A casual aura accompanied Friday rounds, as most of the residents looked forward to their first chance at substantial downtime. On the weekend, everyone would come in early to stabilize patients and have a short rounds. Then only the on-call resident would remain, Clayton on Saturday and Susan on Sunday. Susan did not mind. The six-day call rotation would mean she worked next Saturday as well, but that would open up her next six weekends. She had always preferred to get the hard stuff out of the way early rather than have it hovering overhead.
Aside from the occasional personal tirade, Dr. Kevin Bainbridge demanded orderly rounds. On Monday, Susan had presented her patients first simply because she had taken call that night. Since then, Bainbridge continued to have the residents present their patients in the same order: Susan, then Kendall, Sable, Monk, and Nevaeh last. It seemed more than coincidence that they always tended to run out of time when Nevaeh started talking about some outlandish fad diet or described some new article in Holistic You.
To Susan’s surprise, Bainbridge was not nearly as rigid as she had expected. He had no difficulty accepting alternative forms of medicine, so long as the person who presented it brought concrete evidence of scientific testing and results rather than testimonials or half-baked theories or anecdotal stories. Now that Susan had demonstrated two successes, he seemed willing to listen to anything she wished to try, which boded well for the odd request she intended to make.
Busy with her morning work, Susan had not had a chance to talk with Kendall. As they gathered for rounds, he flashed her a thumbs-up, followed by a jerk of his hand toward Connor Marchik’s room.
Susan smiled back at Kendall.
The moment Susan arrived, Bainbridge waved for her to begin, and she obliged. “Starling Woodruff was discharged yesterday from the Neurosurgery service.”
On the outskirts of rounds, several smiling nurses bobbed their heads.
Susan continued. “Diesel Moore will go home today with outpatient follow-up in two weeks.” She looked directly at Bainbridge. “I’d like permission to take one of my other patients off the unit.”
A spattering of applause followed the question, which startled Susan. Bainbridge gave the nurses a sour look from beneath his glasses. “This is rounds, not a performance.”
The grins disappeared, and red tinged several cheeks. One of the older nurses spoke for the rest. “We’re sorry, Doctor. It’s just that Dr. Calvin met with Sharicka’s parents yesterday. They’ve been reluctant to take their daughter on a home visit, and we’re just happy she’s talked them into it. It would be wonderful to discharge the poor little girl.”
“Discharge!” The word was startled from Susan, and she spoke it too loud. “To juvie or Mars?”
It was the first inappropriate thing Susan had exclaimed at rounds, and it resulted in utter silence. She thought it best to apologize before anyone else found his tongue. “I’m sorry, sir. It’s just that I can’t believe anyone could speak casually about discharging Sharicka Anson. Especially the day after she attempted another murder.”
The nurses all started talking at once, but the upshot seemed to be they had no idea of the incident to which Susan referred. “Don’t you all remember the Heimlich Alicia had to perform on Kamaria Natchez?”
The silence continued, but all eyes rested directly on Susan now. One voice came through the crowd. “You’re blaming that on a four-year-old?”
Susan reached into her pocket, pulled out the piece of red balloon, and dropped it on the desktop. “That’s the culprit. Shortly before Kamaria choked, I saw Sharicka hovering around the medicine cups. Shortly before that, she was skipping around the unit with a red balloon.” Susan spread her hands to signify the conclusion was obvious.
The owner of the single voice stepped forward, a nurse named Shaden. “That’s pretty circumstantial evidence.”
Susan could not deny it. “Yes. But when I put it together with this” — she hefted her palm-pross, then set it down for all to see — “the hospital records of one Misty Anson, Sharicka’s sister, I get the full story. Misty spent months in the PICU after a near drowning Sharicka confessed to.”
Shaden had become Sharicka’s staunch defender. “I think her father put her up to that.”
Kendall entered the fray. “Drowning her sister?”
Shaden gave him a disgusted look. “Admitting to the crime. He knew they wouldn’t jail a little girl, so he asked her to cop to it.”
Susan rolled her eyes. “You think a father deliberately tried to drown one of his daughters, then got the other committed to a long-term, locked psychiatry unit.”
“Why not?”
“Because it doesn’t make any sense.”
Shaden had a theory. “Let’s say the father was trying to force the first daughter to do something by submerging her. It got out of hand. When he realized he had almost killed her, he blamed Sharicka.”
Susan pretended to accept the premise for the purpose of demonstrating its ludicrous aspects. “So he chooses to ‘submerge’ her in a bucket in broad daylight in a neighbor’s yard? Then he calls 911. Within five minutes, he has an alternative story and has trained Sharicka to comply with it.”
“It’s not impossible.”
Susan added to the coincidences, hoping the theory would grow so unwieldy, it toppled for everyone in the room at once. “Another time, he beat their son with a bat at three a.m., got the boy to blame it on his little sister, and also got Sharicka to take the blame for that?”
Shaden shrugged. “It’s certainly more believable than a four-year-old dragging her older, bigger sister to a neighbor’s house to deliberately drown her. An abusive father might turn on any or all of his children. Perhaps they were so afraid of more beatings, they went along with his story.”
Susan did not get into the fact that no other injuries appeared on the Ansons’ other children or on Sharicka herself. Other than the young fosters, no reports of abuse had come from that household before or since that time. She had more than enough ammunition. “And the strangling of an autistic child in the therapeutic foster home?”
Shaden’s protests came slower and less vehemently. “We have only the foster mother’s word on that.”
“Mmm.” Susan accepted his explanation. “And the incident in the bathroom with one of our kids? And the staff member? And Kamaria?” Susan looked at each of the nurses in turn. “Poor Sharicka. She’s just a magnet for getting blamed for other people’s attempted murders. Six times by seven different accusers. What blind bad luck.”
Out of arguments, Shaden could only say, “She’s four years old, and a sweeter child you couldn’t find.”
Susan wanted to complete Shaden’s sentence with “In all the levels of hell,” but she doubted Bainbridge would appreciate the humor.
Dr. Bainbridge took over. “I realize this is a pediatrics unit, but we shouldn’t lose professionalism in our compassion. I’m giving everyone who works on this unit an assignment: Write a one-page paper on how a person with antisocial personality disorder uses ‘charm and wit’ to manipulate others. It’s a hallmark of the condition.”
Shaden had no choice but to step back, although he did add one piece. “You can’t diagnose antisocial in children.”
Dr. Bainbridge did not argue the point. “Which is odd, because the diagnosis requires that the symptoms start in childhood.” He looked around the nursing staff, most of whom appeared either chastened or ready to explode. No one liked being chided by a superior, especially about something that aroused such strong feelings. “Antisocials have an uncanny feel for social situations and an extraordinary ability to manipulate people’s emotions. Anyone in psychiatry who denies falling prey to one at some point has either never treated one or is a baldfaced liar.”