Silent Treatment

by Michael Palmer

  “God. Are there such drugs?”

  “A number of them, actually. They’re called pressors. We use them to treat shock, which essentially is dangerously low blood pressure.”

  “So this stuff—this pressor medication—is what? Injected? Or is it a pill, or a liquid of some sort?”

  Harry smiled grimly.

  “No, no,” he said. “Not by mouth. The patients who need a medication like that are in too much trouble to take anything by—”

  “What is it?… Dr. Corbett?”

  Harry was on his feet.

  “Maybe nothing,” he said. “But it just occurred to me. Evie had an IV in her arm. D-five-W—five percent sugar water. It was what we call a KO infusion. Keep open. Just fast enough to keep the plastic catheter in her vein from clotting off.”

  “So?”

  “It seemed a little unusual to me that she should have one in place the night before her surgery, especially when she had been so stable for so long. I even asked her who ordered it. She thought it was the anesthesiologist. But usually they establish their IVs in the OR.” He headed out of the room. “If anyone calls, I’m at the nurse’s station. I’ll be back in a few minutes.”

  The order in Evie’s chart read:

  D5W; 1000cc; K.O. @ 50cc/hr.

  T.O. Dr. Baraswatti.

  T.O.—telephone order. Harry skimmed through the record. Baraswatti had seen Evie late in the afternoon for the preoperative history and physical required of every patient who was to receive general anesthesia. Four-fifteen, the nurse’s note read. However, the order for the IV wasn’t phoned in until six-thirty. Harry dialed the hospital operator. Dr. Baraswatti was still the anesthesiologist on duty in the hospital. He made no attempt to mask the fact that Harry’s call had awakened him.

  “I don’t know what you’re talking about, Dr. Corbett,” he said in a clipped Indian accent. “I always insert my IVs in the operating room. Why should I wish to do otherwise?”

  “I … I don’t know,” Harry mumbled. He set the receiver down as the anesthesiologist was asking if there were any other questions he could answer.

  Harry sat on the edge of the counter and carefully reviewed Evie’s chart. She had arrived on Alexander 9 at one-thirty. At four-thirty the anesthesiologist had come up, examined her, and written preoperative orders. At six-thirty someone claiming to be that anesthesiologist had called the floor nurse and ordered a keep open dextrose infusion to be put in place. The nurse had notified the intravenous nurse on duty for the hospital. At six-fifty, the IV nurse’s notes stated, she had placed an 18-gauge angiocath in Evie’s left hand. A few hours later, at least according to Maura Hughes, a physician had entered their room. And a short time after that, Evie’s aneurysm had burst—either as a result of, or resulting in, a systolic blood pressure of over three hundred.

  Now, Caspar Sidonis was accusing Harry of the intravenous injection of some sort of pressor that had caused the catastrophe. Was it possible Harry was being set up by Sidonis? The physician described by Maura—real or figment—bore no resemblance to the arrogant cardiac surgeon, who was significantly taller than five eight and had thick, jet hair and a mustache. Something was wrong … very wrong. Bewildered and apprehensive, Harry returned to room 928.

  Maura Hughes was awake and thrashing about.

  “Right after you left she started moaning like she was in pain or maybe having a nightmare,” Tom explained. “Then suddenly, like a shot, she woke up. She’s all over the place right now, fighting the restraints and hallucinating even worse than she was before.”

  “Go ahead and ring for the nurse,” Harry said. Noting that Maura was drenched in sweat, he toweled her face off and assured himself that her IV was open and running. She looked stressed, but not in danger. “It’s probably just the sedation wearing off. None of the medicine we use actually changes what’s going on in a DT patient’s head. All it does is blunt their reaction to it. I’ll check her over.”

  “Gene, Gene, don’t be mean,” Maura sang, thrashing against her restraints. She smiled up at him and suddenly adopted a Dixie accent that would have made Scarlett O’Hara proud. “I swear on my mother’s grave, darlin’, if you’d just get these fuckin’ bugs off me I’d be all right. I’d be fine.”

  Using his own stethoscope and pocket ophthalmoscope, Harry did as good an exam as possible under the circumstances. Maura neither helped him nor fought him. Instead, she kept up a constant verbal stream as she tried to brush away the crawlies. The nurse checked in over the intercom. She was in the conference room getting the change-of-shift report. Unless there was real trouble, she would be in after they were done.

  “I don’t find anything to worry about,” Harry said to Tom. “I think we’re just seeing what her condition is like without the mask of tranquiliz—”

  “Hey, I’m looking for someone named Sidonis. Dr. Cash Sidonis. Something like that.”

  Harry and Tom turned toward the door. A sallow, balding man in a polyester suit stood appraising them. He was holding a frayed, spiral-bound, stenographer’s notepad from which he had read Sidonis’s name. His small, sunken eyes were enveloped in shadow. From six feet away Harry could smell a two- or three-pack-a-day tobacco habit.

  “Lieutenant Dickinson!” Tom exclaimed.

  Squinting, the man bobbed his finger at Tom, trying to place him.

  “The Yalie, right?”

  Tom grimaced.

  “Yes, I guess you could call me that. I’m Tom Hughes. This is Dr. Harry Corbett. Harry, this is Lieutenant Albert Dickinson. He’s a detective in the two-eight. They have an opening for a detective there that I’ve interviewed for. He was on the panel.”

  “You and about half the force,” Dickinson said, none too kindly. “I wouldn’t count on nothing if I was you. The competition is fierce. Fierce. Some of the PR people and the image people think being a Yalie is to your credit. But a lot of us who work the streets ain’t so sure. A lot of us look for the guy with the degree from the College of Hard Knocks, if you know what I mean. Good ol’ Fuck U.”

  His hoarse laugh dissolved into a hacking cough. Tom remained outwardly unfazed. Harry wondered if the man’s abominable rudeness was some sort of test.

  “They call anyone they think graduated from college a Yalie,” Tom explained pleasantly enough. “In my case, not that it matters, it happens to be true.”

  “Corbett, huh,” Dickinson said. “You’re the guy Sidonis’s complaining about. After I talk to him, I want to talk to you. Bastard must have some clout to have them send me here on a night like this. Some fucking clout.”

  “Dammit, get off me!” Maura shouted. “Boogery little ants. Get off! I’m sick of this!”

  Dickinson glanced over at her dispassionately. “Whozis?” he said, jerking his head toward the bed.

  “She’s … um … she’s my sister Maura,” Tom said, forcing himself to stand just a bit straighter.

  Harry noticed that one of Tom’s fists—the one out of Dickinson’s line of sight—was clenched. Dickinson peered at Maura again. In ten seconds his assessment was complete. Maura Hughes was a hopeless drunk.

  “Hey, do you two know why the Irish got the whiskey and the A-rabs got the oil?” he asked suddenly. “Give up? It’s becuz the Irish got to pick first.”

  He was launching into another mucous laugh when Maura spat at him. From eight or so feet away she missed by only a foot.

  “Bitch,” Dickinson muttered, checking to be sure he hadn’t been spattered.

  “Pinhead,” Maura shot back.

  The night-shift nurse interrupted via the intercom.

  “Is there a Detective Dickinson in the room? If there is, you were supposed to check in at the nurse’s station before going into any patient room. Also, Dr. Sidonis is here to see you. He’s in the conference room by the nurse’s station.”

  Dickinson looked at Harry. “Don’t go away, Corbett,” he said. “You neither, Yalie.”

  He shoved his notebook in his suit-coat pocket and left th
e room. Tom waited until he was certain the man was out of earshot.

  “This is not going to be fun,” he said. “Dickinson is totally burnt-out. He wouldn’t go an extra inch to help his own mother.”

  “But he’s on a panel that picks who’s going to make detective.”

  “NYPD logic all the way. I’ve been told I’m the leading candidate to get the promotion, but as you just heard, you never know. I really could’ve done without this little encounter with Albert D.”

  “Sorry.”

  “It’s not your fault. Look, don’t worry about him. Albert’ll annoy you with a few questions from the detective’s how-to manual just to have something to put on his report. Then, when he realizes there isn’t any reason to suspect foul play, he’ll leave and spend the next hour or two at Dunkin’ Donuts.”

  “But there is,” Harry said.

  “Is what?”

  “Reason to suspect foul play.”

  CHAPTER 9

  Harry recounted in detail for Tom Hughes his call to the anesthesiologist and his review of Evie’s chart. He was just finishing when Evie was wheeled back in. Shaken by the sight of her, Harry realized that he had already begun to think of her, of their life together, in the past tense. To all intents, the woman he had been married to for nine years was dead.

  “The EEG showed a little activity,” Richard Cohen reported as she was being reconnected to the monitoring and respiratory systems, “but not much. Certainly not enough to keep the various teams from moving forward if you give the word. As you know, time is pretty crucial here. Organs do begin to break down.”

  “I know,” Harry said. “When do you plan to do a second EEG?”

  “Ten in the morning.”

  Harry looked down at his wife. Over his twenty-five years as an M.D., he had shared every conceivable experience involving death and bereavement. But none of those experiences prepared him for this. A few short hours ago, she was the most important person in his life. A few short hours ago, Sidonis or not, they still had the chance to turn their marriage around, to make it work again. But suddenly, it was over. And now, he was being asked to validate Evie’s death by authorizing the donation of her vital organs. He had always been supportive to families in such situations. When he needed them, the right words had come. But he had never had to make the decision himself.

  “Leave the papers at the nurse’s station,” he heard himself say. “I’ll sign them before I leave. But I want to see her in the morning before anyone moves ahead with this.”

  “I’ll see to it.”

  Cohen thanked him, murmured a brief, somewhat uncomfortable condolence, and left the room. Moments later, her adjustments on the ventilator completed, the respiratory technician followed. Sue Jilson checked Evie’s blood pressure and monitor pattern, and then turned to Harry.

  “The CT tech took this off your wife,” she said coolly, handing Harry the diamond pendant from Tiffany’s. “I didn’t see any sense in putting it back on her.”

  Harry looked at her stonily.

  “I do,” he said.

  He hooked the necklace back in place. When he turned around again, he and Tom Hughes were alone with the two patients. Maura continued her almost nonstop prattle, pausing only to pick tormentors off the bedclothes. The ventilator connected to Evie again was whirring softly as it provided oxygen to organs that were now of value only when considered individually.

  Tom turned off the overhead light, leaving, only the dim over-the-bed fluorescents.

  “I’m really sorry for everything you’re going through,” he said.

  Harry glanced over at his wife.

  “Thanks,” Harry managed to say.

  “If you want to talk some more about it, I have the time, and I’m not at all tired.”

  “In the hall, maybe,” Harry said. “Not in here.”

  They dragged their chairs outside the door. The corridor was dimly lit and silent, save for the white noise of night in the hospital.

  “You don’t have to keep talking about your wife if it’s too hard for you,” Hughes said.

  “It actually might help.”

  “Okay. Just don’t be embarrassed to tell me to shut up. I confess that as a cop, what little you’ve told me so far has me intrigued. What do you think is going on?”

  “I have no idea. There’s probably a stupid, simple explanation for everything. The nurse who took the telephone order got the anesthesiologist’s name wrong.… Some M.D. friend of ours was on the floor seeing another patient and stopped by to see Evie—”

  “That’s two simple explanations. In my experience, when you need to invoke more than one explanation for things happening coincidentally, none of them is the true story. Would you mind going back into the room with me for a minute?”

  Harry considered the request, then followed him in.

  Hughes began pacing deliberately around first Maura’s bed, then Evie’s, checking the walls, the light switches, and the beds themselves. Maura watched him curiously.

  “Rather than assume the most benign explanation,” Tom said, continuing his inspection, “for the moment let’s assume the worst. Some doctor—or perhaps someone planning to pose as a doctor—called in an order to have an IV started in your wife’s arm and gave the real anesthesiologist-on-duty’s name. Later, he entered this room, unseen by the nurses, spoke to my sister, then administered a pressor drug to your wife. Then he left the floor, again managing to avoid being spotted by anyone. We need a motive for why he would have done such a thing, and an explanation as to how he could have made it on and off the floor without being spotted.”

  “Dickinson made it in here without being seen.”

  “One way, he did. The nurses were in their change of shift report when he came on the floor. But having two such opportunities—onto the floor, then off again—let alone planning on them, is asking a bit much.”

  “So what are you looking for now?”

  “Places where our mystery doctor might have left a fingerprint or two. Too bad we don’t have prints of every M.D. on the—”

  “Okay, Dr. Corbett,” Albert Dickinson cut in. “I guess it’s time you and I had a little talk.” The detective, leaning against the doorjamb, sighed wearily. “I’m required to tell you that you have the right to remain silent, but that anything you choose to say may and will be used against you in a court of law. You—”

  “Wait a minute,” Tom said. “Why are you reading him Miranda? Is he being arrested?”

  “Not yet, but he will be. I just thought I’d get through the formalities.”

  “Lieutenant Dickinson,” Hughes went on, “there are some things you don’t know about what’s gone on here.”

  “You wanna know what I do know, Yalie? I know that no matter how much they got—sex, money, power, drugs, or whatever—doctors always want more. That’s just the way they are. Give me an unsolved crime where one of ten suspects is a doctor, and my money’s on the doe every time. Now, Dr. Corbett, if you’d like to—”

  “Lieutenant, another doctor came in to see Mrs. Corbett after Harry left here tonight,” Tom Hughes said.

  “There was no one. The next person to come on this floor after Dr. Corbett left here was you. And by that time, Mrs. Corbett was already on the chute. I checked with the nurses. They have all visitors logged.”

  “Well, the nurses are wrong. Someone was here. A white male in his forties wearing a white clinic coat. Five eight, brown hair, brown eyes.”

  “Who says?”

  Tom’s expression suggested that he was expecting the question but still had found no easy way around having to answer it.

  “My sister,” he said boldly. “The man spoke to her, then went around the curtain to Mrs. Corbett, and then left. It was soon after that her aneurysm ruptured.”

  Dickinson smirked. “Is that what you saw, little lady?”

  “Pinhead. You know, you should fire whoever made you that toupee. I could paint a piece of lettuce with shoe polish and have it look m
ore realistic.”

  Dickinson smiled blandly but it was clear he had been skewered. Harry realized only then that the man was wearing a hairpiece. Score one more for Maura Hughes’s power of observation.

  “Why don’t you have another drink, little lady,” Dickinson said.

  “Maura,” Tom pleaded, “would you please stop with the wisecracks and just tell the detective what you saw?”

  Maura brushed at something on her shoulder but said nothing.

  “Don’t bother,” Harry said. “I don’t think the detective is going to pay much attention. Come on, Lieutenant. Let’s get this over with.”

  “Lieutenant Dickinson,” Tom asked, “do you think it would be worthwhile calling someone over from forensics?”

  “For what?”

  “Maybe the doctor who was here left some prints.”

  “Fingerprint a hospital room, huh. Sounds like a great idea to me, Yalie. I mean there couldn’t have been more than, oh, one or two hundred people in here over the last day.”

  “Almost everyone who’s been in this room, including the doctors, has a set of fingerprints on file with hospital security,” Harry said. “It’s been hospital policy for years, ever since a convicted child molester lied on his application and got a job as an orderly on the pediatric unit.”

  “Great. I’m sure forensics will be thrilled to come out on a night like this because a woman in the goddamn DTs claims she saw someone that not a single other person on this whole floor saw.”

  “I’m telling you, I know my sister, and I know that there was someone here.”

  “And I’m telling you, spiders and ants and giant snakes don’t leave fingerprints. Now, Corbett, let’s get this over. You’ll feel much better when you get everything off your chest.…”

  It was well after midnight by the time Harry finished responding to Albert Dickinson’s unemotional and uninspired interrogation. The detective had dearly made up his mind that the scenario fed to him by Caspar Sidonis was the correct one. Harry, unwilling to allow his wife to run off with another man, had administered a blood-pressure-raising agent to her. Her death would appear to be due to the rupture of her aneurysm, and no questions would be asked. Now, samples of her blood were being sent to the state lab for analysis. If any unusual substances were found, especially ones related to raising blood pressure, there was a good chance that a warrant would be issued for Harry’s arrest.