by Robin Cook
“You people let her die!” Brian snarled through clenched teeth behind his face mask. “You could have made the diagnosis yesterday, but no, you didn’t, you wouldn’t! All because of money.”
The two security men arrived, and they, too, tried to break Brian’s iron grip on Dr. Singh’s clothing, but it wasn’t until he let go that they succeeded. “Easy now!” one of the guards said.
While Dr. Singh calmly rearranged his shirt and jacket, he told the security guards that he was fine and that they should back off. Reluctantly, they let go of Brian, who was continuing to eye Dr. Singh with barely controlled fury. Jeanne regrasped his arm, although she, too, was aghast at the news and had trouble finding her voice.
“We tried very hard to save your daughter,” Dr. Singh said. “I don’t know what you are implying about money, but I can assure you that concerns about cost do not influence one iota of what we do with patients here in the Emergency Department, and they certainly didn’t in regard to your daughter. We pulled out all the stops.”
“I don’t believe you,” Brian snapped, causing the two guards to step forward once more.
Dr. Singh motioned for the guards to stand down. “You don’t believe in the last hour we tried everything possible for your daughter? Is that what you are saying?”
“She was seen here yesterday and the day before,” Brian blurted. “No diagnostics were done. Nothing, and it was probably because the hospital believes I owe hundreds of thousands of dollars. It should have been determined that she possibly had EEE like her mother, who died from it days before right here in this Emergency Department. And if that had happened like it should have, we would have known there was a risk for seizures. But no! Charles Kelley and his profit culture reigns supreme and no testing was done on either occasion.”
“We have no idea of who owes the hospital money,” Dr. Singh said. “I can assure you of that. We take all comers and treat them equivalently. As for a missed diagnosis, that concerns me, and I have already planned to look into it. Meanwhile I have to ask . . . do you want to view your daughter’s body?”
Brian felt the strength suddenly drain out of his body. The instantaneous rage that had overwhelmed him moments earlier was replaced by a paralyzing sense of loss. There was no way that the daughter who’d become the bedrock of his life and lifeline of his emotions with Emma’s passing could be taken from him, too.
“What do you think?” Jeanne asked softly. “Do you want to see her?”
“I don’t know,” he said weakly. “I don’t know if I can take it, but I suppose I should.”
“Do you want me to come with you?”
It took Brian a moment to decide. “Yes,” he said at last. “I would appreciate it. Thank you.”
With Jeanne holding on to his limp arm, they followed the doctor back into the treatment area and finally into the trauma room. A clean white sheet had been draped over the treatment table, covering Juliette’s small body.
Dr. Singh stepped up to the table and grasped the edge of the sheet. He then looked over at Brian and Jeanne. “I want to warn you that by medical examiner rules, we don’t remove various equipment like endotracheal tubes and intravenous devices until the body has been cleared by an authorized medical examiner investigator.”
Neither Brian nor Jeanne responded audibly, but both nodded that they understood.
Respectfully, Dr. Singh slowly pulled down the sheet, progressively exposing Juliette’s pale, fragile body down to the navel. As the doctor had warned, an endotracheal tube distorted her mouth. Intravenous lines ran into both arms, and ECG leads were still attached to her chest. For both Brian and Jeanne, it was a jarring, horrifying sight.
“Did she have EEE like my wife?” Brian asked, averting his eyes.
“The neurology consult believes she did,” Dr. Singh said with regret. “To be sure we’ll have to wait for the blood test to confirm it.”
“Why bother?” he responded bitterly. “Isn’t it a bit too late?”
“Yes, I believe it is too late,” Dr. Singh said as he bowed his head. “I will leave you two. No rush. Stay as long as you would like.” He turned around and walked out into the corridor.
Brian and Jeanne looked at each other, standing alone among all the high-tech equipment of the Trauma 1 room. His eyes brimmed with tears he’d been fighting. “I don’t know why I didn’t think of EEE, either,” he managed between gasps. “I should have.” He picked up the edge of the sheet and pulled it back over Juliette’s body, unable to grasp how he had also been so mentally blind.
With tears running down her own face, Jeanne enveloped Brian with both arms and for several minutes they hugged in silence. “It’s not your fault. You’re not the doctor.”
“I suppose,” he said listlessly.
“You were correct about what you said to the doctor,” Jeanne insisted. “Ultimately it is Charles Kelley’s fault.”
“Charles Kelley and Heather Williams,” Brian added. “I’d be hard put to say who was more responsible.”
Still holding on to each other for mutual support, they headed for the door leading out into the hallway, wondering where they could possibly go from here.
BOOK 3
CHAPTER 35
September 3
What are you going to do with her things?” Jeanne asked. She and Brian were standing at the open door of Juliette’s bedroom, looking in at the disheveled bed. Jeannot Lapin was in a heap on the floor after apparently being batted off the bed during Juliette’s seizure. Jeanne had been surprised when Brian suggested they make the visit the moment they had entered the house.
Without answering, Brian stepped into the room, picked up the stuffed rabbit, and then returned out into the hallway. As he did so, he closed the door behind him. “I’m not going to do anything with her things,” he said. “At least not now. Maybe sometime in the future.”
“Are you sure that is wise?” Jeanne said. “I could at least pack everything for you to get it out of sight. I’m afraid it is going to be painful keeping them around.”
“That’s generous of you,” Brian said. “There’s no need. I’m just going to leave the door closed, but I wanted to return Jeannot Lapin. I know it means something to you, otherwise you wouldn’t still have had it.” He held out the plush toy.
Jeanne took the rabbit and hesitated before responding. The day had been extremely painful for her, and she could only imagine how traumatic it had been for Brian. She’d grown fond of Juliette in the few days that she had known her, and realized it was perhaps that Juliette represented the daughter she’d wanted but never had. And now Jeannot Lapin would always be associated in her mind as Juliette’s friend and not hers. “I appreciate the gesture,” she said at length. “I hope you understand, but I’d prefer to let Jeannot Lapin remain with Juliette.” She reached out and grasped the doorknob to Juliette’s room, looking up at Brian but not yet opening the door. “Do you mind?”
“Of course not.”
Leaving the door ajar for moment, Jeanne went into Juliette’s room. After straightening the covers, she carefully placed Jeannot Lapin on the bed. Once back in the hall, she closed the door behind her.
“I’m sorry to have caught you up in all this,” Brian said as they descended the stairs.
“Don’t be. The best way to stop feeling sorry for oneself is to start feeling sorry for someone else. Losing a spouse is a terrible experience, I can attest to that. But losing a child is far worse. Would you like me to leave or do you want to talk or maybe sit in silence?”
“I’m not sure,” Brian admitted. “But I don’t want you to leave. That’s for certain. I think I’d like to talk.”
“Where should we sit?”
Brian shrugged. He was taking everything moment by moment. “I guess in the office.”
As they entered, Jeanne noticed the bulky, strange-looking shoulder bag on Emma’s desk.
She couldn’t make out what it was, partially because of the dimness in the room. The only windows of the former dining room were high and made of leaded glass. Most of the light was coming in through the archway leading into the living room. Preferring semidarkness, Brian had not switched on the chandelier.
“It’s a rifle bag,” Brian said as he noticed Jeanne peering at it. He threw himself heavily into his desk chair and groaned. On the day Emma died, he thought he had experienced the worst moment of his life, but the pain he was experiencing with Juliette gone was unparalleled.
“It looks odd,” Jeanne said, bending over and looking at it closer. One end came to a protruding cylinder about the size and shape of the business end of a duster. “It doesn’t look long enough to hold a rifle.”
“It’s a special rifle,” Brian said. “It’s a sniper weapon, meaning it is very, very accurate. In order to make it easier to transport, the stock folds against the barrel.”
“My goodness,” Jeanne exclaimed. “What they won’t think of next.” She sat in one of the several side chairs and, like Brian, groaned as she settled in.
Both Brian and Jeanne were physically and emotionally exhausted. Starting at 3:25 a.m. for Brian and 4:45 a.m. for Jeanne, it had been a long day—what felt like the longest day of his life.
The most emotionally difficult part had been in the ED waiting to get the required paperwork done right after they had viewed the body. All at once, there had been a flood of emergency cases arriving by ambulance, including several early morning automobile accidents that had taken the attention of most of the doctors, nurses, and even clerks. To complicate the situation, just before ten o’clock Aimée and Hannah had arrived, both in a panic. From a call to Camila, Aimée had learned Juliette had had a bad seizure during the night and was in the ED. Aimée in turn had called Hannah and both had come directly to the hospital without phoning ahead. When they arrived, it fell to Brian to tell them that Juliette had passed, which put them both into a hysterical condition. As a result, Brian had to spend considerable effort to calm both of them, rather than come to terms with his own deeply broken state.
Luckily for Brian, Hannah eventually took control. Although she had been depressed since Emma’s burial, this new tragedy caused her to regain composure, and she again accepted the burden of planning the next few days. At first Brian expressed some reluctance to go along with the full funeral procedure again after the experience of Emma’s passing, but his reservations were immediately dismissed by Hannah and Aimée. Ultimately, he yielded to their wishes both because objecting would have taken too much energy, which he didn’t have, and because he thought it would be selfish to deny them fulfilling what they thought was their responsibility. It was painfully obvious to Brian that they both were hurting and it was also apparent to him that the planning process was helping them deal with the horror of losing a beloved granddaughter.
Once the paperwork and other formalities had been done at the ED and the body was released, it was off to Riverside Funeral Home. Both Brian and Jeanne followed along but didn’t say much nor were their opinions actively sought. In some regards it had surprised them that neither Aimée nor Hannah objected to or even questioned Jeanne’s presence, since neither had met her before now.
From the funeral home it was on to the O’Briens’, so Brian could tell Emma’s father that one of his granddaughters had passed away and that there was to be another wake in their home. Why it had to be him rather than Hannah, Brian didn’t question, but since Ryan was going to be paying, as Hannah had offered and as he’d done for Emma, Brian felt obligated to deliver the horrible news. It was only after that visit that Brian and Jeanne were able to excuse themselves and walk home to Brian’s house. It felt like the calm after a wildly destructive storm.
“What would you like to talk about?” Jeanne asked after a few minutes of silence.
“I don’t know,” Brian admitted. “It’s hard to concentrate. My mind and emotions are going a mile a minute.”
“I’ll tell you what I’d like to talk about,” Jeanne declared. “I want to talk about feeling pissed that MMH Inwood and Peerless Health have essentially killed both our spouses and your beautiful child. Just sitting with you in the ED brought back the entire saga of my husband’s torture and death like it was yesterday. There were more times than I’d like to count that we were forced to wait in that same waiting room while he suffered and ultimately died.”
“We have a right to be enraged,” Brian agreed. “In fact, I’ve never felt this deeply furious before. Well, that’s not really true. I felt this way the day Emma died, but it’s worse today. There was an ounce of doubt about whether the hospital was responsible for Emma’s death, but there’s none in respect to what happened today. They should have diagnosed Juliette and the fact that they didn’t or wouldn’t infuriates me. Psychosomatic? Please!” Brian’s eyes darted around the room as if he was looking for something to destroy. “I want to break something. Anything.”
“I know how you must be feeling,” Jeanne agreed. “I can remember when Riley died, I had the same inclinations, and I’m embarrassed to say I did break some dishes. But it certainly didn’t solve anything. Let’s funnel this rage we’re feeling into exposing this disaster by using the list your friend has provided us. The fact that there are almost five hundred cases possibly just like ours in Inwood shocks me. What does that mean for the entire city, or the entire country for that matter? This surely can’t be an isolated phenomenon.”
Listening to Jeanne had Brian trying to focus his anger. What she was saying was undoubtedly true, and the details of the one case that Grady Quillen had mentioned to him involving Nolan O’Reilly sounded as heartrending as his own.
“I think this could be a true media event,” Jeanne continued passionately. “Especially if they question how the hell it has come to this in the richest country in the world. There’s no doubt in my mind that the finger will ultimately point at the profit motive of private equity.”
“And Charles Kelley and Heather Williams are certainly poster children for that culture,” Brian added.
“What shocks me is that none of the politicians are focusing on this,” Jeanne said. “There’s lots of talk about healthcare in general, but not specifics about what the situation is doing to individual people like us and how Kelley and Williams and people like them can get away with what they are doing.”
“My guess is that it’s all about money, appropriately enough,” Brian said. “I’ve heard in the past that the healthcare industry, mostly hospitals, health insurance, and drug companies, spend millions on lobbying to maintain the status quo. They like their profits and don’t want change. It means giving big bucks to politicians on both sides of the aisle.”
“Like how much? I’m sure that doesn’t happen in France.”
“Let’s check it out,” Brian said, eager to do something, anything. He turned on his monitor. After typing into Google, “how much per year does the healthcare industry spend on lobbying,” he hit enter. In a millisecond the results flashed onto the screen. “Here it is! My God! Five hundred and ninety-four million dollars in 2019! That’s more than one and a half million dollars a day. That’s absurd.”
“It’s more than absurd,” Jeanne said. “It’s crazy. As I said, that would never happen in France, or anyplace in Europe for that matter. No wonder it’s come to this point. Why is this bribing allowed? I mean, they maybe call it lobbying but surely in this instance it’s pure bribery.”
“As I recall, it has something to do with ‘free speech,’ which I personally think is ludicrous,” Brian said. “It got turned into a constitutional issue. Whether we uncover five hundred stories as sad and tragic as ours, I can’t imagine it would be enough to change this entrenched system, mostly because of the wildly extravagant lobbying but also because of the news cycle. It could be a big story and most likely would be, but then twenty-four hours later, it would be on to
something else.”
“Maybe we could dribble the stories out over time,” Jeanne suggested.
“I don’t think that would work, either,” Brian said with some discouragement. “A handful of sad stories might get on page one the first day, but then subsequent ones would quickly get relegated to less prominent positions. It’s the way the media works. A scoop on day one is often yesterday’s lunch on day two.”
“Does that mean you are giving up on the cases Grady Quillen gave us?” Jeanne asked, sensing Brian’s pessimism.
“Not necessarily. But what we have to do is think up a way to give the story staying power, so that it evolves over time and maintains public interest.”
For several minutes neither Brian nor Jeanne spoke as they pondered. The news cycle was short, particularly in this day and age with the internet supplying instantaneous information 24/7. They stared at each other expectantly, hoping the other would come up with an idea, something to assuage their anger and sadness yet have enough staying power to effect change. But neither spoke until after a kind of visual pas de deux that involved their eyes drifting in tandem over to the bag on Emma’s desk before coming back to stare at each other. Later they would question whose eyes strayed first, but they couldn’t decide. It was as if the idea germinated in both of them simultaneously.
“You said the sniper rifle is very, very accurate,” Jeanne said, breaking the silence. “What does that mean in terms of distance?”
“More than a half mile for most of them,” Briand found himself responding.
“How about this one?” Jeanne said, nodding toward the rifle bag. “Does it have a specific name?”
“It’s called a Remington MSR. And it is particularly accurate out to nearly a mile.”
