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Spotlight: What They Don't Know by Dr. K.V. Scruggs

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What they don’t know can’t hurt them…or can it?

In the year 2030, the government has seized control of healthcare. Routine treatment is administered to patients and monitored via in-home telemedicine. Hospitals have been replaced by the Center for Standardized Medicine (CSM). No one is a bigger proponent of the changes than reporter Cheyenne Rose, who lost her mother shortly after the Healthcare Crash of 2018 and her fiancé ten years later after a freak accident.

Despite her incredible success and popularity, her life feels empty. Then she meets the Reid family and feels drawn to their simple and honest love for each other. When eight-year-old Ridge Reid’s younger brother develops kidney failure, he agrees to donate one of his kidneys to save his brother’s life. But Ridge unexpectedly dies on the table, and the doctor who performed the surgery vanishes.

Faced with a conspiracy that runs far deeper than a single surgery, Cheyenne finds herself thrust into a dangerous investigation. When one of her informants turns up dead, she realizes the people responsible will do almost anything to keep their secret. Cheyenne will risk everything to uncover the truth.

"An exciting adventure into the world of futuristic medicine where nightmarish consequences await. There are clever and unexpected twists and turns, mixed in with murder and romance, and believable characters that command our sympathies."

- Leonard Goldberg, author of The Daughter of Sherlock Holmes

“This propulsive, dystopian thriller thrusts you into a terrifying, futuristic medical world, and leaves you with an ending you’ll never forget.” - Sandra Block, author of The Girl Without a Name

"Down a dark rabbit hole we go, following headstrong Cheyenne Rose and her need for the truth. This suspenseful tale is an anticipatory tale as much as it is a thriller. Intriguing and compelling, the story dares us to consider what kind of medical care we want for our nation and what we're willing to sacrifice to have it." - Nadia Hashimi, author of International Best-Seller, The Pearl that Broke its Shell


Chapter 1


August 29, 2018

Cheyenne Rose watched the police officers pace the length of the line that had formed outside Raleigh City Hospital, their heels scraping in unison against the concrete. Their guns were holstered but never far from their twitchy, nervous fingers. She quickly averted her eyes when one of the officers glanced her way. Cops made her feel like she needed to confess to something, even if there was nothing to confess. She had never so much as stolen a pack of gum in her entire life, but maybe they somehow knew she was supposed to be in school today, or that she had almost failed the seventh grade last year because of all the days she’d missed.

Cheyenne gripped the handles of the wheelchair a little tighter and leaned down. “Mom? You still doing okay?”

Sandra Rose was bent forward with her hands propped on her knees like a tripod, her chest rising and falling at a tempo twice as fast as Cheyenne’s own. The stifling humidity of the North Carolina summer was making it almost impossible for her to catch her breath. Her thin t-shirt had wet circles underneath the armpits and hung on her as though she was nothing more than a skeleton, which was not far from the truth.

Cheyenne made a halfhearted attempt to smooth her frizzy, red hair before realizing it was no use.

“We’re learning about the stock market crash in economics.” She tried to distract her mother.

“Mr. Tremont is a little obsessed.”

“Oh yeah?” Sandra suddenly grabbed her chest, her words cut short and her body rigid.

Cheyenne felt her body tense up, too. She wasn’t sure how much more of this heat her mom could take. Not on top of everything else. She craned her neck to look ahead of them in line, but saw only the same few heads they had been staring at for the last hour and a half.

After a moment, Sandra relaxed. “So. What are you learning?” she asked a little too casually.

Cheyenne kept a wary eye on her mother as she took in the scene around them. Cars were double and triple parked in the lot, and patients were still joining the line, which was wrapped around the building now. People were crowding closer and closer together as they neared the hospital’s main entrance. The double doors opened and closed continuously in response to the weight of the people standing just outside.

“You know how everybody started freaking out and selling their stocks all at once, and how that’s what caused the real problem. Seems sort of similar to what’s happening now.” She didn’t understand why, but it didn’t take a genius to see that, for some reason, people were flocking to the hospital. Too many people.

Sandra nodded. “Seems like everybody’s coming to the hospital just ‘cause. People are saying there’ll be no doctors at all by this time tomorrow, but I don’t know about all that.” Sandra’s smile was pained. “I sure did pick the wrong day to get sick, didn’t I, punkin’?” She strained to force out the last few words before dissolving into a coughing fit.

Cheyenne didn’t answer. Her mom had been sick for a long time. She knew that, and she was sure her mom knew that she knew. But they never talked about it. It was a continuous cycle of good days and bad. Cheyenne would go to school each morning, her mom smiling and waving at the door as she got on the bus. Then, without any warning, she would get home one afternoon and her mom was in bed, too weak to even sit up to eat the dinner that Cheyenne prepared, usually SpaghettiOs or tomato soup.

This would last a couple of days, Cheyenne having to stay home from school to nurse her mom back to health, and then all of a sudden, life was back to normal for several weeks. Inevitably, once Cheyenne had gotten used to things being good again, the cycle would start all over.

It was just the two of them for as long as she could remember, ever since her dad had died in Afghanistan. She had seen pictures of him, but it was like looking at a stranger posing with a younger version of her mom. There were even a couple of pictures with the three of them. Her as a baby, her mom, and a man who just happened to have Cheyenne’s eyes. It was weird seeing that.

The line advanced in front of them a couple of inches, just enough to make Cheyenne feel like they should move forward as well. She knew it was probably from people becoming impatient, moving closer to one another, slowly compressing the line. No real progress. Like going through security at the airport or being in bumper-to-bumper traffic.

She didn’t understand what was going on, but she had a feeling that whatever it was, it was bad. The crowd was growing larger by the minute. For every patient allowed into the building, five more showed up to wait in line. And the influx showed no signs of slowing down.

“You’d think a broken pinkie could wait,” said a large man in a tank top a few feet ahead of Cheyenne, speaking loudly as if wanting to be heard. “I mean, considering.” He gestured toward the line of people.

“Wanna say that to my face?” Another man even further up in the line turned around. “I still have one good fist.”

“Mind your own business,” someone else chimed in. “We’re all here for the same reason. It’s not his fault you’re having to wait.”

“Mind my own business? Are you kidding me right now? That’s all I been doing for the last hour. My wife’s about to have this baby right here in the parking lot, all just so this pansy can get a couple popsicle sticks taped around his finger?”

For the first time, Cheyenne noticed a hugely pregnant woman sitting in a folding chair facing the man. Her head was bent forward, and her eyes were squeezed tight.

“Brent,” the woman whispered. She reached one hand up from where she was clutching her gravid abdomen and batted the air a few times before making contact with his wrist.

“What is it, babe?” He bent down to her level, all his posturing melting away into genuine concern. She said something into his ear, and he stood up like a shot. He looked at her, then at the front of the hospital, then back at her. He said something to her, and she nodded, then slowly stood up with his help. They began to make their way toward the front of the hospital. There was an enlarging dark circle on the back of her dress, and at first, Cheyenne thought the woman had wet herself. Then she realized what it was and looked away, her cheeks burning. The woman continued to leak the clear fluid as she limped toward the entrance of the building. Several people stepped aside for them, but when they got to the man with the broken finger, he stood in their path.

“I don’t think so.” The man’s injured hand was cradled in his other palm, and Cheyenne could see it was more than just a broken pinkie. There was a large amount of gauze stained with yellow, orange and red fluids that looked several days old. Despite the bandage covering it, she could tell his hand was badly misshapen.

“C’mon, dude. Don’t be a douche.” Brent tried to step around him with his wife, but the other man reached out with his good hand in a sort of chopping motion. Before Cheyenne knew what had happened, Brent was lying on the ground clutching his neck and coughing. A couple of women rushed to either side of Brent’s wife, talking her through a poorly timed contraction.

“You’re doing great, sweetie.”

“What’s your name, anyway? Janet, that’s a beautiful name.”

“Pick out a name for this little one yet? Boy or Girl? Surprise? How exciting.”

Janet’s legs started to give out from under her. Someone brought the folding chair to where she now stood, and she collapsed into it.

Brent stood up and rushed the other man, swinging and shouting obscenities. A few surrounding people tried to pull them off of one another, and a few others tried to cut in line. Several more fights broke out ahead of them.

Two policemen ran toward the commotion, their loaded belts bouncing against their hips. The heavy metallic clicking sound reminded Cheyenne of the soldiers she’d seen in movies, trotting across the desert or the jungle, sweat streaming down their faces. The thought made her scoot a little closer to her mom, the sides of their knees touching just enough to remind Cheyenne she wasn’t alone.

She closed her eyes and imagined she was in PE class. Feet shuffling, grunts, skin against skin. All the sounds were familiar and harmless, she told herself, until she heard a guttural scream coming from Janet’s direction.

Cheyenne opened her eyes just in time to see a paramedic running toward Janet, whose legs were splayed open, a ruined pair of panties on the ground beside her. Bystanders averted their eyes, trying to give her some semblance of privacy. She slumped to the right, leaning on one of the women who had rushed to her aid.

“Alright, Janet. This is it. You have to push now.”

“I can’t,” she sobbed. “Not here.”

“Babe!” Brent’s voice came from a few feet away. Cheyenne looked over to see him being handcuffed by one of the cops. “Babe, I’m right here. You’re doing great. Just breathe like we practiced.” He turned to the officer. “Please, man. You don’t understand,” he said. A bruise was already forming along his jawline. “I gotta be there for her.”

“You should have thought of that before starting a fight while a cop was standing five feet away, dickhead.”

Cheyenne glanced down at her mom, feeling weirdly protective, hoping she hadn’t heard that.

“Seriously, please, do you have kids? What if you had to miss one of them being born?”

The policeman didn’t answer, just jerked Brent onto his feet by his armpits as his counterpart handcuffed the other man. “I got bigger shit to worry about than your sorry ass. Look around.”

The policemen hauled away both of the men, Brent kicking and screaming and the other man eerily silent. As they approached the far corner of the hospital building, Cheyenne heard Brent’s voice degenerate into sobs. She had to look away, tears stinging her own eyes. She didn’t think she had ever seen or heard a man cry.

“Where’s my husband? Where’s Brent?” Janet had just finished another round of pushing and was now looking around in a panic. Someone had found a large sheet and had spread it over her knees.

“Janet, he’s fine. He had to sit down. You need to focus, now. You need to push in one…two—”

“Ahhhhh!” Janet bore down, leaning slightly forward and revealing a ring of sweat along the nape of her neck. The dark tendrils of loose hair from her ponytail were matted to her skin.

“That’s it; that’s it. I see the head. Baby’s coming! Next push, guaranteed,” the paramedic said as Janet collapsed in the chair, and her head dangled precariously over the edge.

“Good birth control, huh?” Sandra quipped from the wheelchair in front of Cheyenne.

“Mom!” Cheyenne punched her lightly on the shoulder, but was secretly glad for the distraction from the garish scene playing out in front of her.

Sandra laughed, then immediately broke into a coughing fit. She clutched the arms of her wheelchair and gasped for air.

“Mom, you okay?” Cheyenne stood patting her mom on the back and fanning her face. She could hear the wheezing from where she stood. Her airways were starting to close up.

“Mom!” She bent down, practically yelling in her mom’s face now, but Sandra’s eyes had glassed over. Cheyenne had seen this look before. She didn’t have much time.

She glanced around them, fighting off the panic that threatened to take over. “Help!” she called out to no one in particular. “My mom can’t breathe. I need some help, here!”

“Here you go, doll. See if this helps.” A thin, plastic tube with two inch-long prongs sticking out of one side appeared as if from nowhere. She’d seen one before, knew exactly what to do with it. She grabbed it and positioned the prongs in her mom’s nostrils, wrapping the extra tubing around her ears. Only when her mom’s breathing slowed and her own heart stopped racing did Cheyenne look to see where the oxygen had come from.

Just behind her stood a heavy woman with swollen, discolored legs and feet that spread out across her shoes until the sides were almost flat with the ground. She had a soiled bandage on her right shin. Her face was pretty, though. Her makeup was perfect, and her hair was stylish and short. She leaned on her oxygen tank for support, and Cheyenne could see the indentations left behind by the cannula that was now in Sandra’s nose.

“I heard there’s been looting in New York,” she said. Cheyenne looked around but couldn’t tell who the woman was talking to. “Pharmacies, hospitals…people are taking whatever they can get their hands on right now. Whatever they think they might need…or be able to sell.”

“Will be here, too, I expect. Before too long, judging by the looks of it,” another woman responded. “Less than twenty-four hours since the announcement and the line’s halfway across the parking lot. It’s only gonna get worse.”

“Thank you, ma’am. So much.” Cheyenne’s voice sounded small and timid.

The woman waved her hand. “It’s no biggie. Doc says I really only need it when I sleep.”

“Well, we really appreciate it. Mom just needed a little help till we get inside. Shouldn’t be too much longer, now.”

Cheyenne saw the two women exchange a look.

“Um, do either of you know what’s going on?” she asked, trying to stand a little taller.

“Didn’t you hear?” the first woman replied. “All the doctors are on strike. Say they can’t keep their lights on and their water running with the amount they’re gettin’ paid. Say healthcare reform has bled ‘em dry.”

“Don’t forget all the ‘rules and regulations’,” the other woman chimed in. “They say doctors might as well be a bunch of computers the way it is nowadays. Say it’s not safe for patients. As if this is.”

Cheyenne glanced at her mom, who was listening intently, before venturing, “Who says?”

The woman shrugged. “They got a spokesperson. Kevin? Karl? I don’t know how this is supposed to be better. As of yesterday, when the announcement was made, a third of all the doctors had quit. More are leaving every hour.”

“Who knows if there’s even any doctors left here,” the other woman added, swinging a lazy hand toward the hospital entrance. Her skin reminded Cheyenne of fingertips that had soaked in water too long, only instead of translucent white, it was tan and spotted. She had thinning, brittle hair that she lifted off her neck as she spoke and fanned herself in time with her words. “Maybe we’re all just waiting in this line for nothing.”

Cheyenne’s heart skipped a beat. She hadn’t considered the possibility that their patience wouldn’t eventually be rewarded, that they wouldn’t get to the front of the line sooner or later so her mother could see a doctor. She glanced down at her mom, watching her work for each breath, and felt the panic starting to return. Did they even have a Plan B?

“You think that’s true?” She spoke to her mother now, the other women forgotten.

“Don’t listen to them, Cheyenne,” Sandra whispered, patting the back of Cheyenne’s thigh where her arm rested in an awkward embrace. Cheyenne was barely five feet tall, but she still towered over her mom in the wheelchair. “They’re just repeating rumors they’ve heard. The truth is probably much more boring.” She took a slow, deep breath. Her voice trembled ever so slightly when she spoke again. “Most of the people you see here are just afraid. Everything is going to turn out just fine. It always does.”

Cheyenne wanted to believe her, but she knew her mom had lied to protect her before. She felt like everything she had taken for granted was slipping away. She couldn’t look at her mom, afraid she might start crying. Or worse, that her mom would.

“It’s a boy!” Cheyenne’s gaze followed the voice back to the commotion ahead of them in line. The paramedic now held up an angry, wrinkled baby, as proud as if he, himself, were the father. Janet sat crumpled and sobbing into the chest of a woman who patted her back and stroked her hair.

The paramedic passed off the baby and cut the umbilical cord. Janet was cleaned off and transferred to a wheelchair to be moved inside. It seemed a little late for that, in Cheyenne’s opinion, but what did she know?

Cheyenne sat down on the curb of the sidewalk leading into the hospital, ankles crossed and arms resting on knobby knees. She risked a glance up at her mom. From this vantage point, she didn’t look so sick.

She thought about what the big woman had said. If it was true, if that many doctors had quit in one day, then that would explain these long lines. It might also explain the fights and the fact that the police were there. But if that was the problem, what was the solution?

She racked her brain and couldn’t think of one. And, looking around, it was obvious no one else had any bright ideas, either. How long could this go on before people really started getting hurt? Or worse?

“What do you think is going to happen, Mom?” She wasn’t sure whether she was asking about the crisis unfolding in front of their eyes or her mom’s illness or—the scariest question of all—what Cheyenne was going to do when her mom was no longer around. Maybe all three.

“I don’t know, sweetheart.” Sandra answered all of Cheyenne’s questions in one exhausted, sad breath. “I just don’t know.”

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About the Author

K.V. Scruggs is an alumnus of Clemson University and received her MD from the Medical University of South Carolina in Charleston. She completed her residency in Internal Medicine at the University of North Carolina – Chapel Hill. She is currently working as a hospitalist and lives in Raleigh, North Carolina with her husband and two sons. In her writing, Dr. Scruggs not only draws from her experience as a physician, but as a wife, friend and mother.

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