Silent Treatment

Chapter10

It was almost eight when Harry finallyleft the wreckage of his apartment and took the crosstown bus back to thehospital. The two policemen who had been sent in response to his call had triedfor a few fingerprints, but in the main, their crime-scene check wasuninspired. A robbery in a Manhattan apartment was clearly of little moreinterest to them than a derelict shaking the coins in his cardboard cup atpassersby on the street.

The officers' conclusion, arrived at aftera half hour, was that this was a run-of-the-mill B and E by a professionalthief who might or might not have known Harry would be staying late at thehospital. They brushed aside Harry's concern that the thief had another agenda,and told him that the best he could hope for was that some of the stolen itemssurfaced at a pawnshop or fence known to the police. Meanwhile, Harry would bedoing the smart thing to get what he could from his insurance company, replacewhatever he wanted to, and bank any money left over.

Harry crossed the MMC lobby and headeddown the corridor toward the Alexander Building elevators. All around him, itwas business as usual. He wondered how many hundreds, even thousands offamilies he had passed over the years who were heading into the hospital justas he was today, to see a spouse or child or parent for the last time. His lifewith Evie had been strained and emotionally barren for a long time. But untillast night, he had never completely stopped believing that they would somehowmake it back to the way it once had been between them.

As he passed the nurse's station onAlexander 9, he was aware of the sideways glances and changes in conversations.No doubt the tale of Caspar Sidonis's accusation had already reached theoutermost branches of the hospital grapevine. He had never enjoyed being thesubject of gossip, negative or positive. Now, he shuddered to think of thedistortions the Sidonis story had undergone from one retelling to the next; thesimple truth was bad enough. He also knew that unless explanations surfaced forthe telephone order that established Evie's IV and for Maura Hughes's mysterydoc, there would be more tales to come. Many more.

Evie's parents, Carmine and DorothyDellaRosa, were seated silently at Evie's bedside. A retired postman and anadministrative secretary, married well over forty years, they were pillars ofthe Catholic church in their small New Jersey town. They were also as ordinaryand reserved as their daughter was vibrant and spectacular. Evie was their onlychild.

Harry shook hands with Carmine and kissedDorothy on the cheek. The couple had always been cordial enough toward him, butcould not at their most open ever be considered warm. New Jersey Gothic, Eviesometimes called them.

'We think Evelyn moved her arms,' Dorothysaid.

'She might have. There are reflexes thatcause muscles to contract. They don't really mean anything though, Dorothy. Ican't let you think they do.' Harry gestured to Maura's bed, which was emptyand freshly made. 'Where's the woman who was here?'

'Down the hall in a new room, poor soul,'Dorothy responded. 'The nurses said a bed just came open. They didn't want herdisturbing these. . these moments.'

Harry knew that unless he asked CarmineDellaRosa a direct question, and then only one he was uniquely qualified toanswer, Carmine would let his wife do the speaking for the two of them. Harryhad decided against sharing news of the break-in. Sooner or later he might haveto, but at the moment they were already upset enough by the tragedy and byHarry's decision to have Evie's organs donated.

On the bed beside them, Evie laypeacefully. Her eyes were taped shut, and she remained attached to a ventilatorand IV. But the treatments to reduce brain swelling — hyperventilation to lowerher carbon dioxide level and raise her blood pH, and diuretics to inducedehydration — had been stopped. A second set of required tests — cerebralblood-flow scan, EEG, and attempts at making her breathe spontaneously — hadall confirmed the diagnosis of functional brain death.

Now, there was only the matter of sayinggood-bye and having an attending physician pronounce her officially dead. Thenthe people from the New York Regional Transplant Services would take over. Hetook Evie's hand and held it for a time, wondering if the DellaRosas had heardanything yet of Caspar Sidonis. Before long they would. With the cause ofEvie's death clearly established as a ruptured aneurysm, there was no need forthe medical examiner to demand an autopsy — especially with multiple organdonations at stake. But he had ordered extensive toxicology studies.

'Father Moore just left,' Dorothy said.

'I'm sorry I missed him.'

'He administered the Sacrament of the Sickto Evelyn.'

'Good.'

Evie had not considered herself a Catholicfor years and had made no attempt to have her first marriage annulled. Butneither of her parents would ever admit to the fact.

'I'm just not sure this organ business isthe right thing to do. Evelyn was so … so beautiful.'

'It's the right thing, Dorothy. Evie willbe just as beautiful when this is all over — more beautiful. . Okay?'

'Yes. I … I suppose so. Um. . aboutthe funeral?'

Harry sensed what she wanted him to say.

'Would you like to make arrangements?' heasked.

'Thank you. I would.'

'Anything you do in that regard will beokay. The funeral people you decide to use can call and make arrangements withthe hospital.'

'Do you know if Evelyn has an address bookof some sort?'

'Oh, yes. As a matter of fact, she has ithere. I'll call you later if you want and go through the names with you.'

'That won't be necessary. I have friendswho will call all the numbers. That way anyone who wants to come can do so. Ourchurch isn't that large, but we don't have that much family, so there should beroom. You'll speak to people here?'

'Of course.'

Harry took Evie's purse from beneath herbedside table. She had left her wallet at home, but insisted on bringing in hermakeup, some money, and her address book. He withdrew the small, leather-boundbook and quickly flipped through it. The names were carefully done in Evie'smeticulous block print. Many of them conjured up immediate, vivid memories ofthe happier years of their marriage. He was about to hand the book over when henoticed two small pieces of paper taped inside the back cover. On each was aname, address, and what looked like a social security number. Curious, Harryremoved the slips and dropped them into his jacket pocket, taking pains toshield his movements from Dorothy. Oblivious, she took the address book andthanked him. Then she led her husband back to the bedside and out the door.

'She was such a beautiful girl,' Harryheard her say.

Harry waited until he was certain theDellaRosas would not be returning for any reason. Then he opened Evie's purseagain. In addition to some eye shadow, lipstick, blush, and a twenty-dollarbill, there was a gray rabbit's-foot key chain with three keys on it. Two weredoor keys of some sort, fairly new. Harry checked them against the co-op keyson his own ring. No match. The third was for a mailbox. He was about to examinethe two slips of paper when Ben Dunleavy swept into the room.

Evie's neurosurgeon was respectedthroughout the hospital, but he was also feared for his volatility andintolerance. The decision to delay repair of Evie's aneurysm, although made onsound clinical grounds and decent data, had been his. Now, before he couldoperate on his patient, she was dead.

'Harry,' he said.

His handshake and tone were cooler thanthey should have been given the circumstances. Sidonis had obviously gotten tohim.

'You here to pronounce Evie?'

The neurosurgeon nodded and looked down ather. With no more drama than that, it was done. Harry glanced at the wallclock. Nine-twelve A.M. and thirty-five seconds. Officially, Evie was dead.

'Needless to say, I'm really sorry thishas happened,' Dunleavy said. 'It's been years since I opted to do anythingother than a delayed repair of an aneurysm like hers. Evie is my firstfatality. I've only had two patients even rebleed before I could get them tothe OR, and both of them did fine.'

Harry could read between the lines of whatthe man was saying. He saw no sense in not cutting to the chase.

'Ben, Sidonis may have been having anaffair with Evie. I don't know. But he's wrong about what he's accusing me of

Dunleavy's gaze was dispassionate.

'I hope so, Harry,' he said. 'Let me knowif there's anything else I can do.'

He was gone before Harry could evenrespond. First the nursing staff, now Dunleavy. Even without hard evidence,there were already some unwilling to give him the benefit of the doubt. Harryfelt an unpleasant tightening in his gut. There was going to be trouble.

He sat down in the bedside chair vacatedby Dorothy and took the two pieces of paper from his pocket. They were scraps,one torn from the border of a magazine page, one from a sheet of stationery.Each had a man's name, address, phone number, date of birth, and SocialSecurity number, written in Evie's hand, but hastily. The first was JamesStallings, forty-two years old, with an Upper East Side address. The second, athirty-seven-year-old from Queens, was someone named Kevin Loomis.

Harry put the slips in his wallet and therabbit's foot and keys in his pocket. Then he checked the purse one last timeand dropped it into the wastebasket. Finally, he bent over Evie's body andkissed her gently on the forehead.

'I'm sorry, kid,' he whispered. 'I'm sorryabout everything.'

He brushed her cheek with the back of hishand and left the room. He was nearing the elevators when, from somewhere downthe hall behind him, he heard a familiar voice cry out, 'Hey, will someoneplease get in here! Get in here and get these damn bugs off of me!'

'He winked at me, Sherry. I swear he did.'

Gowned and masked, nurse MarianneRodriguez peered down into the radiant warmer where tiny Sherman O'Banion hadspent virtually every moment of his two and a half weeks on earth. The neonatalintensive care unit at New York Children's Hospital was the finest inManhattan, and it was currently filled to capacity — thirty newborns ranging inbirth weight from just over a pound to ten. Sherman, born at twenty-five weeks,weighed one pound five ounces. His mother was a housewife, staying at home tocare for two other children. His father worked the night shift on the assemblyline of a factory. Considering his birth weight and other problems, Sherman wasdoing pretty well.

'Don't you wonder what some of thesepeanuts are going to grow up to be?' Sherry Hiller asked.

'I'll bet Sherm plays football. Have youseen his daddy?'

The infant, in his pod, looked like avisitor from another planet. There were tubes, wires, and auxiliary machinesall around him. He was draped in Saran Wrap to conserve his body heat. A panelof phototherapy lights shone on him to lessen jaundice. Tiny eye shieldsprotected him from the ultraviolet rays. A ventilator controlled hisrespiratory rate and volume. Sensors on his abdomen and legs measuredtemperature, heart rate, and blood oxygen concentration. An intravenous lineplaced in a tiny vein on his head provided fluid and antibiotics. A tube intohis stomach through his nose delivered formula.

Marianne moved about the warmer, notingdown the infant's temperature, heart rate, and color. His oxygen levels wererunning a bit low, and his dusky color, lab values, and exam had indicated asignificant heart defect that would probably have to be surgically correctedbefore long. But Marianne wasn't all that concerned. She had been an NICU nursefor six years and had seen any number of infants worse off than ShermanO'Banion make it out of the hospital in great shape. Of course, there wereothers who were not so fortunate. Blindness from a number of factors, cerebralpalsy, mental retardation, multiple surgical procedures, death — either suddenfrom cardiac arrest or prolonged from infection — and eventual learningdisabilities were complications that every NICU nurse had to deal with, if notaccept.

There was a tap on the glass from theformula room. Marianne looked over. The woman bringing the specially preparedformulas up from dietary waved at her cheerily with the fingers of arubber-gloved hand. Marianne had never seen the dietary worker before — or atleast felt fairly certain she hadn't. Per protocol, the woman wore a haircover, mask, and surgical gown. Only her stout frame and her dark brown eyeswere apparent. The chestnut eyes had a special spark to them, and Marianne hadthe sense that this was a cheerful person. She motioned for her to set out theformulas on the counter. The nurses would be in to pick them up. The woman noddedher understanding, did as was requested, and left the NICU.

Marianne returned to her duties, pausingto check each piece of equipment. To do her job right required almost as muchmechanical aptitude as medical. But each type of apparatus was backed by a teamof specially trained technicians and, in some instances, an entire department.The cost, short-term and long-range, of neonatal intensive care was astounding.Someone had once told Marianne the actual numbers, which were something likenine thousand dollars a day for difficult cases. One infant, whose mother hadabandoned her in a Dumpster, had remained in the New York Children's NICU foralmost nine months before succumbing to infection. There was a memorial servicefor the child. Only her nurses and a few M.D.s attended. The cost of keepingher alive for those months had been over a million and a half dollars.

'Okay, Sherm,' Marianne said, 'it's chowtime.'

'Bring Jessica's gruel in when you come,will you?' Sherry Hiller asked.

'Sure thing. Does anything need to beadded?'

'Nope.'

The formulas were in labeled bottlescalled Grad-u-feeders — a one-day supply for each of the infants. Some of thefeeders contained supplemented mother's milk. Others were prepared fromscratch. Each was sealed with a tamper-resistant seal that was essentiallyextra-sticky cellophane tape. Marianne gloved before handling the bottles.Then, breaking the seals, she unscrewed the cover of Sherman's bottles andinserted the glucose supplement that had been ordered by the neonatologist.Next she resealed all but one bottle, using a roll of the tamper-resistantsealer that she picked up from the counter. As usual, she wondered why thedepartment bothered with the tape when it was so easily accessible to so manypeople. She checked and double-checked the labels and placed all but one ofJessica Saunders's and Sherman O'Banion's formula bottles in the refrigerator.Then she returned to the warmers.

'How do you handle a hungry man?' she sangas she administered the newborn's feeding down his tube. 'The Manhandler.'

She held the formula over the infant untilit had drained in completely.

'Marianne, could you do Jessica for me?'Sherry asked. 'Little Moonface Logan's monitor alarm keeps going off. I thinkthe leads are loose. I want to replace them all.'

'Sure thing,' Marianne said again.

Marianne was focused on delivering formulato the tiny girl when she heard the alarm from one of the nearby cardiacmonitors. For half a minute, she ignored it, certain that it was coming fromthe loose leads on the infant they called Moonface. The alarm persisted.

'Sher, that's Moonface, isn't it?' shesaid, without looking up.

For a moment, there was only thecontinuing drone of the alarm.

'Holy shit!' Sherry cried suddenly.'Marianne, it's Sherman.'

Sherman's cardiac monitor was showing anabsolutely flat line. Marianne detached the feeding bottle and hurried back tohis warmer. The two-week-old's chest rose and fell in response to hismechanical ventilation. He looked as he always did, except that his dusky colorhad deepened considerably. Now the oxygen saturation alarm was sounding aswell. Marianne checked the leads. None loose. She slipped her stethoscope on tothe infant's chest. Nothing. Not a beat. Quickly, she sped up the ventilatoryrate and began cardiac compression.

'He's coded, Sher,' she said withcontrolled urgency. 'Call it for me and get Laura over here. Damn it all.'

In less than a minute, the resuscitationof Sherman O'Banion was manned by neonatologist Laura Pressman, two pediatricresidents, and two nurses. Marianne delivered meds as they were called for, butshe had a sinking, ominous feeling from the very beginning. Sherman's heartrate had gone from an acceptable 130 straight down to zero. No slowing, noirregular beats. It was the equivalent of a car decelerating from sixty to zeroby hitting a brick wall. Clearly, something within the infant's defective hearthad blown — possibly a muscle band, or one of the fragile dividing walls.Continuing the external cardiac compressions, the NICU team began administeringmedications. Epinephrine. . atropine. . more epi. . bicarbonate. Theyworked on the baby for more than half an hour. But with each passing minute,Marianne became more convinced of the hopelessness of the situation. Finally,Laura Pressman stopped her cardiac compressions. She stepped back from theradiant warmer, looked about at the staff, and shook her head. 'I'm sorry,' shesaid. 'You all did a great job.' Marianne Rodriguez accepted a consoling hugand a few words from Sherry Hiller. Then, battling back the tears she knewwould come sooner or later, she set about disconnecting Sherman O'Banion'stubes and wires. The radiant warmer would be wheeled away and replaced with afreshly cleaned one. And before long, another newborn would be brought in.

Six stories below the NICU, in thesubbasement, the stout dietary worker, her mask, gown, and hair cover still inplace, knocked on the door of a little-used staff men's room, waited, thenslipped inside, locked the door, and turned on the light.

The cardiac toxin she had used was sopowerful that only a miscroscopic amount had been needed. Even if ShermanO'Banion's formula was analyzed, which it almost certainly would not be, no onewould know what to look for, and nothing would be found.

The canvas gym bag was concealed beneath amound of used paper towels in the tall trash basket. Ten minutes later, a manemerged from the restroom carrying the gym bag. In it were the surgical gown,hair cover, and surgical mask, as well, as a pillow, a woman's wig, and acontact lens case. The man had close-cropped brown hair and was dressed injeans, a loose sweatshirt, and well-worn Nikes. His height, weight, and generalappearance were quite unremarkable.