Heart in the Shell

By Scarsky

The genetics research facility is not what it seems…

 

Maura Lassiter, a young doctor specializing in medical emergencies, become a psychiatrist to save lives after her brother's suicide. On a chance encounter, she meets Dan Brunner, a handsome pharmaceutical salesman who leaves an unforgettable impression on her and a surreal sense of having met him before.

 

When a heart condition suddenly threatens her life, Maura is given an enticing offer she cannot refuse - a perfect heart transplant and a highly paid job at a secretive high-tech genetics research facility. It almost seems too good to be true as she falls down a rabbit hole of conspiracies, with obstacles that seem to block her at every turn.

 

Will Maura risk everything to uncover the truth?

• Language: English
• Publisher: Pup Books
• Release date: Mar 14, 2021
• ISBN: 9789811805394

Book preview

Chapter 1

Ahh… Fresh coffee was exactly what she needed.

Jeff’s Java Hut stood on the corner adjacent to the street of the emergency room where Maura worked, which was less than fifty yards from the hospital. With the blizzard in full swing, she had to find it by smell. She was pretty much a coffee addict. She could swear that the place had a fan situated somewhere that intentionally blew the smell of fresh, aromatic coffee through the windows of her hospital. The coffee joint was open until late in the evening. She was sure that the owners made a killing from hospital employees by offering food and beverages that’d make the institutional food at County General appear like a dumpster dive in comparison.

Maura hugged her red woolen trench coat tighter over her scrubs and trudged against the blowing wind into the sudden heated calm of that long-awaited heavenly scent. Even at that late hour, just mere minutes from closing, there was a line—a line that would definitely exceed her break time.

She tapped her heels in gritted irritation when the line stalled as another customer decided to leave an overly complicated and specific drink order.

Urgh! She wrung her hands in frustration. Hurry it up!

She hadn’t clocked out for her impromptu break. She only wanted a fatty, sugary, caffeinated treat and a nap. Definitely a nap. Five minutes would be enough. Was that too much to ask? If only things went her way for a change, she’d be good to go for the rest of her long shift. Or at least until the next crash happened.

Jeff’s was quite a unique place. It had this funny quirk where baristas took orders not by cup sizes but by doses. She waited, watching the employees in lab coats cleaning used tables. Closing time was eminent, but there were still eager coffee junkies queuing up for their fix. She had a hope—feeble, she knew—that the coffee would work its magic on her again.

Dr. Maura, right? Here you go—600 ML caramel mocha P.O, P.R.N, a young, perky brunette announced in a bubbly voice. She was the same barista who always worked the closing shift at Jeff’s. Your drink’s already paid for, miss. Have a good night!

Maura smiled. The coffee dose size, P.O., which amounted to a standard twenty-ounce cup, was a prescription sig abbreviation for by mouth, P.R.N., or pro re nata, which means ‘when necessary’ in Latin. She smiled even more because this was the third time someone had bought coffee for her, and she still didn’t know who it was. Maybe someone on the ward had called it in. But that’d be unlikely since she hadn’t told anyone where she was going and a trip to Jeff’s wasn’t a regular go-to activity for her.

Her eyes did a quick sweep of the café, but there was no one looking at her. The place was nearly empty, and not one of the last lingering customers seemed to be paying any attention to her. With a shrug, she headed for the door, only to find a man in a suit holding it open for her.

″Hi, I’m Dan," he said by way of introduction. It was a direct manner of speaking that Maura was not used to.

Uh, hi. She was slightly flustered by his undeniable good looks. He was over six feet tall and slim, with thick brown hair and hazel eyes that seemed electrically charged. He wore a gray suit and red tie that looked expensive and well-tailored, but no coat. Dimples appeared in his open face as he beamed in a boyish grin.

I was kind of hoping by now your curiosity would outweigh your suspicion that I’m a stalker, he said.

Maura tried to avert her eyes as she exited through the door. Well, I might have, at least up until you said the word ‘stalker.’

This used to be within my work purview. Pharmaceutical rep. I was here visiting, and a memory of you suddenly surfaced, and so I’m here. What a coincidence, wouldn’t you say?

Maura looked the strange man over, but no memory surfaced—although she did feel an acute sensation of déjà vu. It was possible that she’d seen him in passing from a photo or on TV. She didn’t recall Dan, but then again, she wasn’t particularly familiar with making deals for new medications.

Dan read her expression. I know you probably don’t remember me. That’s okay. But I’ve a confession to make. I was the one who bought your coffee. I was wondering if I could walk you back and get a chance to chat with you.

It’s three minutes to the hospital.

″That’s plenty of time." Dan shivered as they set out across the snowy sidewalk to the crosswalk. The hospital walkways were shoveled clear on the other side.

Maura wasn’t sure if letting this stranger walk with her was all right, but she didn’t really have a choice. It’s not like she could just stop him from walking next to her. And, frankly, she was intrigued, even flattered, that a man had gone so out of his way just to chat with her.

Plenty of time for what? she asked as they waited at the traffic light for the walk signal to turn.

The blinking red hand soon disappeared, replaced by the little walking man in white. They crossed.

I want to take you to dinner. How about Saturday night? Technically, I guess, that’s tomorrow. You aren’t working, are you?

Maura was not working, it’s true. She had the weekend off for a change. But she wasn’t sure if she should take him up on his offer. He was still a stranger, albeit a very handsome one. There was something about his eyes that captivated her and wouldn’t let go.

″If not, maybe we can get together for coffee. You owe me, don’t you think? He smiled wide, apparently pleased with himself. See how I set that up?"

Maura laughed despite herself. Clever.

″I was thinking we could go to Aunt Mary’s Speakeasy. It’s close enough to the hospital so that if you ever decide that I’m a creep, you can fake an emergency page and leave. So, what do you say? Is eight a good time for you? We can meet there if you don’t mind."

By then, they’d reached the doors to the lobby. Maura looked at the snowflakes caught on his long lashes, the snow dusting the wide shoulders of his suit coat. Dan was good-looking, seemed to be a high-flier, and had a good sense of humor. She hadn’t dated anyone since…

That last call from Jack. Her brother and his unfortunate death were emotional baggage that she’d been carrying around with her. She needed to do what she often instructed her patients to do—leave the past behind. It was the only way she could move on. Maybe she should give the guy a chance.

Without more thought, she nodded. Okay, Saturday night, eight o’clock.

He extended a handshake. Dan Brunner. You can ask around about me. I’m sure someone still remembers me.

Maura Lassiter. She shifted her cup to her left hand to shake his.

His smile bloomed again, gleeful and childlike.

″Awesome, he said. It’s a pleasure to meet you, Maura."

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Maura pulled the sheet away and dragged herself off the gurney. Groggy, eyes struggling to focus, she glanced at the message on her pager. ER911. A moment later, a voice called over the intercom: Dr. Lassiter to the ER. Dr. Lassiter, ER.

She groaned. Pulling herself from sleep, she hurried down the corridor on Six North toward the elevator and nearly collided with her friend, Stella, a second-year intern.

″Why do people have to have psychiatric emergencies at three a.m.? she asked Stella rhetorically as she pressed the elevator button. Can’t they sleep in and have their trauma after breakfast?"

Stella shrugged. If they did, you’d never get paid overtime.

Maura winced at those words. Her paltry bank statement was something she didn’t want to have to think about. Maybe all the interns at County were in the same boat with student loans bearing down on them like multi-ton weights. She never heard them whining about eating macaroni and cheese for a week straight before the rent was due.

″Thanks, Dr. Obvious."

She stepped into the elevator.

″You’re welcome, Dr. Poverty. Hey, at least it’s payday in a couple of hours."

The elevator doors slid together. What are you talking about?

It’s Friday morning. You have the weekend off, Stella said, smiling before the stainless steel clamped shut. You still planning to go out with that Dan guy?

Maura groaned and slumped into the corner. Days were rushing past her in a stampede of time, the hours too fast to count. Soon, her internship would end, and she’d need to either obtain the only open residency available in the psych department or find employment outside County General. While a residency would undoubtedly be great, what she really needed, what every intern at County General needed, was much simpler, yet more tantalizingly out of reach—about twenty hours of uninterrupted sleep. Still, although she’d only met Dan Brunner once, she was looking forward to their dinner or whatever it was. She didn’t know what to call it. Was it a first date?

She crossed the lobby at a jog, heading for the emergency room. Dark windows displayed the parking lot under a foot of snow. Huge flakes swirled through the streetlights. It must have been freezing outside. She shivered with a brr in spite of herself. The good news was that she’d be on duty for the duration of the blizzard. By the time her forty-eight-hour shift ended, the plows would have cleared the roads. Trading the cold for sleep—she didn’t know which was the better deal.

Sneakers squeaked on the glossy floors. The air was redolent of the brand of antiseptic cleaner that she always thought smelled faintly like milk. She entered her four-digit code into the security check and pushed the glass door open into the ER. Emily Bates, one of the triage nurses, was sitting in triage by herself with a bloody line running down her cheek.

″Careful, Maura! Emily said, showing her cheek. She got me with her nails."

Maura took in the blood on the nurse’s scrubs and furrowed her brows. Who did?

Another nurse, Abbey Green, stepped up with an alcohol pad to clean the cut. It’s not too bad. Doesn’t look like you need sutures, Em.

Maura side-stepped away from Abbey to keep the injured nurse in view. She held the question in her expression. Emily nodded toward the bays. Your patient; she’s over there.

″My patient? Where’s Arthur?" Maura asked, throwing her hands up. Dr. Arthur Weiner was the resident psychiatrist on duty.

″His wife got into a car accident. They took her to St. Vincent instead of here. Emily pressed her lips grimly. Kinda ironic."

Shouting and swearing echoed from an examination area in the back. Maura took a deep breath. Dr. Weiner was on schedule until seven a.m., when Bernard Gates, the attending psychiatrist, would be expected to arrive to start first rounds. Until then, as a senior intern, she was in charge of the psychiatric unit for at least the next four hours.

Maura ran for the examination room. The patient was obviously agitated to the point where she needed to be isolated from the rest of the ward. When Maura entered, she saw an orderly on each side of the bed, a nurse—Donna, she thought her name was—and the attending ER doctor, Kathryn Rutherford. Maura was happy to see that the patient hadn’t been restrained. The orderlies were standing ready, but not holding the woman down. Leather restraints lay on the bed, still rolled up. It was possible that things could turn ugly at any moment if the patient didn’t cooperate.

″What do we have?"

″Patient’s extremely agitated and exhibiting violent acts; wounds to the upper thighs and abdomen, possibly self-inflicted. Dr. Rutherford said. She won’t identify herself."

With no history, Maura was left with few options.

″B-52 IM?" Rutherford suggested one of them--Benadryl with five milligrams Haldol, two milligrams Ativan, given intramuscularly.

While ER docs didn’t have the time to deal with psychiatric emergencies beyond sedation and transfer, Maura didn’t want the patient fully sedated, despite her current state.

″Let’s prep an HA cocktail, just in case." Haldol was an antipsychotic, Ativan—Lorazepam—a benzodiazepine. But it wouldn’t build much trust in the patient to hold her down and inject her like an animal.

She needed the patient to be cooperative to aid in her own recovery, to give a medical history or at least a clue as to who she was and what had brought her to this state. Maura moved to the foot of the bed. She didn’t like what she saw.

The patient was a young woman, mid to late twenties; her honey-blonde hair was matted and twisted upward, eyes unfocused, face frozen in an emotionless state called flat affect. Her hands were held in claws, blood still on her right fingernails from her attack on Emily Bates, her muscles twitching beneath her T-shirt and jeans. Maura saw very red skin on her fingers and toes and white, waxy flesh, an indication of more severe frostbite, on the woman’s bare feet.

″I’m Maura Lassiter, a psychiatrist at this hospital. Can you tell me your name?"

Watery blue eyes sharpened on Maura’s. My babies have been butchered!

Maura wanted to take a step back from her suddenly vehement expression, the fury in her words. But this was just a sick woman. A woman badly in need of help.

″That sounds like something we need to talk about. But here’s the deal. If you continue to show me that you’re a danger to yourself or others, it’s my job to make sure you aren’t, okay? What that means is that these nice men will hold you down, and we’ll shoot you full of drugs and restrain you. That’s not really going to solve much, is it?"

The patient’s breathing increased, but she seemed to be listening.

″Instead, I’d like to offer you something to calm you down a little. Just a couple of pills. Then, we can start talking this through. I’m a doctor, but I can’t cure you. You’ll have to do it yourself. I’ll help as much as I can. But what can we accomplish if you’re knocked out, right?"

Rutherford lingered in the room. She’s been too agitated for us to take vitals but appears to be suffering from hypothermia and superficial to severe frostbite, which may be contributing.

Maura focused on the patient. Would you take something to make you feel calm? You might feel a little drowsy. Here’s the thing; In a few minutes, your hands and feet are going to warm up a little, and it’s probably gonna hurt like a son-of-a-bitch. It would be in your best interest to be lucid enough to consent to treatment. You’ve been outside for a while, and I know you’re cold. I’d like to get you a thermal blanket. How about it?

Out in the ER, an ambulance radioed in their ETA—two car crash victims, broken bones, lacerations, one unconscious, a litany of vitals. Rutherford stepped out. Maura kept her eyes on the patient.

After a few long moments, the woman nodded.

Severe neurologic dysfunction excluded the patient from standard hypothermia protocol, but as Dr. Rutherford said, hypothermia could very well have been contributing to the patient’s state of mind. If Maura could just ease her agitation, they could begin warming baths for the woman’s hands and feet.

″I got it, Doctor."

Maura remained concentrated on the distressed woman. Our first priority is to make you feel less uncomfortable. Have you taken anything prior to your arrival here? Prescription or illicit drugs, alcohol?

The patient shook her head.

″If you don’t want to talk, and I understand if you don’t, is there someone we can contact for you?"

Again, a shake of the head—this time, accompanied by a single tear. Donna returned with a quilted blanket, and Maura carefully covered the woman. One orderly tucked her in while the other plugged the hoses of the blanket into a heating unit and programmed a standard warming sequence.

″Okay then, how about you agree to take a couple of pills?"

The patient looked down at her frostbitten hands. I let them butcher my babies. I deserve to die. I want to die.

I want to die.

Surging memory drew Maura out of the ER, out of the hospital, to a phone call she’d received from her brother, Jack. The last phone call. She was away at school, not far away, only a couple of hours’ drive. But she hadn’t heard him, the desperation in his voice…

″Doctor?"

Maura’s thoughts slammed back to the present. She exchanged a look with the nurse. They now had grounds to hold the patient for observation. It wasn’t nearly as clear as consenting, but it now gave the hospital a lot of leeway. Five milligrams Haloperidol, three milligrams Lorazepam P.O.

The nurse nodded and stepped out to grab the pills.

″Are you feeling warmer? Maura turned back to the patient. Any pain in your hands or feet? The tips of your ears?"

A shake of the head.

″Is it okay if I take a look at your injuries?"

After a moment’s hesitation, a nod.

Maura pulled back the heated blanket. Help me take off these jeans, okay? I like these. Where did you get them? Of course, I’m a little too long in the tooth for the distressed look.

No hint of expression touched the patient’s face, yet she unbuttoned her jeans, allowing Maura to slide them off. One of the orderlies placed the bloody denim in a biohazard bag. Maura observed a half dozen cuts on both inner thighs. She made a mental note that each laceration was within a centimeter of the femoral artery and proximal to the sartorius muscle. It was the place where the big artery was covered only by fascia and skin. If the patient had punctured the major blood vessel, she’d have bled to death in minutes.

″Well, it looks like we can get away with bandages instead of sutures. Let me look at your abdomen. Can you lift off your blouse?"

Four wounds punctured her flat stomach, two on each side, distal and superficial to the naval. Blood seeped freely. The stabs roughly corresponded with the position of the ovaries.

I let them butcher my babies.

The nurse returned with two paper cups. Maura took them, deep in thought. The wounds were not lacerations but incisions.

″You cut yourself with a scalpel." It wasn’t a question.

The patient didn’t respond.

″It looks like you knew what you were doing if you wanted to damage your ovaries or bleed out. You’re a medical professional."

″A surgical nurse," the patient said.

Maura handed over the tiny cup with two pills inside, nodding in encouragement.

The patient swallowed them, and then the water. It would take a few minutes for the drug to enter the bloodstream. Maura covered her again, then motioned for the orderlies to leave. There was far too much going on in the ER to keep them on as babysitters. And given what she now knew, Maura was fairly certain if the patient had wanted to kill herself, she would’ve been long dead before she got to the ER.

A wince crossed the mysterious nurse’s features.

″Feeling coming back to your extremities," Maura guessed.

Teeth bared, the nurse nodded.

″It looks like second-degree frostbite, but we’ll need to consult with a dermatologist. I’ll get the ER doc to write a script for pain. You might want to get your hands under the blanket."

The patient nodded.

″If it’s okay with you, I’d like Donna to bandage you. I’m a psych doc, not a trauma nurse, Maura said. We also need to take your vitals. I’m sure you know the drill."

The patient didn’t react as Donna pulled back the warming blanket and bandaged her wounds, but the trauma nurse gave Maura a look. A long pink scar, nearly invisible, ran upward from beneath her rib cage, disappearing beneath her top. Without a word, Donna clipped a pulse oximeter to her ring finger, the one that looked the least damaged, wrapped the cuff of the automated sphygmomanometer around her arm, and took her temp.

″Thanks, Donna. It’s Donna, right?" Maura asked the ER nurse.

″Yep. Thanks for remembering. Do you need anything else, Dr. Lassiter?"

″Could you call up to Six north and have them prep an observation room?"

″Of course. Should I call patient services?"

Patient services moved patients from room to room, from admissions to physical therapy to discharge.

Maura shook her head. I’ll take care of it. She needed to call Stella, who was currently in charge of the ward and give her an update as well.

The patient’s unfocused eyes remained on Maura the whole time.

″Can you tell me your name?" Maura tried.

″Clara. Exeter."

″You know what happens next?"

Clara Exeter nodded. I’ve expressed suicidal ideation. You’ll hold me for observation for seventy-two hours after I’ve been stabilized.

The patient was becoming more lucid, despite the drugs being absorbed and distributed by her bloodstream. Nervous twitches of agitation persisted, her face remaining emotionless. Still, she hadn’t resisted treatment.

″Do you still feel like you want to hurt yourself?" Maura asked.

Pain flared in Clara’s eyes. I want you to know that I think you’re a pretty good doctor. You look young, but you’re still pretty good.

You look young. That smarted a little. Maura was pushing thirty, lived in a crappy apartment on the crappy east Side, and had a cat for companionship. All her friends were married, her med school friends working in far better paying specialties in far larger, more profitable hospitals.

″That’s probably just the meds talking," Maura deflected.

″No, I just wanted you to know. Because here’s the thing. Even if I’m too chicken shit to do it myself, I still want to die. And I’ll work up the courage eventually. I just wanted you to know that it’s not your fault."

Chapter 2

Ten minutes after Dr. Rutherford wrote a Percocet script for Clara Exeter, the patient crashed hard. Maura stood in the back of the ER, watching two women from patient services wheel the patient toward the elevators on a gurney with one wobbling, squeaking wheel. With sleep, anxiety had lost its grip on her features. Clara was pretty, perhaps even beautiful, despite her crisis. Why had this woman been so desperate to die?

″That was pretty good work."

Maura was startled by Kathryn Rutherford’s voice. Probably not good enough.

″You followed protocol, successfully relieved the greater part of her agitation, got her treated and admitted. Sometimes that’s enough to call it a good day. Rutherford was older, in her late forties, and had stopped dying her prematurely graying hair years ago. She wore it like a badge. I think you’re a shoe-in for the residency position."

″I don’t play politics enough. By the time my internship ends, I’m pretty sure I’ll be working out of a clinic somewhere."

Rutherford shrugged. I’m not on the board, but if I were, you’d have my vote.

″Have you heard about Arthur’s wife?"

″Not good. She slid through a traffic signal and hit a pickup truck head-on. Compound fracture of the femur, fractures of the right tibia, dislocation in both knees, dislocation of the spine at the C7-T1 vertebrae. No compression, luckily, and she’s out of surgery. Good prognosis, but she’ll be down a while."

″What was she doing driving around at two in the morning during a blizzard?" Maura asked.

Kathryn held up her hands. Not my circus, not my monkeys.

Maura changed the topic. I don’t work on a lot of trauma. What happens to Clara after the CT scan?

″I didn’t get a look, but Donna says the wounds were pretty superficial. She’s been in the ER a lot longer than me, so I trust her opinion. The CT’s just a precaution. Unless she’s perforated something below the skin and needs emergency surgery, she’ll be sent up to you for recovery."

Maura took the elevator back to the sixth floor, checking in with the nurse’s station on the