Crisis

by Robin Cook

  Jack groaned inwardly. Bureaucracy was rearing its ugly head.

  “It’s a lengthy process,” Latasha continued. “Essentially, it involves this office convincing the district attorney there is a high suspicion of criminality. On the other hand, if there is no crime involved, then it’s a pro forma procedure here in Massachusetts.”

  Jack’s ears pricked up. “Really? How is that?”

  “All you need is a permit.”

  Jack felt his pulse quicken. “And how do you get a permit?”

  “From the town clerk where the cemetery is located or from the Board of Health if it’s here in Boston. The easiest way would be to contact the funeral director who did the burial in the first place. If the funeral home is in the same town as the cemetery, and it usually is, he knows the town clerk or Board of Health personnel personally. It could probably be obtained in an hour with the right contacts.”

  “That’s good news,” Jack said.

  “If you go ahead with an autopsy, we could help, not doing it here, of course, since this is a public facility, and I can’t imagine our chief authorizing something like that. But we could help by providing specimen jars and fixatives, and help processing the specimens. We could also help with toxicology if it’s appropriate.”

  “Will the death certificate have the funeral home on it?”

  “Absolutely. Disposition of the body has to be recorded. What’s the name again?”

  “Patience Stanhope. She died about nine months ago.”

  Latasha used her computer to bring up the death certificate. “Here it is. September eighth, 2005, to be exact.”

  “Really?” Jack questioned. He got up and peered over Latasha’s shoulder at the date. It seemed a coincidence. September 8, 2005, had been significant in his life as well. It had been the date of the dinner at Elio’s when he and Laurie had gotten engaged.

  “It’s the Langley-Peerson Funeral Home in Brighton who took the body. Want me to write the address and phone number down?”

  “Thank you,” Jack said. He was still marveling about the date. He retook his seat. He wasn’t superstitious, but the coincidence intrigued him.

  “What’s the time frame? When do you see yourself doing this autopsy?” Latasha asked.

  “To be perfectly honest, it hasn’t been decided to actually do it,” Jack admitted. “It’s up to the doctor and his wife. It’s my feeling it would help, which is the reason I suggested it, and why I’m looking into how to go about it.”

  “There is something about the exhumation permit I forgot to mention,” Latasha said as an afterthought.

  “Oh,” Jack said, reining in his enthusiasm.

  “You’ll need the approval and signature of the next of kin.”

  Jack’s shoulders visibly sagged. He chided himself for not remembering what was now so obvious. Of course the next of kin would have to agree. He’d allowed his zeal of helping his sister overwhelm his rationality. He couldn’t imagine the plaintiff agreeing to allow his dead wife to be dug up in hopes of helping the defense. But then he remembered that stranger things have happened, and since doing an autopsy might be the only thing he could offer Alexis, he wasn’t going to accept an unchallenged defeat. But then again, there was Laurie back in New York. If he were to do an autopsy, it would mean staying in Boston, which would get her upset. Like so many things in life, the situation was far more complicated than he’d like.

  Fifteen minutes later, Jack was back in his Hyundai Accent, drumming his fingers on the driver’s-side air-bag cover. What to do was the question. He looked at his watch. It was twelve twenty-five. Any thoughts of returning to the courtroom were nixed, since the court would be in recess for lunch. He could have called Alexis’s cell phone, but instead he decided on paying a visit to the funeral home. With that decided, he unfolded his Hertz city map and plotted his course.

  Driving out of Boston was no easier than driving in, but once he stumbled onto the Charles River, he was oriented. Twenty minutes later, he was on the appropriate street in the suburban area of Brighton, and five minutes after that, he found the funeral home. It was housed in a large, white, wood-frame, previously single-family home built in the Victorian style, complete with a turret and Italianate details. Extending from the rear was a modern addition of an indeterminate style built of concrete block. Most important from Jack’s perspective was that it had ample parking.

  After locking the car, Jack walked around to the front of the building and mounted the stairs to a spacious wraparound porch. There was no porch furniture. The front door was unlocked, so he walked into the building’s foyer.

  Jack’s immediate impression was that the interior was as serene as a deserted medieval library, with muted Gregorian chants providing the appropriate background noise. He would have liked to have said it was as severe as a deserted funeral home, but since it was a funeral home, he felt obligated to come up with something else. To his left was a casket gallery with all the caskets propped open to reveal their velvet or satin interiors. Comforting names like Eternal Bliss were displayed, but prices were not. To the right was a viewing room, which was currently vacant. Rows of collapsible chairs faced a raised dais with an empty catafalque. Floating in the air was a whiff of incense, as though it were a Tibetan souvenir shop.

  At first Jack was confused as to where to go to find a live human, but before he could wander too far, one appeared as if by magic. Jack hadn’t heard a door open or even approaching footsteps.

  “Can I help you?” a man inquired in a barely audible voice. He was slender and austere in his black suit, white shirt, and black tie. With his pasty and cadaverous face, he looked like a candidate for the establishment’s services. His thin, short, and deeply colored dyed hair was plastered to the scabrous dome of his head. Jack had to suppress a smile. The man embodied a familiar but false stereotype of a funeral home employee. It was as if he’d been called by central casting for a part in a ghoulish movie. Jack knew that reality didn’t support the Hollywood image. In his role as a medical examiner, Jack had a lot of interaction with funeral home employees, and none of them resembled the man standing in front of him.

  “Can I help you?” the man repeated slightly louder but almost in a whisper despite there being no one, not even the dead, whom he could have disturbed. He held himself rigidly in check, with his hands clasped piously over his abdomen and his elbows tucked in against his body. The only thing moving were his narrow lips. He didn’t even seem to blink.

  “I’m looking for the funeral director.”

  “At your service. My name is Harold Langley. We are a family-owned and -operated establishment.”

  “I’m a medical examiner,” Jack said. He flashed his official badge quickly enough to be reasonably certain Harold didn’t have time to notice it was not from Massachusetts. Harold visibly stiffened as if Jack were an emissary from the Massachusetts Division of Professional Licensure. Suspicious by nature, Jack thought the reaction curious, but he pressed on. “You people handled the arrangements for Patience Stanhope, who passed away this past September.”

  “Indeed, we did. I remember it well. We also handled the services for Mr. Stanhope, a very prominent gentleman in the community. Also for the only Stanhope child, I’m afraid.”

  “Oh!” Jack grunted in response to information he’d not been seeking. He quickly stored it away and returned to the issue at hand. “Some questions have arisen surrounding Mrs. Stanhope’s death, and an exhumation and autopsy are being considered. Has the Langley-Peerson home had experience doing such a thing?”

  “We have, but on an infrequent basis,” Harold said, relaxing back to his originally restrained, ceremonious self. Jack was apparently no longer viewed as a possible threat. “Are you in possession of the required paperwork?”

  “No. What I’m hoping is that you could help in that regard.”

  “Certainly. What’s needed is an exhumation permit, a transportation permit, and a reinterment permit, and, most importantly, the permit mus
t have the signature of the current Mr. Stanhope as the next of kin. It is the next of kin who must give authorization.”

  “So I understand. Would you have the necessary forms here?”

  “Yes, I believe so. If you’ll follow me, I can give them to you.”

  Harold led Jack through an archway in the direction of the main stairs but immediately turned left into a darkened, deep-pile-carpeted hallway. It was now apparent to Jack how Harold had managed to silently appear.

  “You mentioned that the first Mr. Stanhope was prominent in the community. How so?”

  “He was founder of the Stanhope Insurance Agency of Boston, which was very successful in its heyday. Mr. Stanhope was a wealthy man and quite a philanthropist, which is rare in Brighton. Brighton is a working-class community.”

  “Meaning the current Mr. Stanhope must be a wealthy man.”

  “Undoubtedly,” Harold said as he led Jack into an office as austere as he was. “The current Mr. Stanhope’s history is a marvelous Horatio Alger story. He was born Stanislaw Jordan Jaruzelski, a local boy from a working-class immigrant family who started working at the agency right out of Brighton High School. He was a whiz kid, even though he didn’t go to college, who worked himself up by his bootstraps to management. When the old man passed on, he married the widow, sparking some lurid speculation. He even took the family name.”

  Although it was a bright, sunshine-filled June day outside, inside Harold’s office it was dark enough to necessitate the desk lamp and a floor lamp to be on. The windows were covered by heavy, dark green velvet drapes. After finishing the current Mr. Stanhope saga, Harold went to an upright, four-drawer file cabinet covered with mahogany veneer. From the top drawer, he pulled out a folder. From within the folder, he took three papers, one of which he handed to Jack. The other two he placed on his desk. He motioned toward one of the velvet-upholstered chairs facing the desk for Jack before sitting himself down in his high-backed desk chair.

  “That’s the exhumation permit I gave you,” Harold said. “There’s a place for Mr. Stanhope to sign, giving authorization.”

  Jack glanced at the paper as he sat down. Getting the signature was obviously going to be the deal-breaker, but for the moment, he wasn’t going to worry about it. “Who will fill in the rest after Mr. Stanhope signs?”

  “I will do that. What is the time frame you are looking at?”

  “If it’s to be done, it has to be done immediately.”

  “Then you’d better let me know quickly. I’d have to arrange for the vault company’s truck and a backhoe.”

  “Could the autopsy be done here at the home?”

  “Yes, in the embalming room, working around our schedule. The only problem is we might not have all the tools you would like. For instance, we don’t have a cranial saw.”

  “I can get the tools.” Jack was impressed. Harold looked rather weird, but he was informed and efficient.

  “I should mention this will be an expensive undertaking.”

  “What are we talking about?”

  “There’ll be the vault company and backhoe charge, as well as cemetery fees. On top of that will be our charges for obtaining the permits, supervision, and use of the embalming room.”

  “Can you give me a ballpark idea?”

  “At least several thousand dollars.”

  Jack whistled softly as if he thought the figure high, whereas in actuality he thought it was cheap with all that was involved. He stood up. “Do you have an off-hours phone number?”

  “I’ll give you my cell phone number.”

  “Terrific,” Jack said. “One other thing. Do you know the address of the Stanhope home?”

  “Of course. Everybody knows the Stanhope house. It’s a landmark in Brighton.”

  A few minutes later, Jack was back in the rent-a-car again, drumming the steering wheel while he thought of what he should do next. It was now after two p.m. Returning to the courtroom didn’t thrill him. He’d always been more of a performer than a spectator. Instead of going back into Boston, he reached for the Hertz map. It took him a few minutes, but he located the Newton Memorial Hospital and oriented himself, and eventually arrived at his destination.

  Newton Memorial Hospital resembled almost every suburban hospital Jack had been in. It was built in a confusing hodgepodge of various wings added over the years. The oldest section had period details like decoration on a cake, mostly Greek Revival, but the new structures were progressively plainer. The most recent addition was just brick and bronze-tinted glass with no embellishments whatsoever.

  Jack parked in the visitors’ area, in a lot that backed onto a wetland with a small pond. A flock of Canada geese were floating motionless on the surface like a bunch of wooden decoys. Consulting the fat case file, Jack memorized the names of the people he wanted to speak with: the emergency-room doctor, Matt Gilbert; the emergency-room nurse, Georgina O’Keefe; and the staff cardiologist, Noelle Everette. All three were on the plaintiff’s witness list, and all three had been deposed by the defense. What was troubling Jack was the cyanosis issue.

  Instead of going to the front entrance of the hospital, Jack went to the emergency area. The ambulance bay was empty. To the side was an automatic sliding-glass door. Jack walked in and headed directly to the admitting desk.

  It seemed like a good time to visit. There were only three people in the waiting area; none of them appeared sick or injured. The nurse at the desk looked up as Jack approached. She was dressed in scrubs and had the usual stethoscope slung around her neck. She was reading The Boston Globe.

  “Calm before the storm,” Jack joked.

  “Something like that. What can we do for you?”

  Jack went through his usual spiel, including the ME badge flash. He asked for Matt and Georgina, purposefully using their first names to suggest familiarity.

  “They’re not here yet,” the duty nurse said. “They work the evening shift.”

  “When does that start?”

  “At three.”

  Jack looked at his watch. It was going on three. “So they will be here shortly.”

  “They better be!” the duty nurse said sternly but with a smile to show she was being humorous.

  “What about Dr. Noelle Everette?”

  “I’m sure she’s here someplace. Want me to page her?”

  “That would be helpful.”

  Jack retreated to the waiting area with the other three people. He tried to make eye contact, but no one was willing. He eyed an old National Geographic magazine but didn’t pick it up. Instead, he marveled about Stanislaw Jordan Jaruzelski transforming himself into Jordan Stanhope, and then he brooded about how he was going to get Jordan Stanhope to sign an exhumation permit. It seemed impossible, like climbing Mount Everest not only without oxygen but also without clothes. He smiled briefly at the thought of a couple of bare-assed climbers standing triumphantly on the rocky summit. Nothing is impossible, he reminded himself. He heard Dr. Noelle Everette’s name over an old-fashioned page system. Such a page system seemed like an anachronism in the information age, with grammar-school kids text-messaging.

  Five minutes later the ER duty nurse called him back to the admitting desk. She told him that Dr. Everette was up in radiology and would be happy to talk with him. The nurse then gave him directions.

  The cardiologist was busy reading and dictating cardioangiograms. She was sitting in a small viewing room with an entire wall filled with X-ray films on a movable conveyor belt. The only light came from behind the films and washed her with its fluorescent blue-whiteness, similar to moonlight but brighter. It made the cardiologist appear ghostlike, particularly in her white coat. Jack assumed he looked equally washed-out. Jack was completely forthright. He explained who he was and why he was associated with the case.

  “I am to be an expert witness for the plaintiff,” Noelle said, wishing to be equally forthright. “I’m going to testify that by the time the patient arrived here at the emergency room, we really had no cha
nce to resuscitate her, and I was indignant to learn there had been an avoidable delay. Some of us old-fashioned physicians who treat all comers and not just those who pay us up front are angry bout these concierge doctors. We’re convinced they are self-serving rather than acting in the patients’ best interests, as they claim, and which true professionalism dictates.”

  “So you are testifying because Dr. Bowman is practicing concierge medicine?” Jack asked. He was taken aback by Noelle’s emotional response.

  “Absolutely not,” Noelle said. “I’m testifying because there had been a delay getting the patient to the hospital. Everyone knows that after a myocardial infarction, it is critical to start fibrinolytic and reperfusion treatment absolutely as soon as possible. If that opinion secondarily says something about my feelings vis-à-vis concierge medicine, so be it!”

  “Listen, I respect your position, Dr. Everette, and I’m not here to try to convince you otherwise. Believe me! I’m here to ask you about the degree of cyanosis the patient apparently had. Is that something you remember particularly?”

  Noelle relaxed to a degree. “I can’t say particularly, since cyanosis is a frequent sign seen with severe cardiac illness.”

  “The ER nurse wrote in the notes the patient had central cyanosis. I mean, she specifically said ‘central’ cyanosis.”

  “Listen, when the patient got here, she was close to death, with dilated pupils, a completely flaccid body, and a pronounced brachycardia with total AV black. Her heart could not be externally paced. She was on death’s door. Cyanosis was just part of the whole picture.”

  “Well, thanks for talking with me,” Jack said. He stood.

  “You’re welcome,” Noelle responded.

  As Jack made his way back down to the emergency room, he was even more pessimistic about the outcome of the case than he’d been earlier. Dr. Noelle Everette was going to be a powerful expert witness for the plaintiff, not only because of her expert status as a cardiologist but also because she was articulate and a dedicated physician and because she had been directly involved in the case. “Times have changed,” Jack murmured out loud, thinking that it used to be hard to find a doctor to testify against another doctor. It seemed to him that Noelle was looking forward to testifying, and despite what she’d said, part of her motivation was antipathy toward concierge medicine.