Michael Palmer - Natural Causes

"Is there anything else I can do?"

"No. You switched the phone over to the answering machine?"

"I always do that, Mr. Daniels."

"I know, I know. Good night, Ruth. I'll see you tomorrow."

Matt set down the pay phone receiver and glanced about the busy lobby area. It was six-thirty. Sarah said she would be leaving the hospital at six. But her new bicycle was still chained outside. She had not answered her Motorola page, nor had she responded to two separate voice pages by the hospital operator. A call to her apartment had gotten only her answering machine, and there were no messages from her on the one at his home.

Something significant and unpleasant had occurred involving Sarah and a patient. Matt had learned that much, although no one around MCB seemed anxious to share details. Apparently, she was being asked to take a leave from the hospital. Glenn Paris, to whom Matt had been referred for details, had been tied up in some sort of emergency meeting. Now, feeling more anxious and uncomfortable by the moment, Matt again sought the CEO out in his Thayer Building office.

"I'm sorry, Mr. Paris is tied up on a call," his harried secretary said.

"Break in. Tell him it's Matt Daniels, and that it's an emergency."

"But-"

"Do it, please. Or I'll do it myself."

Less than a minute later, he was ushered into Paris's inner office.

"You can't possibly think she would do such a thing," Matt exclaimed, after Paris recounted the events surrounding Annalee Ettinger. "Mallon and the Graysons have dropped the malpractice suit against her completely. Doesn't that tell you something?"

"Look, all I know is that this hospital has received more negative publicity in the last six months than in the previous six years. And your client is involved in virtually every bit of it. We had to put her on leave until the dust settles and we can sort out what's happened."

"Isn't it clear what's happened? Somebody's tried to frame her."

"For Sarah's sake, I hope that's true. I like her, Daniels. I really do. But as things stand, we have to take action that's in the best interest of the Medical Center of Boston and our patients. There are a good number of people on our medical staff and board of trustees who think that she is a very sick and dangerous person."

"That's utter nonsense."

"I hope so. But at this point, there's nothing I can, or want to, do."

"Listen, Sarah hasn't answered her page for the past hour. Do you have any idea where she might be now?"

"No."

"You've made a mistake," Matt said.

"As I said, I hope so," Paris responded.

Matt was already heading out the door. He made another pass through his office and home answering machines, and left another message on hers. Then he called the hospital operator, who again attempted to reach Sarah by her beeper and the hospital-wide loudspeaker system.

"Tell me," Matt asked, "when you can't get hold of residents who are supposed to be on duty, what's usually going on?"

"That doesn't happen very often," the woman said.

"But when it does."

"Our Motorolas have a display window, but they also can be voice activated. Usually, if a resident is on call and doesn't respond, their page unit is defective, and they're asleep in the house officers' quarters. They wouldn't be able to hear me on the overhead. There is none there. We use the room phones."

"Where are those rooms? Can you call them?"

"Thayer Building. Fourth and fifth floor. But I can't call every room. There are about twenty or twenty-five of them."

"Look," Matt said. "Just in case, could you please keep paging Dr. Baldwin over her beeper every couple of minutes. Use the voice mode. It's very, very important. You've got my name in case she calls in. I'll check back with you shortly. And thank you… Thank you very much."

She's gone for a walk, or else she's sleeping in one of the on-call rooms, Matt told himself as he headed up to Thayer Four. Either possibility makes perfect sense. She's upset over what's happened. A nap or a long walk. I'd do one or the other… So would she…

He began going from room to room, knocking on each door, then trying the knob. Most of the small on-call quarters were open and empty. Two rooms were locked, but in both, a sleepy voice responded to his knock. A third, though unlocked, was also occupied. The resident within, fully dressed, lying facedown, spread-eagle on the narrow bed, was so deeply asleep that he barely stirred when Matt knocked and entered.

You've got to really want it, Matt thought, gazing down at the exhausted young physician. He closed the door with unnecessary care and headed up to the fifth floor. The sixth or seventh door he tried was locked. He knocked and waited for the expected sleepy response. There was none. He knocked again, this time a bit louder. Only visions of the spread-eagle man on the fourth floor kept him from kicking at the door. He decided to check the rest of the floor before knocking any more forcefully. But then, just as he was about to turn away, he heard a woman's voice broadcasted from within the room.

"Dr. Baldwin. Dr. Sarah Baldwin. Please call the operator… Dr. Baldwin. Dr. Sarah Baldwin, the operator please."

"Sarah!" Matt cried out, kicking the base of the oak door with force. The retort, piercing as a gunshot, echoed down the empty corridor. "Sarah!"

Matt stepped back and rammed the sole of his shoe into the center of the door with all his strength. The wood split. A second kick opened a hole large enough for him to peer into the dimly lit room. Sarah was lying peacefully and motionless on the bed. Beside her, on a portable IV pole, a plastic intravenous bag was draining its solution into her arm. Matt reached through the hole and unlocked the door from within. Sarah was warm, but her color was poor. And she was not breathing.

He found a shut-off valve on the intravenous tubing and shut the infusion off. He hollered her name and checked her neck and wrist for a pulse. There was none that he could feel. He tilted her head back, pinched her nose closed, and tried several mouth-to-mouth breaths. After the third one, he thought he felt her jaw move. Again he cried out her name. Then, impulsively, he slapped her sharply across the face. She responded with a single, gurgling breath. He slapped her again. Again she took a breath.

Battling dread unlike any he had ever known, Matt snatched up the phone and dialed the operator.

"I found Dr. Baldwin," he said breathlessly. "She's in cardiac arrest. Fifth floor. Thayer Building. Please get a team up here now!"

October 28

It was a nightmare within a nightmare. At some level of her mind, Sarah struggled to believe that-to remember that as a teen she had always awakened, always been safe and in her bed. But there was nothing she could do with her thoughts, and absolutely nothing she could do with her body, to stem the helplessness, the pain, and the unremitting terror. As they had during countless dreams in her early life, rough hands pinned her on her back, then tied her down. She fought to free herself until her arms and legs burned. But the bonds were like steel.

Then thick, powerful fingers began forcing a wadded cloth between her teeth. She pushed against the cloth with her tongue. She shook her head violently from side to side. But the gag was thrust deeper and deeper into her mouth, clogging the back of her throat and choking her. She strained to pull in air through swollen, narrowed nostrils. Her efforts grew weaker. She prayed for unconsciousness or even death. But always there was just enough air to keep going, just enough to prolong the agony.

Please let me die! Please just let me go to sleep and die…

"Sarah… Honey, listen to me. It's Matt… Try to hold still and listen… Better. That's better. You can keep your eyes closed, but please listen… Sarah, you're on a ventilator. There's a tube down your nose and one down your throat and into your lungs helping you breathe. And they've got you strapped down. Squeeze my hand if you understand all that… Good. Good. Just try and keep calm, honey. I'm going to tell the nurse you're waking up."