Doctored Death

by P. D. Workman

  Kenzie grabbed the two mugs and her bag, re-armed the burglar alarm, and left the house.

  32

  Zachary drove up to where the official Medical Examiner’s van was parked to drop Kenzie off at the correct doors. The night was quiet and still. It wasn’t like crime scenes that Kenzie had seen on TV. Not bustling with action, police walking in and out, crime scene techs dusting every surface for fingerprints or scouring the property for other evidence. No bystanders or media calling out questions, wanting to know what had happened.

  Instead, it was quiet and peaceful. Like the hospital room of someone who was gravely ill or a funeral home. Everyone spoke in hushed voices, moved slowly, and showed deference and respect. When Kenzie entered through the side door, she was met by a security guard who clearly knew who she was and escorted her to the room where the body and Dr. Wiltshire awaited her.

  Dr. Wiltshire talked to one of the nursing staff in a low voice, both of them nodding and looking grave, but not worried. Dr. Wiltshire nodded to Kenzie as she entered the room. There were no police there, no one saying that she needed to put on booties and coveralls to avoid contaminating the scene.

  “This is my assistant,” Dr. Wiltshire introduced her. “Dr. Kenzie Kirsch. Kenzie, Nurse Sheila Cook. We have here,” Dr. Wiltshire indicated the bed, “Mr. Stanley Sexton, age seventy-two. Nurse Cook...?”

  “He pressed his call button,” Nurse Cook explained. “When Jason—Munro—came to see what he needed, Mr. Sexton was unable to speak. He made some noises, but it wasn’t clear whether he was coherent and unable to speak or whether he was unaware of his surroundings and making random noises or the kinds of sounds someone makes when they are asleep. Jason attempted to communicate with him, and when he was unable to get a coherent response, he returned to the nursing station to get someone else to help. By the time he and I got back to the room, Mr. Sexton had passed.”

  Kenzie looked at Dr. Wiltshire to see if there were anything else. It sounded pretty straightforward. Maybe a stroke. They would know better when they examined him. She and Dr. Wiltshire approached the bed together. Kenzie didn’t touch anything, looking the bed and nearby surfaces over for anything that didn’t sit right. It all looked straightforward. No blood or other fluids. No strange smells. No indication that Mr. Sexton had been trying to get out of the bed. The call button was within reach.

  Kenzie heard the click of claws on the hallway floor and turned to see Lola coming in. She approached Kenzie and nuzzled her hand. Kenzie petted her for a minute. “This is Lola,” she told Dr. Wiltshire. “I met her last time I was over.”

  “Hello, Lola,” Dr. Wiltshire said solemnly before continuing with the investigation. He put his fingers over Mr. Sexton’s pulse and waited for a moment. He checked the man’s pupils for reactivity to light. Kenzie certainly couldn’t see any signs of life. “Dr. Kirsch, would you verify lack of pulse?” Dr. Wiltshire said formally.

  Kenzie moved in to obey, wondering why he would want her to verify his findings. When she touched Mr. Sexton’s arm, she was surprised and almost jerked her hand back away. His skin was cool to the touch, waxen under her fingertips. She looked at Dr. Wiltshire. Sexton had been dead for longer than the half hour it had taken them to get to the scene.

  “Better do a liver temp,” Kenzie said in a near-whisper.

  He nodded his agreement.

  Kenzie looked around the small room again. If the staff had lied or misled them about one thing, chances were, there were other things. And it was probably their only chance to spot anything out of place or any evidence that needed to be preserved.

  Lola whined. Looking at how Sexton was positioned on the bed and the sheets pressed down on one side, Kenzie turned to look at Nurse Cook. “Was the dog in here with him?”

  “Well...” Cook looked awkwardly from Kenzie to Dr. Wiltshire and back again. “Yes, Lola was in here earlier.”

  “Sleeping on the bed with him?”

  She nodded. “I didn’t see any harm in it. Mr. Sexton had been agitated earlier, and Lola helped to settle him down so that he could go to sleep. She’s very good with the residents.”

  Dr. Wiltshire raised his eyebrows at Kenzie and nodded, a signal that she had done well. Kenzie scratched Lola’s ears. She examined the dog covertly for any sign of illness. Her eyes and conjunctivas were clear. Her nose, when she shoved her snout into Kenzie’s hand for more love, was wet and cool. Kenzie didn’t smell anything foul. Lola wasn’t limping or favoring any part of her body that Kenzie could see. Her fur was well-brushed and shone. Nothing that Kenzie could see that would give her any reason to believe that Lola was sick with any illness that she might have passed on to the residents at Champlain House. Of course, she could be a carrier of numerous pathogens without ever showing any symptoms.

  “What time was it when Mr. Sexton hit the call button?” she asked Cook.

  “I’m not sure. Not long ago.”

  Kenzie waited for further explanation. Nothing was forthcoming. She looked at Dr. Wiltshire, then back at Nurse Cook. “Don’t you have a system that registers what time a call button is pushed?”

  “Uh, we do,” Cook admitted. She waited for more questions, then looked uncomfortable. “I suppose I can check, if you really need me to.”

  “That would be most helpful,” Dr. Wiltshire agreed.

  Nurse Cook didn’t move to do so.

  “If you could do that now,” Dr. Wiltshire suggested.

  “Well... I suppose.” She eventually gave a shrug and left the room.

  Dr. Wiltshire looked at Kenzie. “The timelines may be a lot broader than they would like us to think. Things don’t move quickly in a place like this. Even at a hospital, it may be an hour before someone answers a call, if it is a busy time or the patient had been bothering them with trivial things.”

  “And he was ‘agitated’ earlier. They might have waited, hoping he’d go back to sleep on his own, rather than having to deal with him.”

  “Would you mind making note of the ambient temperature...?”

  Kenzie went to Dr. Wiltshire’s medical bag and found the electronic thermometer. She turned it on and waited. The room was warm, as she had previously noted. Mr. Sexton’s body temperature would not fall very quickly in that environment. She opened her notebook and wrote down the date and place, Stanley Sexton’s name, the ambient temperature, and a couple of other notes they would want to include when they did up their site report.

  Kenzie looked at the doorway. She had expected Nurse Cook to be back with the information about the time that Sexton had pushed the call button. But so far, there was no sign of her. Had she been unable to find the information? Trying to cover it up? Maybe she had just been sidetracked by another patient or a task that only she could take care of. Dr. Wiltshire pulled off Mr. Sexton’s bedding to examine him in situ. Kenzie looked him over, but nothing jumped out at her as being wrong. He was dressed in light pajamas and had been covered by a sheet and a single thin blanket. Kenzie would have been too warm to sleep there with even just the blanket.

  There were no significant marks or bruises on Sexton’s face or neck. Dr. Wiltshire pulled up his shirt to inspect his torso, then let it fall back into place. Kenzie moved closer. She indicated the mark on Sexton’s arm.

  “He’s had an IV recently.”

  Wiltshire nodded his agreement. There was an IV pole nearby, though no bags hung on it.

  “If there is any possibility that this is an angel of death,” Kenzie murmured, looking toward the door to make sure that Nurse Cook didn’t walk in on the conversation unexpectedly, “then we should take the opportunity to check for insulin tonight. Before it’s had a chance to break down.”

  “Yes. Good thinking. And screen for any other popular drugs used in mercy killings.”

  Kenzie nodded. “Yeah.” She thought about one of Zachary’s previous cases. They had thought at first that it might be an assisted death or mercy killing, but it had turned out that just the opposite was true. The perpetra
tor had wanted the victim to experience as much pain as possible before her death. People’s motives could be very complex.

  Nurse Cook returned to the room with a young man, also a nurse. Kenzie took a couple of steps toward him to confirm that he was, in fact, Jason Munro, the one who had discovered Sexton in distress and had gone for help. He looked extremely uncomfortable. He glanced back at the door as if measuring whether he had the time to run for it. But how far would he get if he ran? Champlain House undoubtedly had his address and would have cops there waiting for him to explain himself. He shifted his feet back and forth and looked at Nurse Cook but didn’t meet her eyes.

  Nurse Cook’s face was stiff, her lips pressed together in a long, thin, downward curving line and her eyes hard and unwavering.

  “This is Nurse Jason,” she said unnecessarily. “He would like to revise his story.” She turned her stony eyes on him and waited.

  Jason gulped. He was still eyeing the door and trying to decide how to get out of the fix he was in.

  Dr. Wiltshire tried to meet Jason’s eyes, giving him an encouraging smile. “Jason? I’m glad you were so quick to come forward so that we can find out the truth of the situation here. It’s essential that we get the real story about what happened tonight, even if you are embarrassed about it or think that we will be upset. I assure you that it will be nothing compared to what would happen if you continue to obfuscate the truth.”

  Jason gave a mute nod.

  “Did Mr. Sexton press the call button tonight?” Dr. Wiltshire prompted, hoping to get the ball rolling.

  Jason shook his head. “No. That isn’t the way it happened.”

  “Ah. Why don’t you tell me, then, how it did happen?”

  “He didn’t press the call button. It was Lola. She was barking.”

  “And you came in here to see what the matter was or to take her away or quiet her down?”

  “Not at first.” He swallowed and looked at Nurse Cook.

  “I see. To begin with, you let it go, hoping that she would quiet down on her own.”

  “Yeah. I mean, yes, sir. Sometimes she barks. She sees a squirrel outside, or she wants to play. Or, I don’t know, she just likes to hear the sound of her own voice.”

  “It’s not the first night that you’ve heard her bark.”

  “No. Sir.”

  “How long did you wait before going to see what she was barking about?”

  Jason’s eyes rolled up toward the ceiling, thinking about it.

  “Tell them the truth,” Nurse Cook warned.

  Jason shrugged with one shoulder. “I don’t really know. That’s the truth. I was trying to ignore her. I didn’t look at the time; I just tried to block her out.”

  “Wasn’t her barking bothering anyone else?”

  “No. No one had woken up. The other staff... they’re used to hearing her bark now and then. And she wasn’t barking constantly. Just one or two barks every now and then.”

  “Go on.”

  “When I went in and looked to see what she was barking about, that’s when I found Mr. Sexton dead.” He stared at a spot on the rug in front of him.

  “He was already dead when you went in there,” Dr. Wiltshire stated.

  “Yes.”

  “He wasn’t incoherent, trying to communicate something to you.”

  “No. Well—no.”

  Kenzie pursed her lips, wondering what else he was trying to hide. They didn’t yet have the full story. He was still trying to hold something back. Dr. Wiltshire recognized this as well.

  “He was dead,” he said slowly. He raised his brows at Nurse Cook. “He has been dead for some time.”

  She rubbed her head, tense fingers showing that she was just barely keeping herself in check. If they weren’t there, she suspected Cook would have flown at the young man, berating him at least, if not giving him a few sharp thwacks with a ruler or whatever else she might have handy.

  “How long?”

  “We will have to determine that. It would be good if we had a witness who could narrow the time frame.”

  “I don’t know,” Jason admitted. “I hadn’t been in there all night.”

  “Not at all?” Kenzie asked in surprise. She was sure that protocol must suggest checking in on each patient at least a couple of times a night. Then again, they were in the independent care unit. Maybe the residents were allowed to just sleep all night without any observation.

  “I checked in on him after he went down to sleep,” Jason said. “He’d been shouting at everyone, angry about something that didn’t make any sense. Kept saying that he was right and trying to sell us bears. Don’t ask me. He was... delusional. I don’t know if he was seeing things or just having trouble finding the right words. Sometimes, dementia patients, they mislabel things, and if you can’t figure out what they meant to say, they just get more upset because you can’t understand them.”

  “Did Mr. Sexton have dementia?” Dr. Wiltshire beat Kenzie to the question.

  Jason said “yes” at the same time as Nurse Cook said “no.” Everybody stood there, looking at each other. Nurse Cook gave Jason a warning look and spoke.

  “Mr. Sexton was not diagnosed with dementia. But he had shown some behavioral changes over the last couple of weeks. That is not uncommon. I don’t know if he would have eventually been diagnosed with dementia or not. And clearly, we will never know now.”

  “So...” Dr. Wiltshire addressed his words to Jason. “Where did this story about Mr. Sexton trying to say something but being incoherent come from? Was that pure invention?”

  “No,” Jason said defensively. “That really happened. I said I checked in on him. He was quiet and Lola was on the bed with him. But he wasn’t asleep. His eyes were open and he was making noises. Like... animal noises. Not words.”

  “Was he moving around? Restless?”

  “No. Just laying there, rigid, his hands kind of, up here.” Jason demonstrated a posture with both hands raised to chest level, fingers forming stiff claws.

  “And did you ask for help?”

  “No.” Jason was looking at the floor again, avoiding Nurse Cook’s wrath. “I just let him be. Figured... at least he was being quiet, and I didn’t want to have to deal with more swearing and paranoid crap.”

  “You should have talked to another nurse if you weren’t sure what to do,” Nurse Cook said. “You should have called the doctor to find out whether to call for an ambulance or if there was some medication he needed. You don’t just leave a distressed patient alone in his bed.”

  And even though he had known that Lola was in with Sexton, a patient in a clearly altered state of consciousness, he had still not looked in on him when Lola began to bark.

  33

  Kenzie had been so caught up in the on-site visit with Dr. Wiltshire that she had completely forgotten Zachary was outside in the car waiting for her. She felt guilty about it, but he had been the one to insist upon the arrangements. And it had been nice to have someone drive her over while she woke up and not to have to worry about being out by herself when it was dark out. It wasn’t like Zachary was the big tough gun-toting private eye they liked to portray on TV. He had a lot of issues and imperfections, and in a situation where they faced mortal danger, she wasn’t sure she would rate his skills over hers. It was just nice not to have to drive and walk through the dark parking lot alone, feeling exposed and vulnerable.

  As she walked behind Dr. Wiltshire and Carlos transporting the body on a gurney to the van, Kenzie tapped the icon with Zachary’s face in her phone app.

  He answered almost immediately. “Hey. How’s it going?”

  “Good. We’re just getting ready to transport, so I’ll be out in a minute.”

  “Great. I’ll drive up.”

  She heard his engine start through the phone and saw his headlights come on across the parking lot. She walked around the van. “That’s Zachary. He’s going to take me home, then I’ll grab my car and come in.”

  Dr. Wiltshi
re pushed up his glasses. “If you like, you can take a break. Have a nap. Come in a little late.”

  “No. I’d like to help with the initial prep. I don’t usually get to be involved in all stages.”

  “All right. You should have told me you were going to have Zachary bring you in. You could drive back to the office with me, and I could drop you at home after work.”

  “No, it’s okay. It was his idea; he wanted to come with me, even though it meant him sitting in the car and extra gas.” Kenzie shrugged. “Just being a gentleman, I guess.”

  “He is a fine fellow.” Wiltshire slapped Carlos on the back, indicating that they were done, and he walked around to the passenger door.

  Kenzie walked over to Zachary’s car and got in. It was cold outside, but there was a toasty pocket of air inside the vehicle, already heated to just the right temperature. Kenzie leaned over to kiss Zachary on the cheek. She buckled herself in and settled down into the seat and her coat, enjoying the warmth.

  “Were you bored to death?”

  “If I was, at least the Medical Examiner would be close by,” he joked.

  Kenzie smiled, happy to see him making a joke, even if it was just a minor one. It was much more natural than the tense silence between them for the last couple of days. “Yes, and I could always assist.”

  “You wouldn’t be allowed to, would you?” he asked. “If you knew the deceased, you would have to... recuse yourself or whatever.”

  “I don’t think there’s any policy that says I would have to. It’s not like a policeman investigating someone he knows. It would probably be best practice, but not a requirement.”

  “Well then, I feel much better knowing that.”

  He pulled out of the nursing home parking lot and drove back toward the house in silence.

  Kenzie watched the road in front of them, but what she was thinking of in the darkness wasn’t just the trip home, nor Sexton’s postmortem. It was her fear that someday it would be Zachary on a slab. And, of course, she would not be involved with his postmortem. No matter how many autopsy photos she and Zachary had looked at together over some meal, there was no way she would be able to handle his like it was just routine.