Dead Certain

by Hartzmark, Gini

  “I’m not sure I understand what you’re talking about,” I replied, settling into one of the leather club chairs opposite his desk and steeling myself for the inquisition.

  “You know very well what I mean, this business with Prescott Memorial Hospital. Do you know who I just got off the telephone with?”

  “I have no idea,” I said.

  “His Holiness Archbishop Greenville.”

  “How spiritually uplifting,” I said, doing my best to sound sincere.

  “Cut the crap, Kate. The archbishop is a very angry man.”

  “Is that allowed? I seem to remember something having to do with the meek inheriting the earth and turning the other cheek.”

  “It seems that the archdiocese has been negotiating with Health Care Corporation to contract out the administration of the church’s hospital operations.”

  “You’re kidding,” I said. The Catholic Church was the single largest provider of health care in the city of Chicago. Joan Bornstein had been right about HCC and their motives. Not that it gave me any satisfaction. Instead it sent a chill down my spine and made me wonder what else I didn’t know about HCC and their plans to take over the Chicago market.

  “Of course, after your mother’s stunt on Saturday night and now this frivolous lawsuit that you’ve filed, they’re being forced to back away from the deal because they’re afraid it will generate too much negative publicity.“

  “Good,” I said, secretly amused by the thought of God’s minions fretting over His PR.

  “What do you mean, ‘good’?” snapped Tillman. “Do I really need to remind you that this is a corporate law firm? Representing large companies like HCC is what we do. How do you think it makes us look when our clients turn on the television and see you and your mother pontificating against big business?”

  “I hope what they see is a Callahan Ross attorney living up to her obligation to represent her client zealously— even when the client is her mother.”

  “The law as it is practiced at Callahan Ross is about money, power, and the pursuit of private good,” Skip Tillman said, rising to his feet to signal that the interview was over. “If it’s crusades you’re interested in, I suggest you go to work for the ACLU.”

  When I got back to my office, I found Cheryl walking down the hall toward me.

  “How did it go?” she asked. “Would you like me to see if I can find you a tourniquet to help stop the bleeding?”

  “No thank you. I stand before you bloodied, but unbowed. Did you manage to get ahold of Claudia?”

  “Not exactly.”

  “What does that mean?”

  “It means that I never managed to reach her but she’s here anyway.”

  “Here?”

  “In your office. I was just on my way up to Tillman’s to get you.”

  “Hold my calls,” I said, the words feeling dry in my mouth.

  I found Claudia on her feet, looking out the window at the windows of the office building across the street. She was still dressed in her scrubs, as incongruous as a Girl Scout uniform in the dark-suit, white-shirt environs of Callahan Ross.

  “Hi, there,” I said warily. “What brings you downtown?”

  “I never thought I’d say this,” said Claudia, turning to face me, her eyes bewildered, her arms stiff with rage. “But I think I need a lawyer.”

  CHAPTER 14

  There is an aspect of the confessional in the practice of law, of confidences accepted and secrets kept. Even so, it seemed strange to be listening to Claudia in the bright light of day. I couldn’t shake the feeling that this was a conversation better suited to our nighttime living room, not surrounded by the ramparts of files in the chill of my Callahan Ross office.

  “The minute I walked through the door, I knew I was walking into an ambush,” she said, pacing the floor, propelled by agitation and disbelief. “It was like I’d showed up at a lynching with a rope around my neck.”

  “What happened? Did they tell you about Mrs. Estrada?”

  “You mean that she was a phony?” she demanded, her voice soft from shock. “That her gallbladder was a setup and that she’d been hired by the hospital?” She gave me a hard look. “Am I the only person who didn’t know?”

  “I only found out this morning. Kyle Massius told me. That’s why I had Cheryl trying to page you. I wanted to warn you—”

  “I went straight from the OR to the morbidity and mortality conference. I didn’t have a chance to call and pick up my pages. I guess they just couldn’t wait to railroad me.”

  “Who’s ‘they’?”

  “I’m not supposed to tell you anything about it, not even who was there. All M&M proceedings are supposed to be secret.”

  “Not between lawyer and client,” I pointed out.

  “And not when the people who are supposed to be educating you decide it’s in their best interests to destroy you.” Hearing this, I felt my heart drop. Massius hadn’t been exaggerating when he’d said that Claudia was expendable.

  “So who was there?” I asked.

  “Carl Laffer, of course. As chief of staff he heads the panel. Raj Banerji, Cameron Strand, and Yoash Wiener were the other physicians. Then there was Sharon Ringle, the hospital’s head of nursing services.”

  “What about McDermott?”

  “Oh, McDermott was there all right. He was wriggling like hell trying to get off the hook, but he was there.“

  “Why? What was he saying?”

  “Right off the bat he demanded to know why he’d been asked to appear before the panel. How could he be responsible if he never went anywhere near the patient? „

  “I thought he was the one who was supposed to take out her gallbladder.”

  “Yes, but his decision was based on faked test results. He only examined her once, and that was only for thirty seconds.”

  “So what did the panel have to say about that?”

  “Carl Laffer seemed determined not to let him off so easily. I’ve actually never seen him so mad.”

  “What was he mad about?”

  “For one thing, the fact that McDermott left me to do the case. Laffer wanted to know why he didn’t send me in to assist Farah Davies with her bleeder. He said I was a highly skilled surgeon who could handle anything. Then he threw the book at him for letting me do the procedure without supervision, as if that made any sense.”

  “And how did McDermott respond?”

  “Oh, you know Gavin. He hemmed and hawed and acted injured. He knows that the hospital needs him more than he needs the hospital. In the end he just said he was sorry and it was never going to happen again. I mean, what are they going to do? Revoke his privileges? It doesn’t matter how furious Laffer is. They both know there’s nothing he can do except yell.”

  “What about the other members of the panel?”

  “Oh, I think everyone thoroughly enjoyed watching McDermott getting reamed. Who wouldn’t want to see him forced to gag down his own medicine?”

  “I mean what did they think about what happened? „

  “The only thing anyone seemed able to agree on was that it had to have been my fault. They raked me over the coals for more than an hour asking me questions about the procedure. What kind of symptoms did she present with? What tests did we run? What kind of incision did I make? What kind of clamps did I use? On and on. Their questions took longer than the actual procedure. But it still doesn’t change anything. Mrs. Estrada’s dead and somehow it has to be because of something I did wrong.”

  “What about the other patients who died? McDermott’s patients?”

  “If I brought them up, it would be professional suicide,” replied Claudia. “I could just imagine what they’d think if I told them about our theory about someone going around killing McDermott’s patients. They’d slap me into a straitjacket and take me down to County. Face it, we have absolutely no evidence that anything of the kind is actually going on. It would just make me look like I was so desperate to cover up my mistakes that I�
��d stoop to saying anything.”

  “Did they tell you that her family has filed suit?” I asked.

  Apparently they hadn’t, because Claudia stopped her pacing and sank into the nearest chair and buried her face in her hands.

  “I wouldn’t get too comfortable if I were you,” I said. “You and I have someone we need to see.”

  Joan Bornstein’s office was ideally located for a medical-malpractice defense attorney. In the heart of the Gold Coast, it was a couple of blocks from the Northwestern medical center in a building that catered to physicians. Joan’s firm had their office on the eleventh floor. Inside, the waiting room was decorated like a tasteful gynecologist’s office in shades of peach and beige. There were comfortable chairs, an assortment of magazines, and classical music played through hidden speakers.

  Having been tipped off by Cheryl about our imminent arrival, Joan was waiting for us at the door.

  “You must be Dr. Stein,” declared Joan, taking Claudia by the hand and drawing her past the receptionist and down the wide corridor that led to her office. “I’ve heard so much about you from Kate, it’s nice to have a chance to finally meet you, even under these circumstances.”

  She ushered us into a spacious, sunlit office that commanded a stunning view of the lake. Out on the water the first sailboats of the season dotted the horizon with their bright spinnakers. It was a soothing view, not much different from the one from my new apartment, but a world away from the sunless canyon of LaSalle Street.

  The interior of her office couldn’t have been more different from the old-money insides of Callahan Ross. At Callahan Ross the walls were white and there were rules for everything, including how many chairs you could have before you made partner (two) and how many personal photographs you were allowed to display (three). Joan’s office, on the other hand, was a dramatic expression of her personality. The walls were painted a deep carnation pink, and the black leather couches were littered with faux leopard-skin pillows. Everywhere you looked, there were pictures of Joan, her husband, and their young son, including one displayed on the credenza directly behind her desk that was apparently taken just moments after Jared was born. It showed Joan, her hair matted with sweat, beaming down at her new arrival, both mother and child still swathed in surgical green.

  As striking a contrast as it presented to the buttoned-down conformity of Callahan Ross, I knew there was more to it than Joan’s flamboyant personality. Like an attorney specializing in divorce, Joan’s practice was a highly intimate one. When a doctor was sued for malpractice, his or her personal competence and integrity were called into question in the most fundamental fashion. While my clients hid their shortcomings behind the corporate veil, Joan’s were being exposed to the most humiliating type of personal scrutiny. Everything about Joan’s office said, this is who I am, trust me.

  While I sipped coffee and enjoyed the view, Joan took Claudia through the events leading up to Mrs. Estrada’s death, pausing frequently to ask questions and quietly making notes.

  “You did the right thing coming to me,” concluded Joan, laying down her pencil once Claudia had finished. I suspected that she said it to everyone who brought their problem to her door, but it was reassuring nonetheless. For Claudia these were uncharted waters. After the security of being part of the medical staff, she now found herself cut adrift, an outsider. “Though I must confess I’m surprised they were so quick to cast you to the wolves, given your association with Kate’s family.”

  “Nobody knows that Kate and I are friends,” answered Claudia. “The last thing I wanted was for everybody to be whispering that the only reason I have my job is that I’m friends with the Prescotts and the Millhollands.“

  “Well, don’t you think that it’s maybe time they found out?” inquired Joan.

  “I’m not so sure we’re such an asset anymore,” I pointed out. “In case you haven’t heard, the family filed suit against HCC this morning, and as we speak, my mother is sucking up to every journalist who’s ever asked her for an interview, in order to explain what a terrible mistake the hospital is making.”

  “In that case maybe you’re right. I think we should start out by focusing on figuring out the best way to defend against these allegations of malpractice that have been leveled against you.”

  “Before we start, I have to ask you how much this is going to cost,” Claudia said, swallowing hard. I knew that her salary, though adequate, was dwarfed by an Everest of debt owed to the government that had financed her education. While her surgical skills would eventually earn her a lavish income, her current net worth consisted of a nine-year-old Honda, an impressive collection of classic CDs, and the outstanding balance on an amazing number of student loans.

  “Don’t worry about that,” I cut in. “Joan and I will work that out.”

  “You know I can’t let you do that,” Claudia protested. “Listen,” I said. “I’ll make you a deal. When my appendix blows, I expect you to take it out and not send me a bill. Not only that, but I expect all the really good painkillers.”

  “Deal.” Claudia laughed in spite of herself.

  “Good,” said Joan, rubbing her hands together. “I’m glad that’s settled then.”

  “There’s still something that Claudia hasn’t told you about,” I said. “Something you should know.”

  “What’s that?” asked Joan.

  “Mrs. Estrada isn’t the first unexplained postsurgical death at Prescott Memorial,” I said.

  It took some prompting, but Joan finally managed to get Claudia to relate what she knew about McDermott’s patients who had died and our theory about an angel of death being at work in the hospital.

  “And you’re saying that, like Mrs. Estrada, all the people who died were Dr. McDermott’s patients?”

  “Well, not necessarily to begin with. For example, Mrs. Estrada was originally Farah Davies’s admission, but she was referred to Dr. McDermott when it was determined that she was a candidate for surgery.”

  “Farah Davies was the one who took that picture,” remarked Joan offhandedly, indicating the picture on her credenza, the one of her immediately following the birth of her eldest. “Now, of the patients who died, how many were you directly involved with, as far as their care?”

  “I don’t know,” replied Claudia. “Maybe one or two. Most of the deaths that occurred after I began my rotation weren’t trauma patients. They were scheduled for routine procedures like tumor removal, bowel resection, stuff like that. I don’t know about the ones before I came.”

  “So,” mused Joan, the gears turning, “these deaths definitely began before you arrived to begin your fellowship?” I immediately saw what she was getting at. If she could establish that all the deaths were part of a pattern, a pattern that began before Claudia even arrived at the hospital, then the case against Claudia was substantially weakened.

  “That’s what I’ve heard,” replied Claudia. “I remember after the first time we lost a patient, the nurses telling me that there had been at least two other similar deaths that had happened before.”

  “I hope you realize that McDermott and the hospital will do almost anything they can to keep us from raising the issue of these other deaths,” said Joan, speaking more to me than to Claudia. “No doubt that will also make them eager to settle with Mrs. Estrada’s family— anything to avoid seeing this matter go to trial.”

  “But if they’re so desperate to keep us from showing that Mrs. Estrada’s death was part of a pattern, won’t that just make them all the more determined to blame it on me?”

  “Yes. But it also gives you something terribly important.”

  “What’s that?”

  “The ability to help yourself,” Joan Bornstein replied. “How?” demanded Claudia, her face lighting up with something very much like hope.

  “Your job is to find out as much as you possibly can about the other patients who died. Review their charts, talk to the nurses who took care of them.”

  “What for? Wha
t am I trying to find out?”

  “You’re looking for patterns. Any kind of similarities. Did they all die at the same time of day? During the same shift? What kinds of medications had they been receiving? What kinds of procedures had been performed? Anything that links them together.”

  “Patient records are confidential,” Claudia reminded her.

  “I know that and I’m not asking you to divulge any information to me or anyone else,” Joan was quick to assure her. “But there are no moral, ethical, or legal reasons why you can’t go back and review patient records. We’ll cross those other bridges when and if you find some sort of pattern in the charts.”

  “And what am I supposed to do in the meantime?” inquired Claudia. “How am I supposed to go into the hospital every day? Half the people I work with think I did something wrong that killed my patient, and the other half assume I’m being set up to take the fall for McDermott. Either way I’m going to be under the microscope.“

  “I know it’s going to be hard,” Joan assured her earnestly, “but now more than ever it’s absolutely imperative that you go into the hospital every day you’re scheduled and continue to do your work according to your usual high standards. You can’t let yourself be coerced or co-opted into making it any easier for them to sabotage your career. It’s all about showing them that you aren’t about to roll over for them. To make them realize that if they want to take you down, they’re going to have to fight you every inch of the way.”

  Claudia absorbed all of this with a kind of grim stoicism. From her face, I couldn’t even begin to guess what she was thinking.

  I prayed that my faith in Joan Bornstein, in whose hands Claudia’s future now rested, was not misplaced. Of course, I was also furious at Gavin McDermott for having put her in a situation that put everything she’d worked so hard for, for so many years, at risk. I was disgusted by his calculation and his cowardice, not to mention his eagerness to offer her up as sacrificial victim.

  But overriding all of this was a terrible sense of fear, fear not just for Claudia, but for myself. Sitting in Joan Bornstein’s office with my old college roommate brought home the fact that it is a small world filled with overlapping relationships and conflicting loyalties. The truth is I didn’t know what I would do if it came down to choosing between saving my roommate’s reputation or that of Prescott Memorial Hospital.