Crisis (30 page)

Jack was impressed and told Latasha so.

"All in a day's work," she said. "What can I do for you?"

"I want to take you up on your offer of autopsy supplies. It appears that it is a go, provided they can be expeditious getting the body out of the ground. I'm going to do it at the Langley-Peerson Funeral Home."

"If you end up doing it after hours, I'd be willing to help, and I could bring a bone saw."

"Really?" Jack questioned. He'd not expected such generosity. "I'd be happy to have your help."

"Sounds like a challenging case. Let me introduce you to our chief, Dr. Kevin Carson."

The chief, who was doing a case on table number one, turned out to be a tall, lanky, pleasant individual with a southern accent who mentioned he was on a first-name basis with Jack's chief, Dr. Harold Bingham. He said Latasha had told him about what Jack was trying to do, and he supported her offer to process specimens and help with toxicology if needed. He said they did not yet do their own toxicology but had access to a superb twenty-four-seven facility at the university.

"You tell Harold hello from Boston," Kevin said before going back to his case.

"I certainly will," Jack responded, although the man was already bent over the body in front of him. "And thanks for your assistance."

"He seems like a pleasant chief," Jack said as he and Latasha went out into the anteroom.

"He's very personable," Latasha agreed.

Fifteen minutes later, Jack stashed a box of autopsy supplies in the trunk of his Accent, moving his basketball gear out of the way in the process. He also slipped Latasha's card with cell phone number into his wallet before climbing in behind the steering wheel.

Although Alexis had suggested another parking facility near Faneuil Hall, Jack was content to return to the one beneath the Boston Common, since it was easier for him to find. He also enjoyed the walk skirting the Massachusetts State House.

Pushing into the courtroom, Jack tried to let the door close as silently as possible behind him. At that moment, the court clerk was swearing in a witness. Jack had heard the name; it was Dr. Herman Brown.

As he stood by the door, Jack's eyes scanned the room. He saw the backs of Craig's and Jordan's heads along with those of their attorneys and the attorneys' associates. The jury seemed as bored as they had the day before, while the judge appeared preoccupied.

He was shuffling papers, glancing at them, and reorganizing them as if he were alone in the room.

Jack's eyes scanned the spectators and immediately locked onto Franco's. From the distance, Franco's eye sockets appeared like featureless black holes beneath his Neanderthal-like brow.

Against his better judgment, Jack smiled and waved. He knew it was foolish, since he was taunting the man, but Jack was unable to stop himself. It was a re-emergence of the risk-taking mentality that he had glommed on to for a number of years as a juvenile coping mechanism for his guilt about surviving his family. Jack thought he saw the man tense, but he could not be certain. Franco continued to scowl at him for several beats longer but then shifted his gaze when his boss scraped his chair back from the plaintiff's table and headed toward the podium.

Berating himself for deliberately provoking the man, Jack thought about finding a hardware store and buying some pepper spray. If there was to be a second confrontation, Jack had no intention of trading blows again. Their difference in size made that an unfair exchange.

Jack returned to scanning the spectators. Once again, he was taken by the number. He wondered how many were the proverbial courtroom junkies, vicariously thrilled by people receiving their comeuppance, particularly the wealthy and powerful. As a successful doctor, Craig was fair game.

Finally, Jack found Alexis. She was sitting in the first row over against the wall, close to the jury box. Next to her seemed to be one of the few empty seats. Jack walked down to the bar, and then by excusing himself, he stepped into the aisle. Alexis saw him coming and moved her belongings to make room. Jack gave her shoulder a squeeze before sitting down.

"Any luck?" Alexis whispered.

"Progress, I hope, but it's now out of my hands. What's been happening here?"

"More of the same, I'm afraid. It was a slow start, since the judge had to deal with some arcane legal stuff. The first witness was Dr. Noelle Everette."

"That couldn't have been good."

"It wasn't. She came across as a superbly trained, thoughtful, and sensitive professional with the added benefit that she's from the community and was involved in the resuscitation attempt. Tony handled it well, I'm sorry to say. The way he questioned her and the way she answered kept the jurors' attention. I even saw the three homemakers nodding at one point -- not a good sign. Her testimony was essentially the same as Dr. William Tardoff's, but to me more effective. She comes off like the doctor everyone wishes they had."

"How was Randolph on cross?"

"Not as effective as he was with Dr. Tardoff but, personally, I couldn't see how he could be, considering how well Dr. Everette came across. I had the feeling he just wanted to get her off the stand."

"That might have been the best stratagem," Jack said. "Did the issue of concierge medicine come up?"

"Oh, yeah. Randolph tried to object, but Judge Davidson is letting it all in."

"Did the issue of cyanosis come up?"

"No. Why do you ask?"

"It continues to be a nettle in my brain. It will be one of the prime things on my mind when and if I do the autopsy."

A sixth sense made Jack turn around and look across the room at Franco. The man was again glaring at Jack with an expression that hovered between a grimace and a cruel smile. On a positive note, from the angle in which Jack was looking, he could see that the left hand side of Franco's face was as red as Jack's. So far, things were apparently equal.

Settling back on the rock-hard oak pew, Jack directed his attention to the proceedings. Tony was at the podium, while Dr. Herman Brown was in the witness box. In front of the bench, the court reporter's fingers were playing incessantly on her small machine to create a verbatim record. Tony was having the witness testify to his impressive academic and clinical credentials, and it had been going on for a quarter of an hour. As chief of cardiology at the Boston Memorial Hospital, he also occupied the chair of the Department of Cardiology at Harvard Medical School.

Randolph had stood on several occasions and offered to stipulate as to the witness's qualifications as an expert to save the court's time, but Tony had persisted. He was trying to impress the jury, and it was working. It became increasingly apparent to everyone that it would be hard to find a witness more qualified in cardiology, or even equivalently qualified. The man's appearance and bearing added to his image. There was a Boston Brahmin aura that was similar to Randolph's but without the hint of disdain and condescension. Instead of cold and distant, he appeared kind and gentle: the sort of person who would go out of his way to put a baby bird back into its nest. His hair was grandfatherly white and well groomed, his posture straight. His clothes were neat but not overly elegant, and they had a comfortable, lived-in look. He wore a paisley bow tie. There was even a hint of self-deprecation, as Tony had to work to get the man to admit reluctantly to his awards and accomplishments.

"Why is this medical Olympian testifying for the plaintiff in a malpractice trial?" Jack whispered to Alexis, but it was more of a rhetorical question, and he didn't expect an answer. He began to wonder if the reason had something to do with Noelle Everette's unexpected comment about concierge medicine when she had said, "Some of us old-fashioned physicians are angry about concierge doctors." Maybe Dr. Brown was one of that group because the concept of concierge medicine flew in the face of the new professionalism that academia was trying to espouse, and more than anyone else at the trial, Dr. Herman Brown was representing academia.

"Dr. Brown," Tony Fasano said, gripping the sides of the lectern with his short, thick fingers. "Before we get to Patience Stanhope's unfortunate and avoidable death --"

"Objection," Randolph said emphatically. "There has been no establishment that Mrs. Stanhope's death was avoidable."

"Sustained!" Judge Davidson declared. "Rephrase!"

"Before we get to Patience Stanhope's unfortunate death, I'd like to ask you if you've had previous contact with the defendant, Dr. Craig Bowman."

"I have."

"Can you explain the nature of your contact to the jury?"

"Objection, Your Honor," Randolph said with exasperation. "Immaterial. Or if it is material in some unfathomable way, then I object to Dr. Brown as an expert witness for bias."

"Counsels approach the bench, please," Judge Davidson said.

Tony and Randolph dutifully grouped at the side of the judge's bench.

"I'm going to be very upset if we have a repeat of Monday," Judge Davidson said. "You're both experienced lawyers. Behave as such! You both know the rules. As to the current line of questioning: Mr. Fasano! Am I to assume you have a relevant rationale for your current line of questioning?"

"Absolutely, Your Honor! The core of the plaintiff's case revolves about Dr. Bowman's attitude toward his patients in general and Patience Stanhope in particular. I call to the court's attention the deprecatory 'PP' classification. Dr. Brown has the ability to provide some insight into the development of these traits during Dr. Bowman's critical third year in medical school and during his residency training. Subsequent testimony will relate them directly to the case of Patience Stanhope."

"Okay, I will allow this line of questioning," Judge Davidson said. "But I want it related quickly to establish its relevance. Am I clear about that?"

"Perfectly clear, Your Honor," Tony said, unable to suppress a slight smile of satisfaction.

"Don't look so goddamned pained," Judge Davidson said to Randolph. "Your objection has been recorded. My judgment, provided Mr. Fasano is being totally honest about relevancy, is that the probative value will outweigh the prejudicial. I admit it is a judgment call, but that's why I'm here. In return I will grant the defense wide leniency on cross-examination. As for the question of bias, there's been ample opportunity to determine that during discovery, and it wasn't. But the issue can be examined on cross.

"And I want the pace to pick up," Judge Davidson said. "I've allocated this week for this trial, and here it is Wednesday already. For the sake of the jurors and my schedule, I want it to conclude on Friday unless there are some particularly extenuating circumstances."

Both lawyers nodded. Randolph repaired to his seat at the defense table while Tony returned to the podium.

"Objection overruled," Judge Davidson called out. "Proceed."

"Dr. Brown," Tony said after clearing his throat. "Would you tell the jury the nature of your contact with Dr. Craig Bowman?"

"My first contact was as his preceptor at Boston Memorial Hospital on his internal-medicine rotation during his third year of medical school."

"Could you explain what this means, since no one in this wonderful jury went to medical school?" Tony made a sweeping gesture down the line of jurors, some of whom nodded in agreement. Everyone was paying rapt attention, except for the plumber's assistant, who was focusing on his nails.

"Internal medicine is the most important rotation and the most demanding during the third year, and perhaps for the entire four years. It is the first time the students have prolonged contact with the patients from the patient's admission to their discharge, and they participate in the diagnosis and therapy under strict observation and supervision by the resident house staff and by the preceptor."

"Was this preceptor group that included Dr. Bowman a large group or a small group?"

"A small group: six students, to be exact. The teaching is intense."

"So you as the preceptor see the students on a regular basis."

"Every day."

"So you can observe the overall performance of each student."

"Very much so. It is a critical time in the student's life, and it marks the beginning of the individual's transformation from a student to a physician."

"So that attitudes that are observed or develop are important."

"Exceedingly so."

"And how do you rate your responsibility as a preceptor vis-a-vis attitudes?"

"Again, exceedingly important. As a preceptor, we have to balance the explicit attitudes toward patients as promulgated by the medical school versus the implicit attitudes often exhibited by the overworked and -stressed house staff."

"There's a difference?" Tony questioned with exaggerated disbelief. "Can you explain the difference?"

"The amount of knowledge medical trainees must assimilate and have immediate recall of is staggering and increasing every year. As pressed as residents are, they can sometimes lose sight of the ultimate humanistic aspects of what they are doing and which form the basis of professionalism. There are also defensive coping mechanisms in the face of suffering, dying, and death that are not healthy."

Tony shook his head in bewilderment. "Let me ask you if I have this correct. In simplified terms, there can be a tendency on the part of medical trainees to devalue individual people, like losing sight of the trees by paying too much attention to the forest."