Excerpt from Code Triage

Chapter One

(Mercy Hospital series #3)

Don’t drop that baby; don’t—

Heart pounding, Officer Nick Stathos slammed the door of his car and sprinted toward the
police perimeter, gaze riveted on the panicky young mother at the window of the second-story
apartment. She clutched her infant against her baggy navy scrubs and leaned farther out to stare
at the scene below: police officers, neighbors in pajamas and robes, patrol cars, a fire truck and
ambulance. Lights sliced red-white-blue through the grayness of the late September morning.
She craned her head backward, and her eyes, mascara-streaked and desperate, followed the San
Francisco PD helicopter hovering above the shabby, converted pink Victorian. Nick hoped that
methamphetamines, once Kristi Johnson’s drug of choice, weren’t at the root of today’s drama.
She’d been allowed to keep her kids after a previous skirmish, and he knew how rare the mercy
of a second chance was. He’d been praying for one in his marriage for the better part of a year.

He jogged forward through a gathering crowd of reporters, flashed his badge at the first in a
line of officers, then slowed to a walk. The mother lifted the baby to her shoulder and
disappeared from view, then returned to lean over the windowsill again. The baby’s legs dangled
limply as she fought with the tattered curtain, and Nick winced at a childhood memory of eggs
dropped from a highway overpass. A baby’s skull wouldn’t have a chance against concrete.
Dispatch had to be wrong—Kristi wouldn’t neglect her kids. Could never harm them. He knew
the girl; he’d patrolled her Mission District neighborhood for nearly five years.

“Stathos, don’t waste your time.” A uniformed officer, a paunchy veteran he recognized
from the Tenderloin station, stepped forward, raising his voice over the dull thwoop-thwoop of
chopper blades. He exhaled around a toothpick clenched between his teeth, breath reeking of
coffee, cigarettes, and bacon. “SWAT’s on the way.” He glanced up at the window and shook his
head. “911 call from a four-year-old, and now Mom—one Kristina Marie Johnson, twenty-two
years old—is refusing to let us do a welfare check. Landlord informed us she has a gun in there.
Says the boyfriend deals meth.”

“Gun?” Nick growled low in his throat. “Let me guess: same landlord who’s been trying to
evict her? Think he could have a reason to lie?” He watched the window. “There’s no gun. The
boyfriend’s under a restraining order and long gone. I’ll talk to her.”

“She’s not talking; that’s the trouble.” The officer crossed his arms. “Her kid told dispatch
she and the baby were left alone all night. That they were ‘real sick.’ You should hear the tape;
it’ll rip your heart out. Said she’d been ‘singing to Jesus’ all night to keep from being scared.
Begged for someone to find her mommy. Then Mom shows up a few minutes before we get here
and won’t let us in. Child Crisis is on the way. The medics need to check those kids.”

“So I’ll talk to her.” Nick pushed past him.

“You can’t fix this one, Stathos. Give it up.”

Nick looked back over his shoulder. “You don’t know me very well. I don’t give up.” His
jaw tensed. “Ever.”

The officer shook his head, eyes skimming over Nick’s jeans and hooded USF sweatshirt.
“Think you’d come up with a better way to spend a free Friday, but go ahead and knock yourself
out. Colton’s in charge. Fill him in, and—”

They both looked up as Kristi Johnson shouted.

“Officer Nick! Don’t let them take my babies! Tell them I’m clean now. You know I am.
Tell them I would never . . .” She shut her eyes and groaned. “This is all a mistake. My girlfriend
sleeps over while I work nights at the nursing home. She comes over after her swing shift.
Always gets here fifteen minutes after I leave.” Her brows drew together. “They’re only alone
for fifteen minutes; that’s all, I swear. I had them tucked into bed, but I guess she didn’t show up
last night. I didn’t know!” She shifted the baby in her arms and his legs swung again, floppy as a
home-sewn doll’s.

Nick stepped forward and cupped his hands around his mouth. “All they want is to make
sure your kids are okay, Kristi.”

“They are. Abby got scared. It gave her a headache and a sick tummy. That’s all. She’s
okay.” She glanced over her shoulder. “She’s my little trouper. Aren’t you, sweetheart?” She
stared down at Nick, her eyes pleading. “Can’t you tell them to go away? I’m here now. This
won’t happen again. Please don’t let them put my kids in foster care.”

Foster care. His gut twisted. “How about we let the medics have a look?”

Kristi glanced out toward the street. “Is one of those social workers down there? from Child
Crisis?”

“No,” he hedged, hoping they’d hold off a few more minutes—and praying it wasn’t
Samantha Gordon who’d been dispatched. Not today. The farther he stayed from her, the better.
The clock was ticking, and if he had any hope of saving his marriage, he couldn’t risk having
Sam in the picture. Even professionally. He shoved the thought—and an all-too-familiar stab of
guilt—aside. “Let the medics have a look, okay?”

“No.” Kristi’s eyes darted back and forth. “You. You come up. Only you. I know I can trust
you.”

He turned to Colton, answered murmured questions and agreed to orders, then took the
offered radio. He glanced back up at the window. “I gave these officers my word you don’t have
a gun.”

“I swear on my baby’s life. You know me. I’m just trying to keep my kids, hold on to a job,
pay the bills . . . save my family.” A tear slid down her face. “Please . . .”

“Okay.” Nick nodded. “I’m coming up.”

He took the creaky stairs two at time, feeling the bulk of his off-duty weapon in the holster
at his waist and breathing in the familiar smell of the old building. All of them the same: cooking
oils, garbage, cat urine, mildewed carpet, soggy newsprint. The cloying stink of poverty,
struggle, and hopelessness. He’d breathed it and worked in it—fought against it—from the day
he was sworn in. For a large part of his life, in truth; he’d be thirty-nine next month and was no
stranger to hard knocks. He had no idea if he’d ever really change things for these people. But
just as he’d said a few minutes ago, he wasn’t giving up. He knew what it was like to grow up
without parents, a real home. If there was any way to keep Kristi Johnson from losing her kids,
he was going to give it a try.

He reached the second-floor landing and saw her peeking through the barely cracked door.

“Nick, are you . . . ?”

“Alone,” he confirmed, hearing what sounded like retching in the apartment beyond.

“What’s going on in there?”

“It’s Abby.” Kristi stuck her head out and peered up and down the hallway before she
opened the door. “She’s throwing up again. A flu bug, I guess. I wanted to give her some 7UP,
but with all those people down there, hassling me . . .”

Nick stepped in, glancing first into Kristi’s red-rimmed eyes—pupils look normal, not
dilated—then scanning the room: portable crib, sofa bed heaped with toys and a piled-high
laundry basket, a flashlight on the pillow next to a stuffed pony and a storybook. The little girl
sat in a beanbag chair on the floor, hair in pigtails, eyes closed, face flushed pink . . . and lips so
cherry red that he wondered if she’d been playing with her mother’s makeup. She wore a fleece
robe and a knit cap and had already dozed off, still holding a vomit-splattered saucepan in her
lap. The baby lay quietly in the crib.

Cold in here. Nick shivered, despite his sweatshirt. The room couldn’t be more than fifty
degrees. He glanced around again. No lights. No TV. “Your power’s off?”

Kristi hugged her arms around herself. “Yes, but only for a couple of days. I got my first
check from the care home last night, and I’m planning to go down there and pay my bill, get the
electricity turned back on. The rent had to be first. My pain-in-the-neck landlord doesn’t cut me
any slack.” She moved toward the window, gazing down. “Things have been tight since I broke
it off with Kurt, but I’m making it work. I told Abby we just have to pretend we’re camping.
That it’s an adventure.” She tried to smile. “Bundle up in extra clothes, play shadow puppet
shows with the flashlight, sing songs, sit close to our little stove, and—” She turned to look at
Nick, her eyes wide. “I see her. That social worker, the blonde. Miss Gordon.”

Sam. Nick’s stomach sank.

“She’s the one from before. She wanted to take the kids then, because of Kurt.” Kristi
plucked at his sleeve, her eyes pleading. “Don’t tell her about the power, please. I’ll have it on by
noon. Like it never happened. I promise.” She jumped as Nick’s radio crackled.

He turned his back to her and lowered his voice. “I’m in,” he told Colton. “So far, so good.
Give me a few minutes.” He turned back as Abby began to cry.

“My head hurts, Mommy.” She moaned, then retched, her shoulders shaking. Kristi hurried
to hold the saucepan, crouching in the narrow space between the beanbag chair, the porta crib,
and . . . Nick’s gaze fell on the round metal object on floor beside them. A sickening sense of
dread washed over him. Did Kristi say stove? Camp stove? His mind flashed to the image of her
at the window holding the baby, his little legs dangling limp as a doll’s.

“Wait,” he said, crossing toward her. “Have you been running a camp stove in here? Is that
propane?”

“Mm-hmm.” She nodded, stroking her daughter’ cheek. “Kurt left it behind. It was his
father’s. But don’t worry; Abby knows it gets hot, don’t you, honey? She’s real careful not to
touch it.”

“Turn it off!” Nick ordered. “And pull Abby up; get her over here in the fresh air while
I . . .”

He dropped the radio on the bed and scooped up the baby, his anxiety increasing as the
infant’s arms and legs drooped, flaccid and still. Please, Lord, don’t let . . . Cradling the boy in
the crook of his arm, he moved toward the open window and popped open the chest snaps on the
fleece sleep suit. He watched the baby’s chest for movement, searched for signs of respirations
while holding his own breath for an endless moment. Cherry red lips like his sister’s . . . Carbon
monoxide? Nick slid a sleeve away and felt for a brachial pulse—it was there. But the breathing
was too slow, weak.

Kristi tugged at the sleeve of his sweatshirt. “What are you doing? What’s wrong with
Finn?”

“Pick up my radio, Kristi.” He kept his voice steady as an aimed weapon. “Hold the button
down. Tell them to send up the medics. Don’t argue with me.” He held her terrified gaze for an
instant longer, insisting she trust him one last time. “Do it. Now.” He exhaled. “Tell them your
baby’s barely breathing.”

“Oh no—”

“Do it,” Nick ordered again, pointing toward the radio.

He raised the baby in the crook of his elbow, bent low, and covered the tiny nose and lips
with his mouth, his brain scrambling to recall CPR protocols. Short breaths. Puff your cheeks;
careful, careful . . . Twenty times per minute. He gently filled the fragile lungs, saw the small
chest rise. He did it again and then over again. He’d do it until the medics got there, and then
he’d keep at it as long as they needed him to. He’d do it; he had to. Inhale; exhale; raise the little
chest, one breath at a time, over and over. Hang on, Finn. I won’t give up on you.

***

Dr. Leigh Stathos brushed back a strand of dark hair and nodded to the nurse readying the gastric
lavage tube—rigid, transparent plastic, thick as a snake. She looked down at her patient. “We’re
going to wash out your stomach. Remove what’s left of the pills and then inject a charcoal slurry
to absorb the rest.”

“Can’t we wait until . . .” The woman’s eyes, red and tear-swollen, darted toward the door of
Golden Gate Mercy ER’s code room. Sirens wailed in the distance. “My husband—is he here?”

Leigh glanced at the young assistant chaplain on the other side of the gurney.

Riley Hale shook her head, streaked blonde hair brushing the shoulders of her gabardine suit
jacket. She cradled a hand under her dark arm sling and gazed down at the patient. “I’m so very
sorry, Mrs. Baldwin,” she said, her Texas cadence stretching the words like pulled taffy. “I left
messages, but unfortunately your husband hasn’t responded.”

“And we can’t wait,” Leigh added firmly, checking the vital sign display on the monitor
screen mounted above the gurney. “Acetaminophen is liver toxic. We don’t know how many
were left in that bottle, and in combination with the other pills and the alcohol you ingested . . .”

The woman clutched the sleeve of Leigh’s white coat, fingers sinking into her forearm. Her
eyes searched Leigh’s face, chin shuddering. “Please, you have to understand. I’ve never done
anything like this,” she insisted, her voice thickened by the drugs, breath pungent with alcohol.
“I don’t drink. Ever. But I haven’t slept since my husband left me two weeks ago. I can’t eat. I
can’t work. I can’t . . .” Her voice dissolved into a wrenching moan. Tears splashed down her
face. “We said vows. He made promises before God. Twenty-three years. Two children. We’re a
family. He can’t be with that woman.” She trembled, her eyes riveted to Leigh’s. “You have to
understand.”

I do. Leigh took a breath, pushing memories down, then extricated herself from the woman’s
grasp. “Please cooperate. If you swallow the stomach tube willingly, the process will be easier.”
Her heart tugged at the painful vulnerability in her patient’s expression. “But regardless, we’re
doing this procedure now. Even if it means restraining your arms and holding you down. We
have to.”

Leigh watched her patient’s eyes for a moment and knew, with familiar and painful
certainty, that this ugly, uncomfortable procedure was nothing compared to what this poor soul
had already suffered. And would continue to endure over the sad months ahead. I’ve been
there—I’ve been you. She squeezed the woman’s hand gently. “We want to help you. Help us do
that.”

She stepped away from the bed so that the nurse could raise the head of the gurney and
explain the procedure. Then watched as she applied lubricant to the end of the tube, slid a bite
block inside the patient’s lips, inserted the tube, and checked its placement. The nurse released
the clamp on the attached tubing to start the flow of liquid from the distended bag hanging above
the gurney. Into the stomach from the bag and back out into a collection container near the
floor—one liter, two, or more, whatever it took to wash out the pill fragments, to save this
woman’s life.

Riley Hale moved close, took hold of the patient’s hand, and murmured words of
encouragement. The woman was cooperating; that was good. That made it easier. But . . .

Leigh saw her patient’s eyes move expectantly again to the exam room door. Hoping for a
glimpse of her husband. Praying, perhaps, that the promises of love and fidelity made before God
would be restored. Leigh knew how that felt. And she knew, too, that though this shattered
woman had chosen to cooperate with having her stomach pumped, swallowing the truth was
much, much harder. Even with vows . . . nothing lasts forever.

She glanced at the large clock on the code room wall, designed to accurately time
resuscitations, ticking second by second during a fight for life. She sighed, thinking of her own
timetable, her own life. So much to do now that she was back in San Francisco full-time. Finish
clearing out the house, turn it over to the leasing company, schedule job interviews, make sure
her sister was settled in a new apartment . . . and following through with her counseling
appointments. Then Leigh could move on with her life. Give up—quit once and for all—the
painful struggle she’d endured for nearly a year. One more week—October 3, and we’re over,
Nick. I need this to be over.

She repeated her orders to the nurse, gave Riley an appreciative smile, and strode across the
ER’s main room toward the doctors’ desk. She glanced at the large assignment board, then
around at the circular arrangement of patient rooms, frowning. Half of the patients were
“campers,” waiting endlessly for admission to rooms upstairs. All too common these days, but
nonetheless frustrating. A large part of the reason she’d gone into emergency medicine was the
fast patient turnover. Many of her friends were internists, family practice specialists, or
pediatricians with office walls full of fading patient photos. They loved it that way, wanted the
long-term relationships—and accepted the turmoil and grief that often came with that—but that’s
not what Leigh signed on for.

She liked it fast, furious, fully caffeinated, and adrenaline-pounding. And as uncomplicated
as possible. “Treat them and street them.” The old ER mantra. Not that she didn’t care—of
course she did, and she wanted to help, use her skills to save lives. But she needed to walk away
when her shift was over and leave it all there. That’s what felt best; that’s what worked for her.
She needed that cushion to keep the job, the people, from getting too close. For anything more,
there were chaplains like Riley. And when Leigh wanted companionship, uncomplicated, painfree,
no strings, she went to the stables and flung her arms around the neck of her horse.

“Dr. Stathos?”

Leigh glanced toward a nurse at the door of an empty patient exam room. “Yes?”

“Looks like we’ve got a heads-up on patients coming our way.” She beckoned, pulling the
red stethoscope from around her neck. “Come take a look at the news.”

Leigh walked into the room, and the nurse turned up the volume on the small patient TV
mounted on the wall. “I’m pretty sure they said they’d be coming to Golden Gate. Possible
carbon monoxide poisoning.”

Leigh watched as the reporter, a familiar woman from a local channel, spoke into the
camera. “. . . initially relayed to 911 operators in a heart-wrenching call from a four-year-old girl.
Thought to be a case of child abandonment, but officers discovered—oh, wait, folks.” Her face
disappeared for an instant, then returned. She nodded eagerly. “In fact, I’ve just located the
officer who first discovered this medical emergency. SFPD patrol officer Nick Stathos.”

Leigh’s breath caught. The camera panned over a group of uniformed officers, a woman in a
steel gray blazer with spiky blonde hair, and focused in on . . . Nick. His face filled the TV
screen. Black hair mussed, shadow of beard growth, and the oh-so-familiar dark-lashed eyes.

“Is it true,” the reporter asked, extending her microphone, “that you were the one who
started CPR on the baby?”

“I did some mouth-to-mouth, that’s all. Until the medics got there.”

“And,” the reporter continued, “you were off duty, but you responded to the call anyway? Put yourself on the line for this family, even when you weren’t required—”

“This is my patrol area,” Nick interjected, dark brows drawing together as if he couldn’t
quite fathom her question. “It’s like my own neighborhood. I know these people. Of course I’d
help them. It’s what I do.”

And who you are, Nick. Always. Leigh swallowed against a raw lump that should have
healed months ago. She couldn’t watch this. If the ambulance brought the family here, fine,
she’d deal with it. Nick was off duty, so he’d likely not accompany them. He’d promised to give
her space, and he’d kept that promise so far. She hadn’t seen more than a passing glimpse of him
since she and her sister moved back into the house the first part of August. Leigh turned to leave
the room just as the reporter asked another question.

“Officer Stathos, is it true that the SWAT team was on its way here because the mother
refused to allow officers and paramedics in? that there may have been weapons in that
apartment? and you volunteered to go in despite that danger?”

Leigh left the room—she didn’t need to hear Nick’s answer. She’d heard versions of it over
and over during the three years they’d been married. Of course he’d taken the risk. He always
did. Because . . . “It’s what I do.” And it was one of the reasons—a pair of soul-killing
reasons—she had to end their marriage.

***

Sam glanced at Nick’s older-model black BMW, parked next to a trio of Vespa scooters. “Okay
if I ride with you to Golden Gate Mercy? That way, Carla can have the city car.” Her eyes—icy
blue-violet in the morning light—met his, and he knew she was forcing the casual expression.

He’d made it clear long ago that their brief affair last November had been a mistake, and
they’d managed to settle into a casual, if awkward, friendship. She was his best friend’s sister
and they still shared grief over his death, but there could be nothing more. These past two
months he’d done his best to avoid her altogether. He knew it hurt her, but with Leigh back at the
house, he wouldn’t let anything jeopardize the chance that they could save their marriage.

“Riding with me isn’t a good idea,” he said, after glancing toward the paramedic crew
loading Kristi and Abby—both already on oxygen—into their rig. Lights flashing, the ambulance
with the baby pulled away from the curb, its siren giving a warm-up yelp.

“But you’re going to the ER, right?” Sam dragged her fingers through her new short hairdo,
and for a moment her expression reminded him so much of her brother, Toby, his best friend,
that his heart stalled. “You promised that mother . . . um . . .”

“Kristi Johnson,” he said, supplying the name and trying not to think that Sam’s report to
Child Crisis would be a deciding factor in the family’s future. “Yeah, she trusts me.”

“Of course.” Sam’s expression lost all casualness. For an instant she looked vulnerable, soft.
Hopeful, maybe. “You’re that kind of guy.” She shifted the clipboard in her arms, and the toughgirl
look returned. “So, catch a ride?”

Nick met her gaze fully. “Leigh’s working.”

Sam hesitated, letting the receding siren fill the quiet between them. Then she sighed. “I’ll
have Carla drop me off.”

“Good—thanks.” He started walking back to his car, then heard her speak again.

“Nick?”

He turned his head. “Yeah?”

“I’m going there. That’s my job. And this was bound to happen sooner or later. Your work,
mine, hers—they all intersect, you know?”

“I know,” he said or tried to. His heart had climbed into his throat, and his breath came in
short puffs . . . almost the same way as when he’d been trying to save Kristi Johnson’s baby.
Because despite a sheaf of legal papers, he refused to believe there would be a divorce. That
Leigh would really end it. He’d barely had a glimpse of her in the past six months—she’d
commuted back and forth from her sister’s treatment center in Sausalito, working just enough
shifts to stay on staff at the hospital. And now, when there was so little time to change his wife’s
mind, he finally had a chance to see her beautiful face again. The same morning she’d finally
meet Samantha Gordon—the reason she’d given up on their marriage.

***

Leigh set down her coffee cup and punched the button on the base station radio. “Golden Gate
Mercy, Dr. Stathos, go ahead.”

“Ten-four, Dr. Stathos. This is Medic Seven, paramedic Kenny Walsh. Coming in Code 3 to
your location with an eleven-month male in respiratory distress. Possible carbon monoxide
poisoning. Monitor shows sinus tach at 104. Respirations assisted via bag valve mask with 100
percent oxygen at 20 breaths per minute. Pulse ox: 99 percent. Skin very pink. Baby lethargic.
Weak cry. We’re attempting an IV line.”

Leigh nodded. “Copy that, Medic Seven. What’s your ETA?”

“Three minutes. Be aware: there are two more victims coming your way.”

More victims . . . It was going to be a busy morning, but she’d get through it. If there was
one thing Leigh had learned in her life, it was that nothing—good or bad—lasted forever.

*** 

* Watch for the release of Code Triage in September 2010 *