Cook,Robin - Mortal Fear.txt

by Mortal Fear (lit)

  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.