The Skeleton's knee

17

Northwestern’s Memorial Hospital was half a block away from the city’s flamboyant old Water Tower, a bright yellow stone survivor of the famous 1871 fire, and at one point, the tallest structure around. That distinction was downright quaint now, since the tower had all the impact of an overdesigned Lego castle next to its flashy, looming, monstrous neighbors.

The hospital, by contrast, was a nondescript urban box, wedged between two busy streets, across from the university’s Chicago campus. I entered the front lobby, looked for the Orthopedic Department, and headed for the elevators.

I’d thought about the various approaches I could take at this early stage, including dragging Runnion along with all his vested authority. But I’d opted for a quieter angle first. Doctors, I’d discovered, have an unusual empathy for what plainclothes policemen do. Perhaps there’s a shared conservatism there, or a sense that we’re both investigators of a sort, or that we play sympathetic roles in the standard human tragedies, but whatever the link, I’ve often found them to be interested and responsive to most low-key inquiries.

My problems, however, were not only that I was a fish out of water, holding a badge with all the impact of a costume prop, but that I was pursuing ancient history. I walked up to the registration counter in Orthopedics and leaned in close to speak quietly with a young nurse who was flipping through a thick file.

She looked up with a slightly pasted-on smile. “Do you have your card?”

“No. I’m not a patient.” I quickly showed her my badge, covering the clearly written Brattleboro across its top with my fingers. “I was wondering if I could speak with either the head of the department or one of its surgeons who was working here, or at least in Chicago, in 1969.”

She stared at me as if I’d just spoken in Latin. “1969?”

“Yes, that’s right. We’re investigating an old case that has recently been reopened, and I’m looking for some expert advice from someone who was working back then.”

I kept my most pleasant smile in place as I watched her blink a couple of times and scratch her head. “Well, this is a first. Let me ask around. What’s your name?”

“Lieutenant Joe Gunther.”

“Hang on a second, would you?” She rose and vanished through a back door, leaving me to prop my elbow on the counter and gaze across the roomful of waiting patients.

She returned a few minutes later, ushered me to a small office down the hallway, and asked me to wait. I did so, reading the framed diplomas and wondering if their owner was the man I was supposed to be meeting. He was certainly of the right vintage-Milton Yancy, Northwestern University Medical School, 1965.

A very short, round, pink-faced man with bristly white hair and a flowered tie bustled through the door and stood looking up at me with a bemused expression on his face. He stuck out a pudgy hand. “Lieutenant? Dr. Yancy at your service. You’ve caused quite a bit of tittering up and down the hallway.”

“Sorry. I tried to be discreet.”

He laughed and sat on the narrow examination table pushed up against the wall, his feet dangling. “Don’t worry about it. I haven’t seen them this animated in quite a while. I hope I’ll be allowed to satisfy their curiosity later.”

I smiled back, pleased by his relaxed manner. “I’ll leave that to you-it’s not confidential.” I opened the oversized manila envelope I’d been carrying and extracted the X-rays and photographs. “These are of a skeleton buried approximately twenty years ago, which we just recently discovered. He had an artificial knee implanted shortly before he died. We think the implant was sold in Chicago in early 1969, but we don’t know who bought it, nor do we know who did the surgery.”

“But it was done at Northwestern.”

I hesitated, sorry to disappoint him. “We don’t know that, either.”

His eyes narrowed and he looked up from the documents I’d handed him. “You said the implant was sold in ’69. Does that mean you’re not even sure the surgery was done that year?”

“I’m afraid not.”

He shook his head. “Good Lord. Are you planning to talk to every orthopedist who was practicing in Chicago back then?”

I put on a brave smile. “I’m hoping to get lucky.”

He looked back at the X-rays and held one up against the light from the window. “Who made this device?”

“Articu-Tech,” I said hopefully.

“Never heard of them. Decent knee, though-a little on the heavy side; European influence.”

“The medical examiner in Vermont found that the cement was impregnated with antibiotics, which an orthopedist friend of mine said implied a hasty operation-one that most likely took place immediately following the trauma. They both agreed that was a sign of a real hotshot, a maverick.”

“Gambling with somebody else’s money,” Yancy muttered, studying the X-ray with renewed interest. “Any idea what kind of trauma it was?”

“No.” Although I was tempted to theorize.

Dr. Yancy finally slid all the pictures back into the envelope and returned them to me. “I can’t help you specifically. The knee’s not familiar, nor is any scenario that might have promoted such haste with the implantation. I was here in 1969, at this hospital in fact, and I’m pretty sure I would remember such a case.”

I nodded, resigned to hitting the road again.

But Yancy wasn’t quite finished. “I am intrigued by the possible motivations behind such a procedure. Your friend was correct, of course-the surgeon was a hotshot, and there weren’t too many of them around in ’69. For that matter, there aren’t too many of them around now. It’s rarely rewarding to stick your neck out in practice without a lot of previous homework. Someone sure did this time, though.”

There was a moment’s silence, during which I murmured, “We think a significant amount of money might have played a part in this.”

Yancy grunted. “It’s possible. Someone who was underpaid, under-recognized, and rash might have found some under-the-counter cash rewarding in several ways, but I wouldn’t downplay the psychological aspects here. We’re a careful, cautious, sometimes even paranoid profession when the risk of a lawsuit drifts our way. We can also be tied to stifling traditional and conventional philosophies. And all this was even truer twenty years ago.

“Many a young surgeon has been known to champ at the bit. That can cause the institution that employs him to bear down and the individual to become sullen and resentful.”

I tapped the envelope with my fingertip. “And you think this might have been the case here?”

He stuck his lower lip out meditatively. “It’s purely hypothetical, but it fits. Medically, there’s no reason to justify the kind of speed that was demonstrated here, which means the motivation lies not with the patient’s medical needs but perhaps with the surgeon’s and the patient’s emotional needs working in tandem. That would more fully explain why the surgeon took the risk-along with the money, it would have been a double revenge against a repressive system.”

I liked it, but as Yancy had implied, it didn’t mean much without a cast of characters. “So where does that leave me?”

He snapped out of his reverie and smiled, spreading his hands. “It leaves me wishing you good luck.” He hopped off the table and opened the door, ushering me out. “I recommend that you go next to the University of Chicago campus, however. Talk to Dr. Philip Hoolihan in Orthopedics. He’s as old as Moses, been in the business forever, and is a homegrown Chicago boy. What you’ve got in that envelope amounts to a passport photo in this business. Hoolihan might recognize it. I’ll give him a call and warm him up a little-he’s not quite as approachable as I am.”

I thanked Dr. Yancy and returned to where I’d parked my car, considerably more hopeful than I’d been an hour ago. Much of it was the comfort of simply getting back to work, instead of acting like a tourist; but it also had something to do with Yancy’s thoughtful meditation. His sending me to Hoolihan was no casual suggestion-it was a definite direction, but given, for reasons of his own, with discretion.

The University of Chicago is built in Old English Gothic style, swarming with rampant gargoyles, crenellations, iron-spiked stone spires, and offset by clusters of tree-shaded quadrangles and a field-sized midway similar in scope to the Mall in downtown Washington, D.C. The whole thing is as incongruous as a Rolls-Royce at a bicycle convention. With more or less fire-gutted, violence-torn, poor neighborhoods all around it, Hyde Park-the area to which the university is overlord-looks captive, besieged, and yet stubbornly wishful, perhaps realizing it has little choice but to hang on.

The broad, courtly, almost royal facade of the school’s medical center further added to the fantasy. I forgot for a moment where I was, so convincing was the allusion to a long-gone Europe, and I slowly entered the building’s courtyard embrace thoroughly impressed by what enough Rockefeller money could do.

Several minutes later, and several floors higher up, I didn’t even have to see Philip Hoolihan to understand Dr. Yancy’s subtle warning about his ineffability. His secretary’s attitude was enough.

“You have no appointment,” she stated flatly, her cold blue eyes contrasting sharply with a soft and luxuriant snow-white hairdo.

I had purposefully announced my name only, not my profession, hoping a show of diplomacy might stand me in good stead. “Dr. Milton Yancy just called. Perhaps Dr. Hoolihan hasn’t had a chance to tell you.”

She resisted using the phone to confirm that. “I seriously doubt it. What is the purpose of your visit?”

“I’m conducting a police investigation,” I reluctantly admitted, utterly convinced of where we were heading with this.

“You’re a policeman?” Her tone let me know just how pathetic she thought my plight to be.

“Yes.”

“May I see some identification?”

I inwardly sighed. Flashing an out-of-state badge was definitely not going to work here, meaning some twenty more minutes would be wasted while Norm Runnion was located and my Valkyrie interrogator satisfied. I decided to use her own methods against her. “I’ll present those to Dr. Hoolihan himself, who is waiting for me, no matter what you’ve been told.”

There was a long, electrically charged pause, during which I impassively returned her ice-cold glare. Finally, no doubt wishing it was my right eye, she stabbed a button on her intercom with the eraser end of her pencil. “Doctor, were you expecting a visit from the police?”

“Send him in.”

Her face darkened and she pointed to a door behind her, without an additional word.

Hoolihan’s office fit the architecture that surrounded it: vast, high-ceilinged, with dark wood-paneled walls and a long stretch of tall diamond-paned windows that reminded me of a captain’s cabin in an ancient man-of-war. The furniture was burnished mahogany, the desk lamp Tiffany, and the drapes and rugs enough to make Scarlett O’Hara weep with envy.

Parked behind the aircraft carrier-sized desk was the man himself-big, bald, and broad across the shoulders, with a craggy, impenetrably hard face, overshadowed by a pair of run-amok tufted white eyebrows.

“Show me the X-rays,” he ordered, indicating the gleaming field of wood before him.

I pulled them out silently and laid them out before him.

He picked them up one by one, swiveled around in his chair, and held them up to the windows behind him. Eventually, he put the last one down and fixed me with a hard, angry look. “What did this man die of?”

“A gunshot wound to the chest.”

His eyes wavered, but only for a second. “You’re not a Chicago cop.” It wasn’t a question.

“No, sir-I’m from Vermont.” I began to dig for my credentials, wondering what had tipped him off.

He waved me to be still. “I don’t care. Go see Kevin Shilly.”

I leaned over the desk and gathered up the negatives. “Who’s he?”

Hoolihan bristled. “Who are you looking for?”

“He’s the surgeon who did this?”

“Ask him.”

I refilled my large manila envelope. “Can you tell me-”

The old man placed both his hands on the desk, as if he was about to vault out of his chair. His face was red with fury. “No, I cannot. What Dr. Shilly may or may not have done is between you and him. He is no longer associated with this facility or this university and is, therefore, not my responsibility.”

“There was bad blood about his departure?”

Hoolihan turned to face the windows. “Good day.”

“Thank you, Doctor,” I said to the back of his head and left the office.

Normally, I would have chatted with the secretary a bit, trying to get a handle on Kevin Shilly’s obviously turbulent history here. But her loyalty to her boss had been made clear a mere three minutes earlier, and I wasn’t too hopeful. Other options would have been to drop by the administrative offices or to find another friendly face in the Orthopedic Department, but Milton Yancy’s words about medical hierarchies came back to me as if in warning. Chances were good that with a man like Hoolihan at the top, people would not be as free-spoken as I needed.

I took the elevator down to the lobby and located a pay phone instead.

“Runnion.”

“Hi, this is Joe Gunther.”

There was a chuckle at the other end. “Been mugged yet?”

“Only by bureaucrats. Can you put a name into your computer and see what comes up?”

“Sure. You hit something?”

“Maybe. Dr. Kevin Shilly-orthopedic surgeon.”

“Hold on.”

I waited ten minutes. Runnion’s voice, when he came back on, was almost apologetic. “We don’t have a thing. I found him in the phone book, though-office only; residence is unlisted.” He gave me an address on North Michigan Avenue.

“Would your files go back twenty years or more?”

“No, but there would’ve been a note to check the archives, along with a reference number.”

I thanked him, promising to give him an update as soon as I could, and then dialed Northwestern Memorial Hospital.

It took twenty minutes to get Dr. Yancy on the line, during which I received several malevolent mutterings for hogging the phone.

“Sorry-I was with a patient. Any luck with the affable Dr. Hoolihan?”

“You weren’t kidding. He gave me one name, without actually saying it was the guy I’m after. Kevin Shilly. Does that ring a bell?”

There was a long pause. I remembered wondering earlier if Yancy had pointed me to Hoolihan in the hopes the old man would say what Yancy could only silently suspect. I knew now I’d been right.

“I know of him,” he finally admitted.

“How?”

“It wasn’t front-page news or anything. He didn’t get in trouble legally. But he did get in trouble. Hoolihan threw him out, from what we heard through the grapevine.”

“He was the one you were thinking about when you mentioned young doctors chafing at the bit?”

“Yes, but I was only guessing.”

“So what else did the grapevine say?”

“He did something like what you described-collected some extra money for a risky procedure that didn’t pan out. I guess that was around ’72 or ’73. Hoolihan and the others at the top had ordered him not to do it, so they had just cause, but there was history there, too. I guess it wasn’t the first time-just the first time he got caught.”

“Shilly didn’t lose his license or get reprimanded?”

“Almost. That’s another reason Hoolihan still bears a grudge. Shilly was pretty political back then, trying to socialize medicine, kick over the old traditions, open the place up to poor neighborhood blacks. And he wasn’t publicity-shy; he had good contacts in the media. When he got canned, a deal was made. Hoolihan was to let it go; Shilly was to keep his mouth shut. End of story. It helped that the patient wasn’t one of the complainers, despite the operation’s failure. Shilly had totally charmed the old lady-so they say.”

“What did he do afterward?”

“In terms of gossip, he pretty much disappeared after his run-in with Hoolihan-did the storefront-practice bit for the disadvantaged for a couple of years, I guess, then decided to hang it up and go for the money. I hear he’s got a high-class private practice north of the river.”

“But no more scandal?”

“Not that I’ve heard. I always thought the entire episode was a little pathetic-basically two good people refusing to bend, to the detriment of everyone. A big waste, especially there. That’s one of the best medical outfits around, except for here,” he added with natural pride. “And Shilly could’ve been one of their stars.”

The address Runnion had given me over the phone put me back in the vicinity of Northwestern Memorial, but far from its comforting atmosphere of institutionalized caring. Indeed, the tall modern steel building I entered forty-five minutes later smacked more of wealth, commerce, and business deals than of medicine. Nevertheless, on the thirtieth floor, attached to an elegant hardwood door, was an ornate brass plaque boasting the name KEVIN SHILLY, M.D.-ORTHOPEDIC SPECIALIST.

Beyond this door was no iron-spined harridan ready to throw me out like Hoolihan’s secretary, nor a white-clad nurse asking if I had an appointment. Instead, I was greeted like a guest by an elegant young woman in a business suit who hovered in style between classy receptionist and upscale therapist.

She rose from her desk and escorted me to a ponderous antique table with two ornate chairs, gesturing for me to sit, explaining all the while that her name was Giovanna, that she was delighted to meet me, and that she’d like to know exactly what my problem was and how Dr. Shilly might be of service.

I knew it was so much shellac-a justification for what was obviously the Oscar of medical fees-but it was soothing, flattering, and unique, guaranteed to make the wealthy lame feel they had finally found their proper healer.

I took my seat, therefore, and gazed placidly into Giovanna’s large hazel eyes. “I was wondering what made Dr. Shilly any different from any other orthopedist.”

For all her grace, Giovanna had been drilled with all the zeal of a hard-nosed encyclopedia salesman. “Years ago Dr. Shilly became aware of how shoddily many patients were being treated by the average hospital staff. Despite their pain and anxiety, they were being reduced to mere numbers on an admission form. Often, they were not assigned fully trained physicians, but residents and even interns. They were used as guinea pigs for medical students and exposed to needless embarrassment and harassment as a result.”

“So Dr. Shilly offers something a little more refined,” I interrupted pleasantly.

She smiled. “That’s well put. However, the fact that Dr. Shilly’s service is more supportive and encouraging is a small thing in itself; what he offers above all is possibly the best orthopedic care available in the city.”

“He’s that good, is he?”

She tilted her head to one side and smiled with irrepressible enthusiasm. “He’s wonderful-the most caring man I’ve ever met.”

It was a great show, improved, no doubt, by Giovanna’s conviction that most of it was true.

“I heard he was thrown out of the University of Chicago for playing fast and loose with the rules.”

Her smile froze.

“I’m a policeman, Giovanna-Lieutenant Gunther. I wonder if you could tell Dr. Shilly that I’d like to speak with him?”

She got to her feet awkwardly, her sales pitch forgotten. “Well, I… Does he…? No, I guess not. Could you wait here a sec?” Scratching her head, disturbing that perfectly brushed hair, she left the reception area.

It didn’t take long. Both the message and the messenger were alarming enough to grant me almost instant gratification. Giovanna returned in five minutes and stiffly asked me to follow her down a short hallway to a pleasant and spacious examining room, complete with more antique furniture. There, I was told to wait.

Using a hostile approach had been a calculated gamble, and not one I’d planned before crossing the threshold. But the exclusive layout of Shilly’s practice, combined with what I knew of his past, suggested a man in a permanent dilemma, hanging between an angry, idealistic youth and a crassly exploitative middle age that had made him what he’d hated years ago: a complicated man who deserved a complicated approach.

He entered quickly, nervously, his tanned, urbane, well-tended face a cross between anger and confusion. He looked beautiful otherwise. His clothes were immaculate, the shoes soft Italian leather, the French cuffs of his shirt peeking out just the right amount from beneath a fashionable jacket. He looked like a Neiman Marcus store manager-better than the customers but dependent upon their cash.

His tone did not match his attire. “What do you want?” he asked brusquely.

I emptied my well-traveled envelope and showed him the X-rays. “This knee implant was done twenty-four years ago.” I paused. “Remember it?”

He snapped the pictures into a wall-mounted light box and peered at them in stony silence for a long time. His face, already tense, was otherwise unreadable to me. “Why do you want to know? What’s this about?”

Interesting side step, I thought. “Do you remember the operation?”

He hedged again. “Do you have any idea how many of these I do every year? Multiply that times twenty-four.”

“It was done fast-the cement was mixed with antibiotics so you wouldn’t have to wait for the wound to stabilize. It was the type of showy stunt you became infamous for at the University of Chicago.”

His face reddened. “That’s total crap. I had new techniques they weren’t willing to try, techniques that are common today. I was good and I was right. They threw me out because they couldn’t admit that.”

I nodded my head toward the X-rays. “That’s not a common technique even today; it’s still a risky shortcut. Why’d you take it?”

He hesitated, watching me. This was the break point; he either went for the bluff or he came up with one of his own. “I didn’t,” he finally said, his voice back under control. “I’ve never seen those before.”

I didn’t show my disappointment, although I shouldn’t have been surprised; I should have known that while a risk-taker might age gracefully, he’s not one to deny his own nature. Shilly had just won his bet that I had no proof connecting him to the negatives.

I shook my head, trying a different angle. “That’s too bad. We know your connection to this guy-but we were hoping you’d just been in the wrong place at the wrong time. Obviously not.” I stood up and collected the X-rays off the light box. “I guess we’ll make you a part of the full investigation.” I looked at our opulent surroundings. “And then we’ll see where we all end up.”

I gave him plenty of time to reconsider, slowly stuffing the X-rays back into the envelope, but he held firm, if none too steadily. The sweat on his forehead told me that. I finally headed for the door, opened it, and looked back at him. “You decide to come clean, call Norm Runnion at Area 6 headquarters.” I gestured at the expensive furnishings of the room. “Be a shame to jeopardize all this for such a little thing.”

His eyes widened slightly at the last two words, but he kept silent.

“Good-bye, Dr. Shilly-for now.”

I checked my watch on the elevator, trying to be philosophical about this snag. For some reason, while I knew my mysterious skeleton’s surgeon had played it fast and loose, I’d never actually thought he’d played a criminal role. Now I wasn’t sure. Shilly’s behavior was either the response of a natural gambler, hoping that a denial would be all that was necessary, or he was more involved than I’d thought. A third possibility-that he hadn’t performed the surgery-was no longer feasible. His body language, Hoolihan’s and Yancy’s suspicions, and my own experience had all killed that one.

I reached the lobby and sought out the guard I’d seen stationed at a TV set-equipped console earlier. A pleasant young black man in his twenties, he smiled as I approached. “Can I help you?”

I pulled out my badge and flashed it at him quickly, doing the fingers-over-the-top trick that had worked once before. “Yeah, I was wondering if you could tell me where the residents of this building park their cars.”

He sat back, the smile spreading to a grin. “And why would you like to know that?”

That threw me off slightly. “Police business-we’re conducting an investigation.”

He nodded affably. “Sounds real good-for who?”

I paused, weighing my options, knowing he’d nailed me. Finally, I just shrugged, pulled out the badge again, and dropped it in front of him. “Sorry-trying to cut corners. For the Brattleboro Police Department, in Vermont. I’m on assignment, working with your local police.”

The smile faded to mere politeness. “I work with the local police, too. I just moonlight here.”

“Call Norm Runnion in Area 6 and ask about me.” I said this with as much joviality as I could muster, since I sensed my interrogator was losing his humor fast. If I didn’t become legitimate quickly, I suspected I’d be a host of the city in a whole new way.

He dialed the phone before him and spoke into it briefly, eventually hanging up with a doubtful expression. “Okay-he says you’re straight.” The emphasis was on the he.

I leaned over and retrieved my disreputable credentials.

He gestured at them as I did so. “I wouldn’t pull that stunt again. You want to know where they park, right?”

“Yeah, I just want to keep an eye on someone here.”

“Who?”

He had me there. It was a question I didn’t need to answer, and another phone call would have made that clear, but the unwritten rules said differently-he’d caught me red-handed, and I owed him one. “Dr. Kevin Shilly.”

He raised his eyebrows and grunted, checking a three-ring binder by the phone. “Mr. Beautiful. Take the elevator to the second basement-slot 2-318. It’s a brown Mercedes-two-seater. There’re enough empty slots that you can park pretty near and keep an eye on it.”

“Thanks.”

He stopped me as I turned to go. “What’s Vermont like?”

“Lots of mountains, lots of trees, lots of bullshitters like me.”

He laughed and waved me off.

The parking basement was typical of its kind-gray, low-ceilinged, with drumlike acoustics, spotty fluorescent lighting, and a regularly spaced army of squatty cement pillars holding the roof up. The Mercedes was where the guard said it would be, and I was able to park my rental behind one of the pillars, but in clear view of slot 2-318.

Why I did so was another matter, and it underlined the uneasy vagueness that had plagued this case from the start.

I had nothing on “Mr. Beautiful.” He, and Fred Coyner, and the defunct Abraham Fuller, and even the left-handed skeleton with the all but perfect teeth could have played different roles from the ones we’d ascribed them, simply because we had no solid proof to make ours the unchallenged truth.

So for now they remained in an orderly row-Shilly, for all his denials, being merely the latest one in line. But sooner or later, I knew one of them would break ranks and lead us in the right direction, and then the entire line, as if by the wave on parade, would follow. It was just a matter of time and perseverance-and maybe a little encouragement.