Deficiency (12 page)

What a depressingly sad person. She will never have a good day from now on, he concluded. And then he thought he could help her and help himself. Vaguely, he recalled an opportunity like this in the past, although the details were as faint and cloudy as the rocks at the bottom of that murky pond at the rear of the tourist house. Struggle as much as he wanted, he would still not get a clear view of them, but that wasn't important. He had the general idea and besides, he didn't like doing the same things repeatedly. A little originality made life so much more interesting.

He waited a good hour and then he left his room in stocking feet, descending the short stairway as softly and quietly as he would if the floor were made of marshmallows. He opened her bedroom door in increments, containing the smallest squeak. She had a small nightlight on, one of those that were plugged into a socket. It threw just enough of a glow to clearly delineate everything in her bedroom. He saw her head on the large, fluffy pillow. The light made it seem as if her face was carved out of white marble. Her whole head looked like it was slowly sinking into the pillow and she would soon be gone from sight, matter of fact. She was on her back and her hands were crossed over themselves and on her stomach just the way an undertaker might have put them. How convenient and how portentous he thought and entered her room.

He stood by the side of her bed and watched her labored breathing. She was lifting her upper lip with every exhale. He couldn't imagine when, if ever, this old woman was attractive. She probably looked old when she was in her twenties, he thought. Time to start the process, he decided and tugged the big pillow out from under her head in one swift motion. Her head fell to the mattress and her eyes popped open.

"Whaaa. What are you doing in here?" she demanded.

"Helping you," he said.

He put the pillow over her face before she could reply. She started to struggle and gag and after a while, he let her breathe. She gasped eagerly, full of hope, and then he put the pillow over her face again and she fought again. Again, he let it up and again she gasped and heaved and choked for air. On and on the process continued: he bringing her to brink and she struggling, each time with less effort. What's more, each time she was free to breathe, it became more labored for her to do so.

Relentlessly, he put the pillow over her face. Her hands were barely pushing and pulling now. She was giving it so little effort that he had to stop sooner.

"Come on now," he urged, "you can do better than that."

She gasped and choked and he did it again and again he released it until finally, while he had the pillow up, she waved her hand, fought for breath, and died.

She died of heart failure, not asphyxiation.

It was his design. Someday soon after he was gone, she would be discovered and that was what they would believe. That was what the coroner would determine. Again, how he knew all this, he couldn't say, but he knew it. What difference did the how make after all?

He brushed down her face to be sure there were no traumas, no evidence of anything against her skin, no pressure, no blows. The pillow had been wonderful.

"Good choice," he told the corpse. "Soft, downy. I kind of like it. Do you mind if I use it tonight?"

He laughed.

Why not? He'll return it to her in the morning, and she won't complain.

She won't complain about anything anymore and she had him to thank for that.

Why couldn't they send thank-you cards back from the afterlife? he wondered. If they could, he would cover a wall.

Terri overslept.

She had not set her alarm clock either. It was the phone that woke her and thankfully so, she thought when she opened her eyes and saw the clock. She threw off her blanket and sprung up like a jack in the box.

"Dr. Barnard," she said swinging her legs over the bed after she had seized the receiver.

"Terri, forgive me for calling so early," she heard Will Dennis say. She knew it was he before he added, "It's Will Dennis." He had that distinct a voice.

"Oh. No, it's fine. Actually, I'm glad you called. I forgot to set my alarm."

Will Dennis laughed.

"Even doctors oversleep, huh?"

"Especially doctors. How can I help you?" she followed, trying not to sound
impatient. She would have to shower and dress in twenty minutes and like a
character on a television commercial, grab some breakfast bar on her way out and
to the office. Grandma Gussie's single-story Queen Anne-style house was just
outside Centerville, so fortunately there wasn't that long a commute to the office. When she was little, she called it the Gingerbread House because of the color of the shingles and the shutters.

"One of my ADA's was summoned to a situation regarding a Kristin Martin from Loch Sheldrake last night. The on-the-scene officer's report has your name on it. How did you come to be the one attending to the victim?"

The sheer coincidence of it was obviously not lost on Will Dennis, whose voice sounded full of wild suspicions.

"I was on my way home from dinner when I saw the patrol car and the vehicle. The officer asked me to look at her when I told him I was a physician."

"So you had time to examine her?"

"Barely. She went into a convulsion quickly. I can't tell you what happened to her except to say it was probably heart failure. What caused it is another…"

"Well, there is evidence of sexual intercourse," he said quickly, "so considering the condition she was in when she was discovered, we would have to consider an assault, but the report from the autopsy I was just given over the phone has thrown me for a loop, as they say."

"Oh. What was it?"

"The official diagnosis is going to be an extreme case of wet beriberi."

She could feel herself holding her breath involuntarily. That diagnosis had lingered like a persistent itch she refused to scratch or acknowledge.

"Wet beriberi," she repeated as though she had to say it to confirm that she had heard it.

"Correct me if I'm wrong, Doctor, but isn't that caused by a vitamin deficiency?"

"B
₁
, thiamine," she said.

"The report claims not a trace of it in her body," Will Dennis said. "Isn't that very unusual?"

"Not a trace? Yes. A very low level would be common in the Third World, a chronic alcoholic, breast-fed babies, but not a trace?"

"That's what they're telling me, which was basically what was on Paige Thorndyke's autopsy report, not a trace of vitamin C in that case. Can you offer any sort of explanation, Doctor?"

"I'm not any sort of expert for this, Mr. Dennis. I just know what any family physician would know."

"I realize that. I'm calling you solely because of the coincidence of your being an attending physician on both these bizarre cases. I wanted you to know about it, first, and then, maybe later, we can talk."

For a second or two, she couldn't speak and then her voice returned.

"Yes, of course. I'm on until five today and then I'm going to the hospital to do rounds," she said.

"You have a worse schedule than I have," he kidded. He was silent a moment. "I really don't know what to make of all this. That's why I'm reaching everywhere. I mean, if someone dies because of malnutrition, I don't see how I can indict anyone unless it was a child and a parent situation involving criminal neglect. And yet, as you pointed out, this sort of phenomenon is too unusual in a highly developed country. We're out here a ways and some people think we're still hicks, but two otherwise healthy young women dying of vitamin deficiencies within a week's time…."

"I understand your concern," she said. "If I were you, I'd have the same and start to bring in some real medical experts," she said. It sounded too much like she was trying to get him off her back, however. "Of course, I'll be glad to add anything I can to any investigation."

"Thank you. What time do you actually begin at the hospital?"

"As I said, I'll leave the office about five and grab a quick bite in the hospital cafeteria before starting my rounds about seven."

"Okay, I'll stop by the hospital and catch you at dinner. The way this is going it might be my only chance to grab dinner tonight, too. Even hospital food has some nutrition in it, right?" he added.

"Right. Although I'm beginning to wonder if it matters all that much where we eat," she quipped.

He grunted.

"If you have a quiet moment, give some thought to what you saw last night, what if anything the girl managed to say, that sort of thing."

"She didn't say…"

"For now, Doctor, I would appreciate it if you would keep what I have told you confidential," he interjected before she could finish. "I have no idea where I'm going with this or what I'm looking for and that makes me a very nervous man," he concluded, thanked her, and hung up.

Makes you nervous, she thought. What do you think it does to me?

She had just backed out of her driveway when her cell phone rang. She had it on speaker and flipped the lid.

"Dr. Barnard," she said.

"Say Doc, you make house calls?" Curt asked.

"Not today," she said dryly. They often had humorous conversations before either of them said anything remotely serious, but she was far from that mood. He heard it in her voice.

"I was hoping to hear from you this morning," he said, a little more irritation in his voice than she expected.

"I overslept. I'm actually rushing to get to the office."

"Oh. Hope it wasn't something I said or did. I did think I would hear from you before you turned in, remember?"

"No. I had a problem last night on the way home, Curt."

"What? What happened?"

"I came upon a woman in trouble. A police car was on the scene and I tried to administer medical aid, but she died shortly after I had arrived."

"Holy shit! What happened to her? Who was she?" he asked rapidly.

She thought about Will Dennis's request to keep the information confidential.

"She had heart failure," she replied. That was at least partially the cause. "Her name is Kristin Martin and she's from Loch Sheldrake."

"Loch Sheldrake? Yeah, I know of a Martin family there. They have a tourist house, one of the last remaining old-time borscht belt properties," he said. "A bed and breakfast type."

"Did you know the young woman?"

"No. Dad did something for the family years ago. I think there was a dispute over a submersible well or something. Heart failure. Jesus. Was she very fat or something?"

"No, Curt," she said. "I don't know the exact cause yet," she said, deciding not to tell him what she already knew. It was still too bizarre and inexplicable.

"Will I see you today?" he asked. "I'm in the office all morning and then I'm off to court, but I have time for lunch, I think."

"I have a full day, Curt, and tonight's my night for hospital rounds, remember?"

"No, but I hope I won't have to get sick to see my wife," he quipped.

"And I hope I don't have to sue anyone to see my husband," she fired back.

He laughed, but it was forced.

"You should have come home with me," he finally said. She had been counting the seconds.

"If I follow that logic, I shouldn't come out of the house, period," she replied.

"Okay, okay. What about meeting for a quick dinner, then? I'll even eat in the hospital cafeteria with you."

"I have to meet with the district attorney about then. He's coming to the hospital."

"Will Dennis? Why?"

"He wants to talk to me about the situation I confronted last night, Curt," she said. She realized half truths made it all even stranger. Curt was far from dense when it came to things like this, she thought. He was silent for a moment.

"Why?" he demanded. "Were there signs of foul play?"

"The woman was totally naked and probably raped."

"What?" He thought a moment. "I don't like the sound of any of this, and I especially don't like you talking to Will Dennis without my being present," he said.

"Huh?" She smiled and froze a laugh. "Why not?"

"I just don't like it. First, maybe an undercover detective, maybe not, and now this."

"You're sounding a little paranoid, aren't you?" she quipped.

"It's my job to be that way, especially when it comes to law enforcement officers who look for the easiest way out, and," he added before she could comment, "who are political creatures."

She stifled any reply. Was he right?

"I have to speak to him, Curt. It would look worse if I didn't. I'll call you right afterward."

"No, you won't, but I'll call you," he said. "Maybe you should have become a paramedic."

"Maybe you should have become a court stenographer," she retorted.

"Right," he said, his voice full of controlled anger.

She flipped the phone closed and concentrated on what she knew she had at the office, hoping she would be able to do just that: focus on her patients, but news of any death in the township traveled fast, even before it made the local radio news.

"Did you hear about Kristin Martin?" Elaine Wolf asked Terri the moment she entered the lobby.

Apparently Elaine Wolf, her one-woman news team, did not have much detail yet and didn't even know Terri's involvement. Will Dennis was keeping the lid tight on this one for as long as he could, she thought, but she knew Elaine would feel betrayed if Terri didn't tell her something.

"I came upon the scene last night and attended her myself," she replied.

"Oh. I didn't hear that. My God, poor you. Well, what happened to her? All I heard was she had a heart attack. A girl that young?"

"We'll have to wait to see," Terri said quickly, trying to make it seem as routine as possible. Before Elaine could ask anything else, Terri continued into the offices. She went directly to Hyman's.

He was on the phone talking to the radiologist at the hospital about Marvin Kaplan's fractured femur. The sixty-year-old plumber had fallen from a ladder in his own home, screaming how he could crawl through sewers, swing on rafters, and lug two hundred pound pipes and not get hurt, but do something for himself…. Hyman had his hands full with him when he was brought to the office and then sent on to the hospital.