Virtually Undead

by Robert I. Katz

  High-Tech Crime Solvers

  Virtually Undead

  USA Today

  Bestselling Author

  Robert I. Katz

  From USA Today Bestselling Author, Robert I. Katz, comes a gripping techno-thriller, part of a multi-author series tied together by an interlocking cast of characters, all centered around the fantastic new promise of high technology and the endless possibilities for crime that technology offers, in a world where getting away with murder can be not only plausible, but easy…if you just know how.

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  Praise for his Work:

  “Surgical Risk is a highly original medical mystery…Peppered with insightful comments on medicine and its practitioners, Surgical Risk is a well-crafted and richly different mystery.” —Mystery Scene Magazine

  “…Kurtz and Barent make a compelling investigate team, and Surgical Risk is a mystery with plenty of suspense and twists.” –Mystery Review Magazine

  “…the expertly realized background and the solid professionalism of the prose and dialogue mark Katz a writer to watch.” –Ellery Queen’s Mystery Magazine (About The Anatomy Lesson)

  “…a suspenseful medical mystery which grabs the reader from the first page and takes us on a ride you won’t soon forget…You can’t put it down.” –Midwest Book Review (About Seizure)

  “…one of the most unlikely and enjoyable amateur detectives around…this battle-loving doc with the snarky sense of humor is outrageous fun.” –Mystery Scene Magazine(About Seizure)

  “Recommended…” —Library Journal (About Seizure)

  Dedication

  To Lynn, Erica, Steven and Jeffrey, who have supported me from the beginning.

  Contents

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  Chapter 9

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  Chapter 17

  Chapter 18

  Chapter 19

  Chapter 20

  Chapter 21

  Chapter 22

  Chapter 23

  About this Book

  About High-Tech Crime Solvers

  About the Author

  Acknowledgment

  A Note to the Reader

  Also by Robert I. Katz

  Virtually Undead©2020 Robert I. Katz

  Chapter 1

  The brain is the softest organ in the human body, barely firmer than a bowl of custard. Brains contain numerous structures within a very small volume and most of these structures are barely visible to the naked eye. A soft organ is an easily damaged organ, and brains are both fragile and poorly defended behind skulls that are not so difficult to crack.

  Brains are tasty, as well, if you’re a lion, a tiger or a bear, and nutritious, with a high fat content. The thought floated through the back of Michael Foreman’s mind. People eat them, too, those who can stomach the idea—cow brains, pig brains, lamb brains and even squirrel brains, (definitely not human brains, thank you, Doctor Lecter), so long as they’re appropriately cooked and seasoned…though there was that tribe in New Guinea who did eat human brains and preferred them raw. Turned out to be a bad idea, since eating uncooked brains gave them Kuru, an inevitably fatal type of spongiform encephalopathy, similar to mad cow disease.

  Nope. Eating raw brains is a bad idea. Pan fried, with a little salted butter, some garlic and a dash of black pepper, that was supposedly the way to go…or maybe in a Szechuan hot pot, or curried—a favorite delicacy, or so Michael had read, in Southern India.

  Not that he had ever eaten a brain. He pondered the idea, now and then, but…no. Just no.

  Strange, how one’s mind wandered at 3:00 AM.

  Concentrate, damn it…

  Delicate, precise movements are required to operate on the brain. It’s not a field for the clumsy. You don’t want to operate on some small, delicate structure and then, oops, too bad about the violin lessons.

  Not a joke. It had happened.

  “Syringe,” he said. “Ten cc.”

  The scrub nurse handed him a syringe filled with ten cc’s of radio-opaque dye. He attached the syringe to the catheter and gently pushed on the plunger. It flowed easily. He injected the whole ten cc’s, ready to stop at the slightest resistance.

  Michael, the nurses and the techs all wore lead aprons under their gowns, the reason why the OR was kept at an otherwise uncomfortable fifty-eight degrees. The anesthesiologist, Bernie Fleck, and his resident were dressed in scrubs and OR jackets. Michael nodded to Bernie and he and his resident moved behind a leaded screen. Michael stepped on the peddle. The x-ray machine beeped and a rotating picture of the patient’s cerebral vasculature appeared on the two big screens suspended on the wall, each tiny vessel delicately outlined, showing no obstruction to blood flow.

  To Michael Foreman, Assistant Professor of Neurosurgery and Radiology, the soft sound of the ventilator, the steady beep of the ECG, the high-pitched tone of the pulse oximeter and the hushed voices of the anesthesiologist and his resident were familiar and soothing. These things meant the patient was soundly asleep, as stable and healthy as it was possible to be under the unfortunate circumstances that had brought him to the OR, and everything was proceeding as it was supposed to.

  The operating room environment was second nature to him. By now, Michael was attuned to it. If anything was out of place or not as it should be, he would know, instantly and without thought.

  The patient was sixty-seven years old with a history of atherosclerotic heart disease, diabetes and hypertension. His name was Sam Levinson. He was borderline obese and led a sedentary lifestyle. He liked to fool himself that a round of golf every other week or so constituted exercise, but riding around in a golf cart, stopping now and then to whack a ball, while eating a ham sandwich and drinking a couple of beers was not what any physician would call actual ‘exercise.’

  Nope. Lousy shape, elevated cholesterol, elevated triglycerides and high blood pressure: a set-up for what had happened to him. Vascular disease rarely exists in isolation. The buildup of occluding plaque in the coronary arteries is almost always mirrored by a similar occlusion in other arteries throughout the body. In this case, more specifically, the carotid arteries, from which a small bit of schmutz (a perfectly acceptable medical term, in Michael Foreman’s opinion), composed of one part fatty cholesterol and three or four parts blood clot, had broken off. It then floated upward and lodged within a smaller artery in the brain, blocking blood flow to the portion of the brain fed by that artery.

  A cerebrovascular accident had immediately ensued—a stroke, in layman’s terms.

  The patient had collapsed, drooling and semi-conscious, one side of his face going slack, able to move but unable to express himself beyond a series of terrified grunts. The patient’s son-in-law, whose own father had not long ago suffered a similar unfortunate event, recognized the signs. A quick call to 911, a short ride in an ambulance, and now, here they were, in the interventional neuroradiology suite at the University Hospital of Staunton College of Medicine, at 3:00 AM in the morning, well within the golden three hours that supposedly allowed for at least a possibility that the offending clot could be removed and the patient’s faculties restored.

  Or not, since it didn’t always work. Floating catheters from the femoral artery in the groin all the way up into the smaller arteries of a patient’s brain, snaking said catheters past an obstruction, blowing up a tiny
balloon at the tip and delicately extracting the balloon, the catheter, and the clot, or sometimes, if the clot could not be extracted, dissolving it with streptokinase or a similar lysing agent, was one of Michael’s principal specialties.

  After removing the clot, Michael had taken multiple x-rays, which showed blood once again flowing without obstruction. The patient also had a small, saccular aneurysm, less than four millimeters in circumference, on the anterior communicating artery at the base of the brain. Michael examined the aneurysm carefully. It was small and would probably never be a problem, but they would have to keep an eye on it: a CAT scan every couple of years.

  That was assuming the patient lived. The operation had gone well but the danger was not over, because approximately fifty per-cent of patients whose clots were successfully removed and whose blood flow was thereby restored, went on to bleed into their brains.

  The procedure had been greeted, only a few short years ago, with universal acclaim. For the first time, a stroke could be treated with something other than supportive care, the damage it caused prevented. Hospitals had spent fortunes installing neuroradiology suites. Fellowships, requiring a minimum of two years’ additional training after completing a residency in either neurosurgery or radiology, hastily sprang up all over the country.

  Sadly, the subsequent experience had disillusioned them all. Approximately thirty percent of patients who underwent the procedure were cured. Approximately thirty percent, after all complications had been factored in, were made worse, and the remainder wound up pretty much where they started, with significant and permanent neurologic deficits.

  Michael sighed. A lot of time, effort and money for not much payoff.

  The history of medicine was full of such miraculous innovations, which time and experience eventually showed to be far from miraculous, and often harmful. In the 1920’s and 30’s, for instance, lobotomy had been all the rage. Thousands of patients had had their brains sliced in two, in the futile hope of doing them some good.

  Then there was the injection of papain into herniated lumbar disks, dissolving them, certainly a cheaper and less invasive option than surgery, until papain turned out to cause fatal anaphylaxis in a significant minority of patients.

  A few years ago, Michael’s GI colleagues had applauded an exciting new procedure to prevent gastro-esophageal reflux by burning a concentric ring around the esophagogastric junction, theoretically tightening up the lower esophageal sphincter…except that it didn’t work.

  There were far more examples than Michael cared to think about (now that he was thinking about it). Deliberately bleeding the patient, for instance, had been practiced for literally thousands of years. Former President George Washington, suffering from a throat infection, had been bled multiple times by his physicians. Not a good idea, as it turned out. Impossible to say, two hundred years later, what had finally killed him: the bleeding or the infection.

  Michael sighed again and shook his head. Even smoking had for many decades been considered a positive benefit to health, lending itself to weight control, decreased anxiety and a reduction in the intensity of inflammatory bowel disease. Too bad about the cancer and the heart disease. Oh, well. An innocent mistake.

  Michael Foreman did not enjoy the glum thought that much of his life’s work might turn out to be, when all was said and done, a waste.

  Still, it was making him rich. One positive benefit, at least. He sometimes felt guilty about that. Not often, but sometimes.

  Another sigh...

  The anesthesiologist grinned behind his mask and rolled his eyes toward the clock.

  Yeah, it was 3:00 AM. Endorphins did tend to be low at 3:00 AM. Might be partially responsible for his suddenly shitty mood.

  Ten minutes later, the catheters had been pulled, the incisions sewed up, the dressings applied and the patient trundled off to the Neuro/ICU.

  Hopefully, he would be okay. With luck, he would wake up with his brain intact, go home to the loving arms of his family and maybe even be scared into eating a healthier diet and getting some real exercise.

  Maybe.

  Chapter 2

  

  t was a small thing, at first. A switch that had only two settings: on or off. When it was on, the light shined green. When it was off, the light turned, first yellow, and then a few seconds later, red.

  Nobody notices, at an isolated intersection in lower Manhattan, if a light that is supposed to turn red, stays green for a few seconds longer than it’s supposed to. Not usually, not early in the morning when there’s not a lot of traffic.

  Except that this was the fourth time it had happened in four nights.

  Josh Greenberg was twenty-three years old and high as a kite but not so high that he was incapable of driving home at 3:00 AM, in his own opinion, at least. His girlfriend, Alyssa Weissman, was not so certain, but since she was just as high as her boyfriend, she didn’t object as strenuously as she otherwise might have.

  Neither of them saw the vehicle that crashed into their car at forty miles per hour. The driver of the car that hit them barely had time to register the late model Toyota that sped into the intersection before his own car was already on top of it. He tried to hit the brake but it was already too late.

  Josh Greenberg died instantly. Alyssa was luckier. The airbags inflated, cushioning the blow, as the Toyota spun in a half circle and came to rest up on the curb. The driver of the car that hit them had also been saved by his car’s airbags. He suffered a broken leg, a broken nose and a shattered elbow, but in the grand scheme of things, these were all minor injuries. He would survive.

  Alyssa was at first awake and coherent but within minutes of the crash, began to grow somnolent. The ambulance crew knew what this meant. They turned the sirens on and drove faster. Ten minutes later, they careened into the parking lot and up to the entrance of the ER at Staunton.

  Michael Foreman had just wearily pulled his clothes back on when the beeper went off. He stared at it. “Oh, shit,” he muttered, then sighing, he picked it up.

  Epidural hematomas result from the rupture of an artery in the epidural space, usually the middle meningeal, most often as a result of trauma to the temporal bone. Ruptured arteries pump out a lot of blood, fast. When an artery ruptures inside a closed space, in this case, the skull, it puts pressure on the brain. The brain, when compressed, has nowhere to go except down and out, through the foramen magnum, squeezing the cerebral cortex into the brain stem, and the brain stem into the spinal cord, turning it all into dead, red jelly.

  Epidural hematomas are acute, life-threatening emergencies.

  Alyssa, however, was lucky. A CAT scan quickly confirmed the diagnosis. Twenty minutes later, she was in surgery. This was an operation that Michael had performed many times before. His hands moved on autopilot. The blood clot in this case was neither small nor delicate. The CAT scan had revealed just where his hands should go. The clot was sucked out, the bleeding stopped and the patient brought to the ICU still intubated. Alyssa would be kept in a barbiturate coma for two days, barbiturate coma having been shown on numerous studies to provide at least some protection against long term sequelae to traumatized brains.

  Alyssa, Michael felt confident, would survive. She might have some long-term damage but probably not, and if she did, the damage would probably be minimal. Michael felt good about Alyssa’s chances. He glanced at the clock as he walked over to the nursing station. It was almost 6:00 AM. His shift was over in just an hour, and he had the day off. Yea. He was too tired to do much of anything except get as much sleep as he could but a day off was better than a day at work.

  He sat down and dictated the OR report, checked off the orders for Alyssa’s continuing care, tiredly pulled himself to his feet and walked out of the ICU doors. A man he didn’t recognize stood there.

  “Doctor Foreman?” the man said.

  The guy was tall, not quite as tall as Michael but bulkier. He was clean-shaven, wore a nice suit and had neatly groomed hair. He was wea
ring a gun in a shoulder holster under that nice suit.

  “Yes?”

  “I’m Lieutenant Harold Strong, NYPD.”

  Michael blinked. “Okay.”

  “The patient you just operated on, Alyssa Weismann—how is she doing?”

  Michael had interacted with the police on a couple of occasions in the past. He knew what he was supposed to say, which was the strict truth. Ordinarily, HIPPAA forbade the revealing of any patient related information to anybody whatsoever without the permission of the patient or authorized next-of-kin. There were exceptions, however, and a legitimate request from law enforcement was one of them.

  “Is there a crime involved here, Lieutenant?”

  Harold Strong’s lip twitched upward. “Maybe not a crime. Maybe an unfortunate series of coincidences. The accident in which Miss Weismann was involved is the fourth one in the past four days at that exact same intersection.”

  “Huh…” Michael shook himself. “Well, she’s doing okay. There’s a good chance she’ll make a full recovery, but we’re keeping her sedated. You won’t be able to talk to her for at least a couple of days.”

  Harold Strong frowned. “Thanks,” he said. “Please let me know if her condition changes.” He handed Michael a card with his name and number. Michael glanced at it and slipped it into a pocket.

  “Certainly,” Michael said. “Will do.”

  A gamemaster has certain responsibilities, not only to the players but to the game itself. He has to make certain that the rules of the game are clearly laid out, that they make sense, that they’re comprehensible, that they’re consistent. Most of all, the gamemaster has to ensure that the rules of the game are followed, that the integrity of the game is preserved.

  It was a heavy responsibility, but one that Ralph Guthrie was happy to assume. Ralph was thirty-three years old, five feet seven inches tall and weighed two hundred ten pounds. He had a high IQ but still lived in his old room in his parents’ apartment, in a three-bedroom high rise in Queens.