“What a brave thing to do.”
“You said it. He had a horrible decision to make and went with what he believed. We’ve done everything we can to make sure Grace and her husband understand that. Unfortunately, while he definitely saved her life, the guy made a bit of a mess of things. The ENT people are going to have to repair the damage to her trachea. But before they can do that, she’s aspirated some blood and now has a bit of a pneumonia.”
“Just make sure she gets you taking care of her until she’s out of here.”
“That’s very kind. No problem. I’ll stay close to her. Speaking of getting out of here, it looks as if your patient Kurt Goshtigian is going to make it.”
“You know what?” Will said. “I’ve been so wrapped up in my own deal that I completely forgot to check on him. Of course, that may also have something to do with the fact that he and his family are suing me for like a gazillion dollars.”
“Maybe they’ll back off once he’s home. He really has had a tough go of it. I lost the pool when he made it through last Sunday. His family’s in there with him now, so you may want to steer clear of room one.”
“Thanks for the warning.”
“I think you’ll remember the room Grace is in,” Anne said with a wry grin. “It was yours.”
Will paused at the doorway to Grace’s cubicle and tried to imagine what he looked like when he was transferred there from the ER on a vent. Grace looked surprisingly good. She was pale and extremely weak, but awake and alert, communicating with her husband by hand signals, some carefully mouthed words, and the clipboard and blank progress notepaper Will knew only too well. She had oxygen running into her lungs through the tracheotomy that had saved her life. On the wall to the right side of the room, her latest chest X-rays were displayed on an illuminated view box—two views, one shot from her back through her front and one taken from side to side. At a brief glance, Will could easily make out the fluffy white density in her left lung that represented the pneumonia he had been told about.
“Greetings,” he said.
Grace managed a weak smile and a wave. In addition to her pallor, her respirations were slightly rapid and shallower than normal. So long as her condition remained like this, the ICU was exactly the place she should be.
You OK?
she wrote.
“Define
okay
. I feel as though I’ve been hit by an invisible bus. I’m trying to fight back at whoever nearly killed me, but nobody seems to notice. How about you?”
Grace made a so-so sign.
“She seems a little more worn out than she was earlier this morning,” her husband observed. “Maybe they shouldn’t have taken her down to radiology for those X-rays.”
“We wheel patients down there if we can because they’re better quality than the films done by the portable machine,” Will replied. “Here’s one of the reasons she’s not feeling better, this white stuff right back here. A pneumonia.”
He pointed to the area on himself. At that moment, another finding in the films caught his eye. There was a small density inside the wall of Grace’s right chest, just below her third rib, perfectly round and much whiter even than the bone, which suggested that the object was metallic. The lateral view confirmed the object’s presence and located it toward the front and fairly deep. Almost certainly, it was a BB.
“Look at this,” he said.
Grace smiled.
BB
, she wrote.
Brother shot me.
“How old were you?”
12.
“On purpose?”
Who knows?
“I never even knew about this,” Mark said. “My wife, shot. What a mysterious, exotic woman you are, Grace. Having met the man, though, I don’t have to stretch my imagination too far to see him doing it and it not be an accident.”
Grace waved him off, but her expression suggested she agreed.
“Did your parents take you to a doctor?” Will asked.
Grace nodded.
“I imagine he said trying to get it out was more trouble than it was worth, and that it would either work itself out or stay there for the rest of your life.”
Another nod.
“Obviously, he was right, because there it is.”
There it is
, she wrote.
“And there it will stay.”
Keep your spirits up.
“I appreciate that. Listen, don’t worry about me. Somehow I’ll come out of this okay. And don’t worry about what’s going to happen with your chemo.”
I know.
“There are alternatives. Right now you should just concern yourself with getting better. Well, I think I should leave you to rest.”
Thanx.
“I’m just grateful you made it. What a thing to go through.”
You, too.
Will smiled, kissed her on the cheek, shook Mark’s hand, and turned toward the door.
“Dr. Grant?” Mark said.
Will turned back. Mark had moved closer to the X-ray view boxes and was peering at Grace’s films.
“Yes?”
“If this BB is here on her chest films, then wouldn’t you expect it to be on her mammograms, as well?”
“Some of the views, yes, of course.”
“Well, it wasn’t there.”
“Pardon?”
“It wasn’t there.”
“Are you sure?”
“As you can probably tell, Dr. Grant, I am a very meticulous man—not obnoxious about it, I hope, but I am a stickler for details. There was no BB on Grace’s breast films—not any of them. Did you see it there, hon?”
She shook her head tentatively.
Never thought about it,
she wrote.
Will tried to remember the distinctive density in Grace Davis’s mammograms, but he couldn’t. It would only have been on a couple of the views—perhaps two or three out of ten—but from what he could tell, it definitely should have been on some. He did sense that, just as with these films, had there been a BB on the mammograms he would not only have noticed but commented on it. Instantly, a meteor shower of questions flashed across his mind. Could the camera angles of the mammograms possibly have cut out the BB? Possible but not likely. Could he, Grace,
and
Mark Davis all have missed the BB in the other set of films? Again, possible but not likely. Did he ever read the radiologist’s dictated report? Doubtful. There wasn’t any question about the cancer that was there, so what the radiologist had to say really didn’t matter to him. Could Grace’s mammograms have been accidentally switched with another woman’s? Ugh. The possibility was sickening but not really feasible, because the cancer in the X-ray had been biopsied and confirmed by a pathologist.
Nevertheless, it appeared quite possible that some sort of mix-up had occurred.
Over two decades of working in hospitals, Will had encountered almost every imaginable permutation of error. Working under enormous time pressures, with massive volumes of patients and procedures, handicapped by human frailties, imperfections, miscommunications, and personality disorders, to say nothing of fatigue, mechanical failure, and the vagaries of biology, caregivers made mistakes. Many of those mistakes passed by totally unnoticed or caused no inconvenience of any great magnitude. Some of them altered lives, and some either devastated lives or, sadly, ended them.
Will knew he had enough problems of his own to work out without trying to track down the source of this odd conflict. Still, he also knew there was no way he wouldn’t do it.
“Guys, listen,” he said, “I don’t have a good explanation for this, but I’m sure there is one—at least I
think
there is one. I’ll check with someone in radiology here, and then I’ll speak to the person at the cancer center who did those mammograms.”
It was only then that he recalled his unpleasant encounter over the phone with radiologist Charles Newcomber. That time he had gone over Newcomber’s head and prevailed, but it would be a pleasure to put the pompous prig on the hot seat once again.
“Please keep us posted,” Mark said.
“Oh, don’t worry,” Will replied, knowing that this time the encounter with Newcomber would occur in person, and that this time he would have the hospital X-rays tucked under his arm. “I will.”
Alone in his office, Augie Micelli sipped on a brandy, stared across the room at a spider plying its trade in the corner, and scratched boxes around words on a yellow legal pad—his way since college of working through problems. From the portable CD player on the floor by his desk, Gene Ammons’s soulful tenor sax was playing “Willow Weep for Me.” A drug addict, Ammons was known as Jug, perhaps for the way he drank, Micelli thought fondly, or maybe for the stretches he did in the jug before, at forty-nine, he died.
Although Micelli had been there at his desk for several hours with a drink close at hand, he was still far more sober than not. There was significant work to do, so he had been treading the delicate line between maintaining a clear head and keeping the shakes in check. It was a case that, when all was said and done, might not even pay the electric bill. But if Will Grant was telling the truth, if he had been framed and was now being purged from medicine much as Micelli, himself, had been, taking the case had been the right thing to do. Now the trick was seeing to it that Grant never made it anywhere near a courtroom, and that meant figuring out how he could have been railroaded so smoothly.
Spread out across the desk and on the floor around him were articles, xeroxed book pages, and printouts from the Internet, all dealing with the narcotic fentanyl. Usual dose; onset of action; route of administration; duration of action; pharmacologic effects; side effects; symptoms of overdose; chemical formula; metabolites. Gene Ammons had moved on to “I Remember You,” Micelli’s favorite on the album, which was to say the one that made him feel most blue.
“Not good,” he muttered as he considered the case, “not good at all.”
The only explanation that fit all the facts was that Will Grant was both an addict and a liar. Micelli bounced the eraser of his pencil on an article dealing with the pharmacokinetics of sufentanil, ten times more powerful than fentanyl, eight hundred times more powerful than morphine, and of carfentanil, which was nearly fifteen times more powerful even than that. He found himself thinking about a statement from one of his law-school professors, and wrote it in block letters at the bottom of the yellow sheet.
IF YOUR BELIEFS DON
’
T FIT WITH THE FACTS
,
THEN JUST POUND THE HELL OUT OF THE FACTS UNTIL THEY DO
.
He snatched up the phone and dialed. Will Grant answered on the first ring.
“Okay, Doctor,” Micelli said, making a series of boxes around the words, “take me through that day again.”
Embarrassed, angry, frustrated, humiliated, impotent. Patty couldn’t remember ever having felt more uncomfortable. For more than two months her life had been consumed by the need to find a killer and bring him—or her—down. Now, to all intents, her part in the case was over. She would be helping to keep the day-to-day operations of her unit moving along while Wayne Brasco would be working with Sean Digby, who had come on board well after she did, and a veteran detective named Brooks, who had transferred to Middlesex from Hampden just a month ago.
“Look at it this way,” Jack Court had tried to explain to her, “with me tied up with this case along with the others, you’re going to be like running this place. Brooks is too new to have that responsibility, and Digby is too green. The rest of them aren’t nearly as competent as you are.”
Bullshit!
In some ways, it felt as if she was leaving the force altogether. She sat at her desk, grateful that the phone hadn’t rung and that no one had felt the need to stop in and talk to her. Set in neat piles on the floor around her were the tangible products of countless hours of work and thought about the managed-care killer—stacks of documents, computer printouts, interviews, newspaper clippings, photographs, and transcripts.
It wasn’t right, she was thinking as she identified each of the piles with a carefully printed sheet and bound them with heavy rubber bands. There was some sort of commission or ACLU lawyer someplace who would be more than happy to take up her banner and prove in court that she was being removed from her case without just cause. But then, even if she could find such a champion, her career on the force would be over. It was lose–lose for her all the way around. If she could just hang in and get past this disappointment and embarrassment, there would be other times for her to prove herself. In fact, although she wasn’t about to tell Court or Brasco, she wasn’t totally certain she was going to let go of this case yet.
Even thoughts of Will and the night just past weren’t enough to give her flagging spirits much of a boost. He was a bright, caring, terrific guy—totally genuine and very attractive. Making love with him was great while it was happening, but she knew, as she suspected he did, too, that both of them were stressed, vulnerable, and needy. The passion, spontaneity, and chemistry between them were real, and she had absolutely no regrets, but she suspected Will would agree that they would probably have been better off to have waited.
Stacked on top of one another, the piles of exhaustive work reached two feet or more. Reluctantly, Patty hauled them down to Court’s office. As far as she could tell, neither the lieutenant nor Brasco had looked at much of what she had amassed to this point, and there wasn’t much chance they would now. The two men were sniggering about something, but stopped abruptly when she arrived and didn’t bother to explain what it was.
“All right, Pat,” Court said with fake cheer, “let’s get this over and get you onto a couple of new cases.”
“I thought maybe we could take a few minutes and I could explain how all this is organized,” she said. “I have these areas cross-referenced. Here’s the key I put together for that.”
She passed over three sheets, single spaced—the product of hours of work. Brasco favored her with a disinterested grin and set the sheets down on the stack, where they would likely remain for eternity. Court, perhaps sensing an impending escalation in tension, cleared his throat.