By the Time You Read This

43

EVEN THOUGH CARDINAL’S CASELOAD was lighter than usual, he still had to pay attention to the petty crimes that are the usual fare in a small city. Break-ins, robberies and assaults demanded investigation, and reams of paperwork had to be completed for court.

In the morning, he had helped track down the former Mrs. Rowley, but Delorme didn’t need him at the moment, so he was making quiet inquiries on the background of Dr. Bell. Internet searches led him to abstracts of papers the doctor had given, boards he had belonged to, degrees he held, and all his affiliations, past and present. He focused on the earliest of Bell’s associations—the Kensington Clinic in London, England. Unfortunately, both the doctors who had been there during Bell’s tenure informed Cardinal that they were far too busy to discuss a former colleague.

He had better luck with Dr. Irv Kantor at the Swindon General Hospital. Dr. Kantor spoke in the sorrowful tones of a former friend.

“I thought Frederick was a good psychiatrist,” Dr. Kantor said. “Hard-working, smart, productive, caring. Nobody had a better understanding of depression. No one.”

“But you sound doubtful,” Cardinal said.

“Well, then there was all the trouble.”

“What kind of trouble?”

“Frederick was a resident here, but he received a reprimand for over-prescribing—which meant he would never get a staff position.”

“Over-prescribing what?”

“Sleeping pills. I think the disciplinary committee thought he must’ve been an addict himself from the amount he was prescribing, but he wasn’t. He was just giving them to an awful lot of patients. A number of them committed suicide with the pills he prescribed.”

“Was he charged with malpractice?”

“One patient’s family tried to bring a charge, but they couldn’t get any psychiatrist to testify that it’s a gross error to prescribe sleeping pills to someone who is not sleeping—even if they are depressed. The most any of us could say is that we might not have prescribed so many pills. It might have been misjudgment, but not malpractice.”

“I’m surprised you’re telling me about it, then.”

“If that were all there was to it, I wouldn’t. But we live in a post-Shipman world—you’re aware of the physician who killed hundreds of patients?”

“Yes, I read about it. There had been suspicions about him for some time, as I recall, but one hospital did not inform another, is that right?”

“That’s right. Nobody talked to each other. And there was more about Frederick. He left Swindon shortly after the committee’s report. We had all liked him, but we also all breathed a sigh of relief when he left. He joined the Manchester Centre for Mental Health—it’s the biggest psychiatric hospital in the north. A couple of years after he went there, they had an extraordinary number of suicides, something like four times the rate in similar hospitals. There was a story in the papers and demands for a National Health investigation, but it didn’t happen for some reason. Frederick moved away, and I believe the matter was dropped.”

“Where did he move to?”

“I don’t know. Once he left here, our paths never crossed again.”

Cardinal put in a call to the Manchester hospital. The personnel department would tell him only the years of Bell’s employment, the Standards and Practice Committee chair refused to give anything at all without a British warrant, and the chief of psychiatry did not return his call.

Cardinal knew that the relationship between those who diagnose patients and those who actually look after them is often bumpy, if not openly hostile. Which was why his next call was to the head of nursing.

Police in Ontario are not normally allowed to gain information by outright subterfuge, and it was an indication of Cardinal’s overstressed state of mind that he, usually a stickler in matters of procedure, gave it barely a moment’s thought.

The Manchester head of nursing was a woman named Claire Whitestone, who had a mannish voice and a tone that suggested she had fifteen other things she would rather be doing than talking to one George Becker, assistant chief of nursing at Algonquin Bay Psychiatric.

“Algonquin Bay,” Sister Whitestone noted. “Sounds like a place where you might run into igloos and polar bears.”

“Bears and Indians,” Cardinal said. “No igloos.”

“What can I do for you?”

“We’ve got a serious problem over here and I need some help from your outfit. Some information. And your administration, your physicians? Well, it’s like talking to a brick wall.”

“You’ll get no sympathy from me, mate. I bang my head on those same walls every single day. Banes of my bloody existence. What’s the problem?”

“I need background on a psychiatrist who used to work with you. He had problems with a previous employer on matters of over-prescribing.”

“I already know who you’re talking about. If you want dirt on Frederick Bell, I can’t give it to you. Despite all the Shipman fuss, there are still all sorts of rules about sharing disciplinary records. It can be done, but it can’t be done quickly, and it can’t be done through me. You have to go through the—”

“Through the National Health Service. I know that.”

“They’re not going to give you anything over the phone, and neither am I. I assume you have laws against slander and libel in your country?”

“Yes, of course.”

“Then you’ll understand why I can’t tell you anything negative about that wonderful, wonderful man, that inspired physician, that shining beacon to us all.”

Cardinal definitely got the feeling she wished it were otherwise. He had an answer prepared.

“We’re going to request every record under the sun,” he told her. “But, as you say, that’s going to take time. Meanwhile, we’ve got people dying over here, and you may be able to save us a lot of time and actually save some lives.”

“Get on with it, Mr. Becker. We’re short-handed over here, it’s already been a hell of a day and I’m facing another shift.”

“I can put it to you very simply. We have a situation here where we have a suspiciously high number of suicides. All treated by the same psychiatrist.”

“Are you getting complaints from patients? Patients’ families?”

“One family member took a swing at the doctor—I’d call that a complaint. And another former patient says he kept encouraging her to write out a suicide note.”

A snort and its slight echo were transmitted to Cardinal via satellite.

“So let me put it to you this way: if we were to get a detailed report from your National Health Service on this doctor, would it be likely to show a similar pattern? Notice I have not named any doctor.”

“Noted and appreciated, Mr. Becker. If the National Health ever got off its collective arse and did a detailed investigation, it would indeed show similar occurrences here.”

“Was there any suggestion of foul play?”

“Other than negligence? Nothing official. But, you know, in my book, when someone jumps off a building—”

“Someone jumped?”

“I’m no bloody forensic expert, but I always found that one suspicious. Mind you, that’s just me. There was in fact a note and everything. But you say he was asking for notes, your doctor.”

“Yes. In at least two cases.”

“That doesn’t sound like good therapy to me. How does it sound to you?”

“Worthy of further investigation.”

“Frankly, Mr. Becker, you don’t sound like a nurse. What are you, exactly?”

“I’m a husband.” The word widower would not come to his tongue. It did not even enter his mind until husband was already out. “My wife went out one day to take some photographs. It appears she jumped to her death, leaving a note.”

There was the briefest of pauses.

“I’m sorry to hear that, Mr. Becker. I’m going to hang up now. You put your question simply, so I can answer it simply. Would an investigation show similarities between our caseload and Algonquin Bay Psychiatric’s? The answer to your purely hypothetical question is a very unhypothetical yes.”

When he got back to the station, Mary Flower held up a plump padded envelope addressed to him.

“Looks like Christmas arrived early for you, John,” she said, and then she coloured. “Sorry. Stupid thing to say,” she muttered, and turned away.

There was no return address on the envelope. Cardinal took it back to his cubicle, opened it and slid the contents onto his desk. Six shiny DVDS.