Consent Deferred - Chapter 1

The rain came in curtains, steady and whispering, a sound like static across the windshield. Claire Redmond sat behind the wheel of her sedan, her fingers curled around a ceramic travel mug embossed with a fading “St. Jerome’s Auxiliary” seal. The tea had gone tepid. She hadn’t yet taken a sip.

She stared through the glass at the parking garage wall in front of her, as though time might reverse if she willed it. The car hadn’t moved yet, though the dashboard had long since flickered to life, the autopilot humming in low idle like a sleeping cat. A pale blue light traced the contours of the center console—waiting.

She was on her way to a meeting she didn’t want to attend. That much was true. God, please don’t let it be Bell, she thought. Or  Legal.   Or worse—Sister Katherine. Who schedules 6:30 am meetings on a Friday? 

She wasn’t late, not yet. But if she left now, she’d arrive just early enough find out who had summoned her.

The car automatically pulled out of the parking garage and began the 25 minute trek to the hospital.

Claire had spent sixteen years perfecting the art of polite invisibility at St. Jerome’s Medical Center, most recently as Director of Research Ethics and Compliance. She had weathered the post-Kennedy rebuild, when the federal government dismantled the old Ethics Review Board  infrastructure and forced hospitals to reclaim local oversight. The early years had been chaos—ethics boards restarting from scratch, forms rewritten overnight, and compliance officers promoted faster than the systems they were supposed to monitor. Claire hadn’t volunteered to lead, but when the dust settled, she’d been the one still standing. She knew the policies because she’d helped write them. She knew the players because she’d survived them.  She was, in no uncertain terms, damn good at her job. Everyone knew it. She was not the kind of person summoned out of the blue.

Unless someone wanted to make a point, the thought was bitter.

Yet late yesterday evening, an encrypted message had dropped into her institutional inbox: “Please report to Room 818 at 6:30 a.m. for a private discussion.” No sender. Just the Hospital's seal. 

The autopilot adjusted the wipers in slow, even arcs. The "whomp-whomp" sound of the wipers as they swept across the windshield was somehow soothing, so she allowed herself to relax a bit, leaned back in her seat, and watched the lights reflect off the slick road as she sipped her tea.

Maybe it’s nothing, she told herself, rubbing her eyes. Probably just some early-morning ego trip—someone in the C-suite who thinks crisis management works better before sunrise, or just likes the sound of their own voice before anyone else has had coffee. Or a scheduling fluke someone forgot to explain.

She didn’t know what was wrong exactly, only that she’d seen the signs, and her gut was telling her something was not right. Sloppy recordkeeping. Pressure due to back-to-back surgical procedures. Accidental use of experimental devices on patients that were caught only after the fact—the two clinic nurses each claimed they were reaching for an approved stent in the cardiac cath lab and the experimental stent was on the wrong shelf.

Claire had flagged these incidents. Both involving the same product. Both the same day. Twice. In writing. Documented. Time-stamped. If they wanted to bury it, they should’ve tried harder.

Last night, she’d even started an email to her colleague at OREAI asking if the new agency could audit the hospital. Just a question. She remembered hesitating, hovering over the “Send” button. But it had been late, and something in her gut said: Don’t. She’d saved it as a draft instead, hidden inside her personal account, using an old alias from her days as a nurse. “KRedHeart42.”

The rain thickened. The vehicle adjusted its speed. Claire glanced down at her phone again, illuminated briefly with a calendar reminder: “6:30 – Private Discussion – Rm 818” And below it: “No additional details.”

The brake lights on the car ahead of her flared. The autopilot didn’t slow down.

“Brake,” she said calmly.

Nothing happened.

“System—brake! Engage manual override.”

“Manual override has been disabled,” a neutral voice responded.

Claire’s hand shot toward the console, tapping the control pad twice. The haptic response buzzed, then dimmed.

“Control transfer denied. Continuing route.”

A sick dread bloomed in her chest.

The car swerved suddenly around the stopped vehicle, tires skimming the shoulder, her mug toppling over into the footwell. She reached for the emergency call—dead signal. No bars. Just a rotating icon.

The screen blinked again.

“Unexpected system update in progress.”

Rain hammered the windshield now, louder than the voice in her throat. The car accelerated as it approached the intersection at 14th and Halston—right where the old pharmacy used to be. 

The light turned yellow. Then red. The vehicle didn’t stop.

“Stop!” she screamed. “Override! Emergency brake!”

The car shot into the intersection.

The school bus came from the right—no time to swerve. She saw its lights first, then the screaming twist of metal, then nothing.

Somewhere beneath the dash, her travel mug had cracked open on impact, leaking tea across the floor mats in a slow, spreading stain.