“Dr. Nour,” Jesse said, “I’d like a minute.”
The doctor barely acknowledged his presence, tapping away at a mobile computer. “Yes, yes, Officer, what is it?”
Jesse couldn’t help but laugh.
That got her attention. She looked up. “I wasn’t aware I said something amusing.”
“I’m actually the Paradise police chief, but that’s not what I was laughing at.”
“Pardon me, Chief. I meant no offense.”
“None taken. And please, call me Jesse.”
“All right, Jesse. But may I ask what you found so amusing?”
“Your impatience.”
She shrugged, and Jesse wasn’t inclined to explain any further.
“You saw a patient here last year, Heather Mackey. She was sixteen at the time. She’d taken a fall and was diagnosed with compressed vertebrae.” He repeated the course of treatment Patti Mackey had described to him. “Do you recall treating her? I would like to discuss her case with you.”
Nour’s expression lost any hint of friendliness. “As police chief, you know I am legally and ethically prohibited from discussing my patients with—”
Jesse cut her off. “She’s dead.”
“My goodness. How?”
“Heroin overdose.”
“I see, yes, follow me.”
Dr. Nour led Jesse to a conference room. At first, they both sat, but when Jesse described how Heather was found by her mother, Dr. Nour rose out of her seat and paced.
Jesse asked again, “Do you remember her?”
Nour looked devastated. “I’m sorry, but I don’t. I treat many, many patients here and in Boston, where my practice is based. You say I diagnosed her with compressed vertebrae and that I prescribed rest, physical therapy, massage therapy, and that Dr. Goldfine gave her Motrin for the pain?”
Jesse nodded.
“That sounds consistent with a course of treatment I might suggest, but without looking at her charts... wait. Will you excuse me for a few moments?”
Ten minutes later she returned, holding a batch of papers in her hand. “I had the staff make a copy of the report from Heather’s visit here and I had my office scan and email the notes from her follow-up visits in Boston.” She sat and reviewed the files. “Yes, Heather had compressed vertebrae.” Dr. Nour stood, came around to Jesse, and slid MRI images in front of him. “See, right here. And, indeed, I did prescribe that exact treatment.”
But something else had gotten Jesse’s attention. “You said ‘follow-up visits.’ How many?”
She checked the files. “Four... yes, four visits in total, including her initial visit with me here at the hospital.”
“Is that unusual?”
“Each case is different, especially with spinal injuries. For instance, I’m sure that if I were to do an MRI on you, Jesse, I might find that you, too, have compressed vertebrae or possibly stenosis of your cervical spine. The general population all have injuries of some form or other. Give me a group of ten men or women with MRIs indicating the identical issue and there’s a likelihood that six of the ten would be asymptomatic and completely unaware of the damage. The remaining patients would likely display a range of symptoms with varying levels of distress.”
“Uh-huh. Fascinating, but what about Heather? Where did she land on the curve?”
“I’m afraid she wasn’t tolerating the pain very well with the Motrin. I prescribed Vicodin.”
“Is that usual, prescribing an opiate for teenagers?” Jesse asked, his tone calm and nonaccusatory.
“I prefer not to prescribe it for anyone, but my notes say she was in obvious distress and she was accompanied by her mother. See the notation here. Whenever I prescribe any controlled substance, I discuss with the patient the drug’s potential lethality and addictive characteristics. I prescribed a fifteen-day course of the drug for Heather. With Vicodin, I am loath to renew the prescription unless the patient reinjures herself or sustains a new injury. My file shows that was not the case with Miss Mackey.”
Jesse said, “That accounts for three visits. What happened on the fourth visit?”
“It was routine. She reported a considerable reduction in pain. Her physical-therapy report showed a marked improvement. She did not return for further treatment or consultation. I hope this has been of some help.”
“Thanks, Doc. At this point, I can’t say.”
“If you think I can be of any further use, please do not hesitate to contact me. Here.” She held a card out to him but pulled it back. When she did, she wrote a number on the back. “That is my cell phone number. I find this very distressing, so I don’t want you to have to go through my office to get in touch.”
Jesse stared at her after taking the card from her, then said, “I understand your distress, but is there any reason in particular Heather’s case disturbs you?”
“Heather’s is not the first such story I have heard. Several of my colleagues have had to deal with similar cases.”
Jesse didn’t say what he was thinking but knew the moment she said what she had about other similar cases that either he or Molly would definitely be getting in touch. A pattern was always easier to track than an isolated case, and if he could establish a pattern, he might find out why Heather Mackey was dead.
Twenty-seven
Jesse called Molly as soon as he got back into his Explorer.
“I need you to do a little investigative work. You might have to charm Lundquist a little bit to help you.”
“What do you need?”
“Dr. Farah Nour. She’s a spine and back specialist at Paradise General and her practice is in Boston. I need to know whatever you can find out about her.”
“You suspect her of something?”
“No, but she is the first link to Heather’s addiction. She prescribed Vicodin for her last year. I doubt she’s involved beyond that, but we should do our due diligence. See if we can connect any other cases like Heather’s to her.”
“Sure thing, Jesse. Where are you headed now?”
“I think I’ll circle back to the Mackeys.”
That was met with a curious silence. Jesse sensed Molly had something to ask but was holding back. And since Jesse was still working his way through things on gut feelings, he wasn’t ready to share.
He said, “I’ll check in later,” and clicked off.
Jesse approached the Mackeys’ house slowly. He wanted to be certain Steve Mackey wasn’t around, and when he saw that the selectman’s BMW wasn’t parked in the driveway, as it almost always was, Jesse pulled over to the curb.
Patti Mackey was a wreck. The other day, when he’d come by to ask about Heather’s recent behavior, Patti had acted the part of the brave parent. The woman who would push on in spite of her girl’s death. The woman who would somehow find a way to make Heather’s death mean something. None of that was in evidence today.
“Jesse!” she said, gasping as she realized the state she was in. “God, I’m a mess. I’m sorry.”
She was dressed in a ratty pink bathrobe and slippers. She wore no makeup and, from the smell of her breath, had been using vodka as a mouthwash.
“What parent wouldn’t be?” he asked. “No need for apologies.”
A light went on behind her reddened eyes. “Have you found something?”
“Can I come in?”
“Oh, please forgive me. Sure, Jesse, come into the kitchen.”
The kitchen. It was almost always the kitchen where people felt most comfortable talking to him. He was suspicious when people asked to speak to him in libraries, offices, or dens. There was just something about kitchens that put people more at ease and made people more willing to speak the truth.