HEMINGWAY CALLED CNN and the news teams descended on the clinic with a well-coiffed vengeance; all that was missing was the Reverend Samuel Parris, a bullhorn, and a gallows. Papandreou and Lincoln were across the street, Papandreou working on a hot dog while Lincoln cautiously sucked a Rocket Pop in a stooped over pose so he wouldn’t drip red, white, and blue all over his shirt. When Hemingway pulled up in the Suburban, Papandreou chucked the last of the dog down and Lincoln tossed his Popsicle in the trash.
Hemingway plowed her way through the gauntlet of camera flashes, halogen lighting, and rhetorical questions. She yanked the door open and stepped into the skating-rink cold of the clinic. There wasn’t a patient in sight.
Director Fenton was behind the receptionist’s desk with her two security men, a troop of blue-suited lawyers behind her—they looked like Custer’s boys just before the shit went down.
“Detectives,” Fenton said as she checked her watch, “as of four minutes ago, the Park Avenue Clinic initiated bankruptcy proceedings. We have willfully placed a significant portion of our capital in escrow to go toward possible restitutions.” The statement was practiced and vague.
“Mrs. Fenton, may we speak with you in private?”
Fenton’s eyes twitched in their sockets and her mouth went flat, and for a second it looked like her operating system had crashed. Then her mouth opened very slowly and she said, “Yes, of course.”
They followed her to the subterranean boardroom and Hemingway noticed that the artwork was gone; empty nails stuck out of the walls at every turn. Papandreou and Lincoln waited in the hallway with Fenton’s legal counsel while Hemingway and Phelps talked to the woman. Fenton dropped into a chair and Hemingway perched herself on the edge of the table. Phelps leaned against the door, arms crossed, the Iron Giant at rest. Or waiting for an attack command.
“Mrs. Fenton, since I left here last time we have learned that Dr. Brayton has killed himself and you held an anniversary celebration last year for the patients.”
Fenton just stared at her.
Hemingway’s knuckles tightened on the edge of the desk and Fenton looked down at them, as if realizing for the first time that they were alone.
“If we had known about Brayton, we wouldn’t have wasted valuable resources looking for him. And if you had told us about the opera, and that almost all of your patients had been there together, we might have been able to warn them. Two more children might be alive.” And with that, Hemingway handed Fenton a photograph of the cryptid child from the bathtub.
The director looked at it for a second, then quickly turned away. Her jaw moved in its mounts and for a second it looked like she might gag.
“That’s William Atchison. He was at the opera that night.” She stabbed another photograph into Fenton’s hand, this one of the Simmons boy on the ferry. “And that’s another patient of Dr. Brayton’s—Zachary Simmons. He was at the opera as well.” She followed these with the color copy of the invitation that Dr. Winslow had printed up for her. “You should have told me about this the first time I sat down with you.” She wanted to knock this woman around.
At that Fenton held up a folder. Hemingway opened it. It was a clipping from the Style section of the Times, dated May 13 of last year. It was a photo taken in front of the Met, Dr. Brayton exiting a limousine. In front of him was a family, a little brown-haired boy in their midst. There was another to his left, and two more in the background. At first Hemingway thought you’d have to be blind to miss the similarity between the children but quickly realized that was what these women had ordered—what they had expected: handsome little men to be.
Fenton began to speak, and all the bite, all the swagger, had left her voice. She sounded tired. “I knew right there. At the opera. It was obvious that they were his. All of them. They were in different sections of the hall, so none of the parents caught on. But I didn’t get to where I am by believing in coincidences. I called my lawyers that night. I had his samples destroyed and I fired him the next morning. He signed his life away to me; I could have put him in jail for the rest of his life. I honestly didn’t know where he had gone—I wanted nothing more to do with the man. This clinic wasn’t built on deceit and I find it very sad that this is its undoing. We have helped a lot of people build beautiful families over the years.” Hemingway thought for the first time that Fenton sounded sincere. “I didn’t know Brayton had killed himself but I can’t say that I’m upset by it.”
“Can you prove that Brayton is father of these children?”
Fenton nodded. It was a defeated gesture. “I have cheek swabs locked away.”
“Whoever is killing these children has known about their connection to one another for a while. Who had access to your files—legally, ethically, physically? How are the files protected? We need to find this guy and we need to do it now. He’s going through these children like some kind of a bad dream.”
“From a legal standpoint, only those directly involved with a particular patient are supposed to access their files: it’s not like a library where browsing and choosing is permitted.
“Actual access to a patient’s record is restricted almost exclusively to physicians, health care providers, nurses, and medical assistants. A receptionist would potentially have access to, and occasionally handle, records, but would be technically prohibited from opening them. It’s not in the job description. From there it gets worse.”
Had she said worse?
“The number of people we employ in the billing department, the medical coders, and the records department is very robust. It’s part of what makes—made—us efficient. These employees have access to a massive amount of information. When they come across any personal information while billing or filing they are supposed to read what was done, code it, bill it, and forget it. Half of the time they don’t even read the patient’s name, only their patient ID number.
“Our paper charts are kept in both the vault as well as a personal fireproof safe in each doctor’s office. They are not left lying around. Our record and chart rooms are locked at all non-practice times but when the office is open, they are unlocked and available to our employees. Our medical records department physically stores all of our records. The runners who work there have total access to all of the patient records but they’re not supposed to look inside them.
“Then things get a little more complicated. At the beginning of last year we transferred all of our patient files to electronic medical records—it’s a new federal law. Access to electronic medical records is limited to authorized employees who need a password. Doctors and nurses are notorious for logging in and leaving their panels open because logging in and out all day long is annoying.
“There are complex security systems within the EMR networks but the measures are not infallible. There are apps that work from laptops, iPhones, iPads and other mobile devices. If a doctor were logged in and not physically with that device, it would be like leaving the file room open for anyone.”
Hemingway thought of the text she had received from Tyler Rochester’s phone; whoever was killing these children was comfortable around technology.
Fenton continued: “Anyone working in coding, billing, medical records, or medical transcription would have all the legal rights in the world to be looking into files. It’s the cornerstone of their job. But there’s a difference between legal and ethical. People check files all the time without any ethical reason whatsoever. Just not my people.
“Federal law mandates that patients’ records be made available to them. If Jane Doe demands a copy of her medical record, she gets it. We return files to patients all the time. Once they are printed and released, who knows who has access to them?” She shrugged.
Fenton had just spread suspicion to most of the people in the country.
Her voice box started back up. “But none of this shifts blame away from Dr. Brayton. We wouldn’t be here if he hadn’t been such a narcissist. I think what he did was unforgivable.”
Hemingway looked down at the photo of William Atchison. “So does the guy who’s killing these boys.”