The 5th Horseman Read online

  I’d just spoken with her!

  “She checked herself out without doctor’s approval. I wheeled her out to the street myself. Helped her into a taxi. Yellow Cab, if that matters. You done with me now?”

  I nodded, said thanks.

  The nurse’s aide continued down the hallway, leaving me in the corridor alone.

  I was heading toward the exit when a nurse in blue scrubs beckoned to me from a room across the hallway. She was a light-skinned black woman, about twenty-five, rounded face, her reddish hair in twists. The ID tag hanging from the ball chain around her neck read “Noddie Wilkins, RN.”

  “You’re with the police?” she asked, her voice low and urgent. “I have to talk to you. I have to tell you what I know. The police should be involved with what’s happening.”

  Chapter 66

  WE DECIDED TO TALK somewhere outside the hospital. Noddie Wilkins and I sat together in my Explorer, sipping cafeteria coffee from paper cups.

  “There’s something weird going on around this hospital,” Noddie told me. “Last week, when I found one of my patients dead, I totally freaked out. Mr. Harris was frisky. He was getting ready to go home, not die. Cardiac arrest? Far as I know, there was nothing wrong with his heart.”

  “You found that suspicious?”

  “That and the fact that when I found him dead, he had coins on his eyes.”

  That threw me for a loop.

  “Coins? What kind of coins?” I asked.

  “Well, they look like coins, but they’re buttons, like from a jacket or a blazer. They have a raised pattern—what do you call that?”

  “Embossed?”

  “That’s it. They were embossed with a medical symbol—snakes winding up a pole with wings at the top.”

  “You’re talking about a caduceus?”

  “That’s right. A caduceus.”

  I felt like I’d dropped through an open manhole, and was still falling.

  Markers had been placed on the eyes of a dead patient.

  How could that be anything but the signature of a killer?

  “This is bad, isn’t it?” said Noddie, taking in the shock on my face. “There’s more.”

  She homed in on me with her big oval eyes, as if she’d been pent up for a long while, and now she needed to talk.

  “First time, maybe six months ago, I found these things on another dead patient’s eyes,” she said. “I thought, coins to pay the ferryman, something creepy like that.

  “But when I found Mr. Harris, I honestly got the screaming-jeebies. And I got mad. I liked that old guy and he liked me and those things on his eyes? Uh-uh. It stunk like old cheese. Something is not right here, Lieutenant.”

  “Why didn’t you call the police?” I asked the nurse, who was nice but didn’t strike me as the sharpest blade in the shed.

  “I reported it to my supervisor, and she said we would take it to Mr. Whiteley. He’s the CEO of the hospital.”

  My heart was pounding, booming in my ears. How had the hospital kept something this bizarre, this sinister, under wraps for so long?

  “I’d like you to swear out a complaint,” I said to Noddie, but the young woman pulled away from me, backed up against the car door.

  “You’ve gotta keep me out of this,” she said. “I can’t swear out anything. Jeez. I need my job. I’m raising two small kids alone. . . .”

  “I hear you,” I said. “I’ll be as discreet as I can. Did you talk with the CEO?”

  “Yeah. He was real stiff with me,” the young woman said, shaking her head at the memory.

  “Said the coins were someone’s idea of a joke, and that if I blabbed, it could cost the hospital plenty—and that would mean cutbacks. He was making a threat.

  “So I dropped it,” she said. “What else could I do? Now I hear talk, that other people have found these things and just go about their business. Months go by and nothing happens.

  “Then bing, bing, bing. Dead patients one after another with coins on their eyes.”

  “How many patients, Noddie? How many?”

  “I don’t know. See these goose bumps? I’m freaking out all over again,” the nurse said, holding out her arm for me to see. “I mean, if it’s just a joke, like Mr. Whiteley said, what’s the punch line? ’Cause I just don’t get it.”

  Chapter 67

  I SAT IMPATIENTLY in a big upholstered chair, dense carpeting underfoot, Fortune magazine splayed out on the blond-wood coffee table—the hushed outer office of Carl Whiteley, Municipal Hospital’s CEO.

  Whiteley’s assistant hung up a phone and told me that Mr. Whiteley could see me now.

  I entered a many-windowed office, where a gray-haired man with smooth pink cheeks and wire-rimmed glasses stood up from behind his desk. He looked like a Republican senator or Santa Claus with a really close shave.

  I shook his hand and showed him my badge, thinking how I had no partner, no warrant, no case file, just Noddie Wilkins’s fear and an unsettling image of Yuki’s mom in my mind.

  “I don’t understand, Lieutenant,” Whiteley said as he sat down and I took the seat across from him. The sun beat through the plate glass and jabbed me in the eyes. “Someone made a complaint to the police? Who? Over what?”

  “You’re surprised? Now I’m the one who doesn’t understand. Your hospital is being sued for malpractice.”

  “That lawsuit is total crap. It’s a travesty.” Whiteley laughed. “This is a hospital, a very good one, but patients die. We’re living in litigious times.”

  “Even so, I have some questions for you.”

  “Okay,” he said, linking his hands behind his head, leaning back in his cushy executive chair. “Shoot.”

  “What can you tell me about the coins your staff has found on the eyelids of deceased patients? How long has this been going on?”

  “Coins,” he said, returning his chair to its original position. Whiteley gave me a condescending look. “You mean buttons, don’t you?”

  “Coins. Buttons. What the hell difference does it make? In my business we call them clues.”

  “Clues to what, Lieutenant? This place is crawling with doctors. We know every patient’s cause of death, and none of them were homicides. Want my opinion? These buttons are a prank. A cruel prank.”

  “And that’s why you didn’t inform the police about any of this?”

  “There’s nothing to report. Patients sometimes die. Where’s the crime?”

  Whiteley was incredibly smug, and I didn’t like him. Not his smooth baby face or his jackass laugh. Or the way he was trying to put me down and fake me out.

  “Covering up evidence is illegal, Mr. Whiteley. Either tell me about those buttons or this pleasant chat of ours is over, and I’m going to arrest you for obstruction of justice and for interfering with a police investigation.”

  “Arrest me? Hang on, Lieutenant. I’m calling my attorney.”

  “Be my guest,” I said. “And while you’re at it, think about this. You’ve still got a pretty good reputation. How’s it going to look when squad cars pull up with sirens blasting and I march you out to the curb in handcuffs?”

  Whiteley reached for the receiver. He punched out a few numbers before angrily pounding the phone back into its cradle.

  “Look, this is ridiculous,” he said, burning a couple of holes into me with his eyes. “We’ve got nothing to hide.”

  He opened a desk drawer, pulled out a cream-colored envelope with the hospital’s logo in the upper left corner. He tossed it lightly onto his desktop.

  “You can buy these buttons in any uniform supply store in the country, Lieutenant,” he said. “I’m cooperating, okay? This idiocy can’t go public. If you do anything to damage our reputation, I’m prepared to take legal action against the city for libel, and against you in particular.”

  “If there’s no causal relationship between the buttons and the patients’ deaths, you’ve got nothing to worry about.”

  I reached for the envelope, my pulse pounding as
I opened the flap and peered inside.

  Shiny brass circlets glinted up at me.

  There were dozens of them, each button smaller than a dime, with a tiny shank on the back, a raised emblem of a caduceus on the front.

  The buttons rattled inside the envelope as I shook it. Maybe Whiteley was right. They were common blazer-cuff buttons. Nothing special about them.

  But we both knew that each pair represented a person who had died here at the hospital.

  “I’ll need a list of all of the patients found with these things on their eyes,” I told him.

  “I can fax it to your office,” said Whiteley.

  “Thanks,” I said, crossing my arms. “Nice of you to offer, but I’d prefer to wait.”

  Chapter 68

  I DROVE BACK to the Hall through medium-heavy afternoon traffic, still feeling the heat of my confrontation with Whiteley and the chilling sight of those damn buttons.

  What in God’s name did it all mean?

  Placing markers on the eyes of the dead was grim, and it was freaky. Was someone playing a cruel prank as Whiteley had said? Or was Municipal Hospital covering up a long history of serial murders?

  The list of the dead that Whiteley had given me rested on the seat beside me.

  I braked at the light at California and Montgomery, snapped on my dome light, and opened the folder. A two-page spreadsheet was inside—the names of thirty-two patients who’d been found dead over the last three years with buttons on their eyelids. For God’s sake!

  Across the top of the grid were the headings “patient name,” “patient’s physicians,” “date of death,” “cause of death.”

  I skimmed the data, then flipped to the second page.

  Leo Harris was last on the list, and just above his name—Keiko Castellano.

  My heart lurched as I stared at the name of Yuki’s mom.

  I saw her sweet face in my mind, then her eyes covered with those vile brass markers.

  Blaring car horns brought me out of my trance.

  “Okay, okay!” I shouted, putting the Explorer in gear. The car jumped forward as I stepped on the gas.

  I was thinking ahead as well.

  Whiteley had said he didn’t want details of the buttons to get out—but a sleazy cover-up wasn’t evidence of murder.

  We already had stacks of bona fide homicides to solve and too few inspectors to handle them. I needed more than a handful of buttons and a list of names before I went to Tracchio or the DA.

  If I wanted some answers, I’d have to work around the edges of the system.

  And I’d have to ask a big favor of a friend.

  Chapter 69

  YUKI SETTLED INTO HER SEAT in the courtroom as the lunch recess ended. Larry Kramer had begun to mount his case in defense of his client, Municipal Hospital. And she’d watched Maureen O’Mara attack his witnesses on cross.

  It had been a spirited dance and good theater for the media, but these had been emotionally draining, grueling days for Yuki.

  She tried to read the jurors’ faces, and it seemed to her that they had been satisfied with Kramer’s string of witnesses, nodding their heads as each doctor, each clever executive explained away deaths that should never have happened.

  Yuki opened her pad and looked over her notes on Carl Whiteley’s testimony that morning. The hospital CEO had been fluent, even funny, under Kramer’s softball questioning.

  Then O’Mara had drilled the CEO, asking him what she had asked the others: “Isn’t it true that pharmaceutical-based fatalities have increased threefold since Municipal was privatized three years ago?”

  Whiteley had agreed—but unlike Sonja Engstrom, he hadn’t flubbed his lines. He whitewashed the individual deaths and threw national statistics at O’Mara, enough data to numb the jurors’ minds.

  “Redirect, Mr. Kramer?”

  “Yes, Your Honor.”

  Kramer stood, addressing his witness from the defense table. “Those statistics you quoted, Mr. Whiteley. Between fifty thousand and a hundred thousand patients die annually from medical errors in the United States. This is commonly accepted knowledge?”

  “That’s right,” said Whiteley. “According to the ISMP, approximately seven thousand people die each year from medication errors alone.”

  Yuki scribbled in her notebook, getting it all down. The facts were shocking, but she didn’t care about what Whiteley had to say. He was an apologist, a corporate suit, the warm-up act. She’d stolen a glance at the defense table during the last recess.

  She’d seen the witness lineup.

  For a week, she’d waited for the next witness to take the stand.

  As soon as Kramer was done with Whiteley, he was going to call Dr. Dennis Garza.

  Chapter 70

  KRAMER SHUFFLED PAPERS as Dennis Garza was sworn in, thinking, You don’t always get the witnesses you want. You get the witnesses you get.

  Kramer looked up to see the undeniably good-looking doctor straighten his Armani jacket as he took the witness seat. He shot the cuffs of his tailored shirt, crossed his legs, sat perfectly straight and completely at ease.

  Garza looked more like a Hollywood actor than a guy who was up to his wrists in blood and guts sixty hours a week.

  But even that wasn’t the problem.

  What worried Kramer was that Garza was as volatile as he was cocky. He’d resisted being prepped, saying that after twenty-two years of medical practice, he was fully capable of answering the charges against the hospital.

  Kramer hoped to hell he was right.

  Garza’s testimony could tip the case. This was it. Kramer smiled tightly and greeted his witness.

  “Dr. Garza, you’re aware of the plaintiffs’ charges?”

  “Yes. And I feel very sorry for the families.”

  “I’m going to ask you specifically about the patients who were admitted by the emergency room while you were on duty.”

  Kramer questioned Garza, beginning to feel better by the minute as the doctor explained away each of the patient fatalities in a reasoned, believable, authoritative voice. Garza was in a great groove.

  “Do you see any pattern in these deaths, Dr. Garza? Anything at all?”

  “I see the absence of a pattern,” Garza said, raking his thick hair away from his forehead. “I see the random, regrettable errors that happen every day in every hospital in the country. In the world for that matter.”

  “Thank you, Dr. Garza. Your witness,” Kramer said to O’Mara.

  Kramer watched Maureen O’Mara walk to the lectern, an expression on her face that cast a cold shadow over Kramer’s newborn feeling of relief. He knew Maureen. Had gone against her a few times before. She was always prepared, always smart, and a strong interrogator.

  But he saw something now in her face that alarmed him.

  She looked eager.

  Chapter 71

  YUKI LEANED FORWARD in her seat as Maureen addressed the witness.

  “Dr. Garza, Jessie Falk was your patient?” O’Mara asked. “Do you remember Jessie Falk?”

  “Yes. Of course I do.”

  “Your Honor, it’s been established that Jessie Falk was admitted to Municipal for cardiac arrhythmia. That her death was caused by the wrongful administration of epinephrine that caused her subsequent cardiac arrest and death.”

  “Mr. Kramer?” asked the judge.

  “That’s fine, Judge.”

  “So stipulated.”

  Yuki felt the tension in the air, imagined the expectation and dread of the dead woman’s husband, a young man sitting only three rows ahead of her.

  “Dr. Garza, how did Mrs. Falk die?”

  “As you said, she had a heart attack.”

  “That’s true, Doctor. But what I mean is, can you describe her death so that we can better understand her last moments?”

  Larry Kramer rose to his feet immediately. “Objection! Your Honor, Counsel is trying to prejudice the jury. This is outrageous.”

  “Your Honor, I’m mere
ly asking how the patient died. That’s what this case is about.”

  “Yes, yes. Of course it is. Dr. Garza, please answer the question.”

  Yuki saw surprise ripple across Garza’s face. That was interesting. He cleared his throat before he spoke.

  “Well, she went into ventricular tachycardia. A very fast heartbeat.”

  “Would you say that would have hurt her and frightened her?”

  “Probably. Yes.”

  “What else, Doctor?”

  “She would have tried to contact anything in her immediate environment.”

  “Claw at the sheets, for instance?”

  “Probably.”

  “Try to call out?”

  “Your Honor!” Kramer broke in. “Out of respect for Mrs. Falk’s family —”

  “I’m touched, Mr. Kramer,” said O’Mara. “Be concerned for my clients now.”

  “Overruled. Dr. Garza, please answer the question.”

  “She may have tried to call out. I don’t know. I wasn’t there.”

  “What else, Dr. Garza? In medical terms.”

  “She went into ventricular fibrillation. As the circulation to the brain decreased, she might have developed clonic movements—like a little seizure. Her skin would’ve gotten clammy. She would have felt dizzy and weak before she went into shock. The entire episode would have taken only two or three minutes until she became unconscious.”

  “Doctor, are you familiar with the term ‘psychic horror’?”

  Kramer got to his feet and spoke in a tone of deep disappointment. “Your Honor, I object. Counsel is trying to inflame the jury.”

  “Overruled, Mr. Kramer. Psychic horror is a legally admissible term. I’m pretty sure you know that. Dr. Garza, please answer the question.”

  “Could I have the question again?”

  O’Mara emphasized each word. “Doctor, do you know the term ‘psychic horror’?”

  “Yes.”

  “Could you please tell us what it means?”