Outback Bartender Sean Cudahy slid another martini across the bar. When he had relieved Trask Bodine at eight o'clock, he had told him that he had already cut the cackling blonde off and was hoping she might eat something and then be sober enough to be put into a cab. Yet, when she winked at him and demanded another he had obliged. It might not be honorable thing to do but he wasn't exactly an eagle scout like his older brother Tom or even a marine like Trask Bodine. No, he didn't live a clean life, and go to marine reserves drill sessions at eight AM. As long as they were rich, he preferred his women a little on the trashy side.
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When he sat in his cousin Alphonse Castiglia's Greenwich Village rowhouse sharing a scotch with him and Dominick Graziano, Joe Scully felt like a lucky man. His wife Jeanine had called off their ridiculous divorce and his son Christopher was the starting quarterback on an undefeated Grosse Point High School team. Beyond that, the power struggle in the Family had settled out once again and with Vincent Castiglia's son and Saverio Graziano's grandson back in control of the Camorese Family there seemed to be more right than wrong in the world. Or there would be if the commission would finally strip the Zacchara Family of their seat. There was history there; the D'Angelo family had been decommissioned, so to speak, in the early eighties. Of course, the aftermath of that had not been pretty, or without bloodshed. Then there was the issue that Anthony Zacchara's daughter had married Roberto Mancusi, the son of Chicago Outfit Boss, Salvatore Mancusi.
"How sure are you that we took out all of Zacchara's inside guys?" his cousin, Alphonse asked as he swirled his glass and then stared into the ice cubes.
In 1986 Joe Scully had learned that NYPD Detective Deke Woods was working with the Zacchara Family against the other five families through a bit of a twisted quid pro quo system. What he hadn't shared upfront with Luigi Camorese, Gino Solieto, or Leonardo Pozzulo, when they signed off on the hit, was that he had started looking into the less than honorable detective because he also happened to be Sonny Corinthos's abusive stepfather. It had been business but it had also been a bit of a personal honor killing. That had come out later. By then it appeared that Zacchara had at least one other inside source so Joe's own lack of transparency had been overshadowed by the need to ferret out the rat.
"There certainly could be someone else. I guess we can really only be certain that Deke Woods is dead and Joey Zamora is in prison. Have there been other incidents?" Joe asked.
"Cops showed up at Sal's; they seemed to be looking for drugs. Maybe they just had some bad information or maybe someone pointed them in that direction," Saverio said.
Sal Luciano owned a Butcher Shop down 86th Street from the fire station he had once worked at with Carmine Cerullo and Raphael Giambetti. It was an extremely clean establishment. Sal washed everything well; sometimes even the money.
"That doesn't really sound like Zacchara or even that hanger on attorney of his, Trevor Lansing. They know we're not in the drug game so what would that even get them?" Joe asked.
"It's Zacchara, it doesn't have to be logical," Alphonse said.
His cousin had a point Joe supposed. Anthony Zacchara had always been sadistic and merciless even as a child. He had been anything but the reasonable or logical choice to head the family after his father in law's death but he had essentially declared himself the new boss and killed entire families of any man who dared to challenge him. Normally the Commission would have reigned him in but sometimes it seemed his ruthlessness made him untouchable. Even so, in later years he had become more and more erratic; a true sociopath. There were rumors he had been responsible for the death of his first wife, Domenicia Vega Zacchara in 1983, but everyone knew he had murdered his second wife, Maria Corelli Zacchara in 1992. It was the first trial of a mafioso where Joe had felt punched in the gut when the jury foreperson said, "We find the defendant not guilty." But on October 16, 1992 that was exactly what a group of individuals who had been paid off, bribed, or both did.
"True, in fact, when it's Zacchara it is basically guaranteed to not be logical. Which is another reason the Commission needs to decommission that whole family," Joe said.
"Maybe, but Zacchara is enough of a lose canon that could have truly tragic results. Anyway, he married his daughter into the Mancusi family and D'Angelo still feels they owe him a great debt because he championed their return to the Commission so it wouldn't be a smooth process, regardless," Alphonse said.
Alphonse was diplomatic just as his father had been, but Joe couldn't quite let the idea go. "From what I hear Salvatore Mancusi wasn't exactly thrilled about that union and definitely doesn't see it as an alliance between the families," he said.
"Salvatore is hardly an altar boy himself! He shot his own son and then let his other son take the blame," Alphonse said.
That was also true but Joe Scully could only accept those words with a shudder. Wasn't there a time when made men were also honorable men?
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As she started down the steps to the Locke Street Pier, Katherine Bell was anything but steady on her feet. She might be swaying and staggering but she was boldened with far too much liquid courage. She was on her way to the launch and she was going to fight her way onto Spoon Island if necessary. She would speak with Stefan!
Six steps away from the bottom she lurched forward unsteadily, and her stiletto heel caught on the step. She flailed a bit futilely but ultimately tumbled the rest of the way down to the concrete of the pier.
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Jason Morgan navigated his motorcycle through the Brooklyn Battery Tunnel. He was meeting Sonny, Joe Scully, and Leonardo Pozzulo at the old Solieto Warehouse in Tribeca. In spite of the name, the warehouse was currently being used by the Pozzulo Family to store several tons of cement powder for use in their paving contracts.
There was a smaller basement under the warehouse that didn't appear on the building blueprints. Purportedly it had been a distillery and speak easy during the prohibition period. More than sixty years later it was used as a different kind of speak easy, as in a place for clandestine meetings and free speech away from the prying eyes or listening ears of law enforcement. Access to the sequestered basement was through a sliding floor panel. The panel was activated with a key which there were five copies; the Solieto, Pozzulo, Camorese, Scully, and Corinthos families each possessed a key.
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Dr. Alan Quartermaine pulled his Mercedes into one of the reserved physician spots immediately outside the PCGH ED, shifted into park, and climbed out quickly. He hit his key fob to lock the car as he jogged over to the ambulance entrance and swiped his badge to enter.
"Uhh, Dr. Quartermaine, you beat the ambulance but your trauma will be going to trauma room 4," one of the ED clerks told him when he entered.
Alan smiled as he headed down the hallway to the resuscitation room. Beating the ambulance definitely reinforced their ability to take second trauma call from home. He forced his countenance to maintain the smile when he walked into the trauma room and saw his resident, Dr. Arthur Cerami, leaning against a wall.
"Good evening, Dr. Cerami, where is the rest of the team?" Alan asked as he grabbed a trauma gown, shoe covers which resembled the waders his father insisted on wearing for the annual family fishing trip, and a mask with eye protection.
Dr. Cerami offered an uninterested shrug of his shoulder. "Dr. Pogue was scrubbing with Dr. Breslin on some gun shot."
"Yeah we're turning into a regular knife and gun club. Port Charles rivals the Middle East in that respect," Mitch Harris said.
Alan supposed his opinion was not completely uniformed since the thirty-year-old nurse had recently returned from a thirteen-month deployment to Iraq. But his thoughts quickly went from there to thoughts of Jason. His mother had mentioned that Jason was going out of town. Apparently, he had stopped by the mansion on Friday to say goodbye. Alan wasn't sure what to make of that.
"Ok, people, look alive. Unidentified caucasian female found down on the Locke Street Pier. GCS 12. Likely head injury and possible pneumothorax. O2 Sats 88% BP 90 over palp," a paramedic Alan thought was named Mike barked out as he and a colleague wheeled into the room.
Alan took his position at the head of the bed and stabilized the patient's neck. "Ok we move on three on my count. 1-2-3," he said.
Once the patient had been moved over to the gurney, he realized the woman in front of him, moaning Stefan, was none other than Katherine Bell. "Katherine, you're here at GH we're going to take care of you," he said as he grabbed a stethoscope and auscultated heart and lungs.
Katherine opened her eyes to his voice, didn't really engage, but had quite the intact gag reflex. Alan didn't detect any abnormal heart sounds but he didn't hear breath sounds over the right chest. He moved his hands up and down along the chest wall. He didn't appreciate step off or crepitus. "Ok, I'm going to need a chest tube set up and let's move her over to our monitors. Dr. Cerami, are you feeling an emergent chest tube tonight or do you want to finish up the primary and secondary surveys?"
"Can't I just put the orders in?" Dr. Cerami asked. He hadn't moved from the wall he had been leaning against.
Alan refrained from rolling his eyes. "Ok, so you're going to need a STAT CMP, CBC, PT/PTT, Type and Cross, HCG, ETOH, and drug screen. Then do a STAT portable Chest X-ray and a Non-Contrast Head CT with extension to get the entire C-spine," he said as he opened up the chest tube tray and slipped into a pair of sterile gloves.
Ideally a surgeon would do the secondary survey expeditiously and use that to guide their orders but everything he had listed would be needed and once he got the lung re-expanded he planned to do the FAST exam and decide if any other imaging was needed based on that.
As he prepped and draped the right chest Alan made a mental note of the behavior that needed to be addressed. He could understand it taking a while to get your bearings as a resident but he had interns who were more hands on in traumas than Dr. Cerami. Actually, he thought all of their interns were more hands on in general than Dr. Cerami.
"Mitch, why don't you hang some LR wide open through the peripheral IV EMS placed and grab me some lidocaine," Alan said as he started to prepare the chest tube with Kelly clamps."
"Here," Mitch said as he opened the lidocaine and held it upside down so Alan could draw out of it. "They only put in a 22-gauge line, so maybe you can place a line after you get your chest tube in," he added.
"Sure," Alan said as he palpated down the chest wall to the fifth intercostal space in the anterior axillary line. He inserted the needle over the inferior rib and then into the pleural space injecting anesthetic as he pulled out.
Alan picked up the scalpel and made his skin incision. He inserted his finger into the incision and made his way into the pleural space. He glanced over at the monitor and smiled as he saw that Katherine's saturations were climbing up which was good evidence that the lung was re-expanding. He picked up the chest tube and used the Kelly clamp to guide it into position. When satisfied he was in good position, he released the clamp and removed it. He reached for his needle driver and suture and started to suture the tube in place as Mitch connected the Pleurevac to the wall suction and connected it to the chest tube.
Katherine's saturations had climbed to one hundred percent by the time he was cleaning up his sharps and removing the drape. Her blood pressure was 110/70. "If that IV is holding up ok I'll go ahead and do the FAST Exam and then if that is ok I can put a Subclavian in on the right side," Alan said.
"Yeah, it's fine actually, but you know ICU will unload some passive aggressive snub if we send the patient up without a central line," Mitch said.
Alan didn't comment, it was really better that way. He picked up the Ultrasound probe and turned to Dr. Cerami. "Would you like to do the honors?" he asked.
Dr. Cerami shrugged his shoulders again. "Not really, how about if I observe?" he asked.
Once again Alan decided silence would serve him well as he placed the ultrasound probe. He was all for having a good understanding of your professional limitations but a surgeon sixteen months into residency should really be capable of a FAST exam for trauma.
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Tony Solieto carefully didn't tell his wife where he was going or who he would be with when he stepped out of the rowhouse they owned in Bay Ridge. Gino Solieto had always been adamant that his daughter knew nothing about his business so in no way could she be considered complicit or culpable in any crimes. He had expected Tony to uphold that same commitment after they married. That was a bit ironic since they had only married because Carla knew he had killed Mark Zullo.
Tony had no regrets about killing Mark Zullo. The guy was a menace; he had raped Tony's sister in law and he dealt drugs for the Zacchara Organization on a school playground. The world was a better place without him. Beyond that, Tony had made a few mistakes. Somehow Zullo had washed up against Pier 16 and his alibi had been broken when it was revealed that his girlfriend, Ally Rescott, had been cited for speeding on the FDR on the night he had tried to say they were at her place. Ally had corroborated his story which only made the cops more suspicious.
When Gino heard from a friend in the Manhattan DA's Office that they were going to have an investigative grand jury and summon the entire Solieto family he panicked. It wasn't just that Tony didn't have a solid alibi but that he had met the cleanup crew at Gino's old Brooklyn townhouse unaware that Carla was staying there while her apartment was being painted. The matter was further complicated by the fact that Carla was an attorney admitted to the bar in NY so she wasn't about to commit perjury to protect him.
So, they had married and Carla had prepared to invoke spousal privilege. The Manhattan DA's Office had been suspicious about their marriage but Carla never received a subpoena along with everyone else and no one was charged after the grand jury. Tony had been all ready to get his annulment and marry Ally when Gino decreed that would look suspicious. Carla had agreed so they decided they would stay married for at least a year and then he was supposed to be free.
Or that had been the plan but, as Sonny Corinthos would say, life happens while you're busy making other plans. Ally got sick of waiting for him so she went back to her ex-boyfriend Danny Roberts and he got sick of celibacy so he and Carla shared a single night of comfort sex. Shortly after that he had been furious with himself but, in time, he had come to accept that his daughter was indeed a blessing. She really was. Now if only Ally could accept that they really were over and he was going to be faithful to his wife.
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Nikolas Cassadine felt surprisingly alone as he paced about the Emergency Department waiting room. His heart sunk when he remembered how he had found Katherine in a lifeless heap at the bottom of the steps down to the Locke Street Pier. At first, he had been afraid she was dead. Then she had moaned. He had called for an ambulance and then made his way to the hospital. Every time he tried to inquire about her condition, he was dismissed with a simple the doctors are still working with her. He hoped those words were much less ominous than they felt.
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Dr. Alan Quartermaine stepped back into resuscitation room 4. "So, the Chest X-ray shows my central line is in good position and the lung is re-expanded. The Head CT shows cerebral contusions with a small subdural. I paged Dr. Ross and he is coming down to see the patient but most likely he is going to take her onto his service with a trauma surgery consult. The cervical spine looks fine on the CT but since her ETOH level is 300 and she has a head injury we can't clear her so that hard collar needs to stay on," he said.
"Do we need to report this as a potential crime?" Mitch asked.
Alan considered the question carefully. Given her alcohol level, it seemed very possible, perhaps even plausible, that Katherine had just fallen. Her injuries could all be consistent with that if she had fallen from any height. Of course, he supposed it was also possible that she had been assaulted. "Why don't you notify the PCPD so they can at least start an incident report. Just stress to them that, given the alcohol level, this really may all be due to a fall."
"I would say based on the imaging that it is most likely a fall. I don't see any contra coup pattern like we would see with a direct blow and the cerebral contusions have more of axonal injury pattern consistent with shearing," Dr. Ross said as he entered the room.
"Yes, that, what he said," Alan said.
"If you put in any orders you want like for the chest tube settings, central line care whatever, I'll admit to my service. I'm likely not going to end up needing to evacuate the subdural but I guess we'll see," Dr. Ross said.
"Thank you, I actually put all of the orders in for SICU admission to me so you can just put in a transfer to your service order. I did order a repeat Head CT for the morning and I ordered 2-hour neurochecks but if you decide you want something different there that is your area. I appreciate your help; I'm actually the second trauma call person so I'll be heading home. Dr. Breslin is on in-house call but you can also call me if you need anything," Alan said.
"Not a problem, patients with acute bleeds should ideally be admitted to neurosurgery even if they aren't likely to be operative candidates. We actually discussed that at our last division meeting," Dr. Ross said.
It all sounded so reasonable but, as he left the Emergency Department, Alan knew it would have played out very differently if Tony had been the neurosurgeon on call. That was a problem. As the current chief of staff, it was his job to resolve it but he felt ill prepared to actually do that. Eight years earlier almost to the day he and Monica had stood up for Tony and Bobbie when they married on a beach in Florida. It was sometimes still so unfathomable to imagine that things had fallen so far apart so fast.
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As Leonardo Pozzulo started up the stairs, Jason Morgan decided that meetings in general were overrated. Attending a few ELQ Board Meetings had been enough to swear him off from corporate America but truly the past hour had not been much better. Sure, the Zacchara family needed to go but what was the point about debating hypotheticals? Jason much preferred to be a man of action.