Guarded Prognosis

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Guarded Prognosis Page 7

by Richard L. Mabry MD


  He’d just finished lathering his face when she appeared in the doorway. When Caden saw her face in the mirror, he could tell something was wrong. He turned back to her and said, “What’s going on?”

  “That was Jean.”

  His father’s procedure wasn’t due to start for another hour. Had something come up? What? Is there a problem with Dad? “Have they done the endoscopy already?”

  “No. The procedure has been cancelled.”

  “I don’t understand.”

  “Jean went by to pick up Henry this morning, and she found him just putting down the phone. The nursing home had called him.” Beth covered the distance between the two of them in a few strides. Heedless of the lather covering his jaw and cheeks, she grabbed Caden and pulled him toward her. Her head buried on his shoulder, she said in a soft voice, “Oh, Honey. They found your mother dead this morning.”

  Beth stood with Caden outside the Sunset Rest Nursing Home. Neither of them said a word, but as they moved up the walk he reached for her hand. At the front desk, he said, “Dr. Caden Taggart. I believe my mother . . . ” He couldn’t finish.

  The receptionist responded in a hushed voice, “I’m so sorry for your loss, Dr. Taggart. Your father and his friend are in the room with your mother now.” She pointed down the hall. “Last door on the left, number seventeen.”

  Because she was looking for it, Beth noted that Caden’s shoulders momentarily slumped a bit when the receptionist indicated his father hadn’t come alone. From her standpoint, Beth was glad that Jean was here. She could provide a shoulder on which Henry could lean—and cry, if need be—the same function Beth saw herself filling.

  Although Caden’s mother—at least, as he knew her—had been lost to him for over a year, today’s events closed the door totally and completely. That was a shock, Beth knew. The fact that there was another woman standing beside his father made the moment even harder for Caden.

  When they reached the closed door of number seventeen, Caden let go of Beth’s hand and tapped gently. There was a murmur from inside the room—a woman’s voice. Beth couldn’t make out what was said, but apparently Caden either took it to be permission or decided to enter anyway.

  He drew a deep breath, opened the door, and stepped inside. Nancy was laid out with the sheet pulled to her chin. The tubes for feeding and urinary drainage had been removed. Other than the closure of her eyes, Nancy looked very much the same as when Beth and Caden had last seen her—mannequin-like and unmoving. Only her pallor and the absence of respiration gave an indication that she was now dead.

  Henry stood immobile at Nancy’s bedside, one hand barely touching the sheet that covered her body. Jean turned to Caden and Beth and said in a soft voice, “I’m so glad you’re here.”

  Caden moved to his father’s side and put one arm around him. Henry recognized his son’s presence with a nod but said nothing. He continued to stare down at the body of his wife.

  Beth motioned Jean toward her. When they were close enough to put their heads together, she whispered, “What happened?”

  “I don’t know,” Jean said quietly. “The administrator called Henry just as he was getting ready to leave for his biopsy. Apparently, the last time the night nurse saw Nancy was around 4:00 a.m. Then, when they went in later to check on her, they found her . . . they . . . ” She shook her head.

  Henry glanced at his son. “I’m not sure how you got here so fast, but I’m glad.”

  Caden squeezed his father’s shoulder, then gazed down at the body of his mother.

  They stood in silence for several minutes before Henry, without looking up, said, “After you’ve had enough time with your mother, I’ll ask the administrator or head nurse to notify the funeral home to pick up her body. The doctor who’s been looking in on her since she was transferred here will sign the death certificate.”

  “What will happen then?” Caden asked in a low voice. He couldn’t force himself to say the words, but Henry would know what his son really wanted to know.

  “Your mother and I talked about this long before her stroke. At that time, she wanted to be an organ donor, but I don’t think that’s an option any more, given her status. She’ll be cremated, and I’ll take care of disposing of her ashes.” He turned his head and stifled a sob.

  “Do you want me to help you make arrangements?”

  Henry shook his head. “No, I can do that. And as for her funeral, she discussed it with our pastor even before . . . before her stroke. The memorial service is already planned.” He took a deep breath. “I haven’t even thought about mine, of course. I guess I should.”

  “Mom was a Christian, wasn’t she?”

  “Oh, yes. She made that decision when she was a little girl. I suppose that’s one reason she never feared death. I, on the other hand . . . ”

  Caden looked over at his father. “Dad—”

  “I’ll be okay,” Henry said. “Let me call our pastor. He’ll need to know about this.” He turned toward the door. As he and Jean left the room, he said in a low voice, “Besides, I think I need to talk with him about myself.”

  Beth moved up to stand beside Caden. He reached down and touched his dead mother’s face. His lips were moving, but no words came forth. She waited for tears to start, but Caden’s eyes remained dry. Finally, he bowed his head. He stood that way for what Beth judged to be a minute or more.

  When he looked up, she said, “She’s better off now. I know it’s hard, but we knew this was coming. We just didn’t expect it right now.”

  Caden shook his head. Then he did something that surprised Beth. Gently, he raised both his mother’s eyelids and bent closer to her body. After a few seconds, he closed the corpse’s eyes. Then he brushed his lips across her forehead and stepped back.

  Beth frowned at this behavior but didn’t say anything.

  After a moment more, Caden turned and squared his shoulders. “I need to talk with my dad. I’m not sure Mother died a natural death. Someone may have murdered her.”

  8

  Caden had never been in this room, but he’d been in ones like it at various times in the past. Every hospital where he worked, from medical school through residency and on to private practice, had a room like this—sometimes more than one of them.

  This room was subtly lit by low-wattage bulbs in table lamps sitting opposite each other, with a sofa in between. The coffee table in front of the sofa bore a Gideon Bible and a box of facial tissues. Upholstered side chairs, their coverings a match for the sofa, sat along the wall. A few artificial flowers, a scrawny ficus tree, and a couple of pictures on the wall completed the decor.

  This was the room where a staff member broke the bad news to the family. The social worker gathered everyone here to discuss the options available for hospice care. The doctor or health care worker revealed how the elderly patient had fallen and suffered a broken hip that would require transfer to a nearby hospital. And, in this situation, two men sat together and made their final decisions after the death of a loved one.

  Caden realized that when he was younger he had looked to his father and mother for guidance in tough situations. But his mother had been unable to give counsel for a year or so. Now, rather than Caden seeking the advice of his father, it was up to him to guide his dad, to convince him there was only one right course of action—right but unpleasant.

  “Dad, I’m pretty sure there were petechial hemorrhages in Mom’s conjunctiva. That means she was choked or smothered. We have to request an autopsy.”

  “You looked at her eyes for a second or two and think you saw them? I think you’re wrong,” his father said. “Why can’t we let your mother rest in peace?”

  “Dad, if I’m wrong, we’ve held up the process of cremation a day or two at most. And no one need ever know. But if I’m right—”

  There was an air of finality to his father’s answer. “No. When I was on pathology, I saw bodies of people who’d died of asphyxiation. I’m familiar with those tiny red areas, petechi
al hemorrhages, in the whites of the eyes. And I don’t think your mother had them.”

  “If you’re sure . . . ”

  “No autopsy. It’s my decision.” His father raised his eyes to look directly at his son. “I realize this is hard for you to accept, but you have to let it go.”

  Caden shook his head. In his mind, it was clear that Jean might have done this. She was a nurse, and she probably wouldn’t have any problem slipping in and smothering Nancy Taggart. Either his father couldn’t see the obvious advantage to Jean if his mother was out of the way, or he simply turned a blind eye to it.

  If his father, as next of kin, wouldn’t authorize an autopsy, Caden toyed with the idea of contacting the police. But would that help? Would they order a medicolegal autopsy? There was nothing to hang their hat on but Caden’s suspicions. His father was already digging in his heels. For Caden to pursue the matter might cause a rift between them that would never heal. Then he’d be left with no parents. At least he still had one right now.

  “Let’s put this behind us and move on. Your mother would want that.”

  His father clapped him on the shoulder, then rose and turned toward the door. “I need to get in touch with the funeral home. I’ll see you at the house.”

  I’ll be there for a while, but I’m not certain I’ll stay. I don’t know if I can.

  When Caden said he didn’t want to move from the motel into his parents’ home today, Beth didn’t try to change his mind. The reason he gave her was that he needed some alone time to process his grief. She figured the real reason was that Jean would be at Henry’s house quite a bit during the next few days, providing support for him and acting as hostess for the many people who’d be coming by. Apparently, this was something Caden didn’t want to face right now. He needed a place to retreat, and the motel would provide that. As for her feelings, she’d put them aside for now. Her main job was to be at her husband’s side through everything she knew would follow.

  As they drove away from Sunset Rest, she gave Caden adequate opportunity to talk if he wished, but he remained tight-lipped. Apparently, if Beth wanted to converse, it would be up to her to start. Finally, when they’d gone about three blocks, she began. “You and your father were together in the family room for a long time.”

  Caden sighed. “I tried to convince Dad to request an autopsy on Mom.”

  “Why?”

  “I think someone murdered her.”

  “What?”

  Beth listened in disbelief as Caden told of seeing tiny red spots in the whites of his mother’s eyes. “So those are evidence of smothering?”

  “Smothering, strangulation, anything that cuts off the air. The individual struggles for breath, it increases the pressure in those tiny vessels in the eyes until they break, and results in red spots that we call petechial hemorrhages.”

  “Who would do such a thing?” Beth asked. She thought she knew where Caden was going with this but wanted to give him a chance to say it.

  “We both know of one possibility, although I can’t convince Dad of it.”

  Beth knew Caden was referring to Jean. She didn’t think that was the case, but perhaps now was not the time to try convincing her husband.

  Caden steered around a slower-moving car, then stayed in the right lane for the turn that was coming up.

  After a few more minutes of silence, Beth spoke up again. “Shouldn’t I call my family and let them know of Nancy’s death? They’re going to want to be here for the service.”

  Caden turned in to the motel and found a parking place. “I guess so. Tell your folks Mom is dead, and you’ll call back when we know the arrangements. And we need to adjust my schedule. I told the office I’d be gone today, but now I don’t know . . . ” He closed his eyes and took several deep breaths. “I can’t handle this. Would you make those calls? I don’t really want to talk with anyone.”

  “Of course.” Beth looked at her watch. “You know, it’s almost one o’clock. Why don’t you get something to eat? I’ll join you in the coffee shop when I’ve made the calls.”

  “I’m not really hungry.”

  “I know, but you’ve got to keep up your strength.”

  Henry Taggart sat alone in his darkened den, the drapes drawn as though by doing so he could shut out the world and ignore the events of the past few hours. In response to Jean’s offer to help, he’d asked her to handle anyone who called or came to the door. For now, he needed solitude.

  Although Nancy had put it together years ago, Henry knew that the ultimate responsibility for her memorial service rested with him. He’d listen to any suggestions Caden and Beth made, of course. Jean had offered to be involved, but somehow that didn’t feel right. Right now, though, Henry didn’t want to make any decisions. He wanted to sit here in the dark and let his thoughts wander.

  The rupture of a tiny blood vessel inside his wife’s skull started the whole process. Neither he nor Nancy had any idea the aneurysm, the weak spot in one of the vessels feeding the brain, was even there. Could it have been treated? Would surgery beforehand have been effective? It doesn’t matter. Nothing matters now. Nancy is dead.

  Why did Caden think his mother was murdered? Henry thought he knew, and it grieved him. Nancy hadn’t been sentient for over a year, and Henry had let Jean into his life to fill the void. She was someone to talk with, someone to share decisions with. But his son resented her.

  Henry didn’t think there were any subconjunctival hemorrhages in Nancy’s eyes. That sign might be diagnostic on TV shows, but he knew better. Even if they were there and he got the police involved, it wouldn’t bring his wife back. No, she was better off. They were all better off, so just let it be.

  Henry had no concept of the passage of time. He could have been sitting there for half an hour or half a day when he was roused from his reverie by a voice he recognized.

  “Dad?”

  Henry looked up and nodded. “Turn on the lights, Caden. I’ve just been sitting here in the dark.”

  “Thinking?”

  “Sort of.”

  Caden turned on the table lamp that stood beside his father’s chair. He sat down opposite Henry. “I’m sorry to leave you alone for a while. I had to—”

  “Don’t worry about it,” Henry said. “I wanted some solitude, too.”

  “We won’t go into the autopsy thing—I respect your wishes on that—but I wish you’d answer one question,” Caden said. “Who would want Mom dead?”

  Henry bowed his head. “You’ve heard the expression, ‘Didn’t have an enemy in the world?’ That was your mother.”

  “If it wasn’t personal, then how about money? What about insurance on her?”

  “When she had her stroke, I cashed in her policies except for one that will just about cover her funeral expenses,” Henry said. “I can’t see any monetary benefit from her . . . from her death.”

  “Nothing else?”

  “No,” Henry said. “And by the way, my policy that names you as beneficiary? It’s paid up, and I don’t plan to change it. You just won’t have to worry about taking care of your mother with the proceeds. Use it however you want—maybe establish a scholarship that will help support residents where you and I trained.”

  “We won’t worry about that right now,” Caden said. “Dad, when will you reschedule your procedure with Dr. Gershwin?”

  “Does it matter?” Henry said. He saw Caden was about to say something, so he held up his hand to stop him. “Let me get past your mother’s funeral. I don’t want to do anything about my own problems right now.”

  “But—”

  “Think about it. If the biopsy shows this is all an anomaly, and I don’t have pancreatic carcinoma, it doesn’t matter if we put it off for a bit. And if the biopsy is positive . . . well, I don’t guess a few more days makes any difference in that case, either.”

  Besides that, if the biopsy is positive, I’m not sure I want the slow death pancreatic cancer could bring. And if I die by my own hand, what doe
s the timing matter?

  9

  Dr. Claude Horner tugged on his pearl-gray tie until he got the knot just right. He shrugged his shoulders to settle the coat of his black suit a bit. Sometimes, when he was in the office, he covered his dress shirt and tie with a white coat. At other times, he wore that white coat over a set of surgical scrubs. Around the house, his dress was quite informal. But today he and his wife Nelda were attending the funeral of his partner’s wife. And although he doubted that Henry Taggart would even notice, Claude felt he had an image to uphold, so he wore his best dark suit.

  He gave his tie a final tug and moved to his wife’s bedroom. He was a morning person, she was an evening person, and after several unsuccessful attempts to mesh their schedules or change them, they’d decided they slept better in separate rooms. They were happy with the arrangement, and Claude frankly didn’t care if others thought it odd.

  “About ready?” he asked.

  Nelda looked at him approvingly. “Claude, you look quite handsome. Think this is okay?”

  He thought his wife’s navy-blue dress, accented with pearls and white cameo earrings, struck just the right note—fashionable yet subdued. “It looks fine.”

  “I guess having Nancy’s service on Saturday was the best option,” she said.

  “I imagine this let some of Henry’s colleagues attend.” Claude hesitated. “Nelda, we need to talk about something before we leave. Let’s sit down.” He led her to the settee that was in the corner of her bedroom.

  Nelda settled herself but frowned as she did so. “What’s this about?”

  “Let me explain what’s gone on before you say anything more. And I definitely don’t want you making a scene or storming out halfway through what I have to say.”

  She nodded, and—consciously or without thinking about it—began to slowly knead the lace handkerchief she pulled from her pocket.

  “Throughout our marriage, I’ve always tried to share everything with you. I guess it’s time to let you in on this.”

 

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