Death Rounds (31 page)

“Jesus Christ” was all I could say. I’d seen bungling before—what the residents had pulled was the sort of near disaster that happened from time to time, unfortunately, in a teaching hospital—but Nurse Brown was outright scary. She deserved everything that Cam had threatened her with, if not outright dismissal. The residents would probably learn from this. What Cam had in mind for them made it unlikely any of them would ever screw up doing tracheal suction again. But I doubted any amount of disciplinary action would ever make Brown into the sort of nurse I’d want near Janet, me, or anyone else.

Yet seeing Cam once more fly into a rage, even over a serious infraction, I was left feeling ambivalent and uncomfortable about him. He was a chief in this hospital. He knew a public blowup could badly disrupt a critical-care unit and interfere with the staff’s calm and concentration. No one was immune to being angry—I’d also wanted to scream at both Brown and the residents—but his performance only added to my doubts about his tendency to lose control. My first impulse was to transfer Janet away from the bunch of them.

“Janet, let me get you out of here and to St. Paul’s, where I can assure you no one like Brown or these residents will get near you.”

“You’d deliver me to the hands of Gary Rossit? No thank you.”

The recollection of him sitting beside Hurst at Death Rounds and grinning up at me flashed through my mind. “Of course not,” I quickly agreed. “Being around him is totally out of the question. But whoever the Phantom is, you’re vulnerable here. I can get someone else--”

“Stop it, Earl!” She leaned back out of my arms and looked me in the eye, a stern expression crossing over her face. “Stewart Deloram wasn’t safe at St. Paul’s, and I told you before, running away is not an option.” She took a breath, as if to continue speaking, then seemed to change her mind. She put her head back against my chest. “As for the residents and nurses,” she added, sounding a little softer, “I’m sure Cam will make certain there won’t be any more screwups by them. Besides, it’s my infection that’s got me scared now. Despite Stewart Deloram doing well, I don’t know how bad I’m going to get, and I want Cam taking care of me.”

I continued to stroke her hair and cradle her against me, glad she couldn’t see the tears that I felt brimming in my eyes. Her straightforward admission of yet another of my fears—that no one knew for certain how ill she might become—nearly made me lose the puny grip I’d managed to keep on my emotions.

As I clung to Janet, I looked through the glass in the front of her room and watched Cam standing in the nurses’ station with his back to me. The overly tall man was engaged in an animated conversation with Brown and another nurse who I presumed was the supervisor. Whatever I thought Brown deserved, I continued to be troubled by the way he kept waving his hands about while stabbing at the air between them with his index finger. Obviously he was still beside himself with fury. The image of his face at Death Rounds, distorted with rage and inches from my own, wasn’t hard to recall. I’d given him the benefit of the doubt then. It was altogether something else to suddenly have him as Janet’s physician now that she’d been attacked. Even when he was focused on the residents, I’d felt disturbed by being in such close quarters with him.

Perhaps it was the shock of having had to resuscitate my own wife, perhaps it was having seen my best friend put near death not twelve hours earlier, perhaps it was the frustration of not being able to prove this killer even existed, certainly it involved my instinct to protect those I loved above all else—whatever the blend of reasons, it was a potent fuel for a rush to judgment.

In a flash any inclination I had to be balanced and fair was gone. Suspicions that I’d tried to keep in check resurfaced with a vengeance and images I’d tried to suppress or explain away flew to mind—Rossit and Hurst glibly chatting before the remains of Phyllis Sanders, the powerful business group ringing Hurst as he manipulated his way through the amalgamation meeting at St. Paul’s, a shadowy figure creeping up on Janet

“Do you have any idea who might have gotten close enough to infect you?” I asked through clenched teeth trying to keep my voice steady and my stomach down.

“No,” she replied meekly. “I’ve been racking my brains about that. To give me
Legionella,
whoever it was would have had to make me inhale a contaminated mist or spray, but no one’s been near me and me alone with anything even resembling an aerosol. At other times, when I’m in close quarters with staff members doing procedures, I’m wearing a mask, gloves, and a gown.” She paused and after a few seconds added, “It’s so frustrating, knowing that sometime in the last few days I must have come face to face with the Phantom!” Then she started to cry.

I was ready to kill whoever had attacked her.

Turning from the window and nuzzling my head against hers, I asked, “Does Cam always get as mad as he did just now? I’ve never seen even a hint of that kind of temper whenever I met him with you.” Thinking the unthinkable was no longer out of bounds.

She sighed, then took a few seconds to answer. “Don’t judge him too harshly. He’s fanatical about kindness to patients, the way we all should be, but for him, well, it’s a special cause.”

I felt a chill run through me.

“What do you mean a special cause?” I persisted, finding it increasingly hard to keep my voice even.

“It’s personal, Earl,” she replied, “something he once told me in confidence that he doesn’t like talked about. It’s got nothing to do with the Phantom, trust me.” She was no longer crying, but she still sounded shaky. I don’t think she suspected the impact her words were having on me.

The chill became a prickle of dampness on my back as I recalled some other words Harold Miller had said at the end of our conversation on my way up here. At the time I was so desperate to see Janet I’d hardly paid attention.
Dr. Mackie ‘s a real stickler about not hurting patients.

I considered very carefully what I was about to say. “Janet, I know that you don’t think I’m good at speculating and that you have a great deal of confidence in Cam, but his behavior this morning at Death Rounds was bizarre.” I paused, waiting for her protest at even a hint of my being about to speak negatively of her friend, but I felt her body stay relaxed against me. Cautiously, I continued, “He was furious that I went into the archives last night and looked through all the old charts of the Phantom’s first victims—”

“You what!” she exclaimed sharply, pushing herself away from me again. She immediately began coughing.

I quickly tried to explain. “Yes, I went through those files, Janet. I had to. After Michael was admitted—”

“Michael?” she croaked, barely able to find her voice as her coughing spell continued. “What do you mean Michael was admitted?” She was sitting bolt upright now.

Damn! In all my concern for her I’d forgotten she didn’t know about Michael. I certainly hadn’t wanted to spring the news on her like this. I reached for her hand. The gesture made her look doubly alarmed. “Janet, we admitted Michael last night in septic shock from what I’m sure is
Legionella,”
I told her, watching her eyes widen. “There’s no sign of staph, but as of this morning he was still unconscious and on a respirator.”

She uttered a little cry. For the next few seconds all she said was “Oh no” over and over while her horrified expression grew until her blanched face looked like a silent, open-mouthed mask. “But how?” she finally demanded. “Where?” Her voice was high and tremulous. “Any time we got near any organisms in the lab we were in protective gear. Cam and Miller made sure of it. They’re both adamant about that kind of thing, especially now. Oh, why did I get him into this!” she wailed.

I took her back in my arms and rocked her.

“What about Donna?” she asked.

“Shaken but holding up when I left her last night.”

Between more of her coughing bouts, we sat in silence, hanging onto each other. I wanted only to let her rest and comfort her, but comfort her with what? My thoughts continued to rage with questions about Cam, and I was increasingly convinced she’d be in danger if she stayed here. But without hard evidence I was unlikely to budge her belief in him.

“Janet, about Cam,” I began again, “you’ve got to listen to me. I swear he’s covering up about the Phantom.” This time I pressed ahead, not wanting to give her the opportunity to interrupt. “Not only is he trying to keep us from drawing attention to the attacks from two years ago, but when I got Williams to instigate a search of the asylum, he seemed most unhappy about that as well. You tell me, if he’s not got something to hide, what’s he afraid we’ll find?”

Janet lifted her head from my chest and gently cradled my face in her hands. “Will you listen to yourself?” she said softly. “I know that it’s because you love me and that you’re frazzled by the fact I’ve been infected”—she took off my glasses, kissed me on my forehead above my mask—“and having had to rescue me from those doltish residents must have scared you silly.” She kissed me again, this time on my eyes, then brushed her lips across my ear while moving her mouth closer to my neck. “Will you listen to yourself?” She brought her head up, still clasping my face in her hands, and, staring me right in the eyes, said, “Come on, get off Cam’s case.”

Before I could sputter an answer, I was startled by the sound of someone clearing his throat behind me.

“Earl, you’ve got to let her rest,” said Cam from the entrance to the room. Sitting on the bed holding Janet, I’d been facing the other way and hadn’t seen him return. He was already in clean protective gear; that meant he must have been putting it on just outside the door while we were talking. His voice was polite, but his presence filled me with anxiety. As I stood up and looked at the man who had become such a dreadful enigma to me, I wondered how much he’d heard of our conversation.

“I’m sorry, Cam,” I protested, making no attempt to hide my hostility, “but I need to talk with her, and under the circumstances—”

“It’s okay, Earl, Cam’s right,” Janet cut me off. “You should go now and let me sleep. Kiss Brendan for me.” She was giving me an order. She pushed herself away and lay back on her pillow. I was disturbed by how drawn she looked.

“That despicable nurse won’t bother you anymore, Janet,” Cam told her, speaking very quietly. “I’ve arranged for only our best ICU staff to take care of you from here on. Anything medical I’ll do myself, that is...” He let his voice trail off and looked sideways at me. “That is, if you still want me as your physician,” he concluded, turning his eyes back toward her.

“Of course. Cam,” she said, sounding surprised but shooting me a warning glare, making it very clear I was to stay silent. “Who else would take care of me but you?”

Cam glanced over at me again, and my stomach writhed like a bunch of cold snakes. But I stood there saying nothing, racked by confusion about what to do as much as gripped by panic. He in turn seemed to relax a notch and stepped closer to the bed. “That’s settled then,” he said, taking Janet’s hand in his.

What if I confronted him, I wondered, tried to scare him off by throwing all my suspicions at him here and now, even without proof? How would he react?

“I now order this beautiful woman to sleep,” he was proclaiming with a warm smile, “which is an important step in getting her back on her feet.” He’d reverted to the pleasant self-confident tone I was used to hearing when he’d kept me laughing at dinner parties.

While Janet’s returning smile revealed how comforted she was by this brilliant physician’s physician, I felt warning bells going off throughout my head telling me to be very, very careful. Since she was staying put, if I opened my mouth and threatened him, I might end up placing her in more danger than if I kept quiet. Perhaps I’d already said too much if he’d eavesdropped on most of what I’d been saying to Janet before he came into the room.

He straightened to his full height, gave her a friendly wink along with a final pat on her hand, and then turned toward me. As pleasant as his expression seemed, his eyes were hard as blue ice. “Now Earl,” he said quietly, gesturing to the door, “how about meeting me in my office after my clinical rounds, say, about eleven? I think you and I should have a chat about what happened at Death Rounds this morning.”

Chapter 16

I needed proof that Janet would believe, even if it pointed to Cam. I figured the best way to get it was to pursue my original plan—go back through the confidential files of University Hospital and find whatever Michael had discovered. Even if
the pattern
hadn’t told
him
who the killer was, that same evidence that had convinced him there was a killer could perhaps point Janet and me toward a name. Except now I’d have to somehow do an end run around Cam to get to those files.

I decided to take my problem to the top, and in Janet’s hospital that meant I had to go down to the third floor and meet with Reginald Fosse, the CEO. His office was housed in the plush confines of the administration wing.

While walking from ICU to the stairs and descending one flight, I worked out the details of what I would say. By the time I was striding over the thick carpets, my torn pant cuff flapping, I’d concocted a scheme made up of a bit of blackmail, a touch of bribery, and a whole lot of bluster.

Reginald Fosse had diplomas for a master’s in business administration and a master’s in health-care administration hanging on his wall, but no M.D. As such he was part of the managerial breed that has taken over the running of hospitals in the United States during the past ten years. This group has served shareholders in publicly traded providers of health care well, but its impact on the health of the nation has been less clear. Every hospital it kept out of bankruptcy hasn’t necessarily been a victory for the sick, especially when it did it with disastrous money savers such as the ill-fated one-day-obstetrical-stay policy for a delivery. Janet had fought against that loopy idea, and Fosse, to his credit, had listened to reason before state legislation forced him to.

He was a pleasant enough looking man. The top of his head was balding, he had a few strands of white hair that he kept combed over it, and his midriff bulged over his belt. But the grandfatherly wire-rimmed glasses he wore perched on the end of his nose made him seem comfortable with his middle age and his smile was full of warmth. He’d agreed to see me right away and expressed his concern about Janet, obviously having already been informed of her admission.