Family Practice Read online

  Second attack actually. First one when the bullet ripped into it. A treacherous thought sneaked into his mind. Could she make it?

  “Pupils,” he asked the anesthesiologist.

  “None. Fixed and dilated.”

  Was he going to lose her? He’d lost a patient once. Torn open a chest and felt the heart die, right in his hands.

  This sure looked like measuring up to another one. CPR didn’t stack up to normal heartbeat. Hell, she could be brain dead already.

  What odds for survival? This ain’t no super-sterile OR. What we have here is an emergency room, full of bacteria, viruses, old blood, old sepsis, just a few feet away from a door to the big, dirty world.

  The heart beat strongly in his hand. He ordered the nurse to give the kid a whopping slug of antibiotics. As long as there’s any hope, sweetheart, I’m hanging in there. You’ve got all I can give you.

  Easy enough to say, but the hardest part was still ahead. A beating heart moved all the time. Made suturing a bitch. As soon as he removed a finger to plant a stitch, blood spurted, obscuring anatomical signboards. Heart muscle was delicate; a misplaced suture that tore loose would not bear thinking about.

  He asked for pledgets, tiny plugs of felt. Once in place, they soaked up blood, which then formed a clot and closed off bleeding.

  Cautiously, he removed a finger, slapped a pledget over the hole, and held it in place while he carefully attached it with running sutures.

  The back of the heart was sturdier, but the exit wound was larger, and he was forced to lift the heart and turn it in order to see the hole. If he lifted too high or turned too far, he’d risk pinching a vital blood vessel. That sure as hell wouldn’t do the kid any good.

  Back aching, he bent over the open chest, carefully dropped a pledget in place, and, working as fast as he dared, managed the sutures.

  Finally, he straightened, flexed his shoulder muscles, and glanced at the wall clock. Twenty minutes from the first cut. A lifetime.

  He looked down at the heart beating strong and steady. The sutures strained, but by God they held. He grinned at the nurse. She grinned back.

  “We can take care of the rest in OR.” He peeled off his gloves and dropped them.

  * * *

  Susan paced outside the emergency-room doors and looked at her watch again. Thirty seconds later than the last time she’d looked. They were still working in there. That must mean something. Oh, God. Jen. Please be alive. Please, God, let her be alive.

  In her mind, she saw Jen’s inert form being tossed on the gurney and sped to the waiting ambulance. At least they’d moved fast. Jen was alive then.

  In California, if a minor child was injured and a parent or guardian wasn’t available, the child was automatically made a ward of the state. It was similar in Kansas. Susan had notified Social Rehabilitation Services, and papers had been drawn up.

  Lieutenant Ben Parkhurst and Detective Osey Pickett had arrived in the wake of the paramedics. Susan had left them to get on with it and taken herself to the hospital. Since she’d driven to the doctor’s office in her little brown Fiat instead of the pickup, she had no police radio, no way to keep in touch. This enhanced her sense of numbness, left her less able to pull in thoughts through her anxiety over Jen.

  A muscular man with a pugnacious jaw, in green surgical garb, came out the emergency room door, covered with blood from the waist down. His shoes squished when he walked.

  “Dr. Sheffield.” She trotted over to him. “How is she?”

  He stopped, turned, and looked at her. “You a relative?”

  “Chief Wren. I’ve not yet been able to reach her mother. What can you tell me?”

  “We’ve patched up the holes in the heart. She’s alive, that’s about all I can say. We’re not done yet, by any means. The bullet tore into her left lung. We’re bringing her upstairs to take care of that now.”

  “What are her chances?”

  The doctor gave a wry smile. “Don’t bet on them. If she makes it—and that’s a big if—no telling what kind of life she might have. The insult to the body was great. Could be more than any eleven-year-old can survive. Maybe I can tell you more after we get the bullet out of her lung.”

  “I’ll need the bullet.”

  He nodded and took off at a fast trot, leaving a trail of bloody footprints.

  The emergency-room doors popped open, and the assistant and nurse trundled the gurney toward the elevator, IV bag swaying on a stand. Jen was covered with a sheet; tubes and wires curled away from every part of her.

  Susan followed onto the elevator, eyes on Jen’s waxy face. The elevator rose. Susan’s knees felt rubbery; she hoped she wouldn’t faint.

  The doors hissed open. The gurney was shoved out. Susan plodded along behind to the operating room and watched Jen disappear inside. Dr. Sheffield, in clean scrub greens, hurried in.

  What was it like to hold somebody’s life in your hands? She leaned against the wall, closed her eyes, and took a few deep breaths. Time seemed to stop. She waited, resting her weight on one foot, then the other. The waiting went on.

  She might scream if she had to wait much longer.

  Finally, the operating room doors opened. A nurse came out with an emesis basin. She handed it to Susan.

  The bullet lay on a gauze pad. Behind the misery that hung over her like nerve gas, her mind noted it was bent at the tip, slightly flattened on one side. Only a little misshapen, easy to recognize the five lands and five grooves and right-hand twist. A .38 Smith and Wesson.

  Routine came through; automatic action made her bag it and label it, have the nurse sign the tag. Downstairs in the emergency room, she gathered Jen’s cut-up white shorts and the shirt with fighting knights—a surprisingly small amount of blood—from the emergency room nurse. She made her way past the lobby and around to the public phone, checked in with Hazel, the dispatcher at the department. Still no word from Jen’s mother. By the time Terry Bryant was reached, would the news be of Jen’s death?

  She told Hazel to send Officer White hotfooting it to the hospital. He was to stick like glue outside Jen’s door when she got out of surgery. She replaced the receiver, slumped against the wall, and stared hard at the floor. People walking by looked at her, and she straightened her shoulders. Better get it together. She couldn’t see Jen again until Jen was out of surgery; an hour, minimum. She couldn’t simply hang out here with worry chewing up her mind, getting in everyone’s way, and not being of any help to Jen. Much as she did not want to leave the hospital, she had a case to work. It wasn’t routine, it had the deep-reaching effects of personal tragedy, but it was imperative she get on it.

  4

  AFTER OFFICER WHITE arrived to guard-dog Jen, Susan dropped off the bullet at the lab, then stopped in at the police department and spread out Jen’s clothes in the interview room—because there was no other place—to dry before they could be bagged and given to the lab. The white shorts, scissored down the front, looked pathetically small; one of the armor-bearing knights on the shirt had a bullet hole in his shield.

  She saw Jen sprawled on the floor, clamped her teeth, and swallowed. She informed Hazel she was headed back to the medical offices and if Jen’s mother called, let her know immediately.

  Across the street from the office building, a crowd had clustered; they stood, some with umbrellas, and watched and watched, sober and quiet. The rain had stopped, but somber gray clouds hung overhead. Trees dripped. Several police cars, Parkhurst’s Bronco, and the ambulance were angled near the entrance. She was irritated, but not surprised, to see the van from the local radio station nearby. The reporter was talking with the onlookers.

  Officer Yancy, posted at the door, was keeping people back. She parked, then noticed in the side mirror that she’d been spotted and the reporter was bearing down on her. With firm determination in her step, she set off for the entrance. Yancy gave her a nod and smartly blocked the reporter.

  “Chief Wren,” the reporter called. A stocky kid
in khaki pants and short-sleeved brown shirt, he looked more like a clean-cheeked high school wrestler than a real-life radio news reporter. “Can you tell us what’s going on?”

  Yancy said, “You’ll have to stay back, Gary; this is a crime scene.”

  “Give me a break.”

  Susan ducked inside before she heard Yancy’s response. The same paramedics who had sped off with Jen were now trundling the covered body of Dorothy Barrington along the corridor. She stepped aside to let them pass. Dr. Fisher, obviously, had already come and gone.

  Kick in, she told her mind. Don’t think about Jen. Concentrate.

  Just outside the murdered woman’s office, Detective Osey Pickett, wearing latex gloves, squatted to collect a sample from the blood soaked into the oatmeal carpet. At her approach, he leaped to his feet in uncoordinated spasms and tossed a hank of straw-colored hair from his guileless blue eyes. “Ma’am.” He jerked to attention. Built along the lines of a scarecrow, he was young, with a prominent Adam’s apple and enormous hands and feet that he never seemed to quite get the knack of managing. In blue jeans and white shirt with the sleeves rolled up, he looked like a hick and acted like one, but underneath the drawling speech and country-boy smile he had a quick mind.

  “How’s it going?”

  “Haven’t found anything like a murder weapon. Why do you reckon anybody’d want this pale carpet in a doctor’s office?”

  “Maybe she saw only clean patients.”

  The desktop, with a leather-edged blotter, held a stack of medical books, blank prescriptions used as bookmarks, AMA journals, various slips of paper with jotted notes, and a folded newspaper in the corner. In the center above the blotter was a marble pen holder with two pens. A gooseneck lamp with a fluorescent bulb added to the grayish daylight coming from the window and shined down into the dregs of a pale, clear liquid that looked like tea. Next to the phone, a small glass vase held one lavender tulip.

  With her hands clasped behind her back so she wouldn’t touch anything, Susan leaned over the desk. What she could see of the blotter had ink squiggles and scratches, nothing legible beyond the odd letter here and there. The slips of paper said things like CAT scan, Lowe’s, gasometry, lipid screen, and glycohemoglobin, protoporphyrin—erythrocytes, plasmas, feces. Notes the doctor had scribbled to herself. None of it meant anything to her, but she would examine them more closely when Osey had finished in here.

  At a right angle to the desk sat a credenza with four neatly cantilevered file folders; next to the files was a typed list of the times and names for today’s appointments.

  Beneath the appointment list was another sheet of paper. With the end of her pen, she eased the top page aside. The paper below had four names printed on it in black ink: Willis, Marlitta, Carl, Ellen. Beside each name was a check; apparently the doctor had gone down the names and ticked them off one at a time. Across the bottom was written “eight p.m.”

  “The receptionist still here?” she asked Osey.

  “Yeah. Ben thought you might want to talk to her. Next office down.”

  Officer Demarco, arms crossed, had taken a stance by the closed door. She tapped on it, then opened it and went in.

  Debra Cole, eyes and nose red from crying, streaks of mascara on her pale cheeks, huddled in an armchair beside a desk with haphazard piles of books and folders; message slips lay scattered around amid a clutter of pens and pencils.

  “Miss Cole, I’d like to ask you a few questions, if you feel up to it.” Susan pulled out the desk chair and sat facing her, leaning slightly forward.

  “I’ve already told you,” Debra said without looking up. “The other one. The lieutenant.” Her hands clutched a soggy tissue.

  “I know you have,” Susan said quietly. “But it would help me if you could go over it again.”

  “It’s Mrs., actually. Not that it matters. It’s Ed’s name. Cole, you know.”

  “Ed is your husband?”

  Debra raised her eyes. She reminded Susan of a deer: soft brown eyes, frightened and defenseless. “Most people take their husband’s names,” she said as though Susan had questioned her integrity. “Except Dr. Dorothy. Well, Marlitta too. She’s married to Dr. Wakeley. Like Barrington was better.”

  Debra was obviously in shock, mind skittering around from one extraneous thought to another. Susan had seen this often. Individuals caught up in homicide tended to skate around on the edges of nonessentials. What lay in the center was too horrid to approach.

  “Do you always work on Saturdays?”

  “Oh, God, it’s all my fault.” Tears filled her eyes. She doubled over and buried her face in her hands; her shoulders shook.

  “Your fault?”

  “Twice a month,” she said dully.

  “Excuse me?”

  “On Saturday. Two Saturdays a month.” She looked at Susan directly, her manner changed, so slightly as to be almost imperceptible, just enough that Susan caught it.

  “Dr. Barrington was the only physician working today. Was that usual?”

  “They’re all Barringtons.” Debra looked away, then down at her lap, and twisted her hands together. “They took turns. They didn’t really want to. Work on Saturday, the rest of them, but Dr. Dorothy said so. They all did what she told them. If I worked Saturday, I got another day off. During the week?” Debra made it a question to see if Susan was following.

  “Same with Faith. She’s the other receptionist. Usually we both worked. They’re really busy, you know? It takes two of us. Just the two days. Saturday and one other during the week. Not always the same day.”

  “I understand,” Susan said. “Why did you say it was your fault?”

  “I should have been here.” The response came a touch too quickly.

  “When?”

  “At noon.”

  “Where did you go?”

  “Home. For lunch.”

  “Where is home?”

  Debra gave her an address in the Riverside trailer park.

  “Was the office usually closed during the lunch hour?”

  Debra nodded.

  “Was Dorothy here when you left?”

  “She had already gone.”

  “Did you lock the doors?”

  “Of course—” Debra paused. “I mean, I must have. I don’t remember exactly doing it, but I always do. I always lock the doors.”

  “Was the door locked when you came back? Did you have to use a key to get in?”

  Debra nodded, but not with any decisiveness.

  “Tell me what happened today.”

  A faint tint of color had come back to her face, but it faded suddenly. Susan wondered if Debra was cut out for this line of work. In a physician’s office, emergencies must arise every now and then. A serious career evaluation might be in order here. “What time did you come in this morning?”

  “Nine o’clock. I’m always careful about that, so I’m sure to be here five minutes before. Unless there’s a blizzard or something. Dr. Dorothy gets—upset if anybody’s late.”

  “Did anything happen this morning that was different from any other Saturday?”

  “Well, there was Dr. Sheffield.” Debra stared at her hands clasped in her lap.

  “Adam Sheffield?” The doctor who was slicing up Jen? “What about him?”

  “He came to see her.”

  “That was unusual?”

  “He didn’t have an appointment or anything. He just came.”

  “And Dorothy saw him?”

  “I don’t think she was real pleased. Her mouth got all tight, like it does.”

  “How long did he stay?”

  “Maybe ten minutes or like that. She had a patient, and she doesn’t like to keep them waiting.”

  “Why did he come to see her?”

  “I don’t know.”

  “Is there anything else you can tell me?”

  “She was late.” Debra’s eyes widened with the enormity of it. “Coming back from lunch. She’s never late. I was starting to get
worried. And then, when she got here, she was mad about something.”

  “About what?”

  “I don’t know. She just was. Her face was all pinched, and she had a newspaper she kept tapping against her palm. She was snippy. And then she said she had to make some phone calls before she could see the patient. She kept a patient waiting. I wanted to tell her about the unscheduled patient she didn’t know about. That would have been Jenifer Bryant.” Tears spilled again. “How is Jenifer? Is she going to be all right?”

  “That’s not certain. Who did Dorothy call?”

  Debra rubbed at her face with the shredded tissue. Susan reached for a box on the desk and placed it on the arm of the chair.

  Debra ripped out a fresh one. “I don’t know who she called. Except Dr. Willis. I heard her talking to him when I brought in Jenifer’s chart.”

  “What did she say?”

  “Something about being at the house this evening. I really was only there a minute. Just to bring in the chart and put it on her desk, you know.”

  “Willis is her brother.” Susan turned a page in her notebook. “Marlitta and Carl are also siblings?”

  “They’re all doctors.”

  “And Ellen? A sibling and a physician?”

  “Just a sister. I mean, she’s not a doctor.”

  “Where did Dorothy have lunch?”

  Debra sniffled into the tissue. A bright ray of sunshine suddenly teased hints of gold from her brown hair, then disappeared as a cloud passed over. “I don’t know.”

  “Where did she usually eat lunch?”

  “Sometimes here. I mean, she’d just eat it at her desk. Something she brought or went out to buy and bring back. Some days she liked to go to the park.” Debra blew her nose. “Who would kill Dr. Dorothy?”

  “You have no idea?”

  “People don’t kill doctors. Doctors make them well.”

  “Dissatisfied patients?”

  “The patients are all going to be really upset.” Debra gulped and held the tissue against her mouth. “I can’t seem to think. I don’t know anything.”