Natural Causes

CHAPTER 22

August 29

JUST AFTER TWELVE NOON, SARAH CROSSED THROUGH the Public Garden and headed onto the Boston Common toward the spot where she was to meet Matt. The day, which had dawned hot, was sultry now. Businessmen in short-sleeved dress shirts, their ties loosened, ate their lunches beneath broad shade trees, their suit coats carefully folded on the ground beside them. All across the field where Minutemen had once trained for the Revolution, pockets of mothers in shorts and tank tops chatted languidly, their children racing about them on the rich summer grass.

Sarah wished she could just stretch out and relax. She wished that she and Matt were meeting for a picnic of pesto turkey sandwiches from Nicole's and then a leisurely stroll along the Charles. Almost anything at all, in fact, would have been preferable to what lay ahead of her. At one o'clock, she and Matt would be in a room on the second floor of the Suffolk Superior Court Building, facing a medical malpractice tribunal.

Matt, who had served on three such tribunals over the past few years, had explained the process to her in some detail, including the option that she not attend at all. He emphasized that physicians being sued seldom chose to be present at this proceeding, especially when, as was the case today, the decision was likely to go against them. But with a flexible outpatient rotation at the hospital and an almost morbid need to experience her legal battle firsthand, there was no way she could stay away.

The tribunal system, begun in Indiana and eventually adopted by Massachusetts, was an attempt to do away with frivolous litigation against physicians. It was hoped that the screening procedure would one day lower the horrific insurance premiums that continued to drive many doctors out of clinical practice. The premiums and retroactive surcharges, totaling over $100,000 annually for some specialists, were a major cause of spiraling health care costs. And adequate coverage was mandatory in the state for licensure. Those physicians who wished to continue practicing in Massachusetts had no choice but to increase their patient load and order more and more "defensive" laboratory tests.

The tribunal, made up of a judge, an attorney, and a physician of the same specialty as the defendant, was not set up to determine guilt or innocence, Matt explained. The only question to be answered today was: Assuming Lisa Grayson's allegations are true, has malpractice occurred?-or in legal terms: Do she and her attorneys have a prima facie case?

"The tribunals find in favor of the plaintiff much more often than not," Matt had explained. "But even in cases where they lose in tribunal, plaintiffs can proceed to trial if they are willing to post a bond-in Massachusetts it's six thousand dollars-to cover court costs and the defendant's legal fees. And even then, the judge can waive the bond if he doesn't believe the plaintiff can afford it. That's obviously not an issue with the Graysons."

A scuffed, grass-stained baseball bounced off the lawn and rolled over the sidewalk, just in front of where Sarah was walking. She picked it up and threw it overhand to the teen who was chasing it. The youth, possibly Hispanic, gloved the toss with reflexive ease and smiled shyly at her from beneath a Red Sox cap.

"Not a bad arm for a girl, huh, Ricky?" she heard Matt call out.

He waved to her from across an expanse of grass and then left the group of boys he had been playing with and loped over. He had on sneakers, a Greenpeace T-shirt, and the trousers to his suit. As he spoke, he gestured with his well-worn mitt as if it were part of his hand.

"Ricky, thanks for the catch," he said as he passed the youth. "That fork-ball of yours is really starting to move. Hey, maybe I'll see you guys tomorrow."

"He's cute," Sarah said.

"He's a felon," Matt replied. "Just kidding… sort of. Those kids out there are a gang. Los Muchachos. A couple of years ago, the court assigned the defense of two of them to me. Nothing too serious, fortunately. Anyhow, I showed them some of my press clippings-only the good ones, of course-and we sort of got to be pals. Now the whole gang is playing ball, and a number of them are working with younger kids, Ricky, there, actually made his high school team. He's got some talent."

"You made all that happen?"

"Hell, no. They made it happen. I just let them know there was nothing uncool about beating up on a baseball instead of someone's head. Next week will mark the end of Ricky's probation. I got a couple of box seat tickets to a Sox-Baltimore game. I originally got them for me and Harry-that's my son. But he had to go back home for some summer school. So I'm taking Ricky instead. It was supposed to be a surprise, but I've already told him. I'm not much good at surprises."

"Where does Harry live?" Sarah asked.

A shadow of sadness darkened Matt's face. "California," he said.

His tone discouraged further questions on the subject. After a few uncomfortably silent moments, he smiled thinly and nodded toward the far side of the Common. "My office is that way."

Sarah was relieved to turn away from his pain and just walk.

Matt's work clothes were in his office, which was on the fifth floor of a converted brownstone. The three-room suite was not nearly as dismal or disorganized as he had painted it to be, Sarah pointed out.

"Everything's relative," he said. "Unfortunately, in this law business, with more attorneys around here than scrod, image counts. Sometime, just for the hell of it, I'll take you to visit Jeremy Mallon's place."

"Spare me," Sarah said.

He introduced her to his secretary, a pleasant, motherly woman named Ruth. Sarah could tell she was eager for conversation even before a word between them was spoken.

"Mr. Daniels is a wonderful man," Ruth began, moments after Matt had gone into the inner office to change.

"He seems that way."

"A good lawyer, too. And a great father. He says you're the most important client he's ever had. He always works hard, but I've never seen him put in hours like he has on your case."

"That's reassuring."

Sarah smiled a little uncomfortably and scanned the narrow coffee table for a magazine of any remote interest to her. She ended up with a dog-earred, four-month-old copy of Consumer Reports. The message she had hoped to deliver to Ruth went unreceived.

"He's here when I leave at night," she prattled on, "and he's here when I arrive in the morning. That lady he was seeing just couldn't understand how important building up this practice is to him, after what's happened with Harry and all. I think that's why she broke it off, because he wasn't paying enough attention to her. I never liked her much anyway. Too snobby, if you know what I mean. Mr. Daniels can do better."

Suddenly Sarah felt torn between asking the woman to stop sharing such personal information about her boss and grilling her for every bit of data she could deliver. She settled on a middle-of-the-road approach.

"What's happened with Harry?" she asked, reflecting on the sadness in Matt's face and thinking the worst.

"Oh, it's not Harry. It's that ex of his. A few years ago, she as much as kidnapped the boy and up and moved to California. Los Angeles, no less. Mr. Daniels fought her in court, but he got no place-even though everybody knows that she drinks too much, and he'd be a much better parent for him."

"That's very sad."

"You said it. And he cares too much about Harry to refuse anything that woman asks. Private school. Summer school. Extra money for clothes. Plus the cost of flying him here and back whenever she permits it. I write a lot of the checks, so I know how much he pays for those trips. I think that's why this case of yours is so important to him. If he does well with it, the medical insurance company will probably send more business his way. Am… am I talking too much? Mr. Daniels keeps scolding me for talking too much to the clients. But the truth is, if there were more clients, I'd probably do less talking, if you know what I mean."

Sarah wondered how long she would have to know her laconic attorney, and how well, before learning as much about him as she had in just two or three minutes with his secretary. At that moment, the ancient intercom on Ruth's desk crackled.

"Sarah, I'm sorry to be taking so long," Matt said. "I called a client about a small matter, and he's had me on hold forever. I won't be much longer. Ruth, take a break from whatever you're doing and entertain her. We don't want her to think we're one of those stuffy, aloof firms."

• • •

The Suffolk Superior Court Building, a granite relic, was a five-minute walk from Matt's office.

"I want to be sure you're not expecting something out of Perry Mason," he said as they waited at a light to cross Washington Street. "Today Mallon gets to put on the gloves and hammer us as mercilessly as he wants-affidavits, letters from experts, the works. After he's done, we get to regale the tribunal with arguments that are roughly equivalent to alleging that Mallon's mother wears army boots. This is the first fire fight we'll be in, only they get to have guns and we don't. So it's not going to be very pleasant. But just remember, it's only a skirmish."

"It sounds awful."

"Don't worry, we'll have our chance. Just don't get rattled by what you hear. As you were told that day in Mr. Kwong's shop, these people are not your friends. I saw him yesterday, by the way."

"Tian-Wen?"

"Yes. I've been over there a few times. I dropped him as a client because of conflict of interest with your case, but I got him Angela Cord. She's an excellent attorney. I really like the old guy. By the way, he says you haven't been by to see him since he got out of the hospital."

"With all that's happening to me I-I just haven't wanted to go. He's a sweet old man. I feel sorry about his getting sick, and then being charged for having that opium. But the truth is, I'm angry, too. That was his opium. He doesn't deny it."

"Yes," Matt said. "But as I recall, you're the one who reminded me that his smoking opium was cultural, not criminal. Besides, he keeps denying ever having opium in his shop. And he still maintains that even if he had smoked fifty times his customary pipeful, he could never have confused that noni herb with chamomile-"

"But he did. Denying responsibility doesn't alter reality. Matt, I've smoked opium. A number of times when I was in Thailand. I know what it can do. And it's quite possible that because of carelessness, or old age, or opium, or some combination of the three, Tian-Wen screwed up. And because of his errors-his mistakes in preparing my supplement-people have died."

"I don't buy it."

"Well, I certainly hope not. You're my lawyer. But until you can prove someone set him up, including who, and why, I've got to believe that he might have been responsible for what happened to those women. And that makes me just as responsible for using him."

They rounded the corner of the concrete and granite mall that fronted the Superior Court Building. Ahead of them, a small group of demonstrators-perhaps twenty-milled about. A single, uniformed policeman kept them back from the steps. Off to one side, a camera crew from Channel 7 was interviewing one of the demonstrators, a gaunt, bearded man who was wearing a full-length, hooded, crimson robe.

"I don't like the looks of this," Matt muttered, stopping some distance away to assess the situation.

"What's it all about?"

"Unless I miss my guess, it's about you. Did you see the Herald this morning?"

Sarah shook her head. "I was in the clinic working at seven. I barely had time for a cup of coffee. Don't tell me I made it again."

"You and your hospital, actually. On page four there's an article about some grant that MCB has just received to build a huge new center to scientifically study certain areas of alternative healing. Is there a Charlton Building?"

"It's the Chilton Building," Sarah said. "It's deserted and boarded up now. In a few months they're going to demolish it to begin work on the center. But that's old hat. Everyone at MCB's known about that for weeks."

"Well, it's news to the Herald. And right across from that item, on page five, is the announcement that you're going before a malpractice tribunal today. Axel Devlin mentioned it as well. 'The beginning of the end for Dr. Flake' is the way I think he put it. Something like that. My office got several calls wanting to know details. I didn't speak to anyone, but Ruth told me it sounded like somebody was organizing a demonstration on your behalf. And I think this must be it."

"Oh, no," she moaned.

"There's no back way into this place unless prior arrangements are made. I don't think we have any choice but to run the gauntlet. So, as your attorney, I'm suggesting you limit your vocabulary for the next minute to four words: 'Thank you' and 'No comment.' Okay?"

"No comment… thank you," Sarah said.

The small demonstration was made up primarily of practitioners of various forms of alternative healing. Sarah recognized some of them, including a very talented chiropractor and an acupuncturist who was once a full professor in Beijing. There were also three women who had taken Sarah's supplement, had normal labor, and delivered without incident. Two of them carried their infants with them in backpacks.

As Sarah and Matt approached, the group fell back and applauded.

"Hang in there," one called out.

"Good luck, Doctor," a woman said. "We're behind you."

She carried a handmade sign that read: