“Certainly,” Virginia said without the slightest hesitation.
Encouraged by the woman’s response, he asked if she could also include the folder labeled hospital mortality articles of interest, and she agreed again without pause. Disconnecting, he felt pleased. He’d decided that getting an idea of Sue’s mindset might be helpful although he didn’t know exactly why.
Having made the call to Virginia and being reminded of the conversation that he’d had with her in Sue’s office, Jack turned on his monitor and googled death ratio. It was a term that had come up when Virginia mentioned Sue’s abiding interest in joining the hospital’s Mortality and Morbidity Task Force. He didn’t find much. Mostly the search turned up articles about mortality rate, a more general term. But then he came across a specific article about death ratio that had been put out by the Mayo Clinic.
Quickly scanning the piece, Jack learned that death ratio referred to a ratio of the number of hospital deaths divided by the expected number of hospital deaths. A value of one meant the hospital was doing as expected. A value of greater than one meant the hospital was not doing so well, and a value of less than one meant it was doing better than expected. When he finished reading, he noticed that there had been no explanation of how the denominator, the expected number of deaths, was determined, although he assumed it had something to do with the expected mortality of each individual illness.
The harsh jangle of Jack’s office phone interrupted him. It was Vinnie calling back. Jack told him to go ahead and make the arrangements for Sue Passero’s body to be released.
“Will do, Señor Commandant,” Vinnie teased. “But, let me ask you, are you sick?”
“I’m not sick,” he said. “Why do you ask?”
“Hey, it’s three o’clock, and you haven’t bugged me, texted me, or nothing for hours.” Vinnie laughed. “I thought for sure you had to be on death’s door.”
“Consider yourself lucky,” Jack said, and hung up the phone.
With Vinnie reminding him how late it was, Jack suddenly had an idea. Since he was still suffering from not knowing what he didn’t know, despite his visit to the MMH, and since he knew that the evening MLIs arrived at three, he thought it was an opportune time to chat with Kevin Strauss. Although he’d read Strauss’s excellent workup on Sue several times, he still thought it might be of interest to talk with the man directly on the outside chance there was something he’d not included, perhaps thinking it was not relevant. With that in mind, Jack snatched up the office phone once again and punched in the MLI office main number.
Chapter 14
Tuesday, December 7, 3:25 p.m.
Just like he had that morning, Jack entered the OCME high-rise through the back receiving bay. Arriving from the rear, he had to pass the double doors of the auditorium to get to the bank of elevators. Believing Laurie was probably in the middle of her presentation to the incoming mayor, he was tempted to poke his head in to get a sense of how it was going, but he resisted. He didn’t have time. He’d connected with Kevin Strauss by phone, and Kevin had told him if he wanted to speak with him in person as Jack had asked, he had to hurry. Kevin told him he already had a full plate of investigations on his schedule thanks to an abnormally large number of death calls just prior to his arrival.
On the fifth floor, Jack passed through the bank of floor-to-ceiling glass that separated the Medical Legal Investigation Department from the hallway. It was a large room segmented into cubicles with chest-high dividers and the building’s structural columns visible. The number of medical legal investigators at the NYC OCME was just about the same as the number of medical examiners, around forty, although their number varied as the turnover rate was higher.
Although he was a relatively frequent visitor to the Medical Legal Investigation Department, he’d never personally met Kevin Strauss, and he had to ask the location of his cubicle. As Jack wound his way into the room, he saw that most of the evening shift’s newly arrived MLIs were on their respective phones. The department was a busy place that served as the gatekeeper for the OCME. Of the seventy to eighty thousand deaths that occurred in New York City every year, about a third of them had to be reported to the OCME because of specific and well-publicized criteria, and every one of those needed to be checked out by one of the MLIs by telephone. Not all of those had to be fully investigated, meaning a site visit, and an even fewer number would be sent in and possibly autopsied, so the MLIs served an important and vital function, which was why they had to be highly trained.
“Kevin Strauss?” Jack questioned as he walked into the cubicle where he’d been directed. A man was sitting at the built-in desk with a sizable list called telephone notice of death on his monitor. When Jack first started at the OCME, these had been done on multi-sheet carbon-paper forms. Now it was all computerized. Down the hall in a much smaller room the communication clerks manned the phones 24/7, taking the “death calls” and entering the information along with a case number directly into the OCME’s database. Those cases were then distributed among the MLIs.
“Dr. Stapleton?” the man questioned as he got to his feet and fumbled with a mask, trying to get the elastic straps around each ear. Jack guessed he was in his late thirties. He was boyish-appearing with a broad face and pug nose, pale of complexion with medium blond, longish hair.
“Thanks for waiting for me,” Jack said. He took the chair Kevin pushed in his direction while Kevin sat back down in his. “I know you’re busy, so I won’t take much of your time.”
“No problem,” Kevin said. He swept wayward strands of hair off his face with his hand. “What’s up?”
“I autopsied Susan Passero this morning,” Jack began. “It was surprisingly clean. No gross evidence of pathology, more specifically no sign of coronary artery disease.”
“That’s surprising.”
“My thoughts as well,” Jack said. “Before I go on, I’d like first to commend you on the workup you did. I was impressed that you’d gotten access to the patient’s digital health record. Your write-up was first rate.”
“It was an easy site investigation,” Kevin said. “I wish they were all like that.”
“Here’s the problem,” Jack said. “Unless Histology comes back with a big surprise, which I sincerely doubt, I’m going to be at a complete loss, which is a problem because I’m under some pressure to come up with the death certificate sooner rather than later. There’s also the rare possibility of an inheritable cardiac conduction problem, which the DNA people are looking into.
“What I wanted to ask you is if there was any other fact, or even an opinion you might have heard or just randomly thought about, that you didn’t put in your report. I know I’m grasping at straws here, but it seems I’m reduced to it. Is there anything that comes to mind... anything at all?”
Kevin snapped his head back, trying to get his hair out of his eyes, but it didn’t work, and he was reduced to using his hand once again. He stared at Jack for several beats with glazed eyes. It was obvious to Jack that he was searching his memory banks. Unfortunately, the short pause was terminated by a negative shake of his head, and he said, “I’m sorry, but nothing comes to mind.”
“Did you get a chance to talk directly with the doctor who ran the resuscitation attempt?” Jack asked. He wasn’t going to name Dr. Carol Sidoti because he didn’t want to admit to Kevin that he’d gone to the MMH. He had several reasons. The first was that it might have offended Kevin by his taking it as a negative reflection on the job he’d done. The MLIs knew the MEs were not supposed to do scene visits. Second, it would have raised some eyebrows, being out of the ordinary, and possibly become part of the OCME gossip mill. If that happened, there was a reasonable chance it would get back to Laurie and cause some personal fireworks.