There were at least a hundred memos to file, as well. Formal documentation-probably dictated to Driscoll-of various meetings and decisions. Nothing that struck him as new or important. More interesting to Hardy, although far more cryptic, were the thirty or forty shorthand reminders and comments that Markham had probably typed to himself. It was obvious that he believed he could write in a secure-probably a passworded-document, but that Driscoll had breached that security and gotten access. But try as he might, Hardy couldn't make much out of them.
Markham's early memos to Portola's administration on Lopez were mostly concerned with the facts of the situation. They were about insurance considerations and a litany of medical explanations of specific decisions that might mitigate their liability in the inevitable lawsuit.
Several memos, both to file and to the Physicians' Group, explored the culpability of a Dr. Jadra, who had been the first physician to examine Ramiro Lopez at the clinic. Somehow, Hardy gathered, it was determined that Jadra's actions were not negligent. The boy's fever had been mild on that first visit. The throat infection had not yet progressed to the point where a reasonable diagnostician would necessarily prescribe antibiotics or even order a strep test. Further, Jadra did not note the cut on Ramiro's lip in his file at all, and when questioned about it later, had no memory of it. These Jadra memos struck Hardy as interesting because he could read the obvious subtext: Markham was looking for a scapegoat, and the case against Jadra would not be as clear-cut as that against Cohn. So these Jadra documents had, to Hardy, an odd, defensive character.
By contrast, when Markham finally recommended that they prepare an 805 on Cohn-which went on her permanent record with the state medical board and the National Practitioner Data Bank-the letter was sharply worded and extremely critical: "…Dr. Cohn's inability to recognize the early signs of necrotizing fasciitis and her failure to recommend highly aggressive treatment was surely the primary factor contributing to the patient's death. By the time he was admitted to the ICU, the disease had progressed to the point where even the most active intervention would probably not have been efficacious. We recommend that Portola suspend Dr. Cohn's clinical privileges for thirty days, that you submit an 805 report on this incident, as required, and that you conduct a full enquiry to determine the advisability of Dr. Cohn's continued employ within the Parnassus Physicians' Group."
Hardy knew what Markham was doing here-trying to distance himself and the hospital from Judith's failure to make an early diagnosis. Again, this decision was about insurance, about getting sued, about the money. From Kensing's perspective, though admittedly biased, the real ultimate culprit in this tragedy had been Malachi Ross, pulling the strings and denying the needed care from on high. Instead, the opprobrium was falling most heavily, and solely, on a relatively newly hired, young female staffer. Even if Judith might have done a better job with the early diagnosis, it was clearly unfair to single her out as the reason the boy had died. Many people contributed, as did the corporate culture, and Hardy thought the whole thing stunk.
It did, however, provide a solid motive for Judith to have hated Markham.
He turned the page and stared uncomprehendingly at the next. Something about Ross he was sure. The initials MR. Then "Priv. Invest." But did this refer to a private investment in one of the drug companies with whom Parnassus did business, or to a private investigator that Markham might hire to keep tabs on his medical director? There was simply no way to know.
He went on to the next page.
"I do not remember." Rajan Bhutan shook his head sadly.
Fisk had had a few ideas he wanted to pursue about the car and some other things, so Glitsky had asked Darrel Bracco if he wanted to sit in with him while he talked to Rajan Bhutan, who'd volunteered to come down to the hall in the early afternoon. Nevertheless, Bhutan seemed nervous and reluctant when he showed up punctually for the interview. He asked Glitsky several times if he needed a lawyer, and once if Glitsky was going to arrest him. Glitsky reassured him that he was free to leave at any time. No one was arresting anyone today.
Bhutan told Glitsky he did not like it that people thought he might have killed someone. Glitsky told him they just wanted to clear up some things he'd said before, maybe get a few more facts. But of course (Glitsky reiterated) he was welcome to call an attorney at any point if he wanted to spend the money.
But now with no attorney, Bhutan was saying he didn't remember the day after Christmas. "You don't remember if you worked at all that day?" Bracco was doing bad cop. Glitsky had already made friends with Bhutan in their earlier interview, and preferred to leave things that way.
"I'm sure there is a record of it," Bhutan responded, wanting to be helpful. "You could check with personnel."
"We've already done that, Rajan, and they tell us you were working that day, and it just seems like you would have remembered. Do you know why? Do you remember Shirley Watrous? She died that day. She was murdered on that day."
Glitsky sat at the head of the table, kitty-corner to both of them. He held up a hand, restraining Bracco for Bhutan's benefit. "Do you remember anything specific about Shirley Watrous, Rajan? Was she a difficult patient, something like that?"
Bhutan hung his head, then raised it again with an effort. "I do remember that name. She was, no, not difficult. There really is no one more difficult than another in the intensive care unit. They are all just people who are suffering."
"The suffering bothers you, doesn't it, Rajan?" Bracco was sitting across from him. There was a video camera masked in an air vent mounted in the corner on the ceiling, an unseen tape running under the table.
"Yes. It's why I became a nurse. My wife suffered terribly before she died, and I learned that I could help."
Glitsky poured more water from the pitcher into Bhutan's paper cup. "Did you ever think you could help patients more by putting them out of their misery?"
"No. I have never done that kind of thing. Not one time."
"Never pulled the plug on anyone when it was clear they were going to die? Anything like that?" Glitsky asked gently.
Bhutan sipped from his cup, shook his head. "No. Always, that is the doctor's decision. I am there only to help, not to decide. If I have a question, I ask a doctor." Again, he drank some water. "And I never know when people are going to die, Lieutenant. No one knows that, not even the doctors. No one but God. In these years I have worked at the ICU, I have seen people come in and think they won't make it to the night. But then, a week later they sit up and can go home. It is just what happens."
Bracco jumped all over that. "Well, Shirley Watrous didn't just happen. Something happened to her. Same as with Marjorie Loring. And you were on duty for both of them. What do you have to say about that?"
Glitsky leaned in helpfully. "Maybe they were belligerent, Rajan. They didn't want you poking at them, changing their beds. Maybe they were making it worse for the others in the room."
Bhutan looked from one inspector to the other. "I don't know what to say. What do you want me to say?"
"You are the common denominator on both of the shifts where these women died, Rajan." Bracco thought they were getting close, and his intensity came through. "We've got another nine or ten people who died in the ICU, and you were on for all of them, as well. If you were sitting here where we are, what would you think?"