Much better.
“Drew was left in Doctor Latham’s care the required five days. At the end of that period, his mother and I returned to the hospital to find Drew remarkably improved.”
“Cured would be more accurate,” Latham said.
“To me, cured implies a complete return to normal,” Sarchi countered, feeling much more confident. “Drew was not normal. He was left with a behavioral tic.” She turned to the laptop on the left, started Drew’s video, and stepped aside, saying, “This was taken seven days after he came home.”
Pelligrino stood and moved closer. Latham remained seated.
The video began with Drew sitting on the floor and playing with some toy trucks. In the lower corner, a counter rolled off the time. After twenty seconds of normal behavior, Drew twisted his neck and appeared to yawn. To save time, Sarchi hit fast-forward, stopping just before the tic struck again. “He exhibits this yawning behavior about every eight to twelve minutes,” Sarchi said.
Latham interrupted. “Doctor Seminoux, did we not discuss the possibility there might be residual behavioral anomalies after treatment?”
“That’s true.”
“Then why are we here?”
“Because of this.” Sarchi stopped the video, opened the file containing Drew’s post-op scans, and navigated to the appropriate image. “The boy’s yawning tic is a classic symptom seen in Huntington’s disease, a disorder normally produced by damage to the medium spiny neurons in the caudate nucleus. When we scanned Drew’s brain, we found lesions in both caudate nuclei here and here.”
Pelligrino leaned in for a closer look.
While he did that, Sarchi found the comparable scans on the laptop containing the pre-op images. Stepping out of the way, she said, “A comparison of the scans we made before Drew was admitted to Doctor Latham’s care show no such lesions.”
Pelligrino studied the comparison scan Sarchi had chosen for him. Then he looked at her. “How do I see adjacent scans?”
Sarchi showed him how to navigate forward and backward.
After examining all the scans showing the caudate nuclei, he turned to Latham. “George?”
“Lesions in the caudate are part of the treatment,” Latham said in a disgusted tone.
Sarchi’s pulse quickened. She had him. If damaging the caudate was part of the treatment, Stephanie’s scans should show the same thing. But they didn’t. He’d just hung himself.
“This is the first time Doctor Latham has ever mentioned that the treatment involves lesioning the caudate,” Sarchi said. “When we conferred in his office before the operation, he said only that he was planning to lesion the ansa lenticularis, which can be reached without damaging the caudate.”
Pelligrino’s brow furrowed. “So you’re saying . . .”
“He mistakenly damaged the caudate by improper positioning of the coordinates on his stereotaxic device.”
Pelligrino looked at Latham.
“The treatment for this boy involved lesions in both sites. The primary benefit was derived from severing fibers of the ansa. I simply didn’t mention the caudate during our conversation, just as I didn’t discuss a hundred other details associated with the treatment.”
Pelligrino turned back to Sarchi. “Is that the extent of your presentation?”
Round one: Latham.
“No sir, I’m not finished. This next video is of a little girl Doctor Latham treated for the same disorder.” Sarchi ran Stephanie’s loop twice so Pelligrino could see the characteristics of her tic. “The shoulder movement is continuous, the flailing of her arm occurs about every twenty minutes. As you can see, this girl was left with an entirely different type of disorder than the boy. Her tic is more typical of a disorder known as ballismus, which is commonly caused by damage to the subthalamus. Just give me a moment to load her MRI scans.”
Sarchi quickly exchanged Drew’s CD for Stephanie’s in both computers. Another few seconds, and she was ready.
“When we scanned the girl’s brain three weeks after she was returned to her parents, we found bilateral damage to the substantia nigra here and here—damage that, as you can see, is not present in the preoperative scans over here.”
She waited for Pellegrino to examine both sets of scans. When he seemed ready to proceed, she said, “Moreover, if you look closely here, you can see that Doctor Latham also caused damage to the girl’s left subthalamus and here, to her left ventrolateral thalamic nucleus. We believe the lesion in the subthalamus was a mistake and the one in the ventrolateral nucleus was intentional, done to alleviate the symptoms the mistake caused.”
Pelligrino looked down his nose at Sarchi. “You keep saying, ‘we.’ Is that an affectation that really means ‘I,’ or did you develop these theories with help?”
His question caught Sarchi by surprise. She’d expected the burden of the proceedings to shift now to Latham. This delay would give him time to work on his reply. And how should she answer? Pierce had forbade her to use his name. Knowing she was on the edge of trouble, she said, “These conclusions are shared by one of this country’s most eminent neurologists.”
“Who?” Latham asked.
“I can’t tell you.”
“Then how do we know he really exists?” Latham said. “I don’t think he does. No one of that standing would ever arrive at the conclusions you’ve presented with so little knowledge of the paralytic disorders I treat. In my opinion, this is solely a delusion of your own making, a distortion from the mind of a confused, ill-informed trainee.”
“If there is such a person as this neurologist, I would certainly like to have the name,” Pelligrino said. “If for no other reason than to satisfy Doctor Latham’s right to know his accusers.”
“I can’t give it to you.”
“As you wish.” He turned to Latham. “George, my inclination is to stop at this point and let you go back to your work, but before we do that, could you just explain the girl’s scans to Doctor Seminoux?”
“Of course.” He looked at Sarchi. “There are several subtypes of the paralytic disorder in question. Drew had one type, the girl had another. In her case, in addition to severing the fibers of the ansa, it was necessary to ablate some cells in the substantia nigra that were sending out conflicting signals. The lesion you saw in the left subthalamus was from a small stroke she suffered a few days before the operation. In my judgment, the chances of recovery from that damage would be greatly improved by lesioning the ventrolateral nucleus on the same side, which I did.”
Pelligrino gave Sarchi a solicitous look. “You see, everything that was done was in both patients’ best interests. I do appreciate your concern, but as you can see, it was misplaced.”
Attempting to salvage the disintegrating situation, Sarchi groped for an advantage. “Why is there no sign of damage to the ansa in the girl’s post-op scans?”
“It all fades with time,” Latham said. “Some areas fade quicker than others.”
Damn . . . she knew that. “What about—”
“You must excuse me now, Doctor Seminoux,” Pelligrino said. “But I have a meeting. Thank you for coming. I’ll leave you in the care of my secretary. She’ll see you out.”
He and Latham headed for the door.
“Wait. What about the girl’s head wounds? If . . .”
They were gone.
“SO YOU DON’T buy Latham’s explanations?” Sharon McKinney asked, taking half of her assembly-produced tuna sandwich from its little plastic coffin.
Sarchi eyed her own egg salad sandwich with suspicion. “I can’t believe I drove four hundred miles to a city renowned for its food and end up eating this in a hospital cafeteria. No, I don’t buy it. My neurologist contact said there was no evidence of any track leading to the ansa on the girl’s scans, and the location of the access holes in her skull was wrong for an ans
a target. I should have demanded that a neurologist and radiologist be there.”
“It sounds like Pelligrino didn’t want to believe you.”
“He didn’t.”
“Then he wouldn’t have brought anyone else in even if you had demanded it.”
“I guess not.”
“What are you going to do now?”
“As usual, I don’t know.”
“It was a rotten thing Latham did in making sure you didn’t get that chief residency.”
“He’s got a real vindictive streak.”
“That worries me. He warned you to stay out of this, but you didn’t. And now he knows it.”
“What more can he do?”
“Depends on how malicious he is.”
Sarchi’s posture grew defiant. “I’m not afraid of him.” Then she wilted. “Actually, I sort of am. But I can’t let this be the end of it. There’s more to Latham’s clinic than appears on the surface.”
“Because some anonymous person sends you an e-mail saying so?”
“Partly. But I can feel it, too.”
“Assuming you do want to push it further, where would you start?”
Sarchi thought a moment then said, “With you.”
“I don’t get it.”
“Didn’t you tell me you knew someone here at the hospital who used to do the PCR tests Latham ordered for all his patients?”
“Yeah.”
“I’d like to know what Latham was looking for.”
“Why is that important?”
“I’m not sure it is,” Sarchi replied, “but it’s a direction to take. And who knows which thread will unravel the garment.”
“But this guy was just following a protocol. He never really knew what the target was.”
“Is there any way he could get me a sample of the primers they were using? I’ve got a molecular biologist friend who could sequence them.”
“Even if he could get them, why would he?”
“That’s where you come in. You have to give him a reason.”
“You want me to screw him for them? I like it—‘Will fuck for primers.’”
“I hope it won’t come to that, but . . .”
Mouth open in mock indignation, Sharon picked an edge off her sandwich and threw it at Sarchi.
ABOUT THE TIME Sarchi reached Jackson, Mississippi, on her way back to Memphis, a cabdriver in Phoenix was loading Jackie Tellico’s luggage into the trunk.
“Airport?” the driver asked.
“You’re a genius,” Jackie replied.
The driver’s hair was thin and stringy, giving him a passing resemblance to someone in Jackie’s past, so as they got under way, Jackie’s mind went back in time.
“I just don’t understand you,” his mother, Vera, had said from across the table. “I thought French toast was your favorite.”
Jackie had picked at his food, unable to tell her what was wrong because of what might happen to him. “Do you have to go out?”
“Glen is a fine man. He opens doors for me and pulls my chair out and has a very good job making ships that cross oceans and bring people things they couldn’t have otherwise. I thought you liked him.”
“I do. I just . . .”
“What?”
“Can I come with you?”
“Not tonight. But I’ll talk to Glen. Maybe we can have a picnic this weekend. Now eat your dinner. We don’t waste food in this house.”
Jackie managed to choke down all but a few pieces of crust. While Vera cleaned up the table and washed the dishes, he stayed at the table and watched, so mixed-up inside. His mother didn’t smile much, but Glen made her laugh, and that made Jackie happy, when they were all together. But when he was left home, it was different.
Although he was only four, Jackie was smart, and even at that young age he had ideas. Later, while his mother was in the bathroom getting ready to go out, Jackie pulled a chair over to the silverware drawer and climbed up to it. He got a sharp knife from the drawer, then put the chair back in its place.
He carried the knife to his room and went to the closet, where he pulled out the huge Teddy bear Glen had won for him at the carnival. Sitting on the floor with the bed between him and the door so his mother couldn’t see what he was doing if she came in, Jackie slit the seam on the Teddy bear’s stomach and pulled out all the stuffing.
In the bathroom, he could hear his mother’s shower running. He knew that as long as the water was running, he could work without worrying about being caught. When he finished, the bear looked as though it hadn’t eaten in a long time. And there was a huge pile of its insides on the floor.
The water stopped.
A few minutes later, the door opened. “Jackie?”
“Over here, Mom.”
“What are you doing?”
“Playing.”
“With what?”
Not yet schooled in the principles of deception, Jackie had no answer. “Nothing.” He put his hands in his pockets, scrunched his neck into his shirt, and looked nervously at the toy chest, where he’d hidden the bear’s guts.
“Come on, I want to wash your face before Glen gets here.”
When she had Jackie clean enough for company, Vera went into her room to dress. This gave Jackie an opportunity to return the knife to its drawer.
Before Glen arrived, Vera puttered around the small apartment, straightening the doilies on the furniture and putting away all the little necessities of life that won’t stay where they belong. She hummed as she worked, making a sound like a butterfly would if it could sing. It was something Jackie ordinarily loved to hear because it made him feel safe.
But not tonight.
Then, over the humming, another sound. Jackie’s heart froze. They lived at the top of a long flight of stairs that creaked whenever anyone used them. And not all creaks were the same.
Uncle Mox.
The steps grew closer, the creaking louder. A knock at the door. While his mother went to answer, Jackie hid behind the bulbous leg of the dining table.
“Hello, Mox,” Vera said. “Punctual as usual.”
Mox wiped his shiny forehead with his handkerchief. Even in winter when the stairwell was so cold you could see your breath in it, the climb made Mox sweat.
“Jackie’s my favorite nephew,” Mox said. “I wouldn’t want to be late. You might get somebody else to sit him. Where is he?”
“Jackie, Uncle Mox is here.”
The stairs began to creak again.
Glen.
It was obvious from the look on Vera’s face that she wanted to throw the door open and run to meet him. But she waited discreetly for his knock.
“Hello, Glen. You know my brother, Mox.”
Jackie wanted to see Glen, too, but while his mother told Mox where they were going and when they’d be home, Jackie slid from the room.
A few minutes later, he heard his door open. “Jackie, my boy, it’s Uncle Mox. You can’t hide from me.”
It was true. He’d tried many times but was always found. There just weren’t any good hiding places in the small apartment. But today would be different.
Mox looked under Jackie’s bed then turned and crept up to the toy box. “Could it be Jackie’s . . . in here.” Mox threw the lid up and stared for a moment at the fill from the Teddy bear, wondering what it was. He thrust his hands into it and felt around. No Jackie.
He went next to the closet and opened the door. On the floor of the closet, the eviscerated Teddy bear lay on its belly, Jackie inside, trying not to breathe too hard.
Mox looked at the bear briefly and shut the closet door. He’d found Jackie once behind the laundry detergent under the sink. Maybe he’d gone there again. He stepped into the hall before
it hit him—that crap in the toy box . . .
Mox went back into Jackie’s room, walked to the closet, and opened the door. “Such a clever young man,” he said, grabbing the bear’s leg and pulling the animal into the bedroom. By the time he’d shucked Jackie out of the bear’s skin, he already had his zipper down.
At those moments, Jackie had wanted to be someone else, someone Mox didn’t know.
Because you couldn’t hide from Mox.
Well, fuck you, Mox, Jackie thought in the cab’s backseat. Even the FBI can’t find me now.
Jackie was not only reliable in the field, he was flexible. It had been less than three hours since the call had come in telling him of a problem that needed attention. It was one of the reasons why he was so highly paid.
To be that untraceable and still be reachable required planning. Jackie worked it by renting a room in a fleabag flophouse using a phony name. There he kept a custom-made telephone that automatically forwarded any call that came in to that number to a similar phone in another rooming house. The second phone then would relay all calls to Jackie’s cell phone, which of course was billed to one of his fake identities. If anyone tried to open either of the relay phones or tap the line to determine the number they were defaulting to, the relay mechanism would disengage.
The cab pulled up at the Delta entrance to the terminal, and Jackie got out. Because the cabby reminded him of Mox, he didn’t bother tipping him. A baggage handler came for Jackie’s luggage.
“Just the big one.”
“Yessir. Where are we going today?”
“Memphis.”
15
SARCHI GOT HOME a little after eleven p.m., so exhausted she covered the last two steps to her bed already asleep. Later, in the predawn hours, when the air was still and the night so quiet time was marked by the tick of an occasional acorn falling onto the dry leaves under the neighborhood trees, a car came down the street and stopped in front of her house. It remained for no more than a minute while the driver studied the surroundings, then moved on.
The next day, feeling as though she was on some planet with twice the gravity of earth, Sarchi used the elevators even when she only had to go up one floor.
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