Unnatural Causes

by Dawn Eastman

  She tried to stop thinking about Ellen’s death, Nick secretly inventorying the drug cabinet, and the mysterious prescription. Just focus on the trees and birds and the sound of a fall breeze through the leaves.

  She stopped short when she got to the garden. Sometimes she would find a family sitting there, but usually it was deserted. This time Matt Gregor was there. He hadn’t seen her yet. He’d draped his white coat over the back of the bench, and the remains of his lunch sat next to him. He was hunched over a notebook, scribbling madly.

  She wasn’t sure whether to interrupt. She realized she was happy to see him. Then she remembered what Gabrielle had said. Well, regardless of whether he’d want to date her, she still liked talking to him. During this dithering, she took a step backward and snapped a branch. Matt looked up and scanned the area. He shut the book and slipped it into the canvas messenger bag that sat at his feet. When his eyes fell on her, his face broke into a warm smile.

  “Dr. LeClair! How nice to see you again.” He gestured at the seat next to him.

  “Dr. Gregor,” Katie said. She walked to the bench and sat, feeling awkward that she had interrupted his break. “I was just out for a quick nature fix. I didn’t mean to intrude.” She slipped her messenger bag strap over her head and dropped the bag on the ground next to Matt’s.

  Matt waved off her apology. “No worries. I have to head back in a couple of minutes anyway. I’m in the ER again this afternoon.”

  “Oh, more locums work?”

  “The regular guy is on a two-week fishing trip,” he said. He leaned over and lowered his voice. “The rumor is that the nursing staff took up a collection and paid for his cabin in the woods. He was so burned out, none of them could stand to work with him anymore.”

  Katie remembered a cantankerous older doctor in the ER earlier in the summer. He’d admitted one of her patients for a “rule out MI,” which meant he had thought there was a chance the guy was having a heart attack, but none of the tests could confirm it. He had been pleasant enough on the phone, but Katie had overheard the nurses on the floor complaining about his grouchiness.

  “Do you think he’ll come back?” Katie asked.

  Gregor shrugged. “Probably. He’s been at it for almost forty years. Hopefully he just needed a break. Or maybe he’s ready to retire.”

  He sat back against the wooden slats of the bench and closed his eyes. “I love this little garden,” he said.

  Katie grinned at him even though he wasn’t looking at her. “Me too. I used to come here during my residency. It was like heaven after a long night on call.”

  “It does help to put things back in perspective.”

  “There’s a train that comes through around midnight,” Katie said. “I used to wait for it before going to sleep—if I was able to go to sleep at all. I liked to think of it traveling far from the worries of being on call. It was reassuring. Reminding me that there is life outside of the hospital.”

  Katie felt her cheeks growing hot. Why was she telling him this?

  He sat forward and looked at her, smiling. “I know that train! I listen for it every time I’m working in the ER. I have this idea that if I hear it go by, I won’t have any major disasters come through the doors that night. If I don’t hear it, and I realize it later, I get this nervous anxiety that doesn’t stop until my shift is over.”

  Katie laughed. “It seems every doc I know has some kind of superstition.”

  “Of course. How else can we control the uncontrollable?”

  They fell silent for a moment, listening to the woodpeckers tap-tapping deeper in the woods and the squirrels and chipmunks rustling through the leaves.

  “You seem more relaxed today than when I saw you over the weekend.”

  “I suppose I am, somewhat.” Katie met his gaze. “I found out this morning that Ellen Riley was likely murdered.”

  “What?” Matt sat up straight. “I hadn’t heard. And why would that make you relaxed?”

  “I didn’t write the prescription for diazepam,” Katie said. “I don’t know how she got it, and I’ve been worried about it since she died. At first I thought I’d forgotten, which was concerning enough. Then I thought maybe someone had called it in from my office. But now that I know she didn’t die from the diazepam, it’s like a weight has been lifted.”

  “I’m sorry you were so worried,” Matt said quietly. “You know that even if you had prescribed it, it wouldn’t have been your fault. We can’t control everything.”

  Katie sighed. “I understand the theory, but it’s hard to put it into practice—I like to imagine that if I just try hard enough, I can keep my patients safe and healthy.”

  Matt turned and looked up into the trees. “That’s a pretty heavy burden you’ve chosen.”

  “I know.”

  “How did she die? If it wasn’t the diazepam?”

  “The chief said it was a Demerol overdose. It was injected, and since there were no vials or syringes at the scene, he’s treating it as a homicide.”

  Matt nodded. “That makes sense. I was surprised that there was so little in her stomach when we were treating her. But murder? That’s not something you see every day in Baxter.”

  “You don’t think it would have made any difference if you knew you were dealing with something other than diazepam?”

  Matt shrugged. “Maybe. We would have used different meds to counteract the Demerol. I was surprised that she crashed so quickly, but now it makes sense. I think by the time she was found, she was already pretty far gone, but maybe we could have saved her if we knew. Actually, I knew Ellen, and I didn’t think she was depressed either. She was such a nice person, I don’t know why anyone would want to hurt her.”

  “How did you know her?”

  “You know, small town and all . . .” Matt glanced at his watch. “I’d better head back. I was supposed to be there twenty minutes ago.”

  “Me too. I have clinic starting in five minutes, and it’s a ten minute walk.”

  Katie reached for her bag at the same time Matt reached for his. The straps got tangled, and they sat laughing with their heads together while undoing the mess. It seemed the more they pulled or threaded the straps, the worse it got. Katie’s heart was racing, and she knew it wasn’t because of the tangled messenger bags. Sitting this close, he smelled like fresh laundry and the breeze through the woods. She would have been happy to sit there all day.

  “Here, wait,” Matt said. “The buckles are stuck.” He deftly unclipped the buckles, and the bags separated.

  Slightly disappointed, Katie stood and put her bag over her shoulder.

  They walked back along the path, crunching the few leaves that had fallen.

  “How did it go when Chief Carlson had you in for questions?” Matt asked.

  “Terrible,” Katie said. “He put me in an empty gray room and shined a light in my eyes. But I didn’t tell him a thing.”

  “Okay, Bourne. I didn’t realize you were so tough,” Matt said. “I had the impression he was more likely to offer you tea and cookies.”

  “He thinks I saved his dog’s life,” Katie said, “so he owes me.”

  “That was you?” Gregor stopped and turned toward her. “I heard about a doctor who rescued Carlson’s dog from a burning building, carried him on her shoulders several miles to a clinic, and resuscitated him using a suture kit and IV fluids.”

  Katie laughed. “It gets better every time I hear it.” They started walking again. “There was no burning building, and I only carried him about ten feet to my car.”

  “That’s not a very exciting story.” Matt frowned dramatically. “I’ll stick with the one I heard.”

  When they came to the fork in the path that led to the hospital and Katie’s clinic, Matt slowed.

  “It was nice to be interrupted by you,” he said.

  Katie looked at her feet and felt herself blush again. “It was nice to barge in on your solitude.”

  She headed down the path and turned ju
st before the bend that would take her past the hospital and toward her clinic. Matt still stood just where she’d left him. He raised his hand, turned, and walked toward the ER.

  14

  Katie arrived at the clinic feeling calm after her walk in the woods. The serenity lasted all of fifteen seconds. Angie approached with a pile of charts and a worried look.

  “Hi, Dr. LeClair. I assume you’ve heard the news about Ellen Riley. Chief Carlson is treating it like a murder.”

  Katie nodded. “I heard.”

  “So has most of Baxter. The phones are ringing off the hook. For some reason, they think we might know something.”

  Katie and Angie both knew why the patients thought they would get some information at the clinic. Debra. Debra was married to Sean, who was an officer in the Baxter police department. And her best friend owned the hair salon. Between those two sources, she knew as much about the town as anyone.

  Katie didn’t say anything, but Angie held up her hand.

  “I’ll talk to Debra again and tell her not to gossip. It’s like she can’t help herself.”

  Angie juggled the pile of charts and pulled a couple out of the middle. “Your first two arrived together—fifteen minutes early. They’re in rooms five and seven.” She handed Katie the charts. “I’m trying to fend off a stack of ‘urgent’ visits that have asked to be seen today. I’ll do some triage and see if any of them really need to come in. Maybe I’ll just tell them we don’t know anything and see if they suddenly feel better.”

  Katie took a deep breath. She hated to accuse anyone at the office, but this had gone too far for her to stay silent. Ever since she’d heard the word “Demerol,” she’d been thinking about that note that she’d seen on Emmett’s desk. “Angie, did you hear how Ellen died?”

  Angie nodded. “I heard it was an overdose.”

  Katie lowered her voice. “This is confidential, but they got the path report back, and it was an overdose of Demerol, not diazepam as they originally thought.”

  Angie swallowed. “Demerol?”

  “Yes, she was injected with Demerol. That’s why they’re treating it as a murder.”

  “Oh, poor Mrs. Riley,” Angie said. She put her hand to her mouth. “I hadn’t heard that part.”

  “I need to know . . . have any meds gone missing from the med cabinet recently?”

  Angie stepped away from Katie and glanced up and down the hallway. “You’ll have to talk to Emmett about that.”

  “Is there something to talk to him about?”

  Angie sighed. “There might be.” She held her hand up when Katie started to speak. “I’m sorry, but that’s all I’m saying. Emmett asked me to keep it to myself, and that’s what I’m doing.”

  Angie flipped through the charts in her hands and continued muttering to herself as she walked down the hall to her office.

  “Thanks,” Katie said quietly, knowing Angie wouldn’t hear her.

  Katie glanced at the charts in her hands. Mrs. Peabody and Miss Simms. They were both in their eighties, but they didn’t realize that yet. Former schoolteachers, they were involved in a synchronized roller skating club and terrorized the streets with their Vespas. They went everywhere together.

  Katie had seen them multiple times during her residency and then twice since she’d started with the practice. She had learned her lesson the first time. She wouldn’t get any information about either woman without first talking to her friend.

  Mrs. Peabody’s chart was on top, so Katie knocked on the door to room five.

  “Hello, Mrs. Peabody.” Katie walked in the room and shook Mrs. Peabody’s hand.

  “Hello, my dear.” Mrs. Peabody’s short silver hair sported a hot-pink streak on the right side, and she wore a matching tracksuit. She was thin and taller than Katie by an inch or so.

  “Is Miss Simms doing okay?” Katie asked.

  “No, she’s not.” Mrs. Peabody sat tall in her chair and wore a put-upon expression. “She hasn’t been sleeping well, and she’s very tired. She doesn’t even want to go on our daily walk. You should check her over, even if she denies it.” Mrs. Peabody nodded to punctuate her order.

  “And how are you doing?”

  “Fit as a fiddle. Nothing wrong with me.” Mrs. Peabody crossed her arms and dared Katie to argue with her steely expression.

  “Why don’t I just step next door and see what I can do for Miss Simms.”

  “Thank you, Doctor.” Mrs. Peabody opened her book and began to read.

  Katie stepped into the hallway and took a deep breath.

  She walked down the hall and knocked on room seven’s door.

  She opened the door and stepped inside. Before she had even shut the door behind her, Miss Simms began talking.

  “I’m so worried about Mrs. Peabody!” Miss Simms paced in the small room. She was shorter than Katie and pleasantly round, with white hair pulled into a bun. “She hasn’t been well.”

  “What seems to be the problem?”

  “She stopped eating completely, that’s the problem!” Miss Simms allowed Katie to lead her to a chair, and she sat.

  Katie glanced at Mrs. Peabody’s chart. Her weight was stable; she’d even gained two pounds since her last visit. This visit must be about Miss Simms then. But she didn’t seem tired. She seemed agitated.

  “And how have you been, Miss Simms?”

  “I’m just fine, except for worrying, of course.” She smoothed her hair, leaned forward, and lowered her voice. “I haven’t been sleeping very well. But it’s because I’ve been so worried about her!”

  “I have a record here, Miss Simms, and Mrs. Peabody has not lost any weight. Maybe her appetite has changed a little, but it’s not affecting her health. I’ll talk to her about this. Don’t worry, okay?” Katie had needed to have both ladies sign HIPAA waivers to allow her to discuss each woman’s health with the other when she first took over their cases.

  Miss Simms pulled a tissue out of her pocket and dabbed at her eyes. “Not Mrs. Peabody, Ellen Riley!”

  Katie was having difficulty keeping up with Miss Simms as she jumped from one concern to another. She sat back in her chair and narrowed her eyes. “What?”

  “Ellen Riley.” Miss Simms sniffed and one lone tear fell. “I’ve been worried about her for weeks, and now she’s dead!” Miss Simms began crying in earnest.

  Katie placed a hand on Miss Simms’s shoulder. “Why were you worried about Ellen Riley?”

  Miss Simms looked up at her from red, wet eyes. “She was such a lovely person. I live next door to the Rileys, you know.” She blew her nose loudly and mopped her eyes. “She always stopped for a chat if I was in my yard.”

  Katie waited for her to continue.

  Miss Simms took a shaky breath. “She and her husband had begun arguing. Not that I was eavesdropping or anything, you understand.” Miss Simms fixed Katie with a forceful stare that would have quelled any classroom jokes and high jinks. “I’ve known Christopher all his life, so I was surprised when I heard them.”

  “All married couples fight sometimes.”

  Miss Simms shrugged. “I wouldn’t know myself, but this seemed out of character for both of them. After that, I saw her in her kitchen on the computer at all hours—as long as her husband wasn’t home.”

  “Have you told Chief Carlson about this?”

  She shook her head. “No, I didn’t think I had anything to tell him. It’s just gossip, really. And I don’t want to tell Mrs. Peabody. She thinks I have too much imagination. No, I don’t think I will tell anyone. I feel better already, talking to you.” She patted Katie’s hand.

  Katie went back to room five.

  “Well?” Mrs. Peabody snapped her book shut. “Are the labs back already?”

  “No, we don’t need lab work today,” Katie said. Miss Simms had had normal labs just two weeks earlier. “But I think she’ll be better from now on.”

  “Well, that’s a relief.” Mrs. Peabody stood to leave. “I’ve been worried since th
at Ellen Riley killed herself. Miss Simms is very sensitive.”

  “Yes, you’ve mentioned that before.”

  Mrs. Peabody leaned closer to Katie and lowered her voice. “I was with Miss Simms the night Mrs. Riley died. I haven’t said anything to her, but I do wonder why Mrs. Riley wasn’t found earlier. I saw her husband come home hours before the ambulance showed up.”

  Katie caught her breath and tried to keep a bland expression on her face. “Excuse me?”

  “Christopher Riley. He came home and went inside around seven o’clock. I think he must have been out running. He had on one of those jogging suits with the hood pulled up. Although why he would need a hood on such a pleasant evening is beyond me. Maybe he’s doing one of those sweat diets?”

  “Are you sure you saw Christopher Riley?”

  “Well, of course I’m sure.” Mrs. Peabody scowled. “He had a key. Miss Simms seems to think he left again around seven-thirty. She says she heard a car. Of course, she can’t see their driveway from the kitchen, but she’s sure she heard a car.”

  “Mrs. Peabody, I really think you should talk to the police about what you saw and heard.”

  “No.” Mrs. Peabody crossed her arms. “That John Carlson has always been a troublemaker. He was in detention more than he was in class. All the practical jokes and shenanigans.” She shook her head and glared at Katie over the top of her glasses. “I’m sure he wouldn’t believe a word I said. And don’t forget this is all confidential. I signed a paper.” She tapped the chart in Katie’s hand as if Katie may have forgotten where the paper was stored.

  Katie wasn’t sure the HIPAA regulations applied to gossip and supposition about non-health-related issues, but she let it slide for now.

  Katie opened the door for Mrs. Peabody, and she sailed out of the room. Mrs. Peabody knocked on door seven and opened it. A few moments later, the two ladies emerged and made their way to the front desk.

  Katie pulled her notebook out of her pocket and added this new information to her ever-growing “plan.” She added a note about Ellen and Christopher fighting recently and her suspicions that the Demerol had come from her own office. She would have to look at everyone who had access to the med room and try to find out why Christopher was home hours before he said he was.