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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"Because they were told to keep quiet-"

"Shut up, Monica," Madelaine Hurst shrieked.

"I won't, not when he's talking about clusters of unexplained deaths and hinting at allegations of murder." As she spoke, she trained her eyes only on Earl, as if forming a corridor that linked them together and excluded everyone else.

"Go on," he urged.

"Monica!"

"Some of the girls who heard those near-death stories found one particular detail doubly peculiar."

"What?"

"Damn it, Monica, I order you to stop."

"Patients didn't just claim they'd seen lights, tunnels, lost loved ones, or themselves floating above their bodies- all that standard stuff." She rattled off the usual catalog of near-death experiences with the contempt of someone who considered such matters to be utter nonsense.

Paul shot to his feet, toppling his chair backward. "Continue and you'll be suspended permanently, Mrs. Yablonsky." He spoke through clenched teeth.

Earl leaned over the table toward her. "No, you won't. Trust me. Talk now, Monica, and nobody can touch you, not even me. What's said in this forum has automatic immunity." He hadn't lied. Anything stated at death rounds could not be subpoenaed in a court of law. The rule had been intended to protect doctors from legal action if they honestly admitted their mistakes so that the rest of the staff could learn from them. But whether the law would protect Monica from a CEO and a nursing supervisor, he had no idea.

Monica must have believed it could. "A lot of the patients said that someone kept whispering questions at them throughout the whole ordeal," she said, never taking her eyes off him.

"Questions?"

"Yeah. Had they seen God? Were they looking down on themselves? What did heaven look like? Crazy stuff."

"You're kidding."

She retrieved a tissue from her pocket and dabbed her eyes, careful not to touch them with her gloved fingers. "I swear, it's the truth."

Earl felt he'd stepped into an elevator and dropped too fast.

Why should he believe her? This might merely be another attempt to throw suspicion on someone else. But the story sounded too bizarre for her to have made it up, and pieces of the puzzle snapped into place, giving an answer he didn't want.

Reluctantly he looked over at Stewart.

The man's pupils grew to the size of quarters.

Oh, my God, Earl thought, his insides plummeting further. "This is what made you say the reports were bogus?" he said, sounding incredulous despite knowing he'd stumbled on the truth.

Stewart's forehead began to glisten under the overhead lights, the effect of a sudden sheen of sweat. "No, honest-"

"Don't lie to me, Stewart!"

"I'm not. I mean, it's not what you think. Please, Earl, you have to believe me-"

"Of course he's lying about it," Monica said, "to protect his ass!" Fury propelled her voice down to its deepest registers, stripping it raw, and the words scraped against the back of her throat. "Who else around here wanted to talk with the dead?"

Department of Clinical Research, subbasement, St. Paul's Hospital

"I swear to you, Earl, I didn't do anything wrong." Stewart's voice shook. He rose from his desk, fluttering his gloved hands here and there, his fingers as tremulous as wings. A lifetime of data on resuscitation outcomes and volumes of scientific papers about critical care towered about him in stacks. Except now the piles seemed about to fall in on him as he cowered at their center, shot up with fear, eyes as jumpy and desperate as any junkie's.

Earl leaned against the closed door and watched with clinical fascination as Stewart spun and turned, until the sight of him falling apart turned repugnant.

As the meeting had disintegrated into confusion, Stewart had fled death rounds, his eyes straining so far to the side toward his accuser that they nearly disappeared into their sockets. Earl had chased after him to his cubbyhole office.

"You lied to me," he said to Stewart.

"Yes, I know, but only about what those patients told me. I knew if word of that got around, people would react exactly the way everyone else at the table did- think that I had something to do with it." He spoke in short, rapid spurts, alternating between a whimper and a bellow. "All it takes is a whiff of shit to finish you off as a researcher in this game. And I've made more than my share of enemies, believe me, though as far as I can see it's for no reason other than envy."

How about on account of insufferable conceit? Earl thought.

"Oh, there'll be plenty of volunteers to mount a whisper campaign against me," Stewart continued, then blanched whiter still. "Oh, God! My funding, it'll dry up overnight-"

"What, specifically, were you afraid these whisperers would say?" Earl interrupted. He tried hard to sound sympathetic, to keep him talking, but found it difficult.

Stewart reacted with an impatient wave. "You know very well. That I'd badgered dying patients without getting their consent." He expanded his restless movements and started to pace. But in a ten-foot cubicle he still ended up turning in circles. "That I precipitated the near-death state to get more material to publish. That I went after immediate accounts of the experience rather than retellings, to silence critics of my original work. All of it crap, but clever enough to do damage."

Earl shuddered from the creeping realization that just as he didn't know for certain whether Stewart would be capable of something so appalling, neither could he dismiss the possibility. With increased foreboding, he asked, "And how might these so-called accusers explain you could pull such a thing off?"

Stewart immediately came to a standstill, looked at Earl, and went so white around the eyes, he seemed about to faint. He laid a hand on his desk as if to steady himself, and slowly sat down again. "You think I did it too, don't you?"

Come across as an ally, Earl told himself. He also sized up Stewart's physique, wondering again if he could have been the man who attacked him. Hard to tell, he thought. Despite spending most of his hours in the darkness of ICU, Deloram had managed to keep reasonably trim. He also had the height and the breadth of shoulders to fit the bill.

"Jesus, Earl," Stewart continued, "you of all people have to believe me. And it could be anyone trying to set me up-"

The ring of his phone cut him off.

"Hello?" he answered. His forehead grew fire red and his skin glistened with sweat again. "No, there's nothing to it," he said to the caller on the other end of the line. "Just some negligent nurse who's trying to blame everyone else…"

His coloring deepened, and his knuckles glowed white under the latex as he tightened his grip on the receiver.

Obviously somebody at death rounds had talked, and word had gotten out. Probably Yablonsky. It fit her style.

"She even tried to incriminate Earl Garnet. I guess it's my turn now. Who knows, maybe next it will be yours." He laughed far too loud and long. "No problem," he cried. His desperate cheeriness set Earl's teeth on edge. In ER, that sound usually accompanied a chilling smile and signaled a person who might go home, open the medicine cabinet, and start counting out pills.

As Stewart continued to reassure his caller, a laptop on his desk began to chime, announcing the arrival of separate e-mails. The noise continued, like a slot machine paying off, and the dread in his eyes deepened at each sound. Still, he managed another pumped-up laugh and gaily suggested, "Let's have lunch sometime soon. Do you like Mexican?"

He hung up and clasped his head in both hands as if he were afraid it would fall off. "This is going to ruin me!" he said, his voice quivering on the edge of a sob. He looked up at Earl with the agonized stare of a man who didn't quite comprehend why his world seemed to be crumbling around him. "I swear, in all my years of research, I never, ever breached a single ethical protocol."

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