a little stir crazy right now.”

  “I should stop in and visit. It’ll give me a reason to bill your insurance.”

  Brad laughed. “Actually, you could write a discharge order. By the way, the Oncology nurse confirmed your alibi for the time of Michael Severn’s death.”

  Alan nodded. “Now you can concentrate on finding the real killer.”

  And you can talk with your son about your brain tumor, Brad wanted to say, but figured he’d be wasting his breath.

  Chapter Twenty-Three

  11:05 a.m., Thursday, January 11th

  The balloon didn’t assuage Sharon’s prickly demeanor. But when Brad announced that she’d be getting discharged, Sharon leapt from the bed and trotted to the patient locker, flung open the door, and began throwing her clothes on the bed.

  “Not quite yet,” Brad said. “Dr. Fenimore will pay you a visit shortly, and sign the authorization.” To her crestfallen face, he added, “It won’t be too much longer.”

  Dejected, Sharon replaced the items in the locker.

  Brad glanced at Sharon’s roommate whose eyelids were closed, but might have been playing possum given her lack of rhythmic breathing. “I’d like to discuss the case,” he whispered. “Where should we go?”

  Sharon brightened. “There’s a lounge at the end of the hall. But let me grab my coat, it’s cold down there.”

  They walked the length of the hall and settled into two leather chairs opposite each other in the non-sunroom. Ice crystals coated the windows, while the storm raged outside. The chill felt bracing to Brad, who had been feeling a little sluggish since his big breakfast, while Sharon sat with her legs tucked under and the down-filled parka pulled tightly about her.

  “It’s probably just as well that I’m getting out of here,” Sharon said. “Everyone seems to know that I’m not a real patient.” Sharon recounted her run in with Nurse Keith Blanton. “He’s got a sadistic streak, if you ask me. You should have seen the way he pumped up the cuff when he took my blood pressure.” She rubbed her arm as if she could still feel the pain.

  Brad remembered Blanton’s name from watching him enter the drug storage room on the hospital’s videotapes. “Carlton promised to get me personnel records and I’ll be sure to check him out.”

  The radiator pipes banged and a steam valve wheezed like a calliope coming to life. Now if it only felt warmer.

  “Ask Carlton about Harold Tangiere too,” Sharon said. “He’s questioning him right now about the death of Michael Severn.”

  Brad wondered why Sharon hadn’t mentioned this point earlier. His concern must have registered on his face, because Sharon quickly added, “I left you a message.”

  Brad frowned. Her phone message said nothing about suspects. He threw up his hands in a what-gives gesture.

  Sharon calmly launched into a convoluted story about her “daffy” roommate and witches, of finding Amanda Witchert, who had spotted a janitor in coveralls and wearing a blue and white knit cap acting suspicious near the room where Michael Severn died. Sharon recalled how—moments after telling this story—Amanda had summoned her to the hallway where she saw the same man.

  “Mrs. Baker—my roommate—went crazy at that news, and the commotion brought Crystal Himes to our room. And when Mrs. Baker told her there was a murder suspect out in the hallway, Crystal summoned Ed Carlton to the 7th floor. He confronted the janitor right out there.” Sharon pointed toward the hall.

  “Harold Tangiere is the janitor?” Brad asked.

  “Yes.”

  “What can you tell me about him?”

  “Remember Nurse Iola T.?”

  Brad bobbed his head.

  “She’s the janitor’s wife,” Sharon explained. “When Carlton went after Tangiere, Pedro ran off to find Iola, and he must have made the whole situation sound dire.”

  Brad flashed her a don’t-keep-me-in-suspense look.

  “Iola showed up just as Carlton was about to escort her husband onto the elevator. She started screaming and tugging on her husband to keep the security chief from questioning him.”

  Brad tried to divine what would have prompted Iola’s overreaction. “Sounds like quite a scene.”

  “Oh, it was.”

  After a moment, Brad asked, “So what are your thoughts about this case?”

  “Well, this wouldn’t be the first hospital with a nurse who decided to play God and determine who deserves to live or die. So we either have a psycho killing off patients, or maybe a disgruntled employee, or…” Sharon paused. “But I’ve been wondering if the multiple deaths are intended to disguise the killer’s real target. I mean, with the drugs that were used, it almost has to be a nurse—”

  “Or doctor,” Brad added. “The medical staff on the seventh floor are prime suspects, because of their proximity to the deaths.”

  “Yes,” Sharon said, “but I’ve noticed that all of the rooms where deaths occurred are near the stairwells at the end of the hall. The killer could have come from another floor. Or if it was one of the nurses here, used the stairs to escape and then re-emerge via the elevator while the staff was busy dealing with the crisis.”

  Brad had already noted the location of the rooms where patients died. He now wondered who assigned the patients to those rooms. If they were anything other than random, it might provide a valuable clue. He scribbled a note to check. The windows rattled behind him and he felt a blast of cold air on the back of his neck.

  “I think we ought to concentrate on the victims,” Sharon said. “I mean, what if the killer had a motive to kill person X, but decided to make it look like a mad man on the loose at Strickland Memorial Hospital. So he kills A, B, & C before killing X. And what makes this theory difficult to prove is that maybe the intended target hasn’t even been killed yet, and up to this point we’re just dealing with so much collateral damage.”

  Brad nodded. He’d reached the same conclusion.

  “Right now we know about three murders and one attempted murder—Dennis Ayers,” Sharon said.

  “No. There have only been two murders,” Brad corrected her. “Remember that the first death… what was his name?” Brad extracted a notebook from his inside jacket pocket and flipped through the pages. “Esposito. Angelo Esposito. He had a risky heart/lung transplant, and was in a very weak condition, practically knocking on the Pearly Gates before his surgery. So his death wasn’t considered suspicious. Dr. Dubei said that the patient’s body had already been released to a funeral home but
that they had requested it back.”

  “Good luck with that.” Sharon shot a glance out the window, crinkled her lips into a scowl, and sighed.

  “What’s wrong?”

  “Nothing.”

  Brad stared at her.

  “It’s this damn cold weather. I think it’s freezing my brain cells.”

  Brad laughed.

  “I’d rather be having this conversation in your office in front of a roaring fire.”

  “The cafeteria advertised hot spiced cider,” Brad said. “Would that help?”

  “Maybe.” Sharon unfurled her feet and planted them on the floor then edged forward in her chair. “Have you done a profile on the victims?”

  “Sure. It feels like days ago, but probably about 1 a.m. They don’t have much in common, except for coming to this hospital. They live in three states, Pennsylvania, New Jersey, and Delaware. Unless they all sat next to each other at a Phillies game one time, I can’t see any evidence that their lives ever intersected until now.” Brad glanced at his watch. “I’ve got an appointment in about twenty minutes to talk with the transplant coordinator. I want to find out if they had any interaction here prior to their admission.”

  Sharon stabbed the air with her finger, as if trying to pinpoint an idea.

  “Alright, how about a connection to one of the nurses? For example, what if Michael Severn and Keith Blanton were college roommates. Aren’t they about the same age?”

  “Your imagination is getting ahead of the facts.” Brad consulted his notebook. “They aren’t the same age. Michael Severn is thirty-nine-years-old, and Carlton told me Blanton is in his early thirties. You think Keith Blanton is creepy. Duly noted.”

  Brad replaced the notebook in his inside jacket pocket, and glanced at his watch.

  “Alan should be here within the hour to arrange for your discharge. Carlton set me up with a workspace on the third floor, just past the security station. Look for me there.”

  Brad stood and Sharon followed him down the hallway. “Nick said he’d dispatch a detective this morning to start their inquiry, but I haven’t heard from him yet.”

  They stopped at the door to her room. Brad glanced in and saw Mrs. Baker’s bluish-gray left-eye staring back at him. He winked at her and the eyelid snapped shut. Brad could only imagine what further adventures Sharon would have with her roommate before Alan discharged her.

  “When do I get that hot apple cider you promised?”

  “Call me when they spring you, and I’ll meet you in the cafeteria.”

  As Brad waited for the elevator, Crystal Himes trudged back to the nurses’ station pushing a cart that he suspected was used to dispense medication.

  “Good morning, Crystal.”

  Her body quaked, as if he had startled her. The long hours without a break were taking their toll. “Sorry,” she said. “I didn’t see you standing there.”

  “Who assigns the patients to specific rooms?”

  Crystal stared back, as if not comprehending the question.

  “Who decides what patients go into what rooms?”

  “Oh. That’s mostly the admissions department.” Crystal’s voice sounded stronger. “When a patient is discharged we let them know that we have a free room. When they have an appropriate admission they make the assignment.”

  Brad wondered what she meant by ‘mostly.’ “What’s an ‘appropriate admission’?”

  “The seventh floor is primarily for surgical patients. Once in a while, if the rest of the hospital is jammed, we might get a different type of patient, someone with pneumonia for example. We never see a pediatric case or maternity.”

  “So if the admissions department sends you a person for Room 717, you don’t have any flexibility to assign them elsewhere?”

  “Well,” Crystal hedged, “I’ve seen circumstances where we move patients.”

  Brad smiled and nodded, hoping to coax more from her.

  “Most of our rooms are double rooms, but if we have a patient where we think they would do better in a private room. For example, if they were having complications from what should have been outpatient surgery, and they are assigned to a room with an overly talkative roommate, we might move them. Or if a toilet malfunctions in a room, then we try to move the patients.”

  “Seems reasonable,” Brad said. “Do you have to pre-authorize a move?”

  She shook her head. “Any duty nurse can make that decision. We just have to notify the admissions department so their records are accurate.”

  “Thanks for your time, Crystal.”

  Brad could find out if any transplant patients were deliberately moved by contacting admissions. One more tidbit to add to the growing list of questions on this confusing case.

  Leslie Carpenter’s office door was wide open and she sat behind an immaculate desk, wearing a green smock that complimented her prematurely silver hair. She was so well put together that Brad doubted she had spent the night in the snow-bound hospital.

  “Come in, Mr. Frame,” she announced. “Close the door and have a seat. Dr. Fenimore told me you’d be stopping by.”

  Brad did as she asked, and wondered what kind of welcome he’d have gotten without Alan’s interceding.

  “I recognized you from your picture in the paper and on television,” Ms. Carpenter continued, “but you look younger in person.”

  For all its prominence as the cradle of American independence, Philadelphia was a rather insular city. When not reporting on corruption by local politicians, the media liked to highlight the comings and goings of Main Line society, from their attendance at a symphony concert at the Kimmel Center to charity fundraisers. Brad tired of his big-fish-in-a-small-pond faux celebrity.

  “Thanks for seeing me. I don’t know if Alan explained why I wanted to talk with you?”

  “I’m afraid not. How do I warrant a visit from a famous detective?”

  Her tone seemed innocent enough, and Brad weighed using a direct approach. The hospital’s rumor mill was already clogged with stories of a potential murderer on the loose. The transplant coordinator’s office would surely know about the dead transplant patients.

  “I’m helping the hospital with the investigation of several suspicious deaths,” Brad began.

  Leslie Carpenter barely blinked.

  “I’d appreciate your help in reviewing the process by which these patients became a candidate for a transplant.”

  Ms. Carpenter folded her hands in front of her on the desk. “I’d like to be of assistance, Mr. Frame, but I don’t have a signed release from any of the patients to disclose information to outside parties.”

  Brad remembered his $1 retainer contract. “The hospital is paying me.” He wanted to add handsomely, but resisted. “I’ve already seen their medical records. I’d just like to get a sense from you about how they got here, and I’m hoping you can tell me if they came into contact with each other prior to receiving a transplant?”

  She cleared her throat, and Brad imagined he heard gears shifting.

  “The process starts with a referral from the attending physician.” She spoke like a lecturer in front of a class who’d covered this material hundreds of times before. “We request medical records and schedule the patient for an initial interview. At that time we discuss the options that are available and do blood testing. In the case of a kidney transplant, where the patient may have a potential donor, we arrange to meet and evaluate that donor. We want to ensure that the donor is in good physical condition, and we do a type and cross match so we know the donor kidney will work.”

  “So the donor and recipient have to have the same blood type?” Due to a high school football injury that prompted emergency surgery for a ruptured spleen, Brad learned early in life that he had a B Negative blood type; not the rarest, but rare enough that the local Red Cross regularly recruits him to donate blood.

  “A compatible blood type, yes. But we also need to look at specific antigens that experience has shown will dictate a good match
.”

  Antigens sounded like a quiz question for which Brad hadn’t read the chapter. He flashed a perplexed grin, hoping she would rescue him.

  “An antigen is a protein. We look at six specific antigens as the best possible predictors for a successful transplant. For example, among siblings we would expect to find a match for all six in twenty-five percent of the cases….”

  Ms. Carpenter’s cell phone chirped. She extracted the phone from her purse, and glanced at the screen. “Pardon me,” she said, “I’m expecting this call.”

  “Would you like me to step out?” Brad asked.

  She shook her head; as she flipped open the phone. “Hi honey. You’re there?”

  Brad heard the timbre of a male voice, but couldn’t make out the words.

  As she listened, her expression darkened. “Oh no.” Carpenter stiffened in her chair. “What did triple-A say?” A pause as she listened. “Four hours?” she screeched.

  This time he could understand the words from the voice on the cell phone. “Mom, I’m okay.”

  Ms. Carpenter swiveled in her chair, and transferred the phone to her other ear, and calmly said, “Alright, where are you now.” After listening for thirty seconds, she said, “Do you have enough money…? Good. Well, I guess we better save your cell phone battery. Call me later today…. Love you.”

  Leslie Carpenter closed and placed the cell phone on her desk, wiped a tear from the corner of her eye, and faced Brad. “I’m sorry. That was my son. He’s a senior at Rutgers—pre-med—classes don’t start until next week after the holiday break, but he made plans to get together with his buddies this weekend. I warned him not to go. Radio and TV are filled with announcements to stay off the roads unless absolutely necessary. But he insisted that he could make it in the four-wheel drive Jeep.” She rolled her eyes. “Well, he broke down on the New Jersey Turnpike, with what he suspects is a frozen fuel line. He called triple-A, but they said it would be at least four hours before they could tow him in this storm. So he walked, walked,” she repeated, with raised eyebrows, “about a mile to one of the service plazas along the Turnpike.” She sighed. “He tells me there’s a Starbucks there, like that’s supposed to make me feel better.”