IT WAS AFTER two in the morning when Sam and I made it to the emergency room. Lisa’s boyfriend, Ian, was in the waiting area, along with several other people. Early Sunday morning was obviously prime time for emergencies. There were only four chairs available in the room: two to Ian’s right and two to his left.
The fluorescent lighting gave Ian’s skin and streaked blond hair a yellow-gray cast, accentuating the worry etched on his face. He looked up and motioned us over. I sat in one of the chairs next to him, and he gave us the latest update, which didn’t sound encouraging.
“When the paramedics found her, they immediately suspected an overdose. They pumped Lisa’s stomach and gave her Narcan to try to stop any further damage. They’re monitoring her closely, but so far she isn’t responding.”
“But how did this happen? Lisa doesn’t do drugs.” I shook my head. “I mean, don’t you think we would have noticed? She’s been living with us for months.”
“Was she taking pain medication for anything?” Sam asked. “Maybe she forgot how many she’d had.”
Ian nodded. “She was taking oxycodone for her migraines, but she’s taken it before without any problems.”
“Oxy?” I asked. “I didn’t know opioids worked on them.” How did I not know my own baby sister was taking narcotics? I’d known about the migraines, of course. She’d had them since she was a teenager. But she’d never let on that they’d gotten that debilitating.
Ian rubbed his eyes. “It was the only thing that helped. And she tried it all.”
I leaned back and stared out the window at the darkness beyond, trying to make sense of what happened. The memory of a few days ago came rushing back, when I’d helped her and Ian paint the space they’d secured for their new wine bar in a funky Seattle neighborhood. An older building, the high ceilings had proven a challenge when it came to renovations—and Lisa had almost fallen off the scaffolding they’d rented. Luckily, Ian had been nearby and caught her before she did.
Had she been taking oxy then? Why hadn’t I noticed? The medication could have made her unsteady. I’d never have let her climb the scaffolding if that had been the case.
A well-dressed couple somewhere in their late thirties came through the emergency room double doors and walked wearily into the waiting room. The woman, her hair disheveled and eyes rimmed red from crying, walked to the two chairs on the other side of Ian. The man plodded in her wake, a blank stare on his face.
I knew how he felt.
I nodded at them as they sat down. The woman looked away. The man’s gaze passed over us as the woman leaned against him. His body rigid, he put his arm around her as she began to cry quietly.
“How did this happen to our baby?” she moaned. The man just stared into space without replying.
A doctor appeared at the nurses’ station. Slender, with jet-black, shoulder-length hair, she stood maybe five-six and had an intense air about her. The nurse nodded in my direction and said something as she handed the woman a clipboard. The doctor glanced over her shoulder and gave me a brief nod. She finished writing on the clipboard and handed it to the nurse. I was out of my chair and standing beside her before she turned around.
“I’m Lisa’s sister, Kate.” I stuck out my hand and the doctor shook it. Her nametag read Dr. Trish Patel.
“Trish Patel, attending physician.”
“Is my sister going to make it?”
Dr. Patel’s expression gave no clues as to how Lisa was doing. Why didn’t doctors ever show any emotion? At least then people could gauge the severity of the problem. It’s like they were taught how to present themselves in medical school—the bland, unemotional expression—all to manage overwrought family members. A little bit of humanity would have gone a long way toward helping me deal with my sister’s overdose.
“We’re cautiously optimistic.”
Optimistic. I could work with that.
“Unfortunately, your sister had fentanyl in her system. Are you familiar with the drug?”
Fentanyl? My mind raced for context. How did she get fentanyl? “Isn’t that the drug that killed Prince?” Dr. Patel nodded. “She was taking oxycodone for her migraines. How would she get fentanyl?”
“That’s the question, isn’t it?” Dr. Patel shifted her weight. “Has your sister ever used cocaine or heroin?”
“Never. She’s afraid of hard drugs. Thought if she took them that she’d be hooked immediately. I was surprised to find out she was taking oxycodone.”
Dr. Patel nodded, weariness plain on her face. The skin around her eyes sagged, and it looked like she hadn’t slept in days. “The reason I ask is that we’ve seen an increase in overdoses involving an especially potent form of fentanyl.
“According to the families, none of these patients had a prior history of illicit drug use. And it’s not just younger people. Last night we admitted a sixty-seven-year-old male with a similar concentration of the drug in his bloodstream. He’d been the picture of health except for some arthritis.” She sighed. “Drug dealers use fentanyl to cut heroin—it’s cheaper and delivers an intense high, and most illicit drug users are aware of the risks. But ingesting it in any form is dangerous, and overdosing isn’t unusual.”
“Was there oxycodone in my sister’s system?”
Dr. Patel shook her head. “Not that we detected. We’re sending a sample to the lab for further testing. We’ve discovered some disturbing chemical abnormalities in recent cases.”
“Such as?”
“A high percentage of lead and mercury. Trace evidence of banned industrial chemicals.”
“Which could have been introduced at any point in the manufacturing process,” I finished for her.
“I’m afraid we’ll see more cases unless and until someone figures out where the drugs are coming from.” The nurse at the station motioned for the doctor. Patel turned to leave. “I need to get back to my patients. If you’d like to see her, you can go in now. Just don’t stay too long. Give your cell phone number to the on-duty nurse, and I’ll call you if there’s any change.”
I nodded and we shook hands.
“I’ll do everything I can to help Lisa,” Patel said. The impassive expression was gone, replaced by obvious concern.
“Thank you. I believe you will.”
Dr. Patel gave me a brief, weary smile and then returned to the nurses’ station. I walked back to where Sam and Ian were sitting.
“The doctor says I can go in to see her for a few minutes.” I glanced at my watch. It was three a.m.
“What caused the overdose?”
“Fentanyl.”
The man sitting next to Ian stiffened and turned. “My son—” he started to say, but was obviously overcome with emotion. The woman lifted her head and glanced at him, then turned to us.
“Our son is in the ER because of fentanyl.” She wiped the tears from her cheeks. “I don’t understand where he got it. He doesn’t take hard drugs.”
“It’s the same with my sister, Lisa,” I replied, adding, “I’m Kate.”
“John and Ellen Whitmore.” The pronounced shadows under John Whitmore’s eyes spoke to the severity of his son’s condition. Ellen Whitmore gave me a brief nod.
Sam narrowed his eyes. “I thought Lisa was taking oxy.”
“She was. How on earth did she get the fentanyl? It’s not like doctors prescribe it like they do oxy.” I shook my head. “The doctor mentioned that there’s been an increase in overdoses from contaminated fentanyl, but no one knows where the stuff’s coming from. And none of the patients have a prior history of serious drug use.”
“Sounds like it might be related to your son’s overdose,” Sam said to the couple.
I turned to Ian. “Where was Lisa tonight?”
“She went to a party in Green Lake.” He clenched and unclenched his fists, as though trying to control his emotions. “I had to work late, so I told her to meet me at home when it was over.” Tears sprang to his eyes, and he wiped at them angrily. “I should never have let her go alone.”
“If you don’t mind my asking,” I said, leaning across Sam to speak to John Whitmore, “where was your son when they found him?”
“At a party.”
“Was it in Green Lake by any chance?”
John Whitmore’s eyes widened. “Yes. Don’t tell me. Your sister?”
I nodded. Bingo. I looked at Sam.
Sam leaned forward and was about to say something when Dr. Patel reappeared at the nurses’ station. We all turned to watch her make her way through the waiting room. The air stilled as the five of us collectively held our breath, waiting to see who she was coming for.
She stopped in front of the Whitmores. Ellen stood first, and John did the same. They held each other, waiting for the doctor to speak. The weariness in Patel’s eyes delivered the news even before she spoke. Jason Whitmore had died. As John stiffened, Ellen Whitmore sobbed, the sound seemingly ripped from deep within her chest. Dr. Patel put her arm around Ellen Whitmore and walked them both through the waiting room and past the double doors leading to the emergency room.
Sam pulled out his phone and nodded toward the nurses’ station. “Go see your sister. I’ll find out what my buddies at Seattle PD can tell me about the rash of overdoses.”
“Thanks.” As I stood, a wave of exhaustion passed through me. I took a deep breath, shook it off, and went to see my sister.
A nurse led me to the intensive care unit, where they’d moved Lisa. The door whispered closed behind me, isolating all sound except for a monitor beeping in the background. Lisa lay immobile on the hospital bed, translucent skin only a shade or two darker than the white bedsheets.
My younger sister had our father’s blue eyes and jet black hair and grandmother’s willowy build. A slight widow’s peak punctuated her heart-shaped face, which matched her sweet, forgiving nature. I, on the other hand, was my mother’s daughter all the way: tall and athletic with green eyes and blond hair. At least when I wasn’t trying to hide my identity. Unfortunately, I also inherited her nature: impulsive and impatient.
Too bad Mom wasn’t around to see it. My biological mother died when I and my older sisters were young, and Maureen, my father’s second wife, had come along soon after to take her place. Dad professed to be happy, but I’d never gotten along with her.
I moved to the side of the bed and put my hand over hers. Her fingers were cold to the touch, like pebbles on a beach. Tears pricked my lids and I stifled a sob. My baby sister was in a coma and there was nothing I could do.
***
As soon as Sam and I got home from the hospital, we fell into bed, exhausted. I woke up hours later, disoriented. As if someone alerted him, Sam appeared at the bedroom door with a cup of coffee and a plate of scrambled eggs and toast. He was spooky like that. He sensed things normal people didn’t and rarely talked about it. I assumed it was because of his training as a shaman growing up in Alaska, but when I asked him, he shrugged the training off and said he learned more being a long-haul truck driver and a cop than he ever did from the village shaman. I didn’t push him to explain.
“I thought you could use some breakfast.” He set the plate on the nightstand and handed me the coffee.
“Thank you.” I breathed in the rich aroma before taking a sip and then glanced at my phone, which I’d left next to the bed. No messages. I decided the lack of contact from the hospital was a good thing.
“No news?” Sam sat on the edge of the mattress.
“Not yet.” I scooped up a forkful of eggs, but my stomach lurched at the smell. I changed my mind and set it down. “Sorry, I’m not very hungry.”
Sam smiled and took the plate back, placing it on the nightstand with my coffee. “No worries. Let me know when you get your appetite back.” He caressed my cheek with his hand. A wave of despair washed through me.
My baby sister was in a coma. I couldn’t help wondering if there was something I could have done to protect her. How did she even get the fentanyl? The drug wasn’t easy to find unless you were acquainted with the street or knew someone who was. Lisa definitely didn’t fit into the street-savvy category.
“What did your friends at the police department say?”
“Like the doc said, there’s been a huge spike in fentanyl overdoses. SPD’s investigating multiple cases.” He leaned over to give me a kiss before he rose from the bed. “I was just going in to work. Thought you might want to take the day off, spend some time with your sister.”
“Thanks. I will.”
Sam left and I brought my breakfast dishes downstairs to the kitchen and put them in the sink. Unable to shake off my worries about Lisa, I wandered into the extra bedroom where she’d been staying, hoping to find something that would explain what happened. I rummaged through her dresser, the closet, and under her bed, looking for something, anything that would make the puzzle pieces fall into place.
Nothing unusual popped out at me. I went into her bathroom and checked the medicine cabinet. The usual stuff lined the shelves: toothpaste, mouthwash, cleanser. I closed the cabinet and glanced at the garbage. A brown prescription bottle peeked through a cloud of tissues. I pulled out the empty container and read the label. Lisa’s oxycodone prescription.
Using the date the prescription was filled and counting the days on my fingers, I concluded that she’d run out the week before. I checked the label. No refills.
I thought back to how she’d acted in the days before her overdose. She’d been happy, although not any more so than usual. And she hadn’t been out of it, leading me to believe that she didn’t have to take painkillers every day.
Oxycodone hadn’t been the cause of the overdose. That was fentanyl’s doing. But if she’d become dependent on painkillers, why use fentanyl? She could have just gone back and gotten another prescription from the doctor who was treating her. I assumed he would have given her at least one more refill, if she’d asked.
I checked the linen closet for evidence but only found sheets and towels and toilet paper. Wouldn’t there be something that would point to where she got the fentanyl? A pill bottle, a phone number, something? Returning to her bedroom, I went through her things again. I didn’t have any better luck than the first time.
Then it hit me. Where was her purse? The pumpkin-colored leather satchel hadn’t been in the locker at the hospital. With new purpose, I searched the rest of the house and came up empty. I called Sam to find out if he’d seen it recently.
“Not that I can recall. The hospital had her driver’s license and insurance card, though. Why don’t you check with Ian? He might know where it is,” Sam suggested.
I hung up and scrolled through my contacts for Ian’s number. When I called, there was no answer. He was either at work or still sleeping—like Sam and me, he’d had a late night at the hospital. I grabbed my bag and headed out the door to find him.
***
Ian wasn’t at work, so I drove to his apartment on Capitol Hill and scored a parking place across the street from his building. The front entry had a call box, and I pressed the buzzer for his apartment.
“Yes?” Ian’s groggy voice floated through the speaker.
“Ian, it’s Kate. Can we talk?”
“Oh. Sure. Give me a sec and I’ll buzz you up.”
The buzzer sounded and the door clicked open. I pushed through and took the elevator to his floor. I’d obviously woken him up, but my sister was in a coma. Being polite wasn’t an option.
He was waiting for me in the doorway to his apartment. Dark circles rimmed his bloodshot eyes, giving him a haggard appearance.
“Looks like you’re doing about as well as I am.”
“Has there been any change?” Ian stepped aside so I could enter.
“No. But at least she’s stable.” Small victories, I thought.
He closed his eyes. “I can’t believe she’s in a coma. She’s just lying there, all alone...” His voice cracked.
“I tried to call you, but there was no answer.” I walked to the couch and sat down. A narrow shaft of sunlight spilled through blackout curtains and sliced across the floor in the otherwise darkened room. A lone lamp on a side table emitted a soft glow. The place smelled of his distinctive cologne and burned toast.
“Sorry. I shut off my phone. I didn’t get home until six and needed sleep.”
“I won’t keep you long. Earlier today I went through Lisa’s things, looking for something that might give me a clue about where she got the fentanyl, but there wasn’t anything. And then I realized I hadn’t seen her purse at the hospital.”
“Maybe the police have it.”
I shook my head. “Sam checked. Do you remember the last time you saw it?”
Ian closed his eyes again as he thought. A few moments later he opened them. “Sorry. I can’t remember.”
A sigh escaped me and I leaned my head back. “Do you have any idea how she might have gotten the stuff?”
“Not that I can think of. All I know is what I told you last night—that she was taking oxycodone for the pain.”
“I couldn’t remember her acting like she’d taken anything during the day. Do you two have any friends that use?”
Ian shook his head. “None.”
“Well, that’s it then.” I rose from the couch to leave. “Do you mind if I use your bathroom? I had way too much coffee this morning.”
“Sure. Down the hall, last door on your left.”
I followed the hallway past two bedrooms and a linen closet to the bathroom. Ian had always struck me as a nice guy with a tendency toward order and cleanliness. He’d be a good match for my sister, who we were certain was allergic to cleaning. My mood plummeted at the thought that they may never have the chance to be a “match.” What if Lisa never came out of the coma? Or, what if she did and suffered brain damage?
When I was finished, I went to the sink to wash my hands. Being the nosy sort, not to mention fiercely protective of my little sister, I eased the door to his medicine cabinet open. Aside from shaving cream, toothpaste, and aftershave, there were two prescription bottles and an herbal remedy for pain. I rotated the bottles so I could read the labels. One of the prescriptions was a muscle relaxant, and the other was oxycodone. The fill dates were over two years old. Turning on the water to mask the sound, I opened first one and then the other to check the contents. The bottle with the muscle relaxers was half full, and the oxy bottle only had three pills left.
Screwing the caps back on, I replaced the bottles, closed the cabinet, and shut off the water before walking into the brightly lit hallway. One of the bedroom doors was ajar. A band of light shone across the floor and onto the bed. Something in that beam of light caught my eye, and I stepped into the room for a better view.
It was Lisa’s purse.