Unnatural Causes

Home > Other > Unnatural Causes > Page 3
Unnatural Causes Page 3

by Dawn Eastman


  Katie put the last chart on top of the “done” pile and sat back, suppressing a yawn. She wanted to go home and get some sleep. But she couldn’t let go of the feeling that there was more to Ellen’s death than suicide. And the question of where she got the prescription still loomed.

  She pushed away from the desk and grabbed the pile of charts. When she opened her office door, she realized that everyone else had left. She’d hoped to have the place to herself so she could discreetly check into Ellen Riley’s medical records. She found a sticky note on the door asking her to lock up on the way out.

  The receptionist, Debra, left every day at five on the dot. Her kids were in some sort of strict day care that charged her for every minute that she was late picking them up. If there were still patients to be seen, she’d be sure the charts were ready to go, and she’d lock the front door. After five, everyone was shown out the back door to the parking lot. Caleb thought it was a creepy system. It meant the patients still waiting never saw anyone leave. How did they know there wasn’t something wrong? Katie had pointed out that most people didn’t see conspiracies, evil plots, and zombie apocalypses in every situation the way he did.

  Being alone after-hours was kind of creepy though. The only lights left on were the ones in the reception area, and the whole office was silent. It was an old building, and as she walked to the chart room, the creaking floor made it sound as if someone was following right behind her. Katie was glad no one was there to see how many times she stopped and turned to check that she was alone.

  She flicked on the light in the chart room and set the pile of folders on the cart to be filed. The windowless room was filled with row after row of metal shelves. She walked to the back of the chart room to the small medicine room where they kept all the medications that they used in the office. Katie pulled her key ring out of her pocket and briefly wondered how many keys there were for this room. She hadn’t needed to use hers yet. So far, the couple of times she’d needed something during her clinic, one of the nurses had gotten it for her. She found the med book right away and turned to mid-August. She ran her finger down the list of patients. Katie caught her breath when she found Ellen’s name in early September. But it was only a refill for her thyroid medication. There were no other entries for Ellen Riley. So no one had called it in from the office. Katie was both relieved and more confused. She had dreaded finding a note reading, “per Dr. LeClair diazepam 5 mg called to such-and-such pharmacy.” But not finding a note left her no closer to finding out how Ellen had gotten that prescription.

  Katie locked up and turned to face the shelves of charts. She went to the section that held the Rs and found Ellen’s chart easily enough, flipping it open. Ellen had come to the practice right after her marriage two years ago. Emmett had treated her for a sinus infection, and she’d been in for a few other minor ailments until three months ago, when she’d switched her care to Katie.

  She remembered Ellen’s visit because it had been during her first week in practice with Emmett and Nick. Katie had been nervous and double-checked everything. Which meant that she was painfully slow and looked up every diagnosis in the evenings to be sure she hadn’t missed anything. All through medical school and residency, there’d always been someone else in charge. Someone else to check that the correct medication was being prescribed or the right test ordered. Katie knew she was a good doctor. But that first couple of weeks had been a leap of faith.

  She skipped ahead in Ellen’s chart to the last time she’d seen her. It had been a week before her death, and Ellen had come in complaining of feeling “run down.” She hadn’t been sleeping, she said. Katie had sensed that she was worried about something, and when she’d asked Ellen about it, she had admitted feeling stressed about something to do with “research” and too many late nights. Katie only vaguely remembered that clinic—Nick had been at the hospital dealing with an emergency, so Emmett and Katie had been seeing his patients plus their own. It had been a crazy, busy day. She scanned to the bottom of the note. There was no mention of diazepam.

  No matter how busy her clinics became, she didn’t think she would forget to chart a medication. And she was sure that she would remember calling it in herself to the pharmacy.

  Katie looked in the other tabs to see if anyone had noted the prescription. She went to the “to be filed” bin and set the chart on the edge of the counter. She’d flipped through half the pile and was into dates from August when a loud crash in the hallway made her jump, and she knocked the chart off the counter. On its way to the floor, she saw that the clips were undone. It hit the ground and scattered papers everywhere. Katie listened at the door, her heart racing.

  Then she heard the rattling and clanking of a mop in a bucket. Marilyn Swanson, the office cleaning lady. Katie had only met her once when she had stayed late to finish up notes. She took several deep breaths to calm her panic. She knelt down next to the spilled chart and had almost finished piling all the pages back into the folder when the door opened.

  “Oh, hello, Dr. LeClair. I thought I heard someone in here,” Marilyn said and looked from the messy pile of papers to Katie. “Can I help?”

  She was taller than Katie and very thin with long, straight dark hair and severe bangs. She had an exhausted manner as if she carried too many burdens. Katie felt tired in her presence.

  “No, but thank you, Marilyn.” Katie crammed the pages into the folder and clutched it to her chest. She’d put it all back together later. “I was just finishing up.” Katie moved past Marilyn and stepped toward the door. She hoped Marilyn couldn’t see which chart she was holding.

  Katie pulled open the door.

  “Wait.” Marilyn held out a registration sheet. “I think you dropped this.”

  Katie took the document.

  Marilyn nodded at the paper in Katie’s hand. “It was sure a shame about Ellen Riley,” she said.

  “Did you know her?” Katie tried to hide her surprise.

  Marilyn nodded. “Christopher Riley and I were in school together, so I’ve known him all my life. Our parents were friends, and we were like cousins growing up. He’s always been very . . . supportive. When I started my cleaning business, he was the first one to sign up and told everyone about it. He helped me get clients all over town.”

  “You must have known Ellen fairly well then,” Katie said.

  “Not really.” Marilyn shook her head. “I only saw her briefly if she was home when I went to do their house. She was always busy with one thing or another.”

  Marilyn bent to plug in her vacuum. Katie took the opportunity to say good evening and escape back to her office.

  4

  Katie tried unsuccessfully to corral all the loose papers and get them back in their proper order. She’d spread them on her desk and was organizing them into piles when her phone chirped with a text message. She glanced at it and sighed. She’d forgotten about her plans with Gabrielle.

  She shoved the papers back in the folder and stuck the whole mess in her bottom desk drawer. She sent a quick “on my way” text, grabbed her bag, turned out the light, and headed for the back door.

  “See you later, Marilyn,” Katie shouted over the vacuum as she passed the file room. Marilyn looked up and waved.

  Katie had met Gabrielle Maldova during her first year in residency at University Hospital on her required obstetrics rotation. Gabrielle was a second-year obstetrics and gynecology resident, and she had taken Katie under her wing while the two of them endured thirty-six-hour calls. On their busiest night, they had delivered twenty-five babies. The OB rotation had left little time for anything else, and they’d bonded in their shared misery. Both of them were now beginning real jobs, and scheduling time to see each other was getting more difficult.

  Katie steered her ancient Subaru hatchback onto the highway and let herself go on autopilot for the short drive to Ann Arbor. Gabrielle lived in a small bungalow far enough off campus to avoid the noise and hectic energy of students but close enough to enjo
y the restaurants and shops that catered to them.

  It was mid-September, and the leaves in Gabrielle’s neighborhood had just begun to change. The few reds, oranges, and yellows gave a preview of the days to come. Katie felt the energy of the campus coming back to life for the fall semester. Autumn always felt like the New Year to Katie. She had lived on an academic schedule for so long, she made resolutions in September rather than January.

  Gabrielle swung the door open before Katie had even turned off the car. “You forgot, didn’t you?” she accused from the porch. She was taller than Katie with dark hair and olive skin. Katie thought she looked exotic and beautiful, and based on her active dating life, the male population agreed.

  “I made a new curry just for you,” she said as Katie climbed the steps. Once a month, they got together for dinner and drinks. They tried something new each time, and eventually the competition had ramped up, with each trying to outdo the other from month to month to win their twice-yearly contest.

  “That sounds perfect. I’m starved,” Katie said, “and I didn’t forget, exactly. I just lost track of time.”

  Gabrielle’s living room was a riot of deep jewel tones. Katie sank into the chocolate-brown velvet sofa and watched while Gabrielle dipped the rims of two martini glasses in what looked like melted caramel. She dumped several premeasured shot glasses into a shaker and made a big production of shaking the concoction. She poured it out and garnished each glass with an apple slice.

  Katie accepted hers with enthusiasm. If caramel was involved, did it really matter what else was in the glass? But she asked anyway. “What’s this?”

  “Taste it, and then I’ll tell you.”

  Katie sipped. As usual Gabrielle had mixed up a winner.

  “So good!” The sweetness of the caramel and the tart apple flavor reminded Katie of fall carnivals and apple picking.

  “It’s a caramel apple martini.” Gabrielle held hers up in a toast and then took a sip.

  “You’re really upping the ante here,” Katie said. “You know I’m still painting my living room and have hardly any furniture.”

  “We can sit on boxes and order pizza next time.”

  Katie grinned at her over the rim of her glass. “You’d love that, wouldn’t you? You could claim the trophy.”

  “That old thing? I couldn’t care less . . .” Gabrielle flapped her hand in dismissal.

  But Katie noticed the empty spot on her mantel where it used to sit.

  Every six months, they voted on who had hosted the best dinners. Katie was currently in possession of the “trophy”—a plastic model of a gastrointestinal tract that they had liberated from a drug representative.

  Katie took another sip and felt warm and happy for the first time since she’d arrived at the hospital for Ellen Riley.

  “So what’s the news from Baxter? Still loving the small-town country-doctor gig?”

  “It’s gotten a little tricky,” Katie replied and set her drink on the table.

  She gave Gabrielle a brief rundown on the visit to the hospital, her concerns about the diazepam prescription, and her recent perusal of Ellen’s file. She sipped her drink and sat back, waiting for her friend’s response.

  “Wow. I thought you’d left all the excitement behind when you joined that practice. Just hypertension and well-child visits.” Gabrielle took a hefty swig of her own martini.

  Katie narrowed her eyes at Gabrielle. The one thing that they disagreed on was the level of excitement they each needed in their jobs. Gabrielle loved the adrenaline rush of an emergency C-section or a baby presenting in an awkward position. She loved to be in the OR for almost any reason. Katie preferred talking to her patients over cutting into them.

  “I could have done without this kind of excitement.”

  Gabrielle nodded. “You really don’t remember writing that script?”

  Katie shook her head. “There’s no record of it in her chart. That’s partly what I was doing so late at the office. I wanted to look over her files after everyone left. Since just requesting it would start the gossip mill turning.”

  She felt uneasy. The drink that had tasted so delicious a few minutes ago now sat like acid in Katie’s stomach.

  Gabrielle tilted her head and looked at Katie. “Let’s talk about it over dinner. Everything is better with curry.”

  They moved to Gabrielle’s small dining area. She’d set the table with a dark-brown tablecloth and bright napkins that completely coordinated with the rest of the living room. Candles of multiple heights flickered playfully on a reflective tray. This was just what Katie needed.

  Gabrielle brought a large bowl out of the kitchen and took the lid off, releasing the delicious aroma of curry, onions, and roast chicken. Katie felt lightheaded from the vodka and hunger.

  The only sounds for the next few minutes were forks on plates.

  “This is unfair. I’m so hungry, and this is so good,” Katie said. “I’m going to have to vote this meal as my favorite. And I was planning all my new decor around the trophy.”

  Gabrielle grinned.

  After she’d cleaned her plate, Katie put her fork down. “I don’t know why I can’t let this Ellen thing go.”

  “Which part—the suicide or the diazepam?” Gabrielle pushed the bowl of chicken curry toward Katie.

  “Both. But right now I’m thinking about the suicide.” Katie picked up her drink and set it back down. “I saw no sign of depression. I know I’d only seen her a few times, and several of them were when I was doing my rotation with Emmett in residency, but still. I think I would have picked up on it. Plus, she’s a psychologist. She started a life coach business when she moved to Baxter. She knew all the signs of depression. I think she would have asked for help.”

  Gabrielle shook her head slowly. “You know the rule about patient histories. Everyone lies. Whether it’s about how much they drink, or how often they exercise, or whether they’re depressed. They all lie about something. Maybe she thought she could handle it.”

  Katie nodded. She agreed with Gabrielle in principle, but something still nagged at her. “You’re probably right. She’s just the first one I’ve lost since I finished residency. She seemed so happy. It just has me questioning . . .” Katie swallowed and blinked her eyes to clear the burning of tears. She adored Gabrielle, but she wasn’t going to cry in front of her.

  Gabrielle reached across the table and squeezed Katie’s hand. Katie gently pulled her hand away and took a swig of water to clear away the last bits of emotion.

  Gabrielle focused on her food for a few minutes.

  When it was clear that Katie was back in control, Gabrielle said, “I made your favorite cheesecake.”

  Katie smiled. “Bring it on.”

  An hour and another drink later, Katie and Gabrielle sat on the couch gossiping about old friends from residency, the nurses in the ICU who were planning an overthrow of the power-hungry head nurse, and the latest surgeon Gabrielle was dating.

  “You skated right past the fact that Dr. Gregor was working in the ER last night,” Gabrielle said. A smile threatened to take over, but she was clearly trying to keep it under wraps. Matt Gregor was well known to Katie and Gabrielle. They’d admired him from afar for most of their residency. He was two years ahead of Gabrielle, and the fact that he had been chief resident meant everyone knew of him.

  Katie felt the betrayal of heat rising in her face. Gabrielle knew that Katie’s recent romantic past was littered with incompatible and inappropriate men. She had always been able to blame her work schedule to end things before they got too serious. Gabrielle also knew about Justin.

  Justin Wright was part of every happy memory from college and medical school. They had met on the Diag at the center of University of Michigan’s campus on a beautiful late September afternoon. Katie had skirted around a group of guys playing Frisbee, but when one of them missed a catch, Katie had jumped up and snagged the flying disc. As the man who’d missed the catch approached to get it back, Kati
e had been struck by his intense blue eyes and crooked smile. She’d smiled at him when he was a few feet away and sailed the Frisbee over his head to his friend, who had leaped to catch it.

  “Impressive,” he said.

  “Thank you,” said Katie.

  “No, I meant Kevin over there. He never jumps for a catch.” He looked at her from under his blond fringe. “He must be trying to impress you.”

  Katie laughed.

  “I’m Justin,” he said. “You should join us; we could use someone who actually knows how to throw.”

  They’d been inseparable after that. Following graduation, they had coordinated Justin’s law school and Katie’s medical school so that they could be together. After five years, Katie had assumed that they would get married eventually. Justin had been talking about having kids, houses, and pets in a way that made Katie nervous, but in a good way.

  In the spring of her last year of medical school, they went to their favorite Mexican restaurant. Katie knew he was nervous about something. He’d been distant and quiet for weeks. Match Day was quickly approaching—the day when medical students across the country found out where they would do their residency. Katie had placed Michigan residencies high on her list, but she had also included some in Chicago and one as far away as California. Justin was nine months into his first job as an attorney, and they both knew that between residency for Katie and being low in the hierarchy for Justin, they would never see each other if she didn’t match in Michigan.

  After the waiter left, Justin cleared his throat. He carefully rearranged his cutlery. Katie’s pulse quickened. He was going to propose. She wasn’t ready to get married, but they could have a long engagement, right?

  “Katie, I think this thing between us has run its course.”

  Katie opened her mouth to say “Yes” and had to stop and process what he had said. Run its course? Like a bad case of the flu or strep throat?

  “What—” Katie stopped and took a deep breath. He was always pranking her about things like concert tickets or vacation destinations. He’d say, “Sorry about the concert; I couldn’t get tickets,” and then he’d hand her an envelope with front-row seats. This was a bizarre way to propose, but maybe not for Justin. “What do you mean?”

 

‹ Prev