Night Shift

Chapter 33

Wednesday, December 8, 8:15 p.m.

“Laurie?” a soothing, dulcet voice asked. Laurie was sitting in the ED waiting area, which was much less crowded after the evening rush had slowed. Hearing her name, she looked up from reading emails on her mobile phone into the eyes of a woman in full personal protective gear including a reflective plastic mask. “It’s me.”

Laurie stood up as Colleen Benn removed the plastic mask. The two women greeted each other warmly. “Thanks so much for coming down to say hello,” Laurie said.

After signing all the admission papers for Jack, Laurie had retreated to the waiting area, and as she had calmed down, she’d remembered one of the hospitalists whom Sue Passero had introduced to her on several occasions, as Sue and she were frequent coworkers plus good friends. Wondering if the woman who Laurie remembered as being particularly friendly was on duty, she had called the hospital’s central switchboard and had her paged. To Laurie’s pleasant surprise, she’d called Laurie’s cell phone after only a few minutes.

“What on earth are you doing here?” Colleen asked. She then gestured for Laurie to sit back down while she took the seat right next to her.

“My teenage-mindset husband who insists on riding his bike all over Manhattan took a nasty spill this afternoon.”

“Oh, God!” Colleen lamented with a shake of her head. “Men will be boys! How is he?”

“He’s still kicking, thank goodness,” Laurie said. “But he’s unconscious from an apparent concussion and has two fractures in his right leg, which are going to need to be surgically repaired. They are waiting for a neurological consult before going ahead with the surgery.”

“How awful. I’m so sorry.”

“I keep reminding myself it could have been worse. But anyway, how are you?”

“Coping. With some difficulty, thanks to the pandemic. I’m wondering if my kids will remember me when this is all over considering the number of shifts I’ve been forced to take. I’ve been practically living here. When I get home, I have to change clothes in the garage and shower in the guest room.”

“I can imagine,” Laurie said. “You frontline healthcare workers have been carrying the burden for all of us. Thank you.”

“You’re welcome. I guess your team has been equally busy.”

“Unfortunately, yes,” Laurie said. “Bringing up an unpleasant subject, I suppose you are aware of Sue Passero’s unfortunate death.”

“Oh, gosh, yes! Such a tragedy for the whole hospital. I still can’t believe it. She was so damn healthy and vital and a true contributor to this institution. It was a shock.”

“You spoke with her often, didn’t you?”

“For sure. Sometimes every day, at least when I wasn’t working the night shift like I am this week. Even then, she’d call me often. She frequently had patients in whatever intensive care unit I was covering. She was such a conscientious doctor.”

“Did she by any chance say anything to you recently about being worried there might be a medical serial killer active here at the MMH?”

“A serial killer? You mean someone killing patients on purpose?”

“Exactly.”

“What a strange question.”

“Unfortunately, it’s not as strange as it sounds. A dozen or more years ago, I was responsible for figuring out that a medical serial killer was operating here. It was a nurse being paid handsomely to kill off certain postoperative patients.”

“Good God! Really? That’s terrible. I never heard anything about it, as it was certainly before my time.”

“I’m not surprised you haven’t heard about it. For the obvious reason it was a PR nightmare. The hospital administration tried to put the kibosh on the story as soon as it was uncovered, and they were reasonably successful. The reason I’m asking the question now is because my husband had been told that Sue recently came across some kind of statistic that suggested to her there might be another such killer.”

“If she was concerned, she never mentioned anything to me,” Colleen said, with a shake of her head. “Wow! I certainly hope it is not the case.”

“Excuse me,” a voice said, “are you Dr. Montgomery?”

Both Laurie and Colleen looked up into the masked face of a doctor in a long white coat. A telltale percussion hammer protruded from one of his pockets, indicating his specialty. Laurie answered in the affirmative.

“I’m Dr. Fredricks. I’m a neurology consult. I’ve examined Dr. Stapleton. He’s suffered a concussion and remains unconscious. On the positive side his cranial computed tomography is entirely normal, as is his neurological exam, including being responsive to what we call noxious stimuli, all of which is encouraging. I have cleared him for emergency orthopedic surgery to stabilize his fractures, and he is on his way upstairs to the operating room. I was told to tell you that Dr. Thomas, the orthopedic trauma surgeon, will be in touch as soon as the case is over.”

“Thank you for letting me know,” Laurie said.

“You are more than welcome. Do you have any questions?”

She thought for a moment before asking how long he thought Jack might be unconscious.

“It’s difficult to know,” the doctor said. “But as I said, his neurological exam is normal, including all reflexes and responses to stimuli. I’m encouraged. If I had to guess, I’d say twelve to twenty-four hours, tops, but there is no way to estimate exactly. Any other questions?”

“I guess not,” Laurie said.

“Very good. If you do, you can page me. I’ll be checking in on him after his surgery.”

“Thank you,” Laurie said.

The doctor nodded, turned around, and hustled back into the interior of the ED.

“Fingers crossed,” Laurie said, looking back at Colleen and trying to make light of the situation.

“That’s all positive news, and I’m sure he will be fine,” Colleen said, trying to be upbeat. “It will be good to get the surgery out of the way. What are you going to do while you wait?”

“I don’t know,” Laurie said with a shrug. “I suppose sit here and answer email. I’m afraid it’s going to be a long evening. I’m really intent on keeping as close a watch over Jack as I can with even a hint of a potential serial killer here. As soon as it is medically okay, I want to have him transferred.”

“Why don’t I take you up to the surgical lounge?” Colleen suggested. “At this time of day, it’s practically deserted and you’ll probably have the place to yourself. There’s also peanut butter crackers and coffee. Have you had anything to eat?”

“No, but I’m not hungry in the slightest.”

“What do you say? It will be better than sharing this space with the cast of characters who come into the ED on a nightly basis.”

“I can’t argue with that,” Laurie said.

“Then let’s go,” Colleen said as she got to her feet. “I’ll not be far away. I’m mostly in the surgical intensive care unit for tonight, which is near the surgical lounge, so I can pop in and check on you now and then.”

“All right,” Laurie said. “I’ll take you up on your offer. I appreciate your thoughtfulness.”

On the way up in the elevator, Colleen had another suggestion. “If you are planning on being here for a long time and intent on keeping an eye on Jack, which I’m sure I can help happen, why don’t we get you a set of scrubs? Not only will you be more comfortable, you’ll need to be in scrubs if I can prevail on the charge nurse to let you in the SICU, where Jack will probably end up after being in the post-anesthesia unit. The other benefit of your coming up to the surgical lounge is that you have an entire locker room at your disposal. There’s even a shower if you are so inclined.”

“Wow! I hadn’t thought about that but it makes sense,” Laurie said. “This is going to take me back to my residency days.”

“Is that a good memory for you or bad?”

“Definitely good,” Laurie said, managing a slight smile at the thought despite her general anxiety.

Twenty minutes later she found herself dressed in a white doctor’s coat over scrubs sitting on a couch in the surgical lounge all by herself. In front of her was a cup of coffee as well as several unopened individual packages of peanut butter crackers. After Colleen had showed her around the lounge and the locker room, she had gone back to the SICU with the promise of poking her head in occasionally. Laurie had Colleen’s mobile number in case she needed to get in touch with her.

Once she was situated, the first thing Laurie did was call home. She had hoped to get Caitlin but got her mother instead as Caitlin had already gone to her quarters once Emma had been put to bed. So as not to worry her mother, she merely said that Jack had been in a bike accident and was having an operation to fix his leg and that she planned on being at the hospital for the time being. Although Dorothy did ask about Jack’s condition, Laurie could tell she was preoccupied by whatever it was that she was watching on the TV. Keeping the conversation short, which was mostly her mother complaining that Jack never should have been foolish enough to ride his bike in the city, Laurie got to chat briefly with JJ. He, too, was preoccupied as he had finished his homework and had moved on to playing computer games. Neither seemed overly upset that Jack was in surgery, which was good as far as she was concerned.

With the job of calling home out of the way, Laurie did what had been on her mind ever since she’d heard about Jack’s accident: call Lou. As the call went through, she hoped she wasn’t interrupting something important. She was always a little reluctant to call Lou in the evening because it was mostly in the evening or the wee hours of the morning that he was the busiest. The moment he answered she asked if he could talk or whether he needed to call her back.

“I’m on a homicide call, but I’m okay for a few minutes,” Lou said. “What’s up?”

“Jack had a serious bike accident.”

“Hell’s bells!” Lou groaned. “How is he?”

“It’s not as bad as it could be,” Laurie said. “But it is still bad. He’s in a concussion-induced coma, but from the neurologist I got the sense they are optimistic and expect him to wake up soon or at least within twenty-four hours. Luckily there are no skull fractures. At this very moment, he’s undergoing surgery to stabilize two fractures of his right leg.”

“That’s bad enough. What are the details of the accident?”

“That I don’t know.”

“Do you know where it took place?”

“They told me, but I can’t remember. Someplace on the Upper East Side, not too far away from the MMH.”

“That will be the nineteenth precinct. Let me call and find out, and I’ll call you back.”

Before Laurie could respond, Lou disconnected. She shrugged. She didn’t know why he was so concerned about the details of the accident. As far as she was concerned, it didn’t make much difference, and it wasn’t what she was interested in talking to him about. Putting her phone down, she picked up one of the cellophane-wrapped peanut butter cracker sandwiches and tore it open. Surprising herself, she had become a little hungry.

After two bites, her phone rang. It was Lou getting right back to her.

“Rush hour at the corner of First Avenue and Eighty-Third Street and not a single witness. Can you believe it?” he said quickly. “Only in New York. Anyway, it’s assumed it was a hit-and-run because the bike was toast, most likely run over by the car or van or whatever it was.”

“Whatever,” Laurie said. “At this stage it’s not going to help the doctors to know exactly what happened or who was at fault. Besides, as fast as he tended to ride, he didn’t need a vehicle to get himself banged up badly. Anyway, why I was eager to talk with you is to get your take on the medical serial killer issue and how probable you think it is. Obviously, I’m concerned with Jack now a patient here.”

“What medical serial killer issue?” Lou asked with obvious confusion. “I don’t know what you are talking about.”

“The medical serial killer that Sue Passero was concerned about,” she said. “The one Jack had heard about from the nurse you and he posted this morning, the one who shared committee responsibilities with Sue.”

“Jack didn’t say boo about any serial killer,” Lou said categorically.

“Really?” Laurie questioned with surprise. “That’s hard to believe. Jack told me that he had you up to speed with all he was learning over here at the MMH.”

“All he said to me was that it was a hotbed of intrigue and animosity, which was why I was trying to dissuade him from going over there playing detective.”

“You knew about him coming here?” Laurie demanded sharply.

“Only after the fact,” Lou said. “Well, except for this afternoon, where I guess he was headed when he had his accident. I had spoken with him just before he left the OCME, and he told me he was going. He also said he was going to meet whoever it was in the ED and not in the hospital proper.”

“Why didn’t you tell me?” she questioned angrily. As tense as she was, every new fact bothered her.

“Hey, I’m not the bad guy here,” Lou said. “Jack told me not to tell you.”

“And you agreed?” Laurie asked with disbelief. “Thank you very much, Detective Soldano. Some friend you turn out to be.”

“Hey, don’t blame me! As I told him, being friends with you two ain’t the easiest job in the world. At his request, I agreed to go along with his wishes and not tattle by giving him just one more day to look into Sue Passero’s case, which was what he asked for. But he certainly didn’t mention anything about a medical serial killer being involved in any way or form. Had he said anything like that, I certainly wouldn’t have agreed to even one day considering what happened the last time you two were involved with a serial killer at the same hospital.”

“All right,” Laurie said, trying to rein in her roiling emotions. “I’m sorry I snapped at you. I’m not myself, and I just couldn’t believe Jack wouldn’t have confided in you about this serial killer idea since he said that you were, quote, ‘on board.’ ”

“Apology accepted,” Lou said. “So, tell me what you know about this medical serial killer issue. I don’t like to think about the possibility, remembering that crazy Jasmine Rakoczi and the mayhem she caused.”

“Honestly, I don’t know much,” Laurie said, surprised Lou brought up the Jasmine Rakoczi episode. She had also been reluctantly reminiscing in the back of her mind about that frightful experience and how close she’d come to being victimized herself. “All I know is the little Jack had been told, namely Sue was convinced of it. And to make matters worse, he’d heard that Sue thought it was a very active medical serial killer, particularly over the last year.”

“Meaning, of course, lots of deaths.”

“Obviously,” Laurie said testily. “That’s what an active serial killer means.”

“Hey, don’t get impatient with me. You doctors speak your own language that we mortals don’t always understand. I just want to be sure I’m getting what you are telling me. Do you have any idea why Dr. Passero felt this way?”

“The nurse that you and Jack autopsied this morning told Jack it had something to do with statistics but didn’t elaborate, saying she would tell him today, when she’d have more time. But in the interim, Jack took it upon himself to get what statistics he could, which proved opposite to what he expected if a serial killer was involved. From the MMH, he learned that their mortality ratio, which is what the hospital uses for accreditation, was not only impressively low but had actually gone down over the last year. He also had our Medical Legal Department look at the MMH monthly death rate reported to the OCME and found that stat had also gone down over the previous year.”

“Whoa!” Lou voiced appreciatively. “Math has never been my forte, but it seems to me all that argues against there being any kind of a serial killer, particularly not an active one.”

“I agree,” Laurie said. “But here’s the rub. Sue allegedly believed it, and Sue Passero was one of the smartest people and most dedicated doctors that I have known. If she truly believed it, I’d have to give the idea significant credence.”

“But her believing it is hearsay,” Lou said.

“True,” she agreed, “but my impression was that Jack gave the source considerable credence. When I combine that with Jack’s concern that Sue’s death might have been a homicide, along with your concern the nurse’s death was a homicide, I’m feeling very uncomfortable having Jack here in this hospital. So much so that down in the Emergency Department, even with Jack unconscious, I brought up the idea of transferring him over to NYU.”

“What was the reaction?”

“I was told by the consulting trauma surgeon it would have been against medical advice, so I let it drop. Jack’s immediate needs certainly trumped my hypothetical concerns. But let me raise one other, perhaps distant but nonetheless disturbing, possibility that I suddenly find gnawing at me, especially now that you have raised the possibility the accident was a hit-and-run. What if Jack’s accident wasn’t an accident, but rather was done on purpose as a kind of attempted assassination?”

For a few seconds Laurie didn’t hear a sound from her phone, making her pull it away from the side of her face to look at the screen. When she could see she was still connected, she put the phone back to her ear and waited.

“As I’ve said, you and Jack can be difficult to be friends with at times,” Lou said finally, breaking the silence with an exasperated sigh. “But I have to give both of you credit for being investigatively creative. I see your point despite the substantial ifs involved, and it’s best to be safe than sorry. Where are you in the hospital right now?”

“I’m in an empty surgical lounge. When I was waiting down in the Emergency Department, I contacted one of the intensive care hospitalists here named Dr. Colleen Benn. I had met her through Sue on numerous occasions. Luckily it turned out she was on duty, so she came by to see me and has been extraordinarily accommodating. It was her suggestion I wait here while Jack is in surgery, which is perfect. The only way it could have been better is if she got me invited into the OR itself.”

“Are you planning on staying at the hospital all night?”

“Absolutely,” she said. “I even turned over the reins at work. I’m going to be here for the duration, until we can transfer him.”

“I’ll come over and keep you company for a bit when I finish here. The crime scene people are taking their time, which is good, but sometimes they drag it out unmercifully. Where do you think Jack will go when he’s finished his surgery? To the VIP section of the hospital?”

“First he’ll be sent to the PACU, at least for a while,” Laurie said. “Then, according to Colleen, he’ll most likely be sent to the surgical intensive care unit, particularly if he’s still unconscious. Colleen is going to try to get me permission to hang out at the SICU desk, which should work because she’s high in the pecking order and happens to be the doctor in charge of the unit for the night.”

“I’ll tell you what I can do,” Lou said. “I’ll call back the nineteenth precinct and have them send a couple of uniformed duty officers to stand outside wherever he may be in the hospital, whether an intensive care unit or a private room. They can check everyone going in and out and keep out anyone who doesn’t belong.”

“I suppose that can appear intimidating,” Laurie said. “But not foolproof. The trouble is that a medical serial killer would have access. That’s what makes it possible for such an individual to do what they do, and it could potentially be anyone from an orderly to the chief surgeon.”

“You’re right about the access issue,” Lou said. “But just having the uniformed officers sitting there can be surprisingly effective. Besides, when I come over, I’ll clue them in to get maximum effectiveness.”

“You’re a good friend,” she said. “I know Jack will be very appreciative.”

“And if anything goes wrong, no matter what it is, call me. The homicide I’m on is fairly close to the MMH, and I can be there in a blink of the eye.”

“By the time you come over here, if I’m lucky I’ll be in the SICU where you would not be able to come.”

“We’ll cross that bridge when we get to it,” Lou said. “Just be sure to have your mobile with you at all times.”

“Will do,” Laurie said. After she disconnected, she took a moment to acknowledge how lucky she was to have a friend as loyal as Lou Soldano. It seemed as if whenever she needed him, he was available, and she couldn’t help but feel this could be one of those times.