Urgent Care (28 page)

“He was a good patient. Better than most of the humans I’ve dealt with.” She squeezed Seth’s arm. “Including you.”

He turned and kissed her. As their lips met, a familiar warmth spread through her, enticing her like a drug. She opened her eyes and pushed away.

Damn it all, she’d spent two long years mastering her emotions, staying in control. She wasn’t about to forget the fact that Seth had hurt her—no matter how loving he acted now. She stood, leaving Seth and DeBakey behind, and washed her hands in the kitchen sink, running the water so hot the steam fogged her vision.

“How about if I make us all some dinner?” she asked, her voice crisp and cheerful as she regained control. Never again would she allow someone to sneak below her guard, let them hurt her.

Never again.

Friday, 2:13 P.M.

GINA AND AMANDA HAD REMAINED WITH NAROLIE, along with the PICU team, while Lucas took her aunt and the translator to the family room to discuss the situation.

“What the hell is going on here?” Dr. Frantz said, slamming the door against the wall as he barreled into the room. “Who told my patient that he had scabies and could go home?”

“Here to check on your other patient, Dr. Frantz?” Gina said, backing away as the PICU team prepared Narolie for transport. “She’s taking Tank’s bed in the ICU.”

“Who?” Frantz frowned, then did a double take as he looked at Narolie, barely visible amid the array of technology. “She was supposed to be discharged this morning.” He scowled and took a step toward Amanda. “What did you do?”

“She did nothing,” Gina said, inserting herself between Frantz and Amanda. “Except protect her patient. Maybe you should consider transferring her to Dr. Stone’s service—wouldn’t want the lawyers to see your name all over the chart.”

“What are you implying, young lady? I don’t care who your father is—”

“You might want to rethink that when I give his name to Narolie’s family. And explain to them how you were going to send a critically ill patient home.”

“How dare you!” He spun on his heel, ready to stalk out, but Gina wasn’t letting him off that easy.

“By the way, I’m the one who discovered Tank’s scabies. You’d better let the folks at Heinz Prep know. I think you’ll have a lot of angry parents on your hands.”

 

 

LYDIA RUSHED INTO THE
PICU
AND HEADED straight to the nurses’ station, avoiding the gazes of the parents sitting vigil at the bedsides of young children. She hated coming here. Too much hope, too much despair, not enough that doctors, nurses, anyone could actually control.

And way too much time to think about it all.

As she rounded the desk and approached the chart rack, she spotted Lucas in the dictation area, talking with someone. The nurses in the ER had filled her in on what had happened in the MRI and how Lucas had taken over Narolie’s case. Thank God, finally Narolie was in the hands of a doctor who’d think twice about her care.

She grabbed Narolie’s chart and scanned the notes from the MRI and the resuscitation that followed. Encephalitis? A catchall term for so many diseases, all of them bad. Very bad. The fact that she’d deteriorated so quickly was more bad news.

Lydia glanced inside the dictation room, trying to gauge whether this was a good time to interrupt, to ask questions about Narolie. Then she saw who Lucas was talking to. The CEO, Oliver Tillman.

“I told you, it’s too early for me to give you a prognosis.” Lucas had raised his voice.

“But most cases of encephalitis require long-term care and rehab, correct?”

“Well, yes. But every patient is different—”

“That’s okay, Dr. Stone. All I require to institute repatriation procedures is a general overview of the situation. Thank you for your time.”

“You can’t just ship her off—”

“It’s in her best interests to be reunited with her family. I’m working to make that happen.” Tillman brushed past Lucas and strode out of the nurses’ station, heading out the doors without a glance at any of the families or patients around him.

“He wasn’t talking about Narolie, was he?” Lydia asked. “What does he mean, reunited with her family? Her family is here.”

Lucas scowled. “Seems the U.S. government’s definition of
family
differs from the Somali one. Narolie isn’t really related to her ‘aunt’ at all. And her P3 visa was based on her entering the country to join blood relatives.”

“So we’ll deal with that later, after we know what’s going on with her. It takes years to deport someone, doesn’t it?”

“If she’s not a valid immigrant, she loses her medical assistance. Which means the hospital will foot the bill for all her care—and unfortunately, given her deterioration, it might be care for a long, long time. Not to mention rehab, if she does improve.”

“She’s that bad off?” Lydia knew that’s what the chart said, but she couldn’t believe that the vibrant girl she’d met yesterday was now lying in a coma.

“Yes. And there’s a loophole in the law that allows hospitals to ‘repatriate’ patients to their native countries. It’s done in the guise of reuniting them with their families to facilitate long-term care, but really it’s all about saving money.”

“You’ve got to be kidding me.” Lydia turned to stare at the doors Tillman had exited through. “Son of a bitch.”

“Tillman says it’s to protect the medical center—the money spent on Narolie if she remains in a persistent vegetative state could be used to care for hundreds of patients.”

“Hundreds of nameless, faceless, future patients. We’ve got to concentrate on the one we know, the one who came to us for help. Here and now.”

“That’s the problem. I’m not sure there is anything we can do to help her.”

 

 

AMANDA FUMBLED THE SUCTION CATHETER. AS IT flew from her fingers she tried to catch it, but it ended up on the floor beside Zachary’s bed.

“Sorry,” she told the respiratory tech as she bent over to pick it up. Too late she realized that she should have let it go—now she had to wash her hands and change her gloves.

“Forget it,” Michael said as he opened a new catheter and deftly threaded it down Zachary’s endotracheal tube. “I’ve got it. Weren’t you supposed to go home—like hours ago?”

Amanda’s sigh sounded loud and pathetic. But she couldn’t help it. Her entire body drooped with fatigue. “I feel like I neglected Zachary and his folks today—I was so caught up with Narolie’s case. And now she’s . . .” She trailed off, her gaze fixed on the closed doors to Narolie’s room.

“You’re good at this, Amanda.” He reattached the endotracheal tube to the ventilator, discarding the catheter and his gloves in one smooth movement. “But you need to learn to pace yourself. You can’t give everything to any one patient—you won’t have anything left.”

She squirmed under his compliments. “Yeah, I guess you’re right.” She helped him finish cleaning up. “I’ll go talk to the Millers and then call it a night.”

“See you in the morning.”

Amanda almost tripped over the threshold of the family waiting room as she sought out Zachary’s parents. They were huddled in the far corner, the dad staring out the window at the angels in the cemetery, the mom pretending to read an out-of-date
Redbook
, her gaze unfocused, her face wet with tears.

“We’re done,” Amanda told them. “He did fine.” She sat down on the chair beside Zachary’s mother. “How are you guys holding up?”

“Fine,” the mother echoed. The dad didn’t respond, seemed lost in the night beyond the window. “I still can’t believe this happened. That we were distracted—that a simple thing like a pop bottle could be so devastating.”

“It’s no one’s fault. Zachary couldn’t have known that the kerosene was in the bottle and your father couldn’t have known—”

“It’s his arthritis. It’s so bad in his hands that he couldn’t handle the childproof lids.” Mrs. Miller swung her head, searching the far reaches of the room for an explanation. “He feels terrible. If Zachary—if anything happens—I don’t know how he’ll, we’ll, face it.” She grabbed Amanda’s hands. “It was only a sip, just a swallow; such a little thing can’t kill my boy, can it?”

Amanda said nothing. They both knew that even a tiny sip was enough to poison a child’s lungs. And they both knew there was nothing they could do except wait and see if Zachary’s lungs could heal.

“You can go in and see him now.”

Mrs. Miller stood. But her husband remained frozen in place. “We’ll be there in a minute.”

“I’ll see you tomorrow, then.” Amanda left them and returned to the PICU. She stopped inside the door, watching Zachary, dwarfed by the machines keeping him alive.

Her entire body felt numb, and she was desperate for sleep, but she wanted to check on Narolie one last time before going home. To her surprise, she found Lydia at Narolie’s bedside, reading the chart.

“We don’t have much time,” Lydia said when Amanda entered.

“Is she getting worse?” Amanda glanced at the monitor. No, everything seemed to be stable—vital signs all normal. The only problem was that Narolie wouldn’t wake up. Even now that the sedatives were out of her system, she remained unconscious. The EEG machine at the base of the bed made a scratching noise as its pens traced out Narolie’s brain-waves: almost flat.

“Tillman found out that her visa might not be valid. He wants to deport her. Already has the hospital attorneys working on it. I figure they won’t get much done over the weekend, but come Monday—”

“Are you nuts?” Amanda’s exhaustion fueled her anger. She jammed her fists into the pockets of her lab coat in an attempt to keep from lashing out and breaking something. “They can’t do that! She’s a patient, helpless—look at her.”

Her voice was sharp with frustration and fatigue. Lydia didn’t seem bothered by it. Instead she merely closed the chart on her finger to hold her place and waited. “Yelling isn’t going to help her. If we can find something we can treat—some medical reason for her to stay—then we can help her.”

Amanda slumped against the glass wall of the cubicle, not caring who saw. “I’ve been through the chart. There’s nothing there. I have no idea what’s causing her encephalitis.”

“You’re exhausted. Why don’t you go home, get some rest? Tomorrow, maybe things will make more sense.”

“I hope so.” Amanda brushed her fingers against Narolie’s cheek. The girl didn’t respond.

 

 

FRUSTRATED THAT THERE WAS NOTHING MORE she could do to help Narolie, Lydia finally left the ICU and headed home. She zipped her parka up tight and dug her hands deep into her pockets as the wind pummeled her. The sleet and snow were gone, leaving patches of black ice in their wake. The sun was also long vanished—if it had ever made an appearance today, Lydia had missed it. Even in the darkness she could feel the moisture-laden clouds pressing down on her, trying to smother all warmth and light.

How did people live like this for five months out of the year? Like moles trapped in a cave, never seeing the light of day. Shivering, she pulled the hood up on her parka, even though she knew it made her look like a wimp—most Pitts burghers were still wearing midweight fall jackets. Maybe she wasn’t cut out to be a Pittsburgher, as tough as the steel the town was famous for.

Like Ruby, Trey’s mom. Now there was a tough lady. Or Nora—Lydia couldn’t even begin to fathom what it had taken to rebuild her life after what had happened two years ago.

She crossed the street and saw that the memorial to Karen now filled most of the block, offerings heaped up against the cemetery fence, flickering votives illuminating them. The police officer was gone, but the cemetery gates were chained shut. She stopped, peering through them at the forlorn angel shrouded in crime-scene tape.

“Kinda scary, ain’t it?”

Lydia jerked around at the sound of Pete Sandusky’s voice, her hand halfway to his face, ready to do some damage. She pulled it back just in time and thrust it back in her pocket, half-embarrassed by her violent reflex. “What do you want, Pete?”

“Same as yesterday. Confirmation before I run a story. Only this time I have more facts.” He walked beside her as she moved down the sidewalk, dodging stuffed animals and flowers. “I saw the photos, Lydia. Heard about how Nora was the one to find Karen. How she lost the rape kit. That the killer could go free because of her incompetence.”

Lydia pushed her hood down so that her vision was unobstructed. She’d told Boyle about Pete and her suspicions that Jim Lazarov had stolen the rape kit, but her vague innuendoes and hearsay weren’t enough for the police to act on. “Nora didn’t lose the rape kit. Whoever showed you those photos stole it. You need to tell the police.”

Pete merely smiled, an infuriating, smug smile. “I don’t reveal my sources to anyone. And my source says he found the photos, that he has no other evidence. So, what’s it going to be, Lydia? You gonna give me the full story, or do I run with what I have?”

He obviously thought she had information that would help Nora. Which was good; it meant he had no idea about Nora being a victim of the same rapist. Not that that would help her if Pete published his story.

Lydia thought furiously. The only thing she had to offer, the only way she could get Pete to quash his story, would be to offer him something more salacious. Would the fact that the CEO of the medical center was having an affair with a murder victim be enough?

“What makes you so certain your source isn’t the killer himself?” she asked, trying to buy time as she thought things through. As much as she despised Tillman, she couldn’t ruin his reputation based on gossip.

“I don’t really care,” Pete answered. “If he is the killer, then I have an inside track. If he isn’t, I still have a story no one else has.”

Maybe Pete’s questionable ethics were contagious. Because Lydia thought of another way she could use her knowledge of Tillman’s affair. She looked past Pete to the lights of the hospital, zooming in on the fourth floor. The floor where Narolie was. Blackmail? To save a patient. Did that make it worth it?