by Robin Cook
Throwing back the bedcovers, she pulled on her robe and slipped her toes into her slippers. As she walked into the bathroom she could feel the discomfort more distinctly. Now it was more like pain, but still quite mild.
As a doctor considering these two symptoms, Laurie’s first concern was early appendicitis. She knew there were a lot of things that could go wrong in the right lower quadrant, and that the diagnosis could be challenging at times. But she knew she was jumping the gun. It was the kind of hypochondriasis she had indulged when she was a medical student. She smiled as she remembered a simple headache in her first year that made her worry that she was coming down with malignant hypertension simply because she’d studied the syndrome the night before. Of course, she didn’t have malignant hypertension, and in a similar fashion, her discomfort and nausea were almost completely gone when she got out of the shower.
Laurie wasn’t hungry, but she forced herself to eat a piece of toast. When that went down okay, she had some fruit. She was convinced that having something in her stomach would help, and it did. By the time she was ready to leave for the OCME, she felt pretty much like her old self.
She waved to Mrs. Engler when the woman’s door cracked open. This time, the bleary-eyed harpy actually spoke, advising Laurie to get her umbrella, since it was supposed to rain.
It was a mild morning, and although overcast, it wasn’t yet raining. Laurie walked north along First Avenue, oblivious to the crush of traffic, wondering if her nausea could be psychosomatic due to stress. What else is new? she thought dejectedly, since she’d never seemed to be able to get her social life to run as smoothly as her professional life.
Laurie’s whirlwind five-week relationship with Roger had recently hit an unexpected bump. They had been seeing each other two or three times a week, as well as every weekend. Laurie didn’t consider the current bump an insurmountable obstacle, but it had been jarring to a degree and made her remember that back in the beginning of their acquaintance, she’d warned herself that adolescent infatuations often did not withstand the test of time. The case in point was Laurie learning only two nights earlier that Roger was married. There had been plenty of opportunities for him to have told her this important fact, but he had chosen not to, for reasons Laurie couldn’t fathom. It was only after Laurie had forced herself to ask him directly that he’d owned up to the truth. He had married a Thai woman some ten years ago when he was stationed in Thailand, and had never gotten a divorce, although he was supposedly now seeking one. Even more upsetting for Laurie was that he’d had several children.
The story became somewhat less damning as it unfolded. The woman was from a wealthy, privileged family, to which she had selfishly returned, according to Roger, essentially abducting the children when Roger was transferred to Africa. Yet his withholding such information set a bad precedent and made Laurie wonder if Roger was not quite the person she had envisioned. It also underscored a growing uneasiness that Laurie felt about the speed of the relationship, coupled with Roger’s pressure for physical intimacy. On top of everything were her unresolved feelings for Jack.
The night before, as she sat in her apartment feeling sorry for herself about the previous night’s revelations, she had had a mini-epiphany. For the first time, she had acknowledged to herself that she actively and deliberately suppressed issues she didn’t want to talk about or even think about. She’d recognized this trait in her parents, particularly her mother, from as far back as Laurie could remember, and her mother’s way of dealing with her recent bout with breast cancer was a case in point. Laurie had always despised the trait. Yet she had never looked at herself in the mirror as her parents’ child. What made her come to the realization was that Roger’s marital status hadn’t been the surprise she liked to pretend. There had been hints, but Laurie had assiduously kept herself from acknowledging any of them. She simply did not want to believe that he was married.
At the corner of 30th Street, Laurie waited for the light to cross First Avenue. As she did so, she thought about how her newly acknowledged personality trait applied to her ailing relationship with Jack. With sudden clairvoyance, it seemed rather clear. She had wanted to put all the blame on him for being noncommittal about their future and for not bringing up the issue of marriage and children. Now she realized she had to share some of the blame as she had failed to bring it up herself. She also realized that his offer to broach the subject on a regular basis had actually been a concession on his part, maybe not a monumental one, but a concession nonetheless. How she was going to communicate all this to Jack, she had no idea. The last time they had spoken on any kind of personal level had been five weeks earlier.
As the light changed and she hurried across First Avenue and up the front steps of the OCME, she thought that having met Roger complicated things. Rather than having problems with one man, she now had problems with two. Although she cared for both of them, she knew she loved Jack, and she found herself longing for his uncompromising candor. Part of the reason she’d gone out with Roger in the first place was to make Jack jealous, an adolescent machination worsened by two complications: First, she hadn’t expected to be as attracted to Roger as she had become; and second, she hadn’t expected the jealousy ploy to work so well.
Although Laurie felt that Jack loved her, his enduring reluctance to make any commitment convinced her his love was not the same as hers. Specifically, he had never made her feel that he valued their relationship as much as she did. She was convinced that he wasn’t going to change and that he was incapable of jealousy.
But now, thanks to his current behavior, she felt differently. The tone of their interactions and conversations had deteriorated over time. When she had first moved back to her apartment, there’d been flippant sarcasm. After she started seeing Roger, it had become nastier, and it made Laurie feel terrible. A month ago, when Jack had asked her to have dinner with him and she told him she had plans to go to the symphony with Roger on the evening in question, Jack had responded by telling her to have a good life. He didn’t suggest an alternative date. The implication was that he didn’t even want to remain her friend.
Waving to Marlene, the receptionist, as she buzzed her into the ID room, Laurie had to smile. The whole situation smacked of a soap opera, and she told herself to put thoughts of the two men out of her mind. Clearly, changing her behavior or anyone else’s was not going to be the easiest thing in the world.
Laurie draped her coat over one of the club chairs in the ID room, placed her umbrella on top, and went directly to the coffee machine. It was Chet’s turn to decide which cases needed to be posted, and he was hard at work, bent over a stack of folders.
Laurie stirred her coffee and checked the time. It was still before eight, but certainly not as early as she used to get in with Jack. She noticed that Vinnie wasn’t there reading his newspaper, suggesting that he was already down with Jack, doing an autopsy. The only sounds Laurie could hear were the chatter of the operators in the communications room, preparing for the day. Laurie enjoyed the relative solitude, knowing that in an hour, the place would be humming with activity.
“Is Jack already downstairs?” Laurie asked, taking a sip of her coffee.
“Yup,” Chet said without lifting his head. Then, suddenly, he looked up when he recognized the voice. “Laurie! Great! I was supposed to give you a message if you came in before eight. Janice is very eager to talk with you. She’s been in here twice.”
“Was it about a recent postoperative patient from the General?” Laurie questioned, her eyes lighting up. She had asked Janice to be sure to let her know if another such case surfaced. If it had, it would mean that not thinking about the two men in her life would be considerably easier, as her four suspicious homicide cases would grow by a hefty twenty-five percent. The two cases she had posted, McGillin and Morgan, she had yet to sign out. The other two had been signed out by Kevin and George, citing the manner of death as natural, a conclusion that Laurie had opposed.
“No, it was
n’t a patient from the General,” Chet said with a teasing smile that Laurie failed to detect. Laurie’s shoulders slumped in disappointment. “It wasn’t one, but rather two!” He reached out and tapped the top of two folders he’d put aside. He then gave them a gentle push in Laurie’s direction. “And both obviously need to be posted.”
Laurie snatched them up and looked at their names: Rowena Sobczyk and Stephen Lewis. She quickly checked their ages: twenty-six and thirty-two, respectively. “Are they both from the Manhattan General?” she asked. She wanted to be sure.
Chet nodded.
For Laurie, it seemed almost too good to be true from the standpoint of a diversion. Her series would grow to six cases, not five. That was a fifty percent increase. “I’d like to do these two cases,” she said hastily.
“You got them,” Chet responded.
Without another word, Laurie grabbed her coat and umbrella. With the folders under her arms, and balancing her coffee as best she could, she quickly headed through communications and the clerical room on her way to the forensic investigators’ office. She was beside herself with curiosity. She’d had to eat a bit of crow over the course of the previous five weeks, as her supposed serial-killer scenario had failed to materialize as a viable possibility and had been dismissed by everyone except Roger. Jack had used the issue to tease her rather sarcastically on several occasions. Even Sue Passero had been dismissive after making what she described as multiple, discreet inquiries around the hospital. Luckily, Calvin had not brought up the issue at all. Nor had Riva.
The hospital charts on the original four cases had eventually arrived in Laurie’s office, and she had completely filled in her matrix but found no smoking gun. In fact, there was no way the cases were related. There were different surgeons, mostly different anesthetists, a variety of anesthetic agents, a significant variation of preoperative and postoperative drugs, and differing locations in the hospital. Worst of all, the toxicology results were completely negative, despite Peter pulling every trick that he could think of with the gas chromatograph and the mass spectroscopy. For Laurie’s benefit, he had truly gone out of his way to find even the most minute traces of an offending agent. And with no agent, no one was willing to give the serial-killer idea any credence, especially since there had been no more cases after Darlene Morgan. Everyone relegated the four cases to the wastebasket of statistical oddities occurring in the inherently dangerous environment of the hospital.
As Laurie popped into the forensic investigators’ office, Bart looked up from his desk. “You’re just in time,” he said, and pointed to the rear of the room to make his point. Janice was in the process of pulling on her coat.
“Dr. Montgomery,” she said. “I was afraid I was going to miss you. I’ve run out of steam, and my bed is calling.” She peeled off her coat and after draping it over her desk chair, sat down heavily.
“Sorry to hold you up,” Laurie said.
“No problem,” Janice said gamely. “This won’t take but a minute. Are those the Lewis and Sobczyk folders you’ve got?”
“They are,” Laurie said, pulling up a chair. Janice took the folders, opened them, and took out her reports, handing them back to Laurie.
“Both these General cases remind me of the other four you were interested in,” Janice said as Laurie scanned the write-ups. Janice cupped her tired face in her hands and leaned her elbows on the desk. She took a deep breath before continuing. “In short, both were young and healthy, both seemed to die of an unexpected cardiac problem, both had had minor surgery less than twenty-four hours earlier, and both obviously could not be resuscitated.”
“They sound remarkably similar,” Laurie agreed. She looked up. “Thanks for giving me a heads-up. Was there something in particular you wanted to tell me that’s not in your summaries?”
“It’s all there,” Janice said. “But there is something I want to emphasize. Although most parameters with the Sobczyk woman are the same, there is one thing that is different. When she was found by the nurses, she was in extremis but still alive. Unfortunately, that quickly changed, despite strenuous intervention. Lewis, on the other hand, had no cardiac or respiratory activity when he was found by nurse’s aides.”
“Why do you think that’s important?”
“Just because it’s different,” Janice said with a shrug. “I don’t know, but last time you spoke with me, you asked me if I had sensed something intuitively about the Darlene Morgan case. I hadn’t, but with Sobczyk, the fact that she was still alive jumped out.”
“Then I’m glad you told me,” Laurie said. “Anything else?”
“That’s it. The rest is in the reports.”
“Needless to say, I’ll like copies of the hospital charts.”
“They have already been requested.”
“Great!” Laurie said. “I’m glad you told me this. If you think of anything else, you know where to find me.”
Laurie gathered up her belongings and went out to the back elevator, eager to get to work. She couldn’t remember being this excited in weeks. As the elevator rose, she thought about what Janice had told her. She wondered if it would be important.
Dashing into her office, Laurie hung up her coat and put her umbrella on top of the file cabinet. Sitting at her desk, she opened both folders and again took out Janice’s reports. After rereading them more carefully, she leaned over, opened one of her desk drawers, then took out the matrix she had drawn from the original four cases. It was attached with a rubber band to the Morgan and McGillin folders, along with copies of the pertinent portions of the other two cases. Undoing the parcel, she held the McGillin folder for a second. She hadn’t been able to give the definitive word to Dr. McGillin about his son’s death as she had so confidently promised, and it made her feel guilty. She hadn’t even spoken with the man in weeks, even though she’d promised to get back to him. As she put the folder down with the other, she made a mental note to call him. She wondered what the man would say if she told him she was entertaining the idea of a serial killer.
Feeling confident in Janice’s assessment, Laurie went ahead and added Lewis and Sobczyk to the matrix, even though she had yet to do the posts. Since Janice anticipated Laurie’s interest, she had done a very complete job on both cases. Even without the hospital charts, Laurie could fill in the boxes for the patients’ ages, the times they had been pronounced dead, their MDs, the surgical procedures they’d undergone, and where in the hospital they’d had their rooms. While Laurie was busy doing this, Riva arrived.
“Adding to that matrix of yours?” Riva questioned, glancing over Laurie’s shoulder.
“There are two more presumed cases. That’s going to make six. Obviously, I haven’t done the posts yet, but they sound exactly the same. Want to change your idea about the manner of death? I mean, this is going to be a fifty percent increase.”
Riva laughed. “I don’t think so, especially since the toxicology has been negative, and I for one happen to know how hard Peter has tried. By the way, how’s your mother? I keep forgetting to ask.”
“She’s doing surprisingly well,” Laurie said. “Of course, I don’t hear much, since she’s acting like the whole thing never happened.”
“I’m glad she’s doing well,” Riva said. “Give her my best! Hey, how is that new beau of yours? You’ve been uncharacteristically silent about him.”
“It’s going well,” Laurie said vaguely. Riva was right; Laurie had not shared much about Roger. Picking up her phone before Riva could ask any more questions, she called down to the mortuary office. She was pleased when Marvin answered. She told the tech about the two cases and said she wanted to do Sobczyk first. With his usual alacrity, he told Laurie he’d be waiting for her.
“See you in the pit,” Laurie said to Riva as she scooped up Sobczyk and Lewis’s folders. As she descended in the elevator she prepared herself mentally for the cases, which was easy, since she half assumed and half hoped she wasn’t going to find much. By the time she had change
d into scrubs, donned her moon suit, and pushed into the autopsy room, Marvin was almost ready. On the way to her table, she had to pass Jack’s.
Recognizing Laurie, Jack glanced at the wall clock before straightening up from the opened body of a sizable elderly lady. A portion of her gray, stringy hair had been shaved to reveal a punched-out, depressed fracture of the skull on the top of her head. “Dr. Montgomery, it appears as if you are adopting banker’s hours these days. Let me guess! I bet the explanation is that you were out painting the town red with your French boyfriend.”
“Very funny,” Laurie said. She fought against her irritation and the urge to walk on. “Actually, you are wrong on both counts. I was home last night, and Roger is as American as you or I.”
“That’s strange,” Jack said. “Rousseau sounds so French to me. Wouldn’t you agree, Vinnie?”
“Yeah, but my name’s Italian, and it doesn’t mean I’m not American.”
“My gosh, you’re right!” Jack said with false contrition. “I guess I’m jumping to conclusions here. Sorry!”
Laurie was embarrassed at Jack’s behavior and the jealous anger he was doing a bad job of repressing. But under the circumstance of being in the autopsy room with Vinnie, she chose to change the subject. She pointed to the elderly woman’s depressed skull fracture. “I see you have a rather obvious cause of death here.”
“The cause maybe, but not the manner,” Jack said. “Such cases are becoming my specialty.”
“Would you care to explain?” Laurie questioned.
“Are you really interested?”
“I wouldn’t be asking if I weren’t.”
“Well, the victim was hastily off-loaded from a cruise ship in the middle of the night. The cruise company claimed an inebriated elderly lady had a fatal fall in the bathroom of her stateroom. They reported there was no suspicious behavior and no violence involved. But I don’t buy it, although she might have been drunk.”