The Diagnosis is Murder (A Dr. Valorian Mystery Book 1) Read online

  “Yes, but her major problem in the ER was chest trauma. Difficulty breathing, lung contusion, hypoxia, broken ribs.” Matthew took a deep breath. “I had to stabilize her first and then do further investigation to fully define all of her problems. I felt it wasn’t indicated to go straight to the OR.”

  The opposing attorney sniffed and hesitated.

  Matthew’s eyes widened. Am I scoring some points here?

  His antagonist smiled and bared those teeth again. “She had abdominal tenderness as well, didn’t she?”

  “Yes, but—”

  “And she was clearly in trouble in the ER, wasn’t she?”

  “Objection,” Robert said. “Let the witness finish his answer.”

  “Sustained,” the judge said. “Finish your answer.”

  “Go ahead,” the opposing attorney said.

  Matthew felt lightheaded. He looked at Robert. “What was the question?”

  Robert sighed and looked away.

  “I’ll rephrase the question: she was clearly in trouble in the ER, wasn’t she, Doctor?”

  “She had major trauma.”

  “She was combative. In fact, Dr. Kline, she was in shock, wasn’t she? She was bleeding internally, wasn’t she?”

  Matthew froze. Vexing, nauseating doubts of his medical competence paralyzed his mind. Later, he remembered his mouth moving but not what he said. He became aware again of the people around him as he stumbled back to his seat at the defense table.

  Next, things got even worse during the opposing attorney’s cross-examination of Matthew’s expert witness.

  “Are you telling me, Doctor, that—given this patient and her condition—you would not have taken her immediately to the operating room?”

  “Well, that depends—”

  “Depends on what, Doctor? Just tell this jury what you would’ve done.”

  “Well, I might’ve taken her to surgery, and I m—”

  “So, you admit that she did have indications for surgery to repair her bleeding liver and spleen?”

  “Possibly, but . . .”

  It was downhill from there, and the plaintiff’s attorney even caught the expert witness in more than one contradiction with his previous deposition testimony, which had been taken some months before the trial. He’d obviously not bothered to read that document to refresh his memory of what he’d said before under oath.

  After the bloodletting, the plaintiff’s attorney flashed that toothy smile again, every one of his slicked-back hairs in place. He acted as if victory, millions of dollars worth of victory, was now within his reach.

  Dr. Matthew Kline sat there, wondering about his worth as a physician, while the jury of well-meaning individuals deliberated among themselves about his abilities, or his lack of them. Robert hadn’t even talked to him since his testimony on the witness stand.

  The jury foreman sent a message to the judge that the jury had reached a decision.

  Matthew sat in the hard wooden chair in front of the hard wooden table facing the judge from the left side of the courtroom. Seated kinglike on his throne, the judge peered down at the courtroom. Ten or so observers, including Matthew’s wife, Lisa, watched with concern from the public seats separated from the combatants’ tables by a railing with a central gate. The plaintiff’s attorney was still smiling.

  Matthew slouched in his seat, weary from days on end of testimony and expert witnesses and arguments and charts and posters and trying to read the jury and feeling bewildered about what the other side was saying about him. It was an effort to breathe, and a queasy, sickening feeling gnawed at his stomach. He was lightheaded, almost to the point of passing out. Matthew had never fainted before, and he’d never in his life been so damn miserable.

  Matthew watched each juror file back to the jury box. Not one juror looked at him. He knew the outcome before it was announced.

  “We, the jury, find in favor of the plaintiff.”

  Matthew bent over and vomited into a trashcan.

  Chapter 8

  On his way home from the coffee shop after dinner with Laura, Alec couldn’t keep his bright red ‘66 Ford Mustang under the speed limit. Laura was even more attractive than he remembered—she was like a perky professor whose demeanor could harden in an instant—and he thought she just might be on to something.

  Alec had been blown away by her uncanny ability to pick up on unusual physical signs in victims of foul play. She was like a forensic pathologist, only before the fact, when most doctors were concerned with keeping people alive and not so much with subtle evidence of malice aforethought.

  He pulled into a parking space in front of his modest first-floor apartment near McLean, Virginia and about two miles from the headquarters of the Central Intelligence Agency. It was ironic, a small-time private dick working in the shadow of the ultimate investigation agency.

  Opening the two front door locks with his keys, he walked down a short hallway past a small table standing under an oval wall mirror and turned left into the living room, which contained against the left wall a dark brown couch with light brown cushioned chairs at each corner. A white chaise lounge completed the arc, which faced a television set in the right corner of the room.

  He sat down in his favorite chair, which had a depression in the soft seat that fit him perfectly. He relaxed there for a long while with a slight smile on his lips. Normally, he’d huddle there and brood over memories of his beautiful wife and five-year-old son. This time, he thought of Laura and her bright green, insistent eyes.

  Alec was jolted from his daydream by the jangling of a telephone. He picked up the receiver. “Hello?”

  “Alec. Where have you been?”

  He recognized the voice. It was Monica Stiles, the wife of the Medical Examiner. Monica was a tall, attractive brunette with hazel eyes. Stewart Stiles had left his previous wife for Monica, who was, Alec guessed, at least ten years younger than Stewart. They’d married three years ago, and she’d probably begun to play around as soon as the honeymoon was over.

  Monica had hit on Alec at the morgue one day, less than a year into her new marriage, when Alec was still a homicide detective. She’d whispered suggestive things into his ear as her husband sliced up a dead body in the next room. Alec had resisted her the first few times. About four months ago, Alec went for it. Not only did he dive headlong into the affair, he also stopped working and dropped out of life for a while.

  Their usual routine was to meet at a hotel off Interstate 66 in Arlington, not too far from her home in Georgetown or his in McLean. Monica called him two or more times a month. Daytime rendezvous were easy, while Stewart was at work. She’d contact him at night when Stewart was at a meeting or out of town, usually at a medical conference.

  “Stewart gone tonight?”

  “Yes, he’s at a long meeting tonight. We’ve got all kinds of time.”

  Alec wondered how long this secret relationship would last. Monica had a huge appetite for sex, and Alec was often easily persuaded.

  Monica said, “How about our usual place?”

  “Sure. Thirty minutes?”

  “I’ll be there.”

  Alec cleaned up, locked his apartment, and got in his car. During the short drive to the hotel, Alec worked himself into a boil, visualizing Monica’s gorgeous, perfectly curved body. He turned into the front drive of the hotel. Monica sat in her Mercedes in the front parking lot, in the shadows between wide circles of light from the night lamps. Alec parked his car and walked over to her, and she lowered the driver’s side window.

  “Room 211,” she whispered.

  Alec strolled into the hotel, a modest but clean place. Monica wouldn’t have settled for a regular motel—not enough class or respectability. He sat in a chair in the lobby for ten minutes reading a magazine, his back to the entrance doorway. Maybe it was an act, but the evening hotel clerks didn’t seem to recognize him. Alec wondered how many secretive affairs were consummated here, under the observant but discreet eyes of the hotel perso
nnel.

  He took the elevator to the second floor. Standing at the door of Room 211, he glanced around; the hallway was empty. After two knocks, Monica opened the door and Alec stepped inside.

  Monica wore a black, see-through negligee. Alec wondered if he’d ever be able to resist her. They embraced and kissed. Alec noticed out of the corner of his eye a king-sized bed with the covers pulled down. Monica hugged him and didn’t move.

  “Everything okay? You seem stressed,” Alec said.

  Monica was quiet for a few seconds. “No, I’m here with you, and that makes everything all right.”

  “You smell nice, like roses.”

  “I bought this perfume just for you.”

  They fell onto the soft mattress, and Monica choreographed the intimate scene atop the squeaky bed, a series of rhythmic dance-like movements accompanied by heavy breathing. Afterwards, they lay stretched out side by side. Alec grinned as he remembered what Laura had said about guys dying after sex—with smiles on their faces.

  Alec dressed, kissed Monica lightly on her cheek, and left the hotel room. Following their usual routine, neither had said anything after their lovemaking.

  As Alec drove away from the hotel, he thought about visiting one of his favorite bars for a nightcap. A car in the rearview mirror distracted him. It stayed the same distance behind him for several turns, and all he could see were the headlights.

  As he continued to drive toward his home, checking the rearview mirror, he heard buzzing in his ears. Every fiber of his mind and body hit high alert whenever the buzzing came. It was part of his ex-policeman intuition—it meant something was not quite right.

  Images of the killer of his wife and son—and of the note he’d left behind at the scene—popped into Alec’s head. The note said that the killing was his revenge for Alec sending him to prison. The guy was a sociopath, who had hired someone to kill his business competitor, but that plan didn’t work. He’d served his time, and then took revenge into his own hands by murdering Alec’s wife and son. So far, the bastard had eluded capture and was hiding out from police, and Alec often wondered when he’d meet up with that sneering face again.

  Alec was about to pull over to the side of the road just a block from his place, when the car turned at an intersection and disappeared. Alec parked, locked the front door of his apartment, and armed the alarm system.

  Later that night, Alec awoke in a cold sweat. He looked over at the clock by his bed. It was 4:20 a.m. This scenario wasn’t unusual. Once a week or so, Alec dreamed of his dead wife and son—a beautiful boy with a mischievous smile and light brown hair that his wife Holly was always combing. She’d combed in vain, because his hair had never wanted to stay in place. Alec stood in the front doorway of his house, a hand on the doorknob, while Holly smiled at him and little Mitch hugged his leg.

  “Daddy, don’t go.”

  As he replayed the dream scenes, a familiar gnawing feeling grew in the pit of his stomach, a burning that threatened to explode out from his abdomen. A tear rolled out of his eye, and he sat up and sobbed.

  Chapter 9

  It was Thursday, the day of Dr. Preswick’s funeral.

  Laura awoke before her alarm. At some point during her college days, Laura had developed an irregular sleeping pattern. Possibly, it had been in the midst of finals one year. She’d accepted the problem as fate—or maybe genetic—and ascribed her fitful sleeping patterns to her personality. She’d wake from a sound sleep for all kinds of reasons, and it would often be something important, like a realization or a sudden understanding. Laura knew she wasn’t alone—many of her female friends over the years had trouble sleeping, too. She decided to research that some day.

  She sat up as a suspect list popped into her mind, recalling hospital gossip about Dr. Preswick’s interest in women other than his wife. Her fingers twitched, like before an important job interview, as she wrote down the list. After readying herself for the day, she plopped down on her couch in the living room and stared at the list.

  Suspects

  1. Mrs. Preswick - Did Dr. Preswick have affairs?

  2. Any jealous girlfriends?

  3. Enemies? Dr. Preswick was an arrogant man, insulted lots of people, did he hurt anyone? other doctors? patients?

  Those eyes with their tiny pupils appeared in Laura’s mind again. A pleasant, jittery feeling surged through her as she put the suspect list on an end table and phoned the ME’s office. She soon heard the ME’s familiar voice. Good, at least he’s still coming to work. Maybe his psychiatrist talked to him.

  “Dr. Stiles, this is Laura Valorian again, concerning Dr. Roderick Preswick’s death.”

  “How can I help you?”

  “During our attempted resuscitation, I noticed that his pupils were pinpoint. We ordered a drug screen, but it was negative for opiates or other drugs or poisons.”

  “Yes, I remember that.”

  “Do you think it’s possible that designer drugs, synthetic opiates, were in his system?”

  “Designer drugs? Interesting idea. I’ve encountered them a few times. They can be difficult to detect.”

  “They often don’t show up on routine drug screens. But I’ve heard about specialized labs that can test for them. Do you think you can send some of his tissue and blood to one of those labs to look for a designer drug?”

  “Sure, I can look into that. Are you worried about anything specific?”

  Laura remembered her earlier research. “3-methylfentanyl, or any relative of fentanyl. Or possibly a Demerol-related drug.”

  “Okay. Got it. Sometimes those labs get backlogged with orders; it may be next week before we get an answer.”

  “No problem. Thanks.”

  “Maybe we can talk about this over lunch, or dinner?”

  Laura inhaled. “Thanks, but I think we should continue talking by phone.” She hung up. He sounds more rational, except that now he’s inviting me out. I wonder what his wife would say about that?

  Before leaving her house, Laura thumbed through her hospital physician address list and jotted down the Preswick home address on the piece of paper with the suspect list, which she folded and tucked in her purse. She attended the funeral of Dr. Preswick at a spacious, imposing church near Tysons Corner, Virginia, west of Arlington. A somber attendant directed her to a parking space near the church. Friends, coworkers and relatives of the deceased packed the sanctuary. A doctor friend delivered an impassioned eulogy, mainly concerning their golfing days together over the years. Mrs. Preswick, dressed in black, seemed duly grievous. At the graveside ceremony, a soft misty rain fell, chilling many of the mourners, including Laura, who couldn’t find space to squeeze in under the small canopy.

  A young woman stood a few people away, to the side of Laura. She was of no particular interest at first, but after while, Laura became intrigued by her expression—it was more of a scowling than a sad face.

  After the funeral, Laura drove east through Arlington on Interstate 66 and crossed the Potomac River on Interstate 395 to begin her sleuthing interviews at her hospital in southeastern D.C. Approaching the rectangular structure, she was reminded that many hospitals had drab and uninspiring exteriors, and hers was no exception.

  Laura pulled into the doctors’ parking lot as the rain stopped. A few hospital personnel were returning from the funeral. Laura walked to her usual entrance door, stepping around puddles in the uneven cement. She had a plan. Surgeons like Roderick Preswick spent a great deal of their time in operating rooms with their OR crews. Some surgeries lasted many hours. Some surgeons talked.

  Laura knew Kathy, the OR Head Nurse, and had treated her in the emergency room for various problems. In the course of her practice, Laura had examined many hospital employees like Kathy for illnesses and injuries, such as accidental needle sticks. Hospital personnel often made a special effort to get to know the emergency room doctors, since these doctors were usually accessible for gratis opinions—the “curbside consult”—about medical problems an
d sometimes even for a quick prescription or two.

  “Kathy, do you have a few minutes?” Laura said as she stuck her head into the head nurse’s office.

  Kathy looked up from some papers she was perusing. “Sure, Dr. Valorian. Come in and have a seat.” She indicated a chair directly in front of her desk. “I welcome any excuse to take a break from these nursing reviews.” A disordered pile of papers hovered beside her on the desk. It appeared that she’d been reviewing the written and computerized nurses’ notes to identify problems with documentation or variances from nursing standards of patient care.

  Her small office was crammed full with the large metal desk, three well-used but sturdy blue armchairs, and wall bookshelves brimming over with nursing and administrative textbooks and documents. Several framed diplomas hung on the wall behind her, and pictures of her children and grandchildren dotted her desktop.

  “I’m sorry about Dr. Preswick,” Laura said. “You must’ve been close to him.”

  “I’ll miss him. He was a good surgeon.” Kathy sighed and looked down.

  In order to get any useful information, Laura figured she had to loosen up Dr. Preswick’s associates. They would have a natural tendency to say nothing bad about the recently departed.

  Laura offered a familiar observation. “Unfortunately, sometimes the most skilled physicians aren’t easily approachable. I mean, their bedside manners may be abrupt at times.”

  Kathy stared at Laura.

  Laura smiled. “I like to think that I’m always warm and friendly to my patients.”

  “You are. And yes, Dr. Preswick was difficult at times. But then, so are other surgeons, and many other doctors for that matter.”

  Laura hadn’t thought of a tactful way to bring up the rumors about Dr. Preswick’s affairs, and it would be awkward to do so at any time, now or later. So, she chose now. “A lot of doctors play around a bit, too. After all, they spend much of their adult lives in the hospital or office.”