by Robin Cook
“That might even be a better idea than mine,” Laurie admitted. “If I were asked who I would consider the most likely suspect in the hospital community, I’d have to say a deranged doctor. It’s passed through my mind that if these deaths are homicides, then whoever is responsible must have a significant knowledge of physiology, pharmacology, and maybe even forensics. Otherwise, we’d already know how he or she is pulling it off.”
“And we both know which group of doctors is the most knowledgeable in those regards.”
“Who?”
“Anesthesiologists.”
Laurie nodded. It was true that anesthesiologists would be the most skillful at dispatching patients, yet despite her comments, she had trouble believing as a doctor herself that a doctor could be behind the killings. It seemed so contrary to a doctor’s role, but then again, it was contrary to the role of all healthcare professionals. And, of course, there was the staggering case in England of a doctor suspected of murdering upwards of two hundred people.
“How about jumping on this idea,” Laurie suggested. “I know it’s Friday, and people are not excited about having a new task plopped in their laps just before the weekend. But we have to do something, and we have to do it fast, and not only because it might prevent more deaths. It might be that our supposed serial killer is also smart enough to know that it would be safer for him to move to another hospital after a certain number of episodes. The assumption here is that he has moved once after six episodes, so there’s reason to believe he could move again after seven. If he does, then our equivalent colleagues at some other hospital, maybe even in another city, will be starting from square one. That was one of the reasons that the other recent, infamous healthcare serial killer here in the metropolitan area wasn’t caught for so long.”
“Hey, Queens might not have been his first hospital.”
“You’re right,” Laurie said with a shiver. “I never thought of that.”
“I’ll get right on it,” Roger promised.
“I’m on call all weekend,” Laurie said, “which means I’ll probably be at the OCME, so call me there. Whatever I can do to help, I’d be happy to do. I know the whole process will be more difficult than I have suggested.”
“We’ll see. Maybe I’ll be able to find a computer nerd in personnel who could help us.” Roger aligned the pages Laurie had given him. “Now, I have something rather interesting to tell you about our cases. By chance, I’ve uncovered a curious commonality.”
“Oh?” Laurie questioned. She was fascinated. “What is it?”
“Now, I don’t mean to suggest that this is significant, but it holds for all seven cases, including Mulhausen last night. All of them were relatively recent AmeriCare subscribers, having joined the plan within the year. I actually discovered it by accident, looking at their subscriber numbers.”
For a moment, Laurie stared at Roger, and Roger stared back. Laurie mulled over this new fact and tried to think how it could be connected. Nothing came to mind although it reminded her of Jack’s comment the day before during the afternoon conference when he learned St. Francis, another AmeriCare institution, had seemingly had a similar series of deaths like hers. He’d said, “The plot thickens.” She’d not had a chance to ask him what he had meant, nor did she follow up this morning when he’d said the new cases “cast a pall over AmeriCare,” but now that Roger had told her this new fact, she was even more eager to ask him to explain. Laurie knew that Jack had a visceral hatred for AmeriCare, which colored his thinking, but still, he was smart and also intuitive.
“I really don’t know if this is significant,” Roger repeated. “But it is curious.”
“Then it has to be significant in some form or fashion,” Laurie said. “But I don’t know how. These victims have all been young and healthy. AmeriCare actively recruits such customers. It’s to their detriment to lose them.”
“I know. It doesn’t make sense, but I thought I should inform you anyway.”
“I’m glad you did,” Laurie said. She stood up. “Well, I’ve got to get back. The reason I’m not doing Mulhausen’s autopsy is that I was supposed to go right up to my office and sign out McGillin and Morgan’s deaths as being natural this very morning.”
“Not so fast!” Roger said. He caught Laurie’s arm and, with a little pressure, eased her back down into her seat. “You’re not getting away that easy. But first, who’s forcing you to sign out the cases as natural?”
“The deputy chief, Calvin Washington. He claims that the Chief, Harold Bingham, is getting pressure from the mayor’s office.”
Roger shook his head. He had a disgusted expression on his face. “I’m not surprised, considering what the hospital president said to me yesterday. He said that I should know for my own good that AmeriCare wants this problem to fade into the woodwork.”
“That’s hardly surprising. It would be a PR nightmare. But how does it come through the mayor’s office?”
“I’m new to the organization, but I’ve gotten the sense that AmeriCare puts a lot of stock on being politically connected, as evidenced by them landing the city contract. I don’t have to remind you that healthcare is big business, and there’s always a lot of lobbying going on about a myriad of issues.”
Laurie nodded as if she understood, but she didn’t. “I’m going to sign them out as natural deaths, but I’m hoping with your help I’ll be changing the certificates in the near future.”
“Enough of this business talk,” Roger said. “More important, how are you? I’ve been really concerned, and frankly, I’ve had to hold myself back from calling you every fifteen minutes.”
“I’m sorry I’ve made you concerned,” Laurie said as her mind frantically searched for a way to placate Roger without lying and without telling him the crux of the problem. “But as I said yesterday, I’m holding my own. It’s just a difficult time for me.”
“I understand. I tried to imagine how I would feel if I had been told I had a marker for a gene that was associated with developing cancer and then allowed to walk out the door. The burgeoning field of medical genetics has to come up with a better way to present this kind of information to patients than they do now, along with some reasonable cures.”
“As someone who’s in the process of going through it, I’d have to agree, although the social worker did make an attempt. But American medicine has always been like that. Technology has been the driving force, pulling the sociology of patient care behind.”
“I wish I knew how to be more supportive for you.”
“I’m afraid at the moment you really can’t be. I’m caught up in my own personal odyssey. But that doesn’t mean I’m not appreciative of your thoughts, and you have been supportive.”
“What about tonight? Can we get together?”
Laurie peered into Roger’s pale eyes. It bothered her that she wasn’t being forthright, but she could not get herself to tell him she was pregnant and was having dinner with Jack because she and Jack had conceived a child. It wasn’t that she thought he couldn’t handle it, because she thought he could. It was more because of her sense of privacy, and until she told Jack, she didn’t want to share it with anyone, even someone she cared for, such as Roger.
“We could have an early dinner,” Roger urged. “We don’t even have to talk about the BRCA issue if you don’t want to. Maybe I’ll already have some personnel data from here or Saint Francis. I mean, it’s possible I could get some, even though, as you say, it’s Friday.”
“Roger, with everything that has happened to me recently, I need some space, at least for a few days. That’s the kind of support I need. Can you try to live with that?”
“Yes, but I don’t like it.”
“I appreciate your understanding. Thank you.” Laurie stood up again, and Roger did the same.
“Can I at least call you?”
“I suppose, but I don’t know how much I’ll want to talk. Maybe it would be better for me to call you. I’m taking it a day at a time.”
Roger nodded and Laurie did the same. There was a brief, awkward moment of silence before Roger reached out and gave Laurie another hug. Her response was as restrained as it had been earlier. Laurie flashed a weak smile and started to leave.
“One other question,” Roger said. He stepped between Laurie and the door. “Does any part of this ‘difficult time’ you’ve described have anything to do with my still being married?”
“To be honest, I suppose a small amount,” Laurie admitted.
“I certainly regret not telling you, and I’m sorry. I know I should have earlier on, but at first it seemed presumptuous you’d care. I mean, I’d gotten to the point I didn’t care myself, like it was a non-issue. Then, when we got to know each other, and I’d fallen in love, and I knew you would care, I was embarrassed for not having told you sooner.”
“Thank you for apologizing and explaining. I’m sure it will help put the issue behind us.”
“That’s my hope,” Roger said. He gave Laurie’s shoulder a tender squeeze, then opened his office door. “We’ll talk.”
Laurie nodded. “For sure,” she agreed, and then walked out.
Roger watched Laurie wend her way among the desks and start down the long corridor. He watched her until she was out of sight, then closed his door. As he moved around his desk and sat down, her scent wafted in the air like a wraith. He was concerned about her, and he was worried that he’d botched their relationship by not being forthright with her, and, more damning, he hadn’t come clean. He was still holding back things that she had the right to know if their relationship was to grow, and, worse yet, he wasn’t telling her the truth about things that he’d already told her. Contrary to what he had suggested, there were unresolved aspects of his relationship with his wife, including unrequited love on his part, which he had not had the courage to tell Laurie, even though she had had the courage to tell him something similar regarding her former boyfriend, Jack.
Roger’s biggest secret from everyone, including his current employers, was that he was a former addict. While in Thailand, he had fallen into the trap of heroin addiction. It had started innocently enough, as a kind of experiment ostensibly so he could better understand and treat patients with the problem. Unfortunately, he had underestimated the drug’s seductiveness and his own weaknesses, especially since the heroin was so freely available. It was at this time that his wife and children left him for the protection of her powerful family. It was also the reason he was transferred to Africa and eventually dismissed from the organization. And even though he had gone through an extensive program of rehabilitation and had been reasonably drug-free for years, the specter of the addiction problem still haunted him every day. One problem was that he knew he drank too much. He loved wine and was surreptitiously drinking at least a bottle a night, which made him worry that he was allowing alcohol to become a substitute for heroin. As a physician, particularly one who’d gone through rehab, he knew the risks.
Roger would have agonized longer, but luckily he had the series of suspicious deaths to occupy his thoughts. Although he had been curious about them on his own, it was Laurie’s commitment to them that had fanned his interest. He’d used the series to foster a relationship with her, and it had worked superbly. As the weeks had gone by, he’d become enthralled with her and began to think that his idea of coming back to the States to salvage some kind of normal life with a new wife, new kids, and the proverbial white picket fence were within his grasp. Then, with a slip of the tongue, disaster had struck. Now he needed the series more than ever as a kind of glue to hold things together. The sooner he got the employee lists she suggested, the better. If he was really lucky and came up with something, he could call her that evening and take it over to her apartment.
Roger used the intercom on the phone to get in touch with Caroline, the most efficient secretary. He asked her to come into his office. Next, he got out the hospital phone directory and looked up the director of the human resources department. His name was Bruce Martin. Roger copied down his extension number, and while he was doing so, Caroline appeared and hovered expectantly in the doorway.
“I need some names and phone numbers over at Saint Francis hospital,” Roger called out. His voice reflected his sudden zeal. “I want to talk to the chief of the medical staff and the director of human resources as soon as possible.”
“Should I get them on the line,” Caroline asked, “or do you want to make the call yourself?”
“Get them on the line!” Roger ordered. “Meanwhile, I’ll have a quick chat with our own Mr. Bruce Martin.”
As Laurie came through the front door of the OCME office, she glanced at her watch. She was appalled. It was almost noon. The taxi ride from the Manhattan General Hospital had taken an incredible hour and a half. She shook her head. New York could be like that, with all of midtown snarled in traffic like an enormous blood clot. The driver had explained that some major dignitary was in town, although he didn’t know whom. Unfortunately, the visit required certain streets to be closed off for the motorcade. As soon as that happened, the entire central portion of the city came to a screeching halt.
Marlene buzzed Laurie in through the main door such that Laurie had to pass the administration area. She was afraid to look through open door, lest Calvin catch sight of her. If she had known she was going to be gone for so long, she would have filled out the two pesky death certificates before she left.
Luckily, the elevator was waiting, so Laurie didn’t have to stand fully exposed in the main hall to anyone coming out of administration. As she rode up, she wondered if Roger would follow up on her suggestion and do the detective work she proposed. The more she thought about the idea, the more optimistic she became that it would lead to something. But even if it didn’t, it would at least give her the feeling that something was being done about the problem. She didn’t even want to think about the individual tragedies that the deaths of young, healthy people in the prime of their lives were causing for their families and loved ones.
Getting off on the fifth floor, Laurie walked quickly down to her office. The door was ajar. Riva was there but on the phone. Laurie hung up her coat and sat down. Centered on her blotter were a series of Post-it notes in Riva’s crisp handwriting. Three said merely “Jack came in.” Two said “Calvin came in,” followed by several exclamation points. The final one said to call Cheryl Meyers.
Hastily, Laurie opened the drawer where she kept the material from her potential serial-killer series and pulled out the McGillin and Morgan folders. From each she took the partially completed death certificates, then reached for a pen. The first certificate was McGillin’s, and she positioned the pen over the place on the form where she had to indicate the manner of death. But she hesitated as a mental battle raged between her responsibility of duty as ordered by a superior and her sense of ethics. For her, it was akin to a soldier being ordered to do something that wasn’t right, for which he could be held responsible. The only saving grace was that in Laurie’s situation, it was not an irrevocable act, and it could be changed. With a sigh, she completed both forms.
At that point, Riva hung up her phone and spun around. “Where have you been? I’ve tried your cell phone a dozen times.”
“I was over at the Manhattan General,” Laurie said. She opened her bag, felt around for her phone, took it out, and checked the LCD screen. “Well, that’s the explanation why I didn’t get your call. I can’t seem to remember to turn the blasted thing on. I’m sorry.”
“Calvin’s been in here twice. I wrote two notes so you’d get the message if you came in when I wasn’t here. To say the least, he’s not very happy you disappeared.”
“I know what it’s about,” Laurie said as she held up the two death certificates. “This is what he was looking for, so all should be okay.”
“I hope so. He was fit to be tied.”
“I see Jack stopped by as well.”
“That’s the understatement of the year. He was here twenty tim
es. Well, that’s a bit of an exaggeration. But even he got a little sarcastic with his comments toward the end.”
Laurie inwardly groaned. After the effort she’d expended getting Jack to agree to have dinner that night, she hoped her absence hadn’t frustrated him enough that he’d call off their date. “Did Jack say what he wanted?”
“No! Just that he was looking for you. As for the last message from Cheryl, she said it wasn’t important, but for you to give her a call.”
Laurie got up, clutching the two death certificates. “Thanks for being a messenger service. I owe you.”
“It wasn’t a problem,” Riva said. “But out of curiosity, what were you doing over at the Manhattan General for so long?”
“Actually, I spent more time in the taxis than I did at the hospital. But I went over there because I had an idea that might help with my supposed serial-killer series.”
“What is it?”
“I’ll tell you later. Right now, I’m going to take these death certificates down to Calvin in person to smooth the waters.”
“What should I say to Jack if he happens to come by yet again?”
“Tell him I’ll be stopping by his office after I see Calvin.”
Laurie retraced her steps to the elevator, feeling a twinge of guilt about not sharing her most current problem with Riva. Yet short of the OB office, she knew she didn’t want to tell anyone that she was pregnant until she’d told Jack. Of course, she knew that if sharing it with Jack turned out to be as bad as it could possibly be, she might not be sharing it with anyone else.
As the elevator descended, Laurie glanced at the now-completed death certificates. Even though they could be changed, and in her estimation probably would, it still bothered her that she’d been forced to compromise her professionalism by filling them out as she had. It seemed to her that kowtowing to the needs of bureaucracy was not only ethically repugnant but also a disservice to the memory of the victims.
Once in administration, Laurie had to sit on the couch to wait. Calvin’s door was closed, and his secretary, Connie Egan, told her the deputy chief was closeted with a police captain. Laurie wondered if it was Michael O’Rourke, Lou’s immediate boss, who was an in-law to the Manhattan General mugging victim. While she waited, she thought about what she was going to say to Jack. If he’d been looking for her as hard as Riva had suggested, it was inevitable he’d ask where she’d been. If he were as jealous as Lou suggested, it was not going to help if he learned that Laurie had gone over to see Roger immediately after getting Jack to commit to having dinner. Yet Laurie promised herself that she wasn’t going to fall into the trap of lying.