The Deception Read online

  “We’ve got a pretty good mix this morning, Doctor,” Sexton said as he sat down next to Connie, spreading the charts out on the table.

  “That young lawyer, Marden—he’s back with his old firm but not trying to make partner in six months by billing twenty hours a day.”

  Connie nodded. “He’s a good man.”

  “Then Janet Phillips is coming in.”

  “I catch her talk show when I can,” Connie said with a slight Philippine accent. “Lovely lady.”

  “She thinks the world of you, Doctor. She’s in a pressure-cooker business. A media headliner at twenty-five, but short-circuited, and bang!” Sexton slapped her chart with the back of his hand. “She was vulnerable, insecure, once the ratings started to slide.… She just couldn’t handle it.”

  Connie nodded sympathetically.

  “We had a few others lined up, but I thought this would suffice for the group therapy session.”

  Connie Puzon looked at Sexton quizzically.

  “Isn’t Donna DiTullio coming over? She’s being discharged tomorrow at noon.”

  “No question about it,” Sexton said. “She’s my showcase for Capricet. I’m writing her case up for the American Journal of Psychiatry.”

  Connie Puzon knew all three patients like the back of her hand. All three followed a familiar pattern. Physically, they seemed perfect specimens—handsome, athletic—but all three had tried to overachieve, Donna DiTullio at the insistence of a demanding father, Marden by chasing the Holy Grail of partnership, and Phillips by getting caught in the lethal cross fire of the ratings war. Each downward spiral was inexorable. There was weight loss at first, followed by an inability to sleep. Sleeping tablets provided temporary relief, but in time these opiates only exacerbated the problem. Next followed low self-esteem, then severe depression, with its insidious grip of frustration, isolation, and hopelessness. Finally, a psychotic breakdown overloaded the mental circuits—all three tried to escape what to them seemed to be unbearable pain and anguish. Marden crashed his Jaguar into a tree, Phillips took an overdose of sleeping pills, and Donna DiTullio slashed her wrists. All three survived, and all three ended up at St. Anne’s, under the care of Dr. Robert Sexton.

  “Want a cup of coffee, Doctor? We still have twenty minutes.” Sexton glanced at his watch.

  “Plain black would be fine, thank you.”

  Sexton left his office and headed for the pantry area just off the overhead passageway crossing the Atrium. For a moment, he paused and looked down over the polished oak railing. At 7:45 A.M., the main lobby of St. Anne’s Hospital, five floors below, was stirring to life. The admitting office’s personnel were busy warming up computers. Nurses in white tunics and aides in green scrubs gathered in small groups at coffee tables.

  The Atrium resembled a Hyatt Regency lobby more than a hospital foyer. Skins of glass stretched over seven floors of pink granite. A waterfall tumbled over beds of lava rock, spritzing a coral-lined pool with a fine spray. Exotic fish of gold, white, and kōki red darted among reeds, lily pads, and tropical flora. And shooting skyward, date palms, Hawaiian koa trees, eucalypti, and giant ficus reached for their place in the morning sun.

  Sexton left the passageway and entered the pantry, where Joe Sousa, a social worker, was sitting with psych nurse Elaine Adamson, both smoking early-morning cigarettes.

  “Good morning,” he greeted them with feigned cordiality. He detested smoking, and it was contrary to Lafollette’s ban.

  “We have a good group coming in this morning. A couple of graduates and Donna DiTullio, who’ll be getting her sheepskin.” Sexton poured coffee into two plastic cups.

  “I understand Donna DiTullio will be back on the courts, perhaps in the New England Open,” the psych nurse said as she ground out the remnants of her Marlboro into a Cinzano ashtray.

  “She really should give up the tour,” Sexton said as he poured some milk into his coffee and stirred slowly. “She’s good, but she’ll never be a Steffi Graf or even a Billie Jean King. And that father of hers will drive her right back to St. Anne’s. We have to make her realize this.”

  “We’ll have a good session,” the social worker said. “Look at Marden and Phillips. They’ve cut back but are functioning better than ever.”

  “No one is ever out of the woods,” Sexton said. “All three exhibited suicidal behavior—they’re still brittle. We’ll start”—he checked his gold Piaget wristwatch—“at eight. That’s ten minutes from now. We go for fifty minutes. I’ll lead the discussion. We want all three to ventilate their behavior patterns, personal events, frustrations, and, of course, their pain, even their thoughts and feelings about suicide.”

  “Isn’t that a little risky?” the psych nurse said. “Talking about suicide?”

  Sexton stood at the pantry door, holding both cups of coffee.

  His voice was authoritative. “Not at all. Years ago, we’d have locked these people in padded rooms, dosed them with antidepressants, even done lobotomies, and hoped for the best. Now we know that their anguish must be shared.

  “I’ll see you shortly. Dr. Lafollette is going to join us.”

  The first session went better than the psych nurse expected. Marden, Phillips, and DiTullio seemed to hit it off. There was in the group that strange camaraderie and candor that develop among hospital patients, particularly in those sharing similar ailments. All three discussed their psychiatric illness and suicidal behavior as though they were in an instructional seminar. DiTullio admitted that slashing her wrists was a timid destructive act—that perhaps she never intended to die—but said that she had a high level of anger, directed mainly at her father, and she had expressed her anger through the suicide attempt.

  The psych nurse took notes throughout. All three patients handled the session sensibly. All were upbeat, even jaunty, showing no evidence of anxiety, not a vestige of depression.

  “Time!” Dr. Lafollette checked the clock on the far wall. “We’ll take ten. I’ve got to go to my office and make a few calls. See you back here shortly.” Dr. Puzon left with him.

  “Anyone for coffee?” Joe Sousa asked. Marden and Phillips raised their hands.

  “I’ll help,” the psych nurse said. “Be right back.”

  Several seconds passed.

  “I’m feeling nauseous.” Donna DiTullio put her hands on her stomach.

  “Want to lie down in my office?” Sexton asked. “There’s a large sofa—”

  “No. I think I’ll just move around a bit. It may be the medication. I’m a bit woozy.”

  “You two just hang out. There are a few magazines.” Sexton looked at Marden and Phillips and gestured toward the coffee table. “I’ve got to go over a few things in my office. Donna, I’ll escort you out.”

  Sexton left Donna just outside the conference room. As he headed toward his office, she walked past the reception area. There was no secretary at the desk. Perhaps it was too early. She went out into the hall, then through another set of swinging doors into the Atrium passageway. She stopped at the low oak rail and fingered it lightly.

  The emerald flora was dappled by the early-morning sunlight. She closed her eyes momentarily and breathed in the scent of hibiscus and plumeria.

  Suddenly she was falling, hurtling down toward the palms and koa trees, plunging into a dark green abyss! She heard someone yell. Then silence.

  2Cardinal Francis Minehan was not pleased when he received the call from Sister Agnes Loretta, the hospital’s administrator, saying that there had been a suicide attempt at St. Anne’s by one of Dr. Sexton’s patients. He had been leery of establishing a psych ward at a general hospital. He was going to close the old facility out, but against his better judgment and that of Sister Agnes, he had gone along with Dr. Robert Sexton and upgraded the department. Sexton had a dossier of impressive credentials, magna cum laude at Columbia Med, a stellar internship and residency in Neurology at Boston General. Sexton came from an old-line family in Mamaroneck, New York, his grandfather having been t
he founder of the Hudson Valley Copper Corporation. It was during his Boston General days that Sexton studied psychiatry, passing his national boards. After a brief stay at the Peabody Sanatorium, Sexton got in touch with the cardinal. He needed no letters of introduction. Sexton was the cardinal’s nephew, the eldest son of his sister Harriet.

  St. Anne’s was a showpiece hospital. Five years ago, at the insistence of Dr. Robert Sexton, it had become a full-service mecca of healing.

  The cardinal’s initial misgivings appeared to be unfounded. Sister Agnes Loretta had nothing but praise for Sexton. His cure rate was the highest on the Eastern Seaboard and he seemed to fit seamlessly into the medical confraternity. He was the cardinal’s designated spokesman on crucial medical issues, testifying before state and national congressional committees and providing the necessary liaison with Blue Cross, Medicare, and the Massachusetts Medical Society, as well as the national affiliates. It was Sexton who countered rising medical costs by piloting a bill through the state legislature partially immunizing charitable hospitals such as St. Anne’s, Boston General, Beth Israel, and others from civil liability for injuries to patients. He was also a lieutenant colonel in the National Guard. With the help of Governor Stevenson, some squash-playing friends on Beacon Hill, and a friendly press decrying high-judgment awards against medical practitioners, he successfully guided another bill, artfully entitled “charitable immunity,” through the legislature that exempted doctors, nurses, and other health-care providers from financial accountability in excess of $100,000 arising from malpractice claims made by patients under their care. The legal limit for personal liability would be the same as the present limit for hospitals: $100,000. But the law would not go into effect for ninety days.

  At first, Sister Agnes Loretta was critical of holding group therapy sessions in the conference room just outside the Atrium passageway. But geographically, the staff offices were located at this level, and Sexton and even Dr. Lafollette felt the setting was ideal for patients who had progressed to an optimum level of recovery. The same could not be said in other departments, where patients sometimes fell off gurneys or went sprawling while hobbling to or from the commode.

  Cardinal Minehan, Monsignor Devlin, and Sister Agnes Loretta, together with Sexton and Lafollette, inspected the Atrium passageway.

  Minehan looked over the rail and shook his head.

  “We never should have allowed mentally disturbed patients to have access to an open area like this.” His hand swept outward. “Especially those with histories of suicidal ideation.”

  Monsignor Devlin and Sister Agnes Loretta nodded in tacit agreement.

  “We had no indication.… There wasn’t a sign the DiTullio girl would jump. She was in good spirits, looking forward to going home,” Sexton said, his face grim. “Her chart was well documented.”

  “Well, I want all of these open spaces paneled with unbreakable glass.” The cardinal patted the rail. “And I want the psychiatric offices relocated to the ground floor. This will be done immediately; Sister Agnes has already called the movers. You will be next to Radiology.”

  Sexton and Lafollette didn’t protest, even though they were locking the barn door after the horse had been stolen.

  The group returned to the conference room, where they were joined by Dr. Consuela Puzon, social worker Joseph Sousa, and the psych nurse, Elaine Adamson, as well as the archdiocesan legal counsel, Charles Finnerty, and a young aide.

  “How is the DiTullio girl doing?” The cardinal addressed the psych nurse, who was holding a hospital chart on her lap.

  “Not well.” She shook her head. “Aside from smashed legs and arms and internal injuries, she has massive brain damage. She’s in a coma in intensive care. Probably won’t survive the week.” The psych nurse spoke in candid nonmedical terms.

  Monsignor Devlin spoke for the first time. “It will be a blessing. Mr. DiTullio called this morning, and he wants a meeting with everyone who was present during this … er, unfortunate occurrence. He’s going to be accompanied by his lawyer.”

  “Let’s run through this again.” Legal counsel Finnerty nodded to his aide, who immediately flipped open his briefcase and readied a tape recorder.

  “We go on the premise that none of you in attendance had any inkling that the DiTullio girl would attempt suicide.”

  There was a collective nodding of heads.

  “We’ve taken the statements of the other two—Marden and Phillips—and they back you up on this observation. But what bothers me”—Finnerty unconsciously adjusted his steel-rimmed glasses—“is that other than Dr. Sexton, no one actually saw her jump. She must have gone right past the pantry, where you two were getting coffee.” He looked at Sousa and Adamson.

  “Well, we were having a quick cigarette,” Sousa said. “We had closed the swinging door. When we heard Dr. Sexton yell—”

  “Hold it a minute!” Finnerty said. “Let’s back up. Where was the receptionist? You say you and the DiTullio girl went by her station.” He looked at Sexton.

  “It was ten minutes to nine. The receptionist wasn’t due on until nine.”

  “How did Marden and Phillips get to the conference room?”

  “It was prearranged. They arrived in separate taxis and took the elevator to the fifth floor.”

  “Unescorted?”

  “They had been here several times before, so they knew how to get here.”

  “They remained in the conference room when you left with DiTullio?”

  Sexton nodded.

  “You’ll have to speak up, so we can get this on the recorder.” Finnerty’s voice had an authoritative tone.

  “That’s right,” Sexton said, his voice throaty and deep.

  “Did you see Donna DiTullio go out into the passageway by herself?” Finnerty looked at Sexton.

  “Yes. She said she needed some air. It’s very cool and pleasant in the Atrium. I thought it would do her good.”

  “But you said that you saw her through the glass aperture in the passageway door. Did you stop to watch her?”

  “No. I was headed to my office. But I had forgotten my notebook, which had some phone numbers in it for calls I had to make. While returning to the conference room, I happened to glance out the glass opening toward the passageway.

  “I saw Donna starting to climb over the rail.” Sexton’s eyes began to mist; he spoke slowly, haltingly.

  “I bolted through the door. I yelled at her, ‘Don’t jump, Donna. For God’s sake, don’t jump!’ ” Sexton’s voice was a raspy whisper. “I ran toward her. She looked at me—I’ll never forget that look. It was—”

  “All right,” Finnerty interrupted, “forget about the look. Legally, it’s not relevant, nor admissible as evidence.

  “Erase that last portion—about the look.” He turned to his aide and gave a cutting motion with his hand.

  Finnerty paused for several seconds. He and his aide exchanged nods.

  “Okay, please continue, Doctor.”

  Sexton cleared his throat.

  “I rushed toward her, trying to stop her. It was too late.…” Sexton lowered his head. Tears rolled down his cheeks.

  No one spoke. A minute dragged by.

  “You okay, Doctor?” Finnerty leapt into the silence.

  “Yes, I’m fine. It was just so unexpected. She was making such progress.…”

  Finnerty removed his handkerchief from his breast pocket and offered it to Sexton.

  “No, I’m okay. Thanks just the same.” Sexton dabbed his eyes with his knuckle.

  “That’s the theme. It was completely unexpected.” Finnerty smiled politely.

  “When both of you heard Bob yell, ‘Don’t jump, Donna. For God’s sake, don’t jump!’ what did you do?” Finnerty looked at Sousa and the psych nurse.

  “We ran through the door. We saw Dr. Sexton standing at the rail. Donna had jumped.”

  “All right. That’s good enough for now.” Finnerty snapped his fingers noiselessly as a cue to his aid
e. “Mr. and Mrs. DiTullio are coming here tomorrow. Just stick to the truth as you have given it here. It may suffice to ward off a lawsuit.”

  Sexton had regained his composure. “Dante DiTullio is the toughest nut I ever came across. We’ve had him in for counseling sessions. I’ve seen parents, especially fathers, who have an insatiable appetite to mold a child into a winner, even when the youngster has only a modicum of talent—hockey, basketball, beauty pageants—you name it. Mr. DiTullio is a classic study on the cause of youth burnout.”

  “Is there any chance of a successful lawsuit?” Monsignor Devlin, himself legally trained and an associate professor of ecclesiastical law at Boston College, inquired of Finnerty.

  “Sure, I learned long ago never to prejudge a case. Our position seems reasonable. When we explain it to the DiTullios and their lawyer, there may not be any suit—especially if Donna DiTullio succumbs, which is more than likely.”

  Devlin let the matter drop. As chief legal liaison between Finnerty and the cardinal, he had authorized many settlements, some involving priests and former altar boys, and he knew that a reasonable up-front offer sometimes quashed litigation along with all its dark publicity.

  Finnerty wanted to put his stamp of authority on the meeting’s windup.

  He addressed the cardinal. “As you know, Your Eminence, thanks to the charitable immunity law, St. Anne’s is responsible for only one hundred thousand, even if its staff and employees are totally liable. But individually, as for your Dr. Sexton, in fact, all of you who were in there with Donna DiTullio that morning”—Finnerty scanned those who had been present—“for the moment, the sky’s the limit.”

  “I thought that the law limited the liability of all health-care providers as well as health-care professionals at one hundred thousand dollars,” Monsignor Devlin said.

  “That’s the kicker. Last year, the legislature passed the Hospital Immunity Bill. This year we took care of the doctors and nurses, but unfortunately the law applies only to suits commenced ninety days from its enactment.”