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Who killed Clinical Medicine? An allegorical murder mystery

Anand Krishnan, Ritvik Amarchand

DOI: https://doi.org/10.20529/IJME.2012.037


Hercule Poirot, the legendary detective, now retired, spent his time growing vegetable marrows. It was a typical day and Poirot was sipping his tisane, reading the day’s paper. He glanced at the Obituaries column (as was his practice now with ripening age). One obit suddenly caught his eye:

“With profound sorrow we announce the passing away of Dr Clinical Medicine (popularly known as Dr Clime) in his sleep. He leaves behind no close kin. His death is mourned by the management and staff of the Global Health Syndicate.”

Poirot recalled his last visit to Dr Clime when he was ill with fever. The doctor had been thorough in his examination! There were many similarities between a doctor and a detective. Both reconstructed their “cases” based on answers to questions. Both Poirot and Dr Clime, had always considered it more important to know the individuals, understand their thoughts and backgrounds rather than run around hunting for clues. But, he realised, he and Dr Clime belonged to a different generation. Today belonged to techno-savvy people like James Bond. He felt a pang of sorrow as he read the obituary, and decided to find out more about the doctor’s death.

He called up his friend, Inspector Japp, also the doctor’s regular patient. The inspector sputtered. “Poirot, how do you always ferret out news about such cases, even when it hasn’t been made public?” Poirot had to assure the inspector that he had no idea what he was talking about. He had only wished to know more about his friend’s death.

“Listen, Poirot,” said Japp, “and keep this to yourself. The doctor probably did not die a natural death. It is a bizarre case and we could do with your help. The local police have called us in. Why don’t you join us?” Poirot decided not to join them. He did, however, agree to help the inspector with the case.

Poirot called Mr Goby, his friend and former agent, and asked him to collect all possible information about Dr Clime and the hospital. Goby reported to him the next day. As was his practice, he settled on to the sofa and spoke, addressing the leg of the centre table.

The Global Health Syndicate had been set up by Mr Health, Mr Soapwater and Dr Clime, each owning equal shares in the firm. As a nursing home, it had earned an excellent reputation and despite being located on the city outskirts, attracted patients from far and wide. In due time, it had grown into a hospital with residential facilities.

Five years earlier, Health had died and his son, Health Jr had succeeded him. Soon, there were rumours that the partners were no longer comfortable with each other and might break-up. The reason had to do with the way Health Jr was running the place. Of late, there were many “modern” treatment practices and commercial activities taking place in the hospital.

Health Jr, an MBA in health care financing, saw the hospital as a “company”. He wanted to introduce professionalism into the hospital; he had modern ideas on how to increase its profits. It had taken him three years into the partnership to learn the ropes. Both the senior partners had proved supportive and he had been very grateful to them, at that time. Of late, he appeared irritated with them, more so with Dr Clime due to his conservative ways of doing things. He had recently recruited a number of new staff without consulting the other partners. These included Dr Young, Ms Gates, and Ms Pills.

Dr Clime was unmarried and had no one to inherit his share. After his death, it would automatically go to the other two partners. He was a widely respected doctor, but age had caught up with him, forcing him to see fewer patients. Then there were those daily skirmishes with his partners on one issue or the other, filling him with a desire to end the partnership. At times, it seemed that he wanted to end his life. He was often heard wishing aloud for death. Dr Clime had started taking sleeping pills on a regular basis. He also had frequent gastric upsets prompting him to order special food from the hospital kitchen.

Mr Soapwater, the third partner, was responsible for the hospital’s cleanliness, and the running of the kitchen. In recent years, his importance had waned and he now spent much time pottering around the garden. It was rumoured that many years ago, Soapwater and Dr Clime had fallen in love with the same girl! The triangle had ended with the girl deserting both the men. For this reason, Soapwater was said to have held a lifelong grudge against Dr Clime.

Ever since Health Jr had taken over, there was a move to induct young people into the hospital. One such was Dr Young, MBBS, MD, specially handpicked by Health Jr to provide advanced healthcare. Dr Young saw most of the patients, while some old faithfuls insisted on consulting Dr Clime. Dr Young often boasted that medical practice had changed since Dr Clime’s times, and one had to be “techno savvy” to keep up with the advances.

Ms Investy Gates was another new recruit. Her job was to oversee a new venture – a laboratory set-up. Gates was competent at her job and most of the staff liked her. Apparently Dr Young had a soft corner for Gates who reciprocated his affection.

Dr Clime had supported. Health’s proposal for a lab. But recently when Dr Young had suggested throwing open the lab services to outside health facilities as well, Dr Clime had raised objections.

Ms Pills, who had also recently joined the hospital, was supposed to be on the payroll of an international drug company which was planning clinical trials at the Global Health Syndicate. She was a no-nonsense person and brusque with the staff. Her exact role in the firm was not clear to most of the staff members, though she was often seen having hushed discussions with Health Jr.

Goby continued to address the leg of the table as he described the events leading to Dr Clime’s death. The day before he had died, there was a tussle between the deceased and Dr Young with regard to the management of a patient, Mr Rich, son of an old friend of Dr Clime. Dr Clime, who had known the young man as a child, knew he was merely a hypochondriac. But, Dr Young, who had seen him on this occasion, had advised a number of investigations and many drugs. Later Rich had paid a customary visit to Dr Clime and showed him the prescription. Dr Clime had felt that all Rich needed was reassurance and not treatment. He suspected that the hospital was using Rich to further increase profits and he had said as much to Health and Dr Young. An enraged Dr Young had warned Dr Clime not to interfere in his management of the patients.

Next morning, when the attendant arrived with tea, he had found Dr Clime dead in his bed. Dr Young rushed to the spot and noticed a knife injury below the heart. The police were informed. Goby left after submitting his report.

Next morning, Inspector Japp updated Poirot about the police investigations:

  1. On the night of Dr Clime’s death, Pills was spotted on the stairs leading to his room at about 11 p.m.
  2. Dr Clime’s window seemed to have been tampered with and the flower bed under it showed heavy boot marks which matched those of Dr Young . Young had an alibi in Gates who had dinner with him. Both said they had retired to their rooms rather late in the night..
  3. A blood-stained knife was recovered from the hospital grounds from behind a shrub. Soapwater had found it while gardening .The blood on the knife matched that of the deceased. There were no fingerprints on it.

As Dr Clime had been on a diet of late,, Health shopped personally for the special diet. Soon after Dr Clime’s death, the ingredients for the special diet had disappeared from the kitchen. The post-mortem report said:

  1. There was a high concentration of arsenic in the nails and hair of the deceased, indicating chronic arsenic poisoning.
  2. The stomach contents showed an overdose of sleeping pills, perhaps taken by Dr Clime.
  3. There were cotton fibres around the mouth and inside the nose indicating that he was smothered to death. The fibres were from the pillow by his bedside. No signs of struggle were seen on the body, probably because the victim was in deep sleep.
  4. There was a deep knife injury in the chest just below the heart. The slight bleeding around it indicated that it was perhaps inflicted after his death.
  5. There was a large malignant growth in the large intestine. The doctor would have died within the next six months due to this malignancy.

Poirot jotted down the important points on his notepad, adding his observations to it:

Mr Health Jr:

  • Motive: profit. Inheriting Dr Clime’s share plus freedom to run the place as he desired.
  • Opportunity: Used to buy the special food
  • Notes: Potential suspect but evidence is weak. The can of special diet has to be traced.

Mr Soapwater:

  • Motive: revenge for losing the girl he loved,
  • Opportunity-: Could have worked through an accomplice in the house staff.
  • Notes: Had access to arsenic materials (weed killer). No direct evidence.

Dr Young:

  • Motive: Jealousy, revenge, footprints match
  • Opportunity: Alibi provided by Gates. (reliable??)
  • Notes: Evidence of matching boot prints. Dr Young, in a fit of rage over the morning’s argument, comes at night and stabs Dr Clime with a knife. But Dr Clime is already dead either due to overdose of sleeping pills or smothering. There is little bleeding. Need to look closely into the alibi provided by Gates.

Ms Pills :

  • Motive: Resents Dr Clime’s opposition of drug trials and her presence. Could have committed the crime on somebody else’s ( Mr Health Jr or Dr Young) prodding.
  • Opportunity: Seen on the stairs on the day of the murder
  • Notes: Pills comes quietly at night and smothers Dr Clime with a pillow. Dr Clime, already in deep sleep, does not offer resistance

Ms Gates:

  • Motive: Not clear. May have grievances against him.
  • Opportunity: Access to chemicals and drugs,
  • Notes: Seems to be shielding Dr Young (a love angle?)

Dr Clime:

  • Motive: tired of life and the constant fights in the hospital. Cancer
  • Opportunity: Immense
  • Notes: Dr. Clime decides to end his life with an overdose of sleeping pills. He knew he had cancer and not many days to live. The daily fights were taking their toll.

Poirot shut his eyes and mentally visualised different possibilities. After ten minutes, he started to build a house of cards. One by one, as the cards went up, and suddenly it “clicked” and he had the solution. This case reminded him of an earlier one “Murder on the Orient Express” wherein seemingly unrelated people had come together and conspired to kill the deceased and provided each other with alibis. Perhaps, in this case also, there were multiple killers who were colluding with each other. The possibility of suicide could not be ruled out too.

The local police closed the case as a ‘Suicide’. No clear evidence was available for prosecution. The killers had beaten Papa Poirot.

Several patients including Poirot deeply mourned the loss of Dr Clinical Medicine. For them an era had ended. However, he was not missed for long at the Global Health Syndicate, which continued to flourish.

About the Authors

Anand Krishnan ([email protected])

Additional Professor

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110 029

Ritvik Amarchand ([email protected])

Senior Research Officer

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110 029

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