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What is that doctor doing in here?
Abigail Miller's heart beat fast and hard as she stood, frozen, in the dark hospital corridor, watching a surgeon empty a large syringe of clear liquid into a patient's IV drip.
Why? What is he doing here? Alone with a patient in a closed-offpart of the hospital?
Abby shook her head. It didn't make any sense.
Dressed in full scrubs with no ID badge that she could spot, the doctor's figure towered over the male patient who lay lifeless on the gurney. As large as the surgeon looked in the narrow corridor, the male patient looked small even on the hospital gurney-his olive skin pale, his head round and bald. He seemed so still.
Abby sucked in a quick breath and decided to backtrack without disturbing the doctor and patient. She wasn't comfortable confronting the tall, imposing surgeon herself, but something about the scene just didn't seem right. Perhaps she could find a security guard She stepped backward and her shoe squeaked as it turned on the tiled floor.
"How did you get in here? This part of the hospital is closed." The doctor spun toward her, his voice booming through the empty hallway. His cold, gray eyes flashed in the dim emergency lighting and chilled her like an arctic blast. The rest of him was hidden beneath a complete workup of surgical scrubs, including face mask, gloves and hat.
"I was just cutting through here. I do it almost every day." Abby forced her lips to move while her eyes stayed fixed on the surgeon. "I was on my way to Maternity. I hope that's not a problem."
"I don't understand how you got into this area." He advanced toward her, forcing her to take several steps back. "The entrances are supposed to be locked. This patient is highly contagious. This area is under restrictions. You shouldn't be here."
Contagious? Abby hadn't heard about any restrictions. Surely there would have been signs, announcements. The sense of something wrong grew stronger. Pulse rising, she skirted to the side of the large man and looked down at the patient's chart attached to the end of the gurney.
N. K. Hancock-TRANSFER.
In the dim lighting, that was all she could read, but she could see that the papers were solid white. If the patient were contagious, the chart would be marked with a prominent red stripe. Abby swallowed hard. Her heart drummed against her ribs. This doctor was lying-if he even was a doctor. She needed to find a security guard, stat. But first, she had to get away. She composed herselfjust enough to keep from sinking under the doctor's menacing glare and looming figure.
"I'm sorry, Dr ." Abby waited but he did not supply a name. With each syllable, she inched herself away from the man and his patient. "I didn't know we couldn't pass through. Again, I'm sorry to disturb you, Doctor. I'll just be on my way." She turned and headed for the stairwell.
"Oh, no, you don't." He was behind her in seconds. Over her. Around her like a giant spider. He grabbed the top of her arm and squeezed her flesh like a vise. His cold eyes flickered in the dim lighting.
She trembled and fought against him, but her struggles were in vain as the grip of his stubby, sausagelike fingertips dug deeper and deeper into her skin. He pulled her tight against his stout belly. She had no hope of breaking free.
Was this her just deserts after finally deciding she would not join the Amish church, defying the wishes of her father?
She'd gone to school to become a nurse, but she hadn't made her final decision about living the Plain life until recently. It had been time to put away one or the other and stop living on the fence. So last week, she'd laid aside her prayer Kapp and her frocks for good. She'd devote her life to nursing, delivering babies and helping others to stay healthy. But the choice had not come without a lot of pain, especially to her father, the Ordnung bishop.
Her father's words still rang through her head-a verse from the Psalms. "If you stand in the counsel of the wicked, you will become wicked."
Had she made the worst decision of her life? Right now, it certainly seemed that way. Tears filled Abby's eyes. Crazy, desperate thoughts swirled around in her mind. She continued to try to break free of the doctor's grip, but she could not come close to matching his strength. Her breathing came in short gasps. She would have yelled but there was no one to hear her.
"You've been exposed." The doctor's tone mocked her as he dragged her across the hallway. "I'll have to give you an injection, too."
"What?" Is he mad? "Please, stop. You're hurting me. Let me go."
With his free hand, he produced another full syringe from the pocket of his scrubs. The needle shook as it came at her. His fingers closed in tighter around her arm as he yanked her sleeve high, exposing the skin above his grip. The hot prick of the needle stabbed her and the drug burned like fire as it entered her bloodstream. "What? What did you just give me?"
The doctor yanked her to the end of the corridor and through the door to the stairwell, not seeming to care that he crashed the door frame's metal edge into Abby's forehead. The blow radiated across her skull. Nausea waved through her gut as the drug made her head light-too light. Her body began to collapse. She could feel her blood pressure fall.
Please, Lord, help me.
Finally, she felt his fingers release her. She slumped to the cold, tiled floor.
The empty stairwell spun around her. The strange doctor had vanished. With all her might, she tried to reach for her cell phone. It was in her back pocket. But the drug was hitting her full force now. Her hand shook uncontrollably and the device dropped from her fingers. Her eyelids closed as she groped the floor desperately for the phone. But it was no use. She was going under and there was nothing she could do to stop it.
Please, Lord help
Abby closed her eyes and the darkness overtook her.
"Code Blue. Code Blue. Paging Dr. Jamison. Room 307. Code Blue. Dr. Blake Jamison."
The announcement blared through the overhead speakers. Everyone in the operatory stopped what they were doing and looked at Blake.
Code Blue? How could there be a Code Blue? It signaled that one of his patients needed resuscitation, but that couldn't be true. He had taken on exactly three patients since transferring to Fairview Hospital. They'd been recovering well, awake, alert and resting as of two hours ago. This had to be a mistake.
"And clip." He opened his gloved hand and waited for the nurse to place the suturing instrument in his palm. With a delicate touch, he closed up the tiny incision, returned the instrument to the nurse and removed himself from the operating area. The surgical staff would have to finish the cleanup after his first surgery at Fairfield Hospital of Lancaster County, Pennsylvania. Apparently, he had an emergency to look into.
"This way, Doctor." One of the nurses tugged at his sleeve, guiding him toward the doors. "Take the service elevator. It's faster. I'll show you."
A minute later, Blake entered a patient-recovery room where a crash team had assembled with a defibrillator. An unresponsive male patient, mid-to-late fifties, lay on the hospital bed. He was not one of the three patients Blake had seen earlier. Blake turned to the young nurse working near the monitors. "I'm Dr. Jamison. I was paged for a Code Blue, but this man is not my patient."
"Cardiac arrest," she said. "Started about fifteen minutes ago. Heart stopped soon after."
"But he's not my patient. I can't treat him. Hospital policy. It could lead to a lawsuit and an insurance nightmare."
She glanced back at the chart and pointed. "Your name is the only one on the chart."
"That's not possible."
She stared back at him with a go-ahead-and-look face.
Blake picked up the chart and thumbed through the pages. Unfortunately, the nurse was correct. His name was there. And what certainly looked like his signature. "I'm telling you this is a mistake. I've never seen this chart before. I've never seen this patient before. What kind of operation do you run here at Fairview?"
"This is no joke, Doctor. This man is in cardiac arrest and that chart says you're his doctor. I'm just the floor nurse. I have nothing to do with doctor assignments."
Blake stepped up to the bedside, opposite the working crash team, and put aside the chart. The nurse was right. He was wasting his breath getting upset with her. He'd have to speak to the appropriate people at the appropriate time-after he had done everything he could to treat the patient. "What's the history in a nutshell?"
"A nutshell is all we have," the nurse continued. "We have no idea. He came in this morning. A transfer patient from New York City. Some sort of insurance issue? Apparently, he's recovering from laparoscopic cholecystectomy."
New York City? The place Blake had just escaped? Or tried to, at least.
He shook the spiraling thoughts of his parents' devastating plane crash out of his head. Today another man's life was on the line. He was a doctor. For the moment, that was all that really mattered. Forget insurance headaches. Forget his own personal grief and struggles to sort out his life.
"You're saying this man had gallstone surgery somewhere else, was brought here and is now in cardiac arrest?"
"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?"
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."
"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.