Mercy Read online

  MERCY

  An ER Thriller

  Rada Jones MD

  apolodor

  This book is a work of fiction. Names, characters, places, and incidents are the product of the author’s imagination or are used fictitiously. Any resemblance to actual events, locales, or persons, living or dead, is entirely coincidental.

  Copyright © 2019 by Rada Jones MD

  All rights reserved.

  No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the author, except for the use of brief quotations in a book review.

  APOLODOR PUBLISHING

  Print ISBN: 978-1-086-83550-2

  Printed in the United States of America

  Price: $9.99

  Cover design: GermanCreative@Fiverr

  Author photograph: Joanna MacLean

  Contents

  Acknowledgments

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  Chapter 9

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  Chapter 17

  Chapter 18

  Chapter 19

  Chapter 20

  Chapter 21

  Chapter 22

  Chapter 23

  Chapter 24

  Chapter 25

  Chapter 26

  Chapter 27

  Chapter 28

  Chapter 29

  Chapter 30

  Chapter 31

  Chapter 32

  Chapter 33

  Chapter 34

  Chapter 35

  Chapter 36

  Chapter 37

  Chapter 38

  Chapter 39

  Chapter 40

  Chapter 41

  Chapter 42

  Chapter 43

  Chapter 44

  Chapter 45

  Chapter 46

  Chapter 47

  Chapter 48

  Chapter 49

  Chapter 50

  Chapter 51

  Chapter 52

  Chapter 53

  Chapter 54

  Chapter 55

  Chapter 56

  Chapter 57

  Chapter 58

  Chapter 59

  Chapter 60

  Chapter 61

  Chapter 62

  Chapter 63

  Chapter 64

  Chapter 65

  Chapter 66

  Chapter 67

  Chapter 68

  Chapter 69

  Chapter 70

  Chapter 71

  Chapter 72

  Chapter 73

  Chapter 74

  Chapter 75

  Chapter 76

  Chapter 77

  Chapter 78

  Chapter 79

  Chapter 80

  Chapter 81

  Chapter 82

  Chapter 83

  Chapter 84

  Chapter 85

  Chapter 86

  Chapter 87

  About the Author

  Afterword

  Overdose excerpt

  About Mercy

  People are dropping like flies in Dr. Emma Steele's ER, and nobody knows why. A new disease? Medication errors? Poisoned oxygen? She must find out, even though her job is in peril, her daughter disappeared, and she'd rather be home, drinking wine.

  Is it a mercy killer? But why kill a healthy patient? Is somebody framing her nurses? Or herself?

  More strange things happen. A patient's death by stolen medications, her orders corrupted by lethal mistakes, her nurse killed. What happens to her daughter? That's worse than death.

  Dr. Steele risks her career and her life to stop the murders. She gets closer and closer to the answers. Until she gets too close.

  If you like Patricia Cornwell and Tess Gerritsen, you'll love Rada Jones. Mercy is a fast-paced medical thriller packed with ER action, flawed characters in ever-changing conflict, crisp dialogue, and wine.

  PRAISE FOR MERCY

  "It was a real page-turner, and I enjoyed it very much! I hope there are more books to come in The Steele Files!"

  "MERCY is a delight to read. It's even better than OVERDOSE. I do love the wine talk. I'm mostly a beer drinker, but reading Mercy almost made me want to rush out and look for those wines. It left me with loads of interesting word images. Definitely a good read!"

  "It is fast-paced, and I like all the threads - the ex-husband, the cranky Dr. Ann, the new dog Guinness and the wine of course. I love the commentary of Guinness on his new humans."

  "The only problem is, it ended, and all I could think was: No! Don't go! It was clever to add a grownup working dog that thinks as a character."

  If there was justice in the world, this book should be dedicated to a dog. Two, in fact.

  Gypsy Rose Lee, my shadow, my soul. The world is emptier since you left it. And Kirby, my irreplaceable friend. She adopted us like Guinness adopted Emma, and enriched our lives.

  But since most dogs can’t read, this book is dedicated to dog lovers.

  If you speak to your dog, thinking she understands you, you’re on track. If you know she can read your mind, you’re with me. If the smile of a dog makes you whole, this book is for you.

  Acknowledgments

  My very special thanks to those who made this book possible.

  Mauri Rex shook me out of my doctorly jargon so that normal people can enjoy this book. She even remembered the dog food that Emma forgot. She had me remove most “WTF?s” Still, there’s plenty left… Thank you, Mauri.

  Joyce Jeffrey spent long rainy hours combing through my draft for inconsistencies – there were many – and told me to fix Boris. If you like him, it’s because of her. If you don’t, it’s because of me. Thank you, Joyce.

  Joanna MacLean warned me about being “on the nose” with some names and prevented me from giving a villain our friend’s name. She was there from the first draft’s muddy struggles to the chiseling of the final draft. Thank you, Jo.

  And finally, my husband Steve. He suffered through it all, good moods, bad moods and downright disasters. He fought valiantly to eliminate the extra comas and to prevent me from capitalizing fentanyl and propofol. He stuck with me through it all.

  For now. But POISON, Book 3, is coming.

  1

  Death: A friend, that alone can bring the peace his treasures cannot purchase, and remove the pain his physicians cannot cure.

  Mortimer Collins

  Sitting in front of the huge mahogany desk, Dr. Emma Steele hoped her boss would get to the point. This week. She’d been listening to him for ten minutes. An eternity, in ER time. He wasted her time while her patients waited. To distract herself, she imagined him as a worm. She didn’t mind being a robin, but eating him? Disgusting. Maybe deep-fried and crusted in Montreal seasoning? With a spicy dip?

  “Emma, you know how much I appreciate you,” he said, moving the tchotchkes on his desk to avoid her eyes.

  She smiled, waiting for “But…” Nothing before “But…” really matters. It’s just lube, helping slide in the message. Like the KY in rectal exams.

  “But your metrics aren’t good. The ER costs are going through the roof. The board grumbles. I can’t hold them off much longer.”

  It’s not them. It’s you, Emma thought. You’ll throw me under the bus, just to say you’re doing something. The metrics can’t get better overnight. You know it, but you’ll step over me to hold on to your job.

  “I understand.”

&nbs
p; “You have a month. If your ER’s metrics don’t improve significantly in a month, I’ll have to let you go. I had to pull a lot of strings to give you that, you know. That’s all I can do.”

  “Thanks, Gus.”

  Dr. Gus Gravelle, vice president of medical affairs of Venice Hospital, nodded without meeting her eyes.

  On her way back, Emma checked her watch. Eight more hours. Today is Vincent’s birthday. He’d be nine. She remembered his red hair, spiking out like a hedgehog. His scent of spoiled milk and baby powder. Her throat tightened. She bit her lip to stop her tears and rushed back to the ER.

  2

  Angel

  I hate Mondays. They suck. The noise is deafening. Monitors alarming, phones ringing, drunks cursing. Still, I hear her moaning as I pass by her room. I glance in. She’s alone. Screaming.

  “Help! Help! Help!”

  “What do you need?”

  “Help! Help!”

  White eyes that used to be green. Thin, greasy hair stuck to her skull. She stinks.

  “What can I do?”

  “Help! Please! Help!”

  “What’s your name?”

  “Gladys.”

  “OK, Gladys. How I can help you?”

  “Help me!”

  She sobs. Tears run down through her deep wrinkles. Her lizard-like hands reach for me.

  I step back.

  She struggles to sit up. She falls back, screaming.

  I grab a pair of gloves to help her up.

  She shrieks, burying her dirty nails in me.

  I pull away and check my hands. Red crescent marks. That’s what I get for helping her.

  “Help me.”

  “I’ll be back.”

  “Don’t go, please, don’t go.”

  She wails.

  I wash my hands twice. I sign into the EMR, the electronic medical record, looking for her.

  There she is. Room 5. Gladys Vaughn, 86. Hip fracture.

  I’d like to look inside her record, but I don’t dare. Thanks to HIPPA, the patient information protection act, if they catch me I’m screwed.

  The computer behind me is on. Whoever used it last didn’t log out. Good.

  I find her record. She’s a wreck. Nursing home. Dementia. Atrial fibrillation. Coumadin.

  She’s screwed. Her expected mortality is 50 percent per year. She only has a few months. Maybe. Bad ones. She’ll hurt when they change her diapers. The flesh of her back will grow holes from lying, rotting in her own urine. It sucks to be her.

  I check her orders. A whiff of morphine. Toradol, Tylenol. They won’t help much.

  I look around. They’re all busy, dealing with their own shit.

  I go to the break room to get my special vial. I draw it, all five hundred micrograms, in a syringe. It’s crystal clear and full. It’s happiness in a vial.

  I head back. She stares like she never saw me.

  “Who are you?”

  I smile. “I’m here to help you.” I attach the syringe to her IV and push the plunger.

  “How’s it going, Gladys? Good?”

  Her anguish softens. She smiles. Gums only, no teeth. She’s happy.

  “I know you. You’re the Angel.”

  Me? The Angel? Then it dawns on me.

  I’m the Angel of Mercy. I’m the Angel of Death.

  I’m the angel.

  Her eyes glow.

  Then they close.

  3

  Emma punched in the code to get back in the ER. It was cold. Air conditioners working overtime, as usual. The light, blue and ruthless, was cold too. Emma checked her phone, looking for an answer from Taylor. She hadn’t heard from her in two days. That was bad news. I wonder what she’s up to. It’s never good.

  She wanted to call her, but she didn’t have time. Full stretchers lined the hallways. Every room must be full. Monitors beeped, patients moaned, phones rang. It smelled like chlorine and blood. Emma waved her ID over the reader to log into the computer system.

  A blood-curdling scream split the heavy background noise. Then another. The circus had started.

  Judy, the charge nurse, touched her shoulder.

  “Dr. Steele, can you go to Room 1?”

  Emma didn’t ask why. She threw her stethoscope over her shoulder and headed to Room 1.

  Monitors screaming. An old woman. Very old. Cyanotic. Eyes closed. Sharp cheekbones pushing parchment skin. She hasn’t had a steak in a while, Emma thought.

  She stepped in.

  Faith, the nurse, a big, beautiful girl, looked up from placing an IV. The other nurse, Brenda, tiny and brown, killed the alarms.

  Emma’s nemesis, Dr. Ann Usher, stood at the foot of the bed, watching the resident intubate. She saw Emma and her gray eyes darkened.

  The resident, a new one, was bent over the patient. He pushed the laryngoscope blade in the half-opened mouth, moving the tongue out of the way to make room for the endotracheal tube.

  The blade is bloody. He’s already tried and failed. Maybe more than once.

  The RT, respiratory therapist, held the ET tube for him. The alarms screamed. Emma glanced at the vitals. The blood pressure’s low. The oxygen sat is in the 80s. Too low to intubate.

  She moved closer. The RT saw her. His face brightened.

  Emma cleared her voice. “You guys need help?”

  The resident looked up. The few remaining teeth clicked as they clamped on the blade.

  “We’re fine, thanks. Let’s go!” Ann said, turning her back to Emma.

  The alarm got shriller, calling danger.

  Oxygen sat 73.

  Emma smiled politely. “You may be. The patient is not.”

  “I can handle this,” Ann snarled.

  “Of course you can. Can she, though? What’s the story?” Emma asked.

  Ann crossed her arms. Her lips tightened.

  “Nursing home patient. 98. Demented. They sent her here for low oxygen and fever. She had an old DNR, but it wasn’t signed,” Brenda answered.

  Emma looked at Ann. “You think she needs intubation?”

  “She’ll die without it, doctor!”

  “She’ll die anyhow. She deserves to die in peace.”

  “The resident needs to learn. This is a good opportunity. No family, no DNR. It’s an excellent case.”

  Emma’s smile vanished.

  “She’s not a case. She’s a person. She deserves comfort and kindness. The resident can learn on other patients.”

  “She has no DNR. We need to do everything, anyhow. We may as well get something out of it.”

  “She’s 98, demented, and dying. She’s not here for our convenience. You have a case for futility. You don’t need to do anything but be kind.”

  Ann’s voice rose. “Have you gotten soft? Have you lost your spark? IF you ever had it? I knew they were wrong the day they put you in charge!”

  Emma’s eyes narrowed, but her voice stayed soft. “She’s your patient. It’s up to you. I’ll review the case. There’s nothing that says patients should suffer so that doctors can learn. She’ll die, no matter what. Soon. The one thing you can do for her is to give her a good death. Put the patient first. That’s the whole point of being a doctor, isn’t it?”

  Ann grimaced as if she’d stepped in a pile of dog poop. “And you call yourself an emergency physician! You may as well be a psychiatrist.”

  “What I call myself is not your problem. What you do is.”

  Her bright red cheeks marring her white face, Ann turned to the resident.

  “Thanks to Dr. Emma Steele, our ED director here, we’ll just let this patient die. That’s how she chooses to practice medicine. I hope you’ll do better.”

  Hands shaking, the resident sat down the laryngoscope. His face flushed, he glanced at the door.

  “She needs comfort. Did you give her anything for pain? For sedation?” Emma asked.

  He shook his head.

  “Try fentanyl. One hundred micrograms to start. Ativan too, if she’s still uncomfo
rtable. We don’t do things just because we can. When we can’t forsake death, we must at least alleviate suffering. That’s why we’re doctors. We always put the patient first. You understand?”

  He nodded.

  Poor kid. He’d like a hole to crawl in. There’s none. I checked.

  Emma left the room. Ann’s shrill voice followed her.