The Silence That Speaks (Forensic Instincts 4)

Conrad shook his head. “The only computer I have here is my laptop—and no accessories.”

“What was on that hard drive?”

Conrad spread his arms wide in noncomprehension. “Just professional material. Certainly nothing of value or importance to anyone but me. And definitely nothing to kill for.”

“Can you guess what they might have thought was on there?”

“Not a clue.”

“Did you keep personal memos or documentation of any kind?”

“Emails. Abstracts. Articles. Videos of cutting-edge surgeries.” He paused. “I can make a full list for you. I’m upset that the material is gone, just as any professional would be. But I don’t feel threatened in any way—not by this.”

“Please make us as comprehensive a list as you can,” Casey said. “Think about it carefully, come up with anything that occurs to you and email us.”

“No problem. I’ll do it as soon as you leave.”

“Good.”

Even more agitated than he’d been before, Conrad propped his elbows on his knees, interlaced his fingers and rested his chin on them. Tension rippled through him like an electric current.

“Also, when we talked on the phone earlier, you asked if I was strong enough to talk about Ronald’s surgery. I am. I discuss it frequently in therapy. I think I can handle talking about it with people who are trying to save my life.” His head inclined slightly. “I’m just not sure how it relates to your investigation. Then again, I’m not sure of anything anymore.”

Casey waved away his confusion. “We didn’t think it related to our investigation, either. But now, we’re wondering if whoever is trying to kill you and Madeline might be motivated by revenge.” She proceeded to fill him in on the situation with Nancy Lexington and her children.

Conrad blinked in momentary shock, and then his shoulders sagged. “I wouldn’t think Nancy, Felicia or Ron were capable of murder. But I saw how they were after I lost Ronald. They were furious. I don’t blame them. But Madeline? She played no part in the surgery, other than just being there at the very end.”

“That doesn’t seem to make her less guilty in Nancy’s mind.” Casey stared straight at Conrad, never pausing or averting her gaze. “We need to discuss the surgery itself, and why anyone would believe that a cardiothoracic surgeon of your caliber would unexpectedly lose a patient—particularly this patient.”

“Unexpectedly? Or on purpose?” Conrad asked the obvious question. “I swear to you that I would never intentionally harm any patient. I took an oath to save lives, and that was always my goal when I walked into the O.R. As for Ronald, he was my closest friend. The only reason I agreed to operate on him, despite our personal relationship, is that I knew I was the best surgeon to perform the surgery. Intent isn’t even in the room, in this case, no matter what anyone believes.”

Casey never doubted the sincerity in Conrad’s tone or body language. He was innocent of any wrongdoing. The idea of killing his friend because he was an obstacle to a hospital merger was preposterous.

“I believe you,” Casey said. “But we need to discuss the unintentional. What went wrong with the surgery and why?”

Conrad sighed, a sigh that rippled through his whole body. “That question haunts me every day. I wish I had an answer for you. The surgery went well. It was a very delicate procedure, which is why Ronald came to me to begin with. He was suffering from aortic valve and ascending aorta disease.” Conrad glanced from Casey to Marc. “I don’t know how familiar either of you is with that disease or with the Bentall procedure.”

“Not a clue on either.” Casey answered for both of them. “All I know is that the aorta is the large artery that leads from the heart.”

“Correct.” Conrad snapped into surgeon mode. “The Bentall procedure involves replacing the aortic valve, the aortic root and the ascending aorta. Ronald was at a crisis point, and needed the surgery done immediately. He insisted that I be the one to perform it. My success rate is over ninety-nine percent,” Conrad stated the last without arrogance, only the factual, statistical reality.

“What happened this time?”

“I honestly don’t know. The surgery itself went flawlessly—everything from dilating the diseased aorta to replacing that diseased section with a Dacron graft. I finished up, and attached the right and left coronary buttons without incident. To be even more cautious, I reinforced the sutures with tissue sealant. Everything looked hemostatic, so we took Ronald off the cardiopulmonary bypass.”

“Which is?”

“Sorry. The CPB is the heart-lung machine. I closed up his chest. Everything looked fine, so I went out to give Nancy the good news, leaving the surgical team to put in the final skin sutures. While I was gone, there was an abrupt drop in Ronald’s blood pressure and massive bleeding from his chest tubes. A Code Blue was announced, and I rushed back to the O.R. We emergently opened the chest.”

“And?”

“And I couldn’t control the bleeding that was coming from the aortic root. By this time, Ronald’s blood pressure had been low for a prolonged period of time, so we had to put him back on the CPB machine. There was massive bleeding from both the coronary buttons. I removed the sealant to visualize the anastomosis, which I then redid. Things got worse, not better. The bleeding was now more diffuse. We were losing him and I knew it. We rushed him to the ICU with his chest open, held together with a vacuum dressing. We did an EEG and a CT scan, both of which confirmed brain death.”

Conrad’s pain echoed from deep inside him. “So the patient—my patient—was declared. I couldn’t believe it. I still can’t. There were absolutely no indications that this would happen.”

“When did Madeline factor in?” Marc asked.

“When the Code Blue was announced. She rushed in, as did the rest of the code team. It was already too late. I’d reopened Ronald and was trying to repair the damage. The code team left the O.R. Madeline stayed. I believe she was in the ICU, as well, but I was concentrating only on Ronald. He was gone. I don’t recall what Madeline did after that.”