by Sue Grafton
“Right.”
“He was also suffering from alcoholic ketoacidosis syndrome. AKA for short. Essentially we’re talking about the buildup of ketones in the blood. Ketones are a type of acid that form when the body breaks down fat for energy. Patients typically have a recent history of binge drinking, little or no food intake, and persistent vomiting. This results in a delay and decrease in insulin secretion and excess glucagon secretion. A lot of hokum here that I’ll skip . . .
“Basically, all patients with severe AKA are dehydrated. Several mechanisms might be responsible, including decreased fluid intake and inhibition of antidiuretic hormone secretion by ethanol. Volume depletion is a stimulus to the sympathetic nervous system, which decreases the ability of the kidneys to excrete ketoacids and can culminate in circulatory collapse.
“My guess is if you go back and talk to his pals, they’ll confirm one or more of the following symptoms. You got a pencil and paper handy?”
I picked up a pen and pulled over a scratch pad, jotting down the list as he recited it.
“Abdominal pain, agitation, confusion, an altered level of alertness. Also, let’s see here . . . low blood pressure, fatigue, sometimes dizziness. Fruity breath is one key, so be sure you ask about that. Smells like acetone.”
“You want verification?”
“It might satisfy any questions his cohorts have. His family might be interested as well. The bad news is, if someone had picked up on his condition and had taken him to the ER in time, he might be alive.”
“Oh, man. I think I’ll keep that to myself,” I said. “Anything else?”
“Well, just running down the page here . . .autopsy showed his heart was enlarged and there was also extensive kidney damage.”
“Also associated with chronic alcoholism I’d imagine.”
“Can be. The only thing that struck me as odd was that blood and urine came back negative for opiates and alcohol.”
I was silent. “You’re saying he was sober?”
“Totally.”
“Are you sure? Because two of his homeless pals swear he was drunk to the end. In fact, Pearl was devastated because he swore up and down he’d quit.”
“Well, there’s no way to know how efficiently he metabolized alcohol, but he was clean on October 7 and probably the day before as well. He might’ve behaved like he was drunk. Kidneys start shutting down and the buildup of toxins can render you incoherent. Lethargy’s another symptom that can mimic inebriation. He might have garbled his words.”
I said, “I’ll ask about that. I’m told he’d been going downhill for months.”
“He was a short-timer. No doubt about that. All I’m saying is what got him wasn’t the result of alcohol consumption during the two or three days prior. The time frame’s a guess on my part, by the way.”
“What about pain pills? I hear he was hooked on those.”
“Nope. No sign of anything in his system,” he said. “At any rate, if you hear something to the contrary, you let me know.”
“I’ll do that. And thanks.”
30
I sat at my desk, wondering what to make of it. I certainly wasn’t going to tell Pearl that Dace might have been saved. She had Felix’s death to deal with and that was enough. She was already blaming herself for the beating that killed him. I picked up my jacket, my bag, and car keys. Ed seemed willing to follow me into the yard, but I couldn’t be sure he’d behave once I was gone. I went back into my apartment and snagged Henry’s house keys. I locked my door, lifted Ed, and tucked him under my arm. He purred happily, perhaps thinking we’d be going through life this way, his warm body pressed against mine. I would have kissed his sweet head, but I didn’t know him that well and I was worried he’d take offense. I unlocked Henry’s door and dropped him inside, a move he also accepted without complaint.
In the car again, I drove along the beach, scanning the grassy areas along the bike path for sight of Dandy or Pearl. I spotted them in their usual place, in the area under the palms, across the street from the Santa Teresa Inn. They’d set up day camp. They had their carts close by, angled against the damp breeze coming off the surf. Both purloined grocery carts were filled with blankets, pillows, and shopping bags that bulged with recyclable bottles and soda cans. There was a redemption center three blocks away and the homeless supplemented their sketchy incomes by turning in glass and plastic for whatever it netted them. Of course, they squandered the money on bad booze and cheap smokes, trusting the good folks in town would see to their room and board.
They’d spread tarps on the grass in the very spot where I’d first made their acquaintance. Dandy was stretched out on his sleeping bag and Pearl was sprawled on a blanket. A third fellow had joined them, and while I didn’t get a good look at him, I wondered if he was going to be a regular now that Felix was gone. I drove past them and pulled into the public lot, where I parked and got out.
The makeshift memorial that had sprung up in the wake of Terrence Dace’s death was looking forlorn. The jars of wildflowers were still grouped together in the sand, but the water was gone and flowers themselves were wilted. The tower of carefully balanced stones had been dismantled. There was no sign of a rock sculpture for Felix, but he’d died in the hospital whereas Terrence had died on the beach. I couldn’t even pretend to understand the unspoken rules for honoring the fallen comrades of those who had no homes.
Dandy watched me approach. Pearl ignored my arrival, except for the face she made, which expressed equal parts disdain and indifference. I suspected she was still miffed at me for not rushing to comfort her during her outburst at the news of Felix’s demise. She paused to light a cigarette and then continued sipping from a soda can that was doubtless laced with whiskey.
I paused on the path within range of them. “Mind if I sit down?”
Dandy moved his backpack. “Make yourself at home.”
He was nicely turned out; fresh shirt, a sport coat only slightly threadbare along the cuffs. As far as I could tell he hadn’t been drinking. Then again, he held his liquor well and he might have been covering. At least there was no pint bottle in sight and when Pearl offered him the soda can, he declined.
As I sat down, Dandy introduced me. “This is Kinsey. She’s a good friend of ours.”
“They call me Plato, the preacher man,” he said. He doffed an imaginary cap and his smile showed a mouth devoid of teeth. Plato was emaciated, a good sixty-five years old, with a frizzy head of gray hair and a long unkempt beard and mustache. His ears were crusty along the edges as though dusted with powdered sugar. His face had that odd red-brown hue that suggested a life spent outdoors without a proper slathering of SPF 15.
I said it was nice meeting him and he said words to the same effect.
That settled, I sat on the section of tarp Dandy’d cleared for me. The ground was damp and hard and even with a layer of plastic and a sleeping bag on top of that, I wasn’t sure how to arrange myself in any semblance of ease. Nor was I clear on how I’d get to my feet again. “I have news about Dace.”
Pearl said, “Whoopee doo,” twirling a finger near the side of her head.
“You’re annoying, you know that? I didn’t have to drive down here looking for you. Are you interested or not?”
Mildly, Dandy said, “Don’t mind her. I’m listening.”
“Thank you,” I replied. “Dace was sober when he died.”
“Well, that’s a load of horse shit, right there,” Pearl said. “We seen him the day before and he was puking his guts out. I know you’re fussy when it comes to body functions, so I won’t say no more except the stuff looked like coffee grounds. You wouldn’t have wanted to get anywhere near the man.”
“He died of liver and kidney failure.”
Dandy said, “Natural causes in other words.”
“Well, natural if you take into account his heart was enlarged and half his internal organs were shot. He wasn’t drunk. That’s the point,” I said. I turned to Pearl. “Did you talk t
o him that day?”
“If you want to call it that. I wouldn’t say we communicated. I said, ‘How’s tricks?’ and he mumbled something that made no sense. He was staggering all over the place, and his skin and the whites of his eyes were yellow. He might’ve turned into a werewolf for all I know.”
“What about an odor?”
“You mean did his breath stink aside from puke? Smelled like nail polish remover, but not even Terrence was that desperate.”
“That was the ketoacidosis. And don’t ask me to explain. I’m just telling you what the coroner’s investigator told me,” I said.
Dandy opened the flap of his backpack and rooted through the interior. After a brief search, he pulled out a prescription bottle and passed it along to me.
The pill bottle was two inches high and the cap was an inch across. The vial was sealed in shrink-wrap. “What’s this?”
“His pills. He told me to hang on to them.”
“Why the seal?”
“So it can’t be tampered with. Those are the pills that made him sick, but the clinic didn’t want to hear about it. They wanted them back. Doctor even threatened to come down here after them.”
“A doctor? Who’s this?”
“The fellow who headed up the deal he was in.”
“That seems weird,” I said. I read the label. Not surprisingly, I’d never heard of the drug. “Why didn’t you mention this before?”
“He said not to. I kept the bottle hid since the day he passed it on to me.”
I shook the container, which rattled lightly. “And these are for what?”
“He had three different meds. One was supposed to knock down his craving for cigarettes and alcohol. Maybe not that particular pill. It could have been the other ones.”
“Like Antabuse?”
“I guess.”
“And he said the pills made him sick?”
“Yes, ma’am.”
“But that’s how Antabuse works. You have one drink and you get sick as a dog. That’s the point.”
Pearl cut in. “You don’t need to lecture us about Antabuse. We know everything there is to know about that crud. Fact is, Terrence hadn’t had a drink. You said so yourself. So now how do you explain it, Miss Smarty-Pants?”
I read the label again, rotating it in my hand as I followed the line of print. The name of the prescribing physician was Linton Reed, M.D.
Dandy’s eyes were fixed on mine. “What’s that look for?”
“I know this name in another context. I’m just surprised to see it here.”
Dandy said, “That’s from the program he signed up for last spring.”
“Alcoholics Anonymous?”
Pearl made a face. “Not them. It’s this other thing. FDA makes the drug companies jump through hoops before a new one gets approved. He took three pills. One was for booze jitters, but I don’t think that’s it.”
“I take it ‘booze jitters’ means what it sounds like.”
“Of course. Mornings, you know how bad your hands shake before you choke down those first couple of belts of hooch?”
I tried not to look quite as blank as I felt. My hands sometimes shook from anger or fear, but not from DTs.
Meanwhile, she was talking to Dandy. “I think those are the ones that kept him leveled out; preventing mood swings, I guess.”
Dandy said, “Naw, now that’s not what it was. Those curbed his sweet tooth. Remember he talked about all the candy he ate? He couldn’t get enough and he still about passed out. Day he got kicked out of the program, they said he had to turn in his pills, as many as he had left. Terrence wasn’t about to.”
“Why was he kicked out?”
“He missed appointments and complained too much. He was always kicking up a fuss and wouldn’t obey the rules. I’m not saying he wasn’t a pain in the ass.”
“Did you ever meet his doctor?” I asked. I was still trying to get my head around the fact that Linton Reed and Dace had crossed paths.
“Not me, and I hope he don’t get ahold of me,” Pearl said. “Terrence was in St. Terry’s that time? He’s so scared of the man he signed himself out.”
“When was this?”
“June, I think. He left the hospital—”
“More like escaped,” Dandy put in.
“That’s right. He got straight on a bus to Los Angeles,” she said. “He spent a month down there until he figured it was safe to come back.”
“Why was he so scared of this guy?”
“Because he’s the one knew Dace was telling the truth.” She pointed at the pill bottle. “The day he died? When you showed up? We figured that’s what you were after.”
“You mind if I hang on to this?”
Dandy said, “Sure thing. Terrence knew what you did for a living. He hoped you’d look into it proper if something happened to him.”
“Nothing happened to him except he died,” I said. “At least as far as the coroner’s office is concerned.”
Pearl said, “The man was fifty-three years old! He enrolled in that drug deal and went straight downhill. Don’t you listen? Same thing happened to his friend Charles.”
“Charles was in the same program?”
“Not both at the same time. Terrence went in later, after Charles died.”
“Why didn’t you tell me this before? How many times have we talked about Dace and this is the first I’ve heard.”
“We didn’t know what he died of. He said they’d claim ‘natural causes,’ which is what you just said. He stole those pills and I’m passing them along because he told me to,” Dandy said. “You ought to look into it.”
“Look into what? He’d been trashing himself for years, in prison and out. You can’t do that and then turn around and express surprise at the damage you’ve done.”
Pearl said, “Pills aren’t the only thing he stole.”
I looked at her with interest. “You’re talking about medical charts.”
“How’d you know?”
“Because I have them.”
“He sent you those?”
“He sent them to himself in care of Harbor House. One of the volunteers made a point of giving me his mail.”
Dandy said, “Well, I’ll be. Good for him. We didn’t know where all that stuff went, especially when them Boggarts walked off with his cart.”
“How’d he manage to steal charts? Those are usually kept under lock and key.”
Dandy smiled. “Easy. He made an appointment at the clinic. They put him in a room to take his clothes off before the doctor came in. Nurse left his chart in that slot outside the door. He waited until she left. He opened the door and made sure wasn’t nobody in the hall. Then he took his chart, put it in his shirt, and walked out calm and easy as you please.”
“They figured it out pretty quick, but Terrence was gone by then,” Pearl said.
“He stole another couple of charts as well,” Dandy said.
“Well, I know that. The man was a regular kleptomaniac,” I said. “How’d he manage to steal the other two?”
Pearl laughed. “This is good. This is my favorite story. Remember he had that shirt and glasses belonged to Charles?”
“In his duffel with the picture ID,” I said. “Green-and-yellow plaid.”
Pearl pointed to show she approved. “So Charles was laying out at the coroner’s a few days before they figured out who he was. Terrence had already took his ID. He figured nobody ever looked a homeless man in the face, so he put on the green-and-yellow-plaid shirt and glasses Charles was wearing when he had his picture took. He made an appointment in Charles’s name, went into the clinic flashing the photo ID, and pulled the same thing. Stole the chart off the back of the door.”
“He did it twice?”
“He did it three times, counting his. Different doctors work different days, and the nurses work different shifts. He made sure he smelt bad enough that everybody was in a hurry to get away from him.”
I could feel my smile fa
de. “It’s all in there, isn’t it? Proof he got sick. Proof he told the doctor. All his lab work. Everything.”
Dandy said, “Yes, ma’am.”
“What do you want me to do?”
Dandy said, “I don’t know, but there’s bound to be some remedy, don’t you think?”
“If I can figure out what it is.”
I slipped the pills into my shoulder bag and struggled to my feet. I dusted off the back of my jeans and turned toward the parking lot. “I should warn you, his youngest daughter’s in town. Anna. Twenty-six years old. Long dark hair, blue eyes. She’s a piece of work.”
Pearl piped up as I was walking away. “Hey. You have any spare Seconals?”
“I left ’em in my other jacket,” I said, as though she just happened to catch me without. She rattled off a list of acceptable substitutes, Nembutals among them, but I didn’t have those either. I gave her five bucks for cigarettes with strict instructions she was to share with Dandy and the preacher man. I knew it was bad form, but given her true preferences, I didn’t think the sin was too great.
As I returned to my car, I glanced at my watch, surprised that it was close to 1:15. Had I eaten lunch? I thought not. I drove home. A check of the loaf of bread I had on hand showed no signs of green. After a brief search, I came up with a jar of Kraft Olive & Pimento cheese spread. I popped off the top, took out a small spatula, and made what I think of as a hand sandwich. I held a piece of bread in my left palm, slathered it with cheese spread, and then folded it in half. I snagged my shoulder bag, locked up, and dined in style as I was crossing the patio. I guess a hand sandwich could be considered fast food. Four bites.
I peered in Henry’s screen door and saw him standing at the counter, unloading groceries. I tapped. He leaned over and unlatched the door so I could let myself in. He said, “Have a seat. I’m almost done.”
I found myself peering down the hall. “Where’s Anna?”
“Out looking for work.”
“Enterprising of her. What’s she have in mind?”
