Critical Judgment (1996)

by Michael Palmer

  "Josh!" she screamed as he raised a pistol and aimed it point-blank at a nurse. "Josh, no!"

  He heard her voice and lowered the gun a fraction. Then slowly, deliberately, he swung it around and pointed it at her face. She tried to call to him, to beg him, but there was no sound. All around her the scene blurred. Movement slowed. The panicked cries of others became muted. The swirling smoke hung motionless. And, finally, there was only the yawning maw of the revolver muzzle, and above it, Josh's eyes, flashing out searing laser streaks of gold. Suddenly, from somewhere far in the distance, a telephone began ringing. Abby struggled to locate the sound. The gun barrel expanded, then disappeared. The hideous eyes sparked, then dimmed, then vanished altogether. The smoke and the screams faded. Now there was only the ringing.

  Shaken, disoriented, and struggling for air, Abby rolled over and slapped her hand down on the receiver. She rarely remembered dreams of any kind and had never experienced one with such horrible vividness. Her mouth was gravel and sand. The T-shirt she had been sleeping in was unpleasantly damp.

  "Hello?" she croaked.

  "Abby Dolan?"

  Abby cleared her throat and worked herself up on one elbow. The images from her nightmare refused to be banished.

  "Yes."

  "Abby, I'm sorry if I woke you. It's Joe Henderson."

  In an instant she was sitting up and forcing herself to concentrate. The hospital president had never called her at home before. It had to be trouble. She glanced at the alarm clock--almost nine-thirty, the latest she had slept in months.

  "Just give me a second to get sorted out, Joe. I was up late last night."

  "I know."

  Uh-oh.

  Abby took a sip of water from a half-filled glass on her night table, then dipped her fingers in it and rubbed them across her eyes. The Josh nightmare was just too goddamn real. Now, it seemed, reality was about to become a nightmare.

  "Go ahead," she said.

  "Abby, I wonder if you might be able to stop down at my office so that we might talk."

  "About what?"

  If Joe Henderson was going to take her off the ER staff, she had no intention of making things easy for him. There was a prolonged silence while he searched for the best response.

  "Abby, it seems you've generated quite a bit of controversy these past couple of weeks. I think it's time I presented things to you the way they've been presented to me. That way you have a chance to respond to them."

  Henderson always had some sort of twang or drawl to his speech. Now he seemed to have both. Abby found herself wondering if either was real.

  "Is this going to be another committee?" she asked.

  "Pardon?"

  Abby ignored the voice in her head that was begging her to stay cool and simply agree to meet with the man.

  "The last time you asked to have a word with me, the day of the accident, I ended up feeling as if I had mistakenly wandered into a fraternity induction ceremony."

  "I'm afraid I still don't understand."

  "Joe, just try to imagine yourself being called into a room to explain your job performance to four women."

  Certain that Henderson expected her to bow out without a struggle, she pictured him now, trying to maintain his never-faltering, political grin.

  "It will be just you and me, Abby. You have my word."

  "What time?"

  "One?"

  She glanced at the clock again. There would be plenty of time to hike up to Ives's camp.

  "I'll be there," she said.

  Abby trudged up the trail to Sam Ives's place with an uncharacteristic heaviness in her chest. In her career as an ER doc she had been party to incalculable tragedies. But until she'd come to Patience, her life outside the hospital had been more tranquil than most. Now, it seemed, she was being attacked from all sides. Oleander, Quinn, Josh, and now Joe Henderson. She had never shied away from making tough choices. It was one part of her job that had spilled over into her personal life. But she hated the straitjacket feeling of having others make decisions for her. And in just an hour or so, she assumed, Henderson was going to do just that.

  Before driving to Ives's mountain she had stopped by the hospital and stocked up on more than the usual number of dressings. In the event she was fired or suspended, it would become considerably more difficult, if not impossible, to obtain the bandages, instruments, and especially the drugs she had been using. The antibiotic was too expensive for the hospital pharmacy to give away, but in response to Abby's urging, the head pharmacist had worked out a deal with one of the drug houses. The cost to Abby was quite manageable.

  She was also worried about the treatments--the regular debridement of infected tissue--that were allowing Ives's wound to heal from the base. She hoped that Lew might take over if she was forced out of town. Of course, if the Colstar forces went for a complete purge, Lew might find himself right behind her on the unemployment line. The truth was, though, she had never gotten even the hint from him or anyone else that his job was in jeopardy. Oleander knew of his anti-Colstar activities, as did Quinn. But somehow Lew had mastered the ability to stay out of the limelight, and out of the way of those who could cause him trouble. Perhaps sometime soon he could give her lessons--Invisibility 101.

  Abby stopped at the edge of the clearing and was about to yell out her usual warning not to shoot when she spotted him. He was swinging in a homemade hammock, suspended between two trees about twelve feet off the ground. A paperback book was propped on his belly.

  "Hey, Doc," he called out, "I thought you said you'd be up today, but I wasn't sure."

  "Ives, how do you get up there?"

  "Same way as I'm about to get down."

  He grabbed a heavy cabled rope and flipped off the hammock without a bit of preparation. He descended under complete control, not even bothering to use his legs. It was only then, for the first time, that Abby realized how powerfully sinewy his arms were.

  "Tell me something," she said. "The night you got beaten up, did you get any decent punches in at the guys who did it?"

  "You know the answer to that."

  "You don't hurt people."

  "I don't even hurt insects if I can help it." He flipped the book onto his worktable. "Louis L'Amour," he said. "You ever read westerns?"

  "I thought you were into the classics."

  "Obviously you haven't ever read Louis L'Amour. Do yourself a favor some day. In fact, here. I've read this one a couple of times."

  Abby knew better than to refuse even though she hadn't read a novel since the day she'd decided to apply for the PRH job. She thanked him and dropped the frayed paperback into her pack.

  "Okay, let's have a look."

  The dual attack of germ-specific antibiotics and the surgical removal of diseased tissue was working. Healthy pink skin was appearing around the edges of the wound. Abby wondered what would happen to Ives if she had to leave Patience entirely.

  "So what's going on with you?" he asked as she cleaned away what little obvious infection remained.

  "What do you mean?"

  "Something's not right with you."

  "How do you know?"

  "Well, it's either the negative ionic aura that's emanating from you, or the terribly sad expression on your face."

  "I didn't realize it was so obvious."

  "Anything you want to talk about?"

  "I've been summoned by the president of the hospital. We're meeting in about an hour. I think he's going to fire me."

  "For what?"

  "I don't know how he'll choose to word the royal decree, but the real reason is that I've been studying the records of patients at the hospital. I feel some of their problems may be due to a toxic exposure from Colstar."

  "Last time you were here, you mentioned something about cadmium."

  "Exactly. So far all the tests run at the hospital for cadmium have been negative. But just in case there's a problem with the lab here, I took some blood from one patient down to San Francisco for an
alysis at my old hospital."

  "Excellent move."

  "I've been trying to review the hospital records of patients I suspect might have been victims, but I'm in hot water for not getting permission from some stupid committee. I haven't identified a cause or pinned down the time of the exposure, but there's some sort of pattern linking these patients. I'm certain of it."

  "Then you've got to keep looking."

  "That's like telling a turtle who's been flipped on her back that she's got to keep walking."

  "Well, my money, if I had any, would be betting you get some sort of warning. From what I've been able to tell, Colstar is a very confident company. I suspect you're a lot less of a concern for them than you think you are."

  "How do you know so much about them?"

  "Like I've told you, I keep an eye on the place. A couple of friends who visit me from time to time used to work there. We talk."

  "Can you help me out in any way? I mean, do you think your friends know anything about a toxic spill or poor handling of cadmium?"

  The hermit shook his head.

  "Doubtful. I can tell you that over the last couple of days there's been a lot of activity around the place. As soon as you've wrapped that leg, I'll get my logbook and show you what I mean."

  Abby finished her work and watched as Ives went to his hut for his sack. His limp was barely perceptible now, even though the wound was far from healed. She remembered how badly hobbled he had been just a few weeks ago and wondered how much pain he must have been having, to give in that much. Ives hadn't talked much about his past, but he did share that he had been a philosophy professor at one of the state schools and, before that, had served in Vietnam. He was uncomplicated and often childishly simplistic in his views of things. Yet he appreciated life on a daily basis more than anyone she had ever known. If--oh, hell, when--she left Patience, she would miss him.

  Ives set his sack on his worktable and opened the logbook.

  "There have been a number of big-shot-type cars cruising up Colstar Hill over the last four days. Two Jags, a Mercedes, a Porsche. I didn't recognize any of them. But the big company event was yesterday," he said. "A stretch limo with none other than Senator Mark Corman in it. You know him?"

  "Of him."

  "He was accompanied by a fellow in a suit--maybe his aide--and the guy I call the Man in Black. My friends tell me his name is Quinn. He must not like making decisions about what to wear each day, because I've never seen him dressed any other way."

  "His name's Lyle Quinn. He's head of security. He may dress like a cartoon, but I believe he's a very dangerous man."

  "Hmmm. Big-shot senator visits battery factory. What do you suppose that means?"

  "Well, for one thing, he's originally from Patience."

  "That's right. I knew that."

  "And for another, according to Josh, Colstar is always competing with other manufacturers for government contracts."

  "I imagine that's it. Corman is probably adding to his store of pork barrels. Speaking of our friend Josh, any word from him?"

  Abby shook her head. She had shared some of what she and Josh had been going through, but this wasn't the time to bring Ives up to speed on the latest sad developments.

  "Listen," she said, "I'm sorry I can't stay, but I've got to go face the music at the hospital. Whatever happens, job or no job, I'll try to be back to see you in three days, right about this time."

  "They won't fire you. Mark my words."

  "We'll see." She started to leave, then returned and gave him a quick hug. "Take care."

  "You take care," he said. "Between now and when I see you again, I'm going to be keeping an eye on my favorite factory and thinking about why a U.S. senator is so interested in batteries."

  CHAPTER TWENTY-FOUR

  Joe Henderson was resplendent in a blue-and-white seersucker suit. His office was on the second floor of the hospital, and Abby noted that he had almost the same view as did George Oleander--across the meadow to the Colstar cliff. She had been interviewed by Henderson on her first visit to the hospital, and although he had made any number of inadvertent remarks that some would have considered sexist, she felt they had hit it off reasonably well. Seated in his pine-paneled office with its hunting trophies, Abby had had no trouble attributing the insensitivity to a man who simply wasn't aware that there was anything objectionable in telling her how unusual it was to see a woman physician as attractive as she was. It was no surprise, then, when he had followed up the inappropriate compliment by asking, "So how'd you end up becomin' a doctor, anyhow?"

  Now she sat rigidly in a low-backed leather chair, waiting for the man to finish praising her skill as an emergency physician and get to the point of their meeting.

  "It's not your overall knowledge or your ability in question here. I want you to know that," he was saying.

  "Then what is it?"

  "Well, frankly, some fairly influential members of the board of trustees and also some members of the medical staff believe they have good reason to question your maturity and your judgment."

  Abby felt some weakening in her resolve not to lose her temper.

  "Explain," she said.

  Henderson ran his fingers through his thinning hair and fiddled with a desk game shaped like a putting green.

  "Well, let's start with the fact that some of our doctors feel you've gone out of your way to make them look or feel inferior to you. As far as I know, none of them has suffered too badly because of your remarks. But this is a very tight community, and the thing we all treasure and protect the most is our reputation."

  Abby was gripping the arms of her chair now.

  "Please, go on," she said.

  "Next there's this business of Peggy Wheaton. There are those who were there that day who feel you had no right to desert her in her moment of crisis in order to tend to ... to the man who killed her in cold blood. Even if, as you say you believed, Peggy had no chance, folks still think that leavin' her the way you did showed poor judgment on your part."

  He paused to give her a chance to comment, but she said nothing. Her jaws were locked as tightly as her hands. Ives was wrong. Henderson was building to a carefully orchestrated crescendo, the grand finale of her termination.

  "And, finally," he went on, "there's this business of your conducting an unauthorized review of hospital records. The rules of this hospital are spelled out quite clearly in our staff bylaws. Because our community is such a closely knit one, the hospital staff felt it was essential to protect patient confidentiality as much as possible. We also wanted to prevent any unauthorized audits that might pit one physician against another. The other night in the record room Mrs. Ricci expressly spelled out the rules to you. Yet we have reason to believe that last evening you again were calling up records, this time from a computer at the community college. Now, I will admit that we don't have absolute proof it was you. But the security built into our new record-keeping system identified that the intrusion was taking place and found the phone number of the bookstore. We got a detailed description from the girl who was working behind the counter."

  "It was me," Abby said.

  "Why? Why would you do such a thing when you knew it was forbidden by hospital law?"

  Abby hesitated, uncertain of how much to share with the hospital president. Obviously, he had ties to Colstar. Everyone in Patience did. But he also ran the institution that was caring for all these patients. It was certain that since Oleander and Quinn knew about the continuing existence of the Alliance, Henderson did, too. But maybe he didn't realize how extensive the toxicity problem seemed to be--and how explosive. Maybe it was time for her to start getting the word out. She tried to think of what damage Henderson could do if he was committed to helping Colstar cover up whatever it was they had done. True, he could fire her. But he was about to do that anyhow. She decided to chance imparting at least some of what she believed was going on.

  "Joe, you said the hospital bylaws were established to protect pati
ent confidentiality. Well, I violated those laws because I believe those same patients' lives may be at stake. And I believe Colstar may be at fault."

  Henderson sat forward and pushed aside his putting green.

  "Then why in the hell didn't you talk to someone?" he asked.

  "Who? Dr. Oleander almost jumped down my throat for ordering cadmium levels on a couple of his patients."

  "All negative, I've been told."

  "See? That's a perfect example of how there are no secrets in this town at all. The things I believe Colstar might have done are crimes. People may even have died because of them. The company could be heavily fined and even shut down. If there's been a deliberate cover-up, people could be sent to prison. So who am I supposed to talk to? Do you want me to ask permission from the records committee to investigate? Well, Martin Bartholomew is the head of that committee, and he's also the head of the employees' clinic at Colstar."

  "I see."

  "So I just decided that the welfare of my patients--your patients, too, incidentally, since they all have been inpatients or outpatients here--was worth breaking that bylaw for."

  "Abby, how can you believe the company is responsible for exposing people to cadmium when there is absolutely no proof? No positive tests. Nothing!"

  "I'm waiting for an independent lab in San Francisco to call with the results on some samples of blood I brought to them."

  "You don't trust our lab?"

  "Quite frankly, I don't trust anyone right now."

  "What patient was it?"

  Again Abby resisted any knee-jerk response. Was there any way she would be putting Cardoza at risk by revealing that it was his blood? Considering her encounter with the man in the ski mask and his pickup, it seemed clear that nothing she could say was going to be hot-off-the-press news.

  "Willie Cardoza," she responded.

  Henderson's attempt at looking surprised missed badly, she thought.

  "You think he was poisoned with cadmium?" he asked.

  "I do, actually. That would explain the violence, the insanity inherent in what he did. I've researched the subject quite thoroughly. Violent, psychotic behavior has been reported from cadmium, especially with high-dose exposure. Cardoza has some physical findings in his eyes, as well, that I think may quite possibly be due to some sort of heavy-metal poisoning. And cadmium is a heavy metal. It would certainly make me feel better to know that he wasn't responsible for what he did, although no matter how the tests turn out, I still defend my decision to work on him and not Peggy Wheaton. I did what every ER doctor is trained to do in a triage situation--treat those who have a chance of making it."