Doctored Evidence Page 2

  A slice of cold pizza with a single bite out of it and an unread newspaper sat on the round oak kitchen table next to an empty bottle of inexpensive red wine and a full pack of menthol cigarettes. On the worn, faded kitchen counter several pieces of unopened mail were scattered haphazardly amid an assortment of harmonicas, which Jake, a professional blues musician, called harps. Two days’ accumulation of unwashed dishes was piled in the sink.

  “I bet you weren’t the only one at Shoreview Memorial who got on Larry’s case about going to St. Pete’s for his own operation. He’s supposed to be one of the boosters for Shoreview.”

  Karen realized Jake was right. When Larry Conkel was told he needed a biopsy on his enlarged heart to determine the cause of his cardiomyopathy, he had scheduled the procedure to be done at the other hospital in the city, St. Peter’s, by a physician not on the Shoreview Memorial medical staff. Larry confided to Karen that he had taken heat from his coworkers at Shoreview about being a “traitor.” The hospital CEO, Joseph Grimes, had spoken to him quite seriously about how it would look if one of Shoreview’s own executives went to “our competitor’s facility.” Grimes considered the city of Jefferson to be the battlefield of a great “holy war” in which only one of the city’s two hospitals would survive. Because HMOs and medical technology were shortening or eliminating hospital stays and the population of Jefferson had not grown in twenty years, there were not enough patients to keep two hospitals viable. So, the hospitals fought for patients like two packs of jackals having a tug-of-war over an antelope carcass. Grimes made sure all the executives knew that filling the beds at Shoreview Memorial was the top priority. And Karen knew Grimes would hold it against Larry if Larry went to St. Pete’s for his biopsy.

  Karen had not ridiculed Larry about his choice of hospital, nor had she preached loyalty. Out of genuine concern, she had simply asked him why he was going to St. Peter’s Hospital. Larry had given an unconvincing explanation about being embarrassed to have Shoreview employees, whom he knew personally and worked with, see him in a hospital gown, strapped to a table. Karen found Larry’s reasoning weak and told him so. She had suggested that Larry weigh the short-term embarrassment against the long-term effect on his career as a result of ticking off Grimes. A week later, Larry had made an appointment with Ed Bernard at Shoreview.

  “I should have stayed out of it,” Karen groaned. “Why am I always handing out advice like I’m so smart?”

  “Because you are so smart,” said Jake, “and you hand out great advice.” He checked the clock on the outdated avocado-colored oven and continued. “Hey, if you’re done eating, are we going to do anything about my long agenda?”

  Karen cocked her head and forced a smile. “Could your agenda wait until tomorrow, Jake? I’m wiped, and I still have the creeps about all this.”

  Jake shrugged good-naturedly, but Karen could see disappointment in his eyes. “Sure, no importa,” he said, “but tomorrow, I’ll need help relaxing.” Tapping the pack of cigarettes on the table meaningfully, he said, “Remember, next week I’m going to quit smoking.”

  Karen just looked at him with a tolerant, knowing smile that said, “Sure you are.”

  Shoreview Memorial Hospital was a mid-sized hospital in a mid-sized city named Jefferson about twenty miles too far from Chicago to be considered a suburb. The hospital’s name was a lie. Although it was within walking distance of a murky, man-made lake formed by a dam on the polluted Weyawega River, there was no view of the shore from Shoreview.

  The structure had been built in two phases seventy years apart. The original building was a homely, two-story box of dirty red brick, full of yellowing linoleum, noisy radiators and asbestos. The new “wing,” as it was called, was actually an envelope, surrounding the original building on three sides. The new wing was four stories high and modern in design—steel, plate glass, and concrete—giving the hospital, as a whole, the appearance of an Atlantic City hotel encircling a hold-out rooming house. The surgical suites, physicians’ offices, and patient rooms were in the new section. The old building housed the administrative offices, including the Legal Department.

  At 8:15 A.M. the next morning—Tuesday—Karen Hayes entered her office, feeling weary after a fitful night’s sleep. She tossed her khaki trench coat on a chair, flopped down behind her desk, picked up the telephone and pushed the blinking red “Message Waiting” button on the console.

  “Enter your code number now,” said a mechanically recorded female voice. Karen pushed 0-6-1-8, the first four digits of Jake’s birthday.

  “You have four new messages in your mailbox” said the voice.

  “Damn, how could I have four messages already?” Karen asked the recording.

  “Message one, received Monday at 6:50 P.M. To hear the message, press 2.”

  “This is Dr. Bernard. Look, Hayes, I don’t appreciate being hung up on. It really pisses me off. So if I’ve committed any malpractice this afternoon, it’s your fault for upsetting me. Anyway, I didn’t get a chance to tell you, you better take control of this Conkel case right away, get the records fixed up, whatever. Just keep me out of any legal shit. I don’t need to remind you or Joe Grimes what my admissions are worth to this hospital. St. Pete’s would be glad to have me on staff any day of the week.”

  “If you would like to hear the message again, press 2. To hear the next message, press 3. To erase the message, press 4.” Karen saw no reason to save Bernard’s repulsive message. She had never “fixed up” a medical record and had no intention of fixing up Larry’s in order to protect Bernard. She did, however, jot a note to remind herself to have Larry’s record put in safekeeping. Records damaging to the physician had been known to “disappear,” leaving the hospital in an embarrassing and indefensible position. She pressed 4 to erase, and 3 to hear the next message.

  “Message 2, received Tuesday at 7:45 A.M. To hear the message, press 2.” Karen did so.

  “Karen, Joe.” It was Joe Grimes, the hospital CEO. “Stop by and give me a report on what we’re doing to avoid a lawsuit on this thing with Larry. We can talk about other business with the Jefferson Clinic, too. Oh, and have your secretary send Larry’s wife some flowers.”

  Not waiting for the prompt, Karen pressed 4 to erase, then 3 and 2 for the next message.

  “Hi there. My name is Dean Williams. I’m a stockbroker at Jackson, DeSalle. From time to time, we have exceptionally attractive investment opportunities …”

  Karen quickly pushed 4, then 3, and then 2.

  “Hello, Mrs. Hayes. This is Deb Jazinski from the surgical nursing team. I don’t know if I should leave this on your voice mail or call you in person, but, well, Larry Conkel gave me a message for you yesterday.”

  Karen sat bolt upright in her chair. A chill passed through her as she stared out through the one window in her office at the denuded branches of the sugar maple, shuddering in the damp November wind.

  “Just before he … well, you know, before … before his surgery, he told me that if he didn’t make it…” the digital tape hissed while she paused, “out of surgery …” She paused again.

  “Spit it out!” snapped Karen into the receiver.

  “Mr. Conkel told me if he didn’t make it, to tell you to look in on Walter. That’s all. Have a nice day.” Karen’s eyes dropped to her lap.

  “If you would like to hear the message again …” Karen pushed the reset button, and dialed her home number.

  “Y-y-yello,” Jake’s baritone voice answered, a Sonny Boy Williamson record playing in the background.

  “Jake, it’s me. I just got a message that has me totally weirded out.”

  “Tell me, tell me.”

  “Some nurse named… I forget, a Polish name, called and said she had a message for me from Larry, before he died.”

  “Heavy, heavy. At least it wasn’t from him after he died.”

  “Don’t make fun, smart-ass. I’m a little scared.”

  “Sorry.”

  Karen described the m
essage, and after a thirty-five-minute discussion of acquaintances and relations all the way back to when they met each other in college, Karen and Jake concluded that they knew no one named Walter to whom Larry Conkel could have been referring. They considered whether the nurse might have heard the name wrong. Larry’s wife’s name was Paula. Sounds a little like Walter; could Larry have said, “Look in on Paula”? Maybe Larry was delirious, what with everything he was going through; maybe the nurse was a schizo; maybe it was a sick prank. Or maybe Karen heard the message wrong. She used the conferencing feature on her phone to play the message back so Jake could hear it. But after another twenty-five minutes of theorizing, they gave up.

  “‘There was the door to which I found no key’,” quoted Jake, “‘there was the veil through which I might not see.’ Omar Khayyam.”

  “Oh, thanks awfully for the literary reference, guy with a bachelor’s degree,” Karen retorted.

  “It was magna cum laude,” he said with mock pride.

  “It was in music. You know, my parents still can’t believe what you do for a living, considering that you have a college degree.”

  Karen and Jake, married for fourteen years, often joked about what was a real sore point with Jake’s in-laws, namely Jake’s occupation. Karen’s father was a cost accountant at a company that made industrial blades and a registered Republican. He listened only to classical music. Karen imitated her father’s deep voice: “A grown man playing a child’s harmonica.”

  “Harp,” corrected Jake.

  “And you play it like an angel,” she gushed, “but my daddy still thinks it’s a joke.”

  Jake sighed with feigned despair. “I guess dat’s why dey call it ‘da blues’.”

  CHAPTER

  3

  Karen Decker had met Jake Hayes in the winter of her junior year in college, when she was twenty years old. Jake was twenty-two at the time, but only a sophomore.

  Karen had been a disciplined, well-organized student, majoring in history, who chose her courses with careful consideration of what each would contribute to her degree requirements, grade point average, and chances for admission to graduate school Jake, on the other hand, took only what seemed interesting.

  Karen had made one and only one attempt to take a college course strictly for the fun of it, a foray into spontaneity and self-indulgence that would last all of ten mortifying minutes. It would be years before it occurred to Karen how well the course had actually worked out.

  It was a music appreciation course, introductory level. She thought it would be a lot of listening to records and reading about composers. The first day of the class, the professor distributed songbooks containing vocal parts for Gregorian chants and other pre-Baroque choral works. The students divided themselves into sopranos, altos, tenors, baritones and basses. Karen was not sure where she belonged. She stood with the altos because it seemed safe, not too extreme.

  The professor had the class singing within the first five minutes of the course. Karen had no idea how to sight-read vocal music and was astonished that everybody else in the class did. After two and one-half years at Hartford College, Karen remained unaware that the school was a magnet for serious music students.

  She tried to get through the first piece by simply mouthing the words, relying on the four other altos and eighteen other voices in the room to conceal her ignorance. The professor silenced the class with a wave of his arm. He was an austere, middle-aged man with steel-rimmed glasses and a military bearing, who always wore a dark suit and tie to class. He pointed his baton directly at Karen.

  “You. I can’t hear you. Sing out.”

  The class repeated the chant, from the beginning. To Karen, the other students sounded like the Mormon Tabernacle Choir. They all seemed to have confidence and beautiful voices. She attempted to duplicate the notes being sung by the other altos. The professor waved the class silent again and aimed the baton at Karen.

  “Sing a descending major scale,” he ordered. “Start here.” He blew a note on his pitch pipe. Karen sang five notes. “You’re not an alto,” the professor declared. He took her songbook away and handed her another. Karen moved to the soprano section while the class watched silently. When the singing started again, Karen put her songbook on her chair and walked quickly out of the classroom. She broke into a run as soon as she was out the door. She wanted to find a deserted restroom and cry. Then she heard a man’s voice call out behind her.

  “Hey! Alto!” She stopped and turned around. It was a tall, broad-shouldered boy in a green plaid flannel shirt and blue jeans. He had long brown hair, a droopy mustache, and wide-set, friendly eyes. She had noticed him in the baritone section, smiling at her. He trotted up to her.

  “Dull class, eh? Good decision to bolt. I’m giving that one a miss, too. I mean, Gregorian chants? Talk about your oldies.” He sang a few notes from the chant. “Remember that one? Big hit for Thelonius the Monk in 1302.”

  By the time the boy paused for breath, Karen had lost the urge to cry. The two talked about course alternatives as they walked across the snow-covered campus to a small diner for coffee, which turned into a long lunch. Karen was charmed and intrigued by the young man, who had introduced himself as Jake Hayes, and who was so different from the other men she knew, especially the pre-med student she was dating at the time. She wondered if Jake had just taken pity on her. She was, however, less charmed when she awoke that night, violently ill from the salmonella bacteria in the greasy diner’s roast beef sandwich.

  She spent three days in the college infirmary recuperating. Jake visited her every day, always managing to avoid arriving when Carl Gellhorn, the pre-med Karen was dating, was there. During those three days, Karen learned that Jake was born in Canada, neither of his parents was alive, and he was a devotee of Eastern philosophies. He had once lived in an ashram in India where he learned to play the sitar and the tabla. He had visited the ashram on a lark, along with a number of his musician friends in the ’70s, but ended up staying for two years. While there, he met and had a love affair with a woman from Crete who spoke no English. Jake spoke no Greek. They had to communicate non-verbally.

  “We were both studying Hindi,” Jake explained. “And over a period of months, we both learned to speak it better and better, until we were able finally to communicate well enough to figure out that we couldn’t stand each other.”

  Karen also learned that before he had entered Hartford College, Jake held a variety of jobs, including piano tuner (he had perfect pitch), instrumental instructor at a boarding school (he was fired for smoking pot with the students), and forklift operator (he “needed the scratch”). He played several musical instruments, and wherever he was and whatever his day job, he usually “played for pay,” as he put it, somewhere, even if it was just ragtime piano at an ice cream parlor.

  Karen came to realize that Jake was a much more attentive listener than Carl, the pre-med student, warmer, funnier, and about eighty percent more physically attractive. She also learned that Jake had just switched majors, from philosophy to music. She was a little disturbed when she deduced that Jake had skipped out on the first day of a required course just to spare the feelings of a stranger. It seemed so frivolous.

  All these years later, Karen knew that Jake was the least frivolous, the most centered, and the most compassionate person she had ever met. How sad, how frustrating, she thought, that her parents still weren’t able to see or appreciate that. But they just couldn’t get past their doubts about the financial security of a blues musician.

  CHAPTER

  4

  Returning from a late lunch on Tuesday afternoon, Karen Hayes paused outside the threshold of her office. Anne Delaney was there, apparently waiting for her. Karen watched as Anne bit futilely at the hangnail on her thumb, having already chewed her fingernails all the way down, and gazed intently out the window. Although she appeared to be blankly staring, Karen knew Anne was checking to see if the first light snow of the season was accumulating on the
front steps of the hospital. She would be relieved to see that it was melting on contact. Slips and falls on the sidewalk were the city’s responsibility. But the stairs were the hospital’s and, therefore, Anne’s.

  Anne Delaney was the Risk Manager at Shoreview Memorial, a job that combined a high level of responsibility with a low level of authority, similar to an air traffic controller for the Luftwaffe. It was her duty to keep as little money as possible from leaving Shoreview coffers to pay for injuries suffered by the hospital’s patients, employees, and guests. She arranged for insurance coverage, investigated claims, and constantly scanned the campus for hazardous conditions that could lead to lawsuits. She also met with persons injured on the hospital campus and their families in an attempt to persuade them not to sue.

  Karen noted that Anne was wearing a black suit—her uniform for meeting with bereaved families—a detail intended to suggest that she respected and shared their pain. Anne paid attention to such details; she was careful and thorough and, consequently, very effective in her job. Today her meeting had been with Paula Conkel, Larry’s widow.

  Anne had an attractive, slightly plump face and curly brown hair. The black suit fit her snugly. Anne’s weight fluctuated, the result of persistent binge eating that also aggravated her chronic heartburn. Karen suspected that Anne’s binge eating and heartburn were symptoms of job-related stress and had even spoken to her about it. But Anne, who was completely devoted to her job and derived great satisfaction from it, dismissed the notion. She lived alone, without pets, boyfriends, or other distractions. She had begun her career in hospital risk management at one of the largest hospitals in Chicago, Raasch Evangelical Medical Center. One evening after work, she was attacked in the hospital parking lot, in a corner of the lot where a burnt-out lightbulb had created a darkened area. Anne’s pugnacity and a powerful set of vocal cords had saved her from becoming a rape victim, but it took ten stitches to close the wound she suffered when her head struck the asphalt.