I switch to the nurse’s narrative section but there is nothing entered there yet. This isn’t too surprising; charting sometimes takes a backseat to actual care when things get hectic. Stuff gets written down as it’s done, but sometimes the notes are scribbled on whatever’s handy—paper towels, the bedsheets, the palm of a hand—and then entered into the computer chart later. A quick scan of the code sheets tells me that Constance was the primary on the case, so I’ll have to wait to talk to her before I can get a thorough history of the night’s events.
I move into a section of the chart that contains documentation by Mr. Minniver’s primary physician. Here I see that the patient underwent a cardiac catheterization just two weeks ago following an episode of chest pain. Curious, I click on the tab that takes me to the cardiologist’s notes and feel my hopes for a quick resolution sink faster than the blood count on a hemorrhaging patient: the cath showed no blockage of any sort, meaning Minniver most likely died of something other than a heart attack.
Since the nurses are all still busy and I have yet to see Constance appear, I head for the room holding Mr. Minniver’s body. He is lying on a stretcher with a sheet across his pelvis and various tubes sticking out of his body. There is an IV in each arm, a breathing tube protruding from his mouth, and a urinary catheter snaking out from beneath the sheet. His chest is covered with little stickers from the cardiac monitors and the EKG machine, and there are also two large pads—one on his upper right chest area and one on the lower left—that are connected to the defibrillator. His skin is cold to the touch and reddish-blue in color, and I can see the edges of a darker purple hue indicative of lividity beginning to form along his back. His hair, which is sparse, white, and short, is sticking up in little tufts along the sides of his head. The top of his head is bald.
The door to the room opens and Constance comes in accompanied by another nurse I don’t recognize. “Hey, Mattie. Sorry to keep you waiting but the place has been crazy busy tonight.”
“No problem.”
“This is Karen Alcott,” Constance says, nodding toward the other nurse. “I’m orienting her and I can tell you it’s been a trial by fire tonight. Karen, this is Mattie Winston. She used to work here but these days she’s with the ME’s office.”
“Nice to meet you,” Karen says, looking thoughtful. Then she adds, “Are you the nurse I heard about who was involved with the nipple incident?”
I nod and quickly turn my attention back to Constance. “What can you tell me about Mr. Minniver?”
“Not a whole lot. The EMTs said his daughter found him slumped behind the wheel of his car in his garage. He was already pulseless when they found him and the daughter didn’t do any CPR. By the time he got here he was straight line on the monitor but we worked on him for about twenty minutes anyway, mainly for the daughter’s sake. We’re guessing he developed chest pain or some other serious symptom and tried to drive himself to the hospital but collapsed before he could. His daughter says he has a cardiac history so we’re guessing he had a heart attack.”
“Is his daughter still here?”
Constance nods. “Her name is Patricia Nottingham. I just left her upstairs outside the chapel. She’s making phone calls.”
“I’ll head up there to talk to her.”
“Can I disconnect this stuff and take him to the morgue?” Constance asks, nodding toward the dead man. “We could use the bed.”
“Not yet. There are some things I need to look into. Let me talk to the daughter first.”
Constance sighs. “Okay, let me know.”
I leave the room, grab my notepad and pen, and head for the second floor where the chapel is located. There is only one person outside in the hall, a fiftyish-looking woman who is pacing and talking on a cell phone. I hang back, watching her for a moment. Her face is drawn and tearstained, and her voice is hoarse, though I’m unsure if that’s its natural state or if it became that way from crying. She sees me and seems to sense that I’m waiting on her because she tells the person on the phone, “There’s someone here. Let me call you back.”
I put on my best sympathetic smile and approach her. “Ms. Nottingham? I’m Mattie Winston. I’m with the Medical Examiner’s office.”
“Oh?” she says, looking confused. Then I see dawning on her face and her expression turns grim. She repeats herself, but with a much more serious tone. “Oh.”
“I’m very sorry for your loss,” I tell her, reciting the standard, wholly inadequate line.
She nods.
“Can we sit down for a minute? I’d like to talk to you about your father.”
Again she nods and after looking around for a chair and finding none in the hallway, she heads toward the chapel. I follow her inside and we settle into the last of three pews on the left side of the room, leaving the two pews in front of us and the three on the right open.
“I understand you were the one who found your father?”
“Yes,” she says, wincing with the memory. “He was in his car, out in the garage.”
“Where in his car was he?”
“Behind the wheel, in the driver’s seat.”
“Were the keys in the ignition?”
“Yes.”
“Was the car running when you found him?”
“No.”
“Was the garage door open or closed?”
“Closed.”
I reach out and put a hand on her shoulder. “I know this isn’t easy for you, but can you describe what he looked like when you found him?”
She takes a deep breath and slowly lets it out. “He was slumped down in the seat. He looked . . . well . . .” Tears well in her eyes and she glances toward the ceiling, trying to regain her composure.
“Was he breathing?” I ask.
She shakes her head.
“Did you check for a pulse?”
“I did,” she says. “But I couldn’t feel one. I tried to shake him, thinking he might be asleep or something because he looked so pink.”
“Pink?”
“Yeah,” she says, sniffling. “His color was very pink, almost red. You know, ruddy looking.”
Ruddy coloring is unusual and it makes me wonder if Mr. Minniver might have tried to commit suicide. Carbon monoxide poisoning typically causes a cherry-red color in the skin and if he was in his car with the garage door closed, carbon monoxide poisoning seems like a possibility.
“Ms. Nottingham, I know you said your father had his keys in the ignition but did you happen to notice whether or not the ignition was turned on?”
Her brow furrows as she thinks about this. “I don’t think so,” she says finally, “because the engine wasn’t running.”
I realize the engine might have been running and the car simply ran out of gas before he was found, but I don’t say so. I’m pretty certain she has no idea what position the ignition was in. “Did you notice any unusual smells in the garage?” I ask. She furrows her forehead, looking confused, so I elaborate. “Like a strong odor of exhaust?”
She thinks a minute and then says, “No, I don’t think so.”
“I understand your dad had a history of heart problems?”
“He did, but he had that bypass surgery they do and he’s been doing pretty well since then. In fact, he was checked out by his cardiologist just two weeks ago and they said his heart looked great.”
This confirms what I read in his chart.
“What happened?” she asks, her voice hitching slightly. She dabs at the tears in her eyes with a worn-looking tissue she has crumpled in one hand. “Was it a stroke or something? I know he was pretty stressed out about some lawsuit he has going on with his neighbor. Could that have led to a stroke?”
“I don’t really know,” I tell her, unwilling to share my suicide theory yet. “We’ll need to do an autopsy.”
She pulls back from me. “You’re going to cut him open?” she says, looking horrified.
“It sounds much worse than it is. An autopsy is a professional, scientific, and dignified process. It’s not much
