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Bitter Medicine (V. I. Warshawski Series #4)

Bitter Medicine (V. I. Warshawski Series #4)

3.6 16
by Sara Paretsky

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New York Times bestselling author Sara Paretsky's fourth V.I. Warshawski novel

Private eye V.I. Warshawski knows her friend Consuelo's pregnancy is already risky-she's sixteen and diabetic. Despite V.I.'s efforts to provide Consuelo with proper care, both mother and daughter die in the local hospital. Suspecting malpractice, V.I. begins an investigation-


New York Times bestselling author Sara Paretsky's fourth V.I. Warshawski novel

Private eye V.I. Warshawski knows her friend Consuelo's pregnancy is already risky-she's sixteen and diabetic. Despite V.I.'s efforts to provide Consuelo with proper care, both mother and daughter die in the local hospital. Suspecting malpractice, V.I. begins an investigation- and a reluctant romance with an ER doctor. But deadly complications arise when a series of vicious murders and an attack on a women's clinic lead her to suspect a cold-blooded cover-up. And if V.I. isn't careful, she just might have delivered her final case...

Editorial Reviews

From the Publisher
"No one, male or female, writes better P.I. books than Paretsky."
—The Denver Post

"Paretsky's books are beautifully paced and plotted, and the dialogue is fresh and smart.... V.I. Warshawski is the most engaging woman in detective fiction."

"The plot [is] fast moving, the dialogue snappy, the premise for murder persuasive.  This novel hasn't a single snag in its springs."
—Chicago Sun-Times

"Paretsky is still the best...she doesn't pull punches."  
—The Washington Post Book World

Publishers Weekly - Publisher's Weekly
Since her debut in Paretsky's Indemnity Only, Chicago private eye V. (Victoria) I. Warshawski has been attracting both enthusiastic readers and critical acclaim. This fourth story narrated by the spiky detective is the series' most suspenseful so far. V. I. brings a teenager about to give premature birth to a private hospital where the mother and her baby die. Since the poor girl's own obstetrician is unavailable, Warshawski's friend, Dr. Tregiere, arrives from his inner-city hospital to check procedures; he's found murdered later. So is the supposedly bereaved husband, member of a street gang that atacks Warshawski during her tenacious investigation of the related cases. There are other appalling deaths as tough V. I. gets to the facts behind a tawdry coverup. The cast of the earlier mysteries again adds flavor here, and the big city's ethnic mix, as enlived by Paretsky, does too. (May 15)
Kay Black
V. I. Warshawski is a female version of the hard-boiled private eye. Victoria doesn’t show emotion or fear — at least on the outside. This new case has struck a little too close to home for her tastes....The characters are engrossing; the plot is convoluted but convincing; and the ending is justified. It is all a matter of whether the reader can become a follower of V. I. Warshawski.
The Mystery Reader Online

Product Details

Penguin Publishing Group
Publication date:
V. I. Warshawski Series , #4
Sales rank:
Product dimensions:
4.20(w) x 7.50(h) x 1.20(d)
Age Range:
18 Years

Read an Excerpt

The Land Beyond O'Hare

The heat and the tawdry sameness of the road drugged everyone to silence. The July sun shimmered around McDonald's, Video King, Computerland, Arby's, Burger King, the Colonel, a car dealership, and then McDonald's again. I had a headache from the traffic, the heat, the sameness. God knows how Consuelo felt. When we left the clinic, she had been unbearably excited, chattering about Fabiano's job, about the money, about the layette for the baby.

"Now Mama will let me move in with you," she crowed, linking arms cajolingly with Fabiano.

Glancing in the rearview mirror, I didn't see any signs of mutual joy on his face. Fabiano was sullen. "A punk," Mrs. Alvarado called him, furious with Consuelo, the darling of the family—that she should love such a one, that she should have become pregnant by him. And choose to bear the child. . . . Consuelo, always strictly chaperoned (but no one could kidnap her and carry her home from school every day), was now virtually under house arrest.

Once Consuelo made it clear she was going to have the baby, Mrs. Alvarado had insisted on a wedding (white, at Holy Sepulchre). But, honor satisfied, she kept her daughter at home with her. Fabiano stayed with his mother. The situation would have been ludicrous, had it not been for the tragedy of Consuelo's life. And to do her justice, that was what Mrs. Alvarado wanted to avoid. She didn't want Consuelo to become a slave, to a baby and to a man who wouldn't even try to find a job.

Consuelo had just finished high school—a year early because of her brilliance—but she had no skills. Anyway, Mrs. Alvarado insisted, she was going to college. Class valedictorian, homecoming queen, winner of numerous scholarships, Consuelo was not throwing those opportunities away for a life of menial, exhausting jobs. Mrs. Alvarado knew what that life was like. She had raised six children working as a cafeteria attendant in one of the big downtown banks. She was determined that her daughter become the doctor or lawyer or executive who would lead the Alvarados to fame and fortune. That maleante, that gamberro was not going to destroy her bright future.

All this I had heard more than once. Carol Alvarado, Consuelo's older sister, was Lotty Herschel's nurse. Carol had begged and pleaded with her sister to have an abortion. Consuelo's general health wasn't strong; she'd already had cyst surgery at fourteen, and was diabetic. Carol and Lotty both tried telling Consuelo these conditions made for troubled pregnancies, but the girl was adamant about having the baby. To be sixteen, diabetic, and pregnant is not a pleasant state. In August, with no air-conditioning, it must have been close to intolerable. But Consuelo, thin and sick, was happy. She'd found a perfect exit from the pressure and the glory heaped on her since birth by the rest of the family.

Everyone knew that it was fear of Consuelo's brothers that kept Fabiano searching for work. His mother seemed perfectly willing to support him indefinitely. He apparently thought if he let things slide long enough, he could slide right out of Consuelo's life. But Paul, Herman, and Diego had been breathing down his neck all summer. They had beaten him up once, Carol told me, half worried—Fabiano had a tenuous connection to one of the street gangs—but it kept him going through the motions of looking for a job.

And now Fabiano had a lead on a live one. A factory near Schaumburg was hiring unskilled labor. Carol had a boyfriend whose uncle was the manager; he had unenthusiastically agreed to help Fabiano if the young man came out for an interview.

Carol had roused me at eight this morning. She hated to bother me, but everything depended on Fabiano's making it to that interview. His car had broken down—"that bastard—he probably broke it himself to avoid the trip!"—Lotty was tied up; Mama didn't know how to drive; Diego, Paul, and Herman were all working. "V.I., I know how much an imposition this is. But you are almost family and I cannot involve strangers in Consuelo's affairs."

I ground my teeth. Fabiano was the kind of half-sullen, half-arrogant punk I used to spend my life with as a public defender. I'd hoped to leave them behind me when I became a private investigator eight years ago. But the Alvarados gave of themselves freely—a year ago Christmas, Carol sacrificed the day to look after me when I took an unplanned bath in Lake Michigan. Then there was the time Paul Alvarado baby-sat for Jill Thayer when her life was in danger. I could remember countless other occasions, great and small—I had no choice. I agreed to pick them up at Lotty's clinic at noon.

The clinic was close enough to the lake that a breeze lifted some of the terrible summer heat. But when we reached the expressway and headed for the northwest suburbs the heavy air slammed at us. My little car has no air-conditioning and the hot wind forced in through the open windows dampened even Consuelo's enthusiasm.

In the mirror I could see her looking white and wilted. Fabiano had moved to the other side of the seat, saying sullenly that the heat was too intense for closeness. We came to an intersection with Route 58.

"The turn should be close by here," I called over my shoulder. "Which side of the road are we looking for?"

"Left," Fabiano muttered.

"No," Consuelo said. "Right. Carol said the north side of the highway."

"Maybe you should be talking to the manager," Fabiano said angrily in Spanish. "You set up the interview, you know the route. Do you trust me to go in by myself or do you want to do that for me?"

"I'm sorry, Fabiano. Please forgive me. I worry for the baby's sake. I know you can handle this by yourself." He pushed aside her pleading hand.

We came to Osage Way. I turned north and followed the street for a mile or two. Consuelo had been right: Canary and Bidwell, paint manufacturers, stood back from the road in a modern industrial park. The low, white building was set in a landscape that included a man-made lagoon complete with ducks.

Consuelo revived at the sight. "How pretty. How nice it will be for you to work with these pretty ducks and trees outside."

"How nice," Fabiano agreed sarcastically. "After I have driven thirty miles in the heat I will be enchanted with ducks."

I pulled into the visitors' parking lot. "We'll go look at the lagoon while you're talking. Good luck." I put as much enthusiasm as I could into the wish. If he didn't get a job before the baby came, maybe Consuelo would forget about him, get a divorce or annulment. Despite her stern morality, Mrs. Alvarado would care for the grandchild. Maybe its birth would free Consuelo from her fears and let her get on with her life.

She bade Fabiano an uncertain farewell, wanting to kiss him but getting no encouragement. She followed me quietly down the path toward the water, her seven-month stomach making her awkward and slow. We sat in the meager shade of the new trees and silently watched the birds. Used to handouts from visitors they swam toward us, quacking hopefully.

"If it is a girl, you and Lotty must be the godmothers, V.I."

"Charlotte Victoria? What a terrible burden for a child. You should ask your mother, Consuelo. It would help reconcile her."

"Reconcile? She thinks I am wicked. Wicked and wasteful. Carol is the same. Only Paul has a little sympathy. . . . Do you agree, V.I.? Do you think I'm wicked?"

"No, cara. I think you're scared. They wanted you to go out by yourself to Gringoland and win prizes for them. It's hard to do that alone."

She held my hand, like a little girl. "So you will be the godmother?"

I didn't like her looks—too white, with red patches in her cheeks. "I'm not a Christian. Your priest will have a thing or two to say about it . . . Why don't you rest here—let me go to one of those fast-food places and get us something cold to drink."

"I—don't leave, V.I. I feel so queer, my legs feel so heavy—I think the baby's starting."

"It can't be. This in only the end of your seventh month!" I felt her abdomen, not sure of what signs to check for. Her skirt was damp and as I touched her I felt a spasm.

I looked around wildly. Not a soul in sight. Of course not, not in the land beyond O'Hare. No streets, no street life, no people, just endless miles of malls and fast-food chains.

I fought down my panic and spoke calmly. "I'm going to leave you for a few minutes, Consuelo. I need to go into the plant and find out where the nearest hospital is. As soon as I do that I'll get back to you. . . . Try to breathe slowly, deep breath in, hold it, count six and breathe out again." I held her hand tightly and practiced with her a few times. Her brown eyes were enormous and terrified in her pinched white face, but she gave me a quavering smile.

Inside the building, I stood momentarily bewildered. A faint acrid smell filled the air, and above it, a hum of noise, but no lobby, no receptionist. It might have been the entrance to the Inferno. I followed the noise down a short corridor. An enormous room opened to the right, filled with men, barrels, and a thicker haze. To the left I saw a grill marked RECEIVING. Behind it sat a middle-aged woman with faded hair. She was not fat, but had the kind of flabby chins that a life of poor diet and no exercise brings. She was working on several mounds of paper in what seemed a hopeless task.

She looked up, harassed and abrupt, when I called to her. I explained the situation as best I could.

"I need to phone Chicago, need to talk to her doctor. Find out where to take her."

Light winked from the woman's glasses; I couldn't see her eyes. "Pregnant girl? Out on the lagoon? You must be mistaken!" She had the nasal twang of Chicago's South Side—Marquette Park moved to the suburbs.

I took a deep breath and tried again. "I drove her husband out—he's here talking to Mr. Hector Munoz. About a job. She came along. She's sixteen. She's pregnant, starting labor. I've got to call her doctor, got to find a hospital."

The flabby chin waggled for a moment. "I'm not sure what you're talking about. But you want to use the phone, honey, come on in."

She hit a buzzer next to her desk, releasing the grill covering the door, pointed at a phone, and returned to her mounds of paper.

Carol Alvarado responded with the unnatural calm crisis produces in some people. Lotty was in surgery at Beth Israel; Carol would call the obstetrics department there and find out what hospital I should take her sister to. She knew where I was—she had been there several times visiting Hector. She put me on hold.

I stood, the phone damp in my hand, my armpits wet, legs trembling, fighting back the impulse to scream with impatience. My flabby-chinned companion watched me covertly while shuffling her paper. I took diaphragm breaths to steady myself and concentrated on a mental run-through of "Un bel dì." By the time Carol returned to the line I was breathing more or less normally and could focus on what she was saying.

"There's a hospital somewhere close to you called Friendship Five. Dr. Hatcher at Beth Israel said it's supposed to have a Level Three neonatal center. Get her there. We're sending out Malcolm Tregiere to help. I'll try to get Mama, try to close the clinic and get out as soon as I can."

Malcolm Tregiere was Lotty's associate. Last year Lotty had reluctantly agreed to resume part time the perinatal practice at Beth Israel that had made her famous. If you're going in for obstetrics, even half time, someone has to cover for you. For the first time since opening the clinic, Lotty had taken on an associate. Malcolm Tregiere, board-certified in obstetrics, was completing a fellowship in perinatology. He shared her views on medicine and had her quick intuitive way with people.

I felt a measure of relief as I hung up and turned to flabby-chins. She was agog watching me. Yes, she knew where Friendship was—Canary and Bidwell sent all their accident cases there. Two miles up the road, a couple of turns, you couldn't miss it.

"Can you call ahead and tell them we're coming? Tell them it's a young girl—diabetes—labor."

Now that the crisis had penetrated, she was eager to help, glad to call.

I sprinted back to Consuelo, who lay on the grass under a sapling, breathing shallowly. I knelt beside her and touched her face. The skin was cold and heavy with sweat. She didn't open her eyes, but mumbled in Spanish. I couldn't hear what she said, except she thought she was talking to her mother.

"Yeah, I'm here, baby. You're not alone. We'll do this together. Come on, sweetheart, come on, hold on, hold on."

I felt as though I were suffocating, my breasts bending inward and pushing against my heart. "Hang on, Consuelo. Don't die out here."

Somehow I got her to her feet. Half carrying her, half guiding her, I staggered the hundred yards or so to the car. I was terrified she might faint. Once in the car I think she did lose consciousness, but I put all my energy into following the dispatcher's hasty directions. On up the road we'd come by, second left, next right. The hospital, slung low to the ground like a giant starfish, lay in front of me. I slammed the car against a curb by the emergency entrance. Flabby-chins had done her part. By the time I had my door open, practiced hands had pulled Consuelo easily from the car onto a wheeled stretcher.

"She's got diabetes," I told the attendant. "She just finished her twenty-eighth week. That's about all I can tell you. Her doctor in Chicago is sending out someone who knows her case."

Steel doors hissed open on pneumatic slides; the attendants raced the gurney through. I followed slowly, watching until the long hallway swallowed the cart. If Consuelo could hold on to the tubes and pumps until Malcolm got there, it would be all right.

I kept repeating that to myself as I wandered in the direction taken by Consuelo's gurney. I came to a nurse's station a mile or so down the hall. Two starch-capped young white women were carrying on an intense, low-pitched conversation. Judging from a smothered burst of laughter, I didn't think it had anything to do with patient treatment.

"Excuse me. I'm V.I. Warshawski—I came in with the obstetrical emergency a few minutes ago. Who can I talk to about her?"

One of the women said she was going to check on "number 108." The other felt her cap to make sure her identity was still intact and put on her medical smile—blank yet patronizing.

"I'm afraid we don't have any information about her yet. Are you her mother?"

Mother? I thought, momentarily outraged. But to these young women I probably looked old enough to be a grandmother. "No—family friend. Her doctor will be here in about an hour. Malcolm Tregiere—he's part of Lotty Herschel's team—you want to let the emergency room staff know?" I wondered if Lotty, world-famous, would be known in Schaumburg.

"I'll get someone to tell them as soon as we have a nurse free." A perfect Ipana smile flashed meaninglessly at me. "In the meantime, why don't you go to the waiting room at the end of the hall? We prefer people off the floor until visiting hours start."

I blinked a few times—what relevance did that have to getting information about Consuelo? But it was probably better to save my fighting energy for a real battle. I retraced my steps and found the waiting room.

Meet the Author

Sara Paretsky is the author of sixteen books, including her renowned V. I. Warshawski novels. Her many awards include the Cartier Diamond Dagger Award for lifetime achievement from the British Crime Writers' Association. She lives in Chicago.

Brief Biography

Chicago, Illinois
Date of Birth:
June 8, 1947
Place of Birth:
Ames, Iowa
B.A., Political Science, University of Kansas; Ph.D. and M.B.A., University of Chicago

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Bitter Medicine (V.I. Warshawski Series #4) 3.6 out of 5 based on 0 ratings. 16 reviews.
Anonymous 3 months ago
not much sleep tonight
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I have enjoyed medical thrillers my whole life, and this one is a great read!
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Guest More than 1 year ago
This is the fourth Warshawski novel I've read and I don't think I'll have the patience to read the fifth one. I came to the conclusion that Sara Paretsky's novels are not for me.While reading the identical storylines I feel deja vu of some sort.A weak plot is filled with unnecessary details that don't add up to much thing and that verbose writing style makes the books at least fifty pages thicker and you often get strayed.I always prefer Louis L'Amour or Ed McBain.
Guest More than 1 year ago
Sara Paretsky's protagonist is a ground breaker, a female private investigator. In Bitter Medicine V. I. Warshawski becomes tangled up in enquiries about the death of a teenage mother and her newborn child. Warshwski took Consuelo to a private hospital when she started labour but they both died. To add to confusion one of Consuelo's doctors, Malcolm Tregiere, is beaten to death the next day. Warshawski gets her face slashed by gang members while investigating Malcolm's murder. She is involved in a violent demonstration and her flat is broken into. All part of being a private investigator. As usual Paretsky keeps us on our toes as the cases unravel.
Anonymous More than 1 year ago
This book is a great crime novel. Full of suspense and will keep your interest.....a page turner. A quick and easy read that will leave you wanting to read more of the author's books.