'Probably. But tenure, as it turns out, comes from the med school, not the hospital. So they've still got their titles. Salaries are a whole other story. Quite a revelation for those of us who thought we had job security. Not that anyone fought for Hardesty. Everyone thought he and his guys were deadwood.'
'No more Psych department,' I said. 'No more free coffee.
What else?'
'Oh, plenty. Does it affect you, there being no Psych department-in terms of your staff privileges, I mean?'
'No, my appointment's in pediatrics. Oncology, actually, though it's been years since I've seen any cancer patients.'
'Good,' she said. 'Then there won't be any procedural hassles.
Any more questions before we go up?'
'Just a couple of observations. If it is Munchausen by proxy, there's some time pressure-the usual picture is an escalating pattern.
Sometimes kids die, Steph.'
'I know,' she said miserably, pressing her fingertips to her temples.
'I know I may need to confront the mother. That's why I have to be sure.'
'The other thing is the first child the boy. I assume you're considering him a possible homicide.'
'Oh, God, yes. That's really been eating at me. When my suspicions about the mother started to gel, I pulled his chart and went over it with a fine-tooth comb. But there was nothing ifly. Rita's ongoing notes were good-he was perfectly healthy before he died and the autopsy was inconclusive, as so many of them are. Now here I am with a living, breathing child and I can't do a thing to help her.'
'Sounds like you're doing everything you can.'
'Trying, but it's so damned frustrating.'
I said, 'What about the father? We haven't talked about him.'
'I don't really have a good feel for him. Mother's clearly the primary caretaker and it's her I've been dealing with most of the time.
Once I started to think of it as a possible Munchausen by proxy, she seemed especially important to focus on, because aren't mothers always the ones?'
'Yes,' I said, 'but in some cases the father turns out to be a passive accomplice. Any sign he suspects something?'
'If he has, he hasn't told me. He doesn't seem especially passive-nice enough. So is she, for that matter. They're both nice, Alex. That's one of the things that makes it so difficult.'
'Typical Munchausen scenario. The nurses probably love them.'
She nodded.
'What's the other?' I said.
'The other what?'
'Thing that makes it so difficult.'
She closed her eyes and rubbed them and took a long time to answer.
'The other thing,' she said, 'and this may sound horribly coldhearted and political, is who they are. Socially. Politically. The child's full name is Cassie Brooks Jones-set off any buzzers?'
'No,' I said. iones isn't exactly memorable.'
