Under the Knife

by Tess Gerritsen

  Pokie laughed. “Brophy’s idea of paradise is an air-conditioned concrete box.” Reaching for the report, he sighed. “That’s it, Davy. I got work to do.”

  “You going to reopen the case?”

  “I’ll think about it.”

  “What about Avery? If I were you, I’d—”

  “I said I’ll think about it.” He flipped open the report, a rude gesture that said the meeting was definitely over.

  David saw he might as well bang his head against a brick wall. He rose to leave. He was almost to the door when Pokie suddenly snapped out: “Hold it, Davy.”

  David halted, startled by the sharpness of Pokie’s voice. “What?”

  “Where’s Kate right now?”

  “I took her to my mother’s. I didn’t want to leave her alone.”

  “Then she is in a safe place.”

  “If you can call being around my mother safe. Why?”

  Pokie waved the report he was holding. “This just came in from M.J.’s office. It’s the autopsy on Decker. He didn’t drown.”

  “What?” David moved over to the desk and snatched up the report. His gaze shot straight to the conclusions.

  Skull X-rays show compression fracture, probably caused by lethal blow to the head. Cause of death: epidural hematoma.

  Pokie sank back wearily and spat out an epithet. “The man was dead hours before he hit the water.”

  * * *

  “VENGEANCE?” SAID JINX Ransom, biting neatly into a freshly baked gingersnap. “It’s a perfectly reasonable motive for murder. If, that is, one accepts there is such a thing as a reasonable motive for murder.”

  She and Kate were sitting on the back porch, overlooking the cemetery. It was a windless afternoon. Nothing moved—not the leaves on the trees, not the low-lying clouds, not even the air, which hung listless over the valley. The only creature stirring was Gracie, who shuffled out of the kitchen with a tray of rattling coffee cups and teaspoons. Pausing outside, Gracie cocked her head up at the sky.

  “It’s going to rain,” she announced with absolute confidence.

  “Charlie Decker was a poet,” said Kate. “He loved children. Even more important, children loved him. Don’t you think they’d know? They’d sense it if he was dangerous?”

  “Nonsense. Children are as stupid as all the rest of us. And as for his being a mild-mannered poet, that doesn’t mean a thing. He had five years to brood about his loss. That’s certainly long enough to turn an obsession into violence.”

  “But the people who knew him all agree he wasn’t a violent man.”

  “We’re all violent. Especially when it concerns the ones we love. They’re intimately connected, love and hate.”

  “That’s a pretty grim view of human nature.”

  “But a realistic one. My husband was a circuit-court judge. My son was once a prosecutor. Oh, I’ve heard all their stories and believe me, reality’s much grimmer than we could ever imagine.”

  Kate gazed out at the gently sloping lawn, at the flat bronze plaques marching out like footsteps across the grass. “Why did David leave the prosecutor’s office?”

  “Hasn’t he told you?”

  “He said something about slave wages. But I get the feeling money doesn’t really mean much to him.”

  “Money doesn’t mean diddly squat to David,” Gracie interjected. She was looking down at a broken gingersnap, as if she wasn’t quite sure whether to eat it or toss it to the birds.

  “Then why did he leave?”

  Jinx gave her one of those crystal-blue looks. “You were a surprise to me, Kate. It’s rare enough for David to bring any woman to meet me. And then, when I heard you were a doctor… Well.” She shook her head in amazement.

  “David doesn’t like doctors much,” Gracie explained helpfully.

  “It’s a bit more than just dislike, dear.”

  “You’re right,” agreed Gracie after a few seconds’ thought. “I suppose loathe is a better word.”

  Jinx reached for her cane and stood up. “Come, Kate,” she beckoned. “There’s something I think you should see.”

  It was a slow and solemn walk, through the feathery gap in the mock orange hedge, to a shady spot beneath the monkeypod tree. Insects drifted like motes in the windless air. At their feet, a small bunch of flowers lay wilting on a grave.

  Noah Ransom

  Seven Years Old.

  “My grandson,” said Jinx.

  A leaf fluttered down from the tree and lay trembling on the grass.

  “It must have been terrible for David,” Kate murmured. “To lose his only child.”

  “Terrible for anyone. But especially for David.” Jinx nudged the leaf aside with her cane. “Let me tell you about my son. He’s very much like his father in one way: he doesn’t love easily. He’s like a miser, holding on to some priceless hoard of gold. But then, when he does release it, he gives it all and that’s it. There’s no turning back. That’s why it was so hard on him, losing Noah. That boy was the most precious thing in his life and he still can’t accept the fact he’s gone. Maybe that’s why he has so much trouble with you.” She turned to Kate. “Do you know how the boy died?”

  “He said it was a case of meningitis.”

  “Bacterial meningitis. Curable illness, right?”

  “If it’s caught early enough.”

  “If. That’s the word that haunts David.” She looked down sadly at the wilted flowers. “He was out of town— some convention in Chicago—when Noah got sick. At first, Linda didn’t think much of it. You know how kids are, always coming down with colds. But the boy’s fever wouldn’t go away. And then Noah said he had a headache. His usual pediatrician was on vacation so Linda took the boy to another doctor, in the same building. For two hours they sat in the waiting room. After all that, the doctor spent only five minutes with Noah. And then he sent him home.”

  Kate stared down at the grave, knowing, fearing, what would come next.

  “Linda called the doctor three times that night. She must have known something was wrong. But all she got from him was a scolding. He told her she was just an anxious mother. That she ought to know better than to turn a cold into a crisis. When she finally brought Noah into Emergency, he was delirious. He just kept mumbling, asking for his Daddy. The hospital doctors did what they could, but…” Jinx gave a little shrug. “It wasn’t easy for either of them. Linda blamed herself. And David…he just withdrew. He shrank into his tight little shell and refused to come out, even for her. I’m not surprised she left him.” Jinx looked off, toward the house. “It came out later, about the doctor. That he was an alcoholic. That he’d lost his license in California. That’s when David turned it into his personal crusade. Oh, he ruined the man, all right. He did a very thorough job of it. But it took over his life, wrecked his marriage. That’s when he left the prosecutor’s office. He’s made a lot of money since then, destroying doctors. But the money’s not why he does it. Somewhere, in the back of his mind, he’ll always be crucifying that one doctor. The one who killed Noah.”

  That’s why we never had a chance, Kate thought. I was always the enemy. The one he wanted to destroy.

  Jinx wandered slowly back to the house. For a long time, Kate stood alone in the shadow of the old tree, thinking about Noah Ransom, seven years old. About how powerful a force it was, this love for a child; as cruelly obsessive as anything between a man and a woman. Could she ever compete with the memory of a son? Or ever escape the blame for his death?

  All these years, David had held on to that pain. He’d used it as some mystical source of power to fight the same battle over and over again. The way Charlie Decker had used his pain to sustain him through five long years in a mental hospital.

  Five years in a hospital.

  She frowned, suddenly remembering the bottle of pills in Decker’s nightstand. Haldol. Pills for psychotics. Was he, in fact, crazy?

  Turning, she looked back at the porch and saw it was empty. Jinx and Gracie had gone i
nto the house. The air was so heavy she could feel it weighing oppressively on her shoulders. A storm on the way, she thought.

  If she left now, she might make it to the state hospital before the rain started.

  * * *

  DR. NEMECHEK WAS a thin, slouching man with tired eyes and a puckered mouth. His shirt was rumpled and his white coat hung in folds on his frail shoulders. He looked like a man who’d slept all night in his clothes.

  They walked together on the hospital grounds. All around them, white-gowned patients wandered aimlessly like dandelion fluffs drifting about the lawn. Every so often, Dr. Nemechek would stop to pat a shoulder or murmur a few words of greeting. How are you, Mrs. Solti? Just fine, Doctor. Why didn’t you come to group therapy? Oh, it’s my old trouble, you know. All those mealyworms in my feet. I see. I see. Well, good afternoon, Mrs. Solti. Good afternoon, Doctor.

  Dr. Nemechek paused on the grass and gazed around sadly at his kingdom of shattered minds. “Charlie Decker never belonged here,” he remarked. “I told them from the beginning that he wasn’t criminally insane. But the court had their so-called expert from the mainland. So he was committed.” He shook his head. “That’s the trouble with courts. All they look at is their evidence, whatever that means. I look at the man.”

  “And what did you see when you looked at Charlie?”

  “He was withdrawn. Very depressed. At times, maybe, delusional.”

  “Then he was insane.”

  “But not criminally so.” Nemechek turned to her as if he wanted to be absolutely certain she understood his point. “Insanity can be dangerous. Or it can be nothing more than a gentle affliction. A merciful shield against pain. That’s what it was for Charlie: a shield. His delusion kept him alive. That’s why I never tried to tamper with it. I felt that if I ever took away that shield, it would kill him.”

  “The police say he was a murderer.”

  “Ridiculous.”

  “Why?”

  “He was a perfectly benign creature. He’d go out of his way to avoid stepping on a cricket.”

  “Maybe killing people was easier.”

  Nemechek gave a dismissive wave. “He had no reason to kill anyone.”

  “What about Jenny Brook? Wasn’t she his reason?”

  “Charlie’s delusion wasn’t about Jenny. He’d accepted her death as inevitable.”

  Kate frowned. “Then what was his delusion?”

  “It was about their child. It was something one of the doctors told him, about the baby being born alive. Only Charlie got it twisted around in his head. That was his obsession, this missing daughter of his. Every August, he’d hold a little birthday celebration. He’d tell us, ‘My girl’s five years old today.’ He wanted to find her. Wanted to raise her like a little princess, give her dresses and dolls and all the things girls are supposed to like. But I knew he’d never really try to find her. He was terrified of learning the truth: that the baby really was dead.”

  A sprinkling of rain made them both glance up at the sky. Wind was gusting the clouds and on the lawn, nurses hurried about, coaxing patients out of the coming storm.

  “Is there any possibility he was right?” she asked. “That the girl’s still alive?”

  “Not a chance.” A curtain of drizzle had drifted between them, blotting out his gray face. “The baby’s dead, Dr. Chesne. For the last five years, the only place that child existed was in Charlie Decker’s mind.”

  * * *

  THE BABY’S DEAD.

  As Kate drove the mist-shrouded highway back to Jinx’s house, Dr. Nemechek’s words kept repeating in her head.

  The baby’s dead. The only place that child existed was in Charlie Decker’s mind.

  If the girl had lived, what would she be like now? Kate wondered. Would she have her father’s dark hair? Would she have her mother’s glow of eternity in her five-year-old eyes?

  The face of Jenny Brook took shape in her mind, an impish smile framed by the blue sky of a summer day. At that instant, fog puffed across the road and Kate strained to see through the mist. As she did, the image of Jenny Brook wavered, dissolved; in its place was another face, a small one, framed by ironwood trees. There was a break in the clouds; suddenly, the mist vanished from the road. And as the sunlight broke through, so did the revelation. She almost slammed on the brakes.

  Why the hell didn’t I see it before?

  Jenny Brook’s child was still alive.

  And he was five years old.

  * * *

  “WHERE THE HELL is she?” muttered David, slamming the telephone down. “Nemechek says she left the state hospital at five. She should be home by now.” He glanced irritably across his desk at Phil Glickman, who was poking a pair of chopsticks into a carton of chow mein.

  “You know,” Glickman mumbled as he expertly shuttled noodles into his mouth, “this case gets more confusing every time I hear about it. You start off with a simple act of malpractice and you end up with murder. In plural. Where’s it gonna lead next?”

  “I wish I knew.” David sighed. Swiveling around toward the window, he tried to ignore the tempting smells of Glickman’s take-out supper. Outside, the clouds were darkening to a gunmetal gray. It reminded him of just how late it was. Ordinarily, he’d be packing up his briefcase for home. But he’d needed a chance to think, and this was where his mind seemed to work best—right here at this window.

  “What a way to commit murder, slashing someone’s throat,” Glickman said. “I mean, think of all that blood! Takes a lot of nerve.”

  “Or desperation.”

  “And it can’t be that easy. You’d have to get up pretty close to slice that neck artery.” He slashed a chopstick through the air. “There are so many easier ways to do the job.”

  “Sounds like you’ve put some thought into the matter.”

  “Don’t we all? Everyone has some dark fantasy. Cornering your wife’s lover in the alley. Getting back at the punk who mugged you. We can all think of someone we’d really like to put away. And it can’t be that hard, you know? Murder. If a guy’s smart, he does it with subtlety.” He slurped up a mouthful of noodles. “Poison, for instance. Something that kills fast and can’t be traced. Now there’s the perfect murder.”

  “Except for one thing.”

  “What’s that?”

  “Where’s the satisfaction if your victim doesn’t suffer?”

  “A problem,” Glickman conceded. “So you make ’em suffer through terror. Warnings. Threats.”

  David shifted uneasily, remembering the bloodred skull on Kate’s wall. Through narrowed eyes, he watched the clouds hanging low on the horizon. With every passing minute, his sense of impending disaster grew stronger.

  He rose to his feet and began throwing papers into his briefcase. It was useless, hanging around here; he could worry just as effectively at his mother’s house.

  “You know, there’s one thing about this case that still bothers me,” remarked Glickman, gulping the last of his supper.

  “What’s that?”

  “That EKG. Tanaka and Richter were killed in just about the bloodiest way possible. Why should the murderer go out of his way to make Ellen O’Brien’s death look like a heart attack?”

  “The one thing I learned in the prosecutor’s office,” said David, snapping his briefcase shut, “is that murder doesn’t have to make sense.”

  “Well, it seems to me our killer went to a lot of trouble just to shift the blame to Kate Chesne.”

  David was already at the door when he suddenly halted. “What did you say?”

  “That he went to a lot of trouble to pin the blame—”

  “No, the word you used was shift. He shifted the blame!”

  “Maybe I did. So?”

  “So who gets sued when a patient dies unexpectedly on the operating table?”

  “The blame’s usually shared by…” Glickman stopped. “Oh, my God. Why the hell didn’t I think of that before?”

  David was already reaching for
the telephone. As he dialed the police, he cursed himself for being so blind. The killer had been there all along. Watching. Waiting. He must have known that Kate was hunting for answers, and that she was getting close. Now he was scared. Scared enough to scrawl a warning on Kate’s wall. Scared enough to tail a car down a dark highway.

  Maybe even scared enough to kill one more time.

  * * *

  IT WAS FIVE-THIRTY and most of the clerks in Medical Records had gone for the day. The lone clerk who remained grudgingly took Kate’s request slip and went to the computer terminal to call up the chart location. As the data appeared, she frowned.

  “This patient’s deceased,” she noted, pointing to the screen.

  “I know,” said Kate, wearily remembering the last time she’d tried to retrieve a chart from the Deceased Persons’ room.

  “So it’s in the inactive files.”

  “I understand that. Could you please get me the chart?”

  “It may take a while to track it down. Why don’t you come back tomorrow?”

  Kate resisted the urge to reach over and grab the clerk by her frilly dress. “I need the chart now.” She felt like adding: It’s a matter of life and death.

  The clerk looked at her watch and tapped her pencil on the desk. With agonizing slowness, she rose to her feet and vanished into the file room.

  Fifteen minutes passed before she returned with the record. Kate retreated to a corner table and stared down at the name on the cover: Brook, Baby Girl.

  The child had never even had a name.

  The chart contained pitifully few pages, only the hospital face sheet, death certificate, and a scrawled summary of the infant’s short existence. Death had been pronounced August 17 at 2:00 a.m., an hour after birth. The cause of death was cerebral anoxia: the tiny brain had been starved of oxygen. The death certificate was signed by Dr. Henry Tanaka.

  Kate next turned her attention to the copy of Jenny Brook’s chart, which she’d brought with her. She’d read these pages so many times before; now she studied it line by line, pondering the significance of each sentence.

  “…28-year-old female, G1PO, 36 weeks’ gestation, admitted via E.R. in early labor…”