Mississippi Blood

by Greg Iles

  “Think about the facts as they’ve been explained, Doctor. Can you come up with any theory that might explain them, short of Dr. Cage intentionally giving the adrenaline to murder the patient?”

  “Well . . . a doctor helping a patient to die might feel some regret in the midst of the act. It’s conceivable that he might try to resuscitate her with adrenaline, and accidentally kill her with it. Due to allergy or simple overdose. The effects of epinephrine can vary widely from patient to patient.”

  “Epinephrine and adrenaline are the same drug, correct?”

  “I’m sorry, yes. But again, a competent physician would know that adrenaline wouldn’t specifically counter the depressive effects of morphine. And finally, again, the evidence shows that a lethal dose of morphine never reached her brain. Why would anyone try to resuscitate a conscious person? It makes no sense.”

  “I suppose he might have tried to resuscitate her in that ten- to thirty-minute window of unconsciousness, if he were suddenly filled with remorse, as you suggested.”

  “Yes, but if so, then why didn’t he call paramedics?”

  “Oh, yes. Thank you for reminding me. Doctor, given the forensic evidence, let me suggest a hypothetical scenario to you, as a forensic expert.”

  At this, I almost throw the kitchen phone onto the floor. Even Judge Elder must have been tempted to step in here, yet the questions roll on, as if Shad is directing this movie as well as acting in it.

  “Our physician means to kill his patient with morphine by injection of an overdose. The patient submits voluntarily, as it was her intent to commit suicide. Due to stress and arthritis, the doctor botches the injection. Soon he realizes that the morphine is not killing the patient. He has no more morphine. The doctor is under a time constraint to leave the house. His patient has been partially sedated by the morphine, so he decides to use what he has on hand to finish the job. He decides to inject her with IV adrenaline, which will send her into cardiac arrest. Because of his profession, and his standing in the community, he’s virtually certain that no questions will be asked, so long as he remains at the scene to call the coroner. He can sign the death certificate himself. It will still be a perfect murder, as he’d planned. Are you with me so far?”

  “Yes.”

  “The problem begins when the adrenaline hits the patient’s system. She does not die quickly. She panics, cries out, flails about. Despite his plan, the doctor is horrified by what he’s done. He might even be afraid that the neighbors or relatives will hear and become alarmed. In his panic he flees the scene, knocking the telephone onto the floor. He knows that by leaving the scene, he is risking an autopsy. But if the adrenaline is detected, he can simply say that he resuscitated the patient and left her alive. That he was in a quandary about what to do. He had to say that, you see? Otherwise he could not explain his failing to report her death.

  “Do you see any problems with this scenario so far?”

  “Only that adrenaline has limited therapeutic value in counteracting a morphine overdose, if he intended to claim he had resuscitated her with it and left her alive.”

  “Might not a general practitioner plead ignorance on that point? Ignorance and desperation?”

  “No. But you’re forgetting the DNR order. Why would he say he had tried to resuscitate her, since she was DNR?”

  “I’ll ask you to answer your own question.”

  “I don’t know.”

  “Think about it.”

  “Well . . . he might claim that, since the woman was his former nurse, and he had great affection for her, he disobeyed the DNR order and saved her.”

  “That would make sense, wouldn’t it?”

  “But then why didn’t he also do chest compressions?”

  “You’re jumping back into what we know now. The doctor’s intent at that point was simply to say he left his patient alive. He had no idea that the woman’s dying agony was being recorded on video. No idea that we would see that he didn’t perform chest compressions or any other lifesaving measures. He intended to claim that he had performed chest compressions, and that she survived. That she must have died subsequent to his intervention.”

  “If he’d performed chest compressions on an elderly woman, the evidence would be obvious. Severe bruising, broken ribs even. But that brings me back to my original problem with the whole scenario.”

  “Which is?”

  “Why did he leave the scene? As I said earlier, if he’d stayed at the scene, no autopsy would have been required.”

  “Exactly. I’ve asked myself the same question many times. Why did he leave the scene? There are three possible answers. One, as he watched Viola die, Dr. Cage was overcome by the horror of his act and could not stand to remain at the scene of the crime.”

  “Right now the jury’s thinking about that video recording,” I say into the phone, “and how Viola was panicking and begging for Dad’s help.”

  “Yep,” Rusty says, pausing the tape. “We’re getting close to your house now. Keep listening. Not much left.”

  “Two, there was something at the scene the doctor needed to destroy as soon as possible.”

  “The videotape Viola made for Henry,” I say.

  “Bingo,” says Rusty.

  “Why hasn’t Shad mentioned that specifically? He didn’t even bring it up in his opening statement.”

  “He will, don’t worry. Listen to the end.”

  “Three, someone arrived on the scene, or was about to arrive—a family member who would ‘raise a stink,’ as you suggested—and the doctor didn’t have the nerve to brazen it out in front of that person.”

  “Lincoln,” I mutter. “Cora testified that Dad knew Lincoln was on his way to Natchez from Chicago.”

  “Yep,” Rusty says in an emotionless voice.

  “Do any of those scenarios sound reasonable to you, Doctor?”

  “I wouldn’t know about the doctor needing to destroy anything. But the other two scenarios sound reasonable. I’ve seen families accuse a doctor of murder after a death. But still, this doctor would know that once he ran, an autopsy would almost certainly be performed. That’s a big risk.”

  “Is it? If he claimed that the adrenaline was used to resuscitate her? Used successfully?”

  “It would be a stretch, medically speaking. I still think the easiest and smartest thing by far—for a doctor meaning to kill his patient—would be to stay on the scene, call the ambulance after the patient expired, and brazen it out. That would almost certainly be the end of it—legally speaking.”

  “But that would require a great deal of nerve, Doctor. And the physician in this case is no longer a man in his prime with little to lose. Further, his reasons for panic fall outside the realm of your medical expertise, so I’ll now turn you over to the tender mercies of the counsel for the defense.”

  “Do you believe this?” Rusty says angrily. “He’s daring Quentin to cross-examine the guy. But by now he’s positive that Quentin won’t. Shad is mocking Quentin Avery, man! I could never have imagined it. We’re a block away from your house. There’s only one thing left.”

  “Let me hear it.”

  “Your witness.”

  “Mr. Johnson, one other scenario just occurred to me.”

  I can tell by the delay before Shad’s reply that the medical examiner has jumped off script. But if Shad doesn’t let him say whatever he wants to say, Quentin might well roll out from behind his table and offer Dr. Phillips the opportunity. Any competent attorney would. I’ve been in this situation myself, and I know Shad has little choice but to let his witness speak, and hope for the best.

  “What’s that, Doctor?”

  “If Dr. Cage meant to murder Mrs. Turner, as you’ve postulated, and he ran out of morphine, which the evidence indicates—”

  “Proves.”

  “Yes, all right. Well, even if everything went as you’ve suggested, once the whole thing went wrong and the doctor knew he was going to be charged with first-degree murder . . .”


  “Yes?”

  “Why didn’t he just say, ‘All right, yes, we had an assisted-suicide pact. I provided the morphine for her to euthanize herself, but she botched the injection, so I let her inject the adrenaline to stop her heart. It wasn’t ideal, but it was all I had.’? Why didn’t he say that? The penalty for physician-assisted suicide is ten years, isn’t it? A murder conviction means life in prison.”

  Shad takes so long with this question that I find myself hoping the pathologist has stunned him into losing his composure. But then Shad comes through with his customary tactical proficiency.

  “He may well intend to say that when he testifies, Doctor. Or if he didn’t intend to say that, he may decide to now. But the fact is, when questioned by the authorities, Dr. Cage said nothing of the sort. In fact, he refused to say anything at all. And that is why we find ourselves here today. I tender the witness.”

  Less than five seconds pass before Quentin Avery says, “No questions, Your Honor,” and I shut my eyes with the dread of a man watching a replay of a fatal accident.

  “We’re here,” Rusty says in my ear. “Finally.”

  “Good.”

  Chapter 26

  I’ve just made a round of all the security guards, making sure they know to expect John Kaiser and that he could appear from anywhere. Tim and I are standing near the back door, discussing the possibility of bringing more men from Texas, when Rusty marches halfway up the hall and waves at me.

  “Dude. I’ve got the whole crowd in there, and we need to get the Quentin issue sorted out before your mom has a real stroke and your dad gets sent up the river.”

  Following Rusty to the den, I find not only my mother but Jenny, Annie, and to my surprise, Miriam Masters. Everyone’s talking at once, but the theme is universal: Quentin Avery has lost his mind.

  “Penn, I can’t calm down,” Mom says in a quavering voice. “My hands have been shaking for the past hour.”

  “Take it easy, now.” I lean down to hug her, but she pushes me away.

  “Take it easy? You’ve got to fire Quentin, son. You’ve got to take over Tom’s defense!”

  “Mom, I can’t fire Quentin. Only Dad can do that.”

  “Then somebody take me to the jail, and I’ll tell him he’s got to do it. Is that where Tom is now? Or do they give him lunch in the courthouse?”

  “There’s a holding cell in the courthouse,” Rusty says softly, “but if I know Billy Byrd, Doc’s back in his cell.”

  Annie’s standing by the television, taking in every word. Few things disturb children more than frightened adults, and Annie was upset before anyone got here. I go over and put an arm around her, telling her softly that things are going to be all right, that everybody’s just upset by a mistake Mr. Avery made. But I can feel her shivering against me.

  “Let’s all calm down,” I say firmly. “There’s got to be some rational reason Quentin is doing what he’s doing. We’ve got three lawyers in this room. Let’s figure it out.”

  Mom suddenly realizes that she’s let herself go in front of her granddaughter. She gets up and leads Annie over to the love seat in the corner, murmuring so softly I can’t make out her words.

  Rusty is watching me expectantly, but it’s Miriam I turn to first. She may be a glorified corporate accountant in her normal life, but she graduated fourth in her class at Stanford Law School, and she did two years in the public defender’s office in San Francisco.

  “What do you think?” I ask.

  She sucks in her lips and shakes her head, obviously as bewildered as the rest of us. “Penn, I’ve never seen anything like it before.”

  “Rusty? You ever see any backwoods Clarence Darrow try something like this?”

  Rusty shakes his head in a perfect imitation of Miriam. “I kept wondering, ‘Is this like a slowdown offense in basketball? Where it looks like the coach is an idiot and the team is shit, even though they’re playing smart?’ But this ain’t no basketball game, bubba. Quentin hasn’t invoked the rule to keep his witnesses sequestered. He didn’t even file for discovery. I’ve never seen that happen in a murder trial. The guy even deferred his opening statement, and let Shad have all the momentum from the word go! I’ve seen that maybe once in my career. He hasn’t made one objection or cross-examined a single witness. And every time Quentin lets some trademark Shad Johnson bullshit pass without objecting, that’s one more thing that’ll never be reversed on appeal.”

  “Bingo,” says Miriam. “That jury has already heard things it never should have heard. Those images will never leave their minds, no matter what instructions the judge gives. I can’t believe Judge Elder isn’t worried about getting reversed based on ineffective assistance of counsel.”

  “It’s Quentin Avery,” Rusty says, stating the obvious. “Lawyers don’t come any more experienced than that. Not in these parts. Not anywhere.”

  “Maybe that’s the problem,” Miriam says, voicing our common fear.

  “Alzheimer’s?” Rusty asks, looking for confirmation in our eyes. “I mean . . . surely it’s in the realm of possibility. The guy’s lost both legs to diabetes already. Could he have had, like, mini strokes or something? Something not obvious, but still incapacitating?”

  “I’m no doctor,” Miriam points out, “but from what I saw this morning, I’d say it’s possible. Penn, did you notice anything worrisome when you spoke to him prior to the trial?”

  “When I saw him at the prison, he did tell me to expect an unconventional strategy. But we’ve hardly talked to each other since. This is his and Dad’s show, and I’m not part of it.”

  My mother cuts her eyes at me, the old maternal reproach.

  “Have you tried to call Quentin?” Rusty asks.

  “At least ten times before you guys showed up. His mobile keeps kicking me to voice mail.”

  “We’ve got to fire him,” Mom insists from the corner. “I don’t see any other way.”

  This draws every eye in the room to her.

  “Nobody can fire Quentin except Dad,” I repeat. “And Dad won’t do it. I wasn’t in the courtroom. Did he look panicked by what Quentin was doing? Or not doing?”

  “All I could see was the back of his head,” Mom says with frustration.

  “He’s not scared,” Jenny says from the sofa. “He just sat calmly through it all. But I don’t know what that says about his mental state.”

  “That could just be resignation. Fatalism.”

  Everyone suddenly looks at me, as though I have the answer to the riddle of Quentin Avery.

  “Whatever Quentin’s doing, ” I think aloud, “it’s been part of his plan all along. As I said, he told me three days ago that he was going to take an unconventional approach to Dad’s defense.”

  “Unconventional,” Rusty grunts. “Like driving thirty miles per hour is an unconventional way to win the Daytona 500.”

  In the wake of this comment, the front door opens and closes softly. A moment later John Kaiser leans past the door frame, acknowledges me with a quick salute, then vanishes. The next thing I hear is his feet padding softly up the stairs.

  My mother is gazing curiously at me, but I ignore her.

  “I think we’ve done what we can here,” I tell them. “Which is basically nothing. I’ll keep trying to reach Quentin. You guys need to eat something. There are sandwiches in the kitchen fridge.”

  “I can’t eat,” Miriam says miserably.

  “I can,” Rusty growls, getting up and lumbering toward the kitchen. “My fingers have about seized up from texting you all those updates.”

  Mom catches my eye over Annie’s shoulder. “Penn, you need to go back to court for the afternoon session. I’ll stay with Annie.”

  I shake my head. “No way. The jury has to see you there, supporting Dad.”

  “Then let’s take Annie with us.”

  Annie claps her hands with relief and excitement. At last we’ve arrived at the simple solution she proposed in the beginning.

  “B
oo, go help Rusty find the sandwiches.”

  She starts to argue, but today my look is enough to propel her into the kitchen. As she vanishes, Mom says, “Penn, what is John Kaiser doing here?”

  “It’s nothing to do with Dad’s trial. Now, you need to brace yourself for the next session. Based on what Shad has done so far, I expect him to recall Cora Revels to the stand, or else he’ll call Lincoln. And they’ll dive straight into the issue of motive. We’re going to hear all about Dad and Viola’s relationship. All about it.”

  My mother’s jaw clamps shut, and her eyes glaze over with suppressed rage. But at whom? Shad Johnson? Or my father?

  “All right,” she says in surrender. “You stay here.”

  I hit speed dial for Quentin’s cell and wait for the automated voice-mail message, but the sound of repeated ringing rocks me back on my heels. I hold up my left hand sharply, and the resulting silence brings Rusty and Annie back from the kitchen.

  “Hello?” says Doris Avery.

  I feel an alarming pressure in my chest, like something’s trying to burst out of it through my constricted throat, but I force myself to be calm. “Doris, this is Penn. Could I please speak to Quentin?”

  “He’s trying to eat lunch. It took us forever just to get to Edelweiss.”

  Edelweiss is only four blocks from the courthouse, but they probably had a harder time getting clear of the courthouse than my crew did. Still, they could easily have answered the phone while stuck in Quentin’s converted van.

  “I really need to speak to him, Doris. You must know that, after what happened in court this morning.”

  Mom’s eyes blaze. She’s about two seconds from snatching the phone out of my hand and reminding Doris who’s paying her husband’s fee.