In this exhilarating new medical thriller by bestselling author Robin Cook, fan favorites Jack and Laurie are lured into the dark underbelly of hospital dangers when an internist dies mysteriously.
Colleagues-turned-spouses Dr. Laurie Montgomery and Dr. Jack Stapleton already have their plates full with demanding forensic pathology work and family pressures. The last thing they need is the sudden death of a colleague. Yet when Laurie’s apparently vital and healthy longtime friend Dr. Sue Passero dies mysteriously in the hopsital parking garage, an autopsy is required, and it falls uncomfortably under Laurie’s purview as the chief medical examiner. So when Laurie asks Jack to take special care with the case, he can hardly refuse.
With his curiosity sparked by an inconclusive autopsy, the indefatigable Jack is compelled to resolve the case at hand, and sets out to investigate on-site at Manhattan Memorial Hospital, even though it means blatantly defying the Office of Chief Medical Examiner’s rules. What started out as an inquiry into Sue’s tragic passing soon turns into a deadly and dangerous chess game between Jack and the clever and deranged killer, who might just administer another lethal blow if Jack isn’t careful.
Release date: December 6, 2022
Publisher: G.P. Putnam's Sons
Print pages: 352
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Tuesday, December 7, 6:45 a.m.
Without making it obvious, Dr. Jack Stapleton put muscle into the mild hill climb on West Drive in Central Park where it bordered the reservoir. It had given him a bit of satisfaction to overtake and pass a small, tight covey of younger, serious cyclists on their imported road bikes, all of them clad in skintight, fancy duds emblazoned with all sorts of European product endorsements and wearing clip-in, expensive bike shoes. He, of course, was on his relatively new US-made Trek bike that was every bit as fancy as the others, but his dress was far different. He was wearing his usual brown, wide-wale corduroy jacket, blue jeans, and an indigo chambray shirt with a dark green knit tie. Instead of bike shoes he had on Nike kicks. His only concession to the forty-five-degree weather were gloves and a scarf.
As he had done practically every morning since he had arrived in New York City to begin his new life and second medical career as a New York City medical examiner at the Office of Chief Medical Examiner, or OCME, Jack was using his bike to commute from his home on the Upper West Side down to the east side of the city. It was a far different mode of transportation than when he’d been a conservative, midwestern ophthalmologist. Back then he drove a Mercedes to his office every day, attired in a glen plaid suit with carefully polished shoes.
The current pacesetter of the group of well-heeled cyclists responded just as Jack envisioned. It would have been demoralizing to have a middle-aged, possibly blue-collar individual pass them, so he stood up and began a chase. There was no way for the cyclist to know that Jack probably rode his bike more often than they did. Nor did they have any idea that Jack also played demanding pickup basketball on a near-daily basis, weather permitting, and was accordingly in tip-top physical shape. The rest of the cyclists followed the lead of the pacesetter, standing up and pumping furiously.
Meanwhile, without making it obvious by remaining sitting, Jack increased his own effort such that his lead slightly increased despite the more obvious efforts of the pursuing bicyclists. Several minutes later, as Jack crested the hill and began his descent, he stopped pedaling and allowed himself to coast, which permitted the clot of pursuers to finally catch and overtake him to regain their sportive dignity.
Under more normal circumstances Jack would have continued the impromptu race all the way to the south end of the park, where he’d exit on his way to work. But on this particular morning, his attention switched from aggravating the “serious” cyclists to musing about the Brooks School that he was passing to his right on Central Park West. It was where his son, JJ, was enrolled in the fifth grade. As if it were yesterday and with understandable chagrin, Jack could remember his disastrous visit there two years earlier, when Laurie, his wife, asked him to go to talk to the school authorities in her stead about their concern that JJ needed to take Adderall for ADHD after JJ had gotten into a few tussles on the playground.
What made Jack an inappropriate substitute for Laurie was that he was absolutely convinced there was nothing atypical with JJ. Combining that reality with his belief in some kind of conspiracy between the pharmaceutical and education industries, both of which seemed in his mind to be overly eager to start kids on what was essentially speed and turning them into nascent druggies. Unfortunately, Jack had made sure that the Brooks School knew exactly how strongly he felt. As a result, he had succeeded in alienating the school authorities, who threated to expel JJ. Ultimately, Jack had agreed—along with Laurie’s insistence—to have JJ at least evaluated by a psychiatrist, who agreed with the diagnosis, but luckily by that time it no longer mattered. The evaluation process had taken long enough that it was apparent to all that JJ was not exhibiting any more playground shenanigans. As a result, the school’s insistence on medication fell by the wayside—that was, until last week, when JJ had had another fight during recess. Suddenly the whole issue had resurfaced, and it was the reason Jack was now on his way to the OCME so early in the morning. The night before, he had been harangued by both Laurie and her mother, Dorothy, who were both championing the use of ADHD medication. Awakening way before the alarm and not wishing to be again subjected to more pressure before rethinking all the pros and the cons of the situation, Jack had decided to leave the apartment before anyone else was awake.
Jack’s normal route would have taken him to the southeastern corner of Central Park, but because of the dramatic uptick in bicycle use in Manhattan due to a combination of frustratingly heavy vehicular traffic, the Covid-19 pandemic, and E-bikes, bike lanes had majorly proliferated. The result was that his commute was significantly faster and safer, although Laurie doubted the latter. Now Jack exited the park in the southwest corner into Columbus Circle. From there, he used the dedicated bike lane to head south on a combination of Broadway and Seventh Avenue all the way to 30th Street. Conveniently, 30th Street also had a bike lane, although it wasn’t as safe since it was merely painted on the pavement alongside the parked cars. Jack’s destination was at the corner of 30th Street and First Avenue, where the old OCME building stood, which still housed the autopsy suite.
As Jack rode east on 30th, his thoughts went back to Dorothy’s role. He recognized she evoked serious ambivalence in his thinking. In relation to his daughter, Emma, who had been diagnosed several years earlier with autism, Dorothy had played a positive role. She had taken it upon herself to organize and then manage the complicated interviewing, choosing, and scheduling of the behavior therapists, speech therapists, and physical therapists who were responsible for Emma’s impressive progress. But even Emma’s improvement was not without some controversy. Jack was inclined to enroll Emma in a specialized school for children on the autism spectrum that was close to the Brooks School. But Dorothy disagreed and so far had convinced Laurie to her point of view.
Worse than the mild disagreement over Emma’s situation was Dorothy’s continued anti-vaccine stance, since she still insisted that it had been Emma’s MMR vaccine that had caused her autism, even though the possibility had been scientifically proven false. Worse still, her anti-vaccine feelings had extended to the Covid-19 vaccine, and no matter what Jack or Laurie said, Dorothy refused the jab. Making her intransigence that much worse was that Dorothy had all but moved in with them to take over the second guest room right after her husband, Laurie’s stern cardiac surgeon father, had passed away three months ago, in September.
On several occasions Jack had tried to broach the issue of establishing some appropriate time frame for Dorothy to move back to her spacious Park Avenue co-op, but Laurie wouldn’t hear of it. It was her belief that Emma was benefitting greatly from having her grandmother constantly around and that Dorothy was still much too fragile to move back to an empty apartment.
All in all, Jack was feeling a bit like the odd man out, especially with Laurie acting more and more like the chief both at work and at home. Not wanting to force the issue and possibly cause a disruption in the fragile home environment, Jack looked to work to occupy his mind and emotions. He needed to scare up some kind of difficult case to monopolize his thoughts. It had worked in the past; investigating a chiropractic death had helped him deal with JJ’s diagnosis of neuroblastoma when the boy was an infant. One of the definite benefits of being a medical examiner was that every day was different and there was always the possibility of confronting a perplexing circumstance. He and Laurie certainly had proven that over the years without an ounce of doubt.
After waiting for a green light to cross First Avenue at the corner of 30th Street, Jack rode down along the old OCME building that had long ago overstayed its usefulness. When it had been built more than a half century ago it had been state of the art. Now it was hardly that. A new autopsy building with offices for the medical examiners and the Toxicology Department was sorely needed. It was supposed to be built near the new high-rise OCME building four blocks to the south but had been held up by budgetary problems. It was one of his wife’s main objectives in her role as the chief medical examiner of the City of New York, and she was counting on the new mayor soon to be sworn in to give it the green light.
Turning in at the receiving bay where bodies arrived and departed, Jack rode between the parked ME Sprinter vans, hoisting his bike up onto his shoulder as he climbed the side stairs up onto the platform. Then, walking the bike, he passed the security office and waved to the guards, who were busy in the process of changing shifts. Jack did the same passing the mortuary techs’ office. Off to the left, where the Hart Island coffins for unclaimed bodies were stored, Jack secured his bike and helmet with a cable lock to a standpipe. He was the only one who used his bike to commute to work, and there was no official bike stand. Nearby was the darkened, isolated autopsy room for decomposing bodies.
Eager to see what the night had brought in terms of new cases, Jack mounted the stairs one floor, passed through the sudden infant death syndrome room, and entered the part of the ID area where the day began for the OCME. It was a little after seven in the morning.
Tuesday, December 7, 7:10 a.m.
Good morning, Jennifer,” Jack said with more alacrity than he felt. In contrast to some of the other forty-one medical examiners, Jack did not make it a habit to project his inner mindset and mood to others, mainly because he was a private person. Dr. Jennifer Hernandez was one of the relatively new medical examiners on staff, and it was currently her turn to be on call for the week, meaning if one of the medical examiners was needed during the night to back up the forensic pathology fellow, she was the designee. It was also her role to come in early, go over the cases that had come in during the night, confirm the need for each to be autopsied, and then divide them up between the medical examiners. “Anything particularly interesting today?” Jack added as he approached the desk where Jennifer was sitting. He tried to act casual.
“I just got here two minutes before you,” Jennifer said. “I haven’t even started looking at them.” In front of her was a modest stack of folders containing the workups done by the medical legal investigators, or MLIs, highly trained physician assistants who went out into the field, if necessary, to investigate all deaths thought to be possible medical examiner cases. The police and hospital supervisory personnel were all highly cognizant of which deaths were required to be reported to the OCME by law and which weren’t. Although the previous day’s haul was extensive since it included the entire weekend, today’s cases were modest in number. Jack estimated no more than about twenty.
“Did you get any calls during the night from the pathology fellow or the MLIs for any problems?” Jack asked, trying not to sound too eager. Cases where the on-call ME participated were invariably more challenging and interesting.
“I didn’t,” Jennifer said. “I gather it was a fairly quiet night. Mostly overdoses.”
Jack inwardly groaned. He wasn’t surprised. They were seeing on average five overdose deaths a day, which were more depressing than intellectually stimulating. There was no forensic mystery involved, only the social question of what was happening to society to foment such an ongoing tragedy, above and beyond the appearance of fentanyl in the drug world. “Do you mind if I take a look?” Jack asked. He was sensitive to not be too pushy with his seniority.
Jennifer laughed. “Be my guest,” she said, gesturing to the stack of folders. It was common knowledge among the MEs that Jack often arrived early to cherry-pick cases to find the most challenging. No one denied him because everyone knew he was the kind of workaholic who always took more than his share of cases, even the routine ones. Jack was the opposite of a slacker, especially when he was stressed out like he was at the moment.
“Oh, no!” a voice cried. Both Jack’s and Jennifer’s head bobbed up as Vinnie Amendola breezed into the room with his ever-present New York Post tucked under his arm. He was a slight, dark-haired, and unshaven man who was dressed in a hooded sweatshirt and baggy sweatpants, looking slouchy despite being the most senior mortuary technician at the OCME. In contrast to his appearance, he was impressively knowledgeable about forensics. Having worked closely with Jack for many years, they were a well-oiled team. “God! I hate to see Dr. Stapleton here this early,” he moaned, rolling his eyes skyward while slapping his paper down onto the side table between two upholstered easy chairs as if angry. “Damn it all! It means I’m going to be stuck in the pit all day listening to his bullcrap. What could I have done to deserve this?” The pit was the nickname for the autopsy room among all the mortuary techs.
“I hope you didn’t get all dressed up for us,” Jack quipped. Lots of sarcastic barbs was the bulk of their normal verbal interaction.
“Let me guess,” Vinnie said as he collapsed into one of the chairs. “Problems on the home front? In-law difficulties? Am I getting close?”
Jack grimaced. Vinnie knew him much too well. “Things could be better,” Jack admitted without elaborating. “What I need is a challenging case.”
Vinnie immediately got the message and didn’t tease further. Instead, he changed his tone and said, “Okay! Anything promising?”
“I haven’t yet had a chance to look,” Jack responded. “How about getting the communal coffee ready?” Making coffee in the morning was one of Vinnie’s self-imposed jobs, as he was usually one of the first people on the day shift to arrive.
“All right, already!” he said, pretending to be irritated.
Jack redirected his attention to the stack of folders, hoping to hit pay dirt, but his optimism quickly dimmed. As Jennifer had warned, the first three were run-of-the-mill overdoses. Although he was certainly aware each was its own personal tragedy, particularly the third case, which involved a fifteen-year-old boy, none of them would be enough to dominate his mind at least for a few days or even for a week, which was what he was hoping to find. But then, like an unexpected slap in the face, the name on the fourth folder jolted him. It was Susan Passero, the name of Laurie’s oldest and closest friend, who also served as her general medical practitioner. Jack also knew her, and he certainly respected her as a first-rate internist as well as personable, socially committed, and a dutiful mother. Although Laurie usually saw Susan solo, mostly for lunch at least once a month, Jack and her husband, Abraham, known as Abby, had on occasion had been included with the women for dinner or to attend some sort of cultural event.
With his pulse quickening, he emptied the folder and hurriedly searched through the contents for the MLI’s investigative workup. As he did so, he hoped that the body downstairs in the cooler would turn out to be a different Susan Passero. As he snapped up the workup, Jack’s worst fears were realized when he read that the deceased was a physician on the staff of the Manhattan Memorial Hospital who had died suddenly in apparent good health, which was the reason it was deemed a medical examiner case.
Jack sighed loudly and involuntarily stared off into the middle distance, already worried about having to call Laurie and give her this disturbing and shocking news. With all the stresses and strains that were happening at home and those associated with her relatively new role as the chief medical examiner—running the largest ME office in the country, with more than six hundred employees and a yearly budget of $75 million—this added emotional burden was potentially going to be horrendous.
“Something wrong?” Jennifer asked, sensing Jack’s reaction.
“I should say,” he answered. He glanced at Jennifer, who knew Laurie well. Jennifer was the daughter of Laurie’s late nanny, and Laurie was largely responsible for Jennifer’s career choice as a physician and a forensic pathologist. ...
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