“Did you provide her with an alternative practitioner?”
“Yes. I encouraged her to see Dr. Lippencott while I was away, but she refused. I also gave her my private contact information and told her to call me any time, day or night.”
“Good. Did she call you?”
“Not that I know of.” It made Kate wonder about the Unavailable caller ID, but Nikki’s cell phone number always displayed on caller ID, and Kate would’ve recognized the Newton area code if Nikki’s parents had tried to reach her. Besides, she’d received the call ten minutes before Ira had given her the bad news.
“Was there any mention of suicide in her recent therapy sessions?”
“Not for the past two or three months at least. But we were in the middle of therapy, so it’s reasonable to assume that she wasn’t entirely out of the woods.”
“Was she stable?”
“Relatively stable, in my judgment.”
“If that’s true, then basically that’s all I need to know.”
Kate could detect deep lines of cynicism on the man’s face. As far as she understood it, Russell Cooper had been Ira’s friend since their undergraduate days at Yale, and he’d successfully handled two of Ira’s lawsuits.
“We’ll argue you met the standard of care,” Russell said, “if it comes to that.”
“I doubt her family would sue me,” Kate muttered.
“You never know. Once the dust settles, after the funeral— that’s the danger zone. The family can commence a wrongful-death action against you and the hospital any time they feel like it, right up until the statute runs out. So the question is: did you depart from the accepted ‘standard of care’ by failing to evaluate Nikki’s mental state?”
She shook her head, while James cleared his throat and said, “Kate’s one of the best child psychiatrists they have. She won an APF award, which is a big deal in our line of work. She’s compassionate and caring and does everything by the book.”
“I’m sure she does.” Russell smiled and slid his glasses back up the bridge of his nose. “Ira speaks very highly of you, Dr. Wolfe. But the hospital will want to make sure it hasn’t breached the standard of care by failing to keep the patient safe from harm. They’ll want to make sure she was properly diagnosed, that an adequate history was taken, and that her medication was appropriate.”
James leaned forward. “Kate would do anything for her patients.”
“James,” she said reproachfully, blushing.
Russell Cooper smiled. “I’m sure that’s true. And the courts have found that a medical provider can’t be held liable for mere errors in judgment. But we need to cover all the bases. Unfortunately, malpractice suits are becoming more commonplace, especially when a patient commits suicide.”
James glanced at her with concern in his eyes.
“What about the funeral?” Kate asked.
“As far as attending the funeral, that’s just fine,” he said. “As a matter of fact, I’d encourage as many staffers as possible to attend. It’s an excellent way to demonstrate the hospital’s concern. However, if you’re going to help out with funeral arrangements, Kate, I’d advise you to keep the meetings short. You can be open to people’s grief, but if they ask about Nikki’s treatment, you need to remind them it’s confidential.”
“Of course.”
“The family may not even think about suing you, but there are plenty of attorneys out there who are on a mission to hold psychiatrists accountable. So by all means, set up a meeting with the family to discuss eulogies, donations, cards, whatever you like. Honor their requests, but don’t volunteer. Let them call the shots. Basically, you want to be supportive without opening yourself up to a lawsuit,” he said. “Any questions?”
Kate frowned. “What happens next?”
“First, the hospital will carry out an internal investigation, sometimes called a psychological autopsy. It will be thorough, but quick. They don’t want to open a can of worms for discovery by the plaintiff’s attorney. However, Risk Management is going to have the hospital’s best interests at heart, Kate. Not yours. So my advice to you would be to cooperate fully, but be cautious. Choose your words carefully. I’d like to be there for the interview. Just a precaution.”
“When will this happen?” James asked.
The attorney shrugged. “Usually right away.”
Kate brushed away a distracting strand of hair and said, “I’ve been trying to figure out how I might’ve handled things differently…”
“Please don’t do that.” Russell shook his head. “Keep those thoughts to yourself. I have one thing I tell every doctor who comes through my door: the family is saddled with the burden of guilt. Nobody needs a psychiatrist who’s saddled with it too.” He checked his watch and tucked in his chin. “Any other questions?”
“I don’t think so.” Kate glanced over at James, who shook his head.
“Good.” His smile was more of a wince. “Let me know when Risk Management gets in touch, and we’ll set up a meeting.”
They all stood up at once.
“Appreciate your help.” James gave him a hearty handshake.
“Nice to meet you both,” Russell said warmly, shaking Kate’s hand.
She smiled gratefully at him. “I feel much better now.”
“No worries. I got your back.”
6
THE ELEVATOR RIDE DOWN to the garage seemed to take forever. They waited an eternity for the valet to get their car.
“Where do you want to eat?” James asked.
“There’s stuff in the fridge,” Kate said, putting on her gloves.
“Okay, listen. After lunch, I’d like to do some role-playing for the Risk Management interview.”
“Seriously? Role-playing?”
“You can’t just wing it. Remember what Russell said. You have to choose your words carefully.”
She shrugged indifferently. “I’d rather go back to work.”
“There’s no more work today. You’re exhausted. I’m exhausted. We were supposed to be in Sedona right now, remember? We’re going home.”
“I’m just saying… it would be nice to keep busy,” Kate objected weakly.
“Nobody’s putting any pressure on you to go back to work but you.”
“Okay, but don’t expect me to be happy about it.”
“I get that. But I’m in charge today. For your own good.”
The car’s heater blew hot air around their ankles as they headed back into Cambridge. It was snowing again. The windshield wipers swept away fat white flakes that landed with stunning clarity on the glass. They drove past the frozen river, while flurries blurred the road ahead. She shivered, cold as marble beneath her winter coat.
All of a sudden, a dark blue sedan in the passing lane veered in front of them and decelerated rapidly. James hit the brakes in order to avoid a collision, and the Lexus skidded across the road, sliding toward the guardrail before coming to an abrupt halt in the emergency lane. “Fuck!” he cried, as their heads jerked forward and their seatbelts took the strain. Kate bit her tongue and could taste warm blood in her mouth.
“Did you see that asshole?” James said through gritted teeth, flashing his emergency blinkers. The blue sedan took the next exit and disappeared into the flurries ahead. “That idiot cut me off. He could’ve killed us! I’m amazed the airbags didn’t deploy.” He looked at her and blinked, climbing down from the dizzying heights of his outrage. “Kate? Your lip is bleeding. Kate?”
She heard a flapping sound and realized it was her wildly beating heart. She saw something strange move toward them through the snow, something odd and whimsical, like a seahorse bobbing around inside an aquarium. It was a little girl. This shocked her so much, she unfastened her seatbelt and got out of the car.
“Where are you going?” James cried out. “Get back in the car!”
Kate stood by the side of the road, staring into the snowstorm, clumpy flakes sticking to her face and hair. She gazed at the falling snow and whispered, “Savannah?” Snow swirled in the wind, creating new shapes, and Kate had the sensation that she was being warned. Danger ahead.
“Kate?” James shouted.