heads constantly turning to survey the room.
As the music ended, the blond stripper picked up her things and ran up
the stairs. There was scattered applause. When the music began again, a
new dancer descended the stairs and whirled about the runway. Dressed in
a flashy, voluminous gypsy costume, she could have been the first
dancer's sisterher older sister.
Very quickly, Jason got the hang of the program. A girl would appear in
some wild costume and dance, taking off more of her clothes as the
number progressed. Forty-five minutes passed and Jason wondered if
Carol Donner was scheduled to appear that night. He asked one of the
waitresses.
"She should be next. Want another round, mister?"
Jason shook his head. He was content to nurse his first beer for the
entire visit. Looking around, he noticed that several of the strippers
had come back down to the floor. They would stop and talk to the man in
the dark glasses and then wander around the room, chatting up the
customers. Jason tried to imagine Hayes, the famous molecular biologist,
there at the bar.
Try as he might, he couldn't.
There was a pause in the music and the runway lights dimmed. A PA system
crackled to life for the first time and announced the next performer:
the famous Carol Donner. The bored patrons propped up on the bar
suddenly seemed to wake up. There were a few catcalls.
The music changed to a softer rock and a figure appeared on the runway.
As the lights came up, Jason was stunned. To his amazement, Carol Donner
was a beautiful young woman. Her skin had a healthy glow and her eyes
sparkled.
She was dressed in a body suit, headband, and leg warmers as though she
were in an aerobics class. Her feet were bare. She moved down the runway
with effortless grace, and Jason noticed that her smile held genuine
enjoyment.
As her number progressed, she removed her leg warmers, a silk sash
around her waist, and then the body suit. The sodden audience actually
cheered as she danced topless back up the stairs. As soon as she
disappeared, the customers sank back into their torpor. Jason kept
waiting for Carol to appear on the floor like the other girls, but after
twenty minutes he decided she might not. He pushed off his stool and
walked back to the man in the sunglasses. One of the body-builders
noticed his approach and unfolded his arms. "Excuse me," Jason said to
the man with the ledger. "Would it be possible to talk with Carol
Donner?"
The man removed his cigar. "Who the hell are you?" Jason was reluctant
to give his real name, and while he hesitated, the man in the dark
glasses motioned to one of the b9dy-builders. Jason felt large hands
take hold of his arm and urge him toward the door. "I only want ..." But
he didn't get to say any more. He was grabbed by his jacket and hastily
escorted the length of the bar and through the dark curtain, his feet
barely touching the floor. With a good deal of humiliation, he found
himself propelled out into the street.
After the radio alarm had awakened him, Jason had to stand under the
shower for several minutes to feel capable of facing the day. The night
before, after he'd returned from the unpleasant visit to the Club
Cabaret, he'd been called back to the hospital. One of his AIDS
patients, a man named Harvey Rachman, had arrested. When Jason had
arrived, the staff had been giving CPR for fifteen minutes. They'd kept
it up for two hours before conceding defeat. The head nurse's comment
that at least the man didn't have to suffer anymore was not much
consolation to a stricken Jason. For Jason it seemed that death was
winning the competition.
The only positive side of inpatient rounds later that morning was the
discharge of one of his hepatitis cases. Jason was sorry to see the girl
go. Now he had only a single patient who was doing well.
In the CCU, Matthew Cowen was no better. In addition to his other
complaints, he was now having trouble seeing. The symptom bothered
Jason.
Harring and Lennox had also complained of impaired vision in the weeks
before their deaths, and again the possibility of some new multisystem
illness crossed Jason's mind. He ordered an ophthalmology consult. After
finishing rounds, Jason headed to pathology to see if the slides from
Hayes's autopsy were done. Maybe they would help explain why so many
seemingly healthy people were suffering cardiovascular catastrophe.
He had to wait while Jackson called a report on a frozen section down to
the OR. It was a breast biopsy and it was positive.
"That always makes me feel terrible," Jackson said, hanging up the
phone.
Then, in a more cheerful voice, he added, "I bet you want to see the
Hayes slides." He searched around on his desk until he foundthe right
folder.
Opening it up, he took out a slide and focused it for Jason. "Wait until
you see this.
"That's Alvin Hayes's aorta," Jackson explained as Jason looked in. The
cellular death and disorganization were evident even to his unpracticed
eye. "It's no wonder it blew," Jackson continued. "I've never seen such
deterioration in anyone under seventy except with established aortic
disease. And let me show you something else." He replaced the slide with
another. "That's Hayes's heart. Look at the coronary vessel. It's like
Cedric Harring's. All the coronary vessels are almost closed. If Hayes's
aorta hadn't blown, he'd have died of a heart attack. The man was a
walking time bomb. And not only that, he had inflammation in the
thyroid, again like Harring.
In fact, there were so many parallels that I went back and looked at
Harring's aorta. And guess what? Harring's aorta was on the verge of
blowing too."
"What exactly are you saying?" Jason asked.
Jackson spread his hands. "I don't know. There are strong similarities
between these two cases. The widespread inflammation-but I don't think
it's infectious. It has more the look of autoimmunity, as if their
immune system had started attacking their own organs.
"You mean like lupus?"
"Yeah, something like that. Anyway, Alvin Hayes was in terrible shape.
Just about every organ was in a state of deterioration. He was falling
apart at the seams.
"He said he wasn't feeling too well," Jason said.
"Ha!" Jackson exclaimed. "That's the understatement of the year."
Jason left pathology, trying to make sense of Jackson's statement. Again
he considered the possibility of an unknown infectious disease despite
Jackson's opinion. After all, what kind of an autoimmune disease could
work so quickly? Jason answered his own question: none.
Before starting the office patients, Jason decided to stop by Hayes's
lab.
Not that he expected Helene to be helpful, but he thought she might be
interested in the fact that Hayes had been so ill the last few weeks of
his life. To his surprise, he saw Helene had been crying.
"What's the matter?"
Helene shook her head. "N
othing."
"Aren't you working?"
if, finished," Helene said.
All at once Jason realized that without Hayes there to give her
instructions, she was lost. Apparently she'd not been apprised of the
big picture, a fact that made Jason pessimistic that she would have
knowledge of Hayes's breakthrough, if there'd been one. The man's
penchant for secrecy was to be society's loss.
"Do you mind if I talk with you for a few minutes?" Jason asked.
"No," Helene said in her usual laconic manner. She motioned him into
Hayes's office. Jason followed, assaulted once again by the graphic
genital photos.
"I've just come from pathology," Jason began, once they were seated.
"Dr. Hayes apparently was a very sick man. Are you sure he didn't
complain of feeling ill?"
"He did," Helene admitted, reversing her previous stand. "He kept saying
he felt weak."
Jason stared across at her. She seemed softer, more open, and he
realized that in contrast to the previous times he'd seen her, her hair
was loose, falling to her shoulders instead of severely pulled back.
"Last time you said his behavior was unchanged," he said.
"It was. But he said he felt terrible."
MORTAL FEAR
Frustrated by this semantic distinction, Jason again was convinced that
she was covering up something. He wondered why, but he felt he'd get
nowhere by confronting her.
"Miss. Brennquivist," Jason said, speaking patiently, "I want to ask
once again. Are you absolutely certain you have no idea what Dr. Hayes
could have been referring to when he told me he'd made a major
scientific breakthrough?"
She shook her head. "I really don't know. The truth was that things had
not been going well in the lab. About three months ago, the rats
receiving growth hormone-releasing factors had mysteriously begun to
die."
"Where did the releasing factors come from?"
"Dr. Hayes extracted them himself from rat brains. Mostly the
hypothalamus.
Then I produced them by recombinant DNA techniques."
"So the experiments were a failure?"
"Completely," Helene said. "But, like any great researcher, Dr. Hayes
was not daunted. Instead he worked harder. He tried different proteins,
but unfortunately with the same fatal results."
"Do you think Dr. Hayes was lying when he told me he'd made a
breakthrough?"
"Dr. Hayes never lied , Helene said indignantly.
"Well, how do you explain it? p' Jason asked. "At first I thought Hayes
was having a nervous breakdown. Now I'm not so sure. What do you think?"
"Dr. Hayes was not having a nervous breakdown," Helene said, rising to
make it clear the conversation was over. Jason had hit a raw nerve. She
was not about to listen to her late boss be calumniated.
Frustrated, Jason went down to his office, where Sally already had two
patients waiting for physicals. Between them Jason escaped Sally long
enough to check the laboratory values on Holly Jennings. The only
significant change from her earlier tests was an elevated gamma
globulin, again making Jason consider a non-AIDS-related epidemic
involving the autoimmune system. Instead of turning the immune system
off, as with AIDS, this problem seemed to turn it on in a destructive
fashion.
. Midmorning Jason got a call from Margaret Danforth, who stated without
preamble, "Thought you should know that Dr. Hayes's urine showed
moderate levels of cocaine."
So Curran was right, Jason realized, hanging up. Hayes was using drugs.
But whether that was related to his claim of discovery, his fear of
being at tacked, or even his actual death, Jason couldn't tell.
He was forced to put aside his speculation as the heavy patient load
pushed him further and further behind. the pressure was heightened by a
call from Shirley, who had apparently learned of his visit to Helene.
"Jason," she said with an edge to her voice, ov please don't stir the
pot.
Just let the Hayes affair calm down."
"I think Helene knows more than she's telling us", Jason said.
"Whose side are you on?" Shirley asked.
"Okay, okay," he said, rudely cutting her off as he was confronted by
Madaline Krammer, an old patient who had been squeezed in as an
emergency.
Up until now her heart condition had been stable. Suddenly she was
presenting swollen ankles and chest rales. Despite strong medication,
her congestive heart disease had increased in severity to the point that
Jason insisted on hospitalization.
"Not this weekend," Madaline protested. "My son is coming from
California with his new baby. I've never seen my granddaughter. Please!"
Madaline was a cheerful woman in her mid-sixties with silvergray hair.
Jason had always been fond of her, since she rarely complained and was
extraordinarily grateful for his ministrations.
"Madaline, I'm sorry. I wouldn't do this unless I thought it was
necessary.
But the only way we can adjust your medications is with constant monitoring."
Grumbling but resigned, Madaline agreed. Jason told her he'd see her
later, and left her in the capable hands of Claudia. By four P. m.,
Jason had just about caught up to his appointment schedule. Emerging
from his office, Jason ran into Roger Wanamaker, whose impressive bulk
completely blocked the narrow hallway.
"My turn," Roger said. "Got a minute for a chat?"
"Sure," said Jason, who never said no to a colleague. He led the way
back to his office. Roger ceremoniously dropped a chart on his desk.
"Just so you don't feel lonely," he said. "That's the chart of a
fifty-three-year-old executive from Data General who was just brought
into the emergency room deader than a doorknob. I'd given him one of our
full-scale executive physicals less than three weeks ago."
Jason opened the chart and glanced through the physical, including the
EKG and laboratory values. The cholesterol was high but not terrible.
"Another heart attack?" he asked, flipping to the report of the chest X
ray. It was normal.
"Nope," Roger said. "Massive stroke. The guy had a seizure right in the
middle of a board meeting. His wife is madder'n hell. Made me feel
terrible. She said he'd been feeling crummy ever since he'd seen us.
"What were his symptoms?"
"Nothing specific," Roger said. "Mostly insomnia and tension, the kind
of stuff executives complain about all the time."
"What the hell is going on?" Jason asked rhetorically.
"Beats me," Roger said. "But I'm getting a bad feeling-like we're on the
edge of some kind of epidemic or something."
"I've talked with Madsen in pathology. I asked him about an unknown
infectious disease. He said no. He said it was metabolic, maybe
autoimmune."
"I think we'd better do something. What about the meeting you
suggested?"
"I haven't called it yet," Jason admitted. "r In having Claudia pull all
my physicals over the last year and checking to see how the patients are
doing. Maybe you should do the same."
"Good idea."
"What about the autopsy on this case?" Jason asked, handing the chart
back to Roger.
"The medical examiner has it."
"Let me know what they find."
When Roger left, Jason made a note to call a meeting of the other
internists early the following week. Even if he didn't want to know how
widespread the problem was, he knew he couldn't sit back and watch while
patients with seemingly healthy checkups ended up in the morgue.
Enroute to his final patient, Jason found himself again thinking of
Carol Donner. Suddenly getting an idea, he made a detour to the central
desk and found Claudia. He asked her to go down to personnel and see if
she could get Alvin Hayes's home address. Jason was confident that if
anybody could do it, Claudia could.
Once again heading for his last outpatient, Jason wondered why he'd not
thought of getting Hayes's address sooner. If Carol Donner had been
living with the man, it would be vastly easier to talk with her at her
apartment than at the Club Cabaret, where they obviously felt rather
protective.
Maybe she'd have some ideas about Hayes's breakthrough, or if nothing
else, his health. By the time Jason had finished with his last patient,
Claudia had the address. It was in the South End.
Cook,Robin - Mortal Fear.txt Page 10