Brainwaves, page 28
part #8 of Joanna Blalock Series
Farelli gave the matter further thought. “I’d still bet Moran is our guy.”
“You may be right,” Jake said, but inwardly he was thinking that brilliant people don’t suddenly become stupid.
30
“Is my sister any better?” Kate asked anxiously.
“She’s a little more responsive.” Dr. Alan Shipman reached over the hospital bed and pinched the skin atop Joanna’s head. She moved her arm slightly. “But she only responds to deep pain.”
“But that’s still a good sign, isn’t it?”
“It gives us room for a little optimism,” Shipman said cautiously.
He glanced up at the row of monitors above the head of the bed. All of Joanna’s vital signs were stable. The clot in her middle cerebral artery had completely dissolved. Shipman watched the blood flowing through the artery and wondered again if there had been any irreparable brain damage.
Kate broke into the surgeon’s thoughts. “We’re so relieved that her last MRI was normal.”
“We’re still not out of the woods, not by a long shot,” Shipman said, and turned to the others in the hospital room. Lori McKay was seated at the bedside, Jake Sinclair leaning against the wall behind her. Shipman took a deep breath, measuring his words. “We’ve restored the blood supply to Dr. Blalock’s brain, but there is no guarantee she’ll have a return of function.”
Kate’s face paled. “Are you saying she may stay the way she is now?”
“That’s a possibility,” Shipman said candidly.
Joanna groaned and then muttered an unintelligible phrase. One of the words sounded like “Johnnie.” She groaned once more before going silent again.
Lori’s eyes widened. “She can talk!”
Shipman shrugged. “It’s mostly gibberish. She made similar sounds off and on throughout the night, according to the doctor at bedside.”
“Did anything she said make sense?” Lori asked.
“Not really,” Shipman replied.
Jake pushed himself away from the wall, concerned. “Who is this other doctor?”
“Mack Brown,” Lori replied. “He’s a good friend of Joanna’s and somebody we can trust.”
“You remember Mack Brown,” Kate reminded Jake. “He was the doctor who looked after me when I caught that terrible virus down in Guatemala. He’s really a nice guy.”
“I’m not sure ‘nice’ is what I want in the person guarding Joanna,” Jake said.
Lori smiled crookedly. “His full name is Johnnie Mack Brown, and he was named after the famous cowboy movie star.”
“So?” Jake asked, unimpressed.
“Mack Brown grew up on a ranch in South Texas roping and riding mustangs,” Lori said. “He’s tougher than dried cactus, and he won’t back down an inch. That’s why I picked him to alternate with me in watching over Joanna. I thought it was a good move.”
“I do, too,” Jake agreed, not wanting to take any chances with Joanna. Not with that bastard Moran
lurking around. But deep down Jake knew he couldn’t cover all the bases, regardless of how hard he tried. Moran was privy to all the ins and outs of a hospital and, given the slightest opening, he would get to Joanna. And with his medical knowledge, Moran would have no difficulty killing Joanna and making her death look natural. And the same would hold true for the Rudds. Earlier Jake had seen the twins, with their white coats on, standing at the nurses station.
Jake sighed sadly and looked down at the motionless Joanna. “How long before we’ll know something definite?”
Shipman shrugged. “Days. Maybe weeks.”
The door to the hospital room opened, and Farelli peeked in. “Jake, can I see you for a minute?”
“Sure.”
Jake motioned for Lori to walk out with him. Outside the door he said, “If you need more help watching Joanna, let me know. There’s a female detective in vice who used to be a nurse.”
Lori considered the idea, then shook her head. “We’ll do better with doctors who really know their stuff.”
“Right,” Jake said, and gently touched her shoulder. “You’re doing a good job for us. I owe you.”
“You don’t owe me anything,” Lori said softly. “I love Joanna, too.”
The police officer outside the door of Joanna’s hospital room had a clipboard on his lap. On it were the names of people allowed entry into the room. Each name was accompanied by a photograph. He watched a doctor approaching and studied his face, then glanced down at the clipboard but saw no
match. By the time the police officer looked up, the doctor had passed.
Christopher Moran kept his eyes straight ahead, but in his peripheral vision he sized up the policeman guarding the door. A big, tough-looking cop who wouldn’t back down from anybody.
Moran continued down the corridor on 6 East, trying to think of a way to get to Joanna Blalock. From reading her chart at the nurses station, he knew that her original brain clot had dissolved. And a second blood clot that had formed had also disappeared after another injection of streptokinase. And although she still hadn’t awakened from her coma, there was now a distinct chance she would.
Only Joanna Blalock could put everything together, Moran thought. Without her, Lieutenant Sinclair was just another bumbling detective looking for evidence he would never find. That was reason enough to kill Joanna. Then there was the botched attempt on her life. What if she knew who pushed her down those stairs? What if she had somehow glanced back before falling? Moran shivered at the possibility.
At the nurses station, Moran peered back down the hospital corridor. The cop hadn’t budged an inch, and he wouldn’t. Even when the cop had to pee, he went into Joanna’s room and locked the door before using her bathroom. There was no getting by that cop. Moran had considered setting off the fire alarm or even starting a small fire to distract the cop, but he knew that wouldn’t work. Nor would sounding a false code blue. That would alert the cops even more. And what if he did manage to get into Joanna’s room? There was still the little bitch Lori McKay or Mack Brown standing in his way.
“Can I help you, Dr. Moran?” a nurse behind the counter asked him.
“Gather up my charts for me,” Moran ordered.
“Would you like me to make rounds with you?”
“After I’ve reviewed my patients’ charts.”
Moran watched the nurse walk over to the chart rack, wondering if the most opportune time to kill Joanna would be while she was off the ward, getting X-rays or some other diagnostic study. But there were problems with that plan, too. The cops wouldn’t go into an X-ray room, but Lori McKay and Mack Brown would. All they’d have to do would be to put on lead aprons or stand behind a lead shield and they could keep an eye on Joanna.
“Here you are.” The nurse came back with an armful of charts and handed them to Moran. “By the way, Mrs. Bell’s serum potassium is almost normal.”
“Good,” Moran said and began flipping through a chart.
Out of the corner of his eye he watched the shapely nurse go into the IV room, where bottles of fluids for intravenous administration were prepared. Since Joanna was still comatose, Moran knew she was receiving IV fluids. But so what? The toxin he planned to use couldn’t be mixed into the usual IV fluids, which came in bottles of a thousand cc’s. It would dilute the toxin far too much.
Moran turned to another chart and pretended to study it. For the toxin to work, he was thinking, it had to be injected into the carotid artery so it would travel directly to the brain in high concentration. Moran could put a needle in Joanna’s carotid artery in a matter of seconds, if he could get to her.
The phone near Moran rang. The nurse hurried over to answer it.
“Yes, Dr. Shipman,” the nurse said into the phone. “I paged you regarding Dr. Blalock’s cerebral catheter.”
Moran focused his hearing, not wanting to miss a word.
“No, no,” the nurse was saying. “There’s been no change in her status. I was calling to ask about the saline drip we’re using to keep the catheter open. The resident wrote the order to use normal saline but didn’t mention adding heparin to stop any little clots from forming. I’m just checking to make certain that wasn’t an oversight.”
Good nurse, stupid resident, Moran thought.
“We’ll add the heparin,” the nurse said. Then she grinned. “I’m glad I caught the error, too.”
Smiling to himself, Moran went back to his charts as the nurse placed the phone down. The catheter was still in Joanna’s brain, and it was being continually flushed with a slow drip from a small bottle of saline. Probably a bottle that held no more than 50 or 100 cc’s. Putting the toxin in that bottle would work wonderfully well. The toxin would go directly to Joanna’s brain and turn it to mush. Joanna would have seizures and then go into irreversible shock, just as Elizabeth Ryan and Mara Gwynn had. Then it wouldn’t matter what Joanna Blalock did or didn’t know.
The nurse came out of the TV room carrying a large bottle of 5 percent glucose in water. She headed down the corridor in a direction away from Joanna’s room.
Moran rapidly glanced around the nurses station. It was deserted, with no nurses or house staff in sight.
Even the corridors were empty, except for the cop outside Joanna’s door.
In an instant Moran dashed across the nurses station into the IV room. His eyes scanned the labels on the bottles, searching for Joanna’s name. On the first go-around he saw only large bottles and none that was labeled blalock. Moran’s attention turned to an upper shelf where the smaller bottles were located. At the far end he saw Joanna’s. It was a lOOcc bottle.
Moran reached into the pocket of his white lab coat and took out a syringe filled with a cloudy fluid. Its needle was covered with a plastic cap. Quickly he pulled off the cap and then reached for the little bottle.
“What are you doing, Dr. Moran?” asked the nurse, coming back into the IV room.
“I was—ah—just—adding a little potassium to Mrs. Bell’s IV,” Moran stammered. “You know, to make sure her level stays up.”
“That’s not Mrs. Bell’s IV,” the nurse said. “It’s Dr. Blalock’s.”
Moran sighed resignedly and shook his head. “I guess I’m going to have to start wearing my glasses.”
“You know better than to do this, Dr. Moran,” the nurse chided him, taking the small bottle from his hand. “You can’t just give patients medications and IVs without telling us. If we allowed that, we wouldn’t know what in the world the patients were receiving. You’ll have to do what the other doctors do. You write the orders, and we’ll give and chart the medications. That way we’ll all be on the same page.”
“You’re exactly right,” Moran said apologetically. “I should have known better.”
Carefully he placed the syringe back in his lab coat pocket, needle end up. “Let me go write the orders.”
Moran walked out stiffly, making certain the needle and syringe in his pocket stayed upright.
As he picked up Mrs. Bell’s chart, two nurses passed the station complaining loudly. Both had refused to work the graveyard shift despite pressure from their superiors.
“Screw it,” the shorter nurse was saying. “One eight-hour shift per day is enough. Let them cover the ward tonight with a rotating nurse.”
Overhearing their conversation, Moran nodded to himself. He would return and try again later that night when only a skeleton staff was on duty. Feeling cautiously with his fingers, he reached in his pocket and recapped the needle on the syringe.
When he returned later, he planned to bring a much larger syringe with double the dose of toxin. Just to make sure.
31
Joanna felt as though she were wrapped up in a dense fog. But now she sensed a bright light. She heard someone in the distance calling her name over and over again.
“Joanna! Joanna!”
The sound grew nearer, the light brighter.
“Joanna! Joanna!”
Slowly her eyelids opened. She saw blurred images that seemed to dance in front of her. Gradually the images came into sharper focus, but they were still difficult to make out.
“Joanna! Can you hear me?”
“Yes,” Joanna muttered, wondering who was calling for her. The voice sounded female.
The image calling to her sharpened and became clear. It was Kate.
Joanna’s lips moved but formed no words. Her eyes closed for a moment. Then she opened them and whispered, “Hi, Sis.”
“Oh, thank God!” Kate leaned over and kissed Joanna’s forehead. “Thank God you’re all right!”
“Where am I?” Joanna asked.
“You’re at Memorial Hospital.”
Kate told Joanna about the fall she’d had and the head injury she’d suffered. “You had a clot in your brain, but they managed to remove it.”
Joanna blinked, trying to concentrate. Her eyelids started to droop, but she forced them to remain open. “Did I have a subdural hematoma?”
Lori McKay stepped in closer to the bed, sniffing back tears. “Stop trying to diagnose yourself.”
Joanna saw the watery streaks on Lori’s face and smiled weakly. “Why the tears?”
“I got something in my eye.” Lori smiled back, then said, “And you didn’t have a subdural hematoma. You formed a thrombus in your middle cerebral artery, apparently from the fall. We used Karen Crandell’s catheter device to dissolve the clot.”
Joanna strained to remember Karen Crandell. The name seemed so familiar. Gradually she recalled the female neurologist who had been murdered at Memorial. “Is the catheter still in?”
Lori nodded. “But not for long, now that you’re awake.”
The door to the hospital room opened and Jake Sinclair tiptoed in.
Kate turned to him and grinned broadly. “Guess who decided to open her eyes.”
Jake hurried over to Joanna. She winked at him.
“You worried the hell out of us,” Jake said.
Joanna wetted her lips with her tongue. “Are you trying to say you’re glad I woke up?”
“Damned right.” Jake gently squeezed her hand and said a silent prayer of thanks. “I’ll tell you, kiddo, for a while there you looked more dead than alive.”
“I must have been a mess,” Joanna said, her eyelids so heavy it was a strain to keep them open. She tried
to concentrate, but weakness overcame her and she floated off into a fitful sleep.
When she awoke, Jake and Kate and Lori were still at the bedside staring down at her. Joanna’s throat was so dry and scratchy she could barely speak. “Could I have some water?” she asked in a whisper.
“Sure.” Kate poured water into a glass with a straw. “Here you go.”
Joanna propped herself up on an elbow and sucked in the cool water, swallowing noisily. Then she lay back. The pillowcase and sheets felt hospital starched.
“I need to know,” Jake said, “if you remember anything about your fall down the stairs.”
Joanna closed her eyes, thinking back. “I was at the top of the stairs near the glass cabinet that holds the fire hose. Then someone came up behind me.”
“Did you see his face?” Jake pressed.
Joanna shook her head. “I only saw two hands coming at me.”
“So you were definitely pushed?”
“I was definitely pushed.”
Jake could barely contain his anger. “Did you get any kind of look at the son of a bitch?”
“Not that I recall,” Joanna said, after a pause. “Maybe it’ll come to me later.”
“You let me know when it does.”
Joanna reached over for the glass and sipped more water. Deep down she knew it was Christopher Moran who had pushed her down the stairs, but she couldn’t prove it. With her current recollection she could never swear to it in a court of law. Maybe it would come to her later, but for now all she could recall were two hands coming at her.
The effort of remembering what had happened
sapped all her strength. She was drifting off again. Even as Jake asked another question, she felt the fog reclaiming her.
Joanna awakened a third time to find herself looking up at a physician she’d never seen before. He was wearing a white laboratory coat and had a stethoscope hanging from his neck.
“Who are you?” Joanna asked.
“I’m Alan Shipman,” he answered. “I’m the neurosurgeon who has been looking after you.”
Joanna tried to swallow, but her throat and tongue were parched. “I feel so dehydrated.”
“We’ve been keeping you on the dry side,” Shipman told her, “to minimize any brain swelling.”
“Do I have any?”
“None so far.”
Shipman reached for a rubber hammer and tested Joanna’s reflexes, then evaluated her motor and sensory functions. “Lift your right leg and hold it up for a count of five.”
Joanna brought her right leg off the mattress and held it up high. She counted slowly to five.
“Excellent,” Shipman said, and gently pushed her leg down. “Now let’s try it with your left leg.”
Joanna raised the leg with an effort and tried to hold it up, but the motion caused a dull pain in her thigh. “One … two .. . three,” she counted, but the pain worsened and the leg flopped down.
“You seem a little weak in that leg,” Shipman remarked.
“Should I try it again?”
“Yes.”
Again Joanna brought her left leg up, but she could
hold it there for only a count of three. The leg dropped heavily.
“Why is my leg weak?” Joanna asked, alarmed. “Have I had a small stroke?”
“That’s one possibility,” Shipman said evenly. “But there are others.”
“Such as?” Joanna pressed.
“Such as peripheral nerve damage from your fall.”
Joanna slowly nodded. “Maybe that’s why my thigh hurts when I try to lift my leg.”
Shipman quickly pulled up Joanna’s hospital gown. At the top of the thigh was a large black and blue mark. “You’ve traumatized your thigh muscles. And that could make the leg weak.”
Joanna wasn’t convinced. “But it could still be a stroke?”
