by Ken Brigham
“I sense that you are hurrying me along,” Shane said. “Very well. I placed a call to a Dr. Frederic delaGuardia. You may recall that he was the physician whom Fitzwallington had seen some time ago. I discovered that the doctor had last seen the artist about a year ago. At that time, the patient had significantly elevated blood pressure and was prescribed a medication. Since the doctor knew the patient to be careless about following up with him, the doctor prescribed a three months’ supply of the medicine and specified three renewals, enough to last for a year at the prescribed dose.”
“Are you going somewhere interesting with this?” asked Seltzer, less than intrigued by the mundane history of an old man with high blood pressure. And the wine was nearly gone.
“Indeed,” Shane responded. “You see, the doctor gave me the name and number of the pharmacy where he had sent the prescription. A short phone call to the pharmacist there revealed from their meticulous records that the initial prescription was filled, but not the remaining three. What do you make of that?”
“The old guy quit his meds. Noncompliant, I think the doctors call that, and from what I read, it is not too rare.”
Hardy had struck noncompliant from his Shane’s words to look up list a while back and was pleased with himself to find an occasion to use it properly.
“That is quite true, my friend, quite true. However, in this case, it may well be that the patient did not neglect to take the prescribed treatment. You see, Issy Essert, being a pharmacist and thus conversant with drugs, volunteered to pick up his lover’s medicines for him and maintain the supply of pills for the once a day regimen.”
“Placebo!” Hardy exclaimed. “The little rat substituted sugar pills for the prescribed drug. Right? But why did he fill the first script with the real thing? And why did he do it?”
“Well,” Shane responded, “according to what the ‘little rat’ told me, he was expecting that his lover would leave him something of value when he died. And, like apparently everyone else, Esser didn’t like the old man. Since he worked in the research pharmacy, Esser would have had access to placebo pills. I learned from my lovely wife that an unnamed person had been recently fired from his job in that pharmacy for stealing placebo pills, a truly baffling offense to the powers that be. I infer that Issy Esser was that person, an inference that could be easily confirmed.”
“Still,” Hardy responded, “why fill the first prescription and not the others?”
“I am surmising now, my friend,” Shane said, draining his glass of sherry and casting a longing glance at the empty bottle resting comfortably on the iron table, “but I am confident of the basic accuracy of my surmise. Esser’s scheme ran a risk that the old guy would recognize that something was amiss with the medicine—an unconvincing container, a suspicious appearance of the pills themselves. So, Mr. Esser filled the first script, emptied the entirely authentic bottle of the active drug, and substituted the placebo pills. Since this was the first time that Fitzwallington had seen the pills, he had no idea what they were supposed to look like. The renewals of the medication did not need to be filled since Esser could just refill the authentic bottle with placebo each three months and those were the only pills the old artist knew. Were any medications recovered by your people from Fitzwallington’s home?”
“Not sure, Shane,” Hardy answered, looking off into somewhere unspecified and contemplating Shane’s tale.
“If so, you could have the medication analyzed. That would establish whether it was drug or placebo.”
“I can see that,” Hardy said. “But would switching the meds be enough to kill the old guy? I mean, it’s not clear to me that we’ve identified a murderer even if this story is entirely true.”
“That,” Shane reacted, “is exactly the problem. Why did the old man die, and who was responsible for his death? It would be difficult to prove that he died of untreated hypertension unless something about the autopsy confirmed that. There was a small brain infarct but not enough for Jensen to attribute his death to a stroke. Possible but not conclusive given the general condition of the old man’s body. Jensen is sticking with his ‘natural causes’ conclusion.”
“Dying of natural causes is not a crime,” Seltzer mused, relishing the last drops of his wine. “Apparently we have two people who aimed to finish the old guy off, and we may not be able to prove whether either of them succeeded.”
“Maybe three,” Shane said.
“You mean Parker Palmer.”
“Right. If Mr. Esser’s story is correct, Parker Palmer may have been the last person to see Fitzwallington alive. But the old guy was yelling at Palmer as he left, so was presumably alive at the time.”
Hardy sat thinking for a while and then said, “Is it possible that the old guy’s blood pressure was so high that the excitement of the argument with Palmer was too much for him?”
“A definite possibility, my man, but how to prove it? He might have had such a surge of adrenalin in the heat of the argument that he died suddenly from a disturbed heart rhythm. The bad news is that such a mode of death leaves nothing specific to be detected at postmortem. So we are still left with no proof.”
“And who was the murderer?” Hardy asked? “Esser, who schemed to prevent treatment of the artist’s hypertension, or Palmer who caused the argument that may have killed him? Neither alone may have done the trick. Were Esser and Palmer unwitting collaborators? Is such a thing even possible?”
“I fear, my friend,” Shane said, “that we may be forced to find satisfaction in the solution of a murder that our system of justice will be unable or unwilling to punish.”
Hardy replied, “I would bet you the price of a fresh case of your Oxford sherry that the chief and his chieflets won’t buy this story. They’ve got themselves a killer and don’t need another one.”
Shane did not respond aloud but thought, the people in charge of the Nashville Metropolitan Police Department seemed to believe in justice when it was convenient while Shane believed in justice as a matter of principle. Perhaps irreconcilable differences.
For the first time that he could remember, Shane thought that his disability may well have spared him some uncomfortable confrontations. But, then, what’s so bad about uncomfortable confrontations for a good cause, dammit!
Shane leaned across the table, put a heavy hand on his friend’s shoulder, looked directly into his eyes, and said like he meant it, “Take them on, Hardy, my man. Take. Them. On!”
ABOUT THE AUTHOR
Ken Brigham is emeritus professor of medicine at Emory University. He is widely published in the scientific literature and has authored or coauthored two previous novels and two nonfiction books. He lives with his wife, Arlene Stecenko, in midtown Atlanta. For more information see www.kenbrigham.com.