Chapter 3 - The Cold Consult
The next morning, the hospital felt different. The fluorescent lights seemed sharper, the smell of antiseptic more aggressive. I had slept for exactly three hours, wrapped in a blanket on my sofa, Anthony Grimaldi’s charcoal coat draped over the back of my chair like a silent, towering sentinel. I hadn't washed it. I didn't know how to return it.
At 8:30 a.m., I was standing at the central scrub sink, prepping for a routine coronary bypass, when Dr. Kenneth Vance, the Chief of Cardiothoracic Surgery, stepped in beside me. Vance was a man of sixty, with teeth too white and an attitude that suggested he had personally invented the human circulatory system.
"Hannah," Vance said, not looking at me as he vigorously scrubbed his forearms with an iodine sponge. "We’ve had an administrative shift this morning. Your 10:00 a.m. valve replacement has been pushed to tomorrow."
I paused, the water running over my soapy hands. "Why? Mr. Harrison has been prepped since six. He’s stable, but he needs that valve."
"A priority consult came through the board," Vance said, his voice dropping into that quiet, political tone he used when wealthy donors were involved. "A private VIP transfer from the south wing. The family requested you specifically."
"Who is the patient?"
"Julian Grimaldi," Vance said, finally turning his eyes to me. There was a strange, guarded look behind his wire-rimmed glasses. "The elder brother. He was admitted through a private ambulance entrance at 4:00 a.m. Acute heart failure secondary to a suspected toxicological event."
My heart skipped a beat. A toxicological event. That was the polite, medical term for a poisoning.
"If it’s a Grimaldi, shouldn't you be handling it, Chief?" I asked, trying to keep my voice completely level. "They have enough money to buy the hospital."
"They don't want me, Hannah. They want the surgeon who spent four hours trying to piece their mother’s aorta back together," Vance said, his jaw tightening slightly with a hint of professional jealousy. "Anthony Grimaldi personally reviewed the staff logs. He signed the assignment order himself. You’re on the case, Collins. Don't screw it up. If a Grimaldi dies on our floor, the board will have our heads before the evening shift."
Ten minutes later, I walked into the private ICU suite on the tenth floor. The floor was entirely blocked off by two men in dark suits who didn't look at my badge—they looked at my face, nodded, and stepped aside.
The room inside was large, overlooking the misty Boston harbor. On the bed lay Julian Grimaldi. He was thirty-eight, resembling Anthony but with a softer, more dissipated look to his features. His skin was gray, his breathing assisted by a high-flow oxygen mask, the monitor above his head displaying a dangerously erratic ventricular rhythm.
Standing by the window, his hands clasped behind his back as he looked out at the rain-slicked city, was Anthony.
He didn't have his overcoat on today. He wore a flawless three-piece charcoal suit that fit his broad shoulders like armor. When he turned around, the silver in his eyes seemed even more brilliant against the sterile white walls of the ICU.
"Dr. Collins," he said, his voice a low vibration that seemed to calm the erratic beeping of the monitor. "Thank you for coming."
"Mr. Grimaldi," I said, stepping up to the bed and immediately checking Julian’s pupillary response with my penlight. "What happened to him?"
"A business dinner that went poorly," Anthony said, his voice entirely devoid of emotion, though the subtle clenching of his jaw betrayed the lethal fury beneath the surface. "A vintage Barolo that contained a digitalis derivative. The poisoner has already been... dealt with. But my brother's heart is failing. Save him, Hannah."
I looked from the monitor to Anthony. "Digitalis induces severe arrhythmias and myocardial depression. His ejection fraction is dropping. If we don't clear the toxin and place a temporary pacing wire immediately, he will arrest within the hour."
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Anthony walked over, standing right beside me at the edge of the bed. He reached down and took his brother's limp, gray hand, then looked up at me.
"I lost my mother in this building, Doctor," he whispered, his voice cracking just a fraction, revealing the immense weight of the crown he wore. "Do not make me lose my brother."
