by Kay Hadashi
“You’re sure I can’t get something for you to wear?”
“Solving a problem, Brock, without making it any bigger than what it needs to be.”
Turning the blouse inside-out, she stapled a new seam down the front where it had been cut open by the Emergency Room staff. Her plaid skirt required the same, the new seam somewhat crooked but mostly hidden in a pleat.
“That’s going to work?” Brock asked.
“Might be a little tight, but it’ll work.” She hammered a few more staples here and there for good measure before handing back the stapler. “Give me a few minutes to shower and dress and you can take me home. My home, not yours.”
Chapter Seventeen
“Remember what happened yesterday?” Brock asked while he drove.
“Is this an official police investigation into the accident, or are you looking for gossip?”
“A little of both, if possible.”
“I kinda remember bits and pieces, right up to when the front end of a cement truck came through the exit door. Everything after that is still pretty blurry. Did anyone…”
“Die? No. In fact, you were the most seriously injured victim. The driver has a few days off while the transit company and police investigate, but everybody else just got some bumps and bruises.”
“I have a few extras, if anyone would like another. For some reason, I get the idea you were there at the accident scene.”
“I was the first responding officer, on patrol just a few blocks away when the call came through.”
Maile lifted a Band-Aid off a knuckle and stuck it down again. “Did I say anything stupid?”
“Like a true nurse, you kept asking if everyone else was okay.”
“Nothing else?”
“In that kind of situation, when somebody takes a solid whack to the head, they say all kinds of things that never make much sense at all. You know that.”
“You’re very diplomatic. Why are we going this way? My place is the other direction.”
“Time for lunch. I imagine you need a meal?”
“As long as it’s not a date. Officially, I’m still married.”
“Your stories tend to change from time to time, Maile.”
“As in?”
“The time you had me take you to your ex’s bar. You told me then that you were free of him.”
“I only hinted that I might be telling a little white lie. There’s a difference. And you weren’t acting as a police officer in that moment.”
“How long will it be before you’re no longer officially married?” he asked.
“According to my lawyer, for whatever good she is, the court clerk needs to put some sort of official seal on the documents that I signed and sent in. Then they make copies to send out to everyone concerned. Once those are in my hand, I’ll officially be divorced. And before you ask, I have no idea how long that takes, and neither does my lawyer. As if she has any answers to anything. Why are we stopping here?”
“Yesterday, after the accident, you kept talking about wanting chop suey. Since you’ve been here before, I thought you’d like Chop Suey City.”
“I was talking about chop suey?”
“Yeah. You want something else?”
“This is okay, I guess. Do these clothes look stupid with the staples in them?”
Brock scanned her for a second. “Nobody will notice anything.”
When they went inside, Maile’s suspicion was verified that they wouldn’t be eating alone when she saw Detective Ota and a couple of beat cops at a large table. Two places were sitting empty, waiting.
“This looks like entrapment,” she said, standing behind her chair, looking at Detective Ota.
“Just want to make sure you’re okay.”
Maile sat and ordered a plate of food. “Before you ask, Detective, I lost the box in the bus accident.”
“What box?” one of the beat cops asked.
Ota told them in no uncertain terms to finish their meals and get back on patrol. Once they were gone, he turned his attention on Maile. “You got it from wherever it was hidden and then lost it?”
“I had it safe and sound and was on my way to the police station with it when the accident happened. I lost everything. My bag, my wallet, IDs.” Maile cursed quietly. “I even lost that envelope you gave me.”
“And everything in the envelope?”
“Yeah. There’s no branch for my bank near the police station, so I made the plan to go to one after I dropped the box off with you.”
“And the box?” he asked.
“In my bag with everything else.”
Ota banged his hand on the table.
“I’m sorry. I know how important that was to you. I even asked if you wanted to give me a ride there.”
“Yes, you did do that. You had to take the bus?”
“My car won’t start anymore. I don’t know what’s wrong with it. It doesn’t care how much I slap it around, it just won’t start.”
“I can come by and take a look on the weekend,” Brock offered.
Ota waved for him to be quiet. “One thing at a time. How bad was the bus damaged?”
“Turned on its side and the center was crushed in at the rear exit door. CSI was there to clear the bus of personal property and check for evidence. I turned the scene over to them and parking enforcement before going back on patrol.”
Maile’s meal was delivered and she began eating. “If they found my bag, where would it have been taken?”
“They don’t look very hard for personal property,” Ota said. “Only if something is suspicious do they collect it as evidence. The bus company might have something, if they’ve started their own investigation. Things like that are often investigated as thoroughly as an airplane accident. It could be days or weeks before anything is available for owners to collect.”
“Can’t you swagger in and flash your badge?” Maile asked.
“Not if it’s an NTSB investigation. They don’t like local cops interfering in what they think is their jurisdiction.”
“Oh, yes, mustn’t meddle in the federal government’s business,” Maile said sarcastically. “I’m sorry. I don’t know what else to do or say.”
“Either do I,” Ota said. He smacked the table again before leaving.
“I don’t know how to apologize to him. I know I screwed up losing the box, but it wasn’t my fault there was a crash.”
“How’d you find the box?” Brock asked, sipping from his teacup. He hadn’t ordered a meal.
Maile told a watered down version of what she’d told Ota, about going to the yacht a few nights before and finding the box hidden in a locked cabinet. “Instead of being seen carrying it home, I hid it behind a building in the commercial area in Hawaii Kai. When I went back to get it yesterday, painters were there. I had to go dumpster-diving to find that dang box, only to lose it on the way home. You know, I’m really starting to hate that box.”
“I think Detective Ota is also.”
“What does he think is so important about it that he needs it so bad?” Maile asked. “At this point, he’s more obsessed with it than I am.”
“I’m not sure. I’m not privy to all the details of the case. But it might have something to do with the murder weapon.”
“The knife that I saw in Frank Swenberg’s eye that’s still missing?”
“Could be. Or more likely it has to do with how the other brother died.”
“The one in the hospital? I never heard how he died, only that it had something to do with an allergic reaction.”
“That looks like murder, also.”
“How so?” Maile asked.
“According to the medical record we received from his doctor on the mainland, Carl had a known allergy to peanuts, which is apparently fairly common in Scandinavians.”
“So what? He ate peanut butter? That’s not murder, just being stupid.”
“The coroner’s report indicated there were no peanuts in his digestive system a
t all, but he did find oil in the circulation system in Carl’s brain. Something called the Circle of…”
“Circle of Willis,” Maile finished. “It’s an important vessel that circles around the center of the brain, where blood from both sides of the neck meet. If someone has an injury or chronic occlusion to one side of the neck, both sides of their brain can still get blood flow because of the Circle of Willis. But there shouldn’t be oil in it.”
“He tested the oil, and found it was a peanut extract. Then he went back to the IV tubing and needle that had been in Carl’s arm, and guess what he found?”
“More oil on the inside of those?”
Brock nodded. “Trace amount. It wasn’t much, but he found a residue.”
“That means someone injected Carl with peanut extract directly into his IV, thinking he’d die from an acute allergic reaction. Instead, he died from an oil embolus that somehow traveled to his brain.”
“Is there science that supports that assumption?” Brock asked. “Why do you think it had something to do with the oil and not an allergic reaction to it?”
“That’s science, not an assumption. Let me explain about what happens when an embolus travels through the body and settles somewhere.”
Brock sighed. “Start by explaining what an embolus is.”
“An embolus is a clump of something in the bloodstream that isn’t blood but flows along with the blood. It could be an air bubble, a glob of fat, thick fatty oil, or a large bolus of medication that hasn’t mixed in with the blood. Most often it’s a blood clot that formed somewhere in the body, usually the legs in sedentary people, and broke off. That clot, glob, clump, whatever, then travels through the circulatory system until it gets stuck somewhere too small for it to fit through. The two most common places for those emboli to get stuck are in a major blood vessel to the lungs, or in the brain. Both can be catastrophic.”
“And that’s where that circle thing comes in?” he asked.
“Circle of Willis, right. Most of the blood clots or emboli that go to the brain get stuck somewhere throughout that small system.”
“Okay, so, what happens when the clot or whatever gets stuck somewhere?”
“Blood can’t flow past that occlusion. Sort of like sticking a marble in a garden hose. The water can’t get past it, or at very best, very little water. All the tissue that is served by that vessel beyond the blockage suffers lack of oxygen and dies. In the brain, the lungs, the heart, that generally causes death, unless the patient can get some sort of emergency intervention. Even then, the intervention often fails.”
“Okay, I think I understand,” Brock said. “Bring it all together and explain how Carl Swenberg died because of the oil in his brain. What I don’t understand is how the oil got in his system in the first place.”
“Pure and simple, somebody had to have injected it. There’s no other way it could’ve got into his circulation except by injecting it through the IV. Even if he had ingested it, it would’ve been digested in his gut, not taken up into his bloodstream. That means someone would’ve needed to draw the oil extract into a syringe and inject it into his IV tubing, the same way meds are given. Only it wasn’t a medication. It would’ve been too thick to have become diluted in the blood and traveled through his system until it got to his brain, causing massive and severe brain death. My guess, and it’s only a guess, is that whoever did that thought he would die from a severe allergic reaction to the peanut extract, making it look like a medical error of some sort. Instead, he died from an intracranial embolus that destroyed a large portion of his brain.”
“Is there any way at all a nurse or doctor could’ve made a mistake and injected the oil thinking it was a medication?”
Shuddering, Maile shook her head. “No way. Med vials are clearly labeled as such, with a rubber stopper at the top that a needle needs to be pushed through to extract the medication. That oil extract would’ve been in a jar with a twist off cap, just like any other essential oil. There would be no way in the world for anybody with any training at all could have made that mistake. No way.”
“But didn’t something like that happen to you?” he asked.
Maile shuddered again. “It wasn’t me,” she hissed. “It was another nurse that made that med error, not me.”
“I never did hear the whole story, only that some kid died on your watch.”
“Don’t…” she said, her fists clenching.
“That’s what Detective Ota told me.”
“And Ota can take a long drive in the ocean with his car windows down.”
“He’s on your side, Maile. He feels bad you’re not at work as a nurse.”
“Yeah, well, with friends like him, ones passing around gossip that I made a med error and a kid died because of it, who needs enemies? No wonder Mrs. Abrams and the federal government disrespect me.”
“Can you tell me what happened with the kid, without it becoming a monumental drama?” Brock asked.
“It is monumental, for that family, anyway. And it’s the root of all the dramas I’m suffering in my life right now. Look, it was a busy shift in the ER. We were overwhelmed with patients, car accidents, heart attacks, falls, you name it, it came in that evening. We got some extra help from nurses from other floors in the hospital. The nurse that helped me was from the maternity ward, and a new grad still in orientation. She really needed more supervision than what I was giving her, but I had her do some of the easier tasks with minor patients, just to take up some slack. Well, this little girl was brought in by her grandfather. He’d run over her leg with a driving mower. That happens way more often than what you might realize. What is it with people thinking their giant lawnmowers are toys?”
“Back to the story about the girl, Mai.”
“Well, we triaged the girl, managed her bleeding and pain, flushed the wounds, and got a surgeon. We were just getting her ready to transport her to surgery when I was called away to a heart attack victim that rolled in. That only added to the half dozen or so patients I was already trying to manage right then, with the help of that new grad who had never worked in emergency medicine.
“While the team and I struggled with the heart attack patient, that nurse came to me with an IV piggyback bag of antibiotics. She asked if she should infuse it. Assuming it was for the kid, I barely looked, but I said yes, go ahead and hang it. That’s a simple enough of a task for any nurse.”
“I don’t see what’s wrong with that,” he said.
“Shouldn’t have been anything wrong with it, if she had followed standard protocol for administering a medication. That includes identifying the patient, double-checking the med was the right one and right dosage, and checking on allergies. She had both the chart and the grandfather sitting there with the kid. The problem was that the IV antibiotic wasn’t for the girl, it was for another patient.”
“And that caused a problem?”
“Yeah, big problem. The girl had a known allergy to that antibiotic, something that nurse would’ve known if she had either looked at the chart, checked the kid’s armband, or asked the grandfather sitting there. But she didn’t do any of that, not even matching the name on the IV bag of medication to the kid’s name. What did happen is she gave an adult dose of antibiotics to a child with an allergy to that medication, and infused it rapidly. That caused a sudden and severe allergic reaction that went unnoticed by anyone, because the nurse abandoned the patient as soon as she hung the med. Basically, she did everything wrong and nothing right.”
“Didn’t the grandfather say anything about the kid when she had the reaction?” Brock asked.
“He thought she went to sleep.”
“And you lost your job over that? It wasn’t your fault. That other nurse made the mistake.”
“Right. But since she was under my supervision as a nurse still in orientation, I was supposed to be watching every little thing she did much more closely. At least, that’s what the hospital is saying. That’s to cover their butts by putting th
e blame on me.”
“What happened to that other nurse?”
“Still working in the maternity ward, getting a paycheck every two weeks, and probably oblivious to the trouble I’m having over her mistake. And if that’s not bad enough, I have Ota going around town telling people I’m responsible for some kid’s death. Does he or anyone else have any idea how that death affects me personally? I’m the one that had to zip that kid into a bag before she was sent to the morgue. That’s what I think about, not how the grandfather was culpable by thinking a lawnmower is a toy, or how an inexperienced nurse was sent to a busy ER by a careless charge nurse, or how that nurse was so terribly incompetent that she broke every rule in the book. I don’t even think of my license or career. I mourn the loss of a pretty little girl whose life ended eighty years too early.” She stood from her chair and glared down at him. “And you, and Ota, and Abrams, and that entire licensing board can shove that in a place that’s nice and dark and cozy so nobody ever has to think about it.”
He reached to take her arm. “Maile…”
She yanked her arm away. “None of you have the slightest idea of what a nurse’s life is like. You don’t know what we think of our work, or how we feel when a patient suffers. All anybody wants from us is a pain shot and a smile, while handing out lies about how everything will be okay again. But it’s not always okay again. And that’s what a nurse is left with to think about, to care about, to feel.”
Chapter Eighteen
For as little as she had in her life, Maile had a heavy key ring full of keys to several places. One of those was to the small community church she and her family had gone to all her life, a place her mother still cleaned on a weekly basis. Her keys were still lost from the bus accident, but she knew of a secret place where her mother kept a spare.
She let herself in the backdoor to the small kitchen and filled a glass with water. Staying at the sink, she took several drinks, spitting out each, trying to get rid of the taste of ginger from her meal, and the speech she’d given to Brock. She rinsed the glass and put it in the strainer, but stayed at the sink.