Devil's Waltz Read online

  Devil's Waltz

  Alex Delaware [7]

  Kellerman, Jonathan

  Ballantine Books (1992)

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  Tags: Alex Delaware

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  The doctors call it Munchausen by proxy, the terrifying disease that causes parents to induce illness in their own children. Now, in his most frightening case, Dr. Alex Delaware may have to prove that a child's own mother or father is making her sick.

  Twenty-one-month-old Cassie Jones is bright, energetic, the picture of health. Yet her parents rush her to the emergency room night after night with medical symptoms no doctor can explain. Cassie's parents seem sympathetic and deeply concerned. Her favorite nurse is a model of devotion. Yet when child psychologist Alex Delaware is called in to investigate, instinct tells him that one of them may be a monster.

  Then a physician at the hospital is brutally murdered. A shadowy death is revealed. And Alex and his friend LAPD detective Milo Sturgis have only hours to uncover the link between these shocking events and the fate of an innocent child.

  Devil’s Waltz

  Alex Delaware – Book 7

  By Jonathan Kellerman

  To my son, Jesse,

  a gentleman and a scholar

  Special thanks to Reuben Eagle

  Allan Marder, Yuki Novick,

  Michael Samet, Dennis Payne,

  and Harry Weisman, M.D.

  Ring out the old shapes of foul disease;

  Ring out the narrowing lust of gold.

  — ALFRED LORD TENNYSON

  1

  It was a place of fear and myth, home of miracles and the worst kind of failure.

  I’d spent a quarter of my life there, learning to deal with the rhythm, the madness, the starched whiteness of it all.

  Five years’ absence had turned me into a stranger, and as I entered the lobby anxiety tickled my belly.

  Glass doors, black granite floors, high, concave travertine walls advertising the names of dead benefactors.

  Glossy depot for an unguided tour of uncertainty.

  Spring, outside, but in here time had a different meaning.

  A group of surgical interns— God, they were taking them young— slouched by on paper-soled scrub slippers, humbled by double shifts. My own shoes were leather-bottomed and they clacked on the granite.

  Ice-slick floors. I’d just started my internship when they’d been installed. I remembered the protests. Petitions against the illogic of polished stone in a place where children ran and walked and limped and wheeled. But some philanthropist had liked the look. Back in the days when philanthropists had been easy to come by.

  Not much granite visible this morning; a crush of humanity filled the lobby, most of it dark-skinned and cheaply dressed, queued up at the glassed-in booths, waiting for the favors of stone-faced clerks. The clerks avoided eye contact and worshipped paper. The lines didn’t seem to be moving.

  Babies wailed and suckled; women sagged; men swallowed curses and stared at the floor. Strangers bumped against one another and sought refuge in the placebo of banter. Some of the children— those who still looked like children— twisted and bounced and struggled against weary adult arms, breaking away for precious seconds of freedom before being snagged and reeled back in. Others— pale, thin, sunken, bald, painted in unnatural colors— stood there silently, heartbreakingly compliant. Sharp words in foreign tongues crackled above the drone of the paging operators. An occasional smile or bit of cheer brightened the inertial gloom, only to go out like a spark from a wet flint.

  As I got closer I smelled it.

  Rubbing alcohol, antibiotic bitters, the sticky-ripe liqueur of elixir and affliction.

  Eau de Hospital. Some things never changed. But I had; my hands were cold.

  I eased my way through the crowd. Just as I got to the elevators, a heavyset man in a navy-blue rent-a-cop uniform stepped out of nowhere and blocked my way. Blond-gray crewcut and a shave so close his skin looked wet-sanded. Black-frame glasses over a triangular face.

  “Can I help you, sir?”

  “I’m Dr. Delaware. I have an appointment with Dr. Eves.”

  “I need to see some ID, sir.”

  Surprised, I fished a five-year-old clip-on badge out of my pocket. He took it and studied it as if it were a clue to something. Looked up at me, then back at the ten-year-old black-and-white photo. There was a walkie-talkie in his hand. Holstered pistol on his belt.

  I said, “Looks like things have tightened up a bit since I was last here.”

  “This is expired,” he said. “You still on staff, sir?”

  “Yes.”

  He frowned and pocketed the badge.

  I said, “Is there some kind of problem?”

  “New badges required, sir. If you go right past the chapel, over to Security, they can shoot your picture and fix you up.” He touched the badge on his lapel. Color photograph, ten-digit ID number.

  “How long will that take?” I said.

  “Depends, sir.” He looked past me, as if suddenly bored.

  “On what?”

  “How many are ahead of you. Whether your paperwork’s current.”

  I said, “Listen, my appointment with Dr. Eves is in just a couple of minutes. I’ll take care of the badge on my way out.”

  “’Fraid not, sir,” he said, still focused somewhere else. He folded his arms across his chest. “Regulations.”

  “Is this something recent?”

  “Letters were sent to the medical staff last summer.”

  “Must have missed that one.” Must have dropped it in the trash, unopened, like most of my hospital mail.

  He didn’t answer.

  “I’m really pressed for time,” I said. “How about if I get a visitor’s badge to tide me over?”

  “Visitor’s badges are for visitors, sir.”

  “I’m visiting Dr. Eves.”

  He swung his eyes back to me. Another frown— darker, contemplative. He inspected the pattern on my tie. Touched his belt on the holster side.

  “Visitor’s badges are over at Registration,” he said, hooking a thumb at one of the dense queues.

  He crossed his arms again.

  I smiled. “No way around it, huh?”

  “No, sir.”

  “Just past the chapel?”

  “Just past and turn right.”

  “Been having crime problems?” I said.

  “I don’t make the rules, sir. I just enforce them.”

  He waited a moment before moving aside, followed my exit with his squint. I turned the corner, half expecting to see him trailing, but the corridor was empty and silent.

  The door marked SECURITY SERVICES was twenty paces down. A sign hung from the knob: BACK IN above a printed clock with movable hands set at 9:30 A.M. My watch said 9:10. I knocked anyway. No answer. I looked back. No rent-a-cop. Remembering a staff elevator just past Nuclear Medicine, I continued down the hall.

  Nuclear Medicine was now COMMUNITY RESOURCES. Another closed door. The elevator was still there but the buttons were missing; the machine had been switched to key-operated. I was looking for the nearest stairway when a couple of orderlies appeared, wheeling an empty gurney. Both were young, tall, black, sporting geometrically carved hip-hop hairstyles. Talking earnestly about the Raiders game. One of them produced a key, inserted it into the lock, and turned. The elevator doors opened on walls covered with padded batting. Junk-food wrappers and a piece of dirty-looking gauze littered the floor. The orderlies pushed the gurney in. I followed.

  General Pediatrics occupied the eastern end of the fourth floor, separated from the Newborn Ward by a swinging wooden door. I knew the outpatient clinic had been open for only fifteen minut
es but the small waiting room was already overflowing. Sneezes and coughs, glazed looks and hyperactivity. Tight maternal hands gripped babes and toddlers, paperwork, and the magic plastic of Medi-Cal cards. To the right of the reception window was a set of double doors marked PATIENTS REGISTER FIRST over a Spanish translation of same.

  I pushed through and walked past a long white corridor tacked with safety and nutrition posters, county health bulletins, and bilingual exhortations to nurture, vaccinate, and abstain from alcohol and dope. A dozen or so examining rooms were in use, their chart-racks brimming over. Cat-cries and the sounds of comfort seeped from under the doors. Across the hall were files, supply cabinets, and a refrigerator marked with a red cross. A secretary tapped a computer keyboard. Nurses hustled between the cabinets and the exam rooms. Residents spoke into chin-cradled phones and trailed after fast-stepping attending physicians.

  The wall right-angled to a shorter hallway lined with doctors’ offices. Stephanie Eves’s open door was the third in a set of seven.

  The room was ten by twelve, with institutional-beige walls relieved by bracket shelves filled with books and journals, a couple of Miró posters, and one cloudy window with an eastern view. Beyond the glint of car-tops, the peaks of the Hollywood hills seemed to be dissolving into a broth of billboards and smog.

  The desk was standard hospital-issue phony walnut and chrome, pushed up against one wall. A hard-looking chrome and orange-cloth chair competed for space with a scuffed brown Naugahyde recliner. Between the chairs a thrift-shop end table supported a coffee maker and a struggling philodendron in a blue ceramic pot.

  Stephanie sat at the desk, wearing a long white coat over a wine-and-gray dress, writing on an outpatient intake form. A chin-high stack of charts shadowed her writing arm. When I stepped into the room she looked up, put down her pen, smiled, and stood.

  “Alex.”

  She’d turned into a good-looking woman. The dull-brown hair, once worn shoulder-length, limp, and barretted, was short, frosted at the tips, and feathered. Contact lenses had replaced granny glasses, revealing amber eyes I’d never noticed before. Her bone structure seemed stronger, more sculpted. She’d never been heavy; now she was thin. Time hadn’t ignored her as she entered the dark side of thirty; a mesh of feathers gathered at the corners of her eyes and there was some hardness at the mouth. Makeup handled all of it well.

  “Good to see you,” she said, taking my hand.

  “Good to see you, Steph.”

  We hugged briefly.

  “Can I get you something?” She pointed to the coffee machine, arm jangling. Gold vermeil bracelets looped her wrist. Gold watch on the other arm. No rings. “Plain old coffee or real café au lait? This little guy actually steams the milk.”

  I said no thanks and looked at the machine. Small, squat, black matte and brushed steel, logo of a German manufacturer. The carafe was tiny— two cups’ worth. Next to it sat a petite copper pitcher.

  “Cute, huh?” she said. “Gift from a friend. Gotta do something to bring a little style into this place.”

  She smiled. Style was something she’d never cared about. I smiled back and settled in the recliner. A leatherbound book sat on a nearby table. I picked it up. Collected poems of Byron. Bookmark from a store named Browsers— up on Los Feliz, just above Hollywood. Dusty and crowded, with an emphasis on verse. Lots of junk, a few treasures. I’d gone there as an intern, during lunch hour.

  Stephanie said, “He’s some writer. I’m trying to expand my interests.”

  I put the book down. She sat in her desk chair and wheeled around facing me, legs crossed. Pale-gray stockings and suede pumps matched her dress.

  “You look great,” I said.

  Another smile, casual but full, as if she’d expected the compliment but was still pleased by it. “You, too, Alex. Thanks for coming on such short notice.”

  “You piqued my interest.”

  “Did I?”

  “Sure. All those hints of high intrigue.”

  She half turned toward the desk, removed a chart from the stack, let it rest in her lap but didn’t open it.

  “Yup,” she said, “it’s a challenging one, that’s for sure.”

  Standing suddenly, she walked to the door, closed it, and sat back down.

  “So,” she said, “how does it feel to be back?”

  “Almost got busted on the way in.”

  I told her about my encounter with the security guard.

  “Fascist,” she said cheerfully, and my memory banks reactivated: grievance committees over which she’d presided. White coat disdained for jeans, sandals, bleached cotton blouses. Stephanie, not Doctor. Titles are exclusionary devices of the power elite. . . .

  I said, “Yeah, it was kind of paramilitary,” but she just gazed at the chart in her lap.

  “High intrigue,” she said. “What we’ve got is a whodunit, howdunit— a did-anyone-do-it. Only this is no Agatha Christie thing, Alex. This is a real-life mess. I don’t know if you can help, but I’m not sure what else to do.”

  Voices from the corridor filtered in, squalls and scolding and fleeing footsteps. Then a child’s cry of terror pierced the plaster.

  “This place is a zoo,” she said. “Let’s get out of here.”

  2

  A door at the rear of the clinic opened to a stairway. We descended to the first basement level. Stephanie moved fast, almost jogging down the steps.

  The cafeteria was nearly empty— one orange-topped table occupied by a male intern reading the sports section, two others shared by slumping couples who looked as if they’d slept in their clothes. Parents spending the night. Something we’d fought for.

  Empty trays and dirty dishes cluttered some of the other tables. A hair-netted orderly circulated slowly, filling salt shakers.

  On the eastern wall was the door to the doctors’ dining room: polished teak panels, finely etched brass nameplate. Some philanthropist with a nautical bent. Stephanie bypassed it and led me to a booth at the far end of the main room.

  “Sure you don’t want coffee?” she said.

  Remembering the hospital mud, I said, “Already filled my caffeine quota.”

  “I know what you mean.”

  She ran her hand through her hair and we sat.

  “Okay,” she said. “What we’ve got is a twenty-one-month-old white female, full-term pregnancy, normal delivery, APGAR of nine. The only significant historical factor is that just before this child was born, a male sib died of sudden infant death syndrome at age one year.”

  “Any other children?” I said, taking out a note pad and pen.

  “No, there’s just Cassie. Who looked fine until she was three months old, at which time her mother reported going in at night to check on her and finding her not breathing.”

  “Checking because she was nervous about SIDS?”

  “Exactly. When she wasn’t able to rouse the baby, she administered CPR, got her going. Then they brought her into the E.R. By the time I arrived she looked fine, nothing remarkable on exam. I admitted her for observation, did all the usual tests. Nothing. After discharge we set the family up with a sleep monitor and an alarm. Over the next few months the bell went off a few times but they were always false positives— the baby was breathing fine. The graphs show some tracings that could be very brief apnea but there are also lots of movement artifacts— the baby thrashing around. I figured maybe she was just restless— those alarms aren’t foolproof— and put down the first episode to some quirky thing. But I did have the pulmonologists look at her because of her brother’s SIDS. Negative. So we decided just to keep a close eye on her during the high-risk period for crib death.”

  “A year?”

  She nodded. “I played it safe— fifteen months. Started with weekly outpatient checkups, tapered off so that by nine months I was willing to let them go till the one-year exam. Two days after the nine-month checkup they’re back at E.R., middle-of-the-night respiratory problems— the baby woke up gasping, with a
croupy bark. More CPR by mom and they bring her in.”

  “Isn’t CPR kind of extreme for croup? Did the baby actually pass out?”

  “No, she never lost consciousness, just gasped a lot. Mom may have been overreacting, but with her losing the first child, who could blame her? By the time I got to the E.R., the baby looked fine, no fever, no distress. No surprise, either. Cool night air can clear up croup. I ran a chest X-ray and bloodwork, all normal. Prescribed decongestants, fluids, and rest and was ready to send them home but the mother asked me to admit her. She was convinced there was something serious going on. I was almost certain there wasn’t, but we’d been seeing some scary respiratory things recently, so I admitted her, ordered daily bloodwork. Her counts were normal and after a couple of days of getting stuck, she was going hysterical at the sight of a white coat. I discharged her, went back to weekly outpatient follow-up, during which the baby would have nothing to do with me. Minute I walk into the exam room she screams.”