Fatal

CHAPTER 18

Code Blue, ICU… Code Blue, ICU… Matt was on Med/Surg 2, writing orders regarding Nikki's transfer to a private room, when the code call sounded. There was little doubt in his mind that the subject of the code was the sixty-something woodsman who had taken her bed. Matt had passed him in the corridor as he was being brought into the unit, and had noticed the pallor around his mouth and slight mottling of his skin, suggesting that his heart was not pumping effectively.

Matt raced to the unit, arriving simultaneously with two nurses and the respiratory therapist. Although he didn't regret the decision to switch from the one-patient-after-another approach in the ER to the more intense, in-depth relationships of primary care, he remained something of a hybrid, and the intense action surrounding a code blue or multiple trauma still brought a welcome rush.

He was in the room before he realized that the cardiologist at the man's bedside was Robert Crook. Matt hadn't seen his nemesis at all since the ill-fated meeting at BC amp;C. Crook greeted his arrival with a scowl and a derisive shake of his head.

"Need help?" Matt asked with accentuated cheeriness.

"I think I have enough," Crook grumbled.

From behind him, nurse Julie Bellet vehemently shook her head and mouthed the word "Stay!"

"Why don't I hang around just in case."

"Suit yourself. Get ready to shock at four hundred joules, please."

One twenty-five should \)e enough, Matt was thinking. Bellet looked over at him imploringly, but all he could do was shrug. The 400 was definitely overkill, but not a serious enough breach to go to war with Crook over.

The cardiologist plowed ahead, setting the defibrillator paddles against the man's chest.

"Clear!.. Ready, shock!"

Julie Bellet depressed the button delivering 400 joules of electricity through the woodsman's chest. Almost immediately, the chaotic spikes of fibrillation were replaced by a rapid, regular rhythm.

"Okay," Crook said in a purposefully matter-of-fact tone, "he's now in a nice, supraventricular tachycardia. Let's give him a milligram of propranolol IV."

No! Matt's mind screamed. Wrong diagnosis, wrong treatment. He moved forward next to Crook.

"Robert," he said, softly enough so that most of those in the room weren't even aware he was speaking, "that's V tach. I'm certain of it. Xylocaine, not propranolol."

Crook glared at him.

"A milligram of propranolol IV," he ordered again. "Make that two. Give it slowly."

Damn! Matt thought, unsuccessfully trying to avoid Julie Bellet's desperate gaze as she and another nurse responded slowly, clearly stalling. War was about to break out.

"Robert," he whispered again, "get some Xylocaine in him and you might be able to keep him from fibrillating."

Crook's sideways look was, if anything, more piercing than before.

"I'll thank you to — "

At that instant, with a flurry of ineffective beats, the woodsman's unstable ventricular tachycardia rhythm degenerated into immediately life-threatening ventricular fibrillation.

"Four hundred joules," Crook ordered, pointedly looking away from Matt. "Get a hundred of Xylocaine into him also. Let's hold off on the propranolol for now."

At that moment, the resuscitation, which should have been straightforward and successful, could easily have gone either way. Fortunately, a power greater than any in the room decided it simply wasn't the old woodsman's time. The electrical countershock was followed by the Xylocaine he should have gotten in the first place, which was then followed by another shock, and suddenly there they were — a decent monitor pattern and a functional blood pressure.

"Nicely done," Matt said.

There was no response from Robert Crook.

In minutes, the patient's cardiac situation had stabilized. His color had improved and his pressure rose and remained constant. Crook motioned Matt to one side of the cubicle, where he could whisper without being overheard.

"Take a word to the wise," he said harshly, "and think about finding another place to practice. Someplace far away from here."

"But I like it here," Matt said. "I grew up here. I always thought I'd grow old here."

"Well, you can damn well grow old someplace else. That is, if you want to grow old. You've stepped over the line, Rutledge."

"I don't know what you're talking about."

"People are going to get hurt, and I won't be a bit surprised if you're one of them."

"Are you threatening m — "

"Dr. Crook?"

Julie Bellet was pointing to the monitor screen, where some irregular beats had appeared.

"Another fifty of Xylocaine IV," Crook blustered. He turned back to Matt. "You didn't fool anyone," he said.

Matt suddenly reached out and grabbed the man by his tie and shirt in such a way that Crook's back screened the move from view of the nurses.

"Neither do you," he rasped. "Don't ever threaten me again."

Stunned, his cheeks flushed with crimson, Crook pulled away and, adjusting his shirt and tie, returned to the bedside.

Matt couldn't remember physically assaulting anyone in his adult life. Stupid! Absolutely stupid! It was dumb luck that no one saw what he did. Fists clenched, he whirled and, without so much as a glance backward, left the ICU. Crook clearly knew about their penetration of the toxic dump, Matt was thinking. But was the warning from Armand Stevenson, or was the cardiologist overstepping the bounds of his position with BC amp;C? And exactly what did he mean by "People are going to get hurt"? What people?

The Slocumbs!

Matt hurried to Nikki's room to see if the police guard had shown up. He had been away from Lewis Slocumb and his brothers way too long already. He arrived at the room just as Officer Tarvis Lyons came lumbering down the hall. Lyons had been Matt's classmate at Montgomery Regional High School. Tarvis's unofficial nickname, Tar Pits, referred to the speed with which he did just about everything. Matt's surprise that Tarvis had made it to graduation at all, let alone without a police record, was nothing compared to his shock when he returned home after his residency to find Lyons was on the force. It was hard to believe anyone would entrust the man with a pair of handcuffs, let alone a service revolver.

"Hey, Ledge, wazzapnin'," Lyons said, using Matt's high school nickname. His voice was an octave higher than one would have expected from his bulk.

"Grimes sent you?"

Matt hoped he hadn't emphasized the "you" as much as he feared he had.

"I was off today. That means I'm available for overtime. The big O.T. The chief says there's a babe that needs watchin'."

"Grimes called Dr. Solari a babe?"

"Urn, I can't remember exactly."

"She's a doctor, Tarvis. That's like twelve years of education after high school. I think she's earned something a little more respectful from you than 'babe.' Grimes coming over?"

"He said he'll be by soon to talk with her."

"Do exactly what he says."

"That's what he said."

"What?"

"He said to wait and do exactly what he says."

Matt sighed. "Listen, post yourself out here. Make sure you or one of the nurses knows anyone who comes in to see her. I have to leave the hospital for a few hours. I'll be on my beeper. Just call the hospital operator if you have any questions and she'll find me."

"I'm all over it, Ledge," Lyons said. "You still playin' hoops?"

"I still play at it. Not much left of the shot, though, or the legs, for that matter."

"You always were a great shot, Ledge."

"Thank you for remembering, Tarvis. Keep a close eye on Dr. Solari."

Matt stood by the doorway and let his eyes adjust to the dimly lit room. Nikki was asleep, breathing sonorously through her oxygen mask. Concerned by what Crook had said, he was anxious to get out to the Slocumbs' farm. He hurried to the nurses' station and wrote an order for a neuro check every thirty minutes for two hours, then every hour after that for five hours. A final glance at Tarvis Lyons, who was pulling a chair out from a deserted room, and he raced off to his motorcycle.

The ride out to the farm seemed interminable. Once again, all the guilt Matt felt about putting Lewis Slocumb in harm's way welled to the surface. Crook was a jerk, but he was right. He had stepped over the line. Maybe it would be better just to let the whole thing drop — forget about the toxic dump and admit that he was no more of a match for Belinda Coal and Coke and their self-serving policies than his father had been. Then he pictured the horribly deformed faces of Darryl Teague and Teddy Rideout. How many others like them would there be? How many were there already? No, he decided as he pulled up in front of the farmhouse, he wasn't going to back off no matter what. He would just be careful not to place anyone else in danger on the altar of his crusade.

Just as Lewis had been waiting for him on the porch for their trip to the mine, Frank was there now. He was leaning against a railing, a potent-looking shotgun cradled loosely in his arms. Matt wondered in passing if they somehow knew he was coming.

"How's he doing?" Matt asked.

"He's had a doggone mizrable time of it, mosly from the pain in 'is shoulder. But he's still alive an' cussin'."

"That's a good sign. Frank, I'm really sorry it took me so long to get back here. The hospital got incredibly busy. I couldn't get away before now."

"We knowed you'd be back soon's ya could."

Not a hint of irritation or entitlement. These men, tough as nails, were used to taking life as it came and to giving their friends every benefit of the doubt. Lewis, wearing tattered jeans and nothing from the waist up, was in the upstairs room, propped by two pillows in a straight-backed oak armchair. His color was surprisingly good. The bandage around his upper chest was blood-soaked, but that was to be expected. The drainage system was intact, and the gauze he had wrapped loosely about the end of the condom was soaked with dried and drying blood. Clearly, the apparatus was functioning quite well.

Frank Slocumb and his brothers had proven to be quite capable nurses. The room was surprisingly clean, and the linens looked as if they might have been washed since he was last there. The three men stood proudly and respectfully to one side of the room as he worked.

"Your brothers have done well by you, Lewis," Matt said, listening with his stethoscope and noting that breath sounds extended to all fields of both lungs.

"They knowed what'd happ'n to 'em if'n they din't. Am Ah gonna live?"

"Frank said you were too ornery to die, and he was right."

Matt put an IV rig together and asked for a heavy wire to be hung from the rough-hewn ceiling as a hook. In less than two minutes Lyle had nailed in precisely what was needed. Matt hung up the small plastic sack filled with powerful antibiotic and started the medication running into Lewis's arm.

"This'll help make sure there's no infection," he said.

"What 'bout this here contraption?" Lewis asked, motioning to the siphon tube.

"Well," Matt replied, "incredible as it may seem, it appears that this here contraption has saved your life." No doubt about it, he was thinking, a letter to the author of Field Emergencies was definitely in order. "Now, the way I see it, we've got three choices. Leave it in, pull it out, or change it."

"You want us ta vote?" Frank asked.

The four brothers whooped at his humor, which had sailed over Matt's head.

"Fit's all the same ta ya, Doc," Lewis said, "Ah'd jes a soon ya din't go stickin' no more stuff in ma chest. Ah din't have the heart ta tell ya, but them pliers ya jammed in thar last time hurt lak hell."

Out of respect for Matt, the three standing brothers kept their guffaws to a minimum.

"Okay, Lewis," Matt said. "I'm going to leave things as they are.

The problem is, if I take the tube out too soon, the lung might collapse again, and if I leave it in too long, infection might set in. But listen, guys, if he starts to get sick with infection — fever, cough, pain, pus, redness spreading through the skin around the hole, anything like that, cut the stitch and just pull the tube out immediately. Got that?"

"Got it," Frank said. "Ya done a fine job, Doc."

Matt took the bandages down, cleaned the wound, and then redressed it.

"Listen," he said. "I've got to talk to you all about something else. I think the people at the mine know it was me who was in that waste dump of theirs. I'm not sure they know that it was Lewis that was with me, but I wanted to warn you. This jerk at the hospital, Crook, is on the board. He made it sound like someone was going to be hurt or killed because of what I did, and that their blood was going to be on my hands."

Lyle and Kyle exchanged sly looks.

"What?" Matt asked. "What's with you two?"

This time it was Lewis who spoke.

"They knowed it 'uz me, Doc. We're sure a thet. Contrary ta what lots a folks round here thank, we got us some frands about — good uns, too. We hear thangs."

"Well, what are you guys going to do to protect yourselves?"

Again the brothers exchanged knowing looks.

"We kin tak care a ourselves," Lyle said. "B'lieve me we can."

Matt gathered his things and then motioned the three brothers out of the room.

"Lewis, you want me to help you back to bed?" he asked.

"Ah kin manage fahn maself. But if'n it's okay with the doctor, Ah'll stay in this here chair a bit longer."

"I'm glad you're doing so well. I still feel really bad about what happened. I don't know what Frank and the boys keep smiling and smirking about, but I'm really worried that those bastards from the mine are going to come after you."

"Ma brothers wuzn't zakly smirkin', Doc. It's jes that — "

A loud, repetitive warning buzzer cut him off. Immediately, there were heavy-booted footsteps across the wood floors downstairs and up the staircase as well.

" 'Scuse me, Doc," Lewis said, standing, unhooking his IV from its makeshift hanger, and dragging his chair out to the hall. "We got us some compny."

Matt hurried along behind him, shutting off the flow valve to prevent blood from backing up into the IV tubing. The footsteps he had heard were the three brothers, moving through their house as if they had drilled for this moment many times. Someone had already shut the alarm off. Kyle raced up the stairs and slid a six-foot by three-foot sheet of metal between where Lewis had positioned himself and the railing. Then he opened the upstairs hall closet and again began unloading their weapons onto the hallway floor. This time Matt noted half a dozen shotguns, a number of handguns, several sophisticated rifles with high-powered sights, and two semiautomatic weapons. Kyle left two shotguns, a heavy pistol, and a rifle with Lewis, then set a black metal box with a keypad and several switches onto Lewis's lap. Next he began lowering weapons through the balustrade to Lyle.

Stunned at the size and scope of their arsenal, Matt could only stand behind Lewis and watch.

"How many?" Lewis called down.

"Ah thank four" was the reply from Frank. "Looks lak ol' Lonnie Tuggle's one of 'em. Ah never did lak him much."

Cameras! Matt thought, incredulous. Somewhere in the trees out there, the legendary backwoods hick Slocumb brothers had set up a warning system and surveillance cameras.

"Frank," he said loudly, "my Harley's outside. Do you want me to move it?"

"Doc, d'ya thank we'd let anythin' happ'n ta thet bee-yew-tee-ful machine a yourn? It's off safe inna barn."

"Lewis, did you know these men were coming?"

"We heard they mot be."

"Jesus," Matt muttered. "Some hermits you guys are. Hey, listen, be careful," he cried out. "I don't want any of you getting hurt. Or me, for that matter."

"Ain't us ya got ta worry 'bout, Doc," Lewis said firmly. "Now ya go on inta thet room behind us an' keep yer nose down jes in case they's stupider than we thank."

Matt did as he was ordered and dropped to his knees just inside the partially open door, a few feet behind Lewis. The eldest Slocumb, all sixty-two or — three years of him, just sat there with his makeshift chest tube still draining blood through the condom, his IV bag lying on the floor next to him, his right hand cradling the pistol, and his left resting on the black box.

"Here they be," Frank said. "Two still inna car. Two sneakin' round back on foot."

"Jes stay cool, boys," Lewis ordered. "No happy fangers. No one says nothin' but Frank."

At that moment there were three sharp raps on the front door.

"It's open," Frank called out. "Lemme see both yer hands as ya come in."

From his vantage point, looking around the metal plate and through the railing, Matt could just see the door as it swung back. The large BC amp;C security guard who had escorted him from the meeting with Armand Stevenson took one step inside. He was maybe six-three, 260, with a shaved head that sat on his shoulders like a basketball. Matt couldn't see Frank, but imagined him across the living room, his shotgun resting lazily in the crook of his arm.

"Lonnie," Frank said.

"Frank. Listen, we don't want any trouble, but we been sent out here to do a job. You know how it is."

"An' whut job'd thet be?"

"Two men trespassed onto mine property the other night. We think one of them was Dr. Rutledge from in town."

"So?"

"An' we think the other was one of you brothers."

"Now, whut meks ya thank that?"

"Look, Frank, we've known each other a long time. Don't bullshit me and I won't bullshit you. Mr. LeBlanc from the mine wants to meet with whichever one of you it was, and also with that doctor. He says they may have been exposed to a dangerous chemical, and that they'll be in some kind of danger if they don't do the right thing."

"Lonnie, you go tell Mr. LeBlanc thet ya tried yer best, but no one here even knowed whut y'uz talkin' 'bout."

"Frank, where're Lewis and the others?"

"Ain't ma word good nuff?"

Matt risked peeking through the railing again just as Lonnie Tuggle pulled a gun from his waistband.

"Frank, one of the two men who trespassed got hisself shot.

There was blood on the stones inside the mine. It wasn't the doctor. Now, where is Lewis?"

"Lewis is rot here," Lewis said, moving forward and resting his gun hand on the railing. "Now it's time fer ya ta go."

"You look a bit under the weather, Lewis," Tuggle said. "You wouldn't by any chance have taken a bullet recently?"

Every muscle in Matt's body was tensed. There was going to be a firefight. He just knew it. He started inching through the doorway toward the shotguns on the floor beside Lewis. If things opened up, there was no way he wouldn't be fighting on the Slocumbs' side.

"Stay there!" Lewis whispered harshly over his shoulder.

Matt sank down to the floor.

"I was told to bring you back with me, Lewis. I can't leave without you."

"Ya can an' ya will, less'n ya want ta leave here feet first."

"I have men with me. One of them's got a gun on Frank right now."

"Ah see 'im," Lyle said from down below. "He best be a darn fast shot ta get Frank an' Void takin' one a these here bullets in the haid."

"Same goes fer you," Kyle said, stepping onto the balcony from the room at the end of the hall, ten feet down from Lewis.

Lewis quickly punched in some numbers on the keypad of the black box.

"This is a warning, Lonnie," he said, pressing the firing button.

The window-rattling explosion from the broad dirt courtyard outside was enough to cause Tuggle to whirl. In that instant, Frank was across the room, his shotgun against the back of the huge man's head.

"Drop the gun! Drop it now, Lonnie."

Reluctantly, Tuggle did as he was ordered.

"Thet bang were 'bout ten feet behind yer car," Lewis called down. "The nex one'll be unner it."

"An' the nex buckshot from this gun'll be in yer brain," Frank added. "Now, yev got ten seconds ta git yer boys an' git outta here. Tell 'im ta set his revolver down afore he moves."

"Do it, Cork," Tuggle ordered.

Tuggle motioned to the man behind Frank, and in a moment, he came into Matt's view, cowed and weaponless. The two of them backed out of the front door and called to the other pair.

"You're going to regret this, Frank," Tuggle said. "You ain't the only one who can blow things up."

"You gotta git t'us ferce, Lonnie. An' you ain't done so good at thet. Do us all a favor an' don' tra it. We don' git much pleasure outta killin' helpless critters. Tell ol' LeClair t'weren' none a us out at the mine. The doctor neither. If'n anythin' happ'ns ta him, yer the one we're gonna blame. Got thet? Ah said, Got thet?"

"Yeah, yeah. I got it."

Matt listened to the car depart and then straightened up and crossed over to Lewis.

"I can't believe you have this place mined," he said.

"Ah had me an adventrous spell back in the lat sixties, an'joined the army," Lewis replied.

"I remember you telling me about that."

"Well, what Ah may not a tole ya was Ah signed up mostly 'cause Ah wanted ta learn how ta blow thangs up. I'z in demolitions in Nam. Come in handy from time to time, blowin' up stumps an' such. Plus nobody gits near to this here place less'n we want 'em to."

"Or away from it, either, it seems. You guys never cease to amaze me."

"Gimme a hand back ta bed, Doc," Lewis said, picking up his intravenous bag and chest tube. "Allis excitement has me a mot tuckered."

Any benefit Matt had accrued from his nap at Nikki's bedside was gone. His eyes burning with fatigue, he gazed up wistfully at the turnoff to his house as he pointed the Harley back toward the hospital. He would make rounds and then sign out to whoever was taking over coverage. After that, bed.

It was still possible the BC amp;C thugs might come after him, but besides being careful, there wasn't anything he could do about it except run, which he wasn't going to do. The Slocumbs had made their point and made it well. Come after us again only if trying to get us is worth dying for. As for the toxic dump, there was no way to predict what Armand Stevenson and the other powers at the mine were going to do. The only thing that was certain at the moment was that because of an anonymous note from a barely educated local who didn't want acknowledgment or even a reward, his long struggle against BC amp;C had been vindicated.

The doctors' parking lot was nearly filled. Just fifteen years old, the hospital now boasted specialists in every area of internal medicine, and most of the surgical specialties as well. It pained him to give BC amp;C kudos for anything, but in fact the company was largely responsible for the continued growth of the place.

He found a space close to the ambulance bay and locked the Harley. Then he crossed the ER and headed up the stairs to Med/Surg 2. Not too surprisingly, Tarvis Lyons was dozing in his seat by the door to Nikki's room, his chin resting on his chest. Something — Matt's footsteps on the tile or perhaps a breeze down the hallway — roused the policeman just before Matt reached him.

"Hey, Ledge, wazzapnin'?" he said.

"Everything okay?"

"Yep. Your lady got off just like clockwork."

"Got off where?" Matt asked, feeling a sudden chill.

"For the MRI you ordered," Lyons said, clearly bewildered.

Matt raced to the doorway. Nikki's bed was empty and had been made, awaiting a return Matt doubted would be happening.

"Tarvis," he said, his pulse hammering, "I didn't order an MRI."