Doc in the Box (19 page)

Katie said, “What makes you think I’ll find anything? The information you need may not be in the hospital computer. Or we might miss something important. Unless you are at the Palace on Ballas—St. John’s Mercy to you—hospital computers are always hopelessly out of date and slow. This is especially true at Moorton Hospital. I was on the computer committee there. Did I ever tell you about that? No? I guess I was too frustrated to discuss it.”

Great. Now she had technical as well as ethical reasons not to do it.

“You have way too much faith in hospital computer records,” she said, digging into a pile of lettuce like she enjoyed it. “The buying is always done by a
committee, so the system is out of date before it starts.”

“Why? The committee is too slow?”

“And stupid,” she said. “The committee I was on was run by guys in suits who spent hours discussing a subject they didn’t know anything about. They had no computer experience and there wasn’t a medical degree in the bunch. They were going to buy this big optical disk ‘jukebox’ to store data, but at the time there was no technology available to
read
this data. Nobody but me thought this was strange.

“I felt like I was telling the emperor he was nekkid. I stood up at this meeting and said, ‘Now let me get this straight … you want to spend two hundred grand for something to store data, but we have no way to easily retrieve this data, and we have no guarantee anyone will invent a way to readily retrieve this data?’

“ ‘Yes,’ said the guys in suits.

“ ‘Why?’ I said.

“ ‘Because we
need
to store it. It’s a Joint Commission requirement,’ they said.

“ ‘But if you can’t get to it, what good is it?’

“ ‘That’s not the point,’ the suits said. ‘We’re not required to be able to retrieve it. The regs only specify that we store it.’ ”

I was impressed. “That’s awesome stupidity. They could be
Gazette
management.”

“The only good thing about the whole experience was that it gave me an intimate knowledge of the Moorton computer system,” Katie said. “We won’t have to spend all night at the hospital checking the records.”

Did she say “we” and “checking the records”? She
was going to do it. She was going to search the medical records for me.

“Nowadays most people can work from their home computer late at night using a modem and a dial-up number. I bet you do that with the
Gazette.”

I nodded, but didn’t interrupt. Keep talking, Katie, I thought. Talk yourself into this. I can’t do it without you.

“I do that all the time when I’m on call. I’ll get a late-night call from the hospital and look up the patient’s lab results from home. I have to. Half the time the residents calling me don’t have a clue what the results are because they’ve been up all night and they’re dead tired.

“I can check most of the hospital records from my home. I’ll narrow down the candidates to a manageable number, maybe ten or twelve. Then we’ll have to go back to the hospital and get those records pulled. That’s the good news. The bad news is my dog Willis likes to sit on my feet when I work at home, and that makes my feet fall asleep.”

“What can I get to keep you and your feet awake? Coffee? Soda? Junk food?”

Katie finished her beer, and said, “Copious amounts of Diet Mountain Dew and coffee. No junk food. If I’m staying awake all night I have to avoid carbohydrates like the plague, or I’ll get a big rush of energy and then a big crash. My late-night snacks of choice are meat, cheese, and scrambled eggs with hot sauce. I like omelets, too, but I suspect you can’t make omelets, can you?”

“I could, but you could patch tires with them. I scramble eggs pretty good, though.”

“That’s your job, then. You can scramble me some
eggs in a few hours, and throw in lots of ham, bacon, and cheese. I’ll need some beef jerky in between. I love to eat beef jerky.”

“Done,” I said. “When do we start?”

“Right now. I don’t have too bad a schedule tomorrow, and you’ll hound me until it’s done. Follow me home, so you can find my house. You can get the snacks later.”

I paid while she ducked into the john to check out the latest philosophy. She came out laughing. “There’s a new one on the wall that fits our situation,” she said. “It says, ‘To err is human, but to really screw up you need a computer.’ ”

I followed her pickup to an old white farmhouse off Manchester Road, surrounded by big shade trees and old-fashioned flowers like bridal wreath, lilac, and iris. Willis greeted us at the door, a big friendly gray-brown mutt with a lot of terrier in his genetic past. There was a great deal of tail-wagging and ear-scratching, then Katie poured out his dinner.

While Willis ate and Katie made coffee, I wandered through the house. It had four rooms originally, two on each floor. The big comfortable living room had a fieldstone fireplace. Other rooms had been added on over the years in a rambling style. The most recent addition was Katie’s, a new kitchen with cherrywood cabinets, a cooking island, and lots of sharp knives I hoped Katie didn’t bring home from work.

Willis and I followed Katie into a small home office. He sat on Katie’s feet. I moved a pile of papers and sat on a small beige sofa. Katie fired up the computer.

“Let me see if I can even get in tonight,” she said. “The system could be down.”

It wasn’t. When I left for the supermarket, Katie was punching keys and Willis had fallen asleep on her feet. At the store I bought cheddar cheese, bacon, and a big ham steak for Katie, a loaf of sunflower seed bread, a dozen eggs, a dozen packs of beef jerky, and two chilled twelve-packs of Diet Mountain Dew. I planned to carbo-load, so I picked up pretzels, onion-and-sour-cream dip, and Oreo cookies for myself.

Back at Katie’s house, I put the food away, popped an iced Dew, and set a stack of beef jerky packs by Katie’s computer. Then I brought out my own laptop, sat on the couch, and started writing the column about Irene and Bill that was due tomorrow afternoon. The Oreos, dip, and Dew powered a huge energy surge, and I had my column written by midnight, when Katie put in a request for scrambled eggs with plenty of ham, bacon, and cheese. I turned out a tasty plate for the two of us, with green onions on top and hot sauce on the side. Katie ignored the loaf of toast I fixed, so I ate that, too.

Then she returned to work, with determination and another Dew. Katie regarded a computer as a balky donkey that had to be beaten, threatened, and cursed frequently to move. She loudly cursed the hospital computer’s slowness and stubbornness. Her standard method of extracting information was to type in the commands, then during the long wait that followed, she’d flick the screen with her finger and snarl, “Cough it up, bitch” or “Spit it out, asshole.” Katie’s computer could be either sex. Once, she thumped the terminal hard on top and yelled, “Come on!” The whole hospital system must have crashed, and I thought our quest was canceled for the night.
We drank Mountain Dew and stared glumly at the screen and the
SYSTEM ERROR
messages. Katie had been ready to print a big file when the whole thing died, and now she wondered if her illegal search had been discovered.

Suddenly, the computer came back on and began spitting out the information, slowly, reluctantly, whining, grinding, and complaining. Katie was searching for colon cancer patients who had all the dead doctors. Then she looked for some problem they had that cried out for vengeance. About one
A.M.
, I crashed on the couch, awakened periodically by Katie’s snarls and threats, plus an occasional thump. At two-thirty
A.M.
, she woke me up and announced that she’d narrowed the killer down to twelve possible candidates, and now we had to look at the hard copy files. She called the hospital’s patient records room for the complete medical records for all twelve. Katie was remarkably alert, but so hopped up on caffeine she talked practically nonstop. I could hardly move. The couch was about as comfortable as a slab of concrete, and my back and neck ached. I stumbled out to my car. Katie packed a thermos of coffee and took a handful of beef jerky. She drove her pickup, and I followed in Ralph. I was so bleary-eyed I could hardly see. The road was a blur and the streetlights had rings around them.

We entered the hospital by an employee entrance in the back of the building. “You wait here in this room. I don’t want anyone to see me wandering around here with a newspaper columnist,” Katie said, shoving me into an office the size of a shower stall. There was barely room for a half-size desk and chair.
She closed the door and I wondered how long it would take me to develop claustrophobia. Perversely, now that I was off the road, I was wide awake. There was nothing to read in the room but a memo for the hospital blood drive and “Moorton Musings,” the incredibly dull in-house magazine for patients, which featured photos of the administration sucking up to rich donors. This was an old issue. It showed a grinning Dr. Brentmoor at a party with his almost ex-wife, a lot of thin well-dressed women, and fat well-dressed men. I was reading the special bequests at the back when Katie returned with a huge pile of well-stuffed files.

“That medical records chick is a Nazi,” Katie said. “She thinks all patients’ medical records are her personal property. You’d think I’d asked to borrow her car. She wouldn’t give me anything until I signed off on all my old delinquent charts. And she wants these back before she gets off work at six, or else. They’re all a bunch of burned-out doctor-haters.”

She parked her rump on the desk and said, “There are twelve patient files here. I think I can weed out some.”

“Can I help?” I asked.

“How?” she said. “You don’t know what you’re looking for and you can’t read the doctors’ writing.”

I spent the next hour in a chair designed by the Spanish Inquisition, listening to Katie mutter to herself. “In. Definitely. That one’s out. No. Maybe. Maybe. No, can’t be him. Wrong doctor.” Then the file would go in the reject pile, and she’d start muttering again. She poured herself coffee and pawed through files. Meanwhile, I was deep into “Moorton
Musings,” which was about as exciting as the
Gazette
editorial page. I read the message from Moorton’s CEO, an article about the dedication of the Herbert Snernford lobby in Building D, and the entire list of Moorton Angels in the magazine. Dr. and Mrs. Brentmoor were on that list, too.

“Okay,” Katie said. “I think I’ve got it down to three people. Let’s go through the list:

“The first one is a twenty-seven-year-old man who died of colon cancer recently. He was unmarried, no children, worked as an engineer up until his death. He’s past wanting revenge, but I wondered if his father, a widower with no other children, might want vengeance against the people who killed his only son. From reading his records, it looks like it took almost two years to diagnose his cancer. The doctor probably didn’t think someone so young could get it. They put him through some tough treatment, but the guy died anyway. The father might be bitter enough over the loss of his only son to kill his doctors.

“The next candidate is a forty-five-year-old woman with inoperable colon cancer. A very sad case. She’s married and has two kids in middle school. She’ll never live to see them grow up. Her white blood cell count is too low and she can no longer tolerate chemotherapy.”

Katie shook her head. “Another stupid diagnosis. The woman had a questionable sigmoidoscopy, so her family doctor, lovable old Dr. Jolley, ordered a CT with contrast. It came back with some very iffy results, but the doctor delayed giving her those results for several months.”

“What does that mean?”

“Reading between the lines, I’d guess the doctor stuck the report in a drawer or buried it on his desk and forgot about it. She had a very fast-growing cancer, and by then it was too late to remove it. The surgeon performed a colostomy to make her more comfortable, and tried to shrink the tumor with chemo and radiation, but that didn’t work. The cancer might have been fatal anyway, but with that delay in treatment she’s going to die for sure.”

I forgot about my aching back and sore neck and being stuck in this small uncomfortable room. All I could think of were these poor people, condemned to death by someone’s carelessness.

“That’s an awful story,” I said. “I’d want to kill the doctors who did that to me.”

Katie had one more file to show me.

“This is the last case, a thirty-year-old man operated on for colon cancer. His initial results looked good, but fourteen months after his operation, they found more cancer.”

“Did it come back?”

“Can’t tell. It was probably in there in a teeny, tiny microscopic amount, and then later … poof! Could have been something the doctors didn’t catch the first go-around, could be something new. But it showed up first in his liver, and then in his colon again. I saw the poor bastard’s path report. Not a chance he’ll make it. He’s discontinued radiation but still takes chemo. It probably keeps him going. I saw something else, too. About six months ago, he requested that copies of his medical records be sent to a lawyer.”

“What’s that mean?”

“He’s thinking about a lawsuit. He’s someone who definitely wants revenge.

“There are some other possible candidates for our killer, but none of them have stories as dramatic as these. I’d say the chances are good that one of these three is the killer. They all had Dr. Jolley for an internist. They all had a sigmoidoscopy at Moorton. They all went to the same oncologist, the late Dr. Brentmoor. They were all treated in the hospital’s radiation oncology department. And they all have reason to be furious. Colon cancer is a very curable cancer, if it’s caught early. If I had to get a tumor, it’s one of the ones I’d want. Provided it was small. And not in the lymph nodes. To die of it would piss me off, too.”

“Do any of these people fit the description of the killer?”

“Well, we don’t know what the dead guy’s father looks like. The woman was fairly tall—five feet nine and one hundred fifty pounds when she was diagnosed, according to her chart. Her weight’s dropped to one twenty now. Her hair’s light brown.

“The guy is about five-eight and he was on the heavy side, about one eighty-nine. He’s down to one forty-two now.”