Broken Promise: A Thriller

Seven

Agnes Pickens was very not happy with the muffins.

There were two dozen, arranged on the platter in the center of the massive boardroom table. Coffee and tea had been set up on a table along the wall, and everything there looked fine. Decaf, cream, sugar, milk, sweeteners. Plus, copies of the hospital’s latest progress report had been distributed around the table where everyone would be sitting. But when Agnes scanned the muffin selection, she did not find bran. She found blueberry and banana and chocolate — and let’s face it, a chocolate muffin was just cake shaped like a muffin — but bran was noticeable by its absence. At least there was fruit.

When you were a hospital administrator and called an early morning board meeting, you had to at least make an effort to offer healthy choices. Even if the bran muffins were passed over in favor of the chocolate, she could at least say they had been made available.

The meeting was set to begin in five minutes, and Agnes had stopped in here to make sure everything was as it was supposed to be. Finding it was not, she went to the door and shouted, “Carol!”

Carol Osgoode, Agnes’s personal assistant, popped her head out a room down the hall. “Yes, Ms. Pickens?”

“There are no bran muffins.”

Carol, a woman in her late twenties with shoulder-length brown hair and eyes to match, blinked hurriedly. “I just asked the kitchen to send up a selection of—”

“I specifically told you to make sure that there were some bran muffins.”

“I’m sorry; I don’t recall—”

“Carol, I told you. I remember quite clearly. Call Frieda and tell her to send up half a dozen. I know they have some. I saw them down in the cafeteria twenty minutes ago. Steal them from there if you have to.”

Carol’s head disappeared.

Agnes set her purse on the table, removed her phone, and realized it was not on. Her HuffPost app had been loading slowly that morning, as well as some of her other programs, so she’d turned the phone off with the intention of turning it back on immediately. A quick reboot. But then her rye toast had popped, and she’d neglected to restart it. So now she pressed and held the button at the top right, but flipped the tiny switch on the left side to mute the ring.

Agnes set the phone on the table, then tapped her red fingernails impatiently on the polished surface. This was not going to be a pleasant meeting. She had not been looking forward to it. The news was distressing. The latest hospital rankings were in, and Promise Falls General had come in below average for the upstate New York region. The closest hospitals in Syracuse and Albany had ranked in the high seventies and low eighties, but PFG had been saddled with a sixty-nine. A totally unfair and arbitrary figure, in Agnes’s estimation. Much of it had to do with perception. The locals figured that if you needed top-quality health care, you had to go to a hospital in a big city. Bigger, at least, than Promise Falls. That meant Syracuse or Albany, or even New York.

Sure, PFG had some trouble eleven months ago with an outbreak of C. difficile. Four elderly patients contracted the bacterial infection, and one of them had died. (Too bad the Promise Falls Standard was still printing at the time; it was front-page material for the better part of two weeks.) But that was the sort of thing that could happen to any hospital, and almost invariably did. Agnes Pickens had instituted even more rigorous hand-washing and cleaning procedures, and had gotten the outbreak under control. And where was the Standard’s front-page story on that?

Ask anyone in town if they’d be happy to be treated at Promise Falls General, and invariably they’d say, “Uh, if you think there’s even a chance of one in a hundred you can get me to Syracuse or Albany before I die, I’ll take a pass on PFG.” Changing that perception was proving to be a challenge for Agnes.

A woman in a pale green uniform and a hairnet walked into the room with a plate of bran muffins.

“Here you go, Ms. Pickens,” she said.

“Frieda, take them off that plate and arrange them with the others,” Agnes said. “And I hope to God you washed your hands before you touched the food.”

“Of course, ma’am.” She added the new muffins to the platter and slipped out of the room as Carol entered.

“They’re here,” she said.

“Send them in,” Agnes said.

Ten people filed in, nodding greetings, making small talk. Local businesspeople, two doctors, the hospital’s chief fund-raiser.

“Morning, Agnes,” said a silver-haired man in his early sixties.

“Dr. Sturgess,” she said, shaking his hand. Then added, “Jack.”

Jack Sturgess, as if anticipating a rebuke, smiled and said, “I’ve started entering my notes into the system this week. Honest. No more paper.”

A few others heard the comment and chuckled as they helped themselves to coffee and tea and settled into the cushioned high-backed chairs around the table’s perimeter. Several helped themselves to muffins, and Agnes noticed at least three of them reaching for a bran.

She liked vindications, no matter how small.

She also liked being in charge. Liked it very much. Here she was, someone who’d never been a doctor, in charge of all this. After graduating nursing school, she’d tried her hand at being a midwife in Rochester for a couple of years, then returned to school for business. Applied, and got, a job in this hospital’s administrative department and, over the years, worked her way right to the top.

Agnes Pickens took her seat at the head of the table and kept her welcome short. “I want to get straight to business,” she said, setting her cell phone, screen up, on the table next to her copy of the hospital report. “You’ll notice on the first page of the document before you that the rankings are in and they are not satisfactory. They are a disgrace. They do not reflect the quality of the work that we are doing here at Promise Falls General.”

A woman at the far end of the table said, “You have to take those things with a grain of—”

“Dr. Ford, I’m speaking. While this ranking is grossly unfair, the only way we’re going to deal with it is to work even harder in every department. We need to look at every single thing we do here and find a way to do it even better. For example, we’re still not where we need to be on computerization of records. It’s vitally important that all relevant patient information be entered into the system to avoid any potential allergy and medication mix-ups. But some staff are still recording information on paper, and leaving it to others to input this data.”

“Not guilty,” Jack Sturgess said. “I’ve gone totally computer.”

“You’re an inspiration to us all,” Agnes said.

Her phone buzzed. She glanced down, saw that it was her sister, Arlene Harwood, calling. She also noticed, for the first time, that she had a couple of voice-mail messages. Agnes felt that whatever they were could wait. The phone buzzed six times, the vibrations traveling the length of the table like a minor earth tremor.

“I’m getting pushback from some staff on this computer filing issue, and I want to get the message out that no one is so special as to be exempt from this. No one. And it’s not the regular rank and file who are resisting. It’s the doctors and surgeons and specialists who seem to think that somehow this duty is beneath them. In part, it’s a generational issue. Younger physicians who’ve grown up with technology are not—”

The phone buzzed again. Arlene trying a second time.

Agnes Pickens hated to be thrown off her game when she was in the middle of something. She picked up the phone, pressed a button to immediately decline the call.

“As I was saying, just because some people who work here, or have privileges here, may not be as computer-savvy as some of their younger colleagues is not an excuse. They are going to have to—”

A text appeared on her phone. From Arlene:

Agnes studied the screen for several seconds. “Excuse me,” she said finally, pushing back her chair. “I want five ideas on how to get this ranking up by the time I come back.” She grabbed her phone, exited the boardroom, and closed the door behind her. She entered her sister’s home number and put the phone to her ear.

“Agnes?”

“I’m in the middle of a board meeting,” she said. “What’s this about Marla?”

“My God, I’ve been calling and calling.”

“What is it?”

“She’s done it again,” Arlene said. “David just called. I sent him by to see her with some chili and—”

“Done what, Arlene?”

“David found her looking after a baby.”

Agnes closed her eyes and touched her free hand to her temple, as if she could magically ward off the headache she knew was coming.

“There’s been no incident here,” Agnes said. “If someone had taken a baby from the hospital I would have been notified instantly. David must be mistaken.”

“I don’t know where she got it,” Arlene said. “But I trust David on this. If he says there’s a baby, there’s a baby.”

“Dear God,” Agnes said. “That child, I swear.”

“She’s not a child. She’s a grown woman, and she’s been traumatized. It’s not her fault.”

“Don’t lecture me, Arlene.” It never ended, Agnes thought. Once an older sister, always an older sister.

Agnes wasn’t just younger than Arlene. She was her much younger sister. Their mother had Arlene at the age of twenty, and didn’t get pregnant with Agnes until she was thirty-five. There was one other child, a boy named Henry, a couple of years after Arlene, and then a gulf of thirteen years. Everyone figured Agnes must have been an accident. Surely their parents hadn’t planned to have her. But once they knew she was on the way, they went ahead and had her. The thought of terminating the pregnancy never even occurred to their parents, and not because they were at all religious or were staunchly prolife.

They just figured, What the hell. Let’s have another kid.

Despite having an older brother and sister, Agnes felt as though she were an only child. The age difference meant her siblings had very little to do with her. They were either in or just starting high school when she came along. So they were never playmates, never went to school together. Arlene and Henry, being two years apart, had a bond Agnes could only dream of. She resented it for years, until Henry was killed in a car accident nearly two decades earlier. Only then, it struck Agnes, did Arlene begin to take a greater interest in her.

Well, it was too late by then.

Arlene seemed to believe she had some kind of family monopoly on wisdom. Did she run a hospital? Had she had that kind of responsibility? Had Arlene worked her way up from nothing to oversee a multimillion-dollar budget? And had David ever been the source of worry to Arlene and Don that Marla had been to her and Gill? Marla had been a challenge from the get-go. The teenage years were a nightmare. Sleeping around, drinking, drugs, ignoring school.

Agnes and Gill had figured that once Marla hit her twenties, things would settle down. But troubles remained. Hints of a personality disorder, difficulty recognizing people, mood swings. One doctor thought she might be bipolar. But at least, with her parents’ financial help, she was living independently in a small house of her own, getting the odd job here and there, and then, more recently, this thing where she reviewed businesses on the Internet.

It gave Agnes hope. Maybe, just maybe, Marla was getting her life back on track. So long as there were no setbacks, she might be able to move on to a more conventional kind of job. Agnes would have tried to find her something at the hospital, but after the incident with the baby, that wasn’t possible.

Agnes might be able to pull some strings somewhere. She knew people in this town. The mayor, the head of the chamber of commerce, the police chief. All of them, as it turned out, women. They understood how important it was to help a child find her way in the world.

But then Marla met that boy.

A student, for God’s sake. From Thackeray College. A local boy, the son of, if you could believe it, a landscaper.

And he’d gotten her pregnant.

What had Marla been thinking, getting involved with someone so young, someone who wasn’t even finished with school? Someone who had no prospects, other than to help his father cut lawns and plant shrubs? Agnes had done some checking up on him. A few years ago he’d even been a suspect in the murder of a local lawyer and his family. The boy turned out to be innocent, but you had to wonder, would the police have even looked at him in the first place if there hadn’t been something off about him? He was getting a degree in English or philosophy or something else equally useless.

Yes, Agnes conceded, what had happened with the baby had been tragic for Marla, and she was more than entitled to grieve. She’d needed time to get over her loss, and Agnes believed she herself had been a good mother through this period, helping to get Marla back on her feet. But who could have predicted what Marla would do? That she would sneak into Agnes’s own hospital and kidnap a newborn?

Several months had passed since then, and Agnes now believed Marla was getting better. She was back doing her Internet reviews from home. The next step would be getting her out of the house, out into the world.

But now this.

Marla with another baby.

“Are they at the house?” Agnes asked Arlene.

“Last time I talked to him, yes,” Arlene said. “I think David was wondering whether to call the police.”

“Tell me he has not done that,” Agnes said sternly. “This does not have to be a police matter. We can sort this out. Whatever’s happened, we can deal with it. Did you call Gill?”

“I called the house and left a message. I don’t seem to have his cell phone number.”

Gill, a management consultant who worked from home, had said something about meeting with a client that morning, Agnes recalled.

“Okay, I’m heading over,” she said, and ended the call.

The boardroom door opened and Jack Sturgess emerged. “Is anything the matter, Agnes?”

Her eyes locked briefly on his. “Marla,” she said.

“What?” he asked. “What’s happened?”

She brushed past him as she returned to the conference room. The board members had the look of guilty children who’d been throwing spitballs while the teacher had been down to the office.

Pickens stood behind her chair. “I’m afraid we’ll have to reschedule,” she said evenly. “Something has come up that demands my immediate attention.”

She tossed her phone into her bag and left the room, passing her office and heading straight for the stairs. The elevator could take forever, especially if a patient transfer was under way. Once Agnes was out of the building, she had her phone out again, brought up a contact, tapped it.

It rang nine times before someone answered. “Yeah?” A man, sounding both surprised and annoyed.

“Gill, we’ve got a problem with Marla,” she said.

“Jesus, when don’t we,” her husband said. “Hang on, let me just... Okay, I was with a client. What’s happened?”

“She’s done it again. She’s taken another baby.”

“Fucking hell,” he said.

“I’m on my way.”

“Let me know what you find,” Gill Pickens said.

“You’re not coming?”

“I’m right in the middle of something,” he said.

“You’re unbelievable,” she said, and dropped the cell back into her purse.

Agnes wondered what, exactly, Gill was really in the middle of. More than likely, some slut’s legs.