John took a few steps into the kitchen and found a renovated kitchen, modern appliances, and marble counters. “Wow. How long have you had this place?”
“About four years. I’ve restored the front of the house and have the bathrooms and bedrooms to go. I dump all my overtime checks into the place and work on one room at a time. I finished the kitchen last month. Took me six months, working late nights and weekends, but I like the way it turned out.”
“I think Melissa and I need you to come over and work on our place. Hell, you could do remodels for half the detective bureau.”
“Don’t you go telling anybody at the station about this. This is what I do to unwind. Besides, half the cops don’t think I should be a detective, and this will only give them more ammunition. I can hear Stark and his cronies telling me I should hang it up and be an interior decorator.”
“Screw them.”
Paula changed the subject. “Let me lock up and we can get over to Central Valley Hospital. You think we can get Trisha Woods to give us a list of everyone who accessed the UNOS system over the past few months? If our killer accessed the system, it would have been during that time.”
“We need to find a way to connect whoever accessed the UNOS system to our victims, and I think I have an idea. But you’re not gonna like it.”
FIFTEEN
The administrative offices at Central Valley Hospital were mercifully separate from the building that housed the doctors, nurses, and clinical operations. Families with sick children didn’t venture into this part of the building, where bean counters billed insurance carriers and shattered lives were reflected as numbers on a spreadsheet.
Steps from the elevator doors, a reception counter blocked access to the offices and the community of cubicles that lay beyond. John and Paula approached the unattended counter where a note taped to the surface directed people to use the phone on the reception desk to contact employees.
John grabbed the phone and scanned the employee directory for Trisha Woods. He tapped in her extension. “Miss Woods? John Penley and Paula Newberry here.”
He listened for a moment, hung up, and heard an electric lock release the short half door set within the counter. The detectives wandered through a maze of light-blue cubicle walls to a back-corner office marked with a small plaque that identified it as the office of Trisha Woods, IT manager.
Trisha sat at a desk and faced a bank of computer monitors that threatened to encircle her work space. Lines, charts, and numbers streamed enough data to overload the senses of a NASA flight controller. She swiveled around in her chair, and her expression softened when she saw John.
“How’s Tommy holding up?” she asked.
“Tommy’s asking questions a kid his age shouldn’t have to think about.”
“It will happen for him.”
“I hope so. This is my partner, Detective Paula Newberry.”
Trisha stood and shook Paula’s hand with an unexpectedly firm grip. She was a fraction of an inch over five feet tall but exuded a larger presence through her demeanor and confidence. “So, Dr. Kelly gave me a rundown on what you’re looking for. The organ-sharing network, right?”
“We’re pursuing an angle that our suspect could be using UNOS as a shopping list. He finds out who needs a transplant and goes hunting for a match,” John said.
“That’s a gruesome theory,” Trisha said.
Paula asked, “Who has access to that kind of data?”
Trisha gestured the detectives to a small sofa. “The system operates on a private network. All patient data are encrypted, and access is restricted from the outside. No remote access. The system is password protected, and only authorized users have access to the medical information and patient data.”
“How many users are there?” John asked as he moved a stack of files and parked on the sofa.
“Nationally, I’m not certain. At this transplant center, we have three categories of users, each with different levels of permissions within the system. We have users with ‘read-only’ permission, but most have full access to enter and edit data, and only a few superusers need access to all the code and software for reports or maintenance. Total, we have less than fifty people with access to the system.”
“If I have access to UNOS, and I need to move a patient up or down on the waiting list for transplant, how do I manipulate the system?” John asked.
Trisha paused before she spoke, not certain how John would take her answer. “Strictly speaking, moving patients up and down on the wait list isn’t manipulation. When the medical condition of one patient or another changes, so does the waiting list. The list doesn’t look the same from one day to the next.”
“I understand that, Trisha, believe me.”
Trisha got the unspoken reference to the detective’s son and nodded.
“What my partner and I are trying to get at is, can I move people up on the waiting list when there is no legitimate medical reason for a change?” Paula asked.
“Well, yes you could, but why would you?”
“If I have an organ to market, I’d want to get it to the person who paid me,” John said.
Trisha’s brow furrowed. “I see what you’re saying, but it’s not that simple. The transplantable organ would have to be acquired, tissue typed and cross matched, then entered into the system. Then, according to your premise, someone would change the UNOS wait list to match it to the donor.”
Paula asked, “So what you’re saying is that it can be done?”
“Well, yes, in theory,” Trisha said.
“Who can make that kind of change in the system? I gather that it would be someone with full access to edit data?”
“Right. Each transplant center has a core set of personnel who do that kind of work. For example, at this hospital, there are two superusers, me and my deputy IT director. Then the regular permissions include the transplant team and their staff. Less than two dozen people total.”
“That narrows it down a bit,” Paula said.
“Can you give us a list of that UNOS user group?” John asked.
“I will check with the hospital administrator, but I don’t see any problem getting that for you.”
“Thanks. Is there any way to show changes in the waiting list and who made the change?” John said as he got up from the sofa.
“I can prepare a report without patient data that will show all transactions, who made changes on the waiting list, when new patients were added, and when they came off the list.”
“How about just changes over the last six months?”
“No problem.”
“Okay, how about patient-specific data?” John pressed.
“Release of patient data is restricted. I can’t give that to you without a court order or consent, of course,” Trisha said.
“What if the patient is my son?”
SIXTEEN
“That was a shitty thing to do,” Paula said. “Asking for Tommy’s records like that.”
“I told you you weren’t gonna like it,” John responded.
“I only met your wife once, but I know she’ll go ballistic when she finds out about this.”
“Then she best not find out.”
Paula looked away from her partner in frustration as they walked out of the business offices at the hospital. “She said she was willing to get us a transaction report. I don’t get why you thought Tommy’s info was necessary.”
“The data aren’t about Tommy. They give us a point in time that a change in the waiting list occurred and who made that change.”
“This is not appropriate procedure . . .”
“Mr. Penley?” someone from behind them called out.
John turned and saw a familiar face, but one he couldn’t quite place.
“You’re Tommy’s father, right?” a worn and tired woman asked.
“Yes, John Penley. I’m sorry . . .”
“Rebecca Gunderson. Steven’s mom.”
Steven Gunderson. The boy listed in the obituary th
is morning.
“Mrs. Gunderson. I’m so sorry. Melissa and I heard about Steven.”
“We don’t know what happened. They told us the surgery went fine. Dr. Anderson said everything would be okay. Then Steven rejected the kidney, and no one will tell us anything.” She stiffened. “Why are you here? Is Tommy all right? Did something happen to him, too?”
“Tommy is still waiting. Excuse me, this is my partner, Detective Paula Newberry.”
The two women exchanged glances but nothing more.
“We are tying up some loose ends on an investigation, that’s all,” John said.
“Mrs. Gunderson, I’m sorry about your son. When did he get his transplant?” Paula asked.
“Last month. Out of the blue. We expected a long stint on the waiting list, but my husband got a call that said they had found a match. Then . . . Steven’s body rejected the transplant. All they said was that it didn’t take. No one will talk to us.”
“How’s the rest of the family taking it?” John asked.
Rebecca Gunderson’s eyes welled. “It’s tearing us apart. Frank, my husband, acts like it’s my fault. He won’t talk to me. He stopped going to work and sits around drinking.”
“Everyone handles grief differently. He can’t possibly think what happened to Steven is your fault.”
“I wish I could say that for certain. But that’s why I’m here. I tried to get answers from these people, and they blew me off.”
“Do you want us to see if we can find out anything for you?” John asked.
Paula jabbed her bony elbow into John’s ribs.
“Would you do that?”
“I can’t promise anything,” John said before Paula cut him off.
“We can’t get involved in that,” Paula said.
Rebecca ignored Paula and stepped in closer to John. “Please find out what happened to Steven. We need closure.”
“We will,” John promised.
Paula headed toward their sedan.
As soon as Paula was out of earshot, John said, “Go meet with Trisha Woods and sign a consent form to allow me to look at your son’s medical records. Without that consent, I can’t help you. You know Trisha?”
Rebecca nodded.
“Good. Make sure you tell her that you want me to get those records. She’s pulling together a bunch of data for me now, and I’d like to get Steven’s records as well.”
Rebecca grabbed John and hugged him. “We have to know what happened. You understand.”
She pushed away from John, straightened her shoulders, turned, and walked back through the doors to the administrative offices.
John watched the determination in her stride and knew that no matter what he found hidden in the dead boy’s medical records, the outcome would not change. Steven Gunderson wasn’t coming back. It was cold, final, and unfair.
John joined Paula back at the car, and she lit into him before his butt hit the seat.
“What the hell was that about?”
“She—”
“Are you out of your mind? We can’t go poking around that kid’s death. It wasn’t homicide. A tragic accident maybe, but there is no evidence of anything wrong here. We have rules.”
“She needs answers,” John said.
“We all need answers, and sometimes life hands you a steaming bag of crap instead. We have policies for this kind of thing.”
“You can’t hide behind policy for the rest of your career. What will some department policy do for us, other than waste my time? You heard her—all of the sudden, the boy gets bumped up on the transplant list. How did that happen? Who made that happen? The UNOS data will connect the dots.”
Paula turned in the passenger seat. “You’re using the kid’s medical information to fill in the blanks on the transaction data that Trisha Woods wouldn’t give us?”
“Yeah, and when we combine it with the information from Tommy’s records, we should start to see if there are any inconsistencies in the data. Was it the same staff person making the entries? Was the data entered from the same transplant center? And when did the organ become available on the UNOS database?”
“Even if the timeline for the donated organs matches with the killings, it could be nothing but coincidence. Without knowing where all the donated organs came from, it’s all speculation.”
“We could ask for an autopsy on Steven Gunderson,” John said.
“He died in a hospital under a doctor’s care. Not likely to get an autopsy on a case like that,” Paula said.
“I bet we could get the parents to push for one. Rebecca said they wanted answers.”
“The hospital is gonna resist that and bring all their lawyers out of the boardroom to block the autopsy.”
“What have they got to hide? They can’t afford the bad press they’d get if they opposed the parents’ request for an autopsy. The hospital’s foundation and grant funding would dry up if they got caught on the bad side of a media storm.”
“And you want to make sure the media gets wind of this?”
John shrugged.
“Won’t the hospital threaten to remove Tommy from the transplant program if you do something that reckless?”
“That is why I can’t be the one to leak this to the press.” John looked at his partner.
“Me? They know we work together.”
“They will be too busy scrambling to cover their asses to put the pieces together.”
A cell-phone ring cut off Paula’s response. John fished the phone from the car’s center console. He’d left it behind when they went into the hospital out of habit.
He answered and then paused. His eyes narrowed, and the vein in his forehead throbbed in time with his heartbeat. “You’re certain?” he said to the caller.
After another pause, he said, “Give me the address.”
Paula mouthed, “Another one?”
John nodded, closed the phone, and tossed it on the console.
“Partial remains in the water in Old Sacramento. The first officer on the scene called it in.”
John turned the ignition, and the sedan rumbled to life. He flipped the car into gear and sped from the hospital parking lot. “If this is our guy, we have a new worry. He’s speeding up with no cooling-off period between his kills.”
Paula sat without a word in response, jaw clenched so tight her lower lip turned ghostly pale.
John cut across town to I Street and pulled to a stop at the waterfront in Old Sacramento near the Delta King, a restored paddle wheel steamboat that once prowled the Sacramento River delta waters.
Paula shook her head. “The time between kills doesn’t matter. If this guy is harvesting and selling organs, he’s a businessman.”
“How does that change anything? He’s still a murderer, businessman or not,” John said.
“What would you do with a white-collar criminal suspected of fraud or insider trading?” she asked.
“I don’t know. Follow the money?”
“This guy is in it for the money, not the thrill of the kill, so we track him by the money trail. It’s business for him,” Paula said.
Two television news vans pulled to the curb at the pier and jockeyed for the best camera position to capture the exclusive breaking-news footage.
“And it looks like business is booming,” John said.
SEVENTEEN
The splintered gangway angled down from the pier to the Delta King riverboat. The river level rose and fell with the seasons, and the gangway sat on hinges that adjusted with the ever-changing water level. Since the river currently ran low, only the paddle wheeler’s pilothouse and twin stacks were visible from the street.
Clusters of people assembled at the edge of the pier near the gangway entrance, gazing down toward the ship’s massive red-and-white paddle wheel. One man pointed at something in the water. The television news crews responded to his cue and swiveled their cameras in hopes of tagging a gruesome find in time for a broadcast at lunchtime.
John
and Paula located a uniformed officer who kept onlookers and media types off the gangway and away from the ship. The officer tucked a clipboard under his arm and pulled a short section of yellow crime-scene tape back like a velvet rope at an exclusive nightclub. The detectives cleared the gangway, and the officer added their names to a list of persons who entered the scene.
The coroner’s technicians had erected a tall white tarp that screened the stern of the boat and the dock from the gawking public above. In spite of the restricted view, the news cameras rolled and hoped for a tarp malfunction that would give them a front-page money shot.
As John and Paula approached the ship’s deck, a pair of technicians, clad in disposable white jumpsuits, hefted a bundle wrapped in a blue plastic tarp to the surface of the dock. A river-rescue dive team untangled the package from the stern paddle wheel and lifted it to the techs on the dock.
The package settled onto the wood deck planking, and river water oozed from the folds in the plastic. The wrapping clung to the contents and molded it into a blue sculpture of semihuman form.
Behind the coroner’s technicians, Lieutenant Barnes motioned for John and Paula.
“When did this get called in?” John asked when he reached the lieutenant.
Paula stopped at the plastic-wrapped remains and began jotting notes in her notebook.
“About twenty minutes ago,” Barnes said.
“Damn, didn’t take long for the vultures to get wind of it.” John tipped his jaw toward the assembled news crews.
“The officer who responded called it in. He’s a rookie and had no idea they listen to the scanners. He feels bad about it. That’s one mistake he’ll never make again.”
“So who found the body?” John said.
Barnes pointed to a gray-haired couple leaning on the deck rail near the gangway. “They decided to walk out on the deck after they finished their brunch. The missus saw what she thought was a couple of salmon getting frisky. A large fish kept bumping up against something. Then the body rolled over, and they got a good look at the face.”
“This one has a face?” John inquired.
“See for yourself,” Lieutenant Barnes said.
At What Cost Page 9
