Sacred Trust

“You don’t have time,” Beverly said. “I hear the ambulance phone now, and we have a mom out in the waiting room with three children she wants to have checked out for sore throats and earaches.”

“How long before our surgeon arrives?” Lukas asked.

Beverly wrote down Cowboy’s vitals on a clipboard. “Any minute now, Dr. Bower. He laughed when I told him who it was. He says he’s had this patient before.” She grinned at Cowboy. “I hear you’re pretty adventurous.”

He returned her smile and blushed again. “The folks I work with aren’t always predictable. Dr. Wong took care of a gash I got in the head when a scared zebra kicked me.” He looked at Lukas. “But why do I need a surgeon for this bite? Can’t you just sew me up and let me get home? Leonardo will be hungry before long, and he’s probably worried.”

“Good,” Beverly said. “Let him worry. Maybe he’ll remember this the next time he confuses you with a beefsteak.”

“Sorry, Cowboy,” Lukas said. “Leonardo bit into a deep artery. That’s surgeon territory.”

“But you’ve stopped the bleeding.”

“With pressure. When we remove the pressure, we’ll be leaving an unstable wound that can burst open at any time. You’ve lost enough blood already. You can’t afford to lose more.”

“But, Dr. Bower—”

“Listen to your doctor.” Beverly laid a hand on Cowboy’s arm. “He knows what he’s doing. Besides, if you’re too eager to get out of here, we’ll think you don’t like our company.” She winked at him. “You never want to offend your local emergency department personnel. You can’t tell when you’ll need them.” She dug into her pocket and pulled out the set of keys she had retrieved from Carol. “I’ll make a deal with you. If you’ll let me drive your car and give me some instructions, I’ll go out to your place when I get off work and feed Leonardo for you.”

Both men stared at her.

“Uh, Beverly,” Lukas said, “you do realize we’re talking about an African lion.”

“I heard through the crack of the door. Besides, I’ve read the chart.”

“Sorry,” Cowboy said in his gravelly voice. “No way am I sending a pretty female out to do the job I should’ve done. Get a man to feed Leonardo, and you can drive him out there in my car.”

Lukas expected Beverly, with her obviously independent spirit, to spit fire. Instead, she gazed bemusedly at Cowboy and nodded. “I’ll see what I can do.”

Someone approached the trauma room entrance. “Dr. Bower?” It was Lauren’s voice.

“Oh, Doc, please,” Cowboy said. “I’m still practically naked here. Don’t give me an audience.”

Lukas slipped through the partially open door, leaving Cowboy his privacy. “Yes?”

“We have an elderly man in exam room one who has just been brought in unresponsive.”

“I’ll be right there.” He rechecked Cowboy’s wound, then crossed to exam room one, where Lauren was rushing through the vitals of an unconscious, toothless elderly man in his pajamas, who was already hooked to a monitor and a nonrebreather oxygen mask.

A worried-looking woman in her thirties stood at the patient’s side, her eyes puffy and red from crying.

“Hello, I’m Dr. Bower,” he said to the woman. “Are you his daughter? Granddaughter?”

“No, I’m Shelly, Frankie’s neighbor. My children go over to see him every day, and today they found him like this on the floor of his living room. I think he’d been trying to call someone, because the telephone receiver was off the hook and lying beside him.”

“Did you bring him in by yourself?”

“Another neighbor helped me get him into the van. We should have called an ambulance, but I just didn’t think. We only live four blocks from the hospital.”

Lukas adjusted his stethoscope and did a quick auscultation of the man’s chest. He had mild tachycardia and slow respiration. His skin was pale and cool to the touch. A quick check of his head and upper body revealed no signs of injury. Lukas didn’t smell alcohol.

“Lauren, let’s get a bedside glucose on him.”

“Yes, Doctor. We have a new patient in room eight who needs you next.” She lowered her voice. “It’s cancer. She’s a DNR.”

Lukas grimaced. Those were the hardest. “Okay, thank you, Lauren.” He checked Frankie’s eyes. The man had good papillary sparing. Lukas quickly but gently turned the patient’s head, holding his eyes open. The eyes remained fixed on the ceiling. Positive doll’s eyes told him that this was either drug related or that there was bilateral brain swelling.

“Shelly, has he been ill recently? A cold? Flu?”

“No. Yesterday he was fine. He always brags about never getting sick.”

“Does he ever drink?”

“You mean liquor? Never.” She held out two prescription bottles. “I brought these. I found them on the bureau in his bedroom. His bottle is almost full, but the other one is empty. It belonged to his wife. She died last year.”

Lukas took the bottles from her and glanced at the names of the drugs. Both were benzodiazepines for sleep. He glanced at the patient and didn’t like what he was thinking.

“Blood sugar’s 125, Dr. Bower,” Lauren said.

“Thank you.” He glanced again at Shelly, hating to ask his next question. “These are tranquilizers. Is it possible he might have taken an overdose of his wife’s prescription?”

Her eyes widened with alarm. “On purpose? No way! I don’t even want to consider it. He’s so good with the kids, and he never seems depressed. He was doing so well after his wife, Doris, died.”

Lukas was also reluctant to believe this kindly looking older gentleman would do anything so drastic. He’d probably flushed his wife’s pills after her death. But what if he hadn’t?

“He hasn’t talked about going to be with his wife lately?” he asked Shelly.

“No.”

“Has he displayed any changes in his normal habits, like changes in sleep time or amount? Changes in eating habits? Has he given any of his personal items, such as jewelry, to friends or neighbors?”

“Nothing that I know about.”

“How long ago did his wife die?”

“About eight months ago. Long enough for him to show signs of depression if he’s going to, I would think.”

“Not necessarily. A wedding anniversary could have set him off, or her birthday, anything of significance to him.” Lukas was well aware of this because his own father had gone through a similar depression after Mom’s death. So had Lukas, though not as severe as Dad’s.

“But they had just celebrated their wedding anniversary before she died,” Shelly said. “And her birthday was two weeks before their anniversary. We celebrated it with them.”

“Okay, thank you, Shelly. Lauren, set him up for a CBC, a comprehensive chemistry panel, a portable chest, and a drug screen. Then set up a heplock. I want him to have a milligram of Romazicon at 0.2 milligrams per minute. We’ll repeat the dose after twenty minutes.”

“What’s that for, Doctor?” Shelly asked.

“Romazicon is the antidote for benzodiazepine overdose, just in case.” At her blank look, he explained gently, “He may have taken too many of these tranquilizers. I don’t want to dismiss the possibility and take a chance on being wrong.”

He glanced at Frankie’s prescription bottle again. Dr. Robert Simeon had prescribed the drug. “Lauren, also put a call in to Dr. Simeon’s office. He’s the family doc. I’m going to check on Cowboy, then look in on the cancer patient. Would you see if that permission to treat has come in for the track student? We’ll need a CT head scan on Frankie if our workup is negative.”