The Doctor Digs a Grave

by Robin Hathaway

  In the silence that followed, Officer Santino smiled apologetically and found a seat in the corner. Horatio continued filing. Jennifer laid the book she had been clutching on a corner of the desk. Fenimore picked it up and riffled through it. Mrs. Doyle took out another parcel from her purse. This one was small, wrapped in brown paper, and tied with string. She placed it on the desk. Fenimore looked up. “Ah.” He recognized the wrapping instantly. “You’ve been to Otto’s.”

  Mrs. Doyle removed the wrapping. At first Jennifer saw only an empty jar. But on closer inspection, she noticed some black things curled on the bottom. As she watched, one of the black things separated itself from the other and started to move up the side of the jar. It had no legs. Like the toy animals you see stuck to the rear windows of cars, it adhered to the glass by suction.

  “Ugh.” Jennifer shivered, as recognition dawned.

  “Now, now,” Mrs. Doyle admonished her, “the leech is a much maligned creature. Just like the bat. They both suffer from bad press.” She picked up a pencil and placed it in the jar. They watched as the leech wrapped itself around it. As soon as she felt it was securely attached, Mrs. Doyle removed it and with a deft motion applied it to the outer edge of Fenimore’s left eye.

  “Doesn’t it hurt?” Jennifer was horrified.

  “Not a bit,” Fenimore said.

  “What does it feel like?”

  “Like a light pinch,” he said, shrugging.

  Fascinated, Jennifer watched Mrs. Doyle draw out the second leech and apply it to the periphery of Fenimore’s right eye.

  “Now you watch. In no time that vivid purple will turn to a pale lavender and then fade away completely.” The nurse patted her patient’s arm.

  To pass the time, Jennifer asked, “How are bats useful, Mrs. Doyle?”

  “Insects, dear. If it weren’t for bats, we’d be overrun with them—gnats, flies, mosquitoes, and the rest. Bats do their work at night, while we’re asleep, so we don’t appreciate them. Right, Doctor?”

  He nodded. Like his two assailants, he thought bitterly.

  The two women looked at him with concern. Slouched in his chair, still in rumpled pajamas, with a leech attached to each eye, he looked very forlorn and un-Fenimore-like.

  Horatio, casting a cautious glance at the officer in the corner, left his filing cabinet to come inspect Mrs. Doyle’s handiwork. “Whew,” he whistled. “Where’d you get those suckers?” He was the first to wake up to the fact that leeches don’t grow on trees. Nor are they available in the average supermarket.

  “A little drugstore on the other side of town,” Mrs. Doyle said enigmatically. She wasn’t about to give out her trade secrets. If there was a run on leeches, they might not be available the next time she needed them.

  Officer Santino coughed discreetly from his corner.

  “Oh, Officer, would you like a cup of coffee or tea?” Having finished her work as a cosmetologist, Mrs. Doyle became the gracious hostess.

  “That would be nice. Tea, please.”

  “I think we could all use a cup,” she said. “Jennifer? Doctor?”

  “I’ll help,” Jennifer said, heading for the kitchen.

  “Make mine java,” Horatio said over his shoulder.

  While the women toiled in the kitchen in a very politically incorrect fashion, Fenimore chatted with Officer Santino. “It was my own fault. I opened the door.”

  “Why did you?”

  “They said they had a message from Rafferty.”

  “Um.” Santino shifted on his chair. “After drugs?”

  “No. They ransacked the place to make it look like a robbery, but they didn’t take anything.”

  “A warning?”

  Fenimore paused. He would have to tell Rafferty anyway. He nodded.

  Conversation lagged until the women came back with the drinks. “It’s almost gone!” Jennifer stopped midway as she was handing Fenimore his tea.

  “What?”

  “The purple. Look, Mrs. Doyle.”

  Mrs. Doyle sniffed, unexcited. She passed a pocket mirror to Fenimore.

  “Bravo, Doyle. You’ve done it again,” he crowed. “That stint of yours in the theater has stood you in good stead.”

  “Theater?” Things were moving too fast for Jennifer.

  “Mrs. Doyle was once a member of Plays and Players,” Fenimore explained.

  Horatio came to inspect. “Not bad.” He sent Mrs. Doyle a grudging look of admiration. “They could use you at the rings.”

  “Rings?”

  “Boxing, Doyle,” Fenimore explained. “Would you like to leave my services and patch up boxers after their fights? The pay’s probably much better.”

  Mrs. Doyle sniffed again.

  “How do you get those suckers off?” Horatio was staring at the leeches.

  For the answer, Mrs. Doyle drew the last surprise from her purse—a saltcellar. She sprinkled a little of its contents on each leech. They let go and fell into her palm. She returned them to the glass jar.

  “I don’t care how you look,”Jennifer said fervently. “How do you feel ?”

  “Fine. Right as rain. A-OK.”

  She shook her head. “What happens to those?” She nodded at the leeches.

  “Oh, they go in the refrigerator,” Fenimore said.

  Jennifer suppressed a shudder, envisaging them between the mustard and the ketchup.

  “Then back to the store,” Fenimore added.

  “You mean they get recycled?”

  “Well, I have no more use for them. And,” he lowered his voice, “with Hercules over there, I don’t expect to.”

  Jennifer shook her head again. “There must be something I can do for you.”

  “Not a thing. This book you brought will keep me occupied for hours.” He tapped the cover of The Lenape, by Herbert C. Kraft. “It just happens to be a definitive work on the Lenape Indians.”

  “Well …” She hesitated, wanting to kiss him but intimidated by the audience: a nurse, a policeman, a file clerk, and a cat. Sal had suddenly emerged from under the radiator, a puff of dust clinging to her tail. Jennifer blew Fenimore a kiss instead.

  As soon as she had gone, Fenimore was out of his chair. “I’ve got to get to work.”

  “Work?” Mrs. Doyle was startled. “Shouldn’t you go back to bed?”

  “Surely you don’t think I put you to all this trouble”—he waved at the cluttered desk—“to send me back to bed.” He was halfway up the stairs. “My public awaits.” He bowed deeply to his audience of four and scurried up the rest of the stairs.

  CHAPTER 23

  STILL LATER THURSDAY MORNING

  Despite the delay for cosmetic surgery, Fenimore arrived at the emergency room of Franklin Hospital at 10:00 A.M. But not alone. Officer Santino stood in the hallway, watching him through the glass door of the ER. The young woman at the desk, cradling a cup of steaming coffee, glanced up. She registered nothing when she saw his face. Three cheers for Mrs. Doyle.

  “I’d like to see the records of Joanne Field.” (He had almost forgotten her Anglicized name.) “She was here on Saturday, October 29th—in the late afternoon, around 4:30. But she left before she could be admitted.” He showed her his identification.

  The nurse blinked. “I think I was on duty, Doctor. Was she a Native American?”

  “Yes.” Another eyewitness? He could hardly believe his good fortune.

  “I’ll get the file.” She disappeared between a pair of sliding glass doors.

  He watched her walk over to a desk and boot up a computer. The scent of the coffee she had left behind reached him. In his convalescent mode, he had wanted tea. In his recovery mode, he wanted coffee. He looked around for the coffeepot. He spotted it in a corner, complete with packets of sugar, milk, and Styrofoam cups. ER employees, apparently, were undaunted by warnings about high cholesterol and recycling. Helping himself, he went back to the reception desk. He had scalded his mouth twice before the nurse came back and handed him a printout.

/>   “It was quiet here that day, Doctor,” she said. “That’s why I remember her. Later on it was a zoo. We had an apartment fire, a three-car accident, and a stabbing. But when your patient walked in, it was as quiet as a church.”

  “Tell me what you remember.”

  “Well, the thing I remember about her is that after a very short time, she walked out. And a few minutes later Dr. Sheehab, two nurses, and an orderly came rushing after her.”

  “What did they say?”

  “The doctor said, ‘That woman who just left is an MVA case. Is there any way we can get her back?’ I said, ‘Her home number must be on her chart.’ And he said—I remember this distinctly—‘She may not make it home.’”

  MVA stood for malignant ventricular arrythmia, a condition known in the popular medical vernacular as “the Pearly Gates syndrome.” If you had it, and it was untreated, that’s where you were headed.

  Fenimore glanced at the file. “Anything else?”

  “No. Except she looked terrible. I almost stopped her myself. But she was moving so fast and looked so determined … .” She shrugged.

  Fenimore thanked her and, still studying the file, felt his way to an empty chair. When he came to the electrocardiograms, he let out a low whistle. No wonder they had run after her. After scanning the computer printout of her SMA 20 blood test, he laid the file aside to consider.

  The report held the following significant facts: distinct abnormalities in her electrocardiograms—heart block, ventricular tachycardia, and MVA. Such irregularities could occur years after complete repair of tetralogy of Fallot. But the presence of another factor altered this conclusion. Her SMA 20 blood test revealed a potassium level of 7. Very high. Top normal was 5. These two results taken together pointed to a different diagnosis altogether: digitalis toxicity. In order to verify this, he must have the blood test of her digoxin level. He riffled through the file. Where was it? Surely they had done one. He went back to the desk.

  “I’m sure it was done, Doctor. Some blood serum is always put in a separate tube with a lab slip requesting a digoxin level.”

  “Then why isn’t it here?”

  She frowned. “I don’t know.”

  A pretty poor show. Fenimore thought that his hospital staff was sloppy, but he had never known them to lose a blood test. Disgruntled, he returned to his chair. As he read on, he discovered that Dr. Sheehab had shared his suspicions. At the end of the file, he had scrawled in his own hand, “Test results suggest possible dig toxicity. Staff prepared to administer FAB to patient, but despite strong recommendations to be admitted to the hospital, she left of her own volition.” He was also covering himself, in case of a lawsuit.

  “FAB,” Fenimore murmured. Fragments of antigen binding. He was familiar with the treatment. Derived from sheep, it was an antibody which, if administered in time, was capable of rendering digoxin inactive. If Sweet Grass had not signed herself out—if she had stuck around long enough to receive this treatment—she might still be alive today. He rubbed his eyes and reached for his coffee.

  If Sweet Grass had been suffering from dig toxicity, he had three questions: (1) When was the lethal dose administered? (2) How? and (3) By whom?

  It might have been administered shortly before her attack, at the picnic. Did one of the picnickers lace her potato salad with powdered digoxin tablets? But Mrs. Henderson had told him that they all had helped themselves from the same serving dishes. If any of them had been seasoned with digitalis, some of the other guests would have developed symptoms.

  Fenimore chucked his Styrofoam cup into the nearest wastebasket. Of course, Sweet Grass might have received the dose earlier, during her visit with Roaring Wings. A little digoxin could easily go unnoticed in a cup of strong herb tea. It was hard to know how fast these drugs would work. It depended on many factors: age, weight, how tired you were, how long it had been since you had last eaten … Then again, Sweet Grass, feeling despondent after the picnic, could have increased her own dose of digoxin. He returned the file to the nurse.

  “I don’t suppose there’s any hope that this patient’s blood serum sample is still lying around the lab.”

  She shook her head. “That’s disposed of right away, especially if the patient checks out before being admitted.”

  He nodded. His own hospital followed the same procedure. But, in order to prove digitalis toxicity, he had to have a sample of that serum. He thanked her and was about to leave when he remembered something. “Uh, one more favor. Could you call George Johnson out here.”

  “The orderly?”

  He nodded.

  She paged him on the intercom. Johnson appeared in a few minutes. A lanky black man with a friendly grin, he was glad to help. Unfortunately, he couldn’t add much to what Fenimore had already gleaned from Johnson’s girlfriend.

  “I don’t know, Doc. It all happened so fast. She was in and out before any of us could blink an eye. It’s not often someone with Pearly Gates takes off. We were all kind of in shock. Even the doc. But there was no stoppin’ her. She was determined.” The same word the nurse had used.

  Fenimore nodded. “Well, thanks anyway.”

  It was a brisk morning. Autumn had finally given Indian summer a swift kick in the pants. Fenimore turned up his collar and buried his hands in his pockets. It was that chilly. Absorbed in his thoughts, he forgot about his shadow, Officer Santino, hovering a few yards behind. He passed a fruit vendor flipping chunks of pineapple, cantaloupe, and strawberries into plastic containers for the lunch crowd. A pigeon abandoned a prize chunk of pretzel to make way for Fenimore, and a homeless man blocked his way to ask for a quarter. He dug into his pocket and came up with one. While his mind was registering these details on one level, it was churning rapidly away on another.

  Sweet Grass had been born with tetralogy of Fallot. The defect had been surgically corrected when she was a child, but she still required a daily regimen of digitalis. Under stress from her pending wedding, she had experienced two episodes of rapid heartbeat. According to her diary, her doctor had prescribed a small dose of Inderal in addition to her regular digoxin, but no increase in her dig regimen. He made a mental note to visit Dr. Robinson later that day.

  As he turned the corner, he kicked a soda can into the gutter, a sure sign that he was preoccupied. Normally, he would have lobbed it into a trash can. (Santino did so.) Sweet Grass had complained to Doris of nausea, headache, and dizziness—all symptoms of simple food poisoning. But she had felt bad enough to seek out the ER. There, they had taken several electrocardiograms. The results were alarming, and she had been strongly urged to admit herself to the hospital. Instead, she walked out. Of course, this denial of her illness could be explained by her pending wedding. She couldn’t face the prospect of an illness that might cause a delay. (Having never been on the brink of matrimony, it was clever of Fenimore to deduce this.)

  Red light. He waited at the curb, oblivious to the other pedestrians elbow to elbow on either side of him. He would feel better if he could absolutely establish the cause of death. But he couldn’t do that without the blood serum sample. Once the cause was established, he could go on to whether it was accidental or deliberate. And, if the latter, who was to blame.

  Green light. He crossed. Facing him was the hospital. Without realizing it, he had circled the block. He decided to go back in and bother the nurse for one more look at the report. Maybe he’d missed something.

  As the nurse handed him the folder, she said, “I just thought of something.”

  He looked up.

  “That blood serum you asked for …”

  “Yes?” His heart rose.

  “It may still be around. There’s a doctor here doing research on MVA. There’s the memo.” She pointed to a notice attached to the corkboard over her desk. “We’re supposed to send a sample of blood serum from all MVA cases to his lab. You might find what you want there.”

  His heart leaped. “What’s his name?”

  “Applethorn.”
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  His heart sank. He knew him. The most suspicious research doctor in all of researchdom. If he asked Applethorn for one of his blood samples, he would immediately suspect Fenimore of trying to steal a jump on his research. Applethorn slunk around the hospital corridors looking over his shoulder even more than the doctors who were on the lamb from the IRS. Nevertheless, Fenimore would have to give it a try. “Thanks. I’ll look into it.” She had been helpful. How was she to know that Applethorn was paranoid?

  CHAPTER 24

  THURSDAY AFTERNOON

  Deciding that a personal visit would produce better results than a phone call, Fenimore scanned the list of names on the board beside the elevators. Applethorn and his lab were located on the fifth floor.

  Fenimore stepped into the elevator, quickly followed by Officer Santino. “I had a little shadow …” Fenimore muttered to himself.

  Applethorn’s office was protected from the rest of the hospital by a heavy glass door. When Fenimore pulled it open, he was met with a hush usually reserved for church sanctuaries. In the tones of a church usher, a jittery receptionist informed him that the doctor would see him presently. Between phone calls, she kept glancing over her shoulder at the door behind her as if the Furies were about to descend on her. The turnover in this job, he suspected, must be fairly high.

  His last encounter with Dr. Applethorn had been at a cardiology conference in Boston. Fenimore traveled there each October to catch up on the latest innovations in his field. The topics that year had been especially erudite and impractical, and Applethorn had been reading one of the principal papers. During the question-and-answer period, Fenimore had asked a question that had cast some doubt on the premise on which Applethorn’s entire research project was based. At the cocktail party afterward, he had caught the research man staring at him once or twice, in a manner that could only be described as malevolent. But that was more than four years ago. He hoped, by now, the doctor had forgotten the incident.