The Diagnosis is Murder (A Dr. Valorian Mystery Book 1) Page 4

  “You just haven’t met the right one yet. I’ll tell you about this guy on our shopping trip. He’d be a great match for you.”

  Laura rolled her eyes. Clarissa had tried to set her up with men before. She was a good friend who, despite Laura’s assurances to the contrary, was convinced that Laura was lonely.

  An image of her ex-husband flashed into her mind, the classmate she’d married during medical school. Lasting almost two years, the marriage was a bad fit, and medical school demands assured its failure. For a while after her divorce, Laura had kept to herself.

  “Laura?”

  “Oh, sorry. I was daydreaming.”

  “You see? You do need a guy. You’re not looking online, are you?” Clarissa said.

  “Not yet.”

  “Good. It’s better to get a personal reference, like from me. You’ve got to give this guy a chance.”

  “All right, we’ll talk about it while we shop. I’ll let you know when I can go.”

  When the call was over, and unable to relax, Laura put on a short blue dress and a touch of perfume, then strolled outside and fired up the Saturn. Her destination was the Majestic Lounge on Mount Vernon Avenue in Alexandria, a lounge often frequented by the health club set—handsome physiques looking for affirmation and consummation.

  She visited this lounge several times a month. Many of the merrymakers were close to her age (or a bit younger), and the piped-in rock music was good. She sat at the bar and had her usual drink—red wine—selecting a malbec.

  “Haven’t seen you since my PowerPoint presentation,” a man said as he approached her.

  Laura recognized him from a recent drug company-sponsored dinner for doctors, and she’d seen him in here before. He was a muscled man in his thirties, probably a serious weight lifter.

  “Can I join you?”

  Laura nodded, and he sat down next to her.

  “You probably don’t remember. I’m Kevin.”

  “I’m Laura.”

  “I noticed before that you drink red wine.”

  “I do.”

  “What kind do you like?”

  She swirled her glass to aerate the wine. “This malbec is good. I often get Italian—chianti, or, when I can afford it, barolo or brunello. They don’t give me headaches, unlike some other red wines.”

  “I’ll remember that.” He sipped from a mug of beer and wiped the foam from his lip with a napkin. “How’s the doctoring business?”

  “Busy, as always.”

  “I used to be an ER nurse, but now I’m a drug rep. Better pay. I mostly visit doctors’ offices. Don’t have a chance to visit ERs that often.”

  Laura felt comfortable talking with Kevin, but she found herself wondering what else they possibly had in common.

  “I’ll let you in on something.” He leaned in toward Laura. “My company is coming out with a new blood thinner drug. There’s a lot of excitement about it. This drug has no significant adverse effects that we know of, and it’s a lot safer than Coumadin or other blood thinners on the market now.”

  “Let’s hope you’re right,” Laura said.

  After twenty minutes or so, Laura’s mind began to wander. “I’ve got to get home. I’ve had a long day.”

  “Wait, can I take you to dinner sometime?”

  Laura smiled. “Let’s just meet here for now.”

  As she stood from her seat, she sensed a presence behind her and whirled around. “Whoa, Eric.”

  Laura’s triathlete suitor pointed at Kevin. “Are you with her?”

  “Right now I am.”

  “What are you doing here? Are you following me?” Laura said to Eric.

  “No, baby. I want to talk to you.”

  “Do you need help?” Kevin said to Laura.

  Eric leaned toward Kevin. “Stay out of this.”

  “Hold on, guys.” Laura held up her hands. “Everything’s okay,” she said to Kevin.

  Laura grabbed Eric’s forearm. “Let’s walk out. I was just leaving.”

  They made their way to the front door of the building and stepped outside. She turned and faced him. “I don’t want to see you any more. When are you going to get that?”

  “Give me another chance. You won’t be sorry.”

  She shook her head. “No, listen to me. We’re just not right for each other.”

  “I can make it right. I know you like me. You need me.”

  “No, I don’t need you. It’s over between us, and stop following me.”

  Several revelers walked out, and Laura turned and followed them. When she was a safe distance away, she looked back. Eric, illuminated by a street lamp, was watching her, his hands on his hips.

  Laura swore she caught the flicker of a smile flash across Eric’s lips.

  Back at home, Laura sat in her living room, mulling over the scenes at the doctors’ parking lot and the lounge. A shiver passed through her. She walked to her computer and opened her music app. Her taste in music spanned several decades of rock and roll: The Beatles, Simon and Garfunkel, David Bowie, Steely Dan, Foo Fighters, Bush, and others. She punched up old favorite by Joni Mitchell: ‘Both Sides Now.’

  Classic melodies and lyrics soon filled the living room. Old rock and roll music was soothing to Laura; it reminded her of carefree college days. She lounged back on the couch and closed her eyes, reminiscing about evenings in her over-the-top picturesque college dorm room.

  After a while, she dragged herself upstairs and crawled into her sprawling, king-sized bed. Cosmo settled into his cushions on the floor nearby. Laura thumbed through a medical journal and then picked up a murder mystery novel from the lamp table by her bed.

  After reading a few pages, her eyelids grew heavy. Images of pasty faces with vacant stares floated across her eyes. Just before she went to sleep, the face of Roderick Preswick appeared.

  His face and eyes were pleading with her.

  Chapter 4

  Derek, dressed in green scrubs, put down his steaming cup of coffee and stood from his chair in the doctors’ office. “You feel okay? Your eyes look bloodshot.”

  It was Tuesday morning, the start of the ER day shift.

  Laura rubbed her eyelids. “I didn’t sleep well last night. I guess Dr. Preswick’s death got to me.”

  “That’s understandable. When can we get the autopsy results?”

  “The formal report won’t be ready for a while, depending on any microscopic and other studies that take time. I’ll call the ME this afternoon to get his initial impression about the cause of death.”

  A gloomy cloud hung over the nurses and the hospital staff. Thaddeus Angelino, the Chairman of Internal Medicine, dropped by the ER to chat with Laura about the tragedy. He caught up with her in the ER hallway.

  “Laur-, what happened to him?”

  Laura winced at Dr. Angelino’s irritating habit of truncating names to one syllable. “I don’t have a clue. Evidently, it was a sudden death.”

  “You sure he wasn’t mugged?”

  “I checked every square inch. There was no sign of injury anywhere.”

  “Well, some injuries are hard to spot.”

  Laura squeezed her eyelids tight. She’d been expecting such a comment. Thaddeus Angelino had to present himself as the fount of all knowledge. He was always ‘right’ and never admitted to even the possibility of being wrong.

  “He seemed so healthy,” Thaddeus said. “Did he have any medical problems we don’t know about?”

  “Not that I know of.”

  “Then I’ll bet somewhere on his body is a subtle clue of a traumatic death.”

  “What . . .” Laura checked herself—her hand in the air—then turned and walked away, muttering to herself, “Don’t tell me how to do my job, Doctor Know-It-All.”

  Derek performed a few procedures that morning, walking between patients with a spring in his step. Laura knew that he appreciated her allowing him to get his gloved hands messy whenever it was appropriate to do so. She stopped by and checked his
progress from time to time.

  At one point, Derek entered a treatment room and approached a patient with a bloody leg. “What happened?”

  “My chain saw bucked and bit my leg.”

  Laura had eased into the room to listen to and observe Derek’s performance.

  After examining a laceration on the front of the man’s thigh just above his right knee, Derek took a deep breath and stepped up to the head of the stretcher. “I’ll inject anesthetic to numb the area, so I can clean it out and stitch it.”

  “Go ahead, do what you have to do.”

  Derek cleaned the skin and used a tiny needle to anesthetize the long laceration. He removed all visible dirt, grit, and blue jean fabric from the tissues, then irrigated and sutured the wound.

  When he finished, Derek removed his gloves and blotted the sweat from his face with a towel.

  Back in the doctors’ office, Laura reviewed the wound repair procedure with Derek. “Well done. You’ve got good surgical technique.”

  Derek beamed. “I’m proud of my hands. One of my hobbies is putting together model airplanes.”

  “You put people together pretty well, too.” Laura stood behind him as he typed his procedure note on the computer. “You looked a bit nervous with that patient.”

  Derek paused. “I guess I didn’t know how I would respond to trauma in the ER.”

  “That’s understandable. Many medical students have to get accustomed to dealing with bloody patients.”

  “Well, growing up, I saw some bloody wounds, but the ER setting is different.”

  “Where are you from?”

  “East of the Capitol.”

  “Let me guess. Baltimore? New Jersey?”

  Derek chuckled. “No. Right here in good old Washington, D.C.—east of the Capitol Building.”

  Laura knew that certain parts of that area of D.C. were rough. She imagined that Derek, raised in east D.C., had experienced more than his fair share of challenging situations. She sat down near him. “Does your family still live in D.C.?”

  “They haven’t left yet. My mother and sister live in the block where I grew up.”

  Laura waited. Derek was staring off into space.

  He sighed and looked down. “My father ran off when I was a baby. I never knew him. I had a brother. He was shot to death in downtown D.C.—and I don’t know who killed him or why.”

  Laura sensed an edge of bitterness to his words. “I’m sorry to hear that.”

  “Maybe he was just in the wrong place at the wrong time.”

  “Is that what got you interested in medicine?”

  “Could be. My brother died in my arms, bleeding.” He crossed his arms. “I felt helpless. I remember thinking that I wanted to learn how to help. I worry that I should’ve done something.”

  Laura was connected with the medical examiner at 3:00 p.m. “Do you have any ideas about Dr. Preswick’s cause of death?” she asked.

  “No abnormal findings yet. His organs were in good condition. No trauma or internal bleeding. His heart looked healthy, no sign of infarction, and he had only minimal coronary atherosclerosis. Those arteries were fairly clean. Still, I guess he could’ve had a lethal arrhythmia for some reason.”

  “You’re doing toxicology tests?”

  “Oh, yes. The tox and microscopic studies are still pending. Right now, I don’t know why he died. Hell, maybe he died during sex.”

  “I’m sorry, what did—”

  Dr. Stiles laughed. “Some guys die that way. That’s how I want to go, during sex.”

  Laura slammed the receiver down. He’s getting worse. He must be off his medications. I’ll let his psychiatrist know.

  She informed Derek of the ME’s preliminary autopsy report.

  Later that afternoon, a nurse approached Laura in the ER hallway. “We have an overdose patient in the critical care room.”

  Laura and Derek followed the nurse to a patient’s bedside. A young woman with attached cardiac monitor leads was alert and lying with her head elevated on the stretcher.

  “Ms. Stein, I’m Dr. Valorian. I understand you took some medications?”

  Ms. Stein didn’t answer.

  Laura looked at the nurse. “What did she take?”

  “She told the triage nurse that she swallowed a lot of her father’s Digoxin,” the nurse said.

  Laura turned to Ms. Stein. “That’s a dangerous medicine to take in overdose. How many did you take?”

  Again, no response.

  “Did you want to harm yourself?” Laura said.

  Ms. Stein shook her head. She pulled out her cell phone. “I need to call my boyfriend.”

  Laura nodded. “Sure, and in the meantime, we’ll do some tests to evaluate the severity of your condition.”

  Ms. Stein held up her hand. “Let me call my boyfriend first.”

  Laura noted irregular heartbeats on the monitor. “She’s having PVCs now,” Laura said to the nurses. “This could be a serious overdose.”

  Ms. Stein spoke into her cell phone, evidently to an answering machine. “I haven’t been able to reach you all day. You have to call me.”

  Laura leaned toward Ms. Stein. “We have to start an intravenous line and draw some blood. We may need to give you an antidote.”

  Ms. Stein punched her cell phone off. “Let me out of here. I don’t want any tests. I have to find my boyfriend.” She swung her legs over the side of the stretcher.

  Laura held up her hands. “Whoa, Ms. Stein, you may have taken a dangerous amount of Digoxin. You could die if we don’t treat you.”

  Ms. Stein began to pull off her monitor leads. “I want to leave. You can’t keep me here.”

  “Security is just down the hall,” the nurse said to Laura.

  “Call them in here.”

  Derek touched Laura’s arm. “Let me know how I can help.”

  Laura stepped in front of Ms. Stein. “We’ll try to find your boyfriend. Just relax and let us treat you.”

  “I’m telling you. I want out of here. I’m not your prisoner.” She began to slide off the stretcher.

  Laura’s body tensed, her voice quivering. “Ms. Stein, you can’t . . .”

  “Yes, I can.” Ms. Stein thrust the palm of her hand against Laura’s chest. “Get out of my way.”

  Laura’s vision blurred, and her head swam. She grabbed Ms. Stein’s shoulders. “Listen, you stupid woman. We have to treat you.” Ms. Stein’s head bobbed back and forth as Laura shook her shoulders. “We need to save your life.”

  Ms. Stein screamed. “Take your hands off me. I’m leaving now.”

  Derek whispered to Laura. “It’s okay now. Let us take over.”

  Laura froze, her face burning, and looked at Derek. Her vision cleared. I’ve lost control again. Take slow deep breaths, slow and deep, slow and deep.

  Laura released her grip on the patient and stepped back. Derek and a security guard grabbed the patient and forced her squirming body down on the stretcher.

  Ms. Stein screamed. “You can’t do this. Let me go.” She sobbed between screams. “I’m suing everyone.” Several nurses helped to secure Ms. Stein to the stretcher with leather restraints.

  “Should we sedate her?” Derek said.

  Laura took a deep breath. Okay, I’m in charge here. Everyone is counting on me.

  She turned to the nurses and spoke over the screaming patient. “I apologize to everyone. Since the patient is a danger to herself, we have to restrain her. Otherwise, she might die. Let’s start an intravenous line and give some Ativan. Draw blood for lab tests, and when she’s sedated, put in a Foley catheter for urine tests.”

  Laura walked out of the critical care room and into the doctors’ office. Derek followed her.

  “I’m sorry you saw that,” Laura said. “I have a temper problem sometimes, especially with people I can’t reason with. I’m working on it.”

  “No worries. You recovered fast.”

  Laura didn’t respond.

  Derek bent tow
ard her. “Are you all right?”

  “Weird things are happening lately. Too much weirdness. That worries me.”

  “You’ve been worried a lot. Are you sure it’s not me?”

  Laura chuckled. “No, it’s definitely not you. If anything, you’re helping me to stay sane, at least most of the time. I’m glad I have you here to talk to.”

  Laura admitted the overdose patient to the ICU for definitive medical and psychiatric care. Even though she’d felt awkward since her loss of composure, her thoughts kept returning to Dr. Preswick’s death.

  Seven o’clock finally arrived, and as Laura walked out of the ER, she didn’t hear Betty say goodbye. She glanced around outside and saw nothing unusual as a security guard escorted her to her car.

  “Is anyone bothering you?” he said as he opened her car door.

  “No, I just get nervous sometimes.”

  The guard shrugged. “Can’t be too careful.” He waved and walked away.

  Laura was off work for the next two days, and she was looking forward to some leisure and recovery time. One of her missions for tomorrow was to amble around the Tidal Basin as the famed Washington, D.C. cherry trees were blooming.

  Laura picked up an order of Chinese food on the way home. Fresh and crisp evening air filled her lungs, but it couldn’t compete with the delicious smell of sweet and sour sauce and hot chicken chow mein that permeated her car during her drive down Highway 1.

  As she turned onto the street that led to her house, a figure darted in front of her car, illuminated in her headlights for a split second.

  “Ahhhh,” Laura slammed on her brakes and swerved to the right. Her tires screeched and the car stopped after several seconds with the front tires against the right curb. She slowed her breathing and peered into the gathering shadows of twilight, studying the area outside her windows. Seeing no movement, she stepped out of the car and surveyed the street and surroundings. “Hello? Anyone there?” Everything was still. Walking and at times jogging in a wide circle around her car, she strained her eyes and ears—but saw and heard no one. I don’t think I hit anyone. She’d seen the lower part of his body and figured he’d disappeared down the street she had turned from. She backed up and drove the short distance to her house. As she walked in through the back door, her heart was still pounding. She sat down at her polished cherry wood dining room table and rested her face in her hands. Weirdness. More weirdness.