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  Murders at Hollings General

  ( Dr. David Brooks - 1 )

  Jerry Labriola

  Jerry Labriola

  Murders at Hollings General

  Chapter 1

  Dr. David Brooks remembered the man behind the surgical mask as shorter and left-handed.

  "Strange," he whispered, turning to Dr. William Castleman, the young Director of Emergency Medicine, "back in the Navy, he was a little man. They used to give him a stool to stand on when he operated."

  "Maybe it was years of military food," Castleman said, straightening his starched white jacket. "Gave him a growth spurt."

  "Sure, and made him ambidextrous." David had removed his blue blazer and placed it across his knees, half again higher than Castleman's.

  They sat together in the center of the first row overlooking Suite 7, the surgical amphitheater of Connecticut's venerable Hollings General Teaching Hospital, on a viewing balcony crowded with doctors, nurses, medical students, administrators and news reporters. Frozen forward, eyes homed in on the operating surgeon, their breathing stalled for a collective silence. Before them, bright lights reflected off an otherwise invisible glass partition. On the wall, a clock's second hand cogwheeled to precisely three thirty. The balcony smelled scrubbed and antiseptic.

  David asked himself whether he remembered wrong.

  Poised to the left of the operating table, its occupant intubated and asleep, the surgeon drummed his latex fingers on the patient's chest awaiting a scalpel to be snapped into his right hand. An anesthesiologist guarded the head of the table while three other physicians were positioned to the right of the body, including the hospital's Chief of Surgery and the Associate Chief. Six nurses bustled among the instruments, lights and monitors. An electrocardio-graphic tracing showed the rhythmical complexes of the patient's heart.

  A rotund nurse broke from the pack and like a hydroplane, glided off to the side. A wisp of chalky hair strayed from her constrictive cap. She eyed the operative field and spoke into a microphone attached to her surgical gown. "Ladies and gentlemen, I'm Virginia Baldwin, the Nursing Supervisor of our Surgical Department. We're indeed honored to have Dr. Raphael Cortez here with us today. He's about to make his initial abdominal incision and the pancreatic transplantation will begin. I'd like to inform you-especially those of you from the media-that the patient is Mr. Charles Bugles, the Board Chairman of this hospital. I mention it because somehow I think it's fitting that he should be the first to receive an organ through the transplantation program here at Hollings General. I'll come back to you every so often during the procedure, but I'll leave the microphone on. It's pretty sensitive and you may pick up instructive interplay here. Dr. Cortez, please feel free to explain anything-anything at all. I'm sure our students would be very appreciative." From a speaker above the viewing balcony, her words resonated against the drone of the patient's monitored heartbeat.

  Castleman stretched up and cupped his hand around David's ear. "Doesn't a doctor like Cortez deserve prime time-like eight in the morning? Why three-thirty?"

  David cupped back, "He may be famous, but he's just a visiting dignitary. Remember, it's his first case here. Anyway, who would they bump? Friedman? Scully? Matthews?" He tweaked his floppy mustache which was as wide as his bow tie. "There'd be mutiny," he added, flashing his thin linear smile, not the curved one-happy and pronounced-when only central incisors would show, their companions retracting out of sight, his skin florid.

  "You kept in touch with the guy?" Castleman asked.

  "Only with Christmas cards."

  "Have you seen him since he arrived?"

  David considered before answering. "No, I haven't had a chance yet. I understand the Credentials Committee acted on him. I don't think anyone's met him except them-and maybe they just looked at his photo."

  The surgeon made the initial transverse incision with a flair. Nurse Baldwin announced, "Here we go"

  Castleman leaned closer to David. "Did he do any transplants when you were in the Navy?"

  "Not really-except on animals. But, he was always experimenting. Then after I left, he started with pancreas trials while everybody else around the country was doing hearts and lungs and kidneys. I guess you'd say he's a pioneer in pancreatic replacements."

  David pushed down on his feet, leveraging his six-five frame for a better view of the surgery forty feet away. He saw the surgeon's eyes flit over the abdominal cavity, toward his assistants and back. They tugged on retractors and applied internal sutures while a nurse dabbed the surgeon's forehead.

  Two minutes into the operation, the Chief screamed, "No, not there, Doctor!" Blood spurted against the palm of his gloved hand. "What are you doing? Where are you cutting?"

  The anesthesiologist said calmly, "Pressure dropping-eighty over forty."

  The Chief said, "Christ, let me get in there!" He ran around to the left of the table and tried to muscle aside the operating surgeon.

  "Get back to your position, Doctor! You may be Chief, but I'm in charge of this case. Open the blood drip to full. Get four more units ready."

  David jumped up and pressed his hands and face against the glass partition. He saw blood well up in the patient's abdomen and heard the beep become thready. Then, there was a continuous hum, the kind that had torn through his stomach too many times before. Castleman bit his knuckle.

  "More sponges!" the Associate Chief shouted. "Ligate above. Ligate above!"

  "I can't see. Suction. Suction, damn it! How can I ligate if I can't see?"

  "Then feel. Son-of-a-bitch, feel!"

  "Can't get a pressure!" the anesthesiologist cried. "Forget the drip-pump the blood in. And push in a pressor."

  Five seconds later, David stared at a straight line on the heart monitor. "Oh, my God!" he said and felt his own blood drain from his face as he regarded Castleman. "And I arranged for Bugles' surgery myself. Cortez. He's supposed to be the best in the world at this thing." He spoke as if wounded by his own words.

  David looked back down. Personnel poured in from adjoining rooms. Faces contorted. The suite swelled into chaos. Babble vibrated from the overhead speaker.

  "Get more suction going-hurry up!"

  "Pressors-pressors-and more blood!"

  "Move over, move over!"

  "Hundred percent oxygen!"

  "Trendelenberg-get him in Trendelenberg position!"

  "He's in it, damn it!"

  "Run the blood in-run it in, c'mon!"

  One doctor injected medication into the patient's heart. Others packed sponges tightly around tubes straining to suction from the operative site.

  David wondered aloud: "Did he cut through the aorta?" He answered his own question. "But, there'd be blood on the ceiling. No, maybe a renal artery. Or more." The heart tracing remained flat.

  David searched the room for the lead surgeon. He had vanished.

  "I'm going down through the lockers. Bill, you go straight down. See if we can head off Cortez."

  David scrambled from the row of wide-eyed, muted onlookers and had to duck as he bolted out a back door, down a flight of steps and into the afternoon quiet of the surgeons' dressing area, on his way to the operating suites on the second floor. He stumbled among the rows of lockers, pushing the pace beyond the usual for this behemoth who now felt more cut out for sleuthing than medicine, instantly obliged to trace a murderer instead of a runaway teenager. Deep in the green interstices, David stopped abruptly when he came upon a small man draped over the bench before an open locker. He was in street clothes and motionless.

  David turned the body over and recoiled at the sight of a pearl dagger handle protruding at an upward angle from the man's left chest.


  He felt for a carotid pulse; there was none. He pulled away the victim's limp arm which had fallen over his face.

  "What … the … hell. It's … Raphael Cortez! Then who …?" Suddenly, David wasn't sure he wanted to graduate to this level of criminal investigation.

  "Code 3 in OR, Code 3 in OR," the public address system blared. David felt his shirt clinging to his shoulders.

  He examined the man's hands. No defensive cuts. He saw no blood around the dagger, yet noted a small pool on the floor below the body and a few spatterings on the bench. David recalled no injury on Cortez's backside but above the belt buckle, he spotted a linear entry wound. He lifted the shirt and found no surrounding discoloration suggesting to him that the dagger's hilt had not been pushed against the skin. Stabbed just enough to paralyze before the final plunge, he thought.

  He leaned over to inspect the dagger. Third left interspace, precisely over the heart.

  "Who's this? Are you okay?" Castleman shouted from behind.

  David stiffened to full height. "Good Christ, man, how about some warning?"

  "Oh, sorry. Who is this?"

  A forehead taller than his colleague, David tapped downward on his chin. "Sorry myself. This here, I'm afraid, is Cortez. The guy upstairs was an imposter. Any sign of him?"

  "None. How could that happen?" Castleman squeezed each word to a higher pitch.

  David preferred his own question: "What about Bugles? Never came around, I assume."

  "Never. He exsanguinated. What the hell's going on, anyway? If Dr. Imposter wanted to kill Bugles, why go to that extreme? Why not a bullet in the parking lot? And then later, using a dagger? Or a stiletto, or what-ever-the-hell that is."

  "Same thing, although this is a big jobbie." Castleman bent forward and circled his head around the dagger.

  "And don't say, `then later," David said.

  "How's that?"

  "Then later implies after, and this was no after. This was before." He nodded toward the body. "He was the first to go."

  "It sounds like you're about to get involved in this one, my friend."

  "That I am," David said, distantly.

  "Well, now you can stop complaining about your fill of simple runaways and missing persons."

  David made a quick notation in a notepad. "Bill," he said, "why don't you notify Administration. And better include Security. I'm sure they know about the botched surgery, but tell them about Cortez. I'm calling Kathy."

  Castleman walked to a wall phone as David rushed down to a small corner office. He sat at a desk and scribbled a few more notes in the pad before placing a call to Kathy Dupre, his past high school sweetheart, present contact at the Hollings Police Department and future Mrs. Brooks. He heard the phone ring only once.

  "Homicide. Detective Dupre here."

  "It's me. You won't believe this. You're sitting down, right?"

  "David, between some of your weird neighborhood visits and some of my weird homicide business, I've heard it all. Remember the book we're going to write Housecalls and Homicides? Yeah, sure. Maybe every so often we should devote a night to writing instead of … but that's a different story. What's up?"

  "Just a couple murders."

  David could hear Kathy thinking. Finally, she asked, "Where are you?"

  "Here, in the hospital."

  "Murders-in the hospital?"

  "You got it. One's a stabbing. The other-poor guy got his belly hacked up. Bled out."

  "His belly?"

  "Right in front of us. In the pit."

  "David, what are you talking about?"

  "The board chairman, Charlie Bugles, was having pancreatic surgery. Remember the Dr. Cortez I told you about-the guy I met in the Navy? Well, he's right around the corner from me. Dead. Fancy dagger stiff in his heart. The surgeon was an imposter. He did his dirty deed, under lights and all-in the amphitheater-then took off. We all saw it. You or somebody better get over here."

  David hung up the phone, hoping Kathy would be assigned to the case, not that he had ever been disregarded by others in the Department. In fact, he enjoyed a unique relationship with them. They called on him when time was at a premium and stressed the advantages of his amateur status, like conducting searches without warrants, or entrapping without legal worries. In return, they documented his cases for future licensure. It had all started during his Navy days. Naval Investigative Service. What better choice for undercover operations than a medical officer, he had been told. After discharge, he pursued medicine and part-time sleuthing, and no one doubted his commitment to both.

  At Cortez's locker, he found Castleman staring at the body.

  "Security's on their way."

  "So are the police," David said. "I'd better do my preliminary snooping."

  "It sounds like an official ritual."

  "Not official at all." He cocked his head. "Come to think of it, if I ever get licensed, there go my snoops."

  "Look, David, I'm probably in the way here so I'll head back to the ER. Hope I can concentrate. Call me if you need me. Good luck … and, jeez, what a hospital."

  "Thanks Bill, and don't be surprised if some administrative types show up there in shock."

  Once alone, David winced when he crouched down on his bad knee to examine the dagger site at close range. He shifted knees. Tendonitis had been kicking up, the price of vigor against younger competitors in percussive karate. Why keep going back to Bruno's? He visualized the matted studio. It even hurts to climb the damn stairs there.

  Teacher lines broadened at his temples as he studied the weapon's entry angle and its handle. Why was it pearly? Too pretty for commandos. It had to be ceremonial, then. He lined up its length against the width of his four-inch palm. It was exactly the same. He mouthed a calculation. Handles are usually forty per cent, meaning the blade in there is six inches. This here's a ten-inch dagger. Some big sucker!

  David put the back of his hand to the side of Cortez's face. It was warm. The body appeared waxy-blue and its lips and nailbeds were pale. He pressed on the skin and it blanched. He verified Cortez had been killed within the hour.

  Stabilizing his flexed knee with his forearm, he lifted himself up and stepped back, inspecting the pool of blood beneath the bench. A tiny interruption in the pool's border registered in a double take, and he cast his gaze over the floor toward the exit at the end of the aisle. He side-stepped to his right, peering down at a string of large, irregular blood stains: one … two … maybe three.

  David walked out the door and into a stairwell. He inspected each step as he descended and found no other traces of blood until he saw two spots on a landing and a single, lighter one halfway down the remaining flight.

  On the first floor landing, the left door opened into a passageway leading to the pathology labs while off to the right was an exit to an exterior alleyway. The route from the lab up to Surgery was the one routinely taken by pathologists for frozen section examinations during surgical procedures. How many times had he traveled that way?

  David peeked into the lab and, scanning its central corridor, detected no blood trail from that vantage point. He paused, then decided to call on his old mentor, Dr. Ted Tanarlde, the hospital's Chief Pathologist. Head down, he strolled past the Emergency Medical System's unused dispatch window and, finding no further stains to that point, hurried past the Autopsy Room and into the sprawl of interconnecting laboratories: Cytology, Hematology, Bacteriology, Chemistry. He fixed a smile on his face and sensed his technician friends had questions on theirs.

  Rounding the far turn, he arrived at Tanarkle's secretary's desk which was tucked in a corner and surrounded by cases of yellow pathology journals under glass. She had just put down the phone.

  "Dr. Brooks. I haven't seen you for weeks," Marsha Gittings said, patting both sides of her hair, straw-colored and mounded like a haystack. Fiftyish, lofty and buxom, David believed she sacrificed breathing freedom for glandular elevation.

  "Hello, Marsha. Ted in?" David picked up a min
iature skeleton from atop a case and blew away its dust.

  "No, he's gone for the day but he'll be back in the morning. Can I help you with anything, or shall I have him call you?"

  "No, that's okay. I'll drop by tomorrow."

  He replaced the skeleton and was about to leave. "David, wait," Marsha said. "What's going on?" "With?"

  "The murders." She kneaded the back of her neck. "It's scary."

  "You know about them already?"

  "Are you kidding? The whole hospital knows." "I don't know what's going on yet, Marsh." "Are you handling any of it?"

  "Yes."

  "Good. Ted will be happy about that."

  David retraced his steps to the landing and felt bothered by the secretary. Murders in a hospital! And I'm bothered because she seems matter-of-fact? But how about me? Or, is even an investigator supposed to wear alarm on his sleeve?

  Careful to use his elbow and not a hand, he pushed on the emergency bar of the other door there and received the full blast of a January squall whipped into the alley along with its snow, like in a wind tunnel. He welcomed the refreshing taste of some flakes and, brushing away the rest, released the door which snapped shut.

  He leaned against the wall and ran his finger over his bottom lip. Did the murderer take his gown and scrub suit and gloves with him, or what? Did he exit deliberately past Cortez? He must have. But why? It's not the quickest way out.

  David headed back through the lockers, pausing to inspect the floor between Cortez's body and Suite 7. He saw no blood and stopped short of entering the suite door, fearing distraction by the few people he heard conversing inside.

  His finger returned to his lips. The son-of-a-bitch must have paused to look at Cortez-the pool is under the bench. So … the blood must have gotten on his toe, on his shoe's surgical slip-ons. But why stop to look at a guy you already killed, especially when you're in a hurry? And the blood can't be from Bugles because there's no trail from there to here. Could the murderer have killed Bugles before he gave the chiv to Cortez? That doesn't figure. He was taking Cortez's place, remember? You couldn't have him and Cortez scrubbing at the same time.