Diagnosis Murder 7 - The Double LIfe (14 page)

"I've heard great things about one of your nurses," Steve said. "Her name is Wendy Duren. What can you tell me about her?"

"She's a firecracker," Mitford said. "She's one of our most energetic and enthusiastic nurses. But I'm afraid she isn't available for long-term care."

"Why not?"

"Nurse Duren prefers to be a utility player. When other nurses are sick, or go on vacation, or simply need an extra hand for a day or two with a difficult situation, she's the one we send. She's up for anything and always with a smile." That could make it harder to connect her with individual patients, Steve thought.

"Maybe I could convince her to settle down with one patient," Steve said. "My father is a very avuncular fellow." 

"You could certainly try, though you'd make a lot of nurses very upset. They just love Wendy to death, and so do the patients."

"I'm sure that's true," Steve said. "May I review her history and references?"

"Of course." Mitford turned to his computer and tapped a few keys. His printer started spitting out pages.

Mitford explained how the nurses were paid and other details that Steve didn't really care about but listened to anyway. Steve assured Mitford that he would call with any questions. The meeting ended with a hearty handshake from Mitford, who wouldn't let him leave without a bag of apples.

Steve went back to his car and reviewed Duren's resume. The first thing he noticed was that she'd moved from hospital to hospital, never staying anywhere for more than two years, which gave him a chill. That innocuous fact matched one of Dr. Hudson's early-warning signals for medical murderers.

Either Duren was a restless spirit, or didn't get along well with others, or was running from something. He was going to find out the answer.

C
HAPTER
F
OURTEEN

Hospitals make a lot of people uncomfortable, but not Steve Sloan. He'd spent time visiting his father at Community General for most of his life. The hospital was almost like a second home.

Although he'd never been to Beckman Hospital in Torrance, Steve felt completely at ease there. More so, it seemed, than Conrad Napp, the vice president of operations.

Napp was a bone-thin man in his fifties who, in his youth, had probably been called lanky. He broke into a flop sweat the instant Steve flashed his badge, identified himself, and said he wanted to talk about Wendy Duren.

"Have you killed anybody, Mr. Napp?" Steve asked. "Maybe your wife or a lover? Or perhaps you ran over someone on your way to work this morning?"

"No, of course not," Napp said, practically collapsing into a seat opposite Steve, who sat on a couch in the administrator's austere office and held his bag of apples in his lap.

The office was so clean, Steve wondered if they performed surgeries on the man's desk when they ran out of operating rooms.

"Why do you ask?" Napp sputtered.

"Because you almost had a heart attack when you saw my badge," Steve said. "I'm still wondering if I should call the cardiac unit."

"I was startled, that's all," Napp said.

"It looked more like terror to me." Steve set the bag of apples on the table between them. "Relax, have an apple. I'm not here to arrest you or tell you that a loved one has died." Napp removed an apple from the bag and took a bite. It actually seemed to calm him down.

"To be honest, Detective, I've been dreading this day for years. I always knew it would come to this."

"What do you mean?"

"Wendy Duren killed a patient, didn't she?"

Steve gave him a hard look. "Why do you say that?" 

Napp bit into his apple with a loud crunch. He chewed for a moment before speaking.

"During the fifteen months she was with us, working in our critical-care ward, there was an unusually high number of deaths," Napp said. "We suspected something was very, very wrong."

"Did you report it to the police?"

"Report what, Detective? These people were critically ill to begin with, so their deaths were not entirely unexpected. Not only that, but several years ago we fired a nurse we thought might be negligent in her care. She sued us for dismissing her without sufficient evidence, and she won a seven-figure settlement. We couldn't afford another costly and embarrassing situation like that."

"But you could afford to let people die."

Napp took another bite of his apple. Steve was beginning to regret giving it to him. In fact, he was tempted to shove the apple down the man's throat.

"We didn't know anything was truly wrong until after Nurse Duren left. The family of one of the deceased patients had an autopsy conducted, and it found lethal levels of digoxin in the dead man's body. We immediately launched an exhaustive internal investigation. The report determined that her presence at the time of all the patient deaths could be coincidental."

If Steve mentally ticked off each item on Dr. Hudson's list of behavioral warning signs of a medical murderer, Wendy Duren matched just about all of them. But what was her motive? Attention? Excitement? Self-loathing? Sexual satisfaction? Playing God? Or was it the pure, unadulterated pleasure of killing?

"On the other hand," Napp continued, "the report determined that negligence or intentional acts of wrongdoing couldn't be ruled out."

"I'm sure that will be a great comfort to the families of all the people she's killed since."

"How do you think I feel? But the fact is, we couldn't prove a thing. There was no definitive evidence of her culpability. It could have been her or any of the other nurses in the ward who were responsible, if, indeed, negligence was involved. We ended up reassigning the entire critical-care staff to other duties in other units. Most of them resented it and ended up leaving the hospital and seeking employment elsewhere."

"Did you warn those other employers?"

"In the absence of any proof, our lawyers advised us not to. They said Duren would sue us and would most certainly prevail, winning damages that would make the other settlement seem like a bargain. We gave them all positive references."

"In other words, you knew she was a killer and you did nothing."

Napp got up, dropped the apple core into his garbage can, and wiped the sweat from his face with some Kleenex.

"My hands were tied."

Steve tried to control his rising anger. "I'm going to need the names of the other nurses on the ward during the period she was working here."

"We'll cooperate any way we can," Napp said. "After consulting with our lawyers, of course."

"Of course."

Steve would have liked to have the names of the lawyers who advised Napp to cover up the patient deaths. He would have liked to arrest them all, and Napp too.

But on what charge?

As infuriating and inhumane as their conduct was, Steve knew that legally the lawyers hadn't done anything wrong. From a financial standpoint, they were probably right. Their conduct was morally reprehensible, but most lawyers, bureaucrats, and corporations could live with that.

"Do you know how she committed the murders?" Steve asked.

"We have a theory," Napp said, "but we couldn't prove it"

"So you keep saying." And if you say it again, Steve thought, I'll shoot you where you stand.

"We think she was getting the drugs by manipulating our computerized disbursement system. She would order drugs for a patient, and then, after receiving the drugs from a motorized dispensing cart, she'd go back into the computer and erase the initial request."

"Then how were you able to figure it out?"

"We noticed a discrepancy between the amount of some drugs stocked in the machine, like procainamide and sodium nitroprusside, and the amount of drugs dispensed to patients. Those drugs, improperly administered, would account for the sudden deaths of some of the patients."

"But to prove it you'd have to notify the families and exhume the bodies for autopsy. You haven't done that."

Napp shook his head. "At that point we didn't see what good it would do to put those families through the pain."

"It would have saved lives."

"No one can be sure of that," Napp said.

"I can," Steve said.

The case was solved.

Steve didn't know who all the suspects were, and he couldn't name a single victim, but that didn't change what he knew in his heart to be true.

The case was solved.

Everything he needed to know was within the information they'd already amassed. All they had to do was sort it out.

It wasn't as insurmountable a problem as it had seemed only twenty-four hours ago. He believed they'd found at least one element around which everything else revolved.

Wendy Duren.

They would start with her and work outward from there. She was the center of the universe in this investigation. And that was what Steve told Amanda, Jesse, and Tanis when they gathered at the beach house that night and began devouring the Chinese food as if they hadn't eaten in weeks. They'd all been so intent on their work that none of them had eaten much during the day, and what they did consume hardly qualified as nourishment.

After dinner, Amanda, Jesse, and Tanis each moved to one of the four dry-erase boards that Steve had propped up on chairs around the living room and began writing up what had been uncovered.

Jesse listed all the dead patients who had been treated at one of the four Valley hospitals within a year of their deaths.

Amanda prepared a list of the doctors, nurses, and technicians the dead patients had in common.

And Tanis made a list of nurses and caregivers who had worked in Beckman Hospital's critical-care unit during the period when the suspicious deaths occurred. She also listed all the personnel employed in the last twelve months through Appleby Nursing Services.

While they worked, Steve stayed out of their way, clearing the dishes and bringing out fresh coffee, cookies, and a bowl of M&M's. When they were done, they joined him at the kitchen table, and everyone regarded the boards in silence.

Some connections were immediately obvious to Steve, but he waited before voicing his thoughts. There was one more fact he wanted to hear first. He turned to Tanis.

"Do any of the nurses or caregivers have a history of car theft?"

"Nope," she said.

"Not even as juveniles?"

"Nope."

"Damn," Steve said.

"But one of them had a brother who did time for stealing cars, stripping them into a pile of parts and shipping them to Mexico."

"Why didn't you say so to start with?"

"A girl has to have some fun," Tanis said with a grin. "And it gets even better."

She walked up to the list of nurses who worked at Beckman Hospital and circled one of the names.

Paul Guyot.

"Gives you shivers, doesn't it?" Tanis stepped back and took a handful of M&M's.

"So who was killing patients?" Jesse asked. "Was it Guyot or Duren?"

"Or was it both of them?" Steve said. "And what the hell are they up to now?"

He picked up a red dry-erase marker and started circling all the places where Paul Guyot's name came up on the other boards.

Jesse followed Steve's lead, grabbed a blue marker, and began boxing all the places where Wendy Duren's name appeared.

Amanda sat down at a laptop and began noting all the interconnections that were appearing on the boards.

When Steve and Jesse were done, the boards were a multicolored mess of lines, circles, and boxes that wouldn't have made sense to anyone else.

Amanda printed out a page, went up to the one empty dry-erase board, and drew a line down the center. She began copying information from the sheet of paper to the board, writing the information in either column, one of which was headed P
AUL
G
UYOT,
the other, W
ENDY
D
UREN.

When Amanda was done, she joined the others, who were standing at the kitchen table and staring at the boards in amazement and horror, as if they were studying four particularly disturbing paintings.

They were looking at four abstract portraits of murder.

The two columns that Amanda wrote read:

Paul Guyot
 

Gary Betz 

Andrew Kosterman 

Emilia Ortega 

Oliver Pritchard 

Melinda Soper

Wendy Duren
 

Hammett Aidman 

John Eames 

Dave Grayson 

Dorothy Myack 

Patricia Ohanian

"These are the patients they cared for who died in the last twelve months," Amanda said.

"My God," Jesse said.

As Steve's gaze shifted between the two columns and the connections made on the other three boards, a clear picture began to emerge.

"Okay, here's what we know," Steve said. "Wendy Duren and Paul Guyot worked together in the critical-care unit at Beckman Hospital in Torrance. During their time there, a number of sudden deaths occurred that officials now believe were murders."

"Duren and Guyot left Beckman," Tanis said, picking up the story. "She joined Appleby Nursing Services, and he went to work in the ICU at John Muir Hospital in West Hills. The fun begins again."

"And the number of deaths of recently hospitalized people with critical health issues reaches epidemic proportions," Amanda said. "Then they find out that Mark is onto them." 

"How?" Jesse asked.

"Guyot works at John Muir," Steve said. "Dad was over there talking with Dr. Barnes and Dr. Dalton. Maybe Guyot saw Dad and got scared."

"Mark's face has been in the papers and on the air a lot lately," Tanis said. "Between the Lacey McClure case and the Nick Stryker scandal, he's had more exposure than Pamela Anderson's breasts."

Steve gave her a look. "I'm sure he'd love the comparison."

"I'm just saying he's known in LA for his work with the LAPD," Tanis said. "Guyot must have wet himself when he saw Mark Sloan way out there in the armpit of the San Fernando Valley. Mark certainly wasn't there to see the sights." 

"So Guyot went looking in the neighborhood for an old, fast car with tinted windows and found one parked on a street in nearby Canoga Park," Steve said. "He stole it and tried to run over Dad with it the next morning."