Murder Suicide
Authors: Keith Ablow
Tags: #Fiction, #Thrillers, #General, #Psychological
Murder Suicide
Clevenger 05
by
Keith Ablow
Contents
The Four Seasons
–
Another Winter Day, One Year Before
The Four Seasons
–
A Spring Day, Nine Months Before
The Four Seasons
–
A Summer Day, Five Months Before
The Four Seasons
–
Just Twenty Days Before
"But when the self speaks to the self, who is speaking?—
the emtombed soul, the spirit driven in, in, in to the central
catacomb; the self that took the veil and left the world—
a coward perhaps, yet somehow beautiful, as it flits with
its lantern restlessly up and down the dark corridors."
—Virginia Woolf, ‘
An Unwritten Novel
’
January 12, 2004, 4:40
A.M.
The shadow of night still clung to a frosty Boston morning, the silence broken only by the crisp, clean sounds of the slide on a Glock handgun being pulled back, a 9mm slug popping up out of the magazine, clicking into the chamber.
John Snow, fifty, M.I.T. professor, genius inventor, stood in an alleyway between the Blake and Ellison towers of the Massachusetts General Hospital, just off Francis Street. He was scheduled for experimental neurosurgery one hour later, surgery that would radically alter his entire life.
He looked down at the gun aimed at his chest. His pulse raced with fear, but it was fear once-removed, like that of a witness to another man’s shooting. He wondered whether that was because he had already said good-bye to the people he loved — or had once loved.
"You can’t do this," he said, his voice trembling, his words wafting off the buildings.
Silence again. A freezing drizzle starting to fall. The gun shaking slightly.
"If you ever want to be more than what you are, you have to be able to reinvent yourself."
The gun steadied.
He heard footsteps in the distance. He glanced down the alleyway, the faintest hope lifting his heavy heart.
The barrel of the gun touched his chest, just below his sternum.
He closed his gloved fist around it.
The barrel pressed harder against him.
The footsteps were coming closer.
"You can’t hold onto the past," he managed, through clenched teeth.
The trigger of the gun started to move.
He sunk to his knees and peered into the darkness, speechless now, his mind finding what comfort it could in the words that had sustained him during his medical odyssey, words from the Bhagavad Gita, the only Hindu text that had inspired Thoreau and Gandhi:
Death is certain for anyone born,
and birth is certain a for thedead;
since the cycle is inevitable,
you have no cause to grieve.
The gun moved a few inches off his chest.
He managed a tight smile.
The trigger started moving, again.
He felt the pain before he heard the blast, pain beyond anything and everything he had ever known or imagined, a bolt of lightning exploding through him, searing into his chest, his arms and legs and groin and head, so that he could barely see and certainly could not feel his blood as it soaked his shirt and hands, spilling through his fingers, onto the pavement. It was pain that obliterated anything in its path, so that after a moment it seemed too great for his body to contain, then too great for his mind to contain. And then it was as though it did not even belong to him. And then it did not exist at all. He was free of it, and of all his suffering, and of everyone — just as he had intended to be.
Paramedics rushed John Snow into the Mass General emergency room at 4:45
A.M.
, unconscious, with shallow respirations. They had radioed ahead, reporting Snow as the victim of a self-inflicted gunshot wound to the chest. Snow’s neurosurgeon, J.T. ‘Jet’ Heller, thirty-nine, was one of the six doctors and five nurses who responded to the code red.
A medical intern named Peter Stratton had heard the gunshot on his way home from a night on call and dialed 911 from his cell phone. Police responded and found Snow collapsed in the alleyway in a pool of blood. His arms and legs were tucked close to his chest, fetal position. A black leather travel bag and a Glock 9mm handgun lay on the pavement beside him.
Snow was stabilized in the field, but his EKG flatlined as he crossed the threshold into the E.R. The team shocked his heart back into rhythm three times, but his pulse never lingered longer than several seconds.
It was Heller who took the heroic steps, starting with a pericardiocentesis. Heart muscle is surrounded by a tough, membranous sac called the pericardium, stretched around it like a latex glove. But a bleed (a pericardial effusion) can occur between the muscle and the membrane, causing the pericardium to swell like a water balloon, putting pressure on the heart and preventing it from pumping. So when Snow’s heart would respond to nothing else, Heller inserted a six-inch hypodermic needle under Snow’s sternum and drove it down toward the heart at a thirty degree angle, aiming to pierce the pericardium, siphon off any pooled blood and free the left ventricle to do its job. He tried seven times, but each time he pulled back on the syringe, he got nothing but air.
Snow’s EKG had been flat line for over a minute.
"Should we call it?" a nurse asked.
Heller swept his long, blond hair back off his face. He stared down at Snow. "Get me a syringe filled with epi," he said.
Epinephrine was a cardiac stimulant sometimes administered intravenously to patients in cardiac arrest. No one moved to get it. They knew J.T. Heller had something much more invasive than an I.V. in mind, and they knew it was futile. Whether the bullet had ripped a hole in Snow’s heart or transected his aorta, the wound had been fatal.
"He’s gone, Jet," Aaron Kaplan, another of the doctors, said. "I know he’s your patient, but..."
"Get me the epi," Heller said, his sapphire blue eyes still fixed on Snow.
The team exchanged glances.
Heller pushed his way past the others to the code cart, rifled through the supplies, came up with a syringe full of epinephrine. He walked back beside Snow, squirted a bit of the epi into the air, then thrust the needle under Snow’s sternum and emptied the 10cc directly into his left ventricle. He glared up at the monitor. "Beat, goddamn you!" He kept staring five, ten, twenty seconds. But there was only that flat line, that terrible hum.
Then Heller took the ultimate step. He reached to the bedside tray, picked up a scalpel and, with no hesitation, cut a six-inch transverse incision below Snow’s sternum, reached into Snow’s chest, grabbed hold of his heart and began open cardiac massage, rhythmically squeezing and letting go of the thick, muscular cardiac walls, trying to manually throw the heart back into gear.
"For Christ’s sake, Jet," another doctor whispered, "it’s over."
Heller pumped even more vigorously. "Don’t quit on me," he kept muttering. "Don’t you quit on me." But it was no use. Every time Heller stopped squeezing, Snow’s EKG drifted back to a flat line.
Heller finally took his bloody, gloved hand out of Snow’s chest. And as he did, Snow began to seize, his whole body trembling like a fish out of water, his teeth chattering, his eyes rolling back in his head. The seizure lasted just half-a-minute. The Snow lay completely still, his eyes staring blankly at the ceiling.
Heller backed away from the gurney. He was soaked with sweat and blood. He stared at Snow, shook his head as if in a daze. "You coward," he said. "You..." He looked up at the others. "I’ll call it." He glanced at the clock on the wall. "Time of death, 5:17
A.M.
"
8:35
A.M.
Grace Baxter, owner of a toney Newbury Street art gallery, wife of George Reese, founder and president of the Beacon Street Bank & Trust, hugged herself to stop from shaking. Her internist had kept her on Zoloft and Ambien and a little Klonopin for about a year, but it was her very first hour of psychotherapy, and quite possibly the very first time someone had listened to her — really listened to her — for anything close to an hour. "I’m sorry to fall apart like this," she whispered. "But the medicines aren’t working. I don’t want to get up in the morning. I don’t want to go to work. I don’t want to get into bed with my husband at night. I don’t want this life."
Dr. Frank Clevenger, 48, glanced out the window of his Chelsea waterfront office at the line of cars creeping over the steel skeleton of the Tobin Bridge as it arched into Boston. He wondered how many of the people inside those cars really wanted to be going where they were headed. How many of them had the luxury of ending up somewhere where they would be expressing something genuine about themselves, or at least something that didn’t make them feel like frauds, playing dress-up? How many of them would be returning to homes they wanted to live in? "Are you thinking of hurting yourself, Grace?" he asked gently, looking over at her.
"I just want the pain to stop." She rocked back and forth in her seat. "And I don’t want to hurt anyone ever again."
Irrational feelings of guilt were one of the hallmarks of major depression. Some patients actually came to believe they were responsible for the Holocaust or for all the suffering in the world. "Hurt them in what way?" Clevenger asked her.
She looked down. "I’m a bad person. A horrible, horrible person."
Clevenger watched tears start down her cheeks. She was thirty-eight and still exquisite, but her wavy, auburn hair, emerald green eyes and the perfect slope of her nose and cheekbones all said she had been otherworldly at twenty-six, when she had married George Reese, fourteen years her senior and already fabulously wealthy. Only now, with her physical presence just beginning to wane, was she confronting the fact that she wasn’t in love with her husband or her work or her lifestyle — not the expensive cars or the private jet or the Beacon Hill townhouse or the vacation homes on Nantucket and in Aspen. She was beginning to suspect that beauty and wealth had carried her far away from her
self
and she didn’t know the way back or whether there ever would be anything left of her if she ever made it back. "Sometimes hurting other people can’t be avoided, Grace," Clevenger said. "Not if you intend to be a complete person yourself."
Baxter folded her hands on her lap. "When I married him, he let me keep my name. It was supposed to be a symbol that neither of us owned the other." Her fingers tugged at the three diamond tennis bracelets she wore on one wrist. Her thumb rubbed the face of the gold and diamond Rolex she wore on the other. Anniversary gifts. They might as well be handcuffs."