Fatal Rounds, page 18
Something still puzzles me. Why hasn’t Megan said anything about my battle with her new beau? I assumed his cozying up to her was to glean information about me—not that I’ve shared any—but maybe I’m wrong. Maybe their relationship is just one more gotcha! gift from him to me. Or maybe it’s even simpler. Maybe he’s just a libidinous male who enjoys spending time with smart blondes and then dumping them when he gets bored or they get too close.
Inside the hospital library, I sit behind the same computer monitor as last week and log in to HealthEMR. Though the room is once again vacant, it’s noisier today than it was when I was here in the evening. Five stories below from a nearby window, a truck backs up and beeps annoyingly, and muffled voices from offices down the hallway make their way through the walls.
For the next two hours, using the same search criteria as before, I research five other surgeons over the last three years. This should give me a decent enough sample to confirm my suspicions.
In that time frame with these surgeons, I find four patients who underwent emergent surgery but died from other causes a relatively short time later. One was the result of a shooting in a bar fight. Two were clear-cut heart attacks confirmed on autopsy (unlike my father whose coronary artery disease was iffy). The fourth patient died from a ruptured cerebral aneurysm, again confirmed on autopsy and leaving little doubt as to the cause of death. None of the patients shared the same surgeon. No doubt there are other deaths I didn’t find, but if the patients weren’t autopsied, they wouldn’t show up in my search.
My findings suggest these four deaths were random and legitimate and not the result of murder like Dr. Donovan’s patients. When I finish recording them in my notebook, I sit back and massage my neck. A med student in a short white coat rummages through a shelf of radiology textbooks. I didn’t even notice him come in.
Satisfied I now have more proof to support Dr. Donovan is a killer—though the how and why remain unclear—I weave my way down two hallways and four flights of stairs until I exit into the parking lot that holds my Civic. Pulling my sunglasses from my satchel, I raise my face to the hot glare and let the summer rays warm away the library’s chill.
I don’t allow myself to get cocky though. This new proof is flimsy, I know that. Although it won’t come without risk, I need something physical. I need to find something tangible that ties Dr. Donovan to these deaths. Though I’ve been trying to avoid it, knowing how much committing a crime would break my father’s heart, not to mention possibly land me in jail, I need to get inside the surgeon’s house.
Since nothing suspicious showed up on the victims’ autopsies, potassium chloride seems a likely and logical weapon. It’s so efficient that it’s used in lethal injections for those on death row. Both components are normal body electrolytes, and yet an overdose would effectively stop the heart. This means the drug would elude the pathologist, especially if the injection site didn’t get close scrutiny. Then again, it demands a good-sized vein for delivery. How easy would that be to do?
Finding a vial of it in Dr. Donovan’s home—or any other dubious drug—would not only strengthen my case, it would get me one step closer to keeping him from killing anyone else. Not that I could tell the police where I found it, of course, but it would at least objectively confirm my suspicions. The big hitch to my theory is that on occasion he’s given Shelly access to his house to water his plants. A man with incriminating evidence in his home would be unlikely to pass out keys.
Still, I have to try.
Crossing the remaining distance to my car, I retrieve my phone from my satchel. Inside my Civic, I pull up my notebook app. There it is. 9536. The security code for Dr. Donovan’s fancy-pants house in Cheshire Hill Estates.
Next I open my contacts. I find the number I typed into my phone when it was offered to me at Jen’s barbecue. Before I press Call, my dad’s voice materializes in my head. Liza, are you sure you want to do this? Is this what a reasonably thinking person would do?
The imaginary question makes me hesitate, my fingertip a hair above the phone tab. I think about the waitress and mechanic who could be Sam’s next victims. I think about my mother at Home and Hearth Healing and her and Maisy’s belief that Sam has been watching her through the trees and bushes, a belief I still don’t know is grounded in fact or delusion. I think about my residency and how hard I’ve worked to become a pathologist.
I think about getting the police to believe me and getting Sam locked up once and for all.
I think about getting revenge for my father’s death.
I press Call and phone Trey.
Asking Shelly for the keys is no longer an option.
24
Within three minutes of my call, Trey meets me by my car in the parking lot.
“That was quick,” I say.
“I was about to grab a coffee in the atrium when you called.” The way his gaze darts between the cars and his hands fidget with the drawstring of his surgical scrubs suggests caffeine is the last thing he needs.
I open the passenger door of my Civic. “Get in.”
As I’m about to do the same on my side, he says, “I don’t have time to go anywhere. Dr. Donovan and I are on call tonight.”
“Weren’t you just on call a couple days ago?”
“I’m covering for someone.”
“Whatever. We’re not driving anywhere. I just need to talk to you. Urgently.” My pointed stare across the car roof must convince him because he climbs in.
The air conditioning has been running for a while, so the temperature inside the car is comfortable. Next to me, Trey smells of latex, probably a remnant of the many surgical gloves he dons throughout the day. His face shows a hint of beard regrowth but nothing like Waseem’s afternoon moss. Staring at him, I wonder how best to proceed with my request. It’s not one a reasonably thinking person would propose.
My silence must unnerve him because he runs the back of his hand over his mouth and says, “Oh God, you know, don’t you?” He closes his eyes and rests his head against the seat. “Of course you do. You two were friends.”
Though I have no idea what he’s talking about, my curiosity is piqued. Instinct tells me to let him elaborate, so, like my psychiatrist, I simply nod and allow Trey to fill the silence.
“Shelly must’ve told you what I did, and after she died you put two and two together.” Trey bangs his skull against the headrest and groans. “Of course you did. You’re too smart not to.”
Normally veering off topic annoys me, especially when I’m on a one-track brainwave like now, but this feels worth my time. “You’re right, so why don’t you tell me exactly what happened?”
His complexion sallows to a sickly shade. “I don’t even know where to start,” he whispers.
“Start at the beginning.”
The surgical resident exhales loudly and slowly. Chest hair peeks out from the V of his scrub top, and his phone pokes out of the left pocket. “It started last Monday night when I was on call. I…a patient…” He buries his head in his hands. “Oh man, I don’t think I can do this.”
“Tell me, Trey. Just spit it out. It’ll be easier that way.” I try my best to sound like Dr. Lightfoot.
He straightens. “It was crazy on the ward. Four patients came through the ER after a car crash. Three needed urgent surgery. The nurses were pulled all over the place—new patients, old patients, post-op patients. Every patient and their uncle seemed to need something that night.
“One guy, a post-op bowel repair with pancreatitis, had been hollering for pain meds all night. I wrote an order for a one-time dose of morphine, but the nurses couldn’t get to it right away. Finally, after I kept pestering them, Sarah, a new RN on the floor, unlocked the med-dispensing cabinet to do it. She grabbed a syringe and was about to pull up the drug when one of her patients stumbled up to us. His IV was ripped out, and blood was dripping down his arm and all over the floor. She cursed and promised she’d be right back, but she wasn’t.
“Meanwhile, the poor guy with pancreatitis—that hurts like a son of a bitch, you know—kept crying for more pain meds. I could hear him all the way over from the drug cabinet.” Trey’s eyes plead with me. “I had to do something, Liza. He was hurting.”
“What did you do?”
“I drew up the morphine myself, or at least I thought I did, and gave it to him.”
“What’s wrong with that?”
“I…” Trey’s voice shakes. He swallows and tries again. “I grabbed the wrong vial and drew up one cc of hydromorphone instead of morphine. That’s ten times…”
“More potent,” I finish for him.
“Yes. So instead of ten milligrams of morphine, he got ten milligrams of hydromorphone.”
“Couldn’t you reverse it with Naloxone?”
“Yeah, if I would’ve realized my mistake in time.” His voice rises in pitch, and his hands start to tremble. “Things were so crazy on the unit, insane. By the time I realized what I’d done he was already breathless and his heart was thready and his—”
“Slow down,” I tell him. “It’s okay.”
Trey exhales and steadies his voice. “We tried to resuscitate him. As you already know, Shelly was the respiratory therapist working that night. But it was too late.”
“What happened then?”
He snorts. “You already know. Why make me repeat it?”
Clearly he’s convinced Shelly told me what happened, but I’m still completely in the dark. “I want to hear your version.”
“It’s awful, Liza.” His eyes pin mine. “I feel like a piece of shit.”
When nothing follows, I have to guess what comes next. “You didn’t tell anyone you dosed the wrong drug, did you?”
His face flashes anger. “You know I didn’t. I didn’t admit to giving anything. Everyone figured the guy just died because he was an old man who had a tough surgery and severe pancreatitis. No one expected him to survive anyway.”
“But Shelly figured it out.” I try to hide my dismay.
“Yep. Said she walked past the room and saw me injecting a drug into the guy’s IV line. She didn’t think anything of it at the time, but once things settled down, she made the connection. Was going to report me right then and there.”
“Why didn’t she?”
“I begged her not to. Begged her to give me some time to come forward on my own. I told her the patient was old and really sick, and that it might not have been the overdose that killed him. I just hope they don’t discover that small amount of drug missing.” Trey squeezes his thighs, the tendons in his hands jutting like rip cords. “She agreed to give me a week.”
This surprises me, but I stay silent. At least it explains what Shelly probably wanted to talk to me about in the cafeteria. Since you’re a doctor and all, she had said.
He shifts in his seat toward me. “Remember when we went to O’Dell’s?”
I nod.
“Remember I said Dr. Donovan did a solid for me when I was a second-year resident? I effed up big time. Could’ve been kicked out of the program, but he covered for me. A patient didn’t die or anything like that,” he adds quickly. “But it was still a serious mistake.”
I don’t enjoy hearing anything benevolent about Dr. Donovan, but I nod again.
“If this gets out about the morphine mix-up, I’ll be a goner. No third strike allowed. Four years of med school and three-plus years of surgery residency down the toilet just like that. I’ll be lucky to get a job draining boils.”
“And then you saw Shelly in the cafeteria with me and…” When he doesn’t respond to my fishing comment, only buries his face in his hands again, I think I know where this is headed. And it isn’t to a good place. “You followed her out when she left.”
With his face still buried, he nods. A sob escapes him.
“And when she threatened to tell her supervisor—or maybe even your supervisor—about the overdose, you…” I stop here, hoping he’ll pick up where I left off.
“Her death wasn’t my fault, I swear. It was an accident and—” Another sob swallows his words. He roughly wipes his eyes and cheeks with his palms and implores me. “You have to believe me. It was an accident.” He exhales slowly, and his torso deflates. “God, it actually feels good to finally get it off my chest. I was going crazy holding it in.”
“And yet you haven’t said much of anything.” My voice hardens. “What happened?”
“We were talking in the hospital garden, just walking around. Somehow we ended up near that stairwell that leads down to the fountain. You know the one I’m talking about?”
“I do. My advisor warned me about it.”
“Exactly.” He slaps his thighs as if I just proved his point. “I was begging Shelly not to say anything about the morphine mix-up.”
Though I’m trying hard to hide my judgment, my face must sour because he adds, “The guy was old, Liza, and he was really sick. He probably wouldn’t have survived anyway. What good would it do to ruin my career over something that was inevitable?”
I grind my teeth. My opinion of Trey nosedives. Cowards are only one step above bullies in my book. I swallow my disgust and hope it doesn’t show. “Of course. What happened then? How did she die?”
“Well, I didn’t kill her if that’s what you’re implying.” His quickness to defend himself fuels my ire.
“I’m not implying anything.”
“I just…well…when she started to leave, saying she’d waited long enough for me to come clean about the hydromorphone, I grabbed her. She tried to jerk away, and I moved forward and…well…maybe I pushed just a bit to try and keep hold of her, and then she slipped and…and…oh God, Liza.” His chest heaves. “She fell down those steps—Jesus, they’re concrete, you know?—and conked her head on the ledge at the bottom. Had she hit anywhere else, she probably would’ve survived, but she hit right on her temple. Probably ruptured her—”
“I don’t need an anatomy lesson, Trey.” The car suddenly feels like an inferno. I crank the air and try to shake the disdain from my voice. “Her body’s in the morgue. The autopsy’s today. Megan’s observing it.”
His eyes widen. “You won’t tell anyone, will you? The place was empty and nobody saw.” He reaches over the gear shift and grips my hands. “Please, Liza, please. What good would it do to say anything now? It won’t change anything. It won’t bring that man back.”
My initial instinct is to report him. To rat him out and make him take responsibility for both deaths, a move of which I’m sure my father would applaud. Now you’re making rational choices, tiger. Then I realize how much Trey’s situation benefits me. How useful it is to have something to lord over him. I’m not proud of this decision. In fact, I might need a shower for just thinking it. But desperate times and all…
I file my father’s advice away. “Listen up, Trey. I’ll keep this to myself, but I need you to do something for me, something that’s going to make you uncomfortable, but I need you to not question me on it.”
He slowly releases my hands. “Are you blackmailing me?”
“Yes.”
He blinks. “Seriously? You’re not joking?”
“Oh please.” I swat the air at him. “Don’t get up on your high horse now. Besides, maybe blackmail is the wrong word, especially since what I need you to do will ultimately help you. It’ll make this whole thing go away.”
His eyes narrow. “What are you talking about?” Wariness in his tone. “What do you need me to do?”
“I need you to get me Dr. Donovan’s keys. Early tomorrow morning while he’s in surgery, so I can copy them before teaching rounds.”
Trey straightens to full posture. It’s easy to read the shocked disapproval on his face. In fact, in his present state, his expressions are so discernable he could model for those emotion cards Dr. Lightfoot used to show me.
“What are you talking about? I can’t do that.”
His sudden sanctity makes me want to slap him. “You just confessed to killing two people. Sainthood doesn’t suit you.”
He shakes his head. “I didn’t kill them. They were accidents. Both of them.”
“Yeah.” My voice drips with sarcasm. “I’m sure the police will be totally cool with that explanation.”
He sags back down.
“Look,” I say. “Dr. Donovan isn’t who you think he is. He’s a killer. A real killer, not just an idiot like you.”
Trey seems so baffled by what I just said he doesn’t appear to notice my insult. “That’s the most ridiculous thing I’ve ever heard.”
I don’t want to give him details. I worry he can’t keep his yap shut. “You’re going to have to trust me, but once this is over, I’ll tell you everything.”
“You’re insane.”
“And you’re a killer who could go to prison for a very long time.”
That shuts him up.
“He’s been stalking my family,” I say. “He killed my father. Did he tell you he threatened me with a restraining order today?”
Trey looks even more dazed. “No, why?”
“Because he knows I’m on to him. Also because I got the cops to question him about Shelly’s death. I have him on tape threatening her.”
Trey’s mouth hangs open for a good five seconds. “Good God, I don’t understand any of this.”
“You don’t have to understand it. Not now. You just have to get me his keys. Grab them while he’s scrubbing in for his first case. Tell him you’ve got to see a patient urgently. Whatever. Just make up an excuse and meet me here in the lot with his keys at seven fifteen tomorrow morning. If you do this, I promise no one will suspect you in Shelly’s death.”
He swallows but says nothing, his eyes glazed.
I snap my fingers in front of his face. “Can you do that for me? Can you get his keys from his locker while he’s scrubbing in?”
