We'll Meet Again

51

On Wednesday morning, Fran had an appointment in Greenwich with Dr. Roy Kirkwood, who had been the primary care physician of Josephine Gallo, the mother of Tim Mason’s friend, whose death Fran had been asked to investigate. She was surprised to find the doctor’s reception room empty-not a usual situation for a physician these days, she thought.

The receptionist slid open the glass that separated her desk from the waiting area. “Miss Simmons,” she said without asking Fran’s name, “the doctor is expecting you.”

Roy Kirkwood looked to be in his early sixties. His thinning silver hair, silver eyebrows, steel-frame glasses, lined forehead, and kindly, intelligent eyes all made Fran immediately think that this man looked like a doctor. If I were here because I was sick, I’d have confidence in him, she decided.

On the other hand, it occurred to her as he politely indicated the seat opposite his desk, she was here because one of his patients was dead.

“It’s good of you to see me, Doctor,” she began.

“No, I would say that it is necessary for me to see you, Ms. Simmons,” he interrupted. “You may have noticed that my reception room is empty. Other than longtime patients, for whom I will care until I can transfer their records to other physicians, I am retired.”

“Has this anything to do with Billy Gallo’s mother?”

“It has everything to do with her, Ms. Simmons. Mind you, Mrs. Gallo might very easily have had a fatal heart attack in any circumstances. But with a quadruple bypass she also would have had a very good chance to live. Her cardiogram was within the normal range, but a cardiogram is not the only thing that can reveal that a patient is in trouble. I suspected she might be suffering from blocked arteries and wanted to do extensive testing of her. My request, however, was vetoed.”

“By whom?”

“By management-Remington Health Management, to be specific.”

“Did you protest the veto?”

“Ms. Simmons, I protested and continued to protest until there was no point. I protested that veto as I have many others in cases where my recommendations that my patients see specialists were denied.”

“Then Billy Gallo was right-his mother might have had a longer life. Is that what you’re saying?”

Roy Kirkwood looked both defeated and sad. “Ms. Simmons, after Mrs. Gallo had the coronary occlusion, I went to Peter Black and demanded that the necessary bypass surgery be done.”

“And what did Dr. Black say?”

“He consented, reluctantly, but then Mrs. Gallo died. We might have saved her if that surgery had been authorized earlier. Of course, to the HMO she was just a statistic, and her death is a plus for the Remington profit line, so you have to wonder if they really care.”

“You did your best, Doctor,” Fran said quietly.

“Best? I’m at the end of my career and can retire comfortably. But God have pity on the new doctors. Most of them start out deep in debt and have to pay back loans for their education. Believe it or not, $100,000 is an average amount they owe. Then they have to borrow to equip an office and set up a practice. The way it stands today, they either work directly for a health maintenance organization, or have ninety percent of their patients enrolled in them.

“Today a doctor is told how many patients he must see. Some plans even go so far as to allot a doctor fifteen minutes a patient and require that he keep a time chart. It is not uncommon for doctors to work a fifty-five-hour week, for less money than they were making before the HMOs took over medicine.”

“What’s the answer?” Fran asked.

“Nonprofit HMOs run by doctors, I think. Also doctors forming their own unions. Medicine is making remarkable strides. There are many new medications and procedures available to doctors, some that enable us to prolong lives and give better quality of life. The incongruity is that these new procedures and services are being arbitrarily denied, as they were in Mrs. Gallo’s case.”

“How does Remington stack up with other HMOs, Doctor? It was, after all, founded by two doctors.”

“By two doctors who inherited the sterling mantle of a great physician, Jonathan Lasch. Gary Lasch wasn’t in the same class with his father-either as a doctor or a human being. As for Remington, it’s as lean and mean as they get. For example, they’ve been systematically shaving services and personnel at Lasch Hospital as part of their ongoing cost-cutting campaign. I only wish Remington and the HMOs they’re absorbing would be taken over by the plan that’s headed by the former surgeon general. He’s the kind of man the health system needs.”

Roy Kirkwood stood up. “I apologize, Ms. Simmons. I realize I’m just letting off steam to you. But I do have a reason. I think you would be rendering a great service if you used the power of your program to wake up the public to this increasingly callous and alarming situation. Too many people are unaware of the fact that the lunatics have taken over the asylum.”

Fran stood up as well. “Dr. Kirkwood, did you know Dr. Jack Morrow?”

Kirkwood smiled slightly. “Jack Morrow was the best. As smart as they come, a great diagnostician, loved his patients. His death was a tragedy.”

“It seems strange that his murder has never been solved.”

“If you think I’m upset with Remington Health Management, you should have heard Jack Morrow. I admit he probably went too far in pushing his complaints.”

“ ‘Too far’?” Fran asked quickly.

“Jack could get hot under the collar. I understand that he actually referred to Peter Black and Gary Lasch as ‘a pair of murderers.’ That’s going too far, although I confess it’s the same way I felt about Black and the system when Josephine Gallo died. But I didn’t say it.”

“Who heard Dr. Morrow make that statement, Dr. Kirkwood?”

“Well, Mrs. Russo, my receptionist, for one. She used to work for Jack. If there were others who heard him, I’m not aware of it.”

“Is she the lady outside?”

“Yes, she is.”

“Thank you for your time, Doctor.”

Fran went into the reception room and stopped at the desk. “I understand you worked for Dr. Morrow, Mrs. Russo,” she said to the small, gray-haired woman. “He was so kind to me when my father died.”

“He was kind to everyone.”

“Mrs. Russo, you knew my name when I came in. Do you know that I’m investigating Dr. Gary Lasch’s death for the True Crime television program?”

“Yes, I do.”

“Dr. Kirkwood just told me that you heard Dr. Morrow refer to Dr. Lasch and Dr. Black as a ‘pair of murderers.’ That’s pretty strong language.”

“He’d just come back from the hospital and was terribly upset. I’m sure it had been the usual business of fighting for a patient who’d been denied a procedure. And then the poor man was shot to death only a few nights later.”

“If I remember correctly, the police decided that a drug addict broke in and surprised him working late in his office.”

“That’s right. Every drawer of his desk was dumped on the floor, and the medical supply cabinet was emptied out. I understand that drug addicts can be desperate, but why did they have to shoot him? Why couldn’t they take what they wanted and just tie him up or something?” Tears glistened in the woman’s eyes.

Unless whoever broke in was afraid of being recognized, Fran thought. That’s the usual reason a burglary becomes a homicide. She started to say good-bye, then remembered the other question she wanted to ask.

“Mrs. Russo, was anyone else around when Dr. Morrow called Drs. Lasch and Black a pair of murderers?”

“Only two people, thank goodness, Miss Simmons. Wally Barry, a longtime patient of Dr. Morrow’s, and his mother, Edna.”