“I’m an anaesthesiologist. And I was the one administering the anaesthetic to Adele that day. We always ask patients about allergies to any medications when we take their history. Most patients have never had the meds before, so how would they know? Do you know if you’re allergic to rocuronium?” Jeffers and I both shook our heads. “Exactly. It happens. It happens more than it should. And until there is a better way of screening medications, it will continue to happen. There is simply no way of knowing.”
“Can you talk us briefly through what happened with Mrs. Penner?” Jeffers asked.
Jayne sighed audibly and tears sprang to her eyes. “She was a lovely woman,” she said. “I remember her husband was driving her crazy with his worrying. She had a wonderful way of teasing him yet being able to comfort him at the same time. It was a routine surgery. But no matter how minor the procedure, there are always risks. We never make promises. Still, no one expected Adele Penner to do anything other than walk out of the hospital a few hours later a little lighter for the removal of a kidney stone.”
“What happened once you were in the O.R.?”
“It was so fast. Everything happened so fast,” Jayne said, her eyes looking at something a million miles away. “I administered the anaesthetic and the reaction was almost instantaneous. We are prepared for this, Detective. As I said, it happens. We immediately gave epinephrine. The patient … Mrs. Penner didn’t respond and was in full cardiac arrest within moments.”
“I thought epinephrine was kind of foolproof,” I said.
“Have you ever heard of Hypertrophic Obstructive Cardiomyopathy?”
“No.”
“The treatment can be worse than the problem. The epinephrine causes the heart to fail, and as a result—”
“Cannot counter the anaphylaxis,” I finished. Jayne Evans nodded. “And Adele Penner had this hypertro—?”
“HOCM. There was nothing in her medical history, but it’s likely it simply hadn’t been diagnosed yet. And maybe it wouldn’t have been. She hadn’t complained of any symptoms as far as I knew.”
“So it was a combination of the allergic reaction and the heart condition,” Jeffers said.
Again Jayne nodded. “We did everything we could. But sometimes.” Jayne took a moment. “We weren’t surprised when the lawsuit came. It was supposed to have been an in-and-out surgery. What happened was against all odds. What did surprise us was how far things went. The venom with which Armin Penner attacked. ‘Malpractice’ is a well-known word in the medical profession. One that no one takes lightly but one that is commonly used all the same. ‘Murder,’ on the other hand …”
“Can you be more specific?”
“More specific than a murder accusation?”
“More specific about why Armin Penner might have felt that was just?”
“Why, Detective? He had just lost his wife to routine surgery. To a series of complications that would have been entirely avoidable if we had only known about things that were impossible to know.” Jayne heaved a heavy sigh. “He didn’t believe those things had happened. The allergic reaction. The pre-existing heart condition. He thought we had made it all up to cover our own asses. To cover up our negligence.”
“Dr. Evans, we know there was a settlement. If Adele’s cause of death was the result of a series of natural, albeit unforeseen, circumstances, why would there have been a payout? Isn’t that an admission of wrongdoing?” Jeffers asked.
“Whether it is or not, these kinds of accusations are damning to reputations, to credibility, to funding … the reach is astonishing. Professionally. Personally. If a few dollars can make everything go away, it’s a small price to pay.”
“But it didn’t go away for Armin Penner. Adele’s life wasn’t a small price.” Jeffers said.
“You know that’s not what I meant.”
Jeffers nodded. “I’m sorry.”
Jayne rose from her seat, crossed to one of the two large windows in the room, and stood looking out for some time.
“I gave the drug, so I became his target,” she said, finally, her back to us. “I was the one he went after the hardest.”
“In what way?” I asked.
“For starters, he claimed the education I’d received in the army was not equal to that achieved in more traditional universities. He had all of my records and transcripts ordered for review. He called into question the qualifications of my professors. He put a blight on the whole program. Or tried to. And then when that didn’t work, he …” She brought a hand to her mouth and bowed her head.
“Jayne?” I asked. “Are you all right?”
“He claimed I was depressed. Suffering from PTSD. That I had some kind of death wish and was a danger to myself and my patients.”
Jeffers flipped through his notes. “Were you diagnosed with—?”
“No!” She turned to face us. “He was grasping at straws. Pulling out anything he could think of that’s associated with military history. Anything that might make me the guilty party. That might explain his wife’s death. And to satisfy him, I was subjected to numerous psychological reviews and was suspended from my job pending the outcome of these. People I worked with, friends, began to look at me as if maybe, deep down, I had harboured this secret. Old patients came out of the woodwork, questioning procedures I had worked on and wondering if, somehow, I was to blame for the tiniest of issues.” She paused. “I went along with all of it. I knew Adele’s death had been clean so I cooperated. For as long as I could. Finally, mercifully, my chief shut the whole thing down and insisted the hospital offer a settlement to the family.”
Jeffers and I sat in a stunned silence as the scope of Armin Penner’s grief circled us, watched us, dared us. It wondered whether we would measure its behaviour against its loss and declare its actions justified or see it as vindictive and calculating.
Images of Penner began floating through my mind. Him in his straw hat and suspenders, holding the weight of the day’s labour on his shoulders. Him with Adele, clean-shaven, smiling, their whole life ahead of them. I thought about how I’d handled my own heartache after my parents died. The pain I’d caused and the blame I’d sought. I could certainly understand his anguish. His need to hold someone accountable. To have answers even when there aren’t any.
“So,” said Jayne Evans, “you think he is still seeking vengeance. Trying to get to me through Al? I took someone he loved, so he …”
“We don’t know, ma’am,” Jeffers said.
“But it’s possible?”
“All the evidence proves Al’s death was the result of an argument that got out of hand. Whoever killed him didn’t set out to do so. However—”
“An accident,” Jayne said. “Like Adele. Ironic, isn’t it?”