Authors: Shawn Grady
“In the liver.”
“So that makes you a key – ”
“Witness. Yes.”
I ran my hand over my cheeks and down to my chin. “What about Martin? What have you found with him?”
“Your report said his body was stiff on your arrival, correct?”
“Yes.”
“The onset of rigor mortis begins anywhere from minutes to several hours after death, depending on the environment.” He stood, the papers trembling finely in his hand. “I’d hoped a careful study of Martin’s liver would turn up more answers. Perhaps a similar cause of death.”
“And . . .”
“Not
and
. But.”
“But . . . ?”
“But I never had the opportunity to study his liver.”
“Why not?”
He looked at Naomi, then back at me. “Because Martin’s body has gone missing.”
The simple fact that Eli, one of the kindest, most levelheaded men I’d ever met, had been thrown into a state of fear gnawed at me to no end. I needed time to piece things together. I asked Naomi, since we were already on hospital property anyway, if she minded following up on Mrs. Straversky, who Bones said had taken a turn for the worse.
At the work area outside Mrs. Straversky’s intensive care room Naomi thumbed through the chart.
A nurse wearing teddy bear scrubs and a Littmann stethoscope walked up. “Hey, girl.”
“Hi, Sharon.” Naomi embraced her. “Is this your patient?”
“One of them. We’ve got half as many nurses up here now as we did this time last year.”
Naomi nodded. “There’ve been big cuts.”
“Deep.” She gave me a once-over and smiled. “Who’s your friend?”
“Oh. We work together at Aprisa. This is Jonathan.”
Just, “We work together”?
I shook Sharon’s hand. “Pleasure to meet you.”
Naomi tucked a strand of hair behind her ear and ran her finger down Mrs. Straversky’s chart. “What’s the story with her? Jonathan said when he brought her in, she was doing good.”
I crossed my arms. “Rapid a-fib conversion. Strong vitals.”
Sharon fingered a roll of clear tape that hung on her stethoscope. “Prolonged a-fib?”
I thought of the time it took Bones and me to haul across the city. “Yeah. Could have been going for a while.”
Sharon looked down. “That’s probably what prompted the CVA.”
“She had a stroke?” Naomi said.
“Yeah. That’s why she’s on the vent.”
I leaned around the doorway to Mrs. Straversky’s room. She lay unconscious with a tube protruding from her mouth. A ventilator humming beside her bed. Two poles with IV pumps and tubing stood beneath a flat-screen monitor that displayed vital signs.
Her rapid pulse rate could have caused her heart to pump ineffectively. Stagnant blood may have coagulated and eventually traveled through her bloodstream until it lodged in a tiny vessel in her brain.
I turned back to Sharon. “You think she threw a clot?”
“Yeah. Head CT scan shows embolic stroke.”
That was it then. If we could have fixed her heart rate before that clot formed . . .
Sharon shrugged. “But what can you do, right?” A woman behind the nurses’station called for her. She waved. “Be right there.” Then to us she said, “Got to show our new intern how to place a Foley.”
Naomi smiled. “Oh, joy.”
“Let me know if you two need anything.”
“Bye, Sharon.”
Naomi sighed and glanced at her watch. “I forgot you worked last night. You must be tired.”
“Coffee would help.”
She bit her lip. “I’ve got the perfect place to enjoy a cup.”
The rooftop breeze made Naomi’s hair dance. “Bet you never had a cappuccino on a landing pad before.”
I shrugged. “Ah, I’m sure I have at some point.”
Naomi elbowed me. “You’re full of it.”
I grinned and sipped from the cup’s plastic top.
Sky hues warped and reflected around the helicopter’s blue exterior. I ran my hand along the curved body.
She led me around the front and pointed at a short metal protrusion on the nose. “Watch out – this gets really hot.”
I pulled my hand from the helicopter’s body, feeling like a child in a glassware aisle.
She smiled. “Come check this out.”
I followed her to the far landing skid, and we sat on the rough step tread. Downtown rose from the valley in a small patch of staggered gray blocks with a white sphere nestled between them. Beyond, the Sierras stretched out in clear view beneath patchy gray-and-white clouds, the winter snowpack retreating to the highest elevations.
I raised my coffee in a toast. “To the best seats in the house.”
She tapped her lid to mine and took a sip. “The city seems so small compared to the mountains. Look. You can see all the way to Job’s Peak.” She balanced the drink on her knees, cupping her hands around it. “Eli really is a special man.”
The espresso hit my throat, warming my chest. I felt my mind wakening, fatigue retreating. “Remember our youth group trip to Mexico?”
“The one where our bus driver got arrested – ”
“For a bag of Yerba Mate tea. Yeah, that one.”
“Poor Mitch. They thought he was a drug mule.”
I laughed. “Eli was my group leader on that trip. You know he drew up the plans for that medical clinic?”
“No, I didn’t. I’m not surprised. He’s amazing.”
“When I told my dad that I wanted to pursue medical school, he treated it like I’d told him I was going to a Giants game. But Eli was ecstatic when I told him. He gave me books and invited me to autopsies and introduced me to instructors up at the med school. He was the one who suggested I become a paramedic first.”
“In some ways he’s been like a father to you.”
“Yeah. How’s your father and mother?”
“My dad is doing everything he can. But Mom’s weak. The prognosis is tepid at best. But we’re prayerful.” She cleared her throat and stood. “Best view seats but not the most comfortable.
You hungry?”
“Famished.”
“There’s that great little sandwich place down in the cafeteria.”
“Let’s do it.”
We sat at a small table next to the windowed wall of the dining area. A delivery truck rolled through the alley below. Steam billowed from the rooftop of a lower building. A din of lunchtime conversation permeated the room. Tables of doctors and nurses and respiratory therapists, some tables with patient visitors. I took a bite of sandwich – turkey with cranberries, cream cheese, and sprouts on wheat bread.
Naomi stared out the window. “I didn’t get the chance to tell you.”
I swallowed. “Tell me what?”
She rested her forearms on the table and picked at the edges of her sandwich. “I spoke with a couple of the other flight nurses about Letell. I think I have a decent picture now of why he and Aprisa didn’t get along so well.”
“What’d they say?”
“I didn’t know this, ’cause I don’t read the paper, but I guess Letell had been a rather vocal dissident against the company. He’d written numerous editorial articles and blog posts on how Aprisa had taken upwards of twenty minutes to get to his house to care for his ailing mother.” She pulled a single sprout from her sandwich and nibbled it. “In past cases the fire department had been able to respond and stabilize her until the ambulance’s arrival. But the last straw for him was when he called 9-1-1 for his mother and the local engine company was already committed on a fire.”
“Is that when she died?”
Naomi nodded. “I guess by the time the ambulance crew got there, his mother was already too far gone for them to even work on her.”
I clenched my teeth and breathed in. “That’s not good.”
She looked at her sandwich and shook her head. “I’d be mad too.”
“So, what then?”
“He goes on this negative PR rampage – phoning and writing all the major media outlets. He even hired a lawyer to sue Aprisa for wrongful death.”
“Wow.”
“Yeah. But you know Aprisa. They put their PR machine in full motion.” She took a bite of sandwich.
“Launched a defensive campaign.”
“Exactly. And they were effective.”
“How?”
“Someone dug up records of a past psychiatric history – a period in the seventies that he’d suffered from post-traumatic stress after serving overseas. They used that as a springboard to paint him as a raving delusional.”
I nodded. “Bones has a buddy that works over at the mental health institute. He said Letell had a paranoid schizophrenic background.”
She took a deep breath. “The defense worked. Reporters dismissed Letell’s rantings as unsubstantiated. With the expenses of legal action, Letell lost his house and moved into a motel downtown.”
“Probably the one I found him at.” The sky looked like a faded blue canopy. In the distance a jet streaked a long white line across it. “So he was going to sue for wrongful death.”
She chewed. “Mm-hmm.”
“And he’d already been upset about delayed response times.”
She nodded.
I rubbed the back of my neck. Maybe it wasn’t just the night shift and weekends. Maybe we were becoming chronically understaffed. “Don’t get me wrong – I’m just going to play devil’s advocate for a minute – but as unfortunate as his mother’s death is, those things happen. We can’t always be there in time, right? What’s the county contract for Aprisa say, anyway? Ninety percent in under five minutes and fifty-nine seconds?”
It was a rhetorical question. I knew full well.
But she shrugged her shoulders. “That’s for you ground medics.
We just fly everywhere.”
“Well, it is. Ninety percent. And that means every month ten percent of patients may not get an ambulance in that time frame, and as far as the county is concerned, that’s just fine.”
She raised and lowered her eyebrows. “All business.”
“Right. Despite how wrong it may seem for Letell and his mother, the county has said this is what’s acceptable.”
“Tort law.”
“Exactly. The king can do no wrong.”
“So there’s no recompense.”
“Yep. No wrongful death. Just an ugly PR situation that was quickly brought to a close.”
She squinted her eyes at me. “You’re too good of a devil’s advocate.”
I sat back and put my hands up. “Hey, I want to be a doctor, not a lawyer. You know what Shakespeare says.”
“First thing, let’s kill all the – ”
“Right.” I looked at the crumbs in my sandwich carton. Only a few eaters remained in the cafeteria. The empty stainless food tray conveyor disappeared into the kitchen through dangling rubber tentacles. “But . . .”
“But . . .”
“But Simon had already been complaining about ambulances taking too long to get to his house. His mother died. He complained again. Then he loses his house.”
“And his life.” Naomi glanced around the room and leaned forward. “What have you seen on the streets? Is it taking longer than usual to get to calls?”
I nodded.
“More than ten percent of the time?”
“Much more. It’s got to be an issue with the county by now.”
She ran her hand behind her ear as if to tuck a strand of hair, though none were loose. “You’d think we’d have heard something if it was.”
I rubbed my chin. “The run charts should reflect response times.”
Naomi studied my face. “What are you considering?”
Good question.
This was unfolding fast.
She sat back. “Are you suggesting . . .”
“We verify. That’s all. We simply verify the numbers I’ve been getting on the ground with what’s in the files.”
Her mouth dropped open.
I looked behind me. Nobody there. “What? What is it?”
“You said numbers. Times
.
” She brought a hand up. “Letell’s numbers . . . What if they were times and dates?”
I brought my hands behind my head.
Of course
. “For his mother’s calls?”
She picked up her purse. “There’s only one way to tell.”
I called in sick for the evening shift and dropped off Naomi with the plan to pick her up again after dark. She had keys to access the business office. We would slip inside through the ambulance bay and gain access to the billing office when no one but the dispatchers were likely to be around. We discussed surveillance cameras but didn’t think there were any inside, just one by the east side of the building. If we went in through the helicopter-pad entrance we’d bypass that. Then we would just have to cross the ambulance bay. There might be a vehicle service technician restocking ambulances as we walked through. We’d have to see what the layout looked like when we got there and avoid being spotted. Just to be on the safe side. It wasn’t like we were breaking any laws. Just stretching the rules. Just . . . verifying.
I slept hard through the afternoon, woken only by the grumbling hunger in my gut around seven thirty. I grilled up a couple chicken breasts and made Caesar salad, leaving half of it in the fridge for my dad, whenever he got home.
Romaine and red onion joined a slice of chicken on my fork. I took a bite and studied Letell’s note.
9. 53.
Nine minutes fifty-three seconds? But when? I decided to follow my instinct and read from left to right. I turned the paper on its side and folded it.
1. 22.
January twenty-second?
I grabbed a pen and jotted down the set of numbers on a sticky note. Above it, in succession from left to right, ran a second set.
17. 55.
And
2. 25.