It was the moment every police wife feared. The harried report of a fallen officer being transported to the ER.
Lilly took a deep breath in an attempt to steady her breathing. She hadn’t heard from Nathan all afternoon . . . and what made it worse was that she was the receiving ER physician.
The sound of the wind deafened the approach of the sirens. The first hint of their arrival was odd white lines unhinged from any person, the reflective stripes of the EMS uniforms as they neared the well-lit trauma bay.
Within seconds, the glass doors parted, and the screams propelled Lilly from the wall. Then she recognized Lee in front of the medical team. She found herself staring but unable to move farther.
“Is it Nathan?” She desperately needed to know and didn’t want to know at the same time.
Lee shook his head. “SWAT call.”
Lilly felt weak with relief. As the gurney passed, she placed her hand on the young man’s chest; his muscles were rigid, his skin soaked.
The SWAT medic began his report as they turned into the trauma bay. “Ryan Zurcher, twenty-eight-year-old male with complaints of severe generalized muscle pain, chest and abdominal pain. Blood pressure 170/100. Heart rate 140. Respirations 32. Patient is pale and diaphoretic. No known injury.”
He was transferred to the ER gurney. Several nurses began connecting the young officer to medical equipment. In her peripheral vision, Lilly could see his ECG tracing appear on his bedside monitor. The normal buzz of the blood pressure cuff cycling barely registered above her patient’s screaming.
She saw Lee hovering in the corner, his large frame pushed in as far as he could wedge it.
“Lee, what happened out there?”
His eyes were wide, his lips quiet.
“What did he tell you before he became sick?”
He stepped toward her. “Lilly, there was nothing. He began to complain about his stomach hurting. Then it just . . . cascaded quickly into what you see. The pain . . . it’s just intense. It’s worse than anyone I ever saw who’s been shot.”
“Did he take something? A drug? Contact with a poison?”
“I asked him. He denied it.”
Lilly turned back to her patient. It was as if his skin was on fire and his body was using his cooling mechanism to drench it. To stick his monitor patches in place, the nurses had dried off his chest.
It was already slick with sweat again. The nurse dropped the rag and quickly bent to retrieve it. The officer’s screams were unbearable, and Lilly could see her nurses were on edge. Rarely did they drop things or seem clumsy.
This was different.
Lilly herself fought the urge to pull her head into her shoulders at the young man’s death throes.
Emergency personnel were used to seeing patients in pain, and they could easily differentiate types of pain. The drug seeker wanting a narcotic fix. Pain from fractures. Ischemic pain as the heart protested a lack of oxygen from clogged arteries.
Zurcher’s pain was an ear-splitting brew of torment. Hopelessness that they couldn’t stop what was happening.
“Ashley, start him on high-flow O2. Let’s get an IV in.”
Her mind filed through several diagnoses, none of which fit his clinical picture. What could possibly cause such intense, whole-body, muscular contraction? High blood pressure? Diaphoresis to the point he sweated off every piece of tape they placed on his skin?
One thing she knew through every worried eye looking her way was she needed to show direction.
A game plan.
Now.
“Denise, let’s run a twelve-lead ECG. Cindy, let’s get these labs. Blood counts, complete metabolic panel, inflammatory markers. Let’s check his cardiac enzymes. Grab a blood culture.”
When the answer wasn’t clear, a broad attack was necessary. Some equated it with throwing noodles at the wall to see what stuck. Hopefully, something would pop up and give a clue as to what was killing the patient.
Normally, it wasn’t such a shot in the dark.
“He’s not even thirty,” one of the nurses commented.
Lilly pulled her bottom lip between her teeth. “It won’t be the first heart attack we’ve seen in a young man. Next, I want him in radiology. Let’s get a CT of his chest and abdomen.”
She turned back to Lee. “Does he have family?”
“Yes, but they’re not exactly mobile.”
“I need someone to go get them. Send a car.”
“Is he . . .?”
It was the unasked question friends and family dreaded but found hard to verbalize. Death. The angel that waited for every person at some point. Yet people were often blasé about their thoughts of God and what that belief meant for them in the end.
Denial as a safety mechanism.
“I don’t know. I need more history. Maybe they’ll know something.”
Lee exited the room. She could see him framed by the window. It wasn’t unusual to have a number of officers at the hospital if one was injured. Considering this seemed more medically related, Lilly wondered why they continued to hover.
“I’ve got the labs,” Cindy stated. “What are we going to do for his pain?”
“Let’s try Valium, two milligrams, and fentanyl, one hundred micrograms, IV and see what it does. Any word on CT?”
“They just called. Should be ten minutes. They had a stat from intensive care that pushed him back.”
“Here’s the twelve-lead.”
She took the pink-and-white-graphed paper in her hands.
The cardiac waves looked normal. It was fast, but anything could cause simple tachycardia. Pain, anxiety.
Check. Check.
“What was his temperature?”
“Mildly elevated. One hundred point two.”
Not high enough to affect his heart rate.
He didn’t show classic signs of a heart attack. Theory one down the drain, although more definitive data would come from the blood work.
The cluster of painful areas could fit a dissecting aortic aneurysm, where the layers of the large artery began to split apart. She listened with her stethoscope again to his abdomen, checking for the classic bruit, a harsh sound like a murmur, which would indicate turbulent blood flow.
Silent.
She continued to assess for this condition. Feet normal color. Good pulses at his ankles. He didn’t seem to have any of the other risk factors other than he was male.
Normally, this would be more likely in men over fifty.
Lilly slid her tongue on the inside of her cheek. His symptomology didn’t fit anything originating from a medical disease in her mind. It had to be something toxic. Either ingested or given.
Her mind flipped through several toxidromes, classic groupings of signs and symptoms indicative of a particular poison.
The young man didn’t fit any of those groupings either. Though not a classic presentation, Lilly sensed it was an avenue worthy to explore.
His illness wasn’t contrived.
“Ladies. I want his clothes stripped off. We’re going to place a catheter and send a urine drug screen. I want to look over his skin and see if there’re any odd markings. Track marks. Bite marks.”
“Human?”
A faint smile tugged at Lilly’s lips. Dark humor was the ER staff’s way of releasing stress. Few others understood its use when someone was suffering. Lilly knew this man’s case hit an instinctual reflex in all of them that something was beyond the norm. Something they needed to find.
“I was thinking more six-legged,” Lilly quipped.
The silver blades of trauma shears flew. No one could undress a man faster than a team of ER nurses. Within minutes, the tube was placed, he was placed in a gown, then covered with a thin white sheet. Already pockets of sweat darkened circular areas.
Lilly stepped next to the bed. First, she picked up an arm and checked the surfaces nestled against the covers. She ruffled her fingernails through the coarse hair of his forearms, looking for hidden needle mark
s. Methodically, she looked at the other arm. Turned his head side to side, she examined closely for anything out of the ordinary.
Nothing.
“Let’s turn him up on his side.”
After the pain medication, his screams had quieted to whimpers.
Two nurses laid gentle hands on the man’s body and pulled him away from her. The medications she’d given thus far made little difference in easing his muscular contractions.
She placed two fingers along his spinal column, feeling the tips of the vertebrae. Not really expecting to find injury but thinking with each sense her fingertips communicated. “Let’s repeat the Valium. He’ll need to be still for the CT.”
When Lilly edged his gown aside near his iliac crest, she found what she was looking for. It was a marking, but not like anything she’d ever seen.
An hourglass had been sliced into his skin near his left flank. Eight small wounds, possibly injection sites, hovered around the hourglass like orbiting moons. The skin was blanched around the tiny, reddened dots. Red streaks groped away from the hourglass into untouched skin.
An infected tattoo?
Lee entered the room and neared her side. She glanced his way while pointing, directing his attention to the marking.
“Any idea what this might be?” Lilly asked.
A slow crawl of recognition hinted of something in his eyes.
“What?” Lilly pressed.
Lee cracked his knuckles. “He mentioned an interesting date.”
“Anything specific? Did they take something?”
“He made it sound like he faded out. Took some allergy medication and fell asleep. In the morning, she was gone.”
“Did he say for sure the pills he took were his?”
“You think she might have given him something?”
Lilly shrugged as the possibility crossed her mind. “Something to knock him out enough to do this? If a man can do it, why not a woman?”
She motioned to her team to ease him back. When his skin made contact with the bed, he screamed as if they laid him on a shallow pool of lit gasoline.
Whatever those marks were, it could be a source of infection. A source of whatever was ailing this young man. Even sepsis didn’t quite fit his clinical picture.
“CT called. They’re ready.”
The nurse repeated the pain med. The young man had his arms clasped into his chest, shivering through clenched teeth. His lips bled from where he’d bitten into them.
“Let’s get him over there.”
Chapter 21
THE SNOW SWIRLED AROUND Keelyn’s entryway as she struggled with holding Sophia and getting her keys in the lock. Sophia began to cry, matching the sound of the howling wind in her ears. Just as she reached to turn the knob, the door released in front of her. A small gasp escaped her lips before she realized Lee’s frame filled the doorway. He took Sophia from her arms and pulled her up into the foyer. The wind whistled through the narrowing crack as he eased the door closed. With his free hand, he pulled her into a tight hug and nestled his face against her cheek. Her mind hazed at the scent of his woodsy cologne; the warmth of his skin against hers tingled her nerves.
A moment she wanted to hold onto forever. Happy. Sweet. Peaceful.
“Didn’t you see my truck on the street?”
She frowned and pulled away, knowing any answer she gave would raise his hackles. Keelyn was never as observant as Lee wanted her to be, which infuriated him, considering her chosen profession. Focused observation was her specialty. The periphery was a different skill.
“I’m sorry. With the snow, Sophia crying—”
“Don’t you test the knob to see if it’s locked before coming in?”
Carrying Sophia, Lee walked to the kitchen table and sat. Sophia danced briefly before she sank into his muscled arms and snuggled her face into his neck. Lee nudged at a pile of disks with his finger. “Why are all these DVDs from Boulder police here?”
“Do you remember the woman in the park?”
“The one with the missing children?”
“Yes. Well, they’re not so sure Rebecca’s not involved. They’ve asked me to review some recordings and help with her interview tomorrow afternoon.” Keelyn eased her coat off her shoulders. She could see the worried cracks harden his face as he rocked the child side to side. “Do you want to talk about it?”
The news had been heavy about the bank incident throughout the evening. Lilly had texted her when she knew the officer’s identity, knowing Lee would be tied up with the sickened officer and the subsequent internal affairs interview.
He shrugged haplessly. “It wasn’t the best day.”
“Why were you even at the incident? I thought you were working with Nathan on Freeman’s murder and when you figured that out we’d know where Raven might be.”
“I got pulled off the case.”
Her mind whirled with suspicion. What was the reason? This would be an unusual move for the chief unless something extraordinary was going on. Lee was a well-respected officer with several commendations.
Did this have something to do with what she felt he was hiding from her?
Keelyn sank into the chair opposite him. In the center of the small farm table was a wicker basket with several toys. She pulled it toward her. Her heart swelled at the thought that Lee had taken time to shop for Sophia. Maybe he was beginning to see a life with all of them together.
“It seems a weapon I reported stolen about three years ago is the same gun used to kill Dr. Lucy Freeman.”
The happiness fleeted as dark shadows of uncertainty clouded her mood.
“How is that possible?”
He shook his head and resettled Sophia, cradling her like an infant. “I wish I knew.”
“Who stole the gun?”
“I don’t know.”
“Meaning you won’t say who the most likely suspect is.”
Lee busied himself tracing his finger over Sophia’s cheek, his deep blue eyes downcast. His jaw tensed, and he closed his eyes. The wave of tension set Keelyn’s heart rate higher. Finally, he turned to her. “There’s something I’ve never told you about my brother.”
“What is it?”
Why did it pain him so much to disclose this information to her? Should there be any secrets between two people pledged to be married?
Lee traced lightly over Sophia’s closed eyes. “Conner has a drug problem. He lived with me for a while, but things got pretty rough between us and I kicked him out. To you, I’ll admit, Conner probably took the gun, but that’s a far stretch from saying he murdered someone. Maybe two people.”
Keelyn’s gut was heavy with his revelation. He’d lied about his relationship with his brother and that utopian relationship had given her additional guilt about Raven. She put her shaking hands under her legs and turned back to Lee. She wanted to question him for more information, but he had physically turned his body away from hers, his shoulder now in direct line with her chest, a nonverbal shout of his mind closing down this topic of discussion.
How far could she push him? “What’s your theory, then?”
“That he took it and sold it for either drugs or money for drugs. It’s not unusual for stolen weapons to cross through several people.”
“What’s Nathan think?”
“Nathan and I aren’t on the same page. Conner is his number one suspect at this point, and the chief is on board. He wants to keep any complaints about conflict of interest at bay.” He bent and placed a light kiss on Sophia’s wispy dark curls. “But enough about my miserable day. How was yours?”
She pulled the wooden mallet for the xylophone from its holder and clapped it against the rainbow-colored metal. The metal notes caused Sophia to lift one eye open and she clenched the mallet in her fist.
“I went to the church identified in the Bibles we found at Raven’s home. I spoke to the minister.”
Lee’s head snapped up in surprise. “You went there without Nathan?”
Kee
lyn nodded without looking up from the wicker basket.
“Find out anything?”
“It’s hard to know where to start.”
“The beginning is always best.”
“The minister, Russell Atkins, had a mentoring relationship with Raven. He was very concerned about her.”
“About her mental stability?”
“That and more. He said she was having trouble with depression. Claimed to another member of the church she was having hallucinations. Called him Lucent.” She fingered through the toys in the basket. The wind knocked at the closed windows. “She worked with a group of people who did outreach ministry with the homeless.”
“Sounds like she was doing very honorable work.”
“One of these homeless individuals she was evangelizing turned up dead. Another one is missing. Someone who goes by CW.”
Lee pointed one of his feet in the direction of her front door. A classic sign for wanting to end the current interaction and leave. In a normal interview, she would dive into the subject matter immediately preceeding that indicator as the individual showed an area of agitation.
His voice was a pitch higher than his normal resonance. “CW?”
She softened her voice. “Do you know who this person might be?”
Lee shook his head yes but responded, “No idea.”
Directional conflict. Just like the bank guard. “You’re sure.”
“Yes, absolutely.”
“You seem stressed out.”
“Just thinking about Ryan.” He leaned toward her to surrender Sophia.
Keelyn took the sleeping child into her arms and settled her upright, fingering the stray curls of her hair. “Is there something you’re not telling me?”
“He was there.”
“What do you mean?”
“Ryan was one of the entry team. Pulled your father out of the house.”
“And you’re concerned now because that’s two suspicious circumstances surrounding men who were there that day.”
“Yes, one dead and one ill.”
“But you don’t know what’s wrong with Ryan. It could be totally unrelated.”
Lee massaged his thumb into his opposite palm. “I don’t think what’s happening to Ryan is all that benign.”
Poison Page 15