“Okay.”
“Hang on a sec.” Laurie walked around to the front of her desk, bent over her computer keyboard, and hit a few keys. In the next moment, her cell phone signaled an alert, as part of the two-step security system that HGH maintained for access to its electronic medical records system. She slid the phone from her pocket and typed in the security code that appeared on the text. Only then would she be permitted access to the record, then she’d also have to type in her own personal identity code, was which was also confidential. “Okay, here’s his grandmother’s file, with my notes from him that night, which came from my conversation with Max.”
“Great.” Eric started to rise to come around the desk, but Laurie held him off with a stagey wink.
“I’m sure you’re not allowed to look at this since you’re on suspended status. So, don’t you dare look at this file. Oops, I think I hear someone paging me, so I’m going to leave.” Laurie straightened up and walked out of the office without another word, closing the door behind her.
Eric rose, intrigued, and went around the desk.
Chapter Fifty-five
Eric scrolled through the first page of Virginia Teichner’s electronic medical records, or EMR, skimming the logged entries of her vital signs on the night of her treatment in the emergency room and scanning the ghostly gray images of her chest X-ray, which showed the amorphous whitish tumor that interfered with her breathing and swallowing. He could see the telltale crosshairs where the X-ray technician had dutifully measured the mass, but you didn’t have to be an oncologist to know that it would kill Mrs. Teichner sooner rather than later.
Eric felt a stab of pain, remembering how lively Virginia had been that night, and how funny, but he had to put that memory behind him for now. He scrolled to the back of the file, where Laurie had typed in her notes, and began reading, picking up the parts about Max: “… grandson vocal on subject of his mother … expresses anger at mother and her neglect of grandmother … grandson resents that mother has ‘milked grandmother for all she is worth and then some’ … grandson seems v. depressed and angry about grandmother’s imminent death … says he ‘can’t stand idea of living with his mother’ and he ‘would be better off if the mother were dead’ … grandson says that mother is ‘useless whore’ … and ‘deserves to die’.….. he ‘hopes that one of her loser boyfriends kills her in her sleep.’ … call Eric for psychiatric consult…”
Eric considered it, though he wasn’t really surprised. Max had expressed anger at his mother in their sessions, and Eric could see with his own eyes that Marie was an irresponsible mother. The hostility was more than Eric might have expected, considering it was expressed to a stranger like Laurie, but that could be explained by the fact that Max was so upset that night, with his grandmother choking at the house, then having to bring her to the emergency room. It wasn’t really a fair picture of Max, Eric thought, then he paused, wondering if he really was making excuses for the boy.
Eric scrolled to the next page to see if there were any more notes, but there weren’t, though he hadn’t reached the end of the Virginia Teichner file. The next page of the EMR was the first page of a previous admission of hers, and he checked the date of the admission. Evidently, two months prior to her admission to the emergency department, Virginia had been admitted to the third floor, which was cardiology, and had stayed there for three days, for observation and treatment of breathing difficulties and chest pain.
Eric remembered that Laurie had mentioned the previous admission that night in the ED, but he must have forgotten. He hadn’t really focused on it before, because it didn’t matter, and it made sense that Virginia, who had such an advanced cancer by the time he met her, would have been admitted to HGH before. Eric checked the top of the page to see which physician had been assigned to her case: Dr. Morris Brexler, Cardiology Chief.
Eric frowned. It was odd that Morris hadn’t mentioned that he’d treated Max’s grandmother. He had just run into Morris downstairs, and they’d discussed the scene at the mall last night, so it would’ve been a natural thing to mention. It didn’t make sense that Morris was omitting it, for some reason. It seemed remotely possible that Morris hadn’t made the connection between Max and his grandmother, but that was unlikely, given that Max had probably been the one to bring Virginia to the hospital in the first place and had undoubtedly visited her, if he even left her side at all.
Eric looked at the upper right side of the page, where the treatment team for each patient was always listed. The treating physician was Morris Brexler, the resident Sara Stone, the assigned nurse Caleb Martieki, and the social worker Martha Girandole. Next to each of the names was the general phone number for the cardiology department. Under HGH procedure, the personal cell numbers of hospital staff were kept confidential, to avoid patients’ calling them at all hours.
Eric scanned the report of Virginia’s vitals and her bloodwork, idly noting the levels, then looked at her MRIs and X-rays of her chest and throat, in which the mass was barely visible, so it must have been a fast-growing tumor. He kept going through the file to see if Morris or anyone else had made any notes regarding Max, but he reached the last page, under Physician’s Notes. There was one relevant note on the first day of Virginia’s admission, on which Morris had noted: “patient accompanied by grandson, no other visitors … grandson is primary caretaker and familiar with medication and eating habits of patient.” On day two of Virginia’s hospital stay, after notes about her breathing issues, Morris noted that, “Patient very worried about mental state of grandson, given her diagnosis.” On day three, Morris made a similar note, “Patient wants referral psychiatrist for grandson w depression, grief counseling.”
Eric flashed on Virginia in the emergency department, how she had collared him and made him pay attention to Max’s problem. Evidently, Virginia had been as insistent with Morris, but Morris hadn’t tried to help her or Max. Eric was beginning to get a bad feeling. He knew Morris was busy, but no busier than any other chief, and Morris should have called him in on a consult, the way Laurie had that night in the ED. Eric wondered if Morris didn’t refer the matter to psychiatry because of their bad blood on the Pharmacy Review Board. Eric wouldn’t have ordinarily entertained that conclusion, but it did seem strange that Morris hadn’t mentioned any of it to him in the breezeway.
“Hey,” Laurie said, entering the office, then closing the door behind her. “Well?”
Eric changed mental gears. “I read it, and I admit it sounds hostile, but it really doesn’t change anything for me.”
“He called his mother a whore.” Laurie frowned and folded her arms, standing on the other side of the desk. “Doesn’t that seem beyond the pale?”
“It’s inappropriate, but I wouldn’t extrapolate too much from it.”
“Why not? Like I said, I know I’m no psychiatrist, but do you know what my mother always told me?”
“What?”
“Men who hate their mothers hate women.”
“That’s not bad,” Eric had to admit.
“Tell me about it. My mom is always right. Just ask her.”
Eric didn’t interrupt her, because he could see she was on a roll, her dark eyes growing animated.
“So it would make a lot of sense to me that Max hated women. His mother is so obviously irresponsible. Marie’s a drunk. Zack is actually too good for her. A kid like Max, who has such anger toward his mother, could easily lose his temper on Renée and kill her, even impulsively.”
“It’s possible, but not likely—”
“Really? Plus I was thinking about what you said, that Renée had a boyfriend and this dog-walking routine. If she was meeting the boyfriend in the morning, then Max could’ve easily known about that routine, too. He could’ve known she had a boyfriend. What if she mentioned that to Max during one of her tutoring sessions?”
Eric didn’t confirm that it was true, and that was how he himself knew about Renée’s having a boyfriend in the first place.
“And if t
hat’s so, then maybe Max got jealous that she was rejecting him. Maybe Max knew she was meeting her boyfriend in the park, and so he went to the park that morning and killed her. It’s completely possible, and it even fits with his profile. I know you don’t see him that way, but I don’t think you’re seeing him objectively anymore.”
“I hear you, but I think I am.”
“So you’re unconvinced?”
“I think so.”
“Whatever, then close down the file.” Laurie came around the desk, leaned over, and reached for the mouse, but her swipe called to the screen the log-in sheet, which showed a record of the times the EMR file had been accessed online, by anyone in the hospital. “Oops, sorry.”
“Wait, don’t close it yet.” Eric glanced at the list, then did a double-take. The EMR had been accessed a slew of times during Virginia’s three-day hospital stay, which was to be expected, but it had also been accessed in the two months since then—twice. “That’s funny.”
“What?” Laurie looked at the screen, the white light of the monitor showing the contours of her fleshy cheeks.
“Why was somebody accessing the file after the patient’s been discharged?”
“I don’t know.” Laurie frowned at the screen. “Any test results or bloodwork that comes after discharge are imported into the file automatically. They don’t show as accessing the file under the EMR system, do they?”
“No. The only people who would have any reason to access the file after discharge are the treating physician and his team.”
“That’s what I was thinking.”
“Maybe if somebody has a question or wants to jog his memory for some reason. I’ve done that once, my entire career.”
Laurie snorted. “I’ve never done it. Who has time? In the ED, if I start looking at files, somebody bleeds out. My practice is strictly plug-and-play.”
“There’s another reason I can think of for accessing the file—to alter it in some way.”
“Whoa, why?”
“And who? I don’t know if they added something or deleted something, but I’m going to find out.” Eric scanned the access entries, and next to each one was a line of twelve asterisks, the encoded identities of whoever had accessed the file. Every physician, nurse, intern, and even orderlies at HGH were assigned an identity code, and the codes appeared as asterisks for security reasons, so that nobody could learn the code of another employee and use it to fraudulently access the EMR system under his name. Eric looked up at Laurie. “Would you be surprised if I told you that Morris Brexler was the treating physician?”
“Morris of Myrtle Beach?”
“Yes.” Eric had confided in her his suspicion about Morris’s taking kickbacks on the Pharmacy Review Board. “Morris treated Virginia Teichner on her previous visit. He even met Max. And he never mentioned it to me, even though I just saw him on the way up.”
“What?” Laurie’s eyebrows lifted in surprise, and Eric returned his attention to the list of access codes, a block set of asterisks, like the stars on the American flag.
“This is fishy.”
“Maybe it’s a mistake?” Laurie shook her head, nonplussed.
“I’m going to find out.” Eric rose.
“What are you going to do? You’re not allowed to be on the premises, officially.”
Eric crossed to the door. “Then I’ll be on the premises, unofficially.”
Chapter Fifty-six
Eric took the stairs two steps at a time. He’d have to hurry if he wanted to catch the guys in the IT department before they went home. He raced downstairs, blew through the exit doors, then jogged down the hall. Luckily, the IT department was in the basement, consigned to an out-of-the-way location near the morgue, and only a janitor was coming toward him in the other direction, pushing an industrial-size floor polisher.
“Hello,” the janitor said, nodding as Eric hustled past.
“Hi.” Eric spotted the sign for the IT department and opened the plain gray door, but it was locked. “Anybody home? Can you give me a hand?”
“Hold on,” said a voice from inside, and in the next moment, the door was opened by a young girl with supershort purple hair, black-framed glasses, and a slouchy summer dress. She appeared to be on her way out, a red knapsack over one arm and white earphones plugged into both ears, from a wire that went into her dress pocket. “We’re closed for the day,” she said, wearily.
“I work in accounting,” Eric said, since she appeared not to recognize him. He had never seen her before, but her employee ID lanyard was around her neck, with the name Julia Meehan. “I’m wondering if you could help me with something, Julia.”
“Not now, I gotta make my train.”
“Please, it’s really important and I have to get it done by tonight, but I forgot about it. It won’t take that long.” Eric pressed his way into the office, and Julia stepped backwards with a heavy sigh, setting her backpack on the floor and unplugging one of her earbuds.
“Okay, whatever.”
“Thanks, I really appreciate it. We had a patient, Virginia Teichner, who was admitted a few months ago for heart issues. She was discharged after a few days, but recently passed away.”
“That’s sad.”
“Yes, it is. Her file was accessed twice after her discharge. It’s kind of unusual, and we’re worried it might be a mistake. As you know, the log-in sheet in the file shows the codes for the IDs but not the names of the employees. We need to know their names so we can follow up, then make sure their time and treatment gets properly billed.”
Julia nodded. “Okay, no problem. Obviously, I can’t tell you which employee has which encoded identity, but I can give you the names of the employees who accessed the file after discharge.”
“That would be great.”
“I’ll take a minute to get that, but it’s easy. What’s the patient’s name again?” Julia went to the middle cubicle against the wall, which was decorated with My Little Pony posters, presumably ironically.
“Virginia Teichner,” Eric answered, spelling the last name.
“This will just be a minute.” Julia woke up her computer, and the monitor came to life with a My Little Pony screensaver, a speckled white pony with a flowing purple mane. She typed in her password, which showed as a line of ten asterisks, then started typing so quickly that it sounded like raindrops on a rooftop. “Please, don’t look at my screen.”
“Sorry, I’m just in a hurry.” Eric turned away.
Suddenly the typing stopped. The room went completely quiet.
“Did you find it?” Eric asked, turning around.
“Who are you?” Julia’s eyes had gone round with fear.
“What’s the matter?”
“There’s an alert with your photo in my email. I’m calling security.”
“No, please,” Eric said, but Julia was already reaching in her pocket for her cell phone.
He turned around, tore open the door, and bolted out.
Chapter Fifty-seven
Eric hurried down the hallway, his thoughts racing. If he couldn’t find out from IT who had accessed the file, then the second best thing was to go to Cardiology and try to find out what had happened during Virginia’s admission. The last admission wasn’t that long ago, so somebody had to remember Virginia and Max, especially given what Max had done at the mall last night. He jogged past the framed landscapes.
He was about to take the stairwell but kept going, bypassing it. Fewer people worked on the basement level and he could run into the new wing of the hospital, which housed the Cardiology Department, and take the stairs from there. The security office was in the older wing, only one floor up, and the security guards would already be on their way down to IT, so he was running away from them. He ran down one hallway, then the next, passing rooms that contained the storage and the hospital’s computer servers. He’d never been on this floor before.
The carpeting ended in glistening tile, and he knew he was headed toward the morgue. He kept go
ing, spotting its stainless-steel double doors on his right. One was opening, and a morgue employee in blue scrubs emerged. Eric caught a whiff of the distinctive formaldehyde odor, then took a left turn down the hall and passed the pathology lab. A young lab technician came walking in the opposite direction, reading on his smartphone, but Eric kept his head down, jogged lightly by him, and reached the stairwell, where he went through the door.
He raced up the stairs, passing the first floor, then the second, nervous as he approached the doorway for the third. He anticipated being recognized in Cardiology because he’d been there for consults many times, since depression and anxiety were prevalent in heart patients. He didn’t know how he’d deal with it, he’d have to play it by ear.
He reached the third-floor landing, opened the door, and took a left. He strode down the glistening hallway, trying to act as normal as possible as he passed into Cardiology. The hallway was empty except for a tall rolling food cart; the dinner service had begun. The nurses’ station was on the left, with two nurses on computers behind the counter, and he recognized one of them, a slim, young African-American woman, Patty Allen. Patty had a lovely face, with a slight up-tilt to her eyes, and she wore her hair smoothed into a thick braid.
“Hi, Patty,” Eric said, arranging his face into a professional mask as he walked to the counter.
“Dr. Parrish?” Patty looked up from her computer, and her broad smile showed that she hadn’t seen the security alert yet. “Oh my goodness, that was incredible, what you did last night at the mall. I was so worried about you! How did that happen? Was that boy a patient of yours?”
“Actually, that’s what I came to see you about.” Eric slid his phone from his pocket, mindful that the other nurse, whom he hadn’t met, was eyeing him warily. “His name is Max Jakubowski, and his grandmother, Virginia Teichner, was admitted here for three days, about two months ago. She had congestive heart failure, and he came with her. That’s according to Dr. Brexler’s notes in the file, and it makes sense to me. Max was her caretaker until she passed away last week.”