I walked down the pathway. As I passed the huddle I recognized one of the men. Presley Huenengarth. The head of hospital Security was smoking a cigarette and stargazing, though the sky was starless. One of the other suits wore a gold shield on his lapel and was talking. Huenengarth didn’t seem to be paying attention.
Our eyes met but his gaze didn’t linger. He blew smoke through his nostrils and looked around. For a man whose system had just failed miserably, he looked remarkably calm.
10
Wednesday’s paper turned the assault into a homicide.
The victim, robbed and beaten to death, had indeed been a doctor. A name I didn’t recognize: Laurence Ashmore. Forty-five years old, on the staff at Western Peds for just a year. He’d been struck from behind by the assailant and robbed of his wallet, keys, and the magnetized card key that admitted his car to the doctors’ lot. An unnamed hospital spokesperson emphasized that all parking-gate entry codes had been changed but admitted that entry on foot would continue to be as easy as climbing a flight of stairs.
Assailant unknown, no leads.
I put the paper down and looked through my desk drawers until I found a hospital faculty photo roster. But it was five years old, predating Ashmore’s arrival.
Shortly after eight I was back at the hospital, finding the doctors’ lot sealed with a metal accordion gate and cars stack-parked in the circular drive fronting the main entrance. An ALL FULL sign was posted at the mouth of the driveway, and a security guard handed me a mimeographed sheet outlining the procedure for. obtaining a new card key.
“Where do I park in the meantime?”
He pointed across the street, to the rutted outdoor lots used by nurses and orderlies. I backed up, circled the block, and ended up queuing for a quarter hour. It took another ten minutes to find a space. Jaywalking across the boulevard, I sprinted to the front door. Two guards instead of one in the lobby, but there was no other hint that a life had been snuffed out a couple of hundred feet away. I knew death was no stranger to this place but I’d have thought murder rated a stronger reaction. Then I looked at the faces of the people coming and going and waiting. Nothing like worry and grief to narrow one’s perspective.
I headed for the rear stairway and noticed an up-to-date roster just past the Information desk. Laurence Ashmore’s picture was on the top left Specialty in Toxicology.
If the portrait was recent, he’d been a young-looking forty-five. Thin, serious face. Dark, unruly hair, hyphen mouth, horn-rimmed eyeglasses. Woody Allen with dyspepsia. Not the type to pose much of a challenge for a mugger. I wondered why it had been necessary to kill him for his wallet, then realized what an idiotic question that was.
As I prepared to ride up to Five, sounds from the far end of the hospital caught my attention. Lots of white coats. A squadron of people moving across my line of sight, rushing toward the patient-transport elevator.
Wheeling a child on a gurney, one orderly pushing, another holding an I.V. bottle and keeping pace.
A woman I recognized as Stephanie. Then two people in civvies. Chip and Cindy.
I went after them and caught up just as they entered the lift. Barely squeezing in, I edged my way next to Stephanie.
She acknowledged me with a twitch of her mouth. Cindy was holding one of Cassie’s hands. She and Chip both looked defeated and neither of them glanced up.
We rode up in silence. As we got off the elevator Chip held out his hand and I grasped it for a second.
The orderlies wheeled Cassie through the ward and through the teak doors. Within moments her inert form had been lowered to the bed, the I.V. hooked up to a drip monitor, and the side rails raised.
Cassie’s chart was on the gurney. Stephanie picked it up and said, “Thanks, guys.” The orderlies left.
Cindy and Chip hovered near the bed. The room lights were off and slivers of gray morning peeked through the split of drawn drapes.
Cassie’s face was swollen, yet it appeared drained—an inflated husk. Cindy took her hand once more. Chip shook his head and wrapped his arm around his wife’s waist.
Stephanie said, “Dr. Bogner will be by again and so should that Swedish doctor.”
Faint nods.
Stephanie cocked her head. The two of us stepped out into the hall.
“Another seizure?” I said.
“Four A.M. We’ve been in the E.R. since then, working her over.”
“How’s she doing?”
“Stabilized. Lethargic. Bogner’s doing all of his diagnostic tricks but he’s not coming up with much.”
“Was she in any danger?”
“No mortal danger, but you know the kind of damage repetitive seizures can do. And if it’s an escalating pattern, we can probably expect lots more.” She rubbed her eyes.
I said, “Who’s the Swedish doctor?”
“Neuroradiologist named Torgeson, published quite a bit on childhood epilepsy. He’s giving a lecture over at the medical school. I thought, why not?”
We walked to the desk. A young dark-haired nurse was there now. Stephanie wrote in the chart and told her, “Call me immediately if there are any changes.”
“Yes, Doctor.”
Stephanie and I walked down the hall a bit.
“Where’s Vicki?” I said.
“Home sleeping. I hope. She went off shift at seven, but was down in the E.R. until seven-thirty or so, holding Cindy’s hand. She wanted to stay and do another shift, but I insisted she leave—she looked totally wiped out.”
“Did she see the seizure?”
Stephanie nodded. “So did the unit clerk. Cindy pressed the call button, then ran out of the room, crying for help.”
“When did Chip show up?”
“Soon as we had Cassie stabilized, Cindy called him at home and he came right over. I guess it must have been around four-thirty.”
“Some night,” I said.
“Well, at least we’ve got outside corroboration of the seizures. Kid’s definitely grand mal.”
“So now everyone knows Cindy’s not nuts.”
“What do you mean?”
“Yesterday she talked to me about people thinking she was crazy.”
“She actually said that?”
“Sure did. The context was her being the only one who saw Cassie get sick, the way Cassie would recover as soon as she got to the hospital. As if her credibility was suspect. It could have been frustration, but maybe she knows she’s under suspicion and was bringing it up to test my reaction. Or just to play games.”
“How did you react?”
“Calm and reassuring, I hope.”
“Hmm,” she said, frowning. “One day she’s worrying about her credibility; then all of a sudden we’ve got something organic to work with?”
“The timing is awfully cute,” I said. “Who else besides Cindy was with Cassie last night?”
“No one. Not constantly. You think she slipped her something?”
“Or pinched her nose. Or squeezed her neck—carotid sinus pressure. Both came up when I was scanning the Munchausen literature and I’m sure there are a few more tricks that haven’t been documented yet.”
“Tricks a respiratory tech might know … Damn. So how in blazes do you detect something like that?”
She pulled her stethoscope from around her neck. Looped it around one hand and unwrapped it. Facing the wall, she pressed her forehead to it and closed her eyes.
“Are you going to put her on anything?” I said. “Dilantin or phenobarb?”
“I can’t. Because if she doesn’t have a bona fide disorder, meds can do more harm than good.”
“Won’t they suspect something if you don’t medicate her?”
“Maybe … I’ll just tell them the truth. The EEG tracings are inconclusive and I want to find the exact cause for the seizures before I dose her up. Bogner’ll back me up on that—he’s mad because he can’t figure it out.”
The teak doors swung open and George Plumb shot through, jaw leading, whit
e coat flapping. He held the door for a man in his late sixties wearing a navy-blue pin-stripe suit. The man was much shorter than Plumb—five six or seven—stocky and bald, with a rapid, bow-legged walk and a malleable-looking face that appeared to have taken plenty of direct hits: broken nose, offcenter chin, grizzled eyebrows, small eyes set in a sunburst pucker of wrinkles. He wore steel-rimmed eyeglasses, a white shirt with a spread collar, and a powder-blue silk tie fastened in a wide Windsor. His wingtips gleamed.
The two of them came straight to us. The short man looked busy even when standing still.
“Dr. Eves,” said Plumb. “And Dr.… Delaware, was it?”
I nodded.
The short man seemed to be opting out of the introductions. He was looking around the ward—that same measuring appraisal Plumb had conducted two days ago.
Plumb said, “How’s our little girl doing, Dr. Eves?”
“Resting,” said Stephanie, focusing on the short man. “Good morning, Mr. Jones.”
Quick turn of the bald head. The short man looked at her, then at me. Intense focus. As if he were a tailor and I were a bolt of cloth.
“What exactly happened?” he said in a gravelly voice.
Stephanie said, “Cassie experienced an epileptic seizure early this morning.”
“Damn.” The short man punched one hand with the other. “And still no idea what’s causing it?”
“Not yet, I’m afraid. Last time she was admitted we ran every relevant test, but we’re running them again and Dr. Bogner’s coming over. There’s also a visiting professor from Sweden who’s arriving any minute. Childhood epilepsy’s his specialty. Though when I spoke with him on the phone he felt we d done everything right.”
“Damn.” The puckered eyes turned on me. A hand shot out. “Chuck Jones.”
“Alex Delaware.”
We shook hard and fast. His palm felt like a rasp blade. Everything about him seemed to run on fast-forward.
Plumb said, “Dr. Delaware is a psychologist, Chuck.”
Jones blinked and stared at me.
“Dr. Delaware’s been working with Cassie,” said Stephanie, “to help her with her fear of needles.”
Jones made a noncommittal sound, then said, “Well, let me know what goes on. Let’s get to the bottom of this damned folderol.”
He walked toward Cassie’s room. Plumb followed like a puppy.
When they were inside I said, “Folderol?”
“How’d you like to have him for a grandpa?”
“He must love Chip’s earring.”
“One thing he doesn’t love is shrinks. After Psychiatry was abolished a bunch of us went to him, trying to get some sort of mental health services restored. We might as well have asked him for an interest-free loan. Plumb was setting you up just now, when he told Jones what you do.”
“The old corporate pissing game? Why?”
“Who knows? I’m just telling you so you’ll keep your guard up. These people play a different game.”
“Duly noted,” I said.
She looked at her watch. “Time for clinic.”
We left Chappy and headed for the elevator.
She said, “So what are we going to do, Alex?”
I considered telling her what I’d put Milo up to. Decided to keep her out of it. “From my reading, the only thing that seems to work is either catching someone in the act or having a direct confrontation that gets them to confess.”
“Confrontation? As in coming out and accusing her?”
I nodded.
“I can’t exactly do that at this point, can I?” she said. “Now that she’s got witnesses to a bona fide seizure and I’m bringing in specialists. Who knows, maybe I’m totally off-base and there really is some kind of epilepsy, I don’t know.… I received a letter from Rita this morning. Express mail from New York—she’s touring the art galleries. ‘How are things progressing on the case?’ Am I ‘making any headway’ in my ‘diagnosis?’ I got the feeling someone went around me and called her.”
“Plumb?”
“Uh-huh. Remember that meeting he wanted? We had it yesterday and it turned out to be all sweetness and light. Him telling me how much he appreciates my commitment to the institution. Letting me know the financial situation is lousy and going to get lousier but implying that if I don’t make waves, I can have a better job.”
“Rita’s.”
“He didn’t come out and say it but that was the message. It would be just like him to then go and call her, set her against me.… Anyway, none of that’s important. What do I do about Cassie?”
“Why don’t you wait to see what this Torgeson says? If he feels the seizures have been manufactured, you’d have more ammunition for an eventual confrontation.”
“Confrontation, huh? Can’t wait.”
As we neared the waiting room I commented on how little impact Laurence Ashmore’s murder seemed to have made.
“What do you mean?”
“No one’s talking about it.”
“Yes. You’re right—it’s terrible, isn’t it. How hardened we get. Caught up in our own stuff.”
A few steps later she said, “I didn’t really know him—Ashmore. He kept to himself—kind of antisocial. Never attended a staff meeting, never RSVP’d to party invitations.”
“With those kinds of social skills, how’d he get any referrals?”
“He didn’t want referrals—didn’t do any clinical work. Pure research.”
“Lab rat?”
“Beady eyes and all. But I heard he was smart—knew his toxicology. So when Cassie started coming in with those respiratory things, I asked him to go over Chad’s chart.”
“You tell him why?”
“You mean that I was suspicious? No. I wanted him to go in with an open mind. I just asked him to look for anything out of the ordinary. He was very reluctant. Almost resentful—as if I was imposing. A couple of days later I got a phone message saying he hadn’t found anything. As in, don’t bug me again!”
“How’d he pay his way? Grants?”
“I assume.”
“I thought the hospital was discouraging them—didn’t want to pay overhead.”
“I don’t know,” she said. “Maybe he brought in his own overhead.”
She frowned. “No matter what his social skills, what happened to him is horrible. There was a time, no matter how ugly things got out on the street, if you wore a white coat, or a steth around your neck, you were safe. Now that’s all broken down. Sometimes it feels as if everything’s breaking down.”
We reached the clinic. The waiting room was overflowing and as noisy as a steam drill.
She said, “Enough whining. No one’s forcing me. What I wouldn’t mind is some time off.”
“Why don’t you take some?”
“Got a mortgage.”
Several mothers waved at her and she returned the greetings. We passed through the door to the medical suite and headed for her office. A nurse said, “Morning, Dr. Eves. Your dance card is full.”
Stephanie smiled gamely. Another nurse came up and handed her a stack of charts.
She said, “Merry Christmas to you, too, Joyce,” and the nurse laughed and hurried off.
“See you,” I said.
“Sure. Thanks. Oh, by the way, I learned something else about Vicki. A nurse I used to work with on Four told me she thought Vicki had a bad family situation. Alcoholic husband who roughed her up quite a bit. So maybe she’s just a bit frayed—down on men. She still bugging you?”
“No. Actually we had a confrontation of our own and reached a truce of sorts.”
“Good.”
“She may be down on men,” I said. “But not on Chip.”
“Chip’s no man. He’s the boss’s son.”
“Touché,” I said. “An abusive husband might explain why I put her teeth on edge. She could have turned to a therapist for help, gotten nowhere, developed a resentment.… Of course, major family stress could also lead her to act out
in other ways—become a hero at work in order to raise her self-esteem. How’d she handle the seizure?”
“Competently. I wouldn’t call it heroic. She calmed Cindy down, made sure Cassie was okay, then called me. Cool under fire, everything by the book.”
“Textbook nurse, textbook case.”
“But like you said before, how could she be involved, when all the other crises started at home?”
“But this one didn’t. No, in all fairness, I can’t say I really suspect her of anything. It just twangs my antennae that her home life’s troubled and she comes over here and shines.… I’m probably just focusing on her because she’s been such a pain.”
“Fun referral, huh?”
“High intrigue, just like you said.”
“I always keep my promises.” Another glance at her watch. “Got to get through my morning exams, then drive out to Century City to pick up Torgeson. Got to make sure his car doesn’t get caught up in the parking mess. Where’d they stick you?”
“Across the street, like everyone else.”
“Sorry.”
“Hey,” I said, feigning insult, “some of us are international hotshots and some of us park across the street.”
“Guy sounds like a cold fish over the phone,” she said, “but he is hot stuff—served on the Nobel Committee.”
“Hoo-hah.”
“Hoo-hah in spades. Let’s see if we can frustrate him too.”
I called Milo from a pay phone and left him another one-beep message: “Vicki Bottomley has a husband who drinks and may beat her up. It probably doesn’t mean anything, but could you please check if there are any domestic violence calls on record and if so, get me the dates?”
Textbook nurse …
Textbook Munchausen by proxy.
Textbook crib death.
Crib death evaluated by the late Dr. Ashmore.
The doctor who didn’t see patients.
Just a grisly coincidence, no doubt. Stick around any hospital long enough and grisly becomes routine. But, not knowing what else to do, I decided to have a closer look at Chad Jones’s chart myself.
Medical Records was still on the basement floor. I waited in line behind a couple of secretaries bearing requisition slips and a resident carrying a laptop computer, only to be informed that deceased patients’ files were housed one floor down, in the sub-basement, in a place called SPI—status permanently inactive. It sounded like something the military had invented.
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