Sisterhood (17 page)

Midway up the center aisle, Wallace Huttner sat with Ahmed Hadawi and the other members of the Medical Staff Executive Committee. Joining that group, occupying the chair just to Huttner’s right, was Peter Thomas.

The back of the amphitheater was the domain of the nurses. Eight of them, all in street clothes, formed a rosette around Dotty Dalrymple, who appeared volcanic in a plain black dress. Janet Poulos was there, along with Christine Beall, Winnie Edgerly, and several other nurses from Four South, including Angela Martin.

On the right-hand side of the hall, several rows behind Edward Lipton III, sat David. He sat alone until the very last minute, when Howard Kim, the anesthesiologist who had helped with Charlotte’s unsuccessful resuscitation, lumbered down the stairs and squeezed into the chair next to him.

John Dockerty had drawn up the guest list for the evening. Dr. Armstrong had made the arrangements.

“I want to thank you all for coming,” Dockerty began. “You must believe me that inquiries such as the one I have requested tonight occur much more frequently on
Columbo
and in Agatha Christie novels than they do in actual police work. However, I want to move forward as quickly as possible on the matter of Charlotte Thomas, a matter involving all of you in one way or another. Theatrics have never been my bag, so to speak, but this meeting seemed like the most effective way for me to gather the preliminary information I need, while at the same time keeping all interested parties informed. In the next few days I’ll be contacting some of you for individual questioning.” He looked down at Margaret Armstrong, who nodded her approval of his opening remarks. Then, sweeping his hair back in place, Dockerty called Ahmed Hadawi and motioned him to a seat angled across from the oak table, so that the pathologist could look at him without completely turning his back to the audience.

“Dr. Hadawi, will you please review for us your involvement in the case of Charlotte Thomas?” Dockerty asked.

Hadawi spread a few sheets of notes in front of him, then said, “On October third I performed a postmortem examination on the woman in question. The gross examination showed that she had a deep pressure sore over her sacrum, moderately advanced coronary artery narrowing, and an extensive pneumonia. It was my initial impression that she had died from sudden cardiac arrest caused by her infections and the generally debilitated condition resulting from her two operations.”

“Dr. Hadawi, is that your impression now?” Dockerty asked.

“No, it is not. The patient’s physicians, Dr. Wallace Huttner and Dr. David Shelton, were present at the autopsy. They requested a detailed chemical analysis of her blood.”

“Help me out here, Dr. Hadawi,” Dockerty cut in. “Don’t you do these chemical analyses routinely on each—er—patient?”

Hadawi smiled sardonically and folded his hands on the table. “I wish that were possible,” he said. “Unfortunately, the cost of postmortem examinations must be borne by the institution involved, and it is hardly an inexpensive proposition, what with sophisticated tissue stains, clerical help, and all else that is required. While we would never knowingly omit a critical stain or test, we of the pathology department must nevertheless temper our zeal with judgment that will enable us to stay within our budget.” He paused for a moment and gave a prolonged, hostile look at Edward Lipton III.

“Please proceed,” Dockerty said, scribbling a few words on the pad in front of him.

Hadawi referred to his notes. “Of the many chemical analyses that were done, two came back with abnormally high levels. The first of these, potassium, was seven-point-four, where the upper limit of normal is five-point-zero. The second was her blood morphine level, which was elevated far above that found in a patient receiving the usual doses of morphine sulfate for pain.”

“Dr. Hadawi, would you please give us your impression of these findings?” Dockerty’s voice was free of even the slightest hint of tension.

“Well, my impression of the potassium elevation—and please keep in mind that it is an opinion—is that it is artificially high, a reflection of events occurring in the tissues during and just after the cardiac arrest. The morphine elevation is an entirely different story. Without question, the level measured in this woman was critically high. Easily, although not necessarily, high enough to have caused cessation of respiration and, ultimately, death.”

Dockerty spent a few seconds distractedly combing
his hair with his fingers. “Doctor, you imply that death was caused by an overdosage of morphine.” Hadawi nodded. “Tell me, do you think an overdose of this magnitude could have been accidental?”

Hadawi drew in a short breath, looked at the detective, then shook his head. “No,” he said. “No, I do not believe that is possible.”

There was not a whisper or movement in the amphitheater. For several seconds Dockerty allowed the eerie silence to hold sway. Then he said softly, “That, ladies and gentlemen, makes Charlotte Thomas’s death murder. And her murder is why we are assembled nere.” Again silence. This time, Hadawi shifted uncomfortably in his seat, anxious to be done with his part.

“Thank you for your help, Doctor,” Dockerty said to him. As Hadawi stood to go, the detective added, “Oh, one more small thing. You mentioned that the chemical tests were ordered by Mrs. Thomas’s doctors, ah”—he glanced at his notes—“Dr. Huttner and Dr. Shelton. Do you remember specifically which one of them actually asked for the tests?”

Hadawi’s dark eyes narrowed as he searched Dockerty’s face for some hint of the significance in his question. Finally, with a bewildered shrug, he said, “Well, as I recall, Dr. Shelton requested the potassium level. The rest of the tests were ordered by Dr. Huttner.”

Dockerty nodded the pathologist back to his row, whispering another “Thank you” at the same time. He searched the hall for a moment and was facing away from David when he said, “Dr. Shelton?”

Howard Kim reached up a massive paw and patted David on the back as he inched sideways past the giant and into the aisle. David had known for a day about the abnormal blood tests, had even heard the wildfire rumor around the wards that some kind of police investigation was under way. Although Dr. Armstrong had not told
him that he would be asked to make a statement, he was not at all surprised to be called by the detective.

Dockerty smiled, shook his hand firmly, motioned him to the seat vacated by Hadawi, and then, seeming at times disinterested, led him minute by minute through the events that followed Charlotte Thomas’s cardiac arrest. Gradually David’s statements became free-flowing and animated. Dockerty’s style made it easy for him to talk. Soon he was sharing information with the disheveled lieutenant in the relaxed manner of two friends in an alehouse. Then, without changing the pace or tone of their conversation, Dockerty said, “Tell me, Dr. Shelton. I understand that shortly before Mrs. Thomas was found by you to be without pulse or respiration, you had a discussion about her and about seriously ill patients in general with Dr. Armstrong here and some of the nurses—namely, ah”—he consulted his notes—“nurses Edgerly, Gold, and Beall. Do you mind telling me what you had to say in that discussion?”

For five seconds, ten, fifteen, David was unable to speak. The question didn’t fit. It made no sense unless … His mind began spinning through the implications of Dockerty’s question to Hadawi as to which doctor had actually ordered the test that had disclosed the high morphine level. The indefinable sense of fear, so vague among his feelings that night on Four South, now thundered through him. His temples began to throb. His hands grew stiff and numb.
Holy shit, he’s going after me! He’s going after me!

At that moment he realized that Dockerty’s eyes had changed from liquid to steel and were locked on him, probing, gauging, boring in. David knew it had already taken him too long—far too long—to react to the question. He inhaled deeply and fought the panic. Loosen up and stop reading so much into this, he thought. Just tell the man what he wants to know.

“Dr. Shelton, do you recall the incident I’m asking
about?” The elaborate patience in Dockerty’s voice had a cutting edge.

Even before he answered, David sensed that his words would be stammered and clumsy. They were. Expressing his thoughts around “er’s” and “ah’s,” he said, “I simply told them … that a patient who is … in great pain with little hope of surviving his illness might … might be treated with some temperance. Especially if the therapy planned is … particularly painful or … dehumanizing … such as being put on a respirator.” He battled back the urge to say more, consciously avoiding the panicked talking that comes with trying to explain an explanation.

Dockerty ran his tongue slowly over his teeth. He bounced the eraser end of his pencil on the table. He scratched his head. “Dr. Shelton,” he said finally, “don’t you think that withholding treatment from a sick patient is a form of mercy killing? Of euthanasia?”

“No, I don’t think it’s a form of any kind of killing.” Molten drops of anger began to smolder beneath his fear. His voice grew strained. His words came too rapidly. “It is good, sensitive clinical judgment. It is what being a doctor is all about. For God’s sake, I’ve never advocated shutting off a respirator or giving anything lethal to a patient.”

“Never?” Dockerty delivered the spark softly.

David exploded. “Dammit, Lieutenant, I’ve had more than enough of your insinuations!” He was totally oblivious now to all the others in the amphitheater. “If you have an accusation to make, then make it. And while you’re at it, explain why I was the one who kept saying that something wasn’t right during the resuscitation. Why I was the one who requested the potass …” The word froze in his mouth. He realized even before Dockerty spoke, what the detective was driving at. “Damn,” he hissed his frustration.

“I have had the chance, Dr. Shelton, to speak briefly
with some of the other physicians and nurses who were with you in Charlotte Thomas’s room. Like you, several of them were concerned that something was not completely right. Apparently the problem was obvious enough for others besides you to pick up on it. Whether or not they would have gone so far as to ask for blood tests on this woman, we’ll never know because you did. At least, for the potassium you did.”

“And you’re trying to say I did that to cover myself and to insure that nobody thought about anything like morphine?” Dockerty shrugged. “This is ridiculous! I mean this is really crazy,” David cried.

“Dr. Shelton,” Dockerty said calmly. “Please get hold of yourself. I am not accusing you or anyone else of anything.”

“Yet,” David spat out.

“Excuse me?”

“Nothing. Are you finished with me?”

“Yes, thank you.” Once again Dockerty appeared as mechanical as he had throughout most of the inquiry. As David stalked back to his seat, he noticed that halfway up the center aisle Wallace Huttner sat staring at him with icy, metallic eyes. Involuntarily, he shuddered.

Dockerty whispered with Dr. Armstrong for several seconds, then called Dorothy Dalrymple. The nursing director extracted herself from her seat with the side-to-side movements of a cork coming free from its bottle. Once released from her chair, she glided down the aisle steps with paradoxical grace. A feminine handshake with Dockerty, then she adjusted herself on the oak chair and smiled that she was ready.

Dockerty led her through a description of Charlotte Thomas’s appearance over the day prior to her death as summarized in the nurses’ notes. “The nurses’ notes are generally written at the end of each shift,” Dalrymple explained. “Therefore, the notes from the October second
evening shift were not done until after the patient’s death. However, the nurse who cared for Mrs. Thomas that night, Miss Christine Beall, saw her at seven o’clock, approximately two hours before her death. Her excellent note states that the patient was—and I quote now—‘alert, oriented, and somewhat less depressed than she has been recently.’ Miss Beall further writes that her vital signs—pulse, respiration, temperature, and blood pressure—were all stable.” Dalrymple swung her massive shoulders and head toward the audience and peered up to where the nurses were grouped. “Miss Beall,” she called out, “do you have anything to add to what I have told the lieutenant?”

Christine, who had been totally depressed and distracted since David’s outburst, was not paying attention. She had learned about the discovery of morphine in Charlotte’s body less than twenty-four hours before. The information had come via a telephone call from Peg, the nurse who had asked her to evaluate Charlotte Thomas in the first place. “Christine, I want to keep you abreast of as much as we know of what is going on here without worrying you unduly,” the woman had said. “There is going to be some kind of inquiry on the case tomorrow night, I’ve been told. A policeman will be there. However, your Sister, Janet Poulos, has reviewed your notes in the patient’s chart. There is nothing there, she feels, that will in any way implicate you. It is our belief that the investigation will be a short-lived and fruitless one, and that Charlotte Thomas’s death will be attributed to the work of an individual whose name and motives will never be discovered. All Sisterhood operations at your hospital will be curtailed indefinitely, and before long the entire matter should just blow over. You are in no danger whatsoever, Christine—please believe that.”

Christine, lips pressed tightly together, was staring
up into the blue and gold dome when Dalrymple addressed her.

Several seats away, Janet Poulos watched helplessly, every muscle tensed by the prospect of Christine leaping to her feet, shouting her confession to the hall, then crying out the only other Sisterhood name she knew: Janet’s. God, she wished there had been enough warning to call Dahlia. Dahlia would have known exactly how to handle things.

Janet’s gaze moved past Christine to where Angela Martin sat, cool blue eyes fixed on the scene below, golden hair immaculately in place. The woman was absolutely nerveless. Even if it had been her name that Christine Beall knew, Janet doubted that Angela would have been ruffled. Almost ten years as members of The Sisterhood and they had never even known one another. Now they were best friends, sharing the excitement and rewards of The Garden and speculating about the mysterious woman who had brought them together.