Chapter 2 — Aftermath

_February 22, 1990, McKinley, Ohio_

{psc} On Thursday morning, when I arrived at the hospital, Nurse Nicole let me know that Doctor Roth wanted to see me. I decided to go straight to his office, wearing my tie and medical coat, and change afterwards.

"You wanted to see me?" I said to Doctor Roth from the door to his office.

"Come in, please, and shut the door."

I did as he asked and sat down across the desk from him.

"How are you?"

"Fine," I said. "I slept OK last night, and I don't feel impaired in any way."

"Good. We have a bit of a staffing problem with losing Shelly for an extended period of time. I spoke with John Cutter and Brent Williams, who's the Acting Chief in the ED, to work out a solution. We've had to juggle, and Medicine is going to lend Emergency Medicine two Residents and bring in _locum tenentes_ to cover. Two are necessary, as he needs to cover for Loretta and for you.

"I'm sure you know that it's nigh on impossible to fill an empty Resident slot in February, and Shelly is a PGY5. The best we could possibly do is someone who failed to Match last year, and that is not something I want to contemplate. That means you'll take on some of Shelly's role and be on-call for the ED. Basically, going back to the old way, or how it is when you aren't on shift."

"It sounds as if my hours are changing."

"As of today, unless you need time to make arrangements for childcare. You'll have Shelly's current 0500 to 1700 shift, the same as we plan for you to have in June."

That meant I could leave at 5:00pm, which was a good thing, and having my weekend free was a good thing. There was, though, one concern.

"What about the Free Clinic?" I asked.

"Doctor Saunders will take over that shift," Doctor Roth said. "We can't afford to lose a surgeon, even if you can't completely cover for Shelly."

I really didn't want to give up that shift, but there wasn't much I could do about it, as nobody outside surgery could perform the procedures I was authorized to do in the ED.

I nodded, "OK. Who from Medicine?"

"Doctor Gómez and Doctor Saunders. The rule used to be more senior Residents, but Doctor Saunders has completed her ED rotation and had very high marks. She works a shift schedule almost identical to yours, so she'll take on your students; you'll take Shelly's."

"The ED will be short an Attending," I observed.

"Fortunately, that's not my problem," Doctor Roth said. "Brent Williams was authorized to accelerate hiring an Attending who was to start in June. He can fill you in, if you want more information.

"OK. Who are Shelly's students?"

"Erin Jackson and Todd Blythe. You interviewed Erin, and she's on our Match list; Todd is Third Year and hasn't decided."

"OK. Does Brent know I won't be in the ED today unless I'm called?"

"Yes."

"Dress code?" I asked with a raised eyebrow.

Doctor Roth laughed, "John Cutter said to cut you some slack and say it would be OK for you to conduct rounds in your scrubs."

"And what do _you_ think?"

Doctor Roth smiled, "That 'advice' from Cutter is similar to 'advice' from your Bishop!"

I laughed and nodded.

"And off the record?"

"I think the public perception is that patients are actually more comfortable with a doctor in scrubs in the hospital. In private practice, ties and medical coats are still appropriate."

"I appreciate it. Who is handling Shelly's surgeries?"

"Some of the more junior Residents will have a chance. I'll see what I can do for you, but with you covering the ED, we have to be smart about it."

"Am I cleared for all procedures?"

"I don't see why not. You seem to be on an even keel, and Doctor Mercer believes it's OK to throw you back into the fray. Go find your students and bring them up to speed on the new plan. You'll be supervising prepping Burke's patients today and tomorrow. Shelly was on his team."

"Any updates on Shelly or Loretta?"

"Shelly continues her recovery, and if it continues apace, she'll move from the CCU to Medicine on Monday. Her liver function is good, which was the obvious concern besides the hypovolemia. Loretta has an incomplete SCI at L3. Late yesterday, she regained some sensory function in her right leg, which is a hopeful sign but is not definitive one way or the other. Neither specialist is willing to make any kind of prognosis at this point."

"OK. I'll check in on both of them each day I'm here."

"Then get to it, Doctor!"

"Right away!"

I left his office and went to the locker room to change into my usual red scrubs, then went to the lounge where I saw a pair of students — a short brown-haired girl and a lanky black-haired guy.

"Good morning, Erin; I presume you're Todd?"

"Yes," he said as they both stood up.

"Hi, Doctor Mike," Erin said. "Shall we present the pre-ops?"

"Yes, please. A quick note before you begin — things will change because I have a different role from Doctor Lindsay. Todd, I'll want to see your procedure book after Erin presents."

"We have two procedures today," Erin said. "We verified all labs and vitals for each patient are in range…"

"Sorry to interrupt, but I'd like to hear the actual vital signs and any labs that are borderline, please."

"Sorry, Doctor."

"It's OK. I do things differently. Continue, please."

"Patient one is a sixty-seven-year-old male scheduled for a resection of a functional adenoma. BP is 150/82; pulse 75; PO₂ 98% on room air; EKG shows normal sinus rhythm with no variation; fasting glucose is 162; cleared for surgery by Doctor Burke.

"Patient two is a nineteen-year-old female scheduled for excision of an osteochondromas of the right knee. BP is 114/62; pulse 64; PO₂ 99% on room air; EKG shows normal sinus rhythm with no variation."

"Distance runner?" I asked.

"Marathons," Erin replied. "All labs were completed and verified for both patients and no anomalies other than the fasting glucose on patient one. Both have been NPO since midnight."

"What's next?" I asked.

"Patient one needs to be shaved and an IV inserted."

"OK. We have a few minutes before we need to do that. Todd, may I see your procedure book?"

Todd handed me his book, and I flipped through it. While I had interviewed Erin, I hadn't worked with her, as I hadn't been in the ED when Erin had served her Clerkship. Her Sub-I would be in April and May, but with my new assignment, I wouldn't see her in the ED.

Todd hadn't had an Emergency Medicine rotation — it was scheduled for April and May as well. His book showed what I considered sufficient procedures for a Third Year who hadn't yet had his Emergency Medicine Clerkship.

"I'm assigned to cover the ED," I said. "That will be our main focus. The usual procedure is for the Fourth Year to stay on the ward and the Third Year to accompany me. If possible, I'll take you both to observe. Any questions?"

"Will we have a chance to scrub in?" Erin asked.

"I can't promise, given I'm a PGY1, and I've been assigned to the ED as part of the trauma surgery program. Let's go see our first patient. Todd is to present when we go into the room. Please introduce me as 'Doctor Mike'."

"Yes, Doctor," he said.

The prep was routine, with Erin inserting the IV and Todd shaving the area where the incision would be made. Doctor Burke came to check on the patient, and Erin presented. Shortly after he left, anesthesia arrived, and twenty minutes later, we moved the patient to OR 2.

"I'm going to go check on Doctor Gibbs and Doctor Lindsay," I said. "Use the time to study, please."

I left the surgical ward and headed for the CCU to see both Shelly and Loretta.

"Morning," I said to Shelly Lindsay. "I hear things are looking up."

"That's what they tell me. Give me a peek at my chart?"

I chuckled because patients weren't usually allowed to review their own charts, and there was no official exception for doctors. I took the chart from the hook at the end of the bed and handed it to her. She flipped through it, handed it back, and I hung it on the hook again.

"Hoping to get rid of the catheter?" I asked with a grin.

"Yeah, but the screws won't let me out of bed until I move to Medicine."

"I've been inside Southern Ohio Correctional Facility in Lucasville," I said. "This is _nothing_ compared to that!"

"What were you doing there?"

"Prison ministry. I thought I told you about that, but perhaps not. Anything I can get you?"

"A pizza?" Shelly suggested.

"I wonder if anyone has ever tried to call for delivery from a hospital bed?"

Shelly laughed, "I should do that just to see Baker's reaction!"

"On a serious note — anything I need to know about your Third Year?"

"He's competent and attentive, about all we can say about most Third Years. You know we put Erin on our Match list, though I don't know if we're her first choice."

"Where else did she interview?"

"Every hospital in Cincinnati. If you recall, she's from Milford, and I think she'd prefer to go back."

"I had the impression during the interview that she had a reason to be in this area."

"Boyfriend, but they broke up right before her Match list was due."

"Well, that was inconvenient. I take it he works here?"

"He's an engineer who works for the McKinley Water Department. They met at a chess tournament and then went to UC together."

"We played against Milford during my Junior year in a regional tournament, but I don't recall seeing her. And I haven't played much at all since I graduated. I bet she knows a friend of a friend who I met in Cincinnati. Anyway, I need to see Loretta and then get back to the ward. I'll come see you tomorrow; call me if you need anything I can provide."

"Thanks, Mike."

I squeezed her hand and then went to Doctor Gibbs' bed.

"Morning, Lor," I said. "Owen Roth said there was a significant improvement."

"Hi, Mike. I have feeling in my right leg except for a few spots on my inner thigh; no voluntary muscle movement, though."

"You had significant trauma, Lor. It's only been three days. Getting feeling back is a good sign. Did they tell you about the staffing changes?"

"No. What?"

"Clarissa Saunders and Antonio Gómez are assigned to the ED until the end of May; I'm covering for Shelly but handling ED consults during my shifts. Obviously, I can't do everything Shelly did, but they're short surgeons, so I'll be doing most of the daily scut. Burke is bringing in two _locum tenentes_ to cover for Clarissa and Antonio. Clarissa will cover my Free Clinic shift as well. Owen Roth says that Brent Williams is going to try to accelerate hiring an Attending and has permission to hire right away if he's able."

"What a mess," Loretta said. "Any more information about what happened?"

"The Sheriff is not saying much because they're still investigating the original incident. He scheduled a press conference for 1:00pm tomorrow to give a status update. They did arrest two suspects in the original incident. You know what happened with the guy who attacked you and Shelly and killed Tracy Sommers. Her funeral is tomorrow."

"Scott Turner, right?"

"And Jill Kleist. Five rounds total, all hits."

"How are you doing?" Doctor Gibbs asked.

"I'm sleeping OK and have no nightmares. I went to the ED yesterday and didn't have a bad reaction."

"Keep talking to your counselor."

"You, too. I hate to cut this short, but I need to get back to the ward. I'll stop in on my way out today."

"Thanks, Mike."

I left the CCU and returned to the ward just in time to be called for a consult. I went to the lounge and asked Todd to join me, and we went down to the ED.

"Mike Loucks, surgery," I said, walking into Trauma 2. "What do we have?"

"Hi, Mike," Naveen Varma said. "Kelly Jordon; twenty-year-old female; high-speed MVA; stable vitals; unit of cross-matched whole blood; abdominal guarding and distension; no penetrating wounds. Ultrasound is ready for you."

"Thanks, Naveen."

I performed an exam and confirmed Naveen's observations, then performed an ultrasound.

"Free fluid in Morison's," I said. "Todd, call upstairs and let them know we have an ex-lap with possible splenic involvement. Report the vitals, please."

"Right away, Doctor Mike!" Todd replied, then made the call.

After a brief conversation with the nurse, he said Doctor Roth wanted to speak to me.

"Yes, Owen?"

"Looks like it's you and me," he said. "Bring your patient up, and both your students can scrub in. We'll decide on whether to do an open or laparoscopic procedure after evaluation."

"We'll be up shortly," I said.

I hung up and asked Naveen to have one of his students call for transport, which they did. Eight minutes later, we wheeled Ms. Jordan into OR3. Todd and I went to the scrub room where Erin was already scrubbing in under the watchful eye of Nurse Ellen. Once we all finished scrubbing in, we joined Doctor Roth, Doctor Birch, and an anesthesiologist I didn't recognize.

"Open procedure, Mike," Doctor Roth said. "You're third surgeon, so you handle the suction, and if there are no complications, I'll have you close."

"Understood," I said.

Fifteen minutes later, the spleen was exposed.

"That doesn't look like a lot of damage," Paul Birch observed.

"I agree," Doctor Roth replied. "Mike, what's the choice for the best prognosis?"

"Resection," I replied. "It's possible to repair minor splenic lacs, but in anyone over eighteen, splenectomy is the preferred choice, based on overall outcomes."

"Mike is correct," Doctor Roth said. "Paul, this should be an easy one. Are you ready to perform your first splenectomy?"

"I am," Doctor Birch replied.

"Then switch places with me, and I'll assist."

The procedure was textbook, with no complications, and I was allowed to close, something I'd done several times. That boded well for my training rotation, which would start in June, as I had demonstrated proper technique and knowledge to move to the next phase, which would include performing initial incisions.

When I completed the last suture, Doctor Roth asked Paul to take the patient to recovery, as I had to remain on call. I was extremely happy I hadn't been called out of the surgery, as that was a distinct possibility, given we were short-staffed.

I had just changed into fresh scrubs when Sarah, the Charge Nurse, let me know that I was needed in the ED for a central line. I called to Todd, and we took the stairs down to the first floor and hurried down the corridor into the ED. I stepped into Trauma 3 to find Ghost and Clarissa working on a patient who had been in a construction accident. I quickly inserted the central line, then, at Ghost's request, performed a pericardiocentesis and finally performed a surgical assessment.

"I'll take him," I said. "Todd, call up and let them know we have a patient coming right up."

He made the call while Ghost filled me in on the vitals and treatment. Clarissa, Max, Todd, and I transported the patient to OR3, which was being hurriedly prepared by the nurses.

"What do we have, Mike?" Doctor Roth asked when my students and I joined him in the scrub room.

"Traumatic amputation of the left arm at the elbow; central line and two litres of plasma; fluid in the pericardium aspirated by pericardiocentesis; BP 90/50; tachy at 110; intubated; PO₂ 96%; five of morphine in the field; tourniquet applied just under forty minutes ago by a co-worker. No recovery of the severed limb."

"Any other injuries?"

"None appreciated. Main concern is hypovolemic shock, but the tourniquet was applied almost immediately and the paramedics got plasma into him right away, along with IV saline."

"OK. It's a cleanup job, then. How much of the arm is left?"

"The humerus appears intact to the trochlea. I'm not sure if there's enough muscle to cover the bone."

"Tendons?"

"None appreciated on visual inspection."

"Julie, get the fluoroscope set up, please," Doctor Roth said to the circulating nurse.

Five minutes later, we were in the OR, and Doctor Ross began examining the patient's arm.

"What have you got for me today, Owen?" Kenneth Cole from Orthopedics asked.

"Traumatic amputation of the left arm at the elbow. Humerus is intact, there does not appear to be enough muscle to cover the end of the bone, and there's significant ligament and muscle damage all the way to the deltoid."

Doctor Cole joined Doctor Roth, and they viewed the fluoroscope together, then Doctor Cole performed a visual examination of the injury.

"I suggest we revise the amputation to facilitate a prosthesis," Doctor Cole said.

"I concur," Doctor Roth said. "Todd, we're done with the fluoroscope," Doctor Roth said. "Please store it. Julie, bone saw tray, please. Mike, no need for you and your students to stay."

"OK," I agreed.

I was disappointed, but I knew I had responsibility for consults, and with Doctor Cole in the OR, there were four surgeons, as Doctor Cole's Resident had come with him. My students and I left the OR and went to the lounge.

"I hear you played on the Milford chess team," I said to Erin. "I know a guy who played with you — Larry Higgins."

"Our best player! He's a Grand Master now. I take it you met him at a tournament?"

"Yes, and then again when Doctor Saunders and I went to interview at UC medical school."

"He didn't get in," Erin said. "So he decided to go to nursing school. He's working at The Christ Hospital in Cincinnati."

"Feel free to refuse to answer, but I strongly suspect you knew the guy who invented 'strip chess'."

Erin laughed, "Oh my God, talk about crazy! I'm sure you're referring to Steve Adams, but it was his girlfriend, Jennifer, who invented it."

"That's the guy," I said. "Was Milford as crazy as the rumors say it was?"

"And then some!" she said, shaking her head. "But it was a lot of fun!"

"I bet! Harding County High was not like that, despite the best efforts of my closest guy friend and me!"

Erin laughed, "I'm pretty sure our High School wouldn't have been nearly as crazy without Steve and his female friends. He's in Chicago now, and from what I hear, he runs a computer company."

"Todd, where are you from?"

"Detroit. I went to University of Detroit Jesuit High School and Academy, an all guys' school. That kind of limited the craziness!"

"Bummer!" Erin declared with a soft laugh.

"Yeah."

I checked my watch and excused myself to call down to the ED to see if Clarissa was free for lunch. She checked, and five minutes later, we met in the cafeteria.

"Having fun with your new assignment?" I asked.

"I did NOT sign up for this! Did you have anything to do with it?"

"No. I only found out this morning when I spoke with Owen. Given the surgical team is already understaffed, losing a senior Resident is a big problem, so they yanked me out of the ED three months early."

"Did you see Doctor Gibbs and Doctor Lindsay?"

"Yes. Loretta regained some sensory function in her right leg, which is a hopeful sign. Shelly's labs look good. She asked me to bring her a pizza."

Clarissa laughed, "And?"

"I suggested she order delivery, and she wondered what Baker would think about that."

"I don't think he'd be amused! Anything I need to know about your med students?"

"They're all basically average," I said.

"How are you holding up?"

"OK. The weird thing is I wasn't scared. I think I was too focused on trying to save Tracy Sommers and the seventeen-year-old victim. I'm very curious to see what Sheriff Tomkins has to say tomorrow. I can't piece together a sequence of events."

"I'm curious, too," Clarissa said. "What did you say to Rachel?"

"Just that Bobby Junior's mom was hurt. I'm not sure how you explain something like that to a two-and-a-half-year-old."

"I'm not sure how you explain it to a thirty-year-old!"

"What's your opinion of gun control?" I inquired.

"An impossible task and the end result will be that only the bad guys and cops have guns."

"Clark would say that means ONLY bad guys have guns!" I observed.

"But you don't agree, right? You've always had good relationships with the police and deputies."

"Except when Angie was missing," I countered.

"That was Dean «сука» (_suka_), not the cops!" {green}("bitch"){/green}

"I almost never use Russian these days."

"That's because you've done the one thing that NOBODY has done since Napoleon — surrendered to the French!"

"And I very much enjoyed the surrender ceremony!" I said with a smirk. "So much so that I was happy to reenact it multiple times!"

"Doctor Pig makes his appearance!" Clarissa exclaimed with a laugh.

"I make no apologies for enjoying sex with a hot French girl!"

"You made no apologies for enjoying sex with ME, Petrovich! And I'm a lesbian!"

"You have the right parts in the right places, Lissa!"

"As I said, Doctor Pig!"

"Nah, Doctor Pig would have drinks with Jill Kleist or Louise Rehling at .38 Special or have taken Deputy Nelson up on her offer to play doctor!"

"Emmy still has the hots for you?"

"What can I say?" I asked with a grin.

"I know how you could make Clark laugh and then cry!" Clarissa smirked.

"How would YOU know?" I asked with an arched eyebrow.

"Just an educated guess based on statistics!" Clarissa smirked.

"And one confirmed by Emmy years ago," I chuckled.

Clarissa laughed so hard she attracted attention of others in the cafeteria. I simply continued eating my lunch nonchalantly.

"You're serious?" Clarissa asked a minute later when she'd finally regained control.

"Deadly', I smirked.

"Can anyone join this party?" Sophia asked, coming up to the table.

"Sure," I said.

"I have to ask — what caused Clarissa to laugh so hard?"

"Mike has a reference who confirms that it's NOT twue what they say about bwack men!" Clarissa said and giggled for the first time in years.

Sophia smirked, "I could have told you that from personal experience! Well, at least with regard to Mr. 'they said you was hung'!"

"This convo just got WAY out of control!" I declared.

"Come on!" Sophia smirked. "You have to say 'and they was right'!"

"And this is where Doctor Mike says he needs to return to surgery!" I said, shaking my head.

"I heard they shuffled people around," Sophia said.

"I'm assigned to Emergency Medicine until the end of May," Clarissa said. "Mike is upstairs but handling consults."

"Have you been to see Doctor Gibbs and Doctor Lindsay?" Sophia asked.

"Yes," I replied. "Doctor Lindsay is doing well, and her liver function tests are all in range. Doctor Gibbs has recovered some of her sensory function in one leg, which is a good sign. And I hate to eat and run, but I do need to get upstairs to supervise my students prepping the next patient."

I left the cafeteria and returned to the surgical ward. The afternoon was routine, with two consults — a rule-out appy and ingested coins — neither of which resulted in admissions. At 5:00pm, I called home to let Kris know I was on my way home, that nothing was wrong, and that I'd explain once I arrived.

_February 22, 1990, Circleville, Ohio_

"Overall, that sounds like a positive thing," Kris observed once I'd laid out the plans for the following three months.

"With regard to the schedule, yes, but you know me – I like the adrenaline rush that comes with Emergency Medicine."

"You'll just have to get 'high' on something else!" Kris said.

"My _other_ rush comes from an activity which is increasingly complicated for the next six months!"

Kris laughed softly, "And yet, Doctor Forsberg says it's OK through the eighth month!"

"With some accommodation for your belly, which makes our preferred lovemaking position difficult!"

"Poor baby! He can have the «minou», but just not the way he prefers!"

"Despite what I said, it wasn't a complaint; it was an observation!"

"Well, this liberated French woman does NOT tolerate the usual antics by French men in such circumstances!"

"Nor does this 'reactionary' American!"

"Do you get hit on?" Kris asked.

"Occasionally," I said. "Interestingly, it's mostly cops because Becky and Kellie have put the word out to nurses and nursing students to stay away, which I appreciate. And no medical student who has enough brains to become a physician would do that at this point, given the changes to the rules."

"Male police?" Kris asked with a goofy smile.

"No!" I chuckled. "Detectives Rehling and Kleist, both of whom are divorced. I did get hit on by a guy once, many years ago. I politely declined, saying I was straight."

"Not Robby, right?"

I chuckled, "Robby and Lee flirted incessantly with me, to the point where Sophia called it 'foreplay' when he joked around. No, it was one of Milena's friends, and he was positive I was gay after two of Milena's female friends danced with me in a way that Sophia described as the hottest thing she'd ever seen where everyone was clothed! One of the girls was behind me, and one in front, and it was extremely obvious what they wanted. I declined, and that's when the guy hit on me."

Kris laughed, "Because no straight male would turn down a threesome with two hot girls?"

"That was his thinking. Let's just say that wasn't the only pair of girls I frustrated."

"Just how many opportunities did you have for having multiple girls at the same time?"

"Plenty!" I chuckled. "I revealed I had done that on two occasions, but, and I'm being completely honest, that was not my thing. I far prefer my one-on-one encounters with you!"

Kris smiled, "But a sexless _ménage à trois_ is OK?"

"Before her final meltdown, Angie suggested that would be the case with whomever I married. I could see how you and she could say that about Clarissa, especially given that she and I will eventually have a baby together. Artificially, of course."

"You love her more than anyone," Kris observed. "And no, I'm not jealous in any way. It's my little sister who is green with envy!"

I chuckled, "And yet, she has her eye on at least one boy at the Cathedral, so the crush will pass."

"Yes, of course! In my experience, they always do. The key is not to do something foolish because of what you Americans call 'puppy love'."

"I'm going to remind you that YOU are an American, my Franco-Russian partner!"

"And yet, I do not subscribe to many of the foolish ideas here, especially about guns."

"I actually had a brief discussion with Clarissa about that and pointed out that Clark would say the theory of 'only the government can have guns' results in _only_ the bad guys having guns."

"Given the racism here, I can understand his point, but can you see mine?"

"If guns, like nuclear weapons, could simply disappear, human beings would still find ways to kill each other, both in small numbers and in large. Before nuclear weapons, we had World War I. How many died at the Battle of the Somme?"

"France lost at least 50,000 killed or missing, and the British Commonwealth nearly twice that many, including close to 20,000 on a single day. I don't know how many of «Les Boches» were killed, but the total casualties were over a million."

"So, ten times Hiroshima or Nagasaki. I recall the number of German soldiers killed was over 150,000, which was more than either atomic bombing. Let's go back before machine guns — how many French died in Napoleon Bonaparte's wars of conquest?"

"Close to two million French soldiers and civilians," Kris admitted. "And as many as five million from other countries."

"Who had most, if not all, of the guns?"

"You are VERY difficult, Mike," Kris said playfully.

"Thank you!" I declared. "Shall we make dinner and spend time together as a family before I take you to bed?"

"Yes!" Kris readily agreed.

_February 23, 1990, McKinley, Ohio_

On Friday, at 1:00pm, the surgical staff who were not in an OR gathered in the lounge to watch the televised coverage of Sheriff Tomkins' press conference.

{block}{tt} Ladies and gentlemen, I have a joint statement on behalf of Chief Donner and myself, then we will take questions.

At approximately 5:30pm on Monday, February 19, uniformed McKinley police officers responded to a domestic disturbance call made to 9-1-1. Upon arrival, police found four gunshot victims, one of whom was deceased. Three victims were transported to Moore Memorial Hospital by the Hayes County Fire Department.

Detectives investigating the original disturbance call filed their final report yesterday with the following conclusions:

An adulterous, romantic relationship between a seventeen-year-old girl and fifty-six-year-old Jack Collins led to the minor girl being impregnated. When her father, Leroy Hoffman, discovered this, he confronted Mr. Collins by brandishing a handgun. The argument grew heated, and Kelly Collins, wife of Jack, retrieved a shotgun and advanced on the arguing men. The shotgun had not been cocked, but when she pointed it at Mr. Hoffman, he fired a round, striking her in the chest, killing her instantly.

Mr. Collins grappled Mr. Hoffman, and they struggled for the gun. The gun discharged, wounding Mr. Hoffman and leaving Mr. Collins in possession of the firearm. At that point, the minor and her older brother, Mark Hoffman, came upon the scene. Mark Hoffman drew a concealed handgun, and he and Mr. Collins engaged in a gun battle in which the minor girl was shot three times and her brother once, while Mr. Collins escaped any injury.

Police secured the scene, but unknown to them, Jack Collins Junior, age thirty-six, had left the scene and had made his way to the hospital in search of Mr. Hoffman. When he arrived at the hospital, he entered the Emergency Department through unsecured ambulance bay doors and was confronted by a nurse, who he shoved out of the way. He brandished the pistol and began looking for Mr. Hoffman.

At that point, he was confronted by Doctor Michelle Lindsay, who had just come out of a trauma room. He shot her once, in the stomach, then fired again, striking Doctor Loretta Gibbs in the back. At that point, members of law enforcement who were in treatment rooms responded. Mr. Collins took cover behind the nurses' station, and when he saw Deputy Tracy Sommers, he fired a single round, striking her in the temple, instantly killing her.

As he began to move, he was confronted by Deputy Scott Turner and Detective Jill Kleist, who each fired at him. Mr. Collins was struck by five rounds and died instantly, bringing the incident to an end.

Deputy Sommers, Deputy Turner, and Detective Kleist acted in the best tradition of law enforcement and brought the incident to an end with minimal loss of life. {/tt}{/block}

The first question was the one I would have asked — why there was no law enforcement presence in the corridor.

{_ "Our practice, in such cases, is to secure the scene and to protect the individual victims. Detective Kleist, Deputy Turner, and Deputy Sommers were each in a treatment room. I didn't say this in my statement, but the time from when Mr. Hoffman brandished his firearm until he was shot by law enforcement was just under fifteen seconds. Mr. Collins was a former Army Ranger and was able to accurately discharge his handgun in what was, for him, a combat situation.

"Both Chief Donner and I have agreed that in future incidents, we will station at least one armed officer at the unlocked entrance. In addition, Moore Memorial will be employing off-duty members of law enforcement as security in the Emergency Department. As those will all be sworn officers, they will be armed." _}

"That can't be the right solution," Sarah, the Charge Nurse, said. "Guns in the hospital?"

"There was a very tense debate about that," Owen Roth said. "That's why it's off-duty cops and deputies. We couldn't allow armed private security. It's not perfect, but the County Board insisted due to liability concerns."

"That seems like a bad reason to bring guns into the hospital," I said. "I mean, I get responding officers and deputies, but armed security? I'm not anti-gun, but it just seems wrong."

"To me, too," Doctor Roth agreed. "The Board approved money for full security doors for the ambulance bay in the new ED. They'll require a swipe card, but there will also be an emergency mechanical release on the inside in case the system fails. We might be able to dispense with permanent security at that point, but I wouldn't count on it."

"Swell," I said.

The rest of the press conference didn't shed any additional light on what happened except to fill in some other background details and to note that Deputy Sommers would be posthumously awarded a medal for gallantry. When it concluded, I still had a question that had not been asked nor answered — how could the seventeen-year-old girl have been shot three times during the events described?

_February 24, 1990, Southern Ohio Correctional Facility, Lucasville, Ohio_

I stopped short when I walked into the common room at the prison, seeing someone I hadn't seen for nearly eight years — Charlie Fox, the rapist who had, for a day, been my roommate. I wondered if he recognized me in the cassock and with a beard, as I'd been clean-shaven when we'd met. He was with an older gentleman in a suit, who I suspected was his dad but who also might have been a Protestant pastor.

I also knew that Len Nelson was in the prison, but I'd heard he was in segregation due to incidents between a group of what amounted to neo-Nazis and black prisoners. I had zero desire to see him, and he was locked up at least until 2015, given his 'twenty-five to life' sentence. His association with the neo-Nazi's would likely mean he wouldn't get out after only twenty-five years.

"Morning, Frank," I said when I sat down at the table with him.

"Morning. I expected you tomorrow, with the deacon who brings communion to Nick. Did your schedule change because of the shootings?"

"Yes. One of the doctors who was shot was a surgeon, so they moved me out of the ED to surgery to help cover, and moved other doctors around to cover the ED, as the Chief Attending was one of the ones who was shot."

"How close were you to the shooting?"

"The Sheriff's Deputy was shot right in front of me, but I never saw the gunman until about twenty minutes after the police killed him. We were in a trauma room, and Deputy Sommers was responding to the gunfire when she was shot after opening the door of the trauma room."

"I'm glad you weren't hurt."

"Me, too!"

We played our usual games of chess, then the group gathered for prayers, including a new addition. Once the prayers were completed, I took time to talk to each man, including the new guy.

"Alan Edwards," he said, extending his hand.

"Doctor Mike Loucks," I said. "And also a chaplain, which I suspect is obvious."

"The black robes kind of gave that away."

"What are you in for?"

"I thought you would recognize the name. You were taking guitar lessons from Anicka Blahnik when I was arrested."

"A plea bargain of eight years for rape, if I recall correctly."

"I was a complete idiot, and I have nobody to blame but myself. Do you play in public at all?"

"When I have time. I'm in a band — Code Blue — with four friends. We play four or five gigs a year."

"What do you play?"

"Mostly covers of rock and pop from the 50s through the current day, though I also play some traditional Russian music on the balalaika."

"I recall Anicka saying you had significant voice talent."

"She and Milena both tried to convince me to sing with Milena and try out for parts in musicals, but I was pre-med, so I simply didn't have the time. Is there anything you need?"

"A time machine to go back and not allow a horny thirteen-year-old to convince me to do something I knew was wrong."

"Fresh out of those," I said.

"What church do you represent?"

"The Orthodox Church in America, whose heritage is the Russian Orthodox Church."

"Some of the best choral music ever written," he said. "The Divine Liturgy by Tchaikovsky is a beautiful masterpiece. The one by Rachmaninoff is almost as good. Do you sing at church?"

"I have, in the past, but again, it was time that interfered. Medicine is all-consuming."

"So is music," Alan observed.

"I agree. Do you have a chance to play?"

"Believe it or not, we have a small group that plays chamber music. I also fiddle, which is far more popular here than Classical."

"I can imagine."

"How often are you here?"

"Once a month. If there's anything you need, let me know, and I'll do my best to procure it or arrange it, with the obvious limitations."

"Thanks."

We shook hands, I said goodbye to the men, then left the prison to head home to Kris and Rachel.