Dead Certain

the proof I needed that Gavin McDermott was the HCC mole. I tried calling Laffer, but whichever number I called led inevitably to his answering service, so I had to be satisfied with leaving messages asking him to call me in the morning.
    It wasn’t hard for me to imagine McDermott selling out for the money. Even though he made what most people would consider a king’s ransom, he had three ex-wives to support and more than a half a dozen children. His eldest, I knew, had just been accepted to Princeton to the tune of $40,000 a year after taxes. And while Patsy had money—she’d played matrimonial roulette enough times—I had no doubt her income and assets had been placed safely beyond McDermott’s reach before she said “I do.”
    The more I thought about it, the more I could also imagine McDermott slipping Pavulon into his patients’ IVs. Even though it didn’t make perfect sense that he would choose his own patients, perhaps he’d been reluctant to bring that kind of suspicion on his colleagues, who might have insisted more actively on some kind of investigation. It would be just like Gavin to be so certain of the unassailability of his own reputation that he’d naturally assume that suspicion would fall on someone else, perhaps on the nursing staff, instead of himself.
    Of course, none of this explained what had happened to Claudia. Had Claudia seen something she shouldn’t have? Perhaps McDermott fiddling with a patient’s IV? Or had she merely spotted something in the patient data that tied all the deaths irrevocably to him?
    I went into the kitchen to retrieve the box of Frango Mints. On the table beside the packages was a pile of mail that I flipped through quickly. Most of it was junk, but there was also a manila envelope that had apparently been hand delivered earlier in the day from Joan Born-stein. I tucked it under my arm and took it back with me to my home office.
    As the night wore on I carefully worked my way through both the file and the chocolate mints. On top was a memo from Dr. Cho summarizing the team’s findings about the patients who had died. Even after I’d read it through twice, it still seemed like gobbledygook. The only thing that struck me about the data was that the patients had been as a rule elderly. With the exception of Mrs. Estrada, all were without close family. Besides the fact that they were all McDermott’s patients, the only other common denominator seemed to be that they were all people who wouldn’t be missed.
    Mrs. Lapinsky, the lone survivor, was by far the most interesting. Elliott had found her in a rehabilitation hospital in Blue Island, where he was planning to visit her the next day. Reading through the summary of her treatment prepared by Dr. Cho, I wondered whether it would turn out to be a wasted trip. Even before suffering a mild stroke as a result of her cardiopulmonary arrest, Mrs. Lapinsky would have made a less-than-reliable witness. She was an alcoholic with a fourth-grade education who’d spent much of her adult life on welfare. A chronological listing of emergency-room visits offered an encyclopedia of complaints: high blood pressure, diabetes, headaches, ulcers, shingles, gallstones, blurred vision, and boils.
    Once, close to the beginning of her rotation, Claudia had told me that the biggest threat to the work of Prescott Memorial Hospital was selfishness. The cruel reality, she explained, is that in any place and at any time roughly 20 percent of the people in society either cannot or will not take care of themselves. It was up to us, said Claudia, to decide if we were going to pick up the tab for the 20 percent, and what we chose to do said more about us than it did about the poor.
    When I protested that the uninsured were not turned away from receiving necessary care, I thought she was going to slug me. True the uninsured can take their diabetes, their tuberculosis, their hypertension, and their obesity to emergency rooms where they must be treated free. But Claudia was quick to point out that treating the uninsured by treating them only in emergencies is often the most expensive course of action, the high price we pay for choosing to look away.
    An uninsured diabetic is cheap to treat when he is delivered comatose to the emergency room and dies. But a more typical emergency-room visit brings charges of between two hundred and five hundred dollars, while the regular checkups and preventive care that would have avoided the coma in the