Thursday, December 27, 2012

Book Reviews by Brookins and Tooley

I have new book reviews for you today, one by Carl Brookins and two by S.D. Tooley. We'll start off with Carl's review of NOVEMBER HUNT by Jess Lourey.


November Hunt
By Jess Lourey
ISBN: 978-07387-3136-0
A 2012 269 page TP release
Midnight Ink Books

The eleventh novel in her Murder By The Month series brings sometime librarian-cum-private investigator Mira James squarely up against some respected town leaders. Mira is angling to become a licensed P.I. and needs many hours of supervised investigation in order to qualify. Given that her account in the local Battle Lake bank is flatter than the pancakes served at the local eatery, she has two powerful motives to take on the investigation of a local philanthropist and business man’s murder by his long time buddy.

November in Minnesota can be cold. Not only does the weather provide impediments, so do many of the town’s citizens, but Mira perseveres against bone-cracking cold and icy stares.  The author is a good writer and the story is enhanced with clever characters, and a lot of tongue-in-cheek dialogue.

The series is known for the self-deprecating insouciance of the main character and her slightly twisted outlook on life. The danger of this kind of approach is in going over the cliff. Sometimes the impact of a really powerfully crafted scene can be lessened by the odd verbal swipe.  The plot is well designed, and while there are few large surprises, the author spins this tale tightly and nicely to its conclusion with the aid of several interesting and amusing characters. This edition contains a series of discussion questions which can be useful to book clubs.

In the spirit of full disclosure, I note that the author and I are long-time acquaintances.

Carl Brookins
www.carlbrookins.com  
http://agora2.blogspot.com
Case of the Great Train Robbery, Reunion, Red Sky

A Cold Dish
By Craig Johnson
Penguin Books, March, 2006 and May, 2012
ISBN-13: 978-0143123170

Walt Longmire is the sheriff in Wyoming’s Absaroka County, an area that appears to have more horses and pigs than people.  When a body is found in the mountains, Walt realizes the deceased was one of the young men who had assaulted a Cheyenne girl two years earlier. It is possible someone is seeking retribution for the crime. Walt relies on his friend, Henry Standing Bear, in addition to a couple deputies, the retired sheriff, and Ruby his dispatcher. Deputy Victoria Moretti is over-qualified for the job and Walt is waiting for the FBI or some big city to lure her away. Vic has the ballistics training and investigative skill Absaroka County sorely needs and Walt would like to groom her to take his job. He is recovering from the loss of his wife several years ago and still lives in their house, a cabin in desperate need of completion. More bodies pile up and by the looks of the antique weapon used, Walt starts to look at even more suspects, one of which could be his friend, Henry. Vic is one of the more interesting characters, possessing the skill and “take no prisoners” attitude of Carol O’Connell’s Kathy Mallory yet with the foul mouth of Dexter’s sister, Debra Morgan. Humor and mystery abound making for a refreshing change from mysteries set in big city precincts.  This is one series I will continue to follow.

S.D. Tooley
Author of the Sam Casey series and the Chase Dagger series

(Note from Mary: This is the first book in the Walt Longmire series.   This great series -- I love it as much as S. D. Tooley does! -- has been made into a TV series that keeps true to the characters as written by Johnson.)



Supernatural Born Killers (#9 in the Pepper Martin series)
By Casey Daniels
Berkley, Sept. 4, 2012
ISBN-13: 978-0425251522

There are a lot of changes in Pepper’s life.  She has a new job and more responsibilities at the Garden View Cemetery.  As the detective to the dead, she is still finding it a challenge to convince Detective Quinn Harrison that she talks to ghosts.  With all these added tasks, Pepper needs help.  And who better to help a ghostbuster than ghosts.  Three such ghosts are more than happy to help with the newsletter, her budget, and secretarial duties.  Course, they want something in exchange.  Easy tasks for someone of Pepper’s stature.  Since the cemetery needs donors, Pepper is encouraged to cozy up to millionaire Milo Blackburne, a Superman fanatic who thinks Pepper is Superman’s long lost love, Lana.  New to the cast of characters are Pepper’s parents.  Pops has just been released from prison and her mother has devised a great family business…a detective agency.  Meanwhile a ghost who just happens to be Quinn’s former partner warns Pepper that someone is going to die at the comic book convention.  This series is always fun and Pepper is a stitch.  There may be a change in Pepper’s life, and I for one welcome it.  Another hit in an enjoyable series.


S.D. Tooley
Author of the Sam Casey series and the Chase Dagger series



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Sunday, December 23, 2012


Merry Christmas, everyone! Just dropping by to share with you my favorite Christmas cookie recipe. Try it! You'll like it!

Christmas Cookie Ingredients:
1 cup of water
1 tsp baking soda
1 cup of sugar
1 tsp salt
1 cup of brown sugar
1 Tbs lemon juice
4 large eggs
1 cup nuts
2 cups of dried fruit
1 bottle Jose Cuervo Tequilla
Sample the Cuervo to check quality.
Take a large bowl, check the Cuervo again, to be sure it is of the highest quality, pour one level cup and drink.
Turn on the electric mixer...Beat one cup of butter in a large fluffy bowl.
Add one teaspoon of sugar...Beat again.
At this point it's best to make sure the Cuervo is still OK, try another cup...just in  case.
Turn off the mixerer thingy.
Break 2 leggs and add to the bowl and chuck in the cup of dried fruit.
Pick the frigging fruit off floor...
Mix on the turner.
If the fried druit gets stuck in the beaterers just pry i! t loose with a drewscriver.
Sample the Cuervo to check for tonsisticity.
Next, sift two cups of salt, or something.  Who giveshz a sheet.
Check the Jose Cuervo.
Now shift the lemon juice and strain your nuts.
Add one table.
Add a spoon of sugar, or somefink. Whatever you can find.
Greash the oven.
Turn the cake tin 360 degrees and try not to fall over.
Don't forget to beat off the turner.
Finally, throw the bowl through the window, finish the Cose Juervo and make sure to put the stove in the dishwasher.

CHERRY MISTMAS!

Wednesday, December 12, 2012

Four Favorite Christmas Books

With Christmas only two weeks away, I thought I'd share with you my take on four currently available books that celebrate the holiday season in vastly different ways. 

 Fans of Jan Karon's Mitford series may recognize the work of Miss Read (the pen name of retired English schoolteacher Dora Saint). Miss Read's gentle stories of life in rural England filled 30 books over a period of 40 years. The 174 page CHRISTMAS TALES contains two novellas, Village Christmas  and The Christmas Mouse. Village Christmas tells the story of the elderly Waters sisters and their initial difficulty accepting the Emery family as new neighbors in the little village of Fairacre. The two households are brought together in an unexpected way, though, on Christmas Day, changing forever the lives of both the Waters sisters and the Emerys. Mrs. Berry of Caxley village faces her own holiday dilemma in The Christmas Mouse when she awakes on Christmas Eve to find two intruders in her home. The first is a mouse. The second is a runaway boy. Both have come seeking refuge from a winter storm, and both are dealt with by Mrs. Berry in the true spirit of the holiday season. For heart warming stories of Christmas good will, I highly recommend Miss Read's CHRISTMAS TALES.


 David Morrell's thrillers have been winning over fans since 1972 when FIRST BLOOD, his first Rambo novel, was released. In THE SPY WHO CAME FOR CHRISTMAS, Morrell once again tackles the gritty side of life, this time on Christmas Eve in the festive city of Santa Fe. A wounded Agent Paul Kagan blows his cover with the Russian mafia to save the life of an infant who may one day bring peace to his troubled homeland. With only the falling snow to cover his tracks, Kagan has little hope of escaping his pursuers -- until he stumbles into the home of an abused woman and her young son whose combined courage is equal to his own strength of purpose. This is a different kind of Christmas tale, one that echoes later scenes from the original Christmas story while also drawing on the eternal theme of redemption and self-sacrifice. Only a storyteller as accomplished as Morrell could blend past with present to create a bone-chilling yet heart-warming story like the one presented here. Well worth reading.

For those who prefer fantasy over spy stories or tales from the English countryside for their Christmas reading pleasure, I highly recommend Terry Pratchett's HOGFATHER. Pratchett's Discworld series has sold in the millions all over the world, making him one of England's bestselling authors of fantasy and satire. The Hogfather is Discworld's version of Santa Claus, and when he goes missing on Hogswatchnight, it's up to Death, in all his bony weirdness, to fill in as the red-suited, white-bearded, sleigh-driving giver of gifts to children. Death (WHO SPEAKS ONLY IN CAPITAL LETTERS) is aided by his manservant Albert, a former wizard who gained near immortality ("near" because he still has 34 seconds of life left in his hourglass life-timer, although the sand doesn't flow as long as he stays put in Death's domain) while Archchancellor of the city of Ankh-Morpork's Unseen University. It's Albert's job to teach Death how to "ho, ho, ho" in a way that doesn't frighten the pants off the little kiddies of the world. Other characters include Susan Sto-Helit, Death's granddaughter (don't ask how this can be; just read the book!); Mister Teatime of the Guild of Assassins (a bad guy, for sure); Ridcully, current Archchancellor of UU whose only Hogswatch wish is for his own personal bathroom (he hates sharing with other wizards); Ponder Stibbons, a young wizard whose greatest triumph has been engineering the building of HEX, a "thinking" machine (think computer); and Foul Ole Ron, Coffin Henry, and the Duck Man, three of Ankh-Morpork more colorful beggars (who are even too poor to belong to the Beggars Guild). And one mustn't forget the Auditors, a ghostly gray group of beings who despise individuality and are at the heart of the mystery surrounding the Hogfather's disappearance. This is a story of the power of belief and what happens to people when beliefs (some will call them myths) are derided as irrational and implausible fantasies. Pratchett has fun with his Discworld, but he's not at all adverse to pointing out mankind's failings while doing so. As Death said when the king gave the beggars a banquet on Hogswatchnight, "DID THAT MAKE YOU FEEL ALL WARM INSIDE? WHERE WERE YOU ALL THE OTHER NIGHTS OF THE YEAR?" Oh yeah, Pratchett will nudge your conscience even while he's tickling your funnybone. If you think you can take it, read the book. :)

Lastly, may I present A MERRY LITTLE MURDER, the first book in my "Rhodes to Murder" mystery series newly released this month as a mass market paperback by Worldwide, a division of Harlequin. 

ER nurse Caroline Rhodes becomes a suspect in a case of multiple murder when she survives a bombing on the psychiatric ward at St. Anne's Hospital. Who could be so evil as to use the trimmings of Christmas to kill six patients and a young student nurse? And why do the police automatically view Caroline with suspicion? Is it something in her past that's drawn their attention, or is it just because she's a newcomer to the little university town of Rhineburg, Illinois? Caroline enlists the help of Professor Carl Atwater to dig into the lives of the seven victims and help her clear her name. What they discover is a tale of scandal and greed rooted in an unholy alliance made many years before. 

Caroline may have dug up proof of the killer's identity, but with the murderer hard on her heels, surviving long enough to expose the truth may take a Christmas miracle.

As you'll notice, there are two covers shown here for A MERRY LITTLE MURDER. The cover pictured above belongs to the Worldwide edition of the book. The cover to the left belongs to the earlier trade paperback and e-book edition.

To learn how I discovered the perfect weapon to use in A MERRY LITTLE MURDER, plus find information on ordering the Worldwide edition of the book, please visit Harlequin's Reader Service webpage at http://simplybooksextra.readerservice.com/simplybooksextra/2012/11/how-mary-v-welk-discovered-the-perfect-murder-weapon/

To order the e-book or trade paperback edition of the book, please visit www.amazon.com/author/marywelk

HAPPY HOLIDAY READING TO ALL, AND TO ALL A GOOD NIGHT!!! 

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Thursday, December 6, 2012

Went Fishing, Caught 4 Deer

My brother-in-law sent me this awesome story. I'm reprinting it here because I'm sure you'll love it as much as I did.

The Best Day Of Fishing Ever! 

Tom Satre told the Sitka Gazette that he was out with a charter group on his 62-foot fishing vessel when four juvenile black-tailed deer swam directly toward his boat.


"Once the deer reached the boat, the four began to circle
the boat, looking directly at us. We could tell right away that
the young bucks were distressed. I opened up my back gate and we helped the typically skittish and absolutely wild animals onto the boat. In all my years fishing, I've never seen anything quite like it!
Once onboard, they collapsed with exhaustion, shivering." 


"This is a picture I took of the rescued bucks on the back of my boat, the Alaska Quest. We headed for Taku Harbour. Once we reached the
dock, the first buck that had been pulled from the water hopped onto the dock, looked back as if to say 'thank you' and disappeared into the forest. After a bit of prodding and assistance, two more followed, but the smallest deer needed a little more help."


"This is me carrying the little guy."


"My daughter, Anna, and son, Tim, helped the last buck to its feet. We didn't know how long they had been in the icy waters or if there had been others who did not survive. My daughter later told me that the experience was something that she would never forget, and I suspect the deer felt the same way as well!"

I told you! Awesome... huh?


"Kindness is the language the blind
can see and the deaf can hear." - Mark Twain


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Monday, November 12, 2012

NO BODY Reviewed by Carl Brookins


NO BODY
by Nancy Pickard
ISBN 0-671-69179-1
pb by Pocket Books, 255 pages


Jenny Cain must surely have a unique profession among amateur puzzle solvers.  She’s the director of the Port Frederick, Maine, Civic Foundation.  The foundation, somewhat unusual in itself, was founded by leaders of this small coastal Maine town to do good works where other sources of money are no longer viable. 

Unfortunately, her job and her natural curiosity frequently lead Jenny Cain into odd places and difficult situations.  Many of those situations are life-threatening.  In this book, Pickard, who has won or been nominated over the years for ten writing awards, weaves a story out of news stories that appear from time to time, about disappearing bodies.  In this case, a visitor to the historic cemetery in Port Frederick discovers that the grave of one of her ancestors is empty.  Jenny is a native of Port Frederick and in her concern for the woman who fell into the empty grave, she discovers that a great many graves in that cemetery are empty.

Curiosity more than piqued, Jenny Cain starts an investigation.  The closer she gets to the answers, the more dangerous becomes the situation.  And then there is the murder of an employee of the one funeral home in town.  Was she killed to keep her from revealing fraud?  Are there other reasons?  What happened to the 113 missing bodies?

Pickard has in Jenny Cain a bright, chipper and credible young woman who can’t resist trying to help people with their difficulties and thus getting into trouble.  Written with a sure hand, Pickard has provided a small cadre of intriguing characters who help give the novel texture, substance and positive pacing.  They’re the kind of people we meet every day.  They’re all people with secrets they don’t wish revealed. And some of the secrets we’d prefer not to learn.  An enjoyable novel of the genre.

Review by Carl Brookins
Case of the Great Train Robbery, Reunion, Red Sky


https://mail.google.com/mail/u/0/images/cleardot.gif

Friday, November 9, 2012

Decomposition: Nature's Way of Claiming the Dead

Mystery writers often spend as much time researching subjects related to crime as they do writing their stories. One thing they must describe correctly is how a murder victim looks to their sleuth or the police. Was the victim discovered only moments after the murder, or did days or weeks pass before the body was found? Time changes everything when it comes to the appearance of the dead, so mystery writers need to know how long it takes for a human body to decompose.

While cleaning out my research files last week, I came across a piece on this very subject. It was written in 2002 by Jamie Downs, chief medical examiner of the Alabama Department of Forensic Sciences, in reply to a question submitted online by a mystery writer. Downs wrote:

"The rate (of decomposition) depends on the environment and the state of the body at the time of death. As a rule of thumb, a body exposed to open air will decay the same amount in one day as a body in water in one week and a body buried underground in one month. Heat speeds decay; cold slows it down. Rigor mortis (the stiffening of the muscles) and livor mortis (pooling of blood) take place within 12 hours of death. Bacteria in the intestine multiply rapidly as soon as metabolism ceases. Many factors determine how long it takes the body to decompose from there. Is the body in sun or shade? Is it summer or winter? Are there carnivores or insects around? Almost immediately, blowflies can feed on an exposed body and lay eggs in it. Bodies buried deep in the ground are protected from flying insects and warm temperatures, so they tend to decay relatively slowly. A body in a typical casket burial can take decades to decay down to the skeleton if embalmed properly, or as little as a year if not. But such decay can happen in a week if the body is outside, if it is exposed to carnivores, or if it has open wounds. Conversely, bodies can last centuries in a very hot and dry environment, which dries out the body, or in a cold and wet setting, where the body fat turns into a form of soap that acts as a protective covering."

Dr. Downs' explanation of decomposition gives writers a good starting point from which further research may be done if needed. 

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Thursday, October 18, 2012

Chest and Head Wounds: First Aid for Your Sleuth

Ellis Vidler has a new book coming out next month. TIME OF DEATH tells the story of artist Alex Jenrette, who has a psychic streak—or is it a curse? While visiting on an island near Charleston, she draws scenes of murder that turn out to be real. The police think she’s involved, the prosecutor fears a psychic witness will destroy his case, and the killer believes she was there. But she wasn’t, and she doesn’t know who’s behind it.

Ellis sent in this week's medical question.

A man has been shot in the chest and is lying face-down. The bloody exit wound is visible on his back. Should the witness turn him over and try to stop the bleeding in front? She can place a wad of cloth over the hole in his back, but would that help? Paramedics are maybe ten minutes away. What should she do? I want him seriously hurt, but he should live to recover.

A second man has been hit over the head with a china lamp as he stuck his head inside a doorway. He’s unconscious, but I don’t want him dead either. Would a head wound bleed a lot? Is he likely to be unconscious for a while or could he recover enough to get to his feet and possibly fire a gun?

Here's my answer.


The important thing in your case, Ellis, is to keep your victim breathing, so yes, the witness should turn him face up, and she can use a wad of cloth to help put pressure on the exit wound when he's on his back. Gravity will then cause most of the blood to flow downward towards the exit wound. There will still be some blood flow from the entrance point, so yes, the witness can cover that wound also. The victim's biggest problem will be a traumatic pneumothorax and/or hemothorax on the affected side of the chest. (Thorax means chest, pneumo refers to air, hemo refers to blood.)

I'm assuming the bullet missed the heart and only hit the lung. A traumatic pneumothorax is a collapsed lung due to trauma, in this case the bullet passing through the lung. A collapsed lung occurs when air escapes from the lung and fills up the space outside of the lung, inside the chest. The lung more or less folds in on itself, making it difficult for the victim to breath. 

A hemothorax occurs when the bullet tears the inner lining of the chest wall or the lining covering the lung. Blood flows out into the space between the chest wall and the lung, and again we have pressure on the lung causing collapse and extreme difficulty breathing. 

Blood loss is generally massive in gunshot wounds to the chest because each side of the thorax (chest) can hold 30-40% of a person's blood volume. The blood will leak out from the wounds, but it will also build up inside the chest cavity around the lungs and the heart and put so much pressure on the heart that it can't pump blood to the brain or the rest of the body and will eventually stop beating. Your witness will see frothy blood flow from the chest wound which indicates air bubbles mixed with the blood. She may also see blood coming from the victim's mouth. 

The witness will mainly want to keep the victim breathing, and may have to assist breathing with mouth-to-mouth resuscitation. Your victim may be conscious when first shot, but shock due to rapid blood loss will render him unconscious within a minute or two. Even if conscious, he'll be too busy trying to breathe to be able to speak.

Ten minutes is a long time to have to wait for your paramedics. If you want this guy to survive for that long, I'd shoot him in the lower right chest so that the affected area is the lower lobe of the right lung. The right lung has three lobes, or sections, so if you shoot him in the third lobe -- the lowest and smallest lobe -- the upper part of the lung has a better chance of staying inflated and helping him breathe. Also, the blood will drain down and away from the heart causing less chance of pressure on the heart from accumulated blood in the chest. I'd have the witness turn him over and apply a wad of cloth to the back, then cover the chest wound with a cloth, then turn the victim on his affected side so the wound opening is down and the good lung is up (helps with breathing and keeping blood from putting pressure on the heart). Then have the witness apply pressure to both the chest and the back wounds using one hand for each wound. Take pressure off the wounds every 4-5 minutes to let air escape from the chest, then apply pressure again. 

http://www.primary-surgery.org/ps/vol2/html/sect0247.html  You can check this site for pictures that may help you understand what happens to the lung.

As for the guy hit over the head with a china lamp, unless the lamp is really heavy, it's unlikely he'd be more than stunned by the blow. So yes, he could easily get up and fire a gun. If the lamp broke and cut his head, yes, he'd have a lot of bleeding. Head wounds bleed like mad. Even a one inch long cut will bleed enough to mat the hair, cause blood to run down the face and neck and reach the shoulders. I saw plenty of patients in the ER who looked like somebody threw a bucket of blood on them, and it turned out they had cuts that only required a few stitches. Of course, the deeper the cut, the more it bleeds, so if you want the guy to fire the gun and miss, a good whack on the head should stun him enough to throw off his aim while also messing with his vision by having blood pour down over his forehead into his eyes.

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Do you have a question concerning medical procedures in the ER, medical care given by paramedics, or first aid hints for use by your sleuth? Send your questions to me at maryvwelk@gmail.com and I'll do my best to answer them.


Wednesday, October 10, 2012

Disposing of Bodies

Mystery writers know how to dispose of bodies -- you either bury them deep in a forest, or you dump them in a place where your sleuth can conveniently stumble over them.

But what happens when your victim dies in the ER? How does the ER staff move the body without sending other patients into hysterics or causing visitors to faint dead away? 

Years ago I worked in a very crowded ER -- one that desperately needed enlarging -- where patients often ended up on carts in the hallways or on chairs under a large hanging clock in the central room. Occasionally someone would die in the ER, generally someone already close to death on arrival or someone the paramedics had been trying to revive as they raced to the hospital. On a slow day, curtains would be drawn around our other patients and the dead person would be whisked away to the morgue unseen by patients or visitors. But when we were overcrowded, and patients and visitors were stacked everywhere in the room, we  were forced to resort to more creative methods of body removal.

When I wrote TO KILL A KING, I included a scene where a dead body needed to be removed from an overcrowded ER in a quiet but creative way. I based the scene on something that had actually occurred in the ER I mentioned above, the one where I worked many years ago. I added a character to the scene who hadn't existed at the actual event, but whose fictional presence added a humorous twist to the story. I'm posting that scene here, and I leave it to you to decide which part is based on fact and which part I included just for the fun of it. Enjoy! :)

From TO KILL A KING, the third 'Rhodes to Murder' mystery:


The charge nurse slid a chart into its slot on the desk. "Now tell me, Cari. What we gonna do with that old gentleman on cart five? I need that cubicle for a live one, but Mr. Gone-To-His-Just-Reward is smack dab in the middle of the room, and I hate to move dead folks past sick ones. Tends to shake their confidence in the ability of the doctors, if you know what I mean."
Caroline laughed. "Leave it to me. I'll move him to the morgue without anyone noticing." She waved to Michelle and Wendy. "Can I tear one of you away from that computer for a minute?"
Michelle looked reluctant, but Wendy was more than ready to abandon her job. After listening carefully to Caroline's instructions, the girl broke into a broad grin.                      
"I took some acting classes back in England," she said in a confident voice. "I'm sure I can pull this off."
"Then follow me." Caroline headed towards the back of the east wing. Passing Susan Kane midway through the room, Caroline called out, "Hey, Sue! We're taking your patient on cart five upstairs."
Susan was starting an IV on a woman on cart two. She looked up in alarm and stuttered, "But…but…he's…"
"I know," sang out Caroline. "No need to worry. We'll take good care of Mr. Gone."
Three minutes later Wendy pulled back the curtain encircling cart five.
"There now, sir. Are you warm enough under that blanket?"
The elderly dead man sat semi-upright on the cart, staring blindly at the ceiling. Propped up by pillows, an oxygen mask hid most of his lower face; a towel draped over the top of his head shielded his forehead and ears. A thick blue blanket covered the rest of his body.
"Let me pull it up a bit. Can't have your chin getting cold now, can we." Wendy tugged on the blanket, tucking it under the edge of the oxygen mask. Ten toes suddenly appeared at the end of the cart.
"Forget the feet, Wendy. Let's go," whispered Caroline as she nudged the gurney out of the cubicle and into the walkway between the other patients' carts.
Caught up in the act, Wendy wasn't listening.
"Oh, dear," the girl exclaimed. She yanked on the blanket, forcing Caroline to pull up. "Mustn't have our piggies sticking out."
"Let's go!" hissed Caroline as several patients sat up to stare in their direction. She smiled at them reassuringly while motioning to Wendy to back off. The girl never moved.
"You'll like your room," Wendy went on in a booming voice, reaching over to pat the dead man's arm. It promptly slid from beneath the covers and fell to his side.
"Enough!" Caroline muttered through clenched teeth as Wendy grabbed for the offending extremity. Ignoring the unit receptionist, she leaned against the cart, gave a mighty shove, and ran right over Wendy's foot.
"Oowww!"
A male medical student raced up, eager to assist the pretty young woman staggering about the room on one foot. Stumbling in his haste, he slammed into Wendy, ricocheted sideways into the cart, and fell headlong across the dead man's legs.
"Son of a…!"
Caroline threw her weight against the cart as it rocked backwards, slamming into her knees. Her action had an opposite effect from the one she'd desired. The pillow propping the dead man's chin toppled to the left and slid to the floor. Unsupported, the heavy skull pitched forward.
"He's not alive!" The medical student gazed up in horror. The oxygen mask had fallen away exposing the waxy features of the corpse. Hovering only inches above the boy's head, the dead man stared down through sightless eyes, his wrinkled face frozen in a toothless grin.
"Oh my gawd!"
His legs spinning uselessly off the end of the cart, the medical student tore at the blanket, struggling to right himself. The thick blue material slithered through his fingers and wadded up against his face, throwing him even further off balance and causing the corpse to bounce up and down in a silent jig.
The hairless head bobbed ever closer to the boy. He scrambled blindly to find purchase on something solid, and after what seemed like an eternity but was only a second, his hand brushed against a knobby object. In desperation, he closed his fingers over it and pulled. As he did so, the last bit of blanket fell away.
Caroline leaped to the side of the cart, but she was too late to avert disaster. The body tumbled over, bent at the waist, the torso flattening the medical student.
Fortunately, the young man never felt the blow. He'd fainted dead away after seeing his fist wrapped around the most private part of Mr. Gone's anatomy.
As for the corpse, he seemed no worse for the wear. His face turned to the side, the old man's head rested squarely on the medical student's soft buttocks.
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TO KILL A KING is available as a Kindle e-book at http://amazon.com/author/marywelk 
 TO KILL A KING will be available in trade paperback at Amazon and B&N later this month.
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Friday, October 5, 2012

Book Reviews

Ellen Hart, Carl Brookins, and William Kent Krueger tour together as The Minnesota Crime Wave. These three have championed the cause of short stories by Minnesota authors via two previous anthologies: Silence of the Loons: Thirteen Tales of Mystery by Minnesota Premier Writers and Resort to Murder: Thirteen More Tales of Mystery by Minnesota Premier Writers.

Now they present us with a new anthology, Fifteen Tales of Murder, Mayhem, and Malice from the Land of Minnesota Nice.

Peter Hautman's excellent introduction sets the stage for short mysteries of every manner, and Marilyn Victor's This Old House kicks off the collection in a startling way. Her tale of two aging sisters feuding over a hidden inheritance has a twist ending that will surprise and delight readers. The Dark Under the Bed, by Richard A. Thompson, is both spooky and disturbing in its portrayal of "the shadow men" who "always come for you at night". This one will give you the chills. 

And then there's Michael Allan Mallory's Desperados, a story of two bank robbers who, when their getaway car breaks down, make the mistake of hiding out in the home of a very resourceful older couple. Brains over brawn wins the day in this fine tale.

Death by Potato Salad features Mrs. Berns from Jess Lourey's Murder-by-Mouth series set in Battle Lake, Minnesota. The town's All Church weekend retreat has never been so lively as this year when Mrs. Berns attend the "Day One Icebreaker Class" called "Miracles with Mayonnaise". Lourey proves once again that even murder can be humorous at times.

Mary Logue, author of the Claire Watkins mysteries, offers two thought-provoking poems to the collection. Her work is followed by Lori L. Lake's An Age-Old Solution, in which two women handle a blackmailer's demands in a most unusual and cunning way.

Next in line is a fine piece by William Kent Krueger. Set in an earlier time, Woman In Ice tells the story of a girl found encased in a block of lake ice and the many townsfolk who visit the local priest believing they are to blame for the young woman's death. This one ends with a twist that I should have seen coming, but didn't.

David Housewright's A Turn of the Card follows a high profile crook's decision making dependence on the reading of Tarot cards by a beautiful young woman. The twists and turns in this story carry through to the end in a most clever and satisfying manner.

Ellen Hart brings a touch of the supernatural to Overstuffed, the story of a woman determined to take revenge on the ex-husband of her dead sister. The author of twenty-eight novels, Hart knows how to weave a tale and does so in a convincing manner in this well written story.

Elizabeth Gunn gives us a solid police procedural story in The Butler Didn't. Was it murder by improvisation, or death by neglect?  One thing is for sure: the butler didn't do it.

Howard T. Crandell is the best actuary in the Twin Cities. On the bad side, his habit of thinking only in term of statistics costs him his job in Lois Greiman's Iced. On the good side, it helps him catch a murderer. This is a character you'll come to love, flaws and all.

Pat Dennis is known for her humorous take on life. That humor shows up in Minnesota Iced where a long-suffering wife decides to terminate her mother-in-law's unwelcome visit by terminating her life. Who said ice fishing wasn't fun? Not Pat! :)

Carl Brookins is known for the three mystery series he writes, all of them set in Minnesota. The Horse He Rode In On features the star of one of those series, private investigator Sean Sean. Terminally short--or height challenged, as he puts it--Sean doesn't enjoy investigating a death while riding a horse that's taller than he. But horses played a part in the death of a city councilman. Sean must figure out exactly what that part was.

Judith Yates Borger writes of friendship gone wrong in Stone Arch Bridge. Kate and Anna had been sidekicks since kindergarten. But then along came Josh, and there went Anna. Can Kate save her friend from a fate worse than death? Only in an unexpected way.

Joel Arnold's Blue-Eyed Mary ends this fine anthology. This well-crafted tale speaks of the love of a son for his mother and the lengths to which he'll go to protect her. This is a sad little story in which the reader's empathy will stretch to include both the living and the dead. Perhaps that is why it was chosen as the concluding story in the collection; the emotions it plays to are so true to real life. 

If you enjoy short stories, I highly recommend you read this latest anthology presented by The Minnesota Crime Wave. You won't regret it.

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Friday, September 14, 2012

Informing Families in a Murder Case

This week's medical question comes from South Carolina mystery writer Ellis Vidler. 

"My question is, how would the victim’s family be told of the death in these circumstances? The victim died on the way to the hospital, maybe 30 minutes to an hour after being stabbed and left for dead. The police or paramedics found his ID in his wallet and located his brother, who was called to the hospital. When the brother gets there, I have him directed to a waiting room. Then, almost immediately, the police detective and the doctor come in to inform him of the death. Which one is likely to give him the news and what would they say? Also, the only ID so far is from the victim’s wallet. Would the detective ask him to identify the victim? I’m not sure how the police and medical staff would deal with this."

I sent Ellis the following answer.


If the police were present when the paramedics originally arrived to care for the victim, the police might have already searched the victim for his wallet. If the paramedics got there first, they wouldn't have searched for a wallet, but they could have found it if it was in a piece of clothing they needed to remove in order to get to the wound. 

The police would be the ones to notify the brother. The brother would be directed to the waiting room by the ER registrar, who would then notify the charge nurse of the brother's presence. The charge nurse would notify the doctor and the police, and then either the charge nurse or the nurse assigned to the victim would come out to meet the brother and take him to a private area, usually a small room off the waiting room, used for the express purpose of informing families of the death or critical condition of their loved one. The doctor and the detective would then go to that room. 

The doctor would be the one who told the brother of the victim's death. He would first introduce himself and the police officer, then he'd verbally verify the relationship of the victim to the person with whom he's speaking. If it is the brother, he'll say so. If it isn't the brother, the presence of a policeman would most probably compel the man to state his true relationship -- friend, business partner, etc. -- to the doctor. If he isn't the brother, the conversation with the doctor would end there due to privacy laws concerning the rights to personal information. The police office would then ask any questions he might have for the man.

If the man is the brother, the doctor would then say how sorry he was to have to inform the man that, despite all efforts by the paramedics, his brother died before arriving in the ER. The doctor would explain the victim's injuries and how critical his condition was when help first arrived. He would reiterate the fact that everything possible was done to save the victim, but how his injuries were so severe that he was unable to survive them. He would then tell the brother that the police officer is investigating the victim's death and that he, the doctor, will leave the officer and the brother alone so that they can talk. He would then add that the brother should tell the staff when he is ready to see the victim and a nurse will take the brother to the victim's room in the ER.

 At this point, your detective would ask the brother some questions to verify his relationship to the victim. If the ID from the wallet is a picture ID, he can ask the brother to verify the identity that way. If the ID doesn't include a picture, he can tell the brother the circumstances under which the victim was found and ask the brother to visually identify the victim as the person listed on the ID. The cop would then accompany the brother into the ER and a nurse would take both men to the cubicle where the body rests on a cart. After identification, the victim would be kept in the ER until the medical examiner's -- or coroner's -- van arrived to collect the body. 

Now even if the patient died in the ambulance, the paramedics would continue resuscitation efforts until they reached the hospital and an ER doctor decided further efforts were useless. The victim's clothes would be bagged if any were removed by the paramedics or ER staff, and they would be sent with the body or given to the police per individual system policy. The ER doctor would not sign a death certificate as that's the province of the ME or coroner, but he would pronounce death and give the time of death as the time he pronounced the victim. This time would be relaid to the ME or coroner's office via telephone by the nurse assigned to the patient. The biological time of death used in any court case would be decided by the coroner or ME, who would rely on the paramedic report, the ER doc's pronounced time of death, and the autopsy report to ascertain the time. In this particular case, the ME or coroner would probably use the ER doc's pronounced time of death as the official record time.

Outside of that initial meeting, the doctor would have no further contact with the brother unless the brother had specific questions concerning the wound and demanded to speak with the doctor. The nurse assigned to the victim would answer any other hospital related questions voiced by the brother, and the detective would be able to tell him about release of the body for burial.

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Friday, September 7, 2012

The Writer's ER: Paramedics and Death Scenes

Mystery writers often create scenes where the protagonist finds someone dead in a house, office, restaurant, or some other setting far from immediate medical help. Sometimes the scene progresses to where the protagonist calls 911 for help. Other times the writer ends the chapter with that scene and jumps ahead to a new chapter where police -- and sometimes paramedics -- are already on the scene. The writer usually concentrates on the activities of the police, and if he does mention the paramedics, it's only to say that, at some point in the story, they cart away the body.

The reason so many writers avoid describing paramedic activity is this: most of them simply don't know what paramedics do when called to a death scene. They rarely see paramedics in action on TV shows, and medical mystery novels like those of Tess Gerritsen or Robin Cook generally incorporate doctors, rather than other medical personnel, as sleuths.

Rather than make a mistake, writers often prefer to skip over the role of paramedics and concentrate instead on better known or easily researched police procedures. Including the actions of the paramedics, though, can sometimes make for a more gut-wrenching scene. It can also tell the protagonist something about the victim that he/she might otherwise never be able to learn -- the victim had an unusual tattoo on his chest or was wearing a patch that delivered medication for a certain disorder that could be relevant to the case.

So what would paramedics do in a mystery novel when a 911 call takes them to a death scene?

First of all, on arrival, paramedics would size up the scene using the information given them by the 911 dispatcher. If they arrive before the police, is it safe for them to enter the area where the victim was found? Did the story's protagonist tell the dispatcher he found a dead body in his office when he arrived for work? Did he mention anything out of the usual, like a gun on the floor near the body? If the paramedics are told of no unusual circumstances surrounding the death and feel the scene is safe, they would approach the victim as if this was not a crime scene. Of course, this means if the victim was poisoned, the paramedics might inadvertently destroy some evidence -- they might move a coffee cup found overturned on the floor next to the victim, or push office furniture out of the way to get to the victim. Doing those things could initially confuse the police investigation and given the story's protagonist a chance to do some snooping.

Now if paramedics arrived at an obvious crime scene due to trauma -- the victim has a knife sticking in his chest or a bullet hole in his forehead -- and they got there before the police, things would go much differently. All paramedics are taught to protect a crime scene, meaning it is imperative they do not contaminate or destroy any possible evidence (bloody footprints, etc.) while ascertaining the condition of the victim. In this case, one paramedic would carefully approach the victim to check for any signs of life.

If found, both paramedics would proceed to give life support via CPR and emergency treatment of wounds while avoiding any unnecessary contact with objects around them. If they had to cut through the victim's clothing, they would avoid areas with bullet holes or other tears and stains. If they applied dressings to wounds, they'd make sure they removed only the wrappings when they left and didn't accidentally pick up any items that could be considered evidence. They would apply dressings to, but not clean the blood from, any bullet wounds present. In stabbing cases, they would not remove the weapon from the victim. If transporting a GSW victim, they'd check for any possible evidence left in their ambulance after transport, such as expended bullets that had tangled in the victim's clothing and dislodged during transport. If their patient had been assaulted and was a victim of asphyxiation, they'd avoid cutting or untying knots in the material used to strangle the person unless absolutely necessary to open the airway and restore breathing.

If no signs of life were present in the victim, the paramedics would back off from the scene until the arrival of the police. While waiting, they would contact their base hospital and report in. Depending on the condition of the body and their system's policies, they may or may not refer to the victim as a "Triple Zero."

So what are signs of life? When can paramedics legally withhold resuscitation efforts? Basically, signs of life include cardiac electrical activity as recognized on a portable heart monitor, a palpable heartbeat (pulse), and active respiratory effort (breathing). Some Emergency Medical Services (EMS) systems, though, expand that definition to include other factors.

The Region XI Chicago EMS system defines "signs of life" as "any respiration, a palpable pulse, a pupillary response, or spontaneous movement". Paramedics working under the Chicago EMS system could withhold resuscitation  from any trauma victim 16 years or older where there is a "trauma-related lethal mechanism of injury" -- be it a car accident or a gunshot wound -- and the victim is asystolic (no cardiac electrical activity), EXCEPT in the cases or drowning, strangulation, lightning strikes or electrocution, situations involving hypothermia, victims with visible pregnancy, or where medical conditions are the likely cause of cardiac arrest (as when someone has a heart attack and goes into cardiac arrest while driving, then crashes his car into a tree).

The Region XI Chicago EMS system's policies and procedures do not include reference to the term "Triple Zero", but they do mirror other area systems' definition of this term when describing other reasons paramedics can withhold resuscitation. Illinois' Region VII EMS groups six EMS state systems consisting of 16 hospitals, 115 fire departments and ambulance services, and almost 5000 EMS providers. Region VII EMA uses the term "Triple Zero" to indicate a victim who is pulseless, non-breathing, and exhibits at least one long-term indication of death. Those indications are: profound dependent lividity; rigor mortis without profound hypothermia; decapitation; decomposition; mummification or dehydration; and putrefaction. Region XI Chicago EMS, while not using the term "Triple Zero", lists those same six circumstances as reasons for withholding resuscitation, but also includes the above mentioned trauma-related circumstances plus incineration and presence of a frozen state of being. Region IX EMS includes some of both the other two region criteria when they call "Triple Zero" a condition "incompatible with life". They also include thoracic.abdominal transection and massive cranial/cerebral destruction as reasons to withhold resuscitation.

Including paramedics in a death scene can benefit a writer in many ways. But because here in the U.S. the Emergency Medical Services program is divided into 300 designated regions, writers are advised to check out the policies of their local region.


Writers can go to http://www.healthstream.com/crsLib/EMS/accred.htm for a listing of state EMS offices with websites. Most EMS websites will offer downloads of their policies and standing medical orders for paramedics.

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Friday, August 31, 2012

Rizzoli & Isles: Death by Drugs

I am a huge Rizzoli and Isles fan. I love both the TV show and the novels by Tess Gerritsen on which the show is based, even though the two are very different.

Anyone who's read Gerritsen's books knows that the producer made some big changes to the two main characters when the TV series went into production. Jane Rizzoli became a street savvy tomboy who eschews dresses and high heels for sweatsuits and gym shoes. Maura also changed into a wackier version of the brilliant pathologist portrayed in Gerritsen's books. Secondary characters were added or transformed in order to appeal to a broader based audience.

Until recently, I was pleased that the producer at least had the good sense to leave the science alone. Gerritsen is a master at writing realistic medical scenes and making sure Maura Isles is up-to-date on the scientific side of crime solving. There are no medical mistakes in Gerritsen's books.

But there sure was a big medical mistake in an episode of the TV program a few weeks ago. A wealthy young man wearing a mask and a cape died suddenly during a kinky sex party. During the autopsy, Maura discovered he'd been INJECTED with POTASSIUM CHLORIDE in an amount sufficient to cause a cardiac arrest. Rizzoli's investigation eventually led her to the wife of the dead man's partner. The police decided she was the logical killer mainly because she was a school nurse and thus had access to potassium chloride and how to inject it in order to kill someone.

WHAT????????

I practically leaped out of my chair at the stupidity of that claim. The writers really got that wrong!

First of all, potassium chloride in its injectable form can only be bought if a veterinarian has prescribed it for use in the care of a sick animal and the individual buying it has a prescription signed by the vet. Even then there are difficulties getting it from an ordinary pharmacy. Generally one must buy such a product from a pet care company that deals in veterinary medicine.

Doctors DO NOT prescribe injectable KCl (potassium chloride) for use by non-medically trained individuals because of the extreme danger of death by overdose. Injectable KCl can only be found in hospitals where trained pharmacists dilute it in solutions of normal saline (NS) or 5% dextrose in water (D5W), or in other medical facilities equipped to administer IV potassium chloride in solutions.

Diluted KCl is given intravenously in varying amounts depending on the  need. Normal human potassium levels range from 3.5 to 5 mEq/L in the blood. If someone has a level lower than 3.5, that person is said to be suffering from hypokalemia. Mild to moderate hypokalemia can be treated with potassium in pill form. Severe hypokalemia, where the potassium level is less than 2.5 mEq/L, is generally treated intravenously using the following solutions: 10 mEq in 100 ml of solution; 20 mEq in 250 ml of solution; or 40 mEq in 500 ml of solution. Depending on the amount of KCl given, it will be infused over a span of one to four hours.

Why so slow when it comes to infusing KCl, you ask. Well, the truth is, the stuff hurts like heck if given too quickly. Patients will complain that the arm with the IV in it feels like it's on fire. If it hurts that much when diluted with saline or dextrose, just imagine how painful it would be if your imaginary killer injected straight undiluted potassium chloride into a victim's vein. Unless the injection was made in a vein close to the heart, the victim would have at least a few moments in which to scream.

How much KCl would it take to kill someone if it was injected undiluted into a vein? Now we're talking what's called LD50 -- the lethal dose for 50% of people weighing 75kg, or 165 lb. It's been estimated that the lethal IV dose of KCl is 30 mg per kg of body weight for a person weighing 75kg, and it has to be injected quickly.

So let's say your killer got his hands on a 10 ml (10cc) bottle containing the usual 2mEq/1ml of injectable KCl. That's 20 mEq KCl in a 10 ml bottle. He needs 30mg/kg, and his victim weighs 75 kg. Multiply 30 x 75 and you get 2250mg of KCl needed to send the victim's heart into an abnormal rhythm that would in all probability lead to a rapid death. 2mEq of KCl = 150 mg, so a 10 ml bottle would contain 1500 mg. Your killer would need to use at least 1 and 1/2 bottles -- or 15 ml (15cc) -- and would probably feel safer going with 20 ml (20cc), the entire contents of two bottle.

Now have you ever seen a 20cc syringe? They're not those little syringes used when you get a flu shot, or the even tinier ones used to administer insulin. They are BIG syringes, not easily hidden in your hand or your pocket. They're not the kind you can easily buy, either.

What I'm trying to say here is this: the SCHOOL NURSE in that episode of Rizzoli & Isles didn't have the ability to get her hands on injectable KCl. School nurses don't have access to that kind of drug, and she had no access to a hospital pharmacy. The only way she could have gotten it was through her pet's vet. But NO MENTION was ever made of her having a pet of any kind, healthy or sick, so forget the vet idea. And where did she get the 20cc syringe, and how did she hide it in the gauzy little outfit she was supposedly wearing when she killed the guy?

Writer mistake, for sure. Now if you're thinking of including a death-by-potassium-chloride scene in your book, remember what you read here and WRITE IT RIGHT!

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Friday, August 24, 2012

A Scene in a Small Rural ER

As promised, this week I'm adding a new feature to CICERO'S CHILDREN called THE WRITER'S ER that will highlight questions from authors concerning medical scenes in their books. As a long-time ER nurse and instructor in ACLS, PALS, and BLS, I have the experience to answer most any question thrown my way. And if I'm ever stumped for an answer, I have friends in the medical field, especially in the field of pre-hospital care and ER care, who I can turn to for help.

That said, the first question I received this week was from Marilyn Meredith, author of over thirty published novels. Marilyn writes the Deputy Tempe Crabbe series under her own name, and the Rocky Bluff P.D. series under the name F. M. Meredith. She is a member of Epic, three chapters of Sisters in Crime, Mystery Writers of America, and serves as the program chair for the Public Safety Writers of America's writing conference. 

Marilyn has been an instructor at many other writing conferences. You can learn more about her books at http://fictionforyou.com. Please visit her blog at http://marilynmeredith.blogspot.com. . 

Marilyn wrote: "I have a character who is a young police officer and she’s been shot in the thigh and shoulder—bled a lot but neither serious. Another officer stopped the bleeding at the scene, she’s taken to the ER, and then where? I want her friend another female officer to be able to see her before they take her to the operating room. One of the nurses is a friend of the 2nd officer (her husband is a police officer too.) She would’ve had x-rays, right? And be getting IVs? Is there a window of time where her friend could speak to her?"

I emailed my answer to Marilyn who graciously consented to let me post her question here. (I'm including a bit more information below then I originally gave to Marilyn. That's because I wanted to clarify what I wrote about the different levels of trauma centers.)

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Yes, Marilyn, there's a window of time when the friend would certainly be allowed to speak with her. That window could be quite large depending on where the injured officer was taken. Are we talking a small rural hospital, or a small, medium, or large city hospital? Population determines the size of a city, with the criteria differing from state to state in the U.S. In a large city, an officer with multiple GSW would be taken to a Level I trauma hospital where surgeons of all specialties are on duty 24/7. Generally speaking, a medium sized city might have a Level I trauma center if it served a larger population outside its city limits. It would definitely have a hospital certified as a Level II trauma center with surgeons of all specialties available to come in within 30 minutes of being called by the ER doc. An example of a medium-sized city that has both a Level I and a Level II trauma center is Aurora, Colorado (population 325,078). One hospital in the city serves as a Level II trauma center for all patients, while another hospital serves as a Level I Pediatric Trauma Center dedicated to injuries in children.

Small cities could have a Level II or a Level III trauma center, Level III being a hospital that can provide care to most trauma patients, but doesn't have a full range of specialists. Level III ERs transfer patients to a higher level trauma center if they require more intensive emergency treatment by a specialist. An example of this would be a gunshot wound to the head that required the services of a neurosurgeon.

There are always exceptions to the city size rule. The population of Park Ridge, Illinois is only 37,775, but it has a Level I Trauma Center. Lutheran General Hospital opened in 1959 when there was still much open land in this Chicago suburb. Over the years it grew, and grew, and grew, until today it is a 645-bed medical center and one of the largest hospitals in the Chicago area. You could probably find the same story playing out in small suburbs of other major cities. But when we're talking about rural areas such as you'd find in states like Utah, Nevada, Oregon, or even in parts of California, you're looking at your hospital being a Level III trauma center. Examples of this would be Yreka, CA (population 7,765) and Wildoma, CA (population 32,176). Both cities are served by Level III trauma centers

In a Level I or Level II hospital ER, the ER doc would not call in a surgeon for a basically non-serious GSW until he had completed his examination and had X-ray and lab results, because he/she would need to know if a surgeon was needed and what kind of surgeon was required. He'd probably call in an orthopedic surgeon if the bullet shattered bone, but the possibility of nerve damage could require a neurosurgeon as well. If your hospital is in a rural area serving maybe 15,000-20,000 people, the hospital would probably have a Level III ER and would transfer the patient to a higher level facilitya Level I or II hospital—if the necessary surgeon wasn't available there.

Even in a Level I or Level II hospital trauma center, your officer would be in the ER for at least 2-4 hours prior to going to surgery if the shooting occurs during the day and if, as you say, those wounds are minormeaning no major arteries were hit and bleeding is controlled. I say "during the day" because the OR suites are already in use during the day, and the only way your victim would be pushed to the front of the OR schedule is if she is bleeding so badly that her blood pressure falls and she goes into shock, the wound is to the chest or abdomen, or the gunshot caused a partial amputation of a limb or some other life-threatening event. She'd probably go to the OR faster in the evening when the OR isn't in regular use. I'd still count on at least 2 hours from arrival in the ER to going to the OR in the evening.

Your victim would have at least one IV in place with a liter bottle of .9 normal saline running slowly, plus an IV line with a heplock in place, that line not being used at present but reserved for use if needed in surgery (more fluids or blood products). X-rays would be taken to look for bone damage and, if the bullet did not exit the wound, to see placement of the bullet in the body. Lab work would be done, a CBC (complete blood count), PT and PTT for clotting evaluation, and probably chemistries (electrolytes, etc), plus a Type & Screen for possible blood transfusion. 

Shoulder wounds can be life-threatening because you have the subclavian and brachial arteries and veins running below the clavicle and down the arm. In order to make them minor wounds, your victim needs to be shot clean through the deltoid muscle on the outer fleshy area of the upper arm. If the bullet doesn't touch the bone but lodges in the muscle, the ER doc can remove the bullet without calling in a surgeon. If the bullet goes clean through without damaging the bone, the ER doc will clean the wound, close it with sutures, apply a dressing, and discharge the patient with antibiotics (may give IV antibiotics also before discharge). If the bullet penetrates the upper arm bone (the humerus) breaking that bone or causing bone splinters to lodge in the surrounding muscle, an orthopedic surgeon would be called in for surgery to remove the bullet and clean up the splinters and/or repair the fracture with plates and screws. Your officer would be out of action for several weeks if the bone was broken, but less time if just a few splinters were removed, maybe 10 days and no heavy lifting for another week. If shot through the clavicle or shoulder blade (scapula), generally no surgery would be needed unless it's for the removal of bone splinters. Treatment for a shoulder blade is a sling. Treatment for a clavicle is a figure eight strap. 

For the thigh wound, if you want it to be minor, the wound must be on the outside of the leg. The femoral artery and vein run down the inside of the leg, and both bleed like mad. Hitting them with a bullet, especially the femoral artery, could cause your officer to bleed out very quickly. Go for the outer fleshy part of the thigh. You'll probably have to have the bullet hit the femur (the upper leg bone). It's hard to miss the femur unless the officer has really fat legs. :) If you want your officer back on her feet quickly, just have the bullet graze the bone so the surgeon just has to remove some splinters. The femur is the strongest bone in your body and doesn't break easily in a younger healthy person. Your officer will be on crutches for a day or so, then may use a cane until she has no pain when weight bearing.

So again, if the wounds are minor, your officer will wait around in the ER for several hours, during which any of her friends can visit her. If she's going to be transferred to another hospital for surgery, it'll depend on how long it takes for an ambulance to arrive for the transfer. We're still talking a couple of hours here because of all the tests, etc.

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And now a heads up to writers like Marilyn and I who include ER scenes in our novels. Be careful of the kind of injury you create for your hero or villain. If you set your stories in rural areas, don't expect to have a thoracic surgeon or a neurosurgeon living right down the block from your hospital. Big money guys like those  tend to stay in the big cities where they have plenty of work to do every day. If you're not sure what kind of hospital ER you should portray in your story, check out hospitals in real areas similar to you setting. For more information on trauma centers, check out the following links:

http://www.facs.org/trauma/verified.html A partial list of trauma centers by American College of Surgeons.
http://www.traumamaps.org  A map of the U.S. showing trauma center availability.
http://www.cdc.gov/traumacare/ Info from the CDC.
http://www.calena.us/California%20Hospitals%20and%20Trauma%20Centers.htm   The Emergency Nurses Association of California's list of state trauma centers.  

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IF YOU HAVE A MEDICAL QUESTION DEALING WITH PRE-HOSPITAL CARE OR CARE IN THE ER, AND WOULD LIKE TO HAVE IT ANSWERED HERE, CONTACT ME AT KLEWORKS@AOL.COM. I'D LOVE TO HEAR FROM YOU.