Jonathan Kellerman - Alex 11 - The Clinic

by The Clinic(Lit)

  Next, autopsy and lab reports:

  The toxicology screen showed a moderate amount of cocaine in Mandy Wright's blood the night of the murder.

  Midnight murder. Hope had been stabbed just after 11:00 p.m.

  I flipped a page.

  The wound pattern, described almost word-for-word as in Hope's file.

  The initial blow to the heart had collapsed the organ, death resulting from exsanguination and shock. Prior to that, Mandy Wright's cardiovascular system had been in excellent condition, the arteries clear and unobstructed. No venereal disease, including HIV. No evidence of any outstanding illness or infection other than minor nasal erosion probably due to cocaine abuse.

  The final paragraph cited significant expansion of the anal opening and fibroid scarring of the rectum indicating a history of anal sex, but vaginal sexual intercourse had not taken place within the past twenty-four hours. Postmortem examination of the pelvic region revealed no tumors or other pathology; however, changes related to past pregnancy were noted.

  That made me think. As did the last line:

  'The fallopian tubes have been ligated; from the degree of atrophy, probably within a year or two!

  'Sterilized? Any record of her having a child?'

  Milo shook his head.

  'And she'd been pregnant before,' I said. 'Meaning an abortion - unless she miscarried. Either before the ligation or at the same time. It's a long shot, but that kind of surgery is Dr Cruvic's specialty. What if he was her L.A. connection?'

  He put the beer down. 'There are lots of obstetricians. That's some leap.'

  'Just throwing out ideas. Should I stop?'

  'No, go on.'

  'Cruvic has money,' I said. 'Drives a Bentley. Those clothes we saw weren't Kmart. Not inconsistent with the kind of guy who might fly down a party girl and pay for her ticket in cash.'

  'First he's her doctor, now he's her party pal?'

  'He could be both. Maybe that's why he performed the ligation rather than having a doctor in Vegas do it. Hell, maybe he was even the father of her child - who'd be in a better position to get himself out of a

  mess than an OB.? We've got him in at least one fib - not knowing Hope before the fund-raiser. Why try to mislead us? Probably because your hunch was right: Their relationship had been more than friendship. And I've got additional support for that.'

  I told him what Holly Bondurant had seen in the parking lot, Marge Showalsky's protest-too-much denials. 'Then there's the matter of his direct hilling for Hope's services. It just doesn't smell right. Plus, I learned something today that tells me he may skirt other ethical boundaries.'

  I repeated my conversation with Mary Farney. 'Operating on a mentally deficient minor and knowing she probably couldn't give informed consent. Maybe he used Hope for backup. Maybe they were involved in other iffy things.'

  'like what?'

  'Who knows? Financial shenanigans. Or maybe they did something really ugly, like take eggs out of one fertility patient and sell them to another.'

  'So where would Mandy fit in?'

  'Wild guess? She could have been an egg donor - young, healthy girl. And she learned something she wasn't supposed to. Or tried to blackmail Cruvic. Or maybe Cruvic's just the kind of guy who loves 'em and kills 'em. Hell, I can go on all day but the bottom line is my gut tells me Dr Cruvic is worth looking into, despite the sex-killer scenario.'

  He got up and walked around. 'We both noticed how hyper Cruvic was, bouncing all over the place. He tried to tell us it was fitness, but maybe it was coke, and there's our link with Mandy. Though Hope's autopsy showed

  no dope in her system and nothing indicates she ever used. Bringing me full circle: If she was cheating with Cruvic - or Locking, or anyone else - Seacrest could have found out and decided she'd rubbed his face in it long enough.'

  'But what connection would Seacrest have to Mandy Wright?'

  He paced some more. 'It's not just flashy guys who fool with girlies. A quiet middle-aged professor might want a hot little playmate, too. And a quiet middle-aged professor would have reason to pay cash to the playmate. And if the playmate realized how vulnerable the professor was and decided to blackmail him, the professor could decide to end his problems: heart, vagina, back. And after succeeding at that, why not go after the wife who's become such a pain in the ass?'

  'Creative,' I said.

  'You're a good influence.'

  'Okay, as long as we're screenwriting, how about this: a threesome. Cruvic, Hope, and Mandy. Or Seacrest, Hope, and Mandy. Or even an unknown guy. Flying down a call girl to spice up a tired relationship. Then, for whatever reason, the guy decides to call it quits. Permanently. Gets rid of Mandy first because murdering a call girl a thousand miles away won't attract attention in L.A. But Hope's a different story. She's prominent, local, smarter. So he waits, planning, waiting for the right time. Then Hope helps him by getting notorious with her book. Which sets up a perfect cover: some nut acting out because of the controversy she generated.'

  He thought about that. 'But if Mandy and Hope

  knew each other, wouldn't Mandy's murder have alerted Hope?'

  'If they'd parted ways, how would she know Mandy'd been killed? Did Mandy's murder get any media coverage?'

  He shook his head. 'Just one small blurb in the Sun the same day. Still, if Hope had been engaged in a three-way with Mandy, wouldn't she be likely to find out?'

  'Okay,' I said. 'Let's say she knew Mandy'd been murdered but didn't connect it to herself. Like you said, prostitutes get killed all the time.'

  He drank, stood, looked out the kitchen window. The sun was small and pale, silvering the tops of the pines, turning them as shiny as Mandy Wright's dress.

  'Great screenplays,' he finally said. 'It would sure be nice to have some facts.'

  'At least,' I said, 'I can look into Cruvic's credentials, see if anything funny shows up.'

  'Do that. My next stop's a chat with Kenny Storm. I want to clear the whole committee angle. I'll also check with Vegas to see if Mandy had health insurance, maybe her sterilization was documented and we can find out who did it. The boyfriend, Barnaby, might know about that, so we'll put out the word for him, too. Anything else occur while I was gone?'

  'I found Reed Muscadine. Like Kenny, he dropped out of school, but for another reason. He was up for a soap-opera part, thought he had it, but it fell through. He denied raping Tessa Bowlby, repeated the same story he told at the hearing.'

  'Credible?'

  'No alarm bells went off, but he's an actor. Take it for what it's worth.'

  'What do you think it's worth?'

  'I don't know. Tessa looked extremely traumatized. I'd like to know what's eating at her. Maybe I'll give her another try.'

  'What's Muscadine like physically?'

  'Very big and muscular, good-looking, body-conscious. His place is basically a gym.'

  'The kind of guy who could overpower a woman and hold her still in order to stab her in the heart.'

  'Easily. He could have subdued her with two fingers. But he seemed pretty calm about being questioned, so either he's innocent or he's honed his craft and was prepared for me. His landlady likes him, says he never causes problems. He claims he's HIV-negative and if he's lying, he's not showing the effects yet. Tessa, on the other hand, looks worn-out. But now that we know about Mandy, what connection could there be to the committee?'

  'Good question, but I want to finish with it, seen too many screwups that seemed perfectly logical at the time. Only one student left, right?'

  'Deborah Brittain. I'll try to get to her tomorrow.'

  'Thanks. I really appreciate this, Alex.'

  He put the file back in the briefcase. 'Thanks for the theorizing, too. I mean it. I'd rather have theories than nothing.'

  I walked him to the door. 'Where to now?'

  'Home for a shower and then talking to fellow gendarmes. Maybe I can turn up some other pretty

  ladies triple-stabbed under big trees, a
nd retreat to the comfort of utter powerlessness.'

  Cruvic's lie about not knowing Hope before the fund-raiser stuck in my head and at 7:00 P.M., with Robin working in her shop, I took a drive over to Civic Center.

  Hoping for what? A glimpse of his Bentley as he left the office? Some pretty face in the passenger window?

  Futile. The pink building's windowless facade gave no indication if anyone was in.

  Not exactly welcoming architecture. The same question: Why set up practice here, away from all the other Beverly Hills medicos?

  Privacy alone didn't answer it. Psychiatrists and psychologists managed to provide confidentiality in conventional office buildings.

  Something to hide?

  Beverly Hills streets are accompanied by parallel back alleys - part of a city plan that intended to keep garbage collection and deliveries out of sight. Hanging a U-turn, I drove back to the nearest intersection - Foothill Drive - where I turned right and into the asphalt strip running behind the buildings. Rear facades, loading docks, dumpsters. Finally, a high pink wall.

  Three parking spots, all of them empty. The building's back entrance was an old-fashioned wooden garage door, dark and crisscrossed by beams. Heavy hasp secured by a large padlock. More like storage space than a doctor's private entry.

  No cars said this doctor had left for the day. Maybe for his nighttime gig at the clinic?

  I reversed direction again, taking little Santa Monica to Century City, then Avenue of the Stars south to Olympic Boulevard West. Another twenty minutes and I was in Santa Monica, and by that time the sky was black.

  A few lights on at the Women's Health Center, a dozen or so cars parked in the sunken lot. Mostly compacts, with the exception of a gleaming silver Bentley Turbo pulled up close to the clinic's main door.

  The chain across the driveway was fastened and locked and a uniformed guard patrolled slowly. Even in the dim light I made out the holster on his hip. When he saw me, he picked up his pace. I sped away before we could read each other's faces.

  Tying up loose ends. The next morning I called the Psychology office and got Mary Ann Gonsalvez's number. The time difference made it 5:00 P.M. in London. No answer, no machine.

  I made coffee and toast and ate without tasting, thinking of the crowd at the women's clinic last night.

  The armed guard, the chain blocking the parking lot.

  Dr Cruvic operating.

  On patients like Chenise Farney?

  Fifteen cars. Even allowing for staff, probably ten or more procedures. And for all I knew he'd been going for hours, bringing them in in shifts.

  Idealism, or profit motive?

  The profit could be high if he was using the clinic's facilities at no cost, and billing the state. The clinic happy to have someone volunteer services to its poor clientele.

  Poor women meant Medi-Cal. Abortion funding was

  always subject to political fluctuations and I had no idea if Medi-Cal paid.

  I made a call to the L.A. Medi-Cal office, was referred to an 800 number in Sacramento, put on hold for ten minutes, and cut off. Trying again, I endured another hold, got through, and was transferred to another 800 number, more holds, two shell-shocked-sounding clerks, and finally someone coherent who admitted that Medi-Cal did indeed reimburse for both terminations and tubal ligations, but that I would need procedure codes, too, in order to obtain specific reimbursement allowances.

  I phoned the med school crosstown and used my faculty status to get the business office at Women's Hospital. The head clerk there referred me to the billing office, which referred me to the direct Medi-Cal billing office. Finally, someone whose tone implied I should have known without asking informed me that abortions were indeed reimbursable by the state at nine hundred dollars per procedure, not including hospital costs, anesthesia, and other incidentals.

  I hung up.

  Nine hundred per procedure. And if you were a canny biller, as Cruvic seemed to be, you could throw in things like nursing charges, operating-room costs, supplies, anesthesia, and jack up the reimbursement.

  Twenty abortions a week added up to just short of a seven-figure income.

  Nice little supplement to the fertility practice.

  Implanting fetuses in the rich, removing them from the poor.

  There were risks, of course: an antiabortion fanatic

  lashing out violently. And if the papers got hold of it, bad press: beverly hills fertility doctor runs nighttime abortion mill. Pro-lifers would excoriate Cruvic for murdering babies and liberals would wax indignant over class inequality.

  And whatever their political bent, Cruvic's fertility patients would shrink from that kind of publicity. And from the fact that their doctor's activities weren't limited to abetting pregnancy - despite the claim on his business card.

  But with that kind of money, Cruvic probably figured the risk was worth it.

  Off-the-path medical building.

  Chains around the clinic parking lot, armed guard.

  Had he been greedy and wanted even more?

  Bloated billing? Cooking the books?

  Hope going along with the fraud?

  But Cruvic had paid her only thirty-six thousand a year, a very small chunk of a million-dollar business.

  Maybe the thirty-six represented only what she'd reported on her tax returns and there'd been other payments, in cash.

  Or had Hope not been a willing partner to fraud and, learning the truth, quit, or threatened to expose Cruvic?

  And died because of it?

  Then what about Mandy Wright? Her only link to obstetrics, so far, was a terminated pregnancy and a tubal ligation.

  Far-fetched, Delaware.

  The most likely scenario was that she and Hope had been murdered by a psychopathic stranger and Cruvic,

  however mercenary and ethically slippery, had nothing to do with it.

  Still, I'd promised Milo to check out his credentials, Deborah Brittain would be in class for the next few hours, and the panicked Tessa Bowlby had a day off. Lots of days off, as a matter of fact: enrolled in only two classes, both on Tuesday and Thursday.

  Reduced academic load.

  Trouble coping?

  I'd give her another try, too, but first things first.

  Calling the state medical board, I found out no malpractice complaints had been lodged against Milan Cruvic, M.D., nor was his license in jeopardy.

  Farther fetched.

  I got dressed and drove to school.

  At the Biomed Library, I looked Cruvic up in the Directory of Medical Specialists.

  B.A., Berkeley - Hope's alma mater, another possible link. They were the same age, too, had graduated in the same class.

  Old friends? I read on. M.D., UC San Francisco -once again, studying in the same city as Hope.

  Then, she'd come down to L.A. for her clinical training and he'd moved to Seattle for a surgery internship at the University of Washington.

  By the book, so far.

  But then it got interesting.

  He completed only one year of his surgery residency at U of W before taking a leave of absence and spending a year at the Brooke-Hastings Institute in Corte Madera, California.

  Then, instead of returning to Washington, he'd transferred specialties from surgery to obstetrics-gynecology, signing on as a first-year resident at Fidelity Medical Center in Carson, California, where he'd finished, passed his boards, and gotten his specialty certification in OB-GYN.

  No listing of any postgraduate work in fertility.

  That wasn't illegal - an M.D. and a state license allowed any physician to do just about anything medical - but it was surprising, even reckless, because fertility techniques were highly specialized.

  Where had Cruvic learned his craft?

  The year at the Brooke-Hastings Institute? No, because he'd been just a first-year resident at the time and no reputable institution would take someone for advanced training at that point.

  Self-taught?

 
Cutting corners in a daring and dangerous way?

  Was that the real reason he practiced away from the other Beverly Hills doctors?

  If so, who sent him referrals?

  People who also wanted to skirt the rules?

  But maybe there was a simple solution: He'd undergone bona fide training but the fact had been accidentally left off his bio.