Sleight of Hand Read online

  Eades shook his head. "No one knew except the school. Mitch was very upset about needing speech therapy, refused to do it during the regular classroom session that the school offered. Said it made him feel like a dummy, so he told all his friends he was working on a special extra credit project." He frowned. "Why all these questions about Mitch? You spoke with the therapist, you know all this already."

  "We think the killer," Jimmy said, lowering his voice, although he knew there was no way to soften the blow, "might have known your son's schedule, might have purposely arranged things so that Mitchell would be the one to find your wife's body."

  Eades flinched at that. Jimmy could understand his discomfort at the idea. Bad enough that someone would want to kill your wife in a horrible fashion. But also to plan it so your only child would be tortured, haunted by the display was a grotesque thought.

  One that only a cop who'd seen too much of the evil people could do would think of. Jimmy calculated how long he'd have until his time toward a full pension was in. Eight years. Days like today, that seemed for-fucking-ever.

  <><><>

  "Dr. Hart, stat to Trauma One."

  Cassie rushed to the trauma room. Once there she found a pair of college-aged boys hovering over a gurney bearing a little old lady wearing only a thin flannel nightgown.

  "What's the story?" she asked, pulling on her gloves.

  "She's our landlady," one of the students answered. "We just found her like this, she'd left her back door open and we saw it when we were leaving for class this morning–"

  "Seventy-two year old found cold and unresponsive on her kitchen floor," Rachel translated. "Brought in by private vehicle, history of angina and hypertension, on nitro and Lasix. No other meds, no allergies." As she spoke, two other nurses cut the nightgown from the woman and began to get her vital signs. Cassie moved to assess her patient.

  "Bag her, she's not breathing. She's cold–someone grab a core temp." Cassie slid her fingers to the woman's carotid pulse and waited a full minute. The monitor showed a slow, irregular heartbeat, but she felt no pulse. "Start chest compressions. Warmed IV fluid, two lines, make sure the oxygen is heated too." She barked out the commands as she completed her examination.

  The patient had an obvious fractured left hip and from the imprint on her skin, had been lying on the tile floor overnight. She was now hypothermic to the point where her heart had slowed and no oxygen could reach her brain. If Cassie could restart her heart and warm her, she had a fair prognosis. Big if, especially given her age and underlying heart disease.

  Just one problem. Hypothermic victims were notoriously susceptible to fatal heart arrhythmias. Any action Cassie took might trigger a lethal heart rhythm.

  She followed the ALS algorithm and instilled warmed fluid into the abdominal cavity where it could diffuse its heat to her patient's organs. Despite her efforts, the patient's heart rhythm deteriorated into ventricular fibrillation, exactly what Cassie feared would happen.

  "Charge the paddles." She gave three shocks in rapid succession, hoping to restart the patient's heart. No result. "Another epi."

  Cassie looked over through the open door as a nurse rushed in with the lab results. Virginia Ulrich stood at the nurses' station talking with Rachel. Probably trying to find out if Cassie was the one who called Children and Youth.

  "Epi's in."

  "Again three-sixty," she said. "Clear!" She hit the button to send the electricity to the monitor pads.

  A strange man in a business suit came to the open doorway. "Dr. Hart. Cassandra Hart?" he called out as if he were a bellhop with a telegram. Beyond him Cassie could see that Richard had joined Virginia Ulrich and Rachel and that they all watched her with anticipation.

  "Out! We're in the middle of a resuscitation," she snapped.

  Instead of being intimidated or leaving, the man entered and approached her. "Are you Dr. Cassandra Hart?"

  "Yes, and this lady is trying her best to die, so whatever you want it can wait." She turned her back on him.

  Then she felt something slide into the back pocket of her scrubs. She whirled around, amazed at the man's rudeness only to see him give her a quick wave.

  "Consider yourself served, Dr. Hart." He walked out.

  Cassie looked past him to see both Richard and Virginia Ulrich smiling at her. Rachel's customary dour look had deepened. Then she realized that everyone in the trauma room was staring at her.

  "Focus, people," she directed her team. "Any pulse?"

  "No pulse."

  "Repeat the epi. Shock again at three-sixty. What's her temp?"

  "Rectal temp is ninety-six."

  Damn, that was almost normal, definitely warm enough that the patient should have responded to their treatment. She quickly re-assessed the patient. She didn't see anything that they had overlooked.

  Cassie sighed, one hand on the woman's neck, her fingers searching in vain for a pulse. "Anyone have any ideas?" she asked. Sometimes as leader of a code you became too focused and could miss something.

  "It's been almost forty minutes," one of the nurses said quietly, her eyes downcast.

  The rest of the team remained silent, each looking at the other professionals in the room.

  "Anyone object to calling it?" Again silence. "Okay, time of death is eleven twenty-two am. Thank you everyone. You all did good work."

  She left her team to go search for the college students and see if any next of kin had arrived.

  Only afterwards did she remember the paper the man had shoved into her pocket. She pulled it out and quickly scanned it. Her eyes widened. It was a restraining order issued by Judge Franklin forbidding her from coming anywhere within fifty feet of Charles Ulrich. What the hell?

  She started back toward the nurses' station but neither Rachel or Virginia Ulrich were still there. Instead she found her boss, Ed Castro.

  "I was just getting ready to call you. A man came into the middle of a resuscitation and gave me this." She stopped when she saw the look on Ed's face. He was furious. At her.

  "Not here. My office."

  He strode back down the corridor to his office. It wasn't until he ushered her inside and shut the door that Cassie became worried. She was in trouble, big trouble. Ed Castro was one of the most agreeable men she'd ever met–easy going was an understatement for his managerial style. He never conducted business behind closed doors.

  Then she saw who was seated in the chair in front of the desk. Karl Sterling, a frown marring his Norman Rockwell features.

  "What the hell's going on?" Ed placed his hands on his desk and leaned forward. "I leave for two days–"

  Cassie held up the restraining order. "I have no idea. I don't understand–"

  "Which is exactly the problem," Sterling put in. "Dr. Hart seems unable to follow simple departmental procedures, much less–"

  "I'll handle this, Karl," Ed snapped. Cassie could see that much of his anger was due to Sterling's presence.

  "Actually, the Executive Committee will be handling it. I am certain that they will recommend an immediate suspension."

  "Suspension! But I haven't done anything wrong," Cassie protested.

  "As if interfering with my patient and ignoring protocol isn't enough, don't you think that being the object of two malpractice suits warrants some action, Dr. Hart?" the pediatrician asked in an icy tone.

  "Malpractice suits?" she managed to choke out.

  "Ms. Tammy Washington is claiming medical neglect and failure to diagnose the illness of her son. While Mr. and Mrs. Ulrich are claiming medical battery," Sterling informed her.

  "Battery?"

  "They state you did not receive informed consent prior to performing the invasive, painful and dangerous procedure of inserting an IO line into their son."

  "That's ridiculous!" She not only had obtained Virginia Ulrich's consent, she had it documented on videotape.

  "You'll be able to tell your side of the story to the Executive Committee Friday morning at eight o'clock. A
nd, I explained to Children and Youth that your report of suspected neglect was the result of ignorance about the complexities of Charlie Ulrich's disease. Not that they'd take you seriously after today."

  "That's enough, Karl," Ed put in.

  "Very well then." The department chairman rose, his posture rigid. He stood in front of Cassie for a long moment, shaking his head as he stared at her. "I tried to help you, Dr. Hart. Believe me, I regret that it has come to this. Such a waste." He departed from the office, the elder statesman delegating his deputy to perform the dirty work.

  "You won't believe who sat beside me on the shuttle from Washington," Ed began. "Senator George Ulrich–the same senator who canceled his appointment with me about the clinic funding. So, good political opportunist that I am, I'm thinking this is fate, I've got the entire flight with him as a captive audience."

  His eyes narrowed, and he leaned forward, steepling his fingers. Cassie cringed, she knew that look all too well. The same look that Ed had given her when she and Maria, his middle daughter, had stolen Ed's prized El Dorado to go joyriding and had smashed the fender. The look that said–have you any idea what your impulsive, thoughtless actions have cost those around you?

  She chewed her lower lip and looked down at the floor. It had been a long time since she had earned that look of disappointment from him. Ed was like a second father to her, and Cassie knew that in the past he'd defended her actions to administrators and others in the hospital hierarchy.

  "I'm sure you can guess that I never had a chance," Ed continued, his glare not softening. "Instead I got an earful about an irresponsible ER physician who was intent on wrecking the Senator's family, turning their private tragedy into a public spectacle, and who wanted to take a gravely ill child away from his adoring mother. Seems this doctor is young, ambitious and refuses to trust the judgment of our own Chairman of Pediatrics who has practiced for over thirty years and has won numerous awards."

  Cassie looked up when he paused, bravely meeting his glare. "Ready to hear my side of it?"

  "I don't care about your side or the Senator's or Sterling's. All I care about is what is best for our patients. Do you really think having the staff in an uproar, watching you and Sterling squabble is going to help Charlie Ulrich?"

  "Of course not. But it's not my fault if Sterling lectured me where everyone could overhear it."

  He raised an eyebrow at that. "From my understanding of it, you started things by not following procedure down here in the ER. And then you accused Virginia Ulrich of abusing her child right at the nurses' station in the ICU. My God, Cassie, why didn't you just announce it over the loudspeakers?"

  "I had no intention of accusing anyone of anything." She faltered, remembering how smoothly Virginia Ulrich had countered all her concerns. The mother had manipulated her into looking like a fool in front of the entire ICU.

  "Let me guess," she went on the offensive, "Senator Ulrich said he'd give you the money for the clinic if I back down?"

  "No, in fact he refused to discuss the clinic at all–said it would be a conflict of interest. And that, as a grandfather myself, I could understand how his mind wasn't focused on such matters while his grandson was so gravely ill."

  "Oh." Hardly the underhanded diabolic machinations she'd expected from the Ulrich family.

  "Then I return here to find these." He flung the malpractice notices onto the desk top. "Not to mention a complaint by Rachel Lloyd stating that you endangered the life of both a patient and one of our own nurses!"

  The veins in his neck began to bulge–a definite danger sign. The ER staff was like family to Ed. No one messed with them, not even his goddaughter.

  "I was trying to–" she stammered, taken aback by Ed's uncustomary outburst of anger. Ed often regaled her with stories of the explosive tempers of his Cuban father and Jewish mother, but he always prided himself on his own even temperament.

  "You were trying to do the police's job for them," Ed cut in, his voice deceptively soft and level, "again. I seem to recall you doing the same thing two months ago–getting yourself and Drake almost killed in the process."

  "But–"

  "No buts! You don't carry a badge, you carry a stethoscope. You have no business interfering with the police or their handling of a potentially violent situation in my ER."

  She cringed. Ed's disapproval hurt almost as much as Drake's had. Ed always supported her choices when it came to her patients and their care, had always trusted her judgment. Until now.

  "It doesn't help matters that the woman you're accusing was having an affair with your ex-husband while you were married. Makes it look like you're out for payback, targeting her."

  Cassie shook her head in confusion. "Richard and Virginia had an affair?"

  "You didn't know? I've been back less than half a day and several people made a point of mentioning it to me–"

  "No, I didn't know. He never–I never–" She stood, planted her palms on his desk top and leaned forward, meeting his gaze. "Ed, you have to believe me, I had no idea who Virginia Ulrich was when I met her. Maybe she looked a little familiar, but after I heard her husband works with Richard's brother, I thought I must have seen her somewhere socially."

  He pursed his lips but finally acknowledged his acceptance of her statement with a slight nod. "Still, it looks bad. Very bad."

  "What are you going to do?"

  He sighed. "I don't have any choice. As of now, you're on vacation until the Executive Committee renders their verdict."

  She was silent. The Executive Committee was composed of department heads and had the power to suspend or even revoke her privileges. Which basically translated to a huge blemish on her career, one which would follow her everywhere she went to practice medicine.

  The only thing worse would be actually being found guilty of malpractice. She swallowed hard and nodded.

  "Have you thought that maybe you came back to work too soon?" Ed asked, his voice lower now, his anger spent. "Maybe your judgment is impaired because of everything that happened–"

  "I'm not crazy!" The words came out strident, harsher than she had intended and so carried with them the opposite connotation. Cassie tried again. "Really Ed, I'm fine."

  He looked away, and she knew he was not convinced. She got to her feet and started to leave, then turned back. "You said we should focus on what's best for our patients. Have you thought about what would be best for Charlie Ulrich if I am right? Would you at least look at what I've found?"

  She held out the papers that had accumulated in the pockets of her lab coat, a peace offering.

  "All right," he said, taking the stack from her. "But this really is more a matter of investigating, not diagnosing–what does Drake say? He's got good instincts about these things."

  Cassie looked down. Drake and Ed were friends, partners in the community clinic.

  "You haven't told him, have you?" Ed asked.

  "We're kind of taking things easy right now," Cassie tried to sound nonchalant and failed. "He needs some space." Why did it sound so reasonable when Adeena said it and so weak coming from her?

  Ed frowned, then nodded. "Do you want me to talk to him about Charlie's case? I'd trust his judgment, even take it to the Executive Committee as an objective evaluation if you'd like."

  It was an offer that was generous–and one she couldn't accept. Drake was her problem, her responsibility–as was Charlie Ulrich. "No, that's okay, I'll talk to him myself."

  <><><>

  "Richard, I need you to do something for me." Virginia leaned forward across the cafeteria table and gently brushed a breadcrumb from his cheek.

  Richard King reveled in the warmth of her touch. Ever since his accident, Virginia seemed the only person willing to touch him, to treat him as a man. Why couldn't his Ella touch him like that? He looked away, his vision blurring as he remembered Cassandra in his arms, her face lit up with a smile meant solely for him. Her hand in his, her body beneath his...

  "This is important." V
irginia's voice returned his attention to the crowded hospital cafeteria. "Important to me, to the baby."

  His gaze dropped to her swollen belly. A baby. Something he'd always wanted with Cassandra, but they'd never had. Maybe if they had, things would have been different, so very different.

  "Is there a problem with the baby?" His words slurred with concern. He reached an unsteady hand out to cover Virginia's. Their on-again, off-again affair had begun while he and Ella were still married, and had deepened into friendship. At least, that's how he remembered it.

  "I'm afraid that filing suit against Dr. Hart isn't enough. I'm afraid that she'll manage to convince Children and Youth to take Charlie from me." Virginia didn't bother to hide her tears from him. He squeezed her hand, wished there was more comfort he could offer her. "Maybe Samantha as well, after she's born. Oh, Richard. What can I do? All I've wanted in my entire life is to be a mother, to have a family of my own."

  He knew. Family was everything to Virginia. She'd been guilt-stricken over their affair, over the way he had seduced her away from Paul Ulrich. But the passion they had was overwhelming, irresistible for either of them. Virginia once told him that without Richard's love, she'd never have the courage to survive Charlie's illness.

  Once upon a time, Richard had been her strength, her hero. He'd never been that for Cassandra–she never needed rescuing, never needed anything from him. And he had so much he was desperate to give her.

  "What can I do?" he asked, uncertain what to make of the anger that surged through him. It was Cassandra's fault that Virginia was in this position. Now he was the one who would have to make things right again. How could the one woman he loved more than anything also be the cause of such pain?

  "Would you meet with the Senator? Tell him everything you know about Dr. Hart? Help him find a way to convince her that I haven't done anything wrong."

  Richard blinked. Tell the Senator about Cassandra? All he remembered were fragments, blurry bits and pieces of memories. What he held on to were the feelings, the overwhelming rapture she stirred in his soul every time he caught sight of her, heard her voice. And the hope, that tiny, secret spark of hope that one day she would be his again.