No Cure for Murder (18 page)
“You needed your sleep, Old Man.”
Jacob rocked back and forth in the chair, then grabbed the footrest lever and jerked to the sitting position. He approached Sarah, extending his hand.
“We’re pleased you decided to come. I hope you can tolerate a little time with the old folks.”
“You guys are great . . . especially Lola,” she whispered.
“I heard that,” said Lola, “I’m old, but not deaf.”
Jacob walked to the kitchen table. “Why don’t you join me, Sarah. I speak adolonics.”
Sarah looking at Jacob with questioning eyes.
“It’s Jacob, Sarah, call me Jacob. Adolonics...teen talk...you know: chillin’, peeps, tight...I know most of the lingo, thanks to Lola.”
Sarah laughed. “You’re almost as funny as Lola...” she paused, staring at Lola. “I mean that in a good way.”
Lola flapped her hand forward in a ‘forget it’ gesture.
“You can help me with the crossword puzzle, Sarah. It’s the modern culture stuff that stumps me.”
Sarah rolled her chair next to Jacob, staring at the almost completed New York Times crossword puzzle.
“Here’s one. Five letters, ending in an ‘a’. Marge’s twin. I don’t have the slightest.”
“Don’t you watch The Simpsons?”
“The cartoon?”
“It’s not a cartoon. It’s an animated sitcom, a satirical parody of the American lifestyle.”
Jacob looked at Lola. “You heard that? Satirical...parody...she’s a middle-aged person in disguise.”
Sarah blushed.
Jacob smiled.
Lola glowed.
“Anyway Dr…., I mean, Jacob, the answer is ‘Selma’.”
“Selma?”
“Marge Simpson’s twin sister is Selma.”
Jacob entered the four other letters, and then completed the puzzle in a flash.
After a pleasant dinner and light conversation, all three stood at the sink. Jacob washed, Sarah dried, and Lola put things away. They moved into the family room.
“I don’t want to spoil a pleasant evening,” said Lola, “but the Carleton Dix thing is all around town.”
“I was going to bring that up with you at our next session, should I...?”
“No, Sarah. We’ll get into it Monday. Jacob’s had his own problems with the chaplain, and I thought you should know that you’re not alone in your disdain for the man.”
“I love Einstein’s quote,” said Jacob. “The difference between genius and stupidity is that genius has its limits. The chaplain is a stupid man, and a dangerous one.”
“Don’t, Jacob,” said Lola. “He’s not stupid, and don’t make the mistake of underestimating him.”
“I won’t, but how can I respect the chaplain, a man of God, who perverts the beauty of his religion to his own ends?”
Sarah stared at Jacob, then at Lola. “Thanks, Jacob. It’s great not to be alone, but Lola, I have much more...”
Lola reached for Sarah’s hand. “I know. We’ll get into it Monday.”
Chapter Thirty-One
When Kate Planchette arrived home, her husband Ben had his worksheets spread across the dining room table. The kids sat before the blaring television in the family room.
“How was…?” he hesitated as Kate’s face said something was wrong.
She leaned over Ben, wrapped her arms around his shoulders and began sobbing. “What happened?”
“It was terrible…I don’t know what happened…I feel like I might have done something wrong.”
“Have a seat, take a deep breath, and tell me what this is all about.”
“You remember Nathan Seigel, Jacob Weizman’s patient?”
“The alcoholic with heart problems of some sort. The guy who had a season pass into CCU.”
“That’s the one, but the man is so much more. I enjoyed taking care of him. You know how attached I can get to some patients.”
“What happened?”
“He died late this afternoon. I feel awful. Something happened. Neither Sharon Brickman nor Jacob understands what caused his death. He looked drunk, had a seizure, then his heart stopped.”
“You said he was fortunate to have lived this long considering his alcoholism and his heart problems. You can only be so lucky.”
“I know, sweetheart, but on my watch, in the hospital, and on a heart monitor and he died anyway.” Kate hesitated. “I think they were staring at me.”
“Don’t do this, Kate. You’re not responsible for everything that happens in the world.”
“But…”
“No buts, Kate. Did you do anything wrong?”
“I don’t think so…”
“Kate?”
“Everything was routine, I think. Maybe I made a mistake. My mind’s been clear, but sometimes I can’t tell when I’m having an exacerbation of the MS.”
“You’re not. I haven’t seen the slightest evidence of the MS in a year. Don’t do this to yourself.”
“You’re right…but…”
“Go see Dr. Roth, if you need reassurance.”
“I’ll think about it.”
Kate tossed and turned through the night, unable to quiet her misgivings. She decided to take the next day off.
When she returned to work, everything seemed normal…or was it?
Mark Whitson was sweating under the bright autopsy lights. He looked up from his dissection as Jacob Weizman pushed open the heavy morgue door.
“We’ve got to stop meeting like this, Jacob. People will talk.”
“That’s what comes from living too long and having your patients’ age with you.”
“Not this one. Nathan Seigel was only fifty-four.”
“A hard living fifty-four years you’ll see if you review his medical records.”
Just then, Sharon Brickman entered. “Let’s get to the heart of the matter.”
“Remember, Sharon,” said Mark, “the body contains other organs.”
“Merely appendages to the heart, gentlemen.”
Mark lifted his scalpel. “As a courtesy to a lady, we’ll examine the heart first.”
“Don’t use the ‘L’ word on me, Mark, people may be ready to believe many things about me, but you’ll never sell me as a lady.”
The room resounded with the coarse vibrations of the electric Stryker saw, its pitch increasing each time the stainless-steel teeth bit into bone. Mark completed the last cut through the chest wall and elevated the incised rib cage and breastplate.
Mark dissected the heart away from the major vessels and surrounding tissue, and then placed it on the digital scale. “Five hundred eighty four grams, nearly twice the weight of a normal heart.”
He next placed the heart on the dissecting board and with scissors and scalpel examined the valves, heart muscle, and the coronary blood vessels. He next sliced through the heart muscle with a razor-sharp chef’s knife as if he were carving a London Broil. “A big flabby heart, consistent with his alcoholic heart disease but I see no evidence of any major coronary event to explain his death. Maybe when I do the microscopic examination, we’ll get more information about why he died.”
Sharon shook her head. “I really hate autopsies that tell us nothing.”
“We always learn something,” said Jacob.
“Just not why he died.”
“You’re pretty fussy, Sharon.”
They stood by as Mark completed his gross anatomic examination of Nathan’s major organs. His liver showed the characteristic signs of alcoholic cirrhosis but the pathologist saw no other obvious abnormalities. “If nothing shows on the microscopic, we’re stuck without a diagnosis.”
“Can you think of any reason for toxicology studies?” said Jacob. “I always think of the arcane when I can’t explain a death.”
Mark picked up the toxicology request form. “We can easily do a broad toxicology screen.”
Sharon pointed to the form. “Add a Lidocaine blood level. Maybe this is an unusual form of Lidocaine toxicity.”
Chapter Thirty-Two
For some reason, it was rare to find an empty seat at Zoe’s table at noon in the doctor’s dining room. Her charm, intelligence, and self-effacing sense of humor made her a big hit with Brier’s medical staff. In addition, the female physicians embraced Zoe as a welcome asset in their battle with the vestiges of sexism in the medical community.
When Jacob pulled up a seat at the table, Ernie Banks, a family practitioner, turned to him. “Hey, Jacob, I have a patient up at Lake Tahoe who needs a house call. Can you make it?”
“Very funny, Ernie. I always wonder why you guys find my making house calls so threatening.”
Jack Byrnes scanned the table. “It makes them look bad, Jacob, even if you weren’t eighty-eight.”
Ernie scowled. “Well said, by an ICU specialist who never leaves the hospital.”
Jacob shook his head. “You have it all wrong. I’m no saint, although compared to some docs in this community…”
“Don’t get him started,” said Ernie.
“Many of my patients are my age or older. Either they can’t get in or the process of traveling to my office is too difficult or stressful. On a busy day, I’m in and out of a home in ten minutes and can handle 98 percent of their problems. It also keeps me moving. Keep moving, gentlemen, and you’ll keep living.”
After Jacob gobbled his bag lunch and excused himself, Edith Keller, an infectious disease expert, turned to Zoe. “When’s Jacob going to retire?”
Sharon Brickman laughed. “Are you kidding? Jacob’s never going to stop on his own...we’ll have to carry him off the field.”
Edith stared at Sharon. “You’re not saying that you see some reason that he should retire?”
“No. Of course not. Jacob’s as smart and as opinionated as ever.”
Edith turned to Zoe. “You haven’t noted anything, have you, Zoe?”
“No, but I don’t see any of us getting sharper as we age.”
“Well,” said Sharon, “Jacob and I don’t always agree, but if I had to debate him in public, I’d be up studying the night before.”
Sharon finished chewing another bite of her sandwich. “Jacob doesn’t believe that it’s age alone that results in cognitive impairment, and I think…or I hope that he’s right. It’s the three D’s: disease, disuse, and disinterest that are the villains. Jacob’s mind works out on a treadmill of stimulation: work, puzzles, interaction with the world around him, and his perverse desire to be right all the time.”
“Well, sooner or later,” said Zoe, “like the rest of us, he’s got to face the calendar. I just hope that it’s on his own terms.”
After lunch, Zoe had one patient to see in the hospital before she returned to the office. Sylvia Brockman was Jacob’s eighty-one-year-old patient with recurrent congestive heart failure. In the last year, she was in and out of the hospital, staying two to three days at a time for a ‘tune-up’.
When Zoe entered room 513, she found Sylvia sound asleep. Zoe shook her several times in an attempt to arouse her, but all she got was groaning.
Zoe pushed the call button. “Can you ask Mrs. Brockman’s nurse to come in here for a moment?”
“Certainly, Doctor,” said the ward clerk.
While she waited, Zoe performed a careful neurological examination, but other than lethargy, she found nothing. Zoe was scanning the chart when her nurse arrived. “How long has she been this way?”
“She slept through my assessment when I came on this morning.”
“I see the night nurse, Marion Krupp, gave her Haldol at 2 a.m., but the chart doesn’t say why.” Zoe paused a moment. “Why is Marion Krupp still working at Brier? I thought they fired her?”
“From what I understand, Marion is fighting her dismissal through her union representative. She’s still around. Getting back to your question, Doctor, during morning report Marion said that Sylvia was confused and belligerent, and that she needed sedation, so she gave her the Haldol as prescribed.”
Zoe pointed to the chart. “The notes don’t reflect any such thing, and everyone knows how Dr. Weizman feels about sedating such a patient. This is disturbing.”
“But,” said the nurse, “you left orders for sedation as needed…Marion thought she needed this, Doctor.”
“Don’t make excuses for Marion’s poor judgment,” said Zoe. She pointed to Sylvia. “This is what happens when nurses don’t listen and substitute their convenience for good patient care. Your head nurse will be hearing from Dr. Weizman…bet on it. He’s going to go ballistic when he hears it’s Marion Krupp again.”
Tommy Wells sat in the shadowed booth at the rear of Kelly’s, a noisy bar in downtown Oakland, near the Alameda County Superior Courthouse.