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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"Oh, I know he lied to try to keep what those patients said from becoming public knowledge. But that's a long way from actually staging some conversation from beyond the grave. And he forced me to ask the one question anyone with half a brain would want to answer before rushing to judge him." He paused, allowing

Thomas a moment to get the point, and continued to scan the offerings on the Web page he'd selected.

The resident frowned at him.

"Come on. Why would Stewart pull something so bush league that pointed so obviously at his own work? Ah- and then there's this." He pivoted the computer screen so they could both see it. Large black letters proclaimed THE KETAMINE-INDUCED NEAR-DEATH EXPERIENCE.

"Holy shit," Thomas said, wide-eyed.

"Before all the trouble started, Monica Yablonsky mentioned in passing that this sort of stuff could be found on the Internet. I didn't think anything of it at the time," Earl said, scanning the summary.

Thomas hunched toward the screen and joined him in reading it.

It seemed to be a legitimate paper that described how a team of scientists had induced classic near-death experiences in some subjects using IV ketamine. Everything could be explained by chemistry. Earl knew the intended pharmaceutical action of the drug as an anesthetic, having used it in ER. But what the article highlighted- how ketamine blocked the neurotransmitter glutamate at certain areas of the brain, called N-methyl-D-aspartate (NMDA) receptor sites, and caused subjects to report seeing bright lights, rushing through tunnels, rising above their bodies, and meeting lost loved ones- went into more detail than he'd seen before. When those same symptoms arrived following a shot in an emergency procedure, Earl simply called them side effects.

"It's a fucking how-to manual," Thomas said, reading alongside him. "And Monica Yablonsky told you about it?"

"Yes, when I first asked her about the reports from Wyatt's patients."

"So you think she could be involved after all?"

"In the near-death stuff? I don't know. Why would she be, unless using ketamine might be connected to some mercy-killing spree she's been part of? But then why would she badger people to describe what they see? And if we're dealing with mercy killings, why are patients left alive to talk about it?"

Thomas sank back in his chair, and frowned in silence. "Everything you say… it's all pretty vague, isn't it?"

"Not really."

"How so?"

"There's someone prowling around the ward with a set of shoulders on him that could stop a truck. Nothing vague about that at all."

"Shit!"

"What?"

"Stewart Deloram has a good set of shoulders."

Earl sighed. "And every reason not to shoot patients full of IV ketamine."

"I hope so, because he's been a great teacher, and I don't want him to be in trouble, except…"

"Except it's hard to be sure of someone once suspicions about them are let loose."

"Yeah. I mean, even now I'm wondering, how do we know a guy like Stewart didn't count on people thinking that he'd never do anything so obvious. Being a little too clever is something he might try, except it backfired on him."

"Maybe." Earl decided not to even mention his worst suspicion, that Stewart might have silenced five patients to avoid the type of scandal that now consumed him. Thomas would really find it hard to believe in Stewart if he heard that one. "We could speculate all day," he said instead, and stood up to end the meeting. "But your study will put some real probables on the table."

Thomas slowly rose to his feet, seeming almost reluctant to leave. "In a way, I'm afraid of what we might find. Finger-pointing can get ugly."

"Leaving a killer at large would be worse," Earl replied, hoping Thomas could remain objective despite a sense of loyalty to Stewart.

The young man nodded, but the eager spark he'd had in his eye at the start of their talk had faded. Probably hadn't put faces on the people they might end up going after when he first offered to help.

"Now, Janet has already done some of the work you'll need," Earl continued. "Of course, it'll save time if she shows you her results, but not in the hospital. Seeing you two huddled together might tip Hurst off."

Thomas's eyebrows arched. "Dr. Graceton's already been doing a cluster study?"

"Obviously our secret held," Earl said, once more pleased with himself for having had the sense to recruit his wife's aid. "So how about dropping over to our house for dinner this evening? You can review her material safely enough there. Until now she's covered only the staff in Palliative Care, but it looks as if we'll have to go beyond them and check the whole hospital. And she can continue to process the data you collect. It'll take the two of you to track everyone we need- nurses, doctors, residents, orderlies, and porters, including who entered the hospital after hours when they weren't on duty."

"But-"

"You see, key card access leaves a computerized record. Of course, I'll have to call in a few favors to get into those databases."

"Yeah, but-"

"So we'll talk more tonight," he said, determined to keep him speechless so that they wouldn't start arguing in circles again, guessing who did what to whom. "And bring your appetite. Janet's the best cook in Buffalo-"

"Dr. Garnet, I'm sorry, but I've been trying to tell you, I already have a dinner engagement tonight."

Feeling sheepish, Earl invited him for tomorrow evening.

5:55 p.m. Palliative Care

Sadie Locke had left Dr. Earl Garnet a message requesting to see him.

Sitting on the side of the bed, picking her way through a dinner tray that held several bowls of different-colored mush, she looked at her reflection in the mirror. I'm definitely better for my weekend at home with Donny, she thought. The pallor of her face had picked up a coppery tinge of tan, and her eyes sparkled, a change that only family and love could evoke.

She looked at her watch. Dr. Garnet had said he'd be here before six.

"Hi, Mrs. Locke," said his now familiar voice from the doorway. "Don't let me interrupt your dinner…"

"Dr. Garnet! Come in, come in." She pushed the meal aside and waved him closer. "The nurses told me you had some excitement here after I left."

He chuckled. "Afraid so."

"Are you all right?"

"My back still twinges after an hour in a chair, and if I turn my neck too quickly, I get a reminder of what happened. Other than that, I'm fine. Now, what can I do for you?"

She motioned him closer still. "It's what I can do for you," she said in a whisper. "I may have seen the person who knocked you out."

"Oh?"

"Yes. Someone tried to come in here in the wee hours of last Tuesday morning, but I scared off whoever it was."

"What!"

"Well, not scared so much as surprised. The individual apparently didn't think I'd be awake."

"What happened?" He sat beside her on the bed.

"I heard someone come in, and thought it might be Father Jimmy- the dear man always drops by, no matter how late his day goes- but saw this form. It was too dark to see his eyes-"

"It couldn't have been one of the nurses?"

"Don't think so. Too big."

"Man or woman?"

"Couldn't tell. Too dark."

"Did he or she say anything?"

"Just that it was the wrong room."

"What about the voice? Might you recognize it?"

"No. The person spoke in a whisper." Her wisps of hair stood up like Dairy Queen curls, and her eyes flashed with pleasure from telling what she knew.

Yet the story troubled Earl. If the visit on Saturday morning had been a second attempt to get in the room, then theories about someone looking for an empty bed for a quickie with a nurse, or even an attempt to rob the old lady's belongings while she'd been on a weekend pass, went out the window. He wanted to ask her if she had any reason to think someone would want to do her harm, but first, he thought, it was better to reassure her. "Sadie, I want you to know it won't happen again. You may have noticed that I've posted a security guard in the hallway."

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