Diagnosis Murder 7 - The Double LIfe

by Lee Goldberg

  "To be honest, Detective, I've been dreading this day for years. I always knew it would come to this."

  "What do you mean?"

  "Wendy Duren killed a patient, didn't she?"

  Steve gave him a hard look. "Why do you say that?"

  Napp bit into his apple with a loud crunch. He chewed for a moment before speaking.

  "During the fifteen months she was with us, working in our critical-care ward, there was an unusually high number of deaths," Napp said. "We suspected something was very, very wrong."

  "Did you report it to the police?"

  "Report what, Detective? These people were critically ill to begin with, so their deaths were not entirely unexpected. Not only that, but several years ago we fired a nurse we thought might be negligent in her care. She sued us for dismissing her without sufficient evidence, and she won a seven-figure settlement. We couldn't afford another costly and embarrassing situation like that."

  "But you could afford to let people die."

  Napp took another bite of his apple. Steve was beginning to regret giving it to him. In fact, he was tempted to shove the apple down the man's throat.

  "We didn't know anything was truly wrong until after Nurse Duren left. The family of one of the deceased patients had an autopsy conducted, and it found lethal levels of digoxin in the dead man's body. We immediately launched an exhaustive internal investigation. The report determined that her presence at the time of all the patient deaths could be coincidental."

  If Steve mentally ticked off each item on Dr. Hudson's list of behavioral warning signs of a medical murderer, Wendy Duren matched just about all of them. But what was her motive? Attention? Excitement? Self-loathing? Sexual satisfaction? Playing God? Or was it the pure, unadulterated pleasure of killing?

  "On the other hand," Napp continued, "the report determined that negligence or intentional acts of wrongdoing couldn't be ruled out."

  "I'm sure that will be a great comfort to the families of all the people she's killed since."

  "How do you think I feel? But the fact is, we couldn't prove a thing. There was no definitive evidence of her culpability. It could have been her or any of the other nurses in the ward who were responsible, if, indeed, negligence was involved. We ended up reassigning the entire critical-care staff to other duties in other units. Most of them resented it and ended up leaving the hospital and seeking employment elsewhere."

  "Did you warn those other employers?"

  "In the absence of any proof, our lawyers advised us not to. They said Duren would sue us and would most certainly prevail, winning damages that would make the other settlement seem like a bargain. We gave them all positive references."

  "In other words, you knew she was a killer and you did nothing."

  Napp got up, dropped the apple core into his garbage can, and wiped the sweat from his face with some Kleenex.

  "My hands were tied."

  Steve tried to control his rising anger. "I'm going to need the names of the other nurses on the ward during the period she was working here."

  "We'll cooperate any way we can," Napp said. "After consulting with our lawyers, of course."

  "Of course."

  Steve would have liked to have the names of the lawyers who advised Napp to cover up the patient deaths. He would have liked to arrest them all, and Napp too.

  But on what charge?

  As infuriating and inhumane as their conduct was, Steve knew that legally the lawyers hadn't done anything wrong. From a financial standpoint, they were probably right. Their conduct was morally reprehensible, but most lawyers, bureaucrats, and corporations could live with that.

  "Do you know how she committed the murders?" Steve asked.

  "We have a theory," Napp said, "but we couldn't prove it"

  "So you keep saying." And if you say it again, Steve thought, I'll shoot you where you stand.

  "We think she was getting the drugs by manipulating our computerized disbursement system. She would order drugs for a patient, and then, after receiving the drugs from a motorized dispensing cart, she'd go back into the computer and erase the initial request."

  "Then how were you able to figure it out?"

  "We noticed a discrepancy between the amount of some drugs stocked in the machine, like procainamide and sodium nitroprusside, and the amount of drugs dispensed to patients. Those drugs, improperly administered, would account for the sudden deaths of some of the patients."

  "But to prove it you'd have to notify the families and exhume the bodies for autopsy. You haven't done that."

  Napp shook his head. "At that point we didn't see what good it would do to put those families through the pain."

  "It would have saved lives."

  "No one can be sure of that," Napp said.

  "I can," Steve said.

  The case was solved.

  Steve didn't know who all the suspects were, and he couldn't name a single victim, but that didn't change what he knew in his heart to be true.

  The case was solved.

  Everything he needed to know was within the information they'd already amassed. All they had to do was sort it out.

  It wasn't as insurmountable a problem as it had seemed only twenty-four hours ago. He believed they'd found at least one element around which everything else revolved.

  Wendy Duren.

  They would start with her and work outward from there. She was the center of the universe in this investigation. And that was what Steve told Amanda, Jesse, and Tanis when they gathered at the beach house that night and began devouring the Chinese food as if they hadn't eaten in weeks. They'd all been so intent on their work that none of them had eaten much during the day, and what they did consume hardly qualified as nourishment.

  After dinner, Amanda, Jesse, and Tanis each moved to one of the four dry-erase boards that Steve had propped up on chairs around the living room and began writing up what had been uncovered.

  Jesse listed all the dead patients who had been treated at one of the four Valley hospitals within a year of their deaths.

  Amanda prepared a list of the doctors, nurses, and technicians the dead patients had in common.

  And Tanis made a list of nurses and caregivers who had worked in Beckman Hospital's critical-care unit during the period when the suspicious deaths occurred. She also listed all the personnel employed in the last twelve months through Appleby Nursing Services.

  While they worked, Steve stayed out of their way, clearing the dishes and bringing out fresh coffee, cookies, and a bowl of M&M's. When they were done, they joined him at the kitchen table, and everyone regarded the boards in silence.

  Some connections were immediately obvious to Steve, but he waited before voicing his thoughts. There was one more fact he wanted to hear first. He turned to Tanis.

  "Do any of the nurses or caregivers have a history of car theft?"

  "Nope," she said.

  "Not even as juveniles?"

  "Nope."

  "Damn," Steve said.

  "But one of them had a brother who did time for stealing cars, stripping them into a pile of parts and shipping them to Mexico."

  "Why didn't you say so to start with?"

  "A girl has to have some fun," Tanis said with a grin. "And it gets even better."

  She walked up to the list of nurses who worked at Beckman Hospital and circled one of the names.

  Paul Guyot.

  "Gives you shivers, doesn't it?" Tanis stepped back and took a handful of M&M's.

  "So who was killing patients?" Jesse asked. "Was it Guyot or Duren?"

  "Or was it both of them?" Steve said. "And what the hell are they up to now?"

  He picked up a red dry-erase marker and started circling all the places where Paul Guyot's name came up on the other boards.

  Jesse followed Steve's lead, grabbed a blue marker, and began boxing all the places where Wendy Duren's name appeared.

  Amanda sat down at a laptop and began noting all the interconnections that wer
e appearing on the boards.

  When Steve and Jesse were done, the boards were a multicolored mess of lines, circles, and boxes that wouldn't have made sense to anyone else.

  Amanda printed out a page, went up to the one empty dry-erase board, and drew a line down the center. She began copying information from the sheet of paper to the board, writing the information in either column, one of which was headed PAUL GUYOT, the other, WENDY DUREN.

  When Amanda was done, she joined the others, who were standing at the kitchen table and staring at the boards in amazement and horror, as if they were studying four particularly disturbing paintings.

  They were looking at four abstract portraits of murder.

  The two columns that Amanda wrote read:

  Paul Guyot

  Gary Betz

  Andrew Kosterman

  Emilia Ortega

  Oliver Pritchard

  Melinda Soper

  Wendy Duren

  Hammett Aidman

  John Eames

  Dave Grayson

  Dorothy Myack

  Patricia Ohanian

  "These are the patients they cared for who died in the last twelve months," Amanda said.

  "My God," Jesse said.

  As Steve's gaze shifted between the two columns and the connections made on the other three boards, a clear picture began to emerge.

  "Okay, here's what we know," Steve said. "Wendy Duren and Paul Guyot worked together in the critical-care unit at Beckman Hospital in Torrance. During their time there, a number of sudden deaths occurred that officials now believe were murders."

  "Duren and Guyot left Beckman," Tanis said, picking up the story. "She joined Appleby Nursing Services, and he went to work in the ICU at John Muir Hospital in West Hills. The fun begins again."

  "And the number of deaths of recently hospitalized people with critical health issues reaches epidemic proportions," Amanda said. "Then they find out that Mark is onto them."

  "How?" Jesse asked.

  "Guyot works at John Muir," Steve said. "Dad was over there talking with Dr. Barnes and Dr. Dalton. Maybe Guyot saw Dad and got scared."

  "Mark's face has been in the papers and on the air a lot lately," Tanis said. "Between the Lacey McClure case and the Nick Stryker scandal, he's had more exposure than Pamela Anderson's breasts."

  Steve gave her a look. "I'm sure he'd love the comparison."

  "I'm just saying he's known in LA for his work with the LAPD," Tanis said. "Guyot must have wet himself when he saw Mark Sloan way out there in the armpit of the San Fernando Valley. Mark certainly wasn't there to see the sights."

  "So Guyot went looking in the neighborhood for an old, fast car with tinted windows and found one parked on a street in nearby Canoga Park," Steve said. "He stole it and tried to run over Dad with it the next morning."

  "But Mark wasn't onto him," Amanda said. "Take a look at the two lists. Only one of the patient deaths he was investigating is among their victims."

  "Guyot tried to kill him for nothing," Tanis said.

  But Steve wasn't paying attention anymore. Something else on the board had captured his attention.

  "All Guyot succeeded in doing was drawing attention to himself when nobody had even noticed him before," Jesse said. "Kind of ironic, isn't it?"

  "This can't be a coincidence," Steve said, still staring at the two columns of names.

  "It's not," Amanda said. "Mark's instincts were right. He just wasn't onto Guyot and Duren yet."

  "I'm not talking about that," Steve said. "Look at the names in those two columns. Those two nurses have each killed five people."

  "Maybe they have a list and split it in half," Jesse said.

  "Or they are taking turns killing," Amanda said.

  "If you're right," Tanis said grimly, "it's time for one of them to kill again."

  "Not if we arrest them first," Steve said.

  CHAPTER FIFTEEN

  It was like preparing for a final exam. After Amanda, Jesse, and Tanis left, Steve spent the next several hours transcribing everything from the boards onto his laptop as a way of memorizing the information. Then he printed out his notes, highlighted the key points, and thought about the best way to present the case to the district attorney.

  The next morning, he went for a jog on the foggy beach, going over all the facts again in his mind, making sure the connections were tight and that his conclusions were solid. He called the hospital to check on his dad as soon as he got back. Susan assured him that his father was doing fine and that there was no reason to be worried. As if it was completely normal for someone to be unconscious for three days and then have a hole drilled in his skull.

  But Steve could not afford to be distracted by his concern for his father right now. He had to focus on making his case.

  He had a quick breakfast of Cocoa Pebbles and coffee, showered, and made the long drive downtown in rush-hour traffic, listening to news radio on the way.

  He met with assistant district attorney Karen Cross in her office. She was white but had the distinctive eyes and delicate features of a Japanese woman. She compensated for that delicacy with a penetrating gaze and an aggressive attitude that made her both alluring and a little frightening, especially for anyone on the witness stand.

  Steve had good reason to be uncomfortable around her. Their last experience together had been a complex, high-profile celebrity murder investigation and trial that nearly cost both of them their careers. During the course of the trial, the police department and the prosecutors were humiliated on national television for weaknesses in their case. Although the authorities were ultimately proved correct and the killer was convicted, the public had a selective memory. The cloud of disgrace remained over the department and the DA's office despite their eventual vindication.

  He would have preferred to work with any other assistant district attorney in the building, but fate, and perhaps a vindictive district attorney, wasn't on Steve's side that morning. Karen was assigned to hear his case, whatever it happened to be.

  She didn't seem any more pleased to see him than he was to see her. She looked at him as if he were a sewage leak that was spilling into her office.

  Her office had two guest chairs, both occupied by stacks of bulging files. Steve knew better than to move them and disrupt her filing system. So he stood awkwardly at the door, his notes in hand, while she irritably cleared a place for him to sit.

  While she moved her files around, he began laying out his case. It wasn't the optimal way for him to present his facts, but at least they could avoid looking at each other while he did it.

  He told her about Mark's initial investigation into the deaths of people who had recently recovered from critical illnesses or injuries and his father's discovery that the number of such cases had reached epidemic proportions.

  By the time Steve got to the attempt on Mark's life, and the investigation that followed, Karen had freed up one of the guest chairs, returned to her seat behind her desk, and was taking notes on a yellow legal pad.

  Steve figured her note taking was a good sign. It showed she was already investing herself in the case. She also hadn't bothered to interrupt him with questions yet, which he took to mean that so far his case was solid.

  So he continued on, explaining in detail how the investigation had led to nurse Wendy Duren, to the suspicious deaths at Beckman Hospital, and finally to Paul Guyot, a nurse now working at John Muir. And just to show he'd done his research, Steve even threw in how Wendy Duren's actions matched Dr. Hudson's sociological profile of a medical murderer in virtually every way. All of which led up to his big finish, the one and only conclusion that could be drawn from the facts.

  "These two are serial killers responsible for at least ten deaths, and probably more," Steve said. "Give me the word, and I'll have them arrested and behind bars within the hour."

  "You have got to be kidding," she said.

  He wasn't quite sure how to interpret the comment. Was she talking about the heinous
acts these two nurses had committed, undetected, for so long? Or was she talking about his case?

  "I'm afraid I don't follow," Steve ventured.

  "There is no way in hell you're arresting these two," she said. "I don't even want you talking to them."

  "You have got to be kidding," he said.

  Now it was her turn to try and figure out what he meant. "What part don't you get?" she asked.

  "These two are killers. They've been killing for at least a year and will probably continue unless we stop them. What possible reason could you have for letting them stay free?"

  She met his gaze. "Because you don't have a shred of proof that they've committed any crimes at all, much less multiple murders."

  "I just gave it to you," Steve said. "The only way it could be any clearer is if the two of them walked in here and confessed."

  "You have a theory, based on guesses, assumptions, and a creative reading of statistics, none of which would stand up to the slightest scrutiny in court," Karen said. "You don't have one piece of physical evidence."

  "I will once we exhume the bodies of the ten people they've killed this year and the patients who died in the Beckman Hospital critical-care unit. I guarantee the medical examiner will find traces of the drugs used to kill them."

  Karen laughed. "How do you expect me to convince a judge to issue all those exhumation orders?"

  "You tell him what I just told you," Steve said evenly, trying hard not to lose his temper. "You walk him through the investigation step by step."

  "I'll tell you what. Let's do that right now." Karen referred to her notes. "Let's start with Grover Dawson, the patient that got your father interested in these deaths in the first place. Mr. Dawson's name isn't on your list of alleged victims. Why is that?"

  "Because Grover Dawson doesn't appear to be a murder victim at this time."

  "'At this time'?" she said. "Do you have evidence to indicate it wasn't an accident?"

  "No."

  "Okay, so Dr. Sloan began his investigation based on an accidental death that, lo and behold, was an accident," she said. "The investigation was off to a great start already."