by A. W. Gray
However Richard acted at the hospital, his fill-in-the-blanks on Presbyterian’s medical admittance forms are a matter of written record. Additionally, Nancy had been a patient at Presbyterian several times in the past—as far back as 1974 (for a teenage pregnancy that ended in a medically approved abortion), and as recently as two weeks earlier for a bout with the flu—and the hospital had an extensive file on her. Richard’s notation in the allergies portion of the hospital admittance form agrees with a doctor’s previous observation in Nancy’s hospital file. Both Richard and the doctor stated in writing that Nancy had experienced past violent reactions to Compazine, which is the most common drug used to combat nausea. The doctor’s note, in fact, is quite a bit stronger than Richard’s: according to the doctor, Nancy’s reaction to Compazine resembled a cerebral palsy attack. Whatever Richard’s notations on the admittance form, and whatever the doctor’s entry on her hospital records, when Nancy arrived, retching and pale, in the emergency treatment section, her temperature and blood pressure were duly noted and a blood sample routinely drawn (though for some unexplained reason the blood sample remained in Emergency until 2:55 the following afternoon, at which time the staff finally sent some of Nancy’s blood off to the lab for a poison-detecting toxology screen). The early formalities out of the way, one of the staff then juiced up a hypo and pumped the new patient full of Compazine.
In later critical courtroom testimony there would be a great deal of disagreement and finger-pointing as to which doctor ordered what drug for Nancy—and, indeed, as to the exact degree of her previous Compazine allergy—but it is abundantly clear that the Compazine injection administered in the emergency room delayed Nancy Lyon’s treatment by several hours. Immediately after the injection, her skin turned the color of red plums, and her pulse raced and slowed like a berserk Geiger counter. Instead of receding, her nausea drastically increased. Her blood pressure dipped to a near-critical level. Her eyes rolled back in her head to the point that only the whites showed, and her eyelids twitched. She drew her legs up on the receiving table into a fetal position and wouldn’t respond to verbal commands. Nancy remained in this near-comatose condition for quite some time while the now frenzied staff applied dopamine to raise her blood pressure and various inhalants and injections in an attempt to bring her around.
It isn’t clear just when the staff checked Nancy’s records and realized that she had had a severe allergic reaction, but sometime around three, she received Benadryl to counteract the Compazine. The Benadryl revived her to the point that she could sit up partway and murmur groggy responses to questions. Understandably, the hospital people then assumed that the Compazine had caused the problem, and continued to treat Nancy for diarrhea and nausea. During Nancy’s initial twelve hours at Presbyterian there was no mention of poisoning, accidental or otherwise.
The same group of nurses and attendants who were on duty in the emergency room when Richard arrived remained at their stations until the seven o’clock shift change. All remember Richard as interested and properly concerned (as previously stated, there was one witness in particular who recalled the exact opposite, that Richard’s attitude was flippant) and also recall his attempts to help the staff figure out what was wrong with Nancy. He seemed greatly puzzled, the nurses and attendants remember, and went to great lengths to tell everything he knew about his wife’s condition. He spoke in an authoritative, slightly nasal voice with a distinct New England accent, and gestured often with his hands to emphasize his point. Richard Lyon, as everyone associated with the case was later to learn, liked to explain things.
“I’ve been gone all day,” he said. “Business trip. One-day turnaround to Houston and back on Southwest Airlines. I’m a project supervisor, this work my company’s doing on the Pavilion Shopping Mall down there, and we had a tenant complaining that the ground underneath his space was sinking. Some kind of underground water leak’s turning the dirt into a quagmire, and I had to go down to, you know, take some soil samples.
“So anyway,” Richard said, “I had to get up early, six, six-thirty, and while I bathed and dressed, Nancy went downstairs to fix the kids’ breakfast. When I came down she had my coffee ready, and we sat and talked a minute. Hold on.” Here Richard’s eyes widened and he snapped his fingers. “That coffee, you think maybe … ? It tasted awful. Nancy and I both had to add milk before we could drink the stuff. I told her it was terrible even with the milk, and I poured mine out in the sink. When I left, Nancy was drinking hers. I told her I didn’t understand how she could swallow it, that’s how bad it was.
“I left home a little after seven,” Richard said, “and drove to the Love Field Garage, ran my credit card through the automatic dispenser for a round-trip ticket, and took the eight o’clock Southwest flight to Houston. Hobby Airport. I rented a car down there to get around, ate lunch with a couple of guys out on, Post Oak Road, I think, and by the time we were through I had to catch the four o’clock back to Dallas. Got home five-thirty, maybe six o’clock, and found Nancy so sick that she couldn’t get out of bed. She was supposed to go to a meeting tonight that she had to call and cancel. I’ve tried everything, even had her doctor phone a prescription into the Eckerd’s Drug on Mockingbird Lane, but those suppositories they gave me didn’t seem to help. By midnight I was pretty sure she wasn’t going to get well on her own, and that’s when we came to the hospital. Damn, that coffee. You think that’s what it could be?”
Richard offered to go home and return with the suspect coffee grounds for testing. The doctors agreed that he should. With the turmoil in the emergency room that night, none of the staff had time to reflect on the amount of detail that he’d included about his Houston trip, but later they were to wonder why Richard had gone to such lengths to establish his whereabouts during the day. It was his story, though, and through all future questioning sessions he would stick firmly to his guns.
Richard returned to his Shenandoah Avenue duplex sometime after three in the morning, shortly after the hospital people had revived Nancy by using Benadryl to reverse the disastrous Compazine injection. Even though there was to be a real donnybrook at trial over Richard’s attitude and demeanor at the hospital, it’s well established that he didn’t leave Nancy’s side until advised to do so by the staff. Now that she was awake, the doctors felt that it was only a matter of time until she fully recovered. Having the patient’s husband fidget in the waiting room would serve no purpose; besides, Richard should be home when his little girls awoke. So he returned to the duplex, got a couple of hours of sleep, and woke his daughters early and arranged for their care. The hospital staff anticipated that when he returned, it would be only to check Nancy out and take her home with him. They were very wrong.
It was also during his initial trip home and back that, according to Richard, he brought the coffee with him to the hospital. He recalls leaving the soaked grounds—still cached inside the filter ring—along with the remainder of the coffee in its original container, with one of the doctors or nurses. He doesn’t remember specifically which hospital person received the coffee, and with the number of white-uniformed nurses and attendants scurrying here and there around the emergency room, his memory lapse isn’t particularly surprising. However, in light of the staff’s later meticulous recording of certain other items brought from the duplex to the hospital, that the coffee wasn’t isolated and tested seems somewhat odd. Nonetheless, the whereabouts of the suspect grounds and partially full container remain a mystery to this day.
When Richard arrived once again in the emergency room, sometime around six-thirty in the morning, Nancy’s condition had worsened. She’d lapsed once more into a coma, and this time nothing that the staff could do was bringing her around. She drifted in and out, her eyelids fluttering uncontrollably, and always there was the intense abdominal pain. Her blood pressure bottomed once again, and a second dopamine injection proved useless. Doctors watched Nancy’s vital signs with intensely furrowed brows; there simply
wasn’t any reason for this healthy young woman to respond as she was. Finally, a few minutes before seven o’clock, a worried gastrologist on duty gave Nancy’s husband the word. Her condition had the hospital staff totally puzzled, and the consensus was that she should be moved upstairs to the Intensive Care Unit. While the staff made ready to load a now unconscious Nancy onto a gurney and roll her to the elevators, Richard went to call her parents. The duty nurse remembers that he stood in front of the pay phone, head bowed, for several minutes before lifting the receiver. At the time she thought he was merely shocked and worried about his wife, but later decided that he may have been mentally rehearsing what he was about to say, choosing his words like a man selecting ripe fruit.
Among any group whose members are in competition, there’s a lot of backstabbing and behind-your-back gossip. The medical community is no exception. With its status as Dallas’ “society hospital,” Presbyterian is the target of more barbs than most of the other institutions around town, and the word at crosstown Baylor Medical Center—which is in a low-income, deteriorating neighborhood—is that “Presbyterian is the only place in Dallas where they issue practice permits based on who the doctor is married to rather than where he went to medical school.” Be that assessment true or false, the staff at Presbyterian recognizes money when it appears, and treats the customer accordingly.
In the mid-morning hours of January 10, as the Dillard clan gathered to stand vigil while Nancy fought for her life in Intensive Care, hospital eyebrows lifted in respect. The London Fog topcoats, Armani suits, and the women’s Neiman’s- and Saks-labeled dresses that trooped in and out of the waiting room during the following days were signs that these were the kind of people to whom Presbyterian caters. And cater Presbyterian does. Between January ninth, when Richard made his early morning call to Sue Dillard, and the fourteenth, when the Presbyterian staff turned off Nancy’s life support, the main waiting room outside Intensive Care became a nearly exclusive stronghold for Nancy’s relatives and friends; on occasions, when the Dillard group grew so large that it spilled out into the corridors, friends and families of other patients were asked by the staff to proceed to the smaller waiting room downstairs.
The Dillards arrived in ones and twos. Sue came with Mary Helen, and the two women set up anxious camp outside the ICU unit. Bill Jr. checked in shortly thereafter, his handsome face set in concern, and along with his wife and mother made a family circle around Richard Lyon in the waiting room. Finally Big Daddy himself arrived, walking fast, his gaze darting from side to side as if he could chase his daughter’s sickness away by sheer determined will. Elder daughter Susan made the drive down from Wichita Falls alone; her dentist husband had patients to see. Susan is a composite of her parents; she has Sue’s classic mouth and nose and wealth of lovely brown-streaked-with-gray hair, but her height and sturdy build are more from Big Daddy’s side of the family. With her arrival at the hospital, the group was now complete. Since Nancy could have visitors only once each hour, and then only two at a time, the group huddled around Richard and made quiet but serious small talk. The Dillards as a whole hadn’t been fond of Richard during the previous year while he’d been separated from Nancy, but—for the time being, at least—crisis caused the family to rally around. However, Richard’s closeness with his in-laws wasn’t to last throughout the day.
Sometime during the morning Susan and Mary Helen had a private conversation. Both women had the same nagging fear on their minds, and as they stood apart from the rest of the anxious group, the two talked over some things that Nancy had told each of them during the previous months. Disturbing things. Stories that they’d both dismissed as Nancy’s fantasies, but now they weren’t sure. Moreso, they were even less certain whether they should let other family members in on what Nancy had said. The doctors and hospital staff seemed totally in the dark as to the cause of Nancy’s condition, but Susan and Mary Helen thought that between the two of them they might have the answer. Because of the implications contained in what Nancy had said, their hesitancy to discuss the matter with Big Daddy and the rest is easily understood. As Big Daddy, Sue, and Bill Jr. gathered around Richard in close conversation, Susan and Mary Helen looked helplessly at each other and wondered what to do.
It was also mid-morning when Mary Henrich learned that Nancy was in the hospital, and she had a great deal more than a passing interest in Nancy’s condition. Ms. Henrich is a pleasant and gentle woman whose looks are deceptive. She’s a society divorce attorney, specializing in the special kinds of divorces had in Highland Park, and she goes after well-heeled, soon-to-be ex-husbands like the Lord himself after the Temple’s money-changers. She’d represented Nancy Lyon before she and Richard had withdrawn their divorce petition just a few months earlier, and also had more than a passing acquaintance with Big Daddy. Mary Henrich was and is a devoted participant in the Masters Swim Club, and had seen Big Daddy at the country club early that day. Like Susan and Mary Helen, Mary Henrich had heard some troubling stories from Nancy during the past year, and like them, Mary wasn’t certain whether she should come forward with what she knew.
Legal ethics had a great deal more to do with her hesitancy than did concern over the implications to Richard, because during her association with Nancy the divorce attorney had developed a dislike for Richard that bordered on hatred. Mary was worried about attorney-client privilege, though, because Nancy had told her lawyer some things in confidence that now might have a bearing on whether Nancy lived or died. It is a no-no among lawyers to give out confidential information without the client’s permission; in fact, divulgence can be grounds for disbarment. But Nancy wasn’t in any condition to give her consent at the moment, so Mary Henrich’s consideration with legal ethics was brief indeed. Her chin firm, she picked up the phone and called the hospital.
At just about the same time that Mary Henrich picked up the phone, Susan and Mary Helen reached a decision. They simply had to tell. Susan was hesitant to be the newsbearer, but not so her sister-in-law. Mary Helen Dillard is made of some pretty stern stuff; she’s held together a marriage that, with a woman of lesser pluck, would have floundered years ago. Her features set in determination, Mary Helen approached the family group, pointedly ignored Richard, and pulled Big Daddy aside.
Dr. Ali Bagheri, though raised in the Middle East amid scenes of babbling confusion, wasn’t ready for the furor surrounding his patient, Nancy Dillard Lyon. It was bad enough that she was losing ground by the minute in the battle for her life, and that the Intensive Care Unit staff—cardiologists and neurologists, assisted by medical aides, in addition to a parade of no-nonsense nurses who moved around ICU with stockinged legs flashing like pale white pistons—couldn’t figure out what was wrong with her. To top it off, by noon on the tenth of January, her family had squared off in the waiting room in two opposing camps. Nancy’s husband, along with what few supporters he could muster, had taken up residence on one side of the waiting room while her parents and siblings were grouped on the other side, the two opposing factions glowering at each other like fighters in their corners waiting for the bell to ring. And the poor doctor, Bagheri thought, is squarely in the middle.
An olive-complexioned man with a neat mustache, groomed like a stallion and handsome enough for a Valentino role, Bagheri was a third-year resident at Presbyterian and a graduate of Southwestern Medical School. Just hours after Richard had brought Nancy into the emergency room—and after she’d survived the disastrous Compazine injection, and then had failed to respond to every known remedy for cramps, vomiting, and diarrhea—the emergency room staff had transferred her to the intensive care unit, and it was in ICU that her treatment came under Bagheri’s supervision. As the ICU staff tried one futile treatment after another, Nancy’s blood pressure dropped by the minute and her pulse alternately raced and slowed. Bagheri realized that the hospital had its hands full just with keeping her alive.
As he was quick to point out in later courtroom testimony, non
e of the errors made in Nancy’s treatment was his fault. As a resident, he made no decisions as to treatment. Those diagnoses were up to the practicing physicians—eventually seven different doctors were to sign off on Nancy’s hospital record—and the resident’s responsibility was merely to see that the prescribed treatments were adhered to. But the Compazine injection plus later problems with Nancy’s treatment in ICU? No way was anyone going to lay that blame on Dr. Ali Bagheri.
But the burden of keeping Nancy’s loved ones abreast of her condition did fall on Bagheri’s shoulders, and it was in performing this duty that he had problems with her family’s attitude. Families, the doctor knew, needed unity in times of crisis. But not only were Nancy’s loved ones not pulling together, they were practically at one another’s throats. Her husband huddled on a bench, all alone except for an occasional supporter who came by to wish him well, while Nancy’s parents and siblings grouped together on sofas and chairs, talked in guarded whispers, and shot icy glances in the husband’s direction.
Businesslike to a fault, Bagheri assumed that whatever rifts existed within the family were none of his affair, but the breakdown in the family created double duty for the doctor. In Nancy Lyon’s case, the husband would demand to know what the staff was doing on her behalf—and then sigh in indignation after Bagheri had told him as much as the resident doctor knew, or in one instance shout, “Look at these dummies. They don’t even know what she’s allergic to,” when he learned of the emergency room Compazine shot—and then Nancy’s father or sister would ask the exact same questions of Bagheri, and the doctor would have to go over it all a second time. In addition to monitoring Nancy’s condition and keeping track of the cardiac arrests, mangled bones, and terminal cancer cases also under ICU’s care, having to duplicate his reports to Nancy’s family was a waste of time as far as he was concerned. Why, Bagheri thought, can’t these people learn to pull together?