John Lescroart - The Oath

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"A particularly strong plot." – Los Angeles Times
"Topical and full of intrigue." – Milwaukee Journal Sentinel
Doctor Eric Kensing is living in fear that he is about to be indicted for the death of a patient. That patient was his boss, Tim Markham. But Kensing and Markham aren't just connected by work – Kensing's wife is one of Markham 's many lovers. It's not looking good for Kensing, so he enlists the help of lawyer Dismas Hardy. Some say Kensing is not worth saving, although others say that Kensing is a special doctor, prepared to do anything to save a patient's life, even defying proper medical procedure. Despite all the damning evidence, Hardy becomes increasingly sure that Kensing is innocent. Against mounting pressure for an arrest, Hardy knows that the only way to save Kensing is to find the real murderer. And like Kensing, he seems to be working within a system that is set up to thwart him and any attempt at real justice…

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"You might not even need them," Bracco told her. "Driscoll's just looking for a way that he can disrupt things at Parnassus. He's bitter. He wants to get back at people, especially people who made life hard on Markham."

Ash nodded, but told them to get a warrant anyway. Fisk came back over to the knot of them, dejected. "She didn't admit he called her, but she said she remembered wrong and changed her mind. She was glad I called. She was going to call me." He looked mournfully around him. "Ten o'clock."

"He called her," Bracco snapped.

"It doesn't matter." Glitsky was in a fatalistic frame of mind after Kensing. "The wife wouldn't have testified at trial against her husband anyway. We haven't lost anything. Not like with Kensing."

The two inspectors shot glances at each other. "What about Kensing?" Bracco asked.

Again, Ash stepped in. "You can take him off your list. He has an alibi for Carla's murder. I was just telling Abe."

This brought them all to silence, which Bracco broke. "So it's all coming down to Carla?"

Glitsky nodded. "Looks like. Is there anybody left without an alibi? What about Driscoll?"

"I asked him this morning," Bracco said. "He might have been talking on the phone."

"To who?"

"His partner, Roger. I was going to check his phone records. It's on my list."

***

After a moment, Fisk perked up. "I don't know if you've heard, Lieutenant, but we've made some progress on the car."

Hardy should have been elated. After all, his client was no longer a suspect. He'd remained on the fifth floor, eschewing an opportunity to visit with either Glitsky or Jackman, waiting on a bench outside the Police Commissioner's Hearing Room until Kensing had come out. Eric told him how it had gone, which was pretty much exactly as Hardy had predicted.

The two men had walked up to John's for a celebration lunch but it had turned out to be a sober affair, in all senses. Hardy made a few-he thought-subtle attempts to get Eric to open up about his girlfriend. How had Judith Cohn gotten along with Markham? With Ross? With all the Parnassus problems, monetary and otherwise, with which Kensing had such difficulty? What were their plans together, if any?

Eric was reasonably forthcoming. She'd only been on staff at Portola for a year after her residency at USC and internship at Johns Hopkins, then two four-month stints-one in Africa and one in South America-with Me´dicins San Frontie`res.

"You know, Doctors Without Borders, although she always gives it the French reading, posters in her room and her bumper sticker even. She's proud of her languages, French and Spanish. And she's a fanatic about the organization, really. I think she's got me half-convinced to go over with her next time-it's Nigeria this summer-although God knows there's enough to do here in this coun try. But if Parnassus does let me go…andmy kids, I don't know how they'd handle it. Remember when decisions used to be easy?"

After they said good-bye, Hardy stood in the sunshine on Ellis Street, about midway between his office and the Chronicle building. It should be over, he knew, but somehow it wasn't. This wasn't the familiar emotional letdown after the conclusion of a trial. There was no conclusion here, not yet.

Someone had murdered Tim Markham and his family. Someone had murdered a succession of patients at Portola.

And he still had his deal with Glitsky. They were sharing their discovery, and he was privy to knowledge that Abe did not share. It rankled and left him feeling somehow in his friend's debt, which was absurd. Hardy had, if anything, done Glitsky a big favor.

But whatever the complications, he knew that he was too involved to quit, even if there was no one left to defend.

It couldn't be the end. It wasn't over.

PART FOUR

33

There was no reason now for Jeff Elliot to use any of the dirt that Driscoll had supplied on Eric Kensing. If he wasn't any longer suspected of killing Markham and his family, then he was a private person with his own private problems, and they were not the stuff of news-at least not the kind of news that made its way into "CityTalk."

Hardy sat in Elliot's cubicle, the stack of paper Driscoll had provided on the rolling table in front of him. He flipped through the pages slowly, one at a time over the course of the afternoon, while Jeff toiled on his next column. It was really a hodgepodge of data. The letters to Kensing that Elliot had shown Hardy the other day, for example, occurred over the course of several years, and were widely separated within the printed documents. Likewise, the memos to Ross and the board on various issues, including Baby Emily and the Lopez boy, occurred in chronological order. Hardy was finding that only a careful reading of all the documents related to any one issue would lead to any real sense of the gravity of the thing over time.

There were at least a hundred memos to file, as well. Formal documentation-probably dictated to Driscoll-of various meetings and decisions. Nothing that struck him as new or important. More interesting to Hardy, although far more cryptic, were the thirty or forty shorthand reminders and comments that Markham had probably typed to himself. It was obvious that he believed he could write in a secure-probably a passworded-document, but that Driscoll had breached that security and gotten access. But try as he might, Hardy couldn't make much out of them.

Markham's early memos to Portola's administration on Lopez were mostly concerned with the facts of the situation. They were about insurance considerations and a litany of medical explanations of specific decisions that might mitigate their liability in the inevitable lawsuit.

Several memos, both to file and to the Physicians' Group, explored the culpability of a Dr. Jadra, who had been the first physician to examine Ramiro Lopez at the clinic. Somehow, Hardy gathered, it was determined that Jadra's actions were not negligent. The boy's fever had been mild on that first visit. The throat infection had not yet progressed to the point where a reasonable diagnostician would necessarily prescribe antibiotics or even order a strep test. Further, Jadra did not note the cut on Ramiro's lip in his file at all, and when questioned about it later, had no memory of it. These Jadra memos struck Hardy as interesting because he could read the obvious subtext: Markham was looking for a scapegoat, and the case against Jadra would not be as clear-cut as that against Cohn. So these Jadra documents had, to Hardy, an odd, defensive character.

By contrast, when Markham finally recommended that they prepare an 805 on Cohn-which went on her permanent record with the state medical board and the National Practitioner Data Bank-the letter was sharply worded and extremely critical: "…Dr. Cohn's inability to recognize the early signs of necrotizing fasciitis and her failure to recommend highly aggressive treatment was surely the primary factor contributing to the patient's death. By the time he was admitted to the ICU, the disease had progressed to the point where even the most active intervention would probably not have been efficacious. We recommend that Portola suspend Dr. Cohn's clinical privileges for thirty days, that you submit an 805 report on this incident, as required, and that you conduct a full enquiry to determine the advisability of Dr. Cohn's continued employ within the Parnassus Physicians' Group."

Hardy knew what Markham was doing here-trying to distance himself and the hospital from Judith's failure to make an early diagnosis. Again, this decision was about insurance, about getting sued, about the money. From Kensing's perspective, though admittedly biased, the real ultimate culprit in this tragedy had been Malachi Ross, pulling the strings and denying the needed care from on high. Instead, the opprobrium was falling most heavily, and solely, on a relatively newly hired, young female staffer. Even if Judith might have done a better job with the early diagnosis, it was clearly unfair to single her out as the reason the boy had died. Many people contributed, as did the corporate culture, and Hardy thought the whole thing stunk.

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