“How’s your patient?” Ronnie asked. He noticed with satisfaction that both IVs were still running, particularly the large-bore catheter he’d put in down in the ED. He intended to use that IV line later.
“He’s rock-solid stable,” Aliyah said. “The hip incision site looks fine with minimal discharge, and the circulation of his foot is fine with the temporary plaster cast on his lower leg. More important, he’s also moving more, suggesting he’s going to come back and join us in the not-too-distant future.”
“Excellent,” Ronnie said, giving Aliyah a thumbs-up although he was not happy about the idea of Jack emerging from his coma. That threat alone argued for his acting sooner rather than later. Skirting the right side of the bed, Ronnie walked up to its head and looked down at Jack Stapleton. His cheek abrasion had been cleaned up, and he looked hardly worse for wear despite the violence of having been propelled airborne by a collision with the Cherokee at twentysomething miles per hour and slamming into the windshield before tumbling off and falling into the street. Ronnie couldn’t help but be impressed despite feeling irritated the man seemed to have nine lives. At the same time, nine lives or not, Ronnie was confident the potassium chloride was going to solve the problem in spades.
“We’re low on ortho beds,” Ronnie said. “So he’ll probably have to stay here even if he wakes up.”
“That’s fine,” Aliyah said. “Once it’s apparent he’s stable, I can help on a couple of the other patients who are more demanding. There’s a couple of sickies in here.”
Ronnie flashed Aliyah another thumbs-up, feeling even more appreciative of her work ethic, and then walked out of the cubicle. As he passed the central desk, he briefly locked eyes with the visitor. He nodded in acknowledgment, but Dr. Stapleton’s wife did not respond. He shrugged. He didn’t care one way or the other.
Leaving the SICU, he also nodded to the two police officers, both of whom nodded back. So much for their contribution, Ronnie thought with derision. Yet their presence did unnerve and bother him to a point, particularly since they were armed, in contrast to himself. Making a snap decision to bolster his nerves, he decided he could use the sense of security and the calmness his SIG Sauer P365 pistol could engender.
Since the hospital was currently problem free and because the pedestrian bridge over to the high-rise garage was only one floor down, he ducked into the stairwell and headed down. A few minutes later, when he arrived at the Cherokee, he slipped into the passenger seat. After giving the Cherokee’s dash a loving pat, he opened the glove compartment and pulled out his prized pistol. Although he knew it wasn’t necessary, he checked the magazine to make sure was full. It was. He then slipped the gun into the right deep pocket of his doctor’s coat before stepping back out of the SUV and locking it up.
As he recrossed the pedestrian bridge, he could feel the pistol gently thumping against his thigh. The weight of it calmed him dramatically by reminding him it was there, just as it had the night before on his visit to Cherine’s apartment. It didn’t matter that the chances of needing it were minuscule in either situation.
Once back in the hospital proper, he reflexively checked his phone to make sure he’d not gotten any calls or texts about hospital problems that required his immediate attention. Since he was still in the clear, he wanted to take advantage of the time to do what was certain to be one of the most important jobs of the evening, namely preparing the potassium chloride for the coup de grâce.
Using the elevator to get up to the sixth floor, he entered the nursing supervisor’s tiny office adjacent to the general medical unit. Locking the door to avoid any possibility of being interrupted, he used a key to open his private drawer in an old-fashioned, upright metal file cabinet. Inside was the entire pharmacopeia of medications that he had amassed over four years for the express purpose of supporting his crusade. The potassium chloride, or KCl, had come from the ED, as had the collection of syringes, although the syringes he could have gotten anywhere.
With appropriate aseptic care, even though he knew it really didn’t matter, Ronnie used multiple vials of concentrated, sterile KCl to nearly fill a 50ml syringe. As he held up the syringe and tapped the side to eliminate any air bubbles, he smiled, knowing he had probably enough concentrated potassium chloride to do in an elephant, much less a human.
Once Ronnie was finished, he replaced the plastic cap on the needle and then deposited the syringe in the depths of his left pocket. After relocking the file cabinet drawer, he left the office. As he walked, he could feel the pistol on the right side and the syringe on the left, and the sensations made him feel wonderfully calm and more in control than he’d felt all evening.
Chapter 35
Thursday, December 9, 1:10 a.m.
For a brief second, Laurie nodded off and caught herself with a start to keep her torso from tipping forward and falling off the desk chair. Although there was plenty of activity in many of the SICU’s cubicles, Jack’s had been calm for more than an hour. His assigned nurse had been off helping her colleagues who needed an extra hand, returning to check on Jack every ten to fifteen minutes.
Laurie stood up for a moment and stretched and took a few deep breaths. Patti Hoagland, the charge nurse, had seen the brief episode and stepped over. It seemed that nothing escaped her notice.
“Dr. Montgomery,” Patti said. “Clearly you are rightfully exhausted. I have a suggestion. You could lie down in one of the empty cubicles, if you’d like. Your husband is remarkably stable, and we’ll be keeping an eye on him as usual. We can certainly let you know if there is any change whatsoever. What do you say?”
“Thank you, but if it is okay, I’ll just move around a little bit and maybe have a bit more coffee.”
“Of course. Please, help yourself.”
Laurie grabbed the mug she had been given earlier and took advantage of Patti’s offer. She went into the room that jutted off from the central desk area. It was where all the drugs, fluids, and other paraphernalia were stored, along with a coffee machine. For the most part, she had followed to the letter Patti’s dictum that she remain seated at her assigned spot within the central desk, and it felt good just to get up and move around. After pouring herself yet another cup of black coffee, she made a beeline back to her seat. She didn’t want to take advantage of Patti’s good graces. In front of Laurie was a monitor that had been set up for her that displayed Jack’s vital signs and ECG. The mesmerizing regularity of the cursors continuously sweeping across the screen had been partially responsible for her drifting off.
All in all, the evening had gone smoothly so far. Jack’s surgery had taken a bit less than the two hours originally estimated, and the surgeon, Dr. Henry Thomas, had come into the surgical lounge, where Laurie was waiting. It was his feeling that the procedure had gone well, and he explained that he used three screws to repair the femoral neck fracture since there was no displacement, the circulation had not been compromised, and the quality of the bone was, in his words, rock solid. With the compound fibula fracture, he’d thoroughly cleaned and debrided the area and reconstituted the fibula with a steel plate and screws and closed the wound without a drain. It was his professional opinion that Jack would do well and ultimately have no limitations or sequalae from either fracture.
Following the surgery, Jack had spent just a little more than an hour in the PACU, and Colleen had been a big help. She’d managed to get Laurie permission to make a brief visit. Jack had appeared quite normal. Even his color was good. As Laurie was leaving the PACU, she was truly thankful that things had gone well and just wished he would wake up.