Too Much Blood

by Jane Bennett Munro

  What next? What else would that poor family have to cope with? They’d lost their husband and father. Gone bankrupt. Had to sell their luxurious home and move into that old firetrap. And now the old firetrap was on fire. What would they do now? Where would they go? How did it happen? Was it an accident?

  Or was it part of the mystery that seemed to shroud the Burke family with an aura of tragedy? It was beginning to sound like one of those Russian novels where everybody loses everything in the revolution and has to cram themselves into squalid apartments together, forty-seven people to a room.

  The house was a total loss. When the sun came up and the fire trucks were gone, only a smoking shell remained. The Maynard children, bless their hearts, came over and diverted the Burke children with a boisterous game of Monopoly on the kitchen table. Jodi came over too, but Kathleen seemed to have vanished, and I asked Jodi where she’d disappeared to.

  “Work,” Jodi said. “I sent her over to my house to get some clothes to wear. Luckily we’re the same size.”

  Elliott had wasted no time, having interviewed Kathleen on Sunday afternoon. Betsy, Elliott’s terminally pregnant secretary, would orient her to the job during the coming week.

  I tried to imagine going off to work, my second day on a new job, straight from having my house burn down, wearing somebody else’s clothes. I failed. Kathleen really was a better person than I could ever be, I decided.

  What a mess. And I had to go to work too. Hal could deal with it.

  He was off because school was out at the college. But I wasn’t in school anymore, so Christmas didn’t mean vacation to me and hadn’t for years; but I still felt cheated. Just another blow to the magic of the season, to my mind.

  My fellow physicians always took a week off for the holidays, but they could cover each other. Back when I was a solo pathologist, I didn’t have that luxury. I’d try to work half-days, preferably mornings; but somebody always managed to have a frozen section or something in the afternoon that would require me to be present. So that didn’t work either.

  But now that I had a partner, I could have an actual Christmas vacation. We had arranged for me to have the week before Christmas off, and Mike the week after. This meant that in only a week, I would actually have a week off. I could hardly wait.

  We had the same workload we always had during the holidays: brutal. All the patients had met their deductibles and had scheduled all their elective surgeries before the end of the year.

  Also, for some inexplicable reason, we always seemed to get a raft of big, ugly cancer cases at this time of year that presented as emergencies: bowel obstructions, GI bleeds, acute abdomens, you name it. They tended to go to surgery in the middle of the night, which required us to deal with unprepped bowel resections full of you-know-what.

  Mike and I would earn our time off, by God.

  Since I wasn’t on call, I decided to do a little detective work while waiting for my slides.

  The electronic medical record revealed that Jay Braithwaite Burke had been our patient. According to his computerized chart, he’d had a long history of deep vein thrombosis—blood clots—and anticoagulant therapy with Coumadin, the most commonly used drug for preventing blood clots. He’d had a completely normal treadmill stress test only six months ago, which was amazing, considering the degree of atherosclerosis I’d found at autopsy. If he hadn’t been on Coumadin and cholesterol-lowering Lipitor all that time, he would have died of a heart attack a long time ago.

  Or a stroke. He’d had his last prothrombin time, which was within the therapeutic range, on October 31st. Halloween. How fitting—blood-sucking vampires, and all that.

  Phlebotomists, those lab personnel whose job it was to draw blood from patients, have been called vampires since the beginning of time. Maybe even before that. It was a cliché so ancient that it had cobwebs on it. But back in the day when I used to draw blood, patients would gleefully tell me, “You know what I call you guys? Vampires!” as if they thought they were the first ones to think of it. I would just smile politely and try really hard not to do an eye-roll.

  Jay’s former physician, the late Tyler Cabot, MD, had diagnosed him with antithrombin III deficiency, a condition that predisposed him to blood clots, and had placed him on a fairly high dose of Coumadin, a dose usually recommended for patients with prosthetic heart valves. Tyler’s replacement, Jeannie Tracy, MD, had maintained him on that dose.

  However, I’d ordered lab tests on his postmortem blood to show his prothrombin time and INR, International Normalized Ratio, which made it possible to compare prothrombin times from different labs using different reagents. Jay’s were higher than the high end of the therapeutic range, but not by much, so an overdose of Coumadin was probably not the reason for all that bleeding. He’d had severe anemia when he died, though—probably from blood loss—but he had normal platelets and no evidence of leukemia.

  Jeannie Tracy, a thirty-five-year-old, petite platinum blonde, had a much more cordial relationship with the lab and with me than had her predecessor. So I had no qualms about wandering down to her office for a little chat, with a courtesy copy of my preliminary report.

  Jeannie had no idea how lucky she was to be here at all. After the fallout from that female surgeon who got murdered three years ago, our gastroenterologist and staff curmudgeon, George Marshall, would repeatedly tell me that it was a good thing Mitzi and I had gotten on staff before she had.

  “It may be the twenty-first century,” he would declaim, “but there are still a lot of chauvinists on this medical staff, by God, and it’s going to be a cold day in hell before another female physician gets in!” He did this while pointing a long, gnarly finger in my face for emphasis, while I resisted the urge to bite it off.

  But blue-eyed Jeannie had charmed even crusty old George.

  While she finished up with her patient, I ensconced myself in the soft desk chair that she had upholstered in a delicate floral fabric. I admired the Christmas wreath on her door, made of flocked Scotch pine boughs and decorated with ribbons and ornaments in shades of blue and silver, while aimlessly leafing through the latest issue of the New England Journal of Medicine.

  I didn’t have to wait long. Jeannie never moved at less than a dead run. After barely five minutes, I heard the pitter-patter of her tiny feet, and she appeared in the doorway.

  “Toni! What a surprise. Do you covet my chair?”

  “No, I covet your wreath.”

  “Do you want one? Donna makes them. I could ask her for you. Want me to?”

  Donna Foster, formerly the late Tyler Cabot’s office nurse, had been overjoyed to be assigned to Jeannie, because she had missed seeing all her old patients. I suspect she found Jeannie a lot easier to work for too.

  I handed her the autopsy report and vacated her chair. “I thought you might be interested in this,” I told her.

  “Oh, thanks,” she said, already reading it as she sank into her chair. “Jesus, Mary, and Joseph!”

  Sweet, soft-spoken Jeannie looked like Tinker Bell but cursed nearly as fluently as I did.

  “Damn,” she continued. “This guy was a walking time bomb.”

  “Exactly my thought,” I said.

  “I hate to think what would have happened if he hadn’t been on Coumadin. Only maybe he was on too much Coumadin, by the looks of this. Do you think … oh, crap … do you think I had him on too high a dose? Because his pro times have all been just fine …”

  “No, no, of course not,” I reassured her. “He was murdered. If he overdosed, it wasn’t on Coumadin. His postmortem INR was not that much above the therapeutic range. This is just an FYI, because he was your patient.”

  “Well, I’m glad it wasn’t anything I did,” she said, looking perplexed, “but if it wasn’t Coumadin, what was it?”

  “Good question. Maybe I ought to get some more tests
done,” I said. “Was he anything more than just a patient to you?”

  Jeannie frowned. “What do you mean?”

  “Did you ever get into that Ponzi scheme of his?”

  She sighed. “I’m afraid so,” she said. “Stupid me. Luckily I haven’t been here long enough to lose as much as some of the other docs.”

  “Did you associate with him socially?”

  “Absolutely not,” Jeannie said. “You know, maybe I shouldn’t say this, now that he’s dead, and don’t tell anybody I said so, but he wasn’t exactly my favorite patient. He struck me as kind of a sleazeball. Quite frankly, he gave me the creeps.”

  “But you got into that Ponzi scheme of his anyway? Why?”

  She dropped her eyes. “Well, he just made it sound so good,” she said.

  Now I was going to have to piss her off. “I heard that he had affairs with a lot of the doctors’ wives and got them pregnant,” I said.

  Jeannie suddenly got very busy with some papers on her desk. “Really,” she said.

  “Yes, really. I was just wondering if he limited his activities to doctors’ wives, or if he included doctors as well.”

  Jeannie picked up a chart and flipped it open. “I really need to put a note in here before I forget something,” she said.

  I refused to take the hint. “Did he ever hit on you?”

  Jeannie slapped the chart shut. “Toni, why are you asking me all these questions?”

  “Did you have an affair with him?” I persisted.

  Jeannie drew herself up to her full height of five-foot-two and came around her desk to face me. “This conversation is over. Was there anything else?”

  “No. I’m sorry, Jeannie. I didn’t mean to be rude,” I said. “But the man was murdered, and I did the autopsy, and I feel obligated to try to figure out who might have had a motive to kill him, that’s all.”

  She put her hands on her hips. “Well, I lost money, but as far as having an affair … Toni, do you realize what it could do to my career if there was the slightest suggestion that I might have had an affair with a patient? I could lose my license!”

  Oops. I hadn’t thought of that. “Well, don’t worry about me,” I said. “This won’t go any further.”

  She seemed mollified. “I just wish I’d been as smart as you were and had nothing to do with him.”

  “Well, I wasn’t that smart, either. I let him put me into a personal corporation, but as far as the hedge fund was concerned, no, I never got into it.”

  She rolled her eyes. “Oh, yeah, don’t I know it,” she said. “I’ve heard all about it. Your name has come up a number of times. Jack Allen seems a bit put out that you never said anything at the time.”

  “I did. They didn’t listen,” I pointed out.

  I let her get back to her patients. I’d found out all I could from Jeannie. She hadn’t come right out and denied having an affair. She also hadn’t admitted having one. She’d just expressed fear that somebody might report her to the State Board of Medicine. Was she protesting too much? Maybe not. She had a lot more at stake than any doctor’s wife. Having sex with a patient was a huge no-no in the Idaho Medical Practice Act, and her license could be jeopardized if it came to the attention of the Idaho State Board of Medicine. It could destroy her career if it ever got out. So she might have had one; all I knew for sure was that she hadn’t had a child by Jay, or anyone else, for that matter.

  Unless she was pregnant right now. But I decided against going back and asking her that. I could look her up in the computer. If she’d had a pregnancy test done here, it would be in there. Jay’d been out of the area for two months, so Jeannie’s affair, assuming there was one, would have had to be pretty recent for her to be pregnant and not showing.

  Apart from any other considerations, it might have been a handy little tool for blackmail, for someone who knew. And blackmail is a dandy motive for murder.

  Ruthie hadn’t mentioned Jeannie as one of Jay’s love interests, but that didn’t mean she hadn’t been one. Maybe Ruthie didn’t know. I sincerely hoped not. If she did, it’d be all over town so fast the dust would fly. People would have to hold on to their hats. Still, that would really screw up anybody who might want to use the information for blackmail.

  Maybe that could be a motive for murdering Ruthie, just to shut her up.

  I found Mitzi Okamoto in her darkened office, looking at films, dictating reports, and eating a candy bar. I had to stifle the urge to slap her silly. I gain five pounds if I just look at a candy bar, and she eats them all the time and never gains an ounce.

  Mitzi’s grandparents, originally from California, had been interned during the war in the Hunt camp at Minidoka. Mitzi’s father had been born there. After the war, they settled in Jerome and farmed. Mitzi went to the University of Washington on the WAMI program, did her residency there, came home to practice, and married her husband, Dave McClure, a CPA, the next year.

  They had two children, ten-year-old Jeremy and the baby Stephanie, who may or may not have been Dave’s. You certainly couldn’t tell by looking at the children, because both of them looked just like Mitzi.

  But in any case, Mitzi and Dave were now divorced.

  I leaned on the doorjamb until she looked up and saw me.

  “Hi,” she greeted me, brandishing the candy bar. “Want a bite?”

  I refused the candy bar, but accepted the implicit invitation to come in and chat. Mitzi and I—friends but never close—still felt comfortable enough to visit each other’s offices from time to time. However, getting information from her now might be problematic, since I wasn’t supposed to know about the trusts.

  “You missed a good party the other night,” I began. “How come?”

  “I just didn’t feel like it,” she said. “I figured everybody would be talking about Jay Braithwaite Burke, and I just didn’t want to hear it.”

  “You figured right,” I said. “The boys were all talking about the money they lost, and the girls were all talking about his wife and his four kids. They said that she was divorcing him because she’d caught him in bed with his secretary, and that now the secretary has moved in with his wife and is helping her with the kids. Isn’t that weird?”

  A spasm of pain briefly crossed Mitzi’s normally impassive countenance, but she said nothing.

  “That’s not all I heard,” I went on. “Care to know what else I heard?”

  Mitzi’s eyes narrowed, but she still said nothing. This was going to be like pulling teeth. Mitzi was so self-contained that her facial expressions rarely gave the slightest clue to what she was feeling. She would be a much tougher nut to crack than Jodi or Jeannie had been.

  “I heard that Jay had affairs with a whole lot of doctors’ wives,” I said. “And also some doctors. Know what that means?”

  Mitzi got up and closed the door to her office, came back, and sat down. “We shouldn’t be discussing this here where people can hear.”

  “Definitely not,” I agreed.

  Mitzi ran her fingers through her short black hair until it stood on end. I had never seen the normally unflappable Mitzi quite so upset. For her, this bordered on hysteria.

  I helped her out. “How much money did you lose?”

  “Seven hundred and fifty thousand,” she replied, eyes downcast. “And I owe the IRS almost that much. How could I be so stupid?”

  “You? Didn’t Dave have anything to say about this? You didn’t get into this alone, did you?”

  “Well, no, of course not. Dave went along with it too.”

  “So did everybody else,” I pointed out. “You were in good company.”

  “I don’t know what possessed me,” she said. “It was like he hypnotized me or something. I couldn’t help myself. Now I cringe just thinking about it. I’m so ashamed.”

 
I knew that the loss of all that money had not upset Mitzi so much as the loss of her self-respect. “Mitzi. You’re not the first woman to have an affair, and you won’t be the last.”

  Mitzi stiffened. “What makes you think I had an affair? Just how stupid do you think I am?”

  Oops. Between Jeannie and Mitzi, I had my foot so far down my throat that I would have to hop back to my office. What could I say? I certainly couldn’t tell her that she and Stephanie were in Jay’s will. I couldn’t betray Elliott’s trust that way. “So, you’re crying for the money you lost?”

  She wiped her eyes. “Well, it was a hell of a lot of money,” she said.

  “Come on, Mitzi. You got pregnant and Dave divorced you. It doesn’t take a rocket scientist to figure out what the connection is.”

  She turned away. “Toni, why are you bugging me like this? It’s none of your business.”

  “It is too. I did the autopsy. The man was murdered. How does that make it not my business?”

  She got up and began to pace, something I couldn’t do in my office; it was way too small. “Toni, please, stop this.”

  “I will if you tell me the truth,” I said. “I promise you it won’t go any further. I don’t gossip. Come on, tell me. Stephanie is Jay’s child, isn’t she?”

  Mitzi stopped pacing. “Okay, yes, she is. Are you happy now?”

  “And Dave knew?”

  “Yes, that’s why he divorced me.”

  “How could he be so sure? Did you have a paternity test?”

  Mitzi laughed bitterly. “How do you think? We hadn’t had sex in a year. There was no way it could be Dave’s.”

  And maybe that made you vulnerable too, I thought. Just like Jodi.

  Maybe all Jay’s conquests had the same problem. I thought it was just me. But that wasn’t enough to make me stoop to have an affair with Jay Braithwaite Burke.

  Do all married men get tired of sex with their wives? I wondered. Someone should put out a bulletin. After all, it could get them killed.