Crisis

by Robin Cook

  By the time Jack got back to the ER, the shift had changed. Although the ER was still peaceful, Jack had to wait to talk with the nurse and the doctor while they got themselves updated on the patients present who were waiting for test results or for the arrival of their personal physicians. It was close to three thirty when Jack finally was able to sit down with them in a small staff lounge area directly behind the admitting desk. Both were young. Jack guessed early thirties.

  Jack said essentially the same thing he’d said to Noelle at the outset, but the emergency-room staff’s response was much less emotional or censorious. In fact, Georgina, in her bubbly style, professed to have been greatly impressed by Craig.

  “I mean, how many doctors arrive at the ER riding with the patient in the ambulance? I can tell you: not many. The fact that he’s being sued is a travesty. It shows how far out of whack the system is when doctors like Dr. Bowman are ambushed by the likes of the ambulance-chaser lawyer on the case. I can’t remember his name.”

  “Tony Fasano,” Jack offered. He was enjoying hearing someone who shared his thoughts, although he wondered if Georgina had heard the social side of Craig’s tale, especially since Leona had come to the ER that fatal night.

  “That was it: Tony Fasano. When he first came snooping around here, I thought he was an extra in one of those gangster movies. I really did. I mean, I couldn’t imagine he was for real. Did he really go to law school?”

  Jack shrugged his shoulders.

  “Well, it wasn’t Harvard, I can tell you that. Anyway, I can’t imagine him calling me as a witness. I told him exactly what I thought of Dr. Bowman. I think he did a great job. He even had a portable ECG machine and had already tested for biomarkers before they arrived here at the ER.”

  Jack nodded as Georgina spoke. He’d read all this in her deposition in which she’d fulsomely praised Craig.

  When she fell silent, Jack said, “What I wanted to talk to you people about was the cyanosis.”

  “What about the cyanosis?” Dr. Matt Gilbert asked. It was the first time he’d spoken. His laid-back personality was overwhelmed by Georgina’s vivacity.

  “You remember the cyanosis, silly,” Georgina said, giving Matt a playful slap on the shoulder before Jack could speak. “She was as blue as a blue moon when they brought her in here.”

  “I don’t think that expression has anything to do with color,” Matt said.

  “It doesn’t?” Georgina questioned. “Well, it should.”

  “Do you not remember the cyanosis?” Jack asked Matt.

  “Vaguely, I suppose, but her general condition trumped everything else.”

  “You described it as ‘central cyanosis’ in your notes,” Jack said to Georgina. “Was there some specific reason for that?”

  “Well, of course! She was blue all over, not just her fingers or legs. Her whole body was blue until they got her on oxygen with the respirator and started doing cardiac massage.”

  “What do you think might have been the cause?” Jack asked. “Do you think it could have been a right-to-left shunt or maybe severe pulmonary edema?”

  “I don’t know about a shunt,” Matt said. “But she didn’t have any pulmonary edema at all. Her lungs were clear.”

  “One thing I remember,” Georgina said suddenly. “She was completely flaccid. When I started another IV line, her arm was like a rag doll’s.”

  “Is that unique, in your experience?” Jack asked.

  “Yeah,” Georgina said. She looked at Matt for confirmation. “There’s usually some resistance. I guess it varies with the degree of consciousness.”

  “Did either of you see any petechial hemorrhages in her eyes, any strange marks on her face or neck?”

  Georgina shook her head. “I didn’t.” She looked at Matt.

  “I was worrying too much about the big picture to see any such details,” Matt said.

  “Why do you ask?” Georgina questioned.

  “I’m a medical examiner,” Jack explained. “I’m trained to be cynical. Smothering or strangulation has to be at least considered in any sudden death with cyanosis.”

  “Now that’s a new angle,” Georgina said.

  “A biomarker assay confirmed a heart attack,” Matt said.

  “I’m not questioning there was a myocardial infarction,” Jack said. “But I’d be interested if something other than a natural process brought it on. Let me give you an example. I once had a case of a woman, arguably a few years older than Mrs. Stanhope, who had a heart attack immediately after being robbed at gunpoint. It was easy to prove a temporal connection, and the perpetrator is sitting on death row to this day.”

  “My word!” Georgina said.

  After giving both individuals a business card that included his cell phone number, Jack headed back to his car. By the time he unlocked the door and climbed in, it was after four o’clock. He sat for a moment, looking out at the small pond. He thought about his conversation with the hospital staff, thinking it was a wash in regard to Craig’s cause between Noelle and Georgina, with one avidly for and one avidly against. The trouble was that Noelle was surely going to testify, whereas Georgina, as she expected, probably would not since she wasn’t on the defense list. Other than that, he hadn’t learned much, or if he had, he was too dumb to recognize it. One thing was for certain: He’d liked and was impressed by all these people, and if he got into an accident and was brought in there, he’d feel he was in good hands.

  Jack thought about his next move. What he would have liked to do was drive back to the Bowman house, suit up in his basketball gear, and have a run with David Thomas, Warren’s friend, over on Memorial Drive. But realistically speaking, Jack knew that if there were any chance of his contributing to the case by doing an autopsy on Patience Stanhope’s earthly remains, he had to force himself to face Jordan Stanhope with the idea of getting him to sign the exhumation permit. The problem was how to get him to do it short of procuring a pistol and holding it to his temple. Jack could not think of a single reasonable stratagem and ultimately resigned himself to ad-libbing while trying to appeal to the man’s sense of justice and fairness.

  Jack took out the three-by-five index card that Harold Langley had given him with Harold’s cell phone number and Jordan Stanhope’s address. Balancing it on the steering wheel, he picked up the trusty Hertz map and tried to find the street. It took a bit of patience, but he located it near both Chandler Pond and Chestnut Hill Country Club. Assuming that the court would have recessed somewhere in the three thirty to four o’clock range, he thought now would be as appropriate a time as any to drop in for a visit. Whether he’d get into the man’s house or not he had no idea, but it wasn’t going to be for lack of trying.

  It took him a half hour of navigating a maddening maze of twisty streets to find the Stanhope house. The fact that Jordan Stanhope was a wealthy man was immediately apparent. The house was huge, with spacious, immaculate grounds, carefully pruned trees and shrubs, and flowering gardens. A shiny, new, dark blue Bentley two-door coupe was parked in the circular drive that fronted the house. A separate three-car garage with a carriage house above was just visible through the trees to the right of the main building.

  Jack pulled his Hyundai Accent up alongside its obscenely expensive counterpart. The juxtaposition was a study in contrasts. He got out of his car and approached the other. He had to look inside the extravagant machine, humorously attributing his unexpected interest to a heretofore unexpressed gene on his Y chromosome. The windows were down, so the aroma of the luxurious leather bathed the whole area. The car was obviously brand-spanking-new. After making sure he wasn’t being observed, Jack stuck his head through the driver’s-side window. The control panel had a simple, rich elegance. Then he noticed something else: The keys were in the ignition. Jack stepped back. Although he thought it was the height of ridiculousness to spend the kind of money he imagined the car cost, the fact that the keys were available unleashed a pleasant fleeting fantasy of breezing down a scenic roa
d in the Bentley with Laurie at his side. It was a reverie that reminded him of a recurrent dream of flying he’d had in his youth. But the daydream quickly dissolved to be replaced by a mild embarrassment of coveting another man’s car, even if just for an imagined joyride.

  Jack skirted the Bentley and approached the front door. His reaction to the car had surprised him on several levels, most important of which concerned the idea of unabashedly enjoying himself. For many years after the fateful plane crash, he’d been unable to do so, since it aroused his guilt of being the only one in the family still alive. The fact that he could entertain the idea now was the best suggestion yet that he’d made significant progress toward recovery.

  After ringing the doorbell, Jack turned back to the gleaming Bentley. He’d thought about what the car meant to him, but now he pondered what it said about Jordan Stanhope, aka Stanislaw Jordan Jaruzelski. It suggested that the man was seriously indulging himself with his new wealth.

  Hearing the door open brought Jack’s attention around and to the issue at hand. In his inside jacket pocket was the signatureless exhumation permit, and it crinkled as he brought his hand up to shield his eyes. The late afternoon sun was reflecting off the polished brass door knocker and momentarily blinded him.

  “Yes?” Jordan questioned. Despite the glare, Jack could tell he was being eyed suspiciously. Jack was wearing his usual jeans, blue chambray shirt, knitted tie, and summer-weight blazer that hadn’t been cleaned or pressed for longer than he cared to admit. In contrast, Jordan had on a plaid smoking jacket with a cravat. From around his silhouette wafted cool, dry air, suggesting the home’s air-conditioning was on despite the mild outdoor temperature.

  “I’m Dr. Stapleton,” Jack began. With a sudden decision to suggest a quasi-official explanation for his visit, Jack fumbled to extract his wallet with his medical examiner badge. He held it up for moment. “I’m a medical examiner, and I’d like a moment of your time.”

  “Let me see!” Jordan said as Jack tried to quickly return the wallet and badge to its normal location.

  Jack was surprised. Rarely did people actually examine his official credentials.

  “New York?” Jordan questioned, glancing back up into Jack’s face. “Aren’t you rather far afield?” To Jack’s ear, Jordan spoke with a mock-melodiousness and a hint of an English accent that Jack associated with elite New England boarding schools. To Jack’s double surprise, Jordan had reached out to grasp Jack’s hand to steady it while he’d studied the badge. His precisely manicured fingers were cool to the touch.

  “I take my job seriously,” Jack said, defensively reverting to sarcasm.

  “And what is your job that brings you from New York all the way to our humble home?”

  Jack couldn’t suppress a smile. The man’s comment suggested he had an ironic sense of humor similar to Jack’s. The home was anything but humble.

  “Who is it, Jordie?” a crystalline voice called from the cool depths of the home’s interior.

  “I don’t precisely know yet, dearest,” Jordan affectionately called back over his shoulder. “It’s a doctor from New York.”

  “I’ve been asked to help with the legal case you are currently involved in,” Jack said.

  “Really!” Jordan said with a hint of amazement. “And exactly how are you intending to help?”

  Before Jack could answer, an attractive, doe-eyed young woman half Jordan’s age appeared from around Jordan and stared at Jack. She had slipped an arm around Jordan’s neck and the other around his middle. She smiled pleasantly, revealing startlingly white, perfect teeth. “Why are you standing here? Invite the doctor in! He can join us for tea.”

  Following the woman’s suggestion, Jordan stepped to the side, motioned for Jack to come into the house, and then led him on a lengthy journey through a central hall, an expansive living room, and out into a conservatory built off the building’s rear. Surrounded on three sides and roofed with glass, the room gave Jack the feeling he was back outdoors in the garden. Although Jack initially had thought “tea” was to be a euphemism for cocktails, he was wrong.

  Ensconced in an oversized white wicker chair with pastel chintz cushions, Jack was served tea, whipped cream, and biscuits by a reserved woman in a French maid’s uniform who quickly disappeared. Jordan and his girlfriend, Charlene McKenna, were seated opposite on a matching wicker sofa. Between Jack and his hosts was a low glass table supporting a silver service with additional sweets. Charlene could not keep her hands off Jordan, who acted as if he were unaware of her overt affection. The conversation initially ranged freely before centering on their plans for the summer, which were to include a cruise along the Dalmatian coast.

  It was amazing to Jack that the couple were willing to do all the talking. He sensed that they were starved for entertainment, since he didn’t have to say much beyond where he was from and that he was currently a houseguest at his sister’s in Newton. After that, all he had to do was give an occasional “un-huh” to indicate he was paying attention. This gave Jack lots of opportunity to merely observe, and he was fascinated. Jack had heard that Jordan was enjoying himself, and had apparently been enjoying himself practically from the day Patience Stanhope had died. There had been little time for mourning since Charlene had moved in with him several weeks after the funeral. The Bentley in the driveway was only a month old, and the couple had spent a portion of the winter in St. Bart’s.

  Thanks to a melding of this new information with his cynical nature, the possibility in Jack’s mind of foul play being involved in Patience’s death became more than a passing thought and made the idea of doing an autopsy even more appropriate and necessary. He thought about going back to the Boston medical examiner’s office with his suspicions, even if entirely circumstantial, to see if they would be willing to approach the district attorney about going to a judge to order the exhumation, because surely Jordan would never agree to one if he’d been in any way responsible for Patience’s death. But the longer Jordan talked and the more apparent it was that he was playing the role of an ersatz, cultured, aristocratic gentleman, the less sure Jack was of Jordan’s response to an autopsy. There had been criminal cases where the perpetrators thought themselves so intelligent that they actively helped law enforcement just to prove how smart they were. The pretender Jordan seemed to be might fall into that category and agree to an autopsy to make the game that much more exciting.

  Jack shook his head. His rationality suddenly kicked in, and he knew without a shadow of doubt that he was letting his imagination run wild.

  “You don’t agree?” Jordan asked. He’d seen Jack’s head motion.

  “No, I mean yes,” Jack said as he verbally stumbled, trying to cover his blunder. The truth was he’d not been following the conversation at that point.

  “I’m saying the best time to go to the Dalmatian coast is during the fall and not the summer. You don’t agree?”

  “I agree,” Jack insisted. “There’s no doubt whatsoever.”

  Mollified, Jordan returned to what he’d been saying. Charlene nodded appreciatively.

  Jack went back to his musing and admitted to himself that the chance of foul play being involved with Patience’s death was infinitesimally small. The main reason was that Patience had had a heart attack and that there’d been too many accomplished physicians involved, including Craig. Craig wasn’t Jack’s favorite person, particularly to be married to his sister, but he was one of the sharpest, most knowledgeable physicians that Jack had ever known. There was no way Jordan could have fooled such a collection of professionals by somehow causing his wife to have a heart attack.

  Such a realization yanked Jack back to square one. The medical examiner’s office could not get him an exhumation and autopsy. If it were to happen, he had to do it himself. In that regard, Jordan’s masquerading as the Boston Brahmin might help. Jack could appeal to him as a gentleman, since true gentlemen have a duty to set the example in ethical behavior by making sure justice prevails. It was
a long shot, but it was all he could come up with.

  While Jordan and Charlene debated the best time of year to go to Venice, Jack put down his cup and saucer and reached into his side pocket to pull out one of his business cards. When a break occurred in the conversation, he leaned forward and with his thumb snapped the card down onto the glass tabletop.

  “I say! What do we have here?” Jordan questioned, immediately taking the bait. Bending forward, he glanced at the card before picking it up to examine it more closely. Charlene took it from him and looked at it as well.

  “What’s a medical examiner?” Charlene asked.

  “It’s the same thing as a coroner,” Jordan explained.

  “Not quite,” Jack said. “A coroner historically is an appointed or elected official tasked to look into causes of death, who may or may not have any specific training. A medical examiner is a medical doctor who’s had graduate training in forensic pathology.”

  “I stand corrected,” Jordan said. “You were about to tell me how you intend to help with my suit, which I have to say I’m finding rather a bore.”

  “And why is that?”

  “I thought it would be exciting, like watching a boxing match. Instead, it is tedious, like watching two people arguing.”

  “I’m certain I could make it more interesting,” Jack said, snatching the opportunity Jordan’s unexpected opinion about the trial afforded him.

  “Please be more specific.”

  “I like your simile comparing the trial to boxing, but the reason the match is uninteresting is because the two boxers are blindfolded.”