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Jim sighed as he pushed himself to his feet. So much for his hopes of dealing with some of the paperwork that had been waiting on his desk for over a week while he spent night after night on twelve hour shifts staking out an abandoned warehouse which, two occasional snitches had assured the PD, was being used by a drug cartel. It wouldn't have been so bad if the stakeout had accomplished anything. Sheer chance had led to the unassociated investigation of an empty warehouse in another part of Cascade where a member of the public had reported seeing lights, and that was where the cartel was found.
The snitches involved had both disappeared, leading the police to assume that they had been paid by the cartel to give false information. Of course, it was also possible that both were dead, their bodies as yet undiscovered.
Jim at least had been able to get a reasonable amount of sleep during the week, although he had not gone in to the station; Blair, resolutely supporting his sentinel at night but with lectures to give by day if he didn't want to lose his paying job, had been surviving on two to three hours of sleep and what appeared to be gallons of coffee. Until he paid back some of the favors he owed several of his fellow TAs, he didn't feel he could ask any of them to stand in for him yet again.
Simon knew all that, dammit! Knew that Jim was tired and Blair exhausted to the point where Jim had flatly forbidden him to visit the PD until he'd caught up on his sleep. Knew that Jim planned on doing nothing but paperwork for a couple of days so that Blair could relax (to some extent) and not worry about Jim being out on the street alone.
That Jim often was on the street alone when Blair was at Rainier didn't matter. Blair was too tired to think objectively about it. It was when Blair was tired that he wasted nervous energy that he could ill spare worrying needlessly. Well, mostly needlessly.
Jim reached Simon's door. "Yes, sir?"
"Sit down, Jim. Coffee?"
Automatically suspicious when Simon was this relaxed inside working hours, Jim shook his head. "No, thanks, Simon. I've had so much coffee recently I'm nearly floating."
"How's the kid?"
"Sandburg? He is floating."
Simon grinned. "Isn't that situation normal for him?"
"It's the only thing keeping him awake for long enough to teach his classes. He's had a total of about fifteen hours of sleep in the last week."
"Yeah. Ouch. Come Saturday I'm switching off his alarm, if he remembers to set it, and just letting him sleep. But you didn't call me in here to ask about Sandburg. What's wrong?"
"I don't know. I don't even know that there is anything wrong. I'm just... unhappy about what might be nothing."
"It's a dead child."
Jim made a face.
"I've got a friend in the insurance business," Simon went on. "He's suspicious, but there's no solid grounds for it. It could all be a very unfortunate coincidence, of course."
"This is the second pre-school child in the family to die suddenly."
"What did the family doctor say?" Jim asked.
"Well, there's part of it. The father is a doctor. It's accepted that it's not a good idea for him to treat his family, so officially it's one of the guy's partners who's the family doctor. Officially the cause of death for both was decided by that partner."
"He's the one who signed the death certificates. But what made Cliff suspicious - the kids were insured for five hundred thousand dollars."
"Each?" Jim asked.
"Each. One of those fixed term insurances that pays out the money after a set time if the insured lives that long - in this case, maturing when the kids reached twenty one - or to the beneficiary if the insured dies; with both these kids, the beneficiary was the mother, not the father who's paying the premiums."
"I suppose... It's a good long-term plan to give your kids a good financial start in life."
Simon went on, ignoring Jim's observation. "The first one died five years ago. This one, just last month. The insurance paid out on the first without a quibble, but although they've paid out again this time, they're not happy about this second death."
"Any other kids in the family?" Jim asked.
"Two - a boy and a girl. The two dead ones were both girls. But the boy's past the age the two girls were when they died, and the girl's a lot younger - about six months. The dead ones were both three when they died. The boy's five - born just before the first daughter died."
"I suppose they're insured for half a million each as well?"
"The premiums have to be pretty steep," Jim commented.
"Yes. But it's over a twenty-one year period, and let's face it, doctors are pretty well off - Wallace could afford it. Cliff did say, though, that if the second girl had died before Wallace took out the policy on the third girl, they would have turned him down as a bad risk."
"Three when they died... " Jim said. "What was the cause of death?"
"Officially... heart failure."
"In a three-year-old?"
"It does seem unlikely, doesn't it," Simon said, "especially twice."
Having established which of Dr. Mundell's partners signed the two death certificates, Jim went to see him.
Dr. Wallace Alder was a middle-aged man with a cheerful demeanor; what could be called 'a good bedside manner'. Jim could see him offering hope even in the face of a terminal prognosis.
"Well, Detective, what can I do for you?" he asked.
"I'm afraid it's a rather sensitive issue," Jim said. "I understand that one of your partners is Dr. Henry Mundell."
"Henry? Yes. Good man. Such a pity about his daughters."
"That's the issue in question," Jim said quietly. "You signed the death certificates for the two girls?"
"Surely heart failure in young children is quite uncommon?"
"It's far from unknown," Alder said, his cheerfulness subtly diminished.
"Even twice in one family?"
"Does someone suspect... well, an irregularity in the deaths?"
"The children were both insured for a substantial amount," Jim said. "Naturally, with two such deaths in a five-year period, and two other children in the family also insured, the company has become somewhat concerned."
"Yes, I... I suppose I can understand that," Alder agreed.
"What can you tell me about these deaths? You said heart failure in children isn't unknown - what would cause it?"
"There are several possible causes," Alder said. "Heart failure in children can be a progressive clinical and pathophysiological condition caused by both cardiovascular and noncardiovascular abnormalities - "
"Sorry, Doctor, you've lost me," Jim interrupted. "How would you explain it to a worried parent?"
Alder hesitated for a moment, giving a wry half-smile. "In other words, put it in simpler terms?"
Jim nodded. "Yes, preferably non-technical terms."
"Technical terms are more accurate - "
"If it's your discipline. But seriously, there's no point in giving me details in words I'd need to check a dictionary to understand."
"A lot of children are born with a heart problem, like a hole in the heart, that can vary quite a lot in severity. Some children need surgical intervention to repair the damage when they're still very young, sometimes only a few days old. Older children born with normal, or apparently normal, hearts can have their hearts damaged by a virus - again that can vary in severity, with a child who has appeared to be perfectly healthy suddenly developing symptoms that say 'severe heart problem'."
"And two in one family?" Jim asked.
"It could be an inherited condition. Inherited cardiomyopathy happens, though not all members of a family necessarily have it. A grandparent might have had it, while the parent is perfectly healthy but has passed the condition on to the next generation. Henry told me that his wife's father had heart problems, as did two of her siblings, so he wasn't totally surprised when two of his children died of heart failure. Upset, obviously, but not totally surprised."
"How had you been treating them?"
Alder colored slightly. "I didn't. I tried to persuade Henry to let me treat them, and I know two of our other colleagues also tried, but he insisted that his wife wanted him to do it."
"But you signed the death certificates?"
"I know it was slightly irregular, but... well... it was professional courtesy. It wouldn't look good if he signed his own children's death certificates, even though he'd been treating them. He did tell me everything he'd done, and it was everything I'd have done and more. I was fully satisfied of that."
Jim nodded slowly. "Could you possibly give his other children a health check?"
"Well, yes, but remember if there's a hereditary condition, it could miss these two even if it killed the other girls. And there's always the possibility that the tendency is there, and could be triggered without warning by a viral infection."
"It would at least satisfy the insurance company that these two don't have an existing heart condition that could kill them at any time."
It was Alder's turn to nod. "And if they do?"
"Obviously we'll have to let the insurance company know. After that... I suspect they'd cancel the insurance and return the premiums that have been paid. They might want the insurance money on the two dead children repaid, less the premiums, on the grounds that if it was hereditary, Dr Mundell had to have known the children were susceptible to having a heart condition."
Alder sighed. "Tough on the family. I know money isn't any recompense for losing a child, but funerals are expensive and even for someone who's well paid, insurance money is a help."
"Yes, it is tough. Let's just hope the other two are healthy."
Alder was already reaching for his office phone, and dialed a two-digit number.
"Hello, Henry. Could you come over to my office as soon as possible? It's not actually a problem, but it is something that could become one... Right, see you in a couple of minutes."
It was actually just over one minute when the door opened and a rather younger, but fractionally overweight, man entered. He looked at Jim, a slight frown on his face. "Do I know you?"
"You might have seen my face in a newspaper," Jim said. "I'm Detective Ellison."
"Detective?" Mundell's voice indicated surprise, but his heartbeat remained steady. So - surprised, but not worried. In Jim's book, that tended to mean either a clear conscience or a hardened criminal, and in this case he felt reasonably sure it was the first.
"I'm sorry, but the company you insured your children with is concerned about the death of your second daughter. One child dying young can happen; two... well... Insurance companies are always alert for scams; they see two sisters dying at three years old as suspicious.
"Dr Alder has explained to me that they could have had a hereditary condition; so I wonder if you'd allow him to run a medical check on your other children, just to reassure the insurance company that neither one has a potential heart problem." Although worded as a question, Jim's tone made it clear that he wanted that examination.
"Yes, of course," Mundell replied. "I've been keeping an eye on them myself - his heart seems to be all right, but young Hugh has seemed a little run down this last three or four weeks, though it could be just that he's missing Norma. I'd always thought that children didn't develop close ties with anyone but their parents until they were about seven or eight, but Hugh was shattered when Norma died."
"Can you get your wife to bring the children in now?" Jim asked.
"There's the phone," Alder said.
Mundell picked it up.
Mrs Mundell arrived inside half an hour, bringing the two children. Even to Jim's inexperienced eye, the small boy walking beside her didn't look well, and he knew from Alder's soft gasp that the dcotor was horrified.
"Henry, I know you said Hugh seemed a bit run down, but I'd call this rather more than 'a bit'," Alder said.
"It's really just since Norma died," Cora Mundell said. "Once he gets over that I'm sure he'll be all right."
"How have you been treating him?" Alder was looking at his colleague, but it was the wife who answered.
"Henry wanted to put Hugh onto medication, but I don't believe in that. I've been giving him as healthy a diet as possible - low in harmful elements like sugar."
"So how do you sweeten things?"
"I don't. Sugar is just empty calories, and artificial sweeteners are full of chemicals, which can't be good for anyone," Cora replied.
"Well, I think I'll start off by getting his blood tested," Alder said. He flicked on an intercom. "Arlene, would you come in and take a blood sample please."
Moments later a nurse entered, and quietly and efficiently took three vials of blood from the child.
"The baby, too," Alder said. "And... I'm sorry, Henry, but I'd like to get your blood and Cora's tested as well."
"Yes, of course," Mundell said, although Cora was frowning and looked unwilling.
Arlene took samples of blood from all three, and as she marked the last one Alder said, "Put an emergency rush on Hugh's."
"Yes, Doctor." She went out.
Alder turned to Cora. "I know you weren't happy about that, but, frankly, you don't look well yourself. As a family you might have picked up a low-grade infection - but Henry, surely you noticed something was wrong?"
Mundell was looking closely at his wife. "How could I not notice?" he said disbelievingly. "Now that you mention it, yes, I do see... Cora, you don't look well."
"Something develops slowly, you're living with the person, you don't see whatever it is that's developing," Jim said. "It takes someone who hasn't seen that person for a while to notice instantly that there's a problem."
Cora was shaking her head. "I don't see how there could be anything wrong," she said. "I've always believed in healthy eating - you know that, Henry! With heart trouble running in my family, how could I not? Natural ingredients, no additives... the children never get anything to drink but milk or water - that's all I drink, though I haven't been able to convince Henry to give up coffee."
"Doctors and cops," Jim said. "I suspect both professions live on the stuff."
"All right," Alder said. "Now that Hugh's blood is being tested, I want to give him a basic check-up."
Jim retreated to a corner out of the way. Theoretically, he knew he should leave, but he wanted to keep an eye on proceedings.
Alder was clearly experienced in dealing with children; Hugh seemed perfectly relaxed as Alder used his stethoscope to check heart and lungs, then tested reflexes...
Finally he shook his head. "Nothing obvious wrong," he said. "We'll have to wait for the blood results."
Even as he spoke the door opened and Arlene came back in, almost running.
"Hugh is suffering from hyponatraemia," she said.
Both doctors gaped at her, then Mundell swung around and glared at his wife. "What have you done?" he demanded. "What have you done?"
"Done?" she asked, clearly puzzled. "Nothing... What do you think I've done?"
"No 'additives'," Alder said. "You said sugar, you said chemicals, but are you also giving your family a low-salt diet?"
"Of course I am!" she exclaimed. "Salt is bad for you! I never add salt to anything. I won't have it in the house."
"Too much salt is bad for you," Alder said. "But the human body needs some. Henry, didn't you realize... ?"
"I knew that all Cora's cooking tasted very bland," Mundell said, "but I didn't know she never used salt. And... and she encourages the children to drink a lot... "
"Of course!" Cora said. "Don't doctors recommend eight pints of water a day?"
"Eight cups of water," Alder said, "but not for children as young as Hugh. Cora, you're killing your children with what you see as kindness."
"What? That's ridiculous!" she snapped.
"You're giving your children a low-salt diet and diluting what they do get by making them drink too much water. You're suffering too, though not quite as badly. I'd guess that Lily, here - " he indicated the baby - "is probably still reasonably healthy because she's still on milk, and Henry isn't too bad because he has lunch out every day, so gets a salt intake then, as well as not drinking as much as you do.
"But you can't give anyone a no-salt diet coupled with too much water. People need some sodium in their bodies."
"So why do nutritionists say not to add salt to anything, and to drink at least eight pints of water a day?" It was obvious to Jim that she still believed what she'd read - or thought she'd read - over what she was being told, and wasn't listening to anything Alder was saying.
"Different people have different requirements, depending on body size and metabolism," Alder said. "And children certainly don't need to drink as much as an adult. Some foods do contain a reasonable amount of sodium and can provide enough for a body's needs, but too much water dilutes that too much. The result is hyponatremia or water intoxication, and people have died from it. You need to add a little salt to the water you cook vegetables in - "
"Vegetables are best raw!" It was obvious that Cora still wasn't prepared to believe that she could have made a mistake, but she was beginning to sound a little hysterical.
"Yes, some are," Alder agreed, "but some are better when they're cooked. You wouldn't eat raw potatoes, would you?"
"Add some salt to the cooking water when you're boiling them. It's not giving your family a massive amount of the stuff, but it's helping to make sure they get enough to keep them healthy."
"No! No! NO! I've already lost two children - giving them salt will kill the others, too!" She pressed Lily so tightly to her chest that the infant screamed. Hugh had already retreated to behind his father.
Mundell moved forward quickly. "Let me have Lily, please, dear?"
"You're as bad as Wallace. You don't believe in giving your children a healthy diet! You'd rather see them poisoned with junk like salt!" Her voice got louder and louder as she struggled to make herself heard above the screaming baby.
"Cora, you're hurting Lily!"
"Better that than let you kill her!"
Arlene stepped forward. "Mrs Mundell, let me have Lily. I'll make sure nobody hurts her."
Cora turned quickly so that her back was to the nurse. "No. I'm the only person who cares! Nobody else - Ah!"
Arlene had jabbed the syringe she had palmed into Cora's arm, dropped it and moved quickly to take Lily from her mother's quickly-relaxing arms. Not even Jim had noticed her moving to get the syringe.
"A sedative? Good thinking, Arlene!" Alder said, and Mundell nodded.
"Yes. Thank you," he said as he caught Cora and lowered her gently to the floor. "Arlene, could I ask you look to after Lily and Hugh for the moment, please. I'll need to contact someone about Cora."
"She's going to need psychiatric care," Alder said quietly.
"I know. God, why didn't I realize? I was treating Norma for heart problems, and all the time it was hyponatremia... That could have been what killed Susie, too."
"We don't actually know that," Jim said quietly. Mundell was probably right, but there was no point in adding guilt to the burden he was already carrying.
"Detective Ellison's right," Alder said. "You said yourself that it's only in the last two or three weeks that Hugh has shown any signs of debilitation - "
Mundell shook his head. "You heard Cora," he said dully. "That was the voice of obsession - and the food she prepared has always been bland. I thought it was just that she might have a particularly acute sense of taste, that to her it wasn't particularly bland... so I just let it go. I should have called her on it years ago. I knew she was aware that a low salt diet was good for people with heart problems... I never thought she'd interpret low salt as no salt - and let's face it, Wallace, that's what she's done."
Jim crossed the bullpen and knocked on Simon's door.
"Enter... Jim. Did you find out anything?"
"The other kids would have died too," Jim said. "The boy within two or three weeks, the other girl in a year or so. But it wasn't an insurance scam, it was just a woman's tragic misinterpretation of something she'd read. Dr Mundell genuinely thought the two girls had heart problems, he thought the boy was developing them too - apparently there's a history of heart problems in his wife's family. It didn't occur to him - or to Dr Alder - that the problem was Mrs Mundell's obsession with giving her family a healthy diet. No salt, no sugar, plenty of water - the kids died from a lack of sodium in their bodies. Mrs Mundell would have died too... though she might have died before she had time to kill the third girl. Mundell himself was all right because he always went to a restaurant for lunch, so he was getting salt there he didn't get at home, and he didn't drink nearly as much water.
"The first death could have been heart disease; Mrs Mundell seems to have become more obsessed with what she thought was 'healthy eating' after that."
"So basically it was accidental death?"
"You could say that. Mundell has had his wife committed - even I could see that she's seriously unstable. Whether she'll ever recover... I wouldn't make any bets on it. Mundell is planning on repaying the insurance money for Norma's death, incidentally, because it was the result of his wife's actions."
When Jim reached home, it was to find Blair preparing dinner.
"That's not a healthy meal, is it, Chief?"
"Jim, I always give you healthy meals - I've got to do something to compensate for all the Wonderburgers you've eaten!"
"Just tell me you haven't cut right back on the salt."
"What's brought that on?" Blair asked.
Jim shook his head. "You don't want to know, Chief. You don't want to know."
Blair looked at him, then smiled. "No, Jim," he said. "I haven't cut back on the salt."