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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More thunder rumbled not too far off.

"Tocco," he called, surprised the dog hadn't stayed by his bed. She hated storms and stuck as close to him as possible whenever they occurred. If alone in the house, she'd head into the basement, and he'd find her there when he came home, huddled in the darkest nook she could find.

He pulled on his clothes and headed downstairs, his feet still bare. "Tocco, come here, girl."

Sleep had helped him. And having saved Jane Simmons. His stock had soared so much with the nurses for that one that maybe he'd have a chance to ride out Yablonsky's accusations. At least at St. Paul's.

His enemies on the Web were another matter.

His mood immediately darkened.

In that forum he'd be held guilty until he could prove himself innocent. Even then, he might never be good enough again for the kind of grant money he used to get. Awarded on merit, it could be denied on a whim. He'd have to convince everyone that crone Yablonsky had concocted the whole thing, tried to use him as a handy scapegoat to cover up her own incompetence. "Or worse," as Earl had put it.

"Tocco!" he called, entering the kitchen. His basement door yawned open as he usually left it, so she could have the run of the house. "Come on up, girl. Suppertime."

He expected to hear the click of her nails on the linoleum-covered steps and the jingle of her collar tags.

Nothing.

"Tocco?"

He flicked on the light switch near the cellar steps.

The darkness below remained.

Bulb must be burnt out, he thought.

"Come here, Tocco," he called out, and started down. The small basement windows, even with the gloom outside, would allow him enough light to see by. She must have really been scared by the thunder.

He reached the bottom of the stairs, certain she'd come out of hiding and greet him.

No dog.

What the hell? he thought, feeling his way through the semidarkness toward one of the spots she often curled up in.

A tiny rectangular window in his laundry room admitted a thin, almost yellow glow as the late afternoon sun penetrated layers of fog blanketing the city. In a far corner lay a shadow darker than the rest.

That's when he caught the first whiff of chloroform.

5:45 p.m.

The steady rumbling chased everyone else inside, but Earl stayed put. The luminous haze of the mist suggested the storm clouds were thinning out. Even if they didn't go for a brisk paddle as planned, it would be as good a place as any to talk with Jimmy alone. One thing was for certain: he wasn't about to let the priest cancel.

He stood on the worn wooden boardwalk of an area called the basin, a harbor where some of Buffalo's more affluent boaters moored their yachts. Less ostentatious sailors kept smaller craft on nearby racks. That's where Jimmy stored his sixteen-footer.

As he waited, Earl found himself carried back to a time in medical school when he and his roommate, Jack MacGregor, would seek relief from their studies by launching paper airplanes from the roof of their apartment building. They would craft various weird shapes and give them stabilizers and lift vents; though some nosedived to the street below, others would rise in the air, catch a breeze, and sail out of sight. The model that went the farthest and highest, no matter how wonky-looking, won.

Jack had always been the more daring of the two in this venture. "Your trouble, Garnet, is not allowing yourself to think outside the box," he'd accused more than once, and with reason. Medicine required pattern recognition, and that meant disciplining one's thoughts to symptoms and signs that were mired in evidence-based facts. The convention gave science its reliability but kept imaginations in check.

So Earl made himself remember those days with Jack whenever he faced a seemingly insolvable problem. Ideas, he'd realized, were often like those crazy paper planes. No matter how silly or bizarre they seemed at first, every now and then one would soar above all the others, usually to his complete surprise, and provide the answer that had eluded him.

The late Jack MacGregor- he'd died over five years ago saving Earl's life- must be proud of him now. Ever since his talk with Stewart's ex-wife and the bizarre confrontation with Michael, Earl's imagination had gone into overdrive with out-of-the-box ideas.

How could he help but look at Stewart's dilemma in a different light? If the man had had a hand in destroying another researcher's life, as odious as that might be, more and more his claim of being set up took on a different resonance.

Michael definitely required a new take, whatever he'd gotten himself into.

And since Jimmy had seen fit to label both of them "the good guys," maybe he could also explain what they were up to.

He glanced at his watch. The priest should have been here twenty minutes ago. He'd been dodging Earl the whole day, claiming to be busy. But Earl had finally cornered him with the suggestion they use Jimmy's daily hour of exercise as a chance to talk, something they'd often done in the past. Jimmy then proposed that they take out the canoe.

Just when Earl figured he'd been stood up, he heard footsteps approach, and a dark shape became visible in the yellow mist.

"We go out there with a storm threatenin'," said a lilting voice, "the good Lord is likely to zot us for our stupidity."

"We can just take a walk instead, Jimmy." No way you're evading me any longer, he added to himself.

"Only if we pick up the pace. After a day like mine, I need to run."

Earl groaned. He'd slipped into shorts, sneakers, and a T-shirt, anticipating a workout on the water, but jogging, especially in a city of smog, never held much appeal, let alone made sense. But what the hell. Once wouldn't kill him. "Lead the way."

They took off along a pedestrian path that curved through a grassy area surrounded by trees, but beyond that, the mist prevented Earl from seeing exactly where they were.

"So what did you want to talk about?" Jimmy asked, breathing as easily as if they were standing still.

Although Earl found the pace a bit more of an effort than Jimmy, biking, swimming, and racing around the yard with Brendan had kept him in reasonable shape. "I had an odd run-in with Michael this morning over a rather selective way he'd filled out Artie Baxter's insurance form. You remember the case?"

"I'll never forget it. What do you mean by 'selective'?"

"No mention of anything that might raise questions about the widow getting the check."

"I thought death from a heart attack would be a straightforward claim."

"Not when falling comatose from too much insulin might have been a factor."

The priest increased the pace. "What are you suggesting?"

"Artie may have deliberately taken too much."

"But you can't be sure."

"No."

"Then Michael did the right thing. Why give the insurance company an out not to pay?"

"I'd normally agree, Jimmy, except this time it seemed a bit too obvious."

"How?"

"A bunch of reasons. One, whenever you have any kind of physical stress- and from what Artie's wife said, he'd been suffering unstable angina for days- blood sugar usually rises in a diabetic. For Artie to make himself fall into a hypoglycemic coma, he would have had to do more than skip breakfast after his regular morning insulin. He would have had to have taken more than usual."

"But if his sugars were high, wouldn't an increase be called for?"

"Yeah, but experienced diabetics can tell when they're slipping into a coma. I just don't see Artie ignoring the symptoms of hypoglycemia."

"And you would have put that down on paper?"

The path tilted upward into an all-encompassing gloom, the momentary hint that the fog would disperse anytime soon vanishing like a false promise. "Probably not. But I wouldn't have gone so much out of my way to make it seem I'd never even thought of it. No physician worth his salt could look at Artie's file and claim that. Not that I would have spelled out my suspicions either, but there are ways to state them subtly. For instance, Michael could have noted that on questioning, the patient 'claimed' to have taken only the regular dose. Then it's the adjuster's problem to put two and two together, or not."

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