“That’s interesting that you noticed,” Lou said. “The investigators posit that Cavanaugh handled it on a regular basis. The thought is that he considered it a kind of trophy of his accomplishments and leafed through it maybe as often as every day. It must have been like his devil’s bible.”
“What a freaking creep,” Jack said. “Your having to kill him was a service to humanity, but it’s a double tragedy in a weird way. He was a prolific killer, but it was also my impression from speaking with him and from what I had been told by one of the emergency medicine doctors that he was a terrific nurse when he wanted to be. He was certainly smart enough and had gotten good nursing training in the navy.”
When the page in question was revealed, both Laurie and Jack audibly sucked in a breath. There was a list of twenty-three names. The next to last was Susan Passero, which caught Laurie’s eye, whereas Jack noticed not only Susan Passero but also the final name, Cherine Gardener.
“What on earth is this list?” Laurie managed.
“The investigators have only checked a handful of these cases so far, but here’s what they believe. In contrast to the front of the book, where all the cases could be considered mercy killings, meaning the victims had serious medical disease, mostly advanced cancer of one form or another, this latter list, except for the last two entries, seem to be cases that should be called hero victims. Ronald Cavanaugh, at some point, branched off from his mercy killing to purposely put various patients in jeopardy by using some toxic medication or overdose purely to get the credit and prestige of being the one to make the diagnosis of what was ailing them and save them in the process. Unfortunately, it didn’t always work out as planned, and that list are the failures, or the patients who died. How many times he tried this hero hoax and with how many patients, we’ll probably never know. All we know is twenty-one times the chosen victim didn’t get enough antidote or didn’t get it soon enough.”
“God! What a fiend!” Laurie spat. She closed the book, took it out of Jack’s hands, and quickly gave it back to Lou as if handling it made her feel complicit. “Where do these people come from? Are they born that way or are they made to be that way?”
“You doctors are better equipped to answer that question than we lay ignoramuses,” Lou said as he repackaged the ledger. “But the investigation into Ronald Cavanaugh’s background has shown a bit of light and seems to point more toward the made route. His parents were killed in an auto accident when he was four, and he was taken in by his maternal grandmother. Unfortunately, she ended up passing away when Ronald was eight, and he ended up in the New York State foster care program. Ronald and another boy two years younger were taken in as foster children by a nurse. Everything seems to have been hunky-dory until the nurse, thanks to a cigarette habit, came down with mouth or throat cancer that required aggressive treatment. From then on things went downhill, and years later she was diagnosed with Munchausen by proxy.”
“Good gravy,” Jack said.
“I think a better expletive than good gravy is called for,” Lou said. “Anyway, I just learned about the syndrome yesterday. It’s big-time weird. But the long and short of it is that Ronald and his foster brother suffered and were constantly in and out of the hospital with myriad complaints, all of which the foster mother was causing using various medications she’d give them, including table salt. Hell, I had no idea table salt could put you in the hospital.”
“If you eat enough of it, it can be fatal,” Laurie said.
“Somehow Ronald Cavanaugh survived even though his foster brother didn’t, and he aged out of the system at eighteen and joined the navy, where he seems to have done okay for himself.”
“He did,” Jack agreed. “He became an independent duty corpsman on a fast-attack nuclear submarine.”
“Good God,” Lou voiced. “Now maybe I understand. Being on a submarine underwater for months at a time would have driven me bonkers.”
Suddenly Lou’s mobile rang in his jacket pocket. Pulling it out, he looked at the screen briefly. “Sorry,” he said to Laurie and Jack. “I’ve got to take this.” He then walked toward the window that faced out onto 106th Street and began speaking in low tones.
Laurie looked down at Jack. “I cannot believe it,” she said with a shake of her head. “This whole mess is much worse than I ever could have imagined. What a disaster for so many families and even the MMH. That beast Cavanaugh killed one hundred and seventeen people, and that’s what we know of. There could have been more.”
“All I can say is that I’m really, really glad he didn’t kill one hundred and eighteen,” Jack said. “And you had an enormous role in preventing it. So, if I haven’t expressed it enough or adequately already, let me say again with true sincerity that I thank you for being there when I needed you.”
Laurie felt some tears of joy threaten to surface, which she wanted to avoid since she considered demonstrative emotionalism one of her weaknesses. To avoid a scene, she merely bent over and gave him a strong, heartfelt hug.
“Ouch,” Jack complained good-naturedly. “You’re forgetting my broken rib.”
“Sorry,” Laurie said. She straightened up and gave him a loud kiss on the cheek and then mussed his already disarranged hair. “There was a time that fateful night when I truly thought that I had failed in keeping watch over you. But, needless to say, I’m enormously thankful that everything turned out as it has, for all of us.”
“Unfortunately, I’ve got to run,” Lou said, interrupting Laurie as he hustled back from where he’d been standing at the window. He was still holding his phone. “But before I go, I have to give you two enormous credit for exposing and ridding the city of this awful man. You guys are quite a forensic team, which I have to admire even if it frequently makes being your friend difficult. Nonetheless you both deserve a medal for what you’ve done. Bravo!”
“Let’s give credit where credit is due,” Laurie said. “We wouldn’t have been able to do what we did without Sue Passero and her commitment as a caring physician. She’s the one who deserves the lion’s share of the credit. If it hadn’t been for her and her ultimate sacrifice, Ronald Cavanaugh would still be merrily carrying on and probably would have continued for years to come.”
“Hear, hear!” Jack and Lou voiced in unison while nodding enthusiastically.