“What is being done to them? Besides the administration of free medical care, which for some reason you seem to oppose?”
I tried to look as composed as my adversary. “At some point, someone at Healthways realized they had access to a valuable set of guinea pigs—a perfect test group for conducting secret drug trials outside the FDA test protocols. I figure it goes something like this—they identify a prime candidate for the presence of the virus, test him to make sure, then slip the patient an experimental drug while they’re at the clinic for some other reason. Then later on, they use the wellness program and the ambulance follow-ups that Healthways is so proud of to track down these same patients and check on the efficacy of the drug—how well it produces killer T-cells to combat the virus, for example—and also to look for any side effects that might have resulted. All without FDA knowledge or approval or the knowledge or approval of the patients themselves. And all with only a slight risk that anyone would give a damn if the side effects turned out to be fatal.”
I looked at Marlin. What I was hoping for was a complete confession. What I got was an elaborate smile that was the exact opposite of the reaction I’d expected to provoke. There was nothing to do but give him all I had, in the hope it would spook him.
“From what I read,” I went on, “this type of thing goes on a lot, though usually in the Third World—multinational drug companies getting a jump on the competition and being first in line at the Patent Office by treating some poor peasant like a white rat. Well, the U.S. has a Third World of its own these days; in San Francisco it’s called the Tenderloin, and Healthways is the only game in this particular part of town. Which means once the feds turn loose, it won’t be hard to come up with proof of what’s been going on.”
Marlin was shaking his head with synthetic compassion. I felt like a kid at Confession who can’t for the life of him provoke an outrage. I tried to up the ante.
“I’ve done some reading on this, Doctor. I know there’s a clamor for new AIDS medications, and that several of them are currently undergoing clinical trials and others have already been through testing and are awaiting FDA approval. Drugs like ddl that don’t destroy bone marrow and maintain their efficacy for a longer period than AZT will be a big boon to their manufacturers if and when they’re approved.”
Marlin shook his head. “I still don’t see the point.”
“The tests run on new drugs developed by the big drug companies are usually done by the companies themselves, in their own labs. But Healthways doesn’t have that kind of facility—it has to rely on the government. The problem is, even though they’ve tried to speed up the approval process by establishing an AIDS clinical-trial group and other accelerated processes, FDA procedures can take forever. Layer and layer of bureaucratic strata, and meanwhile the disease runs rampant. But you don’t have forever, do you, Doctor? Not because so many people are dying, but because Sandstone is going down the financial tubes. So you’re doing your own tests, then running the participants through the blood bank so their screening procedures will give you independent evidence that the virus has been eliminated. When you’ve got enough to make your case, I figure you’ll go public. Not to the FDA, but to the media.”
“Utter nonsense.” Marlin started the car.
“You think you’ve got another pentamidine on your hands, I imagine, a drug that was administered to thousands of patients long before it was approved by the FDA because everyone but the FDA knew it was effective against AIDS-related pneumonia. But what if you’ve come up with another Suranim?—a drug that seemed effective in the beginning but turned out to do major and permanent damage to vital organs. Does it bother you that the race to put Sandstone in the black might be killing people right and left, Dr. Marlin?”
Marlin said nothing, so I answered my own question.
“I suppose not. I suppose all you can see are dollar signs. If the medication’s any good, after you leak word that you’ve come up with a wonder drug, gay-rights groups like ACT UP and Queer Nation will bring so much heat on the FDA to let you release it, you’ll never have to go through the normal testing protocols at all, and the profits will start rolling in immediately. Even if the FDA does its job and makes you test it properly, black-market sales in Africa alone would put Sandstone in the chips for good.”
I swallowed and took a breath. “How do you like it so far, Doctor?”
Marlin was as cool as slush. “Your paranoia is quite advanced, isn’t it?—I’m surprised someone hasn’t petitioned to have you committed.”
“Speaking of which, this is where Nicky Crandall comes in.”
The doctor remained serene. “I’m sorry; I don’t get the connection.”
“The connection is, you’ve been on the payroll of the illicit drug business for years. Way back when Nicky first came to you, out in Walnut Creek, I figure you were already taking under-the-table payoffs from drug companies to administer unapproved medications to your psychiatric patients much the way you’re doing now, though probably not on as wide a scale. I’m guessing that’s why Healthways hired you in the first place, because of your reputation on the fringes of the medical profession for not being scrupulous about the rules.”
Marlin raced the engine and fumed in silence.
“Come on, Doc. The generic drug industry is littered with fraud. They routinely fabricate their product-approval applications—over a hundred generic drugs have been approved for marketing based on phony test results. One congressman said he’d never seen an industry as broadly corrupt as the generic-drug business. I figure you’ve had a part of that action for a long time, Doctor. Even before you took your greed to Healthways.”
“You really are insane, Mr. Tanner,” Marlin said with impressive aplomb. “If you will allow me to do so, I can refer you to someone who can help you.”
“You persuaded Tom to help you get Nicky committed to your clinic just before Tom went off to war. While he was institutionalized, you gave Nicky some experimental drug for mental illness, one with a side effect that provoked the violence Nicky committed on Ellen Simmons once he was released.”
“Perhaps you can give me the name of your witnesses. Or provide me with documentation. Or suggest any other method by which you intend to prove your charge.”
His self-control was infuriating. “I don’t have proof of that part, I admit. I could probably get some if I notified the right authorities and they checked the right records, but maybe not—you no doubt covered your tracks. But if you play your cards right, no one is going to go into that at all.”
The doctor pouted. “What a shame. Not that I admit anything of the sort was occurring, you understand, but it would make a wonderful story, wouldn’t it? Virtually a metaphor for the times.”
“You’re pretty calm, Doctor; I suppose I admire you for that. But there could be murder charges involved in this, remember.”
“How so?”
“I think Tom Crandall guessed what had happened back when Nicky was first committed to your care. When he learned that Nicky was in your clutches again, he looked into the situation and discovered what was going on in the clinics with the AIDS experiments, probably by talking with some of his colleagues in the Healthways EMUs. Which is why Sands had him killed.” I paused for effect. “You really should consider cutting yourself a deal with the U.S. attorney before this all comes out, Doctor. Sands is the one I’m after.”
The doctor put the car in gear. “If you make any of these charges against any of the persons you have mentioned, myself included, I can assure you that slander will be the very least you will be prosecuted for.”
I forced a smile. “That’s what they all say, Doctor. Only no one ever seems to follow through once their lawyer tells them that truth is a complete defense.”
The doctor rolled down his window, then regarded me with what looked like sympathy. “Let me make a suggestion.”
“Sure.”
“A person like you must have friends in law enforcement. Or in the M
edical Examiner’s Office.”
“Both, as a matter of fact.”
“Fine. Let me suggest that you arrange for one of them to examine one of these … guinea pigs, as you call them. Give them Nicholas Crandall himself, if you can locate him. Better yet, have them perform an autopsy on a recent AIDS victim who was formerly a patient at our clinic—I would be happy to give you a name that corresponds with the records at the morgue: Doctor-patient confidentiality terminates upon death, after all.”
Marlin checked for oncoming traffic. “If you dare to follow such a procedure, you will find that no drug that even remotely resembles the type of medication you describe can be found in the blood or tissues of the subjects you have chosen.”
“You sound pretty sure of that, Doctor.”
His look was arrogant and dismissive. “Oh, I am. As sure as I am that your reputation as an investigator and a prognosticator is about to be revised. To your detriment, I’m afraid.” He actually managed a laugh. “Take a good look around the neighborhood, Mr. Tanner. You may be about to become a resident.”
THIRTY-TWO
Sometimes you’re right and sometimes you’re wrong and sometimes you don’t know where the hell you stand. This time I’d been wrong, not on a trivial point but on the central thesis I’d developed to explain Tom Crandall’s death. Dr. Marlin’s tranquillity in the face of my accusation told me as much, as did his suggestion of an autopsy on former Healthways AIDS patients to establish the absence of experimental drugs in their system. Since his challenge seemed a definitive rebuttal to my charge, either Marlin was running a bluff or he wasn’t part of the scam that Healthways was running out of its healthcare system. Because I couldn’t accept either hypothesis, there was nothing to do but go back to the beginning and reason it out a second time.
I was doing just that, strolling down Eddy Street toward my car, trying to decide where I’d gone wrong, when I felt a sudden pain in my side—sharp, searing, insistent. Tension, cramp, heart attack—a series of organic calamities streaked through my mind before I felt the pain a second time, more penetrating than before, and knew its origin was external. As I turned to see who and what had stuck me, a hand clamped my shoulder, the knife inched closer toward my innards, and a voice ordered me to keep moving and not look around. I did what it said, but not before catching a glimpse of my assailant.
He had probably been stalking me since I’d left the office, had come up behind me as I was lost in thought, and had shoved a knife in my side at the approximate level of my kidney for reasons at present unknown. For the moment, Dracula had me in his spell; I felt like a bit player in a spatter film, and in that genre bit players don’t fare too well.
“I hear you been looking for me,” he rasped in my ear, his tone and phrasing an amalgam of every movie tough he’d ever seen. He no doubt reminded himself of Robocop; he reminded me of the hapless gunsel in The Maltese Falcon.
“And now I’ve found you,” I said, trying to hide my apprehension behind a breezy manner. “No wonder I’m so highly paid.”
Dracula didn’t like it that I wasn’t terrified. “Keep on till I tell you,” he ordered roughly, and gave me another jab in the side. Luckily his knife was as blunt as his sensitivity—I was scared as hell.
“I don’t like being trolled for,” he went on as we tangoed down the block. “Down here I’m the one does the fishing.”
I was as affable as a con man reeling in a mark. “That’s what I wanted to talk to you about.”
“What?”
“Your business.”
The pressure above my kidney eased; Dracula sensed a deal. “You looking to sell a pint?”
I laughed.
“Maybe you’re trying to cut me out?” He cackled like a jackal. “Last guy that tried it needed some blood himself when I got through with him.” The knife returned with a vengeance.
“I’m interested in the financial aspects,” I said.
“Yeah? Why?”
“I’m getting into a similar line of work, and I could use some tips.”
“Like what?”
“Like who pays your salary?”
He hesitated. “They don’t like me to talk about that.”
“Are you on straight time or commission?”
“Ah …”
He didn’t know what a commission was. “Do you get more money the more people you recruit?”
“Yeah.”
“Do you go after everyone or do you have a list?”
“I got a list.”
“Who gives it to you?”
“Don and Ron.”
“The ambulance guys.”
“Right.”
“How much do you pay the people you line up?”
Like any entrepreneur, Dracula took pride in his pricing policy. “More than those bitches at the plasma center.”
“What, fifteen a pint?”
“We go twenty for whole blood. That’s sixty-six percent more than plasma pays.”
I wondered who’d done the math for him. “You pay up front or only after they pass the screening?”
“Half and half,” he bragged, a balloon of pride in his voice: Dracula was top-of-the-line.
“You hustle for all the blood banks or only Fremont Memorial?”
I had pressed him far enough. “I send them where I send them,” he grumbled. “This is it.”
Dracula grabbed my arm and tugged me into an alleyway, narrow and dank and lined with a ribbon of trash that looked as if it had been pawed through by several dozen street people in search of an ounce of sustenance. Nothing good was going to come of a trip in that direction, but the tip of the knife still bit into my flesh like a mongoose. What I needed was a diversion.
I was still looking for one when Dracula tugged me to a stop in front of a padlocked doorway beneath a tilted sign that said VINNY’S VIDEO; from the look of it, Vinny had been out of business as long as the Beta format. The poster in the window was a come-on for Heartburn; the expression on Nicholson’s face made me wonder if he and Dracula had sprung from the same gene pool.
“Hold it right here,” Dracula demanded. “Put your hands on your head. Come on; lift ’em and lock ’em.”
I did as he said, which gave Dracula time to give the door a shove. The padlock held, but the hinges didn’t, and the door careened open in reverse to the tune of a wrenching squeal. A moment later, the knife was back in my back and Dracula was urging me inside. I ducked and entered the dungeon. When I bumped my head on the tilted door, my psyche seemed to see it as my due.
From the look of the place, Dracula was the last in a long line of outlaws who had used it as a refuge—the fixtures were ripped out and piled in a corner to make a kind of fort; remains of edible garbage littered the floor; a tattered blanket and some sodden pillows formed someone’s idea of a bed. Additional posters fluttered across the room like the remains of the film festival of hell; a cardboard cutout of the Terminator gave it all a crazy context. The light through the window was as thin and eerie as my young assailant—as with every other time I’d entered the Tenderloin, I wished I had brought my gun.
“Against the wall,” Dracula demanded, and jabbed me again, this time in the stomach—if he did it again, I would have to try something foolhardy. I backed to the wall and wondered how something good was going to happen.
“Some people don’t like you fucking around down here,” Dracula said when I was sufficiently far from him to get a good look at my nemesis.
His smile advertised crooked and jaundiced teeth. His pores had oozed a stream of bilious acid long enough to erode and encrust his cheeks; his hair hung as limp as a mop that had just swabbed the men’s room. His tiny eyes shone too brightly to be powered by normal circuitry.
“I’m only working a gig,” I said by way of explanation. “Just like you.”
“Yeah, well your gig and mine don’t mix.” He seemed almost apologetic now that we were face-to-face. “I got to take you out.”
“You’d be maki
ng a mistake. Homicide is a rough rap.”
It didn’t faze him. “I’m covered to the max on this; the only way I lose is if you keep breathing.”
At this point, the only thing I could think of to do was to rush him or to stall for time. Given my age and the skill with which Dracula brandished the knife, I opted for the latter. “How much are they paying you to stick me?”
He hesitated, then decided what the hell. “Five hundred. There’s guys in Scanlon’s who’d do it for fifty, but they know I get the job done and keep my mouth shut.”
“They’re likely to shut it for you, aren’t they?”
The suggestion didn’t take. Dracula merely cursed and wiped his knife on his sleeve, a butcher preparing to quarter the next side of beef: Although he intended to gut me like a heifer, Dracula didn’t want me to get infected.
“Five hundred’s good, but I’ll do better,” I said.
“How much better?” he asked without much interest.
“A thousand.”
“To do what?”
“Walk out of here and give me half an hour to get lost.”
Dracula examined me as carefully as his namesake had inspected the lissome necks of his victims. “You ain’t got a grand,” he concluded.
“Not on me, no.”
“Not anywhere.”
“I can have it by the end of the day. Anywhere you say. What does it cost you to give me a few minutes? In the meantime, you can tell Chadwick you couldn’t track me down.”
He blinked. “Who said anything about Chadwick?”
“I did.”
“Yeah, well you don’t know much, do you? So I get an extra five large; when they see I fucked up, they’ll, like, take the blood trick away from me.”
I scrambled for an answer. “I can set you up in a better business than blood.”
“Like what?”
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