Authors: Peter Glassman
A little voice spoke to him, “If you steal from us you will pay with your life in an exemplary way.” The voice sounded like it was Crosley Bizetes
Anyone who stole drug or dollars, which was the same thing, from the cartel would become a teaching case. He remembered one woman whose job was packaging the heroin into bricklike units who suddenly got confused. She was one of four-women who worked two-at-a-time in twelve-hour shifts. All packaging personal worked in the nude using clear plastic coverings when needed as protection against the heroin. There were no pockets, bras or sleeves to hide powdered product. However, there were body cavities. The cartel employed a nurse practitioner to check and probe orifices at the end of each shift. All men and women handling the final powdered product got a spot urine check with a heroin dipstick as well as a rectal exam before they left the lab and packaging facility. The women got a vaginal exam with a large illuminated speculum which looked like a huge duckbilled flashlight.
This woman got progressively more incoherent and began vomiting. She was a redheaded attractive thirty-something lady who came, as did the others, with commendations of loyalty, high ethics and knowledge of the penalties for stealing. She continued with dry vomiting.
“I feel sick.” She began staggering and holding onto things to steady herself
The nurse looked at the clear mucoid vomitus. “Are you pregnant?”
“No. Not possible. I’m just sick today.” She continued with dry heaves and held on to her distended stomach. She ran to the bathroom with the nurse right behind her. The redhead retched with her head in the toilet bowl and upchucked two small tubular white rubber narrow balloons full of a white substance. “I have to sit on the toilet.” She turned around and had a violent bout of explosive watery bowel movement productive of more white-filled finger-size balloons.
The cartel nurse shouted for Bizetes, “Cros come in here quick.”
Bizetes examined the rubber objects, “I don’t know what they are but they must be filled with heroin. One of them is broken. What are her pupils like?”
“Pinpoint. And the rubber things are called finger cots. They’re like tiny condoms used to protect fingers from infection. She must have them in her locker and kept going back-and-forth filling them. Her entire GI tract is probably lined with these things.” The nurse did a test on the powder. “It’s pure heroin–our heroin.”
Bizetes turned red. “Take her to the boiling room and tie her to the long steel table after you put a plastic sheet on the floor under it. Use duct tape.”
The woman continued to get more obtunded.
“Quickly. I don’t want her to be unconscious.” Bizetes helped with getting her tied down and spoke to one of the over-muscled male assistants. “Get the movie camera going. I want every second of this to be recorded.”
Linsky and Mindel looked on incredulously.
“What are you going to do?” Mindel stepped out of the way.
“Give me your surgical instrument kit. I need two scalpels–the ones you use to cut into the plaster casts–and a roll of heavy string. I want this on video and take plenty of photographs.” Bizetes donned a plastic coverall, rubber gloves and face shield. He wielded the first scalpel and cut the woman from her breastbone to her pubis after the nurse applied duct tape to her mouth and secured the rest of her to the perforated steel table with abundant tape. Blood spurted high toward the ceiling as the duct-taped body writhed with the eviscerating incision. The rest of her body was immobilized with the extensive duct tape application. The spurts of bright red blood became a slow pulsatile steady ooze as her blood pressure decreased. The blood dripped around her abdomen, through the circular perforations in the steel table and onto the plastic sheet on the floor. The crimson splotches coalesced into slowly moving puddles at Bizetes’ bootee-covered shoes. He continued with the first scalpel to make three lateral cuts from the midline incision. The woman’s intestines escaped outward and tiny redlines of darker blood now mingled with the drippings from the first incision. The non-anesthetized woman’s eyes rolled up under her eyelids and her body relaxed into flaccidity from the first muscular contractile efforts.
Everyone but the nurse and Bizetes stepped back. The nurse was also clad in protective plastic. Bizetes reached under the breastbone and tied the heavy twine around the esophagus just above the stomach. He did the same with a ligature around the rectum.
“Give me the second scalpel.” Bizetes received it in his gloved hand and cut the esophagus and rectum. “Now I’m going to retrieve our stolen goods.”
The woman was unconscious as Bizetes removed her entire gastrointestinal tract as one huge tubular coiling mass of esophagus, stomach, small bowel and large bowel. Seconds later the blood stopped flowing. All pulsations were gone. The woman was dead. He turned to Linsky and Mindel. “Get everything out of her foul guts and make copies of the movie and stills.”
Linsky looked at Mindel, “It’s unbelievable. She swallowed fifty-eight of those finger cots stuffed with heroin. Each one weighs over eight-grams. She was going to take home over $50,000 worth of heroin.”
Bizetes grinned as he took off his bloody coveralls, gloves, booties and mask. “And who knows how many times she’s been doing this. I want surveillance cameras in the bathrooms and locker rooms. Take photos of her carcass as a further example to what happens when you try to take advantage of our good faith.” Bizetes turned to the nurse, “Check between her legs.”
The nurse had Linsky and Mindel spread the thighs of the dead woman apart. “Okay. Here’s where her finger cot supply is.” She held up two adult condoms, one empty and one almost half-f with the two-inch-long finger cots.”
Linsky remembered and thought he would never steal directly from the cartel. Amstel Perkins and all new and current employees were shown this and other documented incidents
.
Despite viewing this “snuff film” both Linsky and Perkins had used the normal mechanism of denial for their subsequent thoughts.
This can never happen to me.
And Abraham Linsky advanced his craving for more money.
If I can get the heroin plaster casts which are not destined to Bizetes’ and Mindel’s labs and do it in a clandestine way I’ll be rich. I can quit and disappear when I reach over a million dollars.
Chapter 12
Norman and Zettler
Dr. Paul Norman had taken care of orthopedic patients with many types of plaster cast immobilizations. The biggest problem was wondering what lay beneath the cast material. At Queens Naval Hospital as in other military stateside hospitals the dilemma was the same. Not having been there for the initial surgery and cast placement was a disadvantage. The only thing they had to help out in terms of bone healing was the X-ray.
Norman wanted the foreign casts removed as fast possible as much as LCDR Skagan did but for different reasons. Skagan wanted to dispose of the disease carrying casts and he wanted to check for the healing status of the limb or limbs. Total body cast patients presented the same problem but on a different level of concern. When the entire torso and limbs were immobilized an environment of hypercoagulation could take place because the blood flow was somewhat stagnant compared to those patients who could ambulate and exercise. Boomer presented such a problem.
“Doc I got itches I can’t scratch.” Boomer’s bed was tilted with the head up for two hours and then head down for two hours. The position changes kept blood moving.
“Let me see you wiggle your toes and bend your feet up and down. If you don’t do this at least six times each waking hour you’ll form blood clots which could travel to your lungs and kill you.” Norman swiped his index finger across his throat to emphasize the lethality of the event.
Boomer’s cast ended at the feet with the toes and three-inches of foot exposed. He complied with Norman’s orders.
“Okay. Now grab those handle springs with your fingertips and open and close them. That’ll give you exercise and blood flow in the arms.” Norman watched him do this easily. Boomer had good arm strength.
“What about the itching?” Boomer blinked his eyes shut.
Norman looked at the oval window in the plaster helmet. To the world Boomer was a mouth, nose and eyes. Norman raised up a wooden yard stick he had brought with him. “You’ve lost weight since you originally had that cast put on. We can cut a few windows of cast out where you itch. That’ll make some space for your corpsman to slide this yardstick to get at the itchy spots.”
Boomer smiled.
“I’ll leave the stick. Just give the corpsman instructions after he shaves your face.” Norman turned to leave.
“Face? He can only get at my moustache area and part of my chin.”
Norman ignored the comment. “Boomer I checked what nerves I can assess and your spinal cord and cranial nerve function seem intact. You have no pain from the broken bones but that could be because of the plaster immobilization. Broken bones only hurt when the fractured pieces move. Your bladder and bowel function are also normal although a bit awkward because of the cast.” He paused as he saw his page light blink at the lighting display above the Nurses Station. 580. 580.580. “I have to go now. I’m being paged.”
‡
“Dr. Norman here.”
“Paul it’s me. Can you have lunch at 12:30?”
“Yes Minnie. Where are you working today?”
Minnie Zettler was a surgical floater this month. When a surgical ward was extra busy or a nurse was absent the floater was called. “I’m in OB. The baby business is booming today. They need everyone they can get down here.”
“You don’t sound too stressed out.”
“Paul Norman, every time I tend a birth I think about our future family. Only two more years in the Navy to us getting pregnant.”
“How about marriage first?” Norman laughed.
“Of course. I just wish the war’s end will get us an early out of the service like you always say.”
“It’ll happen if it’s supposed to happen. It’s up to God and the Navy. Look, we have the weekend off. What do you want to do?”
“How about a drive up to Connecticut and staying overnight at some nice shore place?” She giggled.
“I like the overnight part. Okay it sounds good. I’ll gas up my car tonight. See you at the mess hall for lunch unless the baby business locks you in.” He hung up. Norman’s thoughts drifted to a life that didn’t involve daily air-evacs. He wondered how much of civilian practice would involve trauma. Definitely not like war although the TV newscaster had stated one night that the annual death rate from auto accidents was over 50,000. That was the total mortality so far for the Vietnam War over the past seven years. The yearly death rate from auto accidents was equal to the total Vietnam wartime number killed for the same time period.
Why don’t anti-war activists picket the government and motor vehicle agencies the way they protest the same amount of carnage from combat?
‡
“Hurry, Minnie. Into Del-Room 4.” LCDR Petula Jessel was the head OB nurse. “This baby’s comin’ fast. I called the pediatrician already.”
Zettler was wearing a set of pink OB scrubs and pushed the OB bed from the head end as fast as she could while Jessel pulled the foot but mostly did the steering. “Pediatrician?”
Jessel pressed the automatic Del-room door opener with her elbow. “Yeah, our mother to be here is a heroin user and the baby might be in trouble.”
Zettler shuddered. She’d seen this before. An alcoholic or drug addicted mother was a set-up for a problem baby. Usually the baby lacked the normal newborn baby fat to maintain body heat. But most often they didn’t breathe right and sometimes had to go on a neonatal ventilator.
“I gave our mother-to-be some Lorfan per Dr. Borden’s order. It should help get the kid out screaming but the baby could have a respiratory arrest in the nursery when the Lorfan wears off.” Lorfan was a narcotic antagonist. Jessel secured the locks on the OB bed’s legs.
“Did I tell you Paul Norman wants to specialize in anesthesiology and addiction medicine after the Navy?” Zettler helped move the screaming woman to the narrow delivery table. “God knows there’s a shortage of those out there.” Zettler applied the restraints and got the woman’s legs onto the broad padded stirrups. “Oh Oh, there’s the head.”
The pediatrician and obstetrician came into the room at the same time. A radiant-heated isolette received the baby girl whose mouth was wide open but no sound came out. Suddenly a shrill cry emitted after the pediatrician vigorously suctioned out the baby’s mouth. “I have to get the baby to the nursery and place an umbilical venous line in. These kids get severely hypoglycemic and need intravenous glucose right away.” He left with the baby. The mother stopped yelling and fell asleep.
Jessel took care of the paper work while Zettler assisted with the afterbirth. The Obstetrician checked for lacerations–there were none. “It seems drug and alcohol addiction complicates every specialty in medicine. How the hell does the heroin get into this country?”
“Damned if I know.” Zettler milked some umbilical cord blood from the afterbirth for the lab. “But the press seems to indicate the Vietnam War is somehow implicated for some part of it.”
‡
Ike Kaplan felt relieved at making contact with Stokely.
I’m not alone in this
. He wondered how he’d be coordinating the hospital orthopedic wards with his daily work as a corpsman. The visitors had to be the key intermediaries in the network to mobilize the heroin-plaster casts out of the hospital. There also had to be hospital staff as part of the smuggling cartel which meant military personnel. Kaplan felt that a key player had to be someone like LCDR Philomena Skagan. Was she a part of the criminal element or just a fastidious, compulsive nurse doing her job? He picked up the phone. “Operator can you please page LCDR Skagan for G-1.”
Kaplan watched Skagan’s page light up and then blink. All blinking page numbers seemed to have a sense of urgency. He wondered if it was psychological as he stood staring at the phone willing it to ring. It rang.
“Orthopedics. G-1 Chief Corpsman Kaplan speaking.”
“LCDR Skagan. I’m glad you called Kaplan. I just finished a meeting with the combined infectious disease team and biological waste disposal committee. We’ll be consolidating all removed cast shells to be stored in one orthopedic ward–G-1.”
“What? G-1? Does Dr. Norman know about this?”
“He will within the hour. G-1 was chosen for several reasons. First you have the largest cast room with storage space and a loading dock. Secondly, you’re on the first floor which makes the contractor pick-up less likely to present accountability problems. And third I need someone with your bearing and compulsiveness to ride honcho over the other corpsman and help me keep track of the new arrival cast removals.”
“Ma’am. I think we should meet and perhaps have Dr. Norman in on the logistics of this change in procedure.” Kaplan was excited. Centralizing the cast shells into his domain was a Godsend.
“The only reason you know ahead of LT Norman is you paged me before I called him. I want to meet with both of you in one hour–1500 hours.” Her tone implied there could be no discussion.
“1500 hours. Yes Ma’am. I can’t leave my ward.”
“We’ll meet on G-1 Kaplan. I’ll contact LT Norman.”
Ike Kaplan watched Norman’s page number light up and flash angrily–580. 580. 580. The blinking stopped and the 580 disappeared from the vertical light box. Norman had answered Skagan’s page. All he had to do was stay put which he had to do anyway.
‡
Norman walked briskly into G-1 and stopped at the Nurses Station. “Kaplan LCDR Skagan informed me your part of this meeting.” Norman looked at his watch. “I hope it’s brief. That woman makes me want to run and hide and I have no idea why. I have a big weekend planned off the hospital compound and I wanted to get to the BOQ early tonight.”
LCDR Philomena Skagan arrived promptly at 1500 hours. “Dr. Norman. Kaplan.” She continued into the GMO office. “Let’s convene in your office.”
The two men followed Skagan’s curvaceous posterior. Skagan took Norman’s comfortable office chair behind his desk and motioned for both of them to sit in front of the desk on the Spartan aluminum framed Navy issue armless chairs.
Norman spoke first. “Rank has its privileges even in my own office I see ma’am.”
The thinnest of smiles appeared on Skagan’s face evoking her genetic tiny dimples. “That’s correct Lieutenant. Now find something to take notes on and let’s get to business.”
Norman took out his scut list notepad from his long white coat hanging from the closed office door.
Kaplan had a similar wire bound 3-by-5 pad and clicked his Government Issue black ballpoint pen.
She’s got a lot of balls the way she pushes people around
. He felt a twinge of something telling him it was just a facade. There was something likable about Philomena Skagan. The likable part disturbed him.
She could after all be the enemy.
“Okay. I pushed for this centralization as soon it was suggested. There’s been some sloppiness to keeping track of the plaster carcasses by having to collect them at each orthopedic ward.” Skagan locked her blue eyes onto Kaplan’s dark brown orbs. “Kaplan I like your no-nonsense attitude. The other corpsmen respect you and do what you tell them. You’re responsible and I don’t care if you make the other ortho ward personnel cower. I want this operation streamlined.”
Norman cleared his throat, “Look Philomena what about the casts that have to be removed in the OR–like Boomer Stiles.”
Skagan stood up. “Dr. Norman I did not give you permission to use my first name. It’s LCDR Skagan. Even my friends don’t call me Philomena.” She sat down. “Wherever the casts are removed they’ll be wrapped in plastic, properly tagged and identified and sent to G-1–to you, Kaplan or your designated assistant corpsman.”
“What about LT Sparrow, the ward nurse?” Kaplan looked from Norman back to Skagan.
“Let her tend to her nursing duties. You’re in charge and will use Dr. Norman for any higher level authorizations or decisions. Understand.” She opened a small flat briefcase. “Here are the proper tracking and logistical forms you need. As you can see every ortho ward is accounted for.” Skagan stood up and walked to the door. “We’re done for now.”
Kaplan went to open the door for her. “What do your friends call you, ma’am?”
She let Norman leave and stared at Kaplan. The short silence seemed like an eternity and she spoke while maintaining eye contact. “Before I go I want to commend you for adhering to the cast removal protocol regarding making SGT Stiles comfortable. After your action with Stiles I issued a directive to all orthopedic wards regarding any-and-all fragments of Vietnam originated cast material. They will be tagged, identified and placed with the patient’s final discarded plaster as you did with him.”
She seemed to relax and lingered a few more long seconds. The dimples reappeared without a defined smile but her eyes seemed to sparkle. “Phil. My close friends call me Phil.” She left the ward.