Doctored Evidence Page 16

  “Oh, jeez,” exclaimed Karen, making a face of revulsion. “What kind of sick bastard…” She walked around the car and unlocked the front passenger’s door. Wrinkling up her nose, she reached inside for her cellular phone. It was gone. “Son of a bitch,” she commented, and trotted out of the garage.

  “Y-y-yello.”

  Jake was still listening to Coltrane. “Hi, sweetheart. I need you to come and rescue me after all. My car got vandalized again.”

  “Parking garage again? Good. That urn bit was a real bummer.”

  Karen was shivering and her teeth chattering when Jake arrived in the Mustang. She didn’t wait for Jake to get out of the car; she barely waited for the vehicle to come to a stop before she leapt into the passenger side, hungrily seeking heat. Jake kissed her perfunctorily and got out to examine the Volvo. His eyes were full of concern when he got back in.

  “You downplayed this one a bit, Alto,” he said. “This isn’t just vandalism. Somebody is threatening you.”

  “You think?”

  As Jake looked at her, Karen thought the concern in his eyes had acquired a hint of reproach.

  “Denial isn’t your shtick,” he said. “Yeah, I think the Good Samaritan who called to tell you not to do anything stupid is developing the theme. And I think you think so, too.”

  “Could be,” said Karen.

  Jake reached over and clasped her left hand. She could feel the warmth of his hand through the glove.

  “You’re shaking,” he said.

  “I’m cold.”

  “It’s not that cold. You’re scared.”

  She bit her lip. “I have to go to Paula Conkel’s house. Let’s go.”

  “You don’t want to report this to the police?”

  Karen sighed. “I thought about that while I was waiting for you. The police will view this like the other incidents, as property damage and minor theft. An insurance claim. I can’t tell the police why someone might be threatening me. It’s all confidential, and more significantly it’s just conjecture at this point. I’m not in a position to bring the cops in on this, and besides, I’d lose control of it.”

  “I dig. But at least report it to Max.”

  “I will, tomorrow. Now, Paula’s. Go.”

  CHAPTER

  22

  “You can’t just sit in the car, Jake. Paula might see you out here and think it’s strange.”

  Jake sucked in a deep inhalation of menthol-laced smoke and let it out slowly. “Let me get this straight. We’re going to go in unannounced, and I’m supposed to rap with Paula while you go into Larry’s locked room and rummage around for a file.”

  “Right.”

  “And she won’t think that’s strange.”

  “Get out of the car.”

  Jake shifted his feet nervously on the slate-blue carpeting in the Conkels’ living room. The room smelled of potpourri. Jake hated potpourri. Karen had brandished Larry’s room keys like a badge and blown past Paula with a display of feigned confidence. “Larry borrowed some computer software from me. He told me he took it home. I need it right away. Won’t take a minute.”

  Paula stood with her arms crossed, her mouth in an irritated pout. She was wearing a red sweater with a sequined Christmas tree on it and green stirrup pants, looking quite festive for a grieving widow.

  Jake made an attempt at conversation. “So, Paula, you following the Bulls?”

  “I don’t watch football,” she replied coldly.

  Jake put his hands in his pockets and rocked back and forth on his heels. He noticed that Paula had already moved Larry’s beer mug collection from his office to a large armoire in the living room. “Say, Paula, this might not be a good time to bring this up, but there’s a beer mug in Larry’s collection I’d like to buy from you. It’s the one with the picture of Little Walter on it.”

  “Little who?” snapped Paula. “Excuse me, I have to make a phone call.”

  “Sure,” Jake said quietly. “Go right ahead.”

  A few minutes later, Karen stood in Paula’s kitchen, a cordless phone in one hand and a leather briefcase in the other, being lectured by McCormick. She had not bothered to remove her coat. Her face was flushed, more from emotion than from being overheated.

  “I strongly suggest—no, I demand—that you leave my client’s premises immediately,” bellowed Ben McCormick. “Your direct communication with her is a blatant violation of the canons of ethics. I won’t hesitate for a moment to report you to the State Bar. Your license will be suspended before you’re out of the driveway.”

  “Cool your jets, Ben. I haven’t said one word to her about the lawsuit, which is the subject of your representation. I just stopped by to pick up some of the hospital’s property, which as the hospital’s attorney I have every right to do. Your client admitted me to the premises voluntarily.”

  “Fine. Now, as Mrs. Conkel’s attorney, I am instructing you to leave the premises at once. In ten seconds you will be reported to the police for criminal trespass. One, two …”

  Karen tried to remain cool. “You want to talk reports to the police? I’m giving serious consideration to reporting your client.”

  McCormick paused. “For what, pray tell?”

  “How about criminal conspiracy and murder one?” said Karen. “I have some pretty good evidence that Larry’s death was a homicide. A lot of it points to your client. Which not only puts Paula on the hot seat, it’s a dandy defense to your lawsuit.”

  “This is preposterous!” McCormick exploded. “Threatening criminal charges to extort settlement in a civil action is another violation of the canons of ethics. You’re getting in deeper all the time, Hayes. Just how do you imagine Mrs. Conkel carried off this dastardly deed?”

  “She has two possible accomplices inside the hospital who had the opportunity to do it. Your client also has a perfect motive, in the form of a multimillion-dollar lawsuit, Larry’s estate and life insurance.”

  McCormick chortled derisively. “You’re out in left field, Hayes. While I agree the lawsuit against the hospital is worth millions, the notion that a spouse would set up a medical accident on speculation of a jury verdict is absurd.”

  “Then how come,” asked Karen, “Paula showed up with you in tow the day after Larry’s death? I know how long it takes to get an appointment with Ben McCormick.”

  Jake peered at Karen through the hallway and made slashing gestures with his index finger across his throat, cueing his wife to cut the conversation short. Karen waved him off.

  “My office was already representing her before her husband’s death, on a fraudulent conveyance claim. And that’s the problem with the rest of your so-called motive. Mr. Conkel had advised his wife that he had cut her out of his estate plan months ago. He told her his life insurance benefits and estate all go into a trust, of which she is not a beneficiary.”

  Karen felt a hollow feeling in her stomach. This she had not anticipated. It certainly altered the landscape surrounding Larry’s death. “Who are the beneficiaries?” she asked, failing to completely conceal a note of embarrassment in her voice.

  McCormick cleared his throat. He seemed embarrassed, too. “We don’t know yet. His records are a mess. But my associates are going through everything, page by page. We won’t be surprised in probate court.” McCormick recovered his tone of arrogant bluster. “And now, Ms. Hayes, I’m going to continue counting. Three, four …”

  Karen smiled as Jake pulled the Mustang out of the Conkels’ driveway. Finally, something in one of her investigations had gone her way. She popped open her briefcase. “I took a little abuse, but I got what I came for,” she said. She held a reddish-brown folder aloft. “File number 3!” she exulted.

  Jake shifted the Mustang into first and put his hand in his coat pocket. “I did okay, too,” he said. He pulled his hand out and raised it. “The Little Walter mug!” he exclaimed.

  CHAPTER

  23

  Karen woke up feeling contented Friday morning, in spite o
f her impending layoff. By the time she and Jake had arrived home the night before, enough snow had fallen for Jake to suggest doing something they had not done in years. They filled a wineskin with Chianti, a knapsack with bread and cheese, put on their cross-country skis, and went skiing in the city streets. It was one of many things Jake liked to do that Karen thought was insane before she tried it, but thought was delightful after. Late at night, with a snowstorm in progress, there were almost no vehicles moving about, and the streets made excellent trails. The blanket of fresh snow made the city eerily quiet. Karen and Jake skied through the center of town and over the high, arching bridge with its pretentious pillars and ridiculous lions. Then they broke a trail through the state forest, and picnicked beneath their favorite oak tree on the bluff overlooking the Weyawega Flowage. Afterward, they had showered together, unplugged the phone, and enjoyed long, slow coitus.

  By midmorning, the sun was shining for the first time in two weeks, and the temperature rose into the fifties. Like the snow covering the hospital grounds, Karen’s good mood melted away rapidly after she got to work. First, she had a disturbing conversation with Carl Gellhorn. When she called to ask the Johns Hopkins doctor to put his medical opinion about Larry Conkel’s biopsy in writing, Carl was resistant and sounded uncommunicative, Karen wondered if she had accepted too readily the remarks Carl had left on her voice mail. She pressed him on what he had said.

  “One of the doctors here suggested that it wasn’t fair to apply the standards of a Johns Hopkins academic specialist to a spur-of-the-moment decision made by a small-town practitioner.”

  “There might be something in that,” replied Carl coolly. “I don’t know what standards might apply in the bucolic midwest.” There was a slightly derisive tone in the way he said “midwest,” “Plus, I had the benefit of knowing the outcome. And, after all, I wasn’t there personally to observe what happened.”

  Karen was furious. Now Carl was hedging his opinion, an opinion on which she had relied. She had quoted his impressions to the Chief of the Medical Staff, at some risk to herself. Karen wondered if the “fraternity” phenomenon Jake had described was taking over, and Carl was protecting his fellow physicians. Or, had Carl just been hypercritical and perfunctory in his initial opinion?

  “Carl, what are you saying? Your voice mail message said the case was grossly mismanaged. Was it or wasn’t it?”

  “It’s not that simple, Karen. And don’t get petulant with me. There is no upside for me in criticizing these doctors. Frankly, I thought it took a lot of nerve to involve me in this. All things considered.”

  Karen withered. So that was Carl’s problem. She remembered him as having been so civil when, the night after her first date with Jake, she had broken off their relationship in the middle of a regular Saturday night date. He had remained polite and even friendly right through graduation. All these years later, she realized that she had misinterpreted their relationship. He was not truly a friend after the breakup. He was just waiting in the wings in case she became available again. Not a friend, but an indignant jilted boyfriend nursing a grudge. It was presumptuous of her to ask him a favor. She felt mortified and betrayed at the same time. Carl had spouted off about the case to impress her with how much better he was than the doctors with whom she was associating. But when faced with the prospect of breaking ranks and actually providing evidence against his brethren, he headed for the hills.

  “Okay, Carl. I won’t need anything in writing. Send me a bill for your time.”

  “I will. Give my regards to Jake. Is he still playing the harmonica?”

  Karen considered correcting Carl and explaining that what Jake played was properly called “blues harp,” but she decided it did not matter if Carl thought he had scored a point in some meaningless competition. She ended the conversation quickly and got to work on Larry’s files.

  The remaining vestiges of her earlier good mood disappeared in a flood of frustration when she began to examine file number 3. It contained no memoranda, no letters, no reports, no text at all. Nothing to help explain its cryptic contents, which consisted of several sheets of white paper containing columns of numbers, dates, and dollar amounts. She was right back where she started, not knowing whether the file contained evidence of a conspiracy involving the hospital. If it did not, Karen had planned to promptly send off her report to the Deputy Inspector General. If it did contain such evidence, at least she would know the truth. But the contents of the file were indecipherable. Now she would have to confront Joe Grimes about it. The odds she could get anything out of him were remote, especially in view of the way he had maintained an inscrutable facade when she had ambushed him with her suspicions about Larry’s death. And he had ordered her off the job.

  By midmorning, Karen’s frustration had reached fever pitch. She had not heard back from Anne. She had not heard back from Emerson Knowles. She thought about Grimes and his out-of-bounds business schemes, about Bernard, Caswell, and Herwitz and their flouting of the Medicare laws and the Hippocratic oath, about Futterlieb and his taste for self-anesthetization, about the Medical Executive Committee’s tolerance of patient rape. She thought about the Medical Licensing Board in Illinois, which rarely in its history had taken away a physician’s license for incompetence. She thought about Lou Chambers and Ben McCormick, members of her own profession who would do anything, say anything, to squeeze a fat fee out of someone else’s tragedy. She thought about the medical suppliers who had figured out how to take advantage of a health care system so bloated and slack that they could charge $260 for a piece of plastic that cost $8 to make. She thought about the drug companies that gave away millions of dollars in free merchandise to physicians every year to promote sales, and medical equipment manufacturers that offered doctors everything from Caribbean vacations to prepaid prostitutes as rewards for pushing their products.

  The worst of it was, Karen realized, that what she was seeing at Shoreview Memorial was commonplace, which was why the federal government estimated that the nation’s health care system lost over $100 billion annually to criminal fraud, more than the entire health care budget of most countries. Health care providers collected over $30 billion a year by charging for services they did not even render, more than the booty purloined by all of the burglars, armed robbers, and auto thieves in the country put together. She pondered the American health care system that cost more than twice as much per citizen as those of most other countries. Yet the system managed to rank near the bottom among industrialized nations in such indices of effectiveness as life expectancy and infant mortality.

  Corruption, waste, incompetence, apathy. Unbridled greed. Karen wondered whether it was time to call a Code Blue on the whole system.

  At 11:00 A.M., Anne reported to Karen that the security camera tape showed no one entering or leaving the cath lab from the Saturday afternoon before Larry’s biopsy until the following Monday morning. As usual, Anne had gone beyond the requirements of her assignment. Anne had checked the records of the Materials Management Department, the delivery forms from St. Francis Medical Supply, the disposal manifests and the cath lab schedule. Karen felt warmed and calmed to find someone else in the hospital doing her job and doing it well. Listening to Anne reminded Karen that there were actually a lot of people there who did their jobs well, like Max and Larry, and many of the nurses and doctors. They just weren’t necessarily the ones who got the most attention.

  According to the records Anne collected, the hospital had five dozen catheters on hand the Saturday before Larry died. A dozen were stocked in the cath lab that afternoon. Larry’s catheterization was the only procedure performed in the lab Monday morning. But another dozen catheters were moved to the cath lab on Monday after Larry’s operation.

  “If I remember correctly,” said Karen, “the cath lab nurse said there was only one catheter on the cart Monday morning. Apparently, she was right. That’s why they had to restock Monday afternoon.”

  “Apparently,” said Anne. “But wa
it, there’s more.”

  Anne went on. Two catheterizations had been performed in the lab Monday afternoon and six on Tuesday. On Tuesday night, two events occurred: the medical waste disposal company picked up eight discarded catheters from the waste container, and twelve catheters were returned to Materials Management by the emergency room staff.

  “How did the catheters end up in the ER?” asked Karen.

  “Nobody seems to know,” said Anne. “They were just stuffed into a supply cupboard. Who knows how long they were there? I noticed the addition to stock in Materials Management, and when I asked they told me about how they had been found and returned to stock.”

  Since then, twenty procedures had been performed in the cath lab, twenty catheters had been collected by the waste disposal company, and another two dozen had been delivered to the hospital by St. Francis Medical Supply. Currently, fifty-six were on hand.

  As Anne spoke, Karen quickly penciled a chart showing the number of catheterizations performed, how many catheters were in stock, how many were used, how many were discarded, and how many were left.

  “It looks to me like the dozen stocked in the cath lab on Saturday afternoon walked out and ended up in another department’s supply cupboard.”

  “Looks like,” said Anne.

  “But think about this, Annie. If I add the number of catheters we started out with, sixty, to the number delivered, twenty-four, I get eighty-four. Subtract the number the waste disposal company picked up, twenty-eight, I get fifty-six. That’s the exact number we have on hand.”

  “Sure,” said Anne. “It adds up perfectly. That’s what you’d expect.”

  “No, it isn’t,” said Karen. “I’d expect one to be missing.”