“You’re welcome,” he said, not knowing what else to say. He tried to block memories of his own struggles back when his family perished. It had been the most difficult time of his life.
“The kids, my parents, Sue’s sister, and I are here as a family celebration of Sue’s life.”
“That’s terrific,” Jack said. “Being with family is important after such tragedy. Listen, I won’t take much of your time, but, if you don’t mind, I’d like to ask you if Sue had been talking at all with you recently about everything that was going on at the hospital with her committee responsibilities and such.”
“She didn’t like to talk about hospital affairs or any of her patients,” Abby said. “At the same time, I know she was frustrated of late about getting another committee assignment, but I don’t know the details. Nor did I want to know, because I knew she really wouldn’t want to explain it fully.”
“I remember her saying she didn’t like to bring hospital business home,” Jack said, “so I’m not surprised. But there is one specific issue I’d like to ask you about, but please keep it just between you and me.”
“Of course,” Abby said. “What’s on your mind?”
“Had she said anything to you at all about being convinced that someone at the MMH was hurting patients rather than taking care of them?” He had to smile at his own attempts at evasive language, avoiding the inflammatory term medical serial killer.
“Heavens, no,” Abby said. “What makes you ask that?”
“It would take too long to explain,” Jack said. “I’ll let you get back to your family.”
“What about the death certificate?” Abby said. “I spoke to the insurance agent, and she said the sooner they got that documentation, the sooner they can fulfill the terms of the policy.”
“I’m working on it, for sure,” Jack said. “We have to wait for a couple of tests to come back.”
“Okay, I understand,” Abby said. “My best to Laurie.”
After saying goodbye, he slowly put down his phone. Having learned nothing from Abby, he was becoming even more curious as to what Cherine Gardener was going to tell him tomorrow, especially after hearing from Ronnie that the hospital’s death ratio had been trending downward and not upward. What kind of statistics would point to a serial killer if the mortality ratio was going down? It didn’t seem to make much sense.
With the computer ready, Jack googled medical serial killers, and as he expected he got more than twelve million results in a third of a second. He picked a number with headlines he recognized from Sue’s collection and quickly read them. In one of the first, he found a quote that spurred his imagination — “Although rare, they are more common than most of us imagine” — followed by the recent assertion that on average thirty-five medical murders happen every year in the United States alone. On Wikipedia, he found a lengthy list of medical serial killers and the number of deaths they had been convicted of causing, although almost all of them admitted to far more. Reading on, he found a number of articles about the motivations and psychology of the killers. All in all, it was disturbing reading, even for someone accustomed to death like Jack was.
In the background, Jack heard Laurie’s cheerful voice calling out a hello to everyone as she came up the open stairs to the fifth level. He was tempted to turn off the computer and go out into the kitchen to welcome her, but at that exact moment he’d stumbled across an interesting article associating some medical serial killers with a condition known as Munchausen by proxy, where individuals, in this case medical personnel, derived some gain from causing illness in others. As he read on he learned that the gain could be direct, by making the diagnosis and providing the cure, which resulted in acclaim from colleagues, or less direct, by causing the death of the individual and thereby supposedly saving them from the misery of going through a protracted dying process if they were considered terminally ill.
He shook his head in dismay, recognizing that the old adage it takes all kinds to make a world was certainly a truism. Yet it was difficult to believe people could be so screwed up. He couldn’t help feeling this way, despite having studied a bit of psychiatry in medical school, which had exposed him to the entire spectrum of human mental disorders.
“There you are,” Laurie said brightly, bursting into the room. “Why aren’t you out there joining in? Come on, this is family time!” She came over to Jack and gave him a forceful hug and then playfully messed his hair to indicate she was not really finding fault with him being in the study. She seemed in a particularly good mood.
“You seem happy,” he remarked as he patted his hair back into a semblance of normal.
“I am,” Laurie said. “I feel like the presentation George and I gave to the mayor-elect went superbly. It was obvious from his questions that he was duly impressed with what we have been able to accomplish, and he’s certainly not in the mood to curb our budget. I’m convinced his background in law enforcement is what saved the day, and I’m optimistic he’s going to support the new morgue building lock, stock, and barrel. Now it’s just the city council I have to convince to come up with the funding, not that that is going to be a walk in the park.”
“Bravo,” Jack said.
“My word,” she said, leaning over to look more closely at Jack’s laptop screen. “What on earth are you reading about? Medical serial killers and Munchausen by proxy?”
“It’s been an interesting day for me, too,” he said. “Maybe not as successful as yours. I’ve been on the phone a bit.” Jack was not one to lie, but he thought that being cagey was not a sin. He wasn’t about to admit to having been over at the MMH twice that day for fear of changing Laurie’s mood, yet he was eager to share what he’d learned and get her take. He was nostalgic about how they used to bounce ideas off each other before she had ascended to being the chief. Back then, she’d been as eager as he to go out into the field on difficult cases.
“What have you learned about medical serial killers and Munchausen by proxy?” Laurie asked. She folded her arms and leaned her backside against the desk, staring down at Jack. She was clearly intrigued.
“Some medical serial killers are thought to suffer from Munchausen by proxy,” he said.
“Okay,” she said. “I suppose that makes sense. But what made you motivated to read such an article?”
“I learned something particularly surprising today,” Jack said. “Apparently Sue had recently become worried that there was an active medical serial killer at the MMH, particularly over the previous year.”
“Good gravy! Really?” Laurie questioned. “How did you learn this? From Abby?”
“No, from an orthopedic charge nurse Sue was friends with. They both served on the Mortality and Morbidity Committee and took their positions seriously, becoming more or less comrades in arms. So much so that it created, should we say, ill feelings from some of the higher-ups, who thought of them as provocateurs or co-conspirators. As you know, hospital politics can get vicious, particularly when it involves narcissistic docs and narcissistic administrators, of which there are far too many.”
“Yikes,” Laurie said. “What was Sue’s suspicion of a medical serial killer based on? Any idea?”
“That I don’t know yet,” he said. “The nurse I was speaking with was on duty and couldn’t say much other than to suggest it had something to do with statistics. But later I learned that the hospital’s mortality ratio has gone down, which argues against there being any serial killer or certainly not an active one. She’s off tomorrow and has promised to get in touch with me. So I hope to learn more specifics then.”