"Anaphylactic," Anna said softly, afraid to break into the narrative now that the woman was talking.
"Yeah, that. Made him swell up like a toad. Doc had to give him two or three shots of that adrenalin stuff. And some cortisone."
In Anna's mind, the pieces dropped into place. A previous severe reaction to penicillin was a warning flag to every doctor who treated the patient after that. Never give penicillin or any of the drugs that might produce a similar reaction. Like Omnilex, the antibiotic the fake Eric Hatley received in the emergency room. The drug that undoubtedly killed this woman's son.
"Mrs. Hatley, do you have any family? Do you have anyone who can be with you right now?" Anna asked.
The woman shook her head, and the curtain of listlessness descended once more. "No family. My husband passed last year. Eric was my only child."
"Do you have brothers or sisters?"
She shook her head.
"Was Eric married?"
Again, the head shake. "No, he lived alone—had a bachelor apartment—but he spent a lot of time here. He took care of me. Bought groceries, ran errands, drove me to doctors' appointments. He was such a good son." She sobbed softly."Now I don't have anybody."
"Would you like me to get something for you? Can I do anything?"
"Not unless you can bring Eric back." Mrs. Hatley looked up, and Anna felt the eyes bore into her. "A man came by yesterday. Lawyer. Said Eric shouldn't have died. I signed the papers to sue all the doctors and the hospital and everybody. Won't bring Eric back, but it will pay for somebody to take care of me."
"Mrs. Hatley. One of those doctors you're suing is me."
The woman almost spat her response. "I know."
Anna scanned the faces of the group assembled in the department chairman's office and tried to count the allies among them. Unfortunately, other than the chair, Dr. Fowler, she wasn't sure there were any. Laura Ernst, dressed in a tailored navy suit and plain white blouse, frowned and tapped a yellow pencil on the legal pad she balanced on her lap. Dr. William Dunston, the Dean of Clinical Affairs, brushed a fleck of lint offthe vest of his gray pinstripe suit.
Fowler leaned back in his chair and polished his rimless glasses with the tail of his white coat. "Anna, why don't you tell us what you've learned about the death of your patient, Eric Hatley?"
Anna cleared her throat. "To recap, Mr. Hatley died from a massive allergic reaction during the final phase of his emergency laparotomy for multiple gunshot wounds. We'd given him antibiotic prophylaxis in the form of Omnilex, after confirming he received that drug without incident during an earlier emergency room visit. The pathologist rendered a cause of death as anaphylaxis due to a reaction to Omnilex. Regretfully, I have to agree."
Dunston clasped his hands over his ample belly. "So there appears to be a conflict between the man's prior tolerance of the drug and the massive anaphylaxis he experienced more recently. What do you make of that?"
"I began looking into it." Anna passed Dunston the emergency room record she'd been holding. "The identifying data on this visit matches what we got from Hatley's wallet. However, if you look at Dr. Fell's note, the patient is described as a 'young, African-American male.' Hatley was a middleaged Caucasian."
Dunston scanned the record, then passed it on to Ernst, who read it and frowned. "Can you explain the disparity?" the lawyer asked.
"I believe I can." Anna said. "Someone used Hatley's medical insurance information to get treatment. Maybe he didn't want a venereal disease reported to his own insurance company. More likely, he didn't have insurance but was able to steal Hatley's information and use it. I think that identity theft eventually cost Eric Hatley his life."
"And did you later confirm that Eric Hatley had a history of drug allergy?" Fowler's tone was more neutral than Anna might have liked. Was he going to stand behind her?
Anna described her visit with Wanda Hatley. "Had we known of her son's sensitivity to antibiotics of that class, we could have chosen a different drug, and the odds are that he'd be alive today. But we were unable to contact her while Hatley was in surgery. Instead, we relied on the ER record. In hindsight, I think we made the best possible decision under the circumstances. But he died."
"I believe I asked you not to make contact with this patient's family." There was ice in Ernst's voice. "Now I understand that the mother is taking steps to file a malpractice suit against the medical center and all the doctors involved in her son's treatment."
"She talked with that lawyer before I ever contacted her."Anna regretted her sharp tone as soon as the words were out of her mouth. She might not like Laura Ernst, but she needed her as an ally, not an enemy. "I'm sorry. I'm still trying to figure out why Hatley died. I thought maybe I could learn something from his mother that would shed light on the situation. Obviously, I was wrong."
Dunston looked directly at Anna. "Well, the issue here of someone posing as the patient and leaving false information on his medical record certainly muddies the waters. I'll have to leave it to Laura to sort out the legal ramifications of that." He pursed his lips. "From a medical standpoint, it appears that you acted appropriately, but on flawed information. We don't know how this is going to play out, but I'd like to be kept informed of the progress in this case." He shifted his gaze to Fowler."Please send me a summary of the M&M discussion." Then he swiveled toward Ernst. "I want to be copied on all communication regarding any legal actions." With that, he eased himself upright and left the room.
Ernst was on her feet next. "If I were a plaintiff' s attorney I'd be salivating to get my hands on this case."
"But, I—"
The lawyer stopped Anna with an upraised hand. "Dr. McIntyre, I don't want to argue with you. I'm aware that you and Dr. Nguyn took actions that are defensible, actions that fall entirely within the standard of care. But that doesn't mean we're not in for a fight." She retrieved her briefcase from beside her chair and shoved her legal pad into it. "I'm going to want to research this a bit, but it may be that the person really at fault in Hatley's death is the one responsible for that false information getting into his medical records. Whether any action on that front would be civil or criminal remains to be seen, and it still may not affect our liability." She nodded toward Fowler, then Anna. "Please let me know if you learn anything more."
Ernst paused at the door and looked back at Anna. Anna thought perhaps she was going to ask about her dealings with the Dallas police, inquire whether Donovan had returned her call. Instead, Ernst gave a faint shake of her head, shifted her briefcase to her other hand, and walked out.
Anna started to stand, but Fowler motioned for her to sit."Hang on just a minute, would you?" He walked to the door and closed it, then returned to his seat behind his desk. "I suggest you let Laura worry about the Hatley case for now. In the meantime, what have you found out about your DEA number turning up on forged narcotics prescriptions?"
"Well, there may be more going on than just that," Anna said. She told him about her credit cards and her compromised credit.
"So you think someone is using your identity, not just to write narcotics 'scripts but to buy things and charge them to you. Have you figured out how? And why?"
Anna shook her head. "Unfortunately, I don't have a clue, but I intend to keep looking. The latest development is that the police have questioned me and searched my home."
"The police? Not the DEA?"
"Apparently, I'm under suspicion by both."
"Do you have a lawyer?" Fowler asked.
"I called Laura Ernst during the police search. She had me throw them out and tell them not to come back without a warrant. Then she gave me the name of an attorney. I'm waiting for him to call me back."
"Why do you think they wanted to search your place?"
Anna had to unclench her teeth to answer. "They have this idea that I'm part of some grand narcotics scheme. I keep hoping that they and the DEA will finally decide I'm a victim here, not a criminal. Whatever happened to innocent until proven
guilty? It all seems so unfair."
Fowler held his hands apart, palms up. "Fair's rarely an option in life. Well, keep me posted. I'll see you back here on Friday for the M&M conference."
Anna waited for some word of encouragement from her chairman. Instead, he said, "Good luck," and turned back to the stack of papers centered on his desk blotter.
Anna juggled two bulging grocery sacks while she dug for her keys in a purse that strained at the seams. After struggling for what seemed like five minutes, she set her burdens on the front porch. The key ring was, of course, in the furthest depths of her purse. The lock failed to yield to her first couple of tries. She jiggled the key repeatedly and was about to give up when the lock finally opened. Funny, she didn't recall having any trouble like this in the past. Anna peered at the area of the doorjamb around the lock tongue and wondered if those scratches were fresh. Had someone broken in? And could that person still be inside?
She rummaged in her purse and found her cell phone. She had dialed "9-1" before she stopped. This was silly. She was being paranoid. The lock probably needed some graphite, the scratches were old, and she was getting upset about nothing. Besides that, if she called the police every time she saw a shadow, they might not believe her if she really needed them.
Maybe if she went back to the car and got the tire iron out of the trunk—
"What's up?"
Anna was sure she jumped a foot. She swiveled her head around so quickly she heard the bones in her neck crackle. Nick Valentine stood just offthe porch, his hands in the pockets of his windbreaker. "Did I scare you?" he asked.
"Yes. Definitely." She took a deep breath. "But I'm glad to see you. What brings you here?"
"I tried to call before I left the med center, but there was no answer."
"My cell didn't ring. I must have been in a dead zone."
Nick shrugged. "We haven't talked in a couple of days, and I wanted to see what you've found out." He reached down and hefted the grocery bags. "Let me give you a hand with those."
"No! Don't go in." Anna put her hand on his arm. "Sorry. I'm jumpy. Probably it's nothing, but when I got home, the lock on the front door was sticking. Then I saw some scratches around it and thought maybe somebody had broken in. I was about to call the police."
Nick laid the bags beside the door. "No need for that. Just give me a sec." He turned and hurried to his car. She saw him pull something from the glove compartment and shove it into his jacket pocket before striding back to the porch. He motioned Anna aside. "You stay out here until I check things out."
"Don't do anything foolish."
"I won't." Nick reached into his pocket and pulled out a small revolver. He held it loosely in his right hand, his index finger outside the trigger guard, the short barrel pointing skyward."But if someone is hiding in there, they're going to wish they hadn't picked this house."
"That's it. No intruders inside, and no sign that one's been here." Nick jammed the gun into his pocket before retrieving the grocery bags from the front porch. "Where do you want these?"
Nick noticed a strange look on Anna's face as he helped unpack the bags in her kitchen. "Hey, I don't blame you for being suspicious," he said. "But I looked at those scratches around the lock, and I'm pretty sure they're old. And the lock probably needs some graphite."
Anna pulled a chair away from the kitchen table and dropped into it. "No, I'm glad it was nothing. What has me upset is the sight of you with that gun in your hand." She dry washed her face with a hand that trembled slightly. "I guess I didn't expect that."
"Would you like me to put it away?"
"Please."
Nick went outside and placed the gun back in its resting place under a stack of road maps in his car's glove compartment.Glad I didn't need it. But I'm glad it's there.
As he walked back into the house, he held out his hands in a "look, they're empty" gesture.
"Thanks," Anna said.
Nick picked up the empty paper bags from the counter and folded them carefully before he sat down across the table from Anna. "I'm sorry. I guess I should explain why I have the gun."He leaned forward with his elbows on the table. "During my first year of med school I moonlighted at an all-night convenience store in Lubbock. If you read the papers or watch the news, you know that's a dangerous job. The owner refused to keep a gun behind the counter. He was one of those who believed that if you handed the robber the money, you wouldn't get hurt." Nick began moving the saltshaker in random circles on the tabletop. "I spent my first paycheck on the training course required for a concealed carry permit. Then I bought this gun. Every night I worked, I had it on a shelf under the cash register." He looked down and closed his eyes as the memories came back, sharp-edged and fresh.
Anna's voice was quiet, almost a whisper. "So it kept you safe."
"In a manner of speaking." He opened his eyes and looked directly into hers. "A guy came in at two one morning, hopped up on speed or something. He pulled a gun out of his belt and pointed it at me. Told me to give him all the money in the register. The way his hands were jerking, I was praying that gun didn't have a hair trigger. I pulled out the bills—probably about seventy dollars—and all the time, my eyes never left that automatic in his hand. The barrel looked about as big as the mouth of a tunnel. Then I thought I saw his trigger finger start to twitch." He shook his head, but couldn't stop the film that was unwinding in his head.
"Go on."
Nick wiped a thin film of sweat from his brow. "I was holding my gun under the counter. I'd grabbed it with my right hand while he was watching my left get the bills out of the cash drawer. I saw that movement and decided it was him or me. I pulled the trigger. One shot in the chest. The coroner said he was dead before he hit the floor."
"You did what you had to do," she said. "He could have killed you."
"Maybe." He dropped his hands on the table and stared into Anna's face. "Unfortunately, the only way to be sure of that had sort of a permanent downside to it. I made a decision, and I stuck with it. Then I put it behind me."
"But you still have the gun."
Nick wasn't sure whether it was a question or a statement, and Anna's tone gave him no clue about what she was feeling right now. "I keep my permit up-to-date, and I carry the gun locked in the glove compartment of my car."
"Why?" In that single word, Nick heard both disbelief and disapproval.
"You can't argue that the parts of town around a hospital are generally pretty unsafe, and the place where we work is no exception. Carjackings, robberies, random drive-by shootings. Back when I was going to church regularly, I recall the preacher saying we live in a broken world. I believe he was right."
"So you depend on your gun to protect you?"
"Sure," Nick said. "What's your protection?"
"The same protection I've depended on for years—God."
Nick thought there was less than total conviction in Anna's voice, but decided not to challenge her. Instead, he said, "I'm not sure God and I are on speaking terms anymore. I seem to remember some commandment about 'Thou shalt not kill.' So far as I know, that hasn't been repealed, has it?"
Anna brushed her hair aside with a casual and probably unconscious gesture. "I think there's room for discussion there, Nick. You might be surprised at how much God can forgive, if you'll let him."
Nick wanted to believe Anna, but surely the taking of a human life brought too much guilt for even God to forgive. He'd made his decision that day, and there was nothing he could do to change it. "Anna, I appreciate what you're saying. But if I'd depended on God instead of Smith and Wesson, I might have been the one lying dead on that floor. It's a good thing I decided to look out for myself. But now I have to live with the consequences."
Anna put her hand on Nick's arm. "You really don't, you know. But I don't think this is the time to talk about it. I'll just say thank you for being here for me today."
Nick rose slowly, feeling as though he were a hundred years old. "You know, I was going to
see if you'd like to have dinner with me tonight, but now I don't think I'm very good company. Why don't I head home?"
"Please don't. When I was really down, you kept after me until I went out with you. You really cheered me up, and I appreciate it. I'd like to return the favor." Anna reached into the pocket of her skirt and extracted a multi-colored plastic rectangle. "Besides that, I have a new credit card. Why don't you let me test it out?"
Nick forced a smile. Why not? This probably wasn't the greatest time to be alone anyway. "Sure. This time you pick the restaurant."
6
THE NEXT MORNING, ANNA TOOK HER SECOND CUP OF COFFEE TO THE living room, where the letter lay partially unfolded on her desk, only the DEA seal at the top showing. She brushed her fingertips across the stiffpaper— good quality bond, your tax dollars at work—but didn't bother to pick it up and read it. No need. The words were burned into her mind. Just as Hale promised, the letter had come to Anna's office at the med school the day after she met with the two agents. When Anna called the legal office to notify them of the letter and its contents, she got no further than Laura Ernst's administrative assistant. As though reading from a script—and maybe she was—the woman warned Anna to keep Ms. Ernst informed of further developments. No offer of help. Not a drop of sympathy. Just a boilerplate admonition designed to protect the interests of the medical school. The same kind of response Ernst had given Anna about the Hatley case.
Well, in a way, Anna couldn't blame the woman. She probably fielded a dozen calls like this every week, calls from doctors who were worried about malpractice suits or trying to straighten out problems with licensure or attempting to cut through the Gordian knot of regulations that threatened to strangle the independent practice of medicine. Not much fun to work in the legal office of a large medical center.
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