Luke slowed his pace, counting the steps to distract himself. The metallic echo of each footfall on the steel-grate treads pounded at his skull. He climbed another step, gripped his forehead and squeezed with all the strength he could summon. Suddenly, a sharp stabbing pain pierced his skull. He grabbed the handrail to balance himself.
Just a few more seconds…
His right eye exploded, shattering his senses, emptying his mind. His back arched, the muscles in his face convulsed. Then, just as suddenly as it began, the pain was gone.
He leaned heavily over the handrail, his grip slipping as cold sweat seeped from his palms.
“Dr. McKenna, are you okay?” a woman’s voice asked.
Luke strained to focus his vision. “Yeah. I’m fine.” He pointed to his stomach. “Must have been something I ate.”
When he finally looked up, he recognized the woman. She was a stair climber, like him, part of that small subculture of hospital workers who eschewed elevators.
She looked doubtful, but after he straightened, she stepped past him.
He followed her with his eyes as she walked down the stairs. When she turned back toward him, he said, “If you’re going to the cafeteria, don’t order the lasagna.”
8
“She blames us for her boy’s death,” Caleb Fagan said. “Josue Chaca’s mother is a quiet sort, but I can see it in her face.”
Luke lifted his gaze to the immunologist, whose dyed-brown hair was too dark for his vein-streaked alabaster skin.
They were sitting in the E.R. doctors’ room. Luke had been filling out a Suspected Nonaccidental Trauma report for the Erickson case while listening to Caleb describe his brief visit with the Guatemalan boy’s mother.
“She tell you anything? Anything that might point us to a cause of death?” Luke asked.
The immunologist shook his head. “I assume there’s going to be an autopsy.”
“Sunday.”
“Call me when you get the results back.” Caleb slapped his thighs as if to signal his legs that it was time to leave. “Our folks in Guatemala are going to want to know what you find.”
Luke nodded while looking out the door. It was nine-thirty and the E.R. was taking in wave after wave of children whose illnesses had either been relegated to benign neglect or gone unnoticed by distracted parents slogging through their workweek. Friday nights during the winter months were always hectic, but tonight had turned into a chaotic mess—courtesy of his brawl.
Across the room Chewy Nelson fished blindly into a bag of Cheetos while eyeing the jean-clad posterior of a young blond woman standing just outside the door. The reed-thin intern looked as if he’d turn to salt were he to take his eyes off the woman.
Just as Luke was about to turn back to his report, Barnesdale appeared in the doorway. The man opened his mouth to say something as soon as his eyes found Luke.
But Chewy’s mouth was faster. “Whoa, the Big Kahuna himself. Dr. B, did you hear about the fight? I’m tellin’ ya, it was unfrigginbelievable what Dr. McKenna did to that jumbo burger.”
Barnesdale pitched his head slightly, in the manner of someone trying to decipher a linguistic puzzle, then turned to Luke. “I expect to see you in my office as soon as your shift ends at ten. And you’d better have a damn good explanation for what happened here this evening.”
“This about Erickson?” Luke asked.
“Unless there are any other parents you assaulted tonight—yes, this is about Erickson.” He tapped his watch. “And remember, don’t keep us waiting.”
“Us?”
“The law firm that represents this hospital in litigation. One of their partners is in my office.”
Barnesdale was turning to leave when the desk clerk poked her head through the door and held up two fingers. “Dr. McKenna, line two’s for you. A woman named Tartaglia. This is the third time she’s called. Says it’s urgent. She really wants to talk to you.”
• • •
Kate Tartaglia considered the risks to her career as she passed under the Hollywood Freeway, driving east on Melrose Avenue.
But she had to do something. Another child was dead, and no one was searching for an explanation because, as far as she could tell, no one else at Zenavax even acknowledged the problem.
It wasn’t supposed to be like this. When she joined the company four years ago, she’d brought with her a key discovery from her work at University Children’s. Zenavax’s flu vaccine, like Elmer’s, consisted of an inactivated alphavirus into which they inserted a portion of the influenza virus’s genome. When injected into vaccine recipients, the alphavirus produced copies of a flu-virus-like protein. She had shown Zenavax’s research staff how to amplify the body’s immune system’s response by modifying the alphavirus. The result was a vastly more effective vaccine.
That contribution had given her immediate stature in the company, something she never would have had if she’d stayed at University Children’s. The hospital would have sold or licensed their work to some large pharmaceutical company. And yes, it was their work, not just Elmer McKenna’s. She had made important contributions to his research, but if the hospital had sold the rights to the flu vaccine, the best she could have hoped for was a position in some bloated and slow-moving research department at one of the big drug companies.
At worst, her contributions would have been overlooked and she would have gotten a pat on the head and a pink slip.
So instead she had joined Zenavax, a small entrepreneurial company that put her in charge of its clinical testing programs. The influenza vaccine turned out to be a stunning commercial success and quickly became the best-selling flu vaccine on four continents, including the world’s largest and fastest growing market—China.
Zenavax’s flu vaccine threw off an avalanche of cash that the company was using to develop new vaccines and broaden its product line. Wall Street had rewarded their efforts—her stock options were worth over $2 million—but it hadn’t been only about the money. She had wanted her career to mean something. She had wanted, one day, to look back on her life and know that she had made an important contribution to her field, that she’d been an agent for change.
Lately, though, she had come to feel more like an agent of death.
The faint alarms had first sounded several months ago while she was analyzing blood samples from a group of human test subjects in Guatemala. Zenavax was testing a prototype malaria vaccine on human volunteers who had earlier received the company’s flu vaccine. Blood from several of the test subjects had revealed a similar immune reaction, one that she recognized from her work on the earliest flu vaccine prototype at University Children’s—one that had destroyed an entire colony of laboratory mice.
Immediately, she had told her boss. He listened attentively, perused her data, and assured her that he would look into it. “Let’s not jump to conclusions” was his self-evident and pontifical counsel to her at the time, before reminding her that even unsupported rumors could decimate the value of Zenavax’s stock.
But at least he had examined her data and talked to a few outside experts, or so he said when he later shared the “good news.” He told her that the test results were more easily explained by other causes—probably an autoimmune reaction to one of the many parasitic diseases endemic to Central America. In any case, he said, it didn’t appear to have anything to do with their vaccines.
He had told her what she wanted to hear, and for a few months after that Kate had all but ignored the lingering questions. It was so easy to do when she could throw the data onto a flash drive and toss it into a desk drawer.
Then, four months ago, when she traveled to the Guatemalan village where they were testing the vaccine, her life had imploded. The fragile shell of her world had broken open and a lifetime of self-seeking choices spilled out like a putrid sludge. What had been data elements suddenly became pairs of sunken brown eyes, test subjects became cadaveric young faces, titer levels became heartbeats pounding against the ribs of bodi
es ravaged by…whatever this was.
People were dying, and the only connection among the victims was Zenavax.
She had tried to do something, she reminded herself. One family, a nine-year-old girl and her parents, had been willing to leave their village. She had given them enough money to buy their way into Mexico. She’d worked out a plan to meet the family in Tijuana and, somehow, smuggle them across the border and arrange for medical care. But two weeks later, when she met them at a ramshackle hotel in the Mexican border town, the parents had pleaded for her to take their daughter and leave them behind.
Death was already visiting the parents. She had seen it in their graying skin, in their gasping breaths.
Her body shuddered as a wave of guilt swept through her. She had placed the decrepit child in the trunk of her car and crossed into the U.S., a light-skinned woman waved through by an Immigration agent scanning an ocean of vehicles for stowaways. Once across, she removed the girl’s wasted body from the car’s trunk and laid her on the backseat. The drive to Los Angeles was a lost memory, wiped clean by the terror and dread that had gripped her.
But Kate remembered the gurgling sounds. They started just as she was driving through East Los Angeles on the Santa Ana Freeway. That was when the girl’s breaths slowed to agonal gasps. She was close to death, and both of them knew it.
Kate had panicked. She had left the girl near the Emergency Room entrance of a small community hospital along some frontage road, knowing that the child’s death was certain.
In the final minutes of that child’s life, Kate had treated her as if she were of no more consequence than an afterbirth. She had abandoned her promise to the girl’s dying parents. Now, she could no longer push aside the nightmare.
She drove along the front of University Children’s without giving it a passing glance. Her eyes were aimed at Kolter’s Deli, across the street from the hospital. She peered through the plate-glass window that spanned the restaurant’s entire length, but the interior was too dimly lit to spot Luke.
A dry swallow stuck in her throat. Please be there.
Would he help her? Would he put aside his bitterness toward her, would he listen without condemning her? It would be in his eyes. After a few minutes alone with him, she’d know.
Whatever happened, it was too late to turn back now. Earlier that evening, when Luke hadn’t answered her first call to the E.R. and the hospital operator wouldn’t give her his cell number, she had e-mailed the photograph to him. He hadn’t mentioned it when they finally spoke. Obviously, he hadn’t seen it yet. It was better this way—she wanted to talk with him face-to-face.
Soon, it would all be out in the open.
She was risking everything—everything—but what choice did she have? She couldn’t hold onto the secret any longer.
Kate rubbed a palm against her linen slacks. Moisture seeped through to her thigh.
She made a quick left turn onto a side street, then pulled into an alley and drove along the rear of a string of retail shops before passing the back entrance to the deli. A canister light hanging over the service door flickered to the rhythm of the wind gusts. Funnels of soot rose like fingers grabbing at the swaying telephone lines.
It was 10:09 P.M. when she pulled into a small open-air parking lot in the middle of the block, about twenty-five yards beyond Kolter’s.
Her cell phone rang.
“Hello?”
Oh, God. Her mother.
“Yeah, Mom. I know I haven’t called this week…Yes, Mom, I know you worry about me when I don’t call…Yeah, you’re right, I’m sorry…Mom, listen, I can’t talk right now. I’m meeting someone…Who?…Well, Luke McKenna but don’t…No, Mom, we’re not getting back together—that’s ancient history. This has to do with my work…”
Why did I answer the phone?
“Okay, Mom, believe what you want, but I’m telling the truth. It’s about work…Listen, I gotta go. He’s standing right here.”
Not quite true, but close.
“Okay, Mom, I’ll tell him you said hello…What?…Yes, Mom, I’ll tell him you miss seeing him. I’ve gotta go. Yeah, I’ll call you tomorrow…I promise. Love ya.”
Her body twitched nervously when she saw the dark form in her peripheral vision.
A white lab coat. He was walking toward her, hand over his eyes, dust and debris swirling around him. Even in the dim light she recognized the athletic stride.
Luke. He looked like he had gained some weight.
She groped for the unlock switch on her door.
I thought I told him we’d meet inside the deli…
9
At 10:45, Luke was sitting in a crescent-shaped booth along the front of Kolter’s Deli, turning a coffee mug in his hands while staring up at the helipad atop the hospital. Air-5, the Sheriff’s helicopter he used to fly on as a physician volunteer with the department’s Search & Rescue team, sat motionless under the wash of a floodlight. For a long time, that stint had been important—like a bridge straddling two incongruous identities—but when he relinquished it two years ago, it felt as though he’d reached another milestone in his private twelve-step program.
Luke glanced at his watch again. Kate was a half hour late.
What was going on? After all this time—they hadn’t spoken in over four years—what was so important that she needed to meet with him tonight?
Barnesdale was probably apoplectic, pacing his office with that attorney. He would get to have his tirade. Luke knew he was simply postponing it by an hour or so.
The bell on the front door tinkled. A red-bearded indigent man poked his head inside and sniffed the deli’s aromas like a foraging animal before a busboy shooed him out the door. Moments later an older couple who were dressed for a night at the opera entered the restaurant. For seventy-three years Kolter’s had fought an unresolved struggle for its identity.
The same could be said for University Children’s. Across the street a warm glow glimmered through the enormous stained-glass windows that stretched across the façade of the original hospital structure. Closer scrutiny revealed a medical campus that looked like the architectural equivalent of a Rube Goldberg invention, a new addition having been added every twenty years or so, each time in a seemingly haphazard fashion. The only unifying design concept was concrete.
University Children’s was similar to Kate in that way. Both lacked a defining character. The forces of life seemed to reshape her beliefs and values to accommodate her goals. It was something that had initially attracted him, her openness to different points of view. But gradually it became an irksome divide in their relationship, brought to a head when Zenavax offered her a “once-in-a-lifetime” opportunity, one that seemed to override any loyalty she may have felt for his father.
But it wasn’t her decision to join Zenavax, or the problems she created for his father, that had ended their relationship. It was the way she had justified her decision. Kate reverse-engineered her principles to justify her ambitions. Her opinions shifted around like sand dunes. She seemed to have no moral center, no fixed positions that guided her decisions.
Tonight, though, something about her was different. When they had spoken on the phone, her voice betrayed a fear. There was a vulnerability that she had never revealed in their relationship.
It was like the fear he’d heard in Megan’s voice that night three months ago, after some goon had tried to rape her while she was walking home from the hospital. Luke’s grip tightened around his coffee mug as he recalled the moment when Megan had called him from the Rampart police station.
The fear—no, the terror—had burned in her eyes for weeks afterward. That son of a bitch had stripped away her innocence, stolen the sanctuary of a mind untouched by violence.
But Luke knew it was he who had ravaged their relationship. In the aftermath of that night, he had done everything wrong. And not being able to explain his actions, to either Megan or himself, ripped at his gut.
A chorus of horns sounded on the stree
t.
Luke’s head jerked back. Several cars screeched to a halt outside the deli. He craned his neck and saw a small cluster of people moving clumsily across the street, carrying someone in their arms while plodding toward the hospital. Friday night was bringing the usual mix of gang- and drug-related cases to their hospital.
Moments later traffic began moving again.
Where was Kate?
• • •
Megan looked at her watch—10:48 P.M.—seventy-two minutes until the end of her shift. The second hand was taking its sweet time completing each circuit.
God, I hate trauma duty.
Tomorrow evening was her last E.R. shift. One more night and she’d be done with trauma duty and done with Luke McKenna forever.
And in exactly forty-eight hours she’d board her flight to Guatemala. The Central American rain forests seemed the perfect place to toss aside the emotional upheaval that had dogged her for the past three months. The perfect place to make a new beginning.
She and Susan were sifting through equipment and supplies strewn across the Trauma Unit as the sheriff’s Search & Rescue crew recovered and secured their gear. The three-year-old girl flown in on Air-5 had been pulled from a car that careened off an unlit forest road. She had suffered only minor injuries and was already tucked away upstairs for overnight observation.
One of the pilots, dressed in a green flight suit and carrying a beige helmet under his arm, was standing near the door talking with another resident. In typical male fashion, they were jabbering about Luke’s fight with the football player as though recounting an epic battle that had global significance.
Megan looked at the name stenciled on the pilot’s breast pocket: R.STEVENS.
“That guy’s one strange dude,” the pilot said.
“Whatta ya mean?” the resident said.
“I mean, McKenna’s not your everyday guy. He saved my bacon big-time during a rescue a few years ago.”
Susan shot a glance at the pilot.
Stigma Page 6