Julia Spencer-Fleming - Out Of The Deep I Cry

“I’m sorry about the mess.” Laura Rayfield stood in the doorway, clipboard in hand, sections of her red hair escaping from her braid. “Your officer was searching for something that might provide a lead to what happened to Al, and I haven’t had time to put everything back to rights.”

“I apologize,” Russ said. “Officer Entwhistle should have done that for you.”

“No, no, I’d rather handle it myself. Doesn’t matter, really, unless and until Allan reemerges or we get a new doctor in here.” She tilted her head toward the conference room. “Mind if we sit down while we talk? I’m beat.”

She eyed him as he crutched out of the narrow office and lowered himself into a chair. “Your officer said you’d broken your leg. What happened?”

“Slipped on the ice. Greenstick fracture.”

“Any pins?”

“Two. I’m supposed to be out of this in another five weeks.”

“Who was your orthopedic surgeon?”

“Dr. Stillman.”

She collapsed into the chair opposite him. “He’s good.” She tossed the clipboard on the table. “What can I tell you, Chief? I already gave a statement to Officer Entwhistle last week.”

“I know. I read his report.” He matched up the crutches and laid them on the floor. “It looks like you’ve got half the population of Millers Kill back there in the waiting room. Are we in the middle of an epidemic I haven’t heard about?”

Her mouth twisted. “Yeah. It’s called the no-health-insurance epidemic. These folks are here because the volunteers and I have been calling all our current patients and letting them know we’re about to close up shop. Everyone’s coming out of the woodwork to get their prescriptions or to take care of problems they’ve been putting off. As of April first, their only recourse is going to be the ER.”

“Wow,” Kevin Flynn said. “That really sucks.”

“How come?” Russ asked.

“I’m a nurse practitioner. Do you know anything about nurse practitioners?”

“I know you can examine and treat patients. And write prescriptions.”

“That’s right.” She tucked a loose strand of red hair behind one ear. “We practice in collaboration with a physician. Every NP works under a particular practice agreement that’s filed with the state board. Mine states that I will practice under the direct supervision of Dr. Allan Rouse or such physicians as he may appoint-that’s in case we hand off one of our patients to a specialist-with Dr. Rouse reviewing my patient records no less than every fifteenth day. That covers his two-week vacations.”

“Okay,” Russ said.

“Don’t you see? Without Al here, I’m effectively barred from practicing fifteen days after his disappearance.”

“Can’t you call up whoever is in charge of these things and explain the situation? Get an extension or something?”

“No. In order to resume practicing here at the clinic, I’m going to need to find another M.D. willing to serve as my collaborating physician. Then we’ll have to draw up a practice agreement and a practice protocol and file it with the office of Professions at the Education Department. Then we have to wait until the agreement and protocol are approved.”

“Sounds time consuming.”

“It can be.”

Kevin leaned in. Russ noticed that he and Laura Rayfield had identical coloring. He wondered whom they might have in common on their family trees. “Can’t you apply for the new agreement now?” Kevin asked. “That way, you might not have to wait so long to reopen the clinic.”

She shook her head. “Doctors can be very protective of each other’s turf. Until we know for sure that Al’s”-she flipped her hands: Who knows? -“not coming back, it’s an uphill battle to get another M.D. to sign on as my collaborating physician.” She turned to Russ. “I really hope you find something soon. Not just for Al’s family’s sake, but for the clinic. He’s been carrying this place for thirty years, and it would kill him if he knew we were closing down.”

If something or someone else hadn’t already killed him. Russ pulled his glasses off and polished them on his blouse. “Was he happy here? With his work?”

Laura blew out a puff of air. “That’s hard to say. He was dedicated. Conscientious. He had the kind of emotional control a lot of doctors do, in my experience, good at showing you his calm, controlled side, good at hiding the other stuff.”

“What other stuff?”

“Like I told Officer Entwhistle, he was under a lot of stress in the weeks before he disappeared. That thing with Debba Clow really ate at him. The fact that it was about vaccinations, which he sort of held as the holy grail, made it worse. He had to field a lot of questions from mothers, and justifying his medical decisions wasn’t something Al was good at.” She grinned one-sidedly. “Justifying himself at all wasn’t something he was good at.”

Russ resettled his glasses on his face. “Was anything else bothering him?”

“He was very down about Mrs. Marshall yanking her funding. We all were. Finding out you’re going to lose ten grand a year isn’t any fun. Although she did notify the board of aldermen about the change in funding, which is supposed to trigger some sort of review of our money situation. She sent them a letter the day after she told Al. We got our copy of it the same day he disappeared.” She sighed. “I bet he didn’t even have the chance to read it.”

“How’s this review supposed to work with the aldermen?”

“I don’t know. The letter said something about the provisions of the gift and reviewing the funding.” She shrugged. “The only financial document I’m familiar with around here is my paycheck.”

“Do you have the letter around?”

“It’s in there. It may still be in his in-box. I don’t know.”

“See if you can find that, Kevin.” He indicated the doctor’s office, and the young officer bounced out of his seat and disappeared though the still-open door.

“Any other issues bothering him that you know of? Anything personal?”

“Nothing he shares with me. He seems sort of melancholy at times.” Laura’s face was drawn in, in concentration. She seemed unaware that she was now speaking of Rouse in the present tense. “He’s spoken a few times this spring about Mrs. Ketchem, who started the clinic. I guess this year’s the thirtieth anniversary of her death.” She flipped her hands over. “And he turned sixty-five in February. He’s very fit, you know. Bikes every day during the warmer months. But I think he’s been experiencing one of those times when the reality of how old you are hits hard. You know?”

Russ smiled a little. “I’m turning fifty this November. Believe me, I know.” He leaned forward. “Look, Laura, how long have you worked for Allan Rouse?”

“I practice with him, not work for him.”

He nodded his head. “Sorry.”

“It’s been, jeez, twelve years now. Talk about the reality of getting old.”

He pitched his voice lower. “One of the theories I’m working on is that there may be another woman involved.”

Laura started laughing.

“No?” he said.

She couldn’t speak for a moment. “If you knew Allan…” She took a deep breath, tried to wipe the grin off her face. “No. Absolutely not. Forget that he’s one of the few husbands in the world who genuinely loves his wife. He didn’t have the time to fool around on the side. His whole world was the clinic and home. I doubt he had half an hour a day unaccounted for.” Her face sobered. “Until he disappeared.”

“What about drugs?”

“What about them?” She tilted her head, causing her braid to fall over her shoulder. “You mean, like, did he write his own prescriptions too enthusiastically?”