Night Shift

Chapter 20

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

After traversing most of a darkened Central Park, Jack exited on the West Side at 106th Street and rode the distance to his brownstone. There he hefted the bike up onto his shoulder and climbed the stoop. When he reached the top, he turned around to gaze wistfully over at the small park across the street with its illuminated basketball court whose lights he’d paid to have installed. A game was in progress, and even from that distance he could make out the identities of a number of the players. He felt a definite tug to join, as he loved to play, but regretfully it wasn’t to be. He had decided on his way home that he was going to do a bit of research that evening on medical serial killers and wanted to get to it in short order. He would have preferred to have Sue’s folder, so he’d be sure to read the specific articles she favored. Obviously he couldn’t, but he guessed he’d be able to find on the internet most of the articles she’d printed out. He was also interested in calling Abby to see if he had any knowledge of Sue’s trials and tribulations at the hospital, and if she had ever spoken of the possibility of a serial killer stalking its halls. He doubted it, though, because Sue had said on several occasions that she had a hard-and-fast rule not to bring home any work-related issues.

Once inside, Jack put his bike in the utility room he’d created when they renovated the building. He hung it by its front wheel next to his son’s bike. Also stored in the room was the sporting equipment that he and JJ used in Central Park on weekends and occasional summer evenings when it stayed light until almost nine. He put his empty backpack in one of the cubbies that lined the opposite wall.

He then started up the stairs. Their apartment occupied the top three floors. On the lower three floors they had fashioned six rental units, which paid most of the expenses of the building, including a sizable portion of the mortgage. Jack considered his buying the mid — nineteenth century structure a number of years ago one of the best decisions of his life. As he climbed, his quadriceps complained because of the exercise from riding the bike all day. Just like that morning, on the way home he’d had the opportunity to aggravate a few very serious bicyclists by challenging them speed-wise as they rode around the northern portion of Central Park.

Once inside the apartment he could hear PBS NewsHour, which Dorothy watched religiously every night. The sound drifted down the open stairway from the fifth floor where the kitchen, dining room, living room, family room, and study were located. The fourth floor, where he was now passing, had the guest suite and Caitlin O’Connell’s apartment. Caitlin was their long-term nanny, whom they adored and couldn’t live without since both Jack and Laurie worked every weekday from early morning until early evening.

As the fifth floor progressively came into view, he saw his mother-in-law parked on the couch in front of the TV. JJ and Emma were sitting at the table with JJ playing Minecraft and Emma watching. It was a reassuring sight, particularly because it was evidence of the great strides Emma was making in dealing with her autism. Her case was still being handled by the board-certified behavior analyst organization that Dorothy had originally found, which was providing daily behavioral, speech, and physical therapy. As Jack neared the top of the stairs, he could see Caitlin in the kitchen, who he guessed was cleaning up after making the kids and Dorothy their evening meal.

“Hi, everybody,” he called out, but only Caitlin returned his greeting. Undeterred, Jack went over to the table to kiss the tops of the children’s heads and give each a hug. Both made an effort to resist contact, as they were concentrating on the structure JJ was making. Jack didn’t take it personally and made it a point not to interfere since he was pleased to see Emma’s concentration and interaction with JJ.

“There’s some pasta in the fridge, if you are interested,” Caitlin called out from behind the kitchen island.

“I think I’ll wait for Laurie,” he responded as he turned his attention to Dorothy. As usual at that time of the day her thin form was clothed in her black velvet robe with matching mules. “Hi, Nana, anything interesting on the news?” he asked in a cheerful tone to make social contact and possibly a bit of conversation.

“This newest Covid variant is spreading like wildfire,” Dorothy said in her high-pitched voice, without taking her eyes off the TV screen. “It’s terrible.” She was always particularly caught up in and enthralled with bad-news stories of any sort.

“It is a very transmissible variant,” Jack said. Then he bit his tongue so as not to add: All the more reason to get the goddamn vaccine. For a beat he waited to see if there would be any more interaction, but, like the children, Dorothy ignored him.

Feeling like he’d at least made an effort at being sociable, he walked down the short corridor and went into the study. He sat down on his side of the used leather-topped partners desk he and Laurie had recently found online and booted up his laptop. While that was in progress, he pulled out his phone and placed a call to Abby. Knowing that the burial was to be that evening, he expected to have to leave a voicemail and was surprised when Abby picked right up.

“I’m glad you called,” Abby said without preamble. “I was just about to call you and apologize for cutting you off earlier this afternoon.”

“No need to apologize,” Jack said. Once again, he was mildly caught off guard. He never expected an apology. “I was hesitant to call, knowing you and the kids would be busy with the burial.”

“We’re all done,” Abby said. “I have to give credit where credit is due. The funeral home was terrific and accustomed to Muslim traditions, which they followed to the letter. I’m glad to say that Sue has already been put to rest, Allah bless her soul. So thank you for releasing her body so quickly.”

“You’re welcome,” he said, not knowing what else to say. He tried to block memories of his own struggles back when his family perished. It had been the most difficult time of his life.

“The kids, my parents, Sue’s sister, and I are here as a family celebration of Sue’s life.”

“That’s terrific,” Jack said. “Being with family is important after such tragedy. Listen, I won’t take much of your time, but, if you don’t mind, I’d like to ask you if Sue had been talking at all with you recently about everything that was going on at the hospital with her committee responsibilities and such.”

“She didn’t like to talk about hospital affairs or any of her patients,” Abby said. “At the same time, I know she was frustrated of late about getting another committee assignment, but I don’t know the details. Nor did I want to know, because I knew she really wouldn’t want to explain it fully.”

“I remember her saying she didn’t like to bring hospital business home,” Jack said, “so I’m not surprised. But there is one specific issue I’d like to ask you about, but please keep it just between you and me.”

“Of course,” Abby said. “What’s on your mind?”

“Had she said anything to you at all about being convinced that someone at the MMH was hurting patients rather than taking care of them?” He had to smile at his own attempts at evasive language, avoiding the inflammatory term medical serial killer.

“Heavens, no,” Abby said. “What makes you ask that?”

“It would take too long to explain,” Jack said. “I’ll let you get back to your family.”

“What about the death certificate?” Abby said. “I spoke to the insurance agent, and she said the sooner they got that documentation, the sooner they can fulfill the terms of the policy.”

“I’m working on it, for sure,” Jack said. “We have to wait for a couple of tests to come back.”

“Okay, I understand,” Abby said. “My best to Laurie.”

After saying goodbye, he slowly put down his phone. Having learned nothing from Abby, he was becoming even more curious as to what Cherine Gardener was going to tell him tomorrow, especially after hearing from Ronnie that the hospital’s death ratio had been trending downward and not upward. What kind of statistics would point to a serial killer if the mortality ratio was going down? It didn’t seem to make much sense.

With the computer ready, Jack googled medical serial killers, and as he expected he got more than twelve million results in a third of a second. He picked a number with headlines he recognized from Sue’s collection and quickly read them. In one of the first, he found a quote that spurred his imagination — “Although rare, they are more common than most of us imagine” — followed by the recent assertion that on average thirty-five medical murders happen every year in the United States alone. On Wikipedia, he found a lengthy list of medical serial killers and the number of deaths they had been convicted of causing, although almost all of them admitted to far more. Reading on, he found a number of articles about the motivations and psychology of the killers. All in all, it was disturbing reading, even for someone accustomed to death like Jack was.

In the background, Jack heard Laurie’s cheerful voice calling out a hello to everyone as she came up the open stairs to the fifth level. He was tempted to turn off the computer and go out into the kitchen to welcome her, but at that exact moment he’d stumbled across an interesting article associating some medical serial killers with a condition known as Munchausen by proxy, where individuals, in this case medical personnel, derived some gain from causing illness in others. As he read on he learned that the gain could be direct, by making the diagnosis and providing the cure, which resulted in acclaim from colleagues, or less direct, by causing the death of the individual and thereby supposedly saving them from the misery of going through a protracted dying process if they were considered terminally ill.

He shook his head in dismay, recognizing that the old adage it takes all kinds to make a world was certainly a truism. Yet it was difficult to believe people could be so screwed up. He couldn’t help feeling this way, despite having studied a bit of psychiatry in medical school, which had exposed him to the entire spectrum of human mental disorders.

“There you are,” Laurie said brightly, bursting into the room. “Why aren’t you out there joining in? Come on, this is family time!” She came over to Jack and gave him a forceful hug and then playfully messed his hair to indicate she was not really finding fault with him being in the study. She seemed in a particularly good mood.

“You seem happy,” he remarked as he patted his hair back into a semblance of normal.

“I am,” Laurie said. “I feel like the presentation George and I gave to the mayor-elect went superbly. It was obvious from his questions that he was duly impressed with what we have been able to accomplish, and he’s certainly not in the mood to curb our budget. I’m convinced his background in law enforcement is what saved the day, and I’m optimistic he’s going to support the new morgue building lock, stock, and barrel. Now it’s just the city council I have to convince to come up with the funding, not that that is going to be a walk in the park.”

“Bravo,” Jack said.

“My word,” she said, leaning over to look more closely at Jack’s laptop screen. “What on earth are you reading about? Medical serial killers and Munchausen by proxy?”

“It’s been an interesting day for me, too,” he said. “Maybe not as successful as yours. I’ve been on the phone a bit.” Jack was not one to lie, but he thought that being cagey was not a sin. He wasn’t about to admit to having been over at the MMH twice that day for fear of changing Laurie’s mood, yet he was eager to share what he’d learned and get her take. He was nostalgic about how they used to bounce ideas off each other before she had ascended to being the chief. Back then, she’d been as eager as he to go out into the field on difficult cases.

“What have you learned about medical serial killers and Munchausen by proxy?” Laurie asked. She folded her arms and leaned her backside against the desk, staring down at Jack. She was clearly intrigued.

“Some medical serial killers are thought to suffer from Munchausen by proxy,” he said.

“Okay,” she said. “I suppose that makes sense. But what made you motivated to read such an article?”

“I learned something particularly surprising today,” Jack said. “Apparently Sue had recently become worried that there was an active medical serial killer at the MMH, particularly over the previous year.”

“Good gravy! Really?” Laurie questioned. “How did you learn this? From Abby?”

“No, from an orthopedic charge nurse Sue was friends with. They both served on the Mortality and Morbidity Committee and took their positions seriously, becoming more or less comrades in arms. So much so that it created, should we say, ill feelings from some of the higher-ups, who thought of them as provocateurs or co-conspirators. As you know, hospital politics can get vicious, particularly when it involves narcissistic docs and narcissistic administrators, of which there are far too many.”

“Yikes,” Laurie said. “What was Sue’s suspicion of a medical serial killer based on? Any idea?”

“That I don’t know yet,” he said. “The nurse I was speaking with was on duty and couldn’t say much other than to suggest it had something to do with statistics. But later I learned that the hospital’s mortality ratio has gone down, which argues against there being any serial killer or certainly not an active one. She’s off tomorrow and has promised to get in touch with me. So I hope to learn more specifics then.”

“Well, I’ll be eager to hear what you find out,” she said. “If it is true, it’s critical to find out who it is and put a stop to it. I envy you getting to work on such a case rather than jousting with the city council. It reminds me of when I exposed Jasmine Rakoczi. What a horror if it turns out that the MMH has yet another medical psychopath.”

“I couldn’t agree more,” Jack said. “I can also imagine how much you miss the challenges of being an ME and doing forensics. In fact, maybe you should think about stepping down from being the chief and rejoin us plebeians. I’m serious.” Jack would like nothing better than to have Laurie back as a colleague, both at the OCME and at home.

“Don’t think it doesn’t cross my mind on occasion,” Laurie said wistfully. “But I accepted this challenge, and by God I’m going to see it through. Who are you working with on this? Kevin Strauss? Didn’t you say he was the MLI on Sue’s case?”

“He’s the one, and I went down to 421 to talk with him directly. I wanted to make sure there weren’t any nuances that hadn’t made it into his write-up. I also have Bart Arnold pulling together some statistics on the number of ME cases coming out of the MMH over the last couple of years to see if it’s risen, and if so, how much. I hadn’t heard any red flags like that, have you?”

“I haven’t.”

“It’s all very interesting, and I wonder if none of it would have come to light had Sue not passed on.”

“Well, keep me informed,” she said. She straightened up to head back out to the kitchen. “Do you think you should let Lou Soldano know about the possibility of a medical serial killer at the MMH? You remember how critical he was in the Rakoczi debacle.”

“It’s a little early for that,” Jack said. “I’ve only been told Sue was convinced with no idea why yet, or even if it was based on anything specific. But it is interesting you bring up Lou’s name because I saw him today and hadn’t for some time. He came over to observe the post on a supposed suicide of the wife of one of his junior detectives.”

“I can’t help but notice you used the word supposed. Did you find reason to think otherwise?”

“For sure,” he said. “I’m about ninety-nine-point-nine percent certain it was a homicide, and with no break-in, it was most likely perpetrated by the aggrieved husband. It’s a sad situation, made worse by the woman being pregnant. Understandably Lou is taking it hard, as he is fond of his detective.”

“I can imagine,” Laurie said. She then clapped her hands, indicating her wish to change the subject. “That’s quite enough shop talk! Instead, let’s have some dinner and family time?”

“Sounds good,” Jack said. He turned off his laptop. “But first let me say that Lou had a couple of suggestions for me. He reminded me I shouldn’t play detective, but, more important, he advised me against making waves here on the home front.”

“Bravo!” she said with another clap. “I think both are fabulous suggestions that you should follow.”

“I’m glad you approve,” he said. “So, I’ll resign myself to your mother staying here as long as she likes and verbally give her credit for truly helping with Emma, and I’ll also make a concerted effort not to get into any more arguments with her about vaccines. Regarding Emma, I’ll stop advocating her trying schooling in the near term until there is concerted agreement on it. With that said, I do still oppose the Adderall issue for JJ although I’m not against a second professional opinion. What do you say?”

“I’d say that is significant progress,” Laurie said. “Three cheers for Lou. Now if you would throw in a moratorium on commuting on your bike and finding a different sport than pickup basketball, I’d be willing to sign a truce.”

Jack looked up at his wife with dismay until he caught her smile, indicating she was teasing about the bike riding and the basketball playing, even though she was against both. He laughed. “Okay, you got me! Very funny!”

“I have one more question,” she said. “Have you spoken again with Abby? What’s the status there?”

“I did speak with him not ten minutes ago,” he said. “All is well. The burial took place within the twenty-four-hour period. He and his children and Sue’s sister were having a kind of wake.”

“Oh, dear.” Laurie groaned. “I feel so guilty about not being there for my friend.”

“I’m sure Abby understands. It’s one of the difficulties of having a funeral service so quickly.”

“I suppose,” Laurie said. “Did he mention the death certificate?”

“He did, and I reiterated that I’ll be checking the histology and toxicology tomorrow.”

“Did he seem fine with that?”

“He did,” Jack said.

“Okay, thanks for handling it all,” Laurie said. “I certainly couldn’t have done the autopsy. But be that as it may, let’s try to enjoy some family time.”