Mortal Remains Read online

  “But no word from her, and you suspected nothing?”

  “Of course we were worried. But you don’t know the man we thought she was escaping from. She’d told most of us she was going to leave him, yet insisted we not try and trace where she went. She was afraid he’d track her down by following us if we tried to contact her, so we figured that was why she just cut off all ties. After the police found no evidence of foul play, as far as I was concerned, no news meant she’d gotten away, free and clear.”

  “Do you think he killed her?”

  “Chaz? He was mean enough to. I met him during our cardiology rotation at NYCH and when Kelly had our group up to their country home. He could be a bit of a charmer on the outside, but always found a sneaky way to criticize her, hiding it in a joke. And he could sure throw back the martinis at her parties. His comments got more cutting as the day wore on. None of us liked the son of a bitch.”

  She put down the paper and studied him. “You sound angry.”

  “I am. She was a friend. We all felt protective of her, especially since the rest of the class had given her the cold shoulder from the get-go. Most figured her a dilettante who was just slumming, riding the Braden name. Then when she worked her butt off and cut it better than a lot of them, they resented her more.”

  “Sounds like she was a pretty remarkable lady.”

  “She wanted to do pediatrics, and would have been great at it. Whoever killed her snuffed out all that.”

  “But you went on thinking she’d run off, even when her parents insisted her husband had a hand in her disappearance?” Janet’s blue gaze grew skeptical. “That doesn’t sound like the poke-his-nose-where-it-doesn’t-belong man I married. Didn’t you wonder why she never so much as contacted them?”

  “She seemed to have little to do with her mother and father. I never knew why and, believe it or not, since it wasn’t any of my business, didn’t ask. As I said, we all wanted to believe she’d successfully pulled off a vanishing act. It seems stupid now, but we convinced ourselves.”

  Janet studied him a few more seconds, put her hands around his face, and kissed him gently on the lips. “She was lucky to have you as her friend.”

  Some friend, he thought.

  She turned for the door. “I’ve got to get back to the case room, but should be home in a couple of hours. Can you stop by the store and pick up some milk?”

  “Sure.”

  “And tell Brendan I’ll be there to tuck him in. Poor little tyke probably feels abandoned.”

  “How about I promise we’ll sandwich him between us for his story tonight.”

  She laughed, said, “Love you,” and was gone.

  He hadn’t lied outright to Janet, but what he’d left unsaid seemed tantamount to lying… big-time.

  The ache in his gut spread through him – like a stain.

  8:00 P.M.

  Geriatrics Wing,

  New York City Hospital

  She had no idea how long she’d been dozing when a soft cough roused her.

  “Hi, Bessie.”

  She blinked a few times to bring her eyes into focus on the figure who was standing inside the room. “Melanie? Melanie Collins?”

  “Yes. I just dropped by to say hello.”

  “My, I didn’t hear you come in.”

  “Little wonder. You were snoring like a truck driver. How are you doing?”

  “Well, I obviously could have used you when I came into ER three months ago.”

  “Oh, Bessie, I’m so sorry I wasn’t there.”

  “Pull up a seat.” She gestured to the little-used visitor’s chair with her good arm.

  Melanie obliged.

  Soon they fell deep in conversation making small talk, but after a few minutes Bessie inexorably returned to her present plight. She found release in complaining about it to other doctors, knowing they would best understand the scope of the outrage that had been done to her. When her own patients had gone on and on about their various illnesses, reciting the relapses and symptoms far more than necessary for her to make the diagnosis, she thought it was because they had little else to talk about, their diseases having pervaded every aspect of their lives. Over the last few months she’d come to realize that they’d been venting, sharing their symptoms so they wouldn’t feel so alone – a compulsion, she ruefully acknowledged, that she couldn’t even stop in herself.

  “So-called emergency doctors – they simply didn’t get it the way you did.”

  “Well, I knew your history. And remember, you were already admitted for pneumonia, so there were no delays. Who knows what would have been the outcome if I hadn’t had you on the floor and under my thumb when it happened? But since I did, the rest was easy-”

  “Easy my ass, Melanie. Remember, you’re talking to a physician here. Don’t make excuses for their shoddy work by minimizing how great you were.”

  “Now, Bessie-”

  “I know full well that the blood tests indicated I was properly anticoagulated and shouldn’t have had another embolus. But unlike the bozos this last time, you were smart enough to treat the patient-”

  “ ‘And not the test.’ ” Melanie gave an understanding shake of the head. “I know. I tell that to the residents all the time.”

  “I hope those young punks in ER have at least learned to listen, or pay attention to someone even when they can’t talk.”

  “I’m sure they have.”

  “But look at me.” She laboriously raised her right shoulder and upper limb. Her hand and fingers drooped off the forearm, curled into a lifeless claw. “God, I didn’t think I’d end up like this.”

  “I know.”

  “And does anybody want to talk about it? Not on your life. They all think I’m going to sue.”

  “Are you?”

  “Of course not. I’m a doctor. I won’t go after my own. But I damn well want them to improve – be like you were in training.”

  “Bessie, you’re making me blush-”

  “In ’seventy-four you did nothing less than give me the second half of my life. The residents back then would have done me in, too, if you hadn’t stopped them. I’d never have seen my grandchildren. So give credit where credit is due, I say.”

  “It was nothing.”

  “There you go again. Nothing? My heart racing. Unable to get my breath. And everybody shouting, grabbing at the ECG tracing. I remember everything like yesterday.”

  “Well, you know how it is in a precode when only residents are around.”

  “But you measured out the rhythm and saw it for what it was.”

  As part of developing the lore of her own sickness, Bessie had never stopped extolling to anyone who would listen how someone so young had maintained the presence of mind to pick out such a subtle distinction on a cardiogram in the midst of all that wild confusion. As she told and retold the story, she recalled seeing everything as if from the wrong end of a telescope, feeling desperate for air despite wearing an oxygen mask, and being about to pass out. The chief resident kept yelling for intravenous digoxin while others stuck her with IV needles and shouted a flurry of other orders:

  “Furosemide!”

  “Nitro!”

  “Morphine!”

  Like happy hour at a bar, she’d thought, watching the darkness close in on her.

  A nurse had brought the syringe of digoxin up to the rubber injection port on a small intravenous bag.

  Then that lone clear voice. “No! This is dig toxicity.” And a dark-haired girl with a plain face had grabbed the needle away before it could be injected. “The rhythm strip shows atrial flutter with block,” she added, speaking firmly and loudly enough to cut through the melee without resorting to panicky shouting like everyone else.

  The rest of the team had immediately turned to give her their attention. “Look,” she said, running the long strip of paper upon which the ECG had been printed through her fingers, handling it like a ticker tape and pointing out the salient features.

  Yes, yes,
yes, the doctor in Bessie McDonald had thought, her hearing intact enough to pick up sufficient snatches of the quick-fire explanation to know it was correct even as her vision narrowed to mere pinpoints of light.

  Atrial flutter with block, a hallmark of digoxin toxicity, meant a far too rapid heartbeat where the upper chambers, the atria, pounded along at 300 a minute, and the lower chambers, the ventricles, contracted at exactly half that rate, 150 a minute. The trick? To recognize it from the other arrhythmias where the atria and ventricles raced ahead at the same speed and the drug of choice was more digoxin. Had the chief resident succeeded in giving an additional dose to Bessie, however, he would have entrenched the problem, rendering her myocardium twice as resistant to treatment, and she could have died. Pumping at that speed, the chambers weren’t emptying properly, and her lungs were filling up with fluid. While the other drugs they’d ordered would help empty it out, the definitive step to solve the problem – slowing down her heart – had to be done by a synchronized countershock of electricity.

  Melanie had come through for her on that count as well. Bessie felt the paddles lathering up her chest with lubricant, then “Pow!” A huge white light ripped up the inside of her skull. Yes! Despite the sensation of being kicked by a horse, the jolt of direct current, she knew, would stun the atria, render their conduction pathways refractory to the fast impulses, and allow her own natural pacemaker time to reassert itself. Within minutes she began to feel better, opened her eyes, and saw Melanie smiling at her.

  “Quite a feat for a fourth-year student,” Bessie said. “You know, up until that point, I got the impression nobody on staff appreciated your skills.”

  Melanie chuckled. “Hey, that’s the job of teachers with medical students. Keep ‘em tired and feeling stupid. Makes it easier to stuff them with knowledge. But to what do I owe this trip down memory lane?”

  Bessie reached for the paper with her good arm. “This got me going,” she said, tapping the article about Kelly McShane. “It all happened that same year. I remember her. She was so pretty and pleasant around patients. I thought then she’d make a great doctor. And if you recall, Chaz Braden had been my cardiologist. Come to think of it, he kept ignoring my complaints of being nauseated. That should have tipped him off my digoxin level was rising.”

  “You’ve got a pretty good memory for something so long ago.”

  “What do you expect? I nearly died. As for the time when Kelly McShane disappeared, I figure just about everyone remembers that, at least where they were.”

  “How do you mean?”

  “Thursday, August 8, 1974. That was the night Nixon resigned. He gave a TV speech at nine P.M, announcing he’d be gone by noon the next day. I was glued to my TV at home. And in my office, Friday, the patients and I watched his departure from the White House. I’ll bet you can tell me where you were, too.”

  Melanie frowned a few seconds, as if trying to recall her whereabouts, then shrugged. “Not really. I remember it happening, but not where I was. Must have been busy days on the floors. Say, the nurses told me you’re going to your son’s home to live.” She got up and walked over to the family photos on the bureau, leaning over to get a better look at them.

  Bessie immediately felt excited. The mere mention of what lay ahead brought her to life again. “That’s right. Me on the Big Sur. Fred Junior and his wife have built their dream house, including a cottage for me, plus arranged for private nurses, all thanks to the dot-coms. The kid had the smarts to sell before they went bust, and I’m going out in style.”

  “Hey, I think you should take a doctor along with you.” She delicately fingered the frames as she looked at the pictures one by one.

  “Come along. That would be the dream team, having you in charge. You’ve always been there for me, when you’ve been there at all.”

  Melanie laughed and moved to inspect the figurines near the head of the bed. “Will you listen to yourself? You can’t blame gibberish like that on the stroke.”

  “You know what I mean. You saved my life twice. Why not a third time? I’ll bet there are lots of opportunities for someone like you in California.”

  “Be careful. I might take you up on it.” She carefully picked up the piece depicting Bessie examining an old man. “This is beautiful. Is that you?”

  “A long time ago-” She stopped short at the sight of Tanya standing at the door. How long the young nurse had been there she couldn’t say. “Yes, Tanya?”

  “I’m sorry to interrupt, Bessie, but it’s time for your shot.”

  “Oh!” Melanie said, peeking at her watch, “Well, guess I better be off, then.” She quickly replaced the porcelain figure.

  Bessie flashed an annoyed look at Tanya for interrupting them. She’d been enjoying the company. “Oh, Melanie, please don’t go.”

  “I really have to. Sorry it took me so long to stop by, yet better late than never, eh? Have a good sleep, and I’ll try to see you before you leave.”

  Obviously their visit was over. Contemplating the striking woman Melanie had become in middle age, Bessie reached for her hand and took it in hers. “All the best.”

  “To you as well,” Melanie said, returning the gesture with a warm squeeze.

  Out of nowhere an insolent little question popped into Bessie’s mind. How come such a good-looking woman had never married?

  Once she’d left, Tanya walked over to a stand where a small, multidose bottle of heparin and packets of needles were kept.

  Low molecular weight heparin was another anticoagulant, this one used in small injected doses to prevent blood clots from forming in the limbs of patients who were bedridden. She wouldn’t normally have needed it, being on warfarin and the baby aspirin already, but having thrown two emboli from her heart so far, the doctors were taking no chances.

  Which was fine with Bessie. No way did she intend to be waylaid again and miss the Big Sur, she thought, watching Tanya, who stood with her back turned as she drew up the injection. Her annoyance with the girl vanished. After all, she’d just been doing her job. “Don’t worry, Tanya,” she said with a chuckle, wanting to make amends for her nasty glance of a moment ago. “I won’t faint if I catch sight of the needle.”

  The nurse laughed, but continued to shield the syringe from Bessie’s view as any thoughtful nurse or doctor does when preparing a hypodermic for a patient. “I know, Bessie. It’s force of habit. You’d probably do the same with me if the situation were reversed.” She dropped the bottle in a plastic container for medical waste, pivoted around, and walked to the bedside. “Where do you want it?”

  “Actually, in the mornings I’ve started giving them to myself.”

  “Oh?”

  “Yep. In case they want to keep me on the stuff when I go to my son’s. I don’t want to be totally dependent. Just leave the syringe on my nightstand.”

  Tanya frowned. “You’re sure?”

  “Yep.”

  Tanya hesitated, the capped syringe in her hand, then shrugged. “Okay. You’re the doctor,” she said with a grin, and placed it on Bessie’s side table along with an alcohol swab. “But I can’t stay to talk. We’re short-staffed again.”

  Time to sleep, Bessie decided.

  She rolled over and reached for the syringe and swab. “Might as well be at the good old belly button,” she muttered, whipping up her nightdress and exposing what looked like a horseshoe of pinpricks around her umbilicus. She wiped the skin with an alcohol swab, then managed to bunch up a roll of flesh using the limited movements of her right forearm. With a quick thrust, she sank the needle in to its hilt, and slowly pushed in the plunger.

  Chapter 4

  That same evening, Tuesday, November 6, 9:30 P.M.

  Hampton Junction

  Mark brushed aside a cobweb and sent a nest of spiders scurrying for cover. From a wall of cardboard cartons, he pulled out the third box he’d been through that evening. He was in the basement of his house, the home where he grew up and now lived and worked, rummaging in the
inactive files that his father, Dr. Cam Roper, had stored here for as long as he could recall. The voice of his mother complaining about it ran as clear as a recording through his head.

  “Honestly, dear, you’ve got lots of space in that office of yours in the village. Why clutter us up with this junk? We could make a workshop down here.”

  “That’s why I’m filling it up with this stuff,” his dad had whispered to him, then winked. “To make sure I don’t have to spend our Saturdays down here building stupid shelves.”

  Our Saturdays. Mark smiled at the resonance those words could still evoke.

  That was before he’d lost them both.

  First his mother. Pricked her finger on a needle, he’d been told. Then she fell sick and died in a matter of days. To a five-year-old boy it sounded like something out of a fairy tale, an evil spell cast by a wicked dwarf involving a spinning wheel. But no magic kiss brought her back. Later he’d learned the needle had been a syringe, and the evil had been meningococcus bacteria from a patient with meningitis. She’d infected herself while helping out at his father’s office drawing blood samples.

  Two years later his father died, killed in a freak explosion.

  Aunt Margaret, his mother’s older sister, already widowed at fifty-five and childless, had insisted on moving in and taking care of him. “For a while,” the crusty old woman told him at first.

  She’d stayed for good.

  Even when he’d come back from medical school, she continued to live here. At the time he sensed she wasn’t finished watching over him. Since they were each other’s only family, he didn’t mind.

  Initially he’d set up his own office in town, finding one with a spacious apartment above it. But when Margaret died, he moved in here, practice and all. Just until he had time to dispose of the estate, he told himself. That was two years ago.

  Outside the wind had come up, moaning and whistling against the wooden slat door that led to the yard. The beams above his head creaked and groaned as if the whole structure threatened to lift off the stone foundation, but it never had and, Mark guessed, never would. He easily ignored the sounds, having snuggled under blankets and fallen asleep to them throughout his life. Instead he concentrated on going through the Mcs.