Nick Valentine looked up from the computer and grimaced when he heard the morgue attendant's rubber clogs clomping down the hall. The summons he knew was coming wasn't totally unexpected. After all, he was the pathologist on autopsy call this week, which was why he was sitting in this room adjacent to the morgue of Parkland Hospital instead of in his academic office at the medical school. But he'd hoped for some undisturbed time to get this project done.
The attendant stuck his head through the open door. "Dr.Valentine, you've got an autopsy coming up. Unexpected death in the OR. Dr. McIntyre's case. She asked if you could do it as soon as possible. And please page her before you start. She'd like to come down for the post." The man's head disappeared like that of a frightened turtle. More clomps down the hall signaled his departure.
There was nothing new about an attending wanting a postmortem done ASAP. You'd think they'd realize there was no hurry anymore, but that didn't seem to stop them from asking. At least she was willing to come down and watch instead of just reading his report. Nick turned to the shelf behind his desk and pulled out a dog-eared list headed "Frequently Needed Pager Numbers." He ran his finger down the page. Department of General Surgery. Anna E. McIntyre, Assistant Professor. He picked up the phone and punched in her number. After he heard the answering beeps, he entered his extension and hung up.
While he waited, Nick looked first at the pile of papers that covered half his desk, then at the words on his computer screen. He'd put this offfar too long. Now he had to get it done. To his way of thinking, putting together this CV, the curriculum vitae that was so important in academics, was wasted effort. Nick had no interest in a promotion, didn't think he'd get one even if his chairman requested it from the dean. But his chairman wanted the CV. And what the chairman wanted, the chairman got.
The phone rang. Probably Dr. McIntyre calling back.
"Nick, this is Dr. Wetherington. Do you have that CV finished yet?"
"I'm working on it."
"Well, I need it soon. I want you to get that promotion to associate professor, and I have to be able to show the committee why I've nominated you. Don't let me down."
Nick hung up and rifled through the pile on his desk. Reprints of papers published, programs showing lectures delivered at medical meetings, textbooks with chapters he'd written, certificates from awards received. His professional résumé was pitifully small, but to Nick it represented the least important part of his job. What mattered most to him was what he was about to do—try to find out why the best efforts of a top-notch medical staffhad failed to save the life of some poor soul. If he did his job well, then maybe those doctors would be able to snatch some other patient from the jaws of the grim reaper.
His phone rang. "Dr. Valentine, are you about ready?" the morgue attendant said.
Nick looked at his watch. Almost half an hour, and Dr. McIntyre hadn't responded to the page. He hated to start without her, but he might have to. "Give me another ten minutes."
While he waited, Nick figured he might as well try to make Dr. Wetherington happy. Now, when did he deliver that paper before the American Society of Clinical Pathology? And who cared, anyway?
Anna's administrative assistant met her at the doorway to the outer office. "Dr. McIntyre, I didn't know what to do."
"That's all right, Lisa. I'll talk with them." Anna straightened her white coat and walked into her private office, where two people stood conversing in low tones. Lisa had said, "Two policemen," but Anna was surprised to see that one of them was a woman.
The man stepped forward to meet Anna. "Doctor McIntyre?"
He pulled a leather folder from his pocket and held it open for her inspection. Anna could see the gold and blue badge pinned to the lower part of the wallet, but couldn't read the words on it. The card in the top portion told her, though. It carried a picture beside the words, U.S. Drug Enforcement Administration.
Lisa had been wrong. These people were from the DEA, not the police. Still, an unannounced visit from that agency made most doctors sweat. You never knew when some innocent slip might get you into trouble.
The man flipped the credential wallet closed. "This won't take long."
"Good. I've just finished an emergency case, and I still have a lot to do." Anna moved behind her desk and sat.
"Your chairman said you'd give us as much time as we need."
Anna glanced pointedly at her watch. "Well, have a seat and let's get to it. What do you need from me?"
The man lowered himself into the chair, his expression slightly disapproving. His partner followed suit. "We have some things we need for you to clear up."
"Could I see those credentials again?" Anna said. "Both of you."
They obliged, laying the open wallets on the desk. Anna pulled a slip of notepaper toward her and began copying the information, occasionally glancing up from her writing to match the names and faces on the IDs with the people sitting across from her. The spokesman was Special Agent John Hale, a chunky, middle-aged man wearing an off-the-rack suit that did nothing to disguise his ample middle. Anna thought he looked more like a seedy private eye than an officer of the law.
The woman, the silent half of the pair so far, was Special Agent Carolyn Kramer, a woman who reminded Anna of a California surfer, complete with perfect tan and faultlessly styled short blonde hair. The resemblance stopped there, though. Kramer's eyes gleamed with a combination of intelligence and determination that told Anna she'd better not underestimate the woman. Kramer wore a stylish pantsuit that had probably cost more than Anna made in a week. How could a DEA agent have money for an outfit like that?
Anna handed the badge wallets back to Hale and Kramer."All right, how can I help you?"
Hale pulled a small notebook from his inside coat pocket and flipped through the pages. "Doctor, recently you've been writing a large number of Vicodin prescriptions, all of them for an excessive amount of the drug. Can you explain that?"
"I don't know what you mean," Anna said. "I'm pretty sure I haven't written any more Vicodin 'scripts than usual, and I certainly haven't changed my prescribing practices."
Hale nodded, stone-faced. "What are those practices?"
"I prescribe Vicodin for postoperative pain in many of my patients, but always in carefully controlled amounts, usually thirty pills at a time. By the time they've exhausted that first prescription, I can generally put them on a non-narcotic pain reliever. It's rare that I refill a Vicodin 'script."
Apparently, it was Kramer's turn in the tag-team match. She picked up a thick leather folder from the floor beside her chair, unzipped it, and extracted a sheaf of papers held together by a wide rubber band. "Would you care to comment on these?" Her soft alto was a marked contrast to Hale's gruffbaritone.
Anna's eyes went to the clock on her desk. "Will this take much longer? I really have things I need to do."
Kramer seemed not to hear. She held out the bundle of papers.
"Okay, let me have a look." Anna recognized the top one in the stack as a prescription written on a form from the faculty clinic. She pulled it free and studied it. The patient's name didn't stir any memory, but that wasn't unusual. She might see twenty or thirty people in a day. The prescription read:
SIG: 1 TAB Q 4 H PRN PAIN
At the bottom of the page, three refills were authorized. The DEA number had been written into the appropriate blank on the lower right-hand corner.
Anna squinted, closed her eyes, then looked again. There was no doubt about it. The DEA number was hers. And the name scrawled across the bottom read: Anna McIntyre, M.D.
"Can you explain this?" Kramer asked. A familiar vibration against her hip stopped Anna before she could reply. She pulled her pager free and looked at the display. The call was from the medical center, but she didn't recognize the number. Not the operating room. Not the clinic. She relaxed a bit when she saw there was no "911" entry after the number. If this was about the autopsy, she'd have to miss it.
Hale picked up the questioning as though there had been no interruption. "What can you tell us about all these prescriptions for Vicodin?"
"I suppose the most important thing I can tell you is that I didn't write them." She rifled through the stack, paying attention only to the signature at the bottom of each sheet. "None of these are mine."
"That's your number and name, right?" Kramer said.
"Right. But that's not my signature. It's not even close."
"Can you explain how someone else could be writing prescriptions on your pads using your DEA number?" Hale asked.
"I have no idea." Anna made no attempt to keep the bitterness out of her words. "Sorry, I've just lost a patient, and I'm not in the best of moods. Can't we wind this up? I didn't write these 'scripts, and I don't know who did."
Obviously, Hale didn't want to let the matter go. "You're sure there's nothing you want to tell us?"
"What would I have to tell you? I said I don't know anything about this."
Kramer spoke, apparently filling the role of good cop. "Take a guess. Help us out here." Anna felt her jaw muscles clench. These people were relentless. She had to give them something, or this would never end."I really don't know. I mean, we've got an established routine, and all the doctors here are pretty careful."
Kramer pulled a silver ballpoint from the leather folder and twirled it between her fingers. "Why don't you walk us through that routine?"
Anna wanted to follow up on Hatley's autopsy, talk with her department chair about today's events, eventually sit down and try to relax. She was drained. The agents, on the other hand, seemed to have unlimited time and energy.
"Doctor?" Kramer's voice held no hint of irritation. Patient, understanding, all the time in the world. Just two women chatting.
"Sorry." Anna tried to organize her thoughts. "The prescription pads in the clinic are kept in a drawer in each treatment room. That way they're out of sight, although I guess if someone knew where to look, he could latch onto one when no one was in the room." She looked at the agents. Kramer simply nodded. Hale scowled. "Hey, we know it's not perfect, but that's the way we have to do it. Otherwise, we'd waste all of our time hunting for a pad."
"And do you ever forget and leave the pads sitting out when you've finished writing a prescription?" Kramer asked.
"Sure. Especially when we're in a hurry." Anna's cheeks burned.
Hale turned a page in his notebook and frowned. "How about your DEA number?"
"You'll notice those aren't printed on the forms. Each of us has to fill in our number."
"Maybe someone else had access to your number. Do nurses ever write the prescriptions for you?" This came from Kramer. Anna felt as though she was watching a tennis match, going back and forth between the two agents.
"When we have a nurse in the room with us, yes, she'll write the prescription. I don't know what the other doctors do, but I sign the prescriptions after she writes them. And I add the DEA number to the narcotic 'scripts myself."
The questioning went on for another half hour. Anna's throat was dry, her eyes burned, and she felt rivulets of sweat coursing between her shoulder blades. Finally, she'd had enough. "Look, am I being charged with something? Because if I am, I'm not saying another word without a lawyer."
Hale replaced his notebook in his pocket. Kramer picked up her folder and purse. They let the silence hang for a moment more before exchanging glances, then standing.
"Right now, we're simply investigating, Doctor," Hale said."You may be hearing from the Texas Department of Public Safety and the Dallas Police as well. Also, since your DEA number and identity have been compromised, I'd advise you not to prescribe any controlled substances for now. You'll receive formal notification in writing tomorrow about applying for a new permit."
The agents walked out, leaving Anna with her hands pressed to her throbbing temples.