Knife Music

by David Carnoy

  Only if you venture to that far corner of the room and face back toward the door will you see that the headline reads: “Handicap Doesn’t Slow Detective in Race to Catch Criminals.” Ask him why it hasn’t found a place on the wall and he’ll humbly mutter something about not feeling comfortable about tooting his own horn, he’s no show-off, and the frame would be in the closet if it hadn’t been a gift from his wife. Nicaraguan by birth, she was Pastorini’s housekeeper when they first met, and though they seemed an unlikely match—she barely spoke English, he barely spoke to women—their marriage had only gotten better as she became more fluent in English and he in Spanish. After thirteen years, he liked to tell people it worked because she thought he was too good for her and he thought she was too good for him—and that wasn’t far from the truth.

  The truth about the article is that it embarrasses him for a different reason. Buried in the middle of the piece is a reference to the sexual abuse he calculatingly divulged years ago to extract sympathy. At the time, the acknowledgment had been easily rationalized, a trifling revelation to which he was entitled, to help level the playing field and get the promotion he’d so badly wanted. But today it only represents pity. He looks at the headline and can’t help adding a multiplier. “Double Handicap Doesn’t Slow Detective . . .”

  As a boy, while being treated for polio, a physician had sexually assaulted him. He told the reporter who’d interviewed him for the article that initially he hadn’t known he was being abused. The doctor was crafty and, ironically, patient. Madden’s mother liked reading the magazines in the waiting room, and after their first visit, the doctor suggested she might be more comfortable remaining there, particularly since the boy seemed embarrassed to have her in the room during parts of the check-up.

  “I was nine,” he told the reporter, “I didn’t know what was required or not. But I’d had these exams before. I’d been to several doctors. So it seemed OK.”

  For instance, the doctor would hold his testicles and ask him to cough. Or he’d give him a rectal examination to make sure that his chronic constipation wasn’t “flaring up.” After a few visits, though, the man made incremental adjustments to the routine. His hand lingered a little longer. An extra finger was added to the rectal exam. Then it was not a finger at all.

  “This may hurt a little,” the doctor said, voicing the gentle warning he usually delivered before pricking him with a needle. “But not for long.” Suddenly and excruciatingly, when he heard the man’s zipper open behind him, he realized he’d been terribly betrayed; everything before had been a ruse. He let out a scream—or at least tried to—but the man covered his mouth, stifling the cry, as he raped him.

  When he was through, the doctor pretended nothing happened; it had been as if he’d performed his regular examination. The only difference was this time, after he finished writing some notations in his chart, he handed Madden a box of tissues and said, “Henry, there’s a bathroom next door. Why don’t you take a moment and clean yourself up back there? There’s nothing to be embarrassed about. Just use hot water.” He remembered taking the tissues without saying anything. He was in a daze, certain he knew what had happened yet unable to totally believe it. Before he could get to the door, the doctor stopped him, gently squeezing his arm. “You know, Henry, whatever happens in a doctor’s office is never discussed by the patient or the doctor with anyone else,” he told him. “And that means your parents, too. It’s the law.”

  He never said anything about the incident. And he never asked anybody whether it really was a law, because law or not, he thought his father would think it was his fault, that he deserved it. “The guy was an idiot, he had it coming to him,” his father used to say about people who made bad decisions and had bad things happen to them as a result. He was ashamed that he hadn’t seen it coming or reacted more quickly once he heard the man’s fly open. He should have jabbed him with his elbow or tried to knock over the scale; the loud noise probably would have made him stop. And that was the part he knew his father would never understand—that he hadn’t fought back. So he didn’t say anything for a long time. Of course, years later, he realized he was completely wrong; he should’ve spoken out, for it would have prevented others from being abused.

  “I truly regret that,” he told the reporter, who would end up rewarding his candidness with a modicum of restraint. She provided enough detail without revealing too much.

  “When asked why he was drawn to detective work,” she wrote, “Madden reveals that his motive is partially personal. As a boy, while being treated for polio, a physician sexually abused him. He says that he was unable to confront the truth for many years, until he confided in a fellow officer who was working on a similar case. He regrets not saying anything earlier, for it could have prevented the physician, who was only brought to justice when Madden was in college, from abusing other patients.

  “‘One day, he picked the wrong kid,’ the detective said. ‘I’m sorry I wasn’t that kid. I won’t let it happen again.’”

  After the article came out, people behaved differently toward him. At times, he could tell they were being more cautious in how they chose their words. When certain topics came up, he no longer was a detective but a victim, which he found profoundly disturbing. Happily, Pastorini obliged his request that people “cut the bullshit” and relax and be “the insensitive bastards” they really were around him. But sometimes they took their comments a little too far. Maybe they were overcompensating, but most of them, especially guys like Billings and his partner, Fernandez—and even Pastorini occasionally—were just being pricks for the sake of being pricks. The Martin and Lewis of the office, Billings and Fernandez were constantly joking around. They had this shtick where they’d match up random people in fictional fights. “Madden versus the guy behind the deli counter at Luttiken’s,” they might say. Then they’d go around soliciting opinions and have people comment on the fighters’ strengths and weaknesses. Each week there were two new fighters. And each week they’d declare a winner. For some reason, everybody found it amusing.

  Madden isn’t thinking about all that now, though. He puts his glasses back on, and starts typing on the computer. He’s highlighted the main issues of the report and is now making a list of questions to ask the girl’s friend, Carrie Pinklow, whom she called a few hours before her death and was with her the night the alleged rape took place. The report is based entirely on events that had transpired in the diary and the interview with the girl’s parents. The rest of the file is the diary entries themselves—not the whole diary, just the entries that are relevant to the case, which adds up to twenty-five pages of the girl’s clear, bubbly handwriting.

  The selected pages chronicle a period of about five months. They start in November, when the girl had to have an emergency operation, and finished in late March, about a month after she’d had sex with Cogan, the surgeon who’d performed the operation. It’s a bizarre little story, Madden thinks. Months after being treated at the hospital, Kristen ends up at Cogan’s home late one night after a party, drunk and practically unconscious. Her best friend, Carrie, had brought her there because she was worried about her condition but didn’t want to take her to the emergency room out of fear both girls would get in trouble with their parents. Cogan agreed to let Kristen stay the night in his guest room. Then, according to the diary, he had sex with her while her friend slept in the living room.

  Madden looks at the two photographs he has of Cogan. One is a driver’s license picture, the other a photograph from the local newspaper announcing his marriage to Jennifer McFadden six years ago. The first he got from the DMV, the second from an Internet search.

  Theodore Charles Cogan. Born December 10, 1963, in Chicago. Yale Undergrad. Harvard Med. Trauma surgeon at Parkview Med.

  He’s good-looking, Madden thinks. Intense eyes and a pleasant, confident smile. A doctor—a surgeon, no less—with his looks can have any woman he wants, he thinks. Why, then, the girl?

  No, Madden, he sa
ys to himself. The question isn’t why. It’s why not?

  “Why” is intellectual. “Why not” is impulsive. And poor judgment is ninety percent impulsive.

  His mind begins to drift. He imagines the scene that night—the girl in the doctor’s guest room. Cogan sits down on the bed, starts talking to the girl. Then, lightly, he touches her. Maybe it’s by accident. Maybe it’s a test. But he touches her and she doesn’t seem to mind. Then he lets his hand stray underneath her shirt. And while he’s doing it, he isn’t asking himself why he’s doing it. The point is he can do it. So, why not?

  “What are you doing, Daddy?”

  Madden turns around. His daughter has walked into the room and is standing behind him.

  “Daddy’s doing his homework,” he says.

  She comes and sits in his lap.

  “Who’s that?” she asks, pointing at Cogan’s picture.

  “He’s a doctor.”

  “Did he do something bad?”

  “Maybe.”

  “What did he do?”

  “Something you’re too young to hear about.”

  “Is it X-rated?”

  “Yes.”

  “Are you going to catch him?”

  “I don’t know. It’s going to be very difficult to prove what he did. I’m not sure I can.”

  “That’s why you’re doing your homework?”

  He smiles. “Yeah, that’s why.”

  A short silence. She’s buttered him up, now it’s time for the kill.

  “Can I play on the computer?” she asks.

  “Did you eat breakfast?”

  “Uh-huh.”

  “You sure?”

  “Ask Mommy.”

  Madden looks at his watch. It’s eight-fifteen.

  “Just give Daddy ten minutes,” he says. “Then you can play. But only for half an hour. You have to get ready for church.”

  “I can’t get to the next level in a half an hour,” she says.

  “Sure, you can.”

  “I didn’t last time.”

  “That’s not my fault, is it?”

  “Can’t we go to a later service?”

  “The longer you keep Daddy from doing his homework, the less time you get to play,” he says. “By my calculation, you’re about to lose a minute.”

  She jumps off him.

  “That’s not fair,” she says. “You didn’t say anything before.”

  Madden looks at his watch. “There it is. You’re down to twenty-nine.”

  “Cheater,” she says, and runs out of the room.

  9/ THREE BALLS DANCING

  November 10, 2006—6:57 a.m.

  THE GIRL WAS THE FIRST OF SEVERAL PATIENTS COGAN HAD TO SEE that morning. Residents like Kim also did rounds, but when Cogan was in the hospital he had to see his patients twice a day—once in the morning and once in the afternoon.

  There was O’Dwyer, the big, burly guy who’d gotten cracked in the back by a bar stool and almost lost a kidney. Sanchez, who’d been shot in the leg very close to his groin during a “dispute” over money with a friend. Hart, the Mr. Fix-it, who’d fallen off his roof at ten in the evening. And Traynor, an ungrateful son-of-a-bitch dotcommer who’d wrecked himself on his motorcycle for the second time in two years. When they brought him in four nights ago, Cogan didn’t recognize him because he was so racked up. It took twelve hours of surgery and three surgeons to put him back together. But when he woke up a couple of days later in the ICU, Cogan realized he’d worked on him before.

  “Hey, didn’t I put you back together a couple of years ago?” he’d asked.

  “Déjà vu, Doc,” replied the kid, who was twenty-six and liked to boast to the nurses that he was worth ten million. “Déjà fucking vu.”

  The second accident only seemed to have made him more ungrateful, and Cogan should have known not to joke with him, but this morning, after he finished his examination, he let one slip out: “You know, if you’re going to continue to hurt yourself like this you might think about getting paid for it. Evel Knievel made a nice living breaking his bones.”

  “Is that supposed to be funny?”

  “It’s a polite way of saying maybe you should give the bike a rest for a while. Like indefinitely. You don’t seem to have much luck with it.”

  “They pay you to give personal advice?”

  “No, that’s a freebie.”

  “Well, just do your fucking job and I’ll do mine.”

  “And what would your job be?”

  “To get the fuck out of here.”

  “Let me know when that position opens up, I’d like to interview for it. Does it come with stock options?”

  “I wouldn’t touch it if it didn’t.”

  The list of people went on. These were his trauma patients. He would see them during their hospital stays, then once or twice afterward to make sure his work was holding up. But beyond that, they would see their regular doctors or be passed on to specialists.

  He went to see his elective surgery patients next. Although he was trained as a trauma surgeon and performed that function four nights a week at Parkview, he was boarded as a thoracic surgeon, which meant he was a specialist in chest surgery. In some hospitals, the main reason trauma surgeons took elective cases was to make extra money because they were paid by the number of operations they did. But Cogan, who was on salary, took them for reasons that didn’t offer an immediate pay-off: to stay sharp in his area of expertise, establish a reputation outside trauma, and to appear productive to hospital administrators. He wasn’t planning on leaving Parkview tomorrow, but he knew he would someday, and he wanted to be able to pick his next destination.

  Sometimes he wondered whether the extra work was worth it, for there were days when he felt burnt out and longed to leave the profession altogether. When he was really fried, he prescribed himself a vacation, and his attitude and outlook would improve. But in the last eighteen months he’d noticed that the medicine seemed to be having less and less of an impact. Even after he upped the dosage to a whole month away from the hospital, the all-too-familiar funk returned within a few days.

  He tried not to let the little things get to him, like cocky dotcom douchebags who were making more than him. Or Mrs. Ellen Richter’s hemorrhoids. But inevitably they did.

  Mrs. Richter, age sixty-five, was the first of three lung-cancer patients he saw that morning. Cogan had removed a malignant tumor along with a third of her right lung two days earlier. Her prognosis was good. She might live five years. But this morning a complication had developed completely separate from the cancer. Mrs. Richter had hemorrhoids—she now had pain above and below—and she wanted to know what Cogan could do about it. She wanted him to operate on her again. Demanded it, in fact.

  “Isn’t there some laser surgery you could do?”

  These were the moments that Cogan found most frustrating. A patient in Mrs. Richter’s position should have been happy. She’d gotten through a life-threatening operation. He’d taken out her lung cancer. He might not have cured her, but she was far better off now. And she should have been happy he’d done what he could for her. But here she was, demanding he fix her hemorrhoids at seven in the morning.

  “I understand you’re uncomfortable, Mrs. Richter,” he said. “But right now, you don’t need a surgeon. Right now, we need to get you through this without another operation. I’d rather see you use some cream for the hemorrhoids.”

  “I used the cream.”

  “Well, maybe we can try another one. I’m more concerned with the balls. How are you doing with the balls?”

  Cogan was talking about the small device, an incentive spirometer, lying on the bed next to her. Made out of clear plastic, it housed three small balls that would, when you inhaled with proper gusto into the device’s mouthpiece, rise in their respective compartments.

  “Show me what you can do,” he said.

  Mrs. Richter picked up the device, put it to her mouth, and drew a breath with as much force as she could muste
r. One ball rose halfway up in its compartment, but the other two didn’t rise at all.

  “OK,” he said. “That’s better than yesterday.”

  He told her she had to breathe into the device for fifteen minutes every hour. They needed to get her lung capacity up and make sure she didn’t get an infection.

  “I’ll be back this afternoon and I want to see those balls dancing.”

  “It’s hard.”

  “I know it’s hard. But it’ll feel good when you get them all going. I promise.”

  His next patient was younger, a woman in her fifties named Greer, who was very aware of her body and constantly monitoring it.

  “This seems more like the episodes I was having when you brought Dr. Fein to see me,” she said, describing some pain she was having in her breasts. “With the exception of last night and the night before, my fever was 101 and my breasts felt really heavy and tender. I thought I was getting an infection.”

  She was wearing her own sleeping gown, a thin pajama top that was almost halfway open. She probably left it unbuttoned so she could more easily monitor herself, but unlike a patient he saw yesterday, a forty-two-year-old woman who’d been in a car accident five weeks earlier and hit the steering wheel with her chest, Greer was quite comfortable exposing herself and having doctors and nurses examine her.

  Yesterday’s patient had bruised her sternum and heart, a myocardial contusion. She had large, pendulous breasts that she clearly felt uncomfortable revealing. From the get-go, he’d noticed she was very uncomfortable with his examinations, which automatically put him on alert. He was always careful not to give any wrong impressions when he was examining his female patients, but with certain women he could sense that he really needed to take extra precaution.