Urgent Care Page 3

  To Lydia, every patient she lost deserved more. But she didn’t have the luxury of investing in that emotion. She had to focus on her other patients, give them the best she could.

  “Hell of a way to start a shift,” she muttered, scanning the nurses’ notes for the exact time of death.

  “How do you think she ended up in the cemetery?” a nurse asked as she pretended to straighten the stacks of paperwork at the desk.

  “Did you see the stuff they spray-painted on her?” another said with a shudder. “Like a horror movie.”

  Lydia watched, on alert. She’d called in a crisis counselor, but he hadn’t arrived yet. A few of the staff had broken down, sobbing after Karen’s failed resuscitation. Most swallowed their emotions, their movements now stiff, angry, guarded. And then there were the ones whose curiosity outweighed their grief. As if arming themselves with details about Karen’s death would keep them safe.

  “We need more security around here,” one of the older nurses put in, banging a chart down on to the shelf beside Jason, the desk clerk.

  “What do you want?” Jason asked. “Armed guards patrolling the hallways? This isn’t Baghdad.”

  “You’re not a woman. You don’t understand. I’m afraid to walk to my car. They make us park so far away, and that parking garage is always dark and deserted.”

  Lydia turned to Jason. “Speaking of security, did you send the guys across the street to guard the place where Nora found Karen?”

  “Yeah, they’re waiting for the cops to take over. Here comes Glen now,” Jason said.

  “Morning.” Glen Bakker, the head of security, was a man whose posture screamed military. His shoulders were squared, jaw jutting forward, as he extended his hand and shook Lydia’s. He insisted on shaking hands every time they met—she wasn’t sure if it was a measure of respect or if Glen used the handshake the same way Lydia’s mother had taught her to use it: as a way to get close enough to gauge a person’s real intentions, to get inside their guard. “Rough day all around, isn’t it?”

  “Did the police find anything at the cemetery?”

  “Didn’t look like it. They’re combing the place now, will probably be there for hours.” Glen looked around the ER, his eyes moving back and forth. Cop’s eyes, Lydia recognized. “Is Nora okay? I heard she was the one who found the victim.”

  “She’s fine,” Lydia said, even though she wasn’t sure if that was the truth. She made a mental note to check on Nora as soon as she could. “What about security cameras? Did they show anything?”

  Glen was shaking his head. “The only outside cameras are at the hospital’s main entrance, the ER”—he jerked his chin toward the ambulance bay doors—“the clinics, and the parking garage exits. None of them would have been aimed in the right direction.”

  “Maybe you should think of getting some more,” one of the nurses said.

  “They’ve been in my capital budget for two years, but keep getting the ax. As it is, Tillman and the administration are going to balk about paying for the extra manpower I’ll be asking for.”

  “Even if they approve the money, it will take weeks for you to hire anyone,” Lydia said.

  “Yes’m. I’ll be pulling some overtime myself, hang around down here, keep an eye on things. If anyone feels uncomfortable walking to their car, you make sure they call us. We’ll get them an escort as fast as we can.”

  “I’m sure everyone will appreciate that,” Lydia said, wondering if Glen would make good on his promise. The nurses huffed and walked away. They’d heard it all before.

  “Well, let me go rearrange my men’s schedules. They’re going to love me for this. Especially with everyone wanting time off for the holidays.” He flashed her a salute and sauntered off.

  “What about the Critical Incident Team?” Lydia asked Jason, whose own escape from the emotions the morning had brought seemed to be his video game and iPod. “Did you call them?”

  “Yes. Tommy Z is on call for them today.”

  “Tommy Z?” Great. Lydia and the condescending social worker didn’t get along under the best of circumstances, and these certainly weren’t those. “He’s trained in crisis counseling?”

  Jason grinned, his video game beeping triumphantly. His grin faded as one of the nurses glared at the raucous music. “Don’t worry. The Z-man is cool.”

  Lydia’s previous run-ins with Tommy Zwyczaje had convinced her otherwise, but if he had the training, she had no choice but to let him do his job. Not that she wouldn’t be keeping an eye on him—last thing she needed was a know-it-all social worker messing with her people’s heads.

  “He knows what he’s doing,” Jason added, sensing her skepticism.

  “I wouldn’t count on that,” she muttered.

  “Lydia,” came a voice smooth as whiskey from behind her. “So good to work with you again.”

  Lydia didn’t flinch, even though she hated anyone sneaking up on her. Instead she slowly swiveled in her chair. She was the one caught badmouthing the man, but Tommy Z was the one who appeared to be blushing as he held a hand out for her as if a peace offering. He had dark, wavy hair and rugged Eastern European good looks, though marred by a bad case of rosacea. His wide mouth was stretched into the “aw shucks” grin of a snake oil salesman.

  “Have you run a critical-incident debriefing before?” Lydia cut to the chase, ignoring his hand.

  “Too many, I’m afraid. I’m on the countywide team, have worked incidents at all the major hospitals and a few in the field, like the Ebenezer Church fire where those firefighters died.” He glanced around, then drew closer to her. “What can you tell me about what happened today?”

  “One of my nurses found a woman, stabbed, beaten, sexually assaulted, left for dead in the cemetery.” She kept to the facts. It was the safest way. She had to set an example, couldn’t risk revealing her own emotions. Not here in the ER, not with patients to care for and her staff needing her.

  He winced at her harsh summary of the facts. “The cemetery? So close to the hospital. How’s the victim?”

  “She died. She also worked here as a nurse anesthetist. Karen Chisholm.”

  “Oh my God, but I know Karen! I mean . . . knew. Such a sweet person, I can’t believe . . .” He stared beyond her toward the trauma rooms as if expecting to see Karen’s body there. He cleared his throat and coughed, his face now completely suffused, almost the color of wine. “Has anyone spoken with her family? Do you need me to call them?”

  “The police will take care of that. But I’d like you to talk with Nora—Nora Halloran. She’s the one who found Karen. And Seth Cochran, he’s a fourth-year surgery resident who tried to save her. As well as the others involved in her resuscitation.”

  “A case like this, one of our own, it’s going to traumatize everyone.” He nodded slowly as if accepting a burden. “How’s Nora holding up?”

  “Good enough to do the rape kit.”

  “Still, it’s going to be hard on her. Just because she’s a sexual assault forensic examiner doesn’t make her immune. Especially when it hits so close to home. I think I should start with her.”

  “Why don’t you set up in the family room for now?” Lydia countered as she spotted a pair of familiar faces coming through the ER doors. “I need to see who the police want to interview first.”

  “Of course, I understand. I’ll be there, waiting to help anyone who needs my services.” He took two steps down the hall leading to the small family room before turning back to look at her over his shoulder. “And I’ll be saying a prayer for Karen’s soul.”

  Lydia ignored him, grabbing Karen’s chart before walking over to greet Detective Jerry Boyle and his partner, Janet Kwon. As cops went, Kwon and Boyle were better than most. Which, coming from Lydia, was pretty high praise.

  “Hi, Lydia,” Jerry Boyle greeted her. He shook her hand as he looked around the ER, taking in the number of people hovering nearby, all pretending not to listen. “You the physician of record?”

 
; “Afraid so.”

  He slanted a glance at his partner. “Janet, why don’t you secure the body? I’ll be down shortly.”

  Kwon, a thin thirty-something who would have been pretty if not for her perpetual scowl, nodded and left for OR 13. Boyle motioned to Lydia to join him in an empty exam room.

  “So, how’s Gina? She tell her parents about you two yet?” Lydia was one of the few who knew about Jerry Boyle and Gina Freeman’s engagement. Boyle had sworn her to secrecy—Gina didn’t even know that Lydia knew.

  Boyle hadn’t wanted privacy to chat about Gina. But Lydia wasn’t quite ready to go over everything that had happened to Karen. A moment of normal conversation, a quick reminder that there was life outside of the ER. That was all she needed.

  His smile dimmed. “No. Not yet. She’s fine with my family—even came for Thanksgiving. But her folks and this whole Carnegie Medal thing have her freaked, big time.”

  Lydia sighed. Oliver Tillman, the hospital CEO, was presenting Gina with the award at the annual Angels gala on Saturday. More pressure the emergency medicine resident didn’t need. “I’ll talk with her.”

  “I appreciate it.” Boyle pushed away from the gurney, nodding his thanks. “Before we get into what happened here this morning, I need to talk to you about something else.”

  Lydia wondered what had Boyle suddenly nervous, not meeting her gaze.

  He reached into his pocket and handed her a flash drive. “I asked a friend in L.A. to send me a copy of your mother’s homicide investigation. Here’s everything LAPD had.”

  She stared at the utilitarian black plastic rectangle. So small, it was the size of her finger. Yet it held everything known about her mother’s murder eighteen years ago, when Lydia was twelve.

  Well, almost everything—she hadn’t told the L.A. cops that she had actually witnessed her mother’s brutal killing. Boyle was the only person who knew that. A momentary weakness, confiding her deepest secret to him—and this was how he repaid her? By prying into her life?

  Anger prickled the hair on the back of her neck. “How dare you? You had no right!” Her voice emerged tight, high pitched like a young girl’s. Like a twelve-year-old kid’s.

  The emotions she’d corralled all morning, since Karen’s death, stampeded through her. It wasn’t anger flooding her veins; it was fear. Fear that had remained bottled up inside her until it had aged into stark, naked terror.

  Boyle seemed to understand. He didn’t back away at her outburst. Instead, he touched her lightly on the arm. “Hey. Are you okay?”

  She flinched at his touch. “I’m fine.”

  “I know you have a sore spot when it comes to trusting cops—”

  “Only because it was a cop who killed my mother!”

  “Someone wearing a uniform and carrying a gun, but that doesn’t necessarily make him a police officer. Anyway, you should know, LAPD did work it as hard as they could. Hit a wall, though, when she became a Jane Doe.”

  “What are you talking about?” Lydia and her mother, Maria, might have occasionally lived on the streets and lied to others about who they were, but her mother was no Jane Doe.

  “You didn’t know? Lydia, there is no record of a Maria Fiore. No official records of her at all. You didn’t have any, either, not until you went into the foster care system and children’s services documented you.”

  “But that’s impossible—” Her stomach did a slow dive. The one truth she’d always held on to—even after Maria had died and she had lost everything else—was the Fiore name. That somewhere there was a family she belonged to.

  “Sorry, but it’s true. The only trace of Lydia or Maria Fiore came from your statements to children’s services. They did find a newspaper photo published a few weeks before your mother was killed that identified both of you as Lydia and Marie Ferraro.”

  One of their aliases. “When I won that stupid essay contest.” The annual American Legion contest on your greatest hero of history. Lydia had chosen Thomas Paine. “Maria—” No, not Maria. Not Jane Doe, either. Damn it, Maria had been someone. She was Lydia’s mother. “My mother didn’t realize the picture had been taken. She was so furious about it; I never knew why.”

  “They had her fingerprints, but they led nowhere. There’s DNA, but with no family besides you to compare it to . . .”

  “It’s like she was never even real.” Lydia’s throat tightened. Her whole life was a lie. As fictional as the fairy tales Maria used to spin for clients when she told them their fortune. Maria had lied to her, had fooled Lydia as easily as she had the people she’d conned for a living.

  “I’d say more like she was on the run from someone. Someone who finally found her.” Boyle stared at her, his gaze filled with compassion and worry. They both knew one thing the L.A. cops didn’t: the man who killed Lydia’s mother hadn’t been searching only for Maria.

  He’d wanted Lydia.

  Janet Kwon came barreling through the door before Lydia could think of an answer—or even the right question to ask.

  “Don’t you people know anything about documenting evidence?” she demanded, glaring at Lydia.

  “What’s the problem?” Boyle asked.

  “See for yourself. We’ve lost this case before we’ve even started.”

  THREE

  Thursday, 7:48 A.M.

  AMANDA HELD THE BOY’S HAND AS SHE DOUBLE-CHECKED the settings on the ECMO machine. “The flow rate is holding?” she asked the tech manning the heart-lung bypass machine.

  “Yes, Doctor Mason,” the tech said, addressing her as if she were his superior instead of a mere fourth-year medical student. Amanda opened her mouth to protest, but he flashed her a grin to let her know he was only kidding. “Last gas looked good; we’re fine here.”

  “Okay, thanks, Michael. I just want to be sure before the family comes in.”

  He nodded his understanding. “I know. It’s a long haul. They understand he might not make it, if we can’t wean him off the bypass?”

  Amanda blew her breath out, rustling her bangs, her gaze focused on the three-year-old boy lying in the bed below her. “They know.”

  She squeezed Zachary’s hand. The little boy had never said a word to her—she’d never even seen him awake—but he had touched her heart, he and his family. She and the rest of the PICU team had worked so hard to save him, though despite everything they’d tried, he was still as likely to die as to live.

  Two days ago, Zachary had wandered into his grandpa’s garage. Thirsty, he’d taken a sip from a glass soda bottle, not realizing it contained kerosene instead of cola. By the time he’d been Lifeflighted to Angels he was already in respiratory failure, his lungs sloughing, poisoned from the mouthful he’d aspirated.

  The whole thing was so senseless and tragic—and touched Amanda even more because the exact same thing could have easily happened at her family’s marina back home in South Carolina. Her father was constantly storing things in smaller containers after he bought in bulk. Not anymore, not after Amanda had called him that first night, reminding him that even though her brother’s baby was only crawling, he was a grandfather now. She’d woken him at four in the morning with that call, but he hadn’t been angry.

  Instead, he’d listened to her rant and cry and vent, had told her he’d take care of everything that very day and promised her everything would be okay. The phone call had almost been as good as a long-distance hug and had given her the strength to walk back into the PICU to face Zachary’s family.

  Amanda and the PICU fellow had worked over Zachary all day, through the night, and until Amanda had finally been forced to go home yesterday afternoon. They’d intubated Zachary, switching to the hummingbird—the high-frequency-jet ventilator—when conventional ventilators didn’t work, inserted chest tubes on both sides of his tiny body as his lungs collapsed, then placed him on the lung bypass machine known as ECMO in a last-ditch effort to keep oxygen flowing to his brain and other vital organs. She’d been relieved to see that he was still alive t
his morning when she’d gotten back to the PICU.

  Her attending and the PICU fellow had both realized that Amanda had a good rapport with Zachary’s family, and they allowed her to lead the difficult discussions regarding Zachary’s chances of living: what they should do if his heart stopped, how far they should go, when they should stop.

  The PICU staff all complimented her on how well she handled the family and such a complicated case—her attending had pretty much said she’d be getting an A for the rotation—but that didn’t make the meetings any easier. Each time she left the Millers she felt more exhausted than she did after a night on call. She’d go to the restroom, lock herself in for a precious five minutes of solitude, and cry.

  Then she’d come back to Zachary’s bedside and hold his hand. At this point, there was little more she could do to help him. Modern medicine was forced to take a backseat to the age-old tincture of time.

  “Amanda, got a consult for you,” Terry Wyshkoff, the PICU fellow working with Amanda, said. “Lydia Fiore called from the ER, thinks this kid might need to come up here.”

  Amanda pulled away from Zachary, throwing him a mental kiss, and scrubbed her hands with the bedside antibacterial foam. “That doesn’t sound like Lydia—”

  “You’re telling me. Usually she calls up with a diagnosis and treatment plan and tells me what to order.” A hint of resentment crept into Terry’s tone. Lydia had that effect on a lot of other doctors, not only because of her brusque manner or that she was fairly new to Angels, but mostly because she was usually right. “Guess this kid is a diagnostic dilemma. Sounds like there might be more going on as well; Lydia was a bit vague about the whole thing. Why don’t you check it out, let me know?”

  It wasn’t a request, but still it was nice that Terry phrased it that way. Amanda nodded. “No problem at all. I’ll head right down there.”