Night Shift

Chapter 36

Thursday, December 9, 2:37 a.m.

As Ronnie left the Emergency Department, he felt his pulse quicken. It was now or never as far as Jack Stapleton was concerned. Earlier he’d been interrupted. Within minutes of having filled the syringe with the potassium chloride up in his office, a trauma code had been called, meaning a case had arrived in the ED with the patient in extremis from a bad motor vehicle accident. As with all codes called in the hospital, Ronnie had to drop whatever he might be doing and respond.

The condition of the relatively young male patient had been extremely poor as he had not been wearing his seat belt and had gone through the windshield on impact. As such he had arrived barely alive. Although he had a pulse initially, his heart soon stopped, requiring CPR as well as an emergency thoracotomy. Despite multiple units of blood and a full, lengthy resuscitation attempt, the patient was ultimately declared dead. At that point, Ronnie, along with one of the ED doctors, had to face the family, always a difficult task that had never gotten easier for Ronnie no matter how many times he had to do it.

When Ronnie had been finally finished with the case, the first thing he had done was use one of the ED monitors to check Jack Stapleton’s status. With some relief, he discovered there had been no documented change, and the man was still in the SICU, unconscious.

Getting off the elevator on the third floor, Ronnie rounded the bend and headed down the hallway toward the SICU. As he approached, he could see that the two officers had been changed. Now sat two significantly older white-haired Caucasian patrolmen who seemed much more at home in the hospital. The thinner of the two was tipping back precariously in his metal folding chair as he engaged his partner in an animated conversation replete with exaggerated Italianate hand gestures. Although they were in full uniform, both had removed their hats, which were on the floor beside their seats. As Ronnie neared, they quieted down, and the one who had been leaning back tipped forward with a thump.

As he had done earlier, Ronnie merely nodded an acknowledgment at the two officers and tried to breeze by. He was surprised when the stockier officer, whose name tag read don ware, stuck his hand out, bringing Ronnie to a halt as if he had hit up against a locked turnstile.

“Excuse me, Doctor,” the officer said. “May we see your ID?”

Rolling his eyes, Ronnie lifted the ID that was hanging around his neck and showed it to the officer. As he did so he said, “I’m not a doctor. I’m the nursing supervisor.”

“Excuse me,” the other officer said. His name tag read louie ambrosio. “Do you have business in the unit?”

“Of course I have business,” Ronnie said with demonstrable exasperation, as it were a ridiculous question. The gun in his pocket was close to the officer’s hand and he knew he’d be hard put to explain it, despite having a license to carry. “I told you I’m the nursing supervisor. I have business in the entire hospital.”

The two officers exchanged a glance and then a mutual shrug.

“Thank you, Doctor,” Don Ware said as he retracted his restraining arm.

“I’m the nursing supervisor, not a doctor,” Ronnie snapped as he pushed through the doors.

Once inside, Ronnie stopped to get himself under control. He knew he was tense and the minor interaction with the officer had demonstrated it. But glancing around the interior of the SICU was reassuring, and he calmed quickly. Most of the activity of nurses caring for their assigned patients was within the cubicles in the opposite end of the room from Jack Stapleton’s, which was definitely opportune. Looking in the other direction, he could see no activity in Jack’s cubicle, suggesting Aliyah Jacobs was elsewhere, lending a hand to her colleagues, as she had been doing the last time Ronnie had checked.

Directing his attention toward the central desk, he could see that Patti was involved in an animated conversation with several nurses while Irene was busy with paperwork along with one of the surgical residents. Farther down, Dr. Benn and Jack’s wife were situated behind separate monitors, seemingly preoccupied.

As he would often do, Ronnie started going into each cubicle for a brief check on the status of each patient while working his way down toward Jack Stapleton’s. As he passed the central desk, Patti interrupted her conversation to acknowledge Ronnie. In response, Ronnie stepped over to the counter.

“I trust you’ve been informed about the aneurysm case going on in the OR,” Ronnie said. “It will be coming here to take one of your empty beds.”

“I did hear,” Patti said. “No problem.”

Ronnie gave her a thumbs-up and went into the next cubicle as Patti returned to her conversation.

Coming out of the cubicle right next to Jack’s, Ronnie looked back at the central desk. No one was paying him any heed. It seemed that the timing and the circumstances couldn’t be better. Reaching into his pocket, he fingered the syringe, and then in a blink of an eye stepped out of sight into Jack’s cubicle. Without hesitating, he quickly moved up along the right side of the bed, and with the flow controller he shut off the large-bore IV that he had inserted in the ED. Rapidly taking down the saline container, he pulled out the syringe from his pocket and removed the needle cap with his teeth. After plunging the needle into the container’s port, he used both hands to rapidly distribute the entire contents of the syringe into the saline. He then rehung the saline bag and opened the flow controller completely to allow the IV to run at a rapid rate. He was confident the bag would empty rapidly.

It had all taken mere seconds. In the next instant, he was back out into the main part of the SICU with the empty syringe in his pocket. Resisting an urge to run, he moved as nonchalantly as possible past the central desk. To his relief, no one paid him any heed, other than Irene, who gave him a passing glance. Reaching the swinging doors, he pushed through, once again interrupting the two policemen’s spirited conversation, which he now could tell was about the travails of the Knicks.

With a slight, condescending nod, Ronnie walked past the police and proceeded down the hall. As he got farther away, he had the nearly irresistible urge to shout hurray and punch the air with his fist in celebration, but he did neither. Instead, when he reached the elevator lobby, he calmly pressed the button, knowing full well that within minutes he would be called for a code in the SICU.