Oh, brother, he thought, scars the size of ropes flashing to mind. Making as if he were still studying the gallery, he asked. “What about Dr. Cam Roper? He saw Kelly once. Didn’t he say she was fine? At least that’s what his files indicate.”
“That quack? He was the worst of them all. Made the most terrible allegation that a mother should ever have to hear. He’s the reason I won’t deal with Mark Roper. Like father, like son, I always say.”
He continued to peer at the stills, not wanting to risk charging in too directly. “Oh? What did Cam Roper say?”
“Why, he practically accused me of being the cause of Kelly’s troubles. Claimed I was making her sick-”
“That’s enough, Samantha!” Walter said, standing at the doorway.
“Oh, Walter.” She spoke his name as if uttering a groan of long-endured pain. “I want Dr. Garnet to know how much that man hurt me, so he’ll understand what I’ve been through-”
“It’s none of Dr. Garnet’s business! Don’t you realize he’ll do the same with what you tell him.” He looked directly at Earl, his elderly face chiseled with anger. “It’s disgusting, what so-called physicians get away with saying, all in the cause of making a diagnosis. Well, I nearly sued then rather than let anyone besmirch us. Lucky for him I backed off, but I won’t let you or anyone else stain our reputation now-”
“And I won’t bottle up my agony, Walter, no matter what you say…”
Their accusations and innuendoes flew between them, filling the air with acid rancor.
As he watched and listened, Earl’s thoughts on the couple congealed into specific clinical labels: narcissism, ego, denial – traits common in everyone, but here they presented themselves in pathological proportions, while under them all loomed a terrible diagnosis, just as Walter said.
10:45 A.M.
New York City Hospital
Tommy Leannis eased himself into a floral-patterned settee opposite Melanie Collins. She sat at a small glass table, pouring coffee from a sterling silver pot into delicate porcelain cups with matching saucers – not the freebie mugs sporting drug company logos that he and the other doctors in his clinic used. He glanced around the plush office, eyeing the thick mauve carpet, the oversize mahogany desk, and the matching wall-to-wall bookcase behind it. “You’re sittin’ at the top o’ the world here, aren’t you, Melanie?” he said, cheerily hiding the bitterness he felt at her good fortune. His own career had been a never-ending, sweaty scramble just to end up a mediocre plastic surgeon, competent enough to avoid getting sued, but no star. He’d never shaken off the insecurity that plagued him in medical school, and he incessantly second-guessed himself, going through life with constantly clammy palms. Melanie didn’t have one damn bit more talent at medicine than he. How the hell did she manage to pull all this off?
“Sugar, Tommy?”
“One would be perfect, and just a drop of cream. I’m trying to keep my lean-and-hungry look.”
She smiled, handed him his cup, then settled back in her chair. “I asked you here as an old pal to help me with a problem.”
“Oh?” Old pal, his ass. What did she want? The woman hadn’t once invited him here since she took over as Chief of Internal Medicine five years ago. He sipped the coffee; it was delicious, of course.
“It’s about Earl Garnet. I’ve been beside myself, and maybe it’s nothing, but the strangest thing happened last night.”
“What’s that?”
“Well, we were talking about Kelly – he’s helping Mark Roper investigate her death – and I’d told Mark at the memorial service that Kelly was in love with someone at the time of her disappearance-”
“You did? My God, Melanie, if Chaz Braden hears you said that, he’ll blow a fuse.”
“I know, Tommy, but even he had to suspect. She was practically glowing before she disappeared.”
“Well I never noticed.” Neither did he want her to engage him in any talk of that sort. Maybe she felt immune to Chaz, because of her position, but he sure as hell didn’t.
“Here’s what’s strange, Tommy. I figure Mark briefed Earl about what I said. Yet Earl never once asked who I thought her lover was.”
“So?”
She hesitated, as if reluctant to speak.
He didn’t say anything to encourage her, taking another sip of his coffee instead.
“So do you think it might possibly have been Earl?”
He nearly choked. “Goody Two-shoes Garnet? You’ve got to be joking.”
“They spent a lot of time together, and were always talking-”
“I know, but he was so straitlaced.” You ought to know, he nearly added, remembering that Melanie had made several obvious plays for Earl and gotten nowhere.
“I thought so, too, but maybe we were wrong. I mean, what do you think? Could it be that he didn’t ask about Kelly’s lover because…” She looked questionably at Tommy.
“It was him all along?” He digested the notion a few seconds, rubbing the palm of his hand through the bristly top of his hair, then chuckled, finding the idea not so crazy once he thought about it a bit. Chaz could be such a mean son of a bitch, why wouldn’t Kelly have tried to sneak around on him? Tommy rather liked the possibility that she and Garnet had been fucking each other with no one the wiser. People who misbehaved, broke the rules, and didn’t get found out always pleased him, especially ones who were so outwardly on the up-and-up. It gave sneakiness a touch of class. Maybe he, too, could slip through the cracks and beat the odds – a loser’s lullaby, he knew, yet seductive enough to make him believe even a guy like him might take a chance and come up a winner.
“Tommy?”
She snapped him out of his reverie. “Sorry. The thought of them doing it, under our noses so to speak, took me a bit by surprise.”
“Do you think I’m right?”
“Maybe.”
“I was hoping you’d tell me that I was crazy.”
He flashed a grin and toasted her with his cup. “Then my verdict, dear Melanie, is you’re crazy.”
“What do you think I should do?”
He ignored the question, too busy wondering if there might be a way to use this information to benefit himself.
11:20 A.M.
Central Park, New York City
Earl hurried along the Central Park side of Fifth Avenue. A north wind sent fallen leaves flying in front of him and whipped up the flaps of his coat in bullying gusts. Cellular in his hand, he punched the redial button for Mark’s number. Still busy.
He walked a few blocks more, punched redial again, and got Mark’s answering machine. “Mark, it’s Earl. I just got out of the McShanes’ apartment. Nothing like a home visit to get at the truth in a family. Call me back as soon as you can. I think I figured out what your father really meant in his notes about Kelly. I need you to tell me if you think I’m crazy.”
He shoved the phone back in his pocket and increased his pace, as much to work off his excitement as to combat the damp and cold insinuating itself through his clothing.
Minutes later he felt the receiver vibrate. He had it to his ear halfway through the second ring. “Mark?’
“Yeah. What’s up?”
“Get out your father’s files and take another look at that medical report of Kelly’s first visit. You know how certain symptoms and signs sometimes fit together to remind us, as doctors, of certain syndromes.”
“Of course.”
“I want you to read it over with a question in mind. If you saw that little girl in an ER today, what might you at least think of?”
“Why? I thought we already agreed that the problem was functional.”
“Just humor me.”
“Okay. Hang on a sec.”
It seemed forever before he picked up again.
“I’ve got it in front of me.”
“Give me the differential you went through to rule out organic causes for her complaints.”
“That’s easy. I first thought of chronic disorders s
uch as inflammatory bowel disease or malabsorption syndromes. But my father said that she’d no history of fever, and her blood tests were repeatedly normal. Presumably that meant they showed no history of anemia, elevated sed rates, or protein deficiencies. Without those changes, I wouldn’t even consider the diagnoses.”
“What else?”
“You mean really bizarre stuff?”
“Yes.”
“I don’t know. If she continued to have complaints, and actually lost more weight or started to have night sweats, I might get more aggressive and want to rule out childhood malignancies, leukemia, lymphoma, that sort of thing. But it obviously wasn’t any of those. Kelly lived to be a healthy adult.”
“All the GI complaints. A history of multiple doctor visits, a surgeon persuaded to operate on a normal appendix and do a laparotomy. Batteries of normal blood tests and negative X rays. And the only concrete sign is her being slightly underweight? Add in the mother being a drama queen who even now uses Kelly’s death to make herself the center of attention, and what does all that suggest? Would you still think the visit to your father involved nothing more than a neurotic, overprotective mother seeking excessive reassurances that her daughter was okay? Or would you think of a disorder that wasn’t even officially recognized until about thirty years after your father saw them?”
“Oh, my God! You mean Munchausen by proxy?”
“I’m not willing to go that far. But there are disturbing similarities.”
Munchausen by proxy syndrome was among the darkest of mental illnesses. Named after a German baron in the eighteenth century who’d been notorious for constructing elaborate lies to scam money from unsuspecting victims, it designated a disorder far more fiendish than any con for money. Parents, usually mothers, would deliberately inflict illnesses on their children. The techniques varied, from rubbing the skin raw to simulate mysterious rashes, through feeding them purgatives and laxatives to create bizarre GI symptoms, to smothering. An offender would then present her child to unsuspecting doctors as a medical mystery, and play the role of an untiring, long-suffering parent who sacrificed all to care for her child, reaping the subsequent attention bound to be lavished on her.
The literature related how a few carried off the ruse so well they’d been awarded Mother of the Year citations before being found out. The worst of them ended up killing their offspring outright, casting themselves in the part of the ultimate victim – a grieving mother – guaranteeing showers of sympathy. Earl’s worst nightmare throughout a lifetime of practice, as it was for all physicians, had been that he would miss diagnosing one of these helpless children because a cunning parent outsmarted his clinical skills. Current estimates suggested 30 percent of the victims eventually perished, but the number could be much higher. Mortality statistics were hard to come by because some of the cases that ended in murder were misdiagnosed as crib deaths, and the children who managed to outgrow the clutches of their secret abusers as they became too old to fool might never be diagnosed.
Mark took a few seconds to reply. “You figure Samantha was… Jesus Christ, her own mother was deliberately making Kelly ill-”
“Whoa, Mark! Quit jumping to conclusions. No, I don’t think it was as full-blown as that. At least there’s no evidence of Samantha having gone as far as actually physically injuring Kelly. But there’s one feature of that syndrome that does remind me of Samantha – the concerned mother carting her daughter from doctor to doctor, all the time insisting the child is ill, and, if her manner then was what it is now, playing the part of a self-sacrificing woman to the hilt.”
“I never would have imagined anything like this.”
“Neither did I, the first time you showed the file to me. But seeing Samantha today on her own turf…” He quickly related the highlights of his visit. “… the narcissism, the sense that only her grief counts, her forever playing to an audience, the fact she’s even made a shrine to Kelly – it all fit together with a big clunk.”
Mark let out his breath in a long, mournful whistle.
“Even if Samantha wasn’t physically harming Kelly, and her particular game doesn’t have its own fancy diagnosis,” Earl continued, “years of telling her that she was sick, suffering from a mysterious, terrible ailment that the doctors could neither diagnose nor make better, would be devastating psychologically. She’d be left with problems of anxiety, self-esteem, image, trust – a host of difficulties…” That he could coolly paint such a troubled clinical picture of a woman he once loved brought him up short. “Well, you get the idea.”
“No wonder my father had to give her four years’ worth of psychological support therapy.” Mark’s voice sounded distant, as if he were thinking aloud.
Earl said nothing, thinking what a wounded soul she’d been, and he hadn’t realized it.
“A wretched childhood like that,” Mark continued, “and I never had a clue.”
“How could you, being just a boy? Hell, she never even mentioned a word of it to me.” Yet I should have known, he said to himself. “But from what her parents said today, or rather, what Samantha wanted to tell me but Walter made her clam up about, I think your father had confronted Samantha head-on about what was happening.”
“What do you mean?”
“You know how we often don’t write really legally sensitive stuff in our charts?”
“Of course.”
“He hadn’t put it in writing, but the way Samantha wailed to me about what terrible things he’d said to her, and how Walter went on about having nearly sued him over it, but then backed off, I figure your dad ultimately twigged to what really might have been going on – that’s probably when he wrote Mother? in the margin – and did a follow-up visit with good old Mom and Dad where he made some pretty strong insinuations about the harm Samantha had been doing. Maybe he even threatened to report her if he ever got a whiff of any more visits to doctors over ‘mysterious illnesses.’ Judging from the fact that there were no more surgical scars from dubious operations, the ultimatum seemed to have worked.”
“Son of a bitch.”
“And here’s something else. Read the letter Kelly wrote to your father again, especially the part that says, Regarding the other two matters, we must discuss those. Whatever I plan for myself, I can’t leave and let them go unresolved.” Earl quoted it from memory. “One of the matters she intended to resolve might have been what her mother had done to her. That possibility gives credence to Braden Senior’s insinuations about Samantha.”
“That she might have killed Kelly?”
“We have to look at the possibility. Suppose on the day she intended to run off and start a new life, she finally confronted her mother. Samantha could have erupted in anger, shoved Kelly or struck her. The woman’s fuse is short. Very short. You’ve seen it. I saw it this morning. What if she accidentally killed Kelly?”
Mark said nothing.
“Hello?”
“Yeah, I’m here. It’s a thought, but something about it just doesn’t sit right.”
“What?”
“I don’t know. Something.”
“Something. That’s all you can say?”
“Let me think about it.”
“Okay, okay.” They exchanged a few more suggestions about how to proceed. When he got off the call, Earl felt impatient. He wanted to go home, return to the present, his present – Janet, Brendan, and ER – not poke around in a quarter-century-old muck of other people’s mistakes. It was all so dreary, and what difference did it really make? Kelly was so long gone.
The whole mess also reminded him how easily a life of promise and love could go wrong, perhaps the result of a single mistake or bad choice. Too often, innocence or guilt played no part. Some, like Kelly, flamed out. Others, like Chaz or the McShanes, let themselves sink inexorably into ruin.
No, he couldn’t pull out just yet and leave loose ends that one day might not only ensnare him but devastate Brendan and Janet as well.
He shivered. Christ it was col
d. Either that, or he was coming down with something.
11:35 A.M.
Medical Records,
New York City Hospital
“Could I speak with you a moment, Lena?”
Lena Downie looked up from the log she’d been reviewing at one of the workstations and saw Dr. Melanie Collins standing at the counter. “Why, of course.” She walked over, holding out her hand in greeting. “What can I do for you?”
“Actually, we need to speak in private.”
“Oh!” She glanced over to where the frosted glass door with her name and title stood closed. “My own office is in use right now.” She leaned closer. “A confidential audit,” she whispered. “But we’ll use my secretary’s. She’ll be delighted to take a coffee break.”
Within a minute they were seated across a cluttered desk from each other. Lena glanced at the adjoining entrance to her own domain, making sure it was shut tight, thereby ensuring both rooms were completely soundproof. “Now what can I do for you?”
“This is a sensitive matter, but I know you’re used to dealing with confidences.”
“Of course.”
“It has to do with Kelly McShane’s murder.”
Alarm flickered through Lena, and she reflexively glanced toward her own office.
“You’re one of the best informed people in the hospital,” Melanie said, “and probably no one knows as many of the secrets in this place as you do-”
“Now really, Dr. Collins,” she interrupted, feeling most uncomfortable.
“But you are. And I’ve been deeply troubled by something these last few days that I hoped you’d help me with.”
Lena’s curiosity won out over discretion. “Oh?” she said, reclining in her secretary’s chair. Its spring-loaded back and coaster wheels caught her by surprise, nearly tipping her over.
“It has to do with Dr. Earl Garnet,” Collins went on. “He probably was already down here, helping Mark Roper out with his investigation.”
Lena simply nodded.
“Well, I’m convinced Kelly had a lover – you know how we women can intuit that kind of thing – and I told Mark Roper as much, figuring he had to know as investigating coroner, if he is to have any hope of figuring out who killed Kelly.”
Mortal Remains Page 24