“God,” he whispered to himself as he walked. His anxiety was reverting to anger. “When it rains, it pours.” Up until the moment Sue had gotten active on the M and M Committee, demanding this and demanding that, insisting on getting onto the task force subcommittee, everything had been running perfectly, essentially like clockwork. He’d been totally confident the secret of his behind-the-scenes activities was his alone, and he’d had no fear of being discovered or even suspected. He didn’t have to be a rocket scientist to know that if Sue had succeeded in being appointed to the task force, all the effort he’d expended getting Thomas and Wingate to let him do the work of the subcommittee, which they merely rubber-stamped, would have been put in jeopardy, particularly Ronnie’s insistence that the only data given over to the Compliance Committee once a month was the death ratio and not the raw data including of the total unadjusted number of deaths.
A half a block south on Columbus Avenue was where Ronnie had found a parking spot for his beloved flat-black Cherokee. Using his key fob, he unlocked the vehicle as he approached, and the SUV responded by switching on its interior lights to welcome his return. For him the vehicle was like family, and he took care of it as such. He’d even had an artist paint some flames extending back from the wheel wells. Climbing in behind the steering wheel he first reached over and put his SIG Sauer P365 pistol in the glove compartment. It was his second-favorite possession, which he used frequently at a pistol range not too far away from his apartment and in the woods surrounding his hideaway up in the Catskills. He’d had the gun in one of his jacket pockets on his visit to Cherine’s just in case he needed it, which he certainly hadn’t expected. Still, he thought it best to be prepared, come what may.
Straightening back up in the driver’s seat, Ronnie peered out the front windshield with unseeing eyes as his mind went back to musing about his suddenly worrisome situation and how he’d gotten to where he was currently. He’d always had a soft spot for those people unlucky enough to be diagnosed with incurable, deadly diseases, particularly patients with cancer that had metastasized. As doomed individuals, they were ripe for modern medicine to experiment on, torture, and mutilate needlessly with all sorts of harrowing drugs and horrendous surgical procedures knowing full well it was not going to be curative. As a regular floor nurse, Ronnie had had limited opportunities to save these people from their fate, the same fate his foster mother had suffered, for fear of being exposed by a medical system that had evolved to protect its rights to do what it pleased. It hadn’t been until he’d risen to the role of nursing supervisor that he was able to help a significant number since the role gave him access to the whole hospital and the freedom to roam at will. But the biggest boost to his avowed crusade was when AmeriCare decided, in its infinite wisdom, to save money by reducing the night-shift nursing supervisors from two people to a single individual, meaning, to Ronnie’s delight, there was suddenly no one supervising the supervisors.
On his first night as the sole supervisor, Ronnie was able to save four people from a frightful and painful fate. It was up to him to decide after a death whether it was expected. If it was expected, which was what he always determined, it contributed to the denominator of the mortality ratio, hence making the hospital appear better. Also, it was up to him to declare if a death was a medical examiner case, and he made sure that none of the people whom he had saved from being tortured by the profession were ME cases. But even if they had been ME cases, it wouldn’t have mattered since Ronnie invariably used for the coup de grâce one of the drugs that the patient was already being given, like insulin or digitalis, but in a lethal amount. Over time Ronnie had amassed an entire pharmacopeia of drugs and had them stored in one of his private drawers in the nursing supervisor’s tiny office.
As he got better and better at his personal crusade, something interesting occurred to him one night five months ago in the beginning of July, when he arrived at the bedside of one of his beneficiaries after a code blue had been called. He was required to respond to all the code blues, but on those he was responsible for causing, he never wanted to be the first to arrive to avoid any chance at suspicion of having caused the emergency. On this occasion, when he dashed into the room after an appropriate wait, he couldn’t help but notice that the rather green, new residents, all of whom had just started their graduate training and who had already arrived at the bedside, were seemingly at a loss of what to do. As he was wont to do in such circumstances, Ronnie took control. Since he knew what the problem was in this instance from having caused it, he also knew what would reverse the situation immediately, and before he really thought about what he was doing, he barked out an order for the appropriate antidote.
Later he silently lambasted himself for what he had done, as the hospice patient had been revived and the heart returned to a normal sinus rhythm. As he was preparing to leave, several of the new residents came up to him and congratulated him on his clinical astuteness and willingness to take charge. Ronnie had been surprised at the compliments and also taken aback at how much he enjoyed them. He had been even more amazed at how much it had raised his credibility as a nurse par excellence.
As a result, Ronnie had begun to expand his covert activities to include nonterminal patients if a situation presented itself. As he did this, his clinical reputation had soared. He liked this so much because it ameliorated the mild inferiority complex he’d always had from having gotten his nursing training from the military and a community college rather than a fancy Ivy League university and academic medical center. Although a few of these patients ended up dying, the downside was more than worth the results. He even started to be treated as a clinical equal by some of the attending physicians.
Ronnie started his Cherokee, and it responded with a roar, as he’d customized his muffler to sound like a McLaren 720. Pulling out from the parking spot into the traffic, he headed south with the intention of working his way over to the Queensboro Bridge and then on to his apartment in Woodside. As he drove, he found himself getting angry all over again at Sue Passero and her incessant meddling and how much damage she’d managed to inflict on his world. What had started merely as her complaining about which cases were being presented at the full M and M meetings had morphed into her insistence to get a task force appointment. Although Ronnie had been able to convince both Dr. Thomas and Dr. Wingate it was a bad idea, it had become obvious to Ronnie that Sue was not going to give up, especially after she’d managed to get from him by his own carelessness some of the raw death rate data that showed a rather steep increase in the number of hospital deaths over the year without an associated increase in the severity of the general admissions. Of course, that had been a giveaway to his extensive efforts to eliminate the unnecessary suffering of a hundred or so patients being kept alive without regard for their quality of life or the pain and disfigurement they endured. Now, in retrospect, he realized that he should have shut her down way back when rather than acting as if he were on her side.
As unsettled as Ronnie felt, at least he could give himself credit for ridding himself of both Sue and Cherine before they could do too much damage. He also gave himself credit for cleverly learning that the ME, Jack Stapleton, had been told of Sue’s suspicions, although thankfully without getting any of the corroborating evidence. The previous night when things had quieted down around three, he’d made the effort of getting into Sue Passero’s office using a housekeeping passkey. There he’d been able to easily find the facts and figures Sue had put together from what he had unsuspectingly provided. For his convenience, he’d come across the incriminating papers in a folder right on top of her desk conveniently labeled mortality and morbidity committee. After taking and destroying them, he had thought he was back in the clear until the unexpected meeting with Jack Stapleton and learning that Cherine had known and had agreed to meet with him the next day to spill the beans.