Her Last Breath: A Kate Burkholder Novel (18 page)

I show her my badge and introduce myself. “I’m working on a case and was wondering if someone can talk to me about Paul Borntrager.”

“Oh my goodness.” She presses her hand against her matronly bosom. “That was
awful
about Paul and those sweet little children. Just horrible. I cried my eyes out when I heard what happened. All of us here at the clinic were just crushed.”

A door that presumably leads to the interior of the clinic opens. A young blond woman, also clad in pink scrubs, steps out and then holds open the door for an Amish woman pushing a wheelchair. A boy of about eight or nine sits in the chair, playing with a stuffed bear. He’s wearing trousers and suspenders and a white shirt. Through the thick lenses of his eyeglasses, I see that he suffers with what used to be referred to as lazy eye.

I offer both of them a smile. The Amish woman takes in the sight of my uniform, gives me an obligatory smile, and continues on. The boy, however, hits me with huge, lopsided grin that’s so infectious I find myself grinning back.

“Chief Burkholder, Doctor Armitage has a few minutes until his next appointment,” the receptionist tells me. “He can speak with you now if you’d like.”

“That would be great.”

She stands and calls out to the Amish boy. “See you next week, Jonas! Bye, Sweetie!”

The boy turns in his chair and waves vigorously. “Bye!”

Still smiling, the receptionist motions me through the door. “Third door on the right, Chief.”

My boots thud dully against the hardwood floors as I make my way down the hall. I pass three examination rooms with paper-covered exam tables, laminate counters, and sinks. But all semblance of clinical ends there. Framed photos of farm animals—horses and pigs and ducks—cover the walls. An oil winterscape of Amish children frolicking on a snowy hillside. A second painting depicts a horse and sleigh and a group of children ice skating on a frozen pond.

The last door on the right is partially open, and a brass nameplate reads: D
OCTOR
M
IKE IS IN!
I push open the door and find myself looking into a large office with a double set of French doors that open to a small deck. Judging from the size of the room, I suspect it was originally a master bedroom. It has gleaming hardwood floors and plenty of natural light. An old-fashioned banker’s lamp sits atop a lovingly distressed cherrywood desk, the surface of which is littered with papers and forms and files. On the wall, a dozen or more tastefully framed diplomas and certificates are prominently displayed.

Through the French doors, I see red-stained Adirondack furniture. Two chairs, a lounger, and a table. Beyond, in a small patch of manicured grass, is an old-fashioned rocking horse and a sandbox filled with plastic shovels and colorful buckets. A man in a white lab coat and blue jeans sits on one of the wooden chairs, thumbing something into his phone.

I cross to the French door and push it open. “Dr. Armitage?”

The man startles, and only then do I realize he’s smoking a cigarette. I almost laugh when he makes a feeble attempt to conceal it. He stands and drops the cigarette, sets his foot over it. “Oh, hello.” Hand extended, he starts toward me. “You must be Chief Burkholder.” He glances down at the butt. “I guess I’m busted.”

“It’s not against the law to smoke,” I say.

“Well, it should be. I’m a doctor, for God’s sake. You’d think I’d know better.” He chuckles. “Stupidest damn habit I ever started.”

We shake. His grip is firm, but not too tight. The lack of calluses tells me he doesn’t do much in the way of manual labor. He maintains eye contact with me, his expression intelligent and full of good humor.

“Never too late to quit,” I tell him.

“I plan to.” He gives a self-deprecating laugh. “As soon as the divorce is final. Which should be any day now.”

I nod. “Sorry.”

“Ah, it was my own doing. All work and no play made me a pretty bad husband.” Shrugging, he motions toward the door. “I’ve got about five minutes before my next appointment. Would you like to sit out here or would you be more comfortable inside?”

“Outside is fine.”

“It
is
a nice day, isn’t it?” He settles back into his Adirondack chair.

I sit opposite him and take a moment to look around. The yard is small and fenced with white pickets. A big maple tree shades the corner where an old-fashioned swing set sits. A basketball hoop and backboard has been installed in a gravel area, the mesh net swaying in the breeze. It’s the perfect retreat for kids and stressed-out parents. “This is a nice facility,” I tell him.

“I love this clinic. I love the people—the Amish in particular. I love this part of Ohio.” He grins. “Even the long winters. For the first time in my life I can honestly say the work I do is important—and not only to me.”

“It must be very gratifying.”

“It is. Immensely.”

“I remember reading about the grand opening of the clinic,” I tell him. “I understand most of your work involves genetic disorders.”

“Almost exclusively.” He smiles. “Though I’ve been known to treat a sore throat when indicated. Through the work done here, we’ve identified some genetic disorders that are almost unheard of elsewhere in the world.” That he uses “we” instead of “I” tells me he’s a modest person, content to share his achievements with his colleagues, the mark of a man who loves his work and whose mind enables him to see not only the big picture, but the end goal.

“The Amish are unique in that the gene pool is relatively small,” he adds, leaning forward and gesturing. “Most of our patients are special-needs children. We’re talking quality of life disorders. Cohen Syndrome. Ellis-van Creveld syndrome. Dwarfism. Founder effect inheritable diseases mostly.”

“Founder effect?”

“Disorders that can be attributed to a limited gene pool,” he replies. “We’re working with community leaders on a way to broaden the scope of that pool, and I think we’ve had some success. My colleagues have been in touch with the bishops of church districts in other states. Colorado and upstate New York, mainly. To a lesser degree, Indiana and Illinois. We’re trying to get a relocation-and-exchange program up and running, which is difficult because the Amish are so family oriented. And, of course, the church districts have different rules.” He leans closer to me. “But, if we can overcome those things, if we can get young men and women of marrying age to emigrate to out-of-state Amish communities, marry, and have children in their new locale, we could broaden the gene pool and, in effect, eliminate some of these genetic disorders. Of course, only time will tell if—” He stops himself short. “Sorry. Once I start talking about my work here, it’s hard to shut me up. Used to bore my wife to tears.”

“Sounds fascinating.”

“Or maybe you’re just too polite to tell me I’m boring you to death.”

I smile, find myself liking him. “It’s good to be passionate about your work.”

“Some might argue that I’m a little
too
passionate.”

It’s obvious he’s married to his career—and that his soon-to-be ex-wife had had to compete. I see him as a hopeless workaholic, always coming home late, working weekends, sequestered behind his computer when he’s home at all. Hence the pending divorce. “How long have you been in Painters Mill?”

“Going on eight months now. I came down from Cleveland. Different world up there. I needed a change after my wife filed. I’ll never go back to the big city. This area, this clinic, has been my salvation, so to speak. It’s exciting work, and I couldn’t ask for a better group of people to work with.”

“The Borntrager children were patients here?”

“They were.” His lips twist as if he’s bitten into something rotten. “I couldn’t believe it when I heard what happened to them. I still can’t. Those poor kids. And Paul. My God, I can’t imagine what Mattie must be going through.” He gives me a direct look, and I see a layer of thinly veiled outrage in his eyes. “I heard it was a hit-and-run.”

“It was.”

“Any leads?”

“We’re working on it.”

“I meant to get up to the hospital to see David, but I’ve been putting in long hours here and never made it. How’s he doing?”

“He’s going to be fine.”

“Great. I hear they’ve got an excellent trauma team at Pomerene.”

“I’m wondering, Dr. Armitage—”

“Call me Mike, please.”

“Mike,” I say. “Can you tell me what the children were being treated for?”

“All three were afflicted with Cohen syndrome, to differing degrees.”

“What is Cohen syndrome, exactly?”

“Like most of the disorders we treat here, it’s genetic in nature. Rare, but not so much among the Amish. It causes a delay in mental and physical development. Neutropenia, or low white blood cell count. Hypotonia, which basically means low muscle tone. A whole array of symptoms that can impact a kid’s life in a negative way.” He shakes his head. “Mattie and Paul were good with those kids. It never seemed to bother them that they were special-needs. Hell, they barely noticed. Never complained or felt sorry for themselves or their children. Paul and Mattie loved those kids and raised them the best they could.”

“How well did you know them? Paul and Mattie, I mean.”

“Well, they’d been coming to the clinic since I arrived. It was a professional relationship, you know, just to talk about the kids enough for me to ascertain how they’re doing and gauge improvements or changes, if any.” Looking inward, he smiles. “First month or so we pretty much talked about the weather. Mattie and Paul were wary of me. You know, the whole outsider thing. Until I began working here in Painters Mill, I hadn’t had much contact with the Amish or their culture, so I was clueless. All of us had to open our minds, so to speak. Once that happened, they began to trust me. I think they realized I care, and they knew I’d do my utmost to help their children. They’re good people, Chief Burkholder. Nice family. Kids are well behaved and sweet. I hope to God you get justice for them.”

The urge to tell him I plan to do just that is strong, but I don’t because I know better than to make some emotion-driven promise I may not be able to keep. “How well did you know Paul?”

“He was a great guy. Quiet. Religious. To tell you the truth, he had a pretty wicked sense of humor for an Amish guy.” He chuckles as if remembering. “I only met him a handful of times, but he was terrific.”

Something pings in the back of my brain. “I was under the impression that he had a standing appointment here at the clinic.”

“Mattie was the one who usually brought in the kids. Every week like clockwork. For bloodwork, mostly. The children were on medication offered for free as part of a clinical trial. I like to keep a handle on the levels in the bloodstream. And the neutrophils, of course. We also discussed nutritional needs. Every month or so, I had a psychologist come down from Wooster and we did some problem solving and IQ testing.” He gives a nod. “Mattie was great with them. Attentive. Gentle with discipline. Good instincts. Patient.”

“How well do you know her?”

“Well enough to know those kids were her life. ‘Gifts from God’ is the way she referred to them. I can’t imagine what this did to her.”

We fall silent, and for a moment the only sound comes from the chatter of sparrows from the canopy of the maple tree. “Did either of them mention any disagreements or problems? With other family members or neighbors? Friends or acquaintances?”

“Neither of them ever mentioned any conflicts of any kind. They were the type of folks who seemed to get along with everyone.”

“Is there anything else you can tell me about the family, Dr. Armitage? Any insights you can offer? Or general observations you can share?”

He takes a moment to consider the question, then shakes his head. “Not that I recall. But they were very private people. Not the type to confide. Our relationship was of a doctor-patient nature. When they were here, it was all about the children.” Then he gives me a candid look. “I’m reading between the lines, Chief Burkholder, but it sounds as if there’s something going on here that I haven’t read about.”

“I hate to leave you in the dark, Dr. Armitage, but since it’s an open investigation, I’m not at liberty to discuss the details just yet.”

“I understand.” He sits back in his chair and huffs out a sigh. “It’s such a senseless, unimaginable tragedy. Frankly, it pisses me off.”

My smile feels wan on my face as I rise. “I appreciate your taking the time to talk to me, Dr. Armitage.”

“I wish I could do more.” He gets to his feet and we shake hands again. “If you need anything else, Chief, please come see me.” His mouth twists into an ironic smile. “I’m usually here working until ten or eleven p.m.”

I’m midway to the door when he calls out my name.

I stop and turn to see him striding toward me, his expression troubled. “One more thing,” he says, and stops a few feet away. “This may or may not be relevant to the case, Chief Burkholder, but you asked, so I’m going to skate uncomfortably close to stepping over the physician-patient privilege line and tell you about an observation I made early in my relationship with the Borntragers.”

I feel myself go still inside, silencing my thoughts and the clutter in my brain, the way you do when you know you’re about to hear something important and you don’t want to miss a single word or gesture or the manner in which it’s delivered.

“Let me preface by saying that Paul and Mattie are good and loving parents. Of that, I’m certain.” He sighs, looks down at the floor as if he’s debating how to broach the subject at all. “The first time I examined David, I found a handprint on his behind. A red welt in the shape of a hand with some bruising beneath the skin. It was evident someone had spanked bare skin with a good bit of vigor. When I asked David about it, he said his
datt
smacked him for stealing a pie and then lying about eating it. As you know, David is overweight, which is typical of children suffering with Cohen syndrome. I must admit, I was a little taken aback. I know corporal punishment is an acceptable form of discipline in many households. But the fact that this spanking left a bruise gave me pause. I’m sure you know that, as a physician, I’m mandated by state law to report any indication of child abuse.”