Night Shift

Chapter 18

Tuesday, December 7, 6:14 p.m.

As Jack descended in the elevator, he thought briefly about Lou Soldano’s warning not to play detective because it was dangerous. He knew Lou was correct, as evidenced by that horrendously scary shootout that Jack had been reminded of when he’d crossed the pedestrian bridge to the MMH’s garage. At the time he had definitely been playing detective. Yet in the current situation, he could deny that he was taking any risk since all he was doing was gathering evidence to decide whether a detective like Lou Soldano was needed. Jack still didn’t know whether Sue’s death was a homicide, but this new information that she had believed that a medical serial killer was on the loose seriously raised its specter. If Sue’s death ultimately turned out to be a homicide, the suspected serial killer would have to be a prime suspect. All in all, the nature of Sue’s professional world was far different than Jack had originally suspected, especially considering the reputed mutual animus between her and the triumvirate.

He got off on the third floor. He knew exactly where he was going because he’d visited the MMH surgical complex on several occasions when he’d been guilty of playing detective in the past. After pushing through a couple of swinging doors, he immediately turned right, entering the surgical lounge. The room, as he remembered it, was about thirty feet square with windows that faced one of the inner courtyards. The furniture consisted of a couple of well-worn vinyl couches, a handful of unmatched chairs, a number of dictating stalls, and a TV stand. The TV was tuned to the evening news with the volume turned down. At the far end, away from the entrance, was a kitchen nook with a refrigerator and a coffee machine.

With the operative day drawing to a close, the atmosphere was relaxed despite the room being fairly crowded with more than a dozen people all dressed in the same unisex scrubs. Some had hats or hoods, some didn’t. No one was wearing a mask, although many had one dangling around their necks. Jack took his off, counting on everyone being vaccinated. Most of the occupants were involved in isolated conversations, probably rehashing the events of the day, which created an overall buzz. A few were reading while others were dictating. From his personal experience as an eye surgeon, he knew that the egalitarian look of the environment was a sham since the OR was one of the most hierarchical domains of the hospital, with the surgeons and anesthesiologists invariably thinking of themselves as the top of the heap.

Making sure Sue’s photo was still pointing inward, Jack approached the nearest pair. “Excuse me,” he said, interrupting two women. “Can you tell me if Dr. Henry Thomas or Dr. Carl Wingate are available?”

The pair looked at each other questioningly. Then the first said, “I believe I saw Henry go into the locker room,” whereas the second said, “I saw Dr. Wingate duck into OR eight.”

“Okay, thank you,” he said. “Sorry to interrupt.”

“No problem,” the first individual said. As Jack walked away, he could hear the second person question, “Who the hell is that?” Jack didn’t hear the response because he was already nearing the men’s locker room door. Without hesitation he pushed inside.

He knew what to expect in the locker room. Surgeons who were involved in long, stressful surgeries, like cardiothoracic surgeons, often took showers, whereas those surgeons who were accustomed to short cases, like eye surgeons, didn’t. Orthopedic surgeons were somewhere in between. What Jack was counting on more was that in his experience orthopedic surgeons tended to be a happy, congenial group and easy to talk with.

The locker room was rather crowded, as was the lounge area, but he didn’t have any trouble finding Dr. Henry Thomas. The first person he asked pointed him out. Encouragingly, the orthopedic surgeon was whistling softly as he buttoned his shirt while standing in front of his open locker, suggesting his last case had gone well and that he was in good spirits. Jack’s initial impression just by watching the man for a few beats was that Henry Thomas was an intense, competitive, probably reasonably athletic individual, not so different from himself. His stature was a bit shorter than Jack’s six-foot-one, but stockier, with a threatening spare tire. His eyes were dark and deeply set, and he had a shock of dark brown hair with a bit of salt and pepper over his ears.

“Dr. Henry Thomas?” Jack began, sounding upbeat and cheerful.

Henry stopped whistling and gave Jack a once-over. He then asked in a surprisingly serious, confrontational tone, “Who wants to know?”

Mildly taken aback by this reaction, Jack successfully suppressed his inclination to be sarcastic, as it suggested the man had either a guilty conscience, a wildly inflated ego, or both. Instead, Jack said with a forced smile, “I’m Dr. Jack Stapleton from the medical examiner’s office. I’ve been tasked with looking into the death of Dr. Susan Passero, and I’d like to ask your opinion about the circumstances.”

“My opinion?” Henry raised the pitch of his voice as if it were a silly question. “About the circumstances?”

“Yes,” Jack said. “We are having some difficulty determining the exact cause of her death, and it’s forcing us to look into the whole situation leading up to her demise. I’ve learned that she was at odds with a few people about her hospital committee memberships here at the MMH.”

“Who suggested this?” Henry demanded, obviously taking offense.

“I’m not at liberty to divulge,” Jack said. “What I can say is that you were named as one of the people who feuded with Dr. Passero.”

“Who told you this?” Henry demanded again. He was now clearly angry. “Let me guess: Cherine Gardener?”

“As I said, I’m not at liberty to divulge that information.”

“Well, let me tell you something about Dr. Passero. She was one hell of a left-winger troublemaker, wanting to be on every goddamn committee of this hospital and constantly searching for a reason to get on her high horse and complain. Her causes were endless and constantly expanding, like the oppression of Native Americans, the history of slavery, the plight of trans people, you name it. I could go on and on. I tell you, she was one big pain in the ass and far too much a part of this goddamn woke culture. She and Cherine Gardener were out to ruin this hospital’s reputation. Those of us who care about this venerable institution were equally committed to putting an end to it all.”

With angry gestures, Henry went back to dressing, seemingly having had as much of a conversation with Jack as he could tolerate. Jack watched him. The man radiated hostility, yet was it enough to drive someone to homicide? Jack had no idea, but it certainly added to his theory that Sue’s work environment and reputation among the staff was far different than he’d imagined from knowing her socially.

When Henry finished dressing, he turned to Jack, who had waited patiently. The man was clearly angry. His face had even significantly reddened. “All I can say is good riddance to Dr. Passero! The MMH is better off without her.”

“I did hear that she had a strong desire to join the Mortality and Morbidity Task Force, but that you and other people were opposed to the idea. Would you like to comment on that issue?”

Henry’s facial flush deepened. Jack tensed, thinking the man might take a swing at him. But the moment passed. “I’m finished with this conversation,” he spat. He slammed his locker door and strode off without looking back.

Jack glanced over at the nearest doctor, also in the process of dressing, who was only about six feet away. He was considerably younger than Dr. Thomas and had obviously witnessed the confrontation between Jack and Henry.

“I couldn’t help but overhear your conversation,” the younger doctor said. “Don’t mind Dr. Thomas! He can be quixotic, to say the least, and often flies off the handle. On the plus side, he’s a damned good trauma surgeon and oversees a well-run orthopedic department.”

“He seemed rather quick to take offense,” Jack said.

“It’s his narcissistic style. Don’t take it personally.”

“Have you heard about Dr. Susan Passero’s death?” Jack asked.

“Yes, of course. I didn’t know her, but the word is that she was a respected internist. Rather sad, I’d say.”

“Dr. Thomas seemed to feel she was a firebrand. Had you ever heard anything along those lines?”

“Can’t say I have,” the man said, “but then again, I try to steer clear of hospital politics.”

“Thanks.”

“No problem.”

Turning around, Jack headed back out to the lounge. He wondered if he’d see Henry Thomas perhaps having a coffee or talking with a colleague, but he was nowhere to be seen. Jack had in mind to give him one of his cards in case he came to his senses and was willing to have a more reasonable conversation. After checking his watch to make sure he’d still have plenty of time to hopefully meet Ronald Cavanaugh down in the ED, he approached another pair of women conversing near the windows. The courtyard was lighted with hundreds of small, white lights carefully wound around the trunks and out all the branches of the leafless trees, anticipating the upcoming holiday season.

“Excuse me,” Jack said. “I’m sorry to interrupt, but I’m looking for Dr. Carl Wingate. A few minutes ago, I heard that he was in OR eight.”

“He’s out now,” one of the women said. “That’s him over at the coffee machine.” She pointed toward a very heavyset man of medium height dressed like everyone else: in scrubs and surgical hat. His face was full and rather doughy with a bushy mustache. He had just added cream to a freshly filled mug while chatting with a somewhat slimmer colleague.

After thanking the woman, Jack approached. As he got closer, he could see Carl had distinctive red patches on his cheeks just below his eyes, as if he was wearing rouge. Having been reminded of the approaching holiday season by the festive lights in the courtyard, he imagined that Carl Wingate with a white full beard could make a convincing Santa Claus.

“Excuse me, Dr. Wingate,” Jack said. “I hate to butt in, but can I have a moment of your time?” After the short and turbulent conversation with Henry Thomas, Jack was more prepared on this occasion come what may. He already had one of his medical examiner cards in hand, and he extended it toward the anesthesiologist. The man took the card with his free hand.

“I’ll catch you later,” the colleague said, and headed toward the door.

As Carl examined Jack’s card, Jack went through the same initial introduction he’d given to Henry Thomas, including the issue and apparent controversy about Susan’s hospital committee assignments. As he was talking, Jack’s active and forensically creative mind reminded himself of something that he hadn’t thought of until that moment. Of all people in the hospital, an anesthesiologist might be the most knowledgeable person concerning the best ways to kill someone in a fashion that would be difficult to detect. In a very real sense, every case of general anesthesia required putting a patient into a near-death state, maintaining them, and then saving them at the end of the procedure.

After examining Jack’s card, Carl gestured to give it back.

“No, that’s yours to keep,” Jack said, holding up his hand, palm out. “It will make it easy for you to contact me if, after our chat, you remember something else you think might be significant.”

“I can’t imagine that will be the case,” Carl said. In sharp contrast with Henry Thomas, he spoke with no discernable change in his demeanor after hearing Jack’s introduction. Instead, he merely shrugged, pocketed the card, and then added, “Who have you spoken to so far about Dr. Passero?”

Jack relaxed a degree. Up until that point he’d wondered if Carl was going to react in a fashion similar to Henry Thomas. Jack was relieved when it appeared that wasn’t going to be the case. “I spoke briefly with Dr. Thomas,” Jack said, watching Carl closely. He purposely didn’t mention Cherine Gardener.

“I was told that the doctor had a heart attack,” Carl said, maintaining his composure.

“So far there is no indication that was the case,” Jack said. “And a preliminary screen has ruled out a channelopathy. At this point, we are proceeding as if it wasn’t a natural cause, especially since it has come to our attention that there was some bad blood between her and others on the staff, particularly you, Dr. Thomas, and Peter Alinsky.”

For a few beats, Jack remained silent and watched Carl carefully. The only reaction to Jack’s potential accusation was a slight quivering of the man’s mustache.

“Are you asking me or telling me?” Carl said after a pause.

“I suppose a combination of the two,” Jack said. “Is that a fair description of the relationship between you and Dr. Passero? Was there bad blood?”

“Let me say this: Dr. Passero was, in my estimation, a rabble-rouser. Perhaps she had good intentions, but the resulting turmoil she invariably evoked was not in the best interests of this institution. If you have already spoken with Henry, I’m sure he communicated the same message but probably with more vehemence. You’d also get the same message from Peter. The woman might have been a good internist, but she was a pain in the neck about all her trivial and sundry causes and complaints.”

Jack nodded. He got the message, but he had to restrain himself from asking if Carl felt the possibility of there being a medical serial killer on the loose was trivial. He would have liked to ask, but he was afraid to because he knew that if it were true, it could be anyone on the staff, from janitors to heads of departments like Carl Wingate. After all, as he had reminded himself, who could be a more efficient serial killer than an anesthesiologist? Instead, Jack said, “I understand there was a particular contention about her wish to be on the Mortality and Morbidity Task Force. Is that true and, if it is, why was she denied a seat?”

“Did you ask Dr. Thomas about this?”

“I did, but he didn’t answer. Instead, he abruptly terminated the conversation.”

“I’m not surprised. We all found Dr. Passero an insufferable bane, but particularly Dr. Thomas. None of us wanted her on the task force for the simple reason that if she were, she’d gum up the works for the entire M and M Committee. The task force is a purposely small, decisive working panel whose major role is to choose the cases to be presented at the full committee meetings. If she were on the panel, she’d be insisting every death and every patient mishap be presented, which is clearly impossible because there is only so much time for the full committee hearings. If the task force can’t do its job, nor can the M and M Committee, and if we have no M and M Committee, we lose our hospital accreditation. And if we lose our accreditation, there can be no Medicare and Medicaid payments. If that happened, we’d be forced to close our doors. It’s as simple as that.

“Listen, it’s been a pleasure to meet you, but I’ve got to get back to the OR because there are still several cases going on that I’m supervising.” Carl put his full coffee cup down on the counter as if he had lost the taste for it. “If I think of anything else that you should know about Dr. Passero, I have your card, and I’ll call.”

“I’d appreciate that,” Jack said. He was about to pose one last question to inquire about the M and M Task Force in terms of its membership, but without another word nor even another glance over his shoulder, the Anesthesia Department head abruptly headed for the exit and disappeared.

After pausing for a moment, dumbstruck at the precipitous ending to the conversation, Jack followed. His brief tête-à-têtes with both doctors had not been what he’d expected, and he wondered if a conversation with Peter Alinsky would be similar if he dared to try to contact the man. Once out in the hallway and by looking through the windows of the double swinging doors leading into the OR complex, he could see Wingate heading down the central corridor. It was, Jack thought, rather surprising how similar the interactions had been with both doctors, although the anesthesiologist hadn’t gotten quite so demonstrably irritated.

He shrugged. He hadn’t learned much for his efforts besides that Sue Passero wasn’t universally as liked and respected as had been suggested by Carol Sidoti and Keven Strauss. If a homicide had to be considered, such a fact could very well take on a definite significance in terms of motive, especially with how emotional Henry had grown.

Jack regretted not learning anything new about the medical serial killer issue. Although he had been severely tempted to bring it up with both Henry and Carl, he felt he couldn’t, at least not until he had more information. Before approaching anyone with such a horrendous possibility, he would have to have at least some confirmation whether it was true, above and beyond hearing that Sue was convinced it was. He also wanted to have more of an idea of who it might be. From having glanced at the articles in her Hospital Mortality folder, he knew that anyone on the hospital staff, from orderlies to nurses to doctors, had the opportunity to be a serial killer since all had direct access both to patients and the potential means. With the sheer number of articles that Sue had amassed, there were many more medical serial killers than he realized, and those were only the ones who had been caught. Jack shuddered at the idea of how many additional people there might have been over the years who hadn’t been exposed simply because hospitals are places where death is anticipated, so it isn’t always questioned as much as it ought to be. On top of that was the issue of private equity getting progressively more involved in medicine and wanting to squeeze as much profit as possible out of hospitals by reducing the number of nurses per patient and thereby reducing supervision, making the deed easier for would-be medical serial killers.

Heading toward the elevators while replacing his pandemic mask, Jack tried to get his mind back on track. Although he felt he’d accomplished what he could by taking the time to talk to the two doctors, now it was time to visit the ED in hopes of running into Ronald Cavanaugh. Jack knew he had to return to his primary mission: figuring out the cause and mechanism of Sue’s death.