Photo Credit: Sviatlana Lazarenka
In this medical fiction, Clifford Roderick Barnes disappears after exploiting the hospital’s linen system, then getting entangled with dangerous associates.
This medical fiction tale is one of a collection of stories that are like “Final Destination” meets “The Monkey’s Paw” (W. W. Jacobs, 1902). As such, they are tragedies that appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. The technical details surrounding the event are drawn from real cases in the US OSHA incident report database or similar sources and are therefore entirely realistic, even if seemingly outlandish.
The body of Clifford Roderick Barnes was found by a dog walker, as many cadavers tend to be. An unusually wet summer and a torrential downpour during the night had exposed the bones and released the kind of aroma into the early morning air that dogs find especially intriguing.
It had been a year since Cliff had disappeared under mysterious circumstances during a surprise financial audit. Rumors had swirled through the hospital; the big “E” word had been used in hushed tones. Embezzlement is such a nasty word, and people used it with that conspiratorial demeanor, like they were afraid it might summon demon auditors to rise from the filing cabinets. What had summoned a bevy of auditors was not the mention of any magical word, but the implementation of new software. The new enterprise resource planning software curtailed the need for each department to account for the in and out of goods and materials in quite the same way, and it was going to eliminate all the lists, scribbled notes, and spreadsheets that had eaten up so much time. This was a blessing and a curse. On the one hand, people complained frequently and bitterly of the immense burden of having to keep track of every container, sheet, blanket, and gown coming in and going out. On the other hand, a whole lot of creative accounting went on for a variety of reasons, and most people loved that freedom.
With the new ERP system, everything was scanned in or out, it knew what the EHR said had been used, and it could tally that with what the financial system said had been billed. Over the space of a weekend, as the ERP did all the tallying across all the different systems, some big discrepancies became obvious. There was much scurrying around to hide, excuse, or deny the many little local stashes of stores: scrubs, fluids, pens, drugs, anything that people wanted or liked and feared might suddenly become scarce. The discovery of all these little troves was not the only thing that the sudden transparency brought to light, nor the most serious. It also made it obvious that there was a lot of no accounting for things, sloppy recordkeeping of things received, used, broken, or lost. It ranged from pens to fire extinguishers and it caused panic as it suddenly became obvious that the various spreadsheets were largely a complete fiction—but that wasn’t the most serious issue either. The big issue was not missing equipment, consumables, or drugs, but linen.
As soon as the data were flowing through a single integrated system across the whole hospital, and without cover of myriad department spreadsheets, the new ERP system soon showed that nearly 90% of the linen was not reaching its expected useful life, and a whole bunch of new linen was vanishing before it even reached a ward or unit. From towels to bedsheets, millions of dollars were just evaporating without a trace, except now the ERP system showed in graphic high-resolution detail where the cracks were in the system. Cliff knew that it was just a question of time before these threads would show up as crossing in his hands and that the police would be involved.
It had all started so simply and innocently enough. A bin with soiled linen on its way to the hospital laundry had been left out in the rain over the weekend. It was a totally understandable error; there were five bins instead of the usual three or four parked outside the double doors to be collected, and this one had been around the corner because there were too many to park without blocking the pathway or the doors. It had been a hot and muggy weekend, and by Monday morning the linen was sprouting a fine fur of mold. That was easily solved by sending the tub to sterilization and the linen to the incinerator, but if the loss was made official, at least one janitor would get fired. So, the shift boss had asked Cliff if there was some way to work this out without management involvement, if the janitor could maybe pay off the cost. It was an intriguing puzzle to Cliff. He said something vaguely reassuring and added that he would see what could be done.
It turned out to be easy to bump up the number of items he said had been sent for end-of-life destruction and to create two new columns in his spreadsheet with a variable in one and a formula in the other. Over the next 3 months, a slight variance would steadily make the missing ruined linen balance if anyone actually did a full stock take, but that was unlikely. It was easy to show linen as out of service and then write it off gradually. Dealing with the janitor paying it off would be far more difficult, though, with fake invoices and cash payments that would require receipts and proof of delivery—a far more complicated and risky endeavor. Cliff told the shift boss that it had been handled and not to worry about repayment as long as everyone kept their lips zipped. The whole thing was done and dusted, and Cliff had enjoyed the little transgressive thrill of it. It also got him thinking.
It was a year later when he was playing golf in a random foursome that one of the players asked if he was the Cliff who had so kindly helped his nephew out of a pickle with damaged laundry. Cliff tried to play it cool, and the other three players were friendliness itself. By the ninth hole, Cliff understood the message that if more laundry went missing, they could do something with it. A week later, Cliff had left a plastic bag containing 50 sheets in an alleyway, and a day later picked up an envelope containing 50 used twenty-dollar bills. Cliff put his mind to it and started moving appreciable amounts of linen, using a range of freelance couriers to pick up and drop off whole palettes.
The cash transactions had also evolved into money transfers. He opened a corporate account in Bermuda that was linked to a company he had registered in Panama. That gave him full access to money, which he let pile up, except for buying a few things he didn’t want to be in his personal account at a local bank. He was careful to buy only a few luxury goods for himself and managed to hide his wealth and his smirk quite well. Using the business account, he made several offshore investments and had certain smug thoughts about earning almost as much as the hospital CEO.
Cliff had a simple escape plan for when it was time to bail that was really more a sort of early retirement plan. It involved having a place to go that was out of the reach of the IRS or police and enough money to maintain a comfortable but low-profile life. Using his offshore corporate account, he bought a rental apartment on the coast in Aruba and furnished it in a spartan but tasteful way: oak or rattan furniture, a few Persian carpets and prints on the walls, and a well-appointed kitchen. When the time came to scoot, he could buy his flights out with the business account and leave town with a minimal paper trail. As is very typical of clever men on the periphery of organized crime, Cliff had not much considered how his “business partners” would react when it came time to shut down the show. When he told them that the game was over because of the ERP system and impending discovery, he had expected some degree of disappointment, but that there would be a sort of wry and street-savvy acceptance of “all good things come to an end.” His usual contact took the news well, he thought, but had suggested they quickly go meet his manager just to wrap things up. Cliff glanced at his watch and agreed to the meeting as long as he could be back to finish packing and make his flight. With a big smile, his contact assured him there would be no problem with that, and he ushered Cliff politely into the SUV. Cliff sat back and watched the traffic go by through the tinted windows that seemed so quaintly gangster to him. He would miss this game, he reflected to himself, but as one phase ends, so another begins. In his heart, he was already in Aruba living a comfortable life.
Meeting in a run-down warehouse had seemed fitting as a backdrop to end a rather successful project, and it felt almost romantic. True to what he had been promised, packing and catching his flight would not be a problem; the meeting wouldn’t take long. The boss man, a short chubby middle-aged guy with a warm, meaty handshake and a broad easy smile below a big mustache, had just wanted to confirm that Cliff was ending the supply of laundry. He smiled broadly when Cliff confirmed and shook his hand again, this time cupping his other hand under Cliff’s right elbow. At this sign, someone behind Cliff stepped forward and put a single bullet into the base of Cliff’s skull. Two others caught the body and arranged it on a drop cloth. They wrapped him up in a tight bundle and carried him to a waiting truck. By the time Cliff’s flight left without him, he was securely positioned in a shallow grave, surrounded by a pine forest and the sounds of the night.
