No Cure for Murder
Page 20
“I hope so, Shelly, but when you’re dealing with this kind of sicko, you never know.”
“Anything else, Chief?”
“You’re heading this investigation, Shelly. I’ll give you whatever resources you need. Just catch this son-of-a-bitch...and soon.” He paused and looked up at Shelly. “Let’s not forget the fundamentals.”
“Fundamentals?”
“The fundamentals, such as who do you like, sight unseen, when a husband or wife is killed, and where was Angelina’s husband Milo?”
“He was home, drunk.”
“Alone?”
“So he says. I’ll get on it, Chief.”
Hospitals, like people, have personalities, and can’t avoid the effects of the mayhem surrounding them. Brier Hospital, after years of struggling, had reached the point where its name spelled optimism, competence, compassion, and security. Now it spelled murder.
Before the San Francisco Chronicle article splashed gruesome details about the deaths at Brier, gatherings around the lounges and water coolers spread speculation and supposition like oil on a pond. Now, with increased security and the presence of many new faces, the staff felt like they were working in a fish bowl.
A group of nurses sat in the staff lounge sharing the afternoon newspaper.
“Every time I look over my shoulder,” said Ginny Harrison, “I meet another pair of accusing eyes.”
“In your case,” Mary Oakes said, smiling, “that’s perfectly appropriate.”
“Now I know how you made your way to the top of nursing administration, Mary...ruthlessness.”
Gail Sergeant, another senior nurse said, “Since this whole thing began, I’ve been having terrible nightmares. I suddenly awaken in a sweat, and look around my room making sure nobody’s there.”
“It’s got to be someone on the staff,” said Ginny, “but who?”
Mary shook her head. “It’s difficult to believe that someone you work with, maybe a friend is a serial killer.”
Ginny yawned from lack of sleep. “I don’t know how long I can work under these circumstances.”
“That’s nothing,” said Mary Oakes. “Imagine how you’d feel if you were a patient.”
When Jacob slid his card through the reader at the hospital’s rear entrance, the door lock clicked open and for the first time he faced a security guard.
“Excuse me, sir, but I need to check your ID.”
Jacob smiled. “Andy? Didn’t I deliver you, your brothers, and your little sister?”
“You sure did, Doc, and I’ll never forgive you for bringing my sister into this world. She’s a swift pain in the...”
Andy pointed to the surveillance camera overhead. “Sorry, Doc, but I can’t make any exceptions.”
Jacob pulled the card from his coat pocket and presented it to Andy.
“Thanks, Doc. Please pin it on your coat or wear it on a lanyard or your trip through Brier will be a slow one.”
When Jacob made it to the doctor’s lounge, Warren Davidson was chatting with Jack Byrnes. Jacob pulled up a chair. “It’s like a war zone. I haven’t seen so many uniforms in one place since Vienna.”
“Everyone’s running scared.” said Warren.
“How goes your investigation?” Jack asked.
“We’re not used to second guessing ourselves over the causes of death,” said Warren. “Ninety-nine percent of the time, we know it’s coming and exactly what happened. It’s difficult to look at these cases, especially the ones dying of terminal illnesses and ask; could anything else be going on? I find it hard to be that suspicious.”
“Did you find anything in my cases?” Jacob asked.
Warren opened his folder. “You did have many deaths, Jacob, but your patient population is much older. Let me mention a few names and get your response...did you expect the death or even in retrospect are you suspicious?”
“Shoot.”
“Shannon Hogan?”
“Definitely unexpected and tragic, but we did an autopsy that showed nothing.”
“It was a routine autopsy, Jacob, not a forensic one.”
“Of course. We had no reason to expect foul play.”
“P.J. Manning?”
“Expected, and a blessing. A horrible ALS death. Why would someone kill a person nearing death?”
“Joshua Friedman?”
“If you’re going to hit me with Marion Krupp’s bullshit on that case...”
“Easy, old timer,” said Jack.
“Old timer, my ass. To answer your question, terminal esophageal cancer. Another expected death, not soon enough if you ask me.”
“Nathan Seigel?”
“Now here you may have something. He definitely died as the result of Lidocaine toxicity, but we had no indication that it was deliberate.”
“And finally, Harry Rodman?”
“Harry didn’t die. Why include him?”
“He nearly died of a heparin overdose, Jacob. Could this have been deliberate?”
“God knows. Why would someone want to injure Harry? It makes no sense.”
“It isn’t like you, Jacob,” said Warren, “to be having these kinds of problems with your patients.”
Jacob reddened. “Are you accusing me of something, Warren?”
“Don’t shoot the messenger, Jacob. I’m asking the same exact questions of every doc whose patient died or had some sort of adverse, unexpected event. Don’t get paranoid on me.”
“It’s not paranoia when physicians and nurses question my practice, Warren, and when you give credence to malcontents like Marion Krupp.”
Jacob turned to Jack. “Do you think I’m too old to practice, Jack? Am I delusional and don’t recognize that I’ve outlasted my usefulness?”
“Don’t do this, Jacob. While you don’t have the public image of a young superstar, and while you sometimes become a bit contentious about anything, you can take care of my wife and me anytime. I trust you. You’ve been the best, and in my mind, you still are.”
Chapter Forty-Five
Margaret Cohen came into Jacob’s office after they finished for the day. “Do you have a moment, Jacob?”
“Sure, Maggie.”
“No ‘Maggie’ today, Jacob. I have something...something important.” She paused, her eyes beginning to fill.
“What is it, Margaret? Are you sick?”
“No, I’m as healthy as a horse.” Her hands shook. She walked back from Jacob’s desk and closed the door. “I want to talk with you about Zoe. I’m having problems with her.”
“You were her biggest fan. What happened?”
“What happened was time and experience. She’s lovely and charming and, no question, she’s an asset to the practice...”
“I’m waiting for the ‘but’.”
“When she first came, she charmed everyone, including me. She’s smart and her patients love her, but I don’t think she really likes what she’s doing, and its beginning to show. In addition, I have questions about her character.”
“Go ahead.”
“Maybe you spoiled me, Jacob,” she paused in thought. “No, it’s more fundamental than that. When you say something, I know you mean it. When you promise something, I know, barring death, that you’ll do it. When you tell me something, I know it’s the truth.”
“You’re holding me to too high a standard.”
“Sure I am.” She smiled. More serious now, she continued, “Let me give you a few examples. Do you remember the situation with Peggy Weiss?”
“Of course. What about it?”
“That’s so typical of you. When you commit to someone, you view them through the lenses of a loving father.”
“Mea culpa...you’re right, of course. What’s the point?”
“The point, Old Man, is that if anyone else treated one of our patients like Zoe treated Peggy, you’d be all over their case. With Zoe, you didn’t even see the problem.”
“That’s petty stuff. She’s busy and maybe doesn’t manage her ti
me well.”
“You’re a sweetheart, Jacob, and too loyal. I love you for it, but phone calls are important. Patients waiting for critical results, waiting to find out about their loved ones, needing a sympathetic ear...their physician’s ear. It’s cruel. You’d never do such a thing.”
“What else?”
“Haven’t you noticed that you’re doing lots of referral notes and reports?”
“Yes?”
“We keep them away from Zoe. She promises, but never gets them done.”
“What else?”
“I’m sorry, Jacob. I know you don’t like to hear these things, but you need to know.”
“You’re right. Go ahead.”
“This may be more symbolic than important, but it shows Zoe’s attitude toward her patients. She sees patients with complicated problems too quickly. She’s got to be cutting corners. For what...to find time to talk with her stockbroker?
“Often, I’ll find her standing in the doorway of her office talking with her patient. She did it recently with Brenda Gomez. It’s a clear message to her patients...get out, I’m through with you. The staff sees it and they resent it. She thinks she’s so slick about it, but patients are beginning to recognize her disinterest. A few of Zoe’s patients have requested to transfer their care to you. It’s just wrong. It’s not the way we treat patients in this office.”
“Anything else?”
“Yes. When you consider what I’ve said so far, this is going to sound strange. At first, I thought Zoe was trying to be helpful, but now I’m not so sure.”
“What is it?”
“She’s sticking her nose into the business aspects of the practice, asking for financial information, billing procedures etc. The staff resents this as an intrusion.”
“That seems appropriate to me, Margaret. If she’s going to be a partner, she’s entitled to know and have input into how we do business.”
“Sure, but then she takes every opportunity to cull off your patients, like if you’re late to the office or if you’re delayed with a patient. Again, at first I thought she was trying to be helpful, but now I’m getting the feeling that she’s trying to subvert you.”
“All this is a little disturbing. I’ll talk with her.”
“Okay, but don’t be her grandfather. If you want to help her, be tough. Find out what’s really going on.”
After Jacob and Lola cleared the dinner table that evening and loaded the dishwasher, Jacob paraphrased Margaret’s observations.
“Have you noticed anything, Jacob?”
“Not really. You know me. Once I commit myself emotionally to someone, it’s difficult for me to look behind the curtain of my own conviction.”
“Nothing?”
“Well, nothing specific, except several times I felt that she questioned my judgment.”
“Jacob, sweetheart, you were born arguing with physicians and nurses, you’re an expert. Zoe questions something, yet you say nothing. Weren’t you disappointed a little? Didn’t she hurt your feelings?”
“When you talk about feelings, I get an irresistible impulse to head for the door. Anyway, it wasn’t like that, it’s just...”
“Like Zoe’s the daughter you never had, and unlike our boys, she’s the one who followed you into the profession.” Lola smiled and then caressed Jacob’s cheek. “Don’t fight me on this. You know I’m right.”
“I’m not fighting, but how would you like to live with a mind reader?”
“I’m not reading your mind, but when you’ve lived with someone for almost sixty years and if you’re a shrink, well, you can’t help yourself.”
“You’re too damn smart. Combine that with experience and charisma, you’re a force.”
“I hate the word ‘charisma’, it’s sounds pretentious or ultra-religious, like charismatic.”
Jacob patted Lola’s hand. “Choose your own words, but patients love you. In the early days, I had little regard for psychiatry, but you made me a believer. You really help your patients. In my mind, that makes you a superstar.”
Lola reddened. “Superstar? You’re embarrassing me. You made me blush, you old fart.”
Jacob put his arms around his wife, and thought Lola’s the best thing that ever happened to me.
Lola wiped her eyes. “Now, where were we?”
“Zoe. We were talking about Zoe.”
“Well, one thing for sure, I wouldn’t dismiss anything Margaret has to say.”
“I’m not. That’s why we’re having this discussion. I plan to talk with Zoe, and I thought, since you know her, you might have some insight.”
“I don’t keep myself in shrink mode all the time, but I did notice a few things that concerned me.”
“Like what?”
“I’m going to mention some small things, trivial things, if you like, but perhaps these shine light into her personality. When we first met Zoe and Byron, she made sure to introduce him as ‘professor’, and then treated him with disdain.”
“I never noticed.”
“You probably didn’t notice that you offended her when you failed to fuss over the wine they brought.”
Jacob smiled. “I’m a terrible person.”
“Remember the day I came to meet you for lunch?”
“Yes.”
“Zoe and I chatted for a while and she confided that she wasn’t all that happy with her marriage, wondering how we managed with our busy schedules. She told me about her passing interest in Jews for Jesus and Kabbalah.”
“Bernie must have loved that.”
“She knew he’d hate it, but made no attempt to hide it. I don’t believe that she really understood how he felt about that, especially as a holocaust survivor.”
“She’s spoiled. Bernie said that he argued with Maury, his son, about giving her too much. Maybe she turned out to be a Jewish American Princess.”
“I don’t think so. Sure she’s selfish and self-involved, but I see more.”
Jacob stretched, and then shifted his position on the couch. “You’ve thought about this?”
“Yes. In my experience, there’s a distinction between describing someone’s personality characteristics and identifying them as psychopathology. Everyone can be selfish, paranoid, and a bit narcissistic, but that doesn’t rise to the level of a psychiatric diagnosis. The threshold for diagnosis is disruption. When these characteristics lead to disruption of a life then we label them with a type of personality disorder.”
“You think Zoe has a personality disorder?”
“I don’t know, but I’m suspicious.”
Jacob stared at the ceiling, shook his head, and then smiled. “Maybe you’re right. I’m suspicious of any woman who doesn’t appreciate her husband.”
Chapter Forty-Six
My sessions with Sarah Hughes are going well, Lola thought. As if a weight lifted from her shoulders, Sarah progressed from depressed and withdrawn to lighthearted and optimistic. This morning, she bounded into Lola’s office wearing shorts and a tank top. She virtually jumped into the soft easy chair across from Lola.
Lola smiled. “You look like you’re in a good mood this morning.”
“I feel great.”
“Anything special happening?”
“No, but I’m finding joy in the simple things...the things that I dismissed before. Like last night, I went to dinner with the ‘rents’. We talked and everything...no pressure...no lectures. It was terrific.”
“Maybe they’ve learned something too.” Lola rubbed her chin. “I’m a little out of touch, but when I hear the term ‘rents’ it sounds disdainful. Is it?”
“Maybe you’re right, although I didn’t mean it that way. It’s the way kids talk about their parents, and most of the time it’s not a compliment. I’ll try to break the habit.”
“How’s it going at school?”
“You won’t believe how cliquish school can be. Once I decided that hanging with my old friends was a bad idea, I took time to move into other groups, bu
t with the clubs and the school newspaper, it’s worked out okay.”
“How did your old friends take it?”
“Those losers? They were pissed that I bailed on them, but I don’t give a damn.”
“What about Kelly Cowan? You guys were close.”
Lola watched Sarah cross her arms in an embrace. It didn’t take a psychotherapist to see the effect of that name on Sarah. The room suddenly grew colder. “I’m sorry, Sarah. Why are you upset at the mention of her name?”
“They talked to you about Kelly?”
“They, who?”
“My parents.”
“Absolutely not. I told you I wouldn’t talk with them behind your back. I knew about your friendship with Kelly from the girls in the program. They said you two were close.”
“Yeah, until she went bonkers.”
“You’re sitting with a psychotherapist and you’re criticizing a friend because she needed psychiatric help. I don’t buy it, Sarah. What’s going on?”