by G. H. Ephron
“Well?”
“He didn’t. I looked into that old stalking incident.” I must have looked surprised because Annie added, “It’s my job. Of course I checked her out. She took out an injunction against the guy, a college student. He was killed six months later when his car hit a Greyhound bus that had rolled over on a highway in freezing rain. Doesn’t seem like the kind of thing Emily could pull off, despite her many talents.”
“Just a coincidence,” I said, trying once again to adjust my mental image of Emily.
“Sometimes that’s all it is.”
“You want this to be about those obituaries, don’t you?” I said. Annie grinned and raised her eyebrows, allowing that I might have a point. “Okay. I can see where Philbrick’s death might have had something to do with the lab and a rash of suspicious patient deaths. But Kyle’s death? How does that fit in with dead patients?”
“He was there the morning Philbrick was killed. Maybe he saw something.”
“What?”
“I don’t know. I haven’t figured that part out.” Annie ran her finger slowly around the rim of her glass. “Too bad Emily will be in jail. Now she can’t find out when all those patients had their last appointments at the MRI lab. We’ll just have to find out for ourselves. Go to the families and ask. If they don’t know, try to get at the lab records.”
I didn’t like where this was heading.
“I already contacted Frank Mosticcio’s daughter,” Annie said, rushing ahead full tilt.
“The guy who loved ballroom dancing?”
“No. Mosticcio’s one of the obituaries that Uncle Jack snitched. Died a couple of months ago. Lived in Brookline. You and I have an appointment tomorrow to see his daughter.”
“We do?”
“Yeah. I said I’d come over with a psychologist who works with dementia patients and their families.” My jaw dropped. “Well you do, don’t you? I told her the truth—sort of. That I was looking for families who’d gone through what I’d been going through. I hand-waved a little about why.”
“Hand-waved?”
“I may have suggested I’d be writing about it. I really didn’t have to say much. She said she’d be glad to talk to us. Seemed eager to, in fact.”
“Annie—” I started. All kinds of red flags were waving.
“Peter, you need to know if Emily is guilty or not and I want to nail the bastard that tried to hurt my uncle.” Annie had a way of bringing things into focus. “You’ll give me…” She searched for the word…. “legitimacy. I’ll make you less intimidating.”
“I’m not intimidating.”
“Okay, you’re not. I checked with Gloria, and you’re not busy then either.”
“How would she know? Tomorrow’s Saturday.”
“So are you? Busy, I mean?”
“I guess I am. Now.”
Frank Mosticcio had lived in Brookline on the hill up behind Coolidge Corner. The rambling Victorian had long ago been divided into apartments. A wooden staircase had been slapped onto the side of the house to give the second-floor tenant direct access. When we pulled up, a middle-aged woman in a T-shirt and jeans was removing a sign that said YARD SALE TODAY from the tree in front of the house.
“Sorry, we’re just putting things away,” she told us as we got out of the car.
“I’m not a yard saler,” Annie said. “I’m Annie Squires. I’m here to talk to Frank Mosticcio’s daughter.”
“That’s me. Dorothy Stephanos. Please, call me Dottie.”
Annie shook her hand and introduced me.
“I thought I’d have all this put away by now,” Mrs. Stephanos said, raking manicured fingers through her short blond hair. “My son’s supposed to be helping me out, but…” She looked around as if she expected he might be hiding behind a tree. “Sold a bunch of his own CDs and took off. Kids. Short attention span.” She surveyed the unsold items that littered the lawn. “Now I’m stuck with this mess. Why does it always seem like there’s more at the end of the sale than at the beginning?”
“I’m sure it demonstrates some principle about conservation of stuff,” Annie said as she picked up one of the boxes. “Where do you want this?”
“You don’t need to do that,” Mrs. Stephanos protested.
I followed Annie’s lead and picked up a pair of lamps that looked as if the bases were made from World War II shell casings—miniature bombs dangled from the pulls. Now there was something every household needed. Only fifty bucks for the pair. A bargain.
Mrs. Stephanos led us around the back to a garage where we stashed the unsold items. A half hour later, the three of us had cleared the lawn and were sitting on the porch drinking iced tea. Mrs. Stephanos had brought out a file folder where she kept documents about her father’s illness.
“It’s been a struggle, getting the estate settled. So many details. Well, I’m sure you know what that’s like,” Mrs. Stephanos said, giving Annie a sympathetic look.
“I do, actually,” Annie said, not bothering to correct Mrs. Stephanos’s impression that Annie’s uncle had died. “My uncle was a big hoarder.”
“This is our third yard sale and there’s still more stuff I haven’t gotten to up in the attic. Packed into the eaves. My husband says I should just pay someone to come in and clear the place out. But I can’t bring myself to do that. There could be family photographs and who knows what else.” She sighed, the aluminum chair creaking as she leaned back in it. “Would you believe, I found about a dozen uncashed checks for stock dividends in his toaster oven?”
“I’d believe,” Annie said.
I asked Mrs. Stephanos about her father—when he’d become ill, how the disease had progressed.
“I’d never even heard of it,” Mrs. Stephanos said. “Lewy body dementia. My son says it sounds like a rock group.” She went on to tell us that her father’s physician had suggested he participate in the research study.
She spread the contents of the file folder on the table. There was the consent form she’d signed for her father.
“Do you mind if I look through?” I asked, indicating the other papers in the folder.
“Be my guest,” she said.
Mrs. Stephanos went on, telling us how her father had gotten a series of MRIs—four or five, she thought—at University Medical Imaging. The last one had been a few days before he died.
“He came home from the test and went right to sleep,” she said. “Next morning he was running a fever. I thought it was just a cold. By that night, he was having trouble breathing. I called his doctor but by the time we got him to the hospital it was too late. It was some kind of bacterial infection. Like the one that killed Jim Henson? Galloping pneumonia, one of the nurses called it.”
While she talked, I sifted through the papers in the folder. Mrs. Stephanos had letters from her father’s primary care physician, hospital bills, and medical reports. There was a full-color brochure extolling the virtues of University Medical Imaging, and another tri-fold from Cimgen Pharmaceuticals—that was the company that manufactured Cimvicor. On the front was a photograph of a vigorous older woman and man on a sun-drenched golf course. She was teeing off. In italics and halfway down the first page it said, “Lowering cholesterol reduces the risk of hardening of the arteries, and hardening of the arteries has been linked to heart disease and the onset of dementia.”
Subtle. Doctors could prescribe a lipid-lowering drug like Cimvicor for an “off-label” use such as treatment for dementia, but the company was forbidden by the FDA to advertise an off-label use. They couldn’t come right out and say the drug could be used to treat dementia—but the implication was clear.
“Just curious,” I asked. “Do you recall where you picked this up?”
Mrs. Stephanos took the brochure from me. “I don’t—” she began. She turned it over and noticed something written on the bottom of the back page. Looked like a name and phone number. “Oh yes, I do remember. I picked this up at a family support meeting.”
Drug c
ompanies got away with distributing this kind of misleading information by slipping it in under the radar.
“Dr. Shands was treating your father with medication for Lewy body dementia?” I asked.
“Such a brilliant doctor,” Mrs. Stephanos said. “He was the only one who gave us any hope.”
“Was the treatment helping?”
“Maybe. I’m not sure. It was so hard to watch my father deteriorate the way he did. Over just a few months, he went from being completely independent to needing help getting out of bed. He’d once been a teacher and now he was talking gibberish. Near the end, we had to get someone to stay with him all day. Nights I slept here. I was so exhausted.
“It’s been three months since he passed away and I’m feeling like I’m just now starting to feel normal. At least it’s a comfort knowing that my father’s brain is being used to help find a cure.”
“Your dad’s death was unexpected?” Annie asked.
“His primary care physician had told us that despite the dementia, his heart was strong.”
“So his death came as a shock?” Annie pressed.
Mrs. Stephanos hesitated. “We thought he’d linger. Yes, it was a shock.” There was a long pause as she and Annie locked eyes. “And a relief. I’m sure you know what I mean. In the end, he just slipped away in his sleep. Not twitching and shouting like he’d been doing. It was for the best.”
Annie shot me a look.
22
BY THE end of the weekend, Annie and I had met or talked on the phone with a half-dozen more next of kin. It was turning out to be a mixed bag. Two patients had died more suddenly than expected. For another, it sounded as if death had been a long overdue coda to the final dehumanizing phase of a nasty disease. In another case, the surviving daughter had been estranged from her father and simply didn’t know whether death had been sudden or not.
The key piece of information—when each of the deceased had their last appointment at University Medical Imaging—remained elusive. Family members often didn’t know or didn’t remember.
“If only we’d gotten started in this direction a few weeks ago it would have been so much easier,” Annie pointed out. “Emily could have pulled this information out of their files for us.”
Now Emily Ryan was in no position to get information for anyone. She’d been arrested and booked. In Kyle’s gym bag the police found a “Freudian Slip” like the one she’d used to leave a note on my office. On it was written:
See you at 6.
XX
Emily
Annie still wasn’t buying. “Are you telling me she sat on the steps to the parking lot for twenty minutes holding his gym bag, and never bothered to get rid of the incriminating note?” It was a damned good question.
Monday morning, I found Gloria and Kwan in the conference room. They stopped and gave me an odd look when I walked in.
“What?” I said, immediately.
“We were just talking about Emily,” Kwan said.
“There must be some way we can help her,” Gloria said, her face etched with concern.
I sank down in a chair and told them I wasn’t feeling too optimistic. I’d called outpatient services and they had no record of handling the referral that Emily claimed she got. The administrator got all huffy at the suggestion that her office would be careless enough to make an appointment for a nonexistent patient. They always checked insurance, she said. And they always called to confirm appointments.
“They insist they’d never have given Emily the number of a disconnected phone.”
“But—” Gloria said, looking crestfallen.
“Did either of you see her when she says she came down to look for the patient?”
“I’d gone home,” Kwan said.
“I saw her,” Gloria said. “She asked me if I’d seen anyone wandering around, looking lost.” I could sense how torn Gloria was about revealing the next bit. “Then I think she went outside.”
“Did you see her come back in?” I asked.
Gloria admitted that she hadn’t. “But that doesn’t mean anything. Don’t you see? Someone’s setting her up.”
Gloria and Annie were pretty much on the same page with their conspiracy theories—Gloria thinking Emily had been framed, Annie sure it was all about untimely patient deaths. And me? Parallax. Something had shifted, and despite the fact that more and more evidence was mounting to incriminate Emily Ryan, I was starting to agree with the conspiracists. My gut said she wasn’t a murderer.
Security at the Middlesex County Jail on the top floors of the Cambridge Courthouse was getting more and more extreme—this time it took almost forty minutes to get through their screening process. They confiscated my briefcase and even my Tic Tacs. At least they let me take in a pad of paper and a pen.
Emily was waiting in the cell-like examining room, standing and staring out the barred window. She seemed lost in the baggy gray jump suit that had MIDDLESEX COUNTY JAIL stenciled on the back. Her ponytail was tied low at the nape of her neck. Strands of hair hung loose at the sides. I knew she wasn’t appreciating the spectacular view of the Boston Harbor with the Leonard Zakim Bunker Hill Bridge in the foreground, a fan of cables at either end splayed like a futuristic harp.
“I can’t believe this is happening. How can they think I killed Kyle?”
She sat at the table and put her head down in her arms. I took the chair across from her.
“Outpatient services says that referral you got didn’t come from them,” I said.
Her head snapped up. “But a woman from there called me. That morning. Gave me a name, phone number, reason for referral. Why would I make that up?” She blinked at me. “Oh. I get it. I used it as an excuse. So I could sneak down and kill Kyle and then sneak back up without anyone seeing me.”
“Gloria saw you go outside.”
“Gloria—?” Emily cocked her head to one side, thinking. “Of course I went out. I thought the guy might be lost. I came right back in.” There was a pause. “She didn’t see me come right back in?”
“No, she didn’t.”
“Oh, God,” Emily said. “Who is doing this to me? You heard about the note they found in Kyle’s briefcase? On my notepaper? I have no idea where it came from, because I certainly didn’t write him a note. I didn’t write Kyle notes. I called him. I talked to him. He was a friend. Besides, I only use that notepaper at work.”
She sank back, her gaze roving across the ceiling, from the window to the radiator. Then she gave me a direct look, her eyes bright and intense. “I know what you’re thinking. This woman is out of her mind—who is she kidding?”
“Actually, that’s not what I’m thinking,” I said. “What I think is that someone’s gone to a lot of trouble to make you look guilty.”
Relief swept across Emily’s face. “Will you help me?” She put her hand on my arm. “You’ve got to help me. You’re my only hope.”
“Actually, I’m not,” I said, yanking my arm away and immediately regretting it. I hated the way Emily kept thrusting me into the role of savior, but I knew I was overreacting. The situation was grave, and Emily really did need all the help she could get.
“Maybe it’s not just two murders,” I said. “Maybe it’s about a whole lot of patients who shouldn’t have died when they did. I don’t know if Dr. Philbrick was responsible for these deaths.”
“He couldn’t have been. If he’d known something like that was going on, he’d have blown the whistle.”
“Or maybe that’s it. He was ready to blow the whistle. Maybe that’s why he called me the night he was killed. To ask me to watch Mr. O’Neill. Maybe he still wasn’t absolutely sure.”
“And that would mean—” Emily spoke slowly, putting together her thoughts as she went. “—maybe Kyle was killed because of something he saw that morning when he followed me to the lab?”
But Kyle had told the police he hadn’t seen anything. Maybe he’d been lying. Or maybe…“Wait a minute. Who else was at the lab that mo
rning when you got there?”
“No one.”
“But didn’t Dr. Shands call the police?”
“Jesus,” Emily said, grasping the significance. “Why didn’t Kyle see him park his car in the garage and come in?”
“Could he have walked over, or come by T?”
Emily scoffed at the suggestion.
“Do you remember if you saw Dr. Shands’s car in the garage when you arrived?”
“Honestly, I don’t remember.”
Suppose Shands was already at the lab when Emily got there. Suppose Philbrick collected obituaries because patient deaths seemed suspicious. Suppose there’d been a string of accidents, or even murders, that were being covered up.
I stopped. All I had was a web of supposes. What we needed was evidence, not conjecture. “If this is all about covering up the deaths of patients, then we should back up and ask ourselves who had access to those patients.”
“Anyone at the lab.”
It could easily have been done any number of ways in such a closed system. Bacteria could have been added to the contrast agent Shands injected. It could have been in the sedative administered beforehand to keep patients calm. Doctored packs of the Cimvicor or placebo medication given to patients in the study would have done the trick.
Emily considered for a moment. “Old people with dementia being killed. Immediately makes you think ‘mercy killing.’ But you can be sure that if Dr. Shands or Dr. Pullaski had anything to do with it, it wasn’t about mercy.”
I had to agree. But I was surprised at the clarity of Emily’s observation—up until now she’d spoken of Shands only in the most glowing terms. Maybe prison was fading her rose-colored glasses. Or maybe she’d finally realized that her own survival was at stake.
“He once drew me his grand plan,” Emily said. “Showed me how he targeted different age groups, males and females, at different stages of the disease. Thing is, he does it in life, too—collects the people he needs.”
I’d made a similar observation myself. Shands had Leonard Philbrick, who could handle patients and knew more about MRI technology than anyone. He had Dr. Pullaski, efficient administrator, willing to move funds and deal with unpleasantness.
