Silent Treatment (42 page)

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Authors: Michael Palmer

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“Exactly.”

Harry rolled up the printout and tapped it against his fist. His idea was beginning to take shape.

“Kevin, I really appreciate that you’ve come to me before going to the DA,” he said. “Now I’ve got something to show
you.”

He handed over a folded copy of the poster. Kevin glanced at it, then pulled off into the breakdown lane and turned on the interior light.

“Never saw him before,” he said after half a minute.

“He’s the man who killed Evie. We have proof. I saw him outside her room just before the injection. Her roommate saw him
in
the room. And he left a fingerprint that was identified by the FBI lab. His name’s Anton Perchek.
He’s a doctor, Kevin. An M.D. He’s known all over the world as a master of torture,
and
for keeping victims alive and awake during torture. He was supposed to have died in a helicopter accident escaping from prison six years ago.”

“And you think he’s involved with The Roundtable?”

“I do. I think he’s the one who carries out these … these terminations.”

Kevin handed back the poster and swung the car onto the highway. For a time they rode in silence.

“You’ve got to nail that guy,” Kevin said.

You’ve
got to?
Harry looked at him curiously, but didn’t comment. Kevin’s eyes remained fixed on the road.

“I have a thought,” Harry said. “You said two of the companies involved were Comprehensive Neighborhood Health and Northeast Life and Casualty. I don’t have many patients with Comprehensive, but I do have quite a few covered by Northeast Life. Suppose I admitted one to my hospital and made up a diagnosis that would qualify him for termination under this protocol?”

“Could you do that?”

“I think so. The real question is whether your knight from Northeast Casualty would bite. What’s his name?”

“Pat Harper. He’s Lancelot, the one who made Stallings the offer to join the inner circle.”

“So if anyone’s actively involved in this thing, it would be him. That’s good.”

“But you’re suggesting taking a patient and deliberately exposing him to this Anton Perchek? Who would do such a thing?”

“Actually,” Harry said, “I have someone in mind who would be happy to. Only he’s not exactly a patient of mine. Could you take me to my office? It’s on 116th near Fifth.”

“Sure. I knew it was right to contact you.”

Once again, Loomis’s words and the way he spoke them made Harry feel uneasy. Not once had he talked about the implications for him and his family of what he was doing. In fact, not once had he spoken of his family at all. He had chosen to contact Harry before going to the DA. Why?
You’ve got to nail that guy
. Why not we?

Suddenly Harry knew. What had been troubling him so about the man was that he sounded detached, as if the events he described had happened to someone else entirely. He had chosen to speak with Harry before seeking out the DA because he never had any intention of going to the authorities. In fact, he had no intention of seeing this thing through. All at once a good deal about this strange ride made sense. Loomis’s calmness. His lack of fear. Loomis was an insurance executive. Harry suspected that his death would leave his family well provided for.

“You okay?” Harry asked as they approached the lights of the city.

“Huh? Oh, sure. I’m still worried about what’s going to happen. But I feel much more hopeful after talking to you.”

“Good. We
can
put an end to The Roundtable, you know.”

“I know.”

The sadness in his voice was unmistakable now.

“Kevin, you said you knew about me and the war.”

“What I read in the papers.”

“The platoon I was with was ambushed. We were caught in a vicious firefight, with mortar shells dropping on us from a nearby hill. Most of our kids were killed or hurt badly. I managed to drag three of them to the medevac chopper. That’s what I got the decoration for—as if I even knew what I was doing at that point. Then a shell exploded right behind me. I think it hit a mine, because it seemed like half the jungle blew up. I have no idea who dragged me out of there. It was about a week before I woke up. They had taken what metal and other debris they could out of my back, along with part of one kidney. I spent months in a rehab hospital. The pain was wicked, and for a long time I thought I might not walk.”

“But you did.”

“That’s sort of the point. About three months into my rehab, I decided I couldn’t take it anymore. I snuck off in my wheelchair with a revolver tucked under the sheet. For half an hour—oh hell, I really don’t even know how long—
I sat in the woods with this gun in my mouth and my finger on the trigger.”

“Why didn’t you pull it?”

Harry shrugged.

“I guess I just decided it wasn’t my job.”

They had crossed the river into the city now, and were heading toward Harry’s office.

“Good for you.”

“Hopeless is a relative term, Kevin. James Stallings is pretty much hopeless. You aren’t. Think about that, will you?”

For a moment it seemed Kevin was about to say something, but instead he just nodded and focused on the road. Harry felt he had gone as far as he could in counseling a man he did not know. At least he had made his point. They rode in silence until Loomis pulled up at Harry’s office.

“Is there anything else I should know before I go about creating a worm for Sir Lancelot to bite on?”

“Just follow the protocol,” Loomis said. “I wish you luck.”

Harry stepped out onto the street. The rain had stopped, but the humidity was still close to 100 percent.

“I’d like about a week before you go to the DA,” he said. “If we’re going to pull this off, publicity would really hurt.”

“No problem. I’ll check with you first, anyway.”

“Thanks. And Kevin?”

“Yes?”

“Do everyone a favor and see this one through.”

Loomis looked at him without making eye contact.

“Yeah, sure,” he said. “Thanks.”

It was the middle of the night before Harry found what he was looking for—a male patient, age thirty-five to fifty-five, whose insurance carrier was Northeast Life and Casualty. Max Garabedian, a forty-eight-year-old school custodian. Garabedian, who was compulsive about his work and his body, was something of a hypochondriac. But in
the main, he was healthy. And that was what Harry needed to know. There was only one way his scheme could work, and countless ways in which it could go haywire. But barring a freak accident, having Max Garabedian show up in some hospital when he was already an inpatient at MMC would not be one of them.

Harry considered calling Garabedian to explain what he was about to do. But if the man agreed, he would be open to charges of insurance fraud. No, he decided. Max Garabedian would have to be hospitalized for treatment of his expensive, potentially fatal illness without his knowledge. Harry copied down all the pertinent data the hospital admitting office would need to know.

Now there were only two problems: coming up with an appropriately dire condition, and convincing Ray Santana to become the bait.

CHAPTER 34

Harry stepped off the elevator onto Grey 2 and headed directly for the chart rack next to the nurse’s station. He was trying to be unobtrusive, but he knew that every nurse, aide, and secretary on the floor was aware of his arrival. He was also trying to appear nonchalant, although he felt more and more like he was on night patrol in the jungle. It was his third day of making rounds on the patient in room 218, the man registered as Max Garabedian. In order to clear his name from one felony, he was willfully committing another, probably
several
others. That their charade had survived even this long was a tribute to meticulous preparation and incredible luck. But the clock was ticking.

It had taken two days of intense work before Harry was set to admit Ray Santana to the Manhattan Medical Center. The diagnosis he had chosen for his creation was acute lymphocytic leukemia, complicated by a low white-blood-cell level and bacterial endocarditis—a serious, potentially lethal infection of the heart valves. To up the ante for Sir
Lancelot’s insurance company, he added a code and special note implying that Garabedian was being evaluated for total body radiation and a bone marrow transplant.

To test the case, Kevin Loomis had run the data through the computers of Crown Health and Casualty. The projected cost of treating Max Garabedian’s illnesses over the 2.2 years he was projected to have left to live was $697,000. A bone marrow transplant would add $226,000 to the equation, partly by increasing his life expectancy 13.6 years. If Lancelot was using The Roundtable’s selection program, Max Garabedian would light up on the Northeast Life computers like a flare.

Harry opened Garabedian’s record and reviewed the notes and laboratory reports he had inserted there, including a dictation he had done using the name of the chief of hematology. He had signed the note himself and intercepted the copy as it was being placed in the hematologist’s cubby. Such maneuvers were necessary to keep the nurses and chart reviewers from becoming suspicious. But each move carried with it the danger of discovery, and Harry was definitely feeling the strain. He had been sleeping only four or five hours a night, had absolutely no appetite, and had developed a nasty, dry cough that he felt certain was nothing more than nerves.

And to heighten the tension, there had been absolutely no sign that The Roundtable or The Doctor was nibbling at the bait.

Harry wrote a lengthy, problem-oriented progress note in the chart. As had been the case during the first two days of rounds, no one spoke to him unless he addressed them directly. It was just as well. The less anyone asked him, the less he would have to lie. And lying was something he had never done very smoothly.

To discourage hospital personnel from visiting Max’s room, Harry also added “probable tuberculosis” to the mix—all in all, enough pathology to give even the most intrepid caregiver pause. Given Ray Santana’s gaunt appearance, sallow complexion, and chronic five o’clock shadow, Harry knew that hospital personnel would have no
trouble connecting him with his frightening inventory of diagnoses.

Felony
.

Garabedian, whom Harry had labeled in his admission history “a successful commodities trader,” was admitted to an isolation room. Throughout his hospitalization, he would be tended to by his own special-duty nurses. The night-shift “nurse” was a private detective named Paula Underhill. The day and evening shifts were being covered by Maura, wearing glasses and a brunette wig. As Garabedian would be on precautions, both “nurses” would be required to wear surgical masks and gowns. Of course, Anton Perchek would be masked and gowned as well. But both Maura and Santana felt they would still be able to pick him out. And Paula Underhill, a wiry, Brooklyn-born black belt in Kenpo karate, was more than willing to try.

Felony
.

Having special-duty nurses also helped solve one of the thornier problems Harry had tackled: laboratory tests. He ordered blood work each day, but none of it included Ray’s white-blood-cell count, which would have been normal. But with Garabedian having his own nurses, the nurses on the floor would almost certainly follow his laboratory tests less closely, if at all. The trick had been to create a patient requiring an insufferable amount of work, and then to provide the regular staff with the salvation of a private nurse. Harry did insert fabricated admission blood counts from his office into the inpatient chart and decided he could improvise and produce more lab work depending on what he was hearing from the staff. He was hearing nothing.

Most of the other details were simple to work out—at least in theory. The intravenous line would be taped to Ray’s skin and wrapped in gauze. IV medications would be run into the gauze or into the sink. Oral medications would be discarded immediately or squirreled away beneath Ray’s tongue until they could be. And of course, Percodan or Demerol would be ordered every three to four hours as needed for pain.

Felony
.

The final hurdle was Ray’s absolute insistence on having his gun close at hand. Both the private detective, who was carrying a gun of her own, and Maura, who was not, agreed to help him conceal the weapon if needed.

Felony. Felony. Felony
.

Harry finished his note by indicating that Garabedian’s condition was improving slightly, but that another ten to fourteen days of hospitalization were anticipated. His goal was to fabricate as many complications as possible. Northeast Life and Casualty, like most insurers in the brave new medical world, had a team of peer reviewers that checked the records of hospitalized patients, poised to terminate benefits if the database said it was time for “the diagnosis” to be treated at home.

Outside room 218 was a steel cart with the gloves, gowns, and masks required for infectious-disease isolation. Harry prepared himself and entered the room, closing the door tightly behind him. Maura was in a chair, sketching in an artist’s pad. Ray was propped in bed watching
Regis and Kathie Lee
.

“Any problems?” Harry asked.

“He wants me to give him a bed bath,” Maura said.

“Hey, I got one a couple of times a day from the nurses the last time I was in the hospital,” Ray whined. “Just because I’m not sick is no reason I shouldn’t get tender loving care.”

“No bed baths,” Harry said, “but I will write orders for three enemas a day instead.”

“And to think, I was embarrassed even to ask for one.”

“I assume there haven’t been any sightings.”

“Not even of a nurse. It’s like they think the plague is in here.”

“They do. Maura, anything I can do for you?”

“Just find a way to have you-know-who make an appearance.”

Harry motioned to Ray’s pillow.

“No problem keeping that concealed?”

“Not as long as my nurse, here, keeps volunteering to do things so the people out there don’t have to. They’ve
already thanked her so many times, I wouldn’t be surprised if they took up a collection for her. Any progress in the outside world?”

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