Royal Pains : Sick Rich (9781101559536)

by Lyle, D. P.

  “So you still don’t know what it is?”

  “Patience.” I smiled. “We now know what it isn’t and that’s important. It isn’t your heart, so whatever it is, it’ll be less sinister than that.”

  “Sinister?”

  “Maybe not the best word. Let’s say less threatening.”

  She nodded. “That’s comforting.”

  “I think it might be a problem with one of the nerves that come from the base of your brain. But like I told you earlier, let’s not get too far down that road until we know exactly what we’re dealing with.”

  “What’s next? A surgeon to open my head and look around?”

  I laughed. “I don’t think we have to go quite that far. I’m going to arrange a brain MRI for you over at Hamptons Heritage. Later today. While you’re there they’ll place a Holter monitor on you. It’s a device that records all your heartbeats for twenty-four hours.”

  “I thought you said my heart was normal.”

  “It is. But if what I suspect is indeed the problem, slow heart rates and dizziness, even passing out, can be part of it.”

  “You guys are just full of good news, aren’t you?”

  I smiled. “We try.”

  It’s not every day that you get a call from the medical examiner. Actually the call didn’t come from him. It was from Sergeant McCutcheon. But the medical examiner was sitting right there in McCutcheon’s office. McCutcheon wondered if I was available to drop by for a chat. When I asked what it was about he said they would tell me when I got there.

  If a call like that doesn’t tweak your curiosity you must be in a coma.

  I told him I’d be right over.

  We still had two follow-up visits scheduled, so Divya dropped me by Shadow Pond to pick up my trusty Saab and she took the HankMed van. We arranged to meet over at the high school after we were finished.

  When I entered McCutcheon’s office I was greeted by two somber faces. McCutcheon and Suffolk County’s medical examiner, Dr. James Hawkins. I had met Hawkins a few months earlier during the StellarCare/Julian Morelli investigation.

  Hawkins stood and shook my hand. “Thanks for coming over.”

  “Good to see you again.”

  “Have a seat,” McCutcheon said from behind his desk.

  Curiosity faded to dread as I sat in one of the two chairs that faced his desk. Hawkins took the other.

  “What’s this about?” I asked.

  McCutcheon nodded to Hawkins.

  Hawkins twisted slightly in his chair to face me, one elbow resting on the arm. “Those pills that you got from Kevin Moxley.”

  I hate it when that little electric current goes up the back of your neck. The one that makes the hair stand on end and drops your body temperature a couple of degrees. The one that says the light at the end of the tunnel is a train. A large, fast-moving train with no brakes.

  “Crystal meth?” I asked.

  Hawkins nodded. “Yes. They did contain crystal meth. But they also contained another amphetamine. Methylenedioxymethamphetamine. MDMA.”

  I stared at him for a beat. “Ecstasy?” I glanced at McCutcheon and then back to Hawkins. “They had both crystal meth and ecstasy?”

  “Afraid so.” He slipped off his glasses, rubbed one eye with a knuckle, and then pinched the bridge of his nose. He looked as if a headache might be brewing. He settled his glasses back in place with a sigh. “Sometimes I don’t understand this planet. Why on earth would someone cook up this concoction?”

  “Money,” McCutcheon said. “It always comes down to the money.”

  “When I saw Kevin Moxley he certainly behaved and looked as if he was on amphetamines,” I said. “I know that ecstasy is an amphetamine, but its major effects are more psychedelic. I didn’t see that. Kevin seemed oriented and he certainly understood everything that I said to him.”

  “That likely has to do with the dosing,” Hawkins said. “Those little pink pills were mostly fillers and crystal meth, but there was a very tiny amount of the MDMA.”

  I thought about that for a minute. “Just enough to add a little euphoria to the speed? Something like that?”

  “That’s how I see it,” Hawkins said.

  Methamphetamine alone can create euphoria and hyperactivity. It can also drive your blood pressure and heart rate through the roof and kill you. Happens every day. Toss in a little ecstasy and your brain can get really freaky. Delusions, hallucinations, emotional instability, even seizures. Whoever figured out this combination was trying to get a leg up on the competition by selling a product that had a little more effect. A little more euphoria. And unfortunately, the potential for a little more death.

  “Have you ever seen anything like this before?” I asked.

  “No,” Hawkins said. “I called a couple of my colleagues and neither had they.”

  I looked at McCutcheon. “What’s the plan from here?”

  He leaned forward and rested his thick forearms on the edge of his desk. His biceps and shoulders looked as if they might rip the seams of his shirt. “I’ve issued a department-wide bulletin on the couple Kevin Moxley described. A BOLO. Means ‘Be on the Lookout.’ I wish we had more to go on, but his description is all we have.”

  “And their names,” I said.

  “Probably bogus.”

  That made sense. If you lived and worked in the shadows you probably wouldn’t use the name on your driver’s license.

  “How did Kevin hook up with them?” I asked. “I mean, was it random or did he know how to reach them?”

  “I asked him the same thing. Seems he actually had a phone number for them.”

  “That should help.”

  “Not really. I called the number. Tried to act like a buyer. It didn’t go well.”

  “What happened?”

  “The dude asked me how old I was. I told him fifteen. He asked what grade I was in. I told him I was a sophomore. He asked me who my teacher was. I guessed wrong. I only know a handful of teachers over at the high school and apparently the one I chose taught senior classes.”

  “What happened?”

  “He said that I should have a nice day and hung up.”

  “Can’t you trace the phone or something?” I asked.

  “I did. It’s a prepaid. No way to track it back. He’ll toss it, if he hasn’t already, and crack open another one. Probably has a glove box full of them.” He opened his huge palms toward me. “And life goes on.”

  “So I guess you’re telling me that these people aren’t stupid.”

  “Not by a long shot.” He leaned back in his chair and stuffed the four fingers of his right hand beneath his belt. “I just had a chat with Jerry Hyatt, the principal over at the high school. He says that in the past few months he’s seen an uptick in kids showing up intoxicated or stoned. Not a lot, but some.” McCutcheon scratched an ear. “Not sure how he’d notice. I don’t think stoned kids are all that uncommon in high schools anymore.”

  “From what I hear, Hyatt’s a hands-on guy,” I said. “He takes student issues very seriously. If a trend was to be seen he’d be the guy to see it.”

  “True. He’s definitely hands-on. Unfortunately his hands are also full. I don’t see how the guy could do half of what he does and still keep tabs on all his stoned students.”

  As sad as that was, it was very true. To my mind there were many reasons for it, not the least of which was the ready availability of drugs. Couple that with the fact the classes were usually too big and teachers were overworked and the school system had too little money and the mountain of new rules and regulations and paperwork tied everything in a knot. You mix all that in the blender and you get stoned kids walking the hallways.

  Hawkins slipped his glasses off again. “Now you can see why I insisted on us talking fa
ce-to-face. I wanted to be sure you understood what we’re dealing with.”

  “I understand completely. Wish I didn’t. Wish we didn’t have to. Things are very different than when I was in high school.”

  Hawkins nodded. “And light-years from when I was.”

  “What can I do?” I asked.

  “I want you to help me get the word out. Not just to your doctor friends but to everyone.”

  “I’ll do what I can.”

  Hawkins smiled. “Don’t be so modest. I know about your practice. You see some of the most influential people in the Hamptons. Civic leaders. Community and fund-raising directors. Even the head of the school board if my information is correct.”

  I shrugged.

  “These are the people who can spread the word like a virus in a boot camp. And that’s what we need. More eyes and ears. Shut this thing down before something really bad happens.”

  “I’ll call a few of my patients.”

  “That would help immensely.”

  “I’ll also call the ER director at Hamptons Heritage. He’s a good guy, and he stays on top of this kind of stuff. He’ll send the word out to all the ERs in the area.”

  “I’ve already spoken with Bernard Bernstein over at the Medical Society,” Hawkins added. “He’s going to send out an e-mail blast to all his members.”

  Dr. Bernard Bernstein was president of the Suffolk County Medical Society. I had met him before.

  McCutcheon massaged his neck. “It’s going to be a pain for the department, but let everyone either of you talk to know that we want to be called on any case of amphetamine or ecstasy use that they see or even suspect. I don’t know how many the private practitioners and the ER docs see, but I bet it’s a lot more than we might think.”

  The truth is that the police are almost never notified when someone comes to the ER stoned. It’s just too common. The police would run themselves ragged taking reports. Most of the stoners that do come in are casual users of things like alcohol and marijuana and occasionally ecstasy and even methamphetamines. Usually confused, disoriented, or with dizziness or vomiting or some other toxic symptom. Unless they’ve been assaulted or have assaulted someone or been involved in some accident, the police usually aren’t called. The user’s symptoms are treated and he’s sent home. What McCutcheon was telling me was that that was about to change.

  Hawkins stood. I did, too. He shook my hand. “Thanks, Hank.”

  “Thanks for telling me. I know Kevin Moxley’s mother will be impressed with what you guys are doing.”

  “It’s for kids like Kevin that this is so important,” Hawkins said.

  “True.” I walked toward the door but stopped and turned back to look at Hawkins and McCutcheon. “I think I’ll talk with Principal Hyatt, too. Maybe he has some thoughts on how to combat this.”

  “I’ll let him know to expect your call,” McCutcheon said.

  I left McCutcheon’s office and headed for the high school. On the way I called Divya and told her what I had learned about Kevin Moxley’s cute little pink pills. She was as astonished as I had been. She had just finished the last follow-up and said she’d meet me at the HankMed booth.

  “I’ll be a few minutes late,” I said. “I’m going to swing by and see the principal first.”

  “It’s July. Why would the principal be in his office in July?”

  “Because it’s a year-round job and because summer school is going on.”

  “I never thought of that. I just assumed they had a three-month vacation every year.”

  “Not the principal. Sergeant McCutcheon spoke with him earlier and he said he would be in his office all day, so I thought I’d stop by and talk with him about all this.”

  “See you shortly.”

  Here’s a life lesson: Never put off anything important. Just do it. If you don’t, something equally as important will come along and you’ll be behind the curve. Playing catch-up the rest of the day. Doctors know this. That’s why they make hospital rounds so early in the morning. Before something big comes along. A sick ER patient. An ICU cardiac arrest. Things that can trash the entire day. Particularly if you’re already behind.

  To me, calling some of my more influential patients was important and shouldn’t be put off. The sooner the word on this new drug got out there, the better. So once I parked in the high school lot, I spent the next thirty minutes calling several of my most well-connected patients. Each was shocked at the story I had to tell and was more than eager to spread the word.

  Finally I climbed out of my Saab and set off looking for the principal’s office.

  That’s exactly where I found Jerome Hyatt. I had met him once before and of course knew him by reputation. He had been principal at the high school for more than three decades and was very pro-student. He even demanded that they, and their parents, call him Jerry rather than by his title. That degree of informality could have backfired and led to disrespect, anarchy, and acting out, but Jerry had a knack for garnering respect even in the face of such laxness.

  What was truly amazing was that he had kept the job so long, since siding with students meant that he had to butt heads with the board of education on a regular basis. But even the board members seemed to love him, so he survived despite the occasional skirmish.

  The outside door to his office was closed but unlocked, so I walked in. His secretary’s desk was empty, the computer turned off, so I assumed she was not in today. The interior door that led to his private office was standing open and I saw him, sitting at his desk, head down, reading. I rapped on the doorframe. He looked up.

  “Dr. Lawson.” He stood and came around the desk to shake my hand. “What a pleasant surprise. Sergeant McCutcheon called a few minutes ago and said you’d be contacting me.” He smiled. “Of course I thought it would be by telephone.”

  “We’re working on our booth for the health fair, so I thought it was easier just to come by and see if you were in.”

  “Please, have a seat.” He retreated to his chair. “This is the time of year that’s the hardest. You would think summers would be easy, but with our summer classes as filled as they are and with all the new rules and regulations that are coming into effect next year, like every other year unfortunately, this is what I do with my so-called vacation time.” He waved a hand over the stacks of papers on his desk.

  “Sounds like the life of a doctor.”

  “Very true, though maybe not as life-and-death.”

  “Molding lives is often as important as saving them.”

  “Perhaps.” He shrugged. “But that’s not why you’re here.” He rested his elbows on his desk and laced his fingers before him. “Sergeant McCutcheon told me about this new designer drug.” He shook his head. “I just don’t understand this.”

  “I’m not sure I do either, if that’s any consolation.”

  “I’m one of those who won’t even take an aspirin. For the life of me I can’t understand why anyone would put some unknown and unregulated chemical in their body. It just makes no sense.”

  “You, of all people, know why,” I said. “Teenagers like to live on the edge. Using drugs like this is just part of that.”

  “Unfortunately that’s all too true.” He sighed.

  I flashed on the old Springsteen song made famous by Manfred Mann. “Blinded by the Light.” The lines where Mama told him not to look into the eyes of the sun, to which the reply was that that’s where the fun is.

  This drug was the eyes of the sun. The users were looking for the fun.

  “I understand that this one could be a little more dangerous than the usual,” Hyatt said. “Is that how you see it?”

  I nodded. “Anytime you start mixing drugs—what we call polypharmacy—things can get sideways. And when you mix two different amphetamines like crystal meth and MDMA,
the results can be unpredictable.”

  His face seemed to collapse, pain written in every crease and a deep sadness in his eyes. Jerry Hyatt loved kids and I was sure that seeing a new destructive force enter their lives made him feel that he had failed them in some way. He of course hadn’t, not now and probably not ever, but I knew I would never convince the man sitting before me of that truth, so I didn’t try.

  Instead I said, “I understand you’ve noticed an increase in drugs here at school?”

  “It’s a little soon to tell, but I think so. In the last three months of the school year––say March, April, and May––we sent around a dozen kids home for being in school under the influence of something.”

  “That’s more than usual?”

  “Perhaps. It’s hard to tell with such a short time span and small sample size. I couldn’t say it’s a statistically significant difference, but my gut tells me that that many is a slight increase.”

  “Besides the numbers, was there any difference in the symptoms that the kids displayed?”

  He hesitated for a moment, his brow furrowed. “I would say yes. A couple I can remember seemed to be a little more out of it than the typical stoners we see.”

  “What do you mean by ‘out of it’?”

  “More erratic behavior. More confused than the typical marijuana user. Maybe even a shade more hostile.”

  “Did you involve the police in any of those instances?”

  “Just once. But that was more about the fight that broke out in the parking lot than about the drugs. Though both of the combatants were obviously intoxicated.”

  “What’s your policy on reporting drug use at school to the police?”

  “We try to avoid that if we can. Don’t get me wrong—I think drug use is destructive and criminal. But the ramifications of police and court involvement can be equally destructive.”

  “I can’t say I disagree with that.”

  “Not that I blame the police. It’s just that a kid can sometimes become overwhelmed, even consumed, by the system. Take a minor self-limited problem and make it a permanent mark. It’s often a tough call.”