Title: The Fragrance Shed by A Violet: Murder in the Medical Center
Author: Lin Wilder
Genre: Medical Mystery, Courtroom Thriller
Why did a Houston district attorney decide to involve the state in an area of the law that it has historically treated as sacrosanct: that of medical decision-making?
Why did the DA decide to charge McCall with murder rather than criminal negligence in a civil court?
In a city where the Texas Medical Center reigns as one of the top employers in Houston, housing over three thousand medical researchers making the news with new pharmaceutical discoveries almost daily, why did twelve Houstonians unanimously decide to convict Dr. McCall for intentional murder following her trial?
These are the questions that lead investigative reporter Kate Townsend to write a Pulitzer Prize winning series called Murder in the Texas Medical Center. Haunted by the knowledge that her new-found fame has been purchased at too high a price; Kate is sure that McCall is not guilty.
Texas Governor Greg Bell hires former homicide detective and criminal defense attorney Rich Jansen to fix the escalating problems at the Huntsville Prisons recently inflamed by a lawsuit against infamous inmate Dr. Lindsey McCall.
Dr. McCall is an internationally acclaimed cardiologist, researcher, and a 2002 nominee for the Nobel Prize for Medicine. When Jansen skillfully persuades an incompetent prison medical director to resign, he realizes that this strange saga is just beginning.
Mark Twain wrote that forgiveness was the fragrance shed by a violet upon the heel of the boot that has crushed it. This medical mystery weaves together the lives of two sisters, Lindsey, and Paula, with those of strangers as each cope with loss, betrayal, jealousy, and the exquisitely painful journey to forgiveness.
She lay listening to the unfamiliar night sounds: the pacing of other sleepless prisoners, the occasional echo of a heavy-footed guard making his rounds. Mostly though, she waited for the terror of the dream to subside, for the iron bands around her heart to loosen, and for the awful pressure on her chest to lighten so that she could breathe. And she waited for her heart to climb back down into her chest and out of her throat.
The dream was a familiar one. It had begun four years before following the sudden death of a fifty-two-year-old man whose heart she had catheterized. Dr. Lindsey McCall had surgical hands—a reference to the skill and dexterity that she brought to the Cardiac Catheterization Laboratory at Houston General Hospital. A colleague had made the comment during rounds one day during her cardiology fellowship at Houston General, and it had stuck.
There had been no reason for his death. Nate Morrison was a healthy senior executive with Southwest Oil, one of the largest oil conglomerates in the world. During his annual physical, Morrison had been referred to Houston General for a workup based on nonspecific changes in his cardiac diagnostic tests. Upon reviewing his tests, Lindsey had suspected that the man’s coronaries might be clean—free of coronary artery disease. She was well aware of the numbers. Of the sixty thousand cardiac catheterizations performed each year in the United States, over 30 percent revealed clean coronaries: absence of plaque in the vessels supplying the heart with oxygenated blood. And the procedure was not benign. Complications of cardiac catheterization were not uncommon and ranged from mild hematoma to death. In twelve years, Lindsey had done over five hundred cardiac catheterizations and more than three hundred angioplasties. She had never lost a patient.
But close to 75 percent of the revenue of her department came from referrals from doctors practicing in Texas and the Houston metropolitan area; the physicians at Southwest Oil referred hundreds of patients to Houston General per year, usually for angioplasty or cardiac cath. Furthermore, McCall was well acquainted with the financial realities of her profession—turning down lucrative procedures such as cardiac catheterizations was not smart.
For some reason she could no longer recall, she, rather than one of the cath lab nurses, had gone to see this man the night before the procedure. While she had been reviewing the potential complications with her patient and obtaining his informed consent, Morrison had asked with a wink, “Just how many patients have you lost in your twelve-year career, Dr. McCall?”
His quick-grinned response to her answer had been, “Well then, let’s you and I make sure that I’m not the first, deal?”
Lindsey could picture that conversation as if it had happened a moment ago. Fourteen hours later, he was dead.
As she had done hundreds of times before upon awakening from the dream, Lindsey lay there second-guessing herself—asking all the questions that had been asked by his family, by the morbidity and mortality committee at the hospital, and by her chairman of medicine. The final diagnosis had been sudden death caused by a massive left ventricular infarct most likely from coronary spasm. Neither his family nor the hospital held her responsible. There had never been even the suggestion of negligence on her part.
Her technique had been flawless. She had been calm and confident throughout the two-hour procedure, explaining what she was doing to her patient and laughing at his quick-witted responses. Lindsey had completed the injection of dye into the man’s left anterior coronary artery, and after satisfying herself that it, too, was free of plaque, had almost completely extracted the catheter from his coronary in preparation to end the procedure when she heard the startled cry of her technician.
“Lindsey, he’s fibrillating, he’s fibrillating!”
For just a second, her gaze met that of her lead tech, Ben, who responded to her unspoken question. “He’s been in sinus rhythm for the whole exam—there was never any arrhythmia, not even a PVC!”
Ben was referring to premature ventricular contractions that are frequently harbingers of serious cardiac arrhythmias. Lindsey trusted this guy implicitly; they had worked together for over ten years. If Ben said there had been no warning of this potentially fatal arrhythmia, she believed him. So she and her staff went to work, certain that in just a few minutes, they would get control and be back to the routine work of winding down the procedure.
But they couldn’t.
They had worked for over three hours, along with six members of the hospital’s on-call code team who had responded to the emergency in the Cath lab. They were never able to restore a normal cardiac rhythm, despite massive amounts of antiarrhythmic and other emergency drugs and numerous attempts at electrical defibrillation.
It was the head of the code team who called the code, suspecting that Lindsey was unable to do so. She had dropped her hands and stood staring at the futile electric signals displayed on the cardiac monitor, at the virtually unrecognizable semi-nude and mottled body of Nate Morrison and remembered joking with this man the night before. She remembered his smiles, good humor, and, most of all, his vitality. Then she walked out of the lab to tell his wife that her husband was dead. To tell her that he had had no coronary arterial disease but that he had died. And that she had no idea why.
That was the last time she had accepted a patient for catheterization.
The chairman of Medicine at Houston General had spent hours with Lindsey during that first year following the death of this patient. He had known her since she had been accepted into the cardiology fellowship almost fifteen years earlier and had followed the young woman’s career at first with interest and later with excitement. For that entire year, Lindsey had been exceedingly grateful to Bayer for his concern and, yes, the love she knew he felt for her. She had tried, God knows, she had tried to return to the cath labs at the hospital, but she could not do it. Just opening the door to the labs and beginning to scrub for the procedure evoked a panic reaction so severe that she could not tolerate it. And the idea of seeking a psychiatrist for treatment was unacceptable to her. Naturally, many of her colleagues in Houston and around the country had suggested that some of the newer antianxiety drugs could mitigate her reaction, but the only one who could force her to seek psychiatric and pharmacologic help was Dr. Bayer, and he refused to do so.
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Lin Weeks Wilder holds a Doctorate in Public Health from The University of Texas School of Public Health at Houston and has over thirty-five years of experience in academic health centers. During those years, Wilder published extensively in fields like cardiac physiology, institutional ethics, and hospital management. After ten years of running an online marketing business, and publishing four self-help books, Wilder switched from writing non-fiction to fiction.
The Fragrance Shed By A Violet: Murder in the Medical Center, Do You Solemnly Swear? A Price for Genius and Malthus Revisited: The Cup of Wrath comprise the Dr. Lindsey McCall medical thrillers with many references to the Texas Medical Center where Wilder worked for 23 years. Finding the Narrow Path is an unplanned surprise return to non-fiction. Her latest novel is I, Claudia: A Novel of the Ancient World.
Lin is the recipient of numerous awards for her work, including a Feathered Quill, two NABE Pinnacle Awards, and two IAN Best Books awards.
She is married to a former Marine and psychologist with 25 years of experience counseling ex-combat veterans. They reside in northern Nevada with their two dogs.
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