Unexpected Deaths

By Michael Mayo

Synopsis for Unexpected Deaths

When Jon was appointed six months ago as chief of urology in a veteran’s hospital, not all his colleagues welcomed him warmly. He was too young and enthusiastic for the two older physicians who didn’t want their cushy sinecures disturbed. The mystery in Unexpected Deaths is why patients start dying unexpectedly of cardiac arrest, and especially why only Jon’s patients die—a serious topic treated with wit and black humor.

No definite cause of death can be determined in the first two, so perhaps Jon is just not as good as he thinks. But, by the third one, he wonders if the deaths are murders. He’s sure neither of the two residents, with whom he works, is the culprit. But Algy, one of the two older physicians, who resents working under him, is suspect. This ex-army doc is thin, wiry and fanatical about fitness and diet. Just as he chafes against Jon’s leadership, he abhors the absence of a separate officers’ mess and the lack of respect from lower ranking staff. Sarah is a frustrated, overweight nurse who aspires to be a nurse practitioner but can’t seem to do the work required to fulfill her dream. She has definite views on not prolonging the end of life, so she too is suspect. Finally Lee, a janitor in the urology inpatient unit, is a sullen, unlikable man whose secret hobby is dissecting small animals, usually road-kill and, once, the neighbor’s pet rabbit. The reader is given third person viewpoints for each of these characters as well as for the protagonist, Jon.
The hospital administration strongly censors Jon for the three deaths, citing poor judgment and post-operative care, and his clinical privileges are curtailed. Fortunately, he is befriended by another VA physician, a cardiologist, who agrees that the deaths are probably not random events but murders with IV epinephrine as the agent. This would not only produce a cardiac arrest, but is also virtually undetectable. To restore their reputations Jon and the residents try to solve this mystery themselves rather than report their suspicions to the administration who would likely hush the problem up, move staff around and thus and frighten off the perpetrator.

As Jon and the residents carry out their investigations, we follow the three suspects in and outside the hospital. Sarah and Algy start an affair, which restores his waning sexuality, but then she dumps him for an evangelical minister who preaches the imminence of the Armageddon. Lee murders his mother and buries her in the basement but then digs her up and throws the body in a ditch by a freeway, expecting it to be found, so proving her death and then collecting his inheritance.
The climax of the story comes when Jon goes to the urology unit, dressed in an Easter Bunny suit used by a volunteer to entertain staff children. In this, he can spy on the three suspects after he finds that someone has taken some epinephrine vials and is sure the perpetrator is about to strike again. Jon’s top suspect, Algy, turns out to be the murderer and, suspended from duties pending an investigation, he departs on a road-trip, is pulled over for speeding, has a mental break and shoots the cop. The next morning he is found dead in a motel room, presumably from suicide. Sarah gets engaged to the minister, in spite of the apparent nearness of the end time. Lee is left waiting for his mother’s body to be found and wonders if he should take it from its hiding place and throw it on the freeway. Finally, Jon wonders what he did to make Algy hate him enough to go to such extremes to discredit him, and questions whether his skin is thick enough for an academic career.

• Language: English
• Publisher: Michael Mayo
• Release date: Apr 30, 2013
• ISBN: 9781301858101

Michael Mayo

Michael Mayo is a world-renowned and respected medium and spiritual teacher. He brings a practical, grounded, and evidential style to his spiritual work. With his passion for teaching and helping others discover their own unique spiritual connection, he has taught and worked globally. Throughout his 16+ years of working with the Spirit World, he has demonstrated his ability to connect with departed loved ones in both public demonstrations and private sittings. He created his own online school, The Oakbridge Institute, where he teaches progressive mediumship development courses, weekly development circles, and workshops. He also has been featured on The Shift Network and countless podcasts. By bringing messages of love and hope from the Spirit world, his mission is to show that we, like love, are eternal.

Book preview

Jon pulled into his parking spot at the VA dreading, as he did most mornings, that the shit would hit the fan and bring his honeymoon period to a messy end. He identified the source of his angst as the two older faculty left over from the former regime. They’d been at the VA for more than ten years and he longed for their retirement so he could bring in some new blood. He knew they resented that he was chief of urology over them and, if he were honest, he really didn’t trust them. Today, a Friday in March, winter had returned with horizontal rain and the temperature in the low 40’s.

He made a run for the entrance, not bothering with his umbrella, and took the five flights, two stairs at a time, to the floor that his department shared with General Surgery. As he turned into the corridor that led to his office, he saw his two residents walking in the same direction twenty feet ahead. Jon assumed they were going to their room, but they passed their door and, having reached his, knocked on it.

Hi guys, looking for me? Their presence here at this hour was unprecedented. It had to portend a disaster. He wanted them to blurt it out right away and get it over with, but he needed to keep his cool.

Let me open up so we can get comfortable. Jon noticed both residents looked as if they’d just tumbled out of bed and pulled on whatever came to hand. The senior, Ben, hadn’t shaved and wore sweatshirt and pants that would be okay in the gym, and Anne had on kneed and baggy jeans and a crumpled cotton blouse. They had to have been called in from bed for an emergency.

Have a seat. So what’s up?

They looked at each other and gestured you start . . . no you . . . back and forth while Jon’s anxiety climbed.

For god’s sake spit it out, Jon thought, but said, Go ahead . . . someone.

I was on call and arrived first. Ben came a few minutes later, Anne said.

He’d been out of the ICU for two days. He still had an IV, but we’d pulled off all monitoring as he’d seemed at a low risk for any cardiac event, Ben said.

Guys, who are we talking about? asked Jon, his angst increasing as his patience thinned.

Oh sorry. Mr. Wright.

So, what about him? Jon asked. Mr. Wright been a paraplegic since the Gulf War and Jon and the neurosurgeons had implanted a device to stimulate the bladder nerves so that he could urinate without using catheters and get rid of infections for good. Jon, who felt proud that this new procedure had been a first for the VA, had plans for other neurosurgical approaches that would drag his department into the twenty-first century. For too long, they’d been sitting on their hands offering ways of managing paralyzed bladders that were out of date twenty years ago. Past time for new approaches.

He was found pulse-less just before five this morning. We tried to resuscitate him but he was already cooling and must have been dead for at least an hour before he was found, Ben said.

So it had happened. The disaster Jon had dreaded. The first patient to get a new elective procedure had to go well. Now there’d be naysayers on the numerous VA committees who would deny their precious funding for the program. The vets themselves, always a tight-knit group, would have more ammunition to bad-mouth this operation or any other that involved surgery on the bladder nerves. They all held out for the regeneration of their spinal cords with stem cells; a miracle way off beyond the horizon.

Jon and the residents then discussed practical issues: getting an autopsy, a given for a death so soon after surgery, and talking to the family. Jon had looked forward to a quiet morning analyzing one of his data sets together with some administrative busy work. Now he wouldn’t be able to concentrate. He knew stuff happened. But godammit, why this patient? He was such a neat guy, always so friendly and motivated; Jon had so hoped to give him a shot at life without the catheter.

The family lived way over in the eastern part of the state and apparently his wife had returned home soon after the surgery, as her husband would be in the hospital for several weeks of rehab. Jon predicted she’d arrive back in town in the late afternoon at the earliest. No way could he delegate the difficult task of explaining this unexpected death. And he’d promised to be home early. They had eight guests coming for dinner. Duty entertainment of colleagues and their partners. His wife, Sue, barely knew them. He would be late, and she, totally pissed.

Algy Strickler marched with his tray of oatmeal, bran muffin and orange juice towards the corner of the cafeteria that was partly hidden by a pillar. There he could sit at a small table and be able to see the entrance and the serving lines, but remain unnoticed. After his twenty years as a doc in the army, he’d retired twelve years ago and slid into the VA system. Although he found it much like the military, he missed the segregated dining facilities he used to enjoy with a separate officer’s mess. The VA now did not separate the faculty from the staff, and probably never had. On the way, he added up the calories: 150 for the orange juice, 125 for the oatmeal (without sugar) and 175 for the bran muffin. He reckoned with his four and a half mile run that morning there’d be no net gain in calories until lunch and, so far, almost no fat. From his usual table, he could mentally calculate the calorie and fat loads on the trays as they neared the cashier. He was always disgusted that so many of the staff, and some of the faculty, who should’ve known better, were already obese and carried trays of food totaling 1,000 calories. And all that for breakfast.

Approaching his favorite table, he stopped in disbelief. A young woman sat there. This had never happened at breakfast and only occasionally at midday if he arrived late. He dithered for a moment and she glanced up from her paperback—a romance.

Hello. Want to join me? she asked.

The table could theoretically accommodate two but only if both occupants unloaded their trays. Algy not only didn’t want to unload his tray and then have the hassle of bussing his dishes by hand when he’d finished, but also had no intention of sharing his table with anyone, especially as he would have to sit with his back to the food line. Without responding to the young woman he made for an empty one.

He hated change. Ever since Jon Nielsen, also known to Algy as the little Swede, had taken over as Chief of Service he’d felt insecure. With the previous head, the one who’d recruited Algy, he could take care of any patient whatever their problem. Now, Nielsen had assigned subspecialty areas to him and George, the third member of the faculty and two years Algy’s junior. Nielsen informed them they had to develop centers of excellence, whatever they were, and he even expected them to publish at least two papers a year, otherwise they’d be out of luck for merit pay. How ridiculous at this time in their careers. It had been five years since his name had been in print and that only for a case report that one of the residents had worked up.

His pager went off and the clinic number came up. Let the residents get started. Likely as not they weren’t there, claiming some emergency on one of the nursing units. None worked as hard as he did when in training. Up all night and then in the operating room all the next day. Now, for god’s sake, you have to send them home at mid-day. And all these women physicians. Okay in the right areas of medicine, but urology?

He didn’t go straight to the clinic but decided to take the stairs to the urology nursing unit just to check. Sometimes he’d spotted a lab or x-ray report that the residents had missed and he could catch them out on rounds that afternoon. He found nothing unusual except the missing chart.

Do you have Mr. Wright’s chart? he asked the ward clerk.

No. He died in the night. It’s down in the morgue.

Very interesting. Thank you. That’ll be a blow for our little Swede. Doubt the VA will ante up for more of those fancy procedures in the near future, he thought. They were a triumph of technique over reason. These veterans need simple procedures to manage the bladder. Just stick a catheter in and be done with it.

Sarah looked up and saw Dr. Strickler coming out of the office. She really liked the way he looked after his patients. For her money this new guy was too fond of all that high tech stuff. Poor Mr. Wright had done fine with his catheter for many years then last week had gone through a seven hour surgery and all for nothing.

Careful nurse. I’m in such pain, said Mr. Williams.

Sorry, need to turn you just a wee bit. Here was another one. Whole body riddled with prostate cancer. He didn’t need biphosphonate infusions but a whole lot of tender loving care, and some strong narcotics. Some religious nuts thought life should be extended whatever the cost. Quantity over quality. But these old vets had little to live for. Most lived in crummy nursing homes and, like this guy, every so often had to come back for a tune up and get their bed sores healed. Now that the cancer had disseminated, what was the point of putting him through more chemotherapy?

Nearly time for her break. She’d have an apple fritter with her coffee to celebrate her weekend off that started that evening. A whole two days, not just the odd one during the week that they usually gave her. It happened once in a blue moon, though why the fourth full moon in a season was supposed to be blue she’d never discovered. She planned to go to a party given by one of her high school friends and perhaps meet some new faces. She and Jeff were not making it. He’d been out of a job for weeks and she’d carried them both. He sat around eating nachos and watching TV and never even thought of cleaning up the apartment and getting dinner sometimes.

In line for donuts and coffee, she saw no one she wanted to talk to and felt happy to be left with her own thoughts. She should really have something healthy like oatmeal, but with a BMI of 24 she was only a little over and anyway, she deserved some comfort food. Salivating in anticipation, she headed for the corner table behind the pillar—her favorite. She knew Dr. Strickler liked it too but he’d had breakfast and wouldn’t be back until lunch. It would be a late one at that, with all the clinic patients they had to get through. A year ago she’d worked in the urology clinic and had been appalled by the number of old vets asked to come back every three months. Most should have been discharged back to their own doctors, but the residents were too nervous to do that on their own and the faculty just sat around drinking coffee.

To better concentrate on its taste and texture, Sarah had closed her eyes as she took the first bite of the apple fritter. As she opened them to pick up her coffee she saw the urology resident, Ben Davidson, rushing out of the café carrying a cup of coffee and, presumably, heading for the clinic. Now, he would make a great catch and, according to the rumor mill, he was available. She must dump Jeff. Since he’d moved in, her diet had gone down the drain, his couch-potato lifestyle had become a bad influence, and she could do a lot better. But she needed to lose weight. Ten pounds would do it. Perhaps start now and leave the rest of the fritter. On second thoughts, she would eat the darned thing and not waste money.

Lee threw the lever over gently and squeezed the mop some, but it still dripped as he sloshed it over the bathroom floor. That cow of a head-nurse kept moaning about him leaving the floor too wet, someone will slip and break a hip, she’d said. So he’d made it real dry and the next day the charge-nurse accused him of not cleaning the fucking floor. Damned women. He’d been at this job for ten years with only two to go before he’d get Medicare and could quit. Mother wanted him to stay working to beef up his pension, but he’d had enough. Anyway, he knew she had some money squirreled away somewhere.

This morning, when he’d arrived, there was uproar. Mr. Wright had upped and died. Everyone jumping on him and shocking his chest. Even Lee could see the poor vet was a goner. As much a corpse as the dead kitty he scraped off the road last week, except the cat’s guts were hanging out. Funny they called it catgut when sheep or cows’ intestines were used to make the stuff. Anyway, once they’d finished torturing Mr. Wright’s body, Lee had to help slide it onto the special covered gurney that looked like a canvas-topped coffin. The general public couldn’t see the body but everyone knew it lurked there. It would be better to put a sheet on the body but leave the face uncovered, as most vets look half dead at the best of times. On today’s trip to the morgue he saw no one, as it was too early, and when he got there, damn it, the place was totally silent and empty. Sometimes Lee had seen part of a post-mortem, but they pushed him out if he tried to linger. A few of his road-kill had little external body damage and he only wanted to find out how the experts did it. He had thought of becoming a mortuary technician, but he’d needed a high-school diploma for a start and much more after that.

Time for his break. Lee wheeled the bucket and mop into his closet and closed the door on the mess in there. The bitches had even told him off about the stuff he kept—mostly old newspapers and magazines. Fuck them, it was his place. No one else used it. It’s a fire hazard, the head nurse had said. Last week he’d taken some of it home, but his room there had gotten pretty well stacked up to the ceiling. Mother would be onto him next, if she could ever get to look inside it. About a year ago he’d fitted a padlock and she’d threatened to have someone come and cut it off, but so far nothing had happened.

As Lee walked down the corridor who should be coming the other way but that bossy nurse Sarah something? She acted like she was in charge. No way was he about to let her boss him around, but he found her kind of sexy. A bit overweight but he liked her generous cleavage. As she passed, staring ahead and not making eye contact, he took a look at her ass. Much too big, of course. That was why he’d never had a serious girlfriend. If they had enough on top there was too much at the other end. Not exactly a virgin, he’d done it in his twenties, but it seemed very over-rated and he could do just as well, if not better, on his own.

He grabbed his coffee from the cart and headed out to the Materials Management area behind the dumpsters, where he could enjoy it in peace and smoke a cigarette.

****

Chapter 2

Jon’s frustration level had risen stepwise all morning. He longed to get Mr. Wright’s autopsy done, although it would only show the gross appearance of the organs and might tell them nothing about the cause of death. Then they’d have to wait several days for the tox-screen and the histology. But no one would do anything until the next of kin had authorized the autopsy and the wife was somewhere in a car east of the mountains on roads that were deteriorating rapidly in a late winter storm. So upset had Jon become, that he’d been totally put off eating his lunch and had thrown most of it away.

Right now, as he walked toward the urology floor, he longed to leave and spend some time on his own, but he had to show up for rounds where his two older colleagues would play their usual games, trying to up-stage him and catch out the residents. At exactly two o’clock he walked into the doctor’s room to be greeted by George and Algy smirking and leaning back on government-issued tubular chairs with their feet on the table. Algy’s long legs had knocked over the stack of charts that the residents had organized. Those two acted as if they were still in the armed services, where everyone had their place on the ladder, and those near the bottom expected to be craped on by the seniors higher up.

Jon decided to pre-empt their snide remarks on the subject of the unexpected death. "Well gentlemen,