Diagnosis Completed (Details)
citation: Collier's, October 18, 1952, 130(16):8, 30-31, 33
alias: The Other Arrow
teaser: He guessed instantly what she had died of. But there was still another question: Did she kill herself, or was she killed?
summary: Before retirement, Dr. Lerner takes his young replacement, Dr. Knapp, to visit his last case, Mr. and Mrs. Prine. Lerner explains the wife is diabetic, treated with insulin, and the husband, a druggist who owns the drug store below the couple's apartment, has heart problems, treated with nitroglycerin. His patients' problems are compounded by the fact that they hate each other.
Dr. Lerner is surprised the drug store is closed while Mr. Prine attends
a druggist's convention. As they take a side-street entrance to the Prine's
apartment, Lerner explains Mrs. Prine is the bigger problem of the two; an
invalid personality, a true hypochondriac.
He goes on to explain he prescribes
placebos for Mrs. Prine, that Mr. Prine, the druggist, fills.
When no one answers the door, the two doctors enter the apartment to find Mrs. Prine collapsed across the kitchen table; dead. On the table is an insulin bottle with its top punctured, and a spent hypodermic syringe. Lerner concludes Mrs. Prine died from insulin overdose; insulin shock. He then questions this diagnosis, reasoning Mrs. Prine would have taken sugar to counteract any overdose.
Dr. Knapp finds the little metal box in which Mrs. Prine kept her sugar tablets, opened, and empty. Lerner concludes she knew she was in shock, but is puzzled why the sugar did not prevent her death.
Lerner finds a half empty glass of mustard water, an emetic Mrs. Prine used to get rid of the sugar she had just taken! He conlcudes Mrs. Prine committed suicide by purposely giving herself an insulin overdose. She then had two changes of mind, once to live when she took the sugar, and then to go through with the suicide when she took the emetic.
Lerner explains his way of diagnosis by analogizing symptoms as compass arrows. He looks for the one arrow pointing in a different direction that would invalidate his diagnosis. He then challenges Dr. Knapp to find an arrow in this case pointing in any direction other than suicide.
As Lerner prepares to telephone the police, Knapp finds what he believes
is a suicide note with the final incomplete word Poisoninsu
on
it. When Knapp suggests the insulin had been poisoned, Lerner disagrees because
if true, the fact would be easy to determine, easily implicating the murderer
as Mr. Prine.
Lerner suggests when the insulin is tested, it may be double-strength, causing Mrs. Prine's normal dose to have been an overdose. He wonders if the empty digestion capsule they found in Mrs. Prine's vomit in the sink was in fact a placebo, prescribed by Lerner and prepared by Mr. Prine. He proposes the capsule had been inside one of Mrs. Prine's sugar cubes to make her believe she was being poisoned. This would cause her to take the emetic, dooming herself to die of insulin shock.
If correct, the doctors realize, Mr. Prine has gotten away with murder. Dr. Lerner telephones the police.
Later, Lerner learns the insulin was indeed more than double-strength, and the empty capsule harmless. Mr. Prine however, was found dead in his Chicago hotel room. He died from a stress-related heart attack, his nitroglycerin tablets unable to save him. It seems they looked exactly like the saccharin tablets Mrs. Prine used.
Dr. Lerner is happy to be done with the case, and begin his retirement.
words: 4,470
genre: Mystery (medical)
similar: None
people: Dr. Lerner, Dr. Knapp, Mrs. Prine, Mr. Prine
places: New York, NY: Third Avenue; Chicago, IL
comments: Forthcoming