by Mary Anna Evans
& Lillian Sellers
This week we are sharing mother related mystery short stories in honor of Mother’s Day. Starch was originally published in Plots With Guns in 2004.
In 1954, the word “nurse” was a female one. We worked among women. We were taught by women. We trained at an all-female school that required us to live on-campus–with women, of course. It was an odd time and place to be a lesbian, and this was particularly true for me. I had, at that time, never even heard the word “lesbian” and thus had no idea that I was one.
In those days, on-duty nurses were addressed by their last names, so I was known as “Crain.” I liked the notion of dispensing with “Mrs.” and “Miss,” and all the social baggage that separated women outside the hospital into single girls, married ladies and old maids. The doctors we served were, without exception, male, and we were expected to stand when any of them entered the room, just as gentlemen outside the hospital rose out of respect for ladies. I positively reveled in this perversion of the prevailing custom. If anyone was ever born to be a nurse, I was.
I loved the uniform, white and severe. I kept mine starched so stiff that the collar chafed at my neck. Even our caps were starched to the texture of cardboard. My dark hair was no longer lank when I pinned it up beneath that old-style cap. Its medieval lines suited my strong features and, while I was still not pretty when I wore it, I was surely memorable.
Only one thing could have made me give up my cherished whites. When I was offered a job as a surgical nurse in the OR, I accepted on the spot, even though it meant that my working life would be spent in a nondescript scrub dress. Surgery is a life-or-death proposition, every day. This job was a chance to make people well, every day. People that might have died would roll out of my OR into decades of life. Every day. How could I turn that down? I spent the rest of my career in the OR.
And that is how I found myself face-to-face with bloody, messy, intentional death. Murder.
I was the circulating nurse that night, which meant that my entire purpose for breathing was to make sure that nothing went wrong. When a surgeon or a scrub nurse or an anesthesiologist needed an instrument unexpectedly, the circulating nurse had better by God get it for them. If she was good, she knew what her doctors needed before they did. I was good.
It was an emergency case, a terrible one, the kind of case you remember forever. A twenty-five-year-old woman, more than eight months pregnant, had gone to sleep at the wheel and drifted off the road. Her car rolled twice before slamming into a telephone pole. If you’re old enough to remember 1954, then you already know the worst part. She wasn’t wearing a seatbelt.
I don’t like to think about how many times that poor woman’s body must have slammed into the car door or the steering wheel or the stick shift or the roof of that car. And every impact inflicted its damage. There were no paramedics in those days, simply attendants who loaded the wounded into ambulances and ferried them to the hospital. There were no cell phones, either, so those attendants couldn’t call ahead and warn the hospital what to expect. But in serious cases, and this one was serious, the policeman on the scene used his radio to pass along the bad news. Thanks to that alert lawman, an emergency surgical team began assembling before the patient ever reached the hospital.
I was at home washing my supper dishes when I got the emergency call, but barely ten minutes passed before I parked my car in the hospital lot and hit the ground running. The nursing supervisor met me in the surgical dressing room, briefing me as I peeled off my street clothes and pulled on a clean scrub dress.
“All the other on-call staff were in the hospital when we got the message, so you’re the last to arrive. I’ve helped Moseley suit up. The room is ready and the patient is prepped, so we’re all set.”
“What’s her condition?”
“Head injuries. Multiple broken bones. Internal bleeding. She’s comatose, so Dr. Gomez intubated her in the ER to keep her from aspirating during surgery.”
“So what are we going to fix first?”
“First, we’re going to take the baby. The patient’s thirty-five weeks along. I’d say the baby’s got a lot better chance than she does.”
It made sense. Cesarean sections were performed with lightning speed in those days. Once the patient was anesthetized, the goal was to deliver the child within a minute and a half, before the sleep-inducing chemicals could make their way from the mother’s blood to the baby’s, otherwise the risk of damage to the child was too great. Waiting ninety seconds to begin repairing her internal injuries posed no great risk to the patient, not compared to the damage that had already been done, and in the process, we would save a life.
Rushing into the OR, I noticed that Dr. Lacey was scrubbed up and ready to assist, even though I was sure that Dr. Wilkinson had been on call. Displaying the clairvoyant talents of a true nurse, the supervisor leaned toward me and whispered, “Dr. Wilkinson was supposed to be in the hospital, but…well, he couldn’t be found. Dr. Lacey was here, so we drafted him.”
This did not bode well for Dr. Wilkinson. He was widely known as a man devoted to ethanol and to other men’s wives, but he was a competent doctor. The other surgeons tended to overlook foibles of such a manly nature, so long as patient care wasn’t compromised. Failing to respond to an emergency call, however, was an intolerable offense, even for the old boys’ network.
The surgeon, Dr. Hale, was scrubbed up and ready to get started. Dr. Auburn, the pediatrician who would take charge of the baby, stood with his arms crossed and his head cocked awkwardly, as if he knew that he was useless until his patient was born.
Moseley was laying out the instruments directly on the patient’s draped thigh, where Dr. Hale liked them. Dr. Lacey stood across from her, watching to make sure she did it right. This served only to make Moseley nervous. Doctors can smell fear, just as easily as wild beasts can. They had savaged her daily during her first months on the job, until I took her aside and showed her a few tricks, like how to clip sutures with her left hand. It helps to be ambidextrous when you’re working in quarters as confined as a human body cavity and not all surgeons are good with their non-dominant hand. When they see you do something that they can’t, they’re impressed. And when they’re impressed, they tend to shut up and leave you alone.
Dr. Gomez had moved his rolling equipment chest to its place next to the patient’s head. He was as finicky about his anesthesiology equipment as any of the surgeons were about their tools, and the patient’s life rested in his hands just as certainly as it did in theirs. It’s well-known among nurses that people who choose to be surgeons or anesthesiologists have total confidence in their own god-like powers. This does not make them pleasant people.
Having known perhaps a hundred surgeons in my working life, I have developed a most sincere sympathy for their spouses. While it was a shock to find Dr. Wilkinson dead in the supply closet–actually, he was dead all over the supply closet–in retrospect, it was not surprising that someone hated him enough to kill him. He was a surgeon.
I only stepped into the supply closet to fetch a retractor to replace one that Dr. Lacey had dropped. Retractors were hardly necessary for a C-section, since the overstuffed uterus rises out of the abdomen as soon as it’s opened, making itself easily accessible without mechanical aid. No, retractors would be helpful later in the operation, when we were looking for the bone fragments and punctured organs that might well kill this young woman.
As expected, I found the supply room well-stocked with sterile retractors. People who supply operating rooms believe in planning ahead. Unexpected events kill patients, so redundancy is a cardinal virtue. On the other hand, the closet’s ample supply of surgical tools hadn’t been such a good thing for Dr. Wilkinson. Someone had used a scalpel to send him to his Maker. I studied the wreckage of his body with a detachment born of years spent watching bodies being cut apart and sewn back together.
His throat had been slit, severing the trachea and depriving him of the ability to breathe or to cry for help. Then, not satisfied with merely ending his life, the murderer had enjoyed a moment of recreational surgery. Using the same vertical incision that Dr. Hale would soon use to deliver a baby, the killer had opened Dr. Wilkinson’ abdomen and festooned the supply closet with his entrails. I assessed the volume of blood splashed about and judged that this had been done quickly, before his heart stopped beating.
I remember thinking that it would have been a damn sight neater if the murderer had just taken a gun and shot him.A good nurse pays attention to detail. The lone surgical gown in the hamper next to the door was saturated with blood that was too red. It had been more than three hours since the last patient was wheeled out of this OR, so the freshly soiled gown was the one that the killer had used to fend off Dr. Wilkinson’ blood. If the killer had dropped scrubs into the hamper, I would have known the killer’s gender, because we women wore scrub dresses in those days. Unfortunately, surgical gowns were unisex.
I couldn’t even glean any information from the gown’s size, since surgical gowns were one-size-fits-all, at least in theory. In reality, they fit the doctors quite well. Being a tall, raw-boned woman, I too found them comfortable, but they hung like sacks on the smaller nurses.
An empty cloth wrapper tossed into the hamper with the bloody gown told me that someone had opened a sterile gown, either in preparation for premeditated murder or as a replacement for the clean gown they’d worn into the room. The supply closet had never seemed a particularly threatening place before I realized that it was kept stocked with wide variety of murder weapons, stored alongside a stack of clothing specially designed to protect one’s clothing from spurting blood. Other than the surgical gown and the empty bag, nothing else in my supply closet was out of place–well, except for Dr. Wilkinson and his entrails.
I devoted a moment to his injuries. The scalpel had been wielded by a steady hand, with no hacking or jabbing. Because the abdominal incision had been done hastily, nicking the intestines in a couple of places, I couldn’t say for sure that it had been done by a surgeon. Still, if the murderer didn’t wield a scalpel for a living, I was willing to bet that he or she had watched someone else do it, time and again. I knew a couple of dozen people personally who could have done it, but my circle of friends has always been somewhat atypical.
I backed out of the supply closet and into the OR. Though I’d been with the body hardly a minute and I’d touched nothing, I felt as soiled as if I had lain down and rolled in Dr. Wilkinson’ blood. If one of the five people gathered around the unconscious patient had looked up, my face would have told them something was terribly wrong, but they didn’t. The operation was beginning.
I lingered near the supply closet door, outside the imaginary line that delineated the “sterile field,” the portion of the OR where exacting techniques protected the patient from the infectious organisms that we all carry around with us. The five people inside the sterile field were intent on their work.
The patient’s body was swathed in drapes, with only her pale and bulbous belly exposed. The anesthesiologist had done his job, so the baby needed to come out right way. After that, the woman lying unconscious on the table needed life-saving surgery, immediately. Could I afford to wait until both patients were stable before I let someone know there was a killer loose in the hospital?
I pictured a killer walking down the second-floor corridor, pushing open the double doors labeled, “Surgical Suite–Authorized Personnel Only” and walking in. It had been four hours since the seven-to-three shift had completed the last case of the day and gone home, but that didn’t mean the surgical wing had been deserted all that time. After hours, the cleaning staff carted dirty gowns to the laundry. They washed bloody surgical instruments and took them to Central Supply for sterilization. They restocked the supply closets with freshly sterilized gowns and instruments.
People don’t just walk off the street and decide to take a tour of a hospital’s operating rooms. Maybe the killer was lucky enough to slip in without being seen, but I doubted it. It seemed more likely that Dr. Wilkinson was slain by someone he expected to see, someone who walked past the cleaning staff unnoticed. Suddenly, I saw the five people surrounding an unconscious mother-to-be in a more sinister light. The nursing supervisor had explicitly said that they’d all been in the hospital when the emergency call came in. Any one of them could have ripped Dr. Wilkinson’s guts out.
I looked at Dr. Gomez, rhythmically squeezing the bag delivering cyclopropane and oxygen to the patient. His hands would breathe for her until she was able to breathe again on her own. The sweat beads gathering on his brow didn’t indicate guilt. They didn’t indicate innocence, either, only that his job was both physically and mentally strenuous.
Dr. Auburn, as a pediatrician, didn’t ordinarily frequent the OR, so I ignored him for the time being.
Dr. Lacey stood on the far side of the patient, ready to assist Dr. Hale. His expression was impassive, just as it was during surgeries that ended in amputation or a diagnosis of terminal cancer. Poker players and murderers could learn many a lesson in control by studying surgeons.
Moseley stood on the far side of the patient, nervously counting the sponges arrayed on the tray beside her.
Dr. Hale stood with his back to me, scalpel in hand, preparing to open a woman’s body. There was nothing, no twitching shoulders, no trembling legs, nothing that might have told me whether he knew that Dr. Wilkinson lay dead behind the door I had just closed. He sliced into the patient’s abdomen, and the first bead of blood extended in the wake of his scalpel into a fine, straight, red line. Dr. Lacey went to work sponging the wound and clamping bleeders, and Moseley began a gallant effort to keep up with his and Dr. Hale’s demand for hemostats and scissors and clamps.
Mentally urging her to use both hands like I’d taught her, I left Moseley to her bumbling and tried to think. Would someone have planned to kill a man in a supply closet with a single door that opened into an operating room, which also offered a single door and, thus, only one escape route? Not if they possessed even a particle of good sense, and I didn’t know any dummies who could handle a scalpel the way Dr. Wilkinson’s murderer did.
Dr. Hale’s scalpel sliced through another layer of the patient’s body, opening up the abdominal wall. Dr. Lacey and Moseley hurried to clamp another crop of bleeders. Dr. Auburn took a step forward, anxious to meet his patient. Dr. Gomez just kept pumping gas.
Who would want to kill Dr. Wilkinson? I don’t ordinarily speak ill of the dead, but the man had built a collection of well-deserved enemies. As I’ve said, surgeons are not known for their pleasant personalities. Only the day before, Dr. Wilkinson had lost a patient while Dr. Lacey assisted. He’d laid the blame squarely at Dr. Lacey’s feet, claiming that the younger doctor’s choice of the wrong retractor had hampered his surgical skill, directly causing the patient’s death. I know this, even though the argument took place in the physicians’ private lounge, because their voices were clearly audible to everyone within three counties.
Moseley, on the other hand, had rarely been the butt of the dead doctor’s wrath, despite her incessant fumbling, probably because she was widely believed to be sleeping with him. Given that she’d been caught in a linen closet with Dr. Gomez, and that she’d been named as a party to Dr. Auburn’s divorce, I was inclined to believe the hospital’s formidable army of gossips.
Lover’s quarrels had ended in murder before, though I had trouble picturing ineffectual little Moseley yanking her victim’s intestines out. It was just as plausible to think that Dr. Gomez or Dr. Auburn killed their rival out of jealousy. And, while on the topic of jealousy, the hospital grapevine said that ice-cool Dr. Hale had been heard to swear a long string of oaths involving God, the devil and somebody’s mother, when Dr. Wilkinson was honored for developing a new technique for gall bladder removal. I’d watched Dr. Hale use that technique for years, but he’d been too busy taking care of patients to bother writing a scholarly paper. Was he capable of murder? Well, he was a surgeon. Playing God on a daily basis might give a man a penchant for holy retribution.
The brilliant overhead lights bleached the color from the room. The surgical team’s caps and masks obscured their faces, leaving only their eyes visible. Was one of them hoping to bluff a way out of murder? Was there enough evidence left in the supply closet to convict anyone?
The lights reflected off their hair, their clothes, their eyes, the cloths draping the patient’s body. Everything was thrown into a black-and-white world of light and darkness. The shadows at their feet were night-black, as if the floor had dissolved beneath them and exposed the shallower regions of hell. The living red of the patient’s blood was the only color in the room.
A scalpel was poised above the patient’s exposed uterus, and its surface rippled with the baby’s last languid movements before emerging into life’s stark light. I couldn’t stand by, leaving the care of a mother and her child to a killer. I studied them again, one by one, and it struck me that everyone in the room knew that I’d just come out of the supply closet. If the murderer was present, he or she knew what I’d seen.
Dr. Hale reached into the incision for the baby. Dr. Lacey cursed Moseley for being slow with a clamp, because she still insisted on doing everything with her right hand. This puzzled me, because she knew better, until I noticed her left hand hanging curled and useless by her side. It occurred to me that it was dangerous for a married man to carry on with a jittery woman who knew how to open up his trachea.
How would a short woman slice the throat of a taller man? If she was right-handed, she would stand behind him, reach up and grab his chin with her left hand to pull him down toward her, then bring her right hand up to cut from left to right. She might also accidentally deliver a pretty good slash to her left hand, if she was clumsy. I raised my eyes from a rubber glove that could well be hiding some damning evidence and saw that Moseley had taken her eyes off the patient. She studied me for a bare second and then took her second deadly action of the day.
Using her good hand, she released a hemostat, allowing a major blood vessel to hemorrhage into the patient’s abdomen. While both surgeons rushed to salvage this disaster, Moseley grabbed a scalpel and stepped around the foot of the operating table, toward the door on the far side of the room from me. Then she passed the door, hurrying toward the patient’s head.
Why is she moving away from the door? I wondered, but only for a second, until Moseley lashed out and slashed through the hose delivering oxygen to the patient. Dr. Gomez dived for his rolling supply chest, but she kicked it across the room, forcing another person to choose between chasing her and saving the patient. I was on the wrong side of the operating table. She could be out the door, fleeing into the hospital’s maze of corridors, before I reached her. Perhaps our minds were traveling down those corridors together.
At precisely the moment when I realized she was going to need a hostage to get out of the hospital, she took one. Wrapping her left arm around Dr. Auburn’s waist, she reached up and pressed the scalpel to his throat, saying, “If anybody follows me out of here, he dies.”
The brilliant lights illuminated three doctors doing what they did best. Dr. Lacey was stanching the bleeding of a patient in critical danger, Dr. Gomez was doing his damndest to restore her air supply and Dr. Hale was trying to free a baby from a haven that had turned deadly. There was nobody to stop Moseley but me.
I had chosen to put myself in the middle of emergency situations every day of my working life. That was what I did best. I did not intend to stand by, helpless and watch this one unfold.
Stretching my gangly legs to their full length, I leapt onto the operating table and stood astride the patient, one sensible white shoe on either side of her chest. It was the only time in my life that I knowingly violated a sterile field. I stood there for an instant, probably dropping germs and skin particles into the patient’s open incision and then I launched myself onto Moseley. Her scalpel-wielding hand released Dr. Auburn to deal with the more immediate threat. Me.
She did her best with the scalpel, carving a slice through my tibialis anterior, but she couldn’t reach anything but my leg before I descended on her, feet first. Her left clavicle broke under my right foot, and my left foot took out a couple of her ribs. I presume that the police made sure she got adequate medical care, but I can assure you that she wasn’t treated by anybody at our hospital. The police didn’t trust us.
Later in the day, when my leg wound had been repaired and I was resting in my hospital room, an aide from the nursery walked in with a wheelchair. Settling me into it, she said, “The baby’s mother is…um…not able to visit with her. Nobody knows where the father is. We thought you’d like to get to know her.”
I passed the afternoon and the evening in a rocking chair with the unnamed baby girl. When word of her mother’s condition filtered through the hospital grapevine, we all knew that there would be no sweet mother-daughter moments for a long time, maybe never. After all these years, I guess there’s no harm in saying that the nursery staff brought her to my room for any number of unauthorized visits, hospital regulations be damned.
A couple of weeks later, the baby’s gutless father surfaced, staying in town just long enough to name the baby Rachel and to saddle his mother with Rachel and her older sister. He committed his wife to a place where she would get lifelong care, courtesy of the state’s taxpayers, and I guess that was a good thing. Nothing was going to repair the damage wrought by too much lost blood and too many minutes without oxygen. I trust that she got better care in that institution than he would have given her.
A hospital houses many eyes, and there was always someone anxious to tell me when they’d seen Rachel at church, or at their child’s piano recital, or on the playground. Sometimes I saw her myself, perched in the basket of her grandmother’s grocery cart. In time, I gleaned information from the newspaper which, in a small town, is always happy to report the exploits of a star basketball player or the awards granted to a talented student. It has been a quarter-century since Rachel married and moved away, but I still hear about her now and then.
My life has been long and productive, filled with the work I love and graced by good friends. There have been no lovers and no natural children, but I have not minded that so very much, because once I had a baby. Her name is Rachel, and she became a grandmother a year ago last March. She is fifty years old today.
More short stories, including more mother related ones, can be found in our Terrific Tales section.