Murder Suicide (20 page)

"Exactly," said Heller.

"I helped close," Billy told Clevenger.

"Fantastic," Clevenger said.

"Nobody with a passion for surgery can just watch," Heller said.  "Billy held retractors for four hours straight.  Not a peep out of him.  He earned the right to throw in the last couple staples."

"Somehow I don’t think this is the last time he’s going to want to visit the O.R.," Clevenger said.

"No problem," Heller said.  "He was a champ in there.  Capable.  Respectful.  Everyone liked him."

"I’m gonna start diving into this," Billy said, holding the book up.  He looked at Heller.  "Thanks."

"Thank you."

Clevenger watched them shake hands.

"Night," Billy said to Clevenger, then headed off to his room.

"Night, buddy," he said.  "Love you."  He’d gotten used to the fact that Billy rarely hugged him or said he loved him; the kid had come from a family where all you got for being vulnerable was more pain.  But he felt particularly distant from Billy with Heller standing there.  "How about that drink?" he asked Heller.  He really wanted one.

"Where to?"

"The Alpine?  It’s bare bones, but it’s right down the street."

"I’m not exactly dressed fancy," Heller said.

They walked to the Alpine, a hole-in-the-wall where the bar took up almost half the square footage.  When drinking had been most of what Clevenger was looking to do, the prominence of that bar had seemed fitting, even soothing.  No one went to the Alpine for the coffee, or the décor — dark wood paneling, indoor-outdoor carpeting, suspended ceiling.  They went because it was a stone’s throw from the triple deckers they called home, and because you could buy a beer for a dollar, a gin and tonic for two.

"How about you, Doc?" the bartender, early forties, six-foot-two and all muscle, asked Clevenger.

Clevenger hesitated.  It would be easy to tell him to make it two — as easy as the first step off a tall building.  He ordered a Diet Coke.

"We miss seeing you," the bartender said.

"Miss you, too, Jack," Clevenger said.

"Sounds of it you’re doin’ good, though.  Got that big case.  The professor who shot himself, or whatever."

"Right," Clevenger said.

"So gimme the inside scoop:  Was it suicide or what?"

"We’re still working."

Jack winked.  "Keepin’ it under your hat.  I don’t blame you."  He looked at Heller.  "What’s with the pajamas?"

"He’s a surgeon," Clevenger said.  "Just out of the O.R."

"Two doctors in this joint," Jack said.  He poured the drinks.  "On me," he said.

"Thanks," Heller said.

"Keep it on account, case I get a hernia or an appendix."

"He’s a neurosurgeon," Clevenger said.

"Neuro..." Jack said.  "Brain."  He squinted at Heller.  "Wait... wait... wait a second.  You were
his
surgeon.  The dead professor."

Heller stiffened.  "Right."

"Jet Heller."

"Yes."

"Must of been tough, all that pre-game hype over the guy’s lobotomy, then he gets his brains blown out."

"It’s been very difficult," Heller said.

"Would have been a nice notch in your belt.  Sorry it didn’t work out for you," Jack said.

"I wasn’t worried about a notch in my belt," Heller said.

Jack reached under the bar for a bottle of Johnnie Walker Red.  "Yeah, sure.  I bet you hate headlines."

Heller’s jaw muscles started working.

He started pouring Heller’s drink.  "You’re talking to Jack Scardillo here.  Behind this bar eleven years."  He pushed his drink toward him.  "Enough said?"

"More than enough," Heller said, staring at him.

Jack had been behind the bar long enough to know one thing for sure — when a customer was ready to come over that bar.  He smiled a smile that showed a couple of missing teeth.  "Giving you a little shit."  He held out his hand.

Heller shook it, but his stare stayed icy.  "No problem," he said.

"Let’s sit down," Clevenger said to Heller.  "Everyone’s had a long day."

Clevenger and Heller took a table by the front window, under a neon Budweiser sign.

"Sorry about that," Clevenger said.

"I don’t have enough distance on losing John to joke about it," Heller said.  He nodded at Clevenger’s Diet Coke.  "You don’t drink?"

Clevenger could smell Heller’s scotch, almost taste it.  "Not today."

"Good for you.  Mind if I do?"

"Not at all."

Heller took a long swallow of the scotch.

Clevenger drank down half his Diet Coke.  "You won your battle in the O.R."

"Feels damn good," Heller said.  "Because I remember each and every time I lost.  I’m glad Billy’s first outing wasn’t one of those." He took another sip of his scotch.  "How about you?  Getting past the ugliness with Grace Baxter?"

"I’m still trying to understand it," Clevenger said.

Heller stared into his glass.  "There’s very little in medicine that’s exact," he said.

Clevenger liked the direction Heller was heading.  It felt like it could lead back to Snow’s case.  "In psychiatry, you mean," he said.

Heller looked up.  "Every specialty.  Take pathology.  Now there’s somewhere the general public would say the answers are crystal clear.  You take tissue samples, mount them on slides and look at them under the microscope.  You’d figure you could say
absolutely yes
that’s a cancer,
absolutely no
that is not.  But it isn’t like that.  You can get different readings from very competent pathologists on the same specimen.  I’ve had to send tissue samples to four different labs before I felt confident I was dealing with cancer, not some peculiar-looking, benign growth.  And even then, I end up taking one person’s word over another.  Mass General versus Hopkins.  Hopkins versus the NIH.  Because diseases are actually spectrums."

"Some are," Clevenger baited Heller.

"All of them.  Look at diabetes.  There are clear cases, but there are borderline ones, and subclinical ones.  Maybe the patient has it, maybe he doesn’t.  You draw a blood sugar, and that gives you an equivocal reading, so you need a fasting blood sugar, then a glycated hemoglobin level.  Maybe it’s worth treating, maybe it isn’t.  Same with hypertension.  There are plenty of obvious cases, but they have nothing to do with the real art of medicine.  That comes into play when somebody’s pressure is usually normal, but a little high with a cup of coffee, or with too much stress — where you have to judge whether the disease is there or it isn’t."  He downed the rest of his scotch.

"Epilepsy would be the same," Clevenger said, feeling his own throat warm wonderfully for a split second.  He caught Jack’s eye, pointed at Heller’s empty glass.

Heller nodded, but said nothing.

"I mean, there must be people with abnormal brain wave activity that doesn’t rise to the level of actual epilepsy," Clevenger said.

"Sure," Heller said.  "Two, three percent of the people in this room would show some spike activity if we hooked them up to EEGs."

Clevenger smiled.  "This room?  Five, ten percent."

"That’s why I’m hoping you’re past your guilt over Grace Baxter.  Forget about diabetes, hypertension and epilepsy.  There’s just no way anyone can predict with accuracy whether someone has a fatal depression.  There’s not even a microscope for that.  No EEG.  Nothing."

Jack came by the table with another scotch, left it in front of Heller.  He gave him a little slap on the shoulder as he left the table.

Heller didn’t acknowledge him.

"Let me ask you a question," Clevenger said:  "How about Snow?  What about his EEG?"

"What about it?  He had it all.  EEGs, MRIs, PET scans."

"Were the results crystal clear or did they require interpretation?"

"They were very clear," Heller said.  He picked up his scotch, took a swallow.

"So he had a classic case of epilepsy," Clevenger led.

"If there’s any classic case," Heller said.  "He had a tonic-clonic, fall down, bite-your-tongue seizures accompanied by abnormal electrical activity in multiple parts of his brain, including the temporal lobe and hippocampus."

Clevenger took a sip of his Diet Coke, cleared his throat.  "And the pathology — the abnormal brain activity — satisfied the Ethics Committee.  They were only worried about the side effects of surgery."

"Listen, when you’re dealing with a hospital committee, you know as well as I that everybody is raising every question in the book, real or imagined.  Bottom line:  It was Snow’s life.  He hated those seizures.  He wanted to be rid of them."

That left open the question of whether one or more members of the committee doubted whether Snow’s epilepsy was real.  Clevenger decided to press the point.  "What did the EEG actually show?  You called it
abnormal electrical activity
.  But, like you said, every illness is a spectrum.  So where did Snow fall on that spectrum?  If he hadn’t had such dramatic tonic-clonic muscle jerks and tongue-biting and all that, would you have diagnosed epilepsy based on the EEG alone?"

"But he did have them," Heller said.  He paused.  "What are you really asking me?"

"If I knew Snow really had pseudoseizures, I’d have to wonder about his psychological stability across the board," Clevenger said.

"You would," Heller said.  He smiled, but tightly.  "But that’s not what you’re driving at.  What you really want to know is whether I would have performed experimental brain surgery on John Snow purely to free him from his relationships — from his past — epilepsy or no epilepsy.  To give him a new life.  Isn’t that right?"

Clevenger hadn’t had that specific question in mind, but it was clearly on Heller’s mind.  "Would you have?"

"Maybe."

"Even if the seizures — or pseudoseizures — were a result of stress?"

"Don’t be so concrete, Frank.  You’re a psychiatrist.  I don’t know if it matters whether the precise pathology was in his brain or in his psyche.  He was having big chunks of both removed.  Damaged circuitry and highly stressful relationships.  Presumably, he would have ended up symptom-free either way."

"Then what about a patient without any seizures at all?" Clevenger asked.  "What if somebody just felt like he was at the end of his life and needed a way out, needed to hit the reset button?"

"I don’t know.  Part of me thinks, who am I to deny that person?"

That answer took Clevenger by surprise.  He had Heller pegged as a purist, someone who would be offended at the idea of using a scalpel to do anything other than cut away diseased tissues.  "Wouldn’t that be playing God?" Clevenger asked.

"Better than playing the devil," Heller said.  He smiled, finished off his second scotch.  "Tonight was grand.  Truly.  That woman can see again.  But John would have
lived
again.  She was blind.  He was dead."  He leaned forward.  "Somebody stole that chance from him — and me.  What that person did is as terrible as what John Wilkes Booth or Sirhan Sirhan did.  Maybe worse.  That person robbed us all of the chance to be reborn, resurrected.  In a way, that person killed Christ himself."

Maybe Heller really was manic, Clevenger thought.  "I guess you’ll be looking for another John Snow, then."

Heller shook his head.  "He was one in a million.  An explorer.  Columbus.  John Glenn.  I don’t believe there’s another man out there with his psychological stability and level of intelligence who would be willing to put his vision and speech on the line to start over again.  And he did have sufficient brain pathology to satisfy the Ethics Committee.  Barely enough, but enough.  This was a once-in-a-lifetime for me.  This was my chance to make history."

Clevenger was taken aback again by how Heller took Snow’s death as a personal assault on his legacy, not to mention his God.  "I’m sorry," was all he could think to say.

This time Heller motioned to Jack for a refill.  He focused on Clevenger again.  "I’ve answered your questions, how about you answer a few of mine?"

"I’ll try."

"Billy said you were in D.C."

"That’s right."

"Mind if I ask whether the trip was related to the Snow case?"

"I was following up on a lead," Clevenger said.

Heller nodded.  "I spoke with Theresa Snow.  She told me about her suspicions."

"What did she say?"

"She thinks Collin Coroway killed her husband — over Vortek, and taking the company public."

Snow’s widow was pushing her version of his death pretty hard.  "Okay..." Clevenger said.

Jack brought Heller his third scotch and Clevenger his second Diet Coke, then headed back to the bar, without a word.

"I put two and two together," Heller said.  "Vortek and your trip to D.C.   Did you happen to visit the patent office to check for recent filings under Coroway’s name?"

"No.  But why do you want to know, if you don’t mind my asking?" Clevenger asked.

"When you told me Snow probably didn’t kill himself, I started thinking of this as a crime of passion.  Grace Baxter, distraught lover, kills my patient, then kills herself.  Nobody’s left standing.  But you’re better at this than I am.  And you seem to be looking beyond that scenario."

"I’m not ruling it out."

"Does your gut tell you Collin Coroway killed Snow?"

"My gut and experience both tell me to look at every possibility."

Heller downed half his scotch.  "What are the other possibilities?"

"That’s confidential," Clevenger said.

"Professional courtesy, one doc to another."

"Help me understand why being inside the investigation is so important to you."

Heller ran his finger around the lip of his glass.  "You already understand."  He looked Clevenger in the eyes.  "You saw Grace Baxter for about an hour, right?  And you’ve got a head of steam to find out who killed her.  I know that isn’t just because you want to soothe your conscience.  It’s because you feel you owe it to her, even after that single hour.  Because she was your
patient
.  That’s a mystical, immeasurable connection.  Try to explain it to someone who isn’t a physician — and a goddamn good one — and you’ll get nowhere.  Am I right?"

"Yes."