Monks met him in front of the ER's main entrance. Speidel was about Monks's age, a big bearlike man with thick dark hair and kind, cynical eyes. Like most longtime emergency personnel, he was under no illusions about textbook situations versus bloody, desperate, real ones.
"I need to make it clear, I'm speaking to you in your capacity as QA chair," Monks said. This made the conversation official business: the information exchanged was not available to any outsider, except by subpoena.
Speidel's eyebrows rose. "Nuclear secrets? Terrorist attacks?"
"I've got a Death Review coming up."
Speidel nodded. Word had already gotten around.
The hospital's Quality Assurance system, QA for short, reviewed all internal mishaps and mistakes, from medical errors to people slipping and falling. Everything that happened under its auspices was undiscoverable by the courts – its privacy was protected, including, especially, from lawyers. All personnel, from the chief of staff on down through janitorial, were under a strict injunction of confidentiality. Bribery and ratting did happen, but not often. This maintained rigorous honesty without vulnerability; it was the hospital's method of self-policing and self-educating. Like all systems, it had its flaws, but in Monks's experience, it worked remarkably well.
Eden Hale's Death Review was going through the QA system's standard channels. It was clearly the Emergency Room's case, and up to the ER committee's chair, Speidel, to assign another, nontreating ER physician – not Monks – to review it. The Medical Records department would provide all pertinent information. That physician would then fill out a form, answering three questions: Given the circumstances, was the outcome predictable? Was the treatment within the standard of care? Does this case need review by the full QA committee?
Monks wanted to know what his peers thought – what they would have done in his place; whether he was justified or damned.
"I'd like you to expedite the review, Dick," Monks said. "If it does go to committee, to do it this month instead of next."
Speidel frowned. "That's next Monday, Carroll."
"I know it's a lot to ask."
"Are you kidding? Most guys would put it off indefinitely and hope it went away. I just meant I'm not sure if I have time. I haven't even assigned it yet."
"If I screwed up, I want to know it," Monks said. "The hospital ought to know it, too. There are rumblings about litigation."
Speidel gazed off at the ocean. Monks knew that as liaison and QA chair, he would be acutely concerned about any situation that might reflect badly on the ER.
"All right," Speidel said. "If you don't have any objections, I'll do the initial review myself."
"That's more than fine with me."
"I'll let you know tomorrow morning."
Speidel went back inside. Monks stayed there for a minute, deciding what to do next. A distant fog bank was forming on the horizon, like a mirage. It offered a teasing promise of cooler air. That would be a blessing.
Ray Dreyer's phone number wasn't listed. But he had logged in at the ER desk yesterday. Monks coaxed the charge nurse into looking up his address and phone.
It was almost nine a.m. now, but he was reasonably sure that Dreyer was not an eight-to-fiver. If anything, the call might wake him up.
After four rings, a digital voice answered. "The person you are calling is not available right now-" It seemed that Dreyer wanted to stay anonymous.
Monks waited for the beep, then said, "Mr. Dreyer, this is Dr. Monks. I attended Eden Hale-"
The phone clicked, and a male voice said, "Yeah, I remember."
So Dreyer was screening calls, too. His tone made it clear that he was not feeling any friendlier. Monks decided to forget about social graces and get right to it.
"It turns out that Eden had salmonella in her bloodstream. Food poisoning. Any ideas how she might have gotten that?"
"Hey, I don't know what she ate," Dreyer said. "She had stuff in the refrigerator."
"You didn't stop anyplace after the clinic? A deli, takeout?"
"Uh-uh. We went straight back to her apartment."
"Did Eden keep anything around, like chemicals?"
Dreyer's tone turned wary, probably from worry about recreational drugs. "What kind of chemicals?"
"Insecticides?" Monks said. "Photography equipment, heavy-duty cleaning fluids?"
Dreyer laughed thinly. "She never cleaned anything in her life, except when she took a bath. There's about five tons of makeup, if that counts."
It was a tender sentiment for a lost love.
"What about drugs?" Monks said. "This is just between us. Did she take anything besides the Valium the doctor gave her?"
"No way, man. All she wanted to do was crash."
And so she had, Monks thought.
"Okay, thanks," he said. "We're still working on this."
"So am I," Dreyer said mysteriously.
Monks hung up, walked back out to his battered Bronco, and drove to D'Anton's clinic.
Chapter 15
The clinic's parking lot was almost empty this morning, but the front door was unlocked. When Monks pushed it open, Gwen Bricknell was busy at her desk – exactly as he had last seen her yesterday, except that she was wearing an eggshell-colored dress of light, fine cotton. Monks was not much of a judge of women's clothing, or men's for that matter, but he had a feeling that it was the kind of simple attire that was very expensive. The room was otherwise deserted. When he walked to the desk he caught the scent of her perfume, very faint, musky rather than sweet.
He did not expect her to be friendly, and he was surprised when she smiled and said, "Good morning, Dr. Monks."
He murmured hello, struck again by her sheer beauty. If there was any flaw, it was flawlessness – as if, when D' Anton had sculpted her face, he had razored off the imperfections that lent humanness.
But her eyes, dark like olives, were alive – wary, but not hard with hostility. If anything, she seemed a little frightened. The shock of Eden Hale's death had had time to sink in, he thought. This was not the ER; losing a patient was not something that happened with inevitable regularity.
"We're closed, officially," she said. "I'm just rescheduling appointments."
"Dr. D'Anton was going to leave some records for me. Sorry if this is bad timing."
"No, no, it's fine. Welles – Dr. D'Anton – is taking a couple of days off. He asked me to make you at home. He apologizes for being abrasive yesterday. He was very upset."
"Understandable, of course," Monks said.
"I know this is awkward, Doctor," she said, surprising him again. "I don't mean for it to be."
"I appreciate that, Ms. Bricknell," he said. "I don't like it either. But I need to find out what happened to that young woman."
For the next couple of seconds, Monks had the eerie sensation that whoever was behind Gwen Bricknell's eyes had gone – that he was looking at an absolutely still body whose owner was someplace else. By the time he was aware of it, she was back.
"I'll get the records," she said. She stood and opened the door into the rear office, started to step through, and stopped abruptly.
Monks realized that the nurse, Phyllis, was walking past, just on the other side of the door.
Gwen's shoulders sagged in exasperation. "Phyllis, you are everywhere I turn."