Doctored Death

by P. D. Workman

  “Your burger is still on the table. Do you want that? We can zap it in the microwave for a couple of minutes. And there are fries.”

  He wrinkled his nose. “No.”

  “Are you nauseated or just not hungry?”

  “Just not hungry.”

  “What about ice cream?”

  He tilted his head slightly, a sign that he was considering it. She could often tempt him with ice cream when nothing else would work.

  “I’ll make you a sundae,” Kenzie offered. “No—a banana split.”

  “You’re just doing that to make me eat fruit.”

  “Whatever it takes.”

  He chuckled.

  “So is that a yes?”

  He shrugged and didn’t say no, so Kenzie got up. “Let me know what happens,” she said, indicating the TV. Though, of course, she knew how it was going to end. The plot was not complicated.

  When she returned with his bowl of ice cream a couple of minutes later, Zachary was sitting with his head tipped back and his eyes closed. He startled at her touch and looked surprised by the banana split. He took it from her without comment and just poked at it with his spoon.

  “Is everything okay?” Kenzie asked.

  “Yeah.”

  “You’re acting like you have something on your mind. Do you want to talk about it?”

  “No. No, it’s nothing. I’m fine.”

  “You remember what Dr. B said about ‘it’s fine’?”

  He looked as if it took a great effort to drag his attention from the mound of ice cream to Kenzie’s face. She waited, not feeding him any lines. If she asked a question or told him what she thought was the problem, he would just accept her suggestion and not process his own feelings.

  “I’m just... thinking about this case. And about... Bridget.”

  Kenzie’s anger flared at the mention of Zachary’s ex-wife. She hated that Bridget still had a hold over Zachary. That so much of his emotional real estate was invested in her.

  It was vital for Kenzie to react to this revelation without judgment, but what she really wanted to do was to tell him to get over it. Bridget was out of his life. She had kicked him out physically and emotionally. She was strong and independent. She had a new partner and was pregnant with his baby. Twins, in fact. Bridget had moved on in her life and it was time for Zachary to do the same.

  “What about Bridget?” she asked evenly. She had asked him to tell her his true feelings, not to just brush them off as something that didn’t matter. If she really cared about his feelings, then she had to accept them for what they were and let him express himself.

  “I’m just... I don’t know. I’m worried about her. About how she’s feeling. About the babies. If everything is going to be okay.”

  In fact, they knew that everything was not going to be okay. Both Bridget and the babies had some serious medical issues. Which made it that much harder for Zachary to move on. Leaving Bridget behind when she was healthy and happy with her own life was one thing. But letting her go to deal with her own problems, or to get help from Gordon, her parents, or the community, was unbearable. He had been obsessed with Bridget since he’d met her, and Kenzie expecting him to be able to let go of that obsession was unreasonable. He was doing his best in both individual and couples therapy, but leaving that part of his life behind was not something that would happen overnight. Or even in a year. The wins were incremental, so small that they were sometimes almost impossible to see.

  She thought about Zachary’s faraway voice when he had answered the phone that night. The number of rings it had taken to get through to him. How he hadn’t answered her when she had asked him where he was. Was he stalking Bridget? Sitting in his car staring at her house because there was no other way for him to be part of her life?

  “You’re worried about her,” Kenzie repeated back, hoping he would go on and analyze his own thoughts and feelings to get himself out of the rut.

  “Yeah. I know, I shouldn’t be thinking about her. She’s not part of my life.”

  “You can’t stop yourself from thinking about something. But you can try to think about something else. To distract yourself from Bridget and think about the things that you have more control over. The things that make you happy.”

  “Yes.” He looked down at his ice cream and deliberately pushed his spoon down into the mound of ice cream, bananas, chocolate sauce, and whipped cream. He took a bite. “Being here with you. The way things are going in my life. Our future.”

  Kenzie nodded.

  Zachary took another large bite of the ice cream. He wouldn’t be able to keep it up. Even at the best of times, he wouldn’t finish a whole bowl. A few more bites and he would be done.

  “You should have some too,” Zachary held the bowl toward her. “Didn’t you bring a spoon for yourself? I can’t eat all of this.”

  “Eat what you can.” Kenzie rubbed Zachary’s back, trying to help him relax. “Bridget and Gordon have their own life. They have their own trials and they need to work through them on their own.”

  “Yeah. Just like everyone else.”

  Zachary stared off into space, eyes cloudy. Gone. Kenzie could fight to get his attention back and to work through what was bothering him, but she didn’t have the energy and she didn’t want to hear anything else about Bridget. She pretended that they were both engaged in the mystery show on TV and let it go.

  19

  Kenzie spent as much time as she could the next day going over her notes and thoughts that she had gathered at Champlain House the previous day, trying to put it together in a way that made sense. It was frustrating to see the pieces that did not seem to fit together correctly. Were they missing something, or did they not have the medical knowledge necessary to understand Cartwright’s death?

  In the afternoon when she had a bit more time, she began to go through the computer database and filing system to pull out the deaths that they had dealt with from the nursing home in the past weeks. Most of the nursing home deaths were considered attended deaths and therefore did not go through the ME’s office. Kenzie was surprised when she started to compile the cases that they had dealt with to see how many there actually were.

  Had there been an increase in deaths at Champlain House? Or were the numbers normal and she just hadn’t realized how many there were before? To know for sure, she would have to go back through the database to previous years to see if there had been a change in the number or types of cases that had come through the office.

  Kenzie started a simple table, trying to filter out all the noise. There was too much information on the files and she needed to distill it down to a few key points to look for commonalities. Beginning with name and cause of death.

  There were no homicides. They were all either accidents or natural causes. They were old people living in a nursing home, not gang bangers or street kids. But writing down the causes of death didn’t seem to produce any patterns.

  Falls, strokes, dementia, respiratory issues. They were all very common in that population. There wasn’t any connecting thread. No indication that the majority of them had contracted the virus that the staff thought Mr. Cartwright might have had. No spate of Alzheimer’s Disease or another type of dementia. She had hoped to be able to spot the pattern immediately.

  She started adding in sex and age and pre-existing conditions. There wasn’t a field in the database that would allow extensive discussion of their symptoms in the days or weeks immediately preceding their deaths, so she would have to go to the files for those.

  Dr. Wiltshire walked out of his office suite to Kenzie’s desk. He looked over the notes she was making. “What are you working on?”

  “Previous deaths from Chaplain House. Looking for any patterns.”

  “Ah. Finding anything?”

  Kenzie sighed and pushed it away from her. “No. Nothing obvious. That doesn’t mean there isn’t anything, but I haven’t spotted it yet.”

  “What is your hypothesis?”


  “I don’t have one particular working theory right now. I’m kind of pursuing several different directions. First, we have the Alzheimer’s Disease or the non-Alzheimer’s protein deposits. Alzheimer’s itself can cause death when it becomes so advanced. He did have some minor symptoms the week or so before his death. Some of which his doctor was not aware of.”

  “Oh? What additional information did you find?”

  “They didn’t know about his continence issues. They knew he’d had a few falls, but weren’t aware of the bruises on his legs that indicate he’d been walking into things. I’m not sure yet what else, but he was managing to mask some of his symptoms. I think there was more dementia than was indicated in the doctor’s report.”

  “But still not enough to account for death due to Alzheimer’s Disease.”

  “No.” Kenzie pressed her lips together and thought about the possibilities. “Then there is the possibility that someone caused his death.”

  “Murder?”

  “Angel of death, maybe? I don’t know. Just something I thought of while I was there. Patients don’t usually die in the independent living unit. They usually get transferred to another unit when their health declines. The dementia unit or advanced care. It’s possible that someone has decided to spare residents from having to go through that and ‘save’ them before their condition gets serious enough for them to be transferred.”

  “Possible. Method?”

  “I was looking for a pattern in the previous deaths, but I don’t see one. Something like insulin would be quick, but difficult to detect. Since we would have to test for it within forty-eight hours and it isn’t something we normally look for. But these last few patients,” Kenzie looked at her notes. “They’ve had a wide variety of symptoms. Nothing that I could blame on a single poison or method.”

  “One of the problems with nursing home killings is separating out the natural deaths from the unnatural deaths. Nurses can be pretty good at hiding their methods, and you can’t tell when you start which ones are related. Very difficult to establish a pattern. That’s why most of them aren’t discovered until they confess or are caught in the act.”

  “Great. So if it is an angel of death, good luck on figuring it out. I have another possibility, it’s a bit of a long shot.”

  “Uh-huh?”

  “There is a dog in the unit. She visits other units as well. Not a trained dog, just for emotional support. Likes to sit and get petted by the residents. Maybe seeks out the ones who are sad or declining. She was with Mr. Cartwright when his body was discovered.”

  “With him?”

  “Curled up with his body, apparently.”

  Dr. Wiltshire squinted off into the distance like he was looking into the sun. “They should have included that detail in their report. And you think the dog might have had something to do with his death?”

  “It’s possible. I’m wondering about parasites. Even toxoplasmosis. That can get into the brain and affect behavior.”

  “Do dogs even get toxoplasmosis?”

  Kenzie had looked it up that morning, curious. She had known that people could get it from cats but didn’t know about other animals. “They can. If they eat something that is infected. They don’t normally pass it on to humans like cats do. But if it was the right environment, close contact with an infected animal by someone with a compromised immune system. Maybe someone who was already fighting another infection. It is theoretically possible.”

  “Or if they roll in infected dirt and then a resident pets them,” Dr. Wiltshire suggested. “They get the parasite on their hands and then touch mouth or nose, or the particles become airborne and are breathed in. It’s a possibility. Check the slides for any sign of toxoplasmosis. We can run blood and fecal tests.” He gave a nod. “Those are all viable routes... Alzheimer’s Disease would explain the amyloid plaques, but the brain pathology might just be an anomaly that has nothing to do with his death.”

  Kenzie nodded her agreement. It was a puzzling case. It would be easy to just write it off as ‘natural death’ or ‘unknown causes,’ but they liked to have reasons. It wasn’t very satisfying to say they didn’t know why someone had died. It didn’t provide the same closure to family members. And if they were dealing with a case of a nurse or someone else at the care center putting residents out of their misery, then shrugging off an unexplained death could lead to the deaths of others.

  20

  Kenzie sighed and put her project aside to work on the other things that were burning on her task list. She couldn’t afford to spend so much time on just one case. People didn’t stop dying just because she was still trying to figure out a previous case. She didn’t have to wait for Dr. Wiltshire to tell her that. She would look at the Cartwright file again when she was fresh and the additional lab tests that they had requested had come in. It would be easier to sort things out if they had a bit more data. And if she were fresh, she might just have an insight or two that would help the case along. Until then, there was plenty else to be done.

  Kenzie went to her inbox and started to print the various reports she had flagged earlier in the day.

  She came across Dr. Wiltshire’s transcribed postmortem for the John Doe and remembered her discussion with Zachary over the weekend. She opened the report and browsed through it. At least there was no mystery about the cause of death on that case. Kenzie took it with her to give to Dr. Wiltshire, but before going to his office, stopped to have a look at the personal belongings that had been carefully labeled and put to the side for the man’s next of kin, if one were ever found. Kenzie opened the paper bag to look at the items, but did not take anything out. She frowned and thought about what Zachary had said, then went to talk to Dr. Wiltshire.

  Kenzie poked her head in the door. Dr. Wiltshire was sitting at his desk, one elbow on the table, with his hand over his eyes, unmoving. It was late and he should probably have packed it in a couple of hours before.

  “Can I interrupt you for a minute?” Kenzie asked tentatively.

  He dropped his hand from his eyes, startled. “Kenzie. Are you still here?”

  “Just finishing up a couple of things.”

  “We should both close up and head home. Get a good sleep tonight.”

  “Yeah. I just wanted to ask you about the John Doe.” Kenzie entered Dr. Wiltshire’s office and put the transcribed report on his desk in front of him.

  “Of course. Sorry you couldn’t be a part of this one, but it was pretty straightforward. Not much to learn from this one.”

  Kenzie nodded. She’d seen the blood alcohol results. There couldn’t be much doubt about what had killed the man. The only question was how he had gotten so much alcohol down his throat before succumbing. “The thing is... I’m wondering if he was actually homeless.”

  “Well...” Wiltshire pushed up his glasses. “He was found in an alley. He was dead drunk—quite literally. Clothes soaked. Dirty. Unshaven. All of that says homeless to me.”

  “His clothes... I was just looking at them. They’re not exactly what you would expect from a homeless guy.”

  “Oh? Why? Too expensive?”

  “Well, not really high-end. But... trendy.”

  “And you don’t think that a homeless man could be wearing something trendy? They get clothing donations. Whatever people clear out of their closets. He might have just had an eye for that style. Even homeless people can have good taste—or trendy taste—in clothes.”

  “Yeah. But looking at them, they’re not stained or worn. Dirty from lying in the alley and having alcohol spilled all over them. Maybe got jumped or was rolled after he passed out.”

  Wiltshire frowned and tented his fingers, thinking about it. “Possible, I suppose,” he admitted.

  “His teeth were in good shape.”

  Wiltshire nodded. “If he was homeless, it was probably a recent development. He’d had good dental care. Fillings, no missing teeth, no gum disease.”

  “And his beard growth... doesn’t look th
at extensive or unkempt in the pictures.”

  “With the way the young people grow beards these days, who can say? It was short by some of today’s standards.”

  “Not tangled and dirty?”

  “Dirty... not like some I’ve seen. Not full of food remains or bugs.”

  Kenzie shuddered at the thought.

  Wiltshire smiled. “You wouldn’t believe some of the things I’ve found living in unkempt beards.”

  “Ugh. Not before dinner.” Kenzie had a strong stomach, but the suggestion made her nauseated. “We might want to suggest that the police broaden their search to professionals working in the area he was found, then. Maybe canvass some of the nearby office buildings. I’m sure they’ve already asked around at the nearby bars, but maybe if they say they are looking for a... businessman rather than a homeless guy, they would have better luck.”

  “I’ll pass that along.”

  Kenzie nodded, relieved. “Sounds good. I think I’ll lock up, then. You’re heading out soon too?”

  “I am. And Kenzie,” he stopped her as she was ducking back out the door. Kenzie paused and looked back. “That was a good catch. Good thinking.”

  “Actually... I can’t take the credit on that one,” Kenzie reminded him. “Zachary saw his picture in the news and said he didn’t think the man was actually homeless. Going by his haircut.”

  “Your Zachary has got quite the eye.”

  Wiltshire hesitated, but Kenzie could tell he wanted to say something else to her. She lifted her brows, waiting.

  “How is he doing? How are... the two of you?”

  Kenzie’s cheeks burned. They didn’t talk much about their personal lives while at the office. Wiltshire had known when she and Zachary had broken up. It had been impossible for her to hide her emotions. He had seen reports on Zachary’s kidnapping in the news before that. And he knew, of course, that they were now back together.

  “We’re good. Uh... closer than ever, actually.” Wiltshire had only ever seen the two of them together once, and Kenzie had been furious with Zachary at the time, so she probably hadn’t made a great impression on Wiltshire about the strength of their relationship. Kenzie pressed her hand against her warm cheeks. “As far as how he’s doing... he suffers a lot from depression, and I think... he’s on a downhill right now.”