Requiem for Moses
Page 13
“The doctor was well aware of his patient’s chronic pain. He also was aware that his patient had lost the will to live. That plus his heart condition … Dr. Fox was expecting Dr. Green to die and was not surprised when the wife called. And when she described the body, he was convinced.
“The morgue is always overcrowded. When a physician testifies that a person—his patient—is dead and there is nothing suspicious about the death, the medical examiner’s office is all too ready to release the body. It is just one less that needs pass their examination.”
“Incredible,” Koesler said.
“That’s not all,” Tully added. “Mrs. Green didn’t know she was supposed to notify the police when there’s a death. But the condo’s manager did: He called and a squad car was summoned. The two officers went through the same drill as Mrs. Green did. With the same conclusion: Green was dead, and every indication was that it was natural causes.
“They’re supposed to call Homicide—a matter of routine. They did, and they assured us that the facts were as follows: Sick man died, no sign of anything suspicious. No foul play. Added to this, the family doctor was willing to sign the death certificate.
“The officer here who answered for Homicide made the decision, and told the uniformed guys, ‘We’re not going out.’ At this point, in light of what’s happened, this is now a CYA—”
“A what?” Koesler asked.
The others, familiar with the acronym, smiled. “It stands for ‘cover your ass,’” Tully explained. “This is a classic case where the family files a civil suit against the police and the city. So, before anything like that happens, we get on the stick: CYA. We investigate our own response to this call. We screwed up, is what it is. And before the lawyers get on our back, we find out what happened.
“And it turns out we are not the only screwups. For one, Dr. Fox is in it up to his ears, too.”
“This, of course,” Koznicki said, “is not the end of the story. The widow”—Koznicki smiled broadly, along with everyone else—“strange, I find it so natural to refer to her as a widow. But that is what we must discover: Was she a widow briefly?”
“Some of us were discussing that earlier,” Koesler said. “Not about last night, but this morning.”
“How’s that?” Tully asked.
“Is he … is Dr. Green alive?”
“Reportedly,” Koznicki said. “He has made no appearance since he was taken from the church last night. Except, of course, to his wife and the reporter … Patricia Lennon. We have been in touch with Mrs. Green.”
“Excuse me for interrupting, Inspector,” Koesler apologized. “You were saying about what Mrs. Green did after talking to the family doctor.…”
“Perfectly all right, Father. We are not gathered to deal in niceties and conventions; we are trying to clarify a most obscure phenomenon.
“In any case, after she talked to Dr. Fox, and after the officers visited and verified that the M.E. would release the body and Dr. Fox would sign the death certificate, she contacted her children. They said they would do whatever they could.
“She then contacted Kaufman Funeral Home and learned, after she told them about the Catholic wake, that they would supply a shroud and let her use their refrigeration. And that was all.
“By then, her children had arrived. David was sent to pick up the shroud. Mrs. Green contacted the McGovern Home, requested their best casket, and said that she and Judith would prepare the body.
“After McGovern picked up the body, Mrs. Green visited you, Father, and evidently got your permission for the wake. And that pretty much brings us up to date.”
Koesler shook his head. “I find it difficult to understand how Mrs. Green and her daughter could prepare the body—that, I take it, means they washed and clothed the body—and not discover that he was alive. If he was.”
“I think it would be helpful here,” Koznicki said, “if Dr. Price would comment on all this.”
Chapter Twelve
Koesler slid his chair back from the table. He expected Dr. Price’s presentation would be substantive, and he was eager to learn.
The doctor appeared to be fifty-something. Her tunic-type jacket made it difficult to discern whether she was bulky or slender. Her salt-and-pepper hair was short, naturally curly, and seemingly uncombed. Her habit of running her fingers through her hair made it look unkempt, but somehow attractive.
She spoke without notes or references. “The first thing I want to say, is that I like to think of a coma as the only death you could wake up from. That is”—she smiled, and bowed in the direction of Father Koesler—“unless you come up with a miracle. In that case, of course, you might wake up from real death.
“A person in a coma can and usually does have symptoms very similar to that of death. A person in a coma is very close to death and may easily go one way or the other.
“The mouth open, tongue dry; eyes dry, glassy; fixed stare; no perceivable pulse, no evident respiration. The body has low temperature, it’s cold, and is a bluish color; the person breathes only now and then—could be forty seconds between irregular breaths.
“If the man was dead, we wouldn’t be talking about perceivable pulse or evident respiration. And we wouldn’t be talking about breaths that come irregularly at something like forty-second intervals. We’d be talking about no pulse, no respiration, and no breath.
“But you don’t find the pulse or the respiration unless you search for it.
“As far as Mrs. Green was concerned, her husband seemed dead. And he really did look dead. Dr. Fox had had reason to believe his patient was nearing death. Dr. Green seemed to be willing his own death.
“You know how some people close to death may pull out of it because they have a strong will to live. Well, Dr. Green was going in the opposite direction. His statement was, ‘I’d rather die than go on like this.’ From the description Mrs. Green gave over the phone, Dr. Fox was convinced that Dr. Green was indeed dead. He agreed to sign the death certificate. From his account, the medical examiner’s office agreed to release the body.
“Thus far, no one had checked to see if there were any vital signs. No one outside of his family had even seen or touched the body.
“The police arrived and saw the same scene. The guy looked dead. They might have checked, except probably they were lulled by the assurance of the family physician that he would sign the death certificate and that the M.E. would release the body.
“The uniformed police called Homicide and lulled your officers into believing what everyone else already believed. So Homicide said, ‘We’re not going out.’
“Then Mrs. Green and her daughter prepared the body. They might have found a very faint pulse or an occasional shallow breath. But it would’ve been sheer luck if they had. They certainly weren’t looking for, or expecting, any vital signs—vital signs that, even if present, would be barely functioning.”
“So, Dr. Price,” Koznicki said, “you are suggesting that it is at least possible that Dr. Green was in a coma and not dead.”
“I am suggesting that Dr. Green was in a coma.”
“What about rigor mortis?” Koesler asked.
“What about it?” Price responded.
“I hate to bring it up because I think it destroys the side of this thing that I’m supposed to be defending—that what we’re dealing with here is a miracle.”
“How do you mean, Father?”
“Well,” Koesler explained, “to have a miracle here, Dr. Green would have had to be dead, truly dead. Now, you say he could have been in a coma. But, at least to this point, you cannot say it without fear of contradiction.
“I mean, okay, if he was in a coma, he would appear to be dead. But maybe he wasn’t dead. No one checked closely enough to make certain he was alive. So we are where we were at the beginning: He might have been dead; he might have been in a coma. Because no one checked carefully enough, we cannot prove or disprove one theory or the other.
“But what about rig
or mortis? If Dr. Green was dead, wouldn’t rigor mortis set in?” Dr. Price was slowly shaking her head. Koesler found this somewhat disconcerting, but pressed on. “If not while Mrs. Green and Judith were handling his body, surely then, much later, when the undertakers were preparing the body, getting it in the shroud and everything? Wouldn’t especially those professionals have some doubts? No rigor mortis, no death, correct?”
Dr. Price smiled. “When Inspector Koznicki asked me to come here this morning, and told me what we were going to discuss, I anticipated some attention would be paid to rigor mortis. I am, of course, very practically acquainted with the process. But I foresaw that some of the questions and answers might be kind of speculative. So I did a little research.
“Rigor mortis”—even though some of her information had been gleaned from research books, still she used no notes—“usually begins occurring between two to four hours after death. But there is a large window of time during which rigor may set in. It can, indeed, occur as late as twelve hours after death. One specific case reported twenty-four hours before the process began.
“I can tell you honestly that if I were examining a corpse that had been pronounced dead six hours previously, but there was no rigor mortis present, I would not necessarily at that point be suspicious.
“So you see, Father, the fact that no one detected rigor does not speak to the issue of whether or not Dr. Green was dead. As I understand it, the morticians got the body in a matter of just a few hours. And there you are.
“Really, while this sort of thing does not happen frequently, it does happen.” She searched through her purse and took out a newspaper clipping. “I saved this news story mostly because of the age of the woman involved. Let me read it to you. I clipped it from Newsday.” She read:
Albany, N.Y.—When a national health magazine rated Albany Medical Center as the best hospital in New York state, no one claimed it could raise the dead.
But earlier this week a worker at the hospital’s morgue removed a body bag containing an eighty-six-year-old woman from the morgue’s forty-degree refrigerator—and heard breathing inside.
The woman, Mildred Clarke, of Albany, N.Y., was rushed into emergency, then to intensive care, where she was in critical condition Thursday.
“We’re at a loss for words,” said Greg McGarry, the hospital spokesman.
On Wednesday, an emergency medical team was called to Clarke’s apartment after a manager found her there rigid, cold, unconscious, without pulse and not breathing.
“Sound like what we’ve just been discussing, gentlemen?” Price smiled broadly, then continued reading.
“You look at this woman and you assumed she was dead,” said the manager, Lori Goodman-DiPietro.
She wasn’t alone. She said two emergency fire department medics, a police officer, the coroner, and two morgue attendants thought she was dead, too.
County Coroner Philip Furie checked her. “She was cold as ice … stiff as a board.”
Albany County does not require its coroners to be licensed physicians. Furie, an insurance salesman who was elected to his post, declared Clarke dead. She was taken to the morgue at the medical center.
An hour or so later, the center was called by a funeral home. Morgue employee Herman Thomas, who was removing the body bag, dialed the emergency-room code as soon as he heard the breathing.
Price folded the clipping carefully and returned it to her purse. “Isn’t that a coincidence?” she said. “The details: ‘cold as ice … stiff as a board … rigid … unconscious … without pulse … and not breathing.’
“Not breathing! Well, not when the coroner as well as the apartment manager checked her. But she was breathing when the morgue employee moved her body bag.
“Was Mildred Clarke’s condition a return from the dead, or recovery from a coma? Was she ‘not breathing’—as in ‘dead’—when the coroner checked her? Or was she breathing shallow breaths many seconds apart? Is Mildred Clarke a miracle woman?
“Mrs. Green found her husband in much the same state as the apartment manager found Mildred. He wasn’t breathing, or his breathing went undetected.
“And, gentlemen, I particularly call your attention to the refrigerator in the morgue. Mildred survived that, too, along with all the other things they did to her. Wasn’t Dr. Green headed for a mortuary refrigerator?” she concluded.
“Very good and very helpful, Dr. Price,” said Koznicki.
“Then,” Koesler said, “rigor mortis has no relevance in either the case of Mildred Clarke or Dr. Green.”
“Except,” Price said, “if there is no sign of rigor, it does not necessarily mean that the person is not dead. There may be reasons, explanations, for the lack of rigor—to a point. If, on the other hand, rigor is clearly there, it is one definite sign of death.”
“So,” Koesler said, “is Mildred Clarke a miracle woman? It doesn’t seem as if anyone thinks so. The news of her coming out of a body bag after being pronounced dead is buried in one column of a daily paper.
“Dr. Green, on the other hand, is getting major media coverage not only locally, but also nationally. Is Dr. Green a miracle man? Certainly the public is leaning toward the miraculous.
“Before she was enclosed in a body bag, nobody had heard of Mildred Clarke. After she emerged from the body bag, a few people heard what happened to her. Now she’s lost again from the public’s brief attention span.
“Dr. Green is a celebrity, at least at some level. Before last night, lots of people knew him or knew of him.
“Mrs. Clarke was a nobody who made her extraordinary move in the privacy of a morgue with very few witnesses around. Moses Green was a Somebody who emerged from a casket in a Catholic church in view of an audience of a couple of hundred people.
“The assumption on the public’s part is, clearly, that Dr. Green had a miracle happen to him. And now the public will want a detailed account of what’s it like to be dead … and then to come back from the dead.”
Koznicki looked at his watch. “It is getting late in the day. We must wrap this up. Dr. Price, would you please sum up?”
“Certainly.” She ran a hand through her hair, which snapped back to its former shape like a mattress spring. “Of course”—she nodded in Koesler’s direction—“this could be a miracle.”
“I hasten to remind you,” Koesler interrupted, “that I am not the champion of the ‘miracle’ school of thought. The Catholic Church is going to play a doubting Thomas role.”
“Unfair of me, I confess,” Price said, smiling. “It’s just that with that uniform you wear, you appear to be more at home with miracles than the rest of us. I promise I won’t do that again.”
“You’re forgiven. And, on my part, I promise not to interrupt again.”
“Okay,” Price proceeded. “I’m not looking at anyone in particular when I again state we could be dealing with a miracle. If so, that’s the end of the involvement of science or the police. That, truly, falls into the lap of Religion. And I wish everyone who gets drawn into this lots of good luck.
“But, if it’s not a miracle, then what?
“Then,” she answered her own question, “I think the safest probability is a coma. Green’s condition was too close to either death or a coma to be faked. Some few people have mastered respiratory behavior to the extent that they can control breathing to a remarkable degree. Such a person might be able to breathe rarely and irregularly.
“But we’re talking about cold, dry skin and pinpoint pupils and dry mouth and all the rest of that. I can see no possible way that anyone could simulate all those symptoms. So, I would argue for a coma.
“Now, having said that, what caused the coma?
“One of the things we have here is a heart problem. So, the coma may have resulted from a heart attack, a stroke.
“Or, the coma may have been induced by an overdose of one drug or another.
“Dr. Green was in severe pain from a back condition that appears to be degenerative. Hi
s doctor is unable to diagnose the exact cause. Dr. Green doesn’t respond to any of the administered tests. I’m quite sure that Dr. Fox subjected his patient to every known test. After all, both men are physicians; Dr. Green would know immediately if Dr. Fox were to fudge on any avenue of testing.
“But, since no cause was found, there was little else to be done but try to control the pain. And with pain like this, pain that would force Green to say that he didn’t want to live, they probably went for morphine.
“If Green was on morphine, it shouldn’t be too difficult to determine that even without his cooperation. His doctor, for one source. Or the pharmacy.
“So, then, if Green was on morphine—or any drug that could be lethal in an overdose—the next question would be, why did it happen? An error, or a deliberate act? Both entirely possible.
“The fact that the overdose—and remember, we are in a hypothesis here—the fact that the overdose was not fatal, argues, I think, that it was accidental. But, while I think that the accident theory is the most likely, a strong case could be made that it was intentional.
“The next logical fact we must deal with is that while there’s an overdose, it isn’t fatal. Why not? Was that accidental or intentional?
“Think of the possibilities. Think of someone who, for whatever reason, wanted Dr. Green dead.”
Suddenly, Koesler saw in his mind’s eye a veritable montage of those people he had met last night just before the service was supposed to begin. He remembered that after each of them told of his or her relationship with Dr. Green, Koesler had reflected that it was fortunate the doctor had died of natural causes; otherwise each and every one of them would make a fine candidate as a murder suspect. Now … the police might be thinking of this case in terms of, at least, attempted murder.
“Now,” Price continued, “this ‘someone’ who theoretically wants Green dead is able to get close enough so that he or she has access to the drugs Green is taking. And, indeed, this person does arrange to administer an overdose. If, say the drug were morphine, how difficult could it be to make that overdose fatal?