Dr. Death

by Jonathan Kellerman

  Milo pointed down at the file folder. "All this is in here?"

  Fusco shook his head. "I've limited my written material to data, no supposition. Police reports, autopsies, et cetera."

  "Meaning some of your stuff was obtained illegally, so it can never be used in court."

  Fusco didn't reply.

  "Pretty dedicated, Agent Fusco," said Milo. "Cowboy stuff's not exactly what I'm used to when dealing with Quantico."

  Fusco flashed those big teeth of his. "Pleased to bust your stereotype, Detective Sturgis."

  "I didn't say that."

  The agent leaned forward. "I can't stop you from being hostile and distrustful. But, really, what's the point of playing uptight-local-besieged-by-the-big-bad-Fed? How many times does someone offer you this level of information?"

  "Exactly," said Milo. "When something seems to be too good to be true, it usually is."

  "Fine," said Fusco. "If you don't want the file, give it back. Good luck chipping away at Dr. Mate. Who, by the way, began his own little death trip around the same time Michael Burke/Grant Rushton decided to seriously pursue a career in medicine. I believe Burke took note of Mate. I believe Mate's escapades and the resulting publicity played a role in Michael Burke's evolution as a ward killer. Though, of course, Michael had begun snuffing out patients earlier. Michael's main objective was kill- ing people." To me: "Wouldn't you say that applied to Dr. Mate, as well?"

  Calling Burke by his first name. The hateful intimacy born of futile investigation.

  Milo said, "You see Mate as a serial killer?"

  Fusco's face went pleasantly bland. "You don't?"

  "Some people consider Mate an angel of mercy."

  "I'm sure Michael Burke could manipulate some people to say the same of him. But we all know what was really going on. Mate loved the ultimate power. So does Burke. You know all the jokes about doctors playing God. Here're a couple who put it into practice."

  Milo rubbed the side of the table as if cleaning off his fingertips. "So Mate inspires Burke, and Burke goes up to Seattle for med school. He moves around a lot."

  "He does nothing but move," said Fusco. "Funny thing, though: until he showed up in Seattle and purchased a used VW van, he'd never officially owned a car. Like I said, a retrovirus— keeps changing, can't be grabbed hold of."

  "Who died in Seattle?"

  "The University of Washington hasn't been forthcoming with its records. Au contraire, officially none of their wards have experienced a pattern of unusual patient deaths. But would you take that to the bank? There's certainly no shortage of serials up there."

  "So now Burke's back to girls? What, he's the Green River Killer?"

  Fusco smiled. "None of the Green River scenes match his previous work, but I know of at least four cases that do bear further study. Girls cut up and left tied to trees in semirural spots, all within a hundred miles of Seattle, all unsolved."

  "Burke's fooling with I.V. lines by day, cutting up girls in his spare time, somehow working in med school."

  "Bundy killed and worked while in law school. Burke's a lot smarter, though like most psychopaths he tends to slack off. That almost cost him his MD. He had to spend a summer making up poor basic-science grades, received low marks for his clinical skills, graduated near the bottom of his class. Still, he finished, got an internship at a V.A. clinic in Bellingham. Once again, I can't get hold of hospital records, but if someone finds an unusual number of old soldiers expiring under his watch, I'm not going to faint from shock. He finished an emergency medicine residency at the same place, got a six-figure job with Unitas, moved back to New York, and added another car to his auto arsenal."

  "He held on to the van?" I said.

  "Most definitely."

  "What kind of car?" said Milo. I knew he was wondering: BMW?

  "Three-year-old Lexus," said Fusco. "The way I see it, emergency medicine's perfect for a twisted loner— plenty of blood and suffering, you get to make life-and-death decisions, cut and stitch, the hours are flexible— work a twenty-four-hour shift, take days off. And important: no follow-up of patients, no long-term relationships, office or staff. Burke could've gone on for years, but he's still a psychopath, has that tendency to screw up. Finally did."

  Milo smiled. He'd been living with an E.R. doctor for fifteen years. I'd heard Rick praise the freedom that resulted from no long-term entanglements.

  "Poisoning the boss," Milo said. "The article said he'd been suspended for bad medicine. Meaning?"

  "He had a habit of not showing up at the E.R. when he was supposed to. Plus poor doctor-patient relations. The boss— Dr. Rabinowitz— said sometimes Burke could be terrific with patients. Charming, empathetic, taking extra time with kids. But other times he'd turn— lose his temper, accuse someone of overdramatizing or faking, get really nasty. He actually tried to kick a few patients out of the E.R., told them to stop taking up bed space that belonged to sick people. Toward the end, that was happening more and more. Burke was warned repeatedly, but he simply denied any of it had ever happened."

  "Sounds like he was losing it," said Milo. He looked at me.

  "Maybe heightened tension," I said. "The pressure of working a tough job when his qualifications were marginal. Being scrutinized by people who were smarter. Or some kind of emotional trauma. Has he ever had an outwardly normal relationship with a woman?"

  "No long-term girlfriend, and he's a nice-looking guy." Fusco's eyes drooped lower. His hands balled. "That brings me to another pattern. A more recent one, as far as I can tell. He developed a friendship with one of his patients up in Seattle. Former cheerleader with bone cancer. Burke was circulating through as an intern, ended up spending a lot of time with her."

  "Thought you couldn't get hospital records," said Milo.

  "I couldn't. But I did find some nurses who remembered Michael. Nothing dramatic, they just thought he'd spent too much time with the cheerleader. It ended when the girl died. A couple of weeks later, the first of the four unsolved cutting vics was found. Next year, in Rochester, Burke got close to another sick woman. Divorcée in her early fifties, onetime beauty queen with brain cancer. She came into the E.R. in some sort of crisis, Burke revived her, visited her during the four months she spent as an inpatient, saw her at home after she was discharged. He was at her side when she died. Pronounced her dead."

  "Died of what?" said Milo.

  "Respiratory failure," said Fusco. "Not inconsistent with the spread of her disease."

  "Any mutilation clusters after that?"

  "Not in Rochester, per se, but five girls within a two-hundred-mile radius have gone missing during Burke's two years at Unitas Hospital. Three of them after Burke's lady friend died. I agree with Dr. Delaware's point about loss and tension."

  "Two hundred miles," said Milo.

  Fusco said, "As I've pointed out, Burke has the means to travel. And plenty of privacy. In Rochester, he lived in a rented house in a semirural area. His neighbors said he kept to himself, tended to disappear for days at a time. Sometimes he took along skis or camping equipment— both the van and the Lexus had roof racks. He's in good shape, likes the outdoors."

  "These five cases are missing only, no bodies?"

  "So far," said Fusco. "Detective, you know that two hundred miles is no big deal if you've got decent wheels. Burke kept his vehicles in beautiful shape, clean as a whistle. Same for his house. He's a lad of impeccable habits. The house reeked of disinfectant, and his bed was made tight enough to bounce a hubcap."

  "How'd he get tagged for poisoning Rabinowitz?"

  "Circumstantial. Burke kept screwing up, and Rabinowitz finally put him on suspension. Rabinowitz said the look in Burke's eyes gave him the creeps. A week later, Rabinowitz got sick. It turned out to be cyanide. Burke was the last person to be seen in the vicinity of Rabinowitz's coffee cup other than Rabinowitz's secretary, and she passed the polygraph. When the locals tried to question Burke and put him on the machine, he was gone. Later, they found needle
s and a penicillin ampule in a locker in the physicians' lounge, traces of cyanide in the ampule. Rabinowitz is lucky he took a small sip. Even with that, he was hospitalized for a month."

  "Burke left cyanide in his locker?"

  "In another doctor's locker. A colleague Burke had had words with. Fortunately for him, he was alibied. Home sick with the stomach flu, never left his house, lots of witnesses. There was some suspicion he'd been poisoned, too, but it turned out to just be the flu."

  "So all you've really got on the poisoning is Burke's rabbit."

  "That's all Rochester's got. I've got that." Point- ing toward the still-unopened file folder. "I've also got Roger Sharveneau, certified respiratory tech. Buffalo police never checked out his Burke story, but Sharveneau worked at Unitas for three months, same time Burke was there. Sharveneau mentions Burke, and a week later he's dead."

  "Why didn't Buffalo check out the Burke lead?" said Milo.

  "To be charitable," said Fusco, "Sharveneau came across highly disturbed and lacking credibility. My guess would be severe borderline personality, maybe even a full-blown schizophrenic. He jerked Buffalo PD around for a month— confessing, recanting, then hinting that maybe he'd killed some of the patients but not all of them, calling press conferences, changing lawyers, acting goofier and goofier. During the time he was locked up he went on a hunger strike, went mute, refused to talk to the court-appointed psychiatrists. By the time he gave them the Burke story, they were fed up with him. But I believe he did know Michael Burke. And that Burke had some kind of influence on him."

  I said, "Why would Burke put himself in jeopardy by confiding in someone as unstable as Sharveneau?"

  "I'm not saying he confided in Sharveneau, or gave Sharveneau direct orders. I'm saying he exerted some kind of influence. It could very well have been subtle— a remark here, a nudge there. Sharveneau was un- stable, passive, highly suggestible. Michael Burke's the peg that fits that hole: dominant, manipulative, in his own way charismatic. I believe Burke knew what buttons to push."

  Milo said, "Dominant, manipulative, and he gets away with bad stuff. So what's next, he runs for public office?"

  "You don't want to see the profiles of the people who run the country."

  "The Bureau's still doing that J. Edgar stuff, huh?"

  Fusco smiled.

  Milo said, "Even if your boy really is the ultimate purveyor of evil, what's the connection to Mate?"

  "Tell me about Mate's wounds."

  Milo laughed. "How about you tell me what you think they might be."

  Fusco shifted in the booth, leaned to his left, stretched his left arm across the top of the seat. "Fair enough. I'd guess that Mate was rendered semiconscious or totally unconscious, probably with a strong blow to the head that came from behind. Or a choke hold. The papers said he was found in the van. If that's true, that's at odds with Burke's tree-propping signature. But the wooded site fits Burke's kills. More public than Burke's previous dumps, but that fits the pattern of increased confidence. And Mate was a public figure. I suspect Burke conned Mate into arranging a meeting, possibly by feigning interest in Mate's work. From what I've seen of Mate, an appeal to his ego would be most effective."

  He stopped.

  Milo said nothing. His hand had come to rest atop the file folder. Touching the string. Unfurling it slowly.

  Fusco said, "However the meeting was arranged, I see Burke familiarizing himself with the site before- hand, learning the traffic patterns, leaving a getaway vehicle within walking distance of the kill-spot. Which in his case, could be miles. Probably to the east of the kill-spot, because the east affords multiple avenues of escape. Living in L.A., Burke needs wheels, so I'm sure he's obtained registration under a new identity, but whether he used his own car or a stolen vehicle, I couldn't say."

  "I assume you've combed DMV, done all the combinations of Burke, Rushton, Sartin, Spreen, whatever."

  "You assume correctly. No good hits."

  "You were going to speculate about the wounds."

  "'Speculate.' " Fusco smiled. "Brutal but precise, carved with a surgical-grade blade or something equally sharp. There may also have been some geometry involved."

  "What do you mean by geometry?" said Milo, sounding casual.

  "Geometrical shapes incised into the skin. He began that in Ann Arbor, the last victim, diamonds snipped out of her upper pubic region. When I first saw it, I thought: his idea of a joke— the irony again, diamonds are a girl's best friend. But then he changed shapes with one of the Fresno vics. Circles. So I won't tell you I know exactly what it means, just that he likes to play around."

  "There were two Fresno victims," I said. "Was only one incised geometrically?"

  Fusco nodded. "Maybe Burke had to hurry away from the other kill."

  "Or maybe," said Milo, "both victims weren't his."

  "Read the file and decide for yourself." Fusco drew his glass nearer, touched the corner of his sandwich.

  "Anything more you want to say?"

  "Just that you probably didn't find much trace evidence, if any. Burke loves to clean up. And killing Mate would represent a special achievement for him: synthesis of his two previous modes: bloody knife work and pseudo-euthanasia. The papers said Mate was hooked up to his own machine. That true?"

  "Pseudo-euthanasia?"

  "It's never real," said Fusco with sudden heat. "All that talk about right to die, putting people out of their misery. Until we can crawl into a dying person's head and read their thoughts, it'll never be real." Forced smile, more of a snarl, really: "When I heard about the painting, I knew I had to be more assertive with you. Burke loves to draw. His house in Rochester was full of art books and sketch pads."

  "How good is he?" I said.

  "Better than average. I took some photos. It's all in there. But don't hold me to any specific guess, look at the overall picture. I've done hundreds of profiles, most of the time I miss something."

  "What you've done with Burke goes beyond profiling," I said.

  He stared at me. "Meaning what?"

  "Sounds as if you've made him your project."

  "Part of my current job description is depth research on cold cases." To Milo: "You'd know something about that."

  Milo uncoiled the string and opened the file. Inside were three black folders, labeled I, II, and III. He removed the first, opened it to a page containing five photocopied head shots.

  In the upper left: a color school photo of ten-year-old T-shirted Grant Huie Rushton. Button nose, blond crew cut, Norman Rockwell cute, except this kid hadn't smiled for the camera. Had looked away from it, set his mouth in a horizontal line that should've been merely noncommittal, but wasn't.

  Anger. Cool anger, backed by . . . wariness? Emotional unsteadiness? Furtive, wounded eyes. Norman Rockwell meets Diane Arbus. Or was I interpreting because of what Fusco had told me?

  Next: a high-school graduation shot. At eighteen, Grant Rushton looked more relaxed. Pleasant-looking young man wearing a plaid shirt, face broadened by puberty, the features symmetrical, tending a bit toward pug. Clear complexion but for sprinkles of pimples in the folds between nostril and cheek. Strong, square chin, mouth shut tight but uplifted at the corners. Teenage Grant's hair was several shades darker but still fair, worn to his shoulders with thick bangs. This time, he confronted the lens, full-face— confident— more than that: brash. By then, Fusco claimed, Rushton had murdered and gotten away with it.

  Below the childhood shots was Huey Mitchell's bearded face on a Great Lakes Security badge. The beard was thick, spade-shaped, a mink brown that contrasted with Mitchell's dirty-blond head hair. Running from atop the cheekbones to his first shirt button in an uninterrupted swath broken only by a mouth slit, it rendered any comparison to the other photos useless. Mitchell wore his hair even longer, drawn back tight into a ponytail that dangled over his right shoulder.

  The pale eyes narrower, harder. My flash impression would have been blue-collar resentment. Vital statistics: five
-ten, one eighty, blond hair, blue eyes.

  The bottom row featured two pictures of Michael Burke, MD. In the first, taken from a New York driver's license, the beard remained, this time clipped and barbered to an inch of dark pelt that served the now powerful-looking head well. So did Burke's haircut— razor-layered, blow-dried, worn just above the ears. By his early thirties, Burke's face had begun to reveal the advent of middle age: thinner hair, wrinkles around the mouth, puffiness under the eyes. Overall, a pleasant-looking man, wholly unremarkable.

  This time the stats said five-nine, one sixty-five.

  "He shrank an inch and lost fifteen pounds?" I said.