T Wave (11 page)

Cline folded his arms. “And if I choose not to cooperate with this blatant invasion of hospital and patient privacy?”

Alton felt his temper beginning to rise. “I’d return with the FBI and a warrant. And the chances of this search occurring without the media getting wind of it would drop precipitously.”

“Fine,” grumbled Cline. “It’ll take a few minutes to run the search. Can you wait?”

“Certainly.”

Cline accessed the most confidential database of patient records, searching for discrepancies between hospital admission codes and cause-of-death codes. This approach yielded a small group of patients. Cline then read detailed information from the chart of each of these patients and screened out a few more.

“Okay, here it is,” said Cline. “These four patients meet the initial criteria. We’d have to do a lot more research to determine if there’s anything truly fishy about their deaths.”

The statement grabbed Alton’s attention. Four patients? There might be more to the idea of suspicious patient deaths than he had imagined.

“I understand,” replied Alton. “I’d like to return tomorrow, but I realize you have a hospital to run. Is there someone else on your staff I can work with instead?”

Cline seemed to think for a minute, then shook his head. “I’d rather keep this between you and me. If news of this investigation breaks in the press, we might not ever recover financially. You can keep this investigation confidential, right?”

“Yes, that’s fair. Nothing is proven, and if we do discover some truth to Nancy’s claim, we don’t want to spook the perpetrator into fleeing.”

Relief flooded Cline’s face. “Thank you. Just let me know when you need me here tomorrow.”

That evening, Alton rejoined Mallory in her apartment for dinner. As they ate, they began to share the progress they had made in their respective investigations.

“You first,” prompted Alton.

“Curious, aren’t we?” teased Mallory. “It’s taking a little bit longer than I expected to pull the details together. I need to build a solid case before we can move on the suspects, and I still have a few loose strings to tie off. I should be finished tomorrow or the next day. Then I’ll be able to give you the full scoop all at once.”

“I see,” replied Alton.

“What can you tell me about your investigation?” asked Mallory. “Have you found anything?”

“It’s too early to say. I have to admit I was a little unsure how seriously to take this at first. I mean…people die unexpectedly at the hospital and, especially, the hospice all the time.”

“And now…?” coaxed Mallory with her head askew.

“Now…I’m thinking it’s worth looking into. In the case of two hospice deaths and four hospital deaths, the cause of death wasn’t consistent with the patient’s underlying illness. That doesn’t prove anything, of course. Tomorrow I’ll be looking into the records of these six patients in more detail. Once I do that, I should have enough information to give Wiggins an update.” He leaned back in his chair, exhaled, and frowned.

“Are you all right?” asked Mallory. “You look…worried.”

He set down his fork and turned to face her. “I’m not a cop. What am I thinking, pretending like I know what I’m doing?”

“Sweetie,” she said, “it’s not about the title. It’s about the intellect, and you have that in spades. You could run rings around a lot of the FBI agents I work with.”

Sweetie.
Alton didn’t visibly react to the name but did feel an internal tingle of pleasant surprise. Mallory had never bestowed that nickname on him, and he valued it for the small milestone it represented. It was this endorsement more than her subsequent words that revived his spirits.

“Thanks,” he replied with a crooked smile. “I think you exaggerate my talent, but I’m glad I can use whatever intellect I do possess to help you out.”

Mallory leaned across the narrow expanse of table and gently kissed him. “There’s no one else I’d rather have investigating by my side.”

SATURDAY, JULY 21

CHAPTER 30

The next morning, Ken Goins arrived
at the hospital at 7:00 a.m. for his rhinoplasty surgery. Nancy sat by his side in the pre-op room as the nurse ran through a schedule of the day’s events and confirmed the procedures to be performed.

“Doctor Burns told you you’re going to be pretty sore for a few days, right?” asked the pre-op nurse.

“Yeah,” replied Ken. “I’ll live. Now can we get this over with?”

Later in the morning, the surgery proceeded without a hitch, and the hospital staff moved Ken to a post-op room for observation. By mid-afternoon, he was transferred to a standard hospital room.

Nancy Goins had stayed with Ken throughout the day. She studied the gauze and packing layered on his face. He wouldn’t be leaving his hospital room anytime soon. Ken awoke and noticed his wife. He tried to speak but remained incoherent, still reeling from the effects of surgical anesthesia. A moment later, he drifted back to sleep.

Nancy rose and glided out of the room, heading for the employee parking deck. She emerged from the hospital building to the hottest day yet of the year, and a blast of heat rolled upon her.

She hurried for the comfort of her Rav4’s air conditioning. Once inside the SUV, she turned the dial to “Max AC,” pulled out of the parking lot, and placed a call.

“Are you still game for catching the five-thirty show at AMC?” she shouted over the noise of the air conditioner.

“Yep,” confirmed Dennis. “I’m at Home Depot, so I’ll probably beat you there. Let’s just meet inside the screening room. No need to take a chance of someone seeing us enter together.”

“Okay,” she bellowed. “Wait a minute…Dennis, I just realized I left the business card with Doctor Burns’ phone number on the nightstand in Ken’s room. I’ll have to go back to pick it up. I’ll be there as soon as I can.”

“No worries. That’ll give me time to run one more errand on my list. It shouldn’t take long. We’ll meet up at the movie.”

Nearly sixty minutes later, Nancy arrived at the AMC Theater. The sunlight’s unwavering glare washed the colors from the surrounding foliage, and heat waves rippled across the asphalt parking lot. As Nancy approached the box office, she glanced at a movie poster in one of the
Now Playing
shadow boxes. In the bright sunlight, the poster’s sheen gave an impression that the actors in the photos were sweating. Considering the heat, she wouldn’t have blamed them if they were.

Nancy paid for her movie ticket and entered the cool comfort of the screening room. After casting her gaze about the theater, she spotted Dennis in the second-to-last row and took a seat next to him. After muting her phone, she leaned over and whispered into his ear, “We have the next few days all to ourselves.”

He smiled and put his arm around her. “What do you want to do first?”

“I’ll think of something,” she said, sliding her nearest hand along his thigh.

His eyes opened wide, but he stared straight ahead and made no other movement or sound. Finally, he turned imperceptibly and whispered, “I like the way you think.”

Nancy nudged his ribs with her elbow and giggled.

His expression assumed a greater seriousness as he turned to look into her eyes. “I love you,” he said. “Always remember that.”

Simultaneous with Nancy’s arrival at the theater, Alton concluded his Kruptos workday. Within minutes, he found himself in Stokely Hospital, ready to continue his research into the four patients who had died there under curious circumstances.

Alton tapped on William Cline’s door.

“Enter.”

Alton stepped inside the office. “Good evening, Mr. Cline. Can I trouble you to get access to the records for the four patients we discussed yesterday?”

“Yeah, sure,” said Cline, looking rather morose. “I’ve printed off hardcopy records of their charts and created a folder for each patient. That way, you can take this information with you.”

“Thanks. I appreciate the portability, but if you don’t mind, I’d like to study the material here in the hospital. I might have questions.”

“Why don’t you use Joy’s space out front,” suggested Cline, motioning out the door to the desk normally occupied by his administrative assistant. “She’s gone for the day, and you can use her desk to spread out the materials I’ve given you. Frankly, I’d rather you stay close to this area. That way, if you have any questions, you can ask me rather than someone else who might not be as concerned about the confidentiality of your research. This investigation is still under wraps, correct?”

“Yes, I’ve told no one but the FBI,” confirmed Alton.

“Good. Let’s keep it that way.”

As Alton reviewed the patient records, Wanda, a gregarious and plump nursing technician working four floors below, began checking the vital signs of her assigned patients. Eventually, she entered Ken Goins’ room, noting he had not yet awakened from the anesthesia.

As Wanda leaned over to take Ken’s blood pressure, she noticed the pale hue of his skin. Wanda rushed to complete the measurement and ran into the hall. “Angie, come quick. The patient in one-twenty isn’t looking so good.”

Angie Conrad, Ken’s nurse, hurried to the room. “His heart rate is one ten,” said Wanda, “and his BP is seventy over forty-four.”

Angie called the patient’s doctor. “Doctor Burns, Ken Goins has a rapid pulse, and his BP has dropped over the past few minutes to seventy over forty-four. He appears pale. Can you come?”

“Yes. I’m on the seventh floor with another patient. I’ll be down immediately.”

Dr. Burns arrived and swept back the hospital blanket. As he began to examine his patient, Ken’s breathing stopped.

“What? Call a code! Get the crash cart in here!” ordered Dr. Burns.

Angie raced to the nurses’ station and announced the code over the floor’s public-address system. A medical team scrambled into Ken’s room with a battery of equipment. For over thirty minutes, the team worked feverishly over Ken’s bed but was unable to revive the stricken patient.

Dr. Burns rubbed his eyes. “What the hell is going on around here? Ken Goins was admitted for a frikkin nose job.” Opening Ken’s patient chart, he pulled out a roll of heart-monitoring paper produced during the morning’s surgery. “Look at this. A perfect strip: P wave normal, QRS complex normal, T wave normal. Everything looks exactly as it should.”

Wanda and Angie turned away in disbelief, as stunned as the rest of the medical professionals.

“We need to let the administration know,” said Angie.

William Cline emerged from his office and stood in front of Alton with a bleak expression. “Make that five patients.”

Alton arched an eyebrow. “What?”

“We had a fifth patient die unexpectedly just a few minutes ago, and you’re not gonna believe who it is: Ken Goins—Nancy’s husband.”

Alton was indeed shocked. “What happened?”

Cline explained the nature of Ken’s surgery and of his sudden, unexpected death.

“Is the medical team who treated him still in the hospital?” asked Alton.

“Yes, I believe so.”

“This may be an unprecedented opportunity to get eyewitness accounts while everyone’s memory is fresh. Ask the medical team to meet me at the nurses’ station on Ken Goins’ floor in fifteen minutes.”

Several minutes later, Scrubs wheeled a patient to Five South, the floor on which Ken Goins’ body lay draped in his room. He noticed a group of employees filing into a small conference room at the end of the hall.

“What’s up?” he asked a passing housekeeper with a jerk of his thumb towards the assemblage.

“The patient in room one-twenty died a few minutes ago. I think they’re having some kinda meeting about it.”

Scrubs nodded. As the housekeeper continued down the passage, Scrubs bent down to tie his shoe and casually peered down the long hallway. Nobody was present. He straightened up, walked down the hall, and entered Ken Goins’ room with an air of confidence, as if he had a sanctioned purpose for doing so.

Once inside, Scrubs made a beeline for the patient’s bed and found a white paper cup containing two small tablets. He pocketed the medicine and strode out the door. It wasn’t much, but it was better than nothing, especially since the hospice supply had dried up. He produced a mirthless smile as he considered the tablets. Given the limited number of pills, he might just earmark them for personal consumption.

Alton studied the doctors and nurses gathered around the conference-room table. Many of them wore shocked expressions. They were used to death, but not of this sort. For a moment, Alton’s mind drifted back to Afghanistan, when such expressions in the face of unexpected death had been an all-too-common occurrence.

William Cline addressed the crowd of medical professionals. “This is Alton Blackwell.  He’s a consultant with the FBI, and he’s going to ask you all some questions about Ken Goins’ death. I’m not able to share all the details of Mr. Blackwell’s investigation, but I can’t emphasize enough the confidential nature of this meeting. Our conversation can’t leave this room. If I find out that it has, I promise it will be your last day with Stokely.”

Alton swept his gaze across the room, looking each of them in the face as he spoke. “I know this has been a difficult experience for all of you. As an Army officer, I watched friends smile and laugh one day, only to be carried out in a body bag the next. As tough as our conversation may be, I need you to focus on the questions I’m going to ask. They may be crucial to preventing any more tragedies of this nature at your hospital.”

Several of the attendees nodded.

“William Cline briefed me on Ken Goins’ rhinoplasty surgery and sudden death. I’d like to ensure I have my facts straight.” Alton spent a few minutes confirming the details of the treatment Ken had received over the course of the day.

“Okay,” said Alton, “let’s turn our attention to the timing of Ken Goins’ downturn. When was the last time he was seen in good condition?”

Angie Conrad spoke up. “I finished my hourly rounding at about five o’clock. He was my last patient, so I can say with confidence I saw him in good shape pretty close to that time.”

“Who discovered Mr. Goins in distress?”

“I did,” said Wanda, swallowing. “I came in to take his vitals and he looked all…light gray. Plus his heart rate was up, and his BP was down.”

“And that was at what time?”

“I’m not sure exactly. I think about five forty-five or six.”

“That’s good enough,” reassured Alton. “And what happened next?”

“I called Angie. Once she saw how bad he looked, she called Doctor Burns.”

“I see. We know what happened after that.” Alton returned his gaze to the entire group. “Did Mr. Goins exhibit any symptoms which suggest the cause of death?”

“He died of myocardial infarction—a heart attack,” answered Dr. Burns, “but we don’t know exactly why. We’ll need an autopsy for that.”

The autopsies of the four previous hospital patients hadn’t shed much light on their deaths, and Alton didn’t place much faith in the newest one answering too many questions, either. “Do you have any
theories
as to what caused Mr. Goins’ heart attack?”

Dr. Burns shook his head in chagrin. “No—there was nothing about his condition to suggest he was susceptible to this kind of demise. Otherwise I would have advised against the surgery, especially since it was an elective procedure.”

Alton turned to Angie and Wanda. “Did you see anyone enter the room after seven?”

Wanda responded with a shake of the head and a “no.” Angie also shook her head while adding, “Both of us were busy, Wanda with vitals and me with Mr. Lattimore two doors down. Even if someone had entered Mr. Goins’ room, we probably wouldn’t have seen them.”

“Does the hospital have any security cameras on this floor?”

Angie shook her head. “We do, but they’ve been broken for the past couple of months. Maintenance keeps saying they’ll fix them, but we’re still waiting.”

Alton resisted the urge to shake his own head in frustration.
The security cameras were broken. What were the odds? “Okay, thanks. I believe that’s all the information I need from you all. Everyone, can you write your name and number on this notepad before you leave? I’m also leaving a stack of my cards next to it here on the table. Please take one with you in case you remember any new information.” Alton turned to Cline. “I think I’ll have a talk with the unit secretary. Perhaps she saw something.”

As the meeting’s participants queued up to write down their contact information, Angie pulled Alton aside. “You won’t get anywhere with the unit secretary. She gets tense. She’ll clam up as soon as you say you’re from the FBI.”

“Why? Does she have a record?”

“I don’t think so. She just has panic attacks around authority figures, especially when she’s being questioned. She did the same thing during last year’s Joint Commission audit.”

“Thanks for the heads up,” said Alton. Given the secretary’s central location on the floor, he didn’t want to abandon the idea of questioning her. On the other hand, if she froze up, what good would come of such an approach?