Death Rounds (17 page)

All the while I desperately wanted to ask Stewart some leading questions about who might have done this to him. But should I? In his vulnerable state, he might not be as skeptical as his colleagues, and talking about the Phantom could needlessly add to his fears.

“Stewart,” I began, choosing my words carefully, “if the infection is related to the Sanders case, then your exposure had to have happened in the first hours after her admission. Was there ever anyone around you using an aerosol at that time?”

“No, I went through all that with Rossit.”

“Do you use any nose sprays for allergies?”

“Again, like I told Rossit, no.”

“Did anyone visit Sanders from UH on that first day?”

“Visitors? Besides her son? No. She was in no shape for visitors. You know that. Unless you consider Cam Mackie a visitor.”

“Was anyone else here, during those hours—an orderly, a nurse, someone dressed in isolation garb you might not have recognized— who shouldn’t have been?”

“What do you mean?”

“Could some unauthorized person have come in here and been around you and Sanders, and you not have realized it? In my own department all sorts of people in greens come and go—they’re almost invisible—without my noticing it.”

“I don’t know. It’s possible I suppose, but we’re a lot smaller and more controlled than ER. The nurses would be pretty quick to ask anyone they didn’t recognize what he or she was doing, especially if someone tried to get into this room,” he answered, sounding a little morose and looking around him. I suspected he still couldn’t quite believe he’d ended up a patient in his own domain.

“Is there anyone who you’ve seen around a lot outside of here who may have been following you or want to do you harm?”

“What!” He stared at me, an expression of amazement creeping over his pale face.

I immediately backed off. “Nothing, forget about it. I was just kidding—a bad joke about how shit disturbers like you and Sean could expect Hurst to keep an eye on you. You guys really got him nicely at the meeting today.”

He looked puzzled but seemed to accept the question as a failed attempt to make him laugh. I decided that I couldn’t ask him anything more without scaring him silly or leaving him convinced I was crazy.

When I stopped at the nurses’ station to check his chart, I learned everyone working in ICU had gone on oral erythromycin as prophylaxis against
Legionella,
despite Rossit’s best attempts to assure them it wasn’t necessary. Not a bad idea, I thought. Maybe Janet and Michael should do the same thing.

All the way home I kept wondering how someone from UH could have gotten near Stewart and infected him without his knowing. Despite his protests to the contrary, I was sure he’d be as oblivious as I to the legions of anonymous hospital workers who were around us every day. They could come and go like ghosts or like a phantom. I began to feel overwhelmed again by how nebulous our killer was. Might it be impossible to ever pull him from the shadows? Could he go on forever, moving undetected through the faceless echelons of a hospital, and continue to murder?

I felt a little less hopeless when I remembered Cam had been with Stewart and Sanders during those critical hours. Maybe he had recognized someone he knew from University Hospital, someone he might normally pay no heed to at UH but who may have stuck out in his mind because he or she was at St. Paul’s. I’d ask him tomorrow.

It was only at the entrance to my house that I asked the big question. Why was Stewart chosen as a victim? I couldn’t think of any conceivable motive pertaining solely to him. Then a nasty possibility concerning myself popped unbidden into my head. Perhaps it was a demonstration, a show of power, a message from the killer that he could get anyone he wanted, including people on my turf, and I couldn’t do a thing about it.

The relief Janet showed when she learned I’d soon be with her at UH quickly evaporated when I told her what had happened to Stewart. She was also as disturbed as I was about the implications of the attack. Like me, she no longer included an
if
during our discussions of the killer.

I related the rest of the day’s events during our dinner together, although it felt more like a debriefing than table talk. I wanted to make sure I hadn’t overlooked anything significant.

Janet was quiet afterward, then said, “There is something that doesn’t add up. It’s Rossit. Why would he want the amalgamation to go ahead?”

I’d been too preoccupied about Stewart to have given much thought to Rossit’s peculiar antics at the meeting. “How do you mean ‘doesn’t add up’ ?”

“Whatever he’s cooking up with Hurst, given the likelihood he’ll lose his job as chief to Cam once the merger goes through, I’d have figured he’d be cheering you on, not threatening you or anyone else who was trying to stop the amalgamation.”

I leaned back as I thought more about Rossit. “He may not be as completely out of the running against Cam as everyone thinks,” I finally answered.

“What?”

“Politics can be screwy, and Hurst might figure it would be easier to make deals with a self-serving guy like Rossit than it would be with Cam.”

“That sucks,” Janet said.

“It supersucks when you think he’s probably making the same calculation about every chief, including yours truly, and will only support those he’s sure he can control.”

“Christ!” she muttered, downing her drink—club soda, in deference to both recent and planned efforts at keeping Brendan from being an only child.

“If Rossit thinks he’s got some kind of arrangement with Hurst,” I resumed, “then he might see the merger as an opportunity and not a threat.”

Janet received this observation with raised eyebrows, leaned back, and seemed to savor it for a while. “I see what you mean,” she finally allowed.

I picked up my own drink, a Black Russian, acknowledged that the rules of pregnancy weren’t fair by raising my glass to Janet, then swirled the ice, took a sip, and added, “What
I
don’t get is Rossit’s extraordinary ardor in trying to nail me for the Sanders case. It’s gone way beyond his usual mean streak, and for the life of me, I can’t see how my downfall could benefit him.”

Janet had winced at the word
downfall.
“Has he ever teamed up with Hurst before, during any of these other vendettas he’s carried out?”

The image of Rossit and Hurst huddled together, whispering and pointing toward me, sprang to mind. I shuddered, then answered, “No, at least not that I know of.”

Janet settled back in her chair and twirled the stem of her glass with her left hand. “So,” she began, holding out her right thumb, about to start counting something, “Rossit has outdone even his own smarmy standards in his attempt to crucify you.” She held up her index finger alongside her thumb. “He’s even recruited Hurst’s help, an unusual step for him, to get you into Death Rounds almost immediately.” Her middle finger joined the other two. “And he’s a fan of the merger, as though against all odds he has some trick up his sleeve whereby he could prevail over Cam.” Four fingers were now in the air. “Hurst’s support could be part of that trick, but Rossit’s got to know my hospital’s going to fight as hard as yours to dominate the merger. He’s got to be counting on something more than Hurst’s getting his wish list to help him win the day.” The fifth finger she pointed at me, with an expectant look. It was my turn to provide a piece of the puzzle. “What could be Rossit’s additional hidden trick?” she asked.

Our problem solving often proceeded this way, an idea at a time, layer by layer, back and forth. But usually the topic was interpreting a work of art, where to go on vacation, or how to redecorate the house. Yet it seemed as good a method as any to help unlock whatever might help us get a grasp on our killer who no one else even suspected existed.

And unlock something it did. Another inconsistency, a big one that Stewart had noticed, flew into focus. I sat up and snapped my fingers. “Janet, you’re a genius. If Rossit needed another trick, something more to assure his advantage over Cam, why did he keep ridiculing my diagnosis of the Sanders’s case?”

“What do you mean?”

“Look. One of Cam’s most important responsibilities as chief of ID is the control of hospital-acquired infections. He’d already been unable to explain two cases of
Legionella
involving nurses from UH. What better way for Rossit to undermine Cam’s credibility than to discover a third? By doing so, Rossit could imply that University Hospital had a recurrent problem with the deadly organism and that Cam couldn’t solve it. A scare about uncontained
Legionella,
if it became public, would frighten away patients, shatter public confidence in UH, and be a disaster for the hospital’s contracts with HMOs. With the potential for such a catastrophe tied to Cam’s reputation, the board might hand the chair to Rossit instead.”

I stopped for breath and took a big gulp of the Black Russian. Janet frowned, whether at what I was saying or at my wolfing down forty-proof alcohol, I was too caught up by what I was thinking to pause and ask. “So why wasn’t Rossit shouting the possibility
of Legionella
from the rooftops since day one,” I continued in a rush, “or at least since first thing this morning in the light of our autopsy findings? The case should have been like a gift to him, the ‘extra trick’ you said he needed to ‘win the day’ over Cam. Instead of ridiculing me for suggesting
Legionella,
he should have been encouraging me to confirm the diagnosis.” I caught my breath. “But it was almost as if he’d wanted to suppress any mention of the organism. Why would that be?”

Janet grimaced, then shook her head. “I’ve no idea,” she said quietly.

We sat for a while without speaking, Janet frowning at the rising bubbles in her drink, me slumped back in my chair and letting my eyes roam around the cozy dining room. We ate here with the lights low and candles lit whenever we managed to be home for dinner at the same time, to claim at least a little tranquility despite our insane schedules. The little flames from the candelabra bathed the room in a soft glow that was particularly calming. While they flickered and reflected off the rich mahogany surface of our table and the surrounding furniture, I found myself looking at a chess set we kept on a nearby buffet for the occasional after-dinner game. The candlelight projected shadows of the chess pieces against the wall and made them move and sway as in a dance. The effect was eerie, as though some tactical strategy that defied my understanding were being played out while I watched.

Just as when I played Janet, I thought idly. She always beat me. Her moves inevitably caught me by surprise and seemed to anticipate anything I could throw at her. Like the Phantom, she too was a master of defense.

I continued to watch the shadows of the chess pieces on the wall, letting my thoughts move with them, this way and that.

The Phantom’s only slipup so far was that he hadn’t counted on someone like Janet making the connection between the three nurses.

The turrets of a castle appeared and receded, followed by the shape of a horse’s head, followed by the flicker of an afterthought.

Perhaps he had after all.

If he was such a master tactician, surely he’d have taken into account that someone might see what Janet saw, link the three nurses together, and become suspicious about what was happening. Wouldn’t he then have been circumspect enough to try and prevent that from happening?

“Janet,” I said, startling her, “if you hadn’t known Sanders had
Legionella
but thought she simply had a staph infection, would you have made the connection between her and the other two nurses?”

She thought a minute. “I don’t know. Maybe, maybe not. It certainly wouldn’t have leaped at me the way it did when you mentioned
Legionella.
Why?”

“Because maybe I missed something. I haven’t given much thought to where Phyllis Sanders might have contracted staph on top of the
Legionella,”
I continued. “I simply assumed she must have already been carrying the organism like a lot of hospital workers unknowingly do, harboring it under their nails and up their noses. I knew the bacteria wouldn’t have penetrated into her lung and taken hold if the
Legionella
hadn’t first created breaks in the protective surface of her bronchi, but I never once thought that the staph infection had been anything but a fluke. Now I’m not so sure. What if he’s also found a way to infect his victims with staphylococcus?”

“What! Why would he want to do that?”

“To vary the infection. Such a strategist would have been wary that a third case of
Legionella
could tip his hand and lead to someone figuring out the connection between his victims, exactly the way it did with you. He still had to use the
Legionella
to set up the staph infection, but once the staph became an overwhelming pneumonia and all that pus became apparent, it was reasonable to expect no one would think of
Legionella.”

Janet stared at me, as if daring me to go the next step.

I took the dare. “Obviously, however, the killer would be vigorously opposed to anyone who did think of it.”

Janet became very still. “You’re not serious?”

“The killer would behave toward me exactly as Rossit has from the beginning—doing everything in his power to suppress a diagnosis
of Legionella
in Sanders.”

She looked astonished at what I was saying. “My God!”

“His ‘hidden trick’ might have been to infect personnel at UH, knowing full well how it would reflect on Cam. But two things went wrong. She came to St. Paul’s, instead of going to her own ER, and I found the
Legionella.”

After days of snapping at mists and shadows, I felt I’d finally clamped down on real flesh and bone. I sat perfectly still, astonished that I’d actually come up with my prey, horrified by what I thought I’d uncovered.

“There’s one problem,” Janet said in a cool quiet tone that was scalpel sharp. She immediately seized all my attention. Over the years I’d learned it was the voice
she reserved for disagreeing with a colleague’s opinion when her own diagnosis was bad news—an unexpected cancer, a fetal deformity, or an unpleasant secret that her sharp intellect had discerned.