Ekaterina came in holding another satellite phone and a slip of paper.
“The chief called,” she said. “He has notified Dr. Frogmore’s employer, and obtained the name of his primary care doctor. He suggested that perhaps you should talk to the doctor and fill him in on what you learn. The doctor’s expecting your call.” She handed Dad a paper before disappearing again.
“Dr. Thomas Lanville,” Dad said. “And another 541 area code.”
Dad put the phone on speaker and dialed.
“Lanville.” The voice was deep, gruff, and booming.
“Dr. Lanville, I’m Dr. James Langslow, the local medical examiner here in Caerphilly, Virginia. I have Deputy Horace Hollingsworth with me—he’s our forensic expert, and also in charge of our on-site investigation—and my daughter Meg, who’s helping us with logistics. Thank you for agreeing to talk to us—did Chief Burke explain the situation?”
“After a fashion. I gather you’re snowbound in a five-star hotel, and instead of being able to relax and enjoy yourselves, you have a sudden and suspicious death on your hands, and no real facilities for investigating until the snowplows come to your rescue.”
“That’s pretty much it,” Dad said. “And we understand the deceased was a patient of yours—Dr. Oliver Frogmore.”
“Annoying man,” Dr. Lanville said. “Sorry; not the done thing, speaking ill of the dead, but he really was. Complete hypochondriac—the scientific kind. Gets it into his head there’s something wrong with him, spends hours looking up symptoms, then storms in demanding treatment for something that it only takes a few simple tests to show is not the problem at all.”
“Oh, yes,” Dad said. “I know the kind, the ones who have every crackpot pseudo-medical site on the Internet bookmarked.”
“Well, to Oliver’s credit, he didn’t much hold with Internet research,” Dr. Lanville said. “If it wasn’t the NIH or the Mayo Clinic, he had no time for it. Got himself a whole collection of medical reference books—dozens of them. Maybe hundreds. He used to inspect my bookshelves regularly to see if I had anything new. At least he wasn’t a big TV watcher, thank God. I can’t stand medical dramas, but my husband loves them. I get him to fill me in on what rare diseases they’re featuring each week, so I can have a heads-up on what my hypochondriacs are going to come in with next. Oliver wasn’t quite that bad, but still. There was the whole mushroom thing.”
“Yes,” Dad said. “We understand he was allergic to them.”
“Nonsense! He was no more allergic to them than I am. We did three rounds of testing and there was no sign of any sensitivity to mushrooms. Or any of the other hundred or more possible allergens we tested for. What he had was gallbladder disease.”
“Gallbladder disease,” Dad echoed. “I wouldn’t think that would present with symptoms that resembled mushroom allergy.”
“No, it most certainly wouldn’t,” Dr. Lanville agreed. “You know how he came up with the mushroom allergy idea? He had an artery-clogging over-the-top five-course meal in one of Portland’s most expensive French restaurants, and between the pâté and the duck confit and who knows what else—well, he made his long-suffering gallbladder miserable on a truly epic scale. And then decided that the sauce béchamel aux champignons was to blame.”
“Yes. Easier to give up mushrooms than fatty foods.” Dad nodded as if he’d seen it all before.
“He ended up having his gallbladder out last year, and it was all I could do to keep from saying ‘I told you so’ afterward,” Dr. Lanville said. “At least from what I can tell, he’d been doing reasonably well at keeping to a proper post-gallbladder-removal diet. Whining about it, but doing reasonably well. Was doing, rather. Still getting my head around the notion that he’s dead.”
“Did he have any heart trouble?”
“Not a bit of it,” Dr. Lanville said. “Given his age—seventy-two this August—and his relatively sedentary lifestyle, that’s one of the things I check on regularly. But he’s fine there. Low cholesterol. Low-normal blood pressure. Passes the stress tests with flying colors. Got the cardiovascular system of a man twenty years younger. And funny thing—in all his fits of hypochondria, I can’t ever remember him convincing himself there was anything wrong with his heart.”
“Perhaps because that’s such a common ailment for men his age,” Dad said. “All too real. And much more fun to imagine you’ve got something rare and wonderful.”
“Much more fun!” Dr. Lanville hooted with laughter. “Yes, that’s it exactly. And it would be all too ironic if he died of a heart attack—is that what you’re leaning toward?”
“No,” Dad said. “We won’t know for sure until the autopsy, of course, but I saw what happened—I was sitting at the next table—and it didn’t look to me like a heart attack.”
“Any idea what it was?”
“Well … it’s just speculation at this point. I only have what I observed to go on, both when he had his attack and when Horace, our EMT, and I were treating him. But I’m wondering if it could have been an overdose of vasodilators.”
“Hmm … interesting.” Dr. Lanville sounded thoughtful. And I’d have bet anything that if we could see him, his face would be wearing the same slightly puzzled frown that Dad was showing.
Since they showed no signs of explaining anything, I barged in with a question.
“That medicine Horace found under his table—is that a vasodilator?”
“Yes. A nitroglycerin lingual spray,” he added over the phone for Lanville. “One that delivers 400 micrograms with each pump.”
“He didn’t get that from me,” Dr. Lanville said. “And I can’t imagine why any reputable doctor would prescribe it for someone with absolutely no history of cardiac disease.”
“Do people ever use it for recreational purposes?” I asked.
“I don’t think there’s a chemical out there that some fool hasn’t sniffed, smoked, or shot up with for recreational purposes,” Lanville said. “I suppose nitro’s more plausible than some—the effects for the recreational user are probably similar to poppers.”
“Amyl nitrite inhalers,” Dad translated. “Which have been very popular recreational drugs for decades.”
“And no doubt he could have gotten it on the black market,” Lanville went on. “Everything’s available on the black market these days. But why would he? Given that amyl nitrite is available legally over the counter. And I’ve never seen any evidence that he had an interest in recreational substances other than vintage wine and expensive Scotch.”
“We don’t know for sure it was his,” Dad said. “We have to consider the possibility that someone administered it to him without his knowledge.”
“Damn. Any idea how much?”
“No, but the spray bottle was nearly empty.”
Dr. Lanville whistled in sardonic appreciation.
“And he showed every sign of sudden catastrophic loss of blood pressure,” Dad continued.
“He’d be more vulnerable to that than most,” Lanville said. “Given his normally low blood pressure. I always kept my eye on that, in case it drifted too low, but it was always rock steady at around ninety over sixty.”
“We also found something interesting in his room,” Dad said. “Had you prescribed sildenafil for him?”
I frowned at Horace—what was this sildenafil stuff, and why hadn’t he mentioned finding something interesting?
“What?” Dr. Lanville sounded very surprised. “Never. He never even asked about it. Are you sure?”
“We found five—no, make that six tablets in an unlabeled plastic pill bottle.” Dad held up the little bottle in gloved hands. I was close enough to see the contents—a little cluster of diamond-shaped light blue pills. Nothing I could remember taking—or anyone in my household, for that matter—but they looked vaguely familiar. Annoying that the Internet was out and I couldn’t look up sildenafil.
“What is—” I whispered to Horace.
“Viagra,” he said. “Sildenafil is Viagra.”
“Eww,” I said.
Apparently, I said it a little too loudly. Dr. Lanville burst out laughing.
“Eww is right,” he said. “And I normally like the silver fox look. But the idea of Oliver … well, you never know. There’s someone for everyone, they say.”
“I just have a hard time imagining any of his someones would be here at the conference,” I said. “He doesn’t have a lot of fans in the ornithological community.”
“Let’s face it—he was easy to dislike,” Dr. Lanville said. “Whenever he came in, my nurses would draw straws, and the loser had to do his vitals. But on a serious note—I’m not liking the way this sounds. First nitro and then Viagra.”
“Exactly,” Dad said. “The two of them in combination—”
“Would be a bad thing?” I asked.
“Nitroglycerin’s a vasodilator, as we said.” Dad was in full teaching mode. “Which means it causes the blood vessels to relax and dilate. If you’re having an angina attack, in which the blood vessels leading to the heart aren’t getting enough blood, a vasodilator increases the blood flow, thus providing symptomatic relief. People who are prone to angina sometimes even take it prophylactically when they’re about to experience something they know could bring on an attack—like stress, or exercise.”
“But you have to be careful with the dosage,” Dr. Lanville chimed in. “Because along with increasing the blood flow it also lowers blood pressure. Lower it too much and you’re dead.”
“And Viagra does much the same thing,” Dad continued. “Increases blood flow. Only … um … in a more localized way.”
“And if you combine Viagra with nitroglycerin, it amplifies the risk of a dangerous drop in blood pressure,” Dr. Lanville said. “That’s the first thing they say on all the warning labels.”
“And on the TV commercials,” Horace put in.
“And that’s one thing about hypochondriacs,” Dr. Lanville put in. “They love reading the warning labels. Gives them more scope for working up symptoms. So even if Oliver was taking some kind of medication without telling me, I can’t imagine that he’d do so without studying the warning labels.”
“The Viagra doesn’t have to have been his, does it?” I asked. “Any more than the nitroglycerin spray.”
“Viagra’s definitely available on the black market,” Dr. Lanville said. “And a whole lot more in demand there than nitro. Some idiots use it as a recreational drug. And it’s over the counter in England. So just because I never wrote him a prescription for it doesn’t mean he couldn’t have gotten his hands on it.”
“And just because it was found in his room doesn’t mean he brought it there,” I said. “Say I’m someone who wants to knock off Dr. Frogmore.”
“You’d probably have a lot of company,” Dr. Lanville said.
“And I’m someone who knows about the danger of combining Viagra and nitroglycerin. I spray a lethal dose of nitroglycerin on something I know he’s going to eat, and maybe add in a little ground-up Viagra for good measure. And I discard the spray bottle under the table and hide a few of the pills in his belongings, and hope the police say, ‘Oh, well—combining Viagra and heart meds. Sad but not unexpected.’ And bingo! Someone gets away with murder.”
“I’m glad you don’t have it in for me.” Dr. Lanville chuckled.
“His face was very flushed when he stood up to make his toast,” Dad said.
“Red as a lobster,” I said.
“Textbook,” Lanville said.
“And when he was insulting Dr. Hirano, he seemed to be squinting and peering, as if having trouble seeing him,” Dad added.
“Blurred vision—yes, that would be another symptom.” I could hear Lanville turning pages. One of his medical reference books, no doubt. I suspected Dad was itching at being parted from his own collection.
“The slurring and vision problems could have been the alcohol,” I pointed out. “He’d had a few drinks.”
“Very bad idea to drink when taking either of those medications.” Dad shook his head. “And I noticed him taking some kind of medication during the meal. I didn’t see what. I was going to check on him after the banquet—see if he was okay. Never got a chance.”
“I was sitting closer,” I said. “I heard him ask Dr. Czerny if he had anything for a headache. So probably aspirin or acetaminophen.”
“So someone gave him pills during the dinner,” Horace said. “Could that be how he got the Viagra?”
“I think he’d know the difference,” Dr. Lanville said.
“You doctors might,” Horace said. “Would he?”
“He might not know what they were,” I said. “But if you asked for aspirin and someone handed you a couple of bright-blue diamond-shaped pills, wouldn’t you at least ask what the heck they were?”
“Remember, generic sildenafil isn’t bright blue or diamond shaped,” Dr. Lanville said. “I’m looking at some pictures on the web. Only the ones Pfizer sells under the Viagra trademark come in the blue diamond shape. The generic comes in a variety of shapes, one of which is round and white and not unlike aspirin.”
“But the ones Horace found were the classic Viagra,” Dad said. “So while that doesn’t rule out that someone slipped him something other than aspirin—”
“Point taken,” Dr. Lanville said. “And he could very easily have had a headache—it’s a classic vasodilator side effect. Of course, we won’t know for sure till the autopsy, but I think you’ve pegged it.”
“We’ve pegged it,” Dad said graciously. I was sure if they’d been in the same room together they’d be beaming at each other with professional pride.
“If you like, I can do a little digging here,” Dr. Lanville said. “See if I can find any suggestion that he’s been two-timing me, professionally speaking.”
“That would be very useful,” Dad said. “And we need to start talking to some of the people at Dr. Frogmore’s table. They were closer than any of us were, and might have seen something that would be useful.”
To say nothing of the fact that if either the nitroglycerin or the Viagra tablets turned out to have contributed to Frogmore’s death, they’d be prime suspects.
“Do we know who they were?” Dad turned to me.
“Czerny, Green, Lindquist, and three very quiet young men who clearly wished they were at some other table,” I said. “I’ll see if I can find out their names.”
“Dr. Lanville, while I have you, I wanted to ask about one more thing,” Dad said. “If you don’t mind hanging on until I walk over to where we’ve put Frogmore’s body.”
“No problem. So how long have you been a medical examiner?”
“Only the last few years.” Dad stood up and slowly strolled out, still talking. From the sound of it I could tell that Dad and Dr. Lanville, having bonded over their theory on how Frogmore had died, were moving into one of those congenial far-ranging medical discussions of their weirdest cases and most brilliant diagnoses.