Gerald Warren, the administrator of Richland Memorial Hospital, orchestrates a deadly plan to save his financially struggling hospital by killing those patients who are costing his hospital money due to their lack of health insurance of private funding.
Alex Lowe has painful memories of Richland Memorial Hospital. Five years earlier she watched helplessly as her mother spent her final days of life in bed three of the ICU, suffering needlessly before succumbing to the ravages of metastatic colon cancer. Now as a nurse at Richland, Alex finds herself working in the same intensive care unit, determined to do what she can to prevent the unnecessary suffering of terminally ill patients and banish the demons that have plagued her since her mother's death. Because of her compassionate nature, Alex agrees to help several patients end their lives to prevent further suffering in their final days of life. When her activities are discovered by Gerald Warren, the hospital administrator, Alex gets drawn into an unethical plan Gerald has devised to save the hospital money by taking the lives of hospitalized patients who are costing the hospital money because of their lack of insurance or ability to pay for their care. Faced with the possibility of spending life in prison because of her actions, Alex must decide if she will continue to take the lives of innocent patients or go to the authorities to stop Gerald's deadly plan.
Ella Hibbetts snored softly, unaware of her visitors, her
face illuminated by the flickering light of the television.
Miss Dillard stepped from the shadows and extended her hand
“Here, take this,” she whispered.
Alex hesitated before reaching for the object.
“What is it?” she asked.
“Her medication, the one you were supposed to give earlier
Alex shook her head.
“She doesn’t have any I.V. medications ordered. I’ve already
reviewed her chart.”
“You know what I’m talking about!” Miss Dillard responded.
“And you know what I’m talking about,” Alex replied.
“As her nurse, I’m not giving her anything her doctor hasn’t
“You don’t have a choice,” Miss Dillard growled.
“That’s where you’re wrong,” Alex insisted. “I’ll always
have a choice.”
Miss Dillard snatched the cap from the needle and crimped
the I.V. tubing.
“Gerald will hear about this,” she hissed. “And trust me,
he won’t be pleased.”
Miss Dillard inserted the needle into the I.V. but before she
could press the plunger, Alex grabbed her wrist. The needle
pulled out of the tubing.
“Get your hand off of me!” Miss Dillard whispered angrily.
“You’ve got no right interfering with our plans.”
“And you’ve got no right to take her life!” Alex replied.
“You can’t play God!”
“I’m not playing God. I’m just doing what’s necessary to
save my job and this hospital.”
She grabbed the I.V. tubing and tried again to insert the
needle. Alex reflexively reached for her arm.
“This is wrong! You can’t kill her,” Alex whispered.
As Miss Dillard jerked her arm away the needle embedded
in her left thigh. The plunger depressed partially, injecting the
poison into her thigh. Terror filled her eyes. She could still hear
Tim’s words. “It only takes a small amount. Death is quick.”
Miss Dillard pulled the needle from her thigh and gazed at
the syringe. Only half of a milliliter had been injected.
“Damn you, Alex Lowe. Damn you!” she shouted.
Before Alex could move, Miss Dillard bolted from the
room, still clutching the syringe tightly in her hand.
“Thank you, honey,” a kind voice whispered.
“Ma’am?” Alex asked, startled.
“I said, thank you,” replied Miss Hibbetts. “I saw what
you did for me.”
“What did you see?” Alex asked, clearly shaken.
“Everything, dear. I saw and heard everything.”
Alex stopped at the door.
“I’ve got to go help her,” she said, hurriedly. “Please don’t
talk to anyone before I get back.”
Miss Dillard was slumped over a chair when Alex reached
the nursing station. The syringe had fallen to the floor and
rolled beneath the counter. Alex took her foot and pushed the
syringe behind a trashcan.
“Call a code,” she yelled as she pulled Miss Dillard’s body
from the chair and placed it on the hard, tile floor.
“Already did,” replied the unit clerk. “You didn’t hear it?”
Miss Dillard’s skin was mottled with cyanosis around
her mouth and in her fingers. She did not respond when Alex
called her name and rubbed a knuckle against her sternum. The
charge nurse knelt beside Alex and checked for a pulse while
Alex listened for breath sounds.
“No pulse,” she said.
“Nor respirations,” Alex added.
The small workspace at the nurse’s station became a blur
of activity as the on call physicians arrived and began barking
“Get her on a monitor and start an I.V. We need some blood
work and stat ABG’s. Do we know anything about her?” shouted
the resident in charge.
“She’s Lib Dillard, the night nursing supervisor,” answered
the unit clerk. “I was sitting at the desk when she came running
up the hall screaming that she needed a doctor. She was pounding
her chest and gasping for air. She collapsed and fell over
the chair before I could get to her. I thought she was having a
heart attack. That’s when I called the code.”
“Do we have a rhythm?” the young physician asked, looking
up at the heart monitor.
“Looks like V-fib,” a second physician shouted.
“Shock her with two hundred joules.”
Alex watched helplessly as Miss Dillard’s body jerked from
the surge of electricity.
“She’s still in V-fib!” yelled the physician. “Push an amp
of epi and shock her with three hundred joules.”
With the higher voltage of electricity, her body shook
violently, her head banging against the hard tile floor when her
muscles finally relaxed.
“Damn it, she’s still in V-fib,” the physician shouted. “Turn
it up to three sixty and hit her again. She’s too young to die.”
Everyone in the room watched anxiously as the doctor
placed the paddles on her chest and discharged the electricity.
The spontaneous, uncontrollable contraction of her muscles
reminded Alex of a grand mal seizure. The smell of her burning
flesh was nauseating. The cardiac monitor was flat line.
“How long have we been coding her?” the senior resident
“About twenty minutes,” replied the intern.
“Stop compressions and see if she’s got a rhythm,” he
“Nothing. She’s flat line,” replied the intern.
The senior resident draped his stethoscope over his shoulder
and shook his head.
“It’s no use,” he said. “Let’s call it off. She must’ve had
something catastrophic happen for us to be unable to establish
any kind of rhythm. Has anyone called her family?”
“They’re on their way,” replied a nurse.
“Let me know when they get here, and I’ll speak to them.
I hope they’ll consent to an autopsy. It’d be nice to know what
happened to her.”
An autopsy? Alex shuddered at the thought. How long
would it take for the poison to break down so that it wasn’t
detectable? Would they even check for poisons? Could they
check for poisons? Why should they? There was no reason
to suspect anything out of the ordinary. People die every day,
even people who aren’t supposed to die.
A bright, orange sun was climbing quickly into a cloudless
sky when the shift ended. As Alex took her time card from
her purse, she remembered Miss Hibbetts. She had to know
how much the old lady knew. She punched her time card and
then paced impatiently as she waited for the elevator doors to
“Miss Lowe,” Mr. Warren called out, “I was hoping I’d
catch you before you left the hospital. I left a message on
your answering machine earlier this morning. Have you got
“I’ve got to run upstairs for a few minutes but then I’ll be
free,” she replied.
“Stop by my office before you go home,” he ordered.
“There’s something we need to discuss.”
“Yes, sir,” Alex replied, nodding her head.
She knew it was inevitable, but she never imagined it would
happen so quickly. How had he found out about Miss Dillard’s
death and how much did he know?
~ ~ ~
Miss Hibbetts was eating breakfast when Alex arrived. The
smell of bacon and hot biscuits made her stomach growl.
“Miss Hibbetts, is it okay if I come in?” she asked, pushing
open the door. “I don’t want to interrupt your breakfast.”
“No, no, honey,” Miss Hibbetts replied. “You come right
on in. I thought you’d forgotten about this old lady.”
“No ma’am,” Alex replied, smiling. “Things got kind of
hectic last night and it just slipped my mind.”
“Did that other nurse die?” Miss Hibbetts asked, her green
Alex lowered her head and stared at the floor.
“Yes, ma’am, she did,” she replied.
“I’m sorry to hear that. I’ve always thought it sad whenever
anyone dies. That must have been some powerful medicine she
was going to give me.”
“Yes ma’am,” Alex replied. “It’s was.”
“Why’d she want to end my life?” she asked. “I’ve never
done anything to hurt her. I just don’t understand it.”
“It’s a long and complicated story, Miss Hibbetts. And if
it’s all the same to you, I’d rather not get into the details.”
“That’s up to you, Miss Lowe. That is your name, isn’t it?”
“Yes, ma’am, it is. I’m Alex Lowe. How’d you know?”
“You introduced yourself last night, but then there was a
man who came by earlier this morning asking a lot of questions.
He called you Alex Lowe and described you perfectly.” Miss
Hibbetts paused and stared at Alex. “You’re in some kind of
trouble aren’t you?”
“What did this man look like?” Alex asked.
“Middle aged. Gray hair. Nice looking man. Seemed real
sweet,” she replied.
“What did he ask?” Alex asked.
“Mostly he asked questions about the nurse that died. And
some questions about you. He seemed real interested in what
I might have seen.”
“What’d you tell him?” Alex asked nervously.
“I told him I knew you by his description, but I’d never
seen the other lady he described. He kept asking me if I was
sure I hadn’t seen her and I just kept telling him no.” The
old lady smiled and chuckled softly. “I told the old buzzard
he insulted my integrity, doubting my word like that. I told
him that when someone my age tells you something, you can
believe it. My generation was different from his. We weren’t
raised to tell lies.”
Alex looked puzzled and tilted her head to the side.
“But you told me you saw everything,” she said.
“And I did,” Miss Hibbetts replied, nodding her head.
“Then you lied to him?” Alex asked.
“That’s right, honey. I lied to him. I wasn’t raised that way.
It’s just a little something I developed on my own through the
years. Mama taught me that you don’t lie, but Papa taught me
that you take care of those who take care of you. For some
reason you felt obligated to spare my life last night and until I
could talk to you and hear your side of the story, I felt obligated
to protect you.”
Alex breathed a sigh of relief.
“What’d you see last night?” she asked.
“Which time?” the old lady replied.
“What do you mean which time?” Alex asked.
“I mean the time when you gave Miss Davis the medicine
or the time when the other nurse tried to give me the
“Both times,” Alex replied.
“Well, I really couldn’t see what happened when you gave
Miss Davis the medication, but I knew you were giving her
something from what you’d said to me. Whatever you gave her
killed her, didn’t it?”
“Why do you say that?” Alex asked. “She did die last night,
but she was old.”
Miss Hibbetts smiled.
“Honey,” she said, “it wasn’t five minutes after you left the
room that she started making these crying noises, sort of like
a cat with its tail caught in the screen door. I could hear her
gasping for air and thrashing about in the bed. Then everything
was quiet. I knew she was dead, but there was nothing I could
do about it. And then I saw you come in and check on her. There
wasn’t much commotion after she died so I assumed you had
expected to find her dead.”
“But you were asleep when I came in the room,” Alex said.
“I was faking it,” she replied. “I was too frightened to sleep,
afraid that I might be next. I saw you when you checked on me.”
“What about when the other nurse and I were in your
room?” Alex asked.
“She came in about five minutes before you did. She shined
a flashlight in my face and then just sat in the dark, waiting
for you. I heard everything. I think that’s when I realized that
whatever you gave Miss Davis had been intended for me. Who
ordered the medication?”
“It wasn’t a physician,” Alex replied.
“Was it Gerald?”
“Gerald?” Alex asked.
“Yes, I distinctly remember her telling you that Gerald
would hear about what you’d done, or what you’d refused to do.”
“Do you know Gerald Warren?” Alex asked.
“Gerry Warren?” the elderly lady asked, smiling. “You
might say I know him, seeing how I changed his dirty diapers
when he was a little boy. His mama and I were friends, God
rest her soul. My sister, Ruth, and I lived next door to the
Warrens when Gerry was little. Gerry’s mother worked so he
spent about as much time at our house as he did at his own
house. As I got older and it became apparent that I couldn’t
care for myself, he helped make the arrangements to get me
in a nursing home. He used to bring his mama by to visit me,
but after she died, he quite visiting. I bet I haven’t heard from
him in at least five years.”
Alex took several deep breaths and glanced at her watch.
“Miss Hibbetts, I need to talk some more with you about
what happened last night, but I’ve got to meet Mr. Warren in
his office in just a few minutes. I’ll be back later, if that’s okay
“That’s fine with me.” Miss Hibbetts paused momentarily.
“Miss, I don’t know what you’re involved in, and it’s really none
of my business, but I think you should be careful. The man that
was here earlier scared me. He didn’t seem too pleased about
what happened last night.”
“I appreciate your concern,” Alex replied, “but I’ll be fine.
I’ll be back later.”
As Alex rushed from the room, Miss Hibbetts’ mind drifted
back to the many times she had taken care of Gerald Warren as a
child. She couldn’t help but smile when she remembered how he
had fondly called her Aunt Ella. But the nostalgia quickly faded
as she considered the dangerous situation facing her. Surely
Gerald remembered her! He had to. They had been so close.
But if he remembered her, then why did he want her dead