Dead Certain (4 page)

But I knew her well enough to suspect that it was more than exhaustion that was getting her down. Whenever I asked her what was wrong, she invariably shrugged and reminded me that trauma was not a happy specialty. I worried that what had been damaged was not the heart of some poor innocent from the street, but Claudia’s own.

During the winter, despite the demands of almost endless work, she’d begun seeing someone, a handsome paramedic named Carlos, one of the you-maul-’em, we-haul-’em crew that worked the neighborhood around the Prescott Memorial ER. He was a good-looking soccer player with an infectious grin and a sense of gallows humor that found its natural expression in practical jokes. He’d won her jaded New York heart by teaching her to bowl, drink beer, and watch kung fu movies. The only trouble was that he was married. At least that was the conclusion she’d been forced to draw when a pretty young woman, pregnant and with a toddler in tow, showed up and delivered a bouquet of brightly colored helium balloons to the emergency room as a surprise for her husband on his birthday.

Surgeonlike, Claudia had broken off the relationship cleanly, with a minimum of tears and few words spoken. However, as the weeks went by I’d suspected Carlos of trying to reexert his charm. In addition to a steady stream of cards and flowers, all of which Claudia had promptly sent back, we’d recently started being bothered by hang-up calls, always on nights when Claudia wasn’t scheduled to be at the hospital. Somehow I doubted things were as over in Carlos’s mind as they were in my roommate’s.

“What are you doing home?” I asked, taking a sip of wine and feeling its warmth rush through me.

“Waiting for you,” she replied. “I called you at the office, but the night operator said you were already on your way home. I need your advice about something.“

“Well, if you thought you could buy it with food, you were absolutely right,” I replied. “What’s up?”

“We almost lost another patient today,” Claudia said. “Oh, no!” I exclaimed. “What happened?”

“We don’t know. That’s the problem.”

“So tell me about the patient.”

“She’s a sixty-seven-year-old Caucasian female named Ida Lapinsky. Indigent. History of adult-onset diabetes. Smoker. Probable history of alcoholism. She was admitted through the OB-GYN service, complaining of abdominal pain, and was subsequently diagnosed as having an intestinal obstruction. She was resting in her room following surgery this morning to remove the blockage when she suddenly and for no apparent reason went into respiratory arrest.”

“Were there any complications during the surgery?“

“None. I even tracked down the resident who assisted McDermott on the case and asked him. He said the procedure was completely unremarkable.”

“So what happened to Mrs. Lapinsky?”

“Like I said, nobody knows. Mrs. Lapinsky’s roommate woke up from her nap and noticed that she was turning blue and not breathing. Somehow she managed to call for help. I was at the nurses’ station doing some charting, so I was the one who caught the code. I grabbed the crash cart and was in Mrs. Lapinsky’s room in ten seconds flat. Even so, by the time I arrived, she was unconscious, not breathing, and had no reflexes to speak of.“

“So what did you do?”

“I started 100 percent oxygen, gave her two ampules of sodium bicarbonate and five milligrams of intravenous epinephrine, and began mechanical ventilation.”

“And?”

“I managed to resuscitate her to the point where she was eventually able to resume breathing on her own.“

“So is she okay?”

“Well, there’s okay and there’s okay. It’s too early to tell yet what kind of deficits she might have suffered.“

“What do you mean by deficits?”

“Haven’t you heard the joke? ‘Congratulations, doctor, the good news is you saved the patient. The bad news is she’s going to need to be watered twice a day.’ ”

“I don’t know why they always say that economics is the dismal science when it’s doctors who have such a bleak worldview,” I observed.

“Do you know the three rules of emergency medicine?” inquired my roommate, proceeding to tick them off on her fingers. “One: all bleeding eventually stops; two: all patients eventually die; and three: if you drop the baby, pick it up.”

“I rest my case,” I said, pausing to refill our glasses. “I take it you think that what happened to Mrs. Lapinsky is somehow related to what’s been happening on the surgery service?”

“You mean that our patients are dying for no good reason?” demanded my roommate with a definite edge to her voice. “I guess I’d have to say that what happened to Mrs. Lapinsky definitely fits the trend.”

“But she didn’t die.”

“No,” replied Claudia, “but she should have. It was only a fluke that I was still on the floor and therefore able to get to her so fast. I was supposed to be downstairs in the clinic already, but I’d been running behind all day.“

“It was lucky you were.”

“I’m not so sure. The whole thing is so bizarre. I mean, finally clearing the surgical waiting list is supposed to be the best thing that ever happened to our patients... not a death sentence.”

“How many deaths have there been?” I asked softly. “Five, but six respiratory arrests if you count Mrs. Lapinsky.”

“How many would you expect there to be?”

“Zero, which is exactly the number the unit had until three weeks ago.”

“Maybe it’s some kind of virus,” I ventured, “or a faulty piece of equipment. There has to be some kind of common denominator....”

“There is, but you’re not going to like it.”

“What?”

“All the deaths, they’ve all been patients of Gavin McDermott.”

“You’re kidding,” I said. Gavin McDermott was considered the hospital’s most highly skilled surgeon. He was also a flamboyant character, as famous for riding his Harley to the hospital and his serial trophy wives as he was for his virtuoso performances in the operating room. “How’s he taking all of this?”

“How do you think?” replied Claudia. “By making the lives of everyone around him completely miserable, starting with mine. You should have heard him this afternoon; you’d think I’d tried to kill Mrs. Lapinsky instead of saving her.” She dropped her head into her hands as if trying to shield herself from the memory.

“But why are Gavin McDermott’s patients dying? „

“Nobody knows. Some people are saying that McDermott’s in a slump, that maybe there’s something going on in his life that’s affecting his judgment—you know, marital problems, booze...”

“Is there?”

“How would I know? I only see him once a week when he’s on trauma call. But I’ve got to tell you, I’ve never seen anything from him in the OR that would indicate that his head is anywhere except where it’s supposed to be. He’s flat-out the best surgeon I’ve ever worked with.”

“What about his patients at other hospitals? Are they dying, too?”

“How would I know that? It’s not exactly the sort of thing that anybody’s going to advertise. God knows we’re doing everything we can to keep what’s going on at our hospital a secret.”

“So what do you think is going on? How do you explain it?” I asked.

“I don’t know,” groaned Claudia, shaking her head in frustration. “But I’m starting to think that either Gavin McDermott or Prescott Memorial is just plain jinxed.”

CHAPTER 3

That night after Claudia went to bed, I hauled the box of Prescott Memorial files into the dining room. The only thing standing between me and a good night’s sleep was my mother and her harebrained plan to block the sale of the hospital, and I was determined to spend as little time as possible on it. Indeed, I’d already come up with a short mental list of other lawyers to recommend in my place—lawyers who’d crossed me on deals past and whose suffering at my mother’s hands wouldn’t cost me any sleep.

I set the box on the dining room table, a scarred monstrosity inherited from a previous tenant who’d been forced to leave it behind when there turned out to be no room for it on the moving van. In the years that we’d lived in the apartment I don’t think that Claudia and I had ever eaten a meal there. Instead it was our worktable, though what I was doing on it tonight hardly qualified as work.

What I was doing was just going through the motions. With the letter of intent already signed and the deal set to close in ten days, any attempt to stop HCC was sure to be a quixotic effort. Besides, engaging in a doomed campaign against an experienced and highly motivated corporate adversary was hardly my idea of a mother-daughter bonding experience. When it came to my mother, I figured I should probably stick with what I knew best, fighting about my choice of boyfriends and what I was doing with my hair.

I was also afraid that when it came to the sale of Prescott Memorial, her motives were suspect. Unaccustomed to being crossed, Mother was simply furious at the board members who’d betrayed her by casting their votes to sell to HCC; it had less to do with her concern for patient care than her own ego. I had no interest in using up my professional capital avenging my mother’s injured pride.

However, there was no way I could avoid at least looking at what she’d sent over. Not if I knew what was good for me. Fetching a knife from the block on the kitchen counter, I slit the tape that sealed the box and opened up the flaps. What I saw inside was a nightmare, not an orderly compilation of documents pertaining to the proposed sale of the hospital, but rather every piece of paper in my mother’s possession that was remotely related to the hospital dumped together into a box. I gave it a shake in disgust. It was obvious what importance my mother, whose social calendar was as meticulously laid out as the timetable for a NASA launch, attached to the affairs of Prescott Memorial Hospital.

Eager to be done with the entire charade, I picked up the box and dumped the contents out onto the table. Mixed in with the business documents were envelopes that had never been opened, scribbled notes for seating charts, and an assortment of to-do lists filled with such gripping entries as
lunch with Bitsy
and
fitting at Chanel.
The writing was all in my mother’s characteristic backward slanting script. On several pages the margins were thick with the elaborate curlicues and fleurs-de-lis that she liked to doodle when she was bored.

The phone rang just as I was finishing up separating out the junk. I looked at the clock, deciding whether to answer. I was too tired to get up for one of Carlos’s hangup calls, but there was always a chance that it might be Elliott. Feeling optimistic, I got to my feet and caught it by the fourth ring and was rewarded by the sound of Elliott Abelman’s voice, husky with fatigue, on the other end of the line.

“Are you okay?” he asked. It was his standard greeting, a holdover from the days when I called him only when I was in some kind of trouble.

I’d first met Elliott three years ago when I’d hired him as a private investigator. A former prosecutor and an exmarine, Elliott had just struck out on his own and was as eager to please as he was happy for a piece of Callahan Ross’s business. Since then, Abelman & Associates had become one of the premiere operations of its kind in the country. Employing nearly a hundred full-time investigators in three cities, Elliott’s firm specialized in financial crimes—bid rigging, bribery, computer theft, and embezzlement—the kinds of bloodless offenses that police and prosecutors were ill equipped to handle.

“How’s it going with the trial?” I asked, sliding my back down along the wall until I was sitting comfortably on the floor.

Now that Elliott and I were finally free to see what it would be like to spend time together, circumstances had conspired to keep us apart. A complicated fraud case he’d worked on for two years had finally gone to trial in the ninth circuit downstate in Springfield. In addition to providing testimony about the investigation conducted by his firm, Elliott had also been retained as a consultant by the counsel for the plaintiff. For the last four months he’d been living at the Ramada Inn with the rest of the legal team and trying to run his business on the weekends. Our only contact was made up of the occasional late-night phone call and one or two hurried lunch dates on days when he’d breezed back into town for a few hours.

“In terms of the trial, things are pretty intense,” he replied. “We’re actually just taking a ten-minute break. The defense gets our guy on cross tomorrow, and we still have a lot to do before we’re ready.”

“How did it go on direct?”

“I’ll tell you when we’re done with the cross.“

“Doesn’t it make you miss it?”

“Miss what?”

“Trying cases yourself,” I replied.

“Oh, I don’t know. Only when I think I’d do it better.“

“And would you?”

“Right now, Carlson’s doing a pretty good job for our side. I’ll give you my final verdict after closing arguments on Friday.”

“So you think you’ll go to the jury on Friday?”

“Don’t worry. I’ll be there Saturday night. I promise.“

“I’m not worried,” I assured him. I let a beat pass. “Are you?”

“To quote my favorite modern existentialist philosopher, ‘What? Me worry?’ I mean, what on earth could possibly concern me about the evening? Just because it’s our very first official date and I’m going to meet your entire family while dressed in a rented tuxedo—”