Robin Cook | 17 mins


May 8th

5:49 A.M.

Laurie Montgomery-Stapleton’s eyes popped open much earlier than usual and without Jack Stapleton repeatedly nudging her shoulder. She couldn’t remember the last time she’d spontaneously awakened at such an hour. But her mind was churning because it was going to be an exceptionally busy day. So busy, in fact, that she was going to have to talk Jack, who was still blissfully sleeping next to her, into standing in her stead for at least one of her obligations, and that was not going to be an easy task. A week previous she’d agreed to go into John Junior’s school and meet with his fourth-grade teacher, Miss Rossi, and possibly the school psychologist about JJ’s supposedly recent disruptive behavior. Apparently there had been some aggressive incidents on the playground during recess and other impulse-control episodes. Knowing Jack’s impatience with such issues and his tendency to be less than diplomatic, Laurie hadn’t even broached the subject with him, preferring to handle it herself as she was certain there was nothing wrong with JJ. Now Jack was going to have to deal with the situation on his own because Laurie had newly arisen, pressing work-related obligations down at City Hall that conflicted.

By lifting her head and gazing out of the two large, north-facing sixth-floor bedroom windows, Laurie could tell that the sun had just peeked over the eastern horizon. Although there were closable window treatments and even blackout shades, neither she nor Jack bothered to use them. Several blocks away on the top of a significantly taller building, she could see an old water tower. At the moment it was totally awash with early-morning sunlight, giving the illusion that it was made of gold.

Next Laurie’s eyes turned to glance at the digital clock. It was even earlier than she’d suspected—just a smidgen past 5:50—yet she was totally awake. Laurie had never in her life been a morning person and always struggled to wake up and get out from under the warm covers. It had been particularly true since she’d married Jack, because Jack insisted they keep the bedroom cool, almost cold from Laurie’s perspective. But the real reason Laurie had trouble getting up in the morning was that she was a night owl beyond any doubt. On occasion she’d been known to sleep through an alarm only feet away. When she’d been younger, she’d loved to read fiction far into the night, with a predilection for late-eighteenth-century and early-twentieth-century novels. That began to change once she had become a doctor and needed to keep up with the ever-expanding professional literature. These days, she was obsessed with reading not only the current forensic articles but also all the material she was expected to be familiar with as the chief medical examiner of the City of New York. As the first woman to hold the title and thus a pioneer of sorts, she felt particular responsibility to be the absolute best she could be. To that end she’d had to learn how to read spreadsheets and budgets and all the appropriate reports coming out of the New York City Council, from its various committees, and from the New York City Department of Health and Mental Hygiene. She still sometimes found herself shocked at the sheer volume of documents that landed in her in-box.

Despite Laurie’s commitment to doing her job well, the jury was still out in terms of how she personally felt about having accepted the position. Only now did she have a true idea of the extent of the political aspects of the job. It had been her general understanding that the Office of the Chief Medical Examiner, known as OCME, had fought and gained its independence after its founding in 1918, so that it could speak unencumbered for the dead. Although that was mostly true, she was learning the hard way that the mayor, who had appointed her, and the City Council, which held the purse strings, could exert considerable power, which she had to struggle to resist. It was especially hard since the OCME’s $75,000,000 yearly budget was a tempting target in a city continually starving for funds for other worthwhile obligations. On top of that, the morgue itself, where all the autopsies were actually done, was in need of a multimillion-dollar replacement. At one time it had been state of the art, but that was no longer the case.

Apart from the political headaches of the job, Laurie found that she missed the intellectual stimulation of being personally immersed in the actual forensics, with the responsibility of determining the cause and manner of death. Objectively she recognized that it was best for her to let the nearly forty highly qualified medical examiners handle all the cases—otherwise, as her predecessor, Dr. Bingham, had learned the hard way, every district attorney, police higher-up, fire chief, city bigwig, and mayor would want the chief to do any case they were interested in simply because she was the Top Dog. But for Laurie, it was a sacrifice to take a step back and settle for frequent, unofficial morning rounds down in the morgue, looking over people’s shoulders and asking questions. The closest she came to being intimately involved was Thursday morning, when she regularly assisted one of the forensic pathology fellows on an autopsy. In partnership with New York University Medical School’s Department of Pathology, the OCME trained a handful of fellows to become board eligible forensic pathologists.

With a sense of excitement and no small amount of trepidation, Laurie threw back the covers and stood up. She shivered as her warm feet made contact with the ice-cold floor. Hastily she wiggled her toes into the slippers she dutifully kept at the bedside and pulled on her robe. She always kept both handy in case she had to get up during the night. Jack had not moved a muscle. He was on his back with his arms outside of the blankets, his hands clasped over his chest, and his mouth slightly ajar, the picture of contented repose. Knowing him as well as she did, Laurie had to smile. Jack was not the calm person he appeared at the moment, but rather someone whose mind never stopped and who had little patience for what he called red tape, meaning rules and regulations he didn’t agree with. He didn’t abide fools, or mediocrity, and he was never one to hide his feelings. From where Laurie was standing, she could see the scar on his forehead and his chipped left front tooth, both remnants of his determination to do what he thought was right despite putting himself at risk and getting pummeled for it. Although she loved him, she knew he was a handful, especially now that she was technically his boss. Although Jack was by far the most productive medical examiner on the entire staff, he was also the one who required the most corralling. Laurie knew, because she’d been rather similar in her day.

Closing the door silently behind her, Laurie tiptoed into Emma’s room, which was considerably darker than the master bedroom, thanks to the shades being drawn. Like Jack, Emma was fast asleep on her back, and appeared angelic in the half-light as only a four-year-old girl can look. Laurie had to restrain herself from reaching out and giving the child a hug. After the initial scare and distress evoked by a diagnosis of autism more than a year ago, Emma had been doing surprisingly well in response to thirty hours of behavioral therapy, five hours of speech therapy, and three hours of physical therapy weekly. It was a complicated, intensive schedule that had all been arranged and monitored by Laurie’s mother, Dorothy, who had turned out to be a lifesaver. After she’d initially caused difficulty between Laurie and Jack by camping out in their home after Emma’s diagnosis, Dorothy had truly stepped up to the plate to take on Emma’s situation as her life’s work, shunning all her previous philanthropic commitments. After corroborating the diagnosis with several acknowledged specialists, Dorothy had researched all the best therapists in the city, interviewed them, hired them, coordinated their schedules, and monitored them. And the effort proved worthwhile. After several months there were some positive signs. Emma’s inclination for repetitive movements appeared to lessen, and she began to lose interest in her compulsion to align her stuffed animals. Perhaps most promising, she showed increased ability to interact with JJ with even a few appropriate words. There was still a long way to go, but Laurie and Jack both were optimistic that Emma might prove to be in the group of children diagnosed with autism that do make considerable headway in achieving typical developmental milestones.

Being even quieter than she’d been when she’d entered, Laurie left Emma’s room, closing the door without the slightest sound. Emma was generally a good sleeper and usually didn’t wake up until after seven, but she could be a bear if disturbed, and sometimes it didn’t take much. On cat’s feet Laurie continued down the hall to JJ’s room. Like Emma, JJ was fast asleep in the room’s semidarkness, but unlike Emma, he looked as if he’d been running a marathon in his bed. His covers and sheets were hopelessly twisted around his nine-and-a-half-year-old body, but with his legs and feet out in the cold. Laurie couldn’t help but smile. Even in sleep the boy was a ball of action, although at that particular moment he was totally still. Without fear of waking him, as he was the opposite of Emma in that regard, Laurie extricated the knot of covers and then spread them back over him, including his legs and feet.

Satisfied with what she had accomplished, Laurie turned with the intent of heading downstairs to the kitchen to get some breakfast. The plan was to use this bonus time in her day to go over the material she’d laboriously prepared the night before and would be presenting during her command appearance that morning at a recently scheduled meeting of the City Council’s Committee on Health. It was this meeting and her long-term anathema to speaking in front of groups that had awakened her so early. But she didn’t get far, and an involuntary yelp escaped her lips as she collided with Jack, who had come into JJ’s bedroom behind her and was about to tap her on the shoulder. Even Jack jumped at Laurie’s apparent shock.

“My God!” Laurie managed in a forced whisper. “You scared the hell out of me.”

“I can say the same.” Jack pressed an open palm against his chest in the stereotypical sign of distress. In contrast to Laurie, his feet were bare, and he wore only pajama bottoms to ward against the chill. “Was something wrong with JJ?” He looked around Laurie at the sleeping child.

“No, he’s fine. I just covered him up.”

“What are you doing up out of bed?” he questioned with obvious concern. “I can’t remember the last time I saw you up and about before six. Are you all right?”

“I’m fine. I’m just a little worried about this morning’s City Council Committee meeting,” she said. “I want to go over the material I was working on last night. I told you about it.”

“Yeah, I remember,” Jack said with a dismissive wave of his hand. “That’s so much to do about nothing. You shouldn’t waste your time and emotion on a little mix-up just because a handful of politicians are up in arms.”

“I don’t see it that way, not when the City Council has oversight over the OCME budget,” Laurie said. “Keeping them happy is one of my main responsibilities, especially when we’re in dire need of a new Forensic Pathology building and a new autopsy suite.”

“But the little body switcheroo was an understandable mistake. No one was hurt, and it was easy to rectify.”

“It’s easy for you to say no one was hurt. I heard both families were pretty damn upset and at least one of them is thinking of suing. Dealing with death is hard enough without having to experience the emotional shock of confronting the wrong body in an open-casket wake.”

The origin of the problem was the near-simultaneous arrival at the OCME of two cadavers with the same first and last name, Henry Norton. Even though they received unique accession numbers, the night mortuary tech just checked the name and not the number when the first body was released, meaning both bodies ended up at the wrong funeral homes. To make matters worse, the mistake wasn’t discovered until the family arrived for the first funeral service.

“I truly don’t know how you find the patience for this kind of crap,” he said with a shake of his head. “So what are you going to say to the committee?”

“I’m going to tell them that I personally apologized to both families, which I did. And then I’ll explain the changes in protocol I’ve made in how bodies are released to make sure it doesn’t happen again. I’ve also asked IT to update the case-management system to call attention to similar-named decedents.”

“Well, it sounds like you’ve got the situation well under control.”

“Unfortunately, the problem spread. The funeral home where the mix-up was first discovered is on Staten Island. The director added to his complaint that it takes too long for him to get bodies now that we’ve closed the Staten Island morgue and do the autopsies here in Manhattan.”

“Yikes! So this mix-up of too many Nortons now forces you to justify closing the morgue on Staten Island?”

“It’s worse than that,” Laurie said with a sigh. “One of the Health Committee members is from the Bronx, where the morgue was also closed. She’s claimed that funeral directors in her district have complained about long delays, too. I’ve had to rush together an extensive report on the turnaround times for bodies from all five boroughs. It’s a PowerPoint presentation, and you know how much I detest talking in front of groups.”

“You’ve told me, but it’s a mystery because you always come across like a pro.”

“That’s because I overprepare,” she said. “Hey! Aren’t you freezing? I’m cold, and I’m in a robe and slippers.”

Jack briefly hugged himself and pretended to shiver. “It is a bit chilly.”

“Get your robe and come downstairs,” Laurie said. “I’ll make some coffee. There’s a favor I need to ask you to do for me this morning.”

“Favor?” Jack questioned as he paused at the door to the hallway. “I’m not sure I like the sound of that. What kind of favor?”

“Something I was going to do this morning, but now because of this impromptu meeting down at 250 Broadway, I need you to go in my place.”

“Was this something you were scheduled to do as the chief medical examiner? I don’t need to remind you that I’m not good at politics.”

“No, it’s something I was scheduled to do as a mother. You’ll go as the father, which is totally apropos.”

“How long has this been scheduled?”

“About a week.”

“Are you sure I can handle this?” Jack asked, only half-teasing.

“No, but there’s no choice,” she said with a short laugh. “Get your robe before you freeze to death, and I’ll explain.”

Laurie followed him out of JJ’s room and watched him sprint down the hall toward the entrance to their bedroom. With all his pickup basketball and bike riding, he was shockingly fit. Laurie wished he’d stop both and constantly tried to convince him that the family needed him injury-free, but she had to admit that he did look good and wished she had half of his stamina. The trouble was that being the chief medical examiner, a mother, and chief household engineer left her scant time for herself or any kind of exercise routine.

A few minutes later and even before Laurie managed to get the coffee water boiling, Jack swept down the stairs and into the kitchen dressed in his white summer robe. His feet were still bare.

“Okay, out with it,” he said, pretending to be already irritated.

“You have to go to JJ’s school and meet with Miss Rossi and possibly the school psychologist. The meeting is scheduled for eight, prior to classes. I certainly don’t condone your commuting to the OCME on your bike, but it will make it easy for you since the Brooks School is on your way.”

“I already don’t like the sound of this,” he said.

“I suspected as much. That’s why I intended to just handle it myself unless it turns out a decision has to be made. I’m of the opinion it’s just a temporary misunderstanding. I mean, kids go through phases.”

“JJ is not going through any phase,” Jack said, becoming serious. “What’s this all about?”

“I can’t remember the entire litany,” Laurie said. “But there’s been some aggressive behavior on JJ’s part at recess and difficulty sitting still in class, allowing other children to take their turn, and impulse control. That kind of stuff.”

“Oh, for Chrissake,” he snapped. “There is nothing wrong with JJ except he has a Y chromosome, meaning he has a developing male brain that’s trying to prepare him to go out of the cave and hunt mammoths.”

“You know that, and I know that. But it behooves us to listen and be supportive of the teacher who has to handle eight young male brains all at the same time.”

“That’s what she’s being paid for,” Jack said.

“I’m sure it’s not that easy,” she said. “I give teachers all the respect in the world. I don’t think I could do it.”

“I know I couldn’t do it,” he said. “But that’s neither here nor there. What do you think they’re suggesting?”

“Obviously they’re concerned about attention deficit hyperactivity disorder.” Laurie concentrated on pouring the boiling water into the coffee maker.

“Did they say anything about drugs?”

“Miss Rossi raised the issue,” she said. “That’s all.”

“Good God.” Jack stared off into the middle distance for a few moments as the smell of brewing coffee enveloped the room.

Laurie poured two cups and handed one to him. She could tell his mind was going a mile a minute, and it wasn’t hard to guess the direction.

“My plan was just to go and listen,” Laurie said. “I ask you to do the same. You won’t be required to come to any conclusions today for certain. Just hear what they say and maybe ask a few questions, so you understand their perspective. Mostly listen! Then tonight we can talk about it. It will only take you fifteen or twenty minutes, tops.”

“I don’t know,” he said with a shake of his head. “This overdiagnosis-of-ADHD situation is the kind of nonsense that could turn me into a conspiracist. It certainly seems like the pharmaceutical industry and the elementary education industry are in cahoots. There are just too many school-age kids, mostly boys, being prescribed speed to make them easier to corral. And then we wonder why the same kids take drugs as teenagers. I can tell you now, JJ’s not taking any Adderall. No way.”

“That’s certainly my feeling at the moment,” she said. “But I also know medication can be helpful under the right circumstances. And we need to show some respect for the school’s position, whatever it is. It’s not rocket science that we need to stay on friendly terms.”

“I’m not the natural-born diplomat you are,” he said. “I know that about myself, and I don’t want to alienate the school, which I might do by being honest. Why don’t you go after your Health Committee meeting?”

“I’m sorry, but I’ve got a jam-packed day ahead of me. I’ve got back-to-back obligations all day, including an emergency meeting with Chet McGovern even before I go down to 250 Broadway.”

“What on earth kind of emergency meeting are you having with Chet?”

“Ever since I appointed him director of education at the OCME, he’s really taken on the position with inordinate seriousness, to the OCME’s benefit. He’s upped the level of all our teaching efforts across the board.”

“I’m sorry to sound negative,” Jack said with a roll of his eyes, “but my guess is he took the position just because there are so many young women applying and being accepted as forensic pathology fellows. He’s an incorrigible Lothario. Chasing women is a sport for him.” Jack went to the refrigerator for fruit and milk while Laurie retrieved the cereal from the pantry.

“Maybe that influenced his motivation initially,” Laurie said, knowing Chet’s off-hours inclinations and social history from Jack, “but he’s really put heart and soul into the role of head of education in a way I wouldn’t have expected. This emergency meeting he’s requested is a case in point. He believes one of the NYU pathology residents isn’t acting appropriately on multiple levels. He calls her the Phantom because she isn’t taking her month’s forensic pathology rotation seriously, ignores advice, and often can’t be found.”

All anatomic pathology residents at NYU Medical School were required to spend one month at OCME during their four-to-five-year curriculum. Under the supervision of the OCME director of education, they would assist the medical examiners and learn in the process, but couldn’t sign death certificates. The goal was to introduce them to forensic pathology rather than train them as forensic pathologists. Forensic pathology fellows, on the other hand, had already completed their pathology residency and were required to do autopsies, determine the cause and manner of death, and sign the ultimate death certificate even though officially they were still in training.

“What’s the resident’s name?” Jack asked. He occasionally had pathology residents participate on his cases, although he didn’t go out of his way to encourage it. Jack had a reputation of doing the most autopsies by far of any of the medical examiners, which gave him the opportunity and excuse to cherry-pick interesting cases. As a result, many of the more motivated residents sought him out even though Jack hated being slowed down for any reason. Being a workaholic was one of the ways Jack dealt with his demons.

“Her name is Dr. Aria Nichols,” Laurie said. At that point Laurie and Jack were both eating cereal while standing and leaning their hindquarters against the kitchen countertop.

“I don’t think I’ve met her. But if Chet is interested in her, she must at least be attractive.” He laughed to indicate he was half kidding.

“I think you’re being unfair,” she said. “I don’t think Chet is being personal in the slightest with this woman. My sense is that he’s sincere and truly concerned about her. He even questioned if she should be a pathology resident or even a doctor.”

“Wow,” Jack said around a mouthful of cereal. “She must have brushed him off big-time.”

Laurie waved away his attempt at humor at Chet’s expense and rinsed out her bowl. “I’m impressed that Chet is as concerned as he apparently is, and I’ll be interested in what he has to say. Under Dr. Bingham’s tenure, there was never much attention paid to the NYU anatomic pathology residents. I think that’s got to change, and Chet seems to be doing just that. I want to be supportive.”

“Whatever.” He followed her to the sink. “If this school meeting is only going to take fifteen or twenty minutes, are you sure you can’t tackle it? What about you looping back to the Brooks School immediately after your Committee meeting? I want to support you and JJ and pull my weight, but sending me is a risk. I’m worried that I’ll screw everything up by ruffling feathers. I mean, I feel as strongly about this overdiagnosis of ADHD as I do about the anti-vaccination movement.”

“I already told you I won’t have the time,” Laurie said. “As soon as I can get back to the OCME I’ve got a meeting with the chief of staff, the director of human resources, and Bart Arnold about medical-legal investigators’ pay. It’s an important meeting the four of us have been trying to schedule for weeks. The OCME is falling too far behind compared to what physician assistants can make in the private sector, which is making our MLI recruitment almost impossible. And following that, I’m meeting with the architects about the new morgue building. Actually, I’m even going to have trouble fitting both of those in because at eleven I’m scheduled to be over at the Tisch Hospital for my annual breast-cancer screening.” After Laurie’s mother, Dorothy, had been diagnosed and treated for breast cancer a number of years previously, Laurie had had herself checked for the BRCA gene. When it was determined she, too, was positive for the BRCA1 mutation, she’d adhered religiously to regular screening.

“Okay,” he said, raising his hands in a gesture of surrender. “Now, that’s important! Why didn’t you just say that right off the bat?”

“It’s not my favorite subject,” she admitted. “Actually, I hate it, and I suppose I indulge in a little denial. At least I hate the mammogram part. The MRI I can tolerate because it’s not uncomfortable or painful. Worst of all, the whole screening process makes me terrified all over again. I’m always afraid they are going to find something suspicious and put me in a tailspin. I’m way too busy to have a serious medical problem.”

“You’re also way too important to me and to this family to have a serious medical problem,” Jack said. “Your health comes first. Leave the school meeting to me. I’ll try to be my normal diplomatic self.”

“Thank you,” Laurie said. “Despite your sarcasm, I’m confident you can handle it.” She gave his shoulder a reassuring squeeze.

At that moment Caitlin O’Connell, their live-in nanny, materialized as she came up the open stairs from the floor below. She was as Irish in appearance as her name sounded, with dark hair, fair skin, blue eyes, and a ready smile. She, too, was in her robe.

“Good morning,” she called out, as she approached the granite-topped central island. “What on earth are you two doing up this early, especially you, Laurie? I’ve never known you to be a morning person.”

Laurie smiled and took one last sip of coffee. “Apparently I am one today.”