“Priscilla, please don’t worry. Take some aspirin. Try to calm down. I’ve got to go now. But I’ll see you soon.”
“Yes, all right.” Priscilla hung up the phone, found some aspirin, and waited for Steve to come home.
He was furious.
“Why the hell did you go up there, Pris!”
“Because I had to know. And you were right. They think I did it. Carte said it was something you could buy in the drugstore, and he implied I did it. I don’t even know what he’s talking about. I gave him Annie Jameson’s number, and she’s meeting them over there—Carte and the police.”
“I’m going to call that sonovabitch right now and get a list of the employees out of him,” Steve exploded. “There’s gotta be somebody we know working over there. Somebody with a grudge, Pris.”
Priscilla heard Steve’s end of the phone conversation. She watched his face redden. Finally he hung up.
“Well?” she asked.
“He doesn’t think it’s necessary,” Steve minced in apparent imitation of the doctor. “Well, I’ll get it out of him, or some damn administrator up there, you can bet on that!”
Somehow they got the boys to bed. Mechanically, Priscilla tidied the house, picking up clothes and toys, polishing the kitchen counters, waiting for the doorbell.
The visit was worse than Priscilla expected; she spent most of it in tears. From the beginning it was obvious that both Annie and the young, officious police officer she had brought with her, believed that a finger was being pointed straight at Priscilla. And not just because of Mindy.
“I understand you had another child who died,” the officer said. “We’re going to have to investigate that, too.”
For a while, Priscilla sat wordless, the tears streaming in fine runnels down her face. Steve was yelling about their enemies and a list of Kaiser employees and kept saying that the boys were fine, that they’d be sick if Priscilla was going around poisoning the children. That she was the best mother anyone could have. That she had worked against child abuse for years, that they both had fine reputations in the community. He was shouting.
“But what about Mindy? What will happen to Mindy?” Priscilla finally broke in over Steve.
“I don’t know. Maybe a foster home, Priscilla, just for a little while,” Annie said.
“Oh, no!” Priscilla was shrieking. “Annie, you know I lost one child and now they want to take another! You can’t do this to me!”
“Well, I don’t know, Priscilla. Why don’t we talk to the doctor tomorrow. I’ll set something up. Maybe we can work something out.”
“Annie, you’ve got to do something about the visiting. They’re only letting me visit five minutes an hour. They won’t even let it accumulate. She’s not used to being alone like that.”
“All right, Priscilla. I’ll see what I can do. Why don’t you and Steve plan to come by the hospital tomorrow about noon? I’m sure we can work this out. Please don’t worry.”
Priscilla sat motionless on the orange sofa as they rose and then left. She did not even move when she heard Steve slam the front door after them. She felt rooted, helpless. Because, for once, she didn’t know what to do.
18
Annie was there to meet them as promised. Steve felt as though he’d been treading water in a deep pond for an hour. His big, burly body was floppy with no sleep and worry and uncertainty.
That morning he had called Jim Hutchison.
“Someone’s trying to poison Mindy,” he said. There had been a pause before the minister replied.
“What?”
And Steve had repeated it, explaining what had happened. “We need you up at Kaiser, Jim. Can you come?” It was for Priscilla, really, that he was asking, he knew. Priscilla had leaned so hard on Jim when Tia had died.
“Yes, of course, Steve.” The heavy Irish voice had been reassuring. “I’m just getting ready for the service, but I’ll be up as soon as it’s over. By one o’clock certainly. Don’t worry,” Jim had said.
So they expected him in time for the meeting that Annie Jameson had arranged with Dr. Callas in the ICU Quiet Room.
At noon, Steve and Priscilla drove to the hospital to visit Mindy. Steve did not go in. He couldn’t bear some nurse standing over him, watching every move. He looked through the glass door as Priscilla moved to Mindy’s bed. He knew Pris was crying.
“How is she?” he asked when Priscilla returned five minutes later.
“She looks okay. They’re giving her cereal and bottles. She hasn’t had any diarrhea.”
So it
was
something in the bottle of formula, Steve thought. Maybe the damned doctors had done something right for once. But who? How had it happened? In a way, Steve didn’t want her to be better because now they’d surely be coming after Priscilla. Well, they weren’t going to do it. Not if he had anything to say about it.
And now here with Annie Jameson was Dr. Callas, her face set in accusation. Steve almost flinched. Jim Hutchison wasn’t here. He had called at the last minute and said he couldn’t make it till later, that they should go on without him.
The Quiet Room seemed smaller still, Steve thought, as though a black cloud of threat and danger had entered, seeping under the single door, filling the room. Steve could almost feel it hanging there, ready to shroud them all.
Priscilla was crying before they went into that little room, and she cried on and off throughout the meeting. Annie said they were there to talk about the visiting. It felt good to Steve to have some support. And Annie was effective. She was an older woman with a calm voice and an air of reason.
“I don’t see why the visiting can’t accumulate,” she said to Dr. Callas. “It is so inconvenient for the Phillipses to arrange their lives so that they can be here five minutes each hour.”
“That’s right,” Priscilla broke in. “It’s too exhausting. Either I have to sit outside the door for the other fifty-five minutes and watch the clock, or go home, try to live a normal life, and then rush back.”
“What I suggest—” began Miss Jameson.
“It’s totally ridiculous—”
“Steve—”
“I just wanted to—” he began again.
“Let her finish!”
“Okay. Sorry,” he muttered.
“Why not fifteen minutes every three hours? That’s what I propose.”
Dr. Callas hesitated. “All right, Miss Jameson,” she finally said.
“Now tell me more about these sodium levels,” Miss Jameson said.
They were trying to tie it in with Tia, Steve realized as he listened to Dr. Callas, and that didn’t make sense. Now they were claiming that Mindy was getting sodium from outside. But when Tia’s sodium levels had been elevated, the doctors had always explained that this was a physiological response; Tia was experiencing too much output of fluid too quickly, causing an increased level of sodium in the blood.
So what was going on? he wondered. Had they screwed up in Tia’s case? Was this thing with Mindy just an excuse for Tia? Pris kept saying they’d never tie Tia into this, that Tia was a whole different thing. But Steve wasn’t so sure.
At the end of the meeting, Priscilla and Annie wanted to look in again on Mindy, and as they crossed the hall to the ICU, Steve turned to Dr. Callas.
“Something I don’t understand here. Are you saying it has to be an additional sodium source and not a natural process? Tia always had high sodiums and you explained it away as a physical reaction to diarrhea. Couldn’t Mindy and Tia have the same thing?”
Dr. Callas stopped and looked at him squarely.
“Yes,” she replied. “The two cases are exactly the same.” But what she meant and what he understood were entirely different, and this conversation, much later, was to come back to haunt him.
19
All through the meeting, Evelyn struggled to stay detached. She was outnumbered. It would be easy to give in. It would stop the tears and the shouting and the hysteria.
But over and over, Evelyn kept reminding herself, we know the chemistry, we know what we know, and we know no matter how loudly they scream and holler, that child was poisoned. Remember your data, Evelyn; keep your head.
Last night, at midnight, the nurse had recorded a perfectly formed brown stool. The 9:15 A.M. electrolyte readings reported back from the lab had shown a sodium of 138 milliequivalents per liter, a potassium of 5.3, a chloride of 106, and a carbon dioxide of 26. All were completely normal. And Mindy’s appetite had returned. There was no getting around the evidence of the patient’s own body. It was irrefutable proof.
It had taken Evelyn three tries and lots of scratch paper last night before she had been satisfied with the child abuse form she had filled out. This report was going to the San Rafael police, and to the Marin County Child Protective Services. It involved a family with a certain standing in the community. Both parents were county employees. Evelyn knew she had to be careful with this report. She wanted to be certain that she accused no one, yet she had to make sure that Mindy would be protected. She was proud of the finished product, which ended with the sentence, “The illness is consistent with the addition of a saline cathartic to the child’s intake by some person.” No one could ignore that report.
But they might not know exactly how to deal with it. It was clear that Miss Jameson, for one, was confused about the implications of what had occurred. After the Quiet Room meeting with the Phillipses, Evelyn had conferred with the social worker alone.
Didn’t Dr. Callas think that Mindy might go home with a public health nurse in attendance? Miss Jameson had asked.
“No, it’s not safe,” Evelyn answered.
“Well, couldn’t Mindy go home with them on some sort of basis? Mrs. Phillips has offered to have someone move in with them to keep an eye on Mindy. The most upsetting thing for her is to have Mindy taken away from her, especially after the loss of Tia,” Miss Jameson persisted.
Evelyn looked at her in disbelief. “Look, I know you’re trying to help, but I have to disabuse you of the notion that Mindy can go home with Mrs. Phillips on any basis. Don’t you understand, she’s already killed one child and has tried to kill another!”
“What do you mean? What other child?”
“Tia! At this point I’m sure Tia didn’t die a natural death, either!”
“My goodness! That’s really difficult to take in. I can’t believe it! What evidence do you have? I’m just sure she couldn’t have done that—that you’ll find you’re mistaken,” Miss Jameson said numbly.
“Frankly, I think that’s unlikely. When we start looking through Tia’s chart—knowing what we do about Mindy—I think we’ll find medical evidence. Now we know what to look for. It is so easy to introduce a substance into a child with a naso-gastric tube in place, you know. Just mix it with a little water and inject it into the tube. With a bottle, of course, it’s even easier. And there have been some articles recently about mothers—perfectly ordinary-seeming mothers, incidentally—doing this sort of thing to their children. We were just never suspicious enough, unfortunately.”
“Well, this is a delicate situation as you know. Mrs. Phillips is a county employee who has worked in the Child Protective Services. I don’t want to malign her or slander her or jeopardize her position without proof,” Miss Jameson said.
“You saw Mindy. She’s the proof!”
“She’s also the problem here.”
“Exactly,” Evelyn said.
“Obviously her needs come first. She must be protected. I don’t necessarily agree with your conclusion about Mrs. Phillips, but you’re rendering a professional opinion, and I will go by it. Mindy will not be released to the Phillipses.”
“Thank God!”
So that was one fewer battle that had to be fought, Evelyn thought. But something else was gnawing at her now. Yesterday she had finally admitted to herself the significance that all this had on Tia’s death. But how was she going to tell Sara?
That afternoon, Evelyn started telephoning Sara’s house every half hour. She wanted to make certain she reached her before anyone else. She was worried about what the Phillipses might do to Sara, verbally or possibly even physically. And she was concerned about how Sara might take the news.
She tried, distractedly, to plan for her trip tomorrow to Sacramento. She had been working for months on another child abuse matter, an assembly bill that would enable doctors to take photographs of suspected cases of child abuse without parental consent.
Now she was supposed to go to the capital, sit in on the Criminal Justice Committee, and possibly testify about the bill. The timing was ironic, she thought. If nothing else, it would be a relief to get out of the hospital and away from the Phillipses.
But she still had today to get through. That afternoon, she had finally reached the Physician-in-Chief. He didn’t want to hear about it when she told him what was happening. He made it plain that it was too abhorrent to think about. As though that closed the matter. She sensed that administrative support would be minimal.
Finally, at ten that evening, Sara answered the phone.
“Mindy’s in ICU but she’s all right. Stay there, I’m coming over to tell you about it,” Evelyn said, just as she had practiced it all afternoon.
Evelyn drove slowly west along North San Pedro Road, past the huge pink sprawl of the San Rafael Civic Center with its vivid turquoise roofs, through central San Rafael.
Sara lived in a little cul-de-sac in a two-story block house that lay up alone against a wooded hillside by a stand of pine trees. It was very quiet and hidden. You wouldn’t know it was there if you weren’t looking for it, Evelyn thought randomly.
She focused her mind on Sara, who like her house, was difficult to find. Sara revealed so little of herself. Evelyn realized suddenly that she was not even sure how Sara would react tonight, exactly how shattering this all would be to her. But she knew it would be grim because Sara had trusted Priscilla Phillips and because, when it came down to it, the responsibility for the health of Tia and Mindy belonged quite properly to the primary physician. And that had been Sara.
Sara met her at the door. She looked so slender and frail and tired. Evelyn put her arms around her.
“Mindy’s formula was contaminated with sodium,” she said. “But now she’s okay. Sara, the nightmare is over.” There was a pause.