Dead Certain

holding my hand?” she reported, the lash of the chief of surgery’s words still fresh. “I guess you could say that he did. He told me that if he had anything to say about it, I could consider my career over.”
    “You know he didn’t mean that.”
    “Oh, please, I haven’t even told you the worst part.“
    “Which is?”
    “Mrs. Estrada’s husband overheard the whole thing. He was still in her room collecting her things. He heard every single word.”
    “Did you talk to him?”
    “I tried, but he said that under the circumstances he thought it best if all our communications went through our lawyers.”
    “But won’t the autopsy show what killed her?” I asked, wanting desperately to reassure her.
    “Normally when a patient dies in the hospital after surgery, they don’t do a post. They just assume that the death was caused by whatever underlying disease prompted the surgery.”
    “But I thought you said you couldn’t feel any gallstones.”
    “I couldn’t, but there’s no question her appendix was inflamed, and I performed an appendectomy. Under those circumstances you’d expect McDermott to sign the death certificate, no questions asked.”
    “Will he?”
    “Not now. Mrs. Estrada’s family has requested an autopsy.”
    “Well then, it’s out of your hands. Now it’s up to the medical examiner to find the answers.”
    “The medical examiner isn’t going to be doing the autopsy. I’m sure they’ve hired an independent forensic pathologist.”
    “I didn’t know there was such a thing.”
    “Are you kidding? There’s even a mobile service. They call themselves 1-800-Autopsy. They show up in a black van and do the post on your loved one, parked in your driveway.”
    “Remind me to add that to my list of signs that the apocalypse is near.”
    “For me, I’m afraid it’s nearer than you’d think. I have to appear before the morbidity and mortality board on Monday.”
    “What’s that?”
    “The M&M conference? It’s a confidential, closed-door review board that’s supposed to catch and correct physician error. Every hospital has one, but the proceedings are secret. You aren’t even allowed to take notes. They can be pretty brutal.”
    “Have you ever been asked to appear before one before?”
    “No, but I sat in on them as a resident.”
    “What about McDermott? Doesn’t he share responsibility for all of this?”
    “Oh, sure. He’ll hang his head and say he’s sorry for letting me do the procedure solo, and they’ll give him a rap across the knuckles and tell him not to do it again. Then they’ll hang me out to dry.”
    “Won’t McDermott stand up for you?”
    “Why on earth would he do that when it’s in his best interest to crucify me? Don’t you see? Up until now, every single respiratory-arrest death has been his patient.“
    “So was this one,” I pointed out.
    “But he never even set foot in the operating room. Not only that, but I looked at her chart. He never so much as ordered medication. I mean, unless the pathologist determines at autopsy that Mrs. Estrada died from having her abdomen palpated, then he’s off the hook.”
    “And he gives up his title of Dr. Death,” I mused.
    “Absolutely. Up until this afternoon, everybody’s been whispering about him. Has he lost his touch? His luck? His nerve? Could he be drinking? Dipping into the old pharmacy cupboard? But on Mrs. Estrada he’s clean, which means he has everything to gain from nailing it on me.”
    “Who else knew that you were the one who operated on Mrs. Estrada?” I asked, suddenly seized by a truly terrible thought.
    “The resident who assisted, the scrub nurse, and the anesthesiologist. Maybe the OR coordinator if she ever lifted her nose out of her romance novel.”
    “Anybody else?”
    “No. Not unless McDermott happened to mention it to somebody.”
    “Would he?”
    “Probably not. Technically what he did by letting me do the case wasn’t kosher. He wouldn’t want to advertise it. But I still have no idea what you’re getting at.”
    “Don’t you see? Ever since you’ve been at Prescott Memorial, the hospital has been losing patients, all from respiratory arrest following routine surgery, all Gavin McDermott’s patients. No one can figure out why. Now, all of a sudden, Mrs. Estrada dies the same way after you operate on her.”
    “Pm still not getting it.”
    “To everybody but Gavin McDermott and the handful of people who were actually in the operating room