The Dean, Kurtz pondered, had said much the same thing.
Lenore looked back and forth between Kurtz’ frown and Barent’s bland smile. She shook her head. “It also sounds,” she said, “as if you don’t have much to go on.”
“This is true,” Kurtz said.
Barent leaned forward, his face suddenly intent. “Whoever is doing this knows a lot about the medical center. Most likely, he works there.”
Kurtz had already come to this conclusion. “Seems likely,” he said.
“It could be anybody: a doctor, a lab tech, one of the cleanup staff, even somebody in Security.”
“Even me.”
“I’m willing to bet that it’s not you.”
Lenore gave a gentle, lady-like snort. Barent ignored her. “The Dean isn’t wrong. We could use somebody on the inside, somebody who looks like he belongs there. A cop can’t do that. We don’t speak the language.”
“A cop wouldn’t have to pose as a doctor. As you said, one of the lab techs, even somebody in Security.”
“Possible,” Barent said. His voice was grudging. “But not optimal. We need somebody who has a legitimate excuse to be anywhere at any time, without arousing suspicion. Everybody else there has a specific job. They’re part of a team. The nurses have an assigned station. The cleaning people have shifts and rotations. So does Security. You can’t just wander around. Your co-workers get suspicious.”
“Okay,” Kurtz said, “but I can’t just wander around, either, not when I’m in the OR and not when I’m seeing patients. So, what exactly do you want me to do?”
Lenore made a gagging sound. Kurtz looked at her. Lenore sipped her tea.
“Just what the Dean asked you to do,” Barent said. “Ordinarily, we would resent a civilian butting in, but you’ve been useful before and you know not to step on our toes.” He shrugged. “Keep your eyes open. Look into it. If you find something out, let us know.”
“It sounds,” Kurtz said, “as if you’re not going to be devoting a lot of time to this very important case.” Already, Kurtz reflected, Barent had shown more interest in the case than he had expected. “In fact, the Dean gave me the impression that the police weren’t going to be involved at all.”
Barent grinned. “Like you said, I’m a murder cop. I will be available to consult when needed and I’ll be there if it seems necessary but Harry is taking point on this one—one of the advantages of seniority—but Harry also has bigger cases on his plate.”
Barent took another bite out of his cookie and winked at Lenore. “I got a call from the Captain, who got a call from the Chief of Police, who got a call from somebody on the Board of Trustees. It’s politics. They want it to stop. Okay. We all understand that. We even agree with it, but nobody in the NYPD is going to spend more time on this than they have to.” He stolidly chewed the rest of his cookie, put down the cup of coffee and rose to his feet. “Hopefully, we can solve it quickly.”
Kurtz sighed. “We can always hope.”
Chapter 6
Vinnie Steinberg poked his head over the drapes and peered down at the incision. “How is the Search Committee going?” he asked.
Kurtz looked up. “Not bad. Why?”
“How are you getting along with Serkin?”
Ah, Serkin…from the look on Steinberg’s face, he seemed not to believe that anybody, or at least not Kurtz, could get along with Serkin.
“Just fine,” Kurtz said. Kurtz’ hands kept moving. The case was an inguinal hernia in a healthy fifty-year old. They had perhaps twenty minutes left.
“Yeah?” Steinberg looked doubtful.
“I try to humor him,” Kurtz said.
Steinberg’s eyebrows rose. “Really?”
Kurtz shrugged. “He’s not my chairman. I’ve found that he tends to be perfectly pleasant if you wipe the drool off his chin, pat him on the head and tell him he’s a genius.”
“You tell him he’s a genius?”
“I was speaking metaphorically. Actually, I ignore him as much as possible.”
“Oh. I see. That’s probably just as well.” Steinberg’s face disappeared back down below the drapes. Kurtz could hear him fumbling with the blood pressure cuff. He popped back up a few minutes later. “He’s asked me to be the Director here at Easton.”
“Yeah? What happened to Patel?”
Mahendra Patel had been the Director of Anesthesiology at Easton for nearly ten years. He had been brought in by Gary Austin, the former Chairman of Anesthesiology. That, or so Kurtz had heard, had been a difficult time. The anesthesia staff at Easton used to be private. The Board of Trustees, seeking to make the place more ‘academic,’ had negotiated with Austin to take over the department. This naturally involved putting the anesthesiologists, who formerly billed for their services and kept what they billed, on salary, a considerably smaller salary than their previous private practice income.
Anesthesiologists were more vulnerable to this sort of thing than most other physicians since anesthesiologists were ‘hospital-based.’ Unlike surgeons, they didn’t have their own offices, they didn’t have to build up a practice and they didn’t control patients who would just as likely as not go with them if the institution pissed them off enough to leave. The majority of academic institutions allowed private surgeons to operate, a mutually beneficial relationship. The surgeons were given a courtesy title like “voluntary” or “adjunct” assistant professor and the hospital received more patients. Very few such institutions, however, allowed private anesthesiologists.
The anesthesiologists at Easton had, of course, resisted these efforts. They had hired a lawyer and sued for anti-trust and restraint of trade and had, ultimately, lost. The administration at Easton was happy with the increased revenue. The fact that the department of anesthesiology did not become more academic, did not do more research or train more residents or advance the prestige of the institution in any way, somehow quickly ceased to be a concern.
“Serkin has asked Patel to resign,” Steinberg said.
Patel, so far as Kurtz knew, was a good chief, an excellent clinician, easy to work with and responsive to problems. Kurtz had never heard anything bad about him. “Why? What’s the matter with Patel?”
“In my opinion? Nothing. In Serkin’s opinion?” Steinberg shrugged.
“What does Patel say?”
Steinberg looked around the room. The scrub nurse was peering down at the wound. The circulator was writing something in the patient’s chart on the other side of the OR. Neither of them seemed to be listening, but Steinberg shook his head slowly. “You got a few minutes after the case?” he asked.
“Sure,” Kurtz said.
“Let’s get a cup of coffee.”
Thirty minutes later, they arrived at Kurtz’ office. Steinberg sat down on the couch, took the top off his coffee, blew on it and sipped. He looked surprised. “This isn’t bad.”
“I think they’ve changed vendors.”
“They should have done it a long time ago.”
“True,” Kurtz said. Actually, it was pretty mediocre coffee, only marginally better than the old coffee. Except for the French Vanilla. Kurtz took a sip and smiled to himself. Now that they were in private, Steinberg seemed reluctant to talk. Kurtz got along fine with Steinberg in the OR but they had never socialized. Steinberg had a wife and four kids, wore a yarmulke, went to Schul every Saturday and possessed a stamp collection that consumed whatever was left of his passions after family and work. Not exactly a lifestyle that appealed to Kurtz. Steinberg was a good guy, though. He did a good job and had a keen sense of humor. Kurtz had always liked Steinberg, in a distant sort of way.
“You know about the situation with night coverage?” Steinberg said.
Offhand, Kurtz didn’t. “What about it?”
“Serkin has decided that four residents in house is too many. He wants to cut it down.”
“So?”
“The place is a trauma center. Sometimes we run all night long.”
This, Kurtz knew. Sometimes he ran all night long, too. “That’s what trauma centers do.”
“Sure. But we also run an add-on list. Serkin wants to get rid of the add-on list.”
“Add-ons are a problem,” Kurtz said.
Steinberg rolled his eyes and gave a resigned sigh. “More for us than they are for you, believe me.”
Add-ons were indeed a problem. Easton had sixteen operating rooms, and Staunton had twenty. Every one of those rooms, on an average day, was scheduled to finish at 4:00 PM. Unfortunately, what with late surgeons, sick calls, consent forms that failed to satisfy all the petty legalistic requirements and cases that simply took longer than expected, at least a third of those rooms ran late every day. Then there were the add-ons, theoretically urgent or emergent cases which, most of the time, were simply cases that the surgeon had not been able to fit into his elective time, and so they became ‘emergencies.’ A nice fat add-on list meant that at least a few of the nurses and anesthesia staff didn’t get home until midnight. Kurtz, who liked his evenings, had never booked an ‘add-on’ that was not a true emergency. “So, what’s bothering you?” he asked. “You guys hate add-ons.”
“Just pulling the residents isn’t going to solve the problem. The surgeons are still going to book the add-ons and the nurses aren’t cutting back on staff. They’re still going to be able to run the same four rooms all night long and we aren’t. The system is still going to be designed around add-ons, except for us. We’re going to look bad.”
“Oh,” Kurtz said.
“Patel pointed this out to Serkin at the last Executive Committee meeting.”
“Oh,” Kurtz said again.
“So, a few days after the meeting, Serkin asks me to drop by his office and offers me the job. Patel, it seems, has pissed him off.”
“Tough one.”
“I think so.”
“And what does Patel say about it?”
“I think he’s relieved. Serkin is not the easiest guy in the world to work for.”
“So, what are you going to do?”
Steinberg looked down at his coffee as if searching for enlightenment. He shrugged. “You know all those guys who were willing to manage the Yankees for George Steinbrenner? Sooner or later, they all got fired, but there was always another one waiting to step up to the plate and take a swing at it, willing to delude himself that this time, it would be different.”
“So, you’re going to turn it down?”
“Nope.” Steinberg shrugged again, then looked up at Kurtz. “All those guys George Steinbrenner fired? They all went on to bigger and better things. Even if it doesn’t work out, it’s an opportunity—a chance to show what I can do—and besides, maybe this time, it really will be different.”
“Ah,” Kurtz said. “Well, I certainly wish you luck.”
A hospital is its own little world, each specialized floor its own community, with its own unique character. The cancer wards were quiet, not necessarily grim, but there was always an undertone of tragedy floating through the air. The pediatric floors were happy places, more often than not, since kids tended to get better and go home. The OB wards were happier still, with nurses and new mothers and anxious fathers all milling about, looking forward to the future. The surgical floors were businesslike and organized, the psych wards chaotic and locked from the inside.
Kurtz knew all this but he rarely thought about it. He thought about it now, as he wandered from floor to floor, trying to see the place through the eyes of a potential terrorist. He shook his head. Despite the differences, all the floors shared certain characteristics. All of them had nurses bustling in and out of patients’ rooms and gossiping at the nurses’ station. All of them had housekeepers periodically mopping the floors and changing the linens. The pharmacy technicians pushed their carts down every hallway, re-stocking the PYXIS machines with medications, and all of them had doctors striding down the corridors, most of them wearing suits and ties, with stethoscopes draped around their necks like talismans of power. Another characteristic that they all shared, except for psych and maybe OB and pediatrics, both of which required you to call in before the door could be opened, was that they were easy to get into. At all the other floors, visitors were supposed to check in at the nursing station, and some of them did, at least the first time they arrived, but the place wasn’t exactly security conscious. If you were there and you looked like you knew what you were doing, it was just casually assumed that you belonged. Anybody and his brother could waltz right through. Each floor had a bank of elevators in the middle and two stairways, one at each end. The stairways on peds, OB and psych were locked. The others were all open. This, Kurtz morosely reflected, was not going to be easy. He glanced at his watch and headed for the elevator. Ten minutes later, he was sitting at a table with Patrick O’Brien, cups of coffee at their elbows. “When did it start?” Kurtz asked.
Patrick O’Brian gave him a hurt look. Patrick was pouting. The Administration had made it quite clear that the forces of justice were to cooperate fully with the designated savior on the case, but Patrick still resented it, and Kurtz didn’t blame him in the slightest. Kurtz had been a clerk for CID for a mere two years, which qualified him for exactly nothing. Patrick had put in twenty before retiring to a job as head of security. What made Kurtz better at this than Patrick or any of his men, for that matter?
Nothing. Patrick knew it and Kurtz knew it, too, but none of that made the slightest bit of difference because the Dean wanted Kurtz on the case and the Dean called the shots, at least until the Board of Trustees decided to wise up.
“We’re not sure,” Patrick said. “It could have been going on for months before anybody thought to report it.” He shrugged. “The first one we know of was a little over two months ago, the second was two weeks later. After that…” Harry puffed out his cheeks and let his unhappy gaze wander to the ceiling. “They seemed to come more often, maybe one every three or four days or so.”
“Any breaks in the timing?”
Harry shrugged. “The longest interval was a little over two weeks. The shortest was two days.”
Two weeks could be significant. Two weeks offered plenty of time for a disgruntled employee to take a vacation; an assumption, of course, but considering how long this had been going on, the various locations in which the notes had been discovered and the incidents had taken place, an employee certainly seemed most likely. Then again, it was also possible that the notes had continued to arrive during the supposed hiatus, but that the recipients had chosen to ignore them rather than turn them in.
“You got a roster of all the employees?”
Patrick rolled his eyes and handed Kurtz a folder. The folder was over an inch thick. “You got the hard copy plus there’s a CD with an excel spreadsheet. It’s got all the employees, all the students, all the faculty, including the “voluntaries,” and all patients who’ve been here continuously for the past three months.”
“Many of those?”
“Some kids with congenital anomalies and a few gomers with chronic illness waiting for nursing home placement. Twelve in all.”
Neither gomers nor kids, all of whom were seriously ill and bed ridden, or they wouldn’t be living permanently in a hospital, seemed likely to be the bad guy.
“Any chance of getting vacation schedules?”
Patrick grinned and handed Kurtz another folder.
“Anybody with an obvious grievance?”
“It’s a 600-bed hospital with a transplant program, a cardiac surgery program, multiple ICU’s, a burn center and a trauma center. Approximately two patients die here every week and plenty of others are unhappy with what they perceive as their physicians’ incompetence. I’m not an expert on the quality of medical care but when the physicians say that most people die from their diseases, not because anybody made a mistake, I’ve got no reason to believe otherwise; but sometimes the bereaved don’t see it that way.”
“Are you including Easton?”
Patrick n
arrowed his eyes. “They have their own Security. We have nothing to do with Easton.”
“It’s an affiliated hospital. At least half of the medical staff have privileges there, and I’ll bet that plenty of the nurses and techs work part time at both places.”
“So far as we know, none of the incidents have taken place at Easton.”
Kurtz hesitated. He took a bite out of his sandwich, stolidly chewed, then spoke. “I’m not so sure about that,” he said.
“Why? What do you mean?”
“A couple of weeks ago, I picked up a newspaper in the cafeteria. A drawing fell out. It was pretty ugly. A pregnant woman being stabbed by a man. It looked like something a kid would do. It was crayon, just like all the notes.”
O’Brien sipped from his coke, looked out the window of the little diner. A mild drizzle was falling on the sidewalk. “You found it,” he said.
“Yeah. In a newspaper, sitting on a table.”
“It was never delivered.”
“The drawing? No. I threw it out.”
“None of them have been received at Easton. Not, at least, that we know of, but I think, if there were more than a couple, we would have been told by now. Somebody would have come forward.”
Kurtz shrugged. “So how did the drawing get there?”
“Assuming it was done by the perpetrator, then the guy’s job probably requires him to go back and forth between the two hospitals. Or else somebody at Staunton just happened to pick up the paper, brought it over to Easton and forgot about it. Or maybe it was delivered, and the person who got it stuffed it into a paper and left the paper in the cafeteria.”
“You believe that?”
“Not really. No, you’re probably right. Most likely, it was left there by the perp.”
Kurtz grunted. “Do you have a list of the ones who’ve filed complaints?”
Patrick rolled his eyes to the ceiling and handed over another folder with another disk.
“Thanks,” Kurtz said.
Patrick gave a barely audible sniff.
The Chairmen Page 5