Tuesday, March 28
Russ couldn’t settle on the worst part of having a broken leg. Was it being driven around town like a kid too young for a permit? Or struggling along sidewalks slick with muddy water and the last remnants of crumbling ice, praying he wasn’t going to fall on his ass? He had plenty of time to contemplate both while humping himself up the South Street sidewalk toward the free clinic.
He hadn’t started out the day in the best of moods, and the rapidly falling barometer didn’t help. His leg registered every change in the pressure with a new ache or twinge. The search at Debba Clow’s home yesterday had turned up a big fat nothing, and he was getting that feeling, the one he hated, of chasing his own tail.
“Isn’t this a great day, Chief?” Officer Kevin Flynn feinted side to side across the walk and up and down the stairs, dribbling and shooting an imaginary basketball. He had been detached to squire Russ around, on the grounds that shadowing the chief might be considered advancing his education in law enforcement. “I heard it’s gonna get over fifty!”
Russ paused for a moment to flex his aching hands. He looked up at the gray clouds coursing across the sky, the shafts of sunlight sweeping down the mountains and away to the east. “Forty-five degrees tops,” he said. “And it’s going to rain.” If there was one thing worse than hobbling around on crutches, it was hobbling around on crutches in the rain. He creaked his way up the walk and squared the crutches’ rubber tips on the lowest step.
“Hey, Chief, don’t you want to use the wheelchair ramp?” Kevin paused in front of the door, the imaginary basketball still held between his hands.
“No, I do not want to use the wheelchair ramp.” Russ gritted his teeth and teetered his way to the clinic entrance, where he was forced to let Kevin open the door for him.
The noise, even in the tiny foyer, was confounding. They pushed through the inner doors to a waiting room overflowing with kids, moms, babies, old folks—everyone except the family pet. “What the hell’s going on?” Russ asked.
“Maybe these are all the people who didn’t like to see Dr. Rouse,” Kevin said. “I think he could be kind of intimidating.”
A kid of maybe four broke from the room and dashed across the hall, nearly knocking into Russ. “You come right here this minute, Max!” his harried mother hissed.
Russ beckoned to Kevin with his head. “C’mon, let’s see if we can find Laura Rayfield.”
A strained-looking volunteer behind the reception desk let out a weak “Ha” when Russ told her he wanted to speak to Ms. Rayfield. “Sign the list,” she said. “But I warn you, your wait will likely be well over an hour and a half at this point.”
Of course. He looked like a civilian in his Dockers slit up to the knee and his bomber jacket zipped up over his uniform blouse. “I don’t think you understand,” Russ said. “This is official police business. I’m Chief Van Alstyne. . . .” He forgot he couldn’t just unzip his jacket pocket and haul out his ID. One crutch clattered to the ground. He swore under his breath. “Kevin—,” he started, but the officer had already scooped it up and was holding it out to Russ, beaming like a Boy Scout.
“Thank. You.” Russ lifted his elbow and allowed Kevin to slide the crutch back home. He had retrieved his ID, but it was moot now that the receptionist had seen Kevin’s uniform.
“Oh!” She glanced back and forth between Russ and Kevin. “Is this about”—her voice dropped to a barely audible whisper—“Dr. Rouse’s disappearance?”
“That’s right,” Russ said.
“Oh. Well. That’s a different story, isn’t it?”
Russ allowed as how it was, and let her escort him and Kevin into the conference room, a square space whose elegant moldings and central chandelier gave evidence of its past as a dining room. “You wait right here, and I’ll send Laura to you as soon as she’s done with her current patient,” the receptionist said.
Kevin obediently sat down at the conference table and stared out the windows. Russ stumped around, examining the space. The door opposite the hallway turned out to be the old house’s kitchen, modernized with a cast-off green refrigerator, a microwave, and a coffeemaker. The door between the kitchen and the hallway opened onto the doctor’s office.
It was the size of a roomy closet, but comfortable, with a leather desk chair and a desk that would have been handsome if it hadn’t been covered with heaps and piles of papers. Interspersed among the medical books lining the walls were framed photos of Rouse and his family. There was one of the five of them in what looked like Cape Cod, and another, with the children much younger, taken in Disney World. There was one of a tanner and slimmer Allan with his arm around his tanner and happier wife. They were on the deck of a cruise ship, and the silver frame was engraved with the words OUR 30TH ANNIVERSARY.
“I’m sorry about the mess.” Laura Rayfield stood in the doorway, clipboard in hand, sections of her red hair escaping from her braid. “Your officer was searching for something that might provide a lead to what happened to Al, and I haven’t had time to put everything back to rights.”
“I apologize,” Russ said. “Officer Entwhistle should have done that for you.”
“No, no, I’d rather handle it myself. Doesn’t matter, really, unless and until Allan reemerges or we get a new doctor in here.” She tilted her head toward the conference room. “Mind if we sit down while we talk? I’m beat.”
She eyed him as he crutched out of the narrow office and lowered himself into a chair. “Your officer said you’d broken your leg. What happened?”
“Slipped on the ice. Greenstick fracture.”
“Any pins?”
“Two. I’m supposed to be out of this in another five weeks.”
“Who was your orthopedic surgeon?”
“Dr. Stillman.”
She collapsed into the chair opposite him. “He’s good.” She tossed the clipboard on the table. “What can I tell you, Chief? I already gave a statement to Officer Entwhistle last week.”
“I know. I read his report.” He matched up the crutches and laid them on the floor. “It looks like you’ve got half the population of Millers Kill back there in the waiting room. Are we in the middle of an epidemic I haven’t heard about?”
Her mouth twisted. “Yeah. It’s called the no-health-insurance epidemic. These folks are here because the volunteers and I have been calling all our current patients and letting them know we’re about to close up shop. Everyone’s coming out of the woodwork to get their prescriptions or to take care of problems they’ve been putting off. As of April first, their only recourse is going to be the ER.”
“Wow,” Kevin Flynn said. “That really sucks.”
“How come?” Russ asked.
“I’m a nurse practitioner. Do you know anything about nurse practitioners?”
“I know you can examine and treat patients. And write prescriptions.”
“That’s right.” She tucked a loose strand of red hair behind one ear. “We practice in collaboration with a physician. Every NP works under a particular practice agreement that’s filed with the state board. Mine states that I will practice under the direct supervision of Dr. Allan Rouse or such physicians as he may appoint—that’s in case we hand off one of our patients to a specialist—with Dr. Rouse reviewing my patient records no less than every fifteenth day. That covers his two-week vacations.”
“Okay,” Russ said.
“Don’t you see? Without Al here, I’m effectively barred from practicing fifteen days after his disappearance.”
“Can’t you call up whoever is in charge of these things and explain the situation? Get an extension or something?”
“No. In order to resume practicing here at the clinic, I’m going to need to find another M.D. willing to serve as my collaborating physician. Then we’ll have to draw up a practice agreement and a practice protocol and file it with the office of Professions at the Education Department. Then we have to wait until the agreement and protocol are approved.”
“Sounds time consuming.”
“It can be.”
Kevin leaned in. Russ noticed that he and Laura Rayfield had identical coloring. He wondered whom they might have in common on their family trees. “Can’t you apply for the new agreement now?” Kevin asked. “That way, you might not have to wait so long to reopen the clinic.”
She shook her head. “Doctors can be very protective of each other’s turf. Until we know for sure that Al’s”—she flipped her hands: Who knows?—“not coming back, it’s an uphill battle to get another M.D. to sign on as my collaborating physician.” She turned to Russ. “I really hope you find something soon. Not just for Al’s family’s sake, but for the clinic. He’s been carrying this place for thirty years, and it would kill him if he knew we were closing down.”
If something or someone else hadn’t already killed him. Russ pulled his glasses off and polished them on his blouse. “Was he happy here? With his work?”
Laura blew out a puff of air. “That’s hard to say. He was dedicated. Conscientious. He had the kind of emotional control a lot of doctors do, in my experience, good at showing you his calm, controlled side, good at hiding the other stuff.”
“What other stuff?”
“Like I told Officer Entwhistle, he was under a lot of stress in the weeks before he disappeared. That thing with Debba Clow really ate at him. The fact that it was about vaccinations, which he sort of held as the holy grail, made it worse. He had to field a lot of questions from mothers, and justifying his medical decisions wasn’t something Al was good at.” She grinned one-sidedly. “Justifying himself at all wasn’t something he was good at.”
Russ resettled his glasses on his face. “Was anything else bothering him?”
“He was very down about Mrs. Marshall yanking her funding. We all were. Finding out you’re going to lose ten grand a year isn’t any fun. Although she did notify the board of aldermen about the change in funding, which is supposed to trigger some sort of review of our money situation. She sent them a letter the day after she told Al. We got our copy of it the same day he disappeared.” She sighed. “I bet he didn’t even have the chance to read it.”
“How’s this review supposed to work with the aldermen?”
“I don’t know. The letter said something about the provisions of the gift and reviewing the funding.” She shrugged. “The only financial document I’m familiar with around here is my paycheck.”
“Do you have the letter around?”
“It’s in there. It may still be in his in-box. I don’t know.”
“See if you can find that, Kevin.” He indicated the doctor’s office, and the young officer bounced out of his seat and disappeared though the still-open door.
“Any other issues bothering him that you know of? Anything personal?”
“Nothing he shares with me. He seems sort of melancholy at times.” Laura’s face was drawn in, in concentration. She seemed unaware that she was now speaking of Rouse in the present tense. “He’s spoken a few times this spring about Mrs. Ketchem, who started the clinic. I guess this year’s the thirtieth anniversary of her death.” She flipped her hands over. “And he turned sixty-five in February. He’s very fit, you know. Bikes every day during the warmer months. But I think he’s been experiencing one of those times when the reality of how old you are hits hard. You know?”
Russ smiled a little. “I’m turning fifty this November. Believe me, I know.” He leaned forward. “Look, Laura, how long have you worked for Allan Rouse?”
“I practice with him, not work for him.”
He nodded his head. “Sorry.”
“It’s been, jeez, twelve years now. Talk about the reality of getting old.”
He pitched his voice lower. “One of the theories I’m working on is that there may be another woman involved.”
Laura started laughing.
“No?” he said.
She couldn’t speak for a moment. “If you knew Allan . . .” She took a deep breath, tried to wipe the grin off her face. “No. Absolutely not. Forget that he’s one of the few husbands in the world who genuinely loves his wife. He didn’t have the time to fool around on the side. His whole world was the clinic and home. I doubt he had half an hour a day unaccounted for.” Her face sobered. “Until he disappeared.”
“What about drugs?”
“What about them?” She tilted her head, causing her braid to fall over her shoulder. “You mean, like, did he write his own prescriptions too enthusiastically?”
“He wouldn’t be the first doctor to wind up abusing.”
She leaned back in her chair. “I don’t think so. Like I said, he’s a very healthy guy. The bike’s out back in the carriage house for riding, the fridge is stocked with dark green cruciferous vegetables and low-fat dip, and he takes an aspirin every day. The only drug I’ve seen him use is Xanax. He has a bottle in his desk he dips into occasionally.”
“Xanax. That’s for . . . ?”
“Anxiety. I’m not saying it’s not possible. All I can say is he’s never appeared to be under the influence here at work.”
“At home?”
“I’ve seen him drink too much at their annual Christmas party. That’s about it.” She stretched, cracking her back, and stood up.
“If you, as a medical professional, had a prescription-drug problem, how would you feed your habit? Can you get narcotics sent here?”
She shook her head. “We don’t keep any controlled substances here at the clinic. It’s just an invitation to get ripped off. If I were abusing, I’d write prescriptions for fake names and take them to as many different pharmacies as I could. Not here, in town, not where anyone would know me. I’d tell the pharmacist I was Jane Doe and get my goodies. And I’d make sure not to come back too soon or too often.” She scooped up her clipboard. “Anything else? I hate to give you the bum’s rush, but you saw what it’s like out there.”
Kevin bounced out of Rouse’s office. “I got it, Chief.” He held a letter out to Russ. It had been stamped on the back with a big red REC’D and dated March 17. He flipped it over, took just enough time to see it was addressed to the board of aldermen, and stuffed it into his jacket pocket. “Good work, Kevin.”
The young officer glanced out the window. “Looks like you were right,” he said. “It’s started to rain. Will you be okay if I go get the car? I’ll pull it forward by the entrance so you don’t have to go so far.”
Russ closed his eyes slowly and resisted the urge to break one of the crutches over the edge of the table. He was going to be one mean-tempered bastard when he got old and infirm, he could tell that already. “That’s a great idea. Thanks.”
Kevin said his good-byes to Laura and bobbed down the hallway. Russ bent down and retrieved his crutches.
“Here,” she said, extending her hand. “Let me give you a good pull. It’s a lot easier to get up that way.” She smiled indulgently. “And I bet you won’t let any of the guys at the police station do it for you.”
He grunted. She tugged him upright and he drew the crutches in under his arms. “Okay, one last question. What do you think happened to Dr. Rouse?”
She rested the clipboard against her chest and folded her arms over it. “I think Debba Clow killed him.”
“Why?”
“Because Al had the ability to fire up a person’s temper, and Debba was a woman with a lot of temper to fire up. I couldn’t imagine her going after him on purpose, but all alone out there, with him pushing her buttons? Yeah, I can picture her bashing his head in and then dumping his body somewhere.” She looked toward the hallway, where the patients were waiting. Her lively face was suddenly drained and tired. “What a waste. He was a fine physician.” She glanced up at Russ. “He once told me the greatest compliment old Mrs. Ketchem ever paid him was when she told him no other doctor would ever love this clinic like he did. I suspect she was right.”