The Bitterest Pill

by Reed Farrel Coleman

  Petra repeated. “Yes. Anything. Anything.”

  The woman kissed the girl deeply once again, then told her what was required of her.

  When she had seen Petra safely away, she called Arakel Sarkassian and told him everything was in place.

  Twenty-five

  Short, with a wispy head of steel-gray hair, Dr. Abraham Goldfine was a sprightly man a year or two past his seventy-fifth birthday. He was the most popular pediatrician in town. He had seen one generation of Paradise kids grow into parents themselves. Now those second-generation kids were almost grown and there was no reason to believe he wouldn’t get to see the beginnings of a third generation. Goldfine was one of Jesse’s favorite people in town. The doctor, who’d been widowed for many years, loved baseball. When he’d get tickets from a patient’s family, he would always invite Jesse to come along. The free tickets were great, but what Jesse really enjoyed was Goldfine’s deep understanding of the game.

  “Used to be a pretty fair second baseman, Jesse,” the doctor would say. “We would’ve made a hell of a double-play combo, you and me.”

  But Jesse hadn’t come to the office to talk baseball. The doctor lived in a grand Victorian in Pilgrim Cove, with his practice around back of his house. His neighbors were often a little less than pleased with him, because his house, while a lovely specimen of the Queen Anne style, was never kept in the pristine condition of the surrounding homes.

  The doctor once confided in Jesse, “I think they would try to sue me, but since I saw to all their children, they make allowances.”

  When Jesse came into the office that day, he was greeted by a young woman who looked vaguely familiar. He guessed she caught him trying to figure it out.

  “Morning, Chief Stone,” she said, pointing to her chest. “Anna Marantz. You know, my dad owns the card shop.”

  “Sure. Good morning, Anna. How’s your family?”

  Anna, a petite blond woman with coppery eyes, said, “They’re good.”

  “I thought you were at school.”

  “Amherst, yeah,” she said, shrugged. “I did a year there, but I didn’t like it or it didn’t like me. I’m taking some time off and I figured I’d make a little money for when I go back to another school.”

  “Doc in?”

  “He’s just finishing up with a patient. I’ll tell him you’re here.”

  Anna went into the back. When she returned, she told Jesse the doctor would be out in a few minutes. While they waited, Jesse thought he would use the time to see if Anna, a fairly recent graduate of the high school, knew Heather Mackey.

  “No, I didn’t know her at all, really,” Anna said. “We were two years apart.” But Anna didn’t leave it there. “I mean, I guess we passed each other in the hall sometimes, and everybody knows her father because he’s a selectman and all.”

  Jesse supposed she would have gone on, but the door to the office opened and out came a young Hispanic couple, the mother holding a very young baby in her arms. Doc Goldfine trailed behind them, a reassuring hand on the mother’s shoulder.

  “Rosa will be perfectly fine. It’s nothing more than a cold. If she’s not better in a few days, give us a call and bring her back in.”

  “Thank you, Doctor,” the husband said, and shook Goldfine’s hand. “I will mail you the check on Friday.”

  The doctor smiled. “That will be good. Whenever you can. You just take care of these two.”

  He walked the family to the door and saw them out. He turned to Anna and told her to fit the Ramirezes in if the mother called for another appointment. Then he shook Jesse’s hand and said hello.

  “First-time parents . . .” Goldfine laughed and shook his head. “With the first one, the bottle falls on the floor, they make a new one. By the time the second one comes around, the bottle falls, they wipe it off on their nightshirt and stick it in the baby’s mouth. So, you wanna talk baseball? No, I guess not. Come on in. I don’t have another appointment for about fifteen minutes.”

  Jesse trailed the old man into his office. As he followed, Jesse marveled at the hop in Goldfine’s step and the sparkle in his eyes.

  “You know, Doc,” Jesse said, sitting in one of the old chairs across the desk, “I think we might draft you for the PPD softball team. I don’t know about your range at second, but you could be our designated runner.”

  “Please, Jesse, I’m old enough to carbon-date. So, what’s up? How’s that boy of yours?”

  “Good.”

  “Molly and the girls?”

  “Good.”

  “Oy, Jesse, with baseball, I can’t shut you up. With everything else, one-word answers. So, what’s doing?”

  “Heather Mackey.”

  The sparkle went right out of Goldfine’s eyes. He bowed and shook his head. “I delivered her. I held her in my hands before her own mother. Did you know that?”

  “No.”

  “This was when Steve and Patti still lived in Old Man Mackey’s house around the corner from here. The baby decided to come in the middle of a nor’easter. You couldn’t see your hand in front of your face and it was impossible to drive or for ambulances to get through. Steve called me in a panic. My Bea was still alive then. We walked around the corner. Got there just in time, too. But what can I tell you? How can I help?”

  “Patti says when Heather got hurt last year, they came to see you first.”

  Goldfine held up his right index finger. “Wait.” He called Anna into the office and asked her to get Heather Mackey’s file.

  “Good kid, Anna,” the doctor said when she left. “John Marantz came to me last spring when he heard I was looking for some help. Said Anna was a little lost and could I think about her for the job. What could I say? I’ve known her also since she was like this.” He held his upturned hands close together.

  Anna came back, handed him the file, and left. Goldfine looked it over.

  “Yeah, bad fall. Wrenched her back. She was in a lot of pain. There wasn’t anything I could do but refer her to the back and spine specialist at the hospital, Dr. Nour.”

  “You didn’t prescribe anything for her?”

  Goldfine shook his head. “Prescribe? No. I suggested she use Motrin or Tylenol for the pain until she saw the specialist. Backs are quirky things, and you know my first duty is to do no harm. I was going to leave Heather’s treatment to Dr. Nour. Good at her job.”

  Jesse stood up. Thanked the doctor and asked if he was sure he didn’t want to play for the PPD softball team. Goldfine laughed, but not for long.

  “You find out what really happened with Heather, let me know. Opioid addiction is going to kill off a generation if we don’t watch out. I care for these kids too much to see that happen.”

  Jesse promised he would do everything he could and left, saying goodbye to Anna as he went.

  “Take care,” he said. “And give my regards to your folks.”

  Jesse sat outside in his Explorer, remembering the two babies he had delivered while in uniform in L.A. He wondered about what happened to those kids. He didn’t wonder too long.

  Twenty-six

  Dr. Nour wasn’t anything like Doc Goldfine, neither in temperament nor demeanor. Five-foot-six, with shoulder-length jet black hair, eyes nearly as dark, rich brown skin, and a downturned mouth, she was more the type of doctor Jesse had known at hospitals in L.A.—terse, impatient, and preoccupied. No matter what they said to him, it always seemed to Jesse that it translated into “What? What? I’m busy. Go away.” He didn’t judge them for it. He knew there wasn’t much glory in the profession. As with police work, the public’s perception of the medical arts was television-based.

  “Dr. Nour,” Jesse said, “I’d like a minute.”

  The doctor barely acknowledged his presence, tapping away at a mobile computer. “Yes, yes, Officer, what is it?”

  Jesse couldn’t help but
laugh.

  That got her attention. She looked up. “I wasn’t aware I said something amusing.”

  “I’m actually the Paradise police chief, but that’s not what I was laughing at.”

  “Pardon me, Chief. I meant no offense.”

  “None taken. And please, call me Jesse.”

  “All right, Jesse. But may I ask what you found so amusing?”

  “Your impatience.”

  She shrugged, and Jesse wasn’t inclined to explain any further.

  “You saw a patient here last year, Heather Mackey. She was sixteen at the time. She’d taken a fall and was diagnosed with compressed vertebrae.” He repeated the course of treatment Patti Mackey had described to him. “Do you recall treating her? I would like to discuss her case with you.”

  Nour’s expression lost any hint of friendliness. “As police chief, you know I am legally and ethically prohibited from discussing my patients with—”

  Jesse cut her off. “She’s dead.”

  “My goodness. How?”

  “Heroin overdose.”

  “I see, yes, follow me.”

  Dr. Nour led Jesse to a conference room. At first, they both sat, but when Jesse described how Heather was found by her mother, Dr. Nour rose out of her seat and paced.

  Jesse asked again, “Do you remember her?”

  Nour looked devastated. “I’m sorry, but I don’t. I treat many, many patients here and in Boston, where my practice is based. You say I diagnosed her with compressed vertebrae and that I prescribed rest, physical therapy, massage therapy, and that Dr. Goldfine gave her Motrin for the pain?”

  Jesse nodded.

  “That sounds consistent with a course of treatment I might suggest, but without looking at her charts . . . wait. Will you excuse me for a few moments?”

  Ten minutes later she returned, holding a batch of papers in her hand. “I had the staff make a copy of the report from Heather’s visit here and I had my office scan and email the notes from her follow-up visits in Boston.” She sat and reviewed the files. “Yes, Heather had compressed vertebrae.” Dr. Nour stood, came around to Jesse, and slid MRI images in front of him. “See, right here. And, indeed, I did prescribe that exact treatment.”

  But something else had gotten Jesse’s attention. “You said ‘follow-up visits.’ How many?”

  She checked the files. “Four . . . yes, four visits in total, including her initial visit with me here at the hospital.”

  “Is that unusual?”

  “Each case is different, especially with spinal injuries. For instance, I’m sure that if I were to do an MRI on you, Jesse, I might find that you, too, have compressed vertebrae or possibly stenosis of your cervical spine. The general population all have injuries of some form or other. Give me a group of ten men or women with MRIs indicating the identical issue and there’s a likelihood that six of the ten would be asymptomatic and completely unaware of the damage. The remaining patients would likely display a range of symptoms with varying levels of distress.”

  “Uh-huh. Fascinating, but what about Heather? Where did she land on the curve?”

  “I’m afraid she wasn’t tolerating the pain very well with the Motrin. I prescribed Vicodin.”

  “Is that usual, prescribing an opiate for teenagers?” Jesse asked, his tone calm and nonaccusatory.

  “I prefer not to prescribe it for anyone, but my notes say she was in obvious distress and she was accompanied by her mother. See the notation here. Whenever I prescribe any controlled substance, I discuss with the patient the drug’s potential lethality and addictive characteristics. I prescribed a fifteen-day course of the drug for Heather. With Vicodin, I am loath to renew the prescription unless the patient reinjures herself or sustains a new injury. My file shows that was not the case with Miss Mackey.”

  Jesse said, “That accounts for three visits. What happened on the fourth visit?”

  “It was routine. She reported a considerable reduction in pain. Her physical-therapy report showed a marked improvement. She did not return for further treatment or consultation. I hope this has been of some help.”

  “Thanks, Doc. At this point, I can’t say.”

  “If you think I can be of any further use, please do not hesitate to contact me. Here.” She held a card out to him but pulled it back. When she did, she wrote a number on the back. “That is my cell phone number. I find this very distressing, so I don’t want you to have to go through my office to get in touch.”

  Jesse stared at her after taking the card from her, then said, “I understand your distress, but is there any reason in particular Heather’s case disturbs you?”

  “Heather’s is not the first such story I have heard. Several of my colleagues have had to deal with similar cases.”

  Jesse didn’t say what he was thinking but knew the moment she said what she had about other similar cases that either he or Molly would definitely be getting in touch. A pattern was always easier to track than an isolated case, and if he could establish a pattern, he might find out why Heather Mackey was dead.

  Twenty-seven

  Jesse called Molly as soon as he got back into his Explorer.

  “I need you to do a little investigative work. You might have to charm Lundquist a little bit to help you.”

  “What do you need?”

  “Dr. Farah Nour. She’s a spine and back specialist at Paradise General and her practice is in Boston. I need to know whatever you can find out about her.”

  “You suspect her of something?”

  “No, but she is the first link to Heather’s addiction. She prescribed Vicodin for her last year. I doubt she’s involved beyond that, but we should do our due diligence. See if we can connect any other cases like Heather’s to her.”

  “Sure thing, Jesse. Where are you headed now?”

  “I think I’ll circle back to the Mackeys.”

  That was met with a curious silence. Jesse sensed Molly had something to ask but was holding back. And since Jesse was still working his way through things on gut feelings, he wasn’t ready to share.

  He said, “I’ll check in later,” and clicked off.

  * * *

  —

  JESSE APPROACHED THE Mackeys’ house slowly. He wanted to be certain Steve Mackey wasn’t around, and when he saw that the selectman’s BMW wasn’t parked in the driveway, as it almost always was, Jesse pulled over to the curb.

  Patti Mackey was a wreck. The other day, when he’d come by to ask about Heather’s recent behavior, Patti had acted the part of the brave parent. The woman who would push on in spite of her girl’s death. The woman who would somehow find a way to make Heather’s death mean something. None of that was in evidence today.

  “Jesse!” she said, gasping as she realized the state she was in. “God, I’m a mess. I’m sorry.”

  She was dressed in a ratty pink bathrobe and slippers. She wore no makeup and, from the smell of her breath, had been using vodka as a mouthwash.

  “What parent wouldn’t be?” he asked. “No need for apologies.”

  A light went on behind her reddened eyes. “Have you found something?”

  “Can I come in?”

  “Oh, please forgive me. Sure, Jesse, come into the kitchen.”

  The kitchen. It was almost always the kitchen where people felt most comfortable talking to him. He was suspicious when people asked to speak to him in libraries, offices, or dens. There was just something about kitchens that put people more at ease and made people more willing to speak the truth.

  Patti tried to excuse herself once she made coffee for Jesse, but Jesse grabbed her wrist, gently, and guided her into a seat at the breakfast nook.

  “It will only get harder,” he said, holding her hand, “if you don’t just talk to me.”

  Patti Mackey broke down, sobbing, laying her head on the table.
Usually Jesse made sure to never act in any way that could be misconstrued, but Patti was a friend and in pain. He stroked her hair until she was ready to talk.

  “The other day, when I was here,” he said, voice soft as he could make it, “I knew there were things you wanted to say to me without Steve present. That’s why I’m here, Patti. I spoke with Dr. Nour. She told me about your other visits with Heather. She told me about the Vicodin.”

  Patti Mackey’s hand tensed. All of her muscles tightened at the mention of the drug, but she didn’t stop crying. And then, finally, she lifted her head up from the table, wiped the tears away, and said, “It was me, Jesse. I killed her.”

  His first instinct was to be a friend, to tell her she was wrong and that she wasn’t responsible. But as a cop he knew to just let her talk and let the guilt that was eating away at her out into the open.

  “I let the doctor prescribe Vicodin even after she explained the possible side effects, but Heather was in so much pain, Jesse. She couldn’t sleep, couldn’t eat. Sometimes I even had to help her up in the bathroom. I didn’t know what else to do. It’s hard to watch your child be in that much pain.”

  “Steve doesn’t know about the follow-up visits and the Vicodin?”

  She shook her head. “You know Steve, Mr. Straight Arrow. He doesn’t even like it when I have a few vodkas when we’re at the Gull with friends and everyone’s drinking. He would have disapproved. But I didn’t know what else to do.”

  “I might’ve done the same thing. I hurt my back a few times when I played ball and the spasms were so bad sometimes I couldn’t stand up straight.”

  “I swear, Jesse, I didn’t know she was hooked for a long time.”

  “I’m not here to judge or punish you, Patti. Just tell me what you have to say.”

  “Heather seemed much better after the fifteen days on the drugs. The PT and massage therapy were kicking in. Like Steve said, eight weeks after the injury, Heather was back at it. She said she didn’t want a refill on the Vicodin. She was herself again. And then one day in the spring I was cleaning her room and—”