Rupture Read online

  Meg straightened the covers over her daughter. “Mommy will be right back, okay?”

  Eli followed Meg into the hallway.

  “A pediatric endocrinologist came to see us today. Says there’s a new treatment that can help her diabetes.”

  “The specialists here are top notch,” Eli said to reassure her. “I’m sure they can help.”

  “They have to do something,” Meg said. “I can’t work here and be worried constantly that this will happen again.”

  Eli nodded. “So, home in the morning?”

  “That’s what they say. Look, I have to come in tomorrow around noon to sign reports. I want to know more about that Gaston fellow.”

  Eli looked back in the room at Margaret.

  “There’s a nurse who lives on my block,” Meg said. “She’s coming over tomorrow afternoon for a couple of hours to watch her.”

  “In that case, let’s grab some lunch in the cafeteria,” Eli offered.

  Before Meg reentered her daughter’s room, she turned and said, “There’s something very strange about Gaston’s autopsy.”

  CHAPTER FIFTEEN

  GATES MEMORIAL HOSPITAL

  WEDNESDAY

  12:45 P.M.

  Eli avoided the physician’s dining room, an area partially secluded behind a gourmet coffee stand that would be full of residents and attending physicians at lunchtime. Instead, he chose a table at the edge of the main dining room.

  He placed their trays so that he and Meg could sit next to one another, and he sipped a Coke as he waited for her to arrive. After studying the seating arrangement, Eli scooted her tray to the opposite side of the table.This is silly, he thought.It’s just the cafeteria, not some fancy French restaurant like we’re on a date or something.

  But when Meg arrived, he realized how conspicuous they must look, the only two white coats sitting among patients and their families.

  “No scrubs?” Eli said, noticing Meg’s attire, white blouse and burgundy scarf tied in a knot just above the top button of her coat.

  “I try to clean up before dining with the customers,” she said and winked at him. “I’d hate to have a chunk of spleen stuck on me.”

  Eli motioned for her to sit. “Caesar salad okay? It was that or mystery meat loaf.”

  “Caesar’s fine. Thanks.”

  They began to eat in silence, Meg with her Caesar, Eli with a refried burger off the grill. Eli asked about Margaret and was told she was fine. After a couple of minutes, he reached beneath his chair and brought an oversized brown folder to his lap.

  “What do you have there?”

  Eli removed the film from the folder. “I know it’s early for such an intimate look at my family,” Eli said, delaying as though he was embarrassed. “I was going to show it to a radiologist, but since you made an A in radiology —”

  “I made an A in everything,” she said, cutting him off. “Give it to me.”

  She popped the last crouton in her mouth and held the X-ray up to the fluorescent light while she chewed.

  Even at an angle, Eli could easily see the device’s heavy white imprint in the mid-abdomen.

  After a few seconds she asked, “Why’s the name not there?”

  “I don’t know,” Eli said as though it didn’t matter, “cut off I guess.”

  Meg just stared at him.

  Eli held out his hands with open palms and asked, “What?” He felt like a medical student on rounds getting quizzed about some obscure lab test.

  “What’s the first thing you do when you look at an X-ray?”

  “Here we go, back to med school,” Eli said and rolled his eyes. “Well, Professor Daily. I look at the clavicles to check the orientation, then I —”

  “Wrong.”

  Eli stopped his act. “You’re serious?”

  “You look at the name to make sure it’s the correct patient.” She handed the X-ray back to him. “Whose film is this?”

  Eli held it up against the cafeteria lights. “It’s an X-ray taken of my brother, Henry, when he was a kid.”

  “Your brother?” Meg asked. “Why on earth would he have a graft device like that?”

  Eli began the story. “When Henry was two years old, the doctors told my parents he had a critical stenosis of his aorta. They went in and fixed it with a new type of device. Supposedly, it was a very risky procedure, but it worked.”

  “For aortic stenosis?” Meg asked, trying to understand the indications for the operation. “Was he sick?”

  “I guess so,” Eli answered. “Henry is developmentally delayed. It’s sometimes hard to know when he’s sick or not.”

  The look on Meg’s face told him that was a cop-out.

  “I wasn’t born yet, okay?” Eli said, becoming defensive now. “Henry’s three years older than I am.”

  “But aortic stenosis usually presents much earlier, just after birth.”

  “I know. When I was in medical school, I tried to get more details about Henry’s operation from my father. But he always said it was just a congenital condition that was repaired with surgery. My father was never one to give out much information.”

  Meg gestured toward the X-ray in Eli’s hand. “I can tell by looking at the mesh configuration, it’s the same make as the device we found in your friend Gaston. Are you sure that’s your brother’s film?”

  Within the identification panel in the right upper corner of the film, Eli located the date of birth next to the medical record number. The top of the numbers were clipped off, as though someone was trying to exclude that information as well. But he could still read them.

  11/23/71

  “November 23rd, nineteen seventy-one?” He looked at Meg. “That’s my brother’s birthday.”

  CHAPTER SIXTEEN

  WESTERN TENNESSEE

  HIGHWAY 51, NORTHBOUND

  1:47 P.M.

  Green Hills State Home lies eighty-eight miles northeast of Memphis, accessible only from a two-lane road that runs parallel to the Mississippi River. It was built in the late 1800s along the edge of the Reelfoot Bayou in the northwestern tip of Dyer County. A home for the disabled, both mentally and physically, its name conjured a vision of warmth and pleasantness. But every time Eli visited, he saw roaches under Henry’s bed and smelled the reek of urine in the halls.

  Henry had entered the home on his twenty-eighth birthday, the day after their mother died of breast cancer. Elizer Branch had neither the time nor the patience to deal with a son who required around-the-clock care. A familiar pang of guilt hit Eli whenever he calculated how long his brother had been a resident in that miserable place—over ten years.

  When Meg returned to the morgue following their lunch, Eli took the rest of the afternoon off for the trip. He had no secretary to notify and no idea how to contact his nutty lab assistant. He was not on call again until Thursday night, and the fact that his superior, Karl Fisher, canceled his clinic patients made it much easier to leave the medical center.

  His brother’s X-ray, the device, and what he had been told about the operation years earlier—none of it made sense.What he planned to do when he got to Henry? Eli had no idea.

  Outside of Dyersburg, he turned off the interstate onto a small road that angled back toward the river. Johnson grass that had gone to seed waved high along the asphalt’s edge, and kudzu crept over the shoulder, beaten back by traffic.

  Eli knew he was well out of pager range from the hospital, one of the few times that he could truly be unavailable. Out of reach of the nurses, the residents, the operating room, and especially the emergency room. But then his phone chirped.

  “Damn cell phones,” he muttered, remembering that surrendering all personal numbers was required for staff membership at Gates Memorial.

  “Hello, Dr. Branch?”

  “Yeah, speaking.”

  “This is Felicia from the hospital Credentialing Office. I’m calling you about Dr. Margaret Daily.”

  Eli hesitated before making the commitment. He had ju
st been through the ringer with the credentialing people. They wanted every bit of information on him, from what he did during his college summers to his mother’s maiden name.

  “Yes, what about her?”

  “Are you familiar with Dr. Daily?”

  You can’t even eat lunch with someone. “I know a pathologist named Daily. What’s this about?”

  “We need someone to, well, confirm or vouch for her credentials,” the young female voice said, reluctantly.

  “You mean, she’s not credentialed?” “Technically she is, but we received a phone call, a warning if you will, about her appointment here.”

  Eli’s concern about why Meg was always alone and seemed to have no colleagues quickly surfaced. “Why are you calling me, may I ask?”

  “Dr. Branch, you are well respected here, and —” He heard a sigh. “Aren’t you friends with Dr. Daily? I mean, we’re not trying to pry, but no one else seems to know her.”

  Eli knew that a call from Credentialing was a serious matter. Any question raised about a physician’s credentials or reputation could damage or even end a career.

  “Who made a call about her?”

  “It was the Medical Examiner’s office in Little Rock, her previous place of employment. Seems there was an incident. It could compromise her position here.”

  “Isn’t it a little late for that? What happened?”

  Eli heard the shuffle of papers. “She had an altercation with her former chairman of pathology.”

  “An altercation?”

  “It seems that she —” and then Felicia stopped reading the report and addressed him directly. “Dr. Branch, I’m sure that you will keep this information strictly confidential.”

  The caller had aroused his curiosity now. “Sure, strictly confidential. Did you say Medical Examiner’s office?”

  “Yes, she worked there for three years, 2002 to 2005, after finishing her pathology residency at the University of Arkansas.”

  “There must be some explanation,” Eli said. “Meg—I mean—Dr. Daily is very professional and accomplished in her field.” But as he said this, Eli knew that his words weren’t convincing. In fact, they were hiding his own doubt.

  “She was called to examine a body,” Felicia continued, “middle of the night, supposedly a high-profile case. But she couldn’t find someone to stay with her daughter, so she refused to go in.”

  With the abruptness of a slammed door, Eli realized just how little he knew about Dr. Meg Daily. He tried to remain focused on the line of inquiry. “Surely she didn’t get fired for that, refusing to abandon her child?”

  “According to this call, she struck Dr. Richard Sizemore on August fourth, two thousand five.”

  “Struck?”

  “She beat him in the face with both fists. Fractured his zyg . . .” Felicia stopped as she struggled with the terminology.

  “Zygomatic arch,” Eli said completing the name of the facial bone that formed the outside rim of the eye socket, a structure that could be broken only by a forceful blow.

  “Yes, that’s it,” Felicia confirmed.

  Were talking about the same Meg? Both fists?

  “Listen,” Eli said, “I’ve known her only a few days. What am I supposed to say?”

  Something was missing. Why had she suddenly arrived at Gates Memorial? No history, no acquaintances. A bright, attractive pathologist stuck in the dungeon doing autopsies?

  Maybe there was some truth to this.

  Eli pictured Meg when he first met her, how she sat at the microscope, the smell of her hair. He didn’t want to believe any of it.

  “I hope you have confirmed the source,” Eli said, in Meg’s defense now. “Maybe someone’s a little ticked off they lost a good pathologist.”

  Then Eli remembered an interesting detail that Fisher had told him about the Credentialing Committee. About its current chairman. Dr. James Korinsky.

  “You’re right, Dr. Branch, we don’t want to jump to any conclusions,” Felicia said. “This caller could be completely wrong. But we’re concerned, to say the least.”

  During the next eleven miles to the home, Eli tried to shake the image of Meg pummeling her older, male chairman of pathology. He fantasized doing the same to Fisher. Tie him to that mahogany desk and beat him about the face.

  As he neared his brother’s residence, his vengeful thoughts turned to growing up with Henry. His father always locked the older boy in the laundry room whenever Eli’s friends came over. They had good times together, but certain ugly events dominated Eli’s memory, especially of his own birthday parties.

  His father would cut a chunk of birthday cake, give it to Henry in the laundry room, then lock the door. Eli could not remember a time when his father had actually held or embraced his brother. Instead, Eli pictured Elizer Branch carrying Henry away, to rid the setting of his older son, the affected child who would never amount to anything but a continual source of embarrassment.

  It was at his ninth birthday party, while Eli was passing out pieces of cake, that he overheard his mother talking with one of her best friends.

  “Look at Eli, he’s precious,” the friend had said. “Remember when you talked about stopping the pregnancy because you were afraid of another Henry?”

  His mother answered quietly, in a whisper. “Yeah, that would have been a terrible mistake.”

  At the time, Eli didn’t understand. Now, he could never forget.

  Eli’s Bronco passed a shirtless teenage boy, a red bandana around his neck, struggling to push a mower up an incline. At the top of the grassy hillside stood a small white church. The last time he and his family had entered a place of worship was in Memphis at the Episcopal church on Madison Avenue. He was seven years old, Henry ten. When the minister asked for an offering, their mother opened her coin purse and removed two dollar bills, one for each boy.

  They were told to hold the bill and place it in the collection plate as it passed. Eli folded his dollar, held it between his legs, and watched the gold-colored plate pass from one row to the next. Henry smelled his dollar, raised it above his head, and stretched it tight with both hands. The dollar ripped in half, and Henry let out a shrill laugh.

  As their mother searched for another dollar, Henry continued to fidget and make noise. Eli saw the anger building in his father’s face, and he tried to make Henry stop laughing. When the collection plate started down their pew, Henry yelled “eeeeeee” and leaned forward so fast that he hit his head on the pew in front of them. Eli could still see, as though yesterday, his father smashing the torn piece of dollar over Henry’s mouth and holding it there like a piece of tape.

  The usher approached from behind, leaned over, and whispered, “We are a God-filled people, please remove this boy.” Henry was silent as his father snatched him up and carried him from the building, pieces of the dollar bill falling to the floor. At the altar, the preacher put on a fake smile and said into the microphone, “God help his soul.”

  Eli stayed behind in the pew with his mother, too scared to leave, not even to help his own brother. Afterward, he wished he had never placed his dollar in the gold plate. And he vowed never to enter a church again.

  During the decade of Henry’s occupancy at Green Hills State Home, Eli visited at least twice a year. The sheets on Henry’s bed were always twisted with bits of leaves and dirt smudged at the foot. Patches of mildew suggested months between linen changes. Eli parked his truck on the hot gravel of the parking lot. There were no trees for shade. Certainly no green hills.

  The reception desk was unoccupied, but Eli knew the drill and signed his name on the register.Like anyone cares who comes or goes. As long as the check arrives. Cost was the only thing keeping him from moving Henry to another facility. He’d already checked the few in the region that would even accept his brother.

  Eli went directly to the familiar room. Henry was not there, but his roommate was curled up in bed, the sheet over his head. Eli watched for movement as though the other boy wa
s a patient to see on morning rounds. After several seconds, Eli became alarmed. But a slow inspiratory rise of the sheet, followed by an expiratory fall, reassured him.

  Attached to the foot of the bed, a small rectangular nameplate was pasted to a board with a peel-off adhesive back, the kind of tag a child name searches for on a revolving display at a roadside convenience mart. Green, generic letters spelled JIMMY.

  Eli wondered where Henry might be as he examined his brother’s room. Henry’s grayish bed covers were peeled back and wrinkled. Eli couldn’t bear to look any closer. A small black-and-white television was tuned to a Braves game. The Pirates were winning, five to four. At least the sound was turned down to a tolerable level. It was usually blaring.

  The nightstand between the two beds held a box of Kleenex and a grape soda can crushed in the middle. It had been bent so both ends touched. Eli opened the door of the stand to see a stack of three magazines. On top was a Ladies Home Journal, then a graphic comic book written in Japanese.How depressing. On the bottom, a motorcycle magazine was turned facedown. Eli smiled when he turned it over. A halter-topped girl in tight jean shorts straddled a chrome-plated hog.They must be hiding this one.

  He opened the bathroom door and was hit with an odor that made him cover his mouth. The toilet bowl was full to the brim, with brown water and feces that floated and churned. Eli closed the door and went to complain at the front desk, still unoccupied. He saw a female attendant down the hall, but she darted into a room as he approached.

  If Henry wasn’t in his room watching television, he could usually be found in a wheelchair outside at the rear of the complex. Henry didn’t need the wheelchair, his legs worked fine, but it seemed that almost everyone else had one, so why not him?

  At the back of the building, a concrete deck held a row of six industrial-sized garbage cans. The stifling smell of rotting food hovered in a cloud. A group of pine trees provided shade to only that part of the deck. The other end was used as a plaza for smoking. Henry was sitting in a wheelchair, back to him, a cigarette burned close to the filter dangling from his right hand. He was wearing a tattered John Deere cap with the green bill curved down and frayed at the rim. To Eli, the cap represented one of the few bonds that remained between them. He had given it to Henry on his birthday shortly before Henry entered the home. Since then he had not seen his brother without it.