ONCOLOGY: Cancer Treatment Can Be Murder by M. E. Roche

About the Book

Nora Brady has left the sheriff's department after a personal tragedy leads her to re-evaluate her life. She takes a job in the oncology clinic at Harrison Hospital, where she has been a per-diem nurse for some years. When it's discovered that a patient who had been treated in the clinic dies while on a cruise, but an autopsy reveals no evidence of cancer, Nora and her friends are left to wonder if he was the only victim. Unwilling to alert the perpetrators, Nora, and the team covertly explore the who and why of such a deplorable scheme.

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Jimmy was sitting at his desk when I arrived after work. The medical examiner was part of the sheriff’s department, but Jimmy’s office was in the lower level of the old section of the hospital, across from the morgue. Sitting across from him was Tom King, a detective from the sheriff’s department who I knew well from having worked together. He had also been involved with a friend of mine some time back, so we had become friends on a personal level. Tom and Jimmy were also friends from past sports they’d played.

“What’s up, guys? This looks serious,” I said as I entered the office and pulled up a chair.

“I don’t want to create problems for anyone,” Jimmy began, “but I got some troublesome news this morning and I need your thoughts.”

Tom and I looked at each other and then back at Jimmy. “What news, Jimmy?” Tom asked.

“It’s a strange story.” Jimmy shifted in his seat and glanced down at some papers on his desk. Leaning in, he looked up at us. “I got this call from a friend in San Diego—another medical examiner. You may know this patient he was calling about, Nora. He was a patient in the oncology clinic. Howard Fierstein.”

I nodded. “Howard Fierstein. Sure, I know him. He was receiving treatment a month or so ago, but wasn’t tolerating it, so he and his family decided to switch him to hospice. Just to keep him comfortable.”

Jimmy leaned across his desk. “Well, the story I got was that he seemed to be feeling a bit better, so the family took him off hospice and decided to take him on a cruise. He had always loved the cruises he and his wife had taken in the past.”

“Sounds nice,” said Tom. “So, what’s the problem?”

“Howard had, what appeared to be a heart attack while he was on this cruise. When he got to port, they had to do an autopsy because of it being an unexpected death. The family informed the doctors there that Howard had recently been treated for renal cancer and the oncologists had told them one of the side effects of chemotherapy could be damage to the heart.”

“Ok….” Tom sighed, undoubtedly wondering where this story was going and why he was there.

“The problem,” said Jimmy, shooting an annoyed look at Tom, “was there was no evidence of any cancer when they did the autopsy. Apparently, there was a very small mass on one kidney. It appeared unusual, so my friend did a biopsy. It was benign. If it had been cancer, the usual course of treatment would have first involved surgery, but someone must have known this wasn’t cancer. Even if they truly believed it was cancer and didn’t want to subject Mr. Fierstein to a biopsy and surgery, chemotherapy is usually a later intervention, not the first.”

“But he did have chemotherapy and I thought its purpose was to eradicate cancer,” said Tom.

“That’s true,” I said, “but Howard’s cancer was supposedly advanced, not responding, and he hadn’t been able to tolerate a full course of treatment. He was on hospice because there was nothing more the oncologists said they could do for him. Even if cancer goes into remission, there will usually be some evidence of it having been there.” I turned to Jimmy. “How could that be?”

Jimmy leaned back in his chair. “That’s the problem. How could that happen?”

“That’s strange,” I said. “Usually there would have been all kinds of x-rays and lab work along the way—first to diagnose and then to monitor the effectiveness of the therapy. How could so many things have gone wrong or been skipped in this case?”

“That’s what worries me,” Jimmy replied. “I could see a misdiagnosis, but a series of skewed data? Not likely. Not even possible unless this was something coordinated. Not my area of expertise, but I would love to see his chart and I’m not able to access it. That’s why the two of you are sitting here.”

About the Author

While the product of a Midwest upbringing, M.E. has lived and worked on both coasts as well as in Ireland. As a registered nurse, she has had the opportunity to work in many facets of nursing from pediatrics to geriatrics, from labor representation to administration, including the implementation of hospital information systems for nursing.

While officially retired, she continues to volunteer at a neighborhood clinic where she lives in southwest Florida. When M.E. discovered that nothing had been written about nursing for young readers, since the 1950s and 60s, her first novels were written to address this deficit—to show young readers something of what nursing was like today. As she got to know her characters and their involvement with law enforcement, M.E. decided she needed more direct experience. She connected with her local sheriff’s department and began volunteering with the coroner’s division.

Her adult novels have been a product of that experience, giving Nora Brady the somewhat enviable opportunity to merge her talents for that of nursing with those of law enforcement.

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