The Chain of Chance

by Stanisław Lem

  “How do you explain this disproportion between the sexes?”

  “Stella’s clinics first became famous as treatment centers for men. Potency disorders, falling hair… Later this was played down, but Stella still has the image of being a man’s doctor. So there’s a very logical explanation for the disproportion.”

  “Still, the fact remains… not a single woman was included among the victims, even though Europe has its share of elderly ladies, too. Does Stella operate any clinics in Europe?”

  “No. The European victims never came into contact with Stella. That’s pretty safe to assume, since none of them had visited the States within the previous five years.”

  “Did you ever consider the possibility that there might be two separate operations—one for the Americans, another for the Europeans?”

  “We did consider that. We compared both groups within the same set, but nothing came of it.”

  “Why did he insist on sending his patients to Naples and not somewhere else?”

  “Very simple. He’s a second-generation Italian, Ms family comes from somewhere around Naples, and he probably stood to make a profit through his connections with some of the local balneologists, such as Dr. Giono. Medical confidentiality prevented our gaining access to the correspondence, but it’s only logical that a doctor on the other side of the ocean would recommend patients to Ms Italian colleagues. At any rate, we didn’t uncover anything suspicious in their relationship. I suppose that for every patient he recommended he received a certain percentage.”

  “How do you explain that mysterious blank letter delivered after Mittelhorn’s death?”

  “I suspect it was sent by a member of Mittelhorn’s own family, someone who was familiar with the circumstances of his death and who was as eager as Mrs. Barbour to see the investigation continued but who, for one reason or another, couldn’t or didn’t want to intervene as openly as she did. Someone who had good reason to believe a crime had been committed and was trying to stir up suspicion so the police would keep the case open. The letter was postmarked Switzerland, where Mittelhorn had a number of relatives…”

  “Were there any drug addicts among Dr. Stella’s patients?”

  “Two, neither of them heavy users and both of them elderly men—one a widower, the other a bachelor. Arrived last year around the end of May, beginning of June, took the baths, sunbathed regularly—in short, did everything that according to the statistics should have exposed them to the maximum danger. But the fact is both returned safe and sound. And I shouldn’t forget to mention that one was allergic to pollen and the other to strawberries!”

  “How disastrous!” exclaimed Barth, but neither of us was in the mood to laugh.

  “You figured it was the allergy, didn’t you? So did I.”

  “What kind of drugs were they taking?”

  “Marijuana in the case of the one with the strawberry allergy. The one with hay fever was taking LSD, but only once in a while. His supply ran out just before he flew back to the States; that’s probably why he quit the baths and left ahead of schedule. In Naples he couldn’t get Ms hands on the stuff. The police had just busted up a huge Middle Eastern ring based in Italy, trafficking had stopped, and the suppliers who hadn’t been arrested were lying low.”

  “And the one with the strawberry allergy…” mumbled Barth. “Well, that takes care of that. What about those with mental problems?”

  “Negative. Oh, you know as well as I do there’s bound to be something in everyone’s family closet, but that would be stretching it too far. All the patients in question—victims as well as survivors—were mentally sound. A few neurotics and insomniacs, but that’s about it. Among the men, that is. Among the women patients we found one case of melancholia, one case of depression associated with menopause, and one suicide attempt.” “A suicide attempt, you say?”

  “One of those false alarms on the part of a typical neurotic. Poisoned herself under circumstances where she was sure to be saved. With the others it was just the opposite: not one of them had gone around proclaiming a suicidal mania. On the contrary, the repeated attempts give evidence of a ruthless determination.” “Why only in Naples?” Barth asked. “Weren’t there any cases reported in places like Messina or Etna?”

  “No. Naturally we couldn’t check out every sulfur spring in the world, but a special group was assigned to investigate the ones in Italy. An absolute blank. There was a case of someone dying of a shark attack, another in a drowning accident.”

  “Coburn died in a drowning accident, too, didn’t he?”

  “Yes, but while temporarily deranged.”

  “Has that definitely been proved?”

  “Almost. We know relatively little about the man. Only that when he was served breakfast that time in his room, he hid his toast, butter, and eggs in an empty cigar box, and later put some food on the window sill before going out.”

  “Of course! He suspected poison and wanted to see if the birds…”

  “And he probably wanted to take the box to a toxicologist but drowned before he had a chance to do so.”

  “What about the experts’ reports?”

  “Two thick, typewritten volumes. We even resorted to the Delphi method of polling the experts.”

  “Well?”

  “The majority argued in favor of some unknown psychotropic drug similar in its effect to LSD, though not necessarily having a similar chemical composition.”

  “An unknown drug? What a strange diagnosis.”

  “Not necessarily unknown. These same experts believe it might be a combination of several known substances, since the symptoms of a synergy can seldom be deduced from the effects of its individual ingredients.”

  “What was the minority opinion?”

  “An acute psychosis of unknown etiology. You know how loquacious doctors and specialists can be when they’re in the dark about something.”

  “Only too well. Would you mind giving me another rundown based on the typology of cause of death?”

  “Not in the least. Coburn died an accidental or premeditated death by drowning. Brunner jumped from a window but survived it—”

  “Excuse me, but whatever became of him?”

  “He’s back in the States, in bad health but still alive. He has a vague recollection of certain things but doesn’t like to be reminded of them. All he can remember is having taken a waiter for a member of the Mafia and the feeling of being constantly shadowed. Shall I go on?”

  “Please do.”

  “Osborn was the victim of a hit-and-run accident. The driver of the car has never been found. Emmings twice tried to commit suicide. Died of a self-inflicted gun wound. Leyge, the Swede, drove to Rome and fell from the Colosseum. Schimmelreiter died in the hospital of natural causes, of a lung tumor, after going berserk. Heyne nearly drowned, then slashed his wrists in the hospital. Pulled through but later died of pneumonia. Swift escaped injury. Mittelhorn also tried to commit suicide twice—once with an overdose of sleeping pills, the second time by consuming iodine. Died of internal burns. Titz was killed in a highway accident. Lastly, Adams died in his hotel room at the Hilton in Rome, apparently from suffocation of unknown cause. The Brigg case is still a mystery.”

  “Thank you. Of those who escaped alive, do any remember the initial symptoms?”

  “Yes. One symptom was a trembling of the hands and a noticeable change in the taste of food. We found that out from Swift. Brunner definitely recalls the food’s having an ‘off taste’ but remembers nothing about any trembling of the hands. His testimony is probably the result of a residual psychic effect. At least that was the opinion of the medical experts.”

  “The cause of death covers quite a spectrum, and the suicide victims always seemed to resort to whatever means was available at the time. Did you conduct an investigation based on the cui prodest principle?”

  “You mean did we investigate those who stood to gain financially? That would have been pointless, since there was nothing in the way
of evidence to connect any of the heirs with the individual deaths.”

  “Any press coverage?”

  “A total news blackout. Of course the local papers ran obituaries on each of the fatalities, but these got lost among all the other accident reports. We were worried they might interfere with the investigation. Only one paper in the States, the name of which escapes me, made any mention of the tragic fates met by the patients of Dr. Stella. Stella himself insisted it was the work of some unscrupulous competitor. Even so, last year he didn’t send a single patient to Naples.”

  “So he stopped! Doesn’t that look suspicious?”

  “Not necessarily. One more incident and the publicity could have cost him more than he stood to make on the deal. He couldn’t have been making very much on the kickbacks.”

  “I now propose we play the following game,” suggested Barth. “We’ll call it ‘How to die a mysterious death in Naples.’ The purpose of the game will be to find out how one qualifies for such a death. Will you help me out?”

  “By all means. The list of qualifications will include a person’s sex, age, build, physical disabilities, financial status, plus some other characteristics that I’ll try to specify. To qualify one would have to be a male in his fifties, rather tall, the athletic or the pyknic type, a bachelor, a widower, or divorced, but in any case single during the time spent in Naples. As is evident from the Schimmelreiter case, financial prosperity is not an absolute requirement. Nor should one know any Italian, or if so, only a smattering.”

  “None of the victims was fluent in Italian?”

  “Not one. Now for the more specific characteristics. To be a candidate one should not be a diabetic.”

  “Is that so?”

  “There wasn’t a single diabetic in the whole series. On the other hand, there were five known diabetics among the rheumatic patients sent to Naples by Dr. Stella, all of whom returned home safely.”

  “How do your experts explain that?”

  “I’m not really sure I can answer that. Some ascribed it to the patient’s metabolism, to the formation of acetone derivatives that might possibly have acted as an antidote, though this was challenged by some of the less distinguished—but in my opinion more honest—experts. Acetone derivatives form in the blood when an organism begins to suffer the effects of an insulin deficiency. But nowadays every diabetic is warned to take his prescribed medicine regularly. The next requirement is an allergy. Hypersensitivity to grass, hay fever, asthma. But then there were people who met all of the above conditions and still managed to escape unharmed. Take the patient with the strawberry allergy, or the one with hay fever.”

  “Single, well-to-do men who took the mineral baths, were athletic in build, suffered from an allergy, and didn’t know Italian?”

  “They even used the same antihistamines as the others, in addition to Plimasine.”

  “What’s that?”

  “An antihistamine with the added ingredient Ritalin. Ritalin is α-phenyl-α-piperidineacetic acid methyl ester hydrochloride. The first substance in Plimasine, Pyribenzamine, neutralizes the symptoms of allergic reaction but causes drowsiness and a diminution of the reflexes. That’s why drivers are advised to take it in combination with Ritalin, which is classified as a stimulant.”

  “You’re quite a chemist, I see!”

  “I’ve been taking Plimasine for years. Anyone who has an allergy is to some extent his own doctor. In the States I used to take an equivalent medication, since Plimasine is manufactured in Switzerland. Charles Decker, the man with the hay fever, was also on Plimasine, yet no one touched a hair on his head—Wait a moment.”

  I sat there with gaping mouth like a moron. Barth stared at me in silence.

  “They all showed signs of baldness,” I said at last. “Baldness?”

  “The beginning stages, at least. Wait a minute. Right, Decker had a bald spot, too… at the back of the head. But that still doesn’t… oh, never mind.”

  “But you’re not exactly bald,” observed Barth.

  “Sorry? Oh, right—I’m not. That was an oversight. But if Decker escaped injury… even though he showed signs of baldness… But what connection could there be between baldness and insanity?”

  “Or between insanity and diabetes?”

  “You’re right, doctor, that’s not a valid question.”

  “Was the question of baldness completely overlooked?”

  “The situation was like this. We compared those who died with those who left Naples unharmed. The question of baldness certainly came up. The problem was that verification was possible only in the case of the victims, since most of the survivors would have been reluctant to admit they were wearing a toupee. Human pride being what it is, this is one area where people tend to be extremely sensitive, and getting people to submit willingly to an on-the-spot examination would have been tricky. Also, it would have meant trying to locate the place where the wig or hair transplant had been ordered, and we simply had neither the time nor the staff for that.”

  “Wasn’t it considered very relevant?”

  “People were divided. Some thought it was a waste of time trying to establish whether any of the survivors was anxious to conceal his baldness, and didn’t see what connection that would have with the tragic fates of the others.”

  “Well, then, if you had taken the hair factor into consideration, why did you act so startled a moment ago?”

  “It was a negative correlation, I’m afraid. What startled me was that none of the deceased had tried to conceal his baldness. Not one of them had worn a toupee or undergone a hair transplant. There are such operations, you know.”

  “So I’ve heard. Anything else?”

  “Nothing—except that all the victims were in the process of going bald and made no effort to conceal it, whereas the survivors included both those who were balding and those with a normal head of hair. A minute ago I was reminded of Decker’s bald spot, that’s all. For a moment I thought I’d stumbled onto something. It wouldn’t have been the first time, either. You see, I’ve been at this for so long that now and then I begin seeing things, phantoms…”

  “Oh, that smacks of magic spells, spirits from the other world… But maybe there’s something to it.”

  “Do you believe in the existence of spirits?” A long and hard stare.

  “It’s probably enough if they believed in them, isn’t it? Let’s suppose some fortuneteller was operating in Naples, someone who went after rich foreign clients…”

  “All right. Supposing there was such a person,” I said, sitting up in my chair, “what then?”

  “Let’s assume this fortuneteller tries to win people’s confidence through various kinds of tricks and séances, gives away samples of some miraculous elixir imported from Tibet, some type of narcotic that makes the client totally dependent on him or is passed off as a cure-all for every conceivable ailment… Now let’s suppose that out of a hundred such cases there are some ten or eleven who rashly consume an overdose of the stuff…”

  “Right!” I exclaimed. “But in that case wouldn’t the Italians have been wise to his little game? The Italian police, I mean? The fact is that in some cases we were so familiar with the victim’s routine we knew exactly when he left the hotel, what he liked to wear, which were his favorite newsstands and even which papers he bought, which cabin he used for changing clothes at the beach, what and where he ate, which opera performances he saw… Now we might have missed such a quack or guru in one or two instances, but not in every single case. No, there never was any such person. Besides, the whole thing sounds too far-fetched. It’s not just that none of them knew Italian; but would a Swede with a university education, a rare-book dealer, and a respectable businessman be likely to visit an Italian fortuneteller? Besides, none of them would have had the time…”

  “Refuted but not defeated. Here goes another wild shot.” He sat up in his chair. “If something had them hooked, then it must have strung them along gently and without leaving a t
race. Right?”

  “Right.”

  “No what else could have hooked them in a purely private, intimate, and casual sort of way but—sex!”

  I hesitated before answering.

  “No. Granted, there were a few brief erotic encounters, but that’s hardly the same thing. Believe me, we did such a thorough background check we couldn’t possibly have overlooked anything as ‘big’ as a woman, a sex orgy, or a brothel. No, it must have been something else, something utterly banal…”

  I was a little surprised by these last words of mine, since I’d never thought of it in such terms before. But it turned out to be grist for Barth’s mill.

  “Banal but lethal… Yes, why not! Some shameful and hidden desire, some secret lust that had to be satisfied… Not shameful to us, perhaps, but something that might have meant a horrible scandal for others if it were ever made public…”

  “The circle has closed,” I said. “Because now you’ve come around to the very same position you forced me to abandon a while ago, namely, psychology…”

  Someone honked outside. Looking very young at that moment, the doctor stood up, peered down below, and shook his finger threateningly. The honking stopped. I was surprised to notice it had already grown dark. I consulted my watch and was shocked to discover that I’d taken up three hours of Barth’s time. I stood up to say good-bye, but he refused to hear anything of the sort.

  “Oh, no, you don’t. First of all, you’ll stay with us for dinner. Second, we didn’t settle anything. And third, or, rather, first and foremost, I’d like to apologize for reversing the roles and grilling you like some examining magistrate. I’ll admit I had an ulterior motive, one not exactly worthy of a host… I wanted to find out certain things—both about you and from you—things I couldn’t get from the files. It’s always been my feeling that only a person can convey the atmosphere of a case. At times I was even out to provoke you a little, to needle you, but I must say you took it very well, though you haven’t nearly as good a poker face as you imagine you do… If there’s any thing that can redeem me in your eyes, then let it be my good intentions, because I’m ready to offer you my services. But let’s sit down until dinner’s served. They’ll ring when it’s ready.”