The Diagnosis is Murder (A Dr. Valorian Mystery Book 1)

by Steven Gossington

  Cosmo barked at her. She rubbed his head. “Thanks. I’m all right.”

  Her stomach grumbled from hunger as she picked at her Chinese meal. After disposing of the remains, she stopped in the kitchen. “Cosmo.” His ears perked. “I’m going to try to relax and enjoy the next two days.” Cosmo barked in approval. On her computer, she selected a Carole King song: ‘Been to Canaan.’ Maybe this will settle my nerves.

  After half an hour of listening to enchanting music, she felt less jittery. She did an internet search for miosis and miotic pupils. Several articles intrigued her, and she wrote down information about where to find them again.

  She then clicked to an internet singles and dating site. After a few minutes of studying pages on her computer screen, she exited the site and put her hands to her temples. What am I doing? I deserve to get a computer virus.

  Later, she curled up in bed and glanced across the room at a poster of Einstein—that favorite poster from her college days. A young Einstein with his curly mussed hair looked out at his admirers. On the poster was a quote from him:

  “Imagination is more important than knowledge.”

  Laura shook her head. “I may have enough imagination for the both of us.”

  Her mind wandered back to Dr. Preswick’s death. What if she was dead wrong, and nothing fishy happened at all? What if her pursuit of the case of the tiny pupils turned out to be a stupid wild-goose chase? Not only would that be embarrassing as hell, but her avowed mission to become one of the most respected diagnosticians on the medical staff would be exposed as just a silly pipe dream. She could hear the “Dr. Valorian” jokes now, flying around the hospital hallways.

  Chapter 5

  After work, Dr. Stewart Stiles, Medical Examiner, bounded out of his office building, a broad smile across his face. I have solved many problems today, and I alone will discover why Dr. Preswick died.

  Sally, his department secretary, stood at the door and yelled after him. “Are you sure you’re okay?”

  Stewart ran backward and raised his arms in the air. “Never been better.” He pranced to his car and slapped the roof. “I need to trade up. I deserve an expensive car. Maybe a really fast sports car.”

  He drove to the Neiman Marcus Store on Wisconsin Avenue. Over the next hour, he filled to overflowing ten shopping bags with various items, until he met the limits of his credit cards.

  “Sir, are you celebrating something?” a sales person said with a smile.

  “Just my wonderful life. Don’t you think I deserve these things?”

  “I’m sure you do.”

  Dr. Stiles packed his car with his new treasures and drove to his home, which was unlit as he stepped inside. He couldn’t wait to see the ecstatic expression on his wife’s face when she spotted his mountain of riches, and his excitement grew for the great sex they would have later that night.

  “Monica?” Hearing no response, he searched the house.

  Alone again. Well, that’s okay. I’m not tired. So, where will I go tonight? Someone will appreciate me.

  After unloading all his boxes, Stewart hopped into his car and maneuvered a route to the parking lot of a popular lounge. He walked inside and chose a barstool next to two 40ish women who were talking and laughing and drinking martinis. They toasted each other as Stewart sat down. He ordered an appletini.

  “Hi, I’m Stewart. My friends call me Stu,” he said to the woman next to him. “You can call me Stu.”

  She nodded at him, and then turned to her friend with a puzzled look.

  “I’m a doctor, and one day I’ll be rich and famous.”

  “I’m happy for you.” The woman signaled to her friend, and they picked up their martini glasses and moved to an empty table at the far side of the lounge.

  Stewart leaned in toward the bartender. “You don’t get many famous people in here, do you?”

  “Not many, no sir.”

  Stewart lifted his glass. “Someday soon, they’ll write about me in the medical textbooks, about the rare diagnoses that I’ve made and my amazing cures for difficult diseases, about all the lives I’ve saved.”

  “Will you want another appletini, sir?”

  After regaling whoever would listen for several hours, Stewart managed to find his way home and park in his driveway. His wife Monica ran to him in the living room, her nightgown flapping around her.

  “Stewart, what is all this stuff?” Her open arms indicated the sacks strewn around the living room floor. “Are you sick again?”

  “Presents, for you and me. It’s been way too long since our last gifts. We deserve to celebrate. I’ve got a surefire plan to get rich and famous.”

  Monica groaned and slumped onto a couch, holding her hands to her head. “I don’t know if I can handle this.”

  Stewart sat down next to her, his arm around her shoulders. “What’s wrong? Everything’s going to be fine.”

  Monica looked up. “You told me you were taking your medication.”

  “Medication? I don’t need medication. Can’t you see? I’m everything you need. I’m your Prince Valiant.”

  Monica shook her head, a few tears escaping from her closed eyelids.

  He smiled and hugged her. “It’s okay. The world is ours.”

  Chapter 6

  Laura awoke with a start and squinted at her alarm clock. It was 5:00 a.m. She lay with her eyes open for several minutes.

  Sometimes her subconscious worked overtime during sleep, and she’d awaken with an idea or thought, often concerning a patient she’d recently evaluated.

  “Yes,” she said, pumping her fist. She flew out of bed and hurried downstairs to her study, pulling out several medical reference books and thumbing through the indices for information on narcotics, opiates, and specifically, unusual opiates. She searched the internet on her computer for the same information. After several minutes, she looked up with a smile.

  “This just may be it.”

  She decided that an invigorating jog would clear her mind, and she could pursue her research afterward. Her excitement mounted as she threw on her jogging clothes. I feel like I could run a marathon.

  A few blocks from Laura’s house was the long jogging trail that paralleled the George Washington Memorial Parkway, which was a scenic road, almost 30 miles long, that followed the Potomac River from the western leg of the Capital Beltway all the way south to Mount Vernon, Virginia. The Parkway passed through Alexandria about 10 miles north of its terminus at Mount Vernon.

  Laura enjoyed jogging two or three times a week. For much of her adult life, she ran either in the morning or early evening before twilight, depending on her work schedule. Starting from home, her current jogging route went east along Alexandria streets to the paved trail that hugged the Potomac River.

  On this early morning, a nippy breeze whooshed through the trees. After stretching, Laura jogged several miles south and back along the Parkway trail. Her foot strikes and breaths worked together in a comfortable, synchronous rhythm. I’ll go farther next time.

  She turned off the trail and onto a street toward her house. “Whoa.” She stumbled and almost fell as someone ran up beside her. “Eric.”

  “Hey, baby. Sorry I scared you.” Eric, the triathlete, was dressed in a polo shirt and jeans. He jogged right alongside her.

  Laura frowned at him. “What are you doing?”

  “Watching after you.”

  “I don’t need watching, so stop bothering me.”

  “Can’t I run along with you for a while?”

  “No.” An expletive was about to leap from her tongue, but she hesitated and then sprinted away.

  Eric slowed to a walk and waved after her.

  Laura looked back. What is with him?

  She jogged to her house and showered off the satisfying sweat. Hopping into her car, she backed out of the garage and looked around for any sign of Eric. All was quiet, and she drove out of Alexandria toward the National Mall. Springtime was one of D.C.’s main tourist seasons,
so Laura timed her trip after the worst of the morning traffic.

  Before crossing the Potomac River, she detoured to a shopping area with small shops and fast food restaurants and pulled up near a dumpster, where a man sat in a folding chair under a large umbrella. He was eating a pastry that had probably been baked that morning in one of the restaurants, but it had been unclaimed and so discarded as trash. He recognized Laura, put the food down in his chair and walked to her car.

  “Hello, Ms. Laura.” He had a short, scraggly beard and wore a red baseball cap and a tattered polo shirt and blue jeans.

  Laura liked the fact that he wouldn’t accept money unless he talked with her first. She lowered her window.

  He removed his cap, dusted the top off and showed it to Laura. “Take a look at my new cap. I owe it to you.”

  Laura smiled at him. “That’s a nice cap. It’ll protect your face from the sun.”

  He put the cap back on his head. “You look healthy. Are you still jogging?”

  “Whenever I can manage.”

  “I think I get enough exercise walking back and forth from my tent. It’s about half-a-mile away in the woods.”

  “Do you feel safe around here?”

  “Most of the time. During the day, it’s no problem. If I’m here ‘til sunset, sometimes I see a drug deal going down in the parking lot, and I scoot right back to my tent.”

  “Drug deal?”

  “Sure, I can tell what’s going on, but they usually don’t bother me.” He looked down and shook his head. “I didn’t always live like this. I had a job once—a good job.”

  Laura sighed. Someday I’ll ask him about his previous life. He seems intelligent enough. “Well, try to stay positive.” She removed a 20-dollar bill from her purse and held it out the car window.

  He took the money and tipped his cap to her. “Thanks. You’re so very kind. It’s always a pleasure to see you.”

  She watched him mosey back to his chair and wondered how much longer could he maintain this lifestyle. He’s been able to stay here for a while now. Maybe the cops don’t bother him.

  Laura drove to the Jefferson Memorial. It was sometimes less crowded than other attractions in D.C. and was one of her favorite places, maybe because it was off the beaten path. She pulled into a parking space nearby and ambled around the stately, open-air monument to Thomas Jefferson. She climbed the stairs to gaze at the towering bronze statue of Jefferson, dressed in knee-length pants and a fur-collared coat and clutching a rolled-up Declaration of Independence. At times, Laura was the only person present.

  After a while, she said goodbye to Jefferson, descended the steps, and covered the short distance to the promenade that encircled the Tidal Basin lake. As she walked along the edge of the Basin, her leg muscles had that pleasing, achy sensation she often felt after a long jog. Water in the Basin sloshed near her. Cherry trees displayed bright splashes of white and pink, a visual feast against a backdrop of light blue sky and green grass. The Basin often served as an escape from her work and life stresses and from bustling, noisy city life—a retreat where her thoughts and ideas could flow freely and unobstructed. She wandered along the Basin path for almost an hour, enjoying a sweet scent from the trees and feeling far removed from pain and illness and angry patients and lawsuits.

  Lawsuits. I wonder how Matthew’s doing?

  Matthew Kline, a medical school friend of hers, was a surgeon who practiced at another hospital in Washington, D.C. He was involved in a nasty malpractice lawsuit. Laura knew that his character was being assaulted and slandered. She decided to talk with him about the trial.

  After stewing over the facts and possibilities about Dr. Preswick’s death until her mind ached, Laura realized it was nearing lunchtime. Laura left the cherry trees for her car and wound her way east a few blocks to L’Enfant Plaza, a restaurant and shopping complex. She parked nearby and walked to an eatery inside.

  While chowing down on a turkey sandwich, she sat and watched people. Many of those scurrying around were business or political types. She wondered what their daily lives were like, what they were concerned with, what they thought about. One of these professional people would occasionally show up in her ER with an urgent problem. But the ER didn’t have the kind of atmosphere that facilitated small talk. She never really got to know her patients. There wasn’t enough time for that.

  She stopped chewing and remembered her recent experience in the hospital parking lot. Who was that strange guy watching me? She thought about people that had been angry with her—like some patients over the years. Could he be an unhappy patient? Glancing at the people around her, she shook her head, figuring that she was just being paranoid.

  After the satisfying lunch, Laura strolled around and bought a few items for herself. She kept thinking about Dr. Preswick’s pupils and decided that she was not overreacting—there was something fishy about Preswick’s death. And, if so, she just might know what had killed him.

  I think I’ll call Alec.

  Alec Dupree was an ex-policeman who now did his own private investigating. Laura had met him two years earlier, when Alec was still a homicide detective. He’d visited her emergency room several times during that period to gather information about dead victims of foul play. Alec was only 36 years old, but he’d already had more than his fair share of traumatic life experiences. It was just over a year now since his wife and young son had been murdered by a vengeful psychotic man that Alec had previously arrested and sent to prison.

  Laura rang Alec’s office number from her cell phone.

  “Dupree Investigations.”

  “It’s me, Laura Valorian, from the ER.”

  “Hello. It’s been a while.”

  “I know. I’m glad I connected with you. I’d like to run something by you. Can we meet up?”

  “Sure.”

  “How about dinner tonight?” Laura said.

  “When and where?”

  “How about 6:30, in that coffee shop off Highway 1, in Alexandria. The one we met in before.”

  About six months after the deaths of his wife and son, Alec had joined Laura in that cafe to ask her questions concerning a murder case, a patient that had been declared dead in her ER. Shortly thereafter, Alec had disappeared for several months.

  “You got a suspicious death or something?” Alec said.

  “Maybe.”

  Her next call was to Dr. Stewart Stiles’ psychiatrist, who was at his office.

  “Hi, Laura. What can I do for you?”

  “I want to alert you about something. I’ve had a few odd interactions with Dr. Stiles recently.”

  “You’re worried about another manic episode?”

  “Yes. I’m not sure how bad it is yet, but he seems to be getting worse. Maybe you could check on him?”

  “I will. Thank you.”

  Back at her house, Laura pulled out a toxicology reference book and perused information about drugs of abuse, both common and uncommon ones. On her computer, she searched the internet and read several medical articles. She nodded as she refreshed her memory about one fact: false positives—and false negatives—happen with drug screens, especially when screening for unusual drugs.

  Laura arrived at the coffee shop a few minutes early. Even though the restaurant was only about half full, the servers looked harried. She figured that it must be part of the job description: a server should always appear rushed, even when only a few customers are present.

  Alec strolled into the café, and Laura waved at him. Not quite six feet tall, he had a wiry, muscular build. He never seemed to be in a hurry.

  Laura noticed that his hair was still short and black, all black. He hadn’t changed his hairstyle since the last time she’d seen him. It was just long enough to comb with a part on one side. A curved scar on the right side of his chin, from a knife wound he’d suffered while subduing a murder suspect, reddened when he was angry and faded to flesh when he smiled.

  “Good to see you again,” he said as he slid in
to the booth opposite her.

  “I’ve ordered us coffee. How’ve you been? Is your work load heavy?”

  Alec cleared his throat. “It’s picking up.”

  “By the way, where were you for—what was it—three months or so? I tried to contact you a couple of times.”

  He stared out the window for a few seconds. “Taking care of some important business.” His eyes found her again. “You look good. You been jogging?”

  “Whenever I can get off my duff. It’s my New Year’s resolution every month.”

  They ordered dinner and chatted about various local items and D.C. political happenings.

  “Any interesting ER cases recently?” Alec said.

  “Plenty.” Laura thought of the lady with the popped-out eyeball. “But there’s one in particular I want to talk to you about.”

  Alec sipped his coffee and nodded.

  “Well, it may be nothing. A surgeon I know, or knew, was brought by ambulance to my ER two days ago, dead. At least, he didn’t respond to CPR.”

  “You suspect foul play?”

  Laura paused. “I didn’t see any signs of trauma. The medical examiner did the autopsy but found nothing unusual. His death will probably be listed as sudden cardiac arrhythmia—rhythm disturbance—due to unknown factors, maybe too much alcohol.”

  “Alcohol can do that to the heart?”

  “Yes, on occasion, but usually only in people who are known to be sensitive to it, or who are seriously alcohol poisoned. Dr. Preswick drank socially, evidently without difficulties.”

  Alec waited.

  “There’s something about him that’s been bothering me. His pupils were tiny, almost pinpoint, an unusual finding in a victim of cardiac arrest who’s received CPR and medications.”

  “What do tiny pupils suggest?”

  “Usually drug overdose with narcotics, or sometimes certain insecticides. But narcotics—opiates—are easy to identify on a routine toxicology screen, and insecticide exposure is usually evident from the patient’s history, not to mention you can often smell it on the clothes and skin. His drug screen was negative for everything except alcohol.”