CHAPTER 1

The death itself wasn’t the unusual thing. The unusual thing was we tried to stop it. That first dying heart came on a Thursday night, a little after midnight on May 5th. I remember the date because it was Cinco de Mayo, a Mexican holiday. There’d been celebrations all day long in San Francisco, including in the Presidio where I was working that night.

I was one of two physicians on duty in the ER at Deaconess Hospital, doing the overnight shift, 6 PM to 6 AM. The early part of the shift had been busy. When I arrived at six o’clock, the waiting room was bursting with patients: drunken revelers with lacerations and sprained ankles, tourists with sunburns, picnickers vomiting from food poisoning, six members of a mariachi band with heat stroke and dehydration. We worked fast, moving from one stretcher to the next, seeing the most critical patients first and moving on.

Then, around ten o’clock, the flow of new patients stopped—abruptly, like water from a faucet turned from on to off. By 11:00 PM, there were only four patients in the waiting room. By 11:45, I finished sewing up my last laceration: a three-inch gash on the forehead of an intoxicated coed from San Francisco State.

Then, there was no one. The emergency department had gone from chaos to serenity.

With nothing to do, Hansen, the other physician on duty, went to catch a nap in the staff lounge. I washed up and went over to join Bill—the night nurse—at the nursing station. We sat with our feet up, drinking black coffee from Styrofoam cups, looking across the empty row of stretcher beds. Bill launched nostalgically into a pornographic tale about a buxom nurse he’d known while serving as a medic during the Gulf War. He’d just reached the climax—so to speak—of his story when, suddenly, the calm of the night was interrupted by an announcement over the intercom:

“Code Blue, East Annex, back station! Code Blue, East Annex, back station! ”

“Christ,” Bill said stopping short in his story. “East Annex? That’s the Alzheimer’s unit.”

“Yeah,” I said. Bill and I exchanged puzzled looks.

“Since when do they call Code Blues on the Alzheimer’s unit?” Bill asked.

The announcement came again, sounding now more urgent. “Code Blue, East Annex! Code Blue!” It was an urgent call for help, hospital jargon for, “Come quick, someone’s trying to die.” And, at that hour of the night, it was the duty of the ER doctor to come and stop the dying. Or at least to try.

I jumped up and grabbed the “Code bag,” the big black duffel bag filled with the equipment we’d need to run the Code: defibrillator unit, intubation tubes, cardiac meds.

“Let’s go,” I said.

“But I was just getting to the good part of my story,” Bill said.

“Save it for later.”

We ran out of the emergency department down the long connector tunnel leading to the East Annex. Why were they calling a Code Blue on the East Annex? I wondered as we ran. In my three years of working at Deaconess, this was the first time I’d been called to a Code on the annex. Normally, they didn’t run Code Blues on the Alzheimer’s ward. The patients there were “DNR”—“Do Not Resuscitate.” In other words, when a patient on the annex stopped breathing or went into cardiac arrest, nothing was to be done. No medical heroics. No breathing machines, no cardiac stimulants, no shocking the heart. This was considered the humane thing to do. All the patients on the annex had at least moderately advanced Alzheimer’s disease; all were near the end of life. To prolong the lives of these poor souls at all costs was not the aim of medical care on the East Annex. The aim of medical care on the East Annex was comfort, a safe environment, and, when the time came, death with dignity.

I heard Bill huffing and puffing, falling behind as we ran down the hall. I turned back and saw him slow to a walk.

“I’ll have to…meet…you…” he said breathlessly.

“Maybe if you give up those damn cigarettes,” I called back as I went around the bend in the tunnel.

“Maybe if…I was…a damn jogger like you,” Bill called out.

At the end of the connector, I came to the door leading to the second floor of the annex. Normally, the door was shut and locked. The East Annex was a locked ward because the patients there—at least the ones who were ambulatory—had a habit of wandering off the ward and getting lost when the doors weren’t locked. Now, as I reached the end of the connector, a rotund, uniformed security guard stood at the door holding it open for me. “Straight ahead, past the back station, on the left,” the guard said.

I went through the door and immediately someone shouted out. “Over here!”

I ran to where six or seven people were gathered outside one of the rooms. There’s always a crowd at any Code Blue. Death, either actual or imminent, is always something that fascinates people. Several of the people in the crowd had no business being there: for example, the ward secretary standing on her tiptoes peering in at the door and the two members of the janitorial staff looking over her shoulder.

Elbowing my way into the room, I got my first look at the patient: an elderly, gray-skinned woman wearing pink pajamas. She lay lifelessly on her back on the bed, the covers tossed back. Four people were gathered closely around the bed working on her. The ward tech, a muscular, crew-cut fellow, was performing chest compressions, pumping away on the old woman’s sternum with the heel of his hand. At the head of the bed stood the respiratory therapist, a skinny African-American fellow named Lamont—I had worked with him in the emergency department. Lamont was holding a mask over the patient’s face and squeezing breaths of oxygen from an oxygen bag. At the foot of the bed stood the Code Blue pharmacist, a young Hispanic woman I’d never seen before; she attentively held her tray of Code Blue medicines, ready to dispense whatever might be called for. The fourth person at the bed was Juanita Obregón, one of the East Annex night nurses. Juanita was also a familiar face. She’d been a good friend of mine since my early days at Deaconess. She stood opposite the ward tech, pressing her fingers into the patient’s groin, feeling for a pulse at the femoral artery.

“Pescoe!” Juanita said as I entered the room. Juanita always called me by my last name—not “Philip” or “Phil” or “Dr. Pescoe,” just “Pescoe”. “Thank God. I was in to see her twenty minutes ago, and she was absolutely fine, watching TV. Then, I came in to turn off the television, and she’s unresponsive. Not breathing, no pulse—out.”

Juanita stepped back as I came over on her side of the bed.

“Who called the Code?” I asked.

“I did,” Juanita said.

“Why? She’s an Alzheimer’s patient, isn’t she?”

“Yes,” Juanita said. “All the patients on the annex are Full Code now, while they’re running the study.”

“Study? What study?”

“Neussbaum and his team. They’re running a drug study, some new experimental treatment for Alzheimer’s.”

I looked at Juanita. I hadn’t heard anything about a drug study on the East Annex. Neussbaum, whom Juanita had referred to, was Tucker Neussbaum, the doctor in charge of the Alzheimer’s unit. He’d never said anything to me about a change in resuscitation status on the unit. Of course, now was not the time to start questioning DNR orders—if the little old lady in the pink pajamas had been declared a Full Code, then so be it. My job was to do everything I could to bring her back to life. Now.

I turned toward the ward tech. “Hold compressions,” I said.

The tech stopped pumping on the patient’s chest and stood back. I pressed my fingers into the old lady’s neck and felt for a pulse. Nothing. I unzipped the Code bag, turned on the defibrillator machine, and took out the defibrillator paddles. Tearing open the woman’s pajama top, I pressed the paddles against her bony chest. The paddles acted like heart monitor electrodes, and we all looked at the TV screen on the defibrillator machine. The neon light showed the woman’s heart tracing, a wiggly pattern running across the screen. The wiggly tracing meant there was still some “life” left in the old woman’s heart, still some electrical activity. The heart rhythm was not normal, however, far from it: the woman’s heart was quivering out of control in a rhythm called “ventricular fibrillation.” In order to save her life, something had to be done to stop the quivering. Otherwise, the woman would die.

“V-fib,” I called out. “I’m going to shock.”

I turned the knobs to charge the defibrillator just as Bill came into the room, wheezing like a steam engine.

“V-fib,” I said. “They’re running some sort of drug study, and all the patients are Full Code.” I pressed the paddles firmly down on the woman’s chest. “Stand clear!” I shouted.

Lamont and the ward tech stepped away from the bed, and I activated the defibrillator. A pulse of electricity shot through the woman’s chest causing her back to arch up. We all looked down at the monitor for the second it takes to re-establish the heart rhythm after the jolt of electricity. The neon tracing appeared on the screen, squiggly and still fibrillating out of control. The shock had failed to convert the old woman’s heartbeat to a normal rhythm.

“Okay,” I said, “epinephrine. We need an IV.”

“She already has one,” Juanita said. “Left forearm.”

I looked at the patient’s left forearm, and, just as Juanita said, there was an IV already in place. A rubber-tipped intravenous catheter had been secured with a gauze wrap and tape. The IV was further held in place by a fishnet stocking covering the entire forearm.

I looked at the pharmacist. “Epinephrine, one milligram,” I said. As the pharmacist reached into her box of medicines, I said to the ward tech, “Continue chest compressions. I’m going to intubate her.”

As in a choreographed dance, everyone went into action. The pharmacist took a syringe of epinephrine—adrenaline—from her tray and handed it to Juanita. Juanita injected the heart stimulant into the IV. The tech resumed his chest compressions, and Lamont resumed bagging oxygen to the patient. Meanwhile, I went to the head of the bed and prepared to put a plastic tube down the old woman’s throat so we could breathe for her more effectively.

They say much of emergency medicine is “cookbook medicine,” and a well-trained monkey can perform much of what emergency physicians do. There’s no better example of this than the Code Blue cardiac arrest. Every step in the Code is based on a precisely defined algorithm, and everyone knows the drill. We’d already performed the first step of the algorithm: shock the patient’s heart with 360 Joules of electricity. This had failed to stop the quivering, so we moved to the next steps of the protocol: a shot of intravenous epinephrine and intubation.

“7.5 tube,” I said.

Bill took the throat tube out of the Code bag and handed it to me. Lamont pulled off the oxygen face mask and stepped aside, and I checked the woman’s mouth to see if there was anything inside that might make it difficult to put the tube down—blood, loose dentures, chunks of food. Her mouth and throat were clear.

“Does this patient have any history of heart problems?” I asked Juanita as I put the laryngoscope blade into the mouth and pried open the jaw.

“No, that’s just it,” Juanita said. “Her only medical history is Alzheimer’s disease. Otherwise, she’s the healthiest patient on the ward. Then again, that’s what I said about the last patient who died. This is the second Code we’ve had in three days.”

“Oh?” I said slipping the throat tube into the trachea.

“Yes. Mrs. Messing, she died on Tuesday.”

Lamont attached the oxygen bag to the end of the tube and began pumping 100% oxygen directly into the woman’s lungs.

“Is Neussbaum here tonight?” I asked.

“No. He just left, half an hour ago,” Juanita said. “His resident is on call tonight, Dr. Chester Mott. He’s here.” Juanita motioned with her head toward a young man standing on the other side of the room.

I looked over at the man. I hadn’t noticed him before; he was slumped down in the shadows of the far corner of the room. He was a short, overweight fellow wearing a black tee shirt and surgical scrub pants; he had carrot orange hair that stood out in all directions. He looked like a resident, all right: young, disheveled, sleep-deprived. I figured he must have been sleeping in the call room when the Code was called.

“Okay, hold compressions,” I said. I looked at the heart monitor: the rhythm was still v-fib. Our efforts were getting us nowhere. “Let’s shock again, 360 Joules.”

Bill charged the machine to 360, and I delivered the shock. Again, no change. What’s more, the amplitude of the heart waves on the screen was getting smaller, flatter. It was a bad sign.

I looked over at the resident. “Want to help, do some chest compressions?” I asked.

The resident looked at me with wide, frightened eyes and shook his head, no. I felt my head cock sideways as I looked at him in surprise. No? That’s odd, I thought. Residents were supposed to be keen to jump in and get involved in a Code Blue. Even if they’re nervous and not really eager to do so, at least they’re supposed to pretend. That’s what they’re there for, to learn. However, I decided to cut Dr. Mott some slack. No doubt he was feeling overwhelmed and anxious, the way most residents feel during the heat of a cardiac arrest. If this had been his rotation through the emergency department, I would have insisted. However, this was the Alzheimer’s ward. The young Dr. Mott was supposed to be learning about dementia and urinary incontinence and bed sores, not fibrillating hearts. No need to press him into service if he didn’t feel comfortable with it.

“Continue compressions,” I said turning back to the tech. I looked at pharmacist. “Amiodarone, 300 milligrams, IV,” I said regurgitating the next step of the protocol.

We continued to work down the algorithm, delivering further shocks and further medications. The room became pungent with the smell of the patient’s singed flesh owing to the repeated shocks. Another bad sign. Between shocks and injections, I watched and supervised the Code team. The ward tech had worked up a heavy sweat pumping away at the chest compressions.

“Need a break?” I asked.

“No, I’m okay.”

“Bill can relieve you. Or,” I said raising my voice a little, “maybe the resident.” Mott didn’t move. He just stood there looking down at the floor, his hands folded diffidently over his protuberant belly.

“No, I’m fine,” the tech said; “I’m good.”

I looked at the patient lying lifelessly on the bed. I wondered what it was that had caused her heart to go suddenly haywire. Heart attack? Juanita had said there was no history of heart problems. I looked at the old woman’s face: she had to be at least eighty-five-years-old. Her hair was white and thinned to near baldness at the crown, her forehead covered with age spots. Her cheeks stood out prominently on the bony face, and her eyes were sunk deep into the sockets. I asked myself again: why in the world were we Coding this bent-up old lady with Alzheimer’s disease?

I asked the tech to hold compressions and looked once again at the heart monitor. The tracing was almost flat now. The woman was going to die. I knew it, everyone knew it—we were just going through the motions now.

“Okay,” I said. I could hear the resigned tone in my own voice. “Let’s try another shock—360 Joules.”

We continued our efforts for another ten minutes until the woman’s heartbeat was truly flat-line on the monitor. I delivered one final, ineffective shock then decided to call it quits.

“I’m going to stop,” I said. “Any objections?”

Not surprisingly, no one objected.

“Okay…,” I said looking up at the clock on the wall. “12:57.”

The tech stopped the chest compressions; Lamont stopped squeezing the oxygen bag; the pharmacist closed her box of medicines. Somewhere in the shadows I saw the young Dr. Mott slip silently out of the room. I looked down at the patient. Her face was now a blue-purple color, and the endotracheal tube stuck out of her mouth like the end of a large fish hook.

“Okay,” Juanita said. “12:57. I’ll mark it down as the time of death.”

 

CHAPTER 1

The death itself wasn’t the unusual thing. The unusual thing was we tried to stop it. That first dying heart came on a Thursday night, a little after midnight on May 5th. I remember the date because it was Cinco de Mayo, a Mexican holiday. There’d been celebrations all day long in San Francisco, including in the Presidio where I was working that night.

I was one of two physicians on duty in the ER at Deaconess Hospital, doing the overnight shift, 6 PM to 6 AM. The early part of the shift had been busy. When I arrived at six o’clock, the waiting room was bursting with patients: drunken revelers with lacerations and sprained ankles, tourists with sunburns, picnickers vomiting from food poisoning, six members of a mariachi band with heat stroke and dehydration. We worked fast, moving from one stretcher to the next, seeing the most critical patients first and moving on.

Then, around ten o’clock, the flow of new patients stopped—abruptly, like water from a faucet turned from on to off. By 11:00 PM, there were only four patients in the waiting room. By 11:45, I finished sewing up my last laceration: a three-inch gash on the forehead of an intoxicated coed from San Francisco State.

Then, there was no one. The emergency department had gone from chaos to serenity.

With nothing to do, Hansen, the other physician on duty, went to catch a nap in the staff lounge. I washed up and went over to join Bill—the night nurse—at the nursing station. We sat with our feet up, drinking black coffee from Styrofoam cups, looking across the empty row of stretcher beds. Bill launched nostalgically into a pornographic tale about a buxom nurse he’d known while serving as a medic during the Gulf War. He’d just reached the climax—so to speak—of his story when, suddenly, the calm of the night was interrupted by an announcement over the intercom:

“Code Blue, East Annex, back station! Code Blue, East Annex, back station! ”

“Christ,” Bill said stopping short in his story. “East Annex? That’s the Alzheimer’s unit.”

“Yeah,” I said. Bill and I exchanged puzzled looks.

“Since when do they call Code Blues on the Alzheimer’s unit?” Bill asked.

The announcement came again, sounding now more urgent. “Code Blue, East Annex! Code Blue!” It was an urgent call for help, hospital jargon for, “Come quick, someone’s trying to die.” And, at that hour of the night, it was the duty of the ER doctor to come and stop the dying. Or at least to try.

I jumped up and grabbed the “Code bag,” the big black duffel bag filled with the equipment we’d need to run the Code: defibrillator unit, intubation tubes, cardiac meds.

“Let’s go,” I said.

“But I was just getting to the good part of my story,” Bill said.

“Save it for later.”

We ran out of the emergency department down the long connector tunnel leading to the East Annex. Why were they calling a Code Blue on the East Annex? I wondered as we ran. In my three years of working at Deaconess, this was the first time I’d been called to a Code on the annex. Normally, they didn’t run Code Blues on the Alzheimer’s ward. The patients there were “DNR”—“Do Not Resuscitate.” In other words, when a patient on the annex stopped breathing or went into cardiac arrest, nothing was to be done. No medical heroics. No breathing machines, no cardiac stimulants, no shocking the heart. This was considered the humane thing to do. All the patients on the annex had at least moderately advanced Alzheimer’s disease; all were near the end of life. To prolong the lives of these poor souls at all costs was not the aim of medical care on the East Annex. The aim of medical care on the East Annex was comfort, a safe environment, and, when the time came, death with dignity.

I heard Bill huffing and puffing, falling behind as we ran down the hall. I turned back and saw him slow to a walk.

“I’ll have to…meet…you…” he said breathlessly.

“Maybe if you give up those damn cigarettes,” I called back as I went around the bend in the tunnel.

“Maybe if…I was…a damn jogger like you,” Bill called out.

At the end of the connector, I came to the door leading to the second floor of the annex. Normally, the door was shut and locked. The East Annex was a locked ward because the patients there—at least the ones who were ambulatory—had a habit of wandering off the ward and getting lost when the doors weren’t locked. Now, as I reached the end of the connector, a rotund, uniformed security guard stood at the door holding it open for me. “Straight ahead, past the back station, on the left,” the guard said.

I went through the door and immediately someone shouted out. “Over here!”

I ran to where six or seven people were gathered outside one of the rooms. There’s always a crowd at any Code Blue. Death, either actual or imminent, is always something that fascinates people. Several of the people in the crowd had no business being there: for example, the ward secretary standing on her tiptoes peering in at the door and the two members of the janitorial staff looking over her shoulder.

Elbowing my way into the room, I got my first look at the patient: an elderly, gray-skinned woman wearing pink pajamas. She lay lifelessly on her back on the bed, the covers tossed back. Four people were gathered closely around the bed working on her. The ward tech, a muscular, crew-cut fellow, was performing chest compressions, pumping away on the old woman’s sternum with the heel of his hand. At the head of the bed stood the respiratory therapist, a skinny African-American fellow named Lamont—I had worked with him in the emergency department. Lamont was holding a mask over the patient’s face and squeezing breaths of oxygen from an oxygen bag. At the foot of the bed stood the Code Blue pharmacist, a young Hispanic woman I’d never seen before; she attentively held her tray of Code Blue medicines, ready to dispense whatever might be called for. The fourth person at the bed was Juanita Obregón, one of the East Annex night nurses. Juanita was also a familiar face. She’d been a good friend of mine since my early days at Deaconess. She stood opposite the ward tech, pressing her fingers into the patient’s groin, feeling for a pulse at the femoral artery.

“Pescoe!” Juanita said as I entered the room. Juanita always called me by my last name—not “Philip” or “Phil” or “Dr. Pescoe,” just “Pescoe”. “Thank God. I was in to see her twenty minutes ago, and she was absolutely fine, watching TV. Then, I came in to turn off the television, and she’s unresponsive. Not breathing, no pulse—out.”

Juanita stepped back as I came over on her side of the bed.

“Who called the Code?” I asked.

“I did,” Juanita said.

“Why? She’s an Alzheimer’s patient, isn’t she?”

“Yes,” Juanita said. “All the patients on the annex are Full Code now, while they’re running the study.”

“Study? What study?”

“Neussbaum and his team. They’re running a drug study, some new experimental treatment for Alzheimer’s.”

I looked at Juanita. I hadn’t heard anything about a drug study on the East Annex. Neussbaum, whom Juanita had referred to, was Tucker Neussbaum, the doctor in charge of the Alzheimer’s unit. He’d never said anything to me about a change in resuscitation status on the unit. Of course, now was not the time to start questioning DNR orders—if the little old lady in the pink pajamas had been declared a Full Code, then so be it. My job was to do everything I could to bring her back to life. Now.

I turned toward the ward tech. “Hold compressions,” I said.

The tech stopped pumping on the patient’s chest and stood back. I pressed my fingers into the old lady’s neck and felt for a pulse. Nothing. I unzipped the Code bag, turned on the defibrillator machine, and took out the defibrillator paddles. Tearing open the woman’s pajama top, I pressed the paddles against her bony chest. The paddles acted like heart monitor electrodes, and we all looked at the TV screen on the defibrillator machine. The neon light showed the woman’s heart tracing, a wiggly pattern running across the screen. The wiggly tracing meant there was still some “life” left in the old woman’s heart, still some electrical activity. The heart rhythm was not normal, however, far from it: the woman’s heart was quivering out of control in a rhythm called “ventricular fibrillation.” In order to save her life, something had to be done to stop the quivering. Otherwise, the woman would die.

“V-fib,” I called out. “I’m going to shock.”

I turned the knobs to charge the defibrillator just as Bill came into the room, wheezing like a steam engine.

“V-fib,” I said. “They’re running some sort of drug study, and all the patients are Full Code.” I pressed the paddles firmly down on the woman’s chest. “Stand clear!” I shouted.

Lamont and the ward tech stepped away from the bed, and I activated the defibrillator. A pulse of electricity shot through the woman’s chest causing her back to arch up. We all looked down at the monitor for the second it takes to re-establish the heart rhythm after the jolt of electricity. The neon tracing appeared on the screen, squiggly and still fibrillating out of control. The shock had failed to convert the old woman’s heartbeat to a normal rhythm.

“Okay,” I said, “epinephrine. We need an IV.”

“She already has one,” Juanita said. “Left forearm.”

I looked at the patient’s left forearm, and, just as Juanita said, there was an IV already in place. A rubber-tipped intravenous catheter had been secured with a gauze wrap and tape. The IV was further held in place by a fishnet stocking covering the entire forearm.

I looked at the pharmacist. “Epinephrine, one milligram,” I said. As the pharmacist reached into her box of medicines, I said to the ward tech, “Continue chest compressions. I’m going to intubate her.”

As in a choreographed dance, everyone went into action. The pharmacist took a syringe of epinephrine—adrenaline—from her tray and handed it to Juanita. Juanita injected the heart stimulant into the IV. The tech resumed his chest compressions, and Lamont resumed bagging oxygen to the patient. Meanwhile, I went to the head of the bed and prepared to put a plastic tube down the old woman’s throat so we could breathe for her more effectively.

They say much of emergency medicine is “cookbook medicine,” and a well-trained monkey can perform much of what emergency physicians do. There’s no better example of this than the Code Blue cardiac arrest. Every step in the Code is based on a precisely defined algorithm, and everyone knows the drill. We’d already performed the first step of the algorithm: shock the patient’s heart with 360 Joules of electricity. This had failed to stop the quivering, so we moved to the next steps of the protocol: a shot of intravenous epinephrine and intubation.

“7.5 tube,” I said.

Bill took the throat tube out of the Code bag and handed it to me. Lamont pulled off the oxygen face mask and stepped aside, and I checked the woman’s mouth to see if there was anything inside that might make it difficult to put the tube down—blood, loose dentures, chunks of food. Her mouth and throat were clear.

“Does this patient have any history of heart problems?” I asked Juanita as I put the laryngoscope blade into the mouth and pried open the jaw.

“No, that’s just it,” Juanita said. “Her only medical history is Alzheimer’s disease. Otherwise, she’s the healthiest patient on the ward. Then again, that’s what I said about the last patient who died. This is the second Code we’ve had in three days.”

“Oh?” I said slipping the throat tube into the trachea.

“Yes. Mrs. Messing, she died on Tuesday.”

Lamont attached the oxygen bag to the end of the tube and began pumping 100% oxygen directly into the woman’s lungs.

“Is Neussbaum here tonight?” I asked.

“No. He just left, half an hour ago,” Juanita said. “His resident is on call tonight, Dr. Chester Mott. He’s here.” Juanita motioned with her head toward a young man standing on the other side of the room.

I looked over at the man. I hadn’t noticed him before; he was slumped down in the shadows of the far corner of the room. He was a short, overweight fellow wearing a black tee shirt and surgical scrub pants; he had carrot orange hair that stood out in all directions. He looked like a resident, all right: young, disheveled, sleep-deprived. I figured he must have been sleeping in the call room when the Code was called.

“Okay, hold compressions,” I said. I looked at the heart monitor: the rhythm was still v-fib. Our efforts were getting us nowhere. “Let’s shock again, 360 Joules.”

Bill charged the machine to 360, and I delivered the shock. Again, no change. What’s more, the amplitude of the heart waves on the screen was getting smaller, flatter. It was a bad sign.

I looked over at the resident. “Want to help, do some chest compressions?” I asked.

The resident looked at me with wide, frightened eyes and shook his head, no. I felt my head cock sideways as I looked at him in surprise. No? That’s odd, I thought. Residents were supposed to be keen to jump in and get involved in a Code Blue. Even if they’re nervous and not really eager to do so, at least they’re supposed to pretend. That’s what they’re there for, to learn. However, I decided to cut Dr. Mott some slack. No doubt he was feeling overwhelmed and anxious, the way most residents feel during the heat of a cardiac arrest. If this had been his rotation through the emergency department, I would have insisted. However, this was the Alzheimer’s ward. The young Dr. Mott was supposed to be learning about dementia and urinary incontinence and bed sores, not fibrillating hearts. No need to press him into service if he didn’t feel comfortable with it.

“Continue compressions,” I said turning back to the tech. I looked at pharmacist. “Amiodarone, 300 milligrams, IV,” I said regurgitating the next step of the protocol.

We continued to work down the algorithm, delivering further shocks and further medications. The room became pungent with the smell of the patient’s singed flesh owing to the repeated shocks. Another bad sign. Between shocks and injections, I watched and supervised the Code team. The ward tech had worked up a heavy sweat pumping away at the chest compressions.

“Need a break?” I asked.

“No, I’m okay.”

“Bill can relieve you. Or,” I said raising my voice a little, “maybe the resident.” Mott didn’t move. He just stood there looking down at the floor, his hands folded diffidently over his protuberant belly.

“No, I’m fine,” the tech said; “I’m good.”

I looked at the patient lying lifelessly on the bed. I wondered what it was that had caused her heart to go suddenly haywire. Heart attack? Juanita had said there was no history of heart problems. I looked at the old woman’s face: she had to be at least eighty-five-years-old. Her hair was white and thinned to near baldness at the crown, her forehead covered with age spots. Her cheeks stood out prominently on the bony face, and her eyes were sunk deep into the sockets. I asked myself again: why in the world were we Coding this bent-up old lady with Alzheimer’s disease?

I asked the tech to hold compressions and looked once again at the heart monitor. The tracing was almost flat now. The woman was going to die. I knew it, everyone knew it—we were just going through the motions now.

“Okay,” I said. I could hear the resigned tone in my own voice. “Let’s try another shock—360 Joules.”

We continued our efforts for another ten minutes until the woman’s heartbeat was truly flat-line on the monitor. I delivered one final, ineffective shock then decided to call it quits.

“I’m going to stop,” I said. “Any objections?”

Not surprisingly, no one objected.

“Okay…,” I said looking up at the clock on the wall. “12:57.”

The tech stopped the chest compressions; Lamont stopped squeezing the oxygen bag; the pharmacist closed her box of medicines. Somewhere in the shadows I saw the young Dr. Mott slip silently out of the room. I looked down at the patient. Her face was now a blue-purple color, and the endotracheal tube stuck out of her mouth like the end of a large fish hook.

“Okay,” Juanita said. “12:57. I’ll mark it down as the time of death.”

 

About The Perfect Family

Maggie heard Jamie come into the laundry room, where she was trying to make headway with the family’s clothes. Turning, she saw him drop to sit on the step and got a look at his face. “You all right, honey?”

“Yeah.” Jamie gave her a fake smile. “I gotta talk to you.”

Her pulse rate sped up. Good news never followed that statement. She set the shirt on the washing machine and leaned against it. “Shoot.”

“I have a date Friday night.”

“That’s good, isn’t it?”

“I think so.” His gaze locked with hers. “I hope you do, too.”

“Of course I do. Can we meet her?”

“It’s not a her, Mom. It’s a him.”

“A him?” She stared at her son blankly. The sound of the refrigerator across the room, the ticking of the clock on the wall seemed unnaturally loud. When realization hit, her mother’s heart tightened in her chest. “You have a date with a boy.”

A long pause. “It’s okay, isn’t it?”

Please God let me handle this right. After a moment of speechlessness, she said, “O-of course it is.”

Jamie’s fingers tightened on their dog Buck’s collar. Suddenly, her son seemed smaller, more fragile in his jeans and sweatshirt.

Maggie crossed to him, knelt down and took both of his hands in hers. His were freezing cold. “Honey, you know there’s nothing you could ever tell me, ever do or feel that would make me love you less.”

A frown. “Yeah, I know that.”

Well, she’d done this right. At least he knew her love was unconditional. But oh my God…the ramifications of his admission were far reaching.

“I just…I don’t want this to make you sad. Especially now that you’re so happy about Aunt Caroline.” He glanced down at the linoleum, then back to her again. “Are you upset?”

“That you’re gay?”

“Yeah.”

You have no idea. “No, honey. I love you for who you are.”

“Do you feel bad?”

How honest could she be? With Jamie and herself?

“Only that you didn’t tell me sooner.” Not quite the whole truth, but part of it. The easier part. Again, she thought of all they’d shared. Yet, dear Lord, he hadn’t told her something so vital to who he was. The notion made her stomach cramp.

“There wasn’t any need to tell you. I never wanted to date before. Now I do, which is why I said something today.”

“I guess I can accept that.” Later, she knew, his withholding would haunt her. Pushing away the selfish thought, she cleared her throat. “Does anybody else know?”

His expression was wry. “The guy I’m going on a date with.”

“Who is it?”

“Luke Crane.”

Her jaw dropped open. “Luke Crane? Your brother’s teammate?”

“Ma,” he said, sounding like the adult in the situation. “One out of every ten people is gay.”

She’d knew the stats, had brushed up on them for a section of Psyche 102 she taught.

“Even jocks.”

“I know. I never suspected it about him, though.”

“Did you, about me?”

Maggie had had some concerns. Once or twice she’d brought them up to Mike. The discussion always upset him, so she kept her worry to herself. One night, though, over a bottle of Merlot, she’d confessed her fears about her son to her best friend Gretta. She’d sensed all along Jamie was different, but in the end she decided the best course of action was to let Jamie tell her when he was ready. “I had some suspicions, Jame.”

“Why? Because there were no girls in the picture?”

“Uh-huh.”

And because he’d been interested in theater, and then started hanging out with a group from the plays. Paul and Nick were gay, she knew from Jamie himself. Also, Jamie had no desire to participate in sports beyond a brief stint at diving. Stereotypical thinking, which embarrassed her, but it had been there nonetheless.

Maggie moved to sit next to her son on the step. Buck compensated by lying at their feet. “Does Brian know? About you or Luke?”

“No.”

“Did you tell any of your friends? Julianne?”

“No, definitely not her. She’s so right wing Christian, Mom, I can’t talk to her anymore. Especially about something like this.”

“I’m sorry.” Maggie knew she shouldn’t ask, but like prodding a toothache with your tongue, or taking off a Band-Aid to check a wound, she couldn’t leave this alone. “Did you talk to an adult, honey?”

“Um, yeah. Ms. Carson.”

A sudden prick of tears, which she mercilessly battled back. He’d told another grown woman and not his mother. “H-has she helped you?”

“Yeah. A lot.”

“That’s good.”

“Luke and I aren’t gonna hide being together, Mom. We’re not gonna broadcast our dating either, but kids will find out.”

She groped around her mind for the mother role, one she usually fell into so easily. “How close are you two, Jamie?”

“We’ve been hanging out since the Valentine’s Dance. We got to be friends, then it turned into more.”

“Are you happy?”

He nodded. “My first boyfriend.” His expression turned sappy and Maggie’s heart ached and rejoiced at the same time. Then anger took over–that he’d been deprived of this normal adolescent feeling for so long. “It’s fun, Mom.”

“Good for you, honey.”

They talked about the times Jamie had seen Luke and his giddy feeling was even more evident, making it easier not to think about all he hadn’t shared with her.

After a half-hour, she glanced at the clock. Mike would be home soon. So she was forced to bring up the mechanics of dealing with what Jamie told her. “How do you plan to handle this at home? With the family?”

“Brian’s gotta know before anybody at school finds out. I’ll tell him. You tell Dad.”

Which they both knew would be the hardest part of all this.

Mike’s love for his son was deep. But how on God’s earth was he ever going to reconcile Jamie’s homosexuality with the Catholic religion? He was so single-minded about the church. The thought of how his attitude would influence this huge benchmark in their lives terrified Maggie. She squeezed Jamie’s arm and left her hand there, more for herself than him. “Dad will want to talk to you about all this.”

“I know.”

“What about the rest of the family?”

Since he was a baby, Jamie always got this certain expression on his face when he was troubled. Maggie could read it like a neon sign. “No.”

“No?”

“I don’t want to announce to anyone I’m gay, Mom.”

“What does that mean?”

“That I’m a son, a brother, a friend and an actor, not just a gay man.”

“I understand that.”

“And you didn’t feel the need to announce to anybody that Brian’s straight, did you?”

How wise he was for sixteen. Of course, he’d had time to think this out. And she was still reeling about the effect his disclosure would have on Mike. On all their lives.

“All right. I can abide by that wish, until it’s time for people to know.”

Like Brian’s graduation party, a few months away, if Jamie decided to bring Luke as his date. There were several possibly homophobic people in their lives.

A half-grin from her son. “We’ll tell people on a need-to-know basis.” Standing, he reached out a hand to her. She took it and prayed he didn’t feel hers trembling. When she got to her feet, she hugged him. He held on longer than usual. “I love you, Mom.”

“I love you, too.”

“Come on, Bucky,” he said to the dog, and they both disappeared down the hallway. She heard his feet pound on the steps, the bathroom door close and Buck bark at being left outside.

Dazed, Maggie picked up Mike’s shirt and stared down at it unseeingly. Her heart thudded in her chest as the ramifications of Jamie being gay flooded her. She picked up the stain spray to apply more to cuff, but dropped the can to the floor. Gripping the shirt to her chest, she swallowed hard.

“Stop it Maggie,” she said aloud. This wasn’t a tragedy. If Jamie had a terminal illness, or hit somebody while driving and killed them, or was into drugs that would be a tragedy. His sexual orientation was a simple fact of life.

Forcing herself to move, she put the white clothes in the washer, but random images bombarded her: Brian teasing Jamie about not having a girlfriend…Jamie’s dislike of proms… discussions about having kids, and Jamie saying he wanted some. She thought about Brigadoon. Her son was a boy who’d never experienced longing for the opposite sex but he always played the romantic, heterosexual lead in the plays he loved so much. What had that been like for him?

Her heart ached for her child—what he’d gone through alone, and what he would still go through, even in this day and age. In bigger cities, gay kids were more accepted, but Sherwood was different. And she knew the shattering statistics on gay teen suicide—three times higher than others in the age group.

After she closed the machine’s lid, she went to leave the laundry room, but instead, slid to the floor and wrapped her arms around her waist, trying to squelch her negative thoughts—like the wish to go back to how her life was an hour ago. Like the wish that…no, she wouldn’t even think about that. It took her a while but she won the battle and chose instead to figure out how she could help her son. And her husband.

#

With Buck at his heels, Jamie took the stairs two at a time. He catapulted into the bathroom, slammed the door and lowered the toilet seat. Dropping down onto it, he buried his face in his hands.

Breathe in, breathe out. Again. And again.

When his stomach settled and he didn’t feel like he was going to hurl, he stood and crossed to the sink in front of the mirror. He looked the same. Too skinny. Great hair, now that it was longer, normal nose. Eyes that, some cheerleader had told him, could get him into any girl’s pants. Showed how much she knew. But as he stared at his reflection, he sensed he wasn’t the same and never would be after what just happened in the laundry room.

He’d told her! Finally, after years of self-doubt that made him sick to his stomach, and when that passed, months of feeling like he was going to bust open from the inside if he didn’t let go of his secret, he found the courage to tell her. Luke’s last text message said, If you do, I will. They’d made a pact to approach both their mothers today.

But, oh God, he’d upset her, this woman who’d been the most important person in his life. He could see it in her face, always filled with gentle love and an acceptance most kids couldn’t fathom.

Typical of her, she’d tried to be brave. She said the right things. Yet he knew her almost as well as she knew him and what he’d revealed would cause her worry and pain. He’d pretended he was good, too, that he hadn’t had sleepless nights over who he was, hadn’t gone through stages of self-loathing and recriminations. He was, after all, an actor. And he had come out on the other side, had accepted who he was. Rejoiced in it, even. Finding Luke just brought it all together.

Still, this step was done. Finally, finally done.

After throwing some water on his face, Jamie opened the door and made his way to his own room. Flopping on the bed, with Buck leaping to the foot of it, he checked his text messages. None. He was dying to know how it went with Luke, who was scared shitless of his parents. But like Jamie, being gay had gotten too big to keep inside any more. It took too much energy to keep the door closed on a closet full of secrets. How would Luke’s Mom and Dad handle it? Would they explode, say awful things that could never be taken back? Luke feared the latter, and having gotten to know the Cranes in the last few weeks, Jamie expected the worst.

Linking his hands behind his head, staring up at the ceiling, he thought about his mom again. She hadn’t said any of those awful things and she never would. She’d deal with his being gay and any problems that caused inside her and make his coming out easier for him. Yet Jamie wasn’t out of the woods. Brian would freak, and Jamie would have to smooth over not telling his brother sooner. But it was his Dad’s potential reaction that woke Jamie up in the middle of the night in a cold sweat. Because of the church he belonged to and the religion he embraced, his own father could reject him. His Dad might say those things he could never take back.

And Jamie didn’t know what he’d do if that happened.

Probably sensing tension in him, Buck barked and moved in to nuzzle him. Jamie petted the dog for a while, then grabbed his phone and sent a text saying, So, how’d it go telling your parents?

After a while there was a chime. I couldn’t do it, Jamie. Maybe we should both wait.

Jamie’s hand curled around the cell. “Now you tell me.”

Disappointment shot through him, harsh and acute. When he got past it, he messaged Luke that it was okay, he should wait until he was ready. But it wasn’t okay, really. The plan was to share the joy of coming out to their parents. He wanted to share everything with Luke.

“Shit!” he said aloud. Bolting up, he knew he had to get out what he was feeling, so he went to the desk, to his journal, which was the only place he’d been honest for months. Once again, he poured his heart out on the pages.

Alone

I am alone in this.

I didn’t think I would be.

He promised he would tell.

It was too much for him.

Fear mixes with joy.

Joy colludes with hope.

Hope brings about expectation.

Was he wrong to have told all?

His real self speaks:

No, no, no.

It’s right. No matter what.

Right to be the person you are.

Isn’t it?

   Corporate attorney Pamela Samuels Young has always abided by the philosophy that you create the change you want to see. Fed up with never seeing women or people of color depicted as savvy, hot shot attorneys in the legal thrillers she read, Pamela decided to create her own characters. Despite the demands of a busy legal career, Pamela accomplished her ambitious goal by rising at four in the morning to write before work, dedicating her weekends to writing and even spending her vacation time glued to her laptop for ten or more hours a day.

PROLOGUE

Veronika Myers tried to convince them, but no one would listen. Her suspicions, they said, were simply a byproduct of her grief.

Each time she broached the subject with her brother, Jason, he walked out of the room. Darlene, her best friend, suggested a girls’ night out with some heavy drinking. Aunt Flo urged her to spend more time in prayer.

Veronika knew she was wasting her time with this woman, too, but couldn’t help herself.

“My mother was murdered,” Veronika told the funeral home attendant. “But nobody believes it.”

The plump redhead with too much eye shadow glanced down at the papers on her desk, then looked up. “It says here that your mother died in the hospital. From brain cancer.”

“That’s not true,” Veronika snapped, her response a little too sharp and a tad too loud.

Yes, her mother had brain cancer, but she wasn’t on her deathbed. Not yet. They had just spent a long afternoon together, laughing and talking and watching All My Children. Veronika could not, and would not accept that the most important person in her life had suddenly died. She knew what everyone else refused to believe. Her mother had been murdered.

“Did they conduct an autopsy?” the woman asked.

Veronika sighed and looked away. There had been no autopsy because everyone dismissed her as a grief-stricken lunatic. When she reported the murder to the police, a disinterested cop dutifully took her statement, but she could tell that nothing would come of it. Without any solid evidence, she was wasting everyone’s time, including her own.

“No,” Veronika said. “There wasn’t an autopsy.”

The funeral home attendant smiled sympathetically.

Veronika let out a long, exasperated breath, overwhelmed by the futility of what she was trying to prove. “Never mind,” she said. “What else do you need me to sign?”

* * *

Later that night, Veronika lay in bed, drained from another marathon crying session. She rummaged through the nightstand, retrieved a bottle of sleeping pills and popped two into her mouth. She tried to swallow them dry, but her throat was too sore from all the crying.

Tears pooled in her eyes as she headed to the kitchen for a glass of water. “Don’t worry, Mama,” Veronika sniffed. “I won’t let them get away with it.”

Just as she reached the end of the hallway, a heavy gloved hand clamped down hard across her mouth as her arms were pinned behind her back. Panic instantly hurled her into action. Veronika tried to scream, but the big hand reduced her shriek to a mere muffle. She frantically kicked and wrestled and twisted her body, but her attacker’s grip would not yield.

When she felt her body being lifted off the ground and carried back down the hallway, she realized there were two of them and her terror level intensified. But so did her survival instinct. She continued to wildly swing her legs backward and forward, up and down, right and left, eventually striking what felt like a leg, then a stomach.

As they crossed the threshold of her bedroom, she heard a loud, painful moan that told her she had likely connected with the groin of one of her assailants.

“Cut it out!” said a husky, male voice. “Grab her legs!” he ordered his partner. “Hurry up!”

The men dumped her face down onto the bed, her arms still restrained behind her back. The big hand slipped from her mouth and Veronika’s first cry escaped, but was quickly muted when a much heavier hand gripped the back of her neck and pressed her face into the comforter.

Fearing her attackers were going to rape, then kill her, Veronika defiantly arched her back and tried to roll her body into a tight ball. At only 130 pounds, she was no physical match for her assailants. They easily overpowered her, forcing her back into a prone position. As one man sat on her upper legs, strapping her left arm to her side, the other man bent her right arm at the elbow and guided her hand up toward her forehead.

During the deepest period of her grief, Veronika had longed to join her mother. But now that she was face-to-face with the possibility of death, she fought valiantly for life.

That changed, however, the second Veronika felt something cold and hard connect with her right temple. She stiffened as one of the men grabbed her fingers and wrapped them around the butt of a gun. At that precise instant, Veronika knew with certainty that her suspicions were indeed fact. Her mother had been murdered and now the same killers had come to silence her before she could expose the truth. And just like her mother’s death, her own murder would go undetected, dismissed as the suicide of a grieving daughter. A conclusion no one would question.

As the man placed his hand on top of hers and prepared to pull the trigger, a miraculous, power-infused sensation snuffed out what was left of Veronika’s fear, causing her body to go limp. The heavy pounding of her heart slowed and she felt light enough to float away.

Completely relaxed now, Veronika closed her eyes, said a short prayer, and waited for a glorious reunion with her mother.

   Corporate attorney Pamela Samuels Young has always abided by the philosophy that you create the change you want to see. Fed up with never seeing women or people of color depicted as savvy, hot shot attorneys in the legal thrillers she read, Pamela decided to create her own characters. Despite the demands of a busy legal career, Pamela accomplished her ambitious goal by rising at four in the morning to write before work, dedicating her weekends to writing and even spending her vacation time glued to her laptop for ten or more hours a day.

PROLOGUE

Veronika Myers tried to convince them, but no one would listen. Her suspicions, they said, were simply a byproduct of her grief.

Each time she broached the subject with her brother, Jason, he walked out of the room. Darlene, her best friend, suggested a girls’ night out with some heavy drinking. Aunt Flo urged her to spend more time in prayer.

Veronika knew she was wasting her time with this woman, too, but couldn’t help herself.

“My mother was murdered,” Veronika told the funeral home attendant. “But nobody believes it.”

The plump redhead with too much eye shadow glanced down at the papers on her desk, then looked up. “It says here that your mother died in the hospital. From brain cancer.”

“That’s not true,” Veronika snapped, her response a little too sharp and a tad too loud.

Yes, her mother had brain cancer, but she wasn’t on her deathbed. Not yet. They had just spent a long afternoon together, laughing and talking and watching All My Children. Veronika could not, and would not accept that the most important person in her life had suddenly died. She knew what everyone else refused to believe. Her mother had been murdered.

“Did they conduct an autopsy?” the woman asked.

Veronika sighed and looked away. There had been no autopsy because everyone dismissed her as a grief-stricken lunatic. When she reported the murder to the police, a disinterested cop dutifully took her statement, but she could tell that nothing would come of it. Without any solid evidence, she was wasting everyone’s time, including her own.

“No,” Veronika said. “There wasn’t an autopsy.”

The funeral home attendant smiled sympathetically.

Veronika let out a long, exasperated breath, overwhelmed by the futility of what she was trying to prove. “Never mind,” she said. “What else do you need me to sign?”

* * *

Later that night, Veronika lay in bed, drained from another marathon crying session. She rummaged through the nightstand, retrieved a bottle of sleeping pills and popped two into her mouth. She tried to swallow them dry, but her throat was too sore from all the crying.

Tears pooled in her eyes as she headed to the kitchen for a glass of water. “Don’t worry, Mama,” Veronika sniffed. “I won’t let them get away with it.”

Just as she reached the end of the hallway, a heavy gloved hand clamped down hard across her mouth as her arms were pinned behind her back. Panic instantly hurled her into action. Veronika tried to scream, but the big hand reduced her shriek to a mere muffle. She frantically kicked and wrestled and twisted her body, but her attacker’s grip would not yield.

When she felt her body being lifted off the ground and carried back down the hallway, she realized there were two of them and her terror level intensified. But so did her survival instinct. She continued to wildly swing her legs backward and forward, up and down, right and left, eventually striking what felt like a leg, then a stomach.

As they crossed the threshold of her bedroom, she heard a loud, painful moan that told her she had likely connected with the groin of one of her assailants.

“Cut it out!” said a husky, male voice. “Grab her legs!” he ordered his partner. “Hurry up!”

The men dumped her face down onto the bed, her arms still restrained behind her back. The big hand slipped from her mouth and Veronika’s first cry escaped, but was quickly muted when a much heavier hand gripped the back of her neck and pressed her face into the comforter.

Fearing her attackers were going to rape, then kill her, Veronika defiantly arched her back and tried to roll her body into a tight ball. At only 130 pounds, she was no physical match for her assailants. They easily overpowered her, forcing her back into a prone position. As one man sat on her upper legs, strapping her left arm to her side, the other man bent her right arm at the elbow and guided her hand up toward her forehead.

During the deepest period of her grief, Veronika had longed to join her mother. But now that she was face-to-face with the possibility of death, she fought valiantly for life.

That changed, however, the second Veronika felt something cold and hard connect with her right temple. She stiffened as one of the men grabbed her fingers and wrapped them around the butt of a gun. At that precise instant, Veronika knew with certainty that her suspicions were indeed fact. Her mother had been murdered and now the same killers had come to silence her before she could expose the truth. And just like her mother’s death, her own murder would go undetected, dismissed as the suicide of a grieving daughter. A conclusion no one would question.

As the man placed his hand on top of hers and prepared to pull the trigger, a miraculous, power-infused sensation snuffed out what was left of Veronika’s fear, causing her body to go limp. The heavy pounding of her heart slowed and she felt light enough to float away.

Completely relaxed now, Veronika closed her eyes, said a short prayer, and waited for a glorious reunion with her mother.

About Sharon Donovan

Reaching Carlos DeVeccio’s bedroom, she got a little thrill as old memories surfaced. Just a few more seconds and she’d fall into the arms of her lover. She smiled to herself. She had returned to Vegas for a reason. She was flat broke. But after tonight, Michael would be her ticket back into the lap of luxury. Then she’d be mistress of the manor once more. And more to the point, she’d have access to his billion dollar bank roll. With a devious smile, she shoved her way through the heavy mahogany door. Crossing the threshold, she entered the house of horrors. Carlos DeVeccio had been a real nut, one straight out of the books. But with her fetish for face masks, she loved his collection and had often come into his wing just to admire them. What a thrill it had been to have sex in the coffin, howling along with the werewolf. Some might think it a bit kinky, but they didn’t know what they were missing. Calling out to her lover, her pulse quickened a beat. “Michael, are you here yet, darling?”

That’s when she heard it, manic laughter coming from the final circle of hell. A slither of fear trickled down her spine, releasing a wild gush of adrenaline. Carlos?

She thought about the death of Lacy Diamond. Two Ninja assassinations were no coincidence. Sensing danger, she felt for her sword. It was gone. Panic soared through her. Where the hell was it? The laughter got louder and louder, moving in closer and closer. It seemed to be bouncing off the walls. She couldn’t tell from which direction it was coming. Just then, the bell in the tower gonged, thundering off the walls like cannon balls. Instinctively, she covered her ears with her hands. Where the hell was Michael? Evil eyes from the face masks followed her every move. She had to escape before it was too late. She couldn’t think over the loud gonging of the bell. Every few seconds, the werewolf howled at the moon. She screamed, although she knew no one would hear her. Disoriented by the darkness, she floundered about, searching for the door. Her arms swam in mid air, like a person drowning, searching for an anchor. She had to find a way out of this mausoleum of the living dead.

Perspiration drenched her skin. The chilling laughter got louder, ringing in her ears, louder and louder, closer and closer. The gonging of the bell broke through the last filament of her sanity. The werewolf opened his mouth and howled at the moon. Where was Michael? He was a master swordsman. His fencing skills were extraordinary. He could wield a Ninja star through the air with his eyes closed and hit the mark. Where the hell was he?

Blood thundered in her ears, but not loud enough to block out the manic laughter. It was close but she couldn’t see a thing. She wished she had her sword. She went to run but it was too late. She heard a distinct click. The killer had just depressed the button on her Zorro sword, unleashing a thirty-seven inch blade. His psychotic laughter reached an ear-splitting crescendo just as the bell in the bell tower gonged out its last chime. From the dark shadows, Valentino pounced, her Zorro sword gleaming in the moonlight.

“Surprise!” he thrust the sword straight through her heart. “I promised to make you scream. Darling Candace, let me hear you scream.”

 

About Sharon Donovan

Reaching Carlos DeVeccio’s bedroom, she got a little thrill as old memories surfaced. Just a few more seconds and she’d fall into the arms of her lover. She smiled to herself. She had returned to Vegas for a reason. She was flat broke. But after tonight, Michael would be her ticket back into the lap of luxury. Then she’d be mistress of the manor once more. And more to the point, she’d have access to his billion dollar bank roll. With a devious smile, she shoved her way through the heavy mahogany door. Crossing the threshold, she entered the house of horrors. Carlos DeVeccio had been a real nut, one straight out of the books. But with her fetish for face masks, she loved his collection and had often come into his wing just to admire them. What a thrill it had been to have sex in the coffin, howling along with the werewolf. Some might think it a bit kinky, but they didn’t know what they were missing. Calling out to her lover, her pulse quickened a beat. “Michael, are you here yet, darling?”

That’s when she heard it, manic laughter coming from the final circle of hell. A slither of fear trickled down her spine, releasing a wild gush of adrenaline. Carlos?

She thought about the death of Lacy Diamond. Two Ninja assassinations were no coincidence. Sensing danger, she felt for her sword. It was gone. Panic soared through her. Where the hell was it? The laughter got louder and louder, moving in closer and closer. It seemed to be bouncing off the walls. She couldn’t tell from which direction it was coming. Just then, the bell in the tower gonged, thundering off the walls like cannon balls. Instinctively, she covered her ears with her hands. Where the hell was Michael? Evil eyes from the face masks followed her every move. She had to escape before it was too late. She couldn’t think over the loud gonging of the bell. Every few seconds, the werewolf howled at the moon. She screamed, although she knew no one would hear her. Disoriented by the darkness, she floundered about, searching for the door. Her arms swam in mid air, like a person drowning, searching for an anchor. She had to find a way out of this mausoleum of the living dead.

Perspiration drenched her skin. The chilling laughter got louder, ringing in her ears, louder and louder, closer and closer. The gonging of the bell broke through the last filament of her sanity. The werewolf opened his mouth and howled at the moon. Where was Michael? He was a master swordsman. His fencing skills were extraordinary. He could wield a Ninja star through the air with his eyes closed and hit the mark. Where the hell was he?

Blood thundered in her ears, but not loud enough to block out the manic laughter. It was close but she couldn’t see a thing. She wished she had her sword. She went to run but it was too late. She heard a distinct click. The killer had just depressed the button on her Zorro sword, unleashing a thirty-seven inch blade. His psychotic laughter reached an ear-splitting crescendo just as the bell in the bell tower gonged out its last chime. From the dark shadows, Valentino pounced, her Zorro sword gleaming in the moonlight.

“Surprise!” he thrust the sword straight through her heart. “I promised to make you scream. Darling Candace, let me hear you scream.”

 

Sally Koslow is the author of The Late, Lamented Molly Marx and Little Pink Slips. Her essays have been published in More, The New York Observer, and O, The Oprah Magazine, among other publications. She was the editor in chief of both McCall’s and Lifetime, was an editor at Mademoiselle and Woman’s Day, and has taught creative writing at the Writing Institute of Sarah Lawrence College. The mother of two sons, she lives in New York City with her husband.

Chapter One

Quincy

“A fax hit my desk for an apartment that isn’t officially listed yet–you must see it immediately.” Horton’s voice was broadcasting an urgency reserved for hurricane evacuation. But in 2007, anyone who’d ever beaten the real estate bushes would be suspicious of a broker displaying even an atom of passivity. Shoppers of condos and co-ops in Manhattan and the leafier regions of Brooklyn knew they had to learn the art of the pounce: see, gulp, bid. Save the pros and cons for picking a couch. Several times a week Horton e-mailed me listings, but rarely did he call. This had to be big. “Where is it?” I asked while I finished my lukewarm coffee.

“Central Park West.” Horton identified a stone pile known by its name, the Eldorado, referring to a mythical kingdom where the tribal chief had the habit of dusting himself with gold, a commodity familiar to most of the apartment building’s inhabitants—marquee actors, eminent psychotherapists, and large numbers of frumps who were simply lucky. With twin towers topped by Flash Gordon finials, the edifice lorded it over a gray-blue reservoir, the park’s largest body of water, and cast a gimlet eye toward Fifth Avenue.

“I couldn’t afford that building,” I said. If Horton was trying to game me into spending more than our budget allowed, he’d fail. While the amount of money Jake and I had scraped together for a new home seemed huge to us–representing the sale of our one-bedroom in Park Slope, an inheritance from my mom, and the proceeds from seeing one of my books linger on the bestseller list–other brokers had none too politely terminated the conversation as soon as I quoted our allotted sum. What I liked about Horton was that hewas dogged, he was hungry, and he was the only real estate agent returning my calls.

“That’s the beauty part,” he said, practically singing. “You, Quincy Blue, can afford this apartment.” He named a figure. We could, just. “What’s the catch?” In my experience, deals that sounded too good to be true were–like the brownstone I’d seen last week that lacked not only architectural integrity but functional plumbing.

“It’s a fixer-upper,” Horton admitted. “Listen, I can go to the second name on my list.”

“I’ll see you in twenty minutes,” I said, hitting “save” on my manuscript. I was currently the ghostwriter for Maizie May, one of Hollywood’s interchangeable blow-dried blondes with breasts larger than their brain. While she happened to be inconveniently incarcerated in Idaho rehab, allowed only one sound bite of conversation with me per week, my publisher’s deadline, three months away, continued to growl. I hid my hair under a baseball cap and laced my sneakers. Had Jake seen me, he would have observed that I looked very West Side; my husband was fond of pointing out our neighborhood’s inverse relationship between apartment price and snappy dress. As I walked east I called him, but his cell phone was off. Jake’s flight to Chicago must be late.

Racing down Broadway, I allowed myself a discreet ripple of anticipation. Forget the Yankees. Real estate would always be New York City’s truest spectator sport, and I was no longer content to cheer from the bleachers. Two years ago, my nesting hormones had kicked in and begun to fiercely multiply, with me along for the ride. We were eager to escape from our current sublet near Columbia University. I longed to be dithering over paint colors–Yellow Lotus or Pale Straw; flat, satin, or eggshell–and awash in fabric swatches. I coveted an office that was bigger than a coffee table book and a dining table that could accommodate all ten settings of my wedding china. I wanted a real home. I’d know it when I saw it.

Horton, green-eyed, cleft-chinned–handsome if you could overlook his devotion to argyle–stood inside the building’s revolving door. “The listing broker isn’t here yet,” he said, “but you can get a sense of the lobby.” A doorman tipped his capped head and motioned us toward armchairs upholstered in a tapestry of tasteful, earthy tones. Horton unfurled a floor plan.

I’d become a quick study of such documents. “It’s only a two-bedroom,” I said, feeling the familiar disappointment that had doused the glow of previous apartment visits. Was the fantasy of three bedrooms asking too much for a pair of industrious adults more than twelve years past grad school? Jake was a lawyer. I had a master’s in English literature. Yet after we’d been outbid nine times, Jake and I had accepted the fact that in this part of town, two bedrooms might be as good as it would get.

“This isn’t any two-bedroom,” Horton insisted. “Look how grand the living room and dining room are.” Big enough for a party where Jake and I could reciprocate every invitation we’d received since getting married five years ago. “See?” he said, pulling out a hasty sketch and pointing. “Put a wall up to divide the dining room, which has windows on both sides, and create an entrance here. Third bedroom.” He was getting to how cheap the renovation would be when a tall wand of a woman tapped him on the shoulder.

“Fran!” Horton said as warmly as if she were his favorite grandmother, which she was old enough to be. “You’re looking well.”

The woman smiled and a feathering of wrinkles fanned her large blue eyes. The effect made me think that a face without this pattern was too dull. “Did you explain?” she said. Her voice was reedy, a piccolo that saw little use. She’d pulled her silver hair into a chignon and was enveloped in winter white, from a cape covering a high turtleneck to slim trousers that managed to be spotless, although they nearly covered her toes.

“We were getting to that, but first, please meet my client, Quincy Blue. Quincy, Frances Shelbourne of Shelbourne and Stone.”

I knew the firm. Frances and her sister Rose had tied up all the best West Side listings. I shook Fran Shelbourne’s hand, which felt not just creamy but delicately boned. She stared at my sneakers and jeans long enough for me to regret them, then turned her back and padded so soundlessly that I checked to see if she might be wearing slippers. No, ballerina flats. Across the lobby, elaborately filigreed elevator doors opened. Fran turned toward Horton and me and with the briefest arch of one perfectly plucked eyebrow implored us to hurry. When the doors shut, she spoke softly, although we were alone. “The owner’s a dear friend,” she said. “Eloise Walter, the anthropologist.” She waited for me to respond. “From the Museum of Natural History?”

I wondered if I was supposed to know the woman’s body of work and bemoaned the deficiency of my Big Ten education.

“Dr. Walter is in failing health,” she continued, shaking her head. “This is why we won’t schedule an open house.” Every Sunday from September through May, hopeful buyers, like well-trained infantry, traveled the open-house circuit. Jake and I had done our sweaty time, scurrying downtown, uptown, across, and down again, with as many as a dozen visits in a day. Soon enough, we began seeing the same hopeful buyers–the Filipino couple, the three-hundred-pound guy who had the face of a baby, a pair of six-foot-tall redheaded teenage twins who spoke a middle-European tongue. By my fifth Sunday, in minutes I could privately scoff at telltale evidence of dry rot. Silk curtains draped as cunningly as a sari could not distract me from a sunless air shaft a few feet away, nor could lights of megawatt intensity seduce me into forgetting that in most of these apartments I would instantly suffer from seasonal affective disorder.

“You’ll be the first person to see this one,” Horton added by way of a bonus. I could feel the checkbook in my bag coming alive like Mickey’s broom in Fantasia.

When we stepped out of the elevator on the fourteenth floor, Mrs. Shelbourne gently knocked on a metal door that would look at home in any financial institution. From the other side, a floor creaked. A nurse in thick-soled shoes answered and raised an index finger to her lips, casting her eyes toward a shadowy room beyond. The scent of urine–human, feline, or both–crept into my nostrils, followed by a top note of mango air freshener. “Doctor’s sleeping.” My eyes strained to scan a wide room where old-fashioned blinds were drawn against the noon sun. An elderly woman, her hair scant and tufted, was folded into a wheelchair like a rag doll, despite pillows bolstering her skeletal frame. Dr. Walter looked barely alive. Mrs. Shelbourne placed her hand on my arm. “We shouldn’t stay long in this room. I’m sure you understand. Alzheimer’s.”

“I do–too well,” I said, rapidly beholding the high ceiling and dentil moldings, while memories of my mother, scrupulously archived yet too fresh to examine, begged for consideration. I pushed them away even as my mind catalogued herringbone floors withan intricate walnut border and the merest wink of a crystal chandelier. Mrs. Shelbourne grasped my arm and we hurried into a small, dark kitchen with wallpaper on which hummingbirds had enjoyed a sixty-year siesta. In front of the sink, which faced a covered window, linoleum had worn bare. There were scratched metal cabinets and no dishwasher, and I suspected the stove’s birth date preceded my own. I thought of my unfinished chapter, and cursed my wasted time.

Halfheartedly I lifted a tattered shade. “Holy cow,” I said, though only to myself. Sun reflected off the park’s vast reservoir, which appeared so close I thought I could stand on the ledge and swan-dive into its depth. Far below, I could see tree tops, lush as giant broccoli. The traffic was a distant buzz. I felt a tremor. The subway, stories below? No, my heart. Picking up my pace, I followed the brokers through the spacious dining room and down a hall where I counted off six closets. I peeked into a bathroom tiled in a vintage mosaic of the sort decorators encourage clients to re-create at vast expense. We passed through a starlet-worthy dressing room and entered a bedroom into which I could easily tuck my current, rented apartment, with enough space to spare for a study. As Mrs. Shelbourne pulled the hardware on draperies bleached of color, I could swear that a strobe had begun to pulse. From the corner of my eye I saw a black cat slink away while Horton kicked a dust bunny under the bed, but I took little note of either. As I stood by the window, I was gooey with the feeling I’d experienced when I first laid eyes on the Grand Canyon.

The silvery vista spread casually before me might be the most enchanted in the entire city. I closed my eyes, traveling through time. Women were skating figure eights in red velvet cloaks, their hands warmed by ermine muffs. Bells jingled in the evergreen-scentedair as horses waited patiently by sleighs. I blinked again and the maidens wore organdy, their porcelain skin dewy under the parasols shielding their intricate curls. I fast-forwarded to my girlhood and could imagine the large, glassy pond below was the crystal stream beside my grandparents’ log-hewn cabin in Wisconsin’s northern woods, the bone-chilling waters of Scout camp, perhaps Lake Como of my honeymoon scrapbook.

Beside this champagne view, the fifty-four other apartments I’d considered seemed like cheap house wine, including the possibilities that cost far more–almost every one. I pulled myself away from the window and looked back. Walls were no longer hung with faded diplomas, nor was the carpet worn thin. Mirroring the reservoir, the room had turned gray-blue. I saw myself writing at a desk by the window, lit by sunbeams, words spilling out so fast my fingers danced on the keyboard like Rockettes. This time my manuscript wasn’t a twenty-year-old singer-actress’ whiny rant. It was a novel, lauded by the critics and Costco customers alike.

I could see myself in this room. My face wore deep contentment. The bed was luxuriously rumpled, since a half hour earlier Jake and I had made love, and now he was brewing coffee in our brand-new kitchen, as sleekly designed as a sperm. Perhaps he’d already gone out to bike around the park or was walking our shelter-rescued puppy. Tallulah, the little rascal, loved to chase her ball down our twenty-foot hall.

In every way, I was home. Then I snapped out of it. I was wearing my real estate heart on my sleeve, all but drooling. Quincy Blue, you dumb cluck. I sensed Horton looking at me as if he were a cannibal in need of protein, and checked to see if he and Fran had excused themselves to decide whether they should triple the apartment’s price or merely double it. We walked past another bathroom, this one housing a tub as long as a rowboat, ambled back through the dim hallway, and ended in the living room.

“The view’s even better from here–a pity we can’t pull up the shades,” Mrs. Shelbourne whispered as she walked toward the statue slumping in the wheelchair and greeted her. “Hello, Eloise dear.” She took the woman’s listless hand. “It’s Frances. I wish you could sit at that piano”–she pointed to a piece of shrouded furniture–”and play me Chopin.”

The woman emitted a dry rattle, craned her neck toward Mrs. Shelbourne, and smiled. She was missing several teeth.

“If you wish,” she said clearly. Suddenly Dr. Walter tried to raise herself in the wheelchair. “If you would be so kind as to assist me.” The nurse lumbered to her side. On her aide’s sturdy arm, Dr. Walter walked toward the piano, her posture better than my own. She settled on the cracked black leather stool and stretched her knobby fingers. I covered my mouth with my hands, afraid I might gasp. Her hands fondled the ivories and began to play an unmistakable Chopin mazurka. The Steinway was out of tune andthe pianist wore a faded housecoat, but Dr. Walter’s rendition pleased her audience to the point that even Horton was wiping away tears. The concert continued for almost twenty minutes and then, as if someone had pulled a plug, the pianist’s hands froze. Like a small child, she looked around the room, confused. I was afraid she, too, might cry.

We clapped. “That was exquisite,” Mrs. Shelbourne said hoarsely as the nurse helped her patient back to the wheelchair. “Simply exquisite.”

Dr. Walter closed her eyes and in less than a minute was sleeping. Mrs. Shelbourne thanked the nurse and hurried Horton and me to the elevator. I waited for his chatter, but it was she who spoke. “Tell me your story. I can see from your face that you have one.” She looked at me as if she were the dean of women.