The 5th Horseman

by James Patterson

  YUKI WAITED IN THE LONG LINE outside the ladies’ room. Her arms folded, chin tucked down, she was thinking how powerfully she’d felt O’Mara’s closing, and she was asking herself again why she hadn’t dragged her mother out of Municipal before Garza, that bastard, killed her.

  The line moved so slowly that by the time Yuki entered the washroom, there were only moments left before court was due to resume.

  Quickly, she turned on the cold water faucet, splashed water on her face. Then she reached blindly for the paper towels.

  She patted her face dry and opened her eyes to see Maureen O’Mara in front of the mirror touching up her makeup.

  Yuki was happily surprised to see O’Mara.

  She congratulated her on her closing argument and introduced herself, saying, “I’m with Duffy and Rogers, but I’m here because my mom died recently at Municipal.”

  “I’m sorry to hear that,” O’Mara said, nodding; then she cut her eyes back to the mirror.

  Yuki recoiled at the rebuff. A half second later she realized that O’Mara was probably absorbed, bracing for Kramer’s closing.

  Worrying about the jury.

  Yuki wadded up her paper towel and tossed it into the trash container, taking another look at O’Mara, both in the round and in her reflected image in the glass.

  Maureen O’Mara’s suit was splendid. Her teeth were bleached, and her glorious hair had that seamless glow usually only seen in shampoo commercials. The woman takes care of herself, Yuki thought, and that observation irritated her for some reason.

  She had a thought about how she hadn’t had her own hair cut in months and had been alternating every other day between one of two dark-blue business suits. It was just easier to dress automatically.

  Since her mother died, how she looked just didn’t seem to matter.

  Beside her, O’Mara blotted her lipstick, flicked a stray hair from her collar, and, without another look at Yuki, left the bathroom.

  A broad woman in a pinstriped suit asked Yuki if she minded, she had to reach across her to use the soap.

  “Sure, no problem.”

  Yuki stepped back from the sink, thinking, So what if Maureen O’Mara was a somewhat pampered bitch?

  She still wanted her to win.

  She wanted her to win big.

  Chapter 105

  LAWRENCE KRAMER STRAIGHTENED his papers as the judge took the bench and the bailiff called the court to order.

  He felt strong, and he was eager to begin, glad that he’d gone for his five-mile run that morning, using that uninterrupted oasis of time to review his closing once again.

  He was ready.

  If it hadn’t been for that ass, Garza, he would have no doubt about how the verdict would go. That jerk-off was going to lose his job over this. But it would be small consolation if they lost.

  Kramer stood as the judge called his name. He buttoned his midnight-blue suit jacket and greeted the jury warmly, as if he’d known them for years.

  “There’s a big difference between human error and malpractice,” Kramer said, setting the tone for his closing.

  “Think about what it’s like inside an emergency room. People coming in off the street, the sick and wounded, victims of falls, car accidents, people who are traumatized and sometimes can’t even speak.

  “Think about the speed in which lifesaving decisions must be made even though the doctors don’t know the patients, don’t have their medical history in hand, and don’t have time to do exhaustive tests.

  “When a doctor has to move quickly to save a life, he often has to make a judgment call.

  “This is what I mean.

  “A sixty-five-year-old woman, like your mother or mine, comes into the ER with a transient ischemic attack. It’s a small stroke and an arrhythmic heartbeat at the same time, and if not treated, she could die.

  “One doctor decides to treat the condition with a blood thinner to break up the blood clot.

  “Another doctor might decide that what’s best for that patient is to put in a pacemaker right away.

  “That’s a judgment call.

  “And either way, the decision that doctor makes carries risk; the patient could die in surgery or the patient could die from medication —”

  “Kramer! I’m talking to you. You son of a bitch. You scum. Trivializing my son’s death.”

  A man a few rows back from the defense table was on his feet, yelling at the top of his voice. It was Stephen Friedlander, father of the boy who had died from an insulin shot meant for his discharged roommate.

  Friedlander’s face was gray and mottled, his muscles rigid as he stabbed his finger repeatedly at Kramer.

  “Fuck you,” he said to Kramer.

  Then he spun toward the defense table, jabbed his finger at each of the three attorneys on Kramer’s team, two young men and a woman, their faces blank with shock. “Fuck you! Fuck you! And fuck you!”

  The judge shouted to the bailiff, “Hold him. That man’s in contempt,” even as Kramer appealed to the judge.

  “Your Honor! She’s using shock tactics. Plaintiffs’ counsel orchestrated this stunt.”

  O’Mara shot back, “This is my doing? Are you crazy?”

  “Both of you. In my chambers,” Bevins growled.

  Kramer heard a woman scream! He turned in time to see Friedlander’s face contort, the blood leave his face. The man was obviously in trouble, gasping in short, hard breaths, reaching out his arms. He clutched at the screaming woman beside him before falling across her lap, then spilling out onto the hard stone floor.

  “Call the paramedics,” Bevins yelled to a security guard. “Court is adjourned until two p.m. Bailiff, escort the jurors to the jury room.”

  Pandemonium ensued.

  Kramer saw a man in glasses, a reporter for the Chicago Tribune, charge the fire exit, stiff-arming the lock-release bar on the door.

  The high-decibel alarm on the door screamed as the EMS team clattered up the stairs and entered the courtroom.

  Chapter 106

  CINDY FELT JUMPY AND DISTRACTED as court resumed, the whole terrifying Friedlander scene repeating through her mind on a short loop: the cursing and screaming, the poor man collapsing, the shrill shriek of the alarm as her new friend, Whit Ewing of the Chicago Tribune, had crashed through the emergency exit.

  The judge banged his gavel, and the rustle of whispers across the public gallery quieted.

  “For the record,” Bevins said, “I’ve questioned each member of the jury individually, and I’m satisfied that their judgment of this case won’t be affected by the incident this morning.”

  He looked over to the defense table. “Mr. Kramer, are you ready to continue?”

  “I am, Your Honor.” Kramer walked to the lectern, his genial smile looking forced.

  Cindy leaned forward in her seat, put her hand on Yuki’s thin shoulder. She whispered, “Here we go.”

  “Ladies and gentlemen,” Kramer said. “I have a note here that Mr. Friedlander has been treated and is expected to recover fully from his heart attack.

  “My clients and I feel very badly for him. The man lost his son, and he’s in a lot of pain right now.

  “But as badly as we all feel, your charge as jurors is to decide this case based on the facts, not on emotions.

  “I said earlier that it’s important to distinguish between mistakes and medical malpractice.

  “It’s a mistake when a nurse mixes up medicine on a tray, or a doctor gets distracted by another emergency and forgets to mark up a chart, so the patient gets medicated again. Those are mistakes.

  “Malpractice is gross negligence. For instance. And for your information, these are all real cases that I’m mentioning.

  “A doctor leaves a patient on the operating table while he runs out to make a bank deposit.

  “Or a surgical towel is left inside a patient’s body.

  “A doctor treats a patient while drunk or on drugs, or withholds treatment because of a bias against a p
atient or a class of patients. Or knowingly recommends treatment the patient doesn’t need.

  “That’s gross negligence. That’s malpractice.”

  Kramer pushed off from the lectern and approached the jury, pacing before the railing as he spoke to them.

  “It’s terrible what happened to the people cited in this action. I don’t have to tell you that. You know it already.

  “But in every one of the situations you’ve heard about in this courtroom, doctors and nurses, and even the patients themselves, made the kind of errors that happen in hospitals all across this country, every day.

  “Human errors. Honest mistakes.

  “As much as we’d like to believe that doctors are infallible, that’s an unreasonable expectation.

  “Doctors and nurses are human beings who want to help other people and try their damnedest to do it.

  “Last year one hundred and fifty thousand patients came through Municipal Hospital’s doors with injuries and illnesses. And they received excellent medical care, as good as they would get at any hospital in this city.

  “I’m asking you to strip away my opponent’s inflammatory rhetoric and focus on the difference between mistakes and malpractice, and find in favor of Municipal Hospital.

  “The city of San Francisco, our city, needs this hospital.”

  Chapter 107

  YUKI STOOD WITH CINDY in the corridor outside of courtroom 4A, their backs against the cold marble wall as the courtroom emptied.

  Cindy was excited, the reporter in her pumped up, asking, “So, what did you think?”

  A group of lawyers for the defense and hospital execs passed by, talking about the trial. An old fox in gray tweed was saying, “Thank God for Kramer. Great recovery on his part. That guy’s a superstar.”

  Almost on their heels, O’Mara and her retinue proudly strode down the hallway. O’Mara’s face was impassive as she reached the elevator, the door opening as if it had been expecting her.

  “Yuki?” Cindy asked again. “Your professional opinion. How do you think the jury’s going to decide?”

  Yuki heard the anxiety in Cindy’s voice, saw her tracking the lawyers with her eyes, and knew that Cindy wanted to get into the action on the courthouse steps.

  “Both sides did extremely well, made a hell of a case,” Yuki said. “You know, there’s no ‘reasonable doubt’ in a civil case. They’re usually decided on a ‘preponderance of evidence.’ So each juror will have their own definition of pre —”

  “You can’t even guess?”

  “It’s a coin toss, Cindy. The jury could even hang.”

  Cindy thanked her, said she’d catch up with her later, then made for the stairs, running.

  Yuki waited for the next elevator, got in, and watched the numbers light from four to one.

  Then she exited into the lobby, passed the circular security desk, and stepped out into the brisk October air.

  There were two thick scrums of reporters outside the courthouse, one pack around Larry Kramer, the other around Maureen O’Mara, shoving microphones in their faces, feeding picture and sound to satellite vans parked on McAllister.

  No matter what the outcome, both Kramer and O’Mara were getting a huge media boost that money couldn’t buy.

  As she walked past them, Yuki thought back a couple of months to the last trial she’d litigated, how good she’d been. How she’d stood on those courthouse steps, mobbed by the press.

  How much she’d liked that. But how much she’d changed in the last couple of weeks.

  Yuki’s car was parked at a meter three blocks from the courthouse.

  She removed the parking ticket from her windshield, put it inside her handbag, located her keys, and got behind the wheel.

  She switched on the ignition, then just sat there for a while, looking out at the traffic, at the purposeful pedestrians on the sidewalk pacing past her, lost in their daily routines.

  It was a world that had nothing to do with her anymore. She had no place to go.

  A great torrent of sadness welled up inside her. It was so sudden, she couldn’t even name it. She crossed her arms over the steering wheel, put her head down, and began to sob.

  Chapter 108

  CLAIRE AND I WERE at Susie’s at dinner hour, the smell of barbecued pork and fried plantains making my mouth water and my stomach grumble. As we waited for the others, Claire was telling me about a recent case that had torn her up. She’d been working on it since the small, dark hours of the morning.

  “A nineteen-year-old girl, apparent suicide, was hung by an extension cord wrapped around the bathroom door —”

  “Wrapped around the door?”

  “Yeah. One end was tied to the knob, then the cord was slid under the door, up over the top, then knotted around her neck.”

  “Jeez. She really did that?”

  “It’s really a puzzle,” Claire said, pouring us each a glass of beer from the frosted pitcher. “Her twenty-eight-year-old dirtbag boyfriend with a history of domestic violence was the only witness, of course.

  “He called it into nine-one-one as a suicide after a dispute they had. Said he cut her down, gave her CPR. Oh, and that she’s pregnant.”

  “Aw, no.”

  “Yeah. So the fire department responds first, and now it’s about keeping her body alive to save the baby. So they try to resuscitate her.

  “Then the EMTs take over, and they try to resuscitate her. And then the ER folks at the hospital pound away at her and do a stat C-section.

  “So by the time she comes to me, she’s been through the mill four times, cut up, bruised everywhere, back and neck injuries, and I don’t know what the hell happened to the poor girl.

  “So I’m asking myself, did the boyfriend tune her up, kill her, and then hang her to cover up the homicide? Or was it a suicide, and the trauma is all from the attempts at resuscitation?”

  “What about the baby?”

  “The fetus, yeah. He was too little, only twenty-six weeks old. Lived for a couple of minutes at the hospital.”

  Loretta dropped off the menus and the chips. She told Claire she looked fabulous in royal blue and that I looked as though I needed a vacation.

  I thanked her kindly, told her we were going to wait for Cindy and Yuki before ordering, and asked her to bring some bread. Then I turned back to Claire.

  Claire sighed, saying, “Double homicide or suicide? It’s too soon to tell. I’ve gotta backtrack, interview all the first responders, ask what they actually saw —”

  Claire stopped, and I turned to see Cindy come through the front door.

  Her kitten-gray sweater set off her pink cheeks and her tousled blond hair. But I could read the worry lines in her forehead.

  She was wondering if she and I were okay, or if we had a fight to settle.

  I got up and walked toward her, gave her a big fat hug.

  “I’m sorry, Cindy,” I said. “You were right to do that story on Garza. You were doing your job, and I was off the wall.”

  Chapter 109

  A LITTLE LATER at our table, Cindy’s face looked electric, charged up, excited, and maybe a little scared. She was giving us a detailed update on the malpractice trial when Yuki arrived at Susie’s, very late, and looking like hell, even worse than me. She slid into the booth beside Cindy, who squeezed her hand protectively.

  “You got here just in time,” Cindy said.

  “In time for what?”

  “I’m about to drop a bomb.”

  As radiant as Cindy looked, that’s how totally drained Yuki looked in comparison. Her hair was dull, her eyes were shadowed, and there was a button missing from the front of her pale silk blouse.

  As Cindy set up her tape recorder on the table, I mouthed to Yuki, “Are you okay?”

  “Never better,” she said with a thin smile.

  “So you’ve got your bomb in that little thing?” Claire asked Cindy.

  Cindy grinned. “I can’t reveal her name,” she said, cuing up the tape.
“But she’s a nurse who works at Municipal. Wait’ll you hear this.”

  A bad feeling was coming over me.

  I hoped to God that I was wrong.

  The tape rolled, and a woman’s staticky voice came from the small machine.

  Noddie Wilkins had dropped another dime, this time to the Chronicle.

  “I’ve seen them myself,” Cindy’s source said. “Like in the black of night. You go into the room and the patient is dead, and there are these buttons on their eyes.”

  “Let me make sure I’ve got this right,” I heard Cindy say, her tinny voice incredulous. “When patients die, buttons are put on their eyes?”

  “No, no, not every patient. Just a few of them. I’ve seen it three times, and other people have seen them, too.”

  “I have a million questions, but let’s start with the basics. What do they look like?”

  “They’re metallic buttons, like coins, embossed with a caduceus. And nobody’s ever caught anyone in the act.”

  “How many patients have been found with these buttons on their eyes?”

  “I don’t know. But a bunch.”

  “Do you see a pattern? Does anybody you’ve spoken to? Like a certain age or ethnic group or illness?”

  “I’ve just seen the three, and they were all different. Listen, I have to go now —”

  “One more question. Please. Have you told anyone about this?”

  “My supervisor. He says they’re someone’s sick idea of a joke. But you tell me. It’s scary, right?”

  Noddie’s voice became muffled, as if she was covering the receiver with her hand. She spoke to someone. Her voice was terse when she got back on the line.

  “I gotta go. I’m working and we’re busy. Understaffed.”

  “Call me again if anything —”

  Cindy shut off the tape recorder and looked into our shocked faces. Then she focused on me.

  “Lindsay, tell me, please, is the hospital covering up multiple homicides?”

  I closed my mouth and pushed back from the table.