“Our physician means to kill his patient with morphine by injection of an overdose. The patient submits voluntarily, as it was her intent to commit suicide. Due to stress and arthritis, the doctor botches the injection. Soon he realizes that the morphine is not killing the patient. He has no more morphine. The doctor is under a time constraint to leave the house. His patient has been partially sedated by the morphine, so he decides to use what he has on hand to finish the job. He decides to inject her with IV adrenaline, which will send her into cardiac arrest. Because of his profession, and his standing in the community, he’s virtually certain that no questions will be asked, so long as he remains at the scene to call the coroner. He can sign the death certificate himself. It will still be a perfect murder, as he’d planned. Are you with me so far?”

“Yes.”

“The problem begins when the adrenaline hits the patient’s system. She does not die quickly. She panics, cries out, flails about. Despite his plan, the doctor is horrified by what he’s done. He might even be afraid that the neighbors or relatives will hear and become alarmed. In his panic he flees the scene, knocking the telephone onto the floor. He knows that by leaving the scene, he is risking an autopsy. But if the adrenaline is detected, he can simply say that he resuscitated the patient and left her alive. That he was in a quandary about what to do. He had to say that, you see? Otherwise he could not explain his failing to report her death.

“Do you see any problems with this scenario so far?”

“Only that adrenaline has limited therapeutic value in counteracting a morphine overdose, if he intended to claim he had resuscitated her with it and left her alive.”

“Might not a general practitioner plead ignorance on that point? Ignorance and desperation?”

“No. But you’re forgetting the DNR order. Why would he say he had tried to resuscitate her, since she was DNR?”

“I’ll ask you to answer your own question.”

“I don’t know.”

“Think about it.”

“Well . . . he might claim that, since the woman was his former nurse, and he had great affection for her, he disobeyed the DNR order and saved her.”

“That would make sense, wouldn’t it?”

“But then why didn’t he also do chest compressions?”

“You’re jumping back into what we know now. The doctor’s intent at that point was simply to say he left his patient alive. He had no idea that the woman’s dying agony was being recorded on video. No idea that we would see that he didn’t perform chest compressions or any other lifesaving measures. He intended to claim that he had performed chest compressions, and that she survived. That she must have died subsequent to his intervention.”

“If he’d performed chest compressions on an elderly woman, the evidence would be obvious. Severe bruising, broken ribs even. But that brings me back to my original problem with the whole scenario.”

“Which is?”

“Why did he leave the scene? As I said earlier, if he’d stayed at the scene, no autopsy would have been required.”

“Exactly. I’ve asked myself the same question many times. Why did he leave the scene? There are three possible answers. One, as he watched Viola die, Dr. Cage was overcome by the horror of his act and could not stand to remain at the scene of the crime.”