Crisis

by Robin Cook

  “You hit that hulky hoodlum?” Alexis questioned with disbelief. “What have you become in your adulthood, self-destructive?”

  “People have accused me of that in the not-too-distant past. I like to think of myself as occasionally impulsive with a touch of self-righteous recklessness.”

  “I don’t find this at all funny,” Alexis said.

  “Nor do I,” Jack agreed. “But the episode, especially me getting whacked, helped my argument with Jordan, which I originally thought was hopeless.” Jack reached into his inner jacket pocket and pulled out the exhumation permit. He placed it on the table and smoothed it out with the palm of his hand. “Jordan signed the exhumation permit.”

  Alexis drew the form closer to herself. She looked at Jordan’s signature and blinked several times as if she expected it might disappear.

  “That kind of eliminates any suspicion of his involvement,” Craig said, looking over Alexis’s shoulder.

  “Who knows,” Jack said. “What it does for certain is that it puts the idea of an autopsy on the table as a legitimate option. It’s no longer a mere theoretical possibility, although now we’re up against a time constraint. Assuming that can be overcome, the question is whether you people want me to do it or not. It has to be decided tonight.”

  “My feelings have not changed from this morning,” Craig said. “There’s no way to be sure whether it would help or hurt, and I can make an argument in either direction.”

  “I think there’s slightly more chance it might help than hinder because of the cyanosis issue,” Jack said. “There must be some anatomical explanation, some contributory pathology. But you are right: There are no guarantees.” Jack shrugged. “But I don’t want to push the idea. I’m not here to make things worse. It’s your decision.”

  Craig shook his head. “As confused as I am, it’s hard to make a decision. I think I’m against it because of the unknown, but what do I know. I’m hardly in a position to be objective.”

  “How about asking Randolph?” Alexis suggested. “If something positive were found by the autopsy, he’d have to figure out how to get it admitted as evidence. With rules of discovery, it is not a given it could be.”

  “You’re right,” Jack said. “Randolph should be consulted. It would be an exercise in futility if the findings couldn’t be introduced.”

  “There’s something not right in this picture,” Craig said. “I’m questioning the men’s competence and considering replacing him, and you both think we should let him decide whether or not to do an autopsy.”

  “We can tell him Jordan Stanhope’s story at the same time,” Alexis said, ignoring Craig.

  “Can we get him on the phone and discuss it with him tonight?” Jack asked. “The decision about whether or not to do the autopsy really cannot wait. Even if it’s given a green light, I can’t be certain it will happen. There are too many variables and not a lot of time.”

  “We can do better than call him,” Alexis said. “He lives just around the corner.”

  “Fine,” Craig said, throwing up his hands. He didn’t feel strongly enough about it to overrule both Alexis and Jack. “But I’m not going to be the one to call.”

  “I don’t mind calling,” Alexis said. She got up and went over to the desk.

  “You seem to be feeling better,” Jack said to Craig while Alexis was using the phone.

  “It’s up and down,” Craig said. “One minute I’m depressed and the next minute hopeful that truth will win out. It’s been that way since this mess started back in October. Yet today had to be one of the worst days, hearing Bill Tardoff testify against me. I’ve always been friendly with the man. I really don’t understand it.”

  “Is he a good doctor?”

  Craig glared at Jack before saying, “Ask me that in a couple of days. At the moment, I’d be giving you an emotional response. Right now, I’d like to kill the guy.”

  “I understand,” Jack said, and he did. “What about Dr. Noelle Everette? Does she have a good reputation?”

  “With me or the hospital community?”

  “Both.”

  “Like with Bill, my feelings changed after this malpractice suit. Before I thought she was okay, not great but okay, and I referred to her on occasion. After the suit, I’m as mad at her as I am at Bill. As far as her general reputation is concerned, it’s fine. She’s well liked, although not so dedicated as most.”

  “Why do you say that?”

  “She only works half-time officially, although it’s more like three-quarters time. Her excuse is her family, which is nonsense. I mean, we all have families.”

  Jack nodded as if he agreed, but he didn’t. He thought Craig should have given Noelle’s work ethic a try. He probably would have been happier and a far better husband and father.

  “The reason I asked about Noelle Everette,” Jack said after a pause, “is because she said something interesting today. She said some of the old-fashioned physicians, a group in which she included herself, were angry about you concierge doctors. Does that surprise you?”

  “Not really. I think they might be jealous. Not everybody can switch to a retainer practice. It depends a lot on their patient base.”

  “You mean whether the patient base is wealthy or not.”

  “That’s a big part of it,” Craig admitted. “Concierge practice is an enviable lifestyle compared with the mess standard practice is being put in. I’m making more money in a lot less time.”

  “What happened to your patients from your old practice who couldn’t come up with the retainer fee?”

  “They were referred to other people’s standard practice.”

  “So they were in a sense abandoned.”

  “No, not at all. We spent a lot of time giving them names and numbers of other doctors.”

  To Jack it sounded very much like abandonment, but he didn’t argue. Instead, he said, “So you see the kind of anger Noelle was talking about as stemming from envy.”

  “I can’t think of any other reason.”

  Jack could think of a number, including the concept of professionalism Noelle had mentioned, but Jack wasn’t interested in a debate. It was the malpractice case he was most interested in, so he asked, “Was Patience Stanhope an old patient of yours from your old practice?”

  “No. She was a patient of the physician who started the concierge practice that I’m now essentially running. He’s in Florida and not in the best of health.”

  “So in a sense you inherited her?”

  “In a sense.”

  Alexis came back to the table. “Randolph is coming right over. He’s interested in the autopsy idea but has reservations, including its admissibility, like I feared.”

  Jack nodded, but he was more interested in his conversation with Craig, and he had been debating how to word his next question. “Craig, remember this morning when I mentioned the idea of smothering or strangulation in relation to Patience Stanhope, which I later realized was ridiculous, since she died of a heart attack?”

  “How could I forget?”

  “It’s an example of how medical examiners like me think. I mean, I wasn’t making any allegations of any sort. I was kind of thinking out loud, trying to relate central cyanosis to the rest of the facts. In retrospect, you understand, don’t you? At the time, you were bothered by the suggestion.”

  “I understand, but I’m not myself these days for obvious reasons. I’m sorry.”

  “No need to apologize. I’m bringing it up only because I want to ask you a question that occurred to me when Noelle Everette made her comment about a group of old-fashioned doctors being angry about concierge doctors. It’s a question you might think outlandish, the same way you responded to the mentioning of strangulation and smothering this morning.”

  “You’ve piqued my curiosity. Ask your question.”

  “Can you think of any remotely possible way you could have been set up by Patience Stanhope’s death? What I’m suggesting is that someone might have seen
her passing as a way to put concierge medicine in a bad light. Does this idea resonate at all, or am I once again somewhere beyond the orbit of Pluto?”

  A small smile appeared at the corners of Craig’s mouth and slowly spread inward until he laughed and shook his head in wonderment. “What you lack in rationality, you certainly make up for in creativity.”

  “Remember, it is a rhetorical question. I don’t expect an answer; just tuck it away in the archives of your brain and see if it resonates with any other facts you’ve not told anyone.”

  “Are you suggesting some kind of conspiracy?” Alexis asked. She was as taken aback as Craig.

  “Conspiracy implies more than one,” Jack said. “Like you asked me to do on the phone, I’m thinking out of the box.”

  “That’s way out of the box,” Craig said.

  The doorbell precluded any more talk of malevolent medical machinations, which was how Craig referred to Jack’s idea as Alexis went to the door. When Alexis returned with Randolph Bingham in tow, Jack and Craig were chuckling at other clever names Craig was able to conjure up. Alexis was pleasantly surprised. Craig was showing more normal behavior than he had in months, which was even more unusual, considering the stressful day in court.

  Jack was reintroduced to Randolph. The first time had been outside the courtroom that morning before the trial had recommenced. There hadn’t been much time, and Alexis, who’d done the introducing, merely said that Jack was her brother, whereas now she included details of Jack’s professional qualifications.

  Randolph didn’t say anything during Alexis’s monologue, although he nodded a few times at key points. “I’m pleased to make your acquaintance again,” he said when Alexis concluded.

  “Likewise,” Jack said. He felt there was an unease about the situation. Randolph was irrepressibly staid. Although he’d changed from his meticulously tailored courtroom suit, his idea of relaxed wear was a heavily starched, freshly pressed, long-sleeved white oxford shirt, pleated summer-weight wool pants with a knifelike crease, and a summer-weight cashmere sweater. As further evidence of his primness, he appeared to have shaved, in contrast to Jack and Craig, who both had the expected evening stubble, and his silver hair was as perfectly styled as it had been in court.

  “Should we sit here at the table or go into the living room?” Alexis asked as the host.

  “Wherever you’d like,” Randolph said. “But we must be expeditious; I have a lot of preparation yet to do tonight.”

  They ended up sitting around the table where they’d been before Randolph’s arrival.

  “Alexis has told me about your suggestion of doing an autopsy on the deceased,” Randolph said. “Perhaps you can tell me why this might be important at this eleventh hour.”

  To Jack’s ear, he spoke with the true melodiousness that Jack associated with elite New England schools, and it suddenly occurred to him that Randolph was the archetype to which Jordan aspired. The question of why Jordan wanted to do so was another matter, since Jack found Randolph a passionless man, a prisoner of his restrained formality.

  Jack ran down his short list in favor of an autopsy sans any reference to conspiracy or individually motivated foul-play theories. Then he gave his patented spiel about the role of a medical examiner’s talking for the dead. “In short,” Jack said as a kind of summation, “I believe an autopsy would afford Patience Stanhope her last day in court. My hope is to find enough pathology to clear Craig or, worst case, provide an argument for contributory negligence, since there is documentation the deceased refused a recommended cardiac workup.”

  Jack looked across at Randolph’s arctic-blue eyes for some response. There was none, nor was there from his mouth, which was a small, almost lipless horizontal slash halfway between his nose and the point of his chin. “Any questions?” Jack asked, hoping to generate a response.

  “I don’t believe so,” Randolph said at length. “You’ve stated your case succinctly and well. It is an intriguing possibility, which I had not thought of since the clinical aspects of the case are so clear. My biggest concern involves the admissibility of whatever you might find. If something were to be found truly relevant and exculpatory, I would have to petition the court for a continuance to allow for proper discovery. In other words, it could be up to the judge.”

  “Couldn’t I be called as a surprise rebuttal witness?”

  “Only to refute previous testimony, not to offer new testimony.”

  “I would be refuting the testimony of the plaintiff’s experts claiming malpractice.”

  “It’s stretching the rule, but I see your point. It would be up to the judge at any case, and he’d be ruling over strenuous objections from the plaintiff’s attorney. It would be an uphill struggle and would afford the plaintiff foundation for appeal if it were granted.

  “A final thought that adds to the difficulties of presenting such new evidence is my experience with Judge Davidson. He is known to like to move things along and is already irritated at the slow pace of this trial. There’s no doubt he wants to bring it to a close. He would not look kindly on new evidence brought in at the very last minute.”

  Jack shrugged and raised his eyebrows questioningly. “So you are against it?”

  “Not necessarily. This is a unique case with unique challenges, and we would be foolish not to do everything we possibly can for a positive outcome. New exculpatory evidence could be used as the basis to argue for a new trial through appeal. On the other hand, I believe the chances of finding something exculpatory are slim indeed. With that said, I’d come out sixty-forty in favor of doing it. So there you have it.”

  Randolph stood, as did the others. “Thank you for inviting me over and briefing me,” he said, shaking hands all around. “See you all in court.”

  As Alexis accompanied Randolph to the door, Jack and Craig sat back down. “He fooled me,” Jack said. “Just when I thought he was telling us he was against my doing the autopsy, he tells me he’s for it.”

  “I had the same reaction,” Craig said.

  “One thing this little meeting made me realize is that I don’t think you should change attorneys,” Jack said. “Randolph might be priggish, but he strikes me as keenly intelligent, and under that gentleman veneer, he’s a competitor. He definitely wants to win.”

  “Thanks for your opinion,” Craig said. “I wish I unquestioningly shared it.”

  Alexis returned. She acted mildly irritated. “Why didn’t you tell him about your run-in with Tony Fasano and the threat he gave you?”

  “I didn’t want to confuse the issue,” Jack said. “Same reason I didn’t bring up my wild theories of foul play or the surprising biography of Jordan Stanhope, aka Stanislaw Jaruzelski.”

  “I think that threat issue is more important,” Alexis said. “Doesn’t that bother you, being threatened like that?”

  “Not really. Tony Fasano’s worried about his investment, since he’s surely taken the case on contingency. With that said, he strikes me as someone who blows a lot of hot air.”

  “I don’t know,” Alexis said. “It concerns me.”

  “Well, folks!” Jack said. “It’s time to fish or cut bait. Am I going to try to do this autopsy or not? One thing I haven’t mentioned. From my experience, juries use a commonsense gut reaction in their decision making, but they like facts. Autopsy results are facts that they can grasp in contrast to testimony that is ephemeral and open to interpretation. Try to keep that in mind.”

  “If you can honestly tell me you are not concerned about Tony Fasano’s threat, then I’ll vote for the autopsy.”

  “And you, Craig?” Jack asked. “You’re the principal here. Your vote can trump the rest of us.”

  “My feelings haven’t changed,” Craig said. “I think there’s more chance finding stuff we don’t want to know than things we do. But I’m not going to vote against the two of you and Randolph.” He stood up. “Now I’m going to go up and put myself in the warm and fuzzy hand of a strong hypnotic. With the rest
of the plaintiff experts, Jordan Stanhope, and possibly Leona Rattner slated to testify, it’s going to be a taxing day tomorrow.”

  For a few minutes after Craig had disappeared upstairs, Jack and Alexis sat at the table, lost in their own thoughts. Jack was the first to speak after reaching out and picking up the scotch bottle. “Mixing this hard stuff and a strong hypnotic is not a good idea.”

  “I can’t argue with that.”

  “Have you been at all worried about Craig injuring himself?”

  “You mean overdosing?”

  “Yes, either intentionally or otherwise.” Jack could remember his own struggles with self-destructive thoughts during his years of fighting depression.

  “Of course I’ve thought about it, but that’s one aspect of narcissism in his favor. The devotees generally don’t hurt themselves. Also, his depression has been far from incapacitating, and he has been cycling regularly through periods of normalcy—like tonight, for instance. He probably wouldn’t admit it, but I think you have raised his spirits by being here. It means you care, and he respects you.”

  “That’s nice. But what’s he been taking for sleep? Do you know?”

  “Just the usual. I’ve kept close tabs. I’m embarrassed to say, I’ve even been counting the pills behind his back.”

  “You shouldn’t be embarrassed. That’s being prudent.”

  “Whatever,” Alexis said. She stood up. “I think I’ll head upstairs, check on the girls, and turn in myself. I hate to abandon you, but if Leona Rattner testifies tomorrow, it’s going to be particularly taxing for me, too.”

  “No problem,” Jack said. He got to his feet as well. “I’m tired myself, although I want to read over some of the depositions again. I keep thinking I might be missing something that would be key to keep in mind if and when I do the autopsy.”

  “I certainly don’t envy you working on someone who’s been buried for almost a year. How do you do this kind of work day in, day out? Isn’t it repulsive?”

  “I know it sounds unpleasant, maybe even ghoulish, but it’s actually fascinating. I learn something every day, and I don’t have any problem patients.”