Authors: Carol Cassella
Somewhere below a door slams shut in the corridor, voices hum and dissolve. I grasp the railing to pull myself up and run down to the first-floor hallway. The door to the right of the stairs leads into the furnace room; next to it is the building superintendent’s apartment. The euphoric bantering and laughter from a television set disappears when I ring the bell. A voice calls out in Spanish and then the door swings open.
“Mr. Iglesia.” I brush the hair back from my eyes and start to reach out for his hand but instead clench my arms across my body to stop their trembling. “Mr. Iglesia, I’m Marie Heaton. We met a few years ago—I’m a friend—a colleague of Joe Hillary. Dr. Hillary, on the fifth floor.” He looks cautious, maybe alerted by my nervousness, until he seems to recall me and his narrowed eyes relax.
“I’m sorry to bother you at this hour,” I say. “But I need to find Dr. Hillary. Tonight. He’s…” I take a deep breath and hope I sound reasonable. “It’s urgent. We have a staffing problem at the hospital. A family emergency came up for one of the other doctors, and we have to reach Dr. Hillary to fill in. He’s not answering his telephone or his door, and we need to locate him. I thought I might see something in his apartment—an address or phone number.” I wait for his help, trying to transform the furrows in my face into a look of trustworthy concern.
Mr. Iglesia brings his hand up to his mouth and shakes his head. “I can’t let you in without Dr. Hillary’s permission, Dr. Heaton. I’m sorry.” He looks down at the floor and then back up at me. “You don’t have a key?”
“I do have a key, at home, but I came here straight from the hospital. We have some emergency surgeries coming in later tonight,” I say, holding my breath after each inhalation to slow my heart down, my face flushing hot with the lie.
He rubs the side of his cheek and the hard skin of his palm scruffs across the stubble of his beard. “Well, I’ll have to go in with you. Wait just a minute.” He leaves the door standing half open and walks out of sight. The light from within is yellow and warm; the smell of frying onions and red meat seeps into the hallway. Somebody, a woman, laughs inside, and Mr. Iglesia reappears with an enormous ring of keys jingling like Christmas. He walks ahead of me to the elevator and presses the button. We stand awkward and silent as the creaking weight descends.
“You work at the hospital up on the hill with Dr. Hillary? Yeah, I remember. You still drive that nice silver Audi, huh?”
I nod.
“I like cars. I always notice what kind of car people drive. So, looks like the fall rains are coming early this year.” I am spared having to answer because the elevator doors heave open and we step inside. He circles through the crowded key ring searching for Joe’s; the shrill clang of metal on metal is painful in this small space.
At Joe’s door he knocks and waits for a moment, shrugging his shoulders at me as if shedding a guilty sense that this is an infraction of rules. Then he fits a key into the lock. It won’t turn. He curses softly and clatters through more keys. When he inserts another I hear the smooth unhitching of the mechanism.
Inside it is dark and chilly, and the blinds are still drawn. As my eyes adjust to the faint blue wash of streetlights through the slits, I pick my way around the chairs, his bicycle, record albums and stereo speakers toward the bedroom.
The door is nearly closed and I reach up to push it open, but draw my hand away, hesitating, almost wanting not to know. His apartment feels eerily lifeless, but I fold my fingers into a fist and knock on the bedroom door. No one answers. I open my palm against the wood and push it back. Behind me Mr. Iglesia pauses in the living room, as if shy about venturing farther into his tenant’s privacy. I stand just inside the bedroom, statue still, holding my breath so that I can hear if any other living being also breathes.
I should turn on the light, but in this gloomy room I still feel able to hide from something—what, I am not sure. Do I hope that I will find him here, sleeping so softly I can’t even sense his presence? Or that a letter, perhaps addressed to me, will explain all this in some believable way that leaves hope for both of us? Or is it possible that all the tragic warnings I’ve read about the risks of suicide or overdose in the unmasked addict will include Joe? Had I thought of that when I left him here a day ago, stripped raw to speculate what I would do with my new knowledge?
There is the sound of a footstep behind me, and with a click the overhead light flashes on. Mr. Iglesia has stepped into the room and flicked up the switch. Joe isn’t here. The bedcovers have been pulled up over the pillows and the bureau drawers closed; the floor is bare of its usual piles of laundry and running shoes. I walk across to his dresser looking for an envelope, a piece of paper, anything he might have scribbled, any notes he might have made. There’s nothing. Neither is there any scrap on his bedside table or beside the telephone. But the room has changed since I walked out on him last night. The top of the dresser looks bare. Though I can’t say what’s missing, the usual clutter of watches and keys and coins has been picked through. I turn toward the closet and slide back the paneled hanging doors. A few shirts dangle on hangers, but it is obvious that Joe has packed and gone.
Tuesday dawns
a virtuous blue after all the rain. On the drive to Renton Airfield I see a few trees whose branches are already slashed with orange and red, spilling eagerly into fall as if forgetting winter will follow. The parking lot is almost full, even though it is early, and the sun is blinding as I walk up to the building—what a perfect day to fly, the sky washed clear, boundless and beckoning.
There are only men in this room. Men wearing T-shirts with biplanes embossed in shiny black ink over the breasts; men wearing navy-blue blazers and pricey aviator-style sunglasses; men wearing leather bomber jackets that would be fashionable clichés if not for their authentic purpose. I’m hardly noticed, standing just inside the double glass doors of the lobby, listening to their locker room stories of skirted thunderheads and midair stalls, their brazen landings on uncharted lakes and steelhead streams—so excluded from their jocular camaraderie I am invisible rather than strikingly out of place.
A balding man sits on a high stool behind the counter, his features clustered in the middle of his wide, ruddy face as if pulled taut by a string. He is talking to an older man who wears ear mufflers slung in a horseshoe around his neck, relating some story so hilarious he explodes in spitting laughter between words. If I’d paid much attention to procedures the few times Joe brought me here, I could look for his plane without interrupting them, without the risk of telling them my name and seeing them stamp it into a record book or permanent log.
The man finally notices me, called back to whatever official duty he is paid to do here. He sits cocked up on one hip, braked by a heel lodged over the bottom rung of his stool, still chuckling when he asks me, “What can I do for you, missy, on this gorgeous day?”
The older man pulls the padded ear protectors back on his head and slaps the balding man’s back. “OK, Ray. Spot you a beer tonight.” Then he heads out into the roar of landing and departing planes.
“I’m looking for a friend. He keeps his plane here.”
He raises his eyebrows up the barren slope of his forehead, waiting for me to finish. “Who’s your friend?” he asks at last.
“Hillary. Joe Hillary.”
He punches the keyboard of a vintage computer on the counter and types the seven letters of Joe’s last name with his index fingers.
“Hillary, Joe, let’s see. Not here yet. When are you supposed to meet him?”
“Yet.” What a generous, forgiving word, so opulent with possibility—the carrot perpetually dangled from the advancing stick of denial. I am tempted to leave now and cheat disappointment.
“He didn’t…” I lick my lips, chapped after so much crying and so little sleep. “We didn’t have a set time. I can’t remember when he told me he wanted to leave.”
The man clicks his tongue against his teeth once and shakes his head. “Leave? You need to be waiting for him to come back. He left sometime last night, and his plane…” He cranes his head back, stepping halfway off the stool to look out a back window. “Nope, plane’s still gone.” He flips a pencil back and forth between the fingers of his left hand while his right punches at more keys; each time the new screen lights up I get a clench in my stomach, praying he’ll look and tell me some distinct spot where I’ll find him, some obligatory time of return.
“Doesn’t look like he filed a flight plan, but he might have left that with the tower. I can call over there if you want.”
I cross my arms over my stomach, as if maybe I could force the muscles to loosen up. Why should I bother him to call, when I know Joe has no intention of being found. Not today. Not ever. “Yeah, sure, if you don’t mind.”
He dials the number and after a perfunctory introduction launches into the insider’s dialect of flight. “No go,” he says, dropping the receiver back down. “Couldn’t be going too far if he didn’t file, though.” He falls silent then, tapping the pencil in a quick seesaw against the counter. He’s looking at me closely for the first time since I came into the lobby, seeming to recognize the tight lines around my mouth, my locked arms. “Look, why don’t you have a seat. We’ve got some coffee in the back if you want a cup. I’ll check the bulletin board in the office—sometimes the guys pin a note up there for me.”
“Thanks. No coffee.” I cross my arms tighter. “But if you could check the board. Maybe I got the time wrong.”
He’s back before I can sit down in one of the folding metal chairs scattered along the wall. “You Marie Heaton?”
My face swims in heat. “Yes. I am.”
“Joe left this on my desk with a sticky note asking me to drop it in the mail. Addressed to you. Good thing you got here before it was buried under a pile of papers—wouldn’t have found it till Christmas.” He laughs at this and I force a smile.
“Thanks.” I take from his hands a rectangular manila envelope, and shrug one shoulder. “Must have decided to stay away longer.” I am halfway out the doors when I turn back to him. “You can track a plane, can’t you? I mean, if we needed to find him?”
He studies me for a minute before he answers and his smile dims a bit. He shakes his head. “That’s the beauty of flying. It’s a big sky. You can get lost in it if you choose to.”
I make it halfway home, where I could hide in my own sanctuary with a lock on the inside of the door. But without really planning to, I pull off the highway and wind through the circles and lanes of tidy and obedient suburban Seattle homes to a bluff overlooking Lake Washington—the afternoon sunshine like a million faceted diamonds across the wilderness of water lapping between richly populated shores.
My name slants upward across the the manila in his looping, adolescent script. I hold the envelope beneath my nose wondering if I might smell his spicy aftershave. But there is nothing so personal from him to be here with me when I fold back the brass tabs and run the edge of my forefinger under the flap, opening it.
I turn it upside down and a white, business-size envelope slides onto my lap. It’s not addressed to me. The return address is that of Columbia Hospital, in Florida, where Joe worked just before he came to Seattle; it’s postmarked four years ago. Inside are only a few papers. The first is a copy of Joe’s letter of recommendation from Columbia’s chief of anesthesia to Phil Scoble. The second is Joe’s request for privileges at Columbia. It’s a standardized form I’ve seen a hundred times, filled out for every medical license renewal and every hospital membership and every insurance enrollment—a checklist of health limitations, rule infractions, revoked status or malpractice claims—the de rigueur form every doctor checks off so often we no longer read the questions, and run a long, straight line down the innumerable boxes marked “No.” As always, in the lowest box, is the list of personal fallibilities and handicaps that might impair capacity or cloud judgment, the questions about physical disability and mental illness and substance abuse. Any question answered “Yes” requires an additional page of detailed explanations and therapeutic interventions.
The letter from his former chief lauds Joe’s education and mental agility, his quick-wittedness and clinical acumen. It expounds on the procedural protocols he refined for Columbia’s ICU and trauma response team. The last paragraph of the letter, just above his signature, equivocally exonerates Joe from the documented questions raised during his tenure there of addiction to fentanyl. “No such abuse was ever confirmed, although we were unable to reconcile some discrepancies,” his chief writes. “Certainly we believe any suspected drug use was of limited duration. Dr. Hillary is an outstanding clinician, however I can only recommend him with the caveat that he be scrupulously monitored. It is unfortunate that we cannot keep him on our staff at this time.” On the third page, Joe’s own self-composed exculpations are equally convincing. Maybe I’m alone in spotting the anagrams of pain camouflaged in his apology.
One final page lies below the others. It has only a few sentences, beginning with my name, scrawled almost illegibly in Joe’s handwriting. “Scoble and Hopper cleaned the originals out of my files before the lawyers talked to me. I was never monitored—never even reported to the medical board. They’re selling you out to save First Lutheran.” And below this, in a darker stroke that carves into the surface of the paper: “You are absolved.”
Charlie Marsallis
takes me to lunch at Etta’s in the Pike Place Market two days after I give him Joe’s letter. The district attorney has already dropped the criminal charges against me, but there are still hurdles. The toxicology report in Jolene’s autopsy didn’t list a beta-blocker, so the mechanism of her death remains open for debate—a euphemism for persistent blame, I decide, without saying this out loud. Feinnes could still try to pin some responsibility on me for taking Jolene to the operating room without examining her closely enough to detect signs of her Turner syndrome, without listening to her heart and ordering a cardiology evaluation. Charlie uses the term “degree of negligence,” as if death could be fractionalized.
Still, our lunch has an air of celebration about it. Our discussion of upcoming legal maneuvers and strategies digresses into a conversation about Charlie’s son William, who has a precocious gift for music and a heart-stopping voice for a seven-year-old. I tell him about my father and his eyesight, and he talks about his own parents and the assisted living complex in downtown Seattle he’s moved them to. But I still can’t talk to him about Joe—
my
Joe, not the addict or the deceiver, but the Joe who always knew when I needed his sense of humor; the skeptic who was blindingly determined to live richly, intensely, eternally one step ahead of his own pain.
It isn’t until a week later that Charlie gets a personal visit from the district attorney. He’s received a letter from Joe, postmarked on the Tuesday I discovered his plane missing. In his distinctive, looping script, clearly signed, Joe confesses that he exchanged the fentanyl in Jolene’s syringe for labetalol, a drug that is not on the list of chemicals automatically screened for by the King County toxicology lab.
I should have guessed. Labetalol is kept in the top drawer of every anesthesia cart—the most commonly used beta-blocker in the operating room. In the letter Joe plots out the simple math to show the dose Jolene would have received. In a normal child the dose would probably have done no harm. In a lower dose, it might not have harmed Jolene. But, Joe explains, in a scholarly description of cardiac physiology, the excessive dose Jolene received would have left her heart incapable of forcing blood past the stricture in her aorta. At the end of the letter, he applauds my medical sleuthing for having figured out the drug switch.
The police check with airfields up and down the coast, but no one reports refueling any plane with his N-Number. His credit cards haven’t been used. His bank account was only partially emptied, enough money left behind for the authorities to question whether he was intending to run. His leather duffle bag washes up just north of Marin—some kids building a sand castle find it, half buried at the cusp of a low tide line. Inside are his passport, his wallet, stuffed with credit cards and ID, and some cash. The coast guard does a cursory search for wreckage or any reports of an Emergency Locator Transmitter. Nothing turns up. Eventually the police quit looking for him—his crime doesn’t warrant that many resources in an age of international terrorism. They presume he is dead. But baggage can fall from a plane in any number of ways, I think.
Still, the depositions continue. I sit across from Phil Scoble with conflicting feelings: betrayal, anger, incomprehension, and, sometimes, sympathy, all spilling into an ocean of sadness I’ve hardly begun to navigate. In Phil’s imperturbable, overconfident testimony I hear the same denial Joe must have used, the same unwillingness to stare down his destructive selfishness. If I hadn’t known Phil for so long, if I’d never seen the unattainable expectations pressed on him by Frank Hopper and the board, if I didn’t understand that he has pinned all of his self-worth to his job, it would be easy to hate him for the lies.
At first, Phil and Frank deny the role they played in Joe’s hiring and his lapse back into drug abuse, and it’s almost certain the lawsuit will go to trial. Charlie reassures me I’ll be testifying against others instead of defending myself, but I feel queasy when I envision telling this story to a jury, watching Bobbie listen to the horror of her daughter’s death again. After three weeks of accumulating evidence against them, the hospital’s lawyers convince both that their likelihood of losing, and of facing even bigger penalties, is greater if twelve civilians—most of whom undergo surgery at some point in life—get to decide their fate. So a mediation date is set; a mediation in which I am no longer a defendant. I am allowed, at last, to plan my future.
One final day in front of a video camera, one last time I will sit at this conference table surrounded by lawyers. Then I will leave town, with Charlie’s blessing and a release from any liability for Jolene’s death. We take a break late in the afternoon and I walk down the hall to the bathroom, but it’s closed for cleaning. I skip down one flight of stairs to an identical women’s room on another floor lined with lawyers’ offices and conference rooms. The single stall is occupied, and I stand at the sink running warm water over my hands, dampen a paper towel and daub it over my temples and throat, press it over my closed eyes. Then the stall door opens. Someone is behind me, waiting. I open my eyes, and Bobbie Jansen is looking at my reflection in the mirror.
She’s thinner, older than she looked four months ago, when I saw her sitting at a conference room table like the ones we must have both been at today. She holds a comb half raised toward her hair. We could be two painted masks, we are both so still. One a mask of terrified anticipation, one a mask of tragedy. In her face I see unabated sorrow.
In the last few weeks Bobbie has learned that her daughter’s death was the result of more than one doctor’s incompetence. Jolene died because her Turner syndrome was missed in an underfunded and overcrowded public health clinic. She died when Phil Scoble and Frank Hopper chose to ignore Joe’s suspect references so they could keep First Lutheran’s operating rooms running at full capacity, and their spreadsheets in black ink. She died as she was passed down a chain of committed, conscientious professionals—her pediatrician, Don Stevenson, Mindy, Alicia, me—all of us wanting the best for her, all of us engulfed in a health-care machine that has outstripped our individual competence with its monstrous ambition and complexity. And, yes, Jolene died of an addict’s false confidence, and his willingness to push blame onto whoever was most vulnerable. Even someone he loved.
A thousand words flood my mind. Words of condolence and empathy. Words of explanation and self-acquittal. Words that might approximate some altruistic blessing in the face of sacrifice. Even an openhearted plea to hear her bitterness and rage, if she needs to unleash that on me. The words feel like solid objects I could put in her hands—wood and velvet and sharp glass—tangible, vivid, durable gifts waiting to fall out of me.
Bobbie lets the comb drop into her purse. Her eyes recede, as if an interior light were shutting down. Then she turns away and walks out of the bathroom. Now there is only my face in the mirror, pale and shaken.
I grab my bag off the counter and run into the hallway. The elevator doors are closing and the down arrow flashes off. I punch the button and wait impatiently for the next car in the bank to open, cross the hallway and push the call buttons on the opposite wall.
It’s impossible to stand and wait. I run to the stairwell even though I know I’ll never be able to spiral down ten flights in time to catch her. The elevator bell sounds and I race back to thrust my arm between the doors just before they shut, then pound the parking garage button over and over during the descent.
By the time the doors open Bobbie is already at her car on the far side of the lot. She hears the sound of my heels crossing the concrete floor and turns around, her car key poised to unlock the door of the same badly repaired Ford sedan I saw at Jolene’s funeral.
She doesn’t even look startled, as if she had expected this brash attempt at contact. She squares her shoulders and waits, her keys swinging from her clasped hands, ready to hear whatever has compelled me to chase her. We are two feet apart, face-to-face, and she doesn’t even blink. All the pain I thought I saw has been swallowed into a defeated worldliness, and, for the first time, I comprehend that pain is keenest when a person has a reason to live. Bobbie is not waiting for any resolution—from this lawsuit or from me. She has stopped, here in this deserted garage, for the sole purpose of allowing me to unburden myself. Everything I thought I could tell her is a prayer for my own redemption exacted at her expense. I want her to forgive me for taking her child into the operating room. I want her to forgive me for trusting Joe. I want her to forgive me for wearing the First Lutheran name badge that implied all the brilliance and infallibility of the American medical machine. I have no answers for her. I don’t know her. My fantastic obsession has generated an illusion of intimacy. Her forgiveness is an endpoint I will never reach.
“Ms. Jansen,” I start, and then my voice trails off. She looks down at her keys, as if she is embarrassed for my awkwardness, giving me a moment of privacy to collect myself. After an echoing silence she sorts the car key out from the jangling bunch in her hand, and looks up at me again. “What is it, Dr. Heaton? What do you want to say to me?”
I say the only words I can hear inside my mind: “I’m sorry.” How simple. Two words. At last given the chance to tell Bobbie whatever I might have the courage to express, this is the one thing I understand about Jolene’s death. “I never got to tell you before how very sorry I am.”
Bobbie nods and slips her key into the door lock. “I know. I know you are.” She says it as a simple statement of fact, without any hostility or trivialization. Then she gets into her car and backs out of the parking space, pulls around me and drives away.