“All I can say is that we are not expected to be the police, judge, jury, and executioner for everyone we see who is harming an individual or society as a whole,” I concluded.
“Expected by who? God? Society? The fucking Universe?” he inquired.
“How the fuck should I know?” I asked, more than a little annoyed at his deliberate unwillingness to concede that there should be limits to the extent of our spheres of influence and that we should be constrained to acting within those boundaries.
“Listen,” he said, “I can see that you’re getting worked up here, so I’m not sure that I should tell you the rest. It’s just that, I dunno—I thought that you, if anyone, would understand why I had to do something to help Nancy.”
“I do understand your basic compulsion to help a friend in need. I’m just not sure that I agree with you getting involved in something like this, and I suspect that you’re going to tell me that you utilized extreme measures when you dealt with Carl,” I responded. I had deliberately chosen to avoid an accusatory tone of voice as I acknowledged his comment. I didn’t want to give Hank the idea that he couldn’t count on me as his confidante and unconditional friend.
“So, do you want to hear the rest of the story, or what?” he asked me.
“Of course,” I replied, “and don’t ever worry! Regardless of whether I agree with what you did, I’m not going to judge you. I might tell you that you’re an idiot and that you totally screwed the pooch, but I will never judge you, and I will always maintain your confidence.”
“All right, then—” he returned to his story.
Chapter 44
Hank confirmed that he did decide to intervene on behalf of Nancy and her family. He explained to me that the only way to put a permanent end to Carl’s harassment that was safe, for both himself and Nancy, would be to end his pitiful existence entirely.
The fact that Carl was a reclusive homebody and that, besides Nancy’s family, he had no neighbors in close proximity to his home, made the timing of Hank’s attack a simple detail to plan. The additional facts that Carl had been declared psychologically ‘disabled’ and that he was habitually a heavy drinker—if not also a polysubstance abuser—made the other details of Carl’s comeuppance relatively easy to plan as well.
Just as when Hank and I were planning Brandon’s ambush, Hank felt that creating a scheme resulting in Carl’s unwitnessed, but unsuspicious, death would be the best way to make sure that the authorities would never look too hard for a murderous culprit. Fortunately, he didn’t have to be very creative to come up with a game plan which would be simple to execute and result in a passing that would be perceived as accidental, but not particularly tragic.
Also working in Hank’s favor were the additional facts that his own schedule was easily managed and that anyone who owned a four-wheeler ATV could travel relatively anonymously in the rural area around Carl’s and Nancy’s homesteads. As opposed to automobiles, most four wheelers were relatively similar in appearance. This meant that if someone riding in a car were to pass by an ATV moving parallel to the road or see a four-wheeler parked in somebody’s yard, it was unlikely that they’d notice, or later recall any specific details of the vehicle. Hank knew, therefore, that as long as he wore a helmet with a face shield and nondescript clothing, he could travel via ATV in the area around Nancy and Carl’s properties anonymously. Fortunately, he just happened to have a well-used four-wheeler and all the necessary riding gear.
Chapter 55
It was a Wednesday morning and Hank had reported for work in the O.R. at his usual arrival time of 6:30am. He had looked at the schedule for that day on both Monday and Tuesday of that week and he knew that the caseload was relatively light. As was the norm, Hank made the day’s room assignments for the anesthesiologists. As the Chief, it was his prerogative on such days whether he would be in a room doing surgical cases, or in his office, attending to various administrative duties. It was well known among the O.R. staff that he could be in and out of his departmental office, and even the hospital itself, as he participated in various meetings involving his anesthesia group, the Surgical Department, or his other business interests.
After making the room assignments, he submitted the schedule to the O.R. control desk and informed the nurse supervisor that he had not assigned himself to any of the day’s surgical cases. Next, he went directly to his office, where he signed onto his computer. This would establish his presence in his office, in case he needed to account for his whereabouts that morning. Rather than working on the call schedule or responding to any of the interdepartmental e-mails which were accumulating in his in box, he grabbed his briefcase, which contained several items that he had previously pilfered from the O.R. central supply. He headed to the cafeteria, where he picked up a Gatorade and a protein bar. After signing and dating the paper at the cash register that kept track of purchases to be written off by the hospital, since doctors always eat for free, he left the cafeteria and went into a men’s room just down the hall. Checking to make sure he was alone, he removed the battery panel cover from his cell phone and placed the phone under a faucet, which he then ran for several seconds. He then removed the battery entirely, stuck it in his pocket, and closed up the phone.
He was apparently due for an upgrade and he had insurance on his phone, so he wasn’t the least bit heartbroken that he’d destroyed his cell phone. After leaving the restroom, he headed for the back entrance to the hospital used by the medical staff and hospital employees. He called the O.R. control desk on an in-house phone on the wall just inside the sliding outer doors. He told the Unit Clerk that he had accidentally dropped his phone in the toilet and ruined it, so he was going to run out for a little while to go to the local Sprint Store. He exited the hospital and walked to his vintage Mustang, which was parked in the physicians’ parking lot. He jumped in the car, cranked it up, and hurriedly exited the lot. As he pulled out onto the street, he had to fight the urge to stomp on the gas pedal and leave a satisfying black strip on the pavement. His adrenaline was pumping through his system and he was eager to be done with the morning’s tasks.
Hank turned into the driveway of his palatial house within a few minutes of leaving the hospital, then pulled the classic muscle car into one of the bays of his four-car garage. Hanging from a shelving unit at the rear of the garage were a pair of jeans and a well-worn flannel shirt, which he changed into. He kept a pair of riding boots in the garage with his helmets and gloves. He chose one of the older, well-used helmets, which he kept around to use as a loaner when he had guests over. He donned the boots and grabbed the other riding equipment. He hurriedly walked around the side of the garage and climbed into his Ford F250 Super Duty pick-up truck. The bed of the truck contained a Yamaha Kodiak 450 ATV which he had purchased as an ‘extra’ four-wheeler for friends to use when he felt like inviting someone along to go mudding or trail riding. The Yamaha was not nearly as impressive as the much larger and more powerful Polaris that he rode, so it was much less conspicuous, which made it perfect for the ride he would be taking it on that morning. After cranking the truck up, he opened his briefcase and transferred the items he would need that morning into a small backpack that he’d left in the cab of the truck the night before.
Hank knew where Nancy’s house was due to the fact that he gone there once shortly after she and her husband had purchased the place. After his own marriage had fallen apart and he and Patti had split up the contents of their home, he had found that he didn’t want to keep much of the furniture that had ended up in his garage. Since he was loaded and he knew that a lot of the O.R. staff was living on much more limited budgets, he had decided to give away the unwanted items, many of which were in excellent condition, rather than expending the effort to sell them. Nancy and her husband were grateful to receive his entertainment center, but didn’t have a truck to pick it up, so Hank and his son Peter had taken it to them.
There was an old sand and gravel pit that was no longer in operation about a m
ile and a half from Nancy’s place. Local dirt bike and ATV riders had discovered the place and found it to be a perfect location for some off-road riding. Hank and I had actually been there a few times when we wanted to do some riding without having to venture far from the city to an actual ATV park.
Hank drove in his truck to the gravel pit. As he suspected it would be early on a weekday morning, it was deserted. He pulled in and unloaded the Kodiak using the ramps that he’d stowed in his truck bed. He donned his helmet and backpack after locking up the ramps in the truck bed to keep them from being stolen by some jackass who might pull in while he was gone. The last thing he needed was to be stranded there and faced with a decision to either ride the four-wheeler back home or to leave it there and be forced to come back for it later. Either of these options would greatly increase the probability that he’d be noticed and, potentially, tied to the scene of his imminent crime.
There was a large ditch running along the road most of the way between the pit and Nancy’s house. He was able to ride along it at a pace of about thirty miles per hour, so it only took a few minutes to make the trip to her home. He pulled into her driveway and parked around behind her house, so the ATV was not visible from the road. He knew that Nancy was at work in the O.R., but he figured he should make sure that her son hadn’t stayed home from school, in which case he would definitely be calling either his mother at work or the police to report a strange guy who had shown up riding an ATV. He knocked on her door and rang the doorbell. When no one answered and he saw no movement within the house through the front window, he was satisfied that Nancy’s kid Josh was at school, where he belonged. Removing the helmet, he walked directly back out the driveway and down the road about 100 yards to Carl’s driveway. He noticed a shitty old Chevy pick-up truck parked near the house, which confirmed that Carl was home and available to accept visitors, including the Grim Reaper, whose arrival was impending. Surprisingly, Hank had no feelings of apprehension or doubt as he walked up the drive and onto the dilapidated front porch.
Hank knocked on the door loudly and called out, “Anybody home? I’m having trouble with my four-wheeler and I need to use a phone. Hello, is anyone home?” He figured that this little act would probably disarm Carl, who would otherwise be suspicious of a stranger showing up at his door at that time of day—especially someone who had arrived at his rural home without a car.
Hank heard movement inside the house and soon saw an unshaven face peeking out through the small window in the door. The man’s glaring eyes were bloodshot, his disheveled hair had clearly not been washed for days. His nicotine-stained facial skin and teeth were grotesque, and Hank imagined that he could smell Carl’s foul breath escaping through the minute gaps between the locked door and the doorframe.
“Who the hell are you?” Carl shouted through the door.
Hank put a big smile on his face and answered, “Oh, hello there! My name is Dave and like I said, I’m having trouble with my four-wheeler.”
“What four-wheeler? I don’t see any goddamn four-wheeler!” Carl shouted through the thin, metallic mobile home door.
“Oh right. I pulled into your neighbor’s house and tried them first, but I guess nobody is home over there,” Hank reported.
He heard movement as Carl apparently walked to a side window and checked Nancy’s yard for the presence of an ATV. He could hear the thin floorboards creaking as Carl came back to the door.
“Looks fairly new,” Carl shouted in reference to the Yamaha ATV. “What’s wrong with it?”
“I’m not sure. It’s only two years old and I don’t have many hours on it. That’s what pisses me off, man! It keeps dying on me. Sorry to bug you, but my cell phone isn’t getting reception out here and if I could just use your phone for a minute I’ll call my buddy and get him to come pick me up,” Hank said, impressing himself with his acting ability.
Carl was apparently convinced that Hank, aka Dave, was on the up and up, so he began to let his guard down. Hank could hear him disengaging a deadbolt as he said, “I’ll let you use my phone, but I don’t want you coming in my house. You can use it out there on the porch. No offense, but I just don’t like letting strangers in my home.”
“No problem,” Hank said. “I just appreciate you helping me out.” He took one more look each way down the road in front of the house to make sure no vehicles were approaching.
As Carl opened the door to hand Hank the phone, Hank threw his shoulder into the door. The door crashed into Carl’s forehead and knocked him backward into his living room.
“What the fuck?” Carl hollered as he fell back onto the filthy floor of what appeared to be Carl’s living room. The flooring was made up of tan shag carpet which was extensively stained by cigarette ash, spilled coffee and beer, and—if the aroma was a valid indication—cat piss. He knocked his head on the edge of a flimsy coffee table, which collapsed and barely even broke his fall. Hank shot in through the door and rapidly closed it. Next, he jumped astride Carl and placed his thumbs on either side of his thyroid cartilage, known commonly as the Adam’s apple. As Carl grabbed at his arms, Hank began to squeeze down on the carotid sinuses. These dilated areas of the internal carotid arteries contain baroreceptors (pressure receptors), which function in the maintenance of physiologic blood pressure. Stimulation of these sites, Hank knew, would result in a rapid drop in Carl’s systemic blood pressure. As expected, over the next 10 seconds Carl’s struggling efforts rapidly diminished and he lost consciousness.
At this point, Hank pulled off his backpack and retrieved several items. The first was a syringe containing a drug called Lorazepam that Hank had salvaged from several patient encounters in the Post Anesthesia Care Unit, otherwise known as The Recovery Room. This medication is used as a strong sedative—strong enough to prevent a patient from resisting the maintenance of an endotracheal tube following surgery if prolonged mechanical ventilation was indicated. Hank applied a rubber tourniquet to Carl’s upper right arm and immediately found a vein which he could easily access. He inserted the needle into the antecubital vein overlying the elbow joint and administered a dose which was sure to provide a good twenty minutes of sedation, then removed the tourniquet in order to allow dissemination of the drug throughout Carl’s system.
Next, Hank removed a long, plastic package containing a semi rigid latex tube called a nasogastric tube from the backpack. This tube was a piece of medical equipment which allowed depressurization of the stomach and/or evacuation of its contents via a catheter inserted through the nose and fed down the esophagus into the stomach. He rapidly placed the pre-lubricated tube and then jumped up and found the kitchen. Carl apparently enjoyed quick and easy access to his whiskey. He had two unopened and one half-empty, 1.75 liter bottles on his countertop, which expedited the next step of Hank’s plan. He took one of the full bottles back out into the living room where Carl lay supine, breathing shallowly and not seeming to mind the tube that had been snaked down his nose. Hank inferred from the lack of drainage coming out the end of the NG tube that he must have shown up prior to Carl’s breakfast time, which would facilitate the administration of the rest of Carl’s treatments.
Hank quickly ran down the short hallway and found Carl’s bedroom and his adjoining bathroom. He yanked open the medicine cabinet and found Carl’s bottle of Ativan, which he knew would be there. He had previously checked the Texas State online database which tracks all of the prescriptions a potential patient has received for controlled medications. The purpose of such a database is to allow physicians to determine when their patients have been ‘doctor shopping’ receiving multiple controlled substance prescriptions from multiple medical professionals in their efforts to stockpile prescription medications for distribution or self-use. In this case, the database provided Hank with the information he needed regarding which medication to bring, in injectable form, to match the oral form of the drug that Carl had on hand. Matching the drug in Carl’s system to the prescription he had on-hand would prevent toxicology
red flags from going up during Carl’s autopsy. Alternatively, if his blood carried a drug which he had not been prescribed, it would introduce the possibility that another party had drugged him and that he was the victim of foul play.
He removed three of the Ativan tablets and brought them to the living room, where he crushed them and mixed them with a glass of whiskey. He then drew up the mixture into a 60 mL syringe, connected the syringe to the end of the NG tube, and injected it into Carl’s stomach. He repeated the process several times until he had administered about 12 ounces of strait whisky, which took just a couple minutes. He then gently removed the tube and put it into a plastic Walmart bag, which he replaced into his backpack. He then went about staging the scene.
The broken coffee table, Hank decided, turned out to be a useful prop in the scene that he would now create. Carl got up on a Wednesday morning feeling particularly edgy. It may be difficult for anyone to understand why he was emotionally disturbed on that particular day, as he was clearly living life to its fullest, but Hank figured that he could avoid the effort that it would take to create a backstory that anybody would care to investigate. After draining his bladder, Carl popped a couple of Ativan tablets and left the nearly empty bottle on the counter. He decided, as was probably fairly typical for him, that he would forsake the Cheerios and Pop Tarts in his kitchen cabinet and proceed with a liquid breakfast instead. He brought his favorite low-ball glass and a bottle of booze out to the living room, where he could have a nice glass of Tennessee whisky while enjoying a wake-up smoke. After having a glass of J.D., served neat, and smoking his first Camel no filter cigarette, he started to feel a bit dizzy, so he decided to grab some food after all. He lit his second Camel and stood up from the couch on his way to the kitchen, but immediately blacked out and fell, face first, into the coffee table. The flimsy table collapsed and crumbled. The mostly full bottle of whiskey sitting atop it fell to the floor, where the flammable, amber liquid glugged out of the bottle, making a large puddle in the center of the carpet. The cigarette in his hand landed on a newspaper which was previously on the coffee table but ended up spread across the floor. The paper smoldered until a flame appeared and spread across the paper to the adjacent pool of liquor, which was rapidly soaking into the filthy carpet and the underlying floorboards. The ethanol from the whiskey ignited and within several minutes, the room, including Carl’s unconscious body, was engulfed in flame.
Fatal Flaws Page 28