Twice Dying

by Neil Mcmahon

  “What you’ve provided me so far is pure speculation.” Rydell paused, the stare sweeping them one at a time. “No lawsuit has been filed. There’s no statement from Mrs. Edgery herself, no hard evidence and no witnesses. Only what amounts to unsubstantiated rumor.”

  DeMers listened with a faint, stony smile.

  “He didn’t just falsify data,” Monks said. “He deliberately sclerosed the veins around at least one of Mrs. Edgery’s dialysis shunts, and probably others before it.”

  Rydell leaned sharply forward, as if about to lunge out of his seat.

  “That’s a hell of a serious charge, Dr. Monks, and like the rest of it, completely unsubstantiated.”

  This had started several months earlier, with ASCLEP being contacted by a sharp-eyed surgeon named Becker, chief of a team of transplant specialists. Mrs. Edgery was fifty-five, the wife of an oil executive, living in the quietly posh town of Atherton. She had been stably undergoing dialysis for over two years under DeMers’s care, when her shunt—-an artificial passage between artery and vein, allowing the introduction of blood-filtering needles—suddenly clotted. A new shunt was created, and four months later, it clotted as well.

  This allowed the patient to be categorized as having difficult vascular access, and therefore eligible for the next available organ that matched her tissue and blood types. The problem was that there were hundreds of other hopeful recipients who might already have been waiting years and might be forced to wait years longer, wearing beepers twenty-four hours a day, ready to rush at a minute’s notice to a hospital or even airport. Mrs. Edgery had leapfrogged to the top of the list.

  Dr. Becker had become uneasy for no reason he could pin down. Then, examining her after the transplant operation, he noticed an atypical hardening of the vascular tissue around the shunt. He went back over the records and came away further dissatisfied. There was nothing concrete—DeMers had covered his tracks by showing rising blood urea nitrogen and creatinine levels on his charts—but the sudden jumps had no clear cause and did not jibe with the patient’s previous history.

  The surmise was that DeMers had intimated to Mrs. Edgery that her transplant could be expedited, and in return for a payoff, had injected the veins surrounding the shunt with a sclerosing solution of the type used in healing hemorrhoids, causing them to close off. And that DeMers had done the same thing with previous patients, perhaps several, in order to support a lifestyle best described as glossy.

  But Rydell was right. There was no way to prove this scenario. The surgeons’ suspicions were only that, and the irregularities were not conclusive. DeMers, Monks admitted, was slick.

  Rydell sat back. “I assume it’s clear that the withdrawal of insurance would be extremely damaging to my client, both materially and in terms of reputation. We’d have to strongly consider the possibility of suing ASCLEP.”

  Larrabee had been chain-drinking coffee from a Styrofoam cup, looking as if his mind was on something else. He crumpled the cup with an abrupt popping sound that startled everyone.

  He said, “On April 11, 1996, William Edgery made a fifty thousand dollar cash withdrawal from the Union Street Wells Fargo branch in San Francisco. Just three weeks before Mrs. Edgery’s first shunt malfunction.”

  Monks watched DeMers. His face stayed firm but his skin was turning a curious gray, almost blue.

  “On July 17, Mr. Edgery made a second fifty thousand dollar withdrawal, this rime from a branch in Sacramento. Her second shunt malfunction came two weeks after that.”

  “Objection—”

  “This is not a courtroom, Counselor,” Larrabee said. “Your objections don’t mean dick.”

  “There’s no evidence of any connection.”

  “The Edgerys refused to be interviewed by me. But they’d talk to the IRS. There’ll be a paper trail. There always is.”

  Rydell gave the hard stare a brief try, but it faltered.

  “What’s next, Doc?” Larrabee said to DeMers. “Kidney guys who aren’t too fussy are in big demand down in Mexico. China, too. I hear they’re parting out prisoners over there.”

  DeMers stood with a sudden violent movement, shoving his chair back.

  “My job is to have my patients up walking around. Not wired to a dialysis machine.” He glowered for seconds longer, a large and angry man in a small room, then wheeled and stalked out, slamming the door.

  Monks said, “A hundred grand. Not a bad little tip for a few hours’ work.”

  “I don’t know how you got that information, Larrabee,” Rydell said venomously, “but it wasn’t legal. It remains irrelevant in my mind.”

  Monks stood, walked to Rydell, and leaned close. “How does it feel, to make a career of lying?”

  He felt something touch his arm: Larrabee’s hand. Rydell, tightlipped, stacked papers into his briefcase, his visible composure recovered.

  An utter unconcern for the right and wrong of the situation, Monks thought: only anger because you’ve lost. He thought, we enjoy the highest standard of medical care in history. That standard depends on responsible attorneys protecting responsible physicians, and weeding out the scumbags like DeMers.

  Then there’s the ones like you. When did this figure become an American hero, this bureaucrat with a briefcase who makes a rich living by picking laws apart to confound justice? Who never takes a genuine risk, who contributes nothing of real worth, who has all the time and resources in the world to erect a legal structure that nurtures him and his cronies?

  Monks thought, I make a hundred serious decisions every shift I pull in the Emergency Room, with a significant percentage of them walking the edge of life or death. One mistake, and hordes of sycophants like you are all over me. When you make a mistake, you just add it to your bill at five hundred dollars an hour. If I charge a patient half that, total, I’ve saved him acute misery and maybe his life.

  It breaks my heart, he thought, that I can’t prosecute that son of a bitch DeMers and you along with him. If it were up to me, his next procedure would be in San Quentin, and you’d be mopping the floor.

  Monks said, “If your client walks into this room again, there’ll be a legal secretary here from Richard Cook Associates, recording an official transcript. I’ll deliver it to the county attorney’s office myself. I’m sure I don’t need to remind a man of your standing that tampering with medical records is a felony.”

  Rydell clamped his briefcase shut, stood, and without speaking, left the room.

  “He’s thinking, go ahead, knock yourself out,” Larrabee said. “There’s money in it for him every step of the way.”

  Dennis O’Dwyer sat back in his chair with the relief of a man who had just found out his tumor was benign. DeMers might never have gotten caught, but if he had, it would probably have cost ASCLEP several million dollars. As it was, no information would be passed on to competitors, but any other insurance company would know damned well that ASCLEP had not dropped him for nothing. The best hope was that he would not be able to get more insurance, or the rates would be so ruinous he would be driven out of practice. And if he did keep practicing medicine, other watchdog agencies would be tipped off by this; he would probably be too nervous to try a stunt like that again.

  It was not enough, but it was better than nothing.

  “I appreciate your sense of theatrics, Stover,” Clarisse said reproachfully, “but you might have told me about the payoffs a little earlier. I spent two days getting ready to fist-fight Rydell.”

  “I didn’t want to compromise you, Clarisse. The counselor was right, I got that information in a highly illegal fashion.”

  “Bullshit.”

  “No, really. A pal at Wells Fargo. It’s going to cost the company a bottle of single malt Scotch.”

  “I meant about you protecting my virtue.” There was a brief silence while the men did not look at each other. “Is that true, about China?”

  “It’s a persistent rumor.”

  Monks stood, catching Larrabee’s eye. They walked
with Dennis out to the hall.

  Dennis said, “This Jephson. When he treated Robby Vandenard for killing that fellow in ’84, that wasn’t the first time. The Vandenards brought him in to evaluate Robby clear back in ’71, when his sister was killed. Sealed records, all that. Robby was sent to live with relatives in South Africa immediately after.”

  Larrabee said, “So Jephson was covering for Robby even when he was a kid.”

  Monks remembered the news photo of Robby Vandenard, the age in the eyes of the man who had taken two lives, and then his own, starting at the age of eleven.

  Monks said, “I don’t mink he was ever a kid.”

  Monks cruised slowly up Lokoya Road, in the mountains between Napa and Sonoma, following the crude map Darla Lutey had drawn to the old Vandenard estate. It was at the road’s end, well removed from neighbors. The black iron fence was thickly overgrown with brush, the gate locked with a chain. There was just enough space for him to slip through.

  He walked up a worn asphalt lane, with unkempt tree limbs closing off the sky overhead and crowding the edges. He had gone a good quarter of a mile before the vista opened up again. Steep hills rose on both sides, cresting into a ridge of cliffs ahead. The lower slopes were lush with neglected vineyards. There was a scattering of buildings: a stone caretaker’s cottage, and some sheds, all looking disused.

  And a three-story Victorian mansion that would have been a picture of elegance except for peeling paint and boarded windows.

  A pair of heavy plank doors had been cut into the base of the cliffs. Monks walked to them. They were locked with a rusted iron hasp that looked hand-forged. Behind them would be the wine cellar, where the Vandenards in years past had laid in their private supply, grown and bottled on the estate by the old Italian hands.

  Where Katherine Vandenard, aged fourteen, had been alone one afternoon in the summer of 1971. Until someone came in after her with a grape-picker’s knife.

  Fog lay close to the ground, clinging to the neglected vines like crêpe. The sky was a streaked and moving tapestry of gray. The place was on the way to Mendocino, and Monks had decided to stop, in the vague hope of finding someone who might have more light to shed on whatever had happened between Robby Vandenard and Francis Jephson. Or perhaps, really, to pay respects to the girl whose death was the germinal event in all this.

  He turned to go and stopped. A man was walking toward him from the caretaker’s house. Now Monks could see smoke from the chimney, barely visible against the mist.

  Monks said, “I realize I’m trespassing. I apologize.”

  “You want to show me some ID?” He was lean, bearded, wearing the uniform of men of his type: jeans, work boots, and baseball cap pulled low. At a guess, he was about Monks’s age, beard graying, face heavily weathered, hard-eyed, a man life had not been kind to. He spoke with a twang that brought to mind Larrabee’s words about Merle Lutey: That’s got Okie written all over it.

  Monks handed over his driver’s license. “Are you the owner?”

  The caretaker examined the license.

  “Nope,” he said, handing it back. “Mind telling me what you’re doing here?”

  “I’ve got some business involving the Vandenard family. I thought there might be somebody around who knew them.”

  “Place is owned by an investment group down in the city. I’m just here till they get their price. Don’t know who had it before that.”

  “Sorry to disturb you.”

  “No problem. Truth to tell, it gets kind of lonesome.”

  “I could see that,” Monks said. “Well. I’ll be going.”

  “What kind of doctor?”

  Monks turned back, fearing that he might become trapped in a conversation about this hermit’s ailments.

  “Emergency,” he said.

  “Must take good nerves.”

  “They’re not as good as they used to be.”

  The caretaker’s chin lifted slightly, a gesture that seemed to mean he was satisfied.

  Back in the Bronco, Monks consulted a map of the area. The town of Calistoga was roughly twenty miles north. It seemed quite a coincidence that Francis Jephson had been hiking in this area, and bitten by a rattlesnake, a few weeks after Katherine Vandenard’s death.

  Unless he had really been here, on the Vandenards’ estate, and the location of the snakebite incident had been falsified in order to hush up the reason: to evaluate Robby.

  Monks drove back down into the Napa Valley and turned north on Highway 29 toward Mendocino.

  Chapter 8

  Monks waited for Alison Chapley in the parking lot of the Mendocino Headlands Inn, an older place built on a bluff overlooking the Pacific. The horizon was still light, and the surf breaking on the great ochre rocks threw up rainbows of iridescent spray; but in the redwood forests that sloped up from the coast, night had come.

  They had driven their own cars and checked into separate rooms. Neither had suggested otherwise.

  The motel door opened. She hurried to the Bronco, wrapped in a dark raincoat and scarf, carrying a large woven hemp bag.

  “North on Highway One,” she said. “There’s a turnoff in a couple of miles.”

  He drove through the streets of Fort Bragg, a town of several thousand with a harbor at the south end and a lumber mill taking up most of the north. The demographics were noticeably different than in the Bay Area: loggers, fishermen, pony-tailed ghosts of the sixties, driving vintage American pickup trucks.

  She turned toward him in the seat, her back against the door.

  “Thanks. This would have been tough, alone.”

  “It still doesn’t feel easy.”

  “Easier.”

  The road that led to the Schulte homestead turned inland, a steep series of switchbacks sparsely lined with houses. It quickly became closed in with forest, dripping with mist.

  “I didn’t have time to change,” she said. “Do you mind?”

  He glanced over. She was unbuttoning the raincoat. He caught a glimpse of skin, with brief black bands at breasts and hips, and pulled his attention back to the winding road.

  “No. I don’t mind.”

  “It should be another few miles. Box 1382.” She took something from her bag and leaned forward, then came up more slowly, fingers working their way along her calves, pulling on gray tights.

  Monks said, “How do you want to handle this?”

  She shifted in the seat, with the sound of snapping elastic.

  “Tanager’s seventeen. He’s been held back in school. Maybe he’s a little slow. Maybe because of everything that’s happened with Caymas.” She was taking something else from the bag, unfolding it. “I don’t want him to think we’re from the hospital, at least at first. I’m guessing he’s just trying to hide and get through it all. If we come at him officially he might freeze up. I’ll try to start him talking and see where it goes.”

  “If we’re not us, then who are we?”

  “We’re spreading the word of the Lord.” She smoothed a dress over her front, raising knees and then rump to pull it on. It was denim of a medium blue color, loose-fitting, calf-length.

  “You think that’s fair to the kid?”

  With sudden sharpness, she said, “I don’t think there’s anything fair about any of this. Zip me up.”

  Monks did, fingers fumbling along the bumps of her spine. She retied the scarf with quick jerky motions. It was dark blue, bringing out the pallor of her face, and he realized she was not wearing makeup.

  “I’m not much of an actor.”

  “You’ll do fine,” she said, more kindly. “You don’t have to talk. Just look stern.”

  The fog was thickening, their headlights creating a tunnel, barely penetrating in some pockets. There were no signs of habitation now except for an occasional dirt road entrance marked by a mailbox.

  He said, “Long way for a preacher to come calling.”

  “The Lord loveth not the spirit that is weak.”

  He smiled. Clearly, s
he had been doing her homework.

  “I heard you were getting married,” he said. “A couple years back.”

  She leaned her head against the window, lips twisting briefly.

  “Matthew,” she said. “A rising star in the investment world. He wanted me to quit my job. Move to a safe clean suburb of the mind, away from the slums where the poor people live. You?”

  “Gail and I stay in touch.” While he had never thought of it in those terms, hrs ex, had moved to that suburb, too.

  “You told me once she’d decided you were bad luck, and she was afraid it would rub off.”

  He said, “Chances are she was right.”

  Abruptly, Monks braked hard. A small burly shape was ambling down the road’s center toward them, making no effort to budge. As he skirted it, the headlights picked out a badger’s white mask: beasts that would fight to the death before giving ground.

  He said, “How hard have they tried to find Caymas?”

  “He was scheduled to report to the outpatient clinic in Ukiah for decanoate injections twice a month. Stopped showing up more than a year ago. His family said he’d disappeared. He’s a registered child molester, not allowed to leave the area. There’s a bench warrant out for him.”

  “But nobody’s looking?”

  “They never do. Everybody’s glad those men are someone else’s problem.” She took out a cigarette and held it. With the scarf and dress, it gave her the look of an actress in a Western movie, taking a break. Monks reached to push in the lighter, but she shook her head.

  “I don’t want it on my breath,” she said. “He was attractive to kids—Caymas. Isn’t that strange? The perfect older playmate. Always knew the right thing to say, to coax a child into playing a game. Keeping a secret. Most of the NGIs are scary. But I’ve only met a couple like him.”

  “If we did happen to run into him, you’d recognize him?”

  “He’s not somebody you forget.”