Two more storms followed Oscar, both frightening early on but ultimately duds. Both fizzled over the Atlantic and turned north to places ignored by the storm trackers. Oscar himself brought heavy rains to the Bahamas before breaking up and limping away as a mere tropical depression. When he was gone, the satellite maps were clear for the first time in weeks. Maybe the season was over.
By the end of August, the island was busy again, though the routines were different. Early morning brought supplies and contractors, as opposed to hotel employees, and throughout the day the eastbound traffic over the bridge was diesel trucks, more FEMA trailers, more machinery for debris removal. Westbound traffic was a steady caravan of large industrial vehicles hauling an endless collection of storm damage to bulging landfills on the mainland.
School openings were delayed for two weeks, then a month. One by one, the downtown shops and cafés opened. On Saturday, August 31, almost four weeks after Leo, Bay Books reopened with a flashy party that lasted the entire afternoon, even into the night, and included clowns and stories for the kids, caviar and champagne for their parents, a jazz band, and a late afternoon barbecue on the upstairs veranda with a bluegrass combo and two kegs of beer.
Over its twenty-three-plus years, the bookstore had become the center of downtown Santa Rosa. Bruce opened the doors himself each morning at nine and offered coffee and pastries to the early customers. It stayed open until ten each night, long after all other retailers had called it a day. On Sunday mornings, there were homemade biscuits to go with the newspapers from New York, Washington, Chicago, and Philadelphia, and it was often difficult to find a seat in the second-floor café. Bay Books hosted many author and literary events and a crowd was all but guaranteed. The upstairs shelves were on wheels, and when they were shoved back the floor could seat a hundred. Bruce used it primarily for author readings, but also for book clubs, children’s hours, lectures, student groups, art exhibits, and small concerts. It was a rare day when there was not a gathering of some sort.
The store’s reopening, with its atmosphere of worn rugs and saggy shelves and neat stacks of books in every corner, was soothing to its loyal customers. “Bay” had survived unscathed and was ready for business, so life goes on. The worst was behind the island.
The investigation proceeded at a languid pace that surprised no one who was concerned with it. After several attempts, Bruce managed to get Captain Butler on the phone for an update, but learned little. There were a lot of fingerprints to compare, and that process was moving along with nothing important to report. The Hilton had finally responded with the unsurprising news that no one named Ingrid Murphy had been registered there before the storm. In fact, no one with that name had ever stayed in a Hilton on U.S. soil. Its surveillance footage had either been lost or destroyed, but the company was still searching. Beyond that, Butler had nothing to offer, at least not to Bruce. He implied that he knew more than he could report, but, as always, his vagueness sounded phony. Bruce and Polly conferred by phone. She had not heard from the authorities and was frustrated by the lack of communication.
Bruce talked to Carl Logan, the chief of police, but he was unconcerned. As usual, there was immediate friction between the locals and the state boys, and since the state had assumed jurisdiction there was little Logan could do. He seemed to prefer it that way. Besides, he was trying to run his police department from temporary quarters and all nerves were frayed. During a second call, Logan said, “Come on, Bruce, this is going nowhere.”
“You think it was murder, Carl?” Bruce asked.
“What I think doesn’t matter. If it was a crime it’ll never be solved, not by Butler anyway.”
“If it was a crime,” Bruce repeated to himself afterward. He was mumbling a lot by late August because his two co-sleuths had left the island. Bob was on a lake in Maine waiting for the leaves to turn, while Nick was back at Wake chasing coeds and counting the days until he pursued serious studies in Venice.
The day before Bay Books reopened, Mercer and Thomas had arrived on the island eager to examine the cottage. Larry met them there and gave a quick rundown on the damage, which was slight. A new roof was a good idea, though the current one was good for another year or two. He had already replaced the gutters, one shutter, one window, and a screen door. He had met with the insurance adjuster and they had lined up a contractor to replace the boardwalk to the beach. All in all, the cottage had survived in good shape. A half a mile to the north, a four-story rental had partially collapsed and would soon be razed.
A tourist had been killed there, one of eleven, Leo’s final toll on the island. As Mercer and Thomas drove around, taking in the aftermath, they found it difficult to believe that so many people had died. Camino was a laid-back resort community, a tourist attraction, a wonderful place to live and retire, with little thought ever given to sudden, unexpected death. But then, Tessa had died in a horrible storm less than a mile off the beach.
Bruce wanted her to stop by the store for the reopening and autograph books for the crowd. She and Thomas had lunch in a downtown deli and roamed the streets of Santa Rosa, just like in the old days, before the storm.
Sunday brunch was on the veranda, with Noelle in charge of the details and lively with chatter about her shopping excursions throughout southern France. The morning was overcast but the stifling heat had broken, if only for a day or two. It was the first of September, and only four weeks earlier they had gathered in the same place to toast Mercer and her wonderful new novel, with Nelson still alive and Leo a distant threat.
That crowd was not invited this morning because of the delicate subject at hand. The four of them sat at a round glass table Noelle had found somewhere deep in the Vaucluse, and they ate chocolate waffles and duck sausage while relishing the fact that the bookstore was now open again and life was returning to normal.
Bruce had been adamant that nothing about the novel was to be put in writing. The book report would be an oral one.
Mercer began, “It’s five hundred pages, a hundred and twenty thousand words, dense at times, and I’m not sure if it’s a mystery, a thriller, or science fiction. Not really my cup of tea.”
“More up my alley,” Thomas said as he took over the narrative. It was immediately obvious that he liked the book far more than Mercer did. “Here’s the basic plot. A bad company, privately owned by some bad people, operates a string of low-end nursing homes scattered around the country. Three hundred or so, and not the nicer assisted living places or retirement homes you see advertised. These are the depressing places where you stick your grandparents when you just want them to go away.”
“There are two on the island,” Bruce said.
“And a couple of nice ones as well,” Noelle added. “After all, it is Florida.”
“There are over fifteen thousand nursing homes, rest homes, retirement villages, call them whatever you want, from coast to coast. About a million and a half total beds, and almost all are filled, demand is constant. Many of the patients suffer from various forms of dementia and are out of it, completely. Any experience with advanced dementia?”
“Not yet,” Bruce said as Noelle shook her head.
Thomas continued, “Well, I have an aunt who checked out ten years ago but is still alive, barely, still breathing, shriveled up in a bed with a feeding tube and not a clue about what day it is. She has not uttered a word in five years. We would’ve pulled the plug years ago, but the law does not recognize the right to die. Anyway, my aunt is one of half a million Alzheimer’s patients put away in nursing homes, waiting for the end. The care may not always be good but it’s always expensive. On average, a nursing home charges Medicare between three and four thousand dollars a month per resident. Its actual cost—a few meds, the bed, the nutrients in the tube—is much less, so it’s a profitable business. And a booming one. Six million Americans suffer from Alzheimer’s and the number is increasing rapidly. There is no cure in sight, in spite of billions being spent to find one. In Nelson’s novel, the bad company is expanding in anticipation of future demands.”
“And that’s not fiction,” Mercer said.
“Nelson’s writing about nursing homes?” Bruce asked.
“Hang on,” Thomas said. “As you know, the disease is hideous and degenerative with no way of predicting how fast a patient will wither and die. It’s usually several years. For my aunt, as I said, it’s ten years and counting. But once they completely black out, go unresponsive, and live through a tube, they can still hang on for a long time. At three thousand bucks a month. The nursing home operators have an obvious financial incentive to keep them alive, regardless of how nonresponsive they are. Keep the heart going and the checks roll in. This is an enormous business. Last year Alzheimer’s cost the federal government close to three hundred billion in Medicare and Medicaid payments.”
“Does the novel have a plot?” Bruce asked, tapping his fingers.
“We’re getting there,” Mercer said. “It’s sort of a legal thriller with female characters who leave a lot to be desired.”
“I didn’t write it,” Thomas said with a laugh. “I’m just the messenger. Anyway, the protagonist is a forty-year-old corporate lawyer, male, whose mother is stricken with the disease, and he’s forced to put her in a nursing home where she steadily worsens and is soon out of it. The family is torn and goes through the right-to-die debate and all that.”
“Ad nauseam,” Mercer said. “He really beats it to death, at least in my opinion.”
“Your opinion is of the highbrow literary variety,” Bruce said. “Right now it doesn’t count.”
“All you want to do is sell books.”
“And what’s wrong with that, young lady?”
“Here we go,” Thomas said. “The lawyer’s mother weighs ninety pounds but her heart keeps going. And going. It gets as slow as thirty beats a minute, and the lawyer is monitoring this rather closely, then it begins a slow but unmistakable increase. Thirty-two beats, then thirty-five. When it gets to forty and stays there, the lawyer starts asking questions of the doctors. He’s told such a rise is unusual but not unheard of. His mother is totally unresponsive and that won’t improve, but she won’t die because her heart keeps beating. Month after month her rate fluctuates between forty and fifty and she hangs on.”
Thomas paused for a bite of duck sausage and a sip of coffee. Bruce ate too but asked, “And so, what’s the backstory?”
“There’s a drug called Daxapene that no one knows about. Totally fictional of course, because this is a novel.”
“Got that,” Bruce said.
“Daxapene is not on the market. It is registered, has a trade name, but will never be approved. It’s not exactly legal, not exactly illegal. Not much of a drug, really, because it’s not a stimulant, not a barbiturate, not anything really. It was discovered by accident in a Chinese laboratory about twenty years ago and sold only on the black market here in the U.S.”
Another bite. Bruce waited, then asked, “And what’s the purpose of Daxapene?”
“It extends life, keeps the heart beating.”
“Then why isn’t it a miracle drug? I’d like to invest.”
“It has a rather limited market. It’s not clear if scientists and researchers understand how it works, but it stimulates the medulla, that section of the brain that controls the heart muscle. And it works only in patients who are basically, as they say, brain dead.”
Bruce and Noelle chewed on this for a moment, then she said, “Let me get this straight. There is very little brain activity but enough to pump the heart.”
“Correct,” Mercer said.
“Any side effects?” Bruce asked.
“Only blindness and severe vomiting, but these were discovered by accident in China. There are no clinical trials for patients with advanced dementia whose heart rates steadily increase. Why bother?”
Bruce was smiling and said, “So, the shady company buys the Daxapene from the shady Chinese lab, pumps it into all of its dementia patients on their last leg, keeps ’em alive for a few more months so it can collect a few more checks.”
“Gotta love fiction,” Thomas said.
“Oh, I do. In the novel, how much money is on the line?”
“The bad company owns three hundred facilities with forty-five thousand beds, ten thousand of which are occupied by Alzheimer’s patients, and all of them get a dose of Daxapene each morning either in their feeding tube or in their orange juice. The drug is packaged like it’s just another vitamin or supplement. Most patients in nursing homes get a handful of pills every day anyway, so what’s another little vitamin.”
“The staff has no clue?” Noelle asked.
“Not in the novel. At least in fiction the culture is ‘When in doubt, give ’em another pill.’ ”
“Back to the money,” Bruce said.
“The money is vague because everybody eventually dies. That’s why the drug has never been tested. One patient might hang on for another six months with the help of Daxapene; for another it might be two years. In Nelson’s fictional world, the average is twelve months. That’s roughly an extra forty grand per patient, and he plays around with the figure of five thousand anticipated deaths per year, so something like two hundred million in extra cash from the government.”
“And the company’s annual gross?”
“Three billion, give or take.”
Noelle asked, “If the drug extends life, what’s illegal about it?”
Mercer replied, “Well again, in the novel, the bad guys take the position that they’re doing nothing illegal. But the good guys say it’s fraud.”
“Let’s get back to the plot,” Bruce said. “Assuming there is one.”
“Oh that,” Thomas said with a laugh. “Well, the corporate lawyer has a road-to-Damascus conversion, chucks his high-end career, sues the bad company for keeping his poor mum alive, almost gets killed several times, and eventually wins a big verdict to bring down the bad guys.”
“Predictable,” Bruce said.
“Thoroughly,” added Mercer. “I had it figured out halfway through. Does he really sell?”
“He did, yes. Nelson had some talent but he was a bit on the lazy side. I don’t think he wrote for the female audience.”
“And that’s more than half the crowd, right?”
“Sixty percent.”
“I’ll stick with the girls. And don’t call it chick lit.”
“You’ve never heard me say that.”
Noelle interrupted with “Okay, back to the book. We’re supposed to believe that this novel is responsible for Nelson’s death, right? Seems like a stretch to me.”
Thomas said, “I’ve been digging for two weeks and can’t find anything even remotely touching this story. Nelson is accurate enough with his numbers regarding dementia patients and nursing home beds and the vast sums of money and all that, but from the drug angle there’s nothing. It looks like pure fiction.”
“So who killed him?” Noelle asked.
There was a long gap in the conversation as the food kept their attention for a few moments. Mercer broke the quiet with “And we’re all convinced that it was murder, regardless of what the police might think?”
They all looked at Bruce, who nodded slightly and offered a smug, tight smile, as if he had no doubt.
“I agree,” Thomas said. “But I’m not sure this book will help. His first novel, Swan City, was about arms trafficking, and a much better book, by the way. His second, The Laundry, was about a Wall Street law firm that laundered billions in narcotics money for Latin American dictators. His third, Hard Water, dealt with Russian thugs peddling spare parts for nuclear weapons. It seems like he would have made much scarier enemies with those books.”
“But he really didn’t expose anyone, as I recall,” Bruce said.
Noelle asked, “Was there anything in Nelson’s past that involved pharmaceuticals?”
Bruce shook his head and said, “I don’t think so. His clients were tech firms selling sophisticated software abroad.”
“What happens in the novel?” Noelle asked.
“The bad guys get caught, pay up, go to jail. The Daxapene disappears and old folks start dying.”
“What an awful ending.”
“Thank you,” Mercer said. “I didn’t like the ending, the beginning, or anything in between.”
“What happens to it now?” Noelle asked.
“I’m sure his family will try to sell it,” Bruce said. “It’s worth something on the market. Nelson had a lot of fans. Dying young is usually a good career move.”
“I’ll try to remember that,” Mercer said.
Bruce chuckled and poured more coffee. He looked at Thomas and said, “There must be some bad actors in the nursing home business. Look at all these billboards and TV ads from law firms begging for abuse cases.”
“And the patients are pretty vulnerable,” Noelle said.
Thomas said, “There are eight major players and they control ninety percent of the beds. Six are public, two privately owned. Some get high marks for care, others stay in trouble with regulators and the courts. Nursing home litigation is lucrative in most states, especially here in Florida. Lots of old folks, lots of hungry lawyers. I found a bunch of blogs with horror stories of neglect and physical abuse. There’s even a publication, Elder Care Abuse Quarterly, published by some lawyers in California. But, as I said, the business is so lucrative, because of Medicaid and Medicare, that plenty of companies want a piece of the business. And costs are projected to go through the roof.”
“That’s comforting,” Noelle said.
Bruce said, “Well, dear, you’re not sticking me in one of those places. I’ve always said that when it’s time for the diapers it’s time for the black pill.”
“Let’s talk about something else,” Mercer said.
Nick claimed to be in the library but there was soft music in the background. After being sworn to secrecy, he listened intently as Bruce summarized Nelson’s last novel. Nick had just reread his first three books but did not believe they were revealing enough to get the author killed.
When Bruce finished, Nick said, “Nelson wouldn’t know beans about the nursing home industry.”
“I agree.”
“So he probably had an informant, a whistleblower who found him, probably someone who read and admired his work.”
An informant? Once again, Bruce was a step behind Nick.