The 5th Horseman


By James Patterson

By Maxine Paetro

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Dare to face the most terrifying heights of suspense. From hospital murders to explosive court battles, the Women’s Murder Club takes on their most harrowing challenge yet.

It is a wild race against time as Lieutenant Lindsay Boxer and the newest member of the Women’s Murder Club, attorney Yuki Castellano, lead an investigation into a string of mysterious patient deaths-and reveal a hospital administration determined to shield its reputation at all costs. And while the hospital wages an explosive court battle that grips the entire nation, the Women’s Murder Club hunts for a merciless killer among its esteemed medical staff.

With high-speed thrills and page-turning twists, The 5th Horseman proves once again that James Patterson “has mastered the art of writing” (Chicago Sun-Times).


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Books by James Patterson


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Chapter 1

RAIN WAS DRUMMING HARD against the windows when the midnight-to-8:00 rounds began at San Francisco Municipal Hospital. Inside the ICU, thirty-year-old Jessie Falk was asleep in her hospital bed, floating on a Percocet lake of cool light.

Jessie was having the most beautiful dream she'd had in years.

She and the light of her life, three-year-old Claudia, were in Grandma's backyard swimming pool. Claudie was in her birthday suit and bright-pink water wings, slapping the water, sunlight glinting off her blond curls.

"Simon says, kiss like a butterfly, Claudie."

"Like this, Mommy?"

Then the mother and daughter were shouting and laughing, twirling and falling down, singing out "wheeeeeee," when without warning a sharp pain pierced Jessie's chest.

She awoke with a scream—bolted upright—and clapped both of her hands to her breast.

What was happening? What was that pain?

Then Jessie realized that she was in a hospital—and that she was feeling sick again. She remembered coming here, the ambulance ride, a doctor telling her that she was going to be fine, not to worry.

Falling, nearly fainting back to the mattress, Jessie fumbled for the call button at her side. Then the device slipped from her grasp and fell. It banged against the side of the bed with a muted clang.

Oh, God, I can't breathe. What's happening? I can't get my breath. It's horrible. I'm not fine.

Tossing her head from side to side, Jessie swept the darkened hospital room with her eyes. Then she seized on a figure at the far edge of her vision.

She knew the face.

"Oh, th-thank God," she gasped. "Help me, please. It's my heart."

She stretched out her hands, clutched feebly at the air, but the figure stayed in the shadows.

"Please," Jessie pleaded.

The figure wouldn't come forward, wouldn't help. What was going on? This was a hospital. The person in the shadows worked here.

Tiny black specks gathered in front of Jessie's eyes as a crushing pain squeezed the air from her chest. Suddenly her vision tunneled to a pinprick of white light.

"Please help me. I think I'm—"

"Yes," said the figure in the shadows, "you are dying, Jessie. It's beautiful to watch you cross over."

Chapter 2

JESSIE'S HANDS FLUTTERED like a tiny bird's wings beating against the sheets. Then they were very still. Jessie was gone.

The Night Walker came forward and bent low over the hospital bed. The young woman's skin was mottled and bluish, clammy to the touch, her pupils fixed. She had no pulse. No vital signs. Where was she now? Heaven, hell, nowhere at all?

The silhouetted figure retrieved the fallen call device, then tugged the blankets into place, straightened the young woman's blond hair and the collar of her gown, and blotted the spittle from her lips with a tissue.

Nimble fingers lifted the framed photo beside the phone on the bedside table. She'd been so pretty, this young mother holding her baby. Claudia. That was the daughter's name, wasn't it?

The Night Walker put the picture down, closed the patient's eyes, and placed what looked to be small brass coins, smaller than dimes, on each of Jessie Falk's eyelids.

The small disks were embossed with a caduceus—two serpents entwined around a winged staff, the symbol of the medical profession.

A whispered good-bye blended with the sibilance of tires speeding over the wet pavement five stories below on Pine Street.

"Good night, princess."

Part One


Chapter 3

I WAS AT MY DESK sifting through a mound of case files, eighteen open homicides to be exact, when Yuki Castellano, attorney-at-law, called on my private line.

"My mom wants to take us to lunch at the Armani Café," said the newest member of the Women's Murder Club. "You've gotta meet her, Lindsay. She can charm the skin off a snake, and I mean that in the nicest possible way."

Let me see; what should I choose? Cold coffee and tuna salad in my office? Or a tasty Mediterranean luncheon, say, carpaccio over arugula with thin shavings of Parmesan and a glass of Merlot, with Yuki and her snake-charming mom?

I neatened the stack of folders, told our squad assistant, Brenda, that I'd be back in a couple of hours, and left the Hall of Justice with no need to be back until the staff meeting at 3:00.

The bright September day had broken a rainy streak in the weather and was one of the last glory days before the dank autumn chill would close in on San Francisco.

It was a joy to be outside.

I met Yuki and her mother, Keiko, in front of Saks in the upscale Union Square shopping district. Soon we were chattering away as the three of us headed up Maiden Lane toward Grant Avenue.

"You girls, too modern," Keiko said. She was as cute as a bird, tiny, perfectly dressed and coiffed, shopping bags dangling from the crooks of her arms. "No man want woman who too independent," she told us.

"Mommm," Yuki wailed. "Give it a rest, willya? This is the twenty-first century. This is America."

"Look at you, Lindsay," Keiko said, ignoring Yuki, poking me under the arm. "You're packing!"

Yuki and I both whooped, our shouts of laughter nearly drowning out Keiko's protestation that "no man want a woman with a gun."

I wiped my eyes with the back of my hand as we stopped and waited for the light to change.

"I do have a boyfriend," I said.

"Doesn't she though," Yuki said, nearly bursting into a song about my beau. "Joe is a very handsome Italian guy. Like Dad. And he's got a big-deal government job. Homeland Security."

"He make you laugh?" Keiko asked, pointedly ignoring Joe's credentials.

"Uh-huh. Sometimes we laugh ourselves into fits."

"He treat you nice?"

"He treats me sooooo nice," I said with a grin.

Keiko nodded approvingly. "I know that smile," she said. "You find a man with a slow hands."

Again Yuki and I burst into hoots of laughter, and from the sparkle in Keiko's eyes, I could tell that she was enjoying her role as Mama Interrogator.

"When you get a ring from this Joe?"

That's when I blushed. Keiko had nailed it with a well-manicured finger. Joe lived in Washington, DC. I didn't. Couldn't. I didn't know where our relationship was going.

"We're not at the ring stage yet," I told her.

"You love this Joe?"

"Big-time," I confessed.

"He love you?"

Yuki's mom was looking up at me with amusement, when her features froze as if she'd turned to stone. Her lively eyes glazed over, rolled back, and her knees gave way.

I reached out to grab her, but I was too late.

Keiko dropped to the pavement with a moan that made my heart buck. I couldn't believe what had happened, and I couldn't understand it. Had Keiko suffered a stroke?

Yuki screamed, then crouched beside her mother, slapping her cheeks, crying out, "Mommy, Mommy, wake up."

"Yuki, let me in there for a second. Keiko. Keiko, can you hear me?"

My heart was thudding hard as I placed my fingers to Keiko's carotid artery, tracked her pulse against the second hand of my watch.

She was breathing, but her pulse was so weak, I could barely feel it.

I grabbed the Nextel at my waist and called Dispatch.

"Lieutenant Boxer, badge number twenty-seven twenty-one," I barked into the phone. "Get an EMS unit to Maiden Lane and Grant. Make it now!"

Chapter 4

SAN FRANCISCO MUNICIPAL HOSPITAL is huge—like a city in itself. Once a public hospital, it had been privatized a few years back, but it still took more than its share of indigents and overflow from other hospitals, treating in excess of a hundred thousand patients a year.

At that moment, Keiko Castellano was inside one of the curtained stalls that ringed the perimeter of the vast, frantic emergency room.

As I sat beside Yuki in the waiting room, I could feel her terror and fear for her mother's life.

And I flashed on the last time I'd been inside an emergency room. I remembered the doctors' ghostlike hands touching my body, the loud throbbing of my heart, and wondering if I was going to get out alive.

I'd been off duty that night but went on a stakeout anyway, not thinking that one minute it would be a routine job, and the next minute I'd be down. The same was true for my friend and former partner, Inspector Warren Jacobi. We'd both taken two slugs in that desolate alley. He was unconscious and I was bleeding out on the street when somehow I found the strength to return fire.

My aim had been good, maybe even too good.

It's a sad sign of the times that public sympathy favors civilians who've been shot by police over police who've been shot by civilians. I was sued by the family of the so-called victims and I could have lost everything.

I hardly knew Yuki then.

But Yuki Castellano was the smart, passionate, and supertalented young lawyer who had come through for me when I really needed her. I would always be grateful.

I turned to Yuki now as she spoke, her voice choppy with agitation, her face corrugated with worry.

"This makes no sense, Lindsay. You saw her. She's only fifty-five, for God's sake. She's a freaking life force. What's going on? Why don't they tell me something? Or at least let me see her?"

I had no answer, but like Yuki, I was out of patience.

Where the hell was the doctor?

This was unconscionable. Not acceptable in any way.

What was taking so long?

I was gathering myself to walk into the ER and demand some answers, when a doctor finally strode into the waiting room. He looked around, then called Yuki's name.

Chapter 5

THE NAME TAG over the pocket of his white coat read "Dennis Garza, MD, Dir. Emergency Services."

I couldn't help noticing that Garza was a handsome man—midforties, six foot one, 180 or so, broad-shouldered, and in good shape. His Spanish lineage showed in his black eyes and the thick black hair that fell across his forehead.

But what struck me most was the tension in the doctor's body, his rigid stance and the way he repeatedly, impatiently, snapped the wristband of his Rolex, as if to say, I'm a busy man. An important, busy man. Let's get on with it. I don't know why, but I didn't like him.

"I'm Dr. Garza," he said to Yuki. "Your mother probably had a neurological insult, either what we call a TIA, a transient ischemic attack, or a mini-stroke. In plain English, it's a loss of circulation and oxygen to the brain, and she may have had some angina—that's pain caused by a narrowing of the coronary arteries."

"Is that serious? Is she in pain now? When will I be able to see her?"

Yuki fired questions at Dr. Garza until he put up a hand to stop the onslaught.

"She's still incoherent. Most people recover within a half hour. Others, maybe your mother, take as long as twenty-four hours. Her condition is guarded. And visitors are off-limits right now. Let's see how she does tonight, shall we?"

"She is going to be all right though, right? Right?" Yuki asked the doctor.

"Miss Castellano. Take a deep breath," Garza said. "I'll let you know when we know."

The door to the ER swung closed behind the unpleasant doctor, and Yuki sat down hard on a plastic chair, slumped forward, lowered her face into her hands, and began to sob. I'd never seen Yuki cry before, and it killed me that I couldn't fix what was hurting her.

I did all that I could do.

I put my arm around Yuki's shoulders, saying, "It's okay, honey. She's in good hands here. I know your mom will be better really soon."

Then I rubbed Yuki's back as she cried and cried. She seemed so tiny and afraid, almost like a little girl.

Chapter 6

THERE WERE NO WINDOWS in the waiting room. The hands of the clock above the coffee machine inched around the dial, cycling the afternoon into night and midnight into morning. Dr. Garza never returned, and he never sent us any word.

During those eighteen long hours, Yuki and I took turns pacing, getting coffee, and going to the ladies' room. We ate vending-machine sandwiches for dinner, traded magazines, and, in the eerie fluorescent silence, listened to each other's shallow breathing.

At just after 3:00 a.m., Yuki fell sound asleep against my shoulder—waking with a start twenty minutes later.

"Has anything happened?"

"No, sweetie. Go back to sleep."

But she couldn't do it.

We sat shoulder to shoulder inside that synthetically bright, inhospitable place as the faces around us changed: the couple with linked hands staring into the middle distance, the families with young children in their arms, an elderly man sitting alone.

Every time the swinging door to the ER opened, eyes would snap toward it.

Sometimes a doctor would step out.

Sometimes shrieks and cries would follow.

It was almost 6:00 in the morning when a young female intern with weary eyes and a blood-smeared lab coat came out of the ER and mangled Yuki's name.

"How is she?" Yuki asked, bounding to her feet.

"She's more alert now, so she's doing better," said the intern. "We're going to keep her for a few days and do some tests, but you can visit as soon as we settle her into her room."

Yuki thanked the doctor and turned to me with a smile that was far more radiant than was reasonable, given what the doctor had just told her.

"Oh-my-God, Linds, my mom's going to be okay! I can't say how much it means to me that you stayed with me all night," Yuki said.

She grabbed both of my hands, tears filling her eyes. "I don't know how I could have done this if you hadn't been here. You saved me, Lindsay."

I hugged her, folded her in.

"Yuki, we're friends. Anything you need, you don't even have to ask. You know that, right? Anything.

"Don't forget to call," I said.

"The worst is over," said Yuki. "Don't worry about us now, Lindsay. Thank you. Thank you so much."

I turned to look behind me as I exited the hospital through the automatic sliding doors.

Yuki was still standing there, watching me, smiling and waving good-bye.

Chapter 7

A CAB WAS IDLING in front of the hospital. Lucky me. I slid in and slumped into the backseat, feeling like total crap, only much worse. Pulling all-nighters is for college kids, not big girls like me.

The driver was mercifully silent as we made our way across town to Potrero Hill at dawn.

A few minutes later, I slipped my key into the front door of the pretty, blue three-story Victorian town house I share with two other tenants, and climbed the groaning staircase to the second floor, two steps at a time.

Sweet Martha, my border collie, greeted me at the door as if I'd been gone for a year. I knew her sitter had fed and walked her—Karen's bill was on the kitchen table—but Martha had missed me and I'd missed her, too.

"Yuki's mom is in the hospital," I told my doggy. Corny me. I wrapped my arms around her, and she gave me sloppy kisses, then followed me back to my bedroom.

I wanted to fall into the downy folds of bedding for seven or eight hours, but instead I changed into a wrinkled Santa Clara U tracksuit and took Her Sweetness for a run as the glowing morning fog hovered over the bay.

At eight on the nose I was at my desk looking through the glass walls of my cubicle out at the squad room as the morning tour sauntered in.

The stack of files on my desk had grown since I'd seen it last, and the message light on my phone was blinking in angry red bursts. I was about to address these irritations, when a shadow fell across my desk and my unopened container of coffee.

A large, balding man stood in my doorway. I knew his pug-ugly face almost as well as I knew my own.

My former partner wore the time-rumpled look of a career police officer who had rounded the corner on fifty. Inspector Warren Jacobi's hair was turning white, and his deep, hooded eyes were harder than they'd been before he'd taken those slugs on Larkin Street.

"You look like you slept on a park bench last night, Boxer."

"Thanks, dear."

"I hope you had fun."

"Tons. What's up, Jacobi?"

"A DOA was called in twenty minutes ago," he said. "A female, formerly very attractive, I'm told. Found dead inside a Cadillac in the Opera Plaza Garage."

Chapter 8

THE OPERA PLAZA GARAGE is a cavernous indoor lot adjacent to a huge mixed-use commercial building that houses movie theaters, offices, and shops in the middle of a densely populated business district.

Now, on a workday morning, Jacobi nosed our car up to the curb beside the line of patrol cars strategically parked to block access to the garage entrance on Golden Gate Avenue.

No cars were coming in or going out, and a shifting crowd had gathered, prompting Jacobi to mutter, "The citizens are squawking. They know a hot case when they see one."

I excused our way through the throng as strident voices called out to me. "Are you in charge here?" "Hey, I've got to get my car. I've got a meeting in like five minutes!"

I ducked under the tape and took up a position on the entry ramp, making good use of my five-foot-ten frame. I said my name and apologized for the inconvenience to one and all.

"Please bear with us. Sorry to say, this garage is a crime scene. I hope as much as you do that we'll be out of here soon. We'll do our best."

I fielded some unanswerable questions, then turned as I heard my name and the sound of footsteps coming from behind me. Jacobi's new partner, Inspector Rich Conklin, was heading down the ramp to meet us.

I'd liked Conklin from the moment I'd met him a few years back, when he was a smart and dogged uniformed officer. Bravery in the line of duty and an impressive number of collars had earned him his recent promotion to Homicide at the ripe young age of twenty-nine.

Conklin had also attracted a lot of attention from the women working in the Hall once he'd traded in his uniform for a gold shield.

At just over six foot one, Conklin was buffed to a T, with brown eyes, light-brown hair, and the wholesome good looks of a college baseball player crossed with a Navy SEAL.

Not that I'd noticed any of this.

"What have we got?" I asked Conklin.

He hit me with his clear brown eyes. Very serious, but respectful. "The vic is a Caucasian female, Lieutenant, approximately twenty-one or twenty-two. Looks to me like a ligature mark around her neck."

"Any witnesses so far?"

"Nope, we're not that lucky. The guy over there," Conklin said, hooking a thumb toward the scraggly, long-haired ticket-taker in the booth, "name of Angel Cortez, was on duty all night, didn't see anything unusual, of course. He was on the phone with his girlfriend when a customer came screaming down the ramp.

"Customer's name is"—Conklin flipped open his notebook—"Angela Spinogatti. Her car was parked overnight, and she saw the body inside the Caddy this morning. That's about all she had for us."

"You ID'd the Caddy's plates?" Jacobi asked.

Conklin nodded his head once, turned a page in his notebook. "The car belongs to a Lawrence P. Guttman, DDS. No sheet, no warrants. We've got calls into him now."

I thanked Conklin and asked him to collect the parking-garage tickets and the surveillance tapes.

Then Jacobi and I headed up the ramp.

I'd had way too little sleep, but a thin, steady flow of adrenaline was entering my bloodstream. I was imagining the scene before I saw it, thinking about how a young white female came to be strangled inside a parking garage.

Footsteps echoed overhead. Lots and lots of them. My people.

I counted a dozen members of the SFPD strung around the upward-coiling concrete-ribbon parking area. Officers were going through the trash, taking down plate numbers, looking for anything that would help us before the crime scene was returned to the public domain.

Jacobi and I rounded the bend that took us to the fourth floor and saw the Caddy in question, a black late-model Seville, sleek, unscratched. Its nose was pointing over the railing toward the Civic Center Garage on McAllister.

"Zero to sixty in under five seconds," Warren muttered, then did a fair imitation of the Cadillac musical sting from their TV commercials.

"Down, boy," I said.

Charlie Clapper, head of CSU, was wearing his usual non-smile and a gray herringbone jacket that casually matched his salt-and-pepper hair.

He put his camera down on the hood of an adjacent Subaru Outback and said, "Mornin', Lou, Jacobi. Meet Jane Doe."

I tugged on latex gloves and followed him around the car. The trunk was closed because the victim wasn't in there.

She was sitting in the passenger seat, hands folded in her lap, her pale, wide-open eyes staring out through the windshield expectantly.

As if she were waiting for someone to come.

"Aw, shit," Jacobi said with disgust. "Beautiful young girl like this. All dressed up and no place to go. Forever."

Chapter 9

"I DON'T SEE a handbag anywhere," Clapper was telling me. "I left her clothing intact for the ME. Nice duds," he said. "Looks like a rich girl. You think?"

I felt a shock of sadness and anger as I looked into the victim's dreamy face.

She was fair-skinned, a light dusting of powder across her face, a hint of blush on the apples of her cheeks. Her hair was cut in a Meg Ryan-style mop of tousled blond lights, and her nails had been recently manicured.

Everything about this woman spoke of privilege and opportunity, and money. It was as if she'd been just about to step down the runway of life when some psycho had ripped it all away from her.

I pressed the victim's cheek with the back of my hand. Her skin was tepid to the touch, telling me that she'd been alive last night.

"Larry, Moe, and Curly didn't whack this little lady," Jacobi commented.

I nodded my agreement.

When I first got into Homicide, I learned that crime scenes generally come in two types. The kind where the evidence is disorganized: blood spatter, broken objects, shell casings scattered around, bodies sprawled where they fell.

And then there were the scenes like this one.

Organized. Planned out.

Plenty of malice aforethought.

The victim's clothes were neat, no bunching, no buttonholes missed. She was even wearing a seat belt, which was drawn snug across her lap and shoulder.

Had the killer cared about her?

Or was this tidy scene some kind of message for whoever found her?

"The passenger-side door was opened with a slim jim," Clapper told us. "The surfaces have all been wiped clean. No prints to be found inside or out. And look over here."

Clapper pointed up toward the camera mounted on a concrete pylon. It faced down the ramp, away from the Caddy.

He lifted his chin toward another camera that was pointed up the ramp toward the fifth level.

"I don't think you're going to catch this bird doing the vic on tape," Clapper said. "This car is in a perfect blind spot."

I like this about Charlie. He knows what he's doing, shows you what he sees, but the guy doesn't try to take over the scene. He lets you do your job, too.

I directed my flashlight beam into the interior of the car, checking off the relevant details in my mind.

The victim looked healthy, weighed about 110, stood maybe five foot or five one.

No wedding band or engagement ring.

She was wearing a crystal bead necklace, which hung below a ligature mark.

The mark itself was shallow and ropy, as if it had been made with something soft.

I saw no defensive cuts or bruises on her arms and, except for the ligature mark, no signs of violence.

I didn't know how or why this girl had been killed, but my eyes and my gut told me that she hadn't died in this car.

She had to have been moved here, then posed in a tableau that somebody was meant to admire.

I doubted that someone had gone to all of this trouble for me.

I hoped not.

Chapter 10

"HAVE YOU GOT your pictures?" I asked Clapper.

There wasn't much room to work, and I wanted to get in close for a better look at the victim.

"I've got more than enough for my collection," he said. "The camera loves this girl."

He stowed his digital Olympus in his case, snapped the lid closed.


On Sale
Mar 1, 2008
Page Count
464 pages

James Patterson

About the Author

James Patterson is the world’s bestselling author, best known for his many enduring fictional characters and series, including Alex Cross, the Women’s Murder Club, Michael Bennett, Maximum Ride, Middle School, I Funny, and Jacky Ha-Ha. Patterson’s writing career is characterized by a single mission: to prove to everyone, from children to adults, that there is no such thing as a person who “doesn’t like to read,” only people who haven’t found the right book. He’s given over a million books to schoolkids and over forty million dollars to support education, and endowed over five thousand college scholarships for teachers. He writes full-time and lives in Florida with his family.

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