Dead Certain

hospital would be that different from a large law firm. If I’d bothered to take the time to look beneath the surface, I would have seen that they are both the same—Darwinian systems where survival belongs to the fittest and where leadership, just like in a pride of lions, is earned through successive challenges of nerves and blood. Carl Laffer hadn’t beaten out McDermott and Davies for the chief of staff’s job by being a white-haired elder statesman. He’d gotten it by being the fiercest and most cunning of the three—something I was afraid I hadn’t realized until it was too late.
    Laffer had spent his entire career in the shadow of McDermott’s superior surgical skills. He’d had the difference in their talents publicly thrown in his face in the malpractice suit involving the ten-year-old boy, and he’d paid a heavy price for covering for his colleague. No doubt when HCC approached him, Laffer recognized the company’s plan as not only an opportunity to definitively best his rival, but to finally reap the financial rewards long overdue him.
    Laffer was the one who’d cut a deal with HCC, which is why Packman knew all about the patient deaths. Indeed, telling Packman had been the whole point. With stakes that high, Laffer was leaving nothing to chance. He knew what an attractive figurehead Gavin McDermott would make for HCC, the instant credibility affiliation with the famous surgeon would bring to the company’s efforts in Chicago.
    But Laffer wasn’t about to let that happen, not when it was so easy to tip the scales in his own favor. If HCC was successful in gaining control of health care in Chicago, then whoever they chose to be chief of medical services would wield tremendous power not just over patients, but physicians in the system. My guess was that that was the deal that Laffer had cut with HCC—appointment as chief of medical services in exchange for handing them Prescott Memorial Hospital on a platter. I didn’t think that he’d commit murder for anything less.
    The killings themselves had been easy. Surgeons spend the best part of their fives up to their elbows in gore. They deal in the currency of life and death every day. For most, like Claudia, it makes them appreciate the value of human life, but for a much smaller percentage, their familiarity cheapens it.
    No, for Laffer, the tricky part had been maintaining an equilibrium. On the one hand, the deaths of McDermott’s patients had to be public and conspicuous enough to insure widespread whispers about something being amiss. On the other, he had to avoid any kind of public inquiry that might sour the deal between HCC and Prescott Memorial. No doubt he figured that as chief of staff he’d be able to control any kind of investigation in the guise of overseeing it. What he hadn’t counted on was Mrs. Estrada.
    The identity of undercover patients was, of necessity, a closely guarded secret. Only Kyle Massius and Farah Davies knew the true circumstances of her admission. And while Laffer was undoubtedly aware of the existence of such patients, they posed no threat to him, since their complaints invariably “cleared up” prior to their actually having to go through surgery. Even someone as calculating as Carl Laffer could not have foreseen an undercover patient legitimately requiring emergency surgery, much less the set of circumstances that led to its being performed by someone other than McDermott.
    I’d signed my roommate’s death warrant the day I’d told Laffer that Claudia was my roommate. He knew then and there that there was no way the hospital would be able to pressure her into accepting the blame for Mrs. Estrada’s death, and Joan Bornstein would never rest until the facts behind the other deaths were fully revealed. I’m sure he figured he had no other choice.
    Just like now.
    I was surprised to hear my own voice saying something about the cornices of the bookshelves and how the wood had been imported from Italy. I tried desperately to focus on what Laffer was saying, sickened by the sudden realization that the man who had stabbed my roommate in cold blood had no doubt come to try to silence me.
    Laffer didn’t seem to notice. He was talking about Claudia and her love of books, and how we really needed to plan some sort of memorial service. The people who had worked with her needed a forum in which to express their grief.
    Killing Mrs. Estrada had been Laffer’s only mistake. Not only did he have no way of