Critical (21 page)

“Who is she going to fetch?” Loraine questioned. “Mr. Straus, the hospital president?”

“I have no idea,” Fran said.

“Let's go back to the lounge,” Loraine suggested to Laurie.

“I think that might be a good idea,” Laurie said. She felt anxious from an adrenaline surge engendered by the unexpected confrontation and its potential consequences.

As they walked, Loraine added, “Dr. Sarpoulus has always been uptight, as Fran suggested. Are you sure you want to stay? She was very rude.”

“I'll stay,” Laurie said, with some misgivings. What motivated her was the hope of being able to smooth things over with someone more rational than Cynthia Sarpoulus. Leaving on an unpleasant note certainly would not be helpful if she had additional questions, and there might even be a complaint made about her visit. Laurie specifically wanted to avoid such a possibility.

Back in the surgical lounge, Laurie accepted some coffee and crackers from Loraine. As busy as she'd been, she'd skipped lunch and was famished.

“So it was the CEO's decision not to characterize more fully the staph strains involved in the outbreak?”

“I guess,” Loraine said. “I thought it had been Cynthia's decision, but I guess not.”

Laurie had more questions, but her thoughts were interrupted by Cynthia's reappearance. By her expression, her mood had not mollified. Her sharply defined, full lips were pressed firmly together, and she walked with obvious determination. Behind her came a man and a woman. The woman was of medium height, with blemish-free pale skin, aristocratic features, and a helmet of short, thick hair. She was dressed in an elegant business suit and walked with a decidedly commanding resoluteness while still managing to exude classic femininity.

The man was her antithesis, not only in gender but in his general appearance and the way he moved. He wore a rumpled plaid wool jacket with leather elbows, the kind that Laurie had always associated with academia. Instead of resoluteness, he projected an air of wariness, with his pale eyes constantly on the move as if he were in a potentially hostile environment.

“Dr. Montgomery,” Cynthia said triumphantly. “May I present Dr. Angela Dawson, the CEO of Angels Healthcare, and Dr. Walter Osgood, department head of clinical pathology. I believe you should direct your comments to them.”

“What seems to be the trouble?” Angela demanded. From her tone, it was obvious Laurie's presence was not to her liking.

“I'm afraid I have no idea,” Laurie said, as she got to her feet. Since they were nearly the same height, she and Angela literally saw eye to eye.

Loraine scrambled to her feet. “If there is any fault concerning Dr. Montgomery's presence, surely it is mine,” she said. “Dr. Montgomery called me after she had autopsied Mr. David Jeffries. She asked to come to the hospital for a visit as part of her investigation. I invited her. She only asked to see our OR HVAC system in the engineering spaces, a typical patient room, and the OR itself. I didn't see any problem in that. I suppose I should have run it by Mr. Straus beforehand.”

“As president of the hospital, that would have been wise,” Angela agreed. “It would have saved us this embarrassment.” Then, turning to Laurie, she said, “You do understand that this is private property.”

“I understand,” Laurie said. “But David Jeffries is a medical examiner case, and by law, I have subpoena power for documents and whatnot, and to visit the scene in order to investigate fully the cause and manner of death.”

“There is no doubt legal recourse for you to carry out your duty, but barging in here is not one of them. Someone has already visited us from your office the previous evening and was shown appropriate hospitality. I will be very happy to discuss this with the chief of the OCME, Dr. Harold Bingham, whom I have had the pleasure of meeting on several occasions.”

Laurie felt a chill descending her spine. Despite knowing she ultimately had the legal right to make the visit, the very last thing she wanted was for Bingham to be dragged into this ridiculous brouhaha over nothing, especially since she knew from past experience he'd probably side with the hospital.

“Thank you for your industriousness,” Angela continued. “I'm sure your motivation was to help us, but as you can imagine, this problem has taken a terrible toll not only on some of our patients but on our institution, and, frankly, we are inordinately sensitive to the crisis. When I call Dr. Bingham, I will mention that we are not averse to you or anyone from the OCME visiting our OR, but we will require a warrant and that whoever is designated be tested as a carrier for MRSA. As part of our attempt to deal with this horrible problem, we insist that everyone entering the OR suite be clean.”

“I had not thought of that,” Laurie said, with a touch of guilt. Never once did it cross her mind that she could be a carrier herself, especially from having autopsied an individual just that morning who was chock-full of the bacteria.

“We, on the other hand, are extremely aware of it. But the point is we are not trying to limit your investigation. At the same time, we are certain your visiting our OR would not be enlightening in the slightest. The epidemiologist for the New York City Board of Health, Dr. Clint Abelard, who is a public servant like yourself, has inspected our OR on two occasions and found nothing. Of course, he wasn't allowed in until it was assured that he was not an MRSA carrier.”

“I wasn't aware an epidemiologist had been involved until I got here,” Laurie said. “Obviously, he's much more qualified than I. I'm sorry to have caused any misunderstanding. I hope I haven't inconvenienced you too much.”

“You haven't. Dr. Sarpoulus, Dr. Osgood, and I were here attending the monthly medical staff meeting. It's not as if we had to come all the way from our home office.”

“I'm pleased.”

“There's one other point I wanted to make. You have questioned our decision not to accurately subtype the particular strains of the involved MRSA causing us such havoc. To explain, I've asked Dr. Osgood to accompany me to meet you. I know Dr. Sarpoulus has alluded to the reasons, but Dr. Osgood can explain it better, as he is boarded in both clinical pathology and microbiology. It's important for you to understand we have done every possible thing in our power to rid ourselves of this problem. Anything else would be irresponsible.”

 

FIFTEEN MINUTES LATER,
Angela and Cynthia were in a cab heading south on Fifth Avenue. Walter had stayed behind to meet with the orthopedic hospital's laboratory supervisor. Angela and Cynthia had ridden in silence, with Angela staring out the side window of the taxi and noticing that the trees of Central Park had the very first suggestion that spring was around the corner.

But Angela was thinking less about nature and more about her problems with Angels Healthcare, which seemed to grow with each passing day. The last thing she expected at this late date was a problem with the medical examiner's office. The concern was publicity, which had been a worry from the start. Back when the MRSA cases first occurred, she'd made it a point to contact the chief medical examiner, to convince him that they were on top of the problem to the extent of having reported it to the New York City Department of Health and encouraging the epidemiologist to come to the hospital.

Angela turned to Cynthia. “What was your take on that medical examiner? Did she strike you as an independent sort?”

“Absolutely. Why else would she come out and visit our hospital when there was no mystery about the cause of death. I didn't like her there while we're trying to keep a lid on this affair. That's why I came down to get you. I thought it was something you should handle.”

“I'm glad you did. I considered her a threat the moment I laid eyes on her. I don't know exactly why, but she struck me as very focused and driven, and, to compound it, very intelligent. Did you see how she made eye contact? Most people caught in a similar circumstance would have been cowed to some degree.”

“She did the same to me,” Cynthia said. “I definitely challenged her the moment I heard she was a medical examiner.”

“She worries me,” Angela admitted. “If she manages to get any of this MRSA problem into the press, it will certainly come to the attention of institutional investors as part of their due diligence. If that happens, more than likely the IPO will have to be postponed, or if it's not, it certainly won't be successful.”

“I think you did a terrific job talking to her.”

“You think so? Really?”

“I do. First, you mixed just enough condemnation and commendation, threat and praise, to put her off balance. Second, your warning about calling her boss definitely affected her negatively; I don't think she will be making any more visits, whether announced or not. And finally you made her understand that there are a number of people working on solving the problem who have much more epidemiological training than she has. I'm sure she feels she'd fulfilled her responsibility.”

“I hope you are right,” Angela said, not fully convinced.

“I'm sure I am. I was impressed. You were brilliant. You really played her like a violin.”

Angela shrugged. She wasn't so sure. Her intuition was telling her the opposite, and that Dr. Laurie Montgomery was going to be a problem. Angela wondered if she should talk to Michael about her. But then, after another short session staring out the taxi's window, Angela suddenly pulled her cell phone from her Louis Vuitton bag, slipped it open, and speed-dialed her secretary.

“Loren? Get me Dr. Harold Bingham's number.”

To Cynthia, she said, “I want to be totally certain Dr. Laurie Montgomery behaves.”

 

DR. WALTER OSGOOD
was nervous. The whole time he'd been talking with his supervisor of the Angels Orthopedic Hospital's clinical laboratory, Simon Friedlander, he kept thinking about the surprise visit from the woman medical examiner. He'd explained to her why he'd advised not to bother testing the MRSA to determine their explicit subtype. The woman had nodded repeatedly as if she'd understood, yet he sensed she hadn't agreed. It was subtle but definite, and it worried him.

When he'd finished the meeting with Simon, which had been stressful because of his nervous preoccupation with Dr. Laurie Montgomery's visit, Walter asked if he could use Simon's office to make a private phone call. Sitting at the man's desk, he noticed a family photo. One of Simon's sons was the same age as Walter's only child. Before making his call, Walter picked up the framed photo so he could see the boy's image more clearly. He was an obviously healthy child, with a shock of unruly blond hair and a purposefully silly but happy expression. Walter fought off a sudden surge of sadness, anger, and envy. He put the photo back down, closed his eyes, and took a deep breath to rein in his emotions involving the unfairness of life. At the moment, his son was far from healthy, having been diagnosed with a rare, severe form of Hodgkin's disease requiring what his health insurer deemed “experimental” treatment. At the moment, Walter's son had no hair and had lost a quarter of his former weight.

Opening his eyes, Walter took out his wallet and extracted a small piece of paper with a single phone number with a Washington, D.C., area code. It was supposed to be for emergencies only, and he debated if this qualified. Making a sudden decision, he picked up the receiver and dialed.

On the other end, the phone rang a number of times, and Walter wondered what he'd say if he got voice mail. Just when he thought the phone wouldn't be answered, it was. A deep, wary voice said, “What is it?” There was no hello.

“This is Walter Osgood,” Walter began, but he was immediately cut off.

“Are you on a landline?”

“I am.”

“Hang up and call this number,” the voice said. He rattled off a phone number and hung up.

Walter rapidly wrote the number on the edge of an envelope addressed to Simon. He then dialed the number. The same voice immediately answered. “You were not supposed to call me unless there is an emergency. Is that the case?”

“How do I know what constitutes an emergency?” Walter snapped. “As far as I'm concerned, if it isn't now, it will be.”

“What is it?”

“A New York City medical examiner by the name of Laurie Montgomery came to the Angels Orthopedic Hospital asking questions.”

“Why is that an emergency?”

“She'd autopsied a patient who'd died yesterday from MRSA. She wanted to go into the OR, and had even been up in the engineering spaces.”

“So what?”

“That's easy for you to say. I don't like it. The next thing, it could be in the papers.”

“What's her name again?”

“Dr. Laurie Montgomery from the Office of the Chief Medical Examiner. What are you going to do?”

“I don't know. But I'll keep you informed, and you do the same.”

The line disconnected. Walter glanced at the receiver as if it could answer his question. Then he lowered it into its cradle. The strangest part was that he didn't even know the man's name.