Robert Harris carried the cardboard box of employee files into his small windowless office and set them on the floor next to his desk. Sitting down, he opened the top of the box and pulled out the first file.
After the conversation with Dr. Mason and Ms. Richmond, Harris had gone directly to personnel. With the help of Henry Falworth, the personnel manager, he’d compiled a list of non-professionals who had access to patients. The list included food service personnel who distributed menus and took orders and those who delivered meals and picked up the trays. The list also included the janitorial and maintenance staffs who were occasionally called to patient rooms for odd jobs. Finally, the list ran to housekeeping: those who cleaned the rooms, the halls, and the lounges of the hospital.
All in all, the number of people on the list was formidable. Unfortunately he had no other ideas to pursue save for the camera surveillance, and he knew such an operation would prove too costly. He would investigate prices and put together a proposal, but he knew Dr. Mason would find the price unacceptable.
Harris’s plan was to go through the fifty or so files rather quickly to see if anything caught his attention, anything that might seem unlikely or strange. If he found something that was questionable, he’d put the file in a group to investigate first. Harris wasn’t a psychologist any more than he was a doctor, but he thought that whoever was crazy enough to be killing patients would have to have something weird on his record.
The first file belonged to Ramon Concepcion, a food service employee. Concepcion was a thirty-five-year-old man of Cuban extraction who’d worked a number of food service jobs in hotels and restaurants since he was sixteen. Harris read through his employment application and looked at the references. He even glanced at his health care utilization. Nothing jumped out at him. He tossed the file on the floor.
One by one, Harris worked through the box of files. Nothing caught his eye until he came to Gary Wanamaker, another food service employee. Under the heading experience Gary had listed five years’ work in the kitchen at Rikers Island Prison in New York. In the employment photo the man had brown hair. Harris put that file on the corner of his desk.
It was only five files later that Harris came across another file that caught his eye. Tom Widdicomb worked in housekeeping. What got Harris’s attention was the fact that the man had trained as an emergency medical technician. Even though he’d had a series of housekeeping jobs subsequent to his EMT training, including a stint at Miami General Hospital, the thought of a guy with emergency medical training working housekeeping seemed odd. Harris looked at the employment photo. The man had brown hair. Harris put Widdicomb’s file on top of Wanamaker’s.
A few files later, Harris came across another file that tweaked his curiosity. Ralph Seaver worked for the maintenance department. This man had served time for rape in Indiana. There it was right in the file! Included was even a phone number of the man’s former probation officer in Indiana. Harris shook his head. He’d not expected to find such fertile material. The professional staff files had been boring in comparison. Except for a few substance abuse problems and one child molestation allegation, he’d not found anything. But with this group, he’d only gone through a quarter of the files and had already yanked three that he thought deserved a closer look.
Instead of sitting down and having coffee on her afternoon coffee break, Janet took the elevator to the second floor and visited the intensive care unit. She had a lot of respect for the nurses who worked there. She never understood how they could take the constant strain. Janet had tried the ICU after graduation. She found the work intellectually stimulating, but after a few weeks decided it wasn’t for her. There was too much tension, and too little patient interaction. Most of the patients were in no position to relate on any level; many of them were unconscious.
Janet went over to Gloria’s bed and looked down at her. She was still in a coma and had not improved although she was still breathing without mechanical assistance. Her widely dilated pupils had not constricted, nor did they react to light. Most disturbing of all, an EEG showed very little brain activity.
A visitor was gently stroking Gloria’s forehead. She was about thirty years old with coloring and features similar to Gloria’s. As Janet raised her head, their eyes met.
“Are you one of Gloria’s nurses?” the visitor asked.
Janet nodded. She could tell the woman had been crying.
“I’m Marie,” she said. “Gloria’s older sister.”
“I’m very sorry this happened,” Janet said.
“Well,” Marie said with a sigh, “maybe it’s for the best. This way she won’t have to suffer.”
Janet agreed for Marie’s benefit, although in her own heart she felt differently. Gloria had still had a shot at beating breast cancer, especially with her positive, upbeat attitude. Janet had seen people with even more advanced disease go into remission.
Fighting tears of her own, Janet returned to the fourth floor. Again, she threw herself into her work. It was the easiest way to avoid thoughts that would only leave her cursing the unfairness of it all. Unfortunately the ruse was only partly successful, and she kept seeing the image of Gloria’s face as she thanked Janet for starting her IV. But then suddenly the ruse was no longer needed. A new tragedy intervened that matched Gloria’s and overwhelmed Janet.
A little after two, Janet gave an intramuscular injection to a patient whose room was at the far end of the corridor. On her way back to the nurses’ station, she decided to check in on Helen Cabot.
Earlier that morning and about an hour after Janet had added the coded medication to Helen’s IV and adjusted the rate, Helen complained of a headache. Concerned about her condition, Janet had called Dr. Mason and informed him of this development. He’d recommended treating the headache minimally and asked to be called back if it got worse.
Although the headache had not gone away after the administration of an oral analgesic, it had not grown worse. Nevertheless, Janet had checked on Helen frequently at first, then every hour or so throughout the day. With the headache unchanged and her vital signs and level of consciousness remaining normal, Janet’s concern had lessened.
Now, almost 2:15, as Janet came through the door, she was alarmed to discover that Helen’s head had lolled to the side and off the pillow. Approaching the bed, she noticed something even more disturbing: the woman’s breathing was irregular. It was waxing and waning in a pattern that suggested a serious neurological dysfunction. Janet phoned the nurses’ station and told Tim she had to speak with Marjorie immediately.
“Helen Cabot is Cheyne-Stoking,” Janet said when Marjorie came on the line, referring to Helen’s breathing.
“Oh no!” Marjorie exclaimed. “I’ll call the neurologist and Dr. Mason.”
Janet took the pillow away and straightened Helen’s head. Then she took a small flashlight she always carried and shined it in each of Helen’s pupils. They weren’t equal. One was dilated and unresponsive to the light. Janet shuddered. This was something she’d read about. She guessed that the pressure had built up inside Helen’s head to the point that part of her brain was herniating from the upper compartment into the lower, a life-threatening development.
Reaching up, Janet slowed Helen’s IV to a “keep open” rate. For the moment that was all she could do.
Soon other people started to arrive. First it was Marjorie and other nurses. Then the neurologist, Dr. Burt Atherton, and an anesthesiologist, Dr. Carl Seibert, rushed in. The doctors began barking orders in an attempt to lower the pressure inside Helen’s head. Then Dr. Mason arrived, winded by his run from the research building.