Marker

by Robin Cook

  “What kind of case is he doing?” The warmth of the coffee gave her a contradictory shiver.

  “It’s interesting you should ask. He took a case just like the two you got yesterday.”

  Laurie took the cup away from her lips. Her mouth opened in an expression of surprise. “You mean a case from the Manhattan General?”

  “Yup! Fairly young guy who’d had a routine hernia repair and then promptly checked out for good.”

  “Why did Jack take it? He knows I’m interested in those cases.”

  “He did it as a favor.”

  “Oh, come on, Chet. What do you mean as a favor?”

  “Apparently, Calvin had left word with Janice that if another such case came in, she was to give him a call. Obviously, she did, because he came in just about the same time as Jack and checked it out. When I arrived, he told me specifically he didn’t want you doing it. In fact, he said that you were to have an official paper day today, so you’re free and clear. Anyway, Jack then offered to do the case because he said you’d probably want the results sooner rather than later.”

  “Why did Calvin say that he didn’t want me doing it?” Laurie questioned. It seemed like a deliberately low blow, since the diversion of her series was the only thing she had going for herself in the face of all her problems.

  “He didn’t say. And you know Calvin; it wasn’t as if he was about to offer. He just made it crystal clear you weren’t to do it. He also said that when I saw you, I was supposed to tell you he wanted to see you in his office ASAP. So the message has been delivered. Good luck!”

  “That’s weird. Did he sound angry?”

  “No worse than normal.” Chet shrugged. “I’m sorry. That’s all I can tell you.”

  Laurie nodded as if she understood, but she didn’t. Leaving her coat on one of the ID office’s club chairs, she retraced her route back out through the ID room and into the main reception area. She was nervous. With everything else in her life, in her words, “going to hell in a handbasket,” she wouldn’t have been surprised if her career was somehow in jeopardy as well, although she had no idea what she could have done to irritate Calvin, other than perhaps giving her impromptu talk at yesterday’s conference. But after the fact, when she’d spoken with him, everything seemed to be all right.

  Laurie had Marlene buzz her directly into the administration area, which was tomblike in its stillness. None of the secretaries had yet arrived. Calvin, however, was in his office, scanning documents from his in basket and hastily signing them. He continued the last couple even after Laurie had announced herself. He motioned for her to sit while he gathered up the stack of signed papers and slipped them into his out basket. Then he sat back and eyed Laurie over the top of his rimless glasses, with his chin practically on his chest. “If you don’t already know, the name of the potential new case is Clark Mulhausen, and I suppose you want to know why I insisted you don’t do it.”

  “That would be nice,” Laurie said. She was relieved. Calvin’s tone was hardly strident, suggesting that he wasn’t mad and she wasn’t about to be harangued or, worse yet, put on administrative leave.

  “The long and short of it is that you have yet to sign out those original cases in your so-called series from over a month ago. At this point, you can’t be waiting for any other lab work or whatever, so you’ve got to get them done. To be honest, the chief has been feeling some heat about them from the mayor’s office for God knows what reason. Whatever it is, he let me know he wants them signed out, which means I’m getting heat. Maybe it has something to do with insurance and the families. Who knows? One way or the other, get them done! I gave you a paper day to make sure it happens. Fair enough?”

  “I haven’t signed them out because I can’t in good conscience say they were either accidental or natural, and I know you don’t want me to say they were homicides, because that would suggest a serial killer, and I don’t have any proof—at least not yet.”

  “Laurie, don’t give me a hard time,” Calvin said. He leaned forward intimidatingly, extending his huge head toward her and impaling her with his dark, menacing eyes. “I’m trying to be nice about this. I’m also not trying to stop you from looking into the possibility they are causally related, but for now you’ve got to choose between accidental or natural. I favor natural, like Dick Katzenburg, because there’s no more proof they were accidental than homicidal. The death certificates can always be amended if and when new information becomes available. We can’t leave the cases in limbo forever, and you can’t create a PR firestorm by calling them homicidal or even accidental without some specific justification. Be reasonable!”

  “All right, I’ll do it,” Laurie said with a defeated sigh.

  “Thank you! But damn! You make it sound like I’m asking for the moon. And while we’re on the subject, what have you found out about the Queens cases? Do they fit the same demographics?”

  “So far,” Laurie said in a tired voice. She slouched forward, looking down at the floor with her elbows resting on her knees. “At least from what I could get out of the investigator’s reports. I’m waiting on the charts.”

  “Keep me apprised! Now, get up there to that office of yours and sign out those Manhattan General cases!”

  Laurie nodded and got to her feet. She gave Calvin a crooked smile and turned to leave.

  “Laurie,” Calvin called after her. “You’re acting browbeaten, which is not like you. What’s up? Are you all right? You’ve got me worried here. It distresses me to see you, of all people, moping around.”

  Laurie turned back to face Calvin. She was taken aback. It was not like him to ask personal questions, much less suggest concern. She hardly expected that from any authority figure, especially not the often-curmudgeonly Calvin. The surprise caused unwelcome stirrings of emotion within her, which immediately threatened to surface. Since the very last thing she wanted to do was break down in front of her often-chauvinistic superior, she fought the impulse by taking a deep breath and holding it for a minute. Calvin’s eyebrows slowly arched, and he leaned forward more, as if to encourage her to speak.

  “I guess I’ve got a lot on my mind,” Laurie said finally. She was afraid to make eye contact.

  “Do you care to elaborate?” Calvin asked in a voice that was significantly more mellow than usual.

  “Not at the moment,” Laurie said while flashing Calvin the same crooked smile.

  Calvin nodded. “Fair enough, but remember, my door is always open.”

  “Thank you,” Laurie managed before fleeing. As she walked down the main first-floor corridor, she felt a mixture of feelings to add to her chaotic thoughts. On the one hand, she felt lucky to have gotten away without an emotional scene, while at the same time, she was irritated with herself about yet another episode of her embarrassing demonstrativeness. It was ridiculous that she had to fight against shedding a tear because her boss evidenced a bit of solicitude. On the other hand, she was impressed at having witnessed a side of the deputy chief that she had never seen. And after the nervous pessimism that the call to Calvin’s office had evoked, she felt relief that she was still employed. If she’d been put on leave for some real or imagined transgression, she wasn’t sure she could have handled it. With the new concern about being pregnant combined with her other anxieties, the diversion that her job provided was needed more than ever.

  Sticking her head into the investigator’s office, she asked the chief investigator, Bart Arnold, if Janice was still around. Laurie wanted to learn the details of the Clark Mulhausen case, to be certain it was another to be added to her series.

  “You missed her by about ten minutes,” Bart said. “Anything I can help you with?”

  “Not really,” Laurie said. “How about Cheryl? Is she available?”

  “You’re striking out. She’s already out on a case. Should I have her call you when she returns?”

  “You can relay a message,” Laurie said. “Yesterday, I asked her to put in a request for hospital charts fro
m Saint Francis Hospital out in Queens. I’d like her to amend the request and make it urgent. I need them as soon as possible.”

  “No problem,” Bart said, as he made a note on a Post-it. “I’ll put this on Cheryl’s desk. Consider it done.”

  Laurie headed back toward the ID office to retrieve her coat, but she thought of Jack down in the pit doing the autopsy on Clark Mulhausen. He would have the folder with Janice’s investigative report, which would have all the particulars. Reversing her course, she headed for the back elevator. Not only could she make sure Mulhausen fit the demographics of her series, she’d have an excuse to talk with Jack. Remembering her waffling the previous afternoon outside of Jack’s office, it would be good to have a professional reason to break the ice with him and give her the opportunity to suggest that they get together away from the OCME for a personal discussion. The thought of the kind of conversation she needed to have with him made her tense. In his current state of mind, she had no idea whether or not he’d be receptive either to meet with her or to what she had to tell him. Lou had suggested he would be, but Laurie didn’t know.

  In days past, a gown, a hat, and a mask were all that was needed to drop into the autopsy room for a visit to check out a finding or have a short conversation. Times had changed. Now Laurie had to go into the locker room and change into scrubs before heading over to the supply room to get into her full protective gear, as if she was doing a case herself. Calvin had established the new rules, and they were supposedly cut in stone.

  “Ahhh!” Laurie whimpered as she extended her arm while hanging up her blouse in the locker. She had gotten a sudden stitch in that same abdominal location that had been intermittently troubling her over the previous few days. This time, it was definitely a sharp pain that made her wince as well as withdraw her hand. Gingerly, she placed it over the bothersome area. Thankfully, the pain quickly eased and then disappeared as suddenly as it had appeared. Carefully, she pressed in over the area, but there was no residual tenderness. She extended her arm as she had done when hanging the blouse, but still there was no discomfort. Shaking her head with confusion over whether it had anything to do with being pregnant, she thought maybe she should ask Sue whether she had experienced anything similar during her two pregnancies.

  With the memory of the pain fading into the background, Laurie continued changing into scrubs, and then headed across the hall to climb into her moon suit. A few minutes later, she pushed into the autopsy room. As the heavy door thumped against the jamb behind her, the two people in the room straightened up from bending over the body splayed open in front of them. They both looked over at her.

  “Well, glory be!” Jack quipped. “Is this really Dr. Montgomery already in full regalia, and it is not even eight o’clock? To what do we owe this great honor?”

  “I just want to find out if this case truly fits into my series.” Laurie said as lightly as she could while bracing herself for Jack’s probable continued sarcasm. She advanced to the foot of the table. Jack was on her left and Vinnie on her right. “Please! Go back to work! I don’t mean to interrupt.”

  “I don’t want you to think I took this case away from you. Do you know why I’m doing it?”

  “I do. Chet told me.”

  “Have you seen Calvin yet? I couldn’t read him this morning. He was acting weird. Is everything hunky-dory between you two?”

  “Everything is fine. I was worried myself when Chet told me I was to have an official paper day and that Calvin wanted to see me ASAP. It turned out that all he wants is for me to sign out the earlier cases in my series. I’m supposed to say they were natural.”

  “Are you going to do it? I’m thinking there’s no way they were natural.”

  “I don’t have a lot of choice,” Laurie admitted. “He laid it on the line. I hate the political pressures of this job, of which this situation is becoming a prime example. But, be that as it may, what’s your take on Mulhausen. Does this case belong in my series?”

  Jack looked down into the corpse’s open thorax. He’d already removed the lungs and was in the process of opening the great vessels. The heart was in full view. “So far, I’d have to say yes. The demographics are the same, and I don’t see any suggestion of pathology of any note. I’ll know for sure in a half hour or so when I finish with the heart, but I’ll be very surprised if we find anything.”

  “Do you mind if I look at the investigator’s report in the folder?”

  “Mind? Why would I mind? But I can save you the trouble by giving you the facts. The patient was a healthy thirty-six-year-old stockbroker who’d had an uncomplicated hernia repair yesterday morning and was doing fine. Four-thirty this morning, he was discovered dead in his bed. The nurses’ notes said he was practically room temperature when he was found, but they tried to resuscitate him anyway. Obviously, they got nothing. So, do I think he fits your series? I do. What’s more, I think you are genuinely onto something with this series idea. Obviously, I didn’t at first, but I do now, especially now that you’ve got seven cases.”

  Laurie tried to see the nuances of Jack’s expression, but she couldn’t through his plastic screen. Still, she was encouraged. Somewhat like Calvin, he was acting more affable than expected, and it made her feel optimistic on a number of fronts.

  “What about those cases Dick Katzenburg mentioned yesterday?” Jack asked. “Have they panned out so far?”

  “Yes. At least from the investigators’ reports. I’m waiting for the hospital charts to be certain.”

  “It was a good pickup,” Jack said. “Yesterday, when you got up to go to the microphone to give your little presentation, I was pissed, since it meant that the Thursday-afternoon torture session was going to be extended, but now I have to give you credit. If Dick’s cases do turn out to match yours, your series doubles, which kind of casts a pall over AmeriCare, wouldn’t you say?”

  “I don’t know what it says about AmeriCare,” Laurie said. She was surprised at Jack’s talkativeness. Even that seemed encouraging.

  “Well, as the saying goes, something’s rotten in Denmark: At thirteen cases, it’s gone way beyond coincidence. But it’s interesting there’s no smoking-gun commonality, which is why I hesitate to support your homicide idea, although I’m warming to it. Tell me, have any of the cases occurred in the intensive care unit or the postanesthesia care unit?”

  “None of mine. I don’t know about Dick’s. Mine have all been in regular hospital rooms. Why do you ask? Was Mulhausen in either?”

  “No! He was in a normal room. I’m not sure why I’m asking. Maybe because drugs are handled differently in either the ICU or the PACU than they are on a regular hospital floor. Actually, I’m trying to think of some sort of systems error, like they are all getting a drug that they are not supposed to get. It’s just something else to consider.”

  “Thanks for the suggestion,” Laurie said without a lot of conviction. “I’ll keep it in mind.”

  “I also think you should continue to press toxicology. I still think that ultimately, it’s going to be toxicology that solves this conundrum.”

  “That’s easy to say, but I don’t know what else I can do. Peter Letterman has really gone out of his way, trying to the point of thinking about minutiae. Yesterday, he was talking about checking into some kind of unbelievablely potent toxin from a South-American frog.”

  “Whoa! That’s a bit far afield. That calls to mind the adage, ‘When you hear hoof beats, think of horses, not zebras.’ Something is interrupting these people’s cardiac conduction system. I can’t help but believe it’s got to be a garden-variety arrhythmia drug. How they are getting it is another story.”

  “But that certainly would have shown up in toxicology.”

  “That’s true,” Jack agreed. “What about a contaminant in their IV fluid? Have they all had IVs running?”

  Laurie thought for a minute. “Now that you mention it, they have. But it’s not unusual, since most people who’ve had surgery keep an IV for at least t
wenty-four hours. As far as a contaminant in the IV fluid is concerned, it passed through my mind, but it is extremely unlikely. If a contaminant were involved, we’d have more cases than we have, and it certainly wouldn’t favor the relatively young and healthy, nor just patients having had elective surgery.”

  “I don’t think you should eliminate anything out of hand,” Jack said. “Which reminds me of the question about electrolytes the fellow from Staten Island asked you yesterday after you made your presentation. You told him the levels all tested normal. Is that true?”

  “Absolutely. I made it a point to ask Peter to check into that specifically, and he reported back that they were all normal.”

  “Well, it certainly sounds as if you are covering all the bases,” Jack said. “I’ll finish up with Mulhausen just to be sure there’s no emboli or cardiac pathology.” He repositioned the scalpel in his hand and bent over the corpse.

  “I’m trying to think of all the possibilities,” Laurie said. Then, after a moment’s hesitation, she added, “Jack, could I speak to you for a moment on a personal note?”

  “Oh, for Christ’s sake!” Vinnie said suddenly. He’d been impatiently shifting his weight from one foot to the other during Laurie and Jack’s extended conversation. “Can’t we get this freaking autopsy done?”

  Jack straightened back up and looked at Laurie. “What is it you want to talk about?”

  Laurie glanced at Vinnie. She felt awkward in his presence, especially considering his impatience.

  Jack noticed Laurie’s reaction. “Don’t mind Vinnie. With as much help as he is as an assistant, you can just pretend he’s not here. I do it all the time.”

  “Very funny,” Vinnie responded. “How come I’m not laughing?”

  “Actually,” Laurie said, “I don’t want to talk with you now. What I’d like to do is arrange for us to get together. There are some important things I need to share with you.”

  Jack didn’t answer right away but rather stared at Laurie through the plastic face masks. “Let me guess,” he said finally. “You’re getting married, and you want me to be a bridesmaid.”