Diagnosis Murder 7 - The Double LIfe

by Lee Goldberg

  "You might want to tell Jesse that. He's blaming himself for what happened."

  "It's not his fault," Steve said. "Jesse saved Dad's life." At that moment, paramedics charged through the ER doors, wheeling a bloodied man on a gumey. Susan left Steve and joined the other nurses running alongside the gurney into the trauma room.

  Sitting there alone, Steve finally had a moment to rest, to reflect on the chaotic events of the day, which began when he got a frantic early-morning wake-up call from Susan at his girlfriend Lissy's apartment.

  "Your father has been hurt," Susan said. "Someone tried to run him over in the parking garage."

  Steve drove with his siren wailing, weaving through traffic and blasting through red lights, arriving at the hospital within ten minutes of getting the call. He found Mark unconscious in the ER, an IV in his arm and Jesse tending to him at his bedside.

  Jesse told him about tackling Mark out of the path of a car and that it wasn't an accident. There was no doubt in Jesse's mind about the unseen driver's murderous intent. "But it wasn't the car that hurt Mark," Jesse said. "It was me. I don't have your experience in tackling people. I'm usually the tackle-ee. I took him by surprise from behind, so he never had a chance to break his fall. His head smacked right against the pavement."

  "You knocked him out of the way and didn't get run over yourself. If you ask me, that's a perfect tackle," Steve said. "Is he just out cold or is it more serious than that?"

  "Although there's no sign of a cracked skull or internal bleeding, he does have some minor brain swelling."

  "Does this mean he has brain damage?" Steve asked.

  "No, it's to be expected and nothing to worry about," Jesse said. "He may even be dreaming now."

  "So what do we do?"

  "We wait. Concussions are unpredictable and vary from person to person and injury to injury. Mark could wake up in a few minutes or a few days. There's no way to tell. But we'll monitor him very closely, and we'll call you if there's any change in his condition."

  Steve nodded, chewing nervously on his lower lip. Someone obviously wanted Mark dead, but who? And why?

  As far as Steve knew, Mark wasn't working on any active homicide investigations, and none of the murderers he'd put away had been unexpectedly released from prison on appeal or parole. Of course, that didn't mean one of them hadn't arranged a little vengeance from behind bars.

  "Did Dad say anything to you before the attempt on his life?"

  "He had The Look," Jesse said.

  "What look?"

  "The Look," Jesse said.

  Steve knew The Look. It was the intensity in Mark's eyes when he'd reached the point in his investigation that he knew his adversary, if not by name or face, then by evil intent.

  Now Steve had to somehow reach that point himself. "What did Dad have you doing for him?" Steve asked.

  "Going through hospital records, searching for anything in common among patients who'd died shortly after leaving the hospital for treatment of critical medical conditions."

  "Like Grover Dawson," Steve said. "The guy who died standing at attention."

  "So to speak," Jesse said.

  "How many patients are we talking about?"

  "About eight hundred died within a year, forty-eight within ninety days."

  "That's an awfully big job with nothing to go on," Steve said.

  "Mark was concentrating on the forty-eight," Jesse said.

  "It could still take you weeks to find anything—and that's if there's actually anything there to find beyond the occasional coincidence. That's a big if."

  "Mark loves big ifs," Jesse said wearily. "But I got the impression this morning that he might have found the key to narrowing the search."

  "I don't suppose he gave you a hint?"

  "Just The Look," Jesse said. "And the promise of a free lunch."

  Once Steve left Mark's bedside, the first thing he did was to go to the doctors' lounge, commandeer the VCR, and watch the surveillance footage from the parking garage security cameras. If Jesse had waited a fraction of a second longer to make the tackle, Mark probably would have been killed. Even so, Steve winced every time he thought about Mark's head hitting the concrete.

  The tinted windows of the Camaro were too dark for him to make out the driver, but the assailant had done nothing to obscure the license plate, which led Steve to assume that the car was probably stolen. He called the plate in and, within thirty seconds, found out he was right. The car was reported stolen the day before in Canoga Park.

  He sent officers to interview the owner of the Camaro and canvas the neighborhood where it was stolen to see if anyone might have caught a glimpse of the thief. He also put out an APB on the car.

  Meanwhile, crime scene techs were scouring the hospital parking structure for clues, and officers were interviewing everyone in the building, aside from bedridden patients, on the off chance that they'd seen something.

  Steve was still watching the tape when Amanda came rushing in, distraught over the news about Mark and anxious to do whatever she could to help. She explained the research Mark had had her do, which made Steve smile. His father loved to put Amanda and Jesse to work beating the bushes for clues. And they gladly did it, not so much because they shared Mark's love of homicide investigation but out of respect and loyalty to him. They would do anything for him.

  And Steve was sure they would do anything for him, too, as he hunted for Mark's would-be assassin. He intended to take full advantage of their willingness to help, because he doubted his superiors at the LAPD would authorize him to devote any additional manpower or resources to the case. He'd probably catch hell for the legwork he'd already assigned to uniformed officers.

  It wasn't just because the chief of police wasn't fond of Mark and resented his intrusions into areas of LAPD responsibility. The case wasn't really big enough to merit the kind of effort Steve wanted to put into it. At least not yet.

  It was clear to Steve that Mark was investigating Grover Dawson's accidental death and others like it, despite the fact that there wasn't a shred of evidence indicating foul play. A visit to Mark's office and a peek at his appointments and the notes on his desk confirmed that was what his dad was up to.

  Steve couldn't make sense of the notes, but he tracked down the three doctors whose names were written on Mark's calendar: a cardiologist, an epidemiologist, and a sociologist.

  He was most intrigued by Dr. Tanya Hudson, the sociologist.

  What did his father want from her? Steve went to see her at UCLA to find out.

  Dr. Hudson was a tall, thin redhead in her thirties who was trying hard to dim her beauty and look more academic. But the glasses, prim suit, and plain hairstyle failed to hide her perfect figure and angular features. She looked to Steve like a Baywatch lifeguard trying to go undercover as a psychiatrist.

  Her campus office in Franz Hall was tiny, cramped, and choked with books and papers, so she suggested that they talk in the plaza outside.

  They took a seat on the brick bench around an inverted fountain, where students sat studying, chattering on cell phones, and dangling their bare feet in the water cascading down into a burbling hole.

  "I don't get the point of inverted fountains," Steve said. "They remind me of gigantic toilet bowls that never stop flushing."

  She laughed, and Steve was pleased with himself.

  "I've never thought of it that way. Now, I fear, I'll have that image in my head every time I see this fountain," she said. "Which is daily. So thanks a lot."

  "My pleasure," he said.

  "You said on the phone that you urgently needed to talk to me about your father," she said.

  He told her briefly about the attempt on Mark's life. "I'm trying to retrace my father's steps and figure out what he was onto. That's why I need to know why he met with you and what you told him."

  "I hope he's going to be okay."

  "He's probably out of bed already, examining the tread marks the car left behind," Steve said, thoug
h he knew it wasn't true--Jesse would have called if Mark had regained consciousness. But Steve wanted to put Dr. Hudson at ease.

  "Dr. Sloan was interested in my research. For the last three years I've been hanging out in prisons and mental institutions interviewing doctors, nurses, and other caregivers who've murdered their patients."

  "Is this for a book?"

  She shook her head. "It's for a study, but I'm also trying to create a profile of these mercy killers, angels of death, and murderers with stethoscopes. Your dad has been very supportive of that effort. I want to help hospitals recognize the warning signs in certain individuals before they strike."

  "You think you can screen for killers on an employment application?"

  She smiled. "You're a very cynical man, Lieutenant."

  "It's a requirement of my profession."

  "I think there are certain patterns of behavior typical of these kinds of individuals."

  "For instance?"

  "It would take me three hundred forty-seven pages to answer that question," she said. "Or you could just read my study."

  "I'd prefer to listen to the abridged audiobook version."

  "First, you need to know that there are several kinds of medical murderers. There are, of course, the ones who give patients fatal injections or smother them out of a misguided sense of compassion."

  "Mercy killers," Steve said.

  "But it's never really about easing anyone's suffering," she said. "It's about their own pleasure and neediness. Some do it because they get off on a godlike sense of power."

  "The more they kill, the more invincible they feel."

  "Exactly. Others do it for the attention, a disorder known as Munchausen syndrome by proxy. They like to be at the center of a medical crisis of their own creation."

  "Why don't they just make themselves sick instead of some innocent victim?"

  "They want attention," she said. "They don't want to die. Some don't intend to kill. They just want to set up a medical emergency so they can save the patient's life and be a hero."

  "But they're better at the emergency than the saving."

  "Sadly, yes. Others kill out of disgust—they actually resent the vulnerability and weakness of their patients. But they're really acting out their own self-loathing."

  "I hate myself so I'll kill you?"

  "It's the only time they feel superior to anyone else," she said. "And, of course, there are those who kill simply because they enjoy it. Some even get sexual satisfaction from it."

  "And you think you can spot these murderers?"

  "I think they often reveal themselves if you know what to look for. I advise hospitals to keep track of who dies and who is the last person with the patient. If Nurse Ratched always seems to be the one around when people die, it may not be a coincidence. Watch the numbers. If there's a jump in death rates, go back and see if that occurred during certain shifts, then see if there's one doctor, nurse, or orderly who is always on that shift."

  "Nurse Ratched again," Steve said.

  "Or it may be the nicest, most giving nurse on the ward, the one who always shows up to help once the crisis occurs."

  "Because she gets off, one way or another, on the rush of excitement and the race against death."

  "You're catching on," Dr. Hudson said.

  "I'm a quick study when it comes to murder."

  "Watch nurses or doctors who receive complaints from patients for being rude, abusive, or uncaring. Pay close attention to inexplicable shortages of epinephrine or other drugs in the hospital. It could mean someone is hoarding them to inject into patients."

  "Those seem like pretty obvious signals."

  "You'd be surprised how often they are ignored. When it comes to missing drugs, the assumption is they were stolen for sale or recreational use. Rarely do people consider that the drugs were taken to kill patients," she said. "But there are more subtle indications, too. I warn hospital administrators to be suspicious of anyone who has frequently moved from one hospital to another, is overly interested in death, or has a very difficult time with personal relationships."

  "Based on those last two criteria, I could be a medical murderer."

  "You don't strike me as someone who has difficulty with personal relationships."

  "Ask my ex-girlfriends," Steve said.

  She met his gaze and smiled. "Maybe I will."

  He was pretty sure she was flirting with him, but he was terrible at judging women. Still, he made a mental note to give her a call if his current relationship fizzled.

  Or when, given his romantic history.

  Steve thanked Dr. Hudson for her help and gave her his card, asking her to call him if she thought of anything else that might be helpful.

  "I'll do that," she said, in a way that sounded full of erotic possibility to him. Then again, he could read erotic possibility into just about anything any woman said to him.

  She gave him her card and returned to her office, but Steve remained at the inverted fountain.

  He called Dr. Barnes, the epidemiologist, and discovered after talking to him that Mark might have been onto something after all. Statistically speaking, too many patients were dying for it to be simply bad luck.

  Someone was killing people. A lot of people.

  But Steve didn't have enough evidence to convince his superiors to assign a task force. At least not yet.

  He marveled at his father's instincts and wished, not for the first time, that he shared the trait. Steve knew he was a good detective, but it was a learned skill and he worked hard to get results. He didn't have his father's gift for deduction or his sixth sense for murder.

  Once Mark's instincts were confirmed by the epidemiologist, his dad had taken a crash course in profiling medical murderers from Dr. Hudson and set out to unmask a serial killer.

  Now Steve would do the same. But he was troubled by something else.

  How did the killer find out that Mark was on the case?

  Steve was pondering that question, and many others, when he got the page from Community General, where he now sat in the waiting room, worrying about his father and trying to figure out what to do next.

  He was making an investigative To Do list in his little leather-bound notebook when the elevator doors opened and Jesse came out.

  CHAPTER ELEVEN

  Jesse limped over, looking beaten and exhausted. There were dark circles under his bloodshot eyes and he winced with each step, trying to keep weight off his left knee, which he'd hurt while tackling Mark.

  Steve rose to meet him. "How bad is it?"

  Jesse stumbled past Steve and took a seat. Steve remained standing.

  "Mark is going to be fine," Jesse said. "He'll be out of surgery in about an hour."

  "What happened?"

  "He had a seizure. We ran an MRI and discovered subdural bleeding."

  "What does that mean?" Steve asked impatiently, a tinge of anger in his voice.

  "It's an accumulation of blood beneath the protective membrane around the brain. The skull is rigid bone and it can't expand, so bleeding exerts pressure on the brain, essentially squeezing it into the opening at the base of the skull. If left untreated, the pressure will compress the brain stem, stopping respiration and leading to immediate death. We had to relieve the pressure, and there's only one way to do that."

  "You cracked open his skull," Steve said.

  "It's not that extreme. We're drilling a hole about the size of a quarter to drain the fluid," Jesse said. "Later, we'll seal it with a bone graft or a metal plate."

  "That still sounds pretty extreme to me," Steve said. "Though I suppose there isn't any choice. What are the dangers?"

  "Brain damage, infection, more bleeding," Jesse said. "But I don't think that will happen."

  "You didn't think this would happen either," Steve snapped, then caught himself. "I'm sorry. This is the second time you've saved Dad's life today. What I should be saying is thank you."

  "Don't worry, Steve. I won't leave
him until he's conscious and out of danger."

  "The hell you won't," Susan said, approaching them now. "You haven't slept in over twenty-four hours and you need to get that knee looked at."

  "She's right," Steve said. "I'll stay with him."

  "That won't do Mark or you any good," Susan said. "I have a better idea. I'll keep an eye on Mark while Jesse gets some sleep and you catch whoever did this. Besides, it's my job and I'm pretty dam good at it."

  Jesse looked at Steve. "She has a point."

  "But I'm the only family he has," Steve said.

  "No, you're not," Susan said, without a trace of anger or hurt feelings.

  She was simply stating a fact that, in his worry, he'd overlooked. Mark had always considered Jesse, Susan, and Amanda his family, too.

  "You're right. I'm sorry," Steve said. "I keep saying stupid things that I don't mean."

  "It's okay. You're allowed when a loved one is hurt and you're afraid of what might happen," Susan said. "Saying stupid things is entirely normal in this situation."

  "Thank you." Steve smiled and gave Susan a kiss on the cheek before turning to Jesse. "I'll need those files that Dad gave you."

  Jesse tossed him a set of keys. "They're on the kitchen table."

  Steve nodded and headed out the door, Susan and Jesse looking after him.

  "That's the first time he's ever kissed me," Susan said.

  "That's good to know," Jesse said, rising painfully to his feet and limping past her. "He's never kissed me."

  "Jealous?" she teased.

  Jesse grinned. "A man can dream."

  Steve picked up Jesse's files on the way back to the beach house and brought them into the kitchen, setting the box on the table. He took a bottle of root beer out of the refrigerator, twisted off the cap, and began looking for Mark's copy of Amanda's report.

  He found the report, and a legal pad full of notes, on the nightstand in Mark's bedroom. From what he could gather, Mark had begun sorting the patients based on their cause of death. A lot of the names were circled and connected with arrows to other names. Steve didn't know what the arrows meant.