Lie Still (51 page)

I said, “Yes. It’s really a tragedy. At least it’s over, though.”

After a few seconds I said, “I don’t want to sound stupid, but all this is pretty important to my future. It seems there’s been a murder. Is there any . . . Do you see any way there could be a case against Dr. Lyle?”

They looked at each other silently. After a few blinks, Ken 386

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May said to his partner, “You know, if we can find some evidence in the canyon—the gun and casings—we can tell the DA we’re getting the syringe analyzed. . . .”

Will said to me, “Sure, we’ll go look in the canyon. We’ll get the notes from the kid’s chart. We could go ask around the airport about our ‘Robin,’ but we don’t even have a picture of her. And we’ll go knock on Dr. Lyle’s door and see if she’s dumb enough to say the wrong thing.” He turned to Ken. “I’m going to say right here I am not looking forward to going to the DA for a warrant. With what we got now we can’t even call it a homicide. His death certificate probably says ‘asthma.’ All we have is the word of this ex-doctor who got trashed by his professor and now he thinks she’s out to get him.” He turned to me: “No disrespect intended, Dr. Ishmail.”

“DA might laugh us off the force,” Ken said.

Will said, “And if the DA can’t or won’t get us a warrant, we’ll have to be real polite to Dr. Lyle. Even if we do get one I’m going to bet she’s done a lot of housecleaning by the time we get there. There won’t be a thing that would lead us to ‘Nurse Robin.’ So we’ll do all the legwork, sure, but I’m betting it comes to a big goose egg. We’re not going to be able to do much unless we find ‘Robin.’ There’s a lot of room to hide in this country and you can bet the Mesa PD

ain’t going to be looking door-to-door.”

“But if I had left Dr. Lyle there to die?”

He thought for a few seconds. “Well, that would have made it all different, yes. We would have had to prove you did or didn’t plot to kill her. That would have been interesting, but I suspect the evidence would have backed you up.

We would have been proving your version of the events.

With the physical findings at the scene, the note in the chart, an automatic search warrant, and a condo she had not been able to ‘clean up,’ we might have found ‘Robin.’ I think the picture would probably have been at least filled out enough to clear you.”

May said, “And your not doing mouth-to-mouth resuscitation—not saving her—would not have been the same as LIE STILL

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killing her. In a self-defense situation there’s nothing says you have to go back and try to save the dying.”

A few weeks after Henry’s death, I called Detective Borden to see if they had uncovered anything that might help my case. Will described their search for the canyon with the adobe cabin. It took two days to find it. The day I told them about my “shoot-out” with Dr. Lyle, they asked a county deputy from Globe to go check it out. That night he reported back he couldn’t find it. The first landmark I gave them was the large green sign saying “Tonto National Forest.” Turns out there were several.

The next day they called an assistant ranger from the National Forest district office to help. He couldn’t get away until the day after that. They drove up and together found the right set of ruts and trailed down to the cabin. The assistant ranger said, “Shit, I remember hearing there was an old adobe down in here, but they told me it burnt down.”

Naturally there was no sign anyone had been there for a long, long time. No tracks, no gun, no bullet casings. Only wind.

Detective Borden said, “You know, Doctor, in your world, sometimes the patient dies. In ours, sometimes the bad guys get away.”

My reinstatement hearing at Providence of Glory Hospital actually went better than predicted. Sally Marquam and her Executive Committee had their private powwow over a catered dinner, then invited me in to tell my side of the Henry happenings.

Of course, the key witness against me, “Robin,” was not there. That was not the plus it might have been, though, since everyone there had heard the rumor that I had been suspected of killing her. I had no choice but full disclosure.

I handed out folders with a written synopsis of the events: Henry’s code and resuscitation, how “Robin” had done it, the evidence that “Robin” wasn’t Robin, and finally who had been behind it. I attached as appendices copies of the text material I had found at the Biomed Library and the jour-388

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nal articles about nefarious nurses. Last I included, as much for flavor as argument, photocopies of the cover page of the police file, replete with the file number. Unfortunately it was labeled “Missing Person,” not “Homicide.” While they were reading I picked at the food they gave me.

Mr. Schteichen, the CEO, maintained a look of incredulity through the whole thing. When they had all closed their folders, after a good long silence, he said, “I must say, Dr. Ishmail, I admire your chutzpah in trotting out this whole . . . tale.” He said it with a note of condescension. I took it to mean
adios.
The next day I began looking for work in Nebraska.

Two days later I got the call from Sally Marquam. Instead of dismissal, though, it was a conditional reinstatement. She said Dr. Cunningham had argued vehemently that his fellow physician be treated as innocent until proven guilty. He apparently bullied the others into agreement. I could not tell from Ms. Marquam’s telling whether Dr. Cunningham truly believed my version of the events or perhaps had some other reason for keeping me around.

Maybe as “Staff Raconteur.”

So I worked at Glory for another month. Then the administration signed an exclusive contract with the ER group that covered all of Tucson. I applied with them but they wanted nothing to do with me, answering politely that they had all their own folks lined up. I was left with hard-won clinical privileges at a hospital where a convenient business arrangement had me locked out.

My displacement was not quite complete, though. To this day I am licensed by the State of Arizona to practice within her borders as a physician and surgeon. For years I got to come back at intervals to meet with lawyers.

All of us expected a malpractice suit, so when I was served with the summons it was almost a relief. I expected a certain unity among the lawyers for my insurance company and those for the hospital, but it soon became clear I was seeing war dances done quietly with blandly painted wooden masks.

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I soon figured out the interpretation of the dance: First, I was just a sideshow. All the lawyers knew, especially Ted Priestly, that juries are far likelier to stick it to a faceless hospital than a struggling young doctor.

Second, when Priestly and his team found out about the open police file, albeit a thin one, the hospital, as the employer of the putative criminal, looked like easy pickings.

The hospital’s best defense, though, was the lack of any evidence of anything. Their strategy, then, was to wait, forever if possible.

I thought my side should settle up cheap while the lawyers were focused on other prey and get on with life, but my insurance people, too, wanted to wait. An administrator friend explained to me why: They like the interest they earn on money they keep in reserve for big potential payouts—money they would otherwise have to refund to their policyholders under an agreement with the state medical association. As long as this wrongful death suit was open, they would be justified in keeping $2 million—the upper limit of my policy—

in their very own FHA-backed home mortgage fund.

My lawyer, too, said that settling the matter would be crazy: First, he reminded me, I had not done a thing wrong.

The claim against me had absolutely no merit and should be energetically defended. Second, there was relative advan-tage in uncertainty: I was better off in the job market with an unsettled claim hanging out there than a history of having lost a case, even if we got out cheap.

For added flavor we had, snooping around the edges, the reporter from the
Arizona Republic
who had written the original story about Henry’s ER event. Not surprisingly he had been watching the public filings for Henry’s name. As soon as the suit was filed he began calling everyone involved, even me. He got a chorus of “No comment.” When the judge heard about it he issued a gag order, citing to the attorneys assembled before him the potential for a

“firestorm of innuendo” and making it clear any leaks would mean fines and jail time.

All the reporter could generate was a back-page filler that 390

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the story “first broken by this newspaper” had come to legal action, that So-and-So had said “No comment,” So-and-So had said “No comment,” and the proceedings had been sealed by the judge. Since he didn’t know why they had been sealed, he could not generate even a whiff of legitimate implication. It was boring reading.

So no one was in any rush.

Except Daniel Mendoza and Ted Priestly. They wanted money, and waiting for an unspecified number of years had no appeal. The hospital people said they were happy to wait for the imaginary criminal to be brought forward. Compro-mise was inevitable. Ultimately the two parties negotiated a $1.1 million settlement from the hospital’s reserves.

My lawyers refused all settlement offers, though, doubting Mr. Priestly would ever take us to court when his key witness would be entirely unavailable to testify and could be shown to have used the name and license of a dead male nurse—Robin Benoit. So we waited, stone-faced. Soon enough the Court got fed up with inactivity and told the Priestly side to fish or cut bait: They dropped the claim.

Hard to think of it as vindication, but better than any of the real-world alternatives.

Feeling somewhat immune and maybe a bit cocky, I called the
Republic
reporter. I asked him how he had first heard about Henry’s case. He said, “Somebody phoned in a tip. Happens all the time. Anonymously. Didn’t leave a name but she said she was a nurse and appalled by what she’d seen. I started asking around. Why? Any idea who it might have been?”

Once in a while, Adrienne gets a call from a tiny-town Marcus Welby who needs a one-or two-week break and has to pay for imported coverage. Being mobile and licensed over millions of acres of grassland, I seem to qualify. Last month I went for nine days to Cedar Knoll, Colorado, population 910.

I told this one to Adrienne but I’m not certain she quite felt the jaws of the trap.

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As an intern, I did six weeks of obstetrics and gynecology.

At Maricopa that meant I saw just about everything there was to see—high risk, low risk, smiling faces and streaming tears. I learned that birth is a wondrous, beautiful, happy process—until, abruptly, it’s not. Everyone involved—

Mom, Dad, grandmas, grandpas, techs, nurses, and docs—is smiling away, thinking everything is groovy and then—

Bam!—big trouble. Lots of yelling, running, bleeding, turning blue, brain damage, and death. Nothing like it.

The worst are the total surprises, of course. Everyone is planning on a christening but ends up at a funeral. But some of the disasters are at least partly predictable. Infection and prematurity, of course. Diabetic moms, hypertensive moms.

Really small or really big babies. Placentas awry. Twins are bad, triplets are worse. Anything more than that is a freak show. In the human uterus more are less.

From that rotation I give you the Kletts. They had wanted kids for years. Already in their mid-thirties, they finally managed to conceive triplets, reportedly with no pharmaceutical aid. So blessed, she did everything right.

Never smoked. Made every clinic appointment and took her vitamins.

Kept the faith even when her husband went away to prison—his offense I did not ask about.

Through some miracle, she carried those three fetuses to thirty-seven weeks—term. She was scheduled for a cesarean section within days.

But she got a funny feeling. It was a Saturday night. She came in to be checked. The Chief Resident, who had been following her in clinic, came in from home and saw her himself. Carlos Alvarez. A polished individual, a Spaniard by birth, well dressed, articulate, and as near as I could tell, undisputedly knowledgeable. He examined her by hand, by stethoscope, and by ultrasound. All three babies looked perfect, swimming around in their allotted amniotic fluid, hearts strong, regular, not too fast, not too slow. Then, for no reason other than “good measure,” they put Mrs. Klett on a monitor for two hours—not a single contraction. Dr. Alvarez 392

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explained everything to her and her mother, then sent the five of them home.

When she came back at nine o’clock the next morning, all three babies were dead. Cause unknown.

Mr. Klett did not arrive until 1:00 P.M. It had taken our social worker the intervening four hours to get him a one-day release from state prison. It was clear the authorities wanted him back very soon and he would not otherwise be visiting for some years yet.

An anesthesiology resident got her snockered beyond meaningful consciousness and we induced labor. Mr. Klett stood with his wife through three stillbirths, crying and clenching his teeth.

The dad wanted nothing to do with Dr. Alvarez, that

“slick-talking taco bender,” so it fell to me to sit with them for thirty minutes and try to help them understand that we doctors don’t understand some things that are very important to some people. And to try to deflate Mr. Klett’s need for vengeance. And to stare back at them blankly when they asked me how they were ever going to have children, especially with him still tucked away.

This particular memory strongly colors for me any high-risk OB encounters.

The Marcus Welby of Cedar Knoll, whose practice I was covering, must surely be as lonely as he is anachronistic.

The only doctor for miles. He bought the local hospital to keep it open. Sold his house. Lives in a double-wide mobile home. Altruism and community commitment are not in question.

My second morning in clinic I did a prenatal check on a twenty-two-year-old. All smiles. Only three and a half months along. First pregnancy. But two strikes against her: High blood pressure needing medication even before she got pregnant. That’s high risk. Twins. Also high risk. In combination about as high risk as an early pregnancy can be.