Dead Certain (25 page)

“Hello there, neighbor,” she declared cheerfully as I stopped dead in my tracks.

Julia, her husband, and two daughters lived just down the street from me in a pretty brownstone they were in the process of rehabbing themselves. She was a petite woman, ten years my senior, with a close cap of blond curls and an intelligent, heart-shaped face. From beneath her gray lab coat peaked the last two inches of a pretty floral dress, and sweet little grosgrain ribbons decorated the toes of her shoes. In one hand she held a Styrofoam cup of coffee and in the other a bagel wrapped in paper. Given a hundred chances, most people would never guess that Julia Gordon was a woman who took dead people apart for a living.

“So what brings you down to doctor land?” she asked. Julia was an assistant medical examiner at the Cook County ME’s office. I’d forgotten that their building was just around the corner on Harrison.

“A little arm-twisting session with one of the Prescott Memorial trustees,” I said, figuring that now that we were on the front page of the newspaper, there was no use trying to be coy.

“I won’t ask who was doing what to whom.” She chuckled. “I seem to recall you going to work on me a couple of times, and there was never any question about who was going to end up on top.”

“You wouldn’t happen to have fifteen minutes for a little bit of hypothetical arm-twisting now?” I asked as it suddenly occurred to me that this was too good an opportunity to be missed.

“Hypothetical? Does that mean that no bones will be broken?”

“You have my word that it won’t hurt a bit,” I assured her.

“In that case why don’t we go back to my office. If you want, you can have half of my bagel.”

“I’ve already eaten,” I lied, falling into step beside her. I don’t care how much Muzak and air freshener they pumped into the place, the medical examiner’s office was one of the few places that could kill even my appetite.

One look at the new Robert J. Stein Institute for Forensic Medicine and it was clear that if death were a business, in Chicago at least, it would be booming. A low-slung edifice of gray marble and dark, reflective glass, from the street it looked like any other kind of administrative building. But once you passed through its doors, there was no escaping the fact that the dead are an exacting clientele. Chilly even in summer, the temperature was kept at sixty-five degrees because it was kinder on the bodies. The air was thick with the smells of formaldehyde and decay. We took the elevator to the fourth floor, far from the metal storage lockers and the grisly tile of the autopsy suites with their drains in the floor.

As far as I was concerned, Julia Gordon’s office was gruesome enough. Beside the glossy posters of bullet wounds that decorated the walls, the bookshelves were dotted with anatomical oddities floating in jars. On the back of the door there hung another poster, this one displaying the characteristic tire marks made by various brands. It wasn’t until you looked closely that you realized that all the marks that had been photographed were made in the flesh of the victims of traffic accidents.

I looked around at the files and papers that littered her desk. “I hope I’m not imposing too much on your time,” I began. “You look busy.”

“To be perfectly honest, I’m grateful for the distraction. There’s something I have to do this morning that I’ve been trying to avoid. You’re just giving me a chance to procrastinate a little longer.”

“What is it?” I asked, wondering what a woman routinely dissecting would view with such dread.

“I have to call a resident at a community hospital out in Park Ridge who made an error. She was on duty when the paramedics brought in a four-year-old girl who’d been struck by a hit-and-run driver. Instinctively, and no doubt out of kindness, she insisted on washing the little girl’s body before her parents saw her. I know that she meant to spare the parents, but in doing so she destroyed any evidence that we might have found that would lead to finding her killer. Now, even if an eyewitness were to materialize, I don’t think that would be enough for the prosecutor to take before a grand jury.”

“You make being a lawyer seem like a day at the beach,” I said, thinking about Claudia’s comment about wishing that she had a job where mistakes didn’t matter.

“Oh, I don’t know if our jobs are really that different,” she replied. “After all, what I deal with is the aftermath of people’s fear or greed or stupidity. I’m sure that you could say the same about your work. The only difference is that what I do smells worse and is much more interesting.”

“How can you be so sure that it’s more interesting? „

“Because every life, no matter how tragic or mundane, is a story, and I’m the person who gets to tell the end.”

“I guess that’s what I wanted to ask you about— hypothetically, of course.”

“You and I both know that there’s no such thing as a hypothetical question,” she replied sweetly, “only people who want to put some distance between themselves and what they want to know.”

“In that case I hope you’ll wait before you start leaping to any conclusions,” I replied, suddenly wondering if this was such a good idea. “I wanted to ask you how you might go about killing off hospital patients.” Dr. Gordon raised her eyebrows and shot me an appraising look. “Assuming you don’t want to get caught?” she asked.

“Yes.”

“Well, I don’t know what I would do, because it’s not a question I’ve ever really considered, but I
can
tell you what’s been done in the past. For example, there was a fairly recent case where a male nurse in Oregon was convicted of killing seventeen patients by injecting them with potassium chloride.”

“Is that a poison?”

“No, it’s a drug that’s commonly used in low concentration to control irregular heartbeat. At higher doses it’s fatal.”

“Why did he do it?”

“I don’t think they ever found out. As I recall, there were several witnesses for the defense who all testified that he was a particularly conscientious and devoted caregiver. I believe the theory the prosecution presented to the jury was that his actions were an extreme form of burnout. The defense tried to make the case that the nurse was driven to madness by the escalating demands of managed care.”

“What about the others?”

“Well, by far the most famous case was at the Veteran’s Hospital in Ann Arbor, Michigan, mostly because the number of patients involved was huge. There were something like forty patients—practically an epidemic— who experienced episodes of cardiopulmonary arrest. I don’t know if you are familiar with it, but cardiopulmonary arrest is almost always fatal unless artificial respiration is begun immediately. Fortunately, there was a pair of Filipino nurses who seemed not only particularly vigilant, but highly skilled at the technique. Due to their efforts, out of the forty cases only seven of the patients died.”

“So what happened?” I asked, thinking about the sixteen folders in the trunk of my car.

“Well, naturally the sheer number of incidents involved raised suspicions that something abnormal was going on. An investigation was eventually launched, which led to four of the bodies being exhumed and autopsied.”

“What did they find?”

“Absolutely nothing.”

“You’re kidding.”

“No, but because the deaths occurred on federal property, the medical examiner was able to send tissue samples to the FBI crime lab.”

“Did they find anything?”

“Yes. In every one of the patients they found a drug called pancuronium. It’s a neuromuscular blocking agent that’s actually a synthetic form of curare. It’s most commonly known by its brand name, Pavulon.”

“I thought curare was a poison.”

“If by that you mean that it can be used to kill people, then half the drugs that are commonly prescribed are poisons. Pavulon acts by inducing temporary muscle paralysis. In high enough doses it stops your heart from beating and your lungs from breathing. It’s used in the operating room during anesthesia as part of a mixture of different anesthesia drugs.”

“What does it look like?”

“It’s a colorless, odorless liquid that resembles water. It’s very fast acting, but conversely its effects disappear quickly. That’s why the nurses were able to both induce arrest in their patients and then reverse it.”

“You mean it was the two nurses who were killing off the patients?” I demanded.

“Yes.”

“But again, why?”

“Again, nobody knows for sure. Some people believe that the two women did it to draw attention to what they felt was an acute shortage of nurses. Several psychiatrists were called in to interview them both, and their conclusion was that both women were mentally ill and craved the attention they received whenever they successfully resuscitated a patient.”

“What I want to know is why it took forty cases before they launched an investigation.”

“I wasn’t there so I can’t say, but I think in part it was a natural unwillingness to consider the possibility of foul play in a hospital. You also have to take into account that death is not an unusual occurrence in a medical setting. I hope you’re not thinking of killing off hospital patients?”

“No,” I assured her.

“Then can I ask you what exactly it is that’s prompting your question?”

“I’m afraid not,” I replied apologetically.

“Then at least promise me one thing,” she said, suddenly looking stern. “If your question gets any less hypothetical, you’ll come to me first.”

CHAPTER 18

In big law firms, light and space are the twin talismans of power. Like some principle of relativity, the closer you are to the top, the more you have. There is nothing subtle about the system. At Callahan Ross you are meant to always know exactly where in the hierarchy you are.

The first thing I did when I got into the office was pay a visit to the bottom rung of the ladder, to the airless, light-less world of the messengers and file clerks in order to drop off the box of Claudia’s files. I filled out the rush slip, stopping just long enough to pay tribute to James, the former army drill sergeant who presided over the endless stream of paper that was the lifeblood of the firm.

I decided to climb the six flights of stairs back to my office. I figured it was the only exercise I was likely to get in the foreseeable future. I also knew it was the only time I was going to have to myself that day, and I desperately needed time to think.

What on earth had I hoped to accomplish by spewing out my crackpot theories to Julia Gordon? Did I really think that she would just sit back and wait patiently for more bodies to turn up? She’d probably been on the phone to the police the minute I left her office.

Trudging up the spiral of the firm’s internal staircase, I ascended through the well-ordered precincts of real estate, tax, litigation, antitrust, corporate finance, and international law. With every floor the idea of someone systematically killing off Gavin McDermott’s patients seemed increasingly absurd. If the deaths were indeed the result of the acts of a madman, then it truly was a matter for the police. Perhaps if the truth were revealed, the adverse publicity might discourage HCC from pursuing the hospital, just as my mother’s outspokenness had soured discussions with the archdiocese.

As I finally arrived at the floor that housed the various corporate departments, including my own, I was struck by a truly horrible thought. Elliott had said that there was a difference between being ruthless and ruthlessly refusing to abide by the rules. Was it possible that Gerald Packman was somehow engineering the deaths in order to deliberately make Prescott Memorial seem less desirable and drive down the price? I didn’t like to think that even someone as cold as Packman would be capable of such calculation, but in my experience the higher the stakes, the more ruthless people were prepared to be. Still, if Packman was behind the deaths, then why wasn’t the story public?

What was he waiting for?

On my way back to my office I stopped to see how document preparation was going on Delirium. I found Jeff Tannenbaum at his desk, up to his eyeballs in paper, cursing softly under his breath. Preparing the documents for a transaction of the sort that we’d negotiated between Delirium and Icon was a monumental task. Unlike litigation, the skills required were not those taught in law school, where the focus is on fact finding, argument, and the application of rules to facts.

The side of the law for which most people look to lawyers—planning and getting things done—was learned through apprenticeship. In corporate practice, deals were traded and documented at the speed of a fax machine, and the only way to learn what you needed to know was from someone who was experienced and let you participate in the process. Even so, there was always a moment when you had to let go of your mentor’s hand and walk through the minefield on your own. A combination of circumstances had conspired to make the Delirium-Icon deal a closing that Jeff Tannenbaum would have to handle on his own.

As much as I believed him to be ready—if he wasn’t, we had no business making him a partner—it didn’t make it any easier for me to let go. Most deals are repeats of other deals, with no new ground broken, but the price of error is invariably steep. I asked Jeff if he needed help on anything, and he answered no. It took every ounce of self-discipline I had to take him at his word.