Robin Cook - Marker

As chief of the medical staff, Roger had unfettered access to the credentialing information and records of all physicians associated with the Manhattan General. Three of the five doctors on his list had disciplinary problems. Two of the doctors were euphemistically called "impaired" because of addiction problems to which Roger could surely relate. They were on probation, with some minor limitations in respect to their privileges, after having gone through drug rehab six months ago. The other individual, Dr. Pakt Tam, was involved in multiple malpractice suits that were still pending, all of which involved untimely deaths, although not the ones in Laurie's series. The hospital had tried to revoke his privileges, but he had sued, and his privileges were reinstated by court order pending the trial.

Dr. Tarn's case had stimulated Roger to look up all the doctors whose privileges had been either eliminated or curtailed over the previous six months, with the idea that they could be angry, vengeful, and deranged, or any combination. That inquiry had led to eight doctors. The problem was that he had no way of knowing if any of them had had an association with St. Francis. Quickly, he scribbled a note to himself to call and ask Rosalyn on Monday. He attached the note to the page with the eight doctors and put it off to the side.

The thought about an angry doctor had made Roger think about any disgruntled current or former employee of the hospital, particularly a nurse or someone else who had direct access to patients. If he was going to think about doctors, he had to think about everyone else in the hospital as well, so he'd made a note to talk to Bruce to get a list of employees terminated prior to the mid-November cutoff date, maybe even going back a year. He'd taped the note to the edge of his desk lamp so he'd be sure to see it. At that point, he had begun to get discouraged, but he had pressed on.

The next group Roger had considered was the anesthesiologists. As he had voiced to Laurie, and for the reasons Laurie had concisely specified, he felt their expertise made them prime suspects, and his intuition had paid off with a couple of interesting possibilities. Two had immediately jumped out at him. Both worked the night shift exclusively, and presumably by choice. One was Dr. José Cabreo, who had a history of impairment with OxyContin, as well as several malpractice suits. The other was Dr. Motilal Najah, a recent addition to the professional staff from St. Francis. Roger had printed out copies of both doctors' records and had drawn stars next to their names. Those papers were directly in front of him just off the central blotter. As far as he was concerned, they were his chief suspects, with Najah ahead of Cabreo. Although Najah's credentialing record was clean, the timing of his transfer was just too perfect.

The last group Roger had looked into was the rest of the hospital employees. Comparing the list of people leaving St. Francis after mid-November with the list of new employees at the Manhattan General during the same period, Roger had come up with a group of more than twenty people. At first, the number shocked him, but then, when he thought about it, it made a certain amount of sense. The Manhattan General was the flagship of the AmeriCare fleet, and if there was active recruiting going on, as Rosalyn suggested, it would be natural for most professionals and support personnel to prefer to be at the name institution.

Recognizing his limitations as an amateur sleuth, Roger had known immediately that twenty-three suspects were too many for him to consider. To narrow the group, he had used Laurie's suggestion of considering only those people who worked the night shift at St. Francis and moved to the night shift at Manhattan General. With such narrow parameters, he had no idea if he'd get any hits, but to his surprise, he did. He had gotten seven. The names were Herman Epstein from pharmacy, David Jefferson from security, Jasmine Rakoczi from nursing, Kathleen Chaudhry and Joe Linton from the laboratory, Brenda Ho from housekeeping, and Warren Williams from maintenance.

Roger picked up the sheet containing these seven names. Although it was more people than he had expected, he thought he could deal with seven. As he read over them again, he couldn't help but notice how much the surnames reflected the ethnic heterogeneity of American culture. He felt he could guess the general ancestral origins of all except Rakoczi, although if pressed, he'd say Eastern European. He looked at the various departments involved and realized that all of them would have access to patients in some form or fashion, particularly during the night shift, when oversight was at a minimum. Vaguely, he wondered if he should try to talk Rosalyn into getting him their St. Francis records. Now that he had the beginning of a personal relationship with her, perhaps he would be able to get the information without her sending up a red flag, but there were no guarantees. Yet how else was he to proceed?

Putting the paper down next to the list of anesthesiologists, Roger looked at his watch. It was now a quarter after two in the morning. He shook his head. He couldn't remember the last time he had stayed up so late working. He guessed it had been back in his medical residency. It was a bit depressing, thinking of most of the rest of the city sleeping, but at least he wasn't tired. The bolus of caffeine he'd gotten down in the coffee shop was still coursing around in his bloodstream, making him feel antsy. He even noticed that he'd been unconsciously tapping his right foot. He wished it were about ten P.M. instead of two A.M., because now that he had all these potential suspects, he would love to call Laurie and maybe even suggest that he pop over to her apartment. Unfortunately, that was out of the question. As upset as she was about her BRCA1 situation, he was surely not going to wake her up.

Thinking about the hour made Roger realize that for the first time since he'd been employed at Manhattan General, he was actually in the hospital during the night shift when all the questionable deaths that he and Laurie were interested in had occurred. With the caffeine on board, sleep was out of the question, and as long as he was in the sleuthing mood, he might as well check out the surgical floor where more than half of the questionable deaths had occurred and, while he was at it, at least some of his so-called suspects. With that idea in mind, he picked up the records of the two anesthesiologists and the sheet with the seven individuals who'd transferred from the night shift at St. Francis to the night shift at the General. He looked over them again, committing the names to memory.

Roger was about to get up when another thought occurred to him. Given how wired he was, he knew he'd be up most of the night. Since he'd need some sleep, he'd likely not be back to the office until late morning. With that in mind, Roger dialed Laurie's extension at work.

"It's me, Roger," he said to Laurie's voicemail. "It's after two in the morning, but your suggestion about Saint Francis was on target. It's produced a lot of potential suspects, certainly more than I expected, so I have to give you credit. I'm looking forward to sharing it all with you, and maybe we could get together tomorrow night for dinner. At the moment, I'm heading upstairs to do a bit more detective work, like check out the surgical floor and meet some of the people on my lists while they are on duty. As a teaser, let me tell you about one of the night-shift anesthesiologists, Motilal Najah. I interviewed him when he applied for a staff position. Anyway, I had forgotten that he had come from Saint Francis right after the holidays. Is that a coincidence or what? And he's just the tip of the iceberg. Anyway, I'm going to be here another few hours, so I might not be back here in my office until possibly noon or early afternoon. I'll call you as soon as I get in. Ciao!"