Thirty minutes later, Natalie pushed through the heavy double doors and entered the bustling intensive care unit at Langston Memorial Hospital. The ICU was one big room where the patients’ beds were separated by royal blue curtains. You could hear the blipping and buzzing equipment, the ventilators whooshing up and down.
She spotted Dr. Russ Swinton over by the nurses’ station. He was a no-nonsense professional in his midfifties, saddlebag-tough and emotionless, which made him exactly the kind of person you wanted during an emergency. His dark bushy eyebrows gave him a perpetually glum look. Twenty-one years ago, Russ had examined Natalie after she’d been attacked in the woods. He was younger back then, with a kinder demeanor, but time and experience had taken away his warmth.
“Natalie,” he said crisply. “How can I help you?”
“I came to see how Riley Skinner’s doing.”
“No change in status,” he said with a regretful shake of his head. “We’ve got him on steroids to help with the swelling. No history of epilepsy or any other neurological disorders. He came to us dehydrated, with an elevated temperature and heart rate. He had a small contusion on his right cheek, but no other signs of injury. No body blows or head wounds. No evidence of a physical altercation of any kind.”
“What happened? Why did he start seizing?”
Russ frowned. “We don’t know yet. So far he’s tested negative for epilepsy, meningitis, encephalitis, parasites, brain abscesses, and various other diseases. We’ve also screened for heroin, cocaine, MDMA, amphetamines, antidepressants, convulsants, and psilocybin. He did test positive for alcohol, and now we’re screening for synthetic drugs, which are much more difficult to detect—”
“Synthetic?”
“It’s a possibility. We’ve seen a number of similar cases in the ER this year.”
Synthetic drugs were unregulated, and the ingredients were unknown. Synthetic marijuana, for instance, had very little in common with organic marijuana. Cheap and easy to obtain, these drugs didn’t show up in the most common drug tests and often contained powerful stimulants—it would be like snorting high-grade cocaine times ten.
“Until we can pin it down, we’ll be treating him with antianxiety medication to slow his heart rate and lower his blood pressure, reduce the frantic activity in his brain. There’s something else you should know,” Russ said. “Riley had about three hundred dollars in his pockets, mostly tens and twenties.”
Which implied he was dealing, she thought. “What’s his prognosis?”
“That all depends.” Russ scratched his neck with his finger. “One of my patients was in a coma for six months before waking up with no deleterious effects whatsoever. Others haven’t been so lucky. We’ll have to wait and see. Every case is different.”
Natalie tucked a strand of hair behind her ear. “Any good news?”
Russ picked up a chart. “The CT scan shows no structural abnormalities, such as a stroke or a tumor. His blood pressure is normal, his vitals are stable. So far, we’ve prevented his organs from shutting down. That’s what I’d call good news. We’ll know more once the swelling recedes. We’re dealing with a dire situation, but we’re monitoring it closely.”
“Thanks, Russ. I’m here to pick up the medical records.” She handed him the subpoena. “And collect the outfit he was wearing last night.”
The doctor skimmed through the paperwork—he knew how thorough the BLPD was. “Looks in order. I’ll have Sofia forward you the patient’s medical records. And Monica will fetch Riley’s clothing.”
“Thanks. When will you get the results on the latest tox screen?”
“Hopefully in a few days. I’ll keep you posted.” He pivoted on his heel and was gone.
Five minutes later, one of the nurses came over with a sealed plastic bag full of Riley’s clothes—Levi’s, a pair of scuffed Doc Martens, a plaid flannel shirt, and a gray hoodie with pinprick drops of something dark on the right sleeve, along with Riley’s wallet and keys. Natalie signed the chain of custody form and accepted the bundle. She checked the bag for a cell phone, but there wasn’t any. “Did he have a phone on him when he was admitted?” she asked.
“No, Detective. Just what’s in the bag.” The nurse pointed toward the rear of the ICU. “He’s back there. The last bed at the end.”
Natalie thanked her and headed over. She parted the privacy curtain and stood at the foot of the hospital bed with the heavy bundle in her arms.
Riley’s eyes were closed. There was an endotracheal tube taped to his mouth and an intravenous needle stuck in his arm. His scalp was shaved, and over a dozen electrodes on his head were wired to the EEG machine. A monitor displayed his brainwaves—rolling like ocean waves. Maybe that was what being in a coma felt like, she thought—floating in the middle of the ocean with no land in sight. His ventilator made a rhythmic sucking sound, while the IV bag dripped stabilizing drugs into his system.
In a perverse way, Riley was royalty. Riley’s father had once been a formidable force in this town, a drug kingpin on the west side, trafficking in meth and enjoying the sense of power he got from intimidating others. Then Dominic got busted for drug trafficking and was sent to prison for seven years, and now, as a parolee, he was forbidden to own a weapon, fraternize with other ex-felons, or leave the area. But you never knew when Dominic might try to circumvent the restrictions. On the surface, at least, he’d given up a life of crime for the rustic rewards of farming, just like his father and grandfather before him. But Brandon was convinced it was all an act, and they just hadn’t caught him yet. Now Dominic would be coming after Brandon, despite whatever might’ve caused Riley’s seizures. West side justice was nothing to mess with.
Natalie watched the suction ventilator moving up and down as it kept the boy’s heart alive, while his body remained unresponsive. There was a point at which you sensed the personality, the soul, or whatever you chose to call it, had left the building. All that remained was a beautiful corpse hooked up to a machine. She fervently hoped that he would step back from the abyss.
One of the nurses interrupted, murmuring “sorry,” and made a few adjustments, fluffing the pillows, checking the stats, jotting a few notes on a medical chart. Natalie stepped aside and let her perform her duties.
As the nurse shifted the patient’s johnny off his shoulder, Natalie caught sight of a tattoo—a small red rose surrounded by twisted barbed wire. Identical to the one on India’s wrist.