by Robin Cook
“No, seriously, how old are you?”
Jack thought he should step in at this point, between his wife and his friend.
“How can I help you, Chet?”
McGovern stuck his head around the door and looked down the corridor to make sure Pia hadn’t left.
“Listen! This Columbia med student just came in asking about those two typhoid cases you worked on yesterday. Actually, she came in supposedly interested in an elective, but I guess that was a cover story. For some reason she wants to check the corpses for evidence of alpha radiation because they’d been using some alpha emitter radioisotopes in the lab where your two patients worked. She even brought in her own Geiger counter. When I told her the bodies had already gone she was disappointed. Thanks for being so over-the-top efficient with the death certificates and signing out the cases, Jack!”
“You’re welcome, buddy.”
Jack and Laurie smiled knowingly at each other. This was typical McGovern behavior. Each week there was a new hot prospect. It used to be Laurie felt badly for the man because she thought he was lonely. But that had changed. She was now convinced Chet did not want to find a mate. It was the chase he wanted, and he never tired.
“When I told her the bodies were gone, she wanted to ask you whether your findings were typical for typhoid.”
“Tell her the findings were indeed typical for typhoid, but a very serious case of typhoid from a remarkably virulent strain.”
“How about coming and telling her yourself? She’ll be more impressed.”
Jack looked at Laurie, who shrugged as if to say, “It’s okay by me.” Jack heaved himself to his feet, told Laurie he’d be right back, and followed Chet back to his office.
Chet made the introductions, and Jack could understand Chet’s enthusiasm. Grazdani was fetching. He noticed the Geiger counter. He quizzed Pia about her interest in his cases. She gave him the same story she’d told Chet, and Jack purposely didn’t challenge her although he was tempted. Instead he said, “My understanding is that you’re interested to know if the autopsy findings were typical for typhoid fever. Yes, they were: a very virulent form of typhoid fever. The gut, the target organ of the disease, was in bad shape, which is why they died so quickly. There were multiple perforations into the peritoneal cavity.”
Pia sat up straighter in her chair. “Have you seen anything like that before?” she asked.
“Well, no, not to that extent. But you have to remember that typhoid fever, and especially such a bad case, is rarely seen these days. It’s no longer the scourge it used to be before we had antibiotics.”
Laurie suddenly appeared. She’d decided not to be left out. Chet introduced her to Pia. Pia shook her hand and then turned her attention back to Jack and said, “The strain they were working with and which caused their infections was particularly virulent because it was grown in space, under a NASA program.”
“Really?” Jack said. He made a mental note to ask why no one had mentioned that fact.
“Was the involvement just in the small intestine or was it the whole intestine?” Pia asked.
“It was the whole intestine,” Jack said. “From the duodenum all the way down and including the rectum. In that sense it was unique. Usually it’s just in the small bowel. It was unique enough that I saved some rather large specimens in formalin. I thought they could be used in the future for teaching purposes. We take our teaching responsibilities very seriously around here, right, Dr. McGovern?”
The dig got Chet McGovern to mumble something, and Jack laughed. Pia looked confused, but in actuality she was giddy. She hadn’t even heard Jack’s sarcastic comment. All she had heard was that he’d saved sections of the gut! The bodies were gone, but pieces of the involved intestine were still available.
“I mean, I can’t show you any slides because the specimens haven’t been processed yet because the autopsy was only yesterday. But if you want to view the gross specimens, I’d be happy to show them to you. As for slides, if you provide your contact information, I’ll either tell you when they’re ready and you can come back, or, if you’d prefer, I could send some slides up to you at Columbia Medical School.”
“Oh, absolutely, I want to see the gross specimens,” Pia said. “And I want to see the slides too, when they’re ready.”
Jack looked at McGovern with a smile. “Dr. McGovern, make sure you get Miss Grazdani’s contact information.”
“I’ll be happy to do so,” McGovern said, beaming.
“Well, let’s go up,” Jack said, and all four trooped out of Chet’s office and headed for the stairs. Pia carried both her umbrella and the shopping bag holding the Geiger counter.
On the fourth floor they all filed into the histology lab. The supervisor, Maureen O’Conner, was still on duty. Jack could swear that since redheads had become very cool recently, Maureen’s red curls had gotten redder.
“So what do we have here on a Friday night?” Maureen quipped. “Is this a party or is it work?” She looked from Jack to Laurie to Chet to Pia. Chet made the introductions and Maureen shook hands with Pia.
“I want to look at some samples, if it’s okay, Maureen,” Jack said. “I know it’s late.”
“Ah, it’s never too late for you, Jack,” Maureen said, and Laurie rolled her eyes. Maureen had taken an early liking to Jack and babied him with special attention. Jack’s slides were always available a little quicker than everyone else’s.
Under Jack’s instruction, Maureen took out a number of formalin-filled sample bottles from the sample storage area and put them on an available and reasonably empty bench.
After donning gloves, Jack took out the pale intestine samples and put them on the countertop. He showed Pia the perforations and the marked erosion of the internal, mucosal epithelium that lined the organ. When she saw that Jack was ready to put them back into the sample bottles, Pia asked a question as casually as she could.
“Would you mind if I checked the sample with my Geiger counter?”
Jack shrugged. “It’s okay with me.”
Pia pulled the Geiger counter out of the shopping bag. After opening up the mica port specifically designed for alpha particles, Pia turned on the machine and positioned the Geiger counter as close to the intestinal sample as possible without touching it. Immediately the counter started giving off the clicks that announced the presence of radiation. As Pia moved the instrument even closer the clicks intensified until they were a continuous noise. Then the needle on the counter’s gauge went off the scale.
“Whoa,” said Jack. “What’s that about?”
Pia said nothing and moved the counter away from the sample and then back. It was unmistakable, the sample was emitting radiation, a lot of radiation. She did it again just to be certain, then turned off the Geiger counter and slipped it back into the shopping bag.
The three shocked MEs looked at one another and then at the young med student. Something wasn’t adding up at all. The sample of intestine had come from a man who had been signed out as having died of salmonella poisoning, yet the sample was emitting extremely high levels of alpha-particle radiation. This student had said that they had used radioisotopes in the laboratory as part of the experimental regimen, but could that have caused this radiation?
“What’s going on here?” Laurie asked, addressing Pia. Her voice was even, unchallenging. “This is all rather surprising. Do you have any explanation?”
Pia’s heart was racing, and she felt as though she might actually be in shock. She was not prepared to face the reality that Rothman’s and Yamamoto’s deaths might be a copycat of Alexander Litvinenko’s in London. Pia was terrified of not being able to get to the truth. Now, when it appeared that she’d found it, all she could feel was a rush of anxiety and paranoia. All she wanted to do at that moment was to get the hell out of the OCME, go back to the dorm, and give herself an opportunity to think about the implications of the discovery and what her next step should be.
“Miss, we need you to tell us wh
at you think is going on,” Laurie said, her voice hardening to a degree. “This is an unexpected and very significant finding.”
Pia said nothing. She could feel the eyes of the MEs boring into her. She’d never had any reason to trust anyone in a position of authority. These three weren’t the police or hospital security, but they did work for the city. Who are the bad guys and who are the good guys? She didn’t know. The bigger question was, are there ever any good guys? She had to get away.
Jack was as flabbergasted as anyone else. “You mentioned isotopes, radioisotopes being used in Dr. Rothman’s lab?”
“Um, I’ll have to find out for sure,” Pia said. “I can get back to you in the morning. Do you come in on Saturdays?” She picked up her umbrella and hooked the shopping bag over her shoulder. She eyed the door to the hall.
Chet McGovern was trying hard to think of what Pia had told him about alpha emitters. “Earlier you mentioned something about lead and bismuth, something like lead-213 and bismuth-212, was that it?”
“It was the other way around: lead-212 and bismuth-213, actually. But yes, I did mention those isotopes, and now I have to go back and check to make sure they were the ones being used. I really need to leave.” Pia checked her watch. “Oh my goodness, it’s almost six o’clock. I promised to be back by six and it’s a forty-five-minute subway ride up to Washington Heights.”
The MEs could sense Pia’s acute anxiety. No one was convinced by her display of surprise at the time.
“I think you need to stay here until we get to the bottom of this,” Laurie said. “You might have been exposed yourself. Alpha emitters are dangerous if either ingested or breathed in. There might be other people who need to be checked out.”
“Thank you so much for your help,” Pia said nervously, looking at Laurie and Jack but not quite looking them in the eye. She was itching to get away. “I can be in touch about the isotopes tomorrow.”
Pia didn’t want to be trapped there when the MEs called the authorities, which she knew they would do shortly. She had to finish this on her terms.
“Young lady, what’s going on?” Jack said. “You show up with a Geiger counter in a shopping bag and bruises on your face. Are you a medical student at all? Who sent you here?”
“No one sent me,” said Pia. “I can see how this must look, but I am a medical student. You have to trust me—no one else was contaminated, I’m sure of it. But I can’t stay here, I have to get back, I’m sorry.”
Pia started backing toward the door, and Jack stepped toward her.
“You can’t hold me here if I want to leave,” Pia said. “And I want to leave. Right now!”
Laurie touched Jack on the shoulder, and he paused. Pia turned and walked away quickly. Chet followed and looked back at Jack, puzzlement written on his face. He had no idea what to do. He didn’t even have her cell number. Pia and Chet disappeared. Maureen was confused too, wondering if she should call security.
“She’s right, Jack, we can’t keep her here. She said she’s at Columbia, so she won’t be hard to find.”
“If she wasn’t lying about that too.”
Part of what Jack and Laurie liked about their work as MEs was the unexpected. This was something very new.
“What do you make of it?” Laurie asked.
“I dunno,” said Jack. “There’s a lot she isn’t saying. She suspected there’d be radiation in the bodies. Of course she did, she brought her own Geiger counter! But when she found what she was looking for, she was completely spooked. More like terrified.”
“Definitely,” Laurie said. “We need to get someone to track her down.”
“I agree.”
Jack thought for a second.
“Let’s check the other guy quickly.”
Maureen was glad to have something to do. She fetched Yamamoto’s specimens. They looked for all intents and purposes the same as Rothman’s, mirror images in fact. But whether they were radioactive they had no idea. Pia had taken her Geiger counter with her.
“Should we call DeVries to find out how we can determine what the radioisotope we’re dealing with is?” Jack asked, referring to the OCME head toxicologist.
Suddenly Laurie remembered a disaster kit that the OCME had put together after the agency had recovered from 9/11, the events of which had caught them, and most of the city agencies, completely unprepared. The concern was that if 9/11 had been a nuclear terrorist event, OCME would have been completely unable to cope. So as not to be caught unawares, the disaster kit had been put together. “I think there’s an instrument in the disaster kit that detects radiation,” Laurie said. “And it should be able to identify the radioisotopes involved. You remember? Bingham insisted on getting it.”
Jack didn’t recall, but he trusted Laurie’s memory. When she left to see if she could find the device, Jack called John DeVries, the toxicologist, and asked him how they could identify the radioactive material.
“I honestly have no idea, Jack. My whole career I’ve never had to, thank goodness. The only radioactive cases to come through the OCME in my experience were patients being treated by nuclear medicine so we already knew the identity of the radioisotope. I guess you’ll use atomic absorption somehow but I’ll have to get back to you. It’s Friday night, you know, Jack.”
“I know it is, John. Many thanks.”
That was a dead end for now. Then Laurie returned. She’d found the disaster kit and in it a Berkeley Nucleonics Corp. handheld Model 935 Surveillance and Measurement System, capable of identifying individual isotopes. Together Jack and Laurie read the directions and then used the machine to measure Rothman’s intestine’s emissions. After about five minutes, the result was available. Although mostly alpha particles were being emitted, there was also a low level of gamma radiation. It was the gamma radiation that yielded the result. It was polonium-210!
“The death certificates are wrong, both of them,” Jack said. “Damn it, I missed this completely. This was no accident.”
“Obviously. Do you know much about polonium?”
“I happen to know a little bit about it. First of all, there are no medical uses for it. In fact, you know what it’s mainly used for? It’s mixed with beryllium such that the alpha particles from the polonium cause the beryllium to release neutrons to act as a trigger for nuclear weapons.”
“Good God!” Laurie exclaimed. “How do you know that?”
“I don’t know how I know it, but I know it,” said Jack. He remembered something else. “It was used to kill that Russian guy in London, you remember that?”
“Oh, yes, the defected former KGB officer?”
“Right.”
Laurie and Jack had taken a professional interest in the case a few years back as did most forensic pathologists.
“We have to report this to Homeland Security,” Laurie said.
“Yes,” Jack said. “It doesn’t mean Rothman and Yamamoto were making nuclear weapons, but it does mean that they didn’t die from typhoid fever alone. They had typhoid fever from the salmonella, but they obviously had radiation sickness on top of it. My guess at this point is that the typhoid was a mask for the polonium, which, in retrospect, was probably the lethal agent. I should have questioned the fact that the entire gut was involved.”
“Don’t be hard on yourself,” Laurie said. “I can assure you that no one could have made this diagnosis.”
“I suppose you’re right,” Jack agreed, although he wondered for a moment if he wasn’t just making an excuse for himself. “I have to say, it’s a rather devilishly ingenious way of murdering someone. And whoever did it nearly got away with it. It fooled me. It would have got past everyone if not for that girl. What happened to Chet—maybe he talked her into staying?”
Jack got out his cell phone and called Chet.
“Chet, that girl, is she still here?”
Jack listened for a second.
“All right. You better get back up here.” Jack disconnected. He looked at Laurie. “She’s gone.
According to Chet, no matter what he said, she literally ran out of the building. And he didn’t get her contact information.”
“She’s got to be found. She could be in danger,” said Laurie.
“You’ve got that right. If whoever is involved in this knows what she knows . . .” Jack didn’t finish his sentence. Laurie instinctively knew what he meant. Instead Jack said, “I’ll call the chief. This is going to be a bombshell and a media circus.”
“And I’ll call Lou. And then Paula. It looks like we’re spending more of our Friday night here.”
Jack nodded. He looked over at Maureen. “Sorry about all this,” he said. “A bit of an emergency. Would you mind getting the rest of the specimens? They’re going to have to be put in a shielded container of some kind.”
“Will do,” Maureen said. She’d picked up on Jack and Laurie’s anxiety.
Jack and Laurie then ran out of the histology lab, down the stairs, and back to Laurie’s office. As he punched in the numbers for Dr. Harold Bingham, the OCME chief, Jack could already see the problems that lay ahead: It was a high-profile case involving prominent medical researchers and the cause of death and the manner of death had been missed. At least they’d found it now, but that was unlikely to appease Bingham. It was Bingham who would have to report the findings to the various government agencies and deal with them, a job that Jack was thankful he did not have to do.
While Jack was calling Bingham, Laurie called Lou Soldano on his cell.
“Lou, it’s Laurie. Can you talk?” She dispensed with any pleasantries.
“Hey, Laurie, nice to hear your voice,” Lou said, his tone becoming wary. “What’s happening?”
“We have a situation here at the office. It seems we have a case of polonium poisoning. Remember that case in London four or five years ago?”
“Of course I do!” Lou said gravely.
Laurie took Lou through what she knew—about the mysterious medical student arriving with her Geiger counter, about how she was upset not to find the researchers’ bodies but able to test the tissue Jack had saved, and about her extreme reaction at the findings.