Dr. Death Read online

  "Let's not get distracted," he said. "The precise reason for what happened to Joanne will never be known. Back to the core issue: her disengagement. The first thing to go was entertaining and socializing. She refused to go out with anyone. No more business dinners— too tired, not hungry. Even though all she did in bed was eat. We're members of the Cliffside Country Club and she'd played tennis and a little golf, used the gym. No more. Soon, she was going to bed earlier and rising later. Eventually, she started spending all her time in bed, saying the pain had gotten worse. I told her she might be aching because of inactivity— her muscles were contracting, stiffening up. She didn't answer me. That's when I started taking her to doctors."

  He recrossed his legs. "Then there was the weight gain. The only thing she didn't withdraw from was food. Cookies, cake, potato chips, anything sweet or greasy." His lips curled, as if he'd tasted something bad. "By the end she weighed two hundred ten pounds. Had more than doubled her weight in less than a year. A hundred and ten extra pounds of pure fat— isn't that incredible, Doctor? It was hard to keep seeing her as the girl I married. She used to be lithe. Athletic. All of a sudden I was married to a stranger— some asexual alien. You're with someone for twenty-five years you just don't stop liking them, but I won't deny it, my feelings for her changed— for all practical purposes she was no longer my wife. I tried to help her with the food. Suggesting maybe she'd be just as satisfied with fruit as with Oreos. But she wouldn't hear of it and she arranged the grocery deliveries when I was at work. I suppose I could've taken drastic measures— gotten her on fen-phen, bolted the refrigerator, but food seemed to be the only thing that kept her going. I felt it was cruel to withdraw it from her."

  "I assume every metabolic link was checked out."

  "Thyroid, pituitary, adrenal, you name it. I know enough to be an endocrinologist. The weight gain was simply Joanne drowning herself in food. When I made suggestions about cutting back, she responded the same way she did to any opinion I offered. By turning off completely— here, look."

  Out of the purse came a pair of plastic-encased snapshots. He made no effort to hand them to me, merely stretched out his arm so I had to get up from my chair to retrieve them.

  "Before and after," he said.

  The left photo was a color shot of a young couple. Green lawn, big trees, imposing beige buildings. I'd collaborated with a Stanford professor on a research project years ago, recognized the campus.

  "I was a senior, she was a sophomore," said Doss. "That was taken right after we got engaged."

  For many students, the seventies had meant long coifs, facial hair, torn jeans and sandals. Counterculture giving way to Brooks Brothers only when the realities of making a living sank in.

  It was as if Richard Doss had reversed the process. His college 'do had been a dense black crew cut. In the picture he wore a white shirt, pressed gray slacks, horn-rimmed glasses. And here were the shiny black wing-tips. Study-pallor on the elfin face, no tan.

  Youthful progenitor of the corporate type I'd expected him to be.

  Distracted expression. No celebration of the engagement that I could detect.

  The girl under his arm was smiling. Joanne Heckler, petite as described, had been pretty in a well-scrubbed way. Fair-skinned and narrow-faced, she wore her brown hair long and straight, topped by a white band. Glasses for her, too. Smaller than Richard's, and gold-framed. A diamond glinted on her ring finger. Her sleeveless dress was bright blue, modest for that era.

  Another elf. Marriage of the leprechauns.

  They say couples who live together long enough start to look like each other. Richard and Joanne had begun that way but diverged.

  I turned to the second photo, a washed-out Polaroid. A subject who resembled no one.

  Long-view of a king-size bed, shot from the foot. Rumpled gold comforter strewn across a tapestry-covered bed bench. High mound of beige pillows propped against the headboard. In their midst, a head floated.

  White face. Round. So porcine and bloated the features were compressed to a smear. Bladder-cheeks. Eyes buried in folds. Just a hint of brown hair tied back tight from a pasty forehead. Pucker-mouth devoid of expression.

  Below the head, beige sheets rose like a bell-curved, tented bulk. To the right was an elegant carved nightstand in some kind of dark, glossy wood, with gold pulls. Behind the headboard was peach wallpaper printed with teal flowers. A length of gilded frame and linen mat hinted at artwork cropped out of the photo.

  For one shocking moment, I wondered if Richard Doss had a postmortem shot. But no, the eyes were open . . . something in them . . . despair? No, worse. A living death.

  "Eric took it," said Doss. "My son. He wanted a record."

  "Of his mom?" I said. Hoarse, I cleared my throat.

  "Of what had happened to his mom. Frankly put, it pissed him off."

  "He was angry at her?"

  "No," he said, as if I were an idiot. "At the situation. That's how my son deals with his anger."

  "By documenting?"

  "By organizing. Putting things in their place. Personally, I think it's a great way to handle stress. Lets you wade through the emotional garbage, analyze the factual content of events, get in touch with how you feel, then move on. Because what choice is there? Wallow in other people's misery? Allow yourself to be destroyed?"

  He pointed a finger at me, as if I'd accused him of something.

  "If that sounds callous," he said, "so be it, Doctor. You haven't lived in my house, never went through what I did. Joanne took over a year to leave us. We had time to figure things out. Eric's a brilliant boy— the smartest person I've ever met. Even so, it affected him. He was in his second semester at Stanford, came home to be with Joanne. He devoted himself to her, so if taking that picture seems callous, bear that in mind. And it's not as if his mother minded. She just lay there— that picture captures exactly what she was like at the end. How she ever mobilized the energy to contact the sonofabitch who killed her I'll never know."

  "Dr. Mate."

  He ignored me, fingered the silver phone. Finally our eyes met. I smiled, trying to let him know I wasn't judging. His lids were slightly lowered. Beneath them, dark eyes shone like nuggets of coal.

  "I'll take those back." He leaned forward, holding out his hand for the pictures. Again, I had to stand to return them.

  "How did Stacy cope?" I said.

  He took his time zipping open the purse and placing the snapshots within. Crossing his legs yet again. Massaging the phone, as if hoping a call would rescue him from having to answer.

  "Stacy," he said, "is another story."

  6

  I BOOTED UP the computer. Eldon Mate's name pulled up over a hundred sites.

  Most of the references were reprints of newspaper columns covering Mate's career as a one-way travel agent. Pros, cons, no shortage of strong opinions from experts on both sides. Everyone responding on an intellectual level. Nothing psychopathic, none of the cold cruelty that had flavored the murder.

  A "Dr. Death Home Page" featured a flattering photo of Mate, recaps of his acquittals and a brief biography. Mate had been born in San Diego sixty-three years ago, received a degree in chemistry from San Diego State and worked as a chemist for an oil company before entering medical school in Guadalajara, Mexico, at the age of forty. He'd served an internship at a hospital in Oakland, gotten licensed as a general practitioner at forty-six.

  No specialty training. The only jobs the news pieces had mentioned were civil service positions at health departments all over the Southwest, where Mate had overseen immunization programs and pushed paper. No indication he'd ever treated a patient.

  Beginning a new career as a doctor in middle age but avoiding contact with the living. Had he been drawn to medicine in order to get closer to death?

  The name and phone number at the bottom of the page was Attorney Roy Haiselden's. He'd listed no e-mail address.

  Next came several euthanasia stories:

  The first fe
w covered the case of Roger Damon Sharveneau, a respiratory therapist at a hospital in Rochester, New York, who'd confessed eighteen months earlier to snuffing out three dozen intensive-care patients by injecting potassium chloride into their I.V. lines— wanting to "ease their journey." Sharveneau's lawyer claimed his client was insane, had him examined by a psychiatrist who diagnosed borderline personality and prescribed the antidepressant imipramine. A few days later, Sharveneau recanted. Without his confession, the only evidence against him was proximity to the ICU every night a questionable death had occurred. The same applied to three other techs, so the police released Sharveneau, terming the case "still under investigation." Sharveneau filed for disability benefits, granted an interview to a local newspaper and claimed he'd been under the influence of a shadowy figure named Dr. Burke, whom no one had ever seen. Soon after, he overdosed fatally on imipramine.

  The case prompted an investigation of other respiratory techs living in the Rochester area. Several with criminal backgrounds were found working at hospitals and convalescent homes around the state. The health commissioner vowed to institute tighter controls.

  I plugged Sharveneau's name into the system, found only one follow-up article that cited lack of progress on the original investigation and doubts as to whether the thirty-six deaths had been unnatural.

  The next link was a decade-old case: four nurses in Vienna had killed as many as three hundred people using overdoses of morphine and insulin. Arrest, conviction, sentences ranging from fifteen years to life. Eldon Mate was quoted as suggesting the killers might have been acting out of compassion.

  A similar case from Chicago: two years later, a pair of nurses' aides who'd smothered elderly terminal patients to death as part of a lesbian romance. Plea bargain for the one who talked, life without parole for the other. Once again, Mate had offered a contrarian opinion.

  Onward. A Cleveland piece dated only two months earlier. Kevin Arthur Haupt, an emergency medical tech working the night shift on a city ambulance, had decided to shortcut the treatment of twelve drunks he'd picked up on heart-attack calls by clamping his hand over their noses and mouths during transport to the hospital. Discovery came when one of the intended victims turned out to be healthier than expected, awoke to find himself being smothered and fought back. Arrest, multiple murder charge, guilty plea, thirty-year sentence. Mate wondered in print if spending money to resuscitate habitual alcoholics was a wise use of tax dollars.

  An old wire-service piece about the Netherlands, where assisted suicide was no longer prosecuted, claimed that doctor-initiated killings had grown to 2 percent of all recorded Dutch deaths, with 25 percent of physicians admitting they'd euthanized patients deemed unfit to live, without the patients' consent.

  Years ago, while working Western Pediatrics Medical Center, I'd served on something called the Ad Hoc Life Support Committee— six physicians and myself, drafted by the hospital board to come up with guidelines for ending the treatment of children in final-stage illness. We'd been a fractious group, producing debate and very little else. But each of us knew that scarcely a month went by when a slightly-larger-than-usual dose of morphine didn't find its way into the mesh of tubes attached to a tiny arm. Kids suffering from bone or brain cancer, atrophied livers, ravaged lungs, who just happened to "stop breathing," once their parents had said good-bye.

  Some caring soul ending the pain of a child who would've died anyway, sparing the family the agony of a protracted deathwatch.

  The same motivation claimed by Eldon H. Mate.

  Why did it feel different to me from Mate's gloating use of the Humanitron?

  Because I believed the doctors and nurses on cancer wards had been acting out of compassion, but I suspected Mate's motivations?

  Because Mate came across obnoxious and publicity-seeking?

  Was that the worst type of hypocrisy on my part, accepting covert god-play from those I greeted in the hall while allowing myself to be repelled by Mate's in-your-face approach to death? So what if the screeching little man with the homemade killing machine wouldn't have won any charm contests. Did the psyche of the travel agent matter when the final destination was always the same?

  My father had died quietly, fading away from cirrhosis and kidney failure and general breakdown of his body after a lifetime of bad habits. Muscles reabsorbing, skin bagging as he devolved into a wizened, yellowed gnome I hardly recognized.

  As the poisons in his system accumulated, it took only a few weeks for Harry Delaware to sink from lethargy to torpor to coma. If he'd gone out screaming in agony, would I now harbor any reservations about the Humanitron?

  And what about people like Joanne Doss, suffering but undiagnosed?

  If you accepted death as a civil rights issue, did a medical label matter? Whose life was it, anyway?

  Religion supplied answers, but when you took God out of the equation, things got complicated. That was as good a reason as any for God, I supposed. I wished I'd been blessed with a greater capacity for faith and obedience. What would happen if one day I found myself being devoured by cancer, or deadened by paralysis?

  Sitting there, hand poised to strike the ENTER key, I found that my thoughts kept flying back to my father's last days. Strange— he rarely came to mind.

  Then I pictured Dad as a healthy man. Big bald head, creased bull neck, sandpaper hands from all those years turning wood on the lathe. Alcohol breath and tobacco laughter. One-handed push-ups, the too-hard slap on the back. He'd been well into his fifties by the time I could hold my own against him in the arm wrestles he demanded as a greeting ritual during my increasingly rare trips back to Missouri.

  I found myself edging forward on the chair. Positioning myself for combat, just as I'd done as Dad's forearm and mine pressed against each other, hot and sticky. Elbows slipping on the Formica of the kitchen table as we purpled and strained, muscles quivering with tetany. Mom leaving the room, looking pained.

  By the time Dad hit fifty-five, the pattern was set: mostly I'd win, occasionally we'd tie. He'd laugh at first.

  Alexander-er, when I was young I could climb walls!

  Then he'd light up a Chesterfield, frown and mutter, leave the room. My visits thinned to once a year. The ten days I spent sitting silently holding my mother's hand as he died was my longest stay since leaving home for college.

  I shuttered the memories, tried to relax, punched a key. The computer— perfect, silent companion that it was— obliged by flashing a new image.

  A site posted by a Washington, D.C.–based handicapped-rights group named Still Alive. A position statement: all human life was precious, no one should judge anyone else's quality of life. Then a section on Mate— to this group, Hitler incarnate. Archival photo of Still Alive members picketing a motel where Mate had left a traveler. Men and women in wheelchairs, lofting banners. Mate's reaction to the protest: "You're a bunch of whiners who should examine your own selfish motivations."

  Quotes from Mate and Roy Haiselden followed:

  "The storm troopers came for me, but I wouldn't play passive Jew" (Mate, 1991).

  "Darwin would have loved to meet [District Attorney] Clarkson. The idiot's living proof of the missing link between pond slime and mammalian organisms" (Haiselden, 1993).

  "A needle in a vein is a hell of a lot more humane than a nuclear bomb, but you don't hear much outrage from the morality mongoloids about atomic testing, do you?" (Mate, 1995).

  "Any pioneer, anyone with a vision, inevitably suffers. Jesus, Buddha, Copernicus, the Wright brothers. Hell, the guy who invented stickum on envelopes probably got abused by the idiots who manufactured sealing wax" (Mate, 1995).

  "Sure, I'd go on The Tonight Show, but it ain't gonna happen, folks! Too many stupid rules imposed by the network. Hell, I'd help someone travel on The Tonight Show if the fools who made the rules would let me. I'd do it live— so to speak. It would be their highest-rated show, I can promise you that. They could play it during sweeps week. I'd play some music in the backgrou
nd— something classical. Use some poor soul with a totally compromised nervous system— maybe an advanced muscular dystrophy case— limbs out of control, tongue flapping, copious salivation, no bladder or bowel control— let them leak all over the soundstage, show the world how pretty decay and disease are. If I could do that, you'd see all that sanctimonious drivel about the nobility of life fade away pronto. I could pull off the whole thing in minutes, safe, clean, silent. Let the camera focus on the traveler's face, show how peaceful they were once the thiopental kicked in. Teach the world that the true nature of compassion isn't some priest or rabbi claiming to be God's holy messenger or some government mongoloid lackey who couldn't pass a basic biology course trying to tell me what's life and what isn't. 'Cause it's not that complex, amigos: when the brain ain't workin', you ain't livin'. The Tonight Show . . . yeah, that would be educational. If they let me set it up the right way, sure, I'd do it" (Mate, 1997, in response to a press question about why he liked publicity).