Bambi tossed her hair in frustration. “What started in 1990?”
I gave her the Reader’s Digest condensed version of the saga of Jay Braithwaite Burke’s hedge fund.
Bambi interrupted. “What’s a hedge fund?”
“It’s a superfund,” I explained, “that contains different types of mutual funds, some of which go down when the market goes down and some go up. It also has mechanisms that will sell shares if it drops too far and buy them when the market goes up. It’s meant to protect the investor from losing too much.”
“Darling,” said Mum, “you sound positively erudite on the subject.”
“Fred takes good care of us,” I said.
“That’s our broker,” Hal said baldly, “who told us to stay the hell away from Jay Braithwaite Burke.”
I looked around and saw that the children were absorbed in the early morning cartoons on TV and were not listening to us. Kevin and Renee were tending to the fire.
“So then what happened?” Bambi asked.
“It turned out to be a Ponzi scheme,” I told her. “Everybody lost their money.”
“The freakin’ economy collapsed,” Elliott said. “The investors started taking money out to pay their bills, and the whole thing collapsed. That’s when the freakin’ IRS caught him.”
“And all those doctors wound up owing the IRS hundreds of thousands in back taxes, interest, and penalties,” I said. Thinking of Mitzi, I added, “Millions, some of them.”
“Wow,” said Bambi. “I bet they were pissed.”
“I’m sure they were,” I said, “and one of them sued him, but he declared bankruptcy and disappeared.”
“And then he showed up dead,” said Hal. “Hence the autopsy.”
Bambi appeared fascinated. She leaned forward, arms on the table. “What killed him?”
“An overdose of heparin,” I told her. “That’s a drug used to prevent blood from clotting in people with heart valves, or in people who have had heart attacks or strokes or deep vein thrombosis. Apparently Jay had a history of DVT.”
“Did Ruthie kill him too?” Bambi asked.
“More than likely,” I replied.
After breakfast I went to work and read out Lance’s autopsy slides. As I suspected, the tumor in Lance’s liver and pancreas was pancreatic cancer, specifically a pancreatic ductal adenocarcinoma. Besides the liver, the lymph nodes in the vicinity of the pancreas were also involved, and there were implants in the peritoneum throughout the abdominal cavity and on the surfaces of the small bowel and colon.
The liver, apart from the tumor nodules, showed necrosis around the portal triads—strands of fibrous tissue containing branches of the hepatic artery, hepatic veins, and bile ducts. Many small hepatic veins were thrombosed. This explained why Lance was in liver failure. The bile ducts and the liver cells themselves contained obvious bile plugs, which explained the deep-green, gross appearance of the liver.
There was no evidence of tumor in any of the other tissues.
Lance’s lungs, besides being full of blood, also showed an acute change called diffuse alveolar damage, with areas of reactive fibrosis surrounding collections of black, granular material and the beginnings of hyaline membranes, signaling the onset of adult respiratory distress syndrome.
This is similar to hyaline membrane disease in newborns and is frequently the final insult that carries off seriously ill patients. It had nearly carried off Hal three years ago. It can start with a bacterial or viral pneumonia, or aspiration pneumonia, or any other insult to the lungs—in Lance’s case, smoke inhalation.
It was a toss-up what got Lance first: the lungs, the liver, or the blood loss. His carboxyhemoglobin was only eighteen percent, about double what a heavy smoker would walk around with on a daily basis; but it was not quite toxic, let alone lethal.
I dictated the microscopic description of the slides, the clinical pathologic correlation, the significance of the special studies, and final diagnosis. Cause of death: homicide by poisoning with heparin.
Someone would type it later today, and I would sign it out on the morrow.
I walked home.
The Commander stood in the middle of my living room, hat in hand, looking around at the mess on the floor.
“This is the first I’ve seen of what’s been going on here,” he said. “I’ve been hearing from Kincaid and Vincent about all these fires, but dang! Until I came up this street, I had no idea of the damage involved.” He gestured toward the front window. “Now I can see that the Burkes’ house is a total loss and how badly young Elliott’s house is damaged—and the effect it’s had on all your lives.”
That was quite a speech for the Commander, but he’d been hit with it all at once. We’d kind of gotten used to looking across the street at the blackened heap that used to be Kathleen’s house. And stepping over all the piles of clothing, toys, and sleeping bags on the living room floor had become second nature. It reminded me of the flood scenes in The Nine Tailors by Dorothy Sayers in which the entire village sets up housekeeping in the church until the floodwaters recede and they can go back to their ruined farms and start over.
“This is nothing,” I told him. “You should have seen it when all the Burkes were here too.”
He sat down on the couch next to me and put his briefcase on the floor. He opened it and extracted a handful of papers. “That’s what I wanted to talk to you about,” he said. “Now, I understand they’re in Boise?” He fished a toothpick out of his shirt pocket and stuck it in his mouth.
“Last we heard,” Hal said from his recliner, “they were in the hospital.” He was obliged to raise his voice to be heard over the TV, and I asked the kids to turn it down so we could talk.
Bambi came over and sat on the couch on the other side of me. The Commander looked up and took the toothpick out of his mouth. “Who’s this lovely young lady?”
“Hal’s daughter Bambi,” I said. “She’s interested in police work. Bambi, this is Commander Ray Harris of the Twin Falls Police Department.”
“Happy to meet you, Commander,” she said. “Is it okay if I listen?”
“If the doc says it’s okay, it’s okay,” he said. He stuck the toothpick back in his mouth and spread the papers out on the coffee table. I noticed that one of them was a wanted poster. “See this picture here,” he said, the toothpick bobbing up and down as he spoke. “Mary Bernadette Kowalski, her name is. Here’s an article from the Duluth News Tribune from back in 1995 about the fire she’s supposed to have started. And this here is an obituary you might be interested in,” he said, handing it to me. It was headed “Family Perishes in House Fire” and identified the three bodies found therein as having been Eldon, Marjorie, and Brittany Jo Summers, who had been predeceased by their older daughter, Tiffany Sue. The article was dated June 15, 1995.
“My God,” I breathed. “That’s right about when Tiffany came here.”
“Wow, she killed her whole family,” Bambi said.
“Not her family,” I said. “That’s Tiffany Sue’s family—the family of the child whose identity she supposedly stole.”
“I’m glad you said that, Doc,” said the Commander, moving the toothpick to the other side of his mouth, “because until we match Tiffany’s fingerprints to those we found on the gas cans and those in AFIS, we don’t have absolute proof that the person you know as Tiffany Summers is actually Mary Bernadette Kowalski.”
“You mean to tell me that you haven’t fingerprinted her yet? She’s in the hospital, right over there across the street and down the block,” I said. “Why didn’t Darryl do that when he arrested her? Don’t tell me you didn’t put her under guard in the hospital, either?”
My outburst had to do with the specter of Tiffany escaping and coming back to our house to finish the job she started last night, but the Commander interrupt
ed me. “Now, Doc, that isn’t what I said. We have her fingerprints. We just haven’t matched them yet. We should get that later today. And she is under guard. What I wanted from you is some idea about how long she’d be in the hospital. Pete and Bernie went over there this morning, but the doctor was doing some kind of a procedure on her, so they didn’t have a chance to talk to him. I figured that, you being a doctor yourself, you could give me some idea what’s gonna happen.”
“Have you called St. Luke’s in Boise to find out how the Burkes are doing?” I asked. “That should give you some idea about how Tiffany and Emily are going to do, because they were all poisoned with the brownies that Ruthie made yesterday for them to take to Boise with them. In fact, there might be some brownies left that could be tested. They might be in Kathleen’s car, in which case you’ve already got them, or they may be at Kathleen’s mother’s house, and—oh jeez, I hope Mary Reilly hasn’t eaten any of them, because if she did she’ll be in the hospital too.”
The Commander shifted the toothpick to the other side of his mouth. “Assuming those fingerprints match, we can hold Tiffany for attempted arson, and with the fingerprints from the other fires, we can hold her on those too. And if we can show that she is actually Mary Bernadette Kowalski, who is wanted for that arson in Duluth thirteen years ago in which three people died, we can see that she’s put away for life. But what about the child? What’s gonna happen to her?”
I couldn’t even begin to answer that question.
Bambi tried. “Oh, my God, we can’t let her end up in foster care. Surely somebody will adopt her.” She looked beseechingly at me.
Yikes. Was she suggesting that Hal and I adopt Emily? Surely Kathleen would adopt her. She already had four children, and Tiffany and Emily had lived with her ever since Jay had disappeared. She’d be inheriting millions of dollars, so money shouldn’t be an issue. But if Kathleen didn’t want to, how about Jodi and Elliott? Problem with them would be that they were older. Elliott was pushing fifty. Would they want to add a sixth child to their family, one that was only three years old? Or would she end up in foster care if Hal and I didn’t adopt her?
Would this be my chance to give Hal his immortality?
It was a rhetorical question, because he might not want it anymore. He was six years older than Elliott.
I looked at Hal. He wasn’t looking back at me. He was absorbed in the newspaper, which I was sure he had memorized by now. “Hal?” I said. “Are you listening to all this?”
“Not on purpose,” he said, not taking his gaze off the newspaper. I stared at him as if my gaze could penetrate his skull and make him look at me. It didn’t work.
Bambi took matters into her own hands. “Hal? Couldn’t you and Toni adopt Emily?”
Hal put down the newspaper. “Bambi, I don’t want to discuss it right now. Tell you what. If Jodi and Elliott don’t want to adopt her, and Kathleen doesn’t want to adopt her, Toni and I will talk about it. But not right now. Got it?”
Bambi sighed. “Okay. Whatever you say. Dad.”
Hal rolled his eyes, rustled the newspaper pointedly, and went back to reading it. As far as he was concerned, the discussion was over.
“Well, I reckon you folks will figure something out.”
I’d forgotten the Commander was still there, I’d gotten so wrapped up in the adoption discussion. He’d gotten to his feet and zipped up his parka, preparing to leave. “I’ll see what I can find out about the Burkes—and Mary Reilly too,” he said. Then he was gone.
I felt at loose ends, feeling that I needed to be doing something but having no idea what. I hated that feeling. It made me want to eat something, and that just pissed me off, because I was one of those people who gained weight just looking at food, just smelling food, just thinking about food. It wasn’t fair.
I looked in the refrigerator; nothing there appealed to me. I looked in the pantry; everything there required preparation. I stood in the middle of the kitchen, looking around. A flash of something shiny caught my attention. There on the kitchen counter, nearly hidden behind the toaster oven, stood a clear glass cookie jar, half full of Christmas cookies and tied with a shiny red ribbon.
Hmm. Where had that come from? I picked it up. It was covered by a thin coating of dust, in which I could see smudgy fingerprints. Okay, I know I’m not the best housekeeper, but surely I’d wiped that counter more recently than that. Or maybe not. With all these people in the house, routines went out the window. Perhaps that counter had been wiped off by someone else, like Jodi. Or Mum.
At that time in the early afternoon, everybody was busy doing their own thing. Jodi and Elliott were both at work, the kids had gone to the mall again, and Hal had gone off on an errand—I didn’t know what and didn’t ask, not at this time of year. Perhaps he’d gone shopping for my new coat. Anyway, only Mum and I remained at home, so I asked her about the cookie jar.
“I think it’s Jodi’s,” she said. “Or maybe Kathleen’s, but she probably would have taken it with her to Boise, so it’s probably Jodi’s.”
Just as long as it wasn’t Ruthie’s. Obviously someone had eaten some of them, and nobody here had gotten sick, so I decided that they were safe. I reached in and grabbed a handful. “Mum? Want some cookies?” I asked.
“No, kitten, I’m fine,” she replied.
So I settled down on the couch with a book, made short work of the cookies, and before I knew it, I had fallen asleep, to be awakened by the commotion when everybody arrived home in time for cocktail hour.
Hal and Elliott prepared drinks for everyone, while the kids spread out on the floor in front of the TV, watching The Grinch Who Stole Christmas. Hal prepared lasagna, using our largest baking dish, while I sliced up a loaf of French bread and filled a cookie sheet full of garlic bread.
While the lasagna was baking, I began to prepare a salad. I assembled tomatoes, an onion, a head of lettuce, and a cucumber on the cutting board, and then proceeded to slice the tip of my thumb almost completely off. Only a flap remained attached by a thread of skin.
I stared in disbelief as blood welled up and began to drip on the cutting board. Then it began to hurt—a lot. I gritted my teeth and grabbed a wad of paper towels to stanch the flow.
Hal noticed. “Sweetie? Are you okay?”
“I cut myself,” I said through my teeth. “Get me some ice? Please?”
Mum came into the kitchen. “I’ll get it, Hal, dear,” she said and created a compress out of more paper towels and ice, which she applied to my thumb, discarding the used towels that were already soaked through.
It wasn’t long before the new ones were too. I took the compress off and looked at the tip of my thumb. Nothing had changed. Blood continued to well up just as merrily as before and actually pulsated. As I stared at it, I began to feel queasy and light-headed.
“Mum, I think I need to lie down,” I said. I took two steps toward the living room and fainted.
Chapter 30
It may seem a strange principle to enunciate
as the very first requirement in a Hospital
that it should do the sick no harm.
—Florence Nightingale
I woke up on the couch with Hal applying a wet cloth to my forehead and Mum putting a new compress on my thumb. I felt no better.
“Hal, dear,” she said worriedly, “I don’t think it’s going to stop.”
“Maybe I should take her to the emergency room,” Hal said. “Toni? Can you sit up?”
I did so. The room was spinning, so I closed my eyes and lay back down. “No way,” I told him. “I’m afraid I’ll be sick if I do.”
“No, you won’t. Come on, honey. We’re going to take you to the emergency room and get that stitched up. You’ll feel better once it stops bleeding. Fiona, can you take her other arm, and we’ll get her out to the car?”
“I
’ll do it,” Jodi said. Mum went back in the kitchen, and Hal and Jodi assisted me through the door and into the garage. Hal drove, and Jodi kept pressure on my thumb, which was now wrapped in a hand towel as well as another change of paper towels and the ice pack.
I sat with my head tipped back and my eyes closed, praying that I wouldn’t throw up in the car. Shit, I thought, what the hell’s going on here? Blood shouldn’t bother me. I’m a doctor, for God’s sake, and I was a med tech before that. I deal with blood all the time. It’s usually not mine, though, and not usually pouring out of me so fast.
The towel was already showing patches of red by the time we got there. By the time they got me into a cubicle, it was soaked through.
Jodi looked worried. “Toni, you don’t usually get sick at the sight of blood. What have you eaten today?”
“Breakfast,” I said.
“How about after that? Lunch?”
“I ate some of your cookies,” I replied.
“My cookies? What are you talking about?”
“That cookie jar in the kitchen. Isn’t that yours?”
Her face cleared. “Oh, that isn’t mine. It’s Kathleen’s.”
“How the hell did a cookie jar make it through three fires and end up at our house?” Hal asked. “That’s not the type of thing that generally gets rescued in case of fire.”
“Where’d Kathleen get it?” I asked. “Did she make the cookies?” All this talk about cookies was making me even more nauseated. I took deep breaths.
“I think Ruthie gave it to her,” Jodi said. “You know Ruthie, always baking things to give to people.”
Yeah, right. Things spiked with rivaroxaban. I groaned dismally.
“Well, that didn’t sound very good.” My colleague, Dave Martin, MD, Family Medicine, came in, removed the towels, and said, “Whoa. What’d you do, Toni, cut an artery?”
“Not on purpose,” I said faintly.
He peered at me. “You don’t look so good. Don’t tell me you faint at the sight of blood, you of all people!”
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