Dick Deaver’s life had been transformed. A few years ago, in the space of about three months, he had gone from curmudgeon boss, notorious playboy, and inveterate workaholic to doting grandfather, considerate male companion, and pleasant supervisor of his thriving private detective firm. Dick relished his new self, hardly able to remember those bygone days when he had trolled bars for fresh conquests to assuage the loneliness that his ridiculous lifestyle and grumpy demeanor had brought him. He had been emotionally isolated; his daughter, Dorothy, was the only person in whom he could confide and then only on certain subjects. Which made her relationship with that Philip Sarkis character even more difficult for Dick to countenance.
He not only mistrusted Philip for the dastardly deeds Dick was pretty sure he had perpetrated, but he envied Philip for the tenderness that Dorothy so freely afforded him. Dick had gotten used to having Dorothy all to himself after his beloved wife had died. Though Dorothy professed equal affection for her father, Dick had convinced himself that their special relationship was lost because of Philip, never to return.
But then Ursula came along and stole Dick’s heart. A gritty New York City artist with a mind of her own, Ursula reminded Dick that he could and should share his life with a contemporary and allow his daughter the freedom to show her love in a different way. And what better way to do that than to offer her father the gift he always wanted but would never admit: grandchildren. Emily and Erin stormed the emotional fortress that Dick had constructed when Dorothy left the nest, knocking down every barrier so that Dick’s love spewed forth like water through a giant hole in a dike. And try as he might to sustain an air of aloofness with just about everybody else, Dick couldn’t restrain himself in the presence of the grand-girls, hugging and kissing them at every opportunity, bending his aging, squeaky knees to get on the floor and play their games, relishing every moment he spent with them in a way that he never thought possible. Gradually and inevitably, Dick’s affection for the “mighty mites,” as he called them, and his tender relationship with Ursula turned him back into a happy man, much like the one who had met and married Dorothy’s mother those many years ago.
Though he knew he could never fully trust Philip, he was determined to do better on that front as well. He also realized that sustaining a meaningful relationship with his grandchildren and his daughter meant that Dick would have to figure out a way to get along with his pseudo-son-in-law. Under Ursula’s tutelage, Dick had implemented several coping mechanisms that seemed to work, at least most of the time. First, Ursula had convinced Dick to respect Philip’s career choices. He should avoid referring to Philip’s descent in the academic community, some of which was clearly self-imposed, but instead engage Philip about his job and show some sympathy when Philip pointed out, as he frequently did, how difficult the practice of medicine had become. Dick also had to stop asking about marriage prospects. It was fine to be concerned about his daughter’s future and security, but he had to concede that the choice not to formalize their relationship had been mostly Dorothy’s, who was almost as wary of Philip’s escapades as Dick had been. And perhaps most important, Dick had to adhere religiously to the most important grandparent directive: never, ever criticize parents for any child-rearing judgment, no matter how wrong it seemed. As long as parents loved their children and attempted to do what was best for them, grandparents needed to remain quiet, with the firm but tacit understanding that raising children is anything but an exact science.
So far, Ursula’s counseling had been effective. Philip and Dorothy were delighted to have Dick visit regularly, made even more special when he brought Ursula along. By focusing on the children, Dick avoided the hot buttons that had plagued his earlier interactions with Philip. So he was a bit surprised when Philip pulled him aside during preparations for one of their Sunday afternoon dinners.
“Dick, I’ve been having some problems with our grill on the back deck,” Philip announced, while Dorothy and Ursula were prepping their meal. “Would you mind taking a quick look at it? Weather’s getting better, and I’m pretty sure we’ll want to start cooking out more.”
Dick’s reaction was to glance toward the playroom, wondering what Emily and Erin were up to.
“The girls will be fine for at least a few minutes,” Philip said. “They’re playing with their Barbie dolls.”
“Sure, Philip,” Dick replied warily, suspecting that there was another agenda. “Let’s take a look at your grill.”
“I grabbed a couple of beers. Might as well enjoy the weather,” Philip said, heading for the glass slider, Budweisers in hand.
“OK, Philip, what’s the problem?” Dick asked as the slider closed.
“It’s not about the grill,” Philip said as he took the cover off the Weber and pretended to look at the ignition mechanism.
“Seriously, Philip? This is the best ruse you could come up with? You know more about grills than I do, and you’ve never asked me any handyman stuff before. So what’s on your mind?”
“Come over here, Dick, and pretend you’re looking at this thing,” Philip said, keeping one eye on Dorothy, who was presently intent on chopping vegetables. “I need you to look into a case for me.”
“A case of what?”
“A death that I think could be murder.”
“Really? Around here?”
“Allentown area.”
“Does this have anything to do with that newspaper reporter and doctor who overdosed?”
“Yes,” Philip said, sneaking another peek at Dorothy, who was setting the table. “Look, Dick. I need your help with this, but it’s really complicated. I didn’t want to cold-call you. And we can’t have this conversation now. I just want to know if we can we set up a meeting.”
Dick was reluctant. In addition to accepting her coaching about his behavior with his family and staff, he had promised Ursula he wouldn’t let Philip pull him into another dangerous case. Ursula saw those cases as land mines that would complicate his relationship with Philip and, in addition, anger Dorothy, who was violently opposed to Philip’s amateur sleuthing. Dick came to believe that Philip had finally learned his lesson and would not want to place his family in jeopardy. He shook his head at his own naiveté.
“Philip, I thought you were finished with this stupid stuff.”
“I am, Dick. I promise. I have no intention of getting involved with this case. All I want you to do is a little gentle inquiry. There are good reasons I can explain when we meet. I just can’t do it here and now. It would take too long.”
Dick paused, fingering the red button that, when pushed, would ignite the grill, pretending it didn’t work, in case Dorothy happened to look out on the deck. Despite his years of dealing with Philip’s “adventures,” he was intrigued about this case. The device scandal and the death of the reporter and her doctor boyfriend had been in the papers for days. The facts and the publicity had gotten Dick’s investigative juices flowing to the point that he was now going to do something he would eventually regret for the rest of his life.
“All right, Philip. Set up lunch for this week sometime, and you can lay out your issues.”
“Thanks, Dick. I really appreciate this.”
“Don’t thank me yet. I didn’t say I would do anything. But just in case, is it OK if I bring along someone from my office who can help keep me out of it? That’s if I agree to help.”
“Fair enough, Dick,” Philip replied. “As long as you can guarantee that whoever it is knows how to be discreet.”
Dick nodded, somehow managing not to sarcastically remind Philip that discretion was integral to his business model.
“Now let’s pretend that you fixed the grill and get on with our dinner,” Philip suggested, an invitation that Dick wholeheartedly accepted.
Sunday dinner was as pleasant, as always, although Dick couldn’t stop wondering if his daughter suspected Philip and him of conspiring. If she did sense duplicity, her demeanor didn’t betray her. She and Ursula enjoyed the evening, as they always did.
Philip was able to free himself for lunch two days later and called Dick’s office to set up the meeting. They decided on a deli in the Fairmount section, about halfway between NorthBroad and Dick’s downtown office. Philip was the first to arrive and asked for a booth near the front window. Within a few minutes, Philip watched Dick drive up and parallel park his car at a meter. A smallish, younger man, dressed in well-pressed khakis, maroon V-necked sweater over a white shirt, and highly polished penny loafers, emerged from the passenger side and followed Dick into the restaurant, where they quickly spotted Philip.
“Philip, this here is Al Kenworthy. One of my top investigators. Al is particularly knowledgeable when it comes to medical issues.”
Philip rose to shake Al’s hand. “I’ve heard a lot about you, Al, but I don’t think we’ve ever met.”
Al had a good smile. “No, we haven’t, but I used to work with Dorothy. When she was a student, she spent time in our office. We worked on a number of cases together. Smart lady.”
“And didn’t you do some digging for us on some medical cases a few years back?”
“Yup, I sure did.”
“And you got some pretty impressive results, as I recall.”
“I enjoy research, Philip, especially on the medical side. Not a lot of people know about all the work that goes on behind the scenes, but research is one of the most important things our firm does. I take a lot of pride in my work. It’s not as exciting as field work, but it’s critical nonetheless.”
Philip nodded. From what Dorothy had told him, Al was a relentless investigator who never failed to get to the most important facts of a case, no matter how long it might take or the lengths he needed to go for the details. And as everyone in the firm knew well, Al had a chronic crush on Dorothy that motivated him to dig even harder for a case that Dorothy cared about. Philip smiled, wondering how helpful Al might be to the man who had stolen Dorothy away from him.
He didn’t have to ponder that question very long because Al Kenworthy came out of the gate in a rush, hardly waiting for menus to be delivered, before launching into what he had already learned about the Tiffany Springer affair.
“Dick told me about the case yesterday, Philip,” Al explained. “I spent last evening trolling through multiple news sources. I wanted to be up to speed today. It’s quite a story.”
“I’m acquainted with some of it, but I don’t think Dick is, so why don’t you sum up what you learned, Al.”
Al held forth for the next half hour, pausing only for small bites of his Reuben sandwich or sips of ice water. Philip and Dick used those infrequent pauses to ask questions. Hardly necessary, given the lucidity and completeness of the Kenworthy dissertation, in which he outlined, point by point, what Tiffany Springer had uncovered, how she had synthesized the information, and who she had eventually fingered as the bad guys—people and companies that had been complicit in selling pacemakers and defibrillators to hospitals that were implanted by doctors in patients who may not have needed them.
Philip listened intently to the presentation, made so logically and orderly that for the first time, he felt he had a good grasp of the entire story. Philip was particularly excited to hear the few factoids that Al included about Ray Gilbert and his role in the Springer exposé. The fact that Al had gathered little substantive information about Gilbert himself reflected the fact that he had relied on media reports for his research and hadn’t yet interviewed anyone with direct knowledge of Gilbert’s relationship with Tiffany or his motivation to help her.
“Do you plan to talk to anyone up there who knew Ray and Tiffany personally?” Philip asked.
Al sat forward, excited by the idea, but before he could answer, Dick interjected, “Al’s job is to research the case, Philip. That’s what he does best; in fact, better than anyone else at my firm. We need to let him finish that, as he’ll describe in a few minutes. Until he does, it’s pointless and maybe even dangerous to do personal interviews and such. That’s something I’ll have some of my other people take care of—that is, if we go that far.”
“That’s great, Dick,” Philip said, relieved to hear that Dick was at least open to taking a deeper dive.
“But we want to keep a low profile, right, Philip?” Dick asked.
“Exactly, Dick,” Philip said. “For obvious reasons.”
“I do sense that there’s a lot more to the story, Philip,” Al said as he bit into his Reuben.
“I’m sure there is, Al. What do you propose to do next?”
“Now that I understand the storyline, I have to take a careful look at the facts that generated Tiffany’s story. That will involve looking at the book of business for Sterling and its competitors in that region of Pennsylvania, where she said the bad guys were doing their thing.”
“Are those records difficult to obtain?’
“The financial statements won’t be too hard. A little tougher will be hospital implant volumes. That will involve some gentle hacking, which used to be a lot easier before hospitals and doctors’ offices started putting in better firewalls and security screens.”
“HIPAA?”
“Exactly, Philip. You know this stuff better than I do. To be compliant with federal regulations, the hospitals had to show they were at least making an effort to protect patient information. There are still isolated breaches, but unless there’s a major screw-up, the hospitals are able to cover it up and not disclose it. Because if they do—”
“Major fines and the possibility of jail time,” Philip said. “We have to take computer-based courses on all of that crap, and they spend a lot of time telling us about the dire consequences of a data breach.”
“Which is the most absurd thing, because 90 percent of those violations are caused by administrators, not by doctors.”
“I believe it,” Philip said. “One of our HR people just gave away personal information on about ten thousand employees with one keystroke because she got a phishing email that said our CEO wanted the data.”
“Crazy, right? Most hospitals don’t have fail-safe mechanisms in place to keep that nonsense from happening until it happens. Which is why I hope I won’t have any trouble getting hospital data on pacemaker and defibrillator volumes for the period in question.”
“Won’t they have locked those data down, given the publicity?” Philip asked.
“We’re talking about hospital IT departments, Philip. Pretty much bottom of the barrel when it comes to expertise. I don’t think our computer people will have a problem.”
“Do you think the hospitals will have those data broken down by implanter?” Dick asked.
“Yes,” Philip answered. “Hospitals use data like that all the time, mostly to look for opportunities to save money.”
“How does that work?”
“Pricing always varies among vendors,” Philip explained. “Usually not by a lot. Vendors don’t want to get into a price war. But if a hospital is using a large volume of a particular device, the savings from using a pacemaker that costs only a couple of hundred dollars less can add up.”
“And there’s no difference in quality?”
“Companies are always coming up with new bells and whistles to justify a higher price,” Philip said, “but the reality is that they make very little difference in patient care or outcomes.”
“But how would the purchasing drones at the hospital know that?” Dick asked.
“They don’t, which is why smart hospitals bring doctors into their committee meetings to help them decide on the best and most economical purchasing approaches.”
“Why would doctors care?” Dick asked.
“They can be incentivized by raises that reflect cost savings, or they can get kickbacks,” Philip answered.
“Aren’t kickbacks illegal?”
“They are, unless the hospital goes through a process to put gain-sharing into place,” Al said.
“What’s that?”
“The government’s way of allowing doctors to profit from cost savings. It’s complicated but legal, as long as it’s done according to a precise formula,” Al explained. “And since the government wants that process to be transparent, financial records are in the wind. So that’s how I’ll be able to gather information about the volume of implants for each of the vendors and each of the doctors in those hospitals upstate.”
“Amazing lack of forethought,” Dick observed.
“Yes. Dick did explain to me that Ray Gilbert is the reason you’re interested in the case. And I admire you for caring about your friend. But the first step will be determining if Tiffany had her facts straight.”
“Don’t you think those facts are pretty obvious?”
“They seem to be, Philip,” Dick answered. “But remember what Mark Twain supposedly said: ‘It’s not what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.’”
“So you don’t believe that Sterling or other device companies were pushing physicians to do the wrong thing?”
“Maybe, Philip,” Al replied. “But do you think Tiffany Springer got it entirely right and that there really was criminal behavior? Or could this have been just a few dumb-asses doing the wrong thing for the wrong reasons? Remember, she had a pretty big ax to grind. She was looking to get famous and maybe make Gilbert rich, so the worse she made Sterling look, the better her chances for notoriety.”
“Fame that ultimately got her and Ray killed,” Philip said.
“We aren’t anywhere near that conclusion, Philip,” Dick reminded him.
“And I fear we never will be.”
“Like Dick and I have told you several times now, Philip,” Al concluded, “let’s just take this one step at a time.”