"Okay. Sure." Jeff wasn't crazy about agreeing, but under the circumstances there was nothing else he could do.
"While we're being formal," and Hardy no longer had any intention of being anything but formal in his relations with this client, "this conversation isn't privileged, either. Just so you know."
"All right. So what are you suggesting? Some kind of rampant malpractice? Or something more serious?"
"I'm not suggesting anything," Hardy said. "I'm asking if anything has struck you."
"Well, I'd be surprised if we've filed many eight-oh-fives. I'll go that far."
"What are those?" Hardy asked.
"Reports to the state medical board. When a doctor screws up seriously enough for the administration to suspend his clinical privileges for more than thirty days, then the hospital's supposed to file an eight-oh-five with the state. They're also supposed to forward it to the National Practitioner Data Bank, which is federal-and never goes away. You get listed in the data bank, your career is toast."
"So why don't these things get turned in?" Hardy asked.
"You're a lawyer and you're asking me that? You're a doctor and some hospital writes you up, what do you do? You sue the bastards, of course. You're a patient who finds out your hospital hired a bad doc, you sue the hospital. Everybody sues everybody."
Elliot couldn't resist. "I always assumed you lawyers loved that part," he said to Hardy.
But Hardy was hearing something else altogether. "Are you telling me, Eric, that Portola's got these doctors, and knows it, and they're not filing these reports?"
"Let me answer that by saying that we have people on the staff whom I would not personally choose as my own physician."
"So what really happens when some doctor messes up?" Hardy asked.
"Couple of things. First, you notice I mentioned the magic thirty-day suspension from clinical privileges. So instead you get grounded for twenty-nine days. Ergo no eight-oh-five, right? You're within the guidelines. And no national database."
"Are there any Portola doctors on this database?" Jeff was always chasing the story. "How can I find out?"
"You can't." Kensing's voice was firm. "The public can't get access to it, for obvious reasons. Although prospective employers can. In any event, there's another way reporting doesn't happen. It's probably more common."
"And what's that?" Hardy asked.
"Well, the eight-oh-fives are based on peer reviews."
"Other doctors," Elliot said.
"Right. And there's some feeling among doctors, especially now at Portola, that we're all in this shit storm together, so we better protect one another. If one of our colleagues isn't making the right medical decisions, okay, you go have an informal discussion, mention the standard of care we all strive for. But we're all under this intense financial pressure, we're all working too hard all the time, the bottom line is we're not ratting one another out."
"Never?" Hardy asked.
"Maybe with some egregious lapse-I'm talking inexcusably gross fatal error-and maybe even more than one. But anything less, you're not going to get a peer review at Portola that recommends an eight-oh-five. Most hospitals in the country, I'd bet it's close to the same story."
In the cubicle, Elliot and Hardy looked at each other. "What about other causes of death?" Hardy asked. "Maybe intentional deaths?"
This gave Kensing pause. "What do you mean, intentional?"
"Maybe pulling the plug early, something like that." Hardy considered, then added, "Maybe something like this potassium."
"You're talking murder, aren't you?" No answer was called for. "Do I think that's been going on at Portola?"
"Do you?" Hardy asked.
"Only in my most paranoid moments."
Elliot jumped in. "Do you have many of those, Eric?"
Kensing sighed audibly. "There was another patient in the ICU at the same time as Markham. Did you both know that?"
"I thought there were several," Hardy said.
"That's true. What I meant was that there was another patient who died."
"Who was that?" Hardy's every instinct knew that he was on to something, and that this was part of it.
"His name was James Lector. Seventy-one, never smoked. He'd developed some complications after open-heart surgery and we had him on life support for a couple of weeks, but he was off that and responding to treatment. His vital signs had been improving. I was thinking of moving him out in a few days."
"And he died?" Hardy said.
"Just like that. No reason I could see. Just…stopped."
"I would never reveal a source," Elliot said. "I'd take your name to my grave."
Hardy ignored him. "So besides this man Lector," he asked, "how many would you estimate? Deaths you couldn't explain?"
"Actually, I started keeping track last November. This little logbook I have."
They waited.
He continued. "I thought I'd go back and see if there was a pattern. Maybe something to get them off my back."
Elliot asked him why he started keeping track. "I don't know exactly. I guess now that you ask, I wanted my own ammunition for when they finally got around to firing me. I didn't think anybody was killing patients on purpose, but we were losing patients we shouldn't have-like the Lopez boy, Jeff. So if fiscal policies were affecting medical care, I wanted to come back at them with that. I more or less just thought the place was going to shit and I wanted some record of specifics."
This time, the silence hung for a while. Finally, Hardy asked, "How many, Eric?"
"Not including Tuesday," Kensing said. "Eleven."
17
Whatever the special at Lou the Greek's would turn out to be today, Hardy didn't have a taste for it. He was hoping he could just stick his head through the door and survey the room to see if it contained Wes Farrell.
But no such luck.
Smack in the middle of the lunch hour, the place was wall to wall, three deep ordering drinks. The law continued to be thirst-making work, Hardy noted. He pushed himself into the crowd, got through the crush by the bar, and made a quick tour of the room, exchanging the occasional pleasantry with a familiar face, but mostly moving. If Farrell wasn't here, he didn't want to be, either. Not least because he didn't want to run into Glitsky.
He was still pissed off.
Hardy's call to Farrell's part-time secretary had luckily caught her at her desk and she'd told him her boss was scheduled to be in court all day. She wasn't sure if it was muni, superior, or federal, but she'd guess muni, which meant the Hall of Justice. So Hardy's hunch was lunch at the Greek's, and it turned out he was right. Wes had scored a back booth, invisible from the front door. He shared it with a large, nearly full pitcher of beer and a couple of guys who, in jeans and work shirts, were not dressed to impress any judge Hardy had ever heard of.
Sliding in next to Farrell, Hardy asked how he was doing. "So good I ought to be twins." Wes introduced everybody around the table. It turned out that his two companions-Jason and Jake-were father and son, which Hardy had guessed as soon as he'd sat down. The boy, Jake, maybe twenty years old, was Farrell's client. They were celebrating (hence the beer) because Jake's arresting officer hadn't shown up at his preliminary hearing this morning. Since he was the state's chief witness, the prosecution had dismissed all charges. Hardy had better manners than to ask what those had been.
So, they both insisted, Wes was a hero.
"He's always been one of mine," Hardy agreed. "In fact, that's why I'm here now." He turned to Wes. "Something important's come up. Can I steal you away for a few minutes? You guys mind?"
Just so long as he left the beer, everything was cool.