Compromised, page 31
part #1 of MetroGen Forbidden Love Duets Series
“Pretend it’s a medical student training. Besides, we’re doing for him the thing we couldn’t do for Tiffany,” Angela said. It was true. Tiffany’s WPW contributed to her death as much as the enlarged heart had. She’d been unsavable; the Chief wasn’t.
“I’m in.” Unsurprisingly, her words had swayed Michael fully to this harebrained scheme. “And a medical student on a cardiac in-service.”
“Exactly. Act normal,” Angela advised him. The imp of perverse.
So much for thinking there weren’t doctors wandering the streets on the hunt for emergencies.
Off they went, her pockets full of meds, hunting their own escaped fire chief.
Chapter 55
They were a few blocks from Doctor Row when an ambulance came to a screeching halt next to them. A blonde man was driving.
Erin Hudgens, much healthier than Angela had seen her three months ago, jumped out of the passenger side. Greetings were exchanged and minutes later Michael and Angela were settled in the back of the ambulance with Erin and Theo in the front.
They drove a few blocks to a CCFD SUV. Erin broke the window and grabbed a pile of stuff.
The group examined the papers while Erin checked his phone.
“It’s written in gibberish,” Michael said. The handwriting was slanted and chaotic.
Angela turned her paper upside down. “It’s not writing. It’s drawings.”
Chief Baker had drawn variations of some type of stick figure with either three, four, or five spokes on it.
“It really must have been Haldol. This isn’t like him. But if it was Haldol, I don’t understand how Noah’s even awake to do any of this. 20 mg of Haldol could have taken down three full-grown men, and he’s slim,” Erin said.
“20 mg?” Angela repeated. “How did he get the dose and when?”
“IM in his thigh. He was in the middle of the Atlantis scene. So, around eleven, I think.”
“That’s why. IM has inconsistent onset, and he had a lot of adrenaline to fight it. Then he likely had chest pain, which kept him awake.” Angela was making some rapid calculations. “He’s at the end of the first half-life of the Haldol and is midway through the peak effect of his metoprolol.”
“English please,” Erin said.
“Chief Baker has enough Haldol in his system combined with his metoprolol to kill him suddenly. If his heart rate climbs, he’ll go into SVT and then torsades de pointes, which leads to sudden death.”
“So if he gets upset, he won’t turn into the incredible hulk. He’ll die.”
“Anything that increases his heart. Climbing stairs. Running.”
“The man boxes daily. He won’t think anything of climbing stairs,” Erin said.
“Except his heart rate should normally be slow if he’s fit. We have to find him first,” Angela said.
“And then what?”
“I’ve got this. I stole the meds out of the crash cart, and I’m a defib master.”
“Don’t look at me,” Michael said. “I figured out the Haldol thing and then got the best help I could—which is her. She’s the best.”
“Theo? What is this?” Erin held up one of the pictures.
“A star. Or a hand.”
“A hand?” Erin turned the paper a few times. “Michael, what did he tell you?”
“Umm. It didn’t make sense to me. ‘The many or the one. Blue-green and prosper.’”
“Not ‘live long and prosper’?”
“No, though he stopped beating me with Baby Yoda to look at my hands.” Michael used the nickname Erin had used for Chief Baker’s Halligan bar.
Erin placed her hand on the paper and made the Vulcan sign. She opened the messages on the phone and scrolled.
“Oh MY GOD. Everyone in. Drive.”
“Where?” Theo said as everyone loaded again.
“The North Star Cafe. We need to get there before he confronts both arsonists.”
“Let me get this straight,” Theo Jefferson said in the front seat, having turned off his sirens as they approached the North Star Cafe. “You believe there are two arsonists who work at this sci-fi cafe because Noah wrote down Star Trek messages.”
“I live with the Fire Chief. There’s been a whole lot of arson investigation chatter over the dumpsters. Noah fought someone in a Spock mask blocking the exits to the Atlantis factory. That person had four fingers. The host of the North Star Cafe has four fingers and couldn’t do the ‘live long and prosper.’ A waitress who worked at the North Star Cafe also worked at the Siren Bar the day it burned down.”
Every sentence sounded more outlandish, but here they were.
Theo continued, “Also this—, the Chief got stabbed with Haldol, broke into the house which wasn’t yours, beat up a medical student, got taken to the hospital, and then escaped. And we picked up the same medical student, and with his doctor lover, which forms a second forbidden love couple to join with my fire chief and firefighter forbidden love couple, so we can go save the Chief.”
“Sounds right,” Michael said, holding Angela’s hand.
“Wasn’t there something about bombs?” Angela asked.
“Yes. The arsonists use Atlantis delivery to plant bombs. A lot of them.”
“Hmm,” Michael said, “And to think twenty years ago, they were simply a bookseller.”
Not a banner year for Atlantis, between the sex doll and this. Not even the sparkly dress was worth it.
“And my books will henceforth be ordered through Barnes and Noble, Apple, Google, or Kobo,” Theo said. “You think we have enough to call the police?”
“Seriously? Tell them the arsonists whose names we don’t know might be at the North Star café? One’s usually dressed as an alien, and the other is a Black chick?” Erin said.
“Okay, you have a good point,” Theo said.
“We probably beat Noah here anyway,” she hoped.
They moved to park, and Angela heard commotion in the parking lot.
“He’s got a gun!” someone shouted.
“Never mind,” Erin said. “I think people are already calling the police.”
“Do we wait?” Michael asked, eyes meeting Angela’s. They’d waited for Tiffany Wickwire.
Erin climbed out of the ambulance. “None of those people are bleeding, so he hasn’t started shooting yet. I’m going in.”
“He has a gun. The scene isn’t secure,” Theo warned her.
“Dr. Perkins, will someone pointing a gun at you increase your heart rate?” Erin removed the jump bag from its side compartment.
“It’ll probably work even if he’s on Haldol.”
“Noah can’t wait,” Erin said, aware this was a horrible idea. “Stay sharp.”
“I’m your partner.” Theo got out. “Two in, two out.”
Angela said jumped out the open doors, “I’m coming too.”
“You are not,” Erin said. “We’ll bring Noah to you.”
“And if he’s down? Are you ready to run a full code and then pace him afterward? Can you tell me the danger of using amiodarone if epi doesn’t work?” Angela reminded her. No one in the ambulance could do what she could.
“She means we’ll be with you. It’ll be hard for him to shoot us all,” Michael said.
“Great point,” Theo said. “I have a bad feeling about this.”
He took the defibrillator. Michael had the jump bag with the meds and airway equipment. Angela checked her pockets again for the collection of meds.
She moved the syringe of succinylcholine into her right white coat pocket. It came in a 10 milliliter syringe, so the 200 milligrams it contained should be more than enough if she needed it.
Chapter 56
They didn’t get very far into the North Star Cafe to assess the situation. An Asian guy in some type of sci-fi bathrobe was holding the Chief at gunpoint. A woman fitting Erin’s description as the other arsonist was behind him, less than thrilled with the turn of events.
The man promptly turned the gun on them, yelling, “What are you doing here?”
Erin raised her hands and kept her distance. “The Fire Chief is very ill. We only came here to take him back to the hospital.”
“You’re lying!” He swung the gun back and forth between their group and the Chief, who was standing with his hands outstretched.
The waitress mumbled, “He’s got an IV in his arm, Dan.”
“I came here to talk. You have the best pancakes,” the Chief said.
Dan, the arsonist, waved the gun held in his four-fingered right hand. “You shut up.”
“We don’t want any trouble,” Theo said. “So if you could let Chief Baker go.”
“He needs to pay.”
“For what?” Michael asked.
“He killed my family.”
“Your family?” the Chief asked.
“In August. Do you remember the big apartment fire? You left my family to die. My parents, my little sister.”
“I didn’t kill them,” the Chief said.
“Yes, you did, and then you had the nerve to come to my restaurant—you and the other firefighters. All of you showed up here, drinking, happily moving on. There wasn’t even enough to bury of my parents. I had to identify them by DNA and pay for my little sister’s funeral myself. No one else cared, everyone else forgot. I was going to make you all pay.”
Erin asked the conflicted waitress. “And you? Did you burn down the Siren Bar hoping to kill off our trainees?”
The Chief said, “Or the Atlantis warehouse? Trap innocents inside to get revenge.”
The woman shook her head. “No. I wanted to teach you a lesson. I didn’t know he was going to…”
“But why?” Erin asked. “I risked my life going into the Siren Bar for a fire you set!”
“Why are you drinking this Kool-Aid?” The waitress hissed. “Can’t you see you’re being used? Recruited for the most dangerous jobs no one wants to do. Risk your life every day to fight his war?”
“It’s her life to risk,” Michael said. “There’s no war. She’s saving lives.”
The waitress got upset. “No one builds anything anymore. Atlantis is the worst. Everyone hates them, as they push everyone out of business. And him,” she pointed at the Chief, “He sent his people into danger, not caring if they died. He’s your overlord.”
“Not the socialist versus capitalist crap again. Write your manifesto somewhere else,” Dan, the host said and cocked the gun at the Fire Chief. “It’s time I dealt with you. An eye for an eye. Do you even know you killed my sister Trina when you had your firefighters retreat?”
The name he used sounded familiar. Angela would have thought more about it, but the Chief clutched his chest and went pale. He collapsed to the ground, and Erin ran to him, trauma shears in hand.
“What are you doing!” Dan waved his gun. “I’ll shoot you too.”
Theo knelt next to her and used her trauma shears to cut open the Chief’s scrub top. He felt for a pulse and said, “You don’t need to shoot him, he’s already dead.”
“Don’t try to save him. He deserves what he’s getting,” Dan said.
Angela mentally started the code clock in her head. The Chief needed CPR immediately. It would buy them time to restart his heart.
Dan had directed most of his ire at the firefighters and none at Angela or Michael. It was probably the white coats and Angela’s general blondness. No dumb blonde could be dangerous.
Time to do something brave and horribly stupid.
In a moment of clarity similar to what she had experienced in the cath lab yesterday, she understood exactly what she needed to say and do.
She stealthily uncapped the syringe in her pocket and walked in front of the firefighters and the downed Chief.
“If anyone killed your sister, it was me,” she said calmly.
“What are you doing?” Michael and Dan said at the same time. The arsonist seemed unsure if he should point the gun at the white-coated Angela or the Chief or Erin and Theo.
Angela kept talking, allowing Michael to follow her closely. “Your sister’s name was Christina Nguyen. She was brought in to the MetroGen ER, alive, after a high rise apartment fire.”
The gun shook in the arsonist’s hand. “Who are you?”
“I am Dr. Angela Perkins. I’m a cardiologist at MetroGen. I’m the one who killed your sister.”
“No,” Dan denied. “The firefighters… the Fire Chief… they left her to die.”
“No, they didn’t. Your sister had multiple crush injuries from a wall. A firefighter refused to leave her side and begged us to save her.”
“You’re wrong.”
By Angela’s count, it had been almost two minutes without CPR on the Chief. “I’m not. I ran her code. We did everything we could to save her, but the damage was too great, and I’m the one who said it was time to stop.”
“No. Stop lying. Everyone forgot her.”
“I didn’t forget her. She was fifteen. Her fingernails were painted pink, and her toenails were painted green. I remember.”
“But—” The man was struggling to keep the gun up.
“She’s not forgotten. The end of life, but not of love.” Angela hoped it was warning enough for Michael to be ready to act.
The high-pitched whine of the defibrillator cut through the relative silence of the cafe. The firefighters had started charging it.
The noise distracted the arsonist, and his gun wavered. Michael, understanding she needed him to act because she’d recited his tattoo, seized the man’s wrist.
Angela took her chance.
She stabbed the syringe into Dan’s thigh and depressed the plunger.
Intramuscular dosing of succinylcholine was more predictable than Haldol. A solid 200 mg would have a pretty immediate effect, even with him struggling, shutting down his muscles in less than thirty seconds.
Michael noticed the loss of strength, and easily wrestled the gun away. The arsonist went down, ideally paralyzed for about ten minutes.
Angela didn’t take the time to check on him. He had time. The Chief didn’t. Michael would breathe for him.
She sidestepped over his crumpled form and ran over to the Chief and Erin. She barked an order at Theo. “Restrain the two firebugs. Harper, bag him. You, CPR.”
Erin didn’t need to be told twice. She started chest compressions, and Angela prepped the defib.
“Hold compressions,” Angela said. She slapped the defibrillators pads on his chest and waited for them to pick up his cardiac rhythm. “Come on, show me what you’re thinking.”
The two women looked expectantly at the monitor, which showed a bizarre twisting pattern.
“It’s torsades. A type of V-tach. Time to hit him with 360,” Angela said. “Clear.”
Erin raised her arms and watched Angela press the button on the defib to deliver the shock.
The defib made its weird clunk of electric discharge, and Angela checked his pulse, comparing it to the lack of organized rhythm on the monitor.
She set the clock and said, “You up for more CPR?”
“On it.” Erin resumed the compressions. “What next?”
“We’ll shock him again. Once he’s in sinus rhythm, we can move him,” Angela said and flipped the Chief’s arm over. “He still has his IV in. Quite helpful.”
“Yeah,” Erin said between compressions. “When he wakes up, I’ll tell him it was a good choice.”
“Tell me if you get tired,” Angela said. By her count, the arsonist would breathe on his own in about six minutes. “Our two guys can trade in.”
Police sirens were audible in the distance. Theo set the gun on the counter and said, “Tag me in.”
“Good idea. Charging now, hold compressions.” The monitor was still in the torsades. Angela kept her calm. This was a healthy man who they could easily save if they could get him back. He didn’t have underlying heart disease. “Shocking at 360.”
No change after the second shock.
“Compressions?” Theo asked and went at it with Angela’s nod.
Erin was starting to shake. “Shouldn’t we bag him or something? Aren’t we supposed to…”
“He doesn’t have an airway issue, so it won’t make a difference right now,” Angela said. She’d brought the succinylcholine to paralyze the Chief in case they needed to intubate him. The bag was in use, and if they got his heart back, they’d be fine.
“But the ACLS algorithm says…”
Angela pulled a set of meds out of her left white coat pocket. “I know what it says. Don’t worry. Hoc et bellum.”
“You’re sure?” Erin asked her. “And what did you say?”
“’This is war,’ and I happen to be very good at this. We’re four minutes in to compressions, and I’m giving 2g of magnesium and 1mg of epi. Keep going, but stop when you get to one hundred.” Angela pushed the meds and gave instructions to the other firefighter.
“Got it,” Theo agreed.
Angela recalculated how many seconds it would take to circulate to his heart. If it didn’t work, she’d do the epi and mag another time before trying amiodarone.
Beep.
Beep.
The cardiac monitor came alive. Angela couldn’t help her grin. “Return of spontaneous circulation. He’s in sinus.”
The Chief made a loud gasping noise and opened his eyes.
“Oh my God, Noah!” Theo restrained Erin from embracing her husband.
“Cupcake. Is that you?”
Angela ignored the reunion to notice the arsonist was breathing his own, and Michael had taped the guys wrists together with medical tape. Theo had already used the same tape to restrain the waitress.
Michael smiled back at her for a few seconds, and then scowled. He must have been thinking of how dangerous her plan had been.
The Chief was asking questions about what had been going on and Erin was explaining with one hand on his chest, “North Star I. You figured out the arsonist was missing a finger and had green hands. He was going to shoot you until Dr. Perkins stabbed him and saved your life because your heart stopped.”
“Oh.” He rotated his head to the tied up arsonists. “Who’s the lady?”
