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Horror Houses
Horror Houses
Horror Houses
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Horror Houses

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Horror Houses is a fictional expose about nursing home resident abuse.

Vince's ears turned red..."I don't really care if you are getting tired of my questions... There is an eighty-six-year-old lady awaiting an autopsy..."

Richard lit a Marlboro and blew a smoke ring. "Lookin' good...I cleared 1.9 million by not paying any bills... It's such a beautiful scam and it's all legal."

The sound of Scotty Crook's fist slamming down on the walnut desktop sounded like a sonic boom to Hank Hawkins... "I wanted to get this through your thick head..." Hank shivered at the thought of his gambling losses not being covered... Scotty swiveled...looked up at the oil painting of his dad's first oil well... "I've got him...I own him."

LanguageEnglish
Release dateJan 20, 2022
ISBN9781638812111
Horror Houses

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    Horror Houses - Greg Adams

    CHAPTER 1

    The buzzer at the nurses’ station pierced the quiet of the late, rainy night at Sunny Side Nursing Home. Simultaneously, the call light for Room 38 flashed on the call light board affixed to the dingy white wall. Two nurse aides, asleep in chairs in the adjacent lobby, did not move. Cigarette burns and numerous rips marred the chair.

    Help, help, come to our room, quickly! a woman yelled when no one answered the call.

    Two more residents, in pajamas, awakened at 1:50 a.m. by the goings-on in Room 38, milled about in their doorways. Ethel Franklin, the nurse on duty for the eleven-to-seven shift, heard the commotion on C Hall as she checked a resident’s urinary catheter in Room 5 in A Hall. Sunny Side had three resident halls—A, B, and C, with A Hall continuing straight across to C Hall through the resident lobby. B Hall was situated at a ninety-degree angle to the others with the nurses’ station located at the end of each hall, overlooking the lobby area.

    Ethel, a licensed vocational nurse with sixteen years’ nursing home experience, pushed back a few strands of her thick brown hair, which dangled across her temples and face. She cocked her head, adjusted her brown wire-rimmed glasses, and heard the woman scream again.

    As Ethel ran up A Hall, she dodged a puddle of water from a roof leak. Entering the lobby, she rushed past the two sleeping nurse aides.

    Get off your tails! This is no time for sleeping! We have a problem on C Hall! Ethel yelled.

    The two female aides came to life and slowly rose to their feet. One mumbled, I was sleeping so good, what’s happening?

    They stumbled out of the lobby down C Hall, still groggy from their interrupted naps.

    Ethel ran down C Hall as the noise around Room 38 grew louder. She bounded into Inez and Bessie’s room and saw Bessie leaning over Inez, attempting to hold her roommate on the bed.

    Nurse, Nurse, Inez is having one of them seizures, Bessie said anxiously.

    How long has this been going on, Bessie? asked Ethel.

    ’Bout two minutes. I waked up and heard Inez making this screaming sound and tried the call light. Nobody answered, so I ran out in the hall and yelled for help. I tried to hold her on the bed with all that shaking going on.

    Inez writhed violently in her bed, flailing her arms and legs. Saliva drooled profusely from her pitifully contorted mouth. Her eyes, rolled back in her head with only the whites showing, added to the bizarre look on her face. Her wrinkled forehead jerked often as her neck arched, pulling her entire head back.

    The pressure on her neck made it bulge upward and her chin jut out. Her left arm, already hanging in the bed rail, actually helped hold her convulsing body on the bed. Her body strained and pulled on her left arm.

    Ethel reached into the right pocket of her burgundy uniform blouse and withdrew a soft bite stick, which she placed in Inez’s mouth to prevent her from biting her tongue.

    Inez went limp as the convulsion ended.

    Ethel heard the two aides she had found asleep in the lobby murmuring behind her and barked at them. I need some help over here with Inez. She’s had a seizure. One of you, get on this side of the bed, and the other get on the other side.

    Rain pounded against the window as Inez let out a shrill scream, and her frail eighty-six-year-old body began to flail again on the bed. Her disheveled gray hair stood out wildly in all directions.

    One of the aides assisting Ethel asked, How long’s she been bouncing around like this?

    Started when you two yo-yos were asleep in the lobby. Now get a good hold on Inez’s left shoulder while I free her left arm. I hope it’s not fractured, Ethel said angrily. She freed Inez’s arm. Her convulsions seem to be getting less intense. Let’s let her settle down before I leave her to go to the nurses’ station. Inez went limp and, almost immediately, let out a shrill low scream and began convulsing again. Her head arched back, and her arms and legs wildly gyrated in all directions.

    Hold her down to keep her from falling off the bed, ordered Ethel.

    The convulsions lasted a little over a minute and then Inez, spent from the convulsions, collapsed into a limp state.

    Hold this stick in her mouth. Don’t let her swallow her tongue, and hold her in place on her bed. I’m calling her doctor, Ethel informed them.

    Other residents still stood bewildered in their doorways, wondering about Inez’s situation. Ethel rushed out of Room 38 into the hallway and directed them, Let’s get back to bed, folks. Inez is doing better for now.

    I think Ethel’s mad, said one of the aides.

    Bessie stood at the foot of Inez’s bed and was immediately aware that the aides’ clothing reeked of cigarette smoke. Some of these people are so inconsiderate they think we can’t tell they’ve been smoking.

    Yeah, I guess she’s mad. Big deal. What’s wrong with the old broad, anyway? the aide asked.

    Bessie overheard this comment and retorted, She’s not an old broad. You jerks oughta learn some respect.

    Hello, Dr. Solomon here…

    Dr. Solomon, it’s Ethel at Sunny Side.

    Yes, Ethel, what’s the problem?

    It’s Inez McPherson. She’s had three bad seizures. The first one lasted almost two minutes, the second one started about a minute after the first subsided and lasted a little over a minute. The third also lasted a little over a minute. The convulsions were very intense with lots of contortions, drooling, and arching of her neck. She’s pretty exhausted.

    Dr. Solomon glanced at the digital clock on his bedside table and noted the time as 2:02 a.m. Look at Inez’s chart for the last documented seizure.

    I checked that and the nurses’ notes indicate a moderate seizure four months ago, Ethel responded.

    And what about the last Dilantin level?

    I have that right here. The last blood level indicates 10.1 on May 23.

    Adrenaline began to flow in Dr. Solomon. Hm, only six weeks ago and toward the bottom of normal range. If my memory serves me correctly, Ethel, I raised her dosage at that time in hopes of raising her blood level. Please check those orders.

    I’ve looked at those orders and have them here in front of me. You raised the dosage of her medication from three times daily to four times daily.

    That seems strange, Dr. Solomon said. Have you checked her drug administration records for that medication since I wrote the order for that dosage change?

    Yes, I have, Doc, but I’ll double-check those records. I have them right here. Hold on, Ethel said.

    Dr. Everett Solomon slipped out of bed, cell phone in his hand. After listening a minute, he gently woke his wife, who asked, Headed to the hospital?

    He kissed her. Yes, honey, I have to meet a nursing home resident at the emergency room soon.

    Okay, see you later. I love you, she said, drifting back to sleep.

    Dr. Solomon, I’m back with the drug administration records, Ethel said. Since you wrote the order to change the Dilantin, the documentation indicates all doses given as ordered. Let me check them again.

    Dr. Solomon thought a moment. The situation was getting even stranger the more he was told. Dilantin was the drug of choice for this seizure problem, and if Inez had been getting her medication four times per day as he ordered, her blood level should have been normal, and she shouldn’t have had a seizure.

    He stepped into the bedroom walk-in closet, flipped on the light, slipped off his pajama bottoms, and pulled on a pair of shorts. Forcing his legs into a pair of lightly starched khaki slacks, he methodically slid a tan belt through the belt loops. Next he put on a blue oxford cloth shirt. He grabbed a pair of tan loafers from the closet floor and pulled them on, as he hopped on the right foot and then on the left across the silent bedroom to the bed. He held the portable phone to his ear.

    Okay, Doc. I’m back. All doses are initialed as given, reported Ethel.

    There’s definitely something wrong here, he said. Call for an ambulance to transfer Inez to Stafford County Hospital Emergency Room. I’ll be there when she arrives. No drug orders until after she reaches the hospital. Have the paramedics start an IV line. Thanks, Ethel.

    He knelt by his wife’s bedside, kissed her gently on the cheek, and then returned the phone to its carriage on the bedside table.

    Everett slipped out of the bedroom into the oak-floored hallway, opened the coat closet, and grabbed a blue poplin hooded jacket. Wind chimes outside the window rattled and tinkled in the strong wind, as raindrops pounded violently against the window panes. From the desk in the hallway cubicle, he snatched another cell phone and bounded through the door into the double garage. He got into his car, pulled out of the garage, and called the hospital.

    Stafford County Hospital ER. Lilly Sanders, RN here.

    Yes, Lilly, Dr. Solomon. Inez McPherson will be transported soon by ambulance from Sunny Side Nursing Home. She’s had a bad seizure. Ethel, the nurse on duty at Sunny Side, should have an ambulance in transit by now.

    Yes, I just heard on the scanner that an ambulance is on its way to Sunny Side, Lilly confirmed.

    Good. We’ll need to have blood drawn by the paramedics before they leave Sunny Side. Also, no drug orders until after Inez arrives at the hospital. Please transfer this call to the lab. I’ll see you shortly when Inez arrives. Thanks, Lilly. Dr. Solomon waited briefly on hold for the lab.

    Freddie Parker here. Can I help you?

    We have Inez McPherson coming to ER soon from Sunny Side Nursing Home, Dr. Solomon said.

    Okay, Doc, how can I help you?

    I want you to be at ER when she arrives and take the blood drawn from Mrs. McPherson by the paramedics for a Dilantin level.

    No problem. I’ll be there. I’m heading that way now.

    Great. I’ll see you within the next half-hour.

    Dr. Solomon thought to himself that he didn’t feel good about Inez’s situation.

    Ethel dialed the number for Inez’s next-of-kin to be called in case of emergency, a niece in Sacramento, California. Her name, Ann Murphy, along with her number, had been posted in the front of Inez’s chart.

    Ms. Murphy, Ethel Franklin here at Sunny Side Nursing Home in Melville, Texas. I’m calling you about your aunt, Inez McPherson.

    Yes, yes. What’s wrong? asked Ann.

    Your aunt has had some seizures and her doctor requested that she be transported by ambulance to the emergency room at Stafford County Memorial Hospital here in Melville for further evaluation. I wanted to call you, since you’re next-of-kin to be notified in case of emergency and make you aware what’s going on.

    How is Aunt Inez doing?

    The three seizures lasted one to two minutes each. She’s pretty exhausted from the seizures, but she’s alert and aware that she’s being taken to the emergency room. We’ll know more after she gets to ER. I’ll call you later today and let you know about her condition, Ethel said. Do you have any questions about your aunt?

    No, it sounds as if you and her doctor are doing everything you can. I wish I could be there. Tell her I love her and I’m thinking about her. Would you please call Sharon Gladney? Her family has always been good friends of Aunt Inez. Do you have her number?

    Yes. I’ll tell your aunt what you said, and if you have any questions, feel free to call us. Bye for now.

    The shrill siren screamed as the ambulance from Stafford County Hospital sped through the stormy night to its destination at Sunny Side Nursing Home. Red and blue lights flashed brightly, reflecting brilliantly on the green and white snub-nosed Ford as its driver, John Franks, maneuvered the slick asphalt streets in the midst of the pouring rainstorm. The windshield wipers slapped furiously as the speedometer approached ninety. John braked quickly as the lights of Sunny Side became visible. He entered the driveway and expertly dodged most of the potholes in the parking lot, which resembled a mine field. John hastily backed the ambulance with the other two emergency medical technicians inside to the front entry door of Sunny Side, a home with a reputation for poor resident care. The gleaming, silver-colored doors at the rear of the ambulance popped open with a turn of the inside handle by Sandy Nickles’s wrist, and she and Bob Slocum emerged with a rubber-wheeled stretcher. John killed the engine, ran to Sunny Side’s glass entry door, and held it open as Sandy and Bob carried the stretcher into the lobby, unfolded the legs, and wheeled it toward C Hall.

    The odor of old urine permeated Bob’s nostrils. I smell pee.

    Ditto, replied Sandy and John in unison.

    Sandy pushed her hair out of her face and caught a glimpse of her watch—2:33 a.m. John, Sandy, and Bob cast off their raincoats and threw them on an old sofa in the dimly lit lobby.

    Ethel stepped out of Inez’s room when she heard the paramedic crew, walked up the hall, and motioned them to Inez’s room. Down here in Room 38. The empty stretcher guided by the paramedics rattled down the hall and into Inez’s doorway. The resident Inez McPherson is in the bed next to the window. She’s had three seizures, but has settled down now.

    Hi, Mrs. McPherson. Dr. Solomon wants us to start an N line before we take you to the hospital emergency room, Sandy said. John handed her a needle and she swabbed the area to be injected. The skin is prepped. Now for the hard part, finding a vein that I can get this needle in. John, hold that area just below her elbow. I’m going to try to roll the vein up, pinch it, and try to get this needle in.

    Sandy wiped her forehead. Got a good hold, John?

    Yes, he answered.

    Here goes. The needle penetrated Inez’s skin and red appeared in the needle. We’re in, said Sandy with a relieved sigh. Dr. Solomon wants us to get some blood samples before we transfer you to ER. With a syringe, Sandy drew three tubes of blood. Bob, I’ll insert the IV tubing now so that meds can be administered later at ER.

    Does Mrs. McPherson have anything to transfer with her other than her nursing home chart and hospital transfer form? inquired Bob.

    Nothing else. We tidied her up after the seizure. I believe she’s ready to go. I checked her vital signs and they’re normal, Ethel responded.

    Inez rolled her head toward Ethel and the paramedic team. Her faded blue eyes showed exhaustion, and her face looked drained and pale.

    Ethel spoke to Inez. We’re going to move you over to this stretcher, and these folks are going to take you to the hospital by ambulance. Dr. Solomon wants to see you at the emergency room.

    Okay, Ethel, I’m pretty tired, Inez said.

    The paramedic team efficiently moved Inez to the stretcher, wrapped a sheet and blanket around her, pulled up the side rails, and secured the transport belts.

    Lying on her back, extending her frail right hand to Bessie, Inez squeezed her friend’s hand and said, You know, Bessie, every night when we prayed together, we always prayed we wouldn’t die in this hellhole. Good-bye. I love you.

    I’ll be praying for you, Inez, answered Bessie consolingly as she wiped the tears from her eyes with the back of her hand.

    Ethel leaned over Bessie and said softly, Inez, I called your niece Ann in California to let her know you’re going to the hospital. She said to tell you that she loves you, will be thinking about you, and wishes she could be here. Inez smiled. I also called Sharon Gladney to let her know you’re going to the emergency room. Ethel kissed Inez on her wrinkled cheek.

    Thanks, Ethel, Inez said.

    You’re welcome. You’ve got to go, sweetie. Ethel turned her head, pulled a tissue from her pocket, and wiped the tears that flooded down her cheeks gratefully.

    John, Sandy, and Bob maneuvered the stretcher out to the front entry door. Ethel held the glass door open, as Sandy put her raincoat over Inez’s face to protect her from the incessant rain. Just as John and Bob moved the stretcher out of the nursing home exit, a clap of thunder rumbled and boomed. John opened the ambulance’s rear doors, climbed in, and pulled the stretcher inside while Bob and Sandy pushed from the rear.

    John shouted, I have the stretcher secure inside!

    The back door is closed, and we’re ready to go back here, replied Bob.

    John, in the driver’s seat, exclaimed, Okay, team, we’re on our way!

    The heavy-duty wipers cleared water from the windshield. A bolt of lightning illuminated the driver’s compartment of the ambulance. The loaded ambulance sped out of the parking lot of Sunny Side, the siren screamed, and the bright lights flashed, reflecting vividly in the downpour of the stormy night. John stepped on the accelerator while Sandy phoned ER. Unit number 137 is en route from Sunny Side Nursing Home with Mrs. Inez McPherson. We’ll arrive at the emergency room within three minutes.

    CHAPTER 2

    Lilly, an RN with twenty-two years’ experience in ER, heard a siren as the ambulance sped to the emergency room. She told Karen Black, a recent RN graduate with four months’ experience, that the ambulance from Sunny Side was on its way.

    Lilly and Karen stepped through the swinging doors from ER into the lobby and met Freddie from the lab.

    Hello, ladies. Dr. Solomon called me to get the blood the paramedics drew from Mrs. McPherson, he said.

    Dr. Solomon ran down the hallway leading to the lobby. All four then walked out of the ER lobby area into the covered entrance where the ambulance approached. The rain continued to fall in sheets. The ambulance stopped under the covered area and the foursome went to the rear of the ambulance as the rain-splattered back door opened. John also came to help the two paramedics remove the stretcher holding Inez.

    Sandy told them Inez’s vital signs were normal, and then she told Inez they were at the hospital.

    Karen and Lilly helped the paramedics guide the stretcher into the ER lobby. Dr. Solomon leaned over Inez and said, I felt it best for you to come to ER as soon as possible to check you out since you had those seizures. We’re going to take you into an exam room, and Freddie here from lab is going to take this blood to the lab and run a test on it.

    I’ll get you a Dilantin level as soon as possible, Freddie said.

    The sooner, the better, agreed Dr. Solomon. Do you feel okay, Inez?

    Pretty tired, Doc. Those seizures really wore me out. I don’t have much strength.

    I understand. That’s normal after seizures like those.

    The group of seven rushed Inez into an exam room.

    Lilly whispered to Dr. Solomon, She’s tensing up.

    I’m feeling strange like before, Inez said. She pulled Dr. Solomon by the hand so that his face was about a foot from hers. Those med aides haven’t been giving me all my seizure medicine the last few days."

    With this statement, dead silence came over the exam room. Lilly looked at Karen in disbelief. John wore a crooked frown. Sandy and Bob shook their heads.

    I suspected that, Inez. How many doses were missed? asked Dr. Solomon.

    Inez strained to speak. All nighttime doses for the last three weeks or so, and some during the afternoons.

    Why didn’t you tell somebody, Inez? Dr. Solomon asked her.

    Inez whispered, Some of those aides are mean to us if we complain.

    She jerked and made a shrill scream. Dr. Solomon looked at Lilly and Karen and commented, Here we go again—another seizure. Bob, Sandy, John, would all of you stay with us? We have a lot to do here. Inez is going to be moving around a lot, and we need your help.

    No problem, Doc. We’re here as long as you need us, Bob replied.

    Inez’s arms and legs began flailing wildly, her neck arched backward, and she began drooling profusely. Her eyes rolled back in her head.

    Lilly, let’s protect those arms and legs so she won’t harm herself. Be careful with them. Her skin is very thin. We’ve got to get some intravenous meds started as soon as possible. I know it’s going to be difficult in the midst of this seizure, but we’ve gotta do it.

    We have her legs and arms secured by holding them gently. Sandy’s supporting her head, Lilly said.

    Sandy, keep her airway open, and keep that bite stick in her mouth, the doctor directed.

    The doctor injected the medication and waited. Nothing, and we’ll give only five more milligrams to max out the dose. Let’s get that Dilantin started. The seizures don’t appear to have subsided at all.

    Sandy responded, Right, Doc. No change here. The convulsions are just as intense as ever, and she’s exhausting herself rapidly.

    John and Bob, keep protecting those extremities.

    We will, Doc, Bob assured him.

    The night nursing supervisor stepped into the exam room and moved up to the exam table. Can I help? Looks like there’s plenty going on here.

    It’s been a minute since we injected the second dose of Valium, so now we’ve got to give her everything we have left. Karen, is that Dilantin IV push about ready to go? the doctor asked.

    Ready, Karen responded.

    Okay. Karen, let’s get it started…

    Hook up that monitor so we can monitor the blood pressure and the EKG. Looks like we may have to go to the maximum Dilantin dose. It’ll take twenty-four minutes to push it, so let’s get it started. No time to waste. Inez exhausted herself almost completely with those seizures earlier tonight, and now she’s is in a series of continuous uncontrollable seizures called status epilepticus; time is really getting critical. We’ve gotta get these convulsions stopped real soon. Blood pressure is still looking good and the EKG looks okay. Lilly, get five more milligrams of Valium ready to inject, Dr. Solomon instructed anxiously.

    Freddie worked feverishly in the lab to get a Dilantin level as soon as possible for Inez. He took a sip of his cold coffee from his blue ceramic Cowboys cup and dialed ER. The telephone rang six times before the night receptionist answered.

    Freddie spoke anxiously. Freddie here in lab. We will have a blood level in about one minute. Dr. Solomon needs it stat on Inez McPherson in Exam Room 2. Let me hold, please. It’ll be just a few more seconds now. Ah, here it is now. My gosh, this is low–7.1. Please tell Doc right away.

    I’m headed that way now to give him that info, the receptionist replied, pushing open the door to Exam Room 2 and approaching Dr. Solomon. Freddie just called from lab, and Mrs. McPherson’s Dilantin level is 7.1.

    Oh no! It’s worse than I expected! How much Dilantin have you given so far, Lilly? Dr. Solomon asked her.

    Three hundred milligrams, she replied.

    Her respiration okay?

    Yes, the supervisor answered quickly.

    Give one hundred milligrams of phenobarb IV as soon as possible. This is all we have left, even though she may go into respiratory arrest.

    One hundred milligrams phenobarb drawn and ready to inject.

    Blood pressure and EKG still okay? Lilly nodded.

    Inject it, Dr. Solomon ordered.

    Done.

    How much Dilantin has she received?

    Four hundred milligrams, Karen responded.

    Watch and wait for now. That’s all we can do. Has anyone seen any improvement in her convulsions? No one replied and everyone shook his head. Two minutes passed as Dr. Solomon watched the monitor. He blinked his eyes, and Inez’s blood pressure began to drop. Her body made one last convulsion and went limp. A flat line appeared on her EKG.

    Code, we got a code! screamed Dr. Solomon. Gimme sodium bicarb and epinephrine now, and begin chest compressions. The supervisor put both medications in his hands. This is her last chance, he said, stabbing both meds directly into Inez’s heart. He checked the EKG. No response. Gimme another sodium bicarb.

    Here, Doc. The supervisor quickly placed the medication into his right palm.

    Come on, Inez. He jabbed her chest again. The EKG still indicated a flat line.

    The monitor indicated no blood pressure.

    Keep pumping her chest, the doctor said. Come on, Inez, pull through.

    Silence fell over the room as the EKG showed no improvement, nor did Inez indicate any blood pressure.

    My hands are cramping from the chest compressions. Someone take over, Sandy pleaded.

    Okay, switch out, but let’s keep trying, Dr. Solomon pressed.

    The pumping continued as the respirator breathed for Inez, but she showed no response.

    She’s gone. Cut off the respirator. He looked at his watch—3:35.

    Lilly placed a white sheet over Inez’s face, and the nurses, paramedics, and Dr. Solomon filed out of the room. Inez died from wrongful death because she had a low level of her medication due to missed doses at Sunny Side, he thought. I cannot let this matter pass and not inform appropriate authorities. I must act.

    He slipped off the white jacket he had worn while taking care of Inez and then stepped out of ER into the lobby area.

    Sharon Gladney approached him. Dr. Solomon, Ethel called me from Sunny Side and told me Inez came to ER.

    Yes, she had seizures earlier at Sunny Side and then even more severe uncontrollable ones after she got to ER. She didn’t pull through. He took Sharon’s hand and put his arm around her shoulders. We lost her. We did all we could.

    Tears came to Sharon’s eyes. I know you did. Do you have any idea what caused this?

    I’m not sure right now. We’ll be checking into her situation very quickly. I know your mom, dad, and Inez go back a long way. Neighbors from years ago, I believe I heard Inez say once. What a wonderful, gracious, sweet lady. She always smiled and never complained about her troubles. Ethel will call Inez’s niece in California. Inez will be missed. Bye for now, Sharon, Dr. Solomon said.

    He turned and briskly walked back into ER, wiping a tear from his cheek. What a shame, he thought. He sat at a desk, picked up a phone, and called the number for Sunny Side.

    Sunny Side Nursing Home. Ethel Franklin, RN, speaking.

    Ethel, Dr. Solomon here. Inez didn’t make it. She went into status epilepticus and we couldn’t pull her through. I knew you’d want to know.

    I’m so sorry to hear that. I was hoping she’d be okay, Ethel responded sadly.

    In addition to that bad news, I have some more bad news for you. Before she started the convulsions, she told us in the exam room that some of her doses of Dilantin hadn’t been given to her lately. Also, before the seizure began, Freddie drew blood, and her Dilantin level came back 7.1.

    Oh, no, Doc. That makes a bad situation even worse. That’s terrible.

    You’re right. It appears someone’s really screwed up. I don’t feel I can sit by and not react to what happened to Inez. I haven’t decided what I’m going to do, but I’ll be back in contact with your people there at Sunny Side. Please try to determine how Inez missed those doses. I’ll talk with you later, said Dr. Solomon. Oh, one more thing, Ethel. I’m ordering an autopsy to be performed.

    I certainly understand. I’ll call Inez’s niece and notify her, Ethel said.

    Ethel sat at the nurses’ station doing chart work to get the nurses’ notes current for her shift. She noticed a partially burned birthday candle on the desk, picked it up, and reflected on Inez’s surprise birthday party a few weeks before. A ladies’ group from a local church often made birthday cakes for residents who did not have family or friends who visited them often. The church ladies had decorated the dining room with red and white crepe paper streamers, and Ethel had brought a bouquet of flowers for Inez. When Inez entered the dining room in her wheelchair, Bessie and twenty-two other residents shouted in unison, Surprise! Tears of joy came to Inez’s eyes. She had fun that day with her friends.

    The telephone rang

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