Blood and Money

by Thomas Thompson

  “But when are we going to talk, John?” she pressed. “I’m sick and tired of your stalling around.”

  “I just can’t think right now,” he answered. “I’ll call you later.” With Ann glowering, he got into his Cadillac and drove toward River Oaks, ten minutes away.

  Boot Hill had spent the previous night down the street at the home of his grandparents. On this Tuesday morning, Mrs. Robinson prepared his breakfast and Ash drove him to the River Oaks Elementary School where he was in the second grade. Ash then made a quick trip downtown to check the opening stock market quotations, and when he returned home around ten-thirty his wife said she was anxious to visit Joan and see how she was feeling. Ash dropped her off while he went on another business appointment.

  Mrs. Robinson was met at the front door of her daughter’s home by Archie Green, who led her upstairs to the sickroom. There she discovered her son-in-law, standing at the foot of Joan’s bed, a serious expression on his face. “I think we’d better take her to the hospital, Ma,” he said.

  Up to that point, Mrs. Robinson had no idea how serious her daughter’s illness had become. “The news shocked me,” she would later state in a deposition. “He said he was making arrangements for her to go to Sharpstown Hospital where she would have intensive care and be treated like a queen.”

  “Is an ambulance coming?” asked Mrs. Robinson.

  No, said John. He was going to drive her personally to the hospital.

  It did not seem unusual at the time to Mrs. Robinson that her daughter was going to be treated at Sharpstown, even though it was a new and relatively unknown hospital in the city. Less than fifteen minutes away from the Hill home was the great Texas Medical Center, with some of the world’s finest hospitals and every diagnostic facility known to modern medicine. Yet John Hill was preparing to take his wife to a small suburban hospital, twice as far away.

  As she would look back on the strange morning, events seemed to move in slow motion. Almost languidly, John Hill helped his wife rise from the bed. Effie found a robe. Mrs. Robinson located white socks to put on her daughter’s feet. The group moved out of the bedroom to the head of the curving stairs that led down to the foyer. Effie Green made a move to assist Joan down the stairs. John stopped her. “No,” he said. “She can walk by herself.” His tone was firm, an order, almost a denial of his wife’s illness. Effie would later state that she found it shocking that the doctor would make his wife walk down the stairs by herself. She wanted to put her arms around her mistress and carry her down.

  John helped load his wife into the back seat of her blue and white Cadillac, and Mrs. Robinson drew a light blanket over her legs. Just as they were preparing to leave, Ash Robinson drove up in his black Lincoln and got out with a worried look on his face.

  “Great God almighty!” he swore. “What on earth has happened to this child?”

  John repeated the news that Joan’s condition had worsened, that he felt it best she be hospitalized. He had chosen Sharpstown because she would receive “special care” there.

  Ash leaned into the back seat and comforted his daughter. “How do you feel, honey?” he asked.

  Joan smiled faintly.

  “Do you want me to go with you?” he asked.

  “I’m going,” said Ma.

  With that, John started the car and drove away, leaving Ash standing in the driveway, worrying, wondering.

  It was approximately eleven miles from the Hill home on Kirby Drive to Sharpstown Hospital. It took John Hill almost three quarters of an hour to progress what could have been done in half that time. “He drove like a snail,” Mrs. Robinson would later say. “I felt we were never going to get there. In fact, it was almost like he did not want us to get there.”

  En route, John switched on a classical music tape, and the sounds of a symphony filled the Cadillac. At one point Mrs. Robinson snapped at her son-in-law, “Turn that damn music down, John. I can’t hear myself think.”

  Mrs. Robinson kept asking her daughter, “Honey, how do you feel?” Several times Joan only nodded, but midway, she said, “Mother, I am blind. I can’t see you.”

  Mrs. Robinson turned to her son-in-law. “Did you hear that? What does it mean?”

  “She’s having a blackout,” said John. He did not seem concerned. He repeated his previous statement that the hospital was “alerted” and its emergency facilities geared up to receive Joan.

  But when the car eased into the driveway that fronts Sharpstown Hospital, no team of emergency medical personnel rushed out to admit Joan Hill. In fact, no one seemed to know she was coming. John Hill got out of the car and went into the hospital. His mother-in-law sat for what seemed like several minutes waiting for someone to help her daughter. Finally John appeared with a nurse who was pushing a wheel chair.

  Joan sat up in the back seat of the car, gasping for breath, while her mother pleaded, “Oh, God, hurry!” Joan was lifted carefully and put in the wheel chair and pushed into the hospital. Mrs. Robinson would learn later that the hospital had, in effect, no emergency room facilities at the time. And no intensive care unit whatsoever. The modest suburban hospital was, as one doctor described it in 1969, “a good place to have a baby or get a broken arm fixed—little else.”

  The sick woman was taken to a private room where nurses descended on her for the admitting process. Mrs. Robinson was asked to leave and did so, standing around helplessly in a corridor for more than an hour. John Hill seemed to have vanished as well, and she could find no one to tell her anything.

  Earlier that morning, John had telephoned a physician named Dr. Walter Bertinot who practiced internal medicine at Sharpstown. A capable man, he was nonetheless an unusual choice. Bertinot was not considered one of Houston’s many celebrated doctors of world rank, nor had he ever treated Joan Robinson Hill. He had, in fact, only met the woman once or twice, and that was to shake hands at the annual picnic which the Hills gave at Chatsworth Farm.

  “Why me?” asked Dr. Bertinot. It occurred to him that perhaps John Hill should be treating his own wife, or that the lady’s personal physician might be more suitable to minister to her needs. John Hill’s answer was unusual. He said Joan did not really get along with doctors on a professional basis, but she had once spoken well of Bertinot. He made his wife out to be a problem patient, the kind doctors dread. Bertinot, a quiet, colorless, unemotional man with the character of a college physics professor, could handle a temperamental woman.

  “What are her symptoms?” asked Bertinot. Diarrhea, vomiting, and nausea, replied John routinely. The Sharpstown doctor assumed then and there that Joan Hill was suffering from acute gastroenteritis. Or, in lay language, stomach flu. Bertinot was flattered to be asked to treat one of Houston’s most famous women, but there seemed no urgency to the matter. John Hill’s tone on the telephone was calm and unemotional. There was no mention whatsoever of “intensive care” as the plastic surgeon had told his mother-in-law and the maid.

  The first nurse to attend Joan in her hospital bed took a blood pressure reading and was startled to discover that it was 60/40—perilously low.

  The nurse was so concerned by the reading that she took it again, wondering if the apparatus could be malfunctioning. Once more Joan’s pressure read 60/40. An emergency call was made to Dr. Bertinot, who at that moment was a block away in a small professional building adjacent to the hospital.

  “I dropped everything and went over,” Dr. Bertinot would later say. “I canceled out my whole schedule.”

  When he first encountered Joan Hill, she was sitting up in bed and seemed flushed and short of breath. She did not appear to be a woman in shock, but she had to be in shock with a blood pressure of 60/40. Moreover, Joan greeted Dr. Bertinot by his first name, “Walter,” and smiled at him. All very curious. The doctor ordered IV fluids started immediately in an attempt to build up the blood volume and raise the pressure. The danger here was that the patient would be thrown into terminal shock unless the blood volume was restored. While the nu
rses rigged IVs, Dr. Bertinot methodically took Joan’s medical history, concentrating on the previous few days. Learning that she had been vomiting, suffering from diarrhea, and complaining of general nausea and malaise, he made a snap judgment that he was dealing with some kind of a dysentery, perhaps salmonella, food poisoning.

  Routinely, Dr. Bertinot ordered urinalysis and stool cultures, for if Joan had eaten something that had precipitated food poisoning it could perhaps be determined by studying her feces to see if threatening bacteria were at work there. At this point the condition of his patient did not alarm him, for food poisoning is a common reason for admission to a hospital. But other factors about Joan intrigued him. Why did she seem so rational, when her blood pressure indicated that she was in deep shock? Confounded, Dr. Bertinot summoned a colleague, Dr. Frank Lanza, in consultation. Lanza, a flashy, fleshy young doctor who had once been a professional dancer and who performed a night club act to help his way through medical school, was but two years out of his residency in 1969. And though well trained, neither was he considered one of Houston’s most famous diagnosticians. Before many more days passed, questions would begin to arise as to why John Hill employed two doctors of the then lesser stature of Bertinot and Lanza to treat his wife, rather than engage physicians of world rank just across the city.

  At this midday on February 18, 1969, John Hill was in the operating room at Sharpstown, performing an operation for removal of a scar, and listening to a broadcast of classical music.

  Despite the IV fluids being dumped into her veins, Joan’s blood pressure remained low. Now it occurred to Dr. Lanza that perhaps the woman had septic shock, resulting from a massive bacterial infection somewhere in her body. She had, after all, complained to Effie Green of “burning up” from her neck down. The physician ordered more elaborate blood cultures to search for bacteria, but the trouble here was that the test would take perhaps as long as seventy-two hours. Blood must be placed in agar plates, a gel-like substance, and in this medium, bacteria—if present—will grow.

  By late afternoon, six hours after admission to the hospital, a nurse noted that no urine was passing out of Joan’s body through a kidney catheter. This indicated kidney failure and was alarming to the attending doctors. They directed that the IV fluids be increased, hoping to stimulate the kidney into producing urine. While this was going on, Ash Robinson popped into the room, promising to bring his daughter yellow roses on the morrow, lingering until the nurses banished him.

  Shortly after 8 P.M. her condition became grave. The increased IV fluids had not stimulated the kidney into producing urine, and the blood urea nitrogen level was elevated. A well-respected renal man, Dr. Bernard Hicks, was called in. It took him but a few moments to diagnose serious kidney failure.

  “Should we move her to Methodist?” asked Dr. Lanza. A dialysis machine was available at the cross-town hospital that Dr. Michael DeBakey had made famous. Such a machine could take over the work of a kidney, purifying the blood, while doctors tended to other threatening matters in Joan’s body.

  “No,” answered Dr. Hicks. The woman is too sick to move. Instead he would attempt peritoneal dialysis, placing a tube in the stomach and forcing a blood-purifying solution first in and then out a second tube through osmotic pressure. The procedure turns the entire peritoneal cavity into an artificial kidney and can work as well as a dialysis machine.

  Dr. Walter Bertinot watched, almost unbelieving. He could not have imagined that this critically ill woman before him was the same who had greeted him warmly ten hours earlier and called him by name.

  Dr. Hicks would not begin the peritoneal dialysis without approval from John Hill. Where was he? During the day he had been in and out of his wife’s room a few times, but now he was home. Effie Green took the call from the hospital and summoned her employer from his music room, where he was sitting alone, absorbed in a concerto. When he hung up, he hurried to the door, telling the maid, “We may lose Mrs. Hill. She is very sick.”

  But although the call was made at 9:15 P.M., through the hospital switchboard, John did not show up in his wife’s room until eleven. When he arrived his wife was conscious and, surprisingly, fairly lucid. A nurse present heard Joan beg her husband to stay with her because she was frightened by all of the tubes and contraptions attached to her body. The surgeon nodded agreeably, read her chart, then pushed a chair beside the bed and propped up his feet.

  Dr. Bertinot checked his patient half an hour after midnight and felt there was, if not slight improvement, at least a stabilizing. Blood pressure had raised slightly, and the peritoneal dialysis was working. Since the case was now more or less thrown into the lap of the renal specialist, Dr. Hicks, the physician in charge felt it was all right to go home and get some sleep. “I’ll stay a while longer,” said Dr. Lanza. “You go on home, Walter, and if anything happens, we’ll call you.”

  John Hill, seemingly satisfied with the care his wife was getting, said he was going to spend the night on a couch in the patient records room, just down the hall.

  At 1:30 A.M. on the morning of March 19, Dr. Lanza went home, as had Hicks, the kidney specialist, and Joan Hill was left in the care of nurses and a night resident who was in charge of the patient census. John Hill patted his wife gently and whispered that he would be just down the hall in case he was needed. Drifting now in and out of lucidity, Joan instructed the nurse to make sure that her husband was comfortable. Then she began composing a grocery list for a party she was giving, her mind wandering. The peritoneal dialysis was painful, but she was heavily sedated.

  An hour later the nurse noted that her vital signs showed indications of sudden heart failure. She ran to the doorway and called to the central nursing station to summon the resident with cardiac arrest equipment. At that moment Joan raised her head slightly from her pillow and gasped. “John!” she implored. Frantically she searched for air. Then a torrent of blood raced up from her innards and splashed out of her mouth, staining the pillow red-black.

  Dr. Yama, the resident who was moonlighting from his position in radiology at another hospital, raced into the room and plunged adrenalin into the heart. But it was too late.

  With that final agonal hemorrhage, Joan Robinson Hill was dead at the age of thirty-eight.

  John Hill’s grief shattered the predawn stillness of the hospital. “No!” screamed the plastic surgeon, and then again, and again. He rushed into his wife’s room and saw horror—her blotched and swollen body, her blood fresh on her face and the linens—and he rocked back and forth moaning. His long-time friend, a nurse named Gail Wholey, murmured consolation to him. “I must call my mother,” he suddenly said, and this struck the nurse as odd. Why would John Hill need his own mother before he broke the news to Joan’s parents? The plastic surgeon also instructed the nurse to call his friend, Dr. Jim Oates, and request him to come to the hospital. Dr. Oates and his wife Dotty, also a nurse, lived but a few blocks away from the Hill home, and the two men often played piano duets together. Once they had spent six months polishing a Mozart sonata for appearances at a Methodist church.

  Mrs. Wholey telephoned the Oates home and told them: “Joan Hill is dead. John wants you to come out to Sharpstown Hospital. Meet him in Joan’s room.” Dressing hurriedly, still sleepy and confused, the couple drove urgently to the hospital. It occurred to Mrs. Oates en route that perhaps there had been an automobile accident, but no … the nurse had said Joan was in a room. Had she been killed in a car crash, the nurse would have said the emergency room.

  As soon as they entered the back door of the small hospital, Dotty Oates heard John Hill sobbing. His cries echoed all over the building, and on the second floor, patients had come to their doors and were standing outside to see what tragedy had occurred. John was in the doctors’ lounge, weeping so hysterically than he seemed near collapse. Dotty Oates went to her friend and held him in her arms for several minutes while he gasped out the story of her sudden illness, and decline, and death. “I can’t believe it, Dotty,” he s
aid. “My beautiful wife is gone. Why?”

  Finally Jim Oates spoke sharply, cutting through his friend’s grief. “Okay, John, knock it off. There are things to be done.”

  By this time Joan’s attending physicians, Dr. Bertinot and Dr. Lanza, had been awakened at their homes and had driven back to the hospital. Suddenly the place was full of doctors, and Dotty Oates took the opportunity to slip out and go into Joan’s death room. As she would tell it later: “I couldn’t believe what I saw. The previous Friday, just before the wild game dinner, I had seen Joan Hill fresh from the beauty parlor and she had looked better than I had ever seen her. But this wasn’t the Joan I had seen that day. Often, as a nurse, I have sometimes walked into a patient’s room and encountered someone I know socially. But if I did not know this was Joan’s body, I would not have recognized her. She was extremely edematous, swollen with fluids. Her superficial blood vessels were ruptured all over her body, making her splotched and mottled purple. On her face was the agony of torture. It must have been a painful and terrible death. Her blood was all over her face and her bedclothes.”

  Since the death had occurred almost two hours earlier—it was now near five in the morning—Dotty Oates was annoyed that the body had not been washed and cleaned, as is hospital custom. So she did what any good friend would do. “I washed and cleaned Joan. John kept coming in and bothering me, standing by her bed sobbing. It was a ghastly and terrible scene.”

  In the state of Texas the law required—under criminal penalties—an autopsy to be performed by the county coroner on any person who dies in a hospital within twenty-four hours of admission. The coroner must rule on the cause of death before the body is released for embalming and burial. All doctors know this, certainly all hospital pathologists, but in the most curious and bizarre—and soon to be notorious—death of Joan Robinson Hill, the law was either overlooked, flaunted, or deliberately broken, depending on with whom the authorities talked.