"Excuse me," Roger said to a woman directly in front of him. She was busy writing in a chart but looked up. Like Jazz downstairs, she was dressed in scrubs, but unlike Jazz, she emanated both civility and respect. Also unlike Jazz, she was slightly obese, with a smattering of freckles across the bridge of her nose. "Could you tell me who is the charge nurse?"
"I am. I'm Meryl Lanigan. What can I do for you?"
Roger introduced himself and said that he was inquiring about the recent death.
"The name was Patricia Pruit," Meryl said. "This is the chart. Would you like to see it?"
"I would indeed. Thank you." Roger took the chart and rapidly scanned it. The demographics were as he had feared. Patricia Pruit was a healthy thirty-seven-year-old mother of three. The previous morning, she'd had an uncomplicated hysterectomy for fibroids. Her postoperative course had been entirely uneventful, and she had already been started on clear fluids by mouth. Then came disaster.
Roger looked back down at Meryl. She was waiting for the chart, which she took back.
"It certainly is a tragedy," Roger said. "And so unexpected, given her age and past health."
"It's heartbreaking," Meryl agreed. She opened the chart to the nurses' notes.
"There have been others quite similar on other floors over the last month or so," Roger said.
"So I've heard. Luckily, this is our first. We might take it harder than others, since we're accustomed to much happier outcomes."
"I have a couple of questions, if you don't mind. Did you happen to see a Dr. Najah on your floor tonight?"
"We did, just like we usually do."
"How about Dr. Cabreo?"
"We saw him as well, but only after the code was called."
"How about a nurse named Jasmine Rakoczi, who goes by the name Jazz?"
"Funny you should ask."
"How so?"
"We see a little too much of Ms. Rakoczi most every night. I've even complained to Susan Chapman, who used to be her charge nurse, saying that I didn't want her up here. I'm going to have to go a little higher now that we don't have Susan with us any longer."
"What does Ms. Rakoczi do when she comes up here?"
"She tries to be friendly with the aides. Other than that, she's always looking in the charts, which she has no business doing."
"Do you recall specifically that she was up here tonight?"
"I remember, all right, because whenever I see her, I challenge her. I challenged her tonight, just like I always do."
"What did she say?"
"She said she was the acting charge nurse downstairs and needed some supplies. I can't remember what it was. I sent her into our supply room to get whatever she needed, but I told her then to please leave. I also told her she'd have to replace whatever she borrowed, which she promised she would."
"And she went into your supply room?"
"She did."
"And then what happened?"
"I guess she got what she needed and went back downstairs. I really don't know, because I was off taking care of a problem with one of the patients. And then, of course, we had the code."
"What room was Patricia Pruit in?"
"703. Why do you ask?"
"I'd like to take a look."
"Be my guest," Meryl said while pointing down the appropriate corridor.
Myriad thoughts were swirling around inside Roger's head as he walked toward the patient's room. In his estimation, Jasmine Rakoczi was becoming more and more of an enigma. He kept asking himself why she would constantly be coming up a floor to the OB-GYN section to hobnob with the aides when she seemed so asocial, and why would she be going through OB-GYN charts. It didn't make any sense. What did make sense was that both she and Dr. Najah had come to OB-GYN prior to the code. Of course, he wondered how many others on his transfer list had come as well. For all he knew, it could have been all of them.
Patricia's room was a mess. The debris from the cardiac resuscitation attempt littered the floor. In the frenzy of the event, some of the wrappers, syringes, medication containers, and the like had been merely tossed aside. The bed had been cranked down flat, raised to help with the CPR, and the resuscitation board was still in place. A few telltale droplets of blood were sprinkled across the wrinkled, white sheet.
Unfortunately, what Roger was looking for was not in evidence. The IV pole was in its usual position at the head of the bed, but without the bottle or plastic container of fluid that had to have hung there. As a consequence of being on the scene, Roger had gotten the idea of having the IV contents checked. Since Laurie had told him that toxicology had come up short, maybe testing the IV fluid would yield something.
Roger turned around and went back to the nursing station. He got Meryl's attention and asked her about the missing bottle.
Meryl shrugged her shoulders. "I don't have any idea where it is." She then turned around and yelled to the medical resident who'd been in charge of the resuscitation, asking the same question. He shook his head, indicating that he didn't know, either, before getting back to his sidewalk mini-conference. He and the other residents were still loudly debating why they had been unsuccessful.
"I guess it went down with the patient," Meryl said. "We always at least leave the IVs in place, along with any other tubes."
"This might be a silly question, but I haven't been on staff that long. Where exactly did the patient go?"
"To the morgue, or what we use as the morgue. It's the old autopsy theater in the basement."
"Thanks," Roger said.
"Not at all," Meryl said.
Roger went back to the elevators. He pressed the down button but then eyed the sign for the stairs. He suddenly had it in his mind to ask Ms. Rakoczi why she went to the OB-GYN floor so often, and what it was that she needed that night. Since the elevator was taking its time arriving, Roger used the stairs. As he descended, he acknowledged that the caffeine was finally starting to wear off. His legs felt heavy. He decided that he'd have one more chat with Ms. Rakoczi, hunt briefly for the IV bottle, and then head for home.
The surgical floor was as quiet as it had been earlier. Roger surmised that the nurses were all attending to their patients. He saw some of them as he passed open doors into the patients' rooms. Rather than bother anyone, he thought he'd wait at the nurses' station for Ms. Rakoczi to return. To his surprise, he found her where he'd found her earlier, in the same position, reading the same magazine.
"I thought you said you had patients to see," Roger said. He knew he was being abrasively provocative with someone with a volatile temperament, but he couldn't help himself. This woman was obviously goldbricking.
"I saw them. Now I'm manning the nurses' station. Do you have a problem with that?"
"Luckily for both of us it's not my bailiwick," Roger said. "But I do have another question for you. I followed your suggestion and went upstairs to OB-GYN and spoke with Meryl Lanigan. She said you were a frequent visitor to her floor. In fact, she said you were up there earlier. I'd like to know why."
"For my continuing education," Jazz said. "OB-GYN interests me, but I didn't get much exposure to it with the Marines, for obvious reasons. So I frequently go up there on my breaks. Now that I've learned a bit about the field, I'm thinking of putting in for an opening in OB-GYN."
"So it was for continuing education that took you up there tonight?"
"Is that so hard to believe? Instead of going down to the cafeteria on my lunch hour with my half of the surgical-floor team and talking about drivel, I went up to OB-GYN to learn something. I don't know what it is about this place. Whenever you make an extra effort to improve yourself, you get nothing but grief."
"I don't want to add to your burden," Roger said, struggling to keep the sarcasm from his voice. "But there seems to be a discrepancy. Ms. Lanigan told me that when she confronted you earlier, you said you wanted to borrow something."