T Wave (8 page)

MONDAY, JULY 16

CHAPTER 20

William Cline rested his head on a balled fist as he studied the scrolling figures on his monitor.

“No matter what font you use, the numbers don’t look good,” he grumbled to himself. “If we could just get the occupancy rate up.”

The jarring ring of the office phone interrupted his musings. He hesitated for a moment before answering the incoming call from Leo Jacobin, CEO of Stokely Medical Group.

“Hello, Doctor Jacobin—how can I help you?”

“We announced our quarterly earnings to the street this morning. I assume you dialed into the financial analysts’ conference call a few minutes ago, Cline?”

“Yes—I always do.”

“The company as a whole turned a modest profit, but your hospice continues to run squarely in the red.” Jacobin always referred to Serenity as
your
hospice to highlight the fact that building the facility had been Cline’s brainchild. Jacobin continued, “The PR team assured the analysts that we have a plan for turning around Serenity’s financial performance. The question is, how exactly are we going to do that? Wall Street will give our stock a pounding if we don’t deliver on our promises.”

“I understand, Doctor Jacobin. I’m concerned about the future of the hospice, too.” Cline owned options for ten thousand shares of Stokely stock, options weren’t worth a dime unless the company’s stock price started to climb. Cline knew that fixing Serenity’s financials would send Stokely’s stock through the roof—and assure his continued employment.

“Are you referring terminally ill patients from our east-side hospitals to Serenity?” asked Jacobin.

“Yes, sir. We refer all terminally-ill patients in this hospital and in Lakeview Memorial to Serenity. Of course, a patient has to be dying to give such a referral. Since that’s the outcome the hospitals are trying to avoid, the stream of patients to Serenity is quite unpredictable.”

“Cline, you’re the man who proposed building Serenity, so you had better figure out a way to make it profitable. Are we clear on that?”

“Yes, Doctor Jacobin.”

Cline hung up the phone and studied the ceiling for several minutes, tapping a pencil against his pursed lips as he pondered the directive posed by his company’s most senior leader.

CHAPTER 21

Janice Kell had not yet awakened from her morning colectomy surgery, a procedure in which doctors at Stokely Hospital had removed much of her diseased large intestine. The operation had proceeded smoothly. To ensure her convalescence stayed on track, a procession of doctors, nurses, and nurses’ aides had filed through her room throughout the day to assess her progress.

In the late afternoon, a solitary figure entered the room, observed Janice’s vital signs, and examined the steady drip of the bedside IV. Everything seemed to be in order.

Whistling a refrain from “Shenandoah”, the visitor removed a needle from a lab coat pocket and raised it to chest level. Using a small port on the IV tubing, the visitor emptied the contents of the needle into the IV solution and slipped the needle back into the lab coat’s pocket.

The visitor left the room and sauntered down the hallway, slipping out of sight in under two minutes.

A quarter of an hour later, Nurse Proffitt’s rounds brought her into Janice Kell’s room. Proffitt bent over Janice to assess her progress. The patient’s dull grey skin color and lack of vital signs sent a thrill of alarm through Proffitt’s mind, and she immediately called a code. A team of doctors and emergency nurses rushed in with the crash cart—a wheeled cabinet stocked with emergency equipment and medicines—and worked furiously to restore animation to the unresponsive figure on the bed. 

After twenty minutes, Dr. Meyer, the response team’s chief, wiped his brow and pulled off his latex gloves with a frustrated yank.

“Okay, I’m calling it,” he said. “Time of death is five forty-four.” He turned to Nurse Proffitt. “What happened? What did you observe before she coded?”

Proffitt described the events preceding the code, and Dr. Meyer shook his head. “It doesn’t make sense. Of all the potential post-op problems she might have experienced, I wouldn’t have guessed she’d have an MI. I could understand sepsis or a blood clot…but a heart attack?”

The crash team and Nurse Proffitt filed out of the room, stunned at the sudden loss of a patient whose earlier prognosis had been so favorable.

On the ground floor of the hospital, Janice Kell’s former visitor casually approached a “sharps” box, a sealed, wall-mounted container that provided a safe way to dispose of used needles. The visitor removed the needle from the lab coat’s pocket, dropped it into the sharps box, and passed through the exit door, whistling.

TUESDAY, JULY 17

CHAPTER 22

The next day, Mallory arrived at Stokely Hospital to continue investigating the potential narcotics thefts. She introduced herself to Karen Sofet, the charge nurse.

“Hi,” said Sofet. “I was briefed on your investigation. How can I help?”

“I need to review specific medication-distribution records,” replied Mallory. “In particular, I need your help backtracking the drug records of hospital patients who were eventually referred to Serenity Hospice. I have the list of names here.” Mallory passed the list to Sofet, who in turn passed it to the floor’s secretary with instructions to make a hard copy of each patient’s records.

Mallory chatted with Sofet at the nurses’ station while the secretary printed off the needed information. As she waited, Reginald Oswald swept onto the floor.

“That’s the second time I’ve seen Doctor Oswald here, plus once in the hospice,” said Mallory. “I thought research scientists spent most of their time in a lab. It doesn’t seem like he’d be out and about quite so often.”

“He had a patient die,” explained Sofet, “so he’s coming to see the family to solicit their permission to perform an autopsy. That’s an important part of his work—to assess the treatment’s efficacy.”

“How effective can it be if the patient died?” asked Mallory, scrunching her nose.

Sofet nodded in acknowledgement. “That’s just it. He’s trying to determine the cause of death in order to answer that exact question: did the treatment
help
the patient’s illness or
accelerate
it?”

“I see. So Doctor Oswald’s in the hospital pretty often, then?”

“He’s been here more than usual the last few months, but we always see him now and then. This is the hospital’s GI floor, so all his patients are here in Five South. If he needs to see one of them or their family members, ours is the floor he comes to.” Sofet glanced at an approaching figure and smirked. “There’s Doctor Powell.”

“Yeah—I’ve seen him once before,” said Mallory.

“His theories compete with Doctor Oswald’s,” said Sofet, “Consequently, they aren’t the best of friends. This should be interesting.”

Dr. Powell approached Oswald. “Morning, Doctor Oswald. I heard about your latest patient dying—tough break.” The faintest hint of a smile tugged at the corners of Powell’s mouth, and his eyes twinkled.

“Yes, well, we’re still moving forward,” said Oswald through tight lips. “We have the better science on our side. I entertain no doubts on the eventual success of our therapies.”

If Dr. Powell was irritated by the retort, he made no indication of it. “We’ll see,” he said, turning on his heel to visit his own patients.

Mallory turned to Sofet. “I don’t think they’re gonna go pub crawling together any time soon. And now…it looks like the records are all printed, so I’ll be off to my research. Thanks for your help.”

WEDNESDAY, JULY 18

CHAPTER 23

The next morning, Mallory returned to Serenity Hospice to continue her research. She spent the first hour comparing the hospice’s computerized records to the printed hospital medication records she had obtained the previous day. She connected the final dots and sat back in her chair. It was time to talk with Nancy Goins.

Mallory approached the pine-grain door of Nancy’s office. After tapping, she cracked the door and peered inside. “Can you talk?”

“Yes,” replied Nancy. “As a matter of fact, I wanted to talk to you, too. But why don’t you go first.”

Mallory took a seat in the chair facing Nancy’s desk.

“I think I may be on to something,” said Mallory, “First, we’re
not
seeing a pattern of suspicious narcotics records for deceased patients. I saw only a few incidents in that category, and none of them conclusively pointed to theft.

“On the other hand, I’ve spotted eight incidents of suspicious drug transactions for patients who remained alive at least twenty-four hours after the incident in question. I dug a little deeper and discovered that all of these patients had an above-average acuity rating, indicating they were probably too ill to know for sure whether or not they had taken their medicines. Patient and family complaint records agree with this pattern. Here’s a typical case.” Mallory opened a file folder and reviewed the records of a particular patient with Nancy.

“I think you’re right,” said Nancy. “Someone
is
skimming. I knew it! Only…what do I do now?”

“I’ll need to finish my research to compile enough evidence to press charges. That will take me a few more days. I’ll let you know when I have enough evidence to make an airtight case.

“And now…you said you wanted to talk to me about a different topic?”

“Yes,” replied Nancy. After shutting the door to her office, she sat back down at her desk, facing Mallory. “I don’t quite know where to begin. Um…I’m a little uneasy about a few recent deaths. I’m used to patient deaths, of course, but we’ve had several that just don’t fit the usual pattern. I also heard about two patients at our sister hospital who both died last week from unexpected causes. Maybe it’s nothing, but in case there’s more to it, I figured I’d let you know. You are FBI, after all.”

Mallory arched an eyebrow. “Can you give me the names of the patients and any other details you think might be helpful? And can you tell me what makes their deaths unusual?”

Nancy provided the list, and Mallory quickly scanned it. Due to the considerable hours she had recently logged at the two medical facilities reviewing patient records, Mallory was already familiar with most of the names. Nancy described the circumstances surrounding each death.

“You can see the pattern, right?” asked Nancy after reviewing the patient-by-patient details for nearly half an hour. “In all cases, the cause of death was either unknown or was different from the condition the patients were admitted for.”

“And that’s what has you worried?”

“Yes, this kind of thing happens once every blue moon, but it’s not typical to have so many cases in the space of a few weeks. It just seems suspicious. Here’s the dilemma, though. How do you prove anything? I thought getting to the bottom of this narcotics-theft case would be hard—that seems easy compared to proving someone hastened the death of a hospice patient.”

“I see,” replied Mallory, considering her options. “Let me take this information with me. I’ll run it by my boss and see what he’d like to do.”

“Thanks. I’m glad you’ll be looking at it. This has been bothering me, and I didn’t know who to tell, or if I should even say anything at all.”

That night, Mallory shared Nancy’s concerns with Alton.

“What do you think?” asked Alton. “Is it worth investigating?”

“Honestly, I don’t know. She seemed a bit overly dramatic to me. However, in the unlikely event it
is
true, we can’t just let it drop, can we?”

“No, I suppose not.”

“I told her I’d mention it to Wiggins. He can decide if it should be referred to homicide. That’s their cup of tea.”

Alton nodded and walked to the kitchen, emerging seconds later with a bag of pretzels.

“If there was a homicide in the hospice, would the FBI even have jurisdiction?” he called from across the room.

“Probably not. It would be a local police matter. I guess I’ll just wait and see what Wiggins says.”

He tossed her the bag. “Good call—now let’s have a snack. I’m starving.”

THURSDAY, JULY 19

CHAPTER 24

The next morning, Mallory called Alton on her way to the hospice. “Do you remember Nancy Goins’ worries about a few recent patient deaths she thought were suspicious?”

“Yeah,” replied Alton.

“Well, I passed along the case details to Wiggins, and he says we don’t have sufficient evidence to open a case…” She trailed off.

“What’s wrong? You’re not comfortable with that?”

“You know, I was at the hospice when two of those patient deaths occurred. The staff was baffled at both the speed and underlying cause of the patients’ demise. The more I think about it, the less comfortable I am letting this query drop without any kind of investigation.”

“I see. I have to admit, I’m also a little surprised that no one’s looking into it.”

“The biggest problem we have, though,” said Mallory, “is the minuscule amount of evidence we have to go on. I don’t have time to dig up more—I’m booked solid on the drug case. That’s probably why Wiggins didn’t want to open that can of worms—it’d require a lot of work to build a case we could actually prosecute. For such a long shot investigation, he probably didn’t view it as worth the time and effort.”

After remaining silent for a moment, Alton spoke up. “Why don’t you let me poke around a little? Is it possible for me to have some type of temporary investigatory authority?”

“Yes, but it would have to come from Wiggins. I’ve seen him do that a couple of other times. Maybe he’d do it in this case, too, if he could avoid committing Bureau resources.”

“If he can delegate the authority to me, I can follow up with Nancy Goins and see where that leads. Perhaps I can do a little more research and see how much substance is behind her concerns. I could go to the hospice after my Kruptos workdays are over.”

“Are you sure you don’t mind?” asked Mallory. “It’s not like your day job is all that easy.”

“No, it’s fine. It’ll give me something to do while I’m waiting for you to finish your drug investigation each day. I usually wrap up before you anyway.”

“Okay. Well, that sounds great,” said Mallory. “If there’s anything to Nancy’s suspicions, I know you’ll figure it out.”

“Let’s just hope there’s
not
anything to it. I’ve had enough death to last me a lifetime.”