Night Shift

Epilogue

Saturday, December 11, 2:45 p.m.

Lou Soldano parked his new Malibu at a fire hydrant, tossed his NYPD placard onto the dashboard, and got out. He was just a few doors down from Laurie and Jack’s brownstone on West 106th Street. Carefully he picked up the large manila envelope he had on the passenger-side seat and got out. The weather was rather nice, but it was a bit cold, so he raised the collar of his coat and pulled the lapels together under his chin. He then made his way to their stoop and climbed the ten steps up to the front door.

After ringing the buzzer, he heard Laurie’s voice asking if it was he. “It’s me,” Lou said into the small microphone. A moment later the heavy front door buzzed open, and Lou entered and started up the stairs. As an inveterate smoker for most of his life from teenage years on, he wasn’t looking forward to the five flights, and he took it slowly. He’d been trying to quit smoking for years and did it on a regular basis but always relapsed to the point it had become the hackneyed joke that quitting smoking was easy because he did it all the time.

He had called Laurie and Jack earlier that day because he had something he wanted to show them that he thought they would find very interesting even though also depressing.

By the time he got to the fourth floor, Laurie was waiting for him, holding the apartment door ajar. After Lou had taken off his coat and she had hung it in the sizable closet, they hugged.

“Great to see you,” Laurie said, finally letting go.

“Likewise,” Lou said. “How’s the patient?”

She laughed. “He’s being a pain in the ass, to tell you the truth. He’s so demanding.” Laurie laughed again to indicate she was at least partially kidding. “He’s already saying he wants to get out to buy a new bike, if you can believe it. He’s also already pestering the doctor about when he can play basketball.”

“That sounds like Jack,” Lou said with a chuckle. “I brought a Covid mask if you want me to wear it. Jack has told me your mother isn’t vaccinated.”

“True, but she rarely ventures out. Have you been exposed lately?”

“Not that I know of.”

“Then the mask is up to you. We’re all up to date with the vaccine, including the kids.”

“I’m fine going maskless,” Lou said. “I’ll say hi to Dorothy from afar.” He then followed Laurie up the next flight to the kitchen level, where he said hello to the kids, Dorothy, and Caitlin. Then it was time for the final flight up to the top floor where the bedrooms were, including the master bedroom and the kids’ rooms.

“I don’t know how you people live like this,” Lou complained halfway up. He was out of breath.

“It would be good for you, old man,” she said. “It would probably get you to finally stop smoking.”

“Yeah, I’d stop smoking because I’d be dead,” Lou joked. “Changing the subject, I have to say, Emma is making real progress. I was pleased to see she actually seemed to relate to me, which was a first.”

“She is doing gangbusters,” Laurie agreed. “The team my mother has put together and supervises on a daily basis is doing wonders. I have to say, we’re thrilled.”

Laurie led Lou a short distance down the sixth-floor hallway and into the bedroom, where Jack was lying on the bed against a bank of pillows. His injured right leg in a pneumatic cast was elevated on an additional pillow. Lots of newspapers and a few forensic medical journals were scattered about. The TV was tuned to CNN but muted.

“Hey, buddy,” Lou said, coming into the room and bumping fists with Jack. “How are you?”

“Not too bad, considering,” Jack said.

“I wanted to personally thank you for finally waking up,” Lou said. “You had us worried there for a while.”

“Twelve hours’ rest was all I could manage out of the concussion,” Jack said. “On the positive side, I’m glad I missed all the excitement of the CPR. Ironically enough, the broken rib I got from that ordeal has pained me more than the two leg fractures.”

“What makes me marvel is how you complain about my smoking by telling me how dangerous it is and yet you have persisted in riding a bike around the city.”

“And which I plan to get back to as soon as possible,” Jack said.

“That is a verboten subject,” Laurie stated categorically.

“That reminds me,” Jack said. “Thank your crime scene people for finding a bit of my bike’s paint on the front of the Cherokee. That bastard tried to do me in twice. What a loser.”

“Loser isn’t a strong enough word,” Lou said. “Wait until you see this.”

Opening the manila envelope, he extracted Ronnie’s dog-eared ledger in a clear plastic evidence bag, which he opened in turn. He then handed the well-worn notebook to the couple. Laurie had joined Jack by sitting on the edge of the bed.

“What the hell is this?” Jack asked. He pushed himself up into a more upright sitting position.

“Open it and you’ll see,” Lou said. “Our crime scene people found it up in an HVAC duct in the hall ceiling of Ronald Cavanaugh’s apartment in Woodside, Queens. It’s the main evidence for our investigation.”

With Laurie holding the ledger’s cardboard back cover and Jack the front, they opened it and, starting at the beginning, carefully glanced at a number of pages.

“Jesus H. Christ!” Jack murmured. “Are each of these entries patients that Cavanaugh knocked off?”

“That’s what the investigators believe,” Lou said. “They have already started checking with the Manhattan Memorial Hospital to get individual histories, and it’s proved to be the case. Can you imagine being in AmeriCare’s shoes when all this goes public? I shudder to think of the lawsuits that are going to emerge. But, hey, it was the AmeriCare bigwigs who decided to save money by reducing the night nursing supervisor to one instead of two. This bastard had the run of the hospital.”

“Couldn’t happen to a nicer organization,” Jack said sarcastically as he turned yet another page.

“Here’s the other problem,” Lou said. “None of these patients that have been checked so far were medical examiner cases. That’s why the OCME never got a chance to question the deaths. And the reason was simple. The way the system works is that the night nursing supervisor decides which deaths are medical examiner cases and which ones aren’t, and Ronnie Cavanaugh sure as hell wasn’t going to send any of his victims to the OCME and let you guys figure out what had happened. He was also the one who decided the death was what they call an expected death, meaning each one tended to lower the MMH’s mortality ratio, making the hospital ironically look progressively better the more he killed.”

“It’s tragic,” Laurie said with a shake of her head. “How many total did he kill?”

“You’ll see,” Lou said. “The last two entries, which occurred only days ago, were numbers ninety-three and ninety-four.”

“Good grief,” Laurie said. “What a travesty. He makes Jasmine Rakoczi, who we thought was the devil incarnate with about a dozen victims, seem like an amateur.”

“And the ninety-four patients were just his mercy killings,” Lou said. “Take a gander at the next-to-last page of the book. There’s another list.”

“The cover of this ledger looks like it has seen better days,” Laurie said as she and Jack followed Lou’s suggestion.

“That’s interesting that you noticed,” Lou said. “The investigators posit that Cavanaugh handled it on a regular basis. The thought is that he considered it a kind of trophy of his accomplishments and leafed through it maybe as often as every day. It must have been like his devil’s bible.”

“What a freaking creep,” Jack said. “Your having to kill him was a service to humanity, but it’s a double tragedy in a weird way. He was a prolific killer, but it was also my impression from speaking with him and from what I had been told by one of the emergency medicine doctors that he was a terrific nurse when he wanted to be. He was certainly smart enough and had gotten good nursing training in the navy.”

When the page in question was revealed, both Laurie and Jack audibly sucked in a breath. There was a list of twenty-three names. The next to last was Susan Passero, which caught Laurie’s eye, whereas Jack noticed not only Susan Passero but also the final name, Cherine Gardener.

“What on earth is this list?” Laurie managed.

“The investigators have only checked a handful of these cases so far, but here’s what they believe. In contrast to the front of the book, where all the cases could be considered mercy killings, meaning the victims had serious medical disease, mostly advanced cancer of one form or another, this latter list, except for the last two entries, seem to be cases that should be called hero victims. Ronald Cavanaugh, at some point, branched off from his mercy killing to purposely put various patients in jeopardy by using some toxic medication or overdose purely to get the credit and prestige of being the one to make the diagnosis of what was ailing them and save them in the process. Unfortunately, it didn’t always work out as planned, and that list are the failures, or the patients who died. How many times he tried this hero hoax and with how many patients, we’ll probably never know. All we know is twenty-one times the chosen victim didn’t get enough antidote or didn’t get it soon enough.”

“God! What a fiend!” Laurie spat. She closed the book, took it out of Jack’s hands, and quickly gave it back to Lou as if handling it made her feel complicit. “Where do these people come from? Are they born that way or are they made to be that way?”

“You doctors are better equipped to answer that question than we lay ignoramuses,” Lou said as he repackaged the ledger. “But the investigation into Ronald Cavanaugh’s background has shown a bit of light and seems to point more toward the made route. His parents were killed in an auto accident when he was four, and he was taken in by his maternal grandmother. Unfortunately, she ended up passing away when Ronald was eight, and he ended up in the New York State foster care program. Ronald and another boy two years younger were taken in as foster children by a nurse. Everything seems to have been hunky-dory until the nurse, thanks to a cigarette habit, came down with mouth or throat cancer that required aggressive treatment. From then on things went downhill, and years later she was diagnosed with Munchausen by proxy.”

“Good gravy,” Jack said.

“I think a better expletive than good gravy is called for,” Lou said. “Anyway, I just learned about the syndrome yesterday. It’s big-time weird. But the long and short of it is that Ronald and his foster brother suffered and were constantly in and out of the hospital with myriad complaints, all of which the foster mother was causing using various medications she’d give them, including table salt. Hell, I had no idea table salt could put you in the hospital.”

“If you eat enough of it, it can be fatal,” Laurie said.

“Somehow Ronald Cavanaugh survived even though his foster brother didn’t, and he aged out of the system at eighteen and joined the navy, where he seems to have done okay for himself.”

“He did,” Jack agreed. “He became an independent duty corpsman on a fast-attack nuclear submarine.”

“Good God,” Lou voiced. “Now maybe I understand. Being on a submarine underwater for months at a time would have driven me bonkers.”

Suddenly Lou’s mobile rang in his jacket pocket. Pulling it out, he looked at the screen briefly. “Sorry,” he said to Laurie and Jack. “I’ve got to take this.” He then walked toward the window that faced out onto 106th Street and began speaking in low tones.

Laurie looked down at Jack. “I cannot believe it,” she said with a shake of her head. “This whole mess is much worse than I ever could have imagined. What a disaster for so many families and even the MMH. That beast Cavanaugh killed one hundred and seventeen people, and that’s what we know of. There could have been more.”

“All I can say is that I’m really, really glad he didn’t kill one hundred and eighteen,” Jack said. “And you had an enormous role in preventing it. So, if I haven’t expressed it enough or adequately already, let me say again with true sincerity that I thank you for being there when I needed you.”

Laurie felt some tears of joy threaten to surface, which she wanted to avoid since she considered demonstrative emotionalism one of her weaknesses. To avoid a scene, she merely bent over and gave him a strong, heartfelt hug.

“Ouch,” Jack complained good-naturedly. “You’re forgetting my broken rib.”

“Sorry,” Laurie said. She straightened up and gave him a loud kiss on the cheek and then mussed his already disarranged hair. “There was a time that fateful night when I truly thought that I had failed in keeping watch over you. But, needless to say, I’m enormously thankful that everything turned out as it has, for all of us.”

“Unfortunately, I’ve got to run,” Lou said, interrupting Laurie as he hustled back from where he’d been standing at the window. He was still holding his phone. “But before I go, I have to give you two enormous credit for exposing and ridding the city of this awful man. You guys are quite a forensic team, which I have to admire even if it frequently makes being your friend difficult. Nonetheless you both deserve a medal for what you’ve done. Bravo!”

“Let’s give credit where credit is due,” Laurie said. “We wouldn’t have been able to do what we did without Sue Passero and her commitment as a caring physician. She’s the one who deserves the lion’s share of the credit. If it hadn’t been for her and her ultimate sacrifice, Ronald Cavanaugh would still be merrily carrying on and probably would have continued for years to come.”

“Hear, hear!” Jack and Lou voiced in unison while nodding enthusiastically.