Dead Certain

that Claudia hasn’t told you about,” I said. “Something you should know.”
    “What’s that?” asked Joan.
    “Mrs. Estrada isn’t the first unexplained postsurgical death at Prescott Memorial,” I said.
    It took some prompting, but Joan finally managed to get Claudia to relate what she knew about McDermott’s patients who had died and our theory about an angel of death being at work in the hospital.
    “And you’re saying that, like Mrs. Estrada, all the people who died were Dr. McDermott’s patients?”
    “Well, not necessarily to begin with. For example, Mrs. Estrada was originally Farah Davies’s admission, but she was referred to Dr. McDermott when it was determined that she was a candidate for surgery.”
    “Farah Davies was the one who took that picture,” remarked Joan offhandedly, indicating the picture on her credenza, the one of her immediately following the birth of her eldest. “Now, of the patients who died, how many were you directly involved with, as far as their care?”
    “I don’t know,” replied Claudia. “Maybe one or two. Most of the deaths that occurred after I began my rotation weren’t trauma patients. They were scheduled for routine procedures like tumor removal, bowel resection, stuff like that. I don’t know about the ones before I came.”
    “So,” mused Joan, the gears turning, “these deaths definitely began before you arrived to begin your fellowship?” I immediately saw what she was getting at. If she could establish that all the deaths were part of a pattern, a pattern that began before Claudia even arrived at the hospital, then the case against Claudia was substantially weakened.
    “That’s what I’ve heard,” replied Claudia. “I remember after the first time we lost a patient, the nurses telling me that there had been at least two other similar deaths that had happened before.”
    “I hope you realize that McDermott and the hospital will do almost anything they can to keep us from raising the issue of these other deaths,” said Joan, speaking more to me than to Claudia. “No doubt that will also make them eager to settle with Mrs. Estrada’s family— anything to avoid seeing this matter go to trial.”
    “But if they’re so desperate to keep us from showing that Mrs. Estrada’s death was part of a pattern, won’t that just make them all the more determined to blame it on me?”
    “Yes. But it also gives you something terribly important.”
    “What’s that?”
    “The ability to help yourself,” Joan Bornstein replied. “How?” demanded Claudia, her face lighting up with something very much like hope.
    “Your job is to find out as much as you possibly can about the other patients who died. Review their charts, talk to the nurses who took care of them.”
    “What for? What am I trying to find out?”
    “You’re looking for patterns. Any kind of similarities. Did they all die at the same time of day? During the same shift? What kinds of medications had they been receiving? What kinds of procedures had been performed? Anything that links them together.”
    “Patient records are confidential,” Claudia reminded her.
    “I know that and I’m not asking you to divulge any information to me or anyone else,” Joan was quick to assure her. “But there are no moral, ethical, or legal reasons why you can’t go back and review patient records. We’ll cross those other bridges when and if you find some sort of pattern in the charts.”
    “And what am I supposed to do in the meantime?” inquired Claudia. “How am I supposed to go into the hospital every day? Half the people I work with think I did something wrong that killed my patient, and the other half assume I’m being set up to take the fall for McDermott. Either way I’m going to be under the microscope.“
    “I know it’s going to be hard,” Joan assured her earnestly, “but now more than ever it’s absolutely imperative that you go into the hospital every day you’re scheduled and continue to do your work according to your usual high standards. You can’t let yourself be coerced or co-opted into making it any easier for them to sabotage your career. It’s all about showing them that you aren’t about to roll over for them. To make them realize that if they want to take you down, they’re going to have to fight you every inch of the way.”
    Claudia absorbed all of this with a kind of grim stoicism. From her face, I couldn’t even begin to guess what she was