The 5th Horseman

by James Patterson

  The boy’s naked body was so small and vulnerable. The cast on his arm made him seem even more pitiful in death.

  What had killed the boy?

  How could a broken arm turn into this?

  Jacobi asked the pathologist, “What the hell happened here?”

  “According to his chart, he had a simple fracture of his right humerus and a hairline fracture of the ulna, same arm,” said Dr. Paul. “Apparently, he fell from his bike.”

  “And what else, Doctor?” said Jacobi. “Last I heard, a broken arm isn’t fatal. Or maybe it is at this hospital.”

  “I was told to keep my hands off this kid,” the doctor told us. “So, you know, I can’t even guess.”

  “That’s fine, Dr. Paul,” I said. “The ME is on the way. This little boy is going to the medical examiner’s office.”

  Chapter 117

  IT WAS ONLY 9:00 in the morning, roughly nine hours after Jamie Sweet had died with the side rails up on his hospital bed, presumably surrounded by people who were supposed to take excellent care of him and make him well.

  I left a thoroughly exasperated Jacobi on the second floor with Charlie Clapper and his team. They were processing what was left of the scene: recovering the bed linens and the child’s gown from the laundry, dusting for prints, bagging the trash and the pair of caduceus buttons that had been left inside an empty water glass when the boy’s body was removed from the room.

  I passed my detectives as I walked the corridors, saw that they were interviewing the doctors and nurses in the orthopedic wing, getting a timeline. Who saw the boy alive and when? What medication had he received?

  Who had been on duty last night?

  Who had found him dead?

  I met with Jamie Sweet’s parents in the cramped second-floor waiting room. They were a young couple in their early thirties, huddled together in the corner of the room, caught between anger and shock, wanting to believe anything but what I was telling them.

  “This is fucked-up,” Martin Sweet shouted at me, his face bloated with grief. “Jamie had a broken arm. A broken arm! I want to kill someone, Lieutenant.”

  “I understand,” I said.

  “Do you? I’m holding you responsible for finding out who did this to my son.”

  Beside him, the child’s mother rocked and moaned. Bright red streaks ran from her cheeks to her throat, where she seemed to have raked her skin with her fingernails.

  “I want to die,” she cried into her husband’s chest. “Please, God, let me die.”

  “The chief medical examiner is going to look at Jamie,” I said gently, tears suddenly filling my own eyes. “I’ll call you as soon as I know what happened to him.

  “I’m so very sorry for your loss.”

  Chapter 118

  SOMETIMES A BAD WIND BLOWS.

  A security guard accompanied me to Dr. Dennis Garza’s office on the ground floor, just around the corner from the ER.

  An aggressively thin woman with penciled-on eyebrows and long fuchsia talons stood outside Garza’s office, calmly using the fax machine at her desk.

  Trying like hell to control my breathing and my nerves, I showed her my badge and asked to see the doctor.

  “Dr. Garza was here earlier, but he’s gone out for a while,” she said, dropping her eyes to the gun inside my shoulder holster. “He’s probably at home. Should I call him?”

  I handed her papers. “I have a warrant to search his office. I need his keys.”

  The woman gave me a sidelong look as she unlocked Garza’s office and snapped on the flickering overhead light. She walked to a credenza against the back wall, opened an antique-looking silver cigarette box on its surface.

  The box was empty.

  “He always keeps the file keys here,” she said. “They’re gone. That’s very strange.”

  I told the security guard to break the locks with his crowbar, and I began to methodically trash the place.

  The file cabinets held patient files and medical journals still in their glassine wrappers. I flipped through hundreds of files, graphs, and memos, looking for anything that would trigger a thought or an action, anything that would give me a clue.

  Nothing did.

  I jerked out the top drawer of Garza’s desk, sending pens and paper clips spilling onto the carpet. I pawed through the tangle of office supplies, hoping for brass buttons, a piece of jewelry, or a hospital ID bracelet, any souvenirs or trophies a serial killer might keep of his victims.

  It was all strictly Office Depot.

  An overnighter hung behind the door.

  I yanked the zipper down, tossed the contents: a blue sports jacket, size 42 long; gray pants; black Coach belt; two button-down shirts, one pink, one blue; underwear; a leather tie holder. I found and unzipped a small black case—a diabetes test kit complete with syringes and bottles of insulin.

  Garza was a diabetic.

  His toiletry kit was filled with the normal stuff—toothpaste, razor, mouthwash, some sample packets of a soporific, an acid reducer, pills for erectile dysfunction.

  Why the overnighter?

  Fresh clothing for his court appearance?

  Stuff to wear after spending the night with his girlfriend?

  Either way, this was not evidence of murder.

  I was digging into the corners of the bag and inside the zipper pockets, panting with frustration, when my Nextel rang.

  “I’m down in the nurses’ locker room,” Jacobi said, pausing to cough, then saying words that made me want to name my firstborn Warren.

  “Get down here, Boxer. I’ve got a suspect under arrest on suspicion of murder.”

  Chapter 119

  A SUSPECT UNDER ARREST? I felt as if maybe all our hard work and risk-taking had finally paid off. Now, who was this monster?

  A shifting crowd of nurses and aides were bunched against the far wall of the basement locker room. Some were squawking about their civil rights; others jeered at the cops as they used bolt cutters on the locks of unclaimed lockers.

  Jacobi, bulky and scowling, looked more like muscle than he did a cop. He stood beside a dark-skinned woman in blue scrubs, sitting on a bench between the banks of lockers. Her arms were cuffed behind her back. I didn’t think I’d ever seen her before.

  She was in her forties, with a plain, unlined oval face and short, straightened hair. A gold charm of a praying angel dangled from a chain around her neck.

  She lowered her head and whimpered softly as I approached. Did she know who I was? Was this our killer?

  “I asked this lady if she’d come down to the Hall to answer a few questions. She made a break for the door,” Jacobi said.

  Then he showed me a small plastic box half-filled with caduceus buttons. I took the box and stared into the glinting brass pool. How could anything so harmless-looking have such murderous implications?

  I allowed myself a small but triumphant smile as I looked at Jacobi.

  “These were on the top shelf of this lady’s locker, Lieutenant,” he said. “I sent Conklin and Samuels back to the Hall for a warrant to search her apartment.”

  “What’s your name?” I asked the woman.

  “Marie St. Germaine.” She had a hint of an accent. West Indian, I thought.

  The tag hanging from the chain around her neck identified her as a CNA, a certified nurse’s assistant. That meant that her job took her from floor to floor, giving her the opportunity to get into patients’ rooms.

  And she’d have the means to medicate them.

  Had this woman killed nearly three dozen patients? Maybe even more than that?

  “Did Inspector Jacobi read you your rights?”

  “Yeah, I did. But now that you’re here, I’ll do it again,” Jacobi said, his time-roughened face a few inches from hers.

  “You have the right to remain silent. If you give up that right, anything you say can be used against you in a court of law. You have the right to an attorney. If you can’t afford an attorney, one will be appointed fo
r you. You understand your rights?”

  “You leave that girl alone,” someone shouted from the back of the room. “She did nothing. Let her go.”

  A group of nurse’s aides picked up the chant. “Let her go, let her go.”

  “That’s enough,” I yelled, slamming a locker door with the side of my fist. The chanting cooled to a low rumble.

  “Do you understand your rights?” said Jacobi again.

  “Yes. I do.”

  “Why’d you run, Marie?”

  “I was afraid.”

  “Afraid of what?”

  “The police,” she said.

  I was already thinking how the DA’s office was so overwhelmed with their ever-expanding case load; they’d tell us to kick this suspect unless we had enough on her to convict.

  “Find anything besides those buttons?” I asked Jacobi.

  “This is all hers,” he said, pointing to a pile of humble clothes and toiletries on the bench. The most lethal object in the pile was a Danielle Steel paperback. I emptied St. Germaine’s handbag, finding a worn wallet, a plastic pouch of cosmetics, a purple comb, an overdue phone bill, and a soft wool doll the size of my thumb.

  The doll was crudely made of black yarn and colored plastic beads.

  “What is this?” I asked.

  “It’s for good luck, only.”

  I sighed, dropped the doll back into St. Germaine’s handbag. “Ready to go, Ms. St. Germaine?” I said.

  “I’m going home?”

  As Jacobi and I drove to the Hall with St. Germaine in the backseat of the car, I started thinking ahead to the next forty-eight hours, wondering what Claire’s autopsy of young Jamie Sweet would show, hoping the killer had made a mistake, wondering if St. Germaine had a connection to Dennis Garza.

  Most of all, I was hoping for a confession.

  Hot damn. We’d finally gotten a break.

  We had a suspect in custody.

  Chapter 120

  CINDY’S SENSATIONAL FRONT-PAGE story about the MYSTERIOUS MARKERS OF DEATH had already hit the newsstands by the time we escorted Marie St. Germaine through the front doors of the Hall of Justice.

  The chief had something to feed to the press, but as the day wore on, I started to feel the kind of nausea that comes from going around in circles. Jacobi and I had been in the box with Marie St. Germaine for four hours. The room behind the mirrored glass was packed to the walls with homicide inspectors as well as the chief and the DA.

  For at least an hour, the mayor of San Francisco was back there, too.

  St. Germaine told us she’d been born in Haiti, that she wasn’t a U.S. citizen, but that she’d lived in the United States for nearly twenty years.

  Beyond that, she had little to say. Hunched over in her chair, she cried repeatedly, “I didn’t kill anyone. I did nothing wrong. I am a good person.”

  “Stop that damned crying,” Jacobi said, pounding the table with his fist. “Explain these fricking death buttons so that I understand you. Or I swear to God, INS will have you in shackles on a flight to Port-au-Prince by the end of the day.” That certainly wasn’t the case, but I let Warren do the interview his way.

  St. Germaine’s shoulders started to shake. She covered her face with her hands and blubbered, “I don’t want to talk anymore. You won’t believe whatever I say.”

  If her next words were “I want a lawyer,” we were screwed.

  “Okay, okay, Marie,” I said. “Inspector Jacobi didn’t mean to scare you. We just need to get at the truth. You understand that? Just tell us what you know.”

  The woman nodded. She reached for the box of Puffs on the table and blew her nose.

  “Why did you have those buttons in your locker, Marie? Let’s start there.”

  She seemed to reach out to me at last, turning her back on Jacobi, fastening her attention on my face, my eyes. She didn’t look or act like a killer, but I knew not to be fooled by her appearance.

  “We did this in nursing school,” she told me. “We put coins or shells on the dead people’s eyes back home, to help the dead pass over to the other side. You can check this with my school. Will you call them?”

  Her voice gained strength as she told me, “I found the little boy dead this morning. It wasn’t his time, so I marked him for God. For His special attention.”

  I dragged my chair even closer to St. Germaine. With some difficulty, I put my hand over hers.

  “But did you help him pass, Marie? Did you think the little boy was suffering? Is that why you gave him something to send him to sleep?”

  She ripped her hand away and pushed back from me, making me afraid that I’d lost her.

  “I would kill myself before I would harm that child,” she said.

  I cast my eyes toward the mirror, seeing my own haggard reflection, knowing that half the people watching this interview were thinking that if they were in this room instead of me, they’d crack this woman in half to get at the truth.

  I took the list Carl Whiteley had given me out of my jacket pocket, flattened it on the table. I turned it at an angle so that she could read the thirty-two names, the terrifying death list.

  “Look at this list, Marie. Did you put buttons on these people’s eyes?”

  There was a long silence as the woman ran her finger down the page, silently mouthing the names.

  “I put buttons on their eyes, yes,” she said finally, sitting up straight in her chair and pinning me with an unblinking stare.

  “But I swear to God Himself, I didn’t hurt any of them. I think someone did. And I wanted to make sure that God knows. And that somebody knows in this life, too.”

  Behind me, Jacobi kicked a chair across the room. It bounced off a wall and came to rest on its side.

  “Inspector!” I admonished him, not meaning it for a second.

  My eyes swept back to St. Germaine. “It’s okay, Marie. Pay attention to me. Why didn’t you call the police?”

  “I need my job, lady,” she said indignantly. “Anyway, what’s the use? No one listens to a person like me. You don’t believe me. I can see it in your eyes.”

  “Make me believe you,” I said. “I really want to.”

  Marie St. Germaine leaned toward me, spoke in a confiding tone of voice.

  “Then you should listen to me now. Talk to the doctor in charge of the hospital pharmacy. Dr. Engstrom. You should be talking to her, not to me. I am a good person. She is not.”

  Chapter 121

  SOMEHOW, SONJA ENGSTROM made an ordinary white lab coat look like haute couture. Her short platinum-blond hair was combed back, a single diamond drop hung from a platinum chain at her throat, and she was immaculately made up with an iridescent powder and a hint of rose-colored lipstick.

  Engstrom stood and shook our hands as I introduced Jacobi and myself.

  As we took seats across from her desk, I noticed that her papers were in neatly squared stacks on her desk, pens and pencils all pointing in the same direction in an enamel tray, her diplomas evenly spaced on the wall.

  Only the anxious darting of her light gray eyes from me to Jacobi and back again gave me a hint that her life wasn’t all hospital corners.

  I was looking at Jacobi when a strange expression crossed his face. His mouth twitched, and his eyes squinted.

  I’d worked with Jacobi enough years to know what that look meant.

  He recognized her.

  Dr. Engstrom hadn’t noticed. She clasped her slender hands under her chin and began to speak unprompted.

  She told us that the hospital staff was in turmoil since the jury verdict yesterday, that she herself felt very shaken. “We don’t know who will have jobs,” she said. “Or if the hospital will close. Anything’s possible now.”

  “You think you’ll be fired?” I asked her.

  “I’ve been worried about that for years. Those inexplicable deaths have made me a wreck,” she said, sweeping her hands through her shining hair.

  “I reported my concerns to Carl Whiteley. I s
poke to him more than once,” she told us. “In fact, I prepared a report of what I thought were pharmaceutical-based errors.

  “But Carl and the legal department assured me that my department wasn’t at fault. He said that somebody at the hospital was playing a joke, a prank, and eventually they’d be caught.

  “So on one level, I was relieved. Of course, I know that our computer system is fail-safe, so there was no way. . . .”

  She turned her face to the window as her voice trailed off.

  “Dr. Engstrom,” Jacobi said, “I’m an old-fashioned guy, as you can probably tell from looking at me. I’m not that familiar with computers and such.”

  “It’s very simple, Inspector. Our computer is programmed to dispense medication when a diagnosis is inputted into the system. It’s impossible to prescribe the wrong medication because the machine simply won’t dispense the order if it doesn’t match the diagnosis.”

  “Can’t someone fool with the program?” Jacobi asked. “I mean, don’t some people have passwords?”

  “Everyone on my staff can enter the diagnoses as written into the computer, but they can’t change any data. I’m the only one who can do that, and I have a biometric password.”

  “Beg pardon?” said Jacobi.

  “My password is my fingerprint.”

  “But can’t a doctor enter the wrong diagnosis?” I asked. “That’s possible, isn’t it?”

  “Theoretically, that would be possible, but in actuality, it can’t happen. The doctors themselves are the first checkpoint. My staff is the second. The computer is armed and alarmed against tampering. And you have no idea how methodical I am.

  “I check and recheck prescriptions against the charts all day long. Not just my own work, but the work of all the people in my department.

  “People joke that I’m half a computer myself.”