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

by Steven Gossington

  Laura nodded. She thought that Dr. Sutcliff might qualify as another suspect for her list of potential murderers, so she’d have to figure out a way to interview him. She leaned back in her chair. “I encountered him a few times in the ER when he consulted on surgical patients. I remember no particular problems with his patient evaluations. He seemed clinically sound enough.” She smiled at Derek. “I don’t believe you’re in that kind of danger.”

  “Thanks.”

  Laura wagged her finger at him. “But you’d better stay on your toes around me.”

  “I’ll do my best.”

  “Are you sure you’re okay? You seem really down.”

  “I’m fine. I’ll work through it.”

  “You’ve got talent. Don’t forget that.”

  “I really appreciate your encouragement.” Derek stood and looked at Laura. “By the way, I’m still a little confused about Dr. Preswick’s death. Did he die from a cardiac rhythm disturbance?”

  “I think that’s the correct answer at this point.”

  “Then how do the small pupils fit in?”

  “I don’t know. I’m still working on that.” Laura located and opened a telephone book. She was lucky. There was a listing for a Blake Sutcliff. She copied down the phone number and address.

  A nurse poked her head in the office door. “Dr. Valorian, I just put a child in Room Five. He fell and hurt his arm, and he’s in a lot of pain. Want me to go ahead and order X-rays?”

  “No, we’ll examine him first,” Laura said.

  Derek stepped over to the nurse. “I’ll see the child and then present him to Dr. Valorian.” He followed the nurse to the patient’s room.

  Laura had felt tired all day, and the shift had been a bone crusher. If she dared to lay her head down on the table, she’d probably be asleep within seconds.

  After a few minutes, Derek returned to the office. “This patient is a two year-old boy who slipped and fell this afternoon in the kitchen of his home. He’s crying and holding his right elbow. I found no head injury or skin lacerations. He seems to be in a lot of pain.” Derek led Laura to the patient’s room. A child sat alone on the stretcher, holding his right elbow and whimpering. His mother sat on a chair nearby.

  Laura frowned. Something’s wrong here. After a few seconds, she figured out what bothered her. It was the mother. She wore a short red dress and what appeared to be a pearl necklace. She also wore a scowl on her face and repeatedly looked at her watch, as if she were late for a date.

  Laura knew that this wasn’t a mother concerned about her injured child, and she felt the heat rising up in her face. She walked over to the child, a chubby little boy with short, light brown hair. He had a frightened look on his face. Laura examined his head, chest, back, abdomen, and uninjured extremities. She then inspected the painful arm.

  Most two year-old children are resistant to physical examinations. They cry for their parents and do their best to ward off the doctor. An exception to that expected behavior is if the child senses that something is very wrong, more than a bump on the head or an itchy rash. Something as painful as a broken arm will often occupy their attention so that the physician has an easier time with the examination.

  This little boy didn’t have much fight in him, and he offered only halfhearted resistance to Laura. He didn’t even cry for his mother. Laura noted discolorations on his upper and lower back and thighs, bruises of different ages in purple, green, and yellow hues. She knew those bruises shouldn’t be there. They meant only one thing.

  Nausea swept over Laura, and her hands quivered. She couldn’t control her breathing.

  “Are you feeling all right?” Derek said.

  Laura’s vision blurred. Her head began to spin, and the walls of the room turned blood red. She marched toward the mother, her arms raised . . .

  Laura awoke on a stretcher in another room. Derek and the charge nurse stood at her side. She oriented herself and sat up. “What happened?”

  “You passed out,” Derek said. “I caught you before you hit the floor and helped lift you to a stretcher.”

  “I remember walking toward the mother. I think I yelled at her.”

  “You did. You said something like, ‘How dare you hurt your own child. You’re not fit to be a mother. I’ll show you how it feels to be hurt like that.’ Then you grabbed her around her throat. We had to pry you off. She and her child were both screaming—it got real noisy in there—then you fainted.”

  Laura covered her face with her hands. “Damn, I lost it again. I can’t believe I lost it again.” She closed her eyes and gathered herself for a few minutes, then spoke to the charge nurse. “Have you called security and child welfare?”

  “Yes. That’s all been arranged.”

  “Don’t let that woman leave here with her child.”

  “She’s already tried, but security stopped her. We told her we had to care for her child’s injured arm before they could leave. She’s angry, but she hasn’t tried to run off again.”

  “Good work.”

  “She’s talking about suing you,” the nurse said.

  “That’s fine. She can sue me if she wants to, if she still feels like it after her child abuse investigation.”

  Lucky for Laura, the shift was about over, and she calmed down in the doctors’ office. X-rays confirmed a fracture near the child’s elbow, and his broken arm was splinted. He was admitted to the hospital pediatric service for his own protection, while the mother was interviewed by the child welfare social workers.

  Derek walked into the office and sat down near Laura. “Are you okay?” he asked.

  Laura sighed. “Remember I told you that we all carry baggage? Well, I’ve got baggage, too. Something happened to me, about eight months ago.”

  Derek settled back in his chair.

  “A young girl, 4 years old, came to my ER with bruises on her arms and back. Her mother told me she’d fallen off the swing in their back yard.” Laura stared off into space. “The mother seemed worried enough. I had no reason to doubt the story. I examined the child, ordered X-rays, ruled out any fractured bones, and treated the child for her bruises. The mother was grateful that there were no serious injuries.”

  Laura hung her head and closed her eyes. “Two months later, the paramedics brought the little girl to my ER. She was dead. She had skull fractures and brain injuries. She died from child abuse. Her mother killed her.”

  Derek stared at her, not blinking.

  “I dream about it sometimes. I’m standing at the bedside of a beautiful little girl with blonde hair. She’s limp—like a rag doll—and won’t move despite me shaking her body and screaming at her, ‘Wake up, wake up.’ Other doctors and nurses point at me.” Laura’s eyes were moist. “I go over it again and again in my mind. I see those bruises that surround her upper arms, the red round splotches on her back. The story didn’t fit with those bruises, and I should’ve suspected child abuse that first visit.” She glanced at Derek. “I screwed up.”

  “I’m sorry that happened to you,” Derek said. “How do doctors cope with that?”

  “It helps to have someone you can lean on. In my case, it was my father. He’s helped me more than he’ll ever know. I saw him fall on hard times in the oil business, and all three of us daughters watched him rebound from that. He didn’t give up. He’d say, ‘So, you hit another dry hole. Plug it, and don’t look back. Look for opportunities to improve yourself when you fail.’ ”

  “That’s good advice.”

  “I tell myself over and over that I’ll never again overlook physical findings like those suspicious bruises,” Laura said. “But that damn dream won’t go away.”

  “I have nightmares like that—about my brother.”

  Laura managed a weak smile. “Now we really have something in common.”

  Derek stood and started to walk away, then stopped and turned to Laura. “I was just wondering. The little girl that died—was there a father around?”

  Laura paused and
rubbed her chin. “I think maybe there was a father. I remember a man in the room, standing in the background.”

  “Maybe he was like my father—not involved at all with his kids.”

  “I don’t know. I never talked with him.” Laura tilted her head. “But now that you’ve reminded me, I can visualize his face—it was kind of creepy.”

  For the remainder of the shift, Laura avoided the ER staff as much as possible, interacting with them only when necessary. I’m turning into a basket case. Maybe I need counseling. At 7:00 p.m., she was ready to relinquish the ER to the night shift physician.

  That evening, Laura sat on the couch in her living room with her head back and her eyes closed. Cosmo rested on the floor near her feet, and though Cosmo usually had a calming effect on her, she still felt ill at ease. She hadn’t eaten and wasn’t hungry.

  I’ve got to move on. She hoped she wouldn’t stew obsessively over her recent outbursts. She decided to apologize to everyone the first chance she got.

  Opening her eyes and looking around, she was reassured by the familiar coziness of her home. On her living room wall was a picture of two children in a garden, young girls sitting on a thick carpet of grass, surrounded and protected by trees, bushes, and plants with large colorful flowers. They spoke to each other with animated hands and faces, telling each other secrets in their safe hideaway.

  “I’m digging up secrets, too,” she said, deciding to resume her detective work, which she hoped would get her mind off today’s disaster. She phoned the fired surgery resident, and he answered.

  “Dr. Sutcliff, this is Dr. Laura Valorian. You may remember me from the emergency room. You did a few patient consultations for me in recent weeks.”

  “Of course, I remember you. What can I do for you?”

  “I just heard today that you’d left the hospital, and I wanted to let you know that I’d be happy to write a letter of support or recommendation for you, if you should need one.”

  “Well, thank you. It’s nice of you to call, but I don’t know if anyone can help me now.”

  “Oh?”

  “Actually, I got fired from the hospital by Dr. Preswick.”

  “Why did he do that?” Laura figured her status as an attending physician over residents such as Blake Sutcliff would encourage him to talk.

  “He claims that I changed some orders on one of his patients—a VIP. He says I should’ve consulted him first before making a clinical decision about his patient.”

  “What problem did the patient have?”

  “He was recovering from abdominal surgery for colon cancer and had developed a fever and cough. I diagnosed pneumonia and changed the antibiotic order accordingly. I didn’t call him until later in the day. He got angry and fired me on the spot.”

  “That sounds rather drastic.”

  “We hadn’t been getting along. I think our personalities clashed from the beginning. I guess that was just the last straw for him.”

  “What does this mean for your residency program?”

  He was quiet for a second. “They asked me to leave the program yesterday.” His voice was hoarse. “I only had one year left, and now I’m out of a job, and maybe a career. It’s like the last eight years of my life have been for nothing.” Sutcliff sighed. “I don’t think a letter from you would help me at this point, although it was decent of you to offer.”

  “Well, I’m sorry to hear about all this. I thought you were a good surgery resident. Let me know if I can help you.”

  “Thanks again for calling. It’s nice to talk to someone.”

  Laura hung up the phone. Terminating Blake Sutcliff from his residency program, especially in his fourth year, was an extreme step for the university faculty to take. She wondered if the Preswick situation was only part of the story, and that maybe Dr. Sutcliff had accumulated other problems or complaints in his file.

  She updated her list.

  Suspects

  1. Mrs. Preswick - I’ve confirmed that Dr. Preswick had affairs

  2. Any jealous girlfriends? Yes, Tina Landry

  3. Enemies? Dr. Preswick was an arrogant man, insulted lots of people, did he hurt anyone? other doctors? patients? Yes: Dr. Matthew Kline, Dr. Blake Sutcliff, husband (lab tech) of a patient of Preswick’s who died, and ?Max Flowers (previous business associate)

  She telephoned Alec.

  “Making any progress?” he said.

  “You bet. I have a list of six suspects, all with possible reasons for doing away with our Dr. Preswick.”

  “You’re still convinced he was murdered. That’s good.”

  “There’s another guy that may be in the picture. A previous business associate: Max Flowers.”

  “Dr. Preswick had a business?”

  “Something to do with a new liquid bandage formula. He was in it with Max Flowers, and they tried to convince a surgeon friend of mine, Matthew Kline, to invest with them.”

  “Interesting,” Alec said. “I’ll check into the business records.”

  “Have you found anything?”

  “I know this. You can get designer drugs, synthetic narcotics, right here in our nation’s capital. I have an informant looking for a dealer I can talk to.”

  “Do you think a dealer will give you any information? He might find out who you are—an ex-policeman. He might suspect a sting.”

  “I know. It might be tough to get anything useful.”

  “Then why don’t you set me up as a buyer? I’d be an unknown for sure. I could bribe him for information.”

  “That could be dangerous.”

  “Of course, I’d want you nearby. Let’s try it.”

  Alec was quiet for a few seconds. “Okay, I’ll set it up. We’ll need photos of your suspects.”

  “Recent photos might be difficult, but I’ll see what I can do. I’ll ask Mrs. Preswick about Max Flowers. She might know something about him. Oh, could you do something else for me? One of the suspects is a hospital lab tech. Dr. Preswick had operated on the man’s wife, and she died. The man sued for malpractice, but Preswick won. He then sent some threatening letters to Preswick. Could you get his name from court records, since it was a lawsuit in civil court?”

  “No problem. I’ll call you Monday. Will you be at home?”

  “Yes, I work tomorrow, and I’m off Monday. Then I work Tuesday night. Just call my cell phone.”

  Laura climbed the stairs to her bedroom. No music would fill her house tonight. She stood for a few minutes in front of Einstein’s poster, but even he was no comfort to her.

  She did feel a tiny bit reassured that Eric hadn’t bothered her in a few days. She wondered if he’d finally moved on.

  Breaking routine, she let Cosmo in bed with her. She thought of Derek’s question about the father of the little girl that died.

  Why didn’t the father ever talk with me?

  She tossed and turned for several hours, drifting in and out of sleep, visualizing that little boy with the broken arm. She walked with him down a long, dimly lit hallway. He cried while they walked, a frightened, hopeless kind of wail. Laura then turned into a room and saw a blonde-haired child lying motionless on a bed, blood oozing from wounds on her neck and face. She rushed to the side of the little girl and shook her, screaming, “Wake up. Don’t die.” Laura held up her hands, dripping with the little girl’s blood.

  Laura’s eyes flew open. She was wet with sweat and gasping for air. She hugged Cosmo to her.

  Chapter 14

  Laura felt awkward and embarrassed about her recent blowups, and she wondered how the nurses would treat her. Word of the event would’ve circulated among the nurses by now. She thought about how she should act—how she should carry herself.

  As she eased into the ER to start her Sunday morning shift, she sensed the wariness of the staff. She dove right into her patient care and communicated with the nurses in a polite and professional manner. After a few hours, and with no more Laura breakdowns, most of the nurses warmed up to her—much to Laura
’s relief.

  It was another busy day in the ER. She and Derek worked nonstop. With her uneasiness, Laura knew she had to concentrate even more on her patients’ symptoms and physical signs in order not to overlook something important.

  Derek was the proper gentleman. He didn’t bring up the subject of Laura’s loss of composure. That was fine with Laura, since she didn’t feel like talking about it.

  Later in the afternoon, even though her body felt numb—that thickheaded kind of numbness that follows sleep deprivation—her mind began to dwell again on Dr. Preswick’s death. Despite her efforts at concentrating, it became difficult for Laura to focus on her real job, and she couldn’t wait for the shift to end.

  Derek approached her in the hall. “Can I talk to you about a patient?”

  “Sure.” They walked to the doctors’ office. “What’ve you got?”

  “A guy tells me something is caught in his rectum.”

  “Oh, boy. Was he more specific?”

  “He said a vibrator.”

  “That’s a large object. Can you touch or grab it?”

  “When I did the rectal exam, I think I touched the edge of it. No way could I grab hold of it.”

  Laura had a fleeting vision of a smiling Roderick Preswick in the OR extracting a vibrator from a sedated patient’s rectum. “Well, we’re down one proctologist, but, no matter, we can call a surgeon for a sigmoidoscopy under sedation,” she said. “I hope they can retrieve it then.”