Jonathan Kellerman - Devil's Waltz

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Alex Delaware is asked by a colleague to look into the case of a child who has suffered a variety of ills in her short life and has had to undergo a devastating number of medical investigations. Every time, the clinicians come up with one big zero. Could someone be inducing the symptoms?

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“The widow is still too dazed to hope.”

“Yeah...”

“What?”

“Well,” he said, “I’ve been thinking a lot about your case — the psychology of this whole Munchausen thing — and it seems to me we’ve missed a potential suspect.”

“Who?”

“Your buddy Steph.”

“Stephanie? Why?”

“Female, medical background, likes to test authority, wants to be in the center of things.”

“I never thought of her as attention-seeking.”

“Didn’t you tell me she was some big radical in the old days, Chairman of the interns’ union?”

“Sure, but she seemed sincere. Idealistic.”

“Maybe. But look at it this way: Treating Cassie puts her smack at the center of things, and the sicker the kid is, the more Stephanie gets the spotlight. Playing rescuer, big hero, rushing over to the Emergency Room and taking charge. The fact that Cassie’s a big shot’s kid makes it even tastier, from that standpoint. And these sudden shifts she’s making — Munchausen one day, pancreatic disease the next, then back to Munchausen. Doesn’t that have a hysterical feeling to it? Your goddam waltz?”

I digested all that.

“Maybe there’s a reason the kid goes nuts when she sees her, Alex.”

“But the same logic that applies to Vicki applies to her,” I said. “Until this last seizure, all of Cassie’s problems began at home. How could Stephanie have been involved?”

“Has she ever been out to the home?”

“Just early on — once or twice, setting up the sleep monitor.”

“Okay, what about this? The first problems the kid had were real — the croup, or whatever. Steph treated them and found out being doctor to the chairman of the board’s grandchild was a kick. Power trip — you yourself said she plans on being head of the department.”

“If that was her goal, curing Cassie would have made her look a lot better.”

“The parents haven’t dropped her yet, have they?”

“No. They think she’s great.”

“There you go. She gets them to depend on her, and tinkers with Cassie — best of both worlds. And you yourself told me Cassie gets sick soon after appointments. What if that’s because Stephanie’s doing something to her — dosing her up during a checkup and sending her home like a medical time bomb?”

“What could she have done with Cindy right there in the exam room?”

“How do you know she was there?”

“Because she never leaves Cassie’s side. And some of those medical visits were with other doctors — specialists, not Stephanie.”

“Do you know for a fact that Stephanie didn’t also see the kid the same day the specialists did?”

“No. I guess I could look at the outpatient chart and find out.”

“If she even charted it. It could have been something subtle — checking the kid’s throat and the tongue depressor’s coated with something. Whatever, it’s something to consider, right?”

“Doctor sends baby home with more than a lollipop? That’s pretty obscene.”

“Any worse than a mother poisoning her own child? The other thing you might want to think of, in terms of her motivation, is revenge: She hates Grandpa because of what he’s doing to the hospital, so she gets to him through Cassie.”

“Sounds like you’ve been doing a lot of thinking.”

“Evil mind, Alex. They used to pay me for it. Actually, what got me going was talking to Rick. He’d heard of Munchausen — the adult type. Said he’d seen nurses and doctors with those tendencies. Mistakes in dosage that aren’t accidental, heroes rushing in and saving the day — like pyromaniac firemen.”

“Chip talked about that,” I said. “Medical errors, dosage miscalculations. Maybe he senses something about Stephanie without realizing it... So why’s she calling me in? To play with me? We never worked that closely together. I can’t mean that much to her, psychologically.”

“Calling you in proves she’s doing a thorough job. And you’ve got a rep as a smart guy — real challenge for her if she’s a Munchie. Plus, all the other shrinks are gone.”

“True, but I don’t know... Stephanie?”

“There’s no reason to get an ulcer over it — it’s all theory. I can peel ’em off, right and left.”

“It makes my stomach turn, but I’ll start looking at her more closely. Guess I’d better watch what I say to her, stop thinking in terms of teamwork.”

“Ain’t it always that way? One guy, walking the road alone.”

“Yeah... Meantime, as long as we’re peeling off theories, how about this one? We’re not making headway because we’re concentrating on one bad guy. What if there’s some kind of collusion going on?”

“Who?”

“Cindy and Chip are the obvious choice. The typical Munchausen husband is described as passive and weak-willed. Which doesn’t fit Chip at all. He’s a savvy guy, smart, opinionated. So if his wife’s abusing Cassie, why isn’t he aware of it? But it could also be Cindy and Vicki—”

“What? Some romantic thing?”

“Or just some twisted mother- daughter thing. Cindy rediscovering her dead aunt in Vicki — another tough R.N. And Vicki, with her own child rearing a failure, ripe for a surrogate daughter. It’s possible their pathology’s meshed in some bizarre way. Hell, maybe Cindy and Stephanie have a thing going. And maybe it is romantic. I don’t know anything about Stephanie’s private life. Back in the old days she hardly seemed to have one.”

“Long as you’re piling it on, what about dad and Stephanie?”

“Sure,” I said. “Dad and doc, dad and nurse — Vicki sure kisses up plenty to Chip. Nurse and doc, et cetera. Ad nauseum. E pluribus unum . Maybe it’s all of them, Milo. Munchausen team — the Orient Express gone pediatric. Maybe half the damn world’s psychopathic.”

“Too conservative an estimate,” he said.

“Probably.”

“You need a vacation, Doc.”

“Impossible,” I said. “So much psychopathology, so little time. Thanks for reminding me.”

He laughed. “Glad to brighten your day. You want me to run Steph through the files?”

“Sure. And as long as you’re punching keys, why not Ashmore? Dead men can’t sue.”

“Done. Anyone else? Take advantage of my good mood and the LAPD’s hardware.”

“How about me?”

“Already did that,” he said. “Years ago, when I thought we might become friends.”

I took a ride to Culver City, hoping Dawn Herbert stayed home on Saturday morning. The drive took me past the site of the cheesy apartment structure on Overland where I’d spent my student/intern days. The body shop next door was still standing, but my building had been torn down and replaced with a used-car lot.

At Washington Boulevard, I headed west to Sepulveda, then continued south until a block past Culver. I turned left at a tropical fish store with a coral-reef mural painted on the windows and drove down the block, searching for the address Milo had pulled out of the DMV files.

Lindblade was packed with small, boxy, one-story bungalows with composition roofs and lawns just big enough for hopscotch. Liberal use of texture-coat; the color of the month was butter. Big Chinese elms shaded the street. Most of the houses were neatly maintained, though the landscaping — old birds of paradise, arborvitaes, spindly tree roses — seemed haphazard.

Dawn Herbert’s residence was a pale-blue box one lot from the corner. An old brown VW bus was parked in the driveway. Travel decals crowded the lower edge of the rear window. The brown paint was dull as cocoa powder.

A man and a woman were gardening out in front, accompanied by a large golden retriever and a small black mutt with spaniel pretensions.

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