The Laura Cardinal Novels (64 page)

As Laura saw it, the question was would Barbara Wingate make Erin sick just to get attention?

She liked attention. No doubt about that. Everything she did was geared toward gaining it, every move calibrated for the right effect. Laura got the impression that Barbara Wingate saw herself from the outside, just as other people saw her. Constantly aware of her affect on other people.

Laura wondered where the real Barbara was, or if she existed at all.

Lila reappeared with a heavy book full of newspapers. She leaned over Laura and the scent of roses was overpowering. “Let me see, I think that was the last week of March.”

Expertly, Lila’s lacquered nails flicked through the newspaper. And there it was. Mike and Kathy Ramey died in a car accident March 27, on their way home from a fundraiser in Flagstaff. Killed by a drunk driver not ten miles from home. Laura stared at the black-and-white photo of a mangled car.

She scanned the article. Mike Ramey, 29, and Kathy, 30, were survived by a daughter, Erin. Both Mike and Kathy were general practitioners at the Williams Health Care Center.

Kathy was nine years older than her brother Josh. Laura wondered why Barbara Wingate had waited so long to have another child. It could be she had been married to another man before. It was a small loose end, but Laura could track it down if it turned out to be important. Right now it didn’t seem to be. She looked for the obituaries of Mike and Kathy Ramey the following week, since the
Williams–Grand Canyon News
only came out once a week. The only other relatives mentioned in the obituary were Mike’s brother and his wife and their three children. The brother was stationed in Germany.

Too far away to take Erin? It would certainly be disruptive. At least, though, there was family who could take her if need be.

Lila watched discreetly from the doorway as Laura looked at the obituary. There was nothing new there, except a suggestion that friends donate to the American Cancer Society in lieu of flowers. Laura also glanced over the obituary for Barbara Wingate’s husband. He had died of cancer several years ago. He had been much older than she was.

Laura asked Lila if she knew Barbara Wingate.

“I wrote an article about her last year.”

“Could I see it?”

Lila looked pleased. She found the article page quickly and spread it out for Laura. “I’ll be in the front if you need me,” she said.

The article, written last September, was a puff piece about Mrs. Wingate, cataloging the good works she had done teaching disabled children to ride and rescuing broken-down Thoroughbreds, her charitable work, her former career as a licensed practical nurse in Iowa. Touching lightly on her double tragedies.

Accompanying the article was a photo of Mrs. Wingate with one of her rescued horses and another, smaller photo. In this one, she was teaching a catechism class to high school kids. A half dozen students sat in a semi-circle of folding chairs, Barbara Wingate in the center, writing on a blackboard.

Looking radiant. In her element—the center of attention.

An interesting surprise: The student closest to the camera was Jamie Cottle. Laura thought it ironic. When this picture was taken, neither Barbara Wingate nor Jamie Cottle had been aware of the tragedies looming in their future.

She scanned the article a second time. One detail stuck out—the fact that Barbara Wingate had been an LPN—a licensed practical nurse.

Although Laura had dealt only tangentially with a case involving Munchausen Syndrome by Proxy, she knew the profile as well as anyone in the squad. Number one, people with Munchausen were almost exclusively women. And number two, they were very likely to have worked in the medical profession. They were often bright, articulate, knowledgeable about illness, and spent a lot of time talking to the doctors treating them or their children.

The term “Munchausen” was coined by a doctor in the 1950s to describe patients who faked acute illnesses and dramatized their medical histories. The doctor got the name from a historical account of the Russo-Turkish wars by a flamboyant German baron named Karl Fredrich von Munchausen who made up fantastic stories about his time in the Russian cavalry.

Munchausen by Proxy was worse. Instead of doing bad things to yourself to get attention, you did them to someone else—usually a child in your care. Laura remembered a recent case that received worldwide attention. A woman faked her daughter’s cancer, convincing everyone—doctors, hospitals, even the child herself—that the illness was real. The child had been subjected to painful and traumatic bouts of chemotherapy and other radical treatments.

Laura went over what she knew about Erin. The incident at the soda fountain in Flagstaff, the fact that incidents like it had happened at least twice before. The day Laura had met Erin. The way the girl acted listless, disinterested in the world around her. Jillian’s portrait of a much different girl, one who was active to the point of breaking her arm.

When had that change taken place? After she moved in with her grandmother?

Be careful.
If she acted on this, serious consequences could result. Erin could be taken away and put in a foster home. If she went ahead, she’d have to make sure she did everything right.

The Williams Health Care Center was four blocks over, on Seventh Street just south of the Safeway. One-story building, plate glass windows along the front, the center’s name in letters across a rock face outside. An ambulance parked to the left.

Inside, the place was small-town homey. Quilts on the walls, cornflower-blue chairs lining the perimeter of the common area on the left, a TV set mounted in the corner. Directly in front of her a long blond-wood counter angled back to an inside door, the length topped by plastic windows. Chairs pulled up to each window for patients to demonstrate their proof of insurance.

Laura had spent an hour on the phone with the doctor who testified in the Lynette Stokes case. Lynette Stokes was a Tucson woman who had cut her infant repeatedly and rubbed dirt and even garbage into the wounds to make him ill. In the long run, it had gotten her more attention than she’d planned for. The baby had been adopted by the assistant prosecutor on the case and was flourishing.

Laura expected the doctor to tell her she didn’t have enough to go on. Instead, he suggested she talk to Erin’s doctor and let him know her concerns.

“Most of these cases are based on circumstantial evidence,” he’d told her. “Let me ask you this. How would you feel if you didn’t pursue it?”

So here she was at the Health Center, mulling over what to say. She didn’t want to go in with guns blazing. If it came to the point where it turned into a criminal investigation, she would take what she had to the Yavapai County sheriff’s office, since Barbara Wingate lived in their jurisdiction. She was reluctant to do that now. She knew enough about small towns to understand that if locals investigated, whether or not Barbara Wingate actually abused her granddaughter, the presumption of guilt would stick to her like flypaper.

Laura asked the receptionist if she could talk to Erin Wingate’s doctor.

The young woman glanced at the clock—almost noon. “That would be David Sanchez. You want me to page him?”

“Not if he’s busy.” Laura handed the woman—her name tag said RENEE—her card. “I’m always reachable by my cell—”

“It’s okay. It’s lunchtime anyway.”

Laura waited in the common area, listening as the young woman spoke into an intercom, then looked up brightly. “He’ll be right here.”

When she saw Dr. David Sanchez, her first thought was
Doogie Howser
. He was very young, except for intense dark eyes that seemed to probe politely. He wore a white lab coat over chinos and bright white tennis shoes.

“You wanted to talk to me?”

“I wanted to ask you about one of your patients.”

She saw the switch go off behind his eyes. “You must know that as a doctor, I can’t tell you anything about my patients.“

“I understand. I’ll do the talking.”

He looked at his watch. “There’s a place on the corner that has good coffee. I can spare a few minutes. But don’t think I’m going to let you talk me into saying anything.”

They sat outside at one of two metal tables in the shade of the striped awning. Dr. Sanchez crossed his legs at the knee and took a sip of his coffee. “I’m not sure I should even be here.”

“I understand that,” Laura said. “I wanted to bring something to your attention that you might already know about.”

He shifted legs. “What is that?”

Wary. Young, but oh-so-smart.

Laura outlined her suspicions regarding Barbara Wingate and her granddaughter Erin.

Dr. Sanchez said nothing. He used the plastic stirrer on his coffee, which he took with cream and sugar.

“She
is
your patient?” Laura asked.

Her voice seemed to startle him. “What? Yes. In fact, she’s—” He stopped. His chin went down, his lips closed. He checked his watch again. “Tell you what, I’ve got to get back.” He reached over and tapped her awkwardly on the wrist. “We’ll be in touch.”

Laura watched him go, long-legged, his lab coat flapping around his trousers, the white so bright, setting off his dark skin.

Probably just a year out of med school, with a mountain of debt. Working at the Williams Health Center because it was the path of least resistance. Small towns were hurting for doctors. He’d probably gotten some kind of a deal, signed on the dotted line to get the financial aid he needed. So here he was in Williams, and he had been thrown into the deep end. Two doctors dead. A big hole to fill.

And he had Erin Ramey. The child of the two doctors who had been killed.

He lived in a small town where everyone knew everybody else. Where Barbara Wingate was the quintessential good citizen. No doubt she had friends in every branch of Williams’s small government.

Laura wondered if he would do anything.

Well, she’d planted the seed. It was up to Dr. Sanchez now.

David Sanchez stopped in to say “hi” to Erin and her grandmother and look at the chart.

Erin looked fine. She sat up in bed, drawing pictures of horses in the notebook she’d brought along with her. She loved to draw horses, and she was very good. The corner of her tongue stuck out of her mouth as she drew. Absolutely unconcerned that the bed she was sitting in was in the emergency room.

Used to it by now.

The tests she’d been subjected to amazed him. When he took her on as his patient, he’d called for all of them to be redone. And still her chest x-ray showed clear lungs. The source of the blood was maddeningly elusive.

Pretty stern stuff for a guy just out of residency. But he planned to succeed where others had failed. It might take time, but he would figure it out. The blood had to come from somewhere. It wasn’t from a nosebleed, it wasn’t from her lungs, but there were many places to look. And he would look for them all.

Seeing her now, he felt a pang in his heart. She was a puzzle. So matter-of-fact. She didn’t mind what they did. A tough little kid.

And the grandmother.

Now he looked at her in a new light. Her knowledge, the way she kept coming at him with new theories, constantly engaging him in conversation. As if this were her second home. He got the feeling she could talk for hours about Erin’s illness. She made him nervous, too, just being around her. So much older, but there were times when he found himself attracted to her. Tongue-tied in her presence, which wasn’t like him at all.

And the thing was, he knew she was aware of it. Not just aware of it, but he could tell she enjoyed his attraction to her.

He didn’t like the feeling. He already had a girlfriend.

He looked at the blood on Erin’s blue flowered hospital gown. She had tried to spit into her hand, but it had gotten all over. She looked at him.

“You okay?” he said a little too brightly, ruffling her hair.

“Kind of. It tastes bad.”

“I know. We just have to figure out where it’s coming from, and then we can stop it.”

“Uh-huh.” Skeptical. Like she’d heard that a few times.

Mrs. Wingate watching him watch her. Her large green eyes seeming to catch and keep all the light in the room.

Suddenly, he heard choking sounds. Erin leaning into her hand.

Without thinking, he reached into the top desk drawer, pulled on some gloves and grabbed a slide and a Q-tip.

Blood poured out of her mouth onto her hands. It seemed like a lot, but it really wasn’t.

He was right there with the slide. Why he didn’t think of it before, he didn’t know. Maybe it was as pointless as everything else he’d done, but it was worth a try. He scooped up some of the blood on the Q-tip and put it on the slide. Sandwiched it with another piece of glass. He would take it to the lab and have a Wright stain done just to make sure.

Erin was staring at him. He winked at her.

Thinking,
All this time, and I never thought to look at her blood under a microscope
.

Jeanette Moran was waiting for David to get off the phone. She wanted to firm up plans for tonight. She wanted to go to Doc Holliday’s at the Holiday Inn for dinner, have the prime rib and all the fixings. After the day she’d had, having to put down three ailing animals in a row, she could use a good prime rib and some wine to go with it.

Being a vet wasn’t all puppies and kittens.

Jeanette walked by the microscope set up on the long counter to the right and stopped. She never passed a microscope by if she could help it. It was a compulsion with her. She had to take a peek, even if she didn’t know what it was all about.

David got off the phone a short while later.

“What’s this?” she asked, tapping the microscope.

He looked sheepish. “Just something I thought I’d check out.”

“Like what?”

“I just got this dumb idea in my head, it’s probably nothing.”

“What dumb idea?”

He looked embarrassed. “I just wanted to make sure it was really blood.”

“Oh, it’s blood.”

“I know.”

Jeanette said, “So what is it?”