T Wave (6 page)

CHAPTER 14

Jacob Dunlow continued to fade.

When he had first moved to Washington, Jacob’s forty-year habit of back-breaking labor had precluded a life of complete leisure in retirement. He had chosen to work part-time as a warehouse supervisor for a local produce distributor. Before long, he had earned the respect and friendship of his younger co-workers. Many of them now filed through his hospice room, some staying for minutes, others for hours. Jacob’s capacity to interact with them slowly declined, but he smiled as each new person entered the room and—even now—did his best to speak with them individually.

By mid-afternoon, the last work visitor had left, and only Alton, Mallory, Fahima, and David remained. Jacob’s breathing steadily became more labored. Flashes of pain played across his face, and he seemed less aware of those around him.

Gathering his strength, Jacob peered into David’s face. “Son, I know I don’t have long. Will you stand by me and…hold my hand when it’s time?”

David nodded as hot tears ran down his face. Fahima sobbed and grasped David’s arm. Alton stepped from behind David to place a gentle hand on his friend’s shoulder.

As David gazed on his father’s kind but pain-crossed face, Alton once again recalled the patchwork of memories David had shared during their Army days in Afghanistan: he and his father working the cattle ranch together, chasing stray calves, repairing fences, and enjoying hot dinners after long, frigid days of work. They didn’t always have much, David had said, but they had always had each other. David seemed incapable of believing this close partnership would soon end.

Mallory stood frozen in the middle of the room. As she gazed at Jacob, Alton could almost see the memories of her own father’s sudden death filling her mind. She had never shared the specific details of his death with Alton, citing the topic as too painful to discuss. Over breakfast that very morning, though, she had reflected on her inability to discern which portion of her sadness flowed directly from Jacob’s impending death and which was the product of the haunting recollections of her own father’s demise, memories evoked by the current tragedy. She appeared to still be sorting out her emotions. Finally, Mallory moved next to David and squeezed his free arm.

After a few minutes, Alton and Mallory retreated to the vinyl visitors’ chairs lined up against the opposite wall, leaving David holding his father’s hand with Fahima by his side.

“I love you, Dad,” choked out David. “I hope to be as good a person as you one day.”

“You always were, son,” rasped Jacob. “I love you. I’m so proud of you…so proud of the man…you’ve become.”

David shielded his face with his right hand. Time stopped, and silent tears fell onto the medical blanket. The rising and falling of Jacob’s chest became less distinguishable. At last, his breathing ceased altogether, and his face relaxed into an expression that gave no indication of the pain he had so recently endured.

David sobbed quietly, still holding his dead father’s hand, and Fahima clung to her husband’s side.

Wiping the moisture from his own eyes, Alton stepped into the hallway to summon Nurse Corroto. His somber expression was sufficient to tell the nurse what had transpired.

Corroto entered the room. “You can have as much time as you like.” As she turned to leave, Alton and Mallory accompanied her in order to give their friends some time alone.

Eventually, David and Fahima made their way into the lobby. In a kindly manner, Corroto began the procedures for the disposition of Jacob’s body. One of the steps included a call to a local doctor.

“Did you know your father was a member of a research scientist’s study group?” Corroto asked David.

“Yeah, Dad mentioned that, but he didn’t elaborate.” The effort of responding to Corroto’s question wiped a bit of the blank expression from David’s face, although he still appeared dazed.

Thirty minutes later, the automatic doors of the hospice’s main entrance parted, and a doctor wearing a spotless white lab coat walked through.

“There’s the great man himself,” said Corroto, who had returned to speak with David and Fahima moments earlier.

Alton and Mallory sat in nearby lobby chairs. Mallory leaned over to Alton and murmured, “That’s the guy I met my first day in the hospital—Reginald Oswald. He’s the one researching cures for GI diseases.”

Oswald introduced himself to David and Fahima. “My condolences on the loss of your father.”

“Thanks,” said David, his attention not entirely focused on the man in front of him.

“Mr. Dunlow,” said Oswald, “I need to make a very important request of you, and I’d like for you and your wife to take all the time you need to think about it before answering.”

David nodded while Fahima watched in silence.

“As you know, your father had esophageal varices. I’m researching cures for this and other, similar types of intractable GI diseases. Your father was a research patient of mine. Could I obtain your permission to perform an autopsy on your father to learn more about his exact cause of death? It might provide more insight into the cures I’m trying to develop.”

David remained silent, and Oswald continued. “Your father joined our group knowing that he probably wouldn’t personally benefit from this research—that the benefit would accrue to future recipients of the medicines we’ll eventually develop. In death, the secrets revealed in your father’s body can help other people survive this type of condition.”

“Give me a minute, please.”

“Certainly.”

David and Fahima approached Alton and Mallory. 

“What do you think?” asked David.

“It’s really up to you, David,” replied Alton.

“What do you think your dad would want?” asked Mallory.

“I think I know,” said Fahima. “He is—he
was
—a man who helps other people, like his son.”

David nodded and returned to Oswald. “Okay. You can perform your autopsy. When you’re done, though, I’d like the body back for burial.”

“Thank you. I believe you’ve made the right choice.”

An hour later, Alton and Mallory remained in the hospice while David and Fahima worked with Nurse Corroto to make funeral and transport arrangements.

Waiting in a visitor’s chair, Alton watched the ebb and flow of activity in the hospice lobby. A family brought a large bouquet of flowers and headed straight down the hall on the left. Later, a solemn man with a chauffeur’s cap in his hands waited by the nurses’ station until one of them told him, “Okay, you’re good.” The man was probably a hearse driver. Two young children ran down the right hallway, and a scurrying mom with her hair in a ponytail chased after them.

Alton watched the shift supervisor approach Angelica Kwan, a nurse who had helped care for Jacob yesterday.

“Have you already given that last dose of pain meds to Mr. Gilroy?” asked the supervisor.

“No,” replied Kwan. “He wasn’t responsive when I was making my rounds, so I left them on the nightstand. I asked his family to let me know when he was awake so I could give him the pills, but they probably did it themselves. It wouldn’t be the first time.”

Alton shifted his focus as David returned to share the schedule for his father’s funeral. To give Oswald sufficient time to conduct the autopsy and subsequent research, the ceremony wouldn’t occur for almost two weeks.

Alton stepped outside and placed a brief call to Jake Hines, his manager. In order to stay with his friends throughout these difficult times, Alton arranged to defer his return to Alpharetta. He would continue working from Washington until Jacob’s funeral was over.

The final arrangements complete, Alton and Mallory returned with David and Fahima to their house. While a time of providing companionship and commiseration would surely come, on this evening Alton and Mallory realized their exhausted friends needed time alone. After expressing their deepest sorrow, they left David and Fahima to their private grief.

SATURDAY, JULY 14

CHAPTER 15

The next morning, Reginald Oswald spoke with Fred Sneed, one of his junior researchers, and informed him of Jacob’s passing.

“Dunlow’s death was unfortunate, but hopefully we can learn something from it. We’re still making good progress…better than Powell’s team, and I’d like to keep it that way.”

While the two researchers began their day, Mallory arrived at the hospice to conduct the next stage of her research into the narcotics-theft case. As expected, she had still not found convincing evidence of anyone stealing the drugs of deceased patients. There were three suspicious incidents, but none were conclusive.

Mallory returned to the hospice’s Pyxis system, the locked, computerized machine used to dispense narcotics when needed. Mallory performed cross-checks of Pyxis records against the charts of patients who had remained alive for at least a few days after the drugs had ostensibly been given. She reviewed the log of returned narcotics for evidence that someone had forged the witness signature, comparing different signatures for similarities in writing style. She also reviewed the records of patient and family complaints; all nurses having an unusually high percentage of complaints about medication omissions would warrant a more thorough review.

Mallory and Nancy Goins entered the tiny office that housed the Pyxis narcotics-dispensing system. As they closed the door, Nancy’s cellphone rang. She waved at Mallory to take a seat as she answered it.

“Hello?” said Nancy. “Hi, Mr. Cline…that’s right: we’re at only fifty percent capacity. What would you like me to do about it? Go out on the street and ask someone to start dying so we can fill our beds? Yes, I’ll keep you in the loop. Bye.”

Nancy turned to Mallory. “Sorry about that.”

“No worries,” said Mallory. “I know you have a hospice to run.”

They crowded around the room’s only desk to begin the day’s review. Nancy showed Mallory the Pyxis log and began to explain the specific process used by the hospice nurses to check out and return medicines.

During this discussion, a nurse poked her head in the door. “Mr. Hutchins in room one-fourteen has passed.”

Nancy looked up in surprise. “Really? Were you expecting that?”

“No, not exactly. When I went to see him after report this morning, he seemed pretty alert and oriented. In any case, the family needs some help contacting the funeral home, and everyone else is busy with other patients. Can you help?”

“Yes. Give me five minutes.” She tilted her head and pursed her lips to one side.

“You look puzzled,” said Mallory.

“Well, yes, I am. Mr. Hutchins was only here for respite care. His wife had to go out of town for a few days to see a new grandchild. His son works and can’t care for him full-time, so they brought him here for a few days. He was terminal, of course, but the doctors expected him to live at least another three or four months. His symptoms simply weren’t at the near-death stage yet.”

“Yes, it’s curious,” said Mallory. “Does that happen often—a patient dying sooner than expected?”

“Yes,” admitted Nancy. “Usually, though, a patient dies a few
weeks
early, not a few
months
early. Plus, Mr. Hutchins had COPD, a breathing disorder. You can usually predict pretty accurately when a COPD patient will die since their death is a result of a decline in their body’s ability to absorb oxygen.”

“Do you think the family will ask about his dying all of a sudden?”

“I have no idea. If they do, I’ll need to put them in touch with his doctor. That reminds me, I need to see them about the funeral home arrangements. Please excuse me—we’ll continue our review as soon as I finish helping them.”

“Of course—thank you.”

Mallory hunched over the log to review it on her own but felt vaguely unsettled by the information Nancy had just shared.

CHAPTER 16

That evening, Scrubs heard his wife open the garage door as she returned from work. Her shift should have ended over two hours ago, but in the last few months, she had been working a lot more overtime than usual. Too bad the extra money didn’t seem to help the family budget very much.

Scrubs was drinking a Pabst Blue Ribbon and watching
Family Feud
with a dinner plate balanced on his lap when Jeanette closed the door to the garage. “I left beef stew on the stove,” he called.

Jeanette fixed herself a plate and walked into the den, a lit cigarette already dangling from her lips. After watching television for a minute, she turned to her husband. “I’m worried about trying to get any more stuff right now.”

“How come?”

“There’s been some lady at the hospice asking questions all week.”

“What kind of questions?”

“What our procedures for narcotics are—how we check them out, give them to patients, dispose of them after a patient dies… that kind of thing.”

“Is she a cop?” asked Scrubs.

“I don’t know. She doesn’t look like one, but does it matter? Probably somebody has figured out—or is at least suspicious—that drugs are going missing. If I get busted, I’ll lose my job and my nursing license…maybe even go to jail if they have enough evidence. Then what would we do?”

“Take it easy. You won’t get caught. Maybe you need to be extra careful, though. When do you usually take the stuff?”

“The best time is around shift change, when the nurses who are getting ready to leave start giving report to the new ones coming in. We spend more time giving report than we do with the patients. If I have a confused or especially-sick patient who doesn’t have any family members around, or at least not any who are paying attention, I can usually go in and snag some of their meds. It’s usually easiest a few days before the patient dies, when they’re really out of it. As long I chart that the med was given while they were still alive, I can skim them off pretty easy.”

“How did your bosses get suspicious, then?”

“I’m not sure.” Jeanette shook her head in perplexity. “However, when patients are more aware than they seem, they complain that they didn’t get their meds. Same goes for the families…sometimes they’re paying more attention than you think.”

“If the patients are that zoned out, couldn’t you just give them, like, a Sweet Tart instead? That way, they’d think they took the real deal and you could keep their stuff. No one would complain.”

“Their meds look and taste too different from candy. And if anyone caught me giving candy instead of medicine, I’d be busted on the spot.”

Scrubs pondered for a moment. “Maybe to be safe, you should lay low until your curious friend is finished.”

“She’s not my friend. I’ll be glad when she’s gone. What about you? Can you get any more stuff at the hospital?”

Scrubs shook his head. “I can’t hang out in the patients’ rooms like you can. I have to drop them off and go, or someone would get suspicious right away. When I’m dropping off or picking up, there’s usually a nurse and family members all crowded around in there. Most of the time, I can’t make a move.”

“You got those Oxy pills the other day.”

“Yep. I got kinda lucky on that one, but that don’t happen too often.”

At the conclusion of the game show, Scrubs called Leroy. “Listen, man. The heat’s on at Jeanette’s work. She probably won’t be able to get anything for a while.” He recounted the hospice inquiries.

“How long do I have to wait?” demanded Leroy.

“I don’t know, man. Until that lady stops asking questions…probably a week or two. If Jeanette gets busted, you’ll be cut off for a lot longer than that.” He began to pace the floor, holding the cell phone to his ear.

“What am I gonna tell my dealers?”

“That’s your problem. I never promised you a schedule. It’s not like we can tell the patients when to die.” He ran a hand through his greasy hair.

“Yeah, but if I can’t count on you, I’ll have to find a new source. And you’ll have to find yourself a new buyer.”

“I get the message. I’ll let you know when I have something.”

Scrubs knew his finances were precarious. He dropped onto the couch and tipped his head backwards to stare at the ceiling. He remained motionless for a minute, contemplating his options, but said nothing.