Peter Clement - The Inquisitor

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Several patients die each day at St. Paul 's Hospital, a sprawling complex in Buffalo, N.Y., that takes on the most high-risk cases, including victims of the SARS virus. A few more deaths a week would hardly even be noticed. But hospital vice-president Dr. Earl Garnet, star of Clement's enjoyable line of medical thrillers, perks up when he hears about a strange circumstance in the hospital's cancer wing: a few days before they died, many of the patients reported out-of-body near-death experiences. Someone, Garnet determines, has been taking cancer patients to the brink of death and tape-recording their observations before briefly bringing them back to life. Suspects include the hospital's chaplain, Jimmy Fitzpatrick, who has been lobbying for years to get St. Paul's to relax its policy on withholding pain medication to terminal patients; Monica Yablonsky, the head nurse on the cancer ward whose prickly, unhelpful demeanor makes Garnet wary; and Dr. Steward Deloram, St. Paul's critical care expert who has also done extensive research into near-death experiences. The action in Clement's sixth hospital-based thriller (Mortal Remains, etc.) moves briskly and without an overload of medical jargon. Despite several indistinguishable characters and a few dead-end plot lines-Clement does little with the SARS element after an initial buildup-this entry keeps the author on an ascending trajectory in the genre.

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There were moments when I forgot. Awakening from sleep, I could still surface to the promise of a new day with a peace of mind that belonged to the time before I'd killed. Then the memories would sweep through me, and I would sink beneath the weight of my secret, knowing I could never escape its chains, never redeem myself. But as soon as I started to play my part, I would be okay.

Until I thought of Earl Garnet being on my trail.

Like all good physicians, he had an obsessive nature when it came to solving clinical problems. But if he sensed something wrong- lab mistakes, errors in judgment, incompetent technique- watch out. It was almost as if he took screw-ups like that personally. He was forever lecturing about how they caused avoidable injuries that the culprits could have prevented, and just about everyone at St. Paul's knew he would consider such failures a betrayal of those who had entrusted their lives to his domain in ER. I don't think he consciously aggrandized himself with that way of thinking. It was more an attitude that he'd be damned if anything would go wrong on his watch. None of that bothered me as long as he'd confined himself and his scrutiny to his own department. But now that he'd expanded his territory…

Panic at the thought of capture spread through me like rot. And for the millionth time I silently railed at having been fool enough to think I could get away with it, that I'd be so clever and outsmart them all.

But I'd had this plan, this technique, my ability to wall off what I didn't want to be or feel, I would remind myself. I'd perfected it trying to separate me from her pain, her scars. Except back then I'd learned it too late- I hadn't gotten the barricades up in time to keep her anger from becoming mine. But now, with the trick down pat, I had a cloak to wrap around myself between murders and make me invisible, an entity able to move about like a ghost. Or to paraphrase the philosopher, I don't think, therefore I am not. If Garnet or anyone else ever did realize that a killer had been at work, they'd be after someone who'd vanished, ceased to exist. At least that was what I told myself until I lapsed and thought about what I'd done, like now.

A slow, cold chill shuddered through me despite the heat and extra clothing, and I broke into a clammy sweat.

Shit! If only I'd never started. Or quit at the first death. No one would have known. But instead I pushed on, certain that Algreave had been a fluke, that I could still pull the rest through their sessions. Now I'd no choice but to continue, just to stay clear of the living death of being buried in a prison cell forever or, worse, awaiting execution.

Through half-closed eyes I watched Garnet lounging in a seat nearby, and a surge of resentment grabbed me by the throat. Leave it to old Goody Two-shoes Earl, making this into a roof garden for staff and patients. Rumor had it that he'd arranged for the greenery to be on permanent loan, or at least until the snow flew in the fall. What a fucking god he'd become around here!

My bitterness toward him and his good works surprised me. But why should it? After all, I'd condemned myself to seeing him across a moral divide, the man's inherent decency a luxury I would never again enjoy. Little wonder I envied and hated him for it.

The warmth of my mask and gown grew sweltering, my skin hot and sticky. Nevertheless, I stayed put, glancing around the rest of the area.

A gaunt-eyed woman whose few remaining wisps of hair floated on the breeze like gossamer sat nearby in a wheelchair parked under one of the potted trees. Perfect place for her, I thought.

From a distance of ten yards I could make out the telltale red stripe on her wristband that Palliative Care attached to signal a DNR case. She also had the necessary IV, probably because chemo or radiotherapy had left her unable to drink and eat adequately. Yet she didn't seem gorked. Now and then a nurse or orderly paused to say hello and chat for a while.

That's the kind I would have to select from now on. People who still had their marbles, but for whom there'd be no code when the nurses found them after I'd finished the session. I could no longer allow my subjects to survive and spread tales of near-death experiences. They might recall one detail too many and give me away. At least DNRs meant there'd be no resuscitation team to raise suspicious questions about too many people dying before their time. I doubted their doctors would raise questions either. That would entail an admission their prognoses had been wrong. Or maybe they'd be so grateful for the empty beds they wouldn't entertain many second thoughts about how they had become available.

I continued to study her.

At one point I overheard a snatch of a person's greeting.

"Hello, Sadie…"

I'd need at least a dozen more subjects. Out of them I might get a couple of usable tapes- so many had turned out garbled. But added to the few other good ones I'd managed to record, that could finally be enough to convince everyone. Just the same, the added risks of being discovered scared me shitless. I still had no idea whom I'd seen prowling around Friday night or why the person had been there. No telling when that one might show up again. And since Garnet had decided to stick his nose into the business of that ward, he posed the biggest obstacle of all to my pulling off more undetected sessions.

So how would I get around him?

Until now Palliative Care had been a place where no one thought twice when a person died. Doctors hardly ever ordered autopsies, and family, in their heart of hearts, were secretly relieved at their loved one's passing. In other words, my perfect hunting ground.

And it still could be, despite talk of audits and the bad luck that Earl had taken a particular interest in the place. Because the new VP, medical, fastidious as he might be, had also created his own problems. With a little help, those difficulties might prove useful in several ways. At the very least they should keep him distracted. If they didn't…

I looked at Janet, who lay sprawled on a lawn chair nearby, her protective wear outlining the swell of her stomach.

I dreaded what it might be necessary to do. But a personal tragedy to anguish over- that would sidetrack Garnet.

My own loss once more exerted its iron grip on me, stirring a rage that wouldn't die, not since all those years ago when my world fell apart. The hesitation I'd felt vanished.

I would make it appear accidental. After all, pregnancy could still be a risky business.

1:07 p.m.

Not too bad, Earl thought, surveying the inner corridors of his department.

The line of stretchers in the hallway, once a temporary measure to handle the occasional overflow but now an all too permanent fixture, stood empty, and the modest volume of chatter told him that his staff had the rest of the place under control.

He ducked into the nursing station, and J.S. looked up from where she leaned against the counter riffling through a magazine. "Hi, Dr. G."

"Finally, a bit of rest for the wicked, I see."

"It's about time," she said with a wink, and returned to flipping pages.

He spotted Thomas huddled in a corner with the rest of the residents conducting an impromptu Q &A session. The man had the knack of all good ER teachers, knowing to seize spare moments whenever he could and turn them into mini seminars.

Earl waited for a pause in the proceedings, then signaled him to one side. "If you need me, I'll be in pathology. They're doing a case I want to see."

Thomas's eyes seemed to draw a bead on him. "The Matthews woman?"

Earl nodded. "I saw in the chart you answered the resus call. If it's not too busy here, you could join me-"

"Thanks, Dr. Garnet, but this bunch is pretty green." Thomas gestured with an extended thumb toward the members of his group as they continued an animated and somewhat misinformed discussion about the proper technique for pelvic exams. The corners of his eyes crinkled. "As you can hear, I'd better stay with them." He chuckled, hesitated a second, then glanced right and left, as if making sure no one stood within earshot.

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