T Wave (20 page)

CHAPTER 52

“Regarding the patient murders,” said Alton, “one of our challenges was that we knew of several people who had not only the opportunity but also a plausible motive for committing them.”

“Besides Andrew Powell, you mean?” asked Wiggins.

“Yes, exactly.”

“Like who?”

“One suspect was Nancy Goins.”

Nancy stiffened. “Me? I’m the one who pointed out the murders in the first place. Why would I do that if I was the person killing those poor patients?”

“Agent Wilson and I discussed precisely that same question. In the course of our investigation, we discovered that you and your husband were going through some hard times.”

“That’s true,” admitted Nancy, looking at the table. She raised her gaze back to Alton. “But that’s not a reason to murder someone…at least for me, it isn’t. Plus how would that fit in with all the other patient deaths?”

“Again, those are the same questions Agent Wilson and I pondered. We realized one of two schemes could be playing out. Under the first scheme, you could have simply noticed the string of murders and decided to piggyback on them, making the death of your husband appear to be the latest in the series.

“The second possible scheme was a little darker. You could have orchestrated the whole series from the very beginning for the same reason: to hide your connection to the only person you specifically wanted to see dead, your husband, by making his death look like one out of a series occurring at Stokely properties. Either scenario deflects the attention that would normally accrue to you as the estranged wife of a young, healthy man who suddenly dies. ‘Hey, it’s not me, it’s the hospital maniac.’ But for that approach to work, people had to be aware that a hospital maniac was on the loose in the first place. You would have had to point out the series of murders when people
didn’t
notice.”

“It all sounds so preposterous,” said Nancy, shaking her head, “but…I understand your reasoning, not knowing me.” A shiver ran up her spine. “Thank God you figured out the truth. If you hadn’t, who’s to say how far your theories about me might have played out?”

“Well, we don’t have to worry about that now, do we?” said Alton. “And regardless of any issues you and Ken were having, I’m sure this must still be a difficult time for you. I want you to know that I’m truly very sorry for your loss.”

“Thank you,” said Nancy, eyeing Alton expectantly as if wondering if he had more to share. However, Alton declined to elaborate on any others aspect of Nancy’s personal circumstances.

“Okay,” said Wiggins, growing a little impatient, “is there anyone else you initially suspected whom you’ve now ruled out?”

“Yes,” replied Alton. “Another suspect was William Cline.”

“What? This is preposterous,” protested Cline. “I demand—”

“I didn’t say you did it, Mr. Cline,” interrupted Alton, “just that theoretically, you could have had a reason.”

“What could possibly motivate me to murder in cold blood the patients I’ve sworn to aid?”

Alton frowned at the man’s grandiose rhetoric. “The same drive that led you to attempt to suppress my investigation at virtually every opportunity. Only the threat of a search warrant and the attendant media exposure secured your cooperation.”

“I gave you want you wanted, didn’t I?”

“Yes, eventually. But you showed your true colors early on by letting every decision be guided by the almighty dollar. You own thousands of Stokely stock options that are currently worthless but which could be converted into a small fortune if Stokely’s stock price were to rise. Almost two weeks ago, before I even began this investigation, Agent Wilson was present in Nancy Goins’ office when you called her. You complained to Mrs. Goins about the hospice’s low occupancy rate. You knew that Serenity’s poor financial results were suppressing Stokely’s stock price. You’ve told me yourself, several times, about your concerns for Stokely’s financial results. You went even further with your wife, telling her your job could be on the line if Serenity’s profitability didn’t improve.”

“You spoke with my wife? How dare you—,” began Cline.

“Mr. Cline,” said Alton. “I had to be sure of my facts, and eventually my investigation cleared your name. The only way to get to the bottom of these murders was to learn
all
the facts, not just the ones you’re comfortable with. When I began the investigation, I didn’t know which facts would end up being essential until my research was complete. Until then, I followed up on every reasonable lead. I’m sorry if that bothers you.”

“Fine,” fumed Cline. “It’s not like it matters now anyway, I suppose. But you still didn’t explain why wanting to improve Stokely’s financials would lead me to murder.”

“That’s easy,” said Alton. “Serenity’s occupancy rate has never hit its target, has it?”

“No, but how would that make me—?”

Alton raised an interposing hand. “Technically, you’re responsible for the profitability of all Stokely properties. But as the initiator of the project to build Serenity, your job was riding on its particular success. When you first pushed for the creation of Serenity, you assumed it would be filled to capacity or at least close to capacity, right?”

“Well…yes.”

“And patients have to be dying to warrant a referral to a hospice. What do you do if the occupancy rate is low? One option would be to help them along in their journey to the hospice.”

“I see,” said Cline. “You must have judged my skill in that venture to be rather poor, considering most of the murdered patients died before they could be transferred out.”

“You’re not a medical professional, so yes, you could have been inept in that way. But as I said, Mr. Cline, you’re no longer under suspicion. However, would you mind answering a question, just to satisfy my curiosity?”

“I suppose,” said Cline, eyeing Alton suspiciously.

“You told your wife you’d figured out a way to improve Serenity’s profitability. She noted that it seemed to lift a weight off your shoulders. I also spoke with Leo Jacobin, your boss. He was initially reluctant to share any information with me, but eventually he admitted that you had a plan for Serenity—a plan he might not feel comfortable with. He told me that you and he agreed he didn’t need to know the details.”

“I see. And what’s your question?” asked Cline.

“Just this. What
is
your plan? We know it doesn’t involve an insidious murder plot to increase the hospice’s patient load, but how
are
you planning to improve Serenity’s financials?”

William Cline produced his first smile of the day. “Want to hear something ironic? I started working with my former colleague down the table there, Andrew Powell. I convinced him to begin sending his terminally-ill patients to Serenity instead of that butcher-shop downtown. At first, he didn’t want to. Serenity is so tight with Reginald Oswald, Powell said sending his patients to Serenity would feel like aiding and abetting the enemy.”

Powell nodded in accord with this statement, and Cline continued, “I had been after Powell for months, so to be honest, he surprised me by finally agreeing to go along with it. Probably the referral fee I offered to send to his research grant office for each patient he sent to Serenity didn’t hurt. I figured he was running short on money. Frankly, I didn’t care.”

“I understand the financial benefit to Serenity,” said Alton, “but why keep it a secret?”

“Doctor Oswald reciprocates Doctor Powell’s unfriendliness. If Oswald became aware of Powell’s switch to Serenity, he—Doctor Oswald—might consider taking his business elsewhere. That would leave us worse off than before. I knew the Serenity staff would see Powell around more often, but I had hoped to avoid spreading this news to Doctor Oswald. Neither doctor spends much time in the hospice, so there was a pretty good chance Oswald would never know he had begun to share the hospice with Powell.

“And we needed Doctor Powell’s business—desperately. He oversees a lot of patients at San Cristobel General, and getting more referrals from the doctors of terminally-ill patients at other hospitals will be the key to improving Serenity’s financial performance. It’ll fill our beds, which helps us. And it’ll give more patients and families the opportunity to experience the top-notch end-of-life services that are unique to Serenity.”

Alton experienced some discomfort with the crassness of Cline’s boast, but he had to admit that the facilities and staff at Serenity were first rate. Cline thought quite a bit in terms of money—that was his job, after all—but perhaps it wasn’t his only consideration.

“So shielding this information from your boss was part of your attempt to keep Powell’s switch to Serenity a secret from Doctor Oswald?”

“Yes. Leo Jacobin and Doctor Oswald are golfing buddies. If I told Mr. Jacobin, Oswald would be sure to find out.”

“Okay, this is all well and good,” said Wiggins, “but we still haven’t discussed the true culprit. Do you have any other cleared suspects you want to cover first?”

“No,” replied Alton. “Let’s turn our attention to the curious tale of Andrew Powell, scientific researcher and serial murderer.”

CHAPTER 53

As Alton prepared to describe Andrew Powell’s journey down a forbidding path of evil, he studied the shackled prisoner sitting across the table. The man’s shoulders drooped with a resigned air.

“We’ve had a total of seven cases of inexplicable deaths in the past couple of months,” said Alton, “five in Stokely Memorial Hospital and two in Serenity Hospice. In all cases, the patients were admitted to the hospital for one condition but died of something else. To top it off, the autopsies of the hospital patients couldn’t reveal exactly what
had
killed them. It was a puzzler.

“I began looking into these cases on behalf of the FBI. I searched for trends—for the common thread between them. Frankly, it was challenging to identify any commonality. Some patients were in the hospital, some were in the hospice. Some patients were dying with only weeks or months to live, others had fairly minor conditions. One patient was only in the hospital for a nose job, for Pete’s sake.” At the inadvertent mention of Ken Goins’ death in front of his recent widow, Alton glanced wide-eyed at Nancy, who shrugged in resigned acceptance of the tacit apology.

“I had a glimmer of hope when I noticed that all the patients had stayed on Five South at one time or another,” said Alton. “Could that be a connection somehow? But then William Cline pointed out that Five South is a ‘med-surg’ floor, catering to a wide variety of patients with different conditions. The severity of the patients’ issues I just mentioned bears this out: as I said, some were dying, while others weren’t sick at all. The relatively mild condition of some patients also seemed to eliminate the possibility of a wacko going on a ‘mercy-killing’ spree.”

“The rhinoplasty surgery in particular stood out from the rest. Other than residing on Five South, this patient had almost nothing in common with the others.

“Although I didn’t realize it at the time, I made a key discovery while I was talking with Karen Proffitt, the nurse who cared for Janice Kell, one of the seven patients whose death I was investigating. It wasn’t the information I acquired from Nurse Proffitt that was important but rather a separate conservation I overheard at the time.

“I was already aware of the rivalry between Reginald Oswald and Andrew Powell. They espouse competing theories of the causes and treatment for GI diseases and vie for the same federal grants. Each scientist hopes to prove the superiority of his theories over his competitor’s.

“During my conversation with Nurse Proffitt, Doctor Powell arrived on the floor and encountered Doctor Oswald. Powell rubbed Oswald’s face in the death of one of his—Oswald’s—research patients. I had witnessed this type of rivalry before, and so had Agent Wilson, so it really didn’t surprise me. However, once Powell left, Oswald learned that the patient in question, Ken Goins, was
not
one of his research subjects. Oswald had asked Goins to join his research group, but Goins hadn’t yet agreed to the request.

“To be honest, my initial reaction to the conversation was disappointment in Doctor Oswald. He seemed to be more concerned over one of his tests going wrong than over a patient—any patient—dying.

“I wasn’t hit with the real epiphany from the doctors’ conversation until a couple of nights ago. Previously, I had struggled to fit Ken Goins’ minor surgery into the pattern with the rest of the patients. Then it hit me: Ken Goins wasn’t a patient of Oswald’s, but Andrew Powell
thought
he was. Even though it seemed farfetched, I wondered if Andrew Powell could be mixed up in all this somehow.

“I reconsidered my discovery of the patients having all spent time on Five South at some point. In addition to being a med-surg floor, Five South is also the hospital’s gastroenterology floor. I noticed the ‘GI’ sign hanging in the Five South hallway the second or third time I came in to visit…a sick friend. I knew from the first few days of my investigation that most of my mysteriously-dead patients had been admitted with some type of GI problem, but the death of Ken Goins had disrupted this trend.

“But viewed from Doctor Powell’s perspective, Ken Goins
didn’t
disrupt the trend. Doctor Powell
thought
Ken Goins had been admitted for a GI problem, not rhinoplasty. Viewed from Doctor Powell’s perspective, the trend for which I had been searching snapped into focus. Every single patient had been a member of Reginald Oswald’s GI research group, or so Doctor Powell thought.

“The idea of Doctor Powell’s culpability agreed with another observation I had previously made. For a while, I’ve suspected the murderer was familiar with the hospital.”

“Why?” asked Wiggins.

“Because the security camera on Five South, the floor where all the hospital murders occurred, is broken. Only a frequent visitor like Powell would know that the security camera outside those rooms isn’t operational and that he, therefore, wouldn’t be filmed. Possibly Powell damaged the camera himself to avoid being caught on film.”

A smile tugged at the corners of Powell’s lips, but he declined to explicitly confirm Alton’s conjecture.

“Okay,” snapped Wiggins, “I get all this, but how does that support the idea of Doctor Powell murdering these patients?”

Alton suspected that a man intelligent enough to become a scientific researcher would at some point want to boast about the intricate design of his scheme. With this in mind, he glanced in the direction of the morose researcher. “Doctor Powell, of course you have the right to remain silent, but if you’re so inclined, feel free to correct any incorrect suppositions.”

Powell looked in Alton’s direction but didn’t respond. The man seemed to be in a partial state of shock.

Turning back to Agent Wiggins, Alton continued, “Imagine you’re Andrew Powell in the early years of your research. You’re not only a top-notch gastroenterologist, you’re also researching cures for GI diseases. You’re receiving federal grants, and while it’s too early to assess the efficacy of your treatments, your theories seem sound. You’re at the top of your game.

“Now imagine that another, competing doctor propounds theories that are at odds with yours. Some people start to listen to those alternative theories, and you get knocked a little off your pedestal. Now that competing doctor begins to win the federal grants that had previously been awarded to you. You feel under attack, yet you hope and believe your theories—and the subsequent therapies you’ve developed from them—will prove to be the winners in the long run.

“Over time, however, your problem gets worse. Oswald notches one success after another, and as the results from your test patients roll in, you can see that your treatments aren’t effective. More researchers shift into your competitor’s camp, and your position becomes even more tenuous. What can you do?” Alton paused. “One option—Powell’s option—would be to kill the patients being treated with your competitor’s new therapy. Nothing stifles an R&D project like a string of test-subject deaths, right, Doctor?” he asked, turning to Powell.

“But why kill hospice patients?” asked Wiggins. “They’re going to die anyway.”

“From Powell’s point of view,” replied Alton, “the hospice patients are the most threatening to his theories. If a patient has been declared terminally ill and is then suddenly cured by your competitor’s therapy, your own therapy takes a huge blow. You have to eliminate the possibility of a hospice patient improving and completely discrediting your work.”

Alton turned to Andrew Powell. “How am I doing? Do you feel like commenting?”

Powell emitted a long sigh, as if the spirit of determination had left him for a more suitable home. “I may as well tell you. It’s all going to come out soon enough.”

He sat up a little straighter in his seat and folded his hands in his lap. His gaze seemed to focus on some point in the far distance behind Alton’s head. “First, let me state that while the facts are more or less true as you’ve described them, everything I’ve done has been for the advancement of science. I firmly believe the family of treatments I’m developing will eventually become the gold standard. I just need more time to finish my testing—time that’s running out.”

Refocusing on Alton, Powell nodded. “My research is in shambles. My test patients aren’t recovering—yet—and Oswald’s theories keep experiencing one success after another. As you correctly surmised, one of his hospice patients pulling back from the brink of death could be the last straw—enough to sink my research and my federal funding. I had to act—give myself a little more time to gather test evidence. And I have to confess…I didn’t mind wiping the smirk off of Oswald’s face in the process.”

“Doctor Powell, I have a question for you,” said Alton. “How did you come to labor under the false assumption that Ken Goins was a member of Doctor Oswald’s research group?”

“I can answer that,” chimed in Nancy Goins. “Doctor Powell and I know each other through a hospice trade group. During our quarterly meeting a few months ago, he asked me if I knew any patients with GI problems, and I mentioned that Ken had diverticular disease. He then asked me if Ken would be interested in joining his research group, and I told him Doctor Oswald had already inquired. That pretty much ended the conversation. Doctor Powell didn’t seem very happy with my answer.”

“But Ken never ended up joining Doctor Oswald’s test pool?”

“No,” said Nancy. “Ken said, ‘What’s in it for me? Nothing.’ So he didn’t join.”

Dr. Powell sank back into his chair, the inner turmoil of his thoughts seeming to periodically bubble to the surface.

Alton turned his attention back to Wiggins. “Once we understood the culprit and his reasoning, we simply had to wait for the next patient on Doctor Oswald’s research panel to be admitted to either the hospital or the hospice. I wrote a tracking program and appended it to the admissions software of both facilities. As soon as anyone on Oswald’s list was admitted, the program would send me a text. That’s exactly what happened with Ed Kinkaid, the patient admitted to Stokely Memorial yesterday. The program texted me mid-morning, notifying me of his admission. We moved into the bathroom early in the day, when there were family members and other doctors present. We know the murderer wouldn’t strike unless he thought himself alone.”

Alton turned to Dr. Powell. “One other question. What exactly did you use to kill those patients? Nothing showed up on the autopsies.”

Powell produced a wan smile. “It was childishly easy. I simply gave them a massive overdose of digitalis.”

“The heart medicine?” asked Mallory.

“Very good, Agent Wilson,” replied Powell. “Exactly—it is a heart medicine, but a sufficiently large dose can cause heart failure. Ironic, isn’t it?”

“And since none of these patients were being treated for heart failure, they wouldn’t have been tested for a digitalis overdose in their subsequent autopsies,” inferred Alton.

“You win a gold star too, Mr. Blackwell,” said Powell. “I did have to use a less…shall we say…
refined
approach for one hospice patient. When I arrived there, I couldn’t locate my syringe, but putting a blanket over her face proved to be an effective substitute.”

“No wonder it was so hard to catch you,” said Alton. “As a research doctor, you’d legitimately be in both facilities all the time. Your presence would never draw anyone’s attention.

“A final question, Doctor Powell. Do I have you to thank for the remnants of this knot on the back of my neck?”

Powell appeared confused at first, but recognition quickly set in. “Oh, yes—I remember. As you said, Mr. Blackwell, I move quite unobserved through both facilities. It was just dumb luck that I heard you. I had been seeing Mrs. Moore, a patient on my test panel. When I wrapped up her visit, I thought I’d go ask Nancy Goins if any new GI patients had been admitted to Serenity. When I arrived at her office, I overheard the conversation between you and Agent Wilson.

“Mr. Blackwell, you made a disturbing connection. Patients who die in a hospice almost never have an autopsy, and the autopsies Oswald performed on his patients were specifically targeted to examine GI diseases and his treatments, not conduct an across-the-board assessment. You were the first person to observe the pattern of disconnects between the patients’ conditions and their autopsy results. I knew those discrepancies would be noted in the individual autopsies at the hospital but had hoped the pattern across
multiple
patients would remain unrecognized.”

“So when you heard me make the observation that night, you sprang into action?”

“That was the idea. I tried to improvise, but I don’t get as much mustard behind the Louisville Slugger as I used to.”

Alton touched his wound. It had been enough for his taste.

“Doctor Powell, can I ask you a question?” asked Mallory.

Powell shrugged in a show of indifference.

“When I arrested you yesterday, what did you mean when you said, ‘you can’t stop me’? I mean…at that point, a man of your intellect had to know you weren’t going to escape.”

“I didn’t mean you couldn’t stop me physically,” explained Powell. “I meant you mustn’t stop the research. It’s too important. If I get arrested, this whole line of inquiry shuts down. In fact, could we make arrangements for me to finish a promising clinical study while I await trial? I understand if you decide to send one of your FBI agents to accompany me during the testing.”

Wiggins stared at Powell as if the doctor had conjured up an elephant or a unicorn. “You—a doctor who has made a habit of killing patients—want to go back to your rounds in a hospital? Not in this lifetime.”