In Latham’s arms, Drew’s head suddenly turned to the side, and his mouth gaped open in a grotesque parody of a yawn.
“That’s the other thing I need to mention,” Latham said. “From time to time, he’ll do that. It’s a residual behavior related to his illness. It’s not uncommon and will probably resolve itself in a few months.” He put Drew on the floor. “So, if there are no further questions . . .”
Sarchi and Marge said nothing.
“Then I’ll say good-bye.”
SARCHI WALKED BY the big Christmas tree that had been set up in the hospital lobby long before any other decorations had appeared in Memphis. As she passed, a woman in street clothes walking in the opposite direction glanced at it and commented to her friend. “I guess now they’re gonna make Christmas a permanent holiday.”
Abruptly, eyes and a big red mouth appeared out of the voice-activated tree’s branches. And it spoke. “Hello, there. I hope you’re havin’ a nice day, ’cause I sure am.”
The two women nearly jumped out of their clothes in surprise.
“Would you like to hear a song?” the tree said.
“No, damn it, I wouldn’t,” the woman who’d activated the tree said.
Smiling, Sarchi headed for the cafeteria, where she picked up a Caesar salad and queued up at the cash register behind Mel Pierce, the neurologist she’d questioned about the ansa lenticularis.
“Doctor Pierce, haven’t seen you in a while.”
“I’ve been at a conference in France.”
Pierce was in his mid-forties. He had a high forehead, small eyes, and thin lips, a cold face that made it difficult to picture him with a personal life. But then it was hard for Sarchi to imagine herself with one.
“How’d your nephew come out at that clinic in New Orleans?” he asked.
“He’s cured—running, walking, talking. Except for one small residual tic and a couple of incisions where they made burr holes in his skull, you’d never know any of that happened.”
Pierce paid the cashier and waited while Sarchi did the same.
“Could we talk more about this?” Pierce asked. “I know we spoke briefly about it a week ago, but I’d like to hear the details again of the diagnosis and treatment and more about the boy’s present condition.”
“I’d be happy to tell you what I can.”
They found an empty table, and Sarchi related what had taken place over the past few weeks, finishing with a comment on Drew’s yawning tic. Pierce was the most intense listener she’d ever encountered. When she finished, he said, “You say this apparent yawn is not held like a real yawn, but is cut short and there’s a straining of the muscles?”
“Right. What do you think?”
“This treatment the boy had—has the surgeon written anything about it for publication?”
“Said he’s been too busy.”
Pierce lapsed into thought, the tines of his fork tapping at his fish. “How long has it been since the boy came home?”
“About a week. I’m taking the clips out of his incisions tomorrow.”
“Is the tic changing in frequency?”
“It’s about the same as it has been.”
“Which is how often?”
“It’s variable—maybe five or six times an hour, more if he’s excited.”
“I don’t know if you were aware of it, but that tic is a stereotypical movement associated with Huntington’s disease.”
Sarchi had missed that, but did know HD was a genetically inherited disorder involving degeneration of certain structures of the brain. It was characterized by slow involuntary movements that progressively become more pronounced until voluntary movement becomes impossible. Death inevitably occurs between fifteen and twenty years after onset.
“And I’m sure the boy didn’t have HD,” Pierce said. “That’s one of my particular research interests.”
“What are you saying?”
“I’d like to do another MRI on this boy and see what’s going on now in his head.”
Sarchi was curious enough about that same question to support this proposition when she broached it to Marge, which she did in a phone call to her agency right after lunch.
“Marge, it’s Sarchi. When did you want to bring Drew in tomorrow for me to remove those clips?”
There was a pause, presumably while Marge checked her calendar. “How about four o’clock? That way it won’t break up the whole day.”
“Could we do it at three?”
“If that’s better for you.”
“I had a talk with Mel Pierce at lunch, and he showed a lot of interest in Drew’s yawning behavior.”
“Interest?” Marge said. “What does that mean?”
“He doesn’t understand why it should be happening.”
“He didn’t understand anything when he examined Drew earlier.”
“He’d like to do another series of scans.”
Irritation obvious in her voice, Marge said, “For what purpose?”
“It might explain why Drew has a tic.”
“Do we really care? Doctor Latham said it was going to clear up on its own.”
“This would also help Doctor Pierce with his work—make him a better neurologist.”
“Forgive me for being so selfish, but I don’t care about Doctor Pierce. In the last three weeks Drew has been through enough. Let’s just leave him alone.”
“Would you do it for me?” Sarchi said. “We can schedule it for tomorrow when I take Drew’s clips out.”
“My insurance company is not going to pay for another scan.”
“Pierce will cover the cost from his research grant.”
There was another pause. “Just some scans, nothing more?” Marge said. “No needles?”
“I promise.”
“Where should I bring him?”
“The resident practice clinic across from the hospital, at three o’clock.”
MEL PIERCE POINTED at the scan on the computer. “There’s the explanation for Drew’s HD symptoms.”
On the screen, Sarchi saw a slightly dense track that marked the course Latham’s instrument had followed through Drew’s brain.
“He hit part of the caudate nucleus,” Pierce said. “The caudate contains the medium spiny neurons primarily affected in HD.”
“He hit it? As part of the treatment?” Sarchi asked.
“You said the treatment was to sever the fibers of the ansa lenticularis. I can’t tell if the track reaches the ansa, but he definitely hit the caudate on both sides and left a fair-sized lesion.”
“So he made a mistake.”
Pierce hesitated, apparently weighing his answer. “It’s possible to reach the ansa without going through the caudate. In fact, it’s preferable. It all depends on how you set the coordinates on your stereotaxic device.”
“And he set his wrong?”
Pierce looked at her without speaking, then said, “In my opinion he made a mistake.”
10
“LATHAM TOLD US Drew might be left with some residual behavioral deficits and that they would probably disappear within a few months,” Sarchi said. “But if Drew’s problem was caused by a mistake, Latham’s assurance means nothing.”
“I agree,” Pierce replied.
“Is Drew going to have this thing the rest of his life?”
“It’s hard to say. In time, it could fully resolve. But it’s just as possible it won’t. I wish I could say the odds were distinctly in Drew’s favor, but I can’t. We’ll just have to wait and see.”
The thought that Drew might go through his whole life maimed was horrifying to Sarchi. Kids were so cruel. He’d be taunted mercilessly about it. Drew the spaz. “Hey spaz, we’re over here, why are you lookin’ that way?”
“Better close your mouth spazoid, or somethin’ will fly into it.”
He’d be the last one picked for baseball or basketball, if he could even play those games. What kind of work could he find? Would he be limited to occupations where no one could see him, like some subterranean animal? And could he ever find love? Or would he be so damaged emotionally by the reactions of people to his problem that he would become inaccessible to affection . . . never giving a woman a chance to know him and to love him. The more she thought about it, the angrier she got.
She motioned for Marge to join her and Pierce in the control room, then looked at the scanner tech. “Will you entertain the boy for a few minutes while I speak with his mother?”
“I can do that.”
Marge stepped into the room. “What did you see?”
“Latham screwed up. He damaged a part of Drew’s brain that would never have been at risk if he’d done the operation properly.”
“But Drew is cured.”
“The yawning tic wouldn’t be happening if he’d been more careful.”
“Latham said it would go away.” Marge looked at Pierce.
“The brain in children is very malleable,” Pierce said. “Meaning that it can adjust much better to insult than the adult brain. There’s no way to say for sure what will happen, but I agree that, in time, the tic could disappear.”
“If it doesn’t, you could have the basis for a malpractice suit,” Sarchi said.
“This subject gives me the chills,” Pierce said. “So I’m gonna leave you two alone to discuss it.”
They let Pierce go, then Marge said, “Considering what Latham did for Drew, I hardly think he deserves a malpractice action. Besides, I signed a form waiving the right to sue.”
“I’m not sure that would hold up in court.”
“You sound like you want me to sue.”
“I just want what’s best for you and Drew.”
“Even Pierce agreed that the yawn would go away in time.”
“‘Could go away’ is what he said.” Not wanting to upset Marge, Sarchi decided not to resurrect the entire conversation she’d had with Pierce before Marge joined them.
“Then what’s the rush?” Marge said. “Let’s wait and see what happens.”
IN A WESTBANK mall parking lot, Latham pulled up beside a low-slung black sports car but didn’t get out. He’d been acting uncharacteristically jovial all morning, and now from her own car Lee-Ann saw why.
The door of the sports car opened, and a striking strawberry blonde wearing a shiny pewter raincoat over a cream colored turtleneck and slacks got out. She walked to the passenger side of Latham’s Caddy and got in. Through the rear window of the Caddy, Lee-Ann saw them meet briefly in a kiss, then Latham put the car in gear and headed for the nearest exit to the street.
Trollop. Whore.
The woman was obviously low-bred and easy. She’d probably spread her legs for any man who’d buy her a meal.
But she was also beautiful. It was always the same; the beautiful women get everything. And there was nothing you could do about it if you had bad genes. She’d thought of plastic surgery but knew too many horror stories of operations that went sour, leaving the hopeful patient worse off.
What would it be like to walk past a man and be so attractive he would turn and watch you walk away? Well, don’t worry about it, Lee-Ann, ’cause you ain’t ever gonna have that experience.
What she’d just seen showed her that she’d been right all along. Latham was not worth her love. He was a whoremonger and needed to be punished. But she couldn’t set it up like the last time.
After she’d arranged to meet Greta Dunn to expose him, she’d felt like a Judas. She’d still wanted him hurt, but the prospect of being so directly responsible had made her ache inside. There had to be a better way. A few minutes later, she thought of one.
She was caught up on all of Latham’s billing, and his next operation wasn’t until the day after tomorrow. Even so, she drove back to the office, where she found Julia on the phone with the father of an incoming patient.
When Julia was finished, Lee-Ann said, “Where are the admitting records for Drew Harrison? I need to check something in them.”
Julia went to a bank of file cabinets and found the records, which like those for most of Latham’s kids was quite an armful.
“Is he back from lunch yet?” Lee-Ann asked.
“He said not to expect him before three.”
The image of Latham writhing and sweating on top of his whore flooded Lee-Ann’s vision.
Julia noticed the hard set to her face. “What’s wrong? Did you have an appointment with him?”
“Oh, do I need an appointment now to talk to him?” Lee-Ann snapped. She turned and stormed out. In her black mood, she decided she had never really liked Julia either.
Lee-Ann took Drew’s records to her office and plunked them onto her desk. After a few minutes of staring hot rivets at Latham’s closed office door, she began searching the records for a readable signature.
Finding one a few minutes later, she turned to her computer, logged onto the Internet, and did a search for Sarchi’s home hospital in Memphis. She then went to the hospital’s web page and roamed around, looking for samples of administrator e-mail addresses. With a few of those in her possession, she knew it would be an easy matter to construct the address she really wanted. She then left for the day.
“ANYONE WANT TO see a raging case of triple scabies?” Sarchi asked, coming into the hall of the outpatient clinic where all the residents worked half a day each week. “No takers? Where’s your spirit of inquiry?”
“Ah heard those bugs can jump halfway ’cross a room,” drawled Dave Grant, a second year resident from Houston.
“Well, sure,” Sarchi replied. “I wouldn’t show you the case unless you had quick reflexes.” She turned to her attending, Kate McDaniels, who had just walked in. “Must be something in the air. I don’t think we’ve had a single no-show today.”
“I’ve picked up a bit of news that might interest you,” Kate said.
“Really? What about?”
“The position of chief resident for next year. Koesler’s made his first cut. It’s between you and Rachel Moore.”
“She’d make a good one.”
“Don’t be so damned agreeable to defeat,” Kate said sharply. “There’s nothing wrong with ambition.”
“I just don’t want to get too used to the idea when there’s still doubt about the outcome.”
“Hell, enjoy the prospect. Life isn’t about arrival. It’s about travel. And this is a scenic view out the window. What does it hurt to take a look? Besides, I also heard—and you didn’t get this from me—that Koesler’s leaning distinctly in your direction.”
Without that last comment, Sarchi might not have taken Kate’s advice. But having heard it, she worked the rest of the afternoon with a renewed sense of purpose and a warm glow of satisfaction in her belly.
TODAY HAD BEEN Gail Lanza’s day off from the Campbell Clinic, and she had spent part of it making her famous seven-layer lasagna. Sarchi was aware of this because Carl had invited her to come over at seven for dinner. Carl was allergic to the tannins in red wine, and Gail didn’t like white. So on her way home Sarchi dropped by Buster’s Liquors and picked up a bottle of each.
The crew working on the house next door regularly showed up at first light. Thankfully, though, they were usually gone by the time Sarchi got home, as they were tonight. So far, the place looked worse for their efforts.
She paused on the porch to collect the mail and went inside. Sorting through what had come, she found nothing with her name on it but wastebasket fodder. Linda, however, had received an interesting Orvis catalog, which she briefly thumbed through before putting on Linda’s pile.
; The major order of business before heading to the Lanzas’ for dinner was a long, hot bath. Of less importance, but still on the list, was checking her e-mail. Accustomed to doing many things at the same time, she flicked on the computer so it could boot up while she started the water for her bath.
Returning to the computer a few minutes later, she first checked her personal e-mail account. The initial message there was a reply to a question she had asked the guy setting up the Flint Ridge cave expedition. The remaining three items were obviously spam.
She then navigated to her hospital e-mail account, where the subject heading of the single message waiting for her immediately grabbed her attention. DREW HARRISON. And it wasn’t from Marge. How peculiar. Who would be sending her an e-mail about Drew?
She eagerly opened the message and was rocked by what she saw:
Things are not what they appear at the Latham Clinic. If you haven’t asked yourself why Drew has a yawning tic, do so. To help you with the answer, visit Raymond and Regina Stanhill in Clinton Corners, New York, tel (914) 555-0198. Listen carefully to what they say and think about what you see and hear. Don’t ignore the beginning of it all.
11
SARCHI SAT DUMBFOUNDED, wondering what this message could mean and who could have sent it. The return address bore no name, just a jumble of letters and numbers. From the bathroom, the sound of running water made it hard to think. In a daze, she went to the tub and turned off the faucets.
Returning to the computer, she clicked on the reply box and typed, Who are you? And who are . . .
She brought the original e-mail message to the front and checked the names of the couple mentioned. Her memory freshened, she brought the “reply” box forward and typed, Raymond and Regina Stanhill?
After adding her own name at the bottom, she clicked send. As it departed, she wished she’d also asked how her mystery correspondent knew her e-mail address.
With her reply sent, Sarchi sat reflecting on the possibility that it could be hours or days before she heard back. Or, maybe, she’d never hear. If the author had wanted to be identified, they’d have signed the message.
The Killing Harvest Page 8