Her Protector in ER
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Melanie Milburne
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CHAPTER ONE
‘LISTEN, Dr Truscott.’ Barry Conning slapped the folder he was carrying onto the desk. ‘This is the fifth unexpected death we’ve had in as many months. What the hell is going on?’
Keiva Truscott met the older man’s frowning expression with a cool, composed stare. ‘What exactly are you implying, Barry? That we’re not running Accident and Emergency competently?’
Barry ran a hand through his thinning hair. ‘Look, I know how hard you all work, you especially, but even you have to admit this is highly unusual. Karracullen is a country town. People come to this hospital for medical help, they don’t expect to walk through those doors and a few days later be wheeled out in the back of a mortician’s van. Our job is to save their lives, not send them on their way with wreaths around their necks.’
Keiva drew in a calming breath as she faced the medical superintendent. ‘As far as I’ve been able to tell, all the patients you’re referring to had myocardial infarctions and subsequently died. I’m sure you’ve reviewed the notes yourself, it’s all documented there. I’ve personally reviewed these cases ten times each. People do still die of heart attacks you know.’
‘I know that, but not one of these patients came in with heart problems.’
Keiva clicked the end of her pen once or twice, the breath she’d been holding whooshing out in resignation. ‘Look, I’ll go back through the notes again, see if there’s anything I’ve missed, but I don’t think it will achieve anything. I’m confident we did everything we could in each and every case. The human body is not like a machine where you can predict precise outcomes. It has a habit of doing its own thing at times, including having unexpected heart attacks. Disease can trigger all sorts of responses, heart attacks being one of them.’
‘I hope you can quash any doubts in all these cases,’ Barry said, loosening his tie as if he was suddenly finding it uncomfortable, ‘because there’s a detective arriving in a few minutes to interview you.’
Keiva straightened in her seat. ‘A detective? What do you mean, a detective? Since when did this suddenly become a criminal investigation? We’ve presented all these cases at hospital Grand Rounds. It’s a bad run, yes, but there’s been no incompetent treatment. They’ve all been subjected to peer review, Barry!’
‘Calm down, Keiva, will you? This hasn’t come from within the hospital. You know this is a small town. There have been rumours, lots of them, and now complaints.’ He took out his handkerchief and wiped his forehead. ‘The Medical Registration Board has had five complaints in five months. They’ve approached Police Forensics for advice, and Forensics see a pattern, hence the detective making enquiries. He’s interviewing everyone who’s been working in A and E for the last year. You’re first on his list.’
The pen she’d been holding rolled off the desk to the floor, but she didn’t bother retrieving it.
‘This is unbelievable! Why me first?’
Barry gave a shrug of one shoulder. ‘You’re the one who attended each patient.’
‘I’m a doctor, for God’s sake!’ She sprang to her feet in agitation. ‘It’s my job to attend to patients. I run the A and E department.’
‘You ordered the drugs and procedures,’ Barry pointed out. ‘He’ll want to know what quantities and so on, go through your notes with you, that sort of thing.’
Keiva knew exactly what ‘that sort of thing’ meant. She had little time for the police after what had happened to her father. Their heavy-handed and guilty-until-proven-innocent approach had done more damage than she wanted to think about. It had been ten years and still the sound of a siren made her blood boil.
‘Well, I don’t finish until nine this evening,’ she said. ‘He’ll have to wait, unless you want me to close A and E.’
‘No, of course not, but let’s hope he’s a patient man,’ Barry answered, and shouldered open the door to leave.
Keiva sat down as soon as the door swung shut behind him, her eyes coming to rest on the folder in front of her.
Five people had died soon after they had been in her care. No doctor liked those sort of statistics on their record but she’d done all she could. She was confident she’d followed the appropriate procedure in each case. She could even recall faces and figures. Patients had never been nameless numbers to her; she could recall each and every one as if she’d treated them yesterday.
Pat Grafton had come in with renal colic, not heart symptoms, although he had been overweight and slightly breathless. She’d administered pethidine and within minutes of an IVP he’d passed the offending kidney stone. She’d kept him overnight because as a hard-working farmer she’d known he would be out at dawn instead of resting as she’d advised. She’d been home and asleep when she’d got the call that he’d had a fatal heart attack in the early hours of the morning.
Then there had been Moira Blakely, who’d had a history of drug dependence after a back operation that hadn’t delivered the results she’d been expecting. She, too, had been carrying too much weight, and although her blood pressure had been borderline there had been nothing to suggest she would be dead within hours of being admitted.
The list went on, but as far as Keiva could see she had made the correct diagnoses and done everything according to clinical guidelines.
She sat back in her chair and sighed. She had five hours ahead of her and all she wanted was her bed. A young child had drowned the day before, dead on arrival. The distraught parents’ screams had still been ringing in her head as she’d signed the death certificate.
Sometimes she really hated her job.
Detective Liam Darcy drove into Karracullen in the late evening, the heat and flies so far having escaped him within the confines of his air-conditioned car.
He hadn’t really wanted this assignment, but ever since he’d broken up with Linda he’d felt like he needed a change of scene. Karracullen hadn’t exactly been on his list of must-visit-before-I-turn-thirty-five places, but it was far enough afield to take away the risk of running into his ex-girlfriend with her nine-to-five accountant on her arm.
The hospital was as unpretentious as country hospitals went, he thought. Although the population of the Karracullen district tipped over forty thousand, the public health system was strapped for cash and it certainly showed out here where the bureaucrats didn’t visit.
He parked the car in the doctors’ car park next to a car that had obviously seen better days and better mechanical services than it was now apparently receiving. He could see a pool of oil running a dark trail towards the uneven kerb and grimaced. Bush mechanics had a lot to answer for.
The reception desk and switchboard was manned by a grim-faced woman of indeterminate age who almost barked at him when he approached the desk.
‘Yes?’
He reached into his breast pocket and took out his ID badge. ‘Detective Darcy. I’m on official business.’
‘Who do you want to see?’ She peered at him from over the top of her thick-rimmed glasses.
He inspected his notebook and came to the first name on the list. ‘Dr Keiva Truscott. Accident and Emergency.’
‘You’ve come in the wrong door.’ She pursed her lips and pointed back the way he’d come. ‘Down there and turn left. You can’t miss it.’
He pocketed his badge and walked back the way he’d come, hoping the first interviewee didn’t have a chip on her shoulder a country mile wide. Sheesh! What was with women these days?
He pressed the emergency bell and waited for someone to appear at the window. After about thirty seconds a woman in her late thirties appeared with a welcoming smile on her face.
‘Can I help you, sir?’
He held out his badge. ‘Detective Darcy. I’m here to interview some staff members.’
‘Who in particular would you like to speak to?’
He didn’t need to check his notes, he could remember the name. ‘Dr Keiva Truscott.’
‘Will you excuse me just one minute?’ she asked. ‘I’ll just check if she’s free.’
He thrust his hands in his pockets and inspected the anti-smoking sign for a moment or two, pleased he’d given up the habit years ago.
‘She’s with a patient.’ The woman’s face appeared at the window once more. ‘Could you come back tomorrow?’
He took his hands out of his pockets and straightened to his full height. ‘I’ll wait.’
The woman gave him a wavering smile and disappeared from the window once more. A few moments later she was back with instructions for him to wait in the doctors’ room down the hall.
‘There’s tea and coffee and sandwiches. Help yourself. Dr Truscott won’t be too long.’
‘Thank you.’ Liam nodded and made his way down the corridor, the fragrance of brewed coffee pulling him like a magnet.
He pushed open the door marked DOCTORS ONLY and looked around. There were several comfortable chairs positioned around a square table, a small kitchenette to one side, where a pot of coffee was standing, a jar of sweet biscuits and a platter of sandwiches covered with plastic cling film. A collection of newspapers and magazines was scattered about as if someone had been called away in a hurry, leaving them open and shuffled, the slight breeze from the partially open window sending the sports supplement to the floor.
He poured himself a coffee and, scooping up the paper off the floor, spread it before him and examined the cricket score.
Keiva glanced at the clock as she wrote up the notes of her last patient for the evening.
‘Where did you tell him to wait?’ she asked Anne McFie, the ward clerk in A and E.
‘The doctors’ room.’
Keiva closed her notes and handed them to Anne. ‘He’s been waiting a while.’ She lifted her hair off the back of her neck and groaned, ‘Hell, I wish I didn’t have to deal with this right now. I’m going to get the third degree when all I want is Channel Three and a Chinese take-away.’
‘Best to get it over with,’ Anne said. ‘You’ve got nothing to hide. You’re the best A and E doctor we’ve had here in years. Heaven knows how many others would have died without your skill.’
Keiva removed her stethoscope from around her neck and placed it on the desk. ‘I don’t know…Somehow the police have this habit of making everyone out to be a criminal. Even if you’re not guilty, you feel it by the way they look at you.’
‘I’m not sure that the detective will be looking at you quite that way.’ Anne grinned. ‘Did I tell you he’s gorgeous?’
Keiva rolled her eyes as she shrugged herself out of her white coat. ‘He’s a cop. In my book that means he’s looking for a scapegoat to make himself look good. Another case solved, another promotion.’
‘He’s just doing his job,’ Anne said. ‘Just like you.’
Keiva set her shoulders and turned for the door, schooling her features into clinical calm even though inside she felt like a naughty schoolgirl summoned to the principal’s office.
She didn’t bother knocking. She pushed the door open and scanned the room with a sweeping look, her caramel gaze coming to rest on the most handsome man she had ever seen.
It took all of her clinical training to disguise her start of surprise as the detective met her eyes and rose to his feet.
‘Dr Truscott, I presume?’ Liam held out a large hand, and with just the slightest hesitation she placed hers within it. His fingers were long and tanned and dry, not clammy and sticky but dry.
She swallowed as his grey-blue gaze meshed with hers. ‘I’m Detective Liam Darcy from Forensics in Sydney.’
‘I…’ She cleared her throat. ‘Pleased to meet you.’
‘I’m sorry to bother you while you’re at work, but there are a few questions I’d like to ask. I’m assuming Barry Conning has told you why I’m here?’
‘Yes.’ She reached for a chair and sat down, forcing herself to look relaxed and at ease. She noticed he waited until she was seated before taking the chair opposite.
‘What can I do for you Detective…er…Darcy?’
He held her gaze for a fraction longer than she would have liked, his cool, assessing stare making her want to fidget in her chair.
‘As you are now aware, the Medical Registration Board has received some complaints about some unexpected deaths in this hospital. Police Forensics has been asked to do an assessment. It’s an unusual pattern of deaths. As you were the doctor who treated each of them on admission, I’m afraid we have to ask you some questions.’
‘Fire away.’ She injected confidence in her tone, although his manner did nothing to inspire it. She read arrogance in every line of his handsome face, the straight dark brows drawn slightly together as if in consideration of her viability as a witness, the lean, cleanly shaven chiselled jaw set, the line of his firm mouth hinting at a determined if not somewhat forceful personality. His dark hair was short but styled with some sort of hair product, which suggested he was a man who liked control of all things at all times. Even seated, his considerable height was obvious—she guessed at least a couple of inches over six feet, maybe even more.
‘I take it you write clinical notes on every admission?’ He interrupted her silent appraisal.
‘Of course. That’s standard clinical practice.’
‘On your review of those notes, have you had cause to question your initial diagnosis on any of the cases?’ he asked, his grey-blue gaze very direct.
‘I’ve reviewed my notes several times in these cases and am confident my diagnoses were correct, and that I followed the appropriate procedure for each patient.’
Detective Darcy leaned back in his chair, one arm draped over the backrest as he surveyed her features. The casual pose revealed the holster beneath his suit jacket. She could see the menacing bulge of his gun and wondered why he’d thought it necessary to interview her armed to the hilt.
She shifted her gaze and encountered his cool, studied look. Doing her best not to appear intimidated, she sat back in her seat and waited for his next question.
It seemed an age before he spoke.
‘Dr Truscott, did you know any of the patients in question personally?’
‘This is a relatively small town, Detective. I had met two of them before.’
‘What? Socially?’
‘Yes.’
‘So you recognised them as soon as they arrived in A and E?’
‘Yes, of course I did. That’s not uncommon here.’
‘How well did you know them?’ he asked. ‘Could you recall their names or did you have to check the notes?’
‘I knew their names.’
‘Which patients were they?’
Keiva could feel her tension increasing at the rapid fire of pointed questions but refused to give him the satisfaction of seeing her composure cracking around the edges.
‘Patrick Grafton was a cattleman from a property I’d visited once or twice with friends. He was well known about the place, having been in many times when his wife was ill. Moira Blakeley used to work in the supermarket. There are few people in Karracullen who didn’t come into contact with her some time or other.’
‘And the other three patients?’ He opened his notebook and inspected the names printed there. ‘James Fisher, Keith Henty and Robert Grundle. You weren’t familiar with them?’
She shook her head. ‘I had never seen any of them before they came in as patients.’
‘Can you recall their presenting problems?’
‘I…’ She felt at a slight disadvantage without her notes in front of her, and had to concentrate for a moment to recall the details. ‘James Fisher came in with severe abdominal pain. I diagnosed a ruptured appendix and he was scheduled for emergency surgery later that evening.’
The detective glanced at his notes before returning back to her with an unblinking stare. ‘He had the surgery at eight-thirty and was in Recovery at nine-twenty. Did you see him again?’
‘No…I was busy with a road accident victim, and anyway he was the surgeon’s responsibility by that stage, not mine.’
‘Were you surprised to hear he had a fatal heart attack during the early hours of the morning after his surgery?’
She compressed her lips for a moment. ‘It was unusual. He was in considerable pain when he was admitted. I wouldn’t have thought it was enough to trigger a heart problem, but…’
‘But?’
Keiva shifted in her seat. ‘It happens from time to time.’
‘In twenty-eight-year-old males?’ There was a hint of accusation in his question.
She met his level look with as much equanimity as she could muster. ‘No one is immune to heart disease, Detective Darcy. Bad diet, stress and lack of exercise are all contributing factors, even in younger people, according to some recent studies. And Mr Fisher did have peritonitis and he was overweight.’
‘And yet Mr Fisher showed no signs of heart disease on admission?’
‘We weren’t looking for it,’ she said. ‘He came in with acute abdominal pain so locating the cause of that was the first priority.’
He seemed to give her reply some consideration before moving on to his next question.
‘What about Keith Henty? What can you recall about him?’
‘Mr Henty was a fifty-five-year-old man with a deep laceration to his leg as a result of a brawl. His leg required stitching and we kept him overnight as his blood alcohol level would have been high.’
‘How high?’
She returned his direct look with one of her own. ‘He was drunk, Detective Darcy. Very drunk. As far as we knew, he wasn’t driving so we weren’t obliged to test his blood alcohol level.’
She thought she saw a flicker of amusement at the corner of his mouth but then wondered if she’d imagined it.
‘No heart symptoms?’ he asked.
‘Not that I recall.’ She let out a small breath. ‘He was a difficult patient to treat.’
‘In what way?’
‘He was aggressive, loud, demanding. I’m sure you’ve met the type—the usual loud drunk. His leg was in a bad way but he kept on wanting to leave before we could stem the haemorrhage.’
‘How did you manage to restrain him so he could be treated?’
‘Well, since public funding to country hospitals doesn’t quite stretch to supplying handcuffs to all emergency staff, I’m afraid we have to resort to other means.’
The flicker of amusement was back, this time reflected in his eyes as they rested on her. ‘Such as?’
‘We calmed him down by talking to him as well as administering a sedative. A quick jab and he was a new man.’
‘He was a dead man in a matter of hours,’ he commented wryly.
She ran her tongue over her lips and shifted her eyes from the force field of his. ‘Yes…’
‘What do you remember about Robert Grundle?’ he asked after a slight pause.
‘He came in after a tractor accident. The right side of his body had been crushed by the back wheel. He was semi-conscious on arrival and died post-operatively. We were all surprised he made it that far, to tell you the truth.’
‘According to the post-mortem, he died of a cardiac arrest, not injuries sustained from an accident,’ Detective Darcy said.
‘He lost eight litres of blood, Detective, most of it ending up on the floor of the operating theatre. There aren’t too many seventy-year-old hearts that can cope with that sort of blood loss,’ she pointed out. ‘He died of the after-effects of hypovolaemic shock.’
The detective closed his notebook and gave her a vestige of a smile as he got to his feet. ‘That will do for now, Dr Truscott. I think I’m starting to get the picture. Thank you for your time.’
Keiva rose from her chair on legs that were not as steady as she would have liked, and without bothering to offer her hand made her way towards the door.
‘By the way, Dr Truscott…’ His deep voice sounded from behind her.
Her hand froze on the doorknob and drawing in a prickly breath she slowly turned to face him.
He’d moved from around the other side of the table and was now leaning back against it, his legs crossed at the ankles, his hands resting on either side of him on the wooden surface.
‘Yes?’ She dragged her eyes away from the dark shadow of his gun.
His eyes ran over her in one sweeping, all-seeing glance before coming back to her face. ‘I’d appreciate it if you didn’t leave town without notifying me personally of your whereabouts.’
She stared at him, her mouth dropping open in shock. ‘You surely don’t think I’m in some way responsible for those deaths?’
He gave her an inscrutable look. ‘I make it a policy never to make assessments until all the evidence is before me. But I would appreciate it if you’d co-operate by staying in town until I’ve finished my enquiries.’
‘You’re barking up the wrong tree, Detective.’ She threw him a resentful look. ‘It’s my job to save lives, not destroy them.’
The grey-blue eyes hardened a fraction. ‘It’s my job to find out the truth, Dr Truscott, and I don’t intend to leave Karracullen until I do.’
