Lethal Practice (7 page)

It took me several seconds to gather my thoughts enough to answer. “The ER minutes are filed upstairs with all the other minutes of meetings held around here. You can get them there.” Why the hell hadn’t Kingsly’s staff just given them to him?

Bufort stared at me.

I was regaining my wits quickly now. “As for my personnel records, those are confidential. They contain among other things the record of any peer review or disciplinary action a physician has been subjected to. I’m bound by hospital bylaws to protect that information from unauthorized scrutiny. You would need a subpoena, and it would have to be for a given individual. You can’t just go fishing through a whole department’s confidential files.”

“You refuse?” he asked, still staring at me without blinking.

“You know I have to,” I answered, growing a little impatient at his obvious attempt to intimidate me.

At first he didn’t reply. His expression showed nothing—not anger, not disappointment, not even resentment. But the widened blacks of his eyes warned me he was pumped with adrenaline. I felt my stomach knot as I waited for his next move.

“There’s one file you could give me permission to see.”

“Oh, whose is that?”

“Yours.”

I didn’t believe I’d heard him correctly. He’d spoken very softly, but with an edge in his voice that startled me. “Pardon?”

“You could let me see
your
file,” he repeated, still in a quiet tone, but I noticed that his beefy cheeks were flushed.

A chill went through me. Before I could speak, he spun around and left the office, his two policemen in tow.

I was left standing behind my desk, trying to figure out what had just happened. Bufort
must
have been told he could have any minutes he wanted without having to ask me. And more than anyone he would know he
couldn’t
go through confidential files for the asking.

Then I got it. He hadn’t wanted minutes or files. He wanted me, my reactions. He’d been checking me out. He’d wanted to see how I’d react to him going after old minutes and private files, particularly my own. But why? I felt another twinge of alarm. However crude his bursting in on me had been, he must have had a reason. What had he found or heard about me that interested him? Remembering the parting look on his face was giving me the willies.

My fretting was cut short.

“Ninety-nine, emergency! Ninety-nine, emergency!”

I’d started to run out the door when I heard “Cancel ninety-nine, emergency! Cancel ninety-nine, emergency!”

This meant the arrest code was called off for some reason. I slackened my pace but was still pretty brisk in covering the remaining ground back to the ER.

Susanne met me with an outstretched palm to slow me down. Without my asking, she explained. “One of the cleaning men walked in on the DOA you left in C.”

“I left?”

“Yeah. Our cleaning guy just took a staff CPR course. Saw the body, called ninety-nine, and started mouth-to-mouth.”

“On a corpse?”

“You know civilians. They can’t tell how long somebody’s been dead. Hell, they’re taught not to quit until a medic or someone qualified says so.”

“Where’s he now?”

“In the can, barfing. The corpse is on the way to the morgue.” She shoved a sheaf of papers at me. “Now, for God’s sake, do the paperwork so they don’t send him back.”

It took less than a minute to finish signing off on the forms, but then I hesitated. Looking at my note about the mark on the derelict’s chest after Bufort’s astonishing behavior, I wondered if making a fuss about such an unlikely possibility might draw his attention even more in my direction. Would he see my note as a feeble attempt to send the hospital’s pathologist on a wild-goose chase? If I could have erased the entry and had Watts check out the mark first, I would have. I even wondered if I should document the inappropriate attempt to resuscitate a long-dead corpse. To a trained doctor or nurse, it would have been inconceivable to start CPR on an obvious DOA. I certainly had never imagined that an inexperienced civilian with recent CPR training could walk in on one of our bodies and start pumping.

But the same thing had happened with Kingsly. We never would have noticed the blood coming out from around the broken needle if the two cleaning women hadn’t started CPR on a body that had obviously been dead for hours. If such a scenario was inconceivable to a doctor or nurse in the ER, could the person who murdered Kingsly have made the same assumption—that by the time Kingsly’s body was found it would have been so evidently beyond resuscitation that CPR would never even come to mind, let alone be tried? An experienced resuscitator, trying to get away with Kingsly’s murder, would never have guessed that a course for the non-medical staff in CPR would give him away.

Chapter 5

Watts scowled at me. “Look, why don’t you leave the detecting to the real detectives?” He’d had to delay Kingsly’s autopsy until the forensic experts who’d initially gone over the body for evidence could return from the medical examiner’s office. With his other work backed up, he was not thrilled by my surprise visit. I’d taken the half hour remaining before my meeting with the other chiefs to slip down the back staircase that connected to the morgue and the morass of tunnels leading to Watts’s office in the basement. In the old days at the beginning of the century, a corpse could be dug up at the cemetery, brought to this back door, and then end up on the dissection table, no questions asked and twenty-five dollars forfeited to the grave robber. A generation of friendly family doctors had learned anatomy on such grisly remains.

“Please answer my question,” I said. “What would you have put on the certificate as Kingsly’s cause of death if one of those women hadn’t started pumping him and exposed the needle? Even with his clothes missing would you have started looking for a needle hole in his chest?”

I waited; he was still reluctant to answer.

“Come on, Robert, what would your first thought have been? Kingsly naked, reeking with booze, found dead?”

He took another moment, but then went along with my invitation to play what-if.

“Finally” was all he said at first.

I waited for more.

“Yeah, me and everyone else in the hospital would say he finally did it. Drank and then screwed himself to death, or, at least, died trying to screw. He never actually raped anyone, at least not according to what I heard.”

“Would you expect his clothes to be where he fell, or even be surprised if you’d found him nude?”

“If we didn’t know he’d been murdered?” He thought a minute, then answered slowly, “No, probably not. I’ve heard the guards have found him with half his clothes missing a few other times. The women he’d hit on sure as hell never came up with them.”

Watts thought a bit more. “I might wonder about most of his clothes being gone, but I can’t say I’d make much of it. No, I wouldn’t be surprised. I’d have thought he finally started an MI with his sexual exertions someplace earlier, made it back to his office, and collapsed.”

“What about the thermostat being turned up? Would that make you suspicious?”

“Not necessarily, if I wasn’t suspicious in the first place. I’d likely figure he’d felt cold, being nude, and had jacked up the heat before he arrested.”

“So, with all of us thinking that way, could the actual needle and its mark have gone unnoticed if no one had pumped him?”

“You could count on it. Same thinking as this morning. We all saw how Hurst would have grabbed any chance to cover up and prevent a stink at the hospital. He would have explained it the same way, but in this case we probably would have agreed with him.”

“The point is, Robert, not to think of the setup from Hurst’s mentality but from the mentality of the killer. To count on all these presumptions is to know about the hospital. I mean
really
know. The way you and I do. Only someone intimate with our secrets and foibles would set up this play, dump Kingsly’s nude body in his office with a needle fragment buried in his heart, and still consider it a good plan to cover up a murder.”

“What are you getting at?”

“To think like that, it’s not just someone who knows the hospital. It’s someone so experienced in CPR he never even thought anyone in a hospital would attempt to resuscitate an already stiffening corpse.”

Watts gave me a skeptical look.

“Come on,” I said. “There was every chance of it being called, even by yourself, a freaky but natural death.”

“Okay, Sherlock, so the killer knows the hospital and CPR. Is maybe even one of us. That’s at least five hundred doctors, well over a thousand nurses, and God knows how many other trained staff members.”

I’d already figured how to narrow that group down considerably, but I needed the postmortem on Kingsly to be sure. The problem was, if we found what I expected, I was going to have a hell of a lot more trouble with Bufort.

“Maybe,” I mumbled, getting up to leave. “By the way, we got another DOA that gave me something of a surprise. When I was checking him, I found a mark at his left xiphoid-sternal junction.”

“What!”

“Relax, it’s probably a mole. But given what I found on Kingsly, I’m afraid I overreacted and noted it on the form, asking you to verify it.”

I thought he’d make some parting crack about making moles into mountains.

“Earl, you don’t need a goddamn pathologist to diagnose a goddamn mole, no matter where the goddamn thing is located!” he exploded, shocking the hell out of me.

“Robert, I’m sorry. Don’t bite my head off. I was just being careful, obviously too careful. Let’s forget about it.”

Watts took a breath. “Sorry, Earl, this killing’s got to me too. I shouldn’t have jumped all over you like that. It’s just that it’s doubled my work, and I’m behind as it is. The last thing we need around here is someone of your experience and background seeing needle marks every time you spot a mole.” He smiled, then added, “We all need to relax, and just do what we normally do. Think horses, not zebras, remember?” It was an old saying from medical school. It was meant to keep the overactive imagination of untrained students from galloping off after uncommon diagnoses.

I grinned at him, feeling pretty sheepish. “Thanks, Robert,” I said, then let myself into the warren of tunnels and catacombs outside his dissection room.

Dripping noises mingled with silence; cobwebs mixed with a lot of dust; a jumble of pipes and wires ran overhead. Some of these drooped down in tangles and resembled malignant varices, enlarged tortuous vessels dissected open and left hanging. Several layers of fuzzy mold riddled with scurrying eight-legged life, grown fat on droppings from Watts’s table, covered the pipes and wires.

This was where his next two patients waited to receive their final medical act, shrouded, silent, and parked on stretchers. Then I realized one of them might have been our DOA. Watts would declare him yet another victim of the street, and my embarrassing note would disappear onto some dusty shelf. At least I didn’t have to worry about Bufort’s reaction to it now.

The tunnel stretching in either direction was occasionally pocked with a dim pool of light that added more gloom than illumination. I gratefully fled back up the stairs to the comfort of the noise, confusion, and bright lights of my own department.

Entering my office, I managed to jostle my secretary, who was on her way out with an armload of paper.

“Why, it’s Carole Lament,” I exclaimed playfully, bowing as I held open the door to let her pass.

“I’m glad to see you too.” She laughed. It was a shared joke. We sometimes went the better part of a day without seeing each other, only a string of notes and phone messages connecting us. Then we’d have a chance encounter and quickly update each other in a shorthand possible only after years of working together. “I’ll be back in a minute,” she called over her shoulder. “I need to talk to you.”

Carole Lamont was singly the person who had sustained me most through my time as chief. She kept the department afloat from day to day. More than a dozen doctors, all our residents, and a team of nurses and clerks deferred to her to coordinate staffing and keep the schedule covered. By slowly taking over most of these logistics, she had freed me to concentrate on teaching, medical matters, and standards of care.

Managing an ER is primarily a matter of managing people: knowing who to stroke, who to push, who to nail to the wall. Yet it was Carole who was the keeper of everyone’s secrets. She got them in bits and pieces as she made up the schedule. She knew who was in love, whose marriage was ending, who’d just been dumped, who had a sick child. All of it, even joy, could distract a physician and sabotage patient care. So we watched who wanted more time off, who wanted less, and why. From these requests and the reasons for them—revealed to Carole, not to me—we knew who I could ask to do what and when. Brusque at times, efficient always, Carole had a soft shoulder that was obvious nonetheless and encouraged people to confide in her.

“You heard?” I asked when she came back in the door, unencumbered by paper.

“About the bed closures, yes. About Kingsly, a bit. Is it true what they’re saying?”

“What’s that?”

She lowered her voice. “That he was murdered?”

The gossip network had finally gotten through.

“I’m afraid so.”

“How?”

After my recent encounter with Bufort, I felt no compunction about defying the pompous jerk’s previous order not to discuss the case—it was pointless now anyway—so I told her what I knew. But I left out Bufort’s little visit I didn’t want her worrying about me.

We got down to business. Although most of the chiefs had agreed to attend the meeting, Carole told me that some of them had complained about the short notice. I thought this over for a minute. “Before you leave for lunch, please tell them to meet me in the center classroom. I want them to walk through the mess out front.”

She smiled. We both knew it would save me a few hundred words. I also hoped it would soften their reflexes to resist.

I was wrong on both counts. After I’d told the chiefs my plan, three-quarters of them thought I was as nuts as the scene out front they’d just been made to witness.