Inadvertent Disclosure (20 page)

CHAPTER 32

Clear Brook County General
Hospital

Wednesday morning, 12:30 a.m.

Thirty minutes past midnight,
Sasha, Connelly, and Dr. Kayser pulled in to the dark parking lot of Clear
Brook County General Hospital. They’d made the four-hour drive in a little
better than three and a half hours, thanks to Connelly. Sasha had spent much of
the tense drive with her eyes squeezed shut, as Connelly weaved around drivers
who dared to follow the posted speed limits.

The three stretched their legs
and backs in the cold night air of the lot and then stepped into the blindingly
bright lobby. The wide glass doors closed behind them with a soft pneumatic
whine.

Sasha blinked and took in the
reception area. It was quiet, clean, and, as apparently was mandated by some
regulation, just as relentlessly beige as every other hospital lobby she’d ever
seen. Behind a high, faux-wood counter, a woman wearing green scrubs with an
alternating teddy bear and heart pattern spoke in urgent, hushed tones into a
hands-free telephone headset clipped to her ear.

Sasha pitched her empty coffee
cup into the recycling receptacle just inside the door and made a beeline for
the desk, with Connelly and Dr. Kayser trailing behind her.

It’s all in the presentation,
she told herself. She worked up some moisture in her dry mouth and wet her lips
before she spoke.

“Excuse me.” She was glad to
hear her words come out with some authority rather than as a squeak.

The nurse or whatever she was
sighed and looked up. She gave Sasha the “wait a minute” signal with her index
finger and threw in a side of stink eye for good measure.

“Don’t get the frozen shrimp,”
she said into her tiny mouthpiece, “get the peeled and deveined stuff behind
the counter—it’s on special. Make sure you use my bonus shopper card.”

She imparted these instructions
with an urgency that would have been impressive if it had related to a patient
but that seemed disproportionate to a shellfish sale. She flipped through her
Shopping Kart ad, making no move to wrap up her personal business.

Great.

Sasha squared her shoulders,
stretched up on her tiptoes, and reached over the counter to depress the button
and end the woman’s call.

The woman’s head snapped back,
and her dangly earrings swung wildly.

“Excuse you?!  Who do you think
you are?”

Sasha exhaled. “Attorney Sasha
McCandless, ma’am.” She gestured over her shoulder. “This is Special Agent Leo
Connelly with the Department of Homeland Security and Dr. Alvin Kayser, our
forensic medical expert. As you may imagine, we’re not here about the special
on shrimp down at the grocery store.”

The woman blushed, red blotches
blooming on her neck first, then spreading to her cheeks. Despite her apparent
embarrassment, she just continued to glare at Sasha, arms folded across her
chest.

Sasha plowed forward. “We need
to speak to the physician treating Jed Craybill immediately. If he or she isn’t
out here in three minutes or fewer, I’ll be speaking to your supervisor.” She
squinted at the woman’s name tag. “Are we clear, Doris?”

“Yes,” Doris answered in a sour
voice before hustling through a door marked “Staff Only.”

She disappeared down a narrow
hallway.

As soon as the door swung
completely shut behind her, Connelly burst out laughing.

“Way to trip your bitch switch
right out of the gate, Sasha.”

She swung around and gave him a
warning look. He swallowed the rest of his laughter.

“You’re really worried about
your client,” he said, reading the concern behind her anger.

She didn’t trust herself to
answer, so she just nodded.

The doctor looked away, giving
them some minimal amount of privacy, and Connelly pulled her close for a brief
hug.

He released her as Doris came
bustling back through the door with more than a minute to spare. A
harassed-looking young doctor was on her heels. His brown eyes were tired and
his hair mussed, as though she’d roused him from a nap, but his demeanor was
crisp and all business.

“This is Dr. Brown,” Doris
said, waving her hand toward him, before retreating to the relative safety of
her desk. Out of the direct line of Sasha’s ire, she immediately returned to
her grocery circular.

He stepped forward and scanned
the group, trying to decide which of them to address, even though Doris had
almost certainly told him the little crazy woman seemed to be in charge.

Sasha made it easy for him.
“I’m Sasha McCandless, Mr. Craybill’s attorney. This is Dr. Alvin Kayser; he’s
a geriatric specialist who recently examined Mr. Craybill.”

Sasha looked back at Dr. Kayser
and motioned for him to come take over the discussion.

Dr. Kayser blinked rapidly
behind his glasses but stepped forward with his hand extended.

“Sam Brown, sir,” the younger
man said, visibly relieved to be talking to a fellow doctor instead of the
lawyer or the unnamed federal agent looming behind her.

“Please, Dr. Brown, call me Al.”
Kayser smiled encouragement at him. “Can you give me a quick run down on our
patient’s condition?”

Brown cleared his throat and
gathered his thoughts. Then he slipped in the long-abandoned role of resident
on rounds and launched into a clinical recitation, falling back into the
pattern of precise, quick speech that marked an eager-to-impress medical
student.

“The patient was admitted at
20:30 hours, dehydrated, delirious, and febrile.”

Sasha jumped in. “Who brought him
in?”

He frowned at the interruption
but answered the question. “Deputy Gavin Russell.”

A look passed between Sasha and
Connelly.

“What was your diagnosis at
intake, doctor?” Dr. Kayser asked.

“With the caveat that I’m not
board-certified in geriatrics, I think this situation arose out of a simple
case of inadequate self-care, likely as a result of age-related dementia. Mr.
Craybill was severely dehydrated. He clearly had not been consuming sufficient
fluids, and his primary—uh, former primary—physician, Dr. Spangler, suspects he
also hadn’t been taking his medication as directed.”

Dr. Kayser put up a hand like a
crossing guard. “What medication would that be?”

Sasha called up Kayser’s expert
report in her memory. He hadn’t referenced any meds.

Brown scrunched up his forehead
and tried to remember,  “Uh, I’d have to check the chart. It was one of the OTC
antihistamines. Can’t recall which one offhand.”

“Moving on,” Dr. Kayser said in
a tone that betrayed nothing. “What were your initial orders?”

Brown glanced over at Sasha and
Connelly before deciding to sell out Doris. He cleared his throat and then
said, “There was. . .an error. Someone at intake believed, or assumed, Dr.
Spangler was the patient’s treating physician. After all, she is the doctor of
record for most of our patients. So, she was called in to participate in the
treatment plan.”

He shot an apologetic look at
Kayser. “She neglected to mention that you had taken over Mr. Craybill’s care.”

Technically, Dr. Kayser had
examined Jed for the sole purpose of writing his expert report. But Jed had
been livid at the thought that Dr. Spangler had gotten the ball rolling on the
incapacitation petition and, according to Kayser, had said he would never seek
treatment from her again, under any circumstances. Jed had asked Dr. Kayser to
take him on as a patient, and the two had been trying to work out the
logistics.

Jed may not have communicated
his new plans to Dr. Spangler, but Sasha was confident he would rather be
treated by Dr. Kayser. She was less confident that wish would stand up under
the law. No need to share that tidbit with Dr. Brown.

Brown continued, “When she
arrived, Dr. Spangler ordered intravenous fluids and canceled orders for tests
I had already written. She said we were to take comfort measures only until she
sorted out the ‘mess’ with the patient’s attorney.”

Kayser’s woolly white eyebrows
crawled up his forehead but he let the younger man continue.

“She said there was some sort
of active court case as to the patient’s capacity to make his own decisions.
Until she got the go-ahead from the judge, we were to keep him stable, but
beyond that, it was hands off.”

“In your opinion, did that seem
like a prudent course of action?” Sasha asked.

The doctor took his time
formulating an answer.

Finally, he said, “Look, I took
this position because this is an underserved rural community. Three years here,
and the government forgives my student loans. I don’t know all the nuances of
the local scene. Me, personally, I would have run the battery of diagnostic
tests. The patient presented in a pretty severe state, but the underlying cause
could be something serious or it could be something exceedingly simple and easy
to reverse. The only way to know is to run the tests. But, it wasn’t my call.
Dr. Spangler said he was her patient. And I heard her attorney tell her not to
do anything because he’d spoken to you.”

“Her attorney? Marty Braeburn?”

 “Yes. He came flying into the
exam room and pulled her aside. He told her you had refused to consent to the
county acting on Mr. Craybill’s behalf and that you were on your way here with
some hotshot geriatrics specialist. She lit into him about it, and they argued.
I went out to find a nurse to start a line so we could get fluids into him.
When I came back, the lawyer was gone, and Dr. Spangler was all smiles. Like
nothing had happened.” He ended with a little shrug.

“Can we see Jed now?”

“Sure. I have to tell you, he’s
floating in and out of consciousness, and when he has been conscious, he hasn’t
been lucid. Don’t expect much in the way of conversation, and don’t stay too
long. If nothing else, he needs to rest.”

* * * * * * * * * *

Jed looked bad. Worse than bad,
if Sasha was being honest. His skin was gray and papery. He opened his eyes and
stared at the ceiling with clouded, dull eyes. He was a shadow of the ranting
man she’d sat across from on Tuesday afternoon.

“Jed,” she said and heard the
break in her own voice.

He turned toward her voice and
struggled to lift his head from the pillow.

“Yes, honey?”  He smiled at her,
kind and vague.

He didn’t recognize her. Her
stomach lurched.

“Excuse us for a minute.” She
forced the words out around a lump that had taken up residence in her throat
and motioned for Kayser and Connelly to follow her.

They huddled in the corner furthest
from his bed. Jed folded his hands over his stomach like he was praying and
waited—a picture of patience and understanding,

Sasha kept her voice low.
“What’s going on with him? He’s being so docile. He clearly doesn’t know who we
are. Did he strike you as a man who would just smile and nod at a bunch of
strangers in his hospital room?”

Doctor Kayser placed a gentle
hand on her arm. “No, I can’t say that he did. Sometimes dementia causes people
to act out of character. Usually, we see some kindly little old lady who never
curses fly into a sudden rage. When such an outburst occurs, we chalk it up to
a misfire in the brain. Here, in Mr. Craybill’s case, this more pleasant
demeanor is equally unusual and likely the result of disease.”

“Could dementia really set in
so fast? It’s only been a day and a half since I saw him. He was eating pie. He
was fine!”

Kayser made a motion with his
hands, palms skyward. “Who can say?  Dr. Brown is right. We need to run those
tests to rule out the simple stuff.”

“So, do it.” Connelly said.
“You’re his doctor.”

Sasha and Kayser shared a look.

“What?” Connelly demanded.
“Isn’t that what the guy said he wanted?”

“Yes. Absolutely . . .” Dr.
Kayser trailed off.

“But?”

“But,” Sasha said. “Dr. Kayser
has never taken him on as a patient. He evaluated him for my case, that’s all.
Officially, Jed hadn’t transferred his records or taken any other action that
manifested his intentions to fire Dr. Spangler. Under ordinary circumstances,
that wouldn’t matter so much. But, here, it gives Braeburn an opening to claim
Jed wasn’t competent to hire a new doctor, or he made the decision under
duress, or—who knows what he’ll say, but it’s not so cut and dried.”

“And,” Dr. Kayser added,
“because he doesn’t seem to know who we are, if he is asked to reaffirm that
decision now, who knows what Mr. Craybill will say.”

The three stood silent for a
minute and waited for a brilliant idea to strike one of them. Nothing.