The Midwife Murders

by James Patterson

  Freelancing, when you’re a midwife, means that you’re helping with deliveries but not in connection with a hospital. It’s, well, a totally unconnected freelance job. It’s usually dangerous. It means you have no real support system—no other midwives, no prenatal care, no postnatal care. It’s pretty much like the frontier days when a midwife showed up when the pain began and did her best to help the delivery. Freelancing is usually used by illegal immigrants and drug addicts and very often by women who don’t want anyone else to know they’re giving birth—that would be women like teenage prostitutes and homeless women. Most of the freelance midwives aren’t trained with the depth and knowledge professionals are. At least Tracy Anne has impeccable training and an excellent education. But it’s still a bad thing to do, and because of Tracy Anne’s association with GUH, it’s also totally forbidden by the hospital for her to do it.

  Back to Troy. He’s calmed down a little, but he’s still doing some serious shaking.

  “So Tracy Anne tells me that she’s done six freelance births in the last two weeks, and she did a few more before that. Well, more than ‘a few.’ So many other births that she’s even lost track. It seems the last six were all teenagers and they were all drug addicts. One of them surely had AIDS, Tracy Anne said, and another one was bleeding out so much they had to bring her to a really sketchy off-the-street clinic in Bed-Stuy.”

  Bobby Cilia shakes his head in wonder at the horror of this tale. Blumenthal stands in stony silence.

  “Anyway, Tracy Anne tells me that she’s getting all her freelance jobs from this Russian couple. I know, I know. Just like the ones you’re closing in on—that’s when I knew I couldn’t let the story rest without telling someone. And poor Tracy Anne was ready to kill herself. I mean truly, literally, she was talking about how she was in such deep shit already that there was no way out but to kill herself.”

  I say nothing, but I am incredibly angry and incredibly sad that one of my most trusted midwives has stooped to such a dangerous and unethical level. And I’m thinking, Why? Why do this, Tracy Anne? Okay, I’m sad, but I’m also shocked. No one is better at her job than Tracy Anne. And if you’re thinking that in her I saw the younger me, well, you’re absolutely correct.

  It’s also pretty clear that Troy knows everything about this. He keeps talking, and I keep being amazed. Now Troy tells us that Tracy Anne was paid a thousand dollars per delivery. They were all “at home” deliveries, although the home might’ve been a filthy basement room where dealers were cooking crack, or an outdoor alley in a Bronx housing project.

  “The thing is, Tracy Anne said these Russian people said they were selling the babies to give to rich people. At least that’s what they told Tracy Anne. And of course she believed them. Why not? It made her feel better.”

  “Yep. She wanted to believe them,” says Bobby. And I think he’s right about that.

  I jump in. “Where is Tracy Anne now?”

  “That’s just it,” says Bobby. “She disappeared two days ago. We’re looking for her.”

  I look at Troy. “You don’t know where she is, Troy?”

  “No. I don’t,” he says.

  “Are you sure?” I ask. Big mistake.

  Troy goes from being nervous and contrite to being angry and belligerent. “No, damn it! I absolutely do not know where that girl is hiding out. She’s scared. She’s in trouble with the police, with the hospital, with the Russian crazy people. So of course she’s gone and made herself disappear. She could be dead for all I know.”

  Bobby says, “This girl is deep in the shitter.”

  Troy starts talking again. “Look here, Lucy. I broke a confidence by coming in here. I know that. But I had to …”

  Blumenthal finally says something, and it’s not sympathetic to the situation. “Yeah, you broke a confidence about somebody who broke the law. They don’t give out medals for that.”

  I look at Troy and speak. I’m taking a safety risk with my question. “You’re positive that you don’t know where Tracy Anne is?”

  This time Troy answers calmly. “Positive as a man can be. But please don’t ask me again. My heart hurts every time you ask that question.”

  My mind is rushing with other questions, not just for Troy but for everybody in the room:

  What took Troy so long to tell anyone about this?

  Is Tracy Anne telling the truth? And where the hell is she?

  How can the NYPD get Orlov to talk?

  Where’s Nina?

  And there’s one other question. It’s small and dumb, but I just can’t shake this one out of my head:

  Detective Blumenthal, what’s the deal with you and this Barbara Holt woman?

  CHAPTER 63

  THIRTY MINUTES LATER, FYODOR Orlov is sitting at the table in the same interrogation room where Troy had been questioned. Leon Blumenthal sits on the opposite side of the table, facing Orlov. An armed police officer stands watching both men. Orlov has declined his right to have an attorney present.

  Bobby Cilia and I are on the other side of the mirror in the viewing room. Will Blumenthal be able to get information from Orlov? Both Blumenthal and Orlov look remarkably calm and determined, given the situation.

  “We now know a great deal more about you and your accomplice, Mr. Orlov,” says Blumenthal.

  Bobby looks at me and whispers, “That’s a mistake. Detective B shouldn’t call him mister. He shouldn’t be showing any respect for the guy.”

  My response to Bobby is a very clever: “Yeah, I’m sure you’re absolutely right.” That’s my personal shorthand for If you knew more than your boss, you’d be sitting where he is right now.

  Orlov’s response to Blumenthal is complete silence.

  Blumenthal begins talking again. This time he talks faster. As he talks, he builds up even more speed.

  “We know, for example, that you’ve been assisted by one of the midwives at GUH, Tracy Anne Cavanaugh,” says Blumenthal.

  Orlov’s reaction? A smirk, a sickly smile with twinkling eyes.

  I fantasize about crashing through the two-way mirror and choking the bastard. When that thought passes, I’m not very surprised to find that I’m thinking about Barbara Holt and her Louboutin shoes.

  “Your partner, your lady friend—we have her,” says Blumenthal. This is, of course, a complete lie. “We” do not have Nina. “We” do not even have a clue as to where Nina is.

  “Yeah,” continues Blumenthal. “Your buddy, or girlfriend, or mistress, or whatever the hell you want to call her, is sitting about a hundred feet away from you, down the hall, in a room just like this one. She’s being asked the same questions. She’s just—”

  Orlov stands quickly. The guarding officer steps in toward him and pushes him back down onto the chair.

  “Cuffs, Detective?” the officer asks.

  “No, not yet,” says Blumenthal. “But maybe soon.”

  “You are all so fucking stupid!” Orlov shouts. “You know nothing. You know that there are babies going to rich people who so long for what they cannot make themselves, but knowing even that, you still know nothing.”

  Blumenthal does not react. He lets an icy silence hang in the air, and it is that one minute or so of silence that seems to agitate Orlov.

  The Russian speaks. “You have Nina Kozlova, but you still have nothing.”

  I turn and speak to Bobby Cilia. “Well, we now do have one thing. We just got Nina’s last name.”

  “It’s funny,” Bobby says. “Funny how these Russians are sort of programmed to say people’s full names. The guy doesn’t call her just Nina. He calls her Nina Kozlova.”

  I had never thought of that, but it feels like it could be true. Nina Kozlova.

  The dialogue between Blumenthal and Orlov has fizzled, and I decide it’s eating up time that could be better spent looking for both Tracy Anne and Nina. When I mention this to Bobby, he says, “You’re right. But Detective Blumenthal has his own way of doing things. And his own way of doing things has
been proven mostly successful in the past.”

  “So you think he’ll spend the rest of the day sitting here and allowing Orlov to laugh at him.”

  “No, I don’t, not at all,” Bobby says. “I think he’ll move Orlov into a private interview room.”

  “I’m new to all this. This room here looks pretty private,” I say.

  “Pretty private. The other room, the private room, is very private.”

  “And that means?”

  “That means there’s no video recorder, no two-way mirror, no observers. It’ll be just Detective Blumenthal, maybe myself, maybe another detective, probably an emergency medic. Absolutely no one else.”

  I say nothing. I’m an enthusiastic amateur, but I’m an amateur. Yet I absolutely get what Bobby is saying.

  The liberal in me abhors the concept. The midwife in me says, Why the hell not try it? The babies! How can I forget the babies?

  As if on cue, I look back through the two-way mirror and watch Blumenthal stand up. He looks at Orlov. There’s a slight smile—not quite a pleasant smile—on Blumenthal’s face.

  “I want to thank you for your help and cooperation, Fyodor. In fact, you’ve been so helpful that I’d like to continue this conversation.”

  Blumenthal looks at the cop standing by the door. “Officer, would you please escort Mr. Orlov to room 301B. And after you’ve secured the interviewee, please make the usual arrangements.”

  All Bobby Cilia says is “Told ya, ma’am.”

  CHAPTER 64

  SECONDS LATER LEON BLUMENTHAL enters the observation room.

  “Where will you be taking Orlov?” I ask Blumenthal.

  He ignores my question. Instead he thrusts an iPad into my hands.

  I assume that whatever is on the iPad has something to do with the baby-napping cases.

  “Read it,” Blumenthal says. Then he looks at Bobby Cilia and says, “It’s the official release from the AG’s office.”

  Bobby nods. Obviously Cilia and Blumenthal know something I don’t know. I look down at the screen and read:

  New York State Assistant Attorney General Roseanne Fiore announced today the indictment of Dr. Barrett Katz, chief executive officer, of Gramatan University Hospital, the world-renowned medical complex in midtown Manhattan. Dr. Katz, who has taken a leave of absence, is accused of committing Medicaid fraud by falsifying hospital reimbursement records for guardians of handicapped or otherwise challenged patients.

  Ms. Fiore said, “Dr. Katz’s behavior and methodology were illegal in fact and shocking in scope.” Dr. Katz established bogus deposit accounts for patients, usually senior citizens, with significant dementia challenges. Their guardians were promised special “extra care” treatment for their charges when they agreed that certain Medicare payments be sent to Dr. Katz’s private bank accounts, many of which were set up in Caribbean countries and two cities in southern France, Marseilles and Nice.

  Bail was set at two million dollars for Dr. Katz, and he was released on his own recognizance. No trial date has been set.

  In Dr. Katz’s absence, Dr. Rudra Sarkar, GUH chair of obstetrics and gynecology, will assume the role of CEO. In a statement released by the hospital, Dr. Sarkar said, “We are astonished by these accusations, and we fully stand by Dr. Katz at this time.”

  Dr. Katz was not available for comment. He is said to be at his summer estate in Peconic, Long Island.

  I look at Blumenthal, who shrugs and opens both his eyes in a What can I tell you? expression.

  “How long has this been going on?” I ask.

  “About three years,” he says.

  Then Bobby jumps in: “But the investigation from the AG’s office has only been going for ten months. Even so, the evidence is there.”

  “And how long have you personally, privately, secretly known about this?” I ask Blumenthal.

  “Exactly four days,” he says. Anticipating my anger, he adds, “And that’s the absolute truth. This Katz guy is best buds with half the big shots in New York, and those big shots include the mayor and the commissioner, plus some of Gramatan’s biggest and most important donors.”

  “I believe you,” I say. I do believe Blumenthal, but what pisses me off is that Sarkar never mentioned any of this to me, not even when I saw Katz leave the hospital with what I now realize was a police escort. I should have insisted that Sarkar tell me what was happening. But—a big but—he should have offered up the info without my asking.

  I nod my head slowly, and with an appropriately small smile, I say to Blumenthal, “Maybe NYPD should have set up a whole special unit just to deal with crime at Gramatan University Hospital.”

  “Could be a job in it for you,” Blumenthal says with an equally small smile.

  Before I can invent a wiseass response, my cell phone begins ringing. It’s Troy.

  “What’s up?”

  “I’m back at the hospital,” he says. “I thought you’d want to know.”

  “I told you to go home and rest,” I say.

  “I was going to, and I was just about to leave from here, to go home, but then that Bella Morabito woman showed up. She’s in labor, and the other backup midwife hasn’t shown up yet. The Witten woman showed up, but she’s up to her neck in mothers-to-be.”

  Shit. Bella Morabito is a forty-three-year-old immigrant from Sicily. She has a fifteen-year-old daughter and a history of three miscarriages. She is also just about the nicest woman on earth—warm, funny, friendly. But I’m not looking forward to this delivery. This one could turn out to be very difficult. Like some of Bella’s previous birthing experiences, it may not turn out at all.

  “Stay with Bella, Troy. I’ll be there in ten minutes.”

  CHAPTER 65

  I WALK INTO BELLA’S birthing room and see so many people that it actually takes me a moment to find Bella on her bed. Her teenage daughter, her husband, her mother, Troy, two trainees in the midwife program, plus three other women, who are presumably Bella’s friends or more relatives.

  Bella is groaning significantly, but I recognize it as the healthy groaning of a healthy woman in healthy labor. A small speaker sits on the side table next to a laptop. From the speaker comes a song accompanied only by a guitar. The tune is easily recognizable. The Beatles. “Let It Be,” sung in Italian.

  Quando mi trovo in momenti difficili

  Madre Maria viene da me

  “How are we doing here?” I ask.

  Bella grabs both my hands and says, “Signora Lucy, please make it all good.”

  “We’ll do our best,” I say.

  “No,” she says. “You must do better than that. You must make this happen right.”

  Troy gives me an update: all is well, blood pressure normal, temperature normal, baby in good position, fetal monitor is happy-happy, dilation has grown to nine centimeters.

  “I think we’re ready,” I say.

  “I think we’re very ready,” says Troy.

  Then I say, “I didn’t notice, Troy, are there guards and officers on the floor?”

  “You sure didn’t notice,” says Troy. “We got one NYPD woman and one rent-a-cop right outside this door.”

  Things move quickly, and I advise Bella to steady her breathing. She does. She’s with the plan.

  Then I ask that we clear the room of unnecessary personnel. Apparently nobody in the room believes himself or herself to be unnecessary. So nobody leaves. I’m not going to argue. All I can do is tell Bella’s husband, Marco, to move closer to the bed.

  Only occasionally does Bella let out an “Ooh” or an “Oof” of pain. It all happens quickly.

  “Whoa, mama,” says Troy. “This is happening faster than they do it on TV.”

  Troy’s referring to a GUH midwives joke that every birth on the British television show Call the Midwife requires about two minutes of labor before the baby arrives.

  Back to work.

  Here it comes. The baby’s head crowns, a perfect little yarmulke of jet-black hair. We’re ready to go. T
roy gives the “Little breath, little breath, big push” order, and Bella does her best. A pause, and when Troy says so, Bella pushes again. Almost all of the head is out. Good, very good.

  Troy asks for “One more big push.” Bella gives it. Then again. Then a pause. Then again. Then a push. Nothing. Bella is crying out now. Then she yells, “Spegni quella maladetta musica!”

  “What’s she screaming?” asks Troy.

  Bella’s husband translates. “She says ‘Turn off that damn music.’” Marco slaps the laptop closed. The Beatles are gone, but the baby is simply not moving out of Bella.

  I put my fingers inside. As I feel around, I realize exactly what’s happening. I tell the assembled that “the baby’s shoulders are just too big for delivery.”

  I ask for everyone except the husband and midwife team to leave the room. I urge Bella to extend her legs out from her body, which Marco and Troy help her with. Then we move her onto all fours. But after these less intrusive methods, the baby still won’t budge. I’ve got to perform a “significant” episiotomy. Just like before, nobody moves to leave, but I have more important things to do than police a crowd dispersal.

  “Get them out, Troy,” I say. He opens the door. Friends and some family leave. The door closes. An unpleasant nervous silence falls over the room.

  After Troy and Marco help Bella onto her back again, I begin cutting, carefully but quickly. Nothing’s moving except the scalpel. The baby’s shoulders are really wide. “Who have you got inside there? A Green Bay Packers linebacker?”

  I cut as far as I can sensibly go. There’s some bleeding. I’m not worried, but we can’t cut any more.

  “Call obstetrics and pediatrics,” I say, just short of yelling. “We’ve got shoulder dystocia.”

  “What is dystocia?” Marco asks.

  Troy has an answer for him. “The baby’s shoulders are stuck in your wife’s pelvis.”