Hard To Breathe, page 3
part #2 of Drake Cody Series
The CEO did not introduce himself or extend a hand.
“You're giving the wife of Dan Ogren the best of care, right?”
What? Drake said nothing as he crumpled the towel and threw it into the trash.
“Dr. Cody. Yes, you're the one who’s done some promising research for the university—correct?”
“I'm involved in research. But it's private. It's not for the university.”
“Hmmm. So you say.”
So I say? Yes, I say.
Orderlies gathered the mess from the numerous drapes, blood and fluid bags, medications, and instruments that had been used to resuscitate the near-death patient. As usual after such action, the Crash Room bay looked like a bomb had gone off.
Kline did not appear to notice their surroundings. He stood, staring at Drake with his arms folded on his chest as if waiting for Drake to plead his case. “In my previous position, I oversaw most of the research-related business for the university.”
“I'm busy taking care of patients right now,” Drake said. Why is he here? Who cares what he did for the university?
“That's why I'm here. Dan Ogren and his father, Dan Senior, are special friends of the hospital. Dan is a Board member.” Kline pursed his lips. “It's important that he and his wife receive the very best care.” He glanced about, seeming to notice the blood and medical debris for the first time. He clasped his hands to his chest as if to avoid being soiled.
We should try and give patients the best care? What a novel idea! Drake hoped his growing annoyance did not show.
“We provide every ER patient the best care we possibly can,” Drake said.
Kline shrugged. “I received a call from Dan a number of minutes ago. Apparently, you'd told them you'd be back in a minute. It had already been twelve minutes when he called me. I arrive and she still has not been cared for.” He shook his head. “Totally unacceptable.”
Dan “the man” Ogren had called the CEO after twelve minutes? And Kline had raced in? Drake's expectations about the upcoming confrontation worsened. Dan Ogren was seriously connected. And the new CEO of the hospital clearly knew nothing about emergency care.
“A nurse updated the patient and her husband that I was caring for a critical patient. Did he tell you that?”
“I also heard you chose to spend time taking care of a crazy old man while the Ogrens waited.” Kline frowned. “Mrs. Dan Ogren is a special patient. You need to hop to it.”
A special patient. Really? What are the rest of the patients?
Drake had overheard doctors' lounge mutterings that the new CEO focused solely on the “bottom line” and knew nothing about taking care of patients. Many said that without Jim Torrins’ efforts as chief medical officer, the hospital would have already run aground.
Bashing the CEO occurred in virtually every hospital, but Kline had, in less than a minute, convinced Drake that in his case the gripes were on target.
“And I expect to be updated on the status of Dan's wife.” Kline straightened his tie in the mirror above the scrub sink.
“Dan Ogren and his wife are in the department and both will receive appropriate attention,” Drake said.
Kline gave a dismissive nod. He picked his way out of the Crash Room, veering wide around the untidy remnants of patient care.
Patient privacy law demanded that Drake share nothing about Beth Ogren's condition or care with a non-medical person such as Kline. Drake would not give him one word of update. No doubt the meddling CEO would hear plenty after the impending collision occurred.
Drake paused at the counter just outside the Crash Room, wrestling with what he faced—a wealthy businessman, friend of the hospital's CEO, and hospital board member, had beaten his wife.
A report of suspected abuse against such a powerful figure wouldn’t assure justice or the victim’s safety, but the man’s lawyers would certainly investigate Drake’s past. His throat tightened.
Not reporting was the safest course for him but...
Ideally, he would wait to call the police until he'd repaired Beth Ogren's injuries and had spoken with her alone. Reality made ideal a dream—neither he nor the police had the luxury. When abusers detected suspicion, they often took their victim and left the ER—even with care incomplete. ER staff had no authority to stop them.
Dan Ogren would sense something soon. The police needed time to get to the ER before he could leave.
He dialed the number from memory. As it rang, he sighed. Dan would get the attention he deserved. And Drake would be put dead center in the powerful man's gunsight.
“This is Dr. Drake Cody from Memorial Hospital ER. I’m calling to file a report of suspected domestic abuse with injuries,” Drake said. “Occurred in Minneapolis, the Kenwood neighborhood.” He waited as they routed the call.
An intimidated wife/victim denying assault and a wealthy, influential abuser. Would the law protect Beth Ogren and deliver justice to her powerful husband?
Drake's experience made him doubt that would happen. His instincts called for him to do more.
He'd followed those instincts before and dealt out justice directly to people like Dan. It had destroyed the people he'd loved most and spiraled his life into darkness.
He had to abide by the law, despite the wounds its failings had inflicted on him.
“Yes. Memorial ER. Dr. Cody here. Did you get the information?” He listened. “Have the officers ask for the charge nurse at the triage desk. She'll get me and I'll update them before they go in. Let them know this will be a high-profile case.” He hung up, then rubbed his neck.
This would not go easy. It would not go easy at all.
Chapter 6
Drake stood masked and gowned at Beth Ogren's bedside. Her face lay framed by sterile drapes and centered in the surgical light. A tech had cleaned the wound and set up the plastic surgery instrument tray with the suture types Drake had requested. Beth’s husband remained sprawled on the chair with his hands behind his head.
“Dan, you need to go to the waiting room.” Drake began to put on his surgical gloves.
“I'll stay here,” Dan said.
“You being in the room increases the risk of infection, and it can be distracting for me to make sure you don't feel ill or faint. I'd really appreciate it if you’d step out.”
Dan Ogren's eyes narrowed as he looked at Drake. “I've been sewn up before and people stayed in the room. And blood doesn't bother me. I'm not leaving.” An animal-wary glint showed in his eyes.
“It's different seeing a loved one's injury. I once had a surgeon pass out when I was sewing up his child.” There was some truth to what Drake said, but primarily he wanted Dan gone so he could talk to the injured wife alone.
“I'm not going to pass out. I'll stay here. Did the CEO talk to you? He's a friend of mine.”
“If you won't leave, let me know if you feel sick or light-headed. And please let Beth answer my questions herself.”
The look Dan directed Drake's way was not that of a concerned husband.
The cunning bastard knew Drake had not bought the phony nice-guy act. Beth Ogren would not be talking to anyone alone.
It was best to repair Beth's face before triggering the showdown that loomed. If Drake pushed the confrontation now, Dan might take his wife and leave, her care incomplete.
Beth's injuries were not life-threatening—this time—but the laceration needed expert care.
“Beth, the first step is for me to numb the area.” Drake picked up the syringe loaded with local anesthetic, keeping it off to the side and out of Beth's view. “Do you want me to tell you what I'm doing as we go or not? I'll warn you of possible discomfort either way.”
“Tell me,” she said. Her eyes were closed.
He adjusted the blue surgical drapes, framing her chin.
“I'm going to hold your lower lip. Let me know right away if you feel pain.” He grasped her lower lip and pulled it gently forward. “You'll feel a pinch inside your mouth, a bit like you've probably felt at the dentist.”
Drake introduced the needle in the lowest point of the gutter inside the mouth between the lower teeth and the lip. “You might feel a burning sensation.” He advanced the needle, then injected a small amount of local anesthetic around the nerve serving the chin and lower lip.
“While we give the anesthetic a moment to work, let me tell you about your injuries. A peri-orbital hematoma, basically a nasty black eye. The swelling and maroon color is from blood that has collected under the skin. The eye itself is okay. It will heal completely. You have no broken bones, but your face and jaw are badly bruised. The laceration I’m going to repair is from where the inside of your mouth smashed against your lower teeth. Your teeth cut through the inside of your mouth and out through the skin. I know it looks scary, but I've repaired a lot of these. You'll heal.”
She gave a tight nod.
“I don't want a scar on her,” Dan said.
“Deep wounds heal by scarring.” Drake said. “What my repair does is make the amount of scar and its visibility as minimal as possible. The instructions and follow-up will also address this. If after healing it is bothersome, there are things that can be done.”
Drake lightly touched the needle to her chin. No response. He repeated the maneuver several times all around the wound.
“Let me know right away if you have any discomfort.”
She nodded, still with her eyes closed.
Drake worked quickly as he initiated the three-layer closure. First he placed four stitches on the inside of Beth's mouth, closing the inner laceration. He then changed into new sterile gloves.
“What time did you get injured, Beth?” Drake asked.
“This morning,” she said.
Out of the corner of his eye, Drake saw Dan sit forward.
“No. She's wrong. It was just before we came,” Dan said.
Drake placed one absorbable suture in the deep tissue, which pulled together and aligned the edges of the facial wound.
“Which was it, Beth?” Drake asked. Dan hadn't brought her to the ER until late afternoon. Enough time for a drunk to sleep it off.
“Like he said.” Her eyes were now closed tightly.
“Yeah. She was confused,” Dan said.
Drake placed five fine-gauge sutures, aligning the skin wound in a smooth even line. If it did not become infected, the wound would heal with minimal scarring.
“All done. Do you want to sit up?” Drake said.
She nodded. Drake helped her to the sitting position.
“It didn't hurt,” she said sounding surprised.
“You did great.”
He turned to her husband. “Dan, I'd like you to leave for a moment.”
“I'm not leaving.” The big man took his hands from behind his head and sat up straight.
“Beth, can you ask Dan to leave for a moment?”
She looked at Dan then back to Drake. She shook her head.
Drake sighed.
“Dan, I'd prefer you leave, but if you won't, please don't interrupt.”
“I'll talk whenever I want to.” Dan's good-guy act was long gone.
Beth's eyes darted. She looked as if she wanted to run.
“You're safe, Beth. We can help. Tell me who hurt you,” Drake said.
Dan jumped to his feet.
“What the hell are you saying?” He stood close enough that the smell cologne and alcohol was strong. “I told you she fell down the stairs.”
Drake ignored him.
“Beth, who hurt you?”
She kept her eyes down.
“It's like he said. I fell.” She glanced toward Dan. He gave a barely perceptible nod. Her eyes went to the floor. “I tripped on the stairs.”
Drake sighed.
So sad and ugly. The bastard had her.
Drake slid back on the rolling stool. “I don't believe either of you.”
He looked from one to the other. Beth would not meet his gaze. Dan directed a “you're a dead man” look his way.
The look would probably have intimidated someone who hadn’t survived the Scioto Furnace State Facility for Violent Juvenile Offenders.
“The injuries don't fit with a fall on the stairs,” Drake said.
“You're full of shit,” Dan said. “Get me the CEO. Call Kline. Now.”
Drake focused on Beth.
“You have slight bruising around your neck. You also have what are called petechiae—dozens of tiny spots on the whites and skin around your eye. They occur when someone is choked. The pressure causes pinpoint bleeding.” Drake sighed again. “Also, your eye and mouth wounds fit with being struck with a fist. Unfortunately, my job makes me an expert on injuries that occur when people hurt each other.”
Dan took a step toward Drake, his face crimson, fists clenched.
“Don't be stupid,” Drake said, remaining seated. Getting to his feet might provoke the violence he desperately wanted—but had to avoid. Nothing would be as satisfying as kicking Dan’s ass. The wife-beater had no idea how close to snapping Drake felt. “Don't make things worse for yourself, Ogren. The police will be here any minute.”
“Listen to me, Doc.” Dan's tone had changed with the mention of the police. “You can still undo this. We can make this work. I guarantee you don’t want to do this. If you let the police know you were mistaken, I can make it very worthwhile.”
“Not happening.” Drake shook his head. How much crap had this jerk bought himself out of?
Ogren's face twisted, his eyes hate-filled. “If you do this, you'll regret it. I'm not playing. You and yours—call it off or you're dead.”
In the jungle that had been the Scioto Furnace, Drake had faced threats like this. His survival had demanded violent response. What he'd had to do crept around the boundaries of his conscience like a foul and bloodied beast.
“Quit talking, Ogren. It's done.”
Drake had other patients who needed care. Dan Ogren had earned what the police would do. He deserved worse.
“Beth, a domestic abuse counselor will talk to you about your safety. She’s a person who's been where you are.” Drake took her hand in his and looked her in the eye. “Be honest with the police and listen to the counselor. Otherwise, things will only get worse. You're in real danger.”
A tear rolled down Beth's cheek. The bruised, cut, and swollen sections of face were like puzzle pieces that did not match the loveliness of her uninjured features. Once more, her resemblance to Rachelle struck him.
Another innocent victimized by others. Sadness and anger competed in Drake's head. “Don't let yourself be hurt anymore. Let us help you.” Dan yanked Beth's arm from Drake's hand.
“Get your hands off her. This is bullshit.” He stuck a finger in Drake's face. “You're done in this hospital, boy. I'll destroy you.”
Ogren brushed against him as if to intimidate. Drake grit his teeth and did not engage. His fists remained clenched as he spoke.
“Beth, you have five stitches on your chin that will need to be removed in four days. The other stitches will dissolve. After the police and the counselor, the nurse will go over everything with you. Any questions, just ask them to get me. You need to have someone stay with you tonight as a precaution for head injury. Do you have someone?”
“I'll be staying with her, asshole,” Ogren said.
Drake ignored him. He knew where Dan Ogren would likely be staying.
“Beth, if you need us, we're here. Always.”
Drake exited the room with the empty feeling of one who hadn’t done enough.
Chapter 7
Memorial Hospital, Medical records department, 6:18 p.m.
“Let me show you how, Dr. Rizzini.” The medical coding specialist bent but held her body arched away from Rizz and his wheelchair. Her fingers skimmed over the desktop computer's keys. She hit the last key, then straightened while retreating to the edge of the cubicle. “Depending on what you want to review, just change the dates or the desired report parameters. Make sense?”
He looked up. She couldn't meet his eyes.
“Thanks. You're the best.” Rizz advanced the wheelchair, and she edged further away.
Rizz's fingers skipped over the keyboard, his upper extremities fully functional. A clinical record appeared on the screen. “I'll holler if I need help.”
The coder backed out of the cubicle. Her posture eased as she got clear. She'd tried to look relaxed, but it was plain to him that his “condition” made her uncomfortable.
It had been almost two months since the crazed woman's bullet had trashed his spinal cord. He was paralyzed and insensate from the mid-chest down. Insensate—a medical term no one else used. The inability to perceive sensation, to feel. The loss of movement was straightforward—and brutal. The loss of feeling was something he could never have imagined.
He looked over his shoulder. Only a skeleton crew remained in Medical Records evenings and nights. He slipped the flask from his lap bag and slugged down a swallow of vodka. The liquid heat slid down his throat.
Reading people had always been one of his special gifts. The coder’s effort to hide her discomfort was obvious to him. Similarly, in the ER, he saw through the artifice and attempted deceptions of drug-seekers, malingerers, or others with a hidden agenda. More importantly, he was able to sense the real medical issues in patients who didn't intentionally mislead but unconsciously minimized symptoms due to denial—or exaggerated them due to anxiety or fear their concern would be ignored.
For physicians, interpreting what patients were trying to communicate posed the greatest challenge in diagnosing their problems.
Rizz's ability served him well in the patient-flooded ER—no one could see, evaluate, and treat ER patients faster.
Drake could read patients as well as Rizz, but no one could “treat 'em and street 'em” as fast. It was an ability he prided himself on. He had helped more than his share.
