Empty Beds: A Hospital Mystery
Empty beds. Everyone knows there are two reasons for empty beds in a hospital; one is when a patient is well enough to go home and the other is when a patient dies. This story is about what happens in a hospital when there are more empty beds than usual and they are not from patient discharge. The mystery begins.
Everyone is sad when a patient died, no matter what the reason. On a geriatric floor there are more deaths than on other floors due to the age and frailty of the patients but now it seemed like there had been more deaths than usual for several months. Carlos had been a nurse at St. Bernadette’s since he graduated from nursing school. He had gone to nursing school after his own elderly mother died. He had taken care of her for years since it was only the two of them. While he was in nursing school things came easy to him and his natural ability for nursing was evident. He had a compassionate nature and an ability to absorb the medical terminology as easily as a six year old can learn their ABCs. But why was the death rate rising on his floor? Carlos was very dedicated and considered the floor he worked on his floor and his patients like his family. Since his mother was gone he was able to spend a lot of time at the hospital. His usual shift was evenings, the 4:00 to 12:00, but Carlos would always come in early and often leave late. This new empty bed really got to him. He thought something just wasn’t right and decided when he arrived at 2:00 for his 4:00 o’clock shift that he would look at the medical records and see if he could find a reason. Mr. Bells had been admitted for a broken hip and there was no indication he was in any danger. All of his vitals were good and he had no history of heart disease or in fact any other physical condition that might be life threatening. His medical records listed cause of death as unknown. Again, no cardiovascular disease, no infections, no stroke, nothing to pin the cause of death on. "Patient had complained of numbness in his limb, related to hip surgery," that was it. Certainly not a reason for his death.
Carlos was more mystified than ever so he began looking into the medical records of other patients who had died recently. Mr. Harwich had died the previous Wednesday. His cause of death was ventricular tachycardia (excessively rapid heart rate), but with no reason or explanation as to its cause. The week before Mrs. Nown, cause of death unknown. Prior to death she had been vomiting. Next was Mr. Carr, cause of death unknown. He had experienced abdominal pain and a fading heartbeat. Carlos had been taking notes as he read. He looked at his watch and realized it was 3:55, time to start his shift. His shift went by quickly. He distributed meds, changed a couple of IVs, helped two patients to the bathroom, hooked up a blood transfusion, comforted a patient or two by bringing food or extra pillows and before he knew it it was 12:00 AM. After his shift he went home to get some rest but rest alluded him. "Cause of death unknown" kept going around in his head. He returned to the hospital early the next day. Again he searched medical records and again found deaths were of unknown origin but complaints included facial numbness, slowed breathing, dimness of vision, skin cool and moist. Certainly not good things but also not known causes of death. In the month of June he recorded three deaths (it was going on the fourth week of June), May – 4 deaths, April – 4 deaths, March – 5 deaths, he looked at his watch and realized it was time to start his shift. On Friday he continued his research with the same results, February – 4 deaths, January 4 –deaths, even as far back as December – 5 deaths. These numbers were abnormally high. He was off on Saturday and decided he would spend the day at home, reviewing his notes.
He got up early, had breakfast, and went right to work. As he read his notes for some reason the dates stuck out. He got a calendar and circled the dates, all but two were on a Wednesday. Hadn’t anyone else noticed this ‘coincidence’? Hadn’t anyone else noticed that every Wednesday at least as far back as December (6 months ago) someone had died? This could not be coincidence. He knew this was not normal even for a geriatric floor. He decided to go in again today and look further into these medical records to see if there was any indication leading to a cause of death. No one thought it odd that he came in on his day off, he often did just to help out. He went right to the medical records and began trying to fit the pieces of this puzzle together. No pieces to fit together except as he already thought, every Wednesday one person had died. The two who had not died on a Wednesday had causes of death listed, Mr.Bloom had died of a severe stroke and Mr. Jones had died of complications from his cancer. So what about the rest of the deaths? He couldn’t begin by asking people so he decided to observe. All of the folks at the hospital were dedicated. Of course you had some slackers, Nurse Black was more interested in her love life than her patients but she did her job, though mechanically. Nurse Tommy liked to joke with his patients and had a hard time starting IVs but other than that he was a good nurse. Jeannie, the nursing supervisor was very by-the-book. She was thorough and made sure everyone was on top of their game. Nurse Tony was an LPN who carried out his duties with a smile and a flourish. Patients loved him because he was so gentle when he was taking vitals or treating bedsores. He reviewed all the aides and even the custodial workers on his floor. No one stood out as being other than a good caregiver and someone who wanted to be doing this job. What was going on? Where was the clue he needed to figure this out? What was he missing?
The following Wednesday, Mrs. Carter died. Her cause of death was a slowing heart rate and diarrhea, neither of which had anything to do with her original admission and neither of which seemed like a likely cause of death. Carlos began watching everyone’s movement. He began staying later into the night after his shift to see if there were any malingerers or any obvious neglect. He found nothing amiss. Then he started coming in earlier to see if the day shift possibly held the key. He watched his co-workers and those on other shifts that he didn’t normally work with. Still, nothing.
After weeks of observation, and three more patients dying on a Wednesday, he noticed a very pretty drug rep come in one Wednesday afternoon. Her name was Blair Teton. She was lovely and everyone knew her and seemed to like her. Carlos had not seen her before because she usually arrived around two or two thirty. He knew Blair couldn’t be involved in the mystery because she was a drug rep and had no contact with patients. He watched Blair and listened closely when Nurse Gina (an 8:00 to 4:00 RN) talked to her about the reaction one of her patients was having to one of the drugs Blair distributed. Blair explained the reaction was not a common one but that sometimes geriatric patients reacted differently than younger patients. Their slowed metabolism interacted with the drug. Blair asked if it would be okay for her to talk to the patient and Nurse Gina consented. This peaked Carlos interest because he never realized Blair had any contact with patients. He casually headed for Room 304 to dawdle outside and see if he could hear the conversation. Blair greeted the patient warmly then said, “I am so sorry to hear you are having problems with our new drug. Have you ever had these problems before?” He couldn’t hear the patient’s reply. “Do you really think you need this drug?” Blair asked. Again the patient answered out of Carlos hearing range. Blair then said, “What if I gave you a new and different drug that has been working better than the one you are taking?” The patient must have agreed because Nurse Gina came out and got a fresh glass of water. As they came out of the room Blair said to Nurse Gina, “I can leave you a couple of days worth of pills to see if they help.” She handed a small bottle to Nurse Gina, said good-bye and left.
How many times had this happened Carlos wondered? The drug Nurse Gina administered wasn't ordered by the doctor. Should he report it or wait and see? He decided to wait. Maybe he was imagining things…but he had to at least check the medical records of those in his research and see if any of them had been taking drugs from that drug company. He couldn’t wait for his shift to end to check it out. When his shift ended he immediately pulled the medical records of three of the patients who had died. All three had been on drugs from that company prior to their death and all three had experienced adverse reactions, he checked more and found they too had been on that company’s drugs. He didn’t want to stay too long into the night because he was afraid of arousing suspicion now that he appeared to be making some kind of headway. He decided to do some follow up on his own.
The next day he came in early so he could talk with Nurse Gina. Gina was a likeable gal, short with curly blonde hair cut close to her head. She was friendly and seemed to like Carlos so striking up a conversation with her was easy. Carlos began with the normal pleasantries then asked her about Blair. She looked a little disappointed but told him Blair came in every Wednesday to check on reactions to the drugs from her company. She said, “The nice thing about Blair is she is willing to work with you if there’s a problem.” Carlos asked what she meant by “work with you.” Gina said that Blair would give you replacement drugs on the spot so you don’t have to wait for doctor’s orders and pharmacy refills. It saves a lot of time and aggravation for the patients too. Carlos said that was interesting and asked if Blair did it for everyone or just for Gina. Gina replied, “You know you have to be so careful. Some of the nurses won’t deviate from the rules and in the meantime their patients are suffering. I don’t mind bending the rules a little when it’s going to help my patients. I hope you won’t turn me in.” “Oh no,” said Carlos, “but I would like to know what the new drug is that Blair gives your patients.” Gina’s face got a little red and she admitted she really didn’t know. It seemed to calm her patients so she never checked further. Carlos thought this was the worst excuse for a nurse he had ever met. How could she be so careless with her patients’ drugs? He could see she meant well but knew she was breaking every rule in the book and putting her patients in great danger…maybe even causing their death! He didn’t tell Gina any of this but asked if she could get him one of the pills to look at. She went back into Room 304 and brought one out to him. He thanked her and put it in his pocket. When it was time for his lunch break he went down to pathology and asked his friend John if he could run a test on this pill to see what was in it. He said he had found in on the subway and was curious. Since it was a slow night John said he’d check it out and give him a ring when his report was ready. Within an hour John called Carlos. “You said you found this on the subway?” John said. Carlos replied in the affirmative. “Well, there’s some kind of dangerous nut out there. This pill is Aconite. Aconite is the queen of poisons from the Monkshood plant. It is used extensively in India and other parts of the world to kill people. It attacks the nervous system and sometimes slows the heart rate, other times speeds it up. Symptoms of taking it include red skin, tingling in the tongue and extremities, vomiting, and diarrhea may occur, the list goes on. This is dangerous stuff man.” Carlos thanked him and told him he would like the pill back because he had never seen anything like it before.
The next day, a Wednesday, the patient in Room 304 died, cause of death – fading heartbeat. Carlos’ blood ran cold. Is Blair poisoning Gina’s patient’s with Aconite and if she is, why? Things were getting a little deep and Carlos realized he needed help. John was the best friend he had so he went down to pathology to visit John as soon as his shift was over. He gave John all the details. When he finished John said, “Man, you got a killer right here at St. Bernadette’s. What are you going to do?” "Well, I want you to make copies of all my evidence, the files and my notes. Photocopy the pill in case it gets lost, and then I’m going to try to try to catch Blair in the act but I have to be careful with Gina so she doesn’t suspect."
Carlos worked around Gina and convinced her he was doing a blind study on the new drug. He asked her to help him set it up so Blair would leave the pills for one of Gina’s patients. They decided on the patient and when Gina was off with another patient, Carlos installed a video camera in the room. When Blair came with her pills, her words and actions were recorded on the video camera. Carlos said nothing to Gina but took his evidence including the video tape to the police station. After meeting with several policemen then detectives he was assigned a Detective Cahill. Det. Cahill said he would review all the evidence and call Carlos in the morning. The morning was Tuesday. Det. Cahill asked Carlos to set it up again with Gina for tomorrow. Gina was hesitant this second time but Carlos said he lost the pill and really would like her help. She smiled and agreed. The next day, a Wednesday, Carlos set up the camera. Det. Cahill and some of his men were posted around the floor wearing nurses uniforms or custodial uniforms. Blair came in at 2:45. Gina told her about the patient in Room 306 having a problem with her drug and Blair asked if she could go talk to the patient. Always the same routine. When Blair entered the room she asked the same questions she always did, then gave the pills to Gina for the patient. As Blair left the room she was greeting by several unfamiliar nurses and custodial workers, all policemen and she was under arrest.
Det. Cahill called Carlos to let him know Blair’s story. It seemed Blair was an only child and her parents doted on her and always gave her whatever she wanted. When she was 10 years old her grandparents came to live with them and Blair was no longer the center of attention. She could bully her grandmother but not her grandfather. When Blair was 14 her grandmother died. Soon after her grandmother’s death her grandfather started sneaking into her room at night. She resisted but for a man in his seventies he was very strong and in good shape. He raped her on a regular basis. He told her if she ever said anything he would come in and slit her throat and no one would know. She never told a soul. When Blair graduated from college she got a job with the drug company. Her good looks and personality made her a hit with all the clients and she was soon given the big hospital account. She had made friends in the company in research & development and one of them had told her about Aconite and how dangerous it was and as a pill would kill people. With her connections she was able to find a black market company that would make the Aconite pills for her at a reasonable price. Once she had the pills the rest was easy, every Wednesday (the first time her grandfather visited her at night was a Wednesday) she made sure there was an elderly patient who needed her new drug. She would slip in without Gina knowing and pick the patient, get things ready for her ‘act’. The women she killed for taking away her parents’ affection and the men she killed to repay them for what her grandfather had done. Gina was innocent of murder but was brought up on ethics charges by the hospital. The mystery is solved!
Carlos took a day off.
Other Mysteries I've Written
- The Pigsty Mystery
"Man Abandons Wife and Daughter." What happened thirteen years ago? Did Mr. Van desert his family or is there another reason for his disappearance?
- The Face in the Mirror
Three young women disappeared from this apartment. Now Janine was seeing a face in the mirror. Why was this face in the mirror, who was this face in the mirror and what was she trying to say?