Plan to Kill

by Gregg E. Brickman

  She retrieved her iPhone from her purse and opened a drug reference guide, tapping through the various blood pressure medications she thought he might have taken. Nothing there of interest, but a combination of the drugs given for high blood pressure could cause unusual reactions. Puzzled, she headed to bed, thinking about Peter Sanchez, grieving her lost colleague.

  10

  That night, after receiving report in the nursing office from the departing supervisor, Miki took the elevator to the top floor, intending to make her rounds by walking the stairs and stopping on each unit to talk to staff and check on the sickest patients. She appreciated the design of the Foxworth Building because stairwells on both ends of the rectangle allowed her to cover each level without doubling back.

  She stopped at the sixth floor nursing station, found everything in order, then stuck her head in to see Madeline. Walden sat in the recliner staring into space with an open book, print side down, on his lap.

  "Hello. The cover on that book is beautiful. Did Katie make it for you?" Miki admired the collage of hearts and flowers, which was protected by an outer wrap of clear plastic.

  Walden glanced toward her and smiled, though his eyes looked sad. "She made it for her mother last Mothers' Day. It was their class art project. Madeline used it to cover her Bible." He held the book for Miki to see.

  "It's extra special nice then." Miki picked up the clipboard from the chart rack and stepped in. "Her temperature is normal. Guess the urinary tract infection didn't get much of a hold on her." Miki touched Madeline's forehead with the back of her fingers, then checked her feeding pump and catheter drainage.

  Walden looked her way, pulled a ribbon over to mark his place, and closed the book. "Hey, Murphy. How'd the meeting go this morning?"

  "Just like I expected, except Gardner, Anson, Dr. Irvin, and Mr. Troicki were there."

  "Really? Troicki? Don't see the old board chairman around much on a Sunday morning. Irvin either for that matter."

  "Irvin's been Sanchez's personal physician for years, and he's the second in command on the medical staff. He'll take over as chief until the next election."

  "Learn anything we didn't already know?"

  Miki repeated a few points from the morning meeting, being careful to avoid any mention of Madeline's surgery and Sanchez's reported reaction. "Dr. Ephraim and I told them what happened."

  "When will the autopsy be?"

  "I'm not sure. But I think soon."

  "Will you let me know when you hear something?"

  "I don't think I'll hear anything." Miki paused. "I guess Ephraim will see the reports since she was the treating doc when he died. She might tell us. I'll ask her." Miki thought a moment. "You've been a medic for a while. Did you ever see a patient with the exact symptoms as Sanchez?"

  "Heart attacks look different in the field."

  "I don't think it was. I worked ER for years before moving into supervision. I never saw an MI present like that."

  "Nah, Miki, you're wrong. Myocardial infarction. They sometimes give the slow rhythms if the damage is in a certain place. You'll see when we get the report." Walden stood, glancing at his watch. "Time to get ready for work."

  "It's early."

  "No. I forgot my stuff. I'll have to run home and change into my scrubs."

  Miki frowned. "See you later maybe. I'll go to the ER and have a talk with Ephraim as soon as I'm done with rounds. Maybe I'll learn something that will help me put it together."

  Walden, though always touchy when with his wife, seemed extra edgy. His stuffed-to-capacity backpack sat next to the bed with navy scrubs visible through the half-zippered opening.

  Miki exited the room feeling uneasy. He lied. Why? Maybe he just wanted me to leave, she thought.

  Other than the buzzing about Sanchez's death, the hospital was quiet. Miki finished her rounds, started a couple of hard-stick IVs for a new staff member, checked staffing for the morning shift, stuck her head in pharmacy and the lab, then made her way to the ER around eleven. Typical for a Sunday night, the waiting area was near empty and several stretchers sat vacant.

  Miki found Ephraim in the physicians' dictation area behind the nursing station. "How you doing, Jo?"

  Ephraim glanced at Miki, her expression pained. "I've been wracking my brain, trying to determine what I could have done to save Peter's life. Didn't get any sleep, and now I'm paying the price. I'm in a fog. Good thing it's quiet. Steven Baxter's coming in around midnight to relieve me."

  "I didn't get a lot of rest either, but I think I can function."

  She spun her chair around to face Miki. "Sheila was home. We went for brunch and took the dogs to the park. When I finally climbed in bed, I couldn't relax. She went to the hospital, and I quit trying to sleep."

  "Sheila came home for the day? That's unusual, isn't it? I thought she stayed in Miami on her work days." Miki scooted a chair over and sat.

  "Usually. She came home because I was upset, and she knew Peter, too. She's been at Jackson Memorial for years. She knew us as residents."

  "She work the ER then, too?"

  "Thrived on it. Still does. The ER nurses there are a breed unto themselves."

  "True." Miki paused. "I was thinking, researching drugs, worrying about Sanchez's symptoms and the code. Even though I'm probably wrong, I can't help but think it's a drug reaction. The unusual symptoms. The heart problems with it. And the fact we made no progress."

  "I had the same thoughts, so I spoke with Saul Irvin. He said Peter was taking Lasix along with a couple of antihypertensive drugs. It took them all to get his blood pressure under control, which at least explains the dehydration and the low potassium levels."

  "Would he have added any other drugs himself?"

  "Possibly. As egotistical as he was, he thought he could handle almost everything. But when he started having problems, he saw Irvin right away. I don't know. Maybe I should make sure the ME has all the information."

  "Good idea."

  Ephraim reached for the telephone and dialed. "I'd like to leave a message for Dr. Youngquist, please." While she waited, she removed a paper from her pocket. "Tell him Peter Sanchez took the following medications." She read the list, spelling the drug names. "Dr. Youngquist can get the details about Sanchez's health problems from Saul Irvin." Ephraim recited Irvin's telephone number twice for the message taker.

  Miki stood. "Now we'll see what we can see."

  Miki's hospital cell phone buzzed. "Murphy." She listened. "Fine, I'm coming." After jotting a note, she waved goodbye to Ephraim and left, continuing the phone conversation as she stepped into the hall. "No, central supply is staffed but doesn't have a courier tonight. I'll get the supplies and bring them to you."

  John Walden leaned against the wall outside the dictation room.

  Curious, Miki knitted her brows and glanced at him, thinking about asking why he was there. His bewildered expression stopped her. "What's up?" she asked.

  "I was waiting to talk to you. I want to apologize for rushing you away earlier this evening. I, well, I didn't have to go home to dress. I didn't want to deal with you or anyone. Dr. Levine was in earlier. She told me she didn't like the results of Madeline's renal function tests. She thinks maybe Madeline is having more kidney problems."

  "I'm so sorry. I know it's hard on you." Miki touched Walden's forearm.

  "It's not me I'm worried about. Katie visited this afternoon. She didn't want to come, but I forced her. Told her that her mama was getting better. Madeline didn't even move her hand a little when Katie was there. Now this. Katie will think I lied to her."

  "As Katie grows, she'll understand how difficult this is for you. Keep her in the loop. Tell her what's going on. She's a mature little girl. She'll sort through it."

  "I hope so." Walden moved away, then returned. "I've been thinking about quitting my job with the fire department and working here full-time."

  "Why?" Miki said.

  "Katie, mostly. Working here full-time nights, I'd
have a more set schedule and could be with her every day. Bring her here more often. What do you think?"

  "From paramedic with the city to ER tech here is a big pay cut, but I know there are openings. That's why I ask you to come in so often."

  Walden nodded. "I'll talk to personnel. Tomorrow morning."

  "Get the details before you decide."

  "Good idea. Yes." He moved away then stopped. "I don't think they need me here tonight. Maybe I should go home. I'll be fresh in the morning to make my decisions."

  "Check with the charge nurse. If she agrees, it's fine with me."

  Miki watched Walden lean over the counter to talk to Arlene Porter, thinking his eyes lingered a bit too long on her overflowing bosom.

  The radio on the side counter came to life, and Porter moved to respond. Walden headed toward the exit, walking fast and not looking back.

  After listening and responding to the squawky transmission, Porter said in a loud voice, her Jamaican accent thick, "Four ambulances incoming, auto accident, six injured, two critical." She took a step toward where Walden had stood, "Damn, he's gone already. I was going to send him for Ephraim."

  Miki raised a hand to catch Porter's eye. "He's already out the door. I'll get the doctor, then I have to make a run for supplies for one of the floors. I'll give you some help in a few minutes."

  Porter nodded, sending her long braids into motion, then headed toward the trauma room at a fast trot.

  11

  The tall, thin man waited until the guard left his station in the ER waiting area, then strolled through as if he had important business. Access was easy. The arriving ambulances had captured everyone's attention, and his timing was perfect. The man knew the way as well as he knew the way to the kitchen in his own home.

  He stood in the temporary corridor, gazing at the Troicki construction zone. He checked his watch, figured on spending an hour or so exploring before the night security man made rounds, then ducked under a Visqueen flap covering an opening in the molded plastic wall. The men used it during the day to access the bathroom and cafeteria in the facilities building.

  Removing a flashlight from the side pocket of his black cargo pants, he hurried into the site. He stopped, pulled a dark cap over his head, tugged down the sleeves of his black shirt, slipped on gloves, then stepped around a partial wall into a roughed-in passageway, switching on the light and moving with stealth. Closer inspection confirmed the electrical work was unfinished. No way would this building be finished by the scheduled opening date, a mere three months away. More important, it would not be complete enough by his scheduled closing date—six weeks at the outside. He coughed sharply, swallowed, covering his mouth with his arm to block the sound.

  Finding a protected corner, the man crouched low and turned off the light. The slow progress on the Troicki building was a shock. His intention had been to wait on the building and include it in his plans, but overwhelming need drove him to move faster. Maybe now was the time to reconsider. Encircled in his own long arms, he wept.

  When empty, he dried his face on his sleeve and thought about Sanchez. The lack of drama with Sanchez's death bothered him. Why hadn't there been more action, people crying, and accusations flying? Nothing. When the wife left the hospital, walking across the parking lot with a friend, she'd said she wasn't surprised. Her husband didn't take care of his health. The man knew that wasn't true, at least not of late. He'd wanted to tell her that, but stayed hidden in the shadows instead.

  Cope. Adjust. Explore. Find a place. Do something dramatic, obvious, perhaps obscene, yet not leading to him. Untraceable. Something to push the police off-track when they investigated.

  It took several minutes to regroup. The glow of his digital watch caught his eye. "Damn. I've wasted almost twenty minutes." Muttering, he edged from his hidey-hole, turning and shining his light around, making sure there wasn't a scrap of evidence of his visit.

  The temporary hallway was empty with the doors closed on either end. He made his way to the section of loose Visqueen and crossed to the other side where workers had stapled the opposite panel in place, isolating the old hospital building.

  It took five minutes to remove the staples with his pocketknife and slide them into the cellophane wrapper on his cigarette pack for safe keeping. He made a mental note to find something to use as a tack hammer, but if need be, his thumb would work. When he practiced, the staple bit into his flesh as it slid into place.

  After he lifted the bottom-left corner, the opening was large enough to crawl through. Staying low, the man traversed the ten-foot open space separating the old building from the temporary corridor, then pulled on a glass side door to the old hospital's emergency department. It rocked on its hinges. Standing back, he placed his foot against the doorframe, grabbed the handle with both hands, and pulled. The lock sprung.

  He pitched himself through the open door, pushed it closed with his feet, then lay on the floor expecting someone to respond to the loud noise. He waited, his breathing labored, for two full minutes before rising to his feet.

  The door on the Foxworth Building side of the walkway rattled, then swung open.

  The man flattened his body against the adjacent concrete block wall. At an angle through the cloudy glass, he saw a slight, blond woman in green scrubs and white lab coat hurry along. Miki Murphy. Still here. Still working. Maybe in the way. He remained motionless, even holding his breath, until Miki passed and exited the corridor on the far end.

  After duckwalking under the side window, the man stood and left the old ER, moving into a dark hall. A familiar ache in his joints pulled him up short, and he stopped to rest. He ran his forearm over his sweat-drenched forehead, then took several deep breaths, restoring his belief in himself. His body reeked, but there was another odor as well, something more basic—a faint, putrid aroma of death.

  It had been many months since his last visit to the old hospital building, but the layout was fresh, as it he'd been there yesterday. To the left was the old radiology department, a possible location, no windows, and one exit at the far end of the hallway. Perhaps that would make a safer entrance, avoiding the south side of the building and the Troicki Outpatient Center construction zone.

  The man explored to the left, switching on his flashlight after moving well inside the area. Further along the hall, the smells became less intense. The knowledge that he moved away from the source was comforting, grounding.

  The first room was long and narrow and held the original wall-mounted chest x-ray machine. He entered and directed the beam around. To the left, a small door led to a processing area shared by two examination rooms.

  The door creaked on its ancient hinges. He stopped, listening for any response to the sudden noise. A scratching, perhaps. He switched off the light and waited. The scratching sounded closer, then something brushed his trousers and he shuddered. Rats. He stomped his feet and heard skittering. Again, he crashed his foot onto the hollow floor. Silence.

  The man waited but heard nothing more. Perhaps the rat remained there, perhaps not. Feeling safer, he turned on the flashlight. A dozen or more pairs of red eyes glowed at him from thin, gray faces. They were getting food somewhere, but not enough. The creatures looked hungry. A shudder racked his body. He scanned the floor, found a gaping hole into the crawl space below, then retreated from the six-by-six space.

  Years ago, a technician complained about rodents occupying a den under this section of the building, but he discounted it until learning the radiology wing sat on a wood-framed foundation—unheard of in modern day Florida construction where concrete was the material of choice. It surprised him that one of the hurricanes raging through over the seventy-year life of the structure hadn't blown it apart.

  The next examination suite was suitable. The imaging table sat dead center in the twelve-by-twelve space with the outdated overhead camera docked to the side, out of the way.

  He stopped moving and heard the rats. They could work to his advantage when the time
came.

  A opening to the rear revealed a bathroom with a single commode facing a wall-hung ceramic sink.

  He nodded his head, pleased with the accuracy of his memory.

  The flashlight beam illuminated thick mats of cobwebs high in the corners. Closer inspection revealed several huge spiders clinging to the webs. Meanwhile, large palmetto bugs scurried across the floor as if intent on avoiding the bright yellow circle moving around them. Bugs as large as rats, he thought, then laughed aloud at his own joke. Excellent.

  The offices and waiting areas beyond the exam area were vacant and not suitable for his scheme. Continuing to the far end of the department, he took a moment to study the exit. The handle and lock were new, replaced after a building inspection the previous year. It wouldn't be possible to force it from the outside. Deciding it was, nevertheless, the safest path, he took a moment to ease open the door and stuff the lock mechanism with debris.

  There was one other old, closed area deep within the decaying structure worthy of checking. It was a place where distance and thick walls would cover any noise, prevent interference, and delay discovery, at least for a while.

  Reversing his direction, the man passed the old ER lobby where he had entered the building and turned left. He crouched to pass the bank of windows facing the Foxworth Building, then stood to full height, turning into another branch, and heading into the bowels of the old structure.

  The air, heavy with the stench of mildew and decay, became thicker, warmer, damper. The flaking bile green paint on the walls brightened a shade under the direct beam of his torch. Old, square ceramic tile faced the walls halfway up from the floor. The blackened grout sprouted slivers of fungi. Overhead, the once-white ceiling tile was dark with decay.

  The door to the central supply department stood open, loose on its hinges. He entered, pausing to listen after each step, aware of possible dangers, remembering the vermin and the hole in the floor. This section of the building sat on a concrete slab, but he didn't know about partial crawl spaces. He didn't know about rats.