Lisa Gardner - Alone

Have a seat," the pediatrician said at last. He gestured to a file-covered chair, then belatedly grabbed the stack of papers.

"How can I help you?"

"I understand you're in charge of Nathan Gagnon's care," Bobby said.

"For the past year, yes. Nathan was referred to me by another Pediatrician, Dr. Wagner, when she failed to make progress on his care."

"Nathan has an illness?"

"Officially, he's listed as FTT."

FTT?" Bobby asked. He took out a small spiral notebook and a pen. "Failure to thrive. Basically, from birth, Nathan's been behind the curve in size, weight, and key developmental benchmarks. He's not developing in a 'normal' manner."

Bobby frowned, not sure he was getting it.

"The boy's too small?"

"Well, that's one element. Nathan's height of thirty-four inches puts him in the lowest one percent for a four-year-old boy, and his weight-twenty-six pounds-doesn't make the curve at all. His condition, however, has to do with more than just size."

"Explain."

"From birth, Nathan has struggled with vomiting, diarrhea, and spiking fevers. He seems constantly malnourished-he's had rickets, his blood phosphate levels are too low, same with blood glucose levels. As I said before, he's lagged behind almost all traditional benchmarks for development-he didn't sit up until he was eleven months old, he didn't cut teeth until he was eighteen months old, and didn't walk until he was twenty-six months old. None of that is considered good. And then, in the past year, his condition appears to have worsened. He's had several attacks of acute pancreatitis as well as two bone fractures. He's failed to thrive."

Bobby flipped a page in his notebook.

"Let's talk about the bone fractures. Isn't it unusual for a four-year-old to have two broken bones in one year?"

"Not for a patient such as Nathan."

"What do you mean?"

"Nathan suffers from hypophosphatemia-low phosphate. Combined with the rickets, his bones are unusually brittle and prone to fracture. For the record, he also bruises quite easily."

Bobby looked up sharply.

"Why do you say that?"

"That's why you're here, isn't it? To find out if Nathan was being abused. To prove to yourself you killed the right man." Dr. Rocco added quietly, "For the record, I think you aimed just fine."

Bobby scowled. He hadn't expected this turn in the conversation, to be called head-on. He felt overexposed and it pissed him off.

"Do you think Nathan was being abused?" Bobby asked tightly-"There are a lot of ways to harm a child," Dr. Rocco replied.

"Did someone break Nathan's bones?"

"No. Rickets broke Nathan Gagnon's bones. I can tell from the Xrays."

Bobby sat back. Dr. Rocco's assessment didn't please him. In fact, it left him more confused than ever.

"So what's wrong with this kid? Why does he have all these problems?"

"I don't know."

"You don't know?"

"That's essentially what a diagnosis of FTT tells you-we don't know. We can't pinpoint an exact cause, so the boy remains under the catchall umbrella of failure to thrive." "Well, Doc, you must have explored some options?"

"Sure. We conducted initial tests-complete blood count, lead levels, urinalysis, and a set of electrolyte values. We've tested him for diabetes, reflux, malabsorption, and cystic fibrosis. One of the best endocrinologists in the country has examined Nathan for thyroid diseases, metabolic disorders, and hormonal imbalances. Then a nephrologist studied Nathan's kidneys and did more tests related to electrolytes, diabetes, and anemia. I've tested Nathan, I've studied Nathan, and I've sent him to the best experts I know. And I still don't have a diagnosis for him. Medically speaking, there's nothing majorly wrong with Nathan Gagnon, except for the fact that he's very, very sick."

Bobby was starting to hate this conversation. He twirled his pen between his fingers, then put it down and picked it up again.

"You didn't like Jimmy Gagnon," he said bluntly.

"Never met the man."

"Never?"

"Never. Nathan's been in my office two or three times a month. For that matter, he's been rushed to the emergency room four times in the past six months. And not once have I ever met Jimmy Gagnon. That tells you something right there."

Bobby regarded the doctor's country-club looks.

"So when did you start sleeping with Catherine?"

The man didn't bother to appear shocked.

"She deserved better than him," he answered evenly.

"A neglected wife?" "Worse." The doctor leaned forward, his face growing intent.

"You're not asking the right questions yet. Maybe Nathan had a medical reason to bruise easily, but Catherine didn't."

"Jimmy beat her?"

"I saw the bruises myself."

"Black eyes?"

"Give the guy some credit. He never hit her where just anyone could see. I used to go to school with guys like Jimmy. They figured if they beat their girlfriends in private, it gave them some class."

"You could've reported it."

"Really? So some cop could look at me the way you're looking at me right now? I didn't even need to be sleeping with her. As long as I simply wanted to be sleeping with her, none of you uniforms would've taken me seriously."

"Ever consider dealing with Jimmy yourself?"

"I thought about it."

"And?"

"I went to the house once. When I knew Catherine and Nathan were away. I knocked on the door, but no one was home."

"And you never returned? Man's beating the woman you love, so you show up at an empty house and that's action enough?" Bobby's voice was cold.

"What would you have me do?" Dr. Rocco said tightly.

"Threaten him with a gun?"

The barb was meant to hurt. Bobby merely shrugged and told the man honestly, "That's what I would've done."

Dr. Rocco finally flushed. He leaned away from Bobby, crossing his arms in front of his chest and staring at a spot on his desk.

"I told her to leave him," he said at last.

"You'd take care of her?" Bobby glanced meaningfully at the doctor's left hand where he was wearing a gold band.

Again, the good doctor refused to be cowed.

"I would've been honored."

"But she didn't do it. She stayed."

"She said I didn't know what I was saying. She said if she ever left Jimmy, he'd destroy her life and anyone else who tried to help her. She said my career would go down in flames."

"Did you believe her?"

"Yes. I don't know. I'd never met Jimmy Gagnon, remember? I'd just heard the stories. But then, six months ago, Jimmy found out about our… relationship. I had written some letters. I guess Catherine hadn't the heart to destroy them. Things were rough for her. The notes, I wrote them to give her hope."

Bobby waited.

"Next day, a private investigator was in my office, asking all sorts of questions about Nathan. He had a signed affidavit from Jimmy demanding release of his son's medical records. Within ten minutes, the investigator's strategy was clear. He wanted to know if Nathan's condition could be the result of prolonged starvation or some other form of parental abuse. Basically, he suggested that Nathan's illness had been caused by Catherine-that she was starving her son to death."

"Is that possible?"

"I don't believe so."

"You don't believe so?" Bobby arched both brows.

"You just told me the kid has some kind of hard-to-diagnose disease. Now you're saying she could've done it?"

"Look, without having pinpointed a specific cause for Nathan's condition, medically speaking I can't rule anything out. Sure, one or more of his parents could be physically starving him. Or someone could be tampering with his food, or someone could be mentally manipulating him not to eat. As a doctor, I've followed up with Catherine, Nathan, and the various nannies about his eating habits. We gotten answers assuring me that the boy is receiving plenty of food and plenty of the right kind of food. But at the end of the day, I'm still just the doctor. I go home to my family, and Nathan goes home to his."