Intervention

13

3:42 P.M., TUESDAY, DECEMBER 2, 2008

NEW YORK CITY

(9:42 P.M., ROME)

Jack was thoroughly disgusted with himself. For the second time in two days, he’d completely lost control. Yesterday it had been with Ronald Newhouse, illustrating just how poorly he was handling his son’s illness. Thinking back on his actions in the chiropractor’s office embarrassed him, especially since it was Laurie who bore the brunt of the tragedy, while he fled the house on a daily basis to avoid even thinking about it. Today he’d essentially blamed his four-month-old son for his lapse of sanity, which was even more embarrassing than railing against a quack chiropractor. Guiltily, he thought about how Laurie would respond when she learned he’d told Bingham and Calvin about JJ. Although they hadn’t discussed it openly, both saw the situation as an utterly private affair.

Jack was still sitting at his desk, where he’d retreated after the dressing-down in Bingham’s office. He looked at his in basket, which was overflowing with laboratory results and information he’d requested from the medicolegal investigators. He knew he should get to work, but he couldn’t get himself to start.

He glanced over at his microscope and the stacks of beckoning microscope slide trays, each representing a separate case. He couldn’t do that, either. As preoccupied as he was, he worried he’d miss something important.

Seemingly paralyzed, Jack put his head in his hands. With his elbows on the desk and his eyes closed, he tried to decide if he was actually getting depressed. He couldn’t let that happen again. “Pitiful!” he snarled out loud through clenched teeth, his head still bowed.

Vocalizing such a harsh opinion of himself was like being slapped. Jack sat back upright. Having in a sense hit bottom, he rallied. With the same rationale that the best defense was a good offense, the way he approached the meeting with Bingham and Calvin, a state of mind that he wished he’d maintained rather than becoming the wimp he had for fearing to be put on leave, Jack steered his mind back to his alternative-medicine crusade. “The hell with you, Bingham!” Jack snapped. Suddenly, instead of being cowed by Bingham, he was defiant. Though he was initially motivated by a desire to distract himself from JJ’s illness, he now thought of the crusade as a legitimate goal in and of itself and certainly not simply a writing exercise for a forensic pathology journal. Instead it was a bona fide way to inform the public about an issue they should care deeply about.

His motivation restored, Jack raised his head and scooted his chair over from the work area of his desk to his computer monitor. With a few clicks of his mouse, he was looking at his e-mail, checking to see if any of his colleagues had responded to his request for cases involving alternative medicine. There were just two: Dick Katzenberg from the Queens office and Margaret Hauptman from Staten Island. Jack cursed under his breath at the lack of response from the others.

Taking out a couple of three-by-five cards, Jack wrote down the names and accession numbers. He then sent another group e-mail to all the MEs, thanking Dick and Margaret by name for responding, and exhorting the others to follow their lead.

Jack grabbed the index cards and his jacket and headed out. He wanted to pull the files on the two cases, which meant dashing over to the records department in the new OCME DNA building on 26th Street.

Jack hurried past the old but newly renovated Bellevue hospital complex and into the new OCME DNA building, which was set back from First Avenue by a small park. The building itself was a modern skyscraper sheathed in a mixture of blue-tinted glass and light tan polished limestone and towered over the old hospital. Jack was proud of the structure, and proud of New York for having built it.

Jack flashed his OCME ID card and was buzzed through the security turnstile. The records department was on the fourth floor in a spotless office lined with floor-to-ceiling faux-hardwood vertical drawers. Each massive drawer held eight four-foot-wide horizontal shelves. At the end of the day, each aisle had a fold-out wall of the same faux wood that was closed and locked.

The front desk of the department was staffed by a smiling woman named Alida Sanchez. “What can we do for you?” she asked in a lilting voice. “You look particularly motivated.”

“I guess I am,” Jack admitted, returning the smile. He handed over the two index cards, asking to see the records.

Alida glanced at them before standing up. “I’ll be right back.”

“I’ll be waiting,” Jack said. He watched her walk away in the direction of the East River, visible through the windows. A few moments later, she reappeared with a folder. She returned to the desk and handed it to Jack. “Here’s the first, to get you started.”

Jack opened the record and pawed through the medicolegal report, autopsy notes, autopsy report, telephone-notice-of-death forms, and case worksheet until he came to the certificate of death. Pulling this form out from the others, he noticed that the immediate cause was the same as Keara Abelard’s, vertebral artery dissection. On the next line of the form, after the phrase “due to or as a consequence of,” was written “chiropractic cervical manipulation.”

“Perfect,” Jack murmured to himself.

“Here’s your second file,” Alida said, returning from a more distant aisle. Curious, Jack opened the second folder and pulled out the death certificate. Glancing at the “immediate cause of death” line, he was surprised to see that it included “melanoma.” Lowering his eyes to the next line, he saw that the death was a consequence of cancer that had spread to the liver and brain. Confused as to why Margaret would have sent the case, he moved on to part two of the cause of death. There was a line designated as “other significant conditions contributing to death,” where Margaret had written that the patient had been advised to use only homeopathy for six months.

“My goodness,” Jack said.

“Is something wrong, doctor?” Alida asked.

Jack looked up from the death certificate, and then held it up in the air. “This case has opened my eyes to another negative side of alternative medicine I’d not given any thought to.”

“Oh?” Alida questioned. In her job, she wasn’t accustomed to having conversations with the MEs, especially after the records department had moved away from the morgue to the new building.

“I used to think that alternative medicine like homeopathy was at least safe, but it isn’t so.”

“What is homeopathy exactly?” Aida asked.

As Jack had read an entire chapter on it the previous evening in Trick or Treatment, he had a rapid answer he wouldn’t have had otherwise. “It’s a type of alternative medicine based on the very unscientific idea that “like treats like.” In other words, if a plant causes nausea when it’s been eaten, then the same plant will cure nausea when it’s taken in a very diluted amount, and I’m talking about a severe dilution such that there might be only a molecule or two of the active ingredient.”

“That sounds rather strange,” Alida commented.

“Tell me about it,” Jack said with a laugh. “But as I said, at least I thought it was safe until you gave me this case.” He again waved the death certificate in his hand. “This case underlines the fact that people can buy into alternative-medicine therapies like homeopathy to the extent that they might forgo conventional medicine, which, in certain circumstances, can offer a cure only if the conventional therapy is started early enough, like with certain cancers. This case that you gave me is such a case.”

“That’s terrible,” Alida voiced.

“I agree,” Jack said. “So thank you for your help.”

“You’re most welcome. Is there anything else I can do for you?”

“There’s been talk of digitalizing OCME records. Has that started?”

“Most definitely,” Alida said.

“How far along is it?”

“Not very far. It’s time consuming, and there are only three of us.”

“How many years do you go back?”

“We haven’t even done a year yet.”

Jack rolled his eyes in disappointment. “Not even a year yet.”

“It’s a very laborious process.”

“How could I search through all the OCME records for deaths associated with alternative medicine, like the two you pulled for me?”

“I’m afraid it would have to be record by record, which could literally take years, depending on how many people were tasked to do it.”

“That’s the only way?” Jack asked. It was not what he wanted to hear.

“That’s the only way until all the records are digitalized. And even with the digital records, you’d only find those charts where the medical examiners added the words alternative medicine in the cause-of-death box.”

“Or chiropractic or homeopathic, et cetera, et cetera,” Jack added. “Whatever type of alternative medicine was involved.”

“Correct, but I wouldn’t imagine too many medical examiners would add such a thing. After all, on the death certificates of people dying of therapeutic complications, you don’t see conventional or orthodox medicine stipulated as a contributing factor, or orthopedic surgery, or any other specialty, for that matter. The only possible place it might turn up, if the medical examiner didn’t include it on the death certificate, would be in the investigator’s report under ‘other observations.’ Even then it would be unlikely, since in my experience, investigators rarely write anything there at all.”

“Shit!” Jack exclaimed. Then, realizing what he’d said, he excused himself. “I’m just so desperate for this information,” he said. “I wanted to know how many deaths the OCME has seen over the last thirty years or so that involved alternative medicine. It’s that type of statistic that gets people’s attention.”

“Sorry,” Alida said with a forced smile.