No Cure for Murder
Lawrence W. Gold, M.D.
Dedication
To my wife, Dorlis, for incredible dedication and support.
In memory of Charles M. Gold
(1908-2008)
He loved life, his family, and taught us not to fear aging.
Acknowledgments
Donna Eastman of Parkeast Literary, a great editor who made this possible.
Joseph Barron, a true renaissance man, my writing buddy. Gone but not forgotten.
Writers groups on both coasts. WOW in Palm Coast, Florida and Sierra Writers in Grass Valley.
Chapter One
Julie Kramer pulled off her sweat-soaked green surgical cap as she entered the recovery room at Brier Hospital. “Where is Mrs. Hogan?”
The recovery nurse checked her clipboard. “She’s in bed one, Doctor.”
Julie walked to the gurney and placed her hand on Shannon’s cheek. “Are you awake?”
Shannon Hogan drew the thin sheet up to her neck. “I think so. It’s freezing in here.”
Julie brought a heated blanket to Shannon and reviewed the results of the colonoscopy just completed.
Shannon heard the cold words and felt Julie’s warm hand on her shoulder. “I’m sorry, what did you say?”
“I wish there were other words than tumor or cancer...they spark our primal fear like shouting ‘fire!’ in a crowded theater.”
Shannon held her face between both hands and cried.
Half listening to Julie’s explanation, Shannon tried to absorb the surgeon’s meaning. Like a drowning woman, she fought for the surface and gulped for the essence of life just in time to hear the reassuring words. “Thirty years ago, cancer was a death sentence. Not anymore.”
Julie grasped Shannon’s hands. “We found it early, that means you’re going to be around for a long time.”
Shannon and Peter Hogan were deeply religious people and had their faith tested through a lifetime of loss. First came the tragic death of their six-year-old daughter Mandy to leukemia. Then the business failures, the loss of their home in the Berkeley Hills fires of 1991, Peter’s heart attack and bypass surgery, and Shannon’s cranky, stubborn mother who lived with them for twenty years, proving that misery, indeed, loved company. With her mother gone, the kids settled and Pete’s retirement in sight, Shannon made a tragic error; she forgot that providence had not lost its special interest in her.
With retirement a year away, Pete came home one night with a pile of brochures.
Shannon scanned the colorful photos. “Mexico! We can’t move to Mexico.”
“South of the border, we can live like royalty. They have everything we’ll ever need.”
After several trips, they settled on San Miguel de Allende for their retirement. It had perfect weather, a large American community, and cultural richness...their dream come true. They’d sell their home and be on their way.
So much for that, Shannon thought one morning, three weeks before they were to leave. It began with non-stop cramps in her abdomen, followed by the shocking bright red blood in the toilet. Colonoscopy and the dreadful diagnosis followed, bad news delivered with blinding speed.
Peter walked alongside the gurney as they wheeled Shannon toward the elevator and surgery. “You must get her through this, Julie.”
Julie placed her hand on his shoulder. “Don’t worry, Pete, Shannon will be just fine.”
After the fourth hour, Julie came into the surgical waiting room. Her smiling face was the most beautiful thing Pete had seen in his lifetime.
Naturally, that wasn’t the end of it. Weeks of complications followed. Cycles of desperation and relief, then more despair, and finally the answer to their prayers, Shannon was nearing discharge.
As I enter 502, Shannon Hogan’s room, I see my hazy outline cast against the wall from the subdued indirect lighting. I blend with the shadows and move in silence to her bedside.
Her face reflects the peace of untroubled sleep, a few moments of respite from her pain. She’s caught in a dream, ignorant of the futility of it all, as if her denial could stem the inevitability of the final release—the ultimate freedom to a life everlasting.
I smile in anticipation, feeling the force of my will over her existence, a power reserved to the few.
When I reach into the pocket of my white coat, I feel the syringe. It’s warm from my body heat. It’s 30ccs of a milky fluid—my special gift.
Sterile syringe...what a joke.
It’s time.
I withdraw the syringe, rub it against my cheek, and then caress it as if it were a chess piece, a captured queen. The clear plastic IV line is within my reach as I find the intravenous injection port. The pink cover over the hypodermic slides off exposing the shiny stainless steel needle. It sparkles gaily as its razor sharp tip pierces the rubber stopper of Shannon’s IV line.
I look up, staring at the heavens through the two floors above and say my silent prayer.
I grasp Shannon’s sleep-warmed hand, giving it a gentle squeeze. Her eyes flutter then open. Shannon looks around and tries to focus on my silhouette. With the light behind, I know that all she can see is my outline.
“What...” she begins, but I silence her with a whisper. “It’s going to be all right. He is with us tonight.”
Shannon trembles. I’m certain she’s not sure if this is a nightmare.
I feel warm as I push the plunger slowly, inexorably down the barrel toward the syringe’s base. Shannon grimaces as the fluid burns the veins of her arm. Then her lips part to scream. I quickly cover her mouth with my leather-gloved hand. She grasps my arm trying to escape, but I hold her still with my other hand. She’s remarkably strong until the medication forces her muscles to relax, to twitch, then they refuse to respond to her commands to contract. Finally, the muscles surrender to the potent power of the paralyzing potion.
She’s awake, I can tell, a silent witness to her death, but she’s unable to move a muscle.
Her pupils widen in panic.
Her heart pounds.
She tries to breathe...smothering...gasping in her mind, but frozen.
Shannon’s conscious brain cries, please...please...no...no...Pete...Mandy...My God, no... no...no!
I take a serene sigh of satisfaction, raise the sheet to her neck, and caress her face. A single small tear streaks over her cheeks from the corners of her pleading eyes.
My work done, I stroll to her door and depart.
Chapter Two
Ginny Harrison stared at the clock—just minutes left to make a final dash through her assigned patients before morning report. Although exhausted from a busy, understaffed night shift, she felt satisfied. She’d handled each curve ball pitched by her difficult patients during the eight-hour inning.
When Ginny reached Shannon Hogan’s room, she sensed it at once.
Something is wrong.
She pushed the door open, rushed to the bedside, touched Shannon’s cold hand, and felt the throbbing terror pass through her abdomen. She flipped on the overhead light. Shannon’s rosy face had turned an ashen purple-blue in the bright fluorescence. Ginny’s hand hovered over the Code Blue button at the head of the bed...
Is it too late? she thought.
She pushed the button.
Code Blue 5th Floor, Code Blue 5th Floor, Code Blue 5th Floor, screamed the PA system throughout the hospital.
Ginny applied her mouth to Shannon’s cold lips, gave three quick deep breaths, then placed both hands, one above the other, on the lower part of the breastbone and began cardiac compressions. She felt Shannon’s sternum groan under her pressure. She counted each compression...one, one thousand, two, one thousand, three, one thousand. In moments, the room filled with members
of the Code Blue team.
Too late, Ginny thought. Shannon’s gone.
“Jack!” Ginny shouted, as Dr. Jack Byrnes entered the room followed by Ahmad Kadir, his resident from UC San Francisco. “She was fine just two hours ago.”
Jack Byrnes had consulted on Shannon’s case and as the medical director of the Intensive Care Unit, he supervised the code. When he placed the defibrillator paddles on her chest, the monitor traced a listless line across the screen. The cooling body, fixed and dilated pupils told it all. He turned to Ahmad. “Let’s call it. We’re too late.”
Ginny clutched Jack’s arm. “No...please.”
Jack’s head swung in a pendulum of hopelessness.
The team’s reaction to Jack’s announcement was like opening a beautifully wrapped gift box and finding it empty. Their energy and enthusiasm, like that of the disappointed child, evaporated in an instant.
Jack looked across the room. “Has anyone called Dr. Weizman?”
“No,” said Ginny.
Jack dreaded the need to awaken the old-timer so early in the morning. “I’ll do it.”
“Get me Dr. Weizman,” Jack asked the hospital operator. Seconds later, he heard the phone click.
“Dr. Spelling here.”
Zoe Spelling had joined Jacob in Family Practice two years ago.
“Oh, Zoe, I was trying to reach Jacob.”
“I’m on call tonight. Can I help you?”
“It’s about Shannon Hogan. The nurses found her dead this morning.”
“My God. What happened?”
“Don’t know.”
“I’ll have the answering service put you through to Jacob. He’s cared for that family for years. He’ll want to know.”
Jack waited on hold for several seconds, when the phone clicked. “Dr. Weizman, here. So what’s so important it can’t wait a little longer?” came the words with a hint of an Austrian accent.
“Jacob, it’s Jack Byrnes. I have bad news for you.”
“Say it.”
“Shannon Hogan’s dead. Her nurse found her thirty minutes ago. It was too late to try to resuscitate her.”
“My God...the expected, I can deal with, but surprises like this, I hate. Have you called her husband Pete?”
“No. I’ll do it now.”
“I’ll be right in.”
“That really isn’t necessary, Jacob. I’ll deal with him.”
“Thanks for the thought, Jack, but after sixty years of practice, I know my responsibilities. I may be old, but that I remember.”
Jack smiled. “I’ll have the orderly meet you at Brier’s front door with your walker.”
“For a nice guy, Jack, you can be a real...what’s the technical term…oh yes, a schmuck.”
Jack laughed. “I’ll see you when you get here.”
Jack thought his interchange with Jacob reflected an interesting phenomenon. They had jumped seamlessly from the somber gloom of death, worse because it was unexpected, to the light-hearted banter of physicians working under the double whammy of stress and disappointment.
Shrinks call humor of this type a defense mechanism. Jack wasn’t so sure. When Jack first experienced this type of humor during his internship, it smacked of indifference, like a doc at the end of a failed code blue, announcing, “Well, that sure made me hungry. Who wants pizza?”
Now that he was part of this brotherhood, Jack understood that anguish endured alone, like pain at night, was always worse. Humor, like the cool strength of gravity that binds our solar system, draws people together by its warmth.
Of all the senior physicians at Brier Hospital, it was only Jacob Weizman’s calm congeniality that allowed Jack to treat the eighty-eight-year-old esteemed physician as he would a contemporary.
Jacob Weizman and his wife Lola were Holocaust survivors. Jacob came to New York City after the Second World War and ran a General Practice for several years before moving to Berkeley.
Jacob graduated from the University of Vienna Medical School two years before Hitler’s invasion of Austria. He accepted a teaching position at that venerable institute, well known for a faculty that included some big names in the history of medicine, including Semmilweis and Billroth, among others. Jacob’s father, a senior officer at the Bank of Vienna, shared his pride in Jacob’s achievements with anyone who’d listen.
The Nazi invasion of Austria began on March 12, 1938. By mid-March, 138,000 Jews came under the control of German troops. The Germans immediately disseminated anti-semitic hate propaganda in newspapers and magazines and destroyed Jewish businesses. In a matter of weeks, they removed all Jewish professors and instructors from Austrian universities. The Nazi SS captured and sent Jacob and his entire family to Auschwitz concentration camp. Jacob was the sole survivor. He never talked about his dark days at Auschwitz, except to recall for his children the icy Saturday, January 27, 1945 when Soviet forces liberated the camp. That day, Jacob and Lola Ophir, another survivor, left together. She was to become his wife of fifty-eight years.
Jack Byrnes had, on occasion, caught a glimpse of the tattooed numbers on Jacob’s forearm, the inky image of a world gone mad and the symbol that cried, “Never Again.”
Jack’s thoughts returned to Shannon. What the hell happened?
Shannon Hogan, age sixty, had been through a horrendous hospital course. She spent three weeks in the ICU recovering from complications of surgery for a bowel obstruction secondary to colon cancer. Jack hated to characterize anyone with cancer as fortunate, but the bowel obstruction had revealed the tumor early, and without evidence of local or distant spread, her prognosis was good. Even someone in this business who sees death on an almost daily basis, never really gets used to it, especially when the end arrives without notice.
Jack grabbed Shannon’s chart, found her home number and dialed to reach Pete, her husband.
The sleep-distorted voice answered. “Hello. Who’s calling?”
“Pete, it’s Jack Byrnes...”
“What’s wrong?” came his alarmed reaction.
“It’s Shannon. You’d better get down here in a hurry.”
“What is it?”
“Just get here right away.”
Is this small deception an act of kindness or of cowardice? Jack thought.
Pete lived only four blocks from Brier Hospital. A few minutes of anxiety for Pete, and a moment of mental preparation for both of them.
Ten minutes later, Jacob Weizman walked up to Jack as he was making his final note on Shannon’s chart.
Jack looked up.
While Jacob knew the term degenerative change accurately described the physical affects of aging, the word degenerate, its cognate, had a sardonic appeal for him. Something about the term ‘dirty old man’ made him smile. Hardly the giant at five feet six inches, Jacob couldn’t deny the recent measurements showing that he’d become even more vertically challenged—two more inches gone. He looked a bit like Sigmund Freud with a white beard and a matching full head of hair combed straight back. He wore a cream-colored Harris Tweed sport coat, a matching vest and bow tie.
Jacob looked around. “Is he here yet?”
“He should be here any moment.”
Jacob turned to Ahmad, extended his hand. “Jacob Weizman.”
“I’m sorry, Jacob. Ahmad Kadir is with me on an intensive care rotation. He’s a resident at UC.”
Ahmad, dark-skinned and heavily bearded, looked Middle Eastern. “Nice to meet you, sir,” said Ahmad with a subtle Palestinian accent. He hesitated a second before accepting Jacob’s extended hand.
Jacob turned back to Jack. “What happened?”
“Don’t have the slightest. She was recovering well. It’s a shocking loss.”
Jacob stroked his beard. “We’re going to need an autopsy.”
Ten minutes later, the door of the elevator opened and a red-faced and anxious Peter Hogan stepped out. As he rushed toward Shannon’s room, Jack moved from the nursing station and stepped in his path. “I’m so so
rry, Pete. It’s too late.”
He paled. “Too late? What are you talking about?”
“We tried everything, but she died in her sleep.”
Peter clenched his jaw and reddened. “Died? What the hell are you talking about? She was getting better. She was going home in a few days. We were moving to Mexico...”
Jacob walked up to them. “I’m so sorry, Peter. She was sleeping...she didn’t suffer.”
Pete tried to push past them into her room. Jack held him back for a moment, and then felt Pete sag in his arms. They sat him into a wheelchair. He leaned forward and wept.
After a few minutes, Pete raised his head. “What happened, Jacob?”
“I don’t know. We sure didn’t expect this. Maybe it was a heart attack or a stroke.” Jacob hesitated for a moment. “I’d like to get an autopsy. Then we’ll know.”
“My God. Hasn’t she been through enough? I can’t stand the thought of her being cut open like that.”
Jacob placed his hand on Pete’s shoulder. “It’s not that way. It’s more like surgery.”
Asking a grieving family for permission to perform an autopsy felt like hitting a person when they were down, but Jacob tried to get one on his patients when the cause of death was unclear.
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