Night Shift

Chapter 14

Tuesday, December 7, 3:25 p.m.

Just like he had that morning, Jack entered the OCME high-rise through the back receiving bay. Arriving from the rear, he had to pass the double doors of the auditorium to get to the bank of elevators. Believing Laurie was probably in the middle of her presentation to the incoming mayor, he was tempted to poke his head in to get a sense of how it was going, but he resisted. He didn’t have time. He’d connected with Kevin Strauss by phone, and Kevin had told him if he wanted to speak with him in person as Jack had asked, he had to hurry. Kevin told him he already had a full plate of investigations on his schedule thanks to an abnormally large number of death calls just prior to his arrival.

On the fifth floor, Jack passed through the bank of floor-to-ceiling glass that separated the Medical Legal Investigation Department from the hallway. It was a large room segmented into cubicles with chest-high dividers and the building’s structural columns visible. The number of medical legal investigators at the NYC OCME was just about the same as the number of medical examiners, around forty, although their number varied as the turnover rate was higher.

Although he was a relatively frequent visitor to the Medical Legal Investigation Department, he’d never personally met Kevin Strauss, and he had to ask the location of his cubicle. As Jack wound his way into the room, he saw that most of the evening shift’s newly arrived MLIs were on their respective phones. The department was a busy place that served as the gatekeeper for the OCME. Of the seventy to eighty thousand deaths that occurred in New York City every year, about a third of them had to be reported to the OCME because of specific and well-publicized criteria, and every one of those needed to be checked out by one of the MLIs by telephone. Not all of those had to be fully investigated, meaning a site visit, and an even fewer number would be sent in and possibly autopsied, so the MLIs served an important and vital function, which was why they had to be highly trained.

“Kevin Strauss?” Jack questioned as he walked into the cubicle where he’d been directed. A man was sitting at the built-in desk with a sizable list called telephone notice of death on his monitor. When Jack first started at the OCME, these had been done on multi-sheet carbon-paper forms. Now it was all computerized. Down the hall in a much smaller room the communication clerks manned the phones 24/7, taking the “death calls” and entering the information along with a case number directly into the OCME’s database. Those cases were then distributed among the MLIs.

“Dr. Stapleton?” the man questioned as he got to his feet and fumbled with a mask, trying to get the elastic straps around each ear. Jack guessed he was in his late thirties. He was boyish-appearing with a broad face and pug nose, pale of complexion with medium blond, longish hair.

“Thanks for waiting for me,” Jack said. He took the chair Kevin pushed in his direction while Kevin sat back down in his. “I know you’re busy, so I won’t take much of your time.”

“No problem,” Kevin said. He swept wayward strands of hair off his face with his hand. “What’s up?”

“I autopsied Susan Passero this morning,” Jack began. “It was surprisingly clean. No gross evidence of pathology, more specifically no sign of coronary artery disease.”

“That’s surprising.”

“My thoughts as well,” Jack said. “Before I go on, I’d like first to commend you on the workup you did. I was impressed that you’d gotten access to the patient’s digital health record. Your write-up was first rate.”

“It was an easy site investigation,” Kevin said. “I wish they were all like that.”

“Here’s the problem,” Jack said. “Unless Histology comes back with a big surprise, which I sincerely doubt, I’m going to be at a complete loss, which is a problem because I’m under some pressure to come up with the death certificate sooner rather than later. There’s also the rare possibility of an inheritable cardiac conduction problem, which the DNA people are looking into.

“What I wanted to ask you is if there was any other fact, or even an opinion you might have heard or just randomly thought about, that you didn’t put in your report. I know I’m grasping at straws here, but it seems I’m reduced to it. Is there anything that comes to mind... anything at all?”

Kevin snapped his head back, trying to get his hair out of his eyes, but it didn’t work, and he was reduced to using his hand once again. He stared at Jack for several beats with glazed eyes. It was obvious to Jack that he was searching his memory banks. Unfortunately, the short pause was terminated by a negative shake of his head, and he said, “I’m sorry, but nothing comes to mind.”

“Did you get a chance to talk directly with the doctor who ran the resuscitation attempt?” Jack asked. He wasn’t going to name Dr. Carol Sidoti because he didn’t want to admit to Kevin that he’d gone to the MMH. He had several reasons. The first was that it might have offended Kevin by his taking it as a negative reflection on the job he’d done. The MLIs knew the MEs were not supposed to do scene visits. Second, it would have raised some eyebrows, being out of the ordinary, and possibly become part of the OCME gossip mill. If that happened, there was a reasonable chance it would get back to Laurie and cause some personal fireworks.

“Yes, but only by phone,” Kevin said. “She was the one who called in the death to communications, and I spoke to her briefly. When I got to the MMH, she’d left. I did get to talk with the night ED supervisor, Dr. Phillips, who told me about what he’d heard and allowed me to read all the ED’s notes, including Dr. Sidoti’s write-up. What I got out of all of it was that the ED team really pulled out all the stops on the resuscitation attempt and were really bummed it wasn’t successful. I didn’t mention this in the report, but they tried for several hours and were reluctant to give up. I don’t know if that is helpful.”

“During your investigation did you get the feeling that Dr. Sue Passero was well liked?”

“Absolutely,” Kevin said. “I believe that’s why they continued the resuscitation long after it was obvious it wasn’t going to work.”

“How about with the hospital administration? Did you get any sense of her reputation with them?”

“No, not at all,” Keven said with a shake of his head. “There was no need to talk to the administrator on call.”

“What about the two nurses who originally started the resuscitation in the garage? Did you talk with either of them?”

“Indeed I did,” Kevin said. “I talked with Ronnie Cavanaugh at length, who’s one of the MMH’s night nursing supervisors. If you want to talk to anyone yourself about the case, he’s the one I’d recommend, and not just because he’s the one who initially found the patient slumped in her car. He’s a sharp dude. I’ve dealt with him in the past on quite a few occasions because he’s the individual who makes the vast majority of the night-shift death calls from the MMH, most of which don’t require our making a site visit because he’s so thorough, and he knows what we are looking for.”

Kevin’s praise of Ronnie Cavanaugh reminded Jack of Dr. Sidoti’s equally as complimentary comments as well as her recommendation Jack should chat with him if he wanted any more details. Although at the time Jack had thought trying to meet with him would be difficult since he worked at night, he recalled Dr. Sidoti saying that the man made a habit of coming into the ED an hour or so early. Suddenly Jack had the idea of stopping by there on his way home when he planned on picking up the folders Virginia said she’d leave for him at the information desk. It seemed like a reasonable plan provided the man showed up early enough for Jack to get home around seven.

“You didn’t mention the name of the other nurse involved in the initial CPR. Was there a reason?”

“I didn’t think it was important,” Kevin said. “I got all I needed and more from Ronnie Cavanaugh. And she didn’t stay in the ED during the resuscitation attempt. Her major contribution was to call the ED while Ronnie started the CPR. I can certainly get her name if you think it is important.”

“It wouldn’t hurt,” Jack said. He didn’t mention that he already knew her name.

“Well, is that it?” Kevin asked after a pause. “If so, I’ve got to get my act together here.”

“One other question,” Jack said. “In your report you described Ronnie as saying he’d seen some improvement initially, but you didn’t explain what the improvement was.”

“Oh, sorry,” Kevin said. “My bad! I should have been more specific. It was that the patient’s cyanosis improved. I thought it was an interesting point because it suggested to Ronnie that the resuscitation might work, but probably the brain went too long without oxygen.”

“All right, thank you,” Jack said, getting to his feet. “If you think of anything else at all, don’t hesitate to give me a call, and I’ll do the same if I think of any more questions.”

“Will do,” Kevin said as he also stood. The two men touched elbows, smiling at employing the pandemic method of greeting and saying goodbye.

Leaving the Medical Legal Investigation Department, Jack eyed the bank of elevators but then remembered that Forensic Biology Director Naomi Grossman’s office was just down the hall. As desperate as he was, he couldn’t help himself from stopping in with the hope of getting some information, even if only preliminary, about the possibility of a channelopathy. What he did get was a chuckle out of Naomi, accusing him of expecting the impossible since he’d delivered the samples only hours earlier. But his visit wasn’t totally in vain. It evoked a call from Naomi to one of her laboratory supervisors to remind the team that the case was of particular interest to the chief, Laurie Montgomery. On the same call, she asked that a rapid screening test be done, which wouldn’t be final, meaning defining a specific channelopathy, but would merely determine if a channelopathy existed. Jack was ecstatic, believing he’d saved himself days, if not weeks.

Pleased with himself, he descended in the elevator to the main floor and headed back toward the freight receiving dock. This time when he passed the doors into the auditorium, he stopped. Curious about how Laurie was making out and if the presentation to the incoming mayor was still in progress, he pushed open the door and stuck his head inside.

The auditorium was large enough to seat several hundred people, but Jack estimated there were only about twenty or thirty currently, all seated way down by the lectern in the first couple of rows. Since the lights were significantly dimmed, they were mere silhouettes. With so few people, Laurie could have used the conference room in the old OCME building where the weekly Thursday medical examiner meetings were held. But the old conference room didn’t have the high-tech audiovisual equipment the new auditorium had, which she was using to full advantage. At the moment, Laurie was in the middle of a professionally made PowerPoint presentation about the enormous benefits the NYC OCME provided to the city.

Careful to avoid making any noise, Jack let the auditorium doors close. He’d seen the presentation a number of times and had participated in creating it. Besides, with so much on his mind, he knew he wouldn’t be able to just sit there and listen. Instead, he trusted Laurie would tell him how it all went that evening. Knowing how nervous she’d been, he hoped it was going well.