The 5th Horseman (12 page)

In response to O’Mara’s questioning, the serious-looking doctor in black-framed glasses told the court about a night when he was the attending physician in the ER and a thirty-year-old woman named Jessica Falk was brought in by ambulance.

“Ms. Falk had been swimming in her pool,” said Chen. “She felt woozy and dialed nine-one-one. She was in ventricular fibrillation when she came into the ER. We defibbed her, got her heart back into normal sinus rhythm so she was stabilized. She was doing just fine,” Chen told the jury. “Then she was transferred to the ICU.”

“Please go on, Dr. Chen,” said O’Mara.

“I knew Ms. Falk pretty well — our daughters go to the same day care center — so I stayed on top of her case. I looked in on Jessie about six hours later, when I was going off my shift. We talked for a while, and she was okay. She missed her little girl was all. But when I checked her chart the next day, I learned that she’d had irregular heartbeats, probably the result of conductive disturbance — and she died.”

“Doctor, did you find that unusual?”

“I thought it was unusual for a woman of Jessica’s age and physical condition.”

“And so, what did you do?”

“I called for a postmortem and a board review.”

“And what were the findings of the autopsy?”

“Somehow Jessie Falk had received epinephrine. It was not prescribed.”

“And what would be the effect of epinephrine on that type of cardiac patient?”

“Epinephrine is a synthetic form of adrenaline for God’s sake. She should have gotten lidocaine, an antiarrhythmic. That would have smoothed out her heart rate. Administering epinephrine was like giving her cocaine. It would be lethal for a cardiac patient.”

“So that’s a pretty big mistake, isn’t it, Dr. Chen? What happened when the hospital board reviewed Ms. Falk’s case?”

“Actually, no action was taken,” the doctor said, biting off his words.

“No action?”

“Well, nothing with respect to Jessie Falk, anyway. I was terminated two weeks later.”

“Because you blew the whistle?”

“Objection! Counsel is leading the witness,” Kramer said, coming to his feet.

“I’ll rephrase, Your Honor. Dr. Chen, why was your employment terminated after twelve years?”

“I was told it was for ‘budgetary reasons.’”

O’Mara dropped her head, letting the power of the doctor’s words stand without embellishment. Then she lifted her face to the witness.

“I only have one more question, Dr. Chen. Who was the doctor who admitted Jessica Falk through the emergency room?”

“Dr. Dennis Garza.”

“To your knowledge, did he conduct a follow-up exam of Mrs. Falk when she was in the ICU?”

“His signature was on the chart.”

“Thank you. That’s all I have for you, Doctor.”

AS KRAMER GOT UP to cross-examine Dr. Chen, Yuki swung her head, scanning the courtroom until she found Dr. Garza three rows ahead on the aisle. That scum.

He was getting up from his seat, raking his black hair away from his forehead as he headed toward the door. Yuki’s face burned.

Where is that bastard going? Get back here, Garza. You need to listen to this!

Yuki stood, too, excusing herself, working her way across the row of knees again, stepping on toes, banging the bench-back with her briefcase.

“Sorry, sorry, sorry.”

By the time she reached the hallway, Garza was out of sight.

Yuki saw elevator doors closing. She ran forward, pressed the button, reversing the doors. But the elevator car was empty.

She arrived at the lobby in time to see the back of Garza’s navy-blue jacket, the man striding purposefully, heading away from her and out of the courthouse.

Yuki followed him, her heels clacking loudly on the lobby floor. Now she was wondering what she was going to say or do when she caught up with him.

This was so unlike her, Yuki thought as she pushed open the heavy door, stumbling into the blinding light outside. She wasn’t this impulsive.

She was organized, disciplined.

But right now, she couldn’t stop herself. The obsession was taking over, as if she were in a wild Hitchcock movie.

Yuki searched the sidewalk, saw Garza heading along McAllister toward the Civic Center, head up, forging through the pedestrian traffic.

Yuki followed, running at times to catch up with him, then pacing herself behind him; finally, she called out his name. “Garza!”

The doctor stopped, and he spun around to face her. He squinted his eyes against the sunlight.

Yuki drew closer, stopping just short of handshaking distance.

“I’m Yuki Castellano.”

“Yes, I know who you are. The question is, why are you stalking me?”

“I asked the medical examiner to autopsy my mother’s body,” she said.

Garza struggled not to look surprised. “I hope that made you feel a lot better. Did it?”

“I do feel better, Doctor, because I don’t feel crazy anymore. But I am in a rage. My mother died because you screwed up. Again.”

Garza looked incredibly annoyed now.

“Me? Personally? You’re sure of that?”

“Don’t play games with me. I’m talking about my mother!”

“I’m sure the ME will send me her report. Maybe I’ll even read it.” Then Dr. Garza turned away and walked to a black Mercedes parked at the curb.

He opened the car door and stooped to get in, but then he stopped. He looked back at Yuki. “Hey, why don’t you sue me, bitch? What an original idea. Join the crowd.”

IT WAS 6:15 ON WEDNESDAY NIGHT, and Claire and I were in our favorite booth at Susie’s. The calypso band was tuning up with the Jimmy Buffett national anthem, and we’d ordered a pitcher of draft while we waited for Yuki and Cindy to show.

Claire and I clinked glasses, then continued unloading the small complaints that are like fleas on a dog — not life-threatening, but annoying as hell.

“You know Bob Watson?” Claire said.

“Your assistant, Bob?”

“Yes. My dear, strong, willing, smart, workaholic assistant, Bob. He’s moving to Boston, and now I have to promote the mayor’s twenty-two-year-old niece.”

“What? She’s a courtesy hire?”

“Shoved right down my larynx. Child’s called Bunny.” Claire moaned. “Bunny can hardly lift her coffee cup, let alone a two-hundred-fifty-pound body.

“Keeps changing the CDs from Shostakovich to hip-hop. ‘Dr. Washburn, we need the right music.’ Sure thing, Bunny. No rush. Mr. Doe here is resting comfortably.”

I laughed, snorting beer up my schnoz just about the time Cindy blew in and plopped into our booth.

“Greetings, girlfriends.”

“Back at you, girl reporter,” said Claire. “Where’s Yuki?”

“I just left her in front of the courthouse. She sends her regrets.”

“She’s still really hurting?”

“Terribly,” Cindy said. “But she’s focused on the trial. She’s even more obsessed than I am.”

Loretta dropped off the menus and a basket of plantain chips as Cindy told us about her past few days in court.

“Dr. Dennis Garza’s name came up again today. A ten-year-old girl lost her mother because of an overdose of her prescribed medication. Garza checked her in through the ER. Jamison Funeral Home checked her out.

“You listen to the stories in court, and you really want to nail someone for this shit,” Cindy continued, blowing the wrapper off a drinking straw. “Don’t ever go to a hospital if you can help it. More people die of accidents in the hospital than die from breast cancer, AIDS, or in car accidents.”

“Come on!”

“Lindsay, medical errors are among the top ten causes of death in America. And I’ve done some research on Garza. Statistically, he’s holding up his end.”

“Do tell,” said Claire.

“Every place Garza worked,” Cindy said. “Cleveland, Raleigh, Albany, and here. The body count climbs when he shows up at a new hospital.”

“What you’re talking about, it’s a national scandal,” Claire said, setting her glass down hard on the table. “Dirty medical practitioners moving around the country, and the hospitals don’t turn them in ’cause they don’t want to get sued.”

Cindy nodded her agreement. “It’s how so-called angels of death rack up dozens and sometimes hundreds of victims before they’re caught — if they ever are.”

“It’s no wonder Yuki’s obsessed with Garza,” I said. “She’s sure he’s responsible for killing her mother.”

“I can tell you this for a fact,” said Cindy. “Someone at that hospital is responsible for what happened to Keiko. She should be at home right now. Drinking tea. Telling Yuki what to wear and how to get married.”

SAN FRANCISCO’S MORNING rush-hour snarl had eaten up fifteen precious minutes of drive time, and now Cindy was late. She pushed open the courtroom door, waved at Yuki, who was sitting behind the rail, then bumped everyone in the press row down a seat as she squeezed in.

A sidebar was in progress, a fairly heated one, Cindy thought. O’Mara and Kramer were arguing in lowered voices at the base of the judge’s bench.

Judge Bevins had listened long enough. “I don’t see the problem, Mr. Kramer.” Bevins flicked his ponytail, adjusted his bifocals. “Both of you, step back. Let’s get going.”

Kramer spun away from the bench, and Maureen O’Mara took the lectern. She tossed her mane of titian hair. A sign of victory? Then she called a witness to the stand.

There was a buzz in the courtroom as a striking fortyish woman with short platinum-blond hair was sworn in. Her slim European designer suit in shades of olive green combined with her crisp, white man-tailored shirt spoke of uncommon style and confidence.

“What’s going on?” Cindy whispered to the reporter beside her. This dude was like Clark Kent in the flesh — early thirties, dark-haired, bespectacled, remarkably cute in a nebbishy sort of way.

“Hello. I’m Whit Ewing. Chicago Tribune,” he said.

“Sorry. I’m Cindy Thomas.”

“Of the Chronicle?”

“That’s me.”

“I’ve been reading your reports. Not too bad.”

“Thanks, Whit. So, what’s the beef?”

“O’Mara is calling a defense witness as part of her case-in-chief. It’s a pretty clever tactic. Kramer can’t cross-examine his own witness—”

“So she gets over on him until he puts the witness on himself.”

“Very good.”

“Thanks, bud. I owe you one.”

“I just may hold you to that,” he said, grinning.

The sharp crack of Judge Bevins’s gavel brought the court to order.

“Please state your name,” said O’Mara.

“Dr. Sonja Engstrom.”

“Dr. Engstrom, what is your position at Municipal?”

“I’m director of pharmacy.”

“Here we go,” Whit Ewing said to Cindy. “The windup for the pitch.”

SONJA ENGSTROM LISTED her credentials succinctly, said that she’d been at Municipal for seven years and was responsible for the systems and people who dispense medication. She seemed suitably impressed with herself, too.

O’Mara asked, “Could you tell the jury about those systems that you’ve put in place, Doctor?”

“Sure. We have an automated computer system linked to a dispensing mechanism.”

“What can you say about the accuracy of this system?”

“I’d say it’s ninety-nine point nine percent bulletproof.”

“Could you please explain?”

Cindy got it all down on her laptop. A physician would take a patient’s lab results and enter the diagnosis into the computer. The computer program would offer a menu of appropriate drugs, and the doctor would pick one. Then a nurse would pull up the patient’s name on the computer and enter her code.

“It’s a password, right? Everyone has their own code?” O’Mara asked.

“Exactly.”

“Please go on.”

“At the same moment the nurse enters her code, one of our pharmacists reviews and enters the order for that patient. This releases the brake on the machine that dispenses the drugs.”

“So it’s a kind of digital vending machine.”

“Correct,” said the witness, seemingly pleased with herself and with O’Mara for getting it right. “The nurse takes the patient’s drug out of a pocket in the machine and administers it to the patient.”

“A ‘bulletproof’ system?”

“Very close. The program can’t be altered, and the security codes leave an auditory trail.”

“I see,” said O’Mara. She walked back to her table, consulted her notes, turned back to the witness.

“Could a technician load the wrong drugs into the machine’s ‘pockets’?”

“I suppose it’s possible. . . .”

“Please answer yes or no.”

“Yes.”

“Could someone withhold a drug after removing it from the machine? Divert it, say, for personal use.”

“Yes.”

“If a physician makes a wrong diagnosis, wouldn’t the wrong medication be dispensed to the patient?”

The witness was blinking her eyes rapidly. Flustered maybe, Cindy thought, but more than that, she looked pained. So much for 99.9 percent reliability.

“Yes, but—”

“Thank you,” O’Mara cut in. “Now, isn’t it true that the number of pharmaceutical-based fatalities has increased threefold since Municipal was privatized three years ago?”

“Don’t you think this worries me? I’ve turned over every stone,” Engstrom said, her voice rising, wavering for the first time since she’d taken the stand.