Джонатан Келлерман - When the Bough Breaks

He’d been brought in by ambulance, battered, crushed, skull shredded, all but his most rudimentary bodily functions gone. Yet thousands of dollars had been spent delaying the inevitable, and enough pages had been filled to create a medical chart the size of a textbook. I leafed through them: nursing notes, with their compulsive accounting of intake and output, the child reduced to cubic centimeters of fluid and plumbing: I.C.U. graphs, progress notes – that was a cruel joke – consultations from neuro surgeons neurologists, nephrologists, radiologists, cardiologists; blood tests, X rays, scans, shunts, sutures, intravenous feedings, parenteral nutritional supplements, respiratory therapy, and, finally, the autopsy.

Stapled to the back inside cover was the sheriff’s report, another example of jargonistic reductionism. In this equally precious dialect, Carey Nemeth was V, for Victim.

V had been hit from behind while walking down Malibu Canyon Road just before midnight. He’d been barefoot, wearing pajamas – yellow, the report was careful to note. There were no skid marks, leading the reporting deputy to conclude that he’d been hit at full force. From the distance the body traveled, the estimated speed of the vehicle was between forty and fifty miles per hour.

The rest was paperwork, a cardboard snack for some downtown computer.

It was a depressing document. Nothing in it surprised me. Not even the fact that Gary Nemeth’s private pediatrician of record, the physician who’d actually signed the death report, was Lionel Willard Towle, M.D.

I left the chart stuck under a stack of X-ray plates and walked toward the elevator. Two eleven-year-olds had escaped from the ward and were waging a wheelchair drag race. They whooped by, IV tubing looping like lariats, and I had to swerve to avoid them.

I reached for the elevator button and heard my name called.

“H’lo, Alex!”

It was the medical director, chatting with a pair of interns. He dismissed them and walked my way.

“Hello, Henry.”

He’d put on a few pounds since I’d last seen him, jowls fighting the confines of his shirt collar. His complexion was unhealthily florid. Three cigars stuck out of his breast pocket.

“What a coincidence,” he said, giving me a soft hand. “I was just about to call you.”

“Really? What about?”

“Let’s talk in the office.”

He closed the door and scurried behind his desk.

“How’ve you been, son?”

“Just fine.” Dad.

“Good, good.” He took a cigar out of his pocket and made masturbatory motions up and down the cellophane wrapper. “I’m not going to beat around the bush, Alex. You know that’s not my way – always come right out and say what’s on your mind is my philosophy. Let people know where you stand.”

“Please do.”

“Yes. Hmm. I’ll come out and say it.” He leaned forward, either about to retch or preparing to impart some grave confidence. “I’ve – we’ve received a complaint about your professional conduct.”

He sat back, pleasurably expectant, a boy waiting for a firecracker to explode.

“Will Towle?”

His eyebrows shot skyward. There were no fireworks up there, so they came back down again.

“You know?”

“Call it a good guess.”

“Yes, well, you’re correct. He’s up in arms about some hypnotizing you’ve done or some such nonsense.”

“He’s full of shit, Henry.”

His fingers fumbled with the cellophane. I wondered how long it had been since he’d done surgery. “I understand your point; however Will Towle is an important man, not to be taken lightly. He’s demanding an investigation, some kind of–”

“Witch hunt?”

“You’re not making this any easier, young man.”

“I’m not beholden to Towle or anyone else. I’m retired, Henry, or have you forgotten that? Check the last time I received my salary.”

“That’s not the point–”

“The point is, Henry, if Towle has a gripe against me, let him bring it up before the State Board. I’m prepared to swap accusations. I guarantee it will be an educational experience for all concerned.”

He smiled unctuously.

“I like you, Alex. I’m telling you this to warn you.”

“Warn me of what?”

“Will Towle’s family has donated hundreds of thousands of dollars to this hospital. They may very well have paid for the chair you’re sitting on.”

I stood up.

“Thanks for the warning.”

His little eyes hardened. The cigar snapped between his fingers, showering the desk with shreds of tobacco. He looked down at his lost pacifier and for a moment I thought he’d break into tears. He’d be great fun on the analyst’s couch.

“You’re not as independent as you think you are. There’s the matter of your staff privileges.”

“Are you telling me that because Will Towle complained about me I’m in danger of losing my right to practice here?”

“I’m saying: Don’t make waves. Call Will, make amends. He’s not a bad fellow. In fact the two of you should have a lot in common. He’s an expert in–”

“Behavioral Pediatrics. I know. Henry, I’ve heard his tune and we don’t play in the same band.”

“Remember this, Alex – the status of psychologists on the medical staff has always been tenuous.”

An old speech came to mind. Something about the importance of the human factor and how it interfaced with modern medicine. I considered throwing it back in his face. Then I looked at his face and decided nothing could help it.

“Is that it?”

He had nothing to say. His type seldom does, when the conversation gets beyond platitudes, entendres, or threats.

“Good day, Doctor Delaware,” he said.

I left quietly, closing the door behind me.

I was down in the lobby, which had cleared of patients and was now filled with a group of visitors from some ladies’ volunteer group. The ladies had old money and good breeding written all over their handsome faces – sorority girls grown up. They listened raptly as an administration lackey gave them a prefabricated spiel about how the hospital was in the forefront of medical and humanitarian progress for children, nodding their heads, trying not to show their anxiety.

The lackey prattled on about children being the resources of the future. All that came to my mind was young bones ground up as grist for someone’s mill.

I turned and walked back to the elevator.

The third floor of the hospital housed the bulk of the administrative offices, which were shaped in an inverted T, paneled in dark wood, and carpeted in something the color and consistency of moss. The medical staff office was situated at the bottom of the stem of the T, in a glass-walled suite with a view of the Hollywood Hills. The elegant blonde behind the desk was someone I hadn’t counted upon seeing, but I straightened my tie and went in.

She looked up, contemplated not recognizing me, then thought better of it and gave me a regal smile. She extended her hand with the imperious manner of someone who’d been at the same job long enough to harbor illusions of irreplaceability.

“Good morning, Alex.”

Her nails were long and thickly coated with mother-of-pearl polish, as if she’d plundered the depths of the ocean for the sake of vanity. I took the hand and handled it with the care it cried out for.

“Cora.”

“How nice to see you again. It’s been a long time.”

“Yes it has.”

“Are you returning to us – I’d heard you resigned.”

“No, I’m not, and yes, I did.”

“Enjoying your freedom?” She favored me with another smile. Her hair looked blonder, coarser, her figure fuller, but still first-rate, packed into a chartreuse knit that would have intimidated someone of less heroic proportions.