Harmful Intent (33 page)

Trent was already looking forward to the day he'd walk in and tender his resignation, thereby ruining this Mrs. Mecklenburg's day.

“Mr. Harding,” Mrs. Mecklenburg said, turning her attention from the application to the applicant. Her oval face was partially obscured by large round glasses. “You've indicated on your application that you have worked at four other Boston hospitals. That's a bit unusual.”

Trent was tempted to groan aloud. This Mrs. Mecklenburg seemed intent on playing this interview game to its bitter end. Although he felt he could say just about anything and still be hired, he decided to play it safe and be cooperative. He was always prepared for such questions.

“Each hospital offered me different opportunities in terms of education and responsibilities,” Trent said. “My goal has been to maximize my experience. I gave each institution almost a year. Now I've finally come to the conclusion that what I need is the stimulation of an academic setting like the sort Boston City provides.”

“I see,” Mrs. Mecklenburg said.

Trent wasn't through. He added: “I'm confident that I can make a contribution here. I'm not afraid of work and challenge. But I do have one stipulation. I want to work in the OR.”

“I don't think that will be a problem,” Mrs. Mecklenburg said. “The question is, when can you start?”

Trent smiled. It was so goddamn easy.

 

Devlin's day wasn't going any better than the previous one. He was on the North Shore, and had visited two Everson households in Peabody, one in Salem, and was now on his way out the causeway to try one on Marblehead Neck. The harbor was to his left and the ocean to his right. At least the weather and the scenery were nice.

Fortunately people had been home at each of his stops. This round of Eversons had even been marginally cooperative, if wary. But no one had heard of a Christopher Everson. Devlin again began to question his intuition that had told him Christopher Everson was from the Boston area.

Reaching Harbor Avenue, Devlin turned left. He cast an admiring eye at the chain of impressive homes. He wondered what it would be like to have the kind of money it would take to live like this. He'd made some serious money over the last couple of years, but had blown it in Vegas or Atlantic City.

The first thing Devlin had done that morning was go to police headquarters on Berkeley Street and visit Sawbones Bromlley. Dr. Bromlley had been associated with the Boston Police Department since the nineteenth century, or so the legend had it. He gave officers physicals and treated simple colds and minor scrapes and scratches. He didn't inspire a lot of confidence.

Devlin had shown him the notes he'd picked up from Rhodes's hotel room and asked him what they were about. The result had been like turning on a water faucet. Sawbones had launched into a twenty-minute lecture on the nervous system, and the fact that it had two parts. One for doing things that you wanted to do, like drink or feel something; and another for doing the things that you didn't want to think about, like breathing or digesting a steak.

Up until that point Devlin had been doing fine. But then Bromlley said that the part of the nervous system that did the things you didn't want to think about had two parts. One was called sympathetic and the other parasympathetic. These two parts fought against each other, like one made the pupil big, the other made it small; like one gave you diarrhea, the other stopped you up.

Devlin had done pretty well even to there, but Bromlley went
on to talk about how nerves worked and how anesthetics screwed them up.

From then on, Devlin had had a hard time following, but he'd figured since his interest only went so far as the notes, it didn't much matter. Bromlley loved a captive audience, so Devlin had just let him roll on. When it had seemed Sawbones had arrived at a point of conclusion, Devlin reminded him of his initial question. “Great, Doc, great! But back to the notes for a minute. Is there anything about them that strikes you as surprising, or suspicious?”

Sawbones had looked befuddled for a moment. He'd studied the notes again, eyeing them through his thick bifocals. Finally he'd said a simple no; everything seemed quite clear, and whoever had jotted down the information about the nervous system had gotten it right. Devlin thanked him and left. The trip had been useful only in that Devlin was more convinced than ever that like Rhodes, this Christopher Everson was also a doctor.

On Marblehead Neck, Devlin pulled up to a low, ranch-style house. He checked the number from his list. It was the one he wanted. He got out of his car and stretched. The house wasn't on the water, but he could make out its sparkles through the trees that lined the lane leading down to the harbor.

Devlin walked up to the door and rang the bell. An attractive blonde about Devlin's age answered the door. As soon as she caught sight of Devlin, she tried to shut it again, but Devlin gently eased the tip of his cowboy boot into the crack. The door stopped. The woman looked down.

“I think your boot is blocking my door,” she said evenly. She looked him straight in the eye. “Let me guess: you're selling Girl Scout cookies.”

Devlin laughed and shook his head in disbelief. He never could anticipate people's reactions. But the one thing he appreciated more than anything else was a sense of humor. He liked this woman's.

“Excuse me for appearing so rude,” he said. “I just want to ask you a simple question. One question. I was afraid you were about to shut the door.”

“I have a black belt in karate,” the woman said.

“No need to be nasty,” Devlin said. “I'm looking for a Christopher Everson. Since this house is listed as belonging to an Everson, I thought that there was a remote possibility someone might have heard of this man.”

“Why do you want to know?” the woman asked.

When Devlin explained, the woman eased up on the door.

“Seems to me I read about a Christopher Everson in the newspapers,” she said, wrinkling her forehead. “At least I'm pretty sure it was Christopher.”

“In a Boston paper?” Devlin asked.

The woman nodded. “The
Globe.
It was a while ago. A year or more. It caught my eye because of the name, obviously. There aren't that many Eversons around here. My husband and his family are from Minnesota.”

Devlin didn't quite agree with her on the paucity of area Eversons, but didn't argue the point.

“Do you recall what the article was about?” Devlin asked.

“Yeah. It was on the obituary page. The man died.”

Devlin got back in his car, feeling angry at himself. The idea that Christopher Everson was dead never occurred to him. Starting the car, he made a U-turn and headed back to Boston. He knew exactly where he wanted to go now. The drive took him half an hour. Parking at a hydrant on West Street, he walked to Tremont and went into the State Department of Public Health.

The Registry of Vital Records and Statistics was on the first floor. Devlin filled out a form for obtaining Christopher Everson's death certificate. For the year, he put 1988. He knew that could be altered if necessary. At the counter he paid his five dollars and sat down to wait. It didn't take long. The year wasn't 1988; it turned out it was 1987. Regardless, within twenty minutes Devlin was walking back to his car with Christopher Everson's death certificate.

Instead of starting the car, Devlin perused the document. The first bit of information that struck him was the fact that Everson had been married. His surviving spouse was a Kelly Everson.

Devlin remembered his trip to her house. That's where he'd heard that strange noise, like empty cans dropping on a tile floor, but no one had come to the door. He picked up his Everson list, where he'd circled K. C. Everson for a call back. He checked the address against the one on the death certificate. They were the same.

Devlin went back to the death certificate. Christopher Everson had been a physician. Glancing down at the cause of death, he saw it had been ruled a suicide. The technical cause of death was listed as respiratory arrest, but below that there was a note
saying that this had been secondary to the self-administration of succinylcholine.

With sudden anger, Devlin crumpled the death certificate and tossed it onto the backseat. Succinylcholine had been the crap that Jeffrey Rhodes had injected into him. It was a wonder Rhodes hadn't killed him.

Starting the car, Devlin pulled forward and merged with the traffic on Tremont Street. Once again he was looking forward with particular relish to getting his hands on Jeffrey Rhodes.

The noontime traffic slowed Devlin's progress. It took him longer to drive from downtown Boston to Brookline than it had to drive all the way into town from Marblehead. It was almost one o'clock in the afternoon by the time he turned onto Kelly Everson's street and drove by her house. He saw no activity, but he did notice a definite change. All the curtains were drawn on the first floor. The day before they had been open. He remembered cupping his hands on the glass to peer in the dining room. Devlin smiled. As far as he was concerned, you didn't have to be a brain surgeon to know something was up.

After pulling a U-turn in the middle of the next block, Devlin passed a second time, trying to decide what to do. He made a second U-turn, then pulled to the side of the road and parked. He was two doors down from the Everson house, on the opposite side of the street. For the moment he couldn't decide on the best course of action. From experience he'd learned that if that was the case, it was best to do nothing.

“Keep the change,” Jeffrey said to the taxi driver as he got out in front of the city morgue. The driver said something to him he didn't hear. He bent closer.

“I'm sorry, what did you say?” Jeffrey asked.

“I said, what the hell kind of tip is fifty cents?” To punctuate his feelings the cabbie threw the change from his window, then took off with a screech of rubber.

Jeffrey watched the two quarters spiral on the sidewalk. He shook his head. Boston cabdrivers were a breed unto themselves. He bent down and picked up the coins. Then he looked up at the façade of the Boston city morgue.

It was an old building covered with a patina of filth that extended back to the time when coal was the major source of heat in the city. The edifice was embellished with stylized Egyptian motifs, but the effect was hardly regal. The structure looked more like something from the set of a Hollywood horror movie than a house of scientific medicine.

Jeffrey went through the front entrance and up the flight of stairs, following signs for the Medical Examiner's office.

“Can I help you?” a matronly woman asked as Jeffrey approached the counter. Behind her were five old-fashioned metal desks, haphazardly arranged. Each was piled high with an assortment of letters, forms, envelopes, and manuals. Jeffrey felt as if he'd stepped twenty years back into the past. The telephones, all grim black, were rotary.

“I'm a physician from St. Joseph's Hospital,” Jeffrey said. “I'm interested in a case that I believe was scheduled for autopsy today. The name is Karen Hodges.”

Instead of answering Jeffrey, the woman picked up a clipboard and ran her finger down the list. She got halfway down
the page before she said, “That's one of Dr. Warren Seibert's cases. I'm not sure where he is. Probably up in the autopsy room.”

“And where is that?” Jeffrey asked. Although he'd been practicing medicine in Boston for almost twenty years, Jeffrey had never been to the city morgue.

“You can take the elevator, but I don't advise it,” said the woman. “Go around the corner and take the stairs. When you get upstairs, take your first right, then a left. You can't miss it.”

Jeffrey did as he'd been told. He'd heard the phrase “you can't miss it” many times. This time it was true. Before he got anywhere near the autopsy room, he could smell it.

The door was ajar. Jeffrey timidly peered in from the threshold, half afraid to go farther. It was a room about forty feet long and twenty wide. A bank of frosted windows filled most of one wall. Fetid air swirled from an old-style rotating fan sitting atop a metal file cabinet.

There were three stainless-steel autopsy tables in the room, and all three were occupied by naked corpses. Two of the bodies were men. The third was a woman. The woman was young and blond, and her skin was like ivory but with a faintly bluish cast.

Each table had a two-person team working over it. The room was abuzz with cutting, slicing, sawing, and muted conversation. Jeffrey thought they were all men, but he wasn't sure. They were all dressed in scrub clothes covered by rubber aprons. They wore protective Plexiglas goggles over their eyes. Their faces were covered by surgical masks. On their hands were heavy rubber gloves. In a corner stood a large soapstone sink with continuously running water. A radio was balanced on the edge of the sink and played incongruous soft rock music. Jeffrey wondered what Billy Ocean would think if he could see this scene.

Jeffrey stood by the door for almost a quarter of an hour before one of the men in the room noticed him. He passed Jeffrey on the way to the sink with what looked like a liver to wash it under the running water. He stopped the moment he saw Jeffrey. “Can I help you?” he asked suspiciously.

“I'm looking for Dr. Seibert,” Jeffrey said, fighting a mild sensation of nausea. He'd never appreciated pathology. Autopsies had always been an ordeal in medical school.

“Hey, Seibert, you got company,” the man called over his shoulder.

One of the men standing over the woman's corpse looked up,
then over at Jeffrey. He was holding a scalpel in one hand. His other hand was deep inside the corpse's torso.

“What can I do for you?” he asked. His tone was a lot friendlier than the first man's.

Jeffrey swallowed. He felt a little dizzy. “I'm a doctor from St. Joseph's,” he said. “From the department of anesthesia. I'm interested to know what you found on a patient by the name of Karen Hodges.”

Dr. Seibert left the table after a nod to his assistant and came over to Jeffrey. He was a good inch taller than Jeffrey, probably about six-one. “Were you the gas-passer on the case?” he asked. He still had the scalpel in his hand. His other hand was bloody. Jeffrey couldn't bear to look any lower than the man's shoulders. His apron was unspeakably spattered. Jeffrey concentrated on Seibert's eyes. They were bright blue and rather arresting.

“No, I wasn't,” Jeffrey admitted. “But I'd heard the problem occurred during epidural anesthesia. My interest in the case stems from the fact that there have been at least four comparable cases in the last four years that I know of. Was the drug involved with Karen Hodges Marcaine?”

“I don't know yet,” Seibert said, “but the chart is in my office—down the hall on the left just past the library. Be my guest. I'll be through in here in fifteen or twenty minutes.”

“The case you're working on now wouldn't be Gail Shaffer, would it?” Jeffrey questioned.

“Right on,” Seibert said. “First time in my career I've had two good-looking young females in a row. It's been my lucky day.”

Jeffrey let that comment go. He'd never been comfortable with pathology humor. “Any clues on gross pathology as to the cause of death?”

“Come on over,” Seibert said with a wave of his bloodied hand. He started back toward the table.

Jeffrey followed hesitantly. He didn't want to get too close.

“See this?” Seibert questioned after he'd introduced Jeffrey to his assistant, Harold. He pointed with the handle of the scalpel to the gash high on Gail's forehead. “That was one hell of a blow. Fractured the skull into the frontal sinus.”

Jeffrey nodded. He began to breathe through his mouth. He couldn't bear the smell. Harold was busy removing the entrails. “Could the blow have killed her?” Jeffrey asked.

“Possibly,” Seibert said, “but an NMR was negative. We'll see when we get the brain out. Apparently she also had some
cardiac trouble, even though there was no previous history. So we'll be looking at the heart pretty carefully.”

“Will you be testing for drugs?”

“Absolutely,” Seibert said. “We'll be doing a full toxicology screen on blood, CSF, bile, urine, and even what we aspirated out of her stomach.”

“Here, let me help,” Seibert said to his assistant when he saw that Harold had succeeded in freeing the abdominal organs. Seibert grabbed a long flat pan and held it while Harold lifted the mass of slippery organs and transferred them into the container.

Jeffrey turned away for a moment. When he looked back, the body had been gutted. Harold was on his way to the sink with the organs. Seibert was casually poking around inside the abdominal cavity. “You always have to be on the lookout for the unexpected. You never know what you're going to find in here.”

“What if I suggested to you that both these women were poisoned?” Jeffrey said suddenly. “Would you do anything differently? Would you run any other tests?”

Seibert stopped abruptly. At that moment he was deep into Gail's pelvis with his gloved right hand. He slowly raised his head to take another look at Jeffrey, almost as if to reevaluate his opinion of the man. “Do you know something that I should know?” he asked, his tone more serious.

“Let's say I'm posing it as a hypothetical question,” Jeffrey said evasively. “Both women had seizures and cardiac problems without a history of either—or so I understand.”

Withdrawing his hand, Seibert stood up and faced Jeffrey across the gutted hull of Gail Shaffer's body. He thought for a moment, then looked down at the dead woman.

“No, I wouldn't do anything differently,” he said. “There isn't really a difference between self-poisoning, euphemistically known as recreational drug use, and being poisoned—at least not from a pathology point of view. Either the poison is in the deceased's system or it isn't. I suppose if I were told a specific poison was involved, it would influence how I processed some of the individual tissues. There are certain stains for certain poisons.”

“What about a toxin?” Jeffrey asked.

Seibert whistled. “Now you're talking serious stuff. You mean like phytotoxins or tetrodotoxin. You've heard of tetrodotoxin, haven't you? It's from puffer fish. Can you believe they're licensing sushi bars to serve that stuff? Hell, I wouldn't touch it.”

Jeffrey could tell he'd touched on one of Seibert's areas of interest. Seibert's enthusiasm for toxins was clear.

“Toxins are phenomenal,” Seibert went on. “Man, if I wanted to do away with somebody, there's no doubt in my mind I'd use a toxin. Lots of times no one thinks to look for signs of them. The cause of death seems natural. Hey, you remember that Turkish diplomat that was knocked off in Paris? That had to be a toxin. It was hidden in the end of an umbrella and somebody just walked by the guy and gave him a little jab in the ass. Bingo, the guy was writhing around on the platform. Dead in minutes. And did they figure out what it was? Hell, no. Toxins are murder to identify.” Seibert grinned at his joke.

“But
can
you detect them?” Jeffrey asked.

Seibert shook his head with uncertainty. “That's why I'd use 'em if I were to knock somebody off: they're a bitch to trace. As to whether you can detect them, I'd have to say yes and no. The big problem is that a very little bit of some of these toxins goes a very long way. They only need a few molecules to do their dirty work. I'm talking about nano-nano moles. That means our usual old standby, the gas chromatograph, combined with a mass spec, often can't pick the toxin out of all the other organic compounds floating around in the sample soup. But if you know what you're looking for, like tetrodotoxin, say, because the deceased dropped dead at a sushi party, then there are some monoclonal antibodies tagged with either fluorescein or a radioactive marker that can pick the stuff up. But I'm telling you, it ain't easy.”

“So sometimes you can't find the toxin unless you know specifically what it is,” Jeffrey said, suddenly disheartened. “That sounds like a real Catch-22.”

“That's why it can be the perfect crime.”

Harold came back from the sink with the tray of organs. Jeffrey took the opportunity to study the lab's ceiling.

“Harold, you want to get the brain out?” Seibert asked his assistant. The man nodded, put down the tray on the end of the table, then walked around to the head.

“I'm sorry to be interrupting like this,” Jeffrey said.

“Hey, no problem,” Seibert said. “This kind of interruption I can stand. This autopsy crap gets a little boring after a while. The fun of this job is in the analysis. I never liked to clean fish when I went fishing, and there's not a lot of difference between that and doing an autopsy. Besides, you've sparked my curiosity.
How come the questions about a toxin? A busy man like you didn't come down here to play twenty questions.”

“I told you there have been at least four other deaths during epidural anesthesia. That's very unusual. And for at least two of them, the initial symptoms were subtly different than one would expect from a reaction to a local anesthetic.”

“How so?” Seibert asked.

One of the other pathologists raised his head and called over, “Hey, Seibert, you goin' to make that case your life's work just because she's got a good body?”

“Up yours, Nelson,” Seibert called over his shoulder. Then, to Jeffrey, he said, “He's just jealous I got two in a row. But it evens out. My next one will probably be a sixty-year-old alcoholic who'd been floating in Boston Harbor for three weeks. You should see what that's like. Ugh! The gas that comes out you could run your car on for a week.”

Jeffrey tried to smile, but it was difficult. The mental images these men talked in were almost as bad as the actualities.

Responding to the goading of the other pathologist, Seibert picked up a thick suture material swagged onto a strong cutting needle and began to suture Gail Shaffer's Y-shaped autopsy wound. “Now where were we?” he said. “Oh yeah. How were the symptoms different?”

“Right after the Marcaine was given, the patients got a sudden and striking parasympathetic reaction with abdominal pain, salivation, perspiration, and even miotic pupils. It was only for a few seconds, then they had grand mal seizures.”

Harold had cut around Gail's head with a scalpel. Then, with an awful ripping sound, he pulled the scalp down over the woman's face. The skull was now exposed. Jeffrey tried to turn sideways to keep from seeing.

“Don't you see those kinds of symptoms with a toxic reaction to local anesthetics?” Seibert asked. He was lifting the needle up over his head like a cobbler after each running stitch to take up the slack.

“Yes and no,” Jeffrey said. “The seizures for sure. Also the miotic pupils have been described in the literature, although for the life of me, I can't explain it physiologically, and I've never seen it. But the transient salivation, the sweating and lacrimation, I've never even read about.”

“I think I'm getting the picture,” Seibert said. There was a sudden whirring noise and Gail's body began to vibrate. Harold was using a power saw to cut off the crown of the head. Soon
he'd be lifting out the brain. Seibert had to speak louder to be heard. “As I recall, local anesthetics block transmission at synapses. Any initial stimulation you might get is because inhibitory fibers can be blocked first. Am I remembering this right?”