"I mean, how do I find out who's following me?"
"Sorry. If you need a baby delivered, I'm your man. But playing Sam Spade, that's not really my strong suit. What do the police say?"
Elena turned toward the window. "I don't really have enough to justify making a complaint. What do I say? We saw headlights behind us? It's a creepy feeling, that's all." She opened her mouth and closed it again.
"What were you about to say?"
"It's like my midnight phone calls. And the notes. I don't have anything substantial. And I don't want to bring in the police until I have a bit more proof. Besides . . ."
"Yes?"
"This is silly. But it's possible the stalker is a deputy sheriff I met my first day in town. And if that's true, going to the police might warn him off. I don't want to do that. I want to catch him so he can be punished."
David took in a deep breath. "I had a patient who was the object of a stalker. They caught the guy red-handed. Do you want to know how that case came out?"
"It sounds like I don't want to know, but tell me."
"In Texas, stalking can be anything from a misdemeanor to a minor felony, depending on the circumstances. This guy got off with a fine and probation."
"What did your patient do?"
"She moved out of state."
"I'm not about to do that."
David turned to face Elena. He put his arm over the backseat and leaned in toward her. "I have to agree with you. The best thing to do is face this head-on. Besides, I can't see you running away from it."
"Will's investigator is trying to track down the phone calls. Maybe he can get a handle on whoever's following me as well."
"Sounds reasonable. In the meantime, don't forget that I'm here for you." For as long as it takes.
"I hope you don't mind if I sit down for a few minutes before I fix lunch," Dora Kennedy said.
"Not at all," Elena said. "Just rest for a moment." If you're cooking fried chicken, I'll wait as long as I have to.
"I'm sorry you didn't feel up to coming to church with us this morning." Dora carefully put her Bible on the coffee table in the living room, squaring it on top of the magazines there. "Matthew preached quite a good sermon."
Dora eased her ample bulk onto the sofa and patted the seat beside her. Elena joined her, wondering if a sermon, or at least a mini-sermon, was forthcoming. "I had to make rounds, then there was a patient in the emergency room."
"I thought Dr. Brown was on call this weekend," Dora said.
"He is, but I was walking through when the ambulance brought the man in, and . . . I don't know. I guess I hated to see Emmett called away from his Sunday morning when I was right there. As it turned out, it was pretty simple. This woman fainted at church. She'd been put on a new blood pressure medicine, and it dropped her pressure too much. She'll see her internist tomorrow and get the dose adjusted."
"Ever since you came here, Matthew and I have wondered why you've seemed so troubled," Dora said. "I guess you'll tell us about it when you're ready. But something he said this morning might help you."
Elena's guard went up. "Oh?"
Dora reached for the Bible and opened it in the middle. She thumbed through the pages until she found what she wanted. She pointed to a verse she'd highlighted with a yellow marker. "I don't have my glasses. Would you read that?"
Elena took the book, finding it surprisingly heavy. It had been a long time since she'd held a Bible. This one had large print—obviously a concession to Dora's failing eyesight—and ample margins that were filled with scribbled notes. She found the marked passage, cleared her throat, and read. "Where can I go from Your Spirit? Or where can I flee from Your presence?"
"That's from Psalm 139," Dora said. "It's one of my favorites. And what Matthew said was that, like David who wrote that, all of us face problems and trials. Running away does no good. But wherever we are, and whatever we do, God is always there. We don't even have to look very hard for Him. We simply have to open our eyes."
"Thank you," Elena said. "One of these days maybe I'll sit down with you and your husband and tell you all the problems I'm having. But I'm not ready to do that right now."
"You don't have to tell us about them until you're ready. And God already knows them, you know."
Almost unconsciously, Elena ran her eyes down the remainder of the column. She stopped at the bottom, and the words hit her as though they'd been written especially for her. "Search me, O God, and know my heart; Try me and know my anxious thoughts; And see if there be any hurtful way in me, and lead me in the everlasting way."
"See if there be any hurtful way in me." If she'd acted in a fugue state, she needed to know it—for the safety of her patients. For her own peace of mind. Finding out might mean a major change in the way she practiced medicine. It could even spell an end to her ability to care for some patients. But she needed to do it. She closed the Bible. "Excuse me. I need to call Cathy and get a name and address."
Elena paused in the doorway. "Thank you for sharing that, Dora. And thank Matthew for me too."
Elena's attention was focused on the message slips in her hand and the problems awaiting her on this Monday morning. She tapped absently on the door of Charlie Lambert's ICU room and was about to open the door when a voice inside the room said, "I don't care."
She backed away and listened as the speaker continued. "This hospital can't afford to give free care. I insist you make arrangements for a transfer to a charity facility immediately."
The door opened and Nathan Godwin almost knocked Elena down as he scurried from the room. Through the open door, she could see Mrs. Lambert standing at the foot of her husband's bed, crying. Dr. Shelmire stood beside her, looking daggers at the retreating administrator.
Elena hesitated in the doorway. This really wasn't her fight, and she couldn't add anything right now except maybe a shoulder for Mrs. Lambert to cry on. Then again, maybe that was what would help. She'd been here—sort of—and was more qualified than most to say "I understand."
Dr. Shelmire was the first to see her. "Dr. Gardner, come in. You should hear this too."
Elena eased into the room and took up station beside Mrs. Lambert. On the bed, the endotracheal tube was still in Charlie's throat, but the respirator was turned off, and he was breathing on his own. As Elena watched, Charlie thrashed around a bit and a few nondescript moans escaped around the tube that held his vocal cords apart. "Reacting a bit more, I see."
"Yes," Shelmire said. "He's beginning to react, although he's got a ways to go. I guess you heard what our hospital administrator said. He wants Mr. Lambert transferred to another hospital. Of course I've refused, at least until he's stable and more reactive."
Elena moved a bit so she was in Mrs. Lambert's line of sight. "Dr. Shelmire and I will handle this. Don't let it worry you."
Mrs. Lambert knuckled her eyes, spreading tears across her cheeks. "I slipped out to get some breakfast. When I came back Min, that Mr. Godwin was at Charlie's bedside. He started in on me, and then Dr. Shelmire came in." She looked at the neurosurgeon. "Thank you for standing up to that awful man. How can he be making these decisions? He's not even a doctor."
Shelmire and Elena exchanged looks. Elena said, "Actually, he is a—"
"You're right. He's only an administrator," Shelmire said. "Medical decisions are up to us. And rest assured that Charlie is going to get the care he needs."
Mrs. Lambert followed Dr. Shelmire into the hall to talk further while Elena moved to the head of the bed and did a quick exam on Charlie. He was definitely better, but he was a long way from "waking up."
As Elena turned to leave, her hip bumped the partially open drawer of the bedside table. She started to close it but stopped when she saw what it contained, in addition to a washcloth and a Gideon Bible. Nestled in the corner of the drawer was a syringe-needle unit, still in its plastic case. Beside it was a small vial of injectable material. Elena picked it up and read the label: Anectine. Her heart raced and a cold
sweat dotted her forehead. Who had put it here? And why would they want to kill Charlie Lambert?
Elena studied the diplomas and certificates on Marcus Bell's office wall. Bachelor's degree from Princeton. Medical school at Columbia. Surgery residency at NYU. Certified by the medical boards of New York and Texas. Fellow in the American College of Surgeons. Master of Business Administration in Health Care Services from SMU.
She could imagine the history behind the displays. His education and training were in the New York/New Jersey area, so he was probably from that region. Marcus had told her he was widowed, and she could identify with a desire for a change of scenery after that event. She wasn't sure why he'd picked this mid-sized Texas town for relocation. Maybe, as with her, it was the only life raft available in an ocean of trouble.
He'd come here to practice surgery, but somewhere along the line there came an appointment as chief of staff. To be better prepared for that role, he'd done something Elena would never have tackled. He went back to school—probably part-time—to get that MBA. Then, for reasons that apparently had more to do with politics than capabilities, "Dr." Nathan Godwin had taken over most of the administrative duties at Summers County General. That couldn't have sat well with Marcus. Well, if that was the case, he would love what she had to tell him now.
"Sorry to keep you waiting." Marcus sank into the chair behind his desk and handed her one of the two Diet Cokes he carried. "Don't drink it if you don't want it, but I sort of figured that if your day was like mine, you'd either want to rehydrate or use it as an icepack on your head." As if to illustrate, he held the frosty can first against one temple, then the other. He leaned back, put his feet on an open desk drawer. "What's up?"
Elena popped the top on the can and took a long swallow. "I was in Mr. Lambert's room this morning."
Marcus looked blank.
Elena went on to explain. "He's a patient in ICU who had an intracranial bleed six days ago. Mr. Lambert sort of fell through the cracks of the system and has no insurance coverage. He's recovering from surgery. He's off the vent, but he still has a ways to go. Godwin was in there this morning trying to browbeat Dr. Shelmire into sending Lambert to a charity hospital—I guess he meant Parkland."
"Unfortunately, that seems to be Nathan's motto. If it doesn't pay the bills, ship it out. I presume Shelmire stood firm."
"He did, but here's where it gets interesting. The drawer of the bedside table was partly open. On my way out, I started to close it when I saw a syringe and a vial of Anectine inside." She drank deeply from the can, then brushed a stray lock of hair from her eyes. "Someone—and, in my mind, everything points to Godwin—planned to inject Lambert with it."
"Wow!" Marcus chewed on his lower lip. "Clever. Anectine is easy to get in the hospital. Snatch a vial off any anesthesia cart. Inject it IV, just like they do when they put a patient to sleep. But this time, when it paralyzes the muscles, there's no ventilator to take over breathing. And in, what? A couple of minutes? Anyway, in short order, the patient is dead. And the beautiful part is that the drug is metabolized so fast that, by the time of an autopsy, there's no trace. That is, assuming they think to look for it at all."
"That's the way I see it. The question is, what do we do?"
"I don't suppose you brought the vial and syringe with you?"
Elena's mind began to race ahead. She could see where this was headed, and she didn't like it. "No. I was so shocked that I put the vial back in the drawer, slammed it shut, and left. Then I called your office and made this appointment."
Marcus rocked forward, and his feet hit the floor with a resounding splat. "Let's get up to the ICU. I want to see this for myself."
In a few minutes, they stood side-by-side in Lambert's room. Mrs. Lambert hadn't seemed unduly concerned to see two doctors, one of them unfamiliar, show up. By now, she probably wasn't surprised by anything. A week in an ICU would do that, Elena thought.
"Mrs. Lambert, this is Dr. Bell. He's a colleague. I was telling him how well Mr. Lambert is doing." Elena tried to muster her biggest smile. "We're going to be here for a bit. Would you like to slip out and get something to drink, maybe get a sandwich in the cafeteria?"
"That would be lovely. I'll only be a few minutes."
Marcus closed the door behind Mrs. Lambert. He drew the blinds, cutting off the view of the room from the nurses' station. "We don't need anyone else peeking at us right now."
Elena's hand hovered over the drawer pull. She started to use the tail of her white coat to open the drawer, then realized that there were dozens of fingerprints already there. No need to try to protect against adding more to the drawer pull. And what about the vial? Were there fingerprints there too? If so, maybe they could be checked. If the culprit had ever been fingerprinted, that would pin down his identity—or hers. Of course, Elena would have to give her prints for comparison, because they'd be on the vial as well.
"Well, open it." Marcus's voice had an edge. Was he as nervous as she was?
She yanked the drawer open and gasped. It contained the same Gideon Bible and washcloth she'd seen earlier. Nothing else. The syringe and the vial—with her fingerprints—were gone.
Restless nights were nothing new to Elena, but this one had them all beat. For hours she watched the numbers on the clock change. The minutes ticked away, the hours rolled over, but still sleep eluded her. Instead, her mind called the roll of the demons pursuing her.
When she finally fell into a troubled sleep, somewhere near dawn, wakefulness gave way to nightmares, always featuring the triumvirate of doctors she'd come to call "the tribunal."
"You were going to kill that patient," the monk-like doctor said.
"We have your fingerprints on the vial," came the pronouncement of the doctor with Coke-bottle glasses.
"Your only hope is to beg us for mercy," said the movie star clone.
"I didn't do it. I didn't do it." Elena tried to say the words, but nothing would come out. They lodged in her throat like a lead weight. She couldn't swallow. She couldn't breathe. She was choking, suffocating.
"This is your punishment." The middle doctor looked over his glasses at her, and his countenance was like an Old Testament prophet proclaiming doom on a city. "Just as your patient was to die, so shall you be starved for life-giving oxygen. Your brain cells will begin to die like waves of soldiers advancing into a cannon's fusillade. Your heart will quiver in fibrillation, no longer able to pump blood. Soon, all your organs will cease to function."
"When?" she choked out.
"Your death will be announced by the ringing of this bell." The handsome doctor held up a small brass bell and began ringing it. "When it stops, you will cease to exist."
Elena tried to reach out her hand to grab the bell and ring it. No matter how far she reached, it always remained just a few feet away. She stretched out her arm, again and again.
Her hand hit something, there was a crash, and Elena snapped awake. The tribunal was gone. She was in a strange bed, in a strange room. The lamp she'd knocked off the bedside table lay on the floor, its shade askew. Slowly it came to her. This was the Kennedy home. She was in their guest room. And the ringing was her cell phone, the ring tone she'd assigned to the hospital.
Elena sat up, pulled the covers around her to combat the chill she felt, even though the room was warm. She picked up the phone from her nightstand.
"Dr. Gardner."
"Doctor, I'm sorry to bother you this early. This is Glenna Dunn. I'm working in the ICU, and your patient, Charles Lambert, has a temp of a hundred and two. What would you like us to do?"
"Give me a second." Elena looked at the clock. Four-twenty-two. She'd been asleep less than two hours. She padded to the bathroom and splashed water on her face. She cupped her hand and drank from the faucet. Better, but only slightly. She struggled to get her mind back in gear. "Glenna, I'm back. When did you notice this?"
"We didn't wake him for vital signs through the night. That was Dr. Shelmire's order."
&n
bsp; "That's okay. So, what was his 9:00 p.m. temp?"
"Ninety-nine two. He was a little behind on his fluids, so we speeded up his IV. He seemed okay during the night, but honestly, I didn't keep a really close eye on him. We had a couple of pretty sick patients, and we're working short-handed. That's why they called me in to work up here on my day off from the ER."
"So why did you take his temperature now?"
"When things finally settled down, I had a look at my other patients. He looked flushed, so I used the old manual thermometer—you know, hand to the head—and he felt warm. That's when I checked his temp."
"Get a CBC. Urinalysis and culture from his catheter. I may want some other things, maybe a chest X-ray and blood cultures, but I want to see him first. I'll be there in about an hour. Call me if something else comes up before then."
"Do you want me to give him an aspirin suppository?" Glenna asked.
The mental index cards rippled in Elena's brain. Lambert wasn't taking anything by mouth—didn't even have a feeding tube in place. So oral meds were out. There were no IV drugs proven to effectively lower fever. An aspirin suppository would be the best choice, but aspirin had an effect on bleeding and clotting. It was a long shot, but if the fever was due to seepage of blood from the brain into the spinal fluid, aspirin might aggravate the bleeding. Besides, fever was a sign, not a disease. With a temp no higher than this, it was better to hold off and find the cause.
It took only a couple of seconds for Elena to parse the possibilities and say, "No. Hold off on any meds until I get there. See you soon."
She replaced the lamp on the table and started climbing into the clothes she'd laid out the night before, a habit born of long experience with calls in the middle of the night. As she dressed, she wondered what this latest development in the Lambert chronicle might represent. Was it something simple, like a urinary tract infection? More intracranial bleeding was possible, but quite unlikely. As she dressed, she tried unsuccessfully to ignore the possibility that kept popping into the forefront of her thoughts. Did this represent another attempt to kill Charles Lambert?
Prescription for Trouble - 03 - Diagnosis Death Page 18