saying this man had gallstone surgery somewhere else, was brought here and is now in cardiac arrest?”
She nodded.
“What medication has he been given? Does he have any known allergies?”
“I don’t know. As you saw for yourself, there’s not much in the chart and he only arrived an hour ago,” the nurse said. “We can’t seem to revive him. Hospital policy is to give it fifteen minutes. Should we call?”
“Not yet. Draw blood,” Blake said. “I want a basic workup. And while we are waiting, continue efforts. I want to know more about what’s going on.”
The nurse took blood samples and scampered out of the room. The crash team continued to work.
“Stand by,” one of the crew said. The other member prepared the electric plates to try to restart the patient’s heart. “Three, two, one.”
The man’s body popped from the voltage. The monitor beeped once before the flatline signal returned. Wait and repeat. Blake glanced through the chart. He was still certain he’d never seen this paperwork before or the patient who went with it—Nicolas Hancock. The name was not familiar. But on the last page, there it was—Dr. Blake Jamison. With a likeness of his signature.
Clearly, someone had made a very big mistake and Blake intended to find out who was responsible.
After a few minutes, the nurse returned with the basic blood screen. She handed the report to him almost breathless.
He read over the graphs and figures. Adrenaline levels were off the charts. That would certainly cause someone to go into cardiac arrest. “Any idea why his adrenaline would be so high?”
“No, sir.”
Blake looked up at the IV drip. “Did you attach this?”
“No, sir. He arrived with the IV in place. But I did replace the fluids.”
Blake tried to think of a scenario where a patient would have so much adrenaline in his body. The only explanation that came to mind was that he’d received a dose of epinephrine—a drug which could not be tested for, since the body already made it naturally. But a dose large enough to cause this sort of reaction was anything but natural.
This man’s cardiac arrest was looking as if it had been induced. Blake shook his head. Something very strange was going on here, but there was one thing that was certain—Mr. Nicolas Hancock was dead.
“It’s time to call,” he said. “Time of death is twelve-oh-seven.”
The nurse wrote down the hour.
“Is there a next of kin?” Blake would hardly know what to say to them.
“No, sir,” the nurse answered, her tone softening a touch. “His file says to contact his lawyer in case of an emergency. I’ll be glad to do that for you.”
“Thank you.” Blake rubbed his chin, deep in thought. This was not what he’d signed up for. He’d come to Lancaster County hoping for some peace to get past the loss of his parents, and to figure out what to do with the sudden discovery that he’d been adopted as a baby.
But he could hardly think with all this unorthodox nonsense at the hospital. If this had been an accident of some sort, then someone had really fouled up, medically speaking, with this patient. Blake wanted to know who and why. “I’m not signing a death certificate until I get some more information on this patient. This situation is—” Blake could not keep the strain of emotion from his voice “—unacceptable—medically, ethically and professionally unacceptable. Get the hospital administrator down here. Someone needs to look into this.”
The nurse began to shut down the machines. “I’ll inform Dr. Dodd.”
Blake headed toward the door. He felt a dark cloud over him. The same one he’d had over him in NYC. He stopped in the doorway and turned back to the nurse. “So you changed the drip bag. But did you change the IV tubing?”
She shook her head. “No. The tubing was securely in place. I didn’t see any reason to insert another IV needle into the patient.”
“Then save the entire IV, tubing and all, in a hermetically sealed container. It’s possible medications or a mixture of medications were administered prior to his arrival that caused the cardiac arrest. We have to cover ourselves legally in this day and time. Also, I’d like a copy of that chart. I want to find out how my name became associated with this patient.”
“Of course, Doctor. Naturally.”
Naturally? There was nothing natural about any of this. This was the twenty-first century. You didn’t lose patients to gallstone surgery.
“Dr. Blake Jamison. Dr. Blake Jamison, please report to the E.R. as soon as possible. Please report to the E.R.”
No way. This is not happening. Blake let out a deep sigh as he stepped back into the elevator. At least it’s not a Code Blue.
“This way, Doctor. Follow me.” Janice, a nurse assigned to assist him in the E.R. just the day before, held a grim expression. She led him to bay ten, where she stopped and flipped back a flimsy blue curtain.
“She’s one of our nurses...Abigail Miller.” Janice pulled him inside.
“I don’t know her.” Blake shook his head. A face that beautiful he definitely would have remembered. He drew closer. She was early twenties, pale with a long, golden braid flung across her shoulder. Her forehead had a nasty contusion. Her left arm sported a rough and fresh abrasion. “What happened to her?”
Janice shrugged. “The custodian found her like this in the stairwell off the third floor. Out cold. She hasn’t even blinked.”
“Pulse?”
“Rapid. BP low. This was found next to her.” She handed him a large syringe.
Epinephrine, he read on the side label. Blake handed the syringe back to the nurse. With his other hand, he felt the woman’s racing pulse at her neck. Her breathing was labored. Traumatic stress? “Get her on a monitor. Are you sure she was injected?”
Janice shook her head. “It was beside her. That’s all I know.”
“Is she known to have any severe allergies?”
Janice shook her head again. “No. She’s never sick. Healthiest person I’ve ever met.”
“You’re sure nothing’s broken? You moved her?”
This time Janice nodded. “Yes, Doctor. I’m sure the orderlies were very careful. No one would want to hurt Abigail.”
Blake touched her cold cheek. “Miss Miller? Miss Miller? Wake up. I need you to tell me what happened.”
On the outside, she lay there like Sleeping Beauty. On the inside, Blake knew that her body was fighting for its life. Janice rolled up the mobile heart monitor and began to put the sensors in place. As the cold nodes stuck to her skin, Abigail awoke with a start. She sat up, gasped for air and tried to reach for Janice. “It hurts. My chest. It hurts. I can’t bre—”
The heart monitor sensors reacted with an alert.
Blake kept a firm hand on the woman’s shoulder, pushing her back down to the bed. “Prep me a dose of Inderal, stat,” he said. “She’s going into cardiac arrest.”
Just like Nicolas Hancock.
TWO
Streams of blinding white light seeped under Abigail’s heavy eyelids. Beeps and buzzes echoed in her ears. Everything around her whirled in a blurred circle. Fatigue. Nausea. Pain. Everywhere pain. Especially her head.
“Ugh.” She lifted a sore arm only to touch a nice hard knot on the front of her head. Ouch. What in the world? Where am I?
She glanced around