Natural Causes

by Michael Palmer

  “They are. They’re boiled and drunk as some sort of tea. As you can see, each item has several names. Baldwin recommends them over the standard supplements pregnant women are required to take. She claims a study done in the jungle somewhere proved the herbs are superior to what she calls ‘processed vitamins.’ ”

  “Fascinating. Go on, Andy.”

  “Well, most everyone at MCB thought the Summer girl was the second DIC case at our hospital. She wasn’t. She was the third.” He slid across the letter from the New York medical examiner. “As you will see from studying the hospital records I’ve copied, all three women who got DIC—the two who died, and the one who is still in the hospital—have one definite thing in common besides the fact that they all were MCB patients. All three opted to take Baldwin’s herbal porridge.”

  It was clear from Mallon’s expression that no further explanation was necessary.

  “Does any other obstetrician prescribe these?” he asked.

  “No.”

  “Where does she get them?”

  “From some herbalist in Chinatown. Do you want me to find out who?”

  “Absolutely. There’s no time tonight, though. As soon as we’re done, I’m going to fax these over to Devlin. And don’t worry. No one else will lay hands on those records. Tell me, do you think taking these herbs could have caused that blood problem?”

  “Not by themselves, I don’t. But there are examples—many examples, actually—of an allergy to one substance sensitizing patients to the action of something else.”

  “Give me an example,” Mallon said, scratching notes on a pad.

  “Well, let’s see. A number of antibiotics—tetracycline is probably the best known—cause extreme sensitivity to sunlight in certain patients. The reaction is not completely understood and can be very, very severe. We have no idea which tetracycline users are going to get it. Many don’t. So we just tell everyone who gets put on the drug to stay covered up.”

  “Yes, I remember that now. Have you had a chance to study this list?”

  “I’ve looked it over. None of it makes much sense to me. I tried looking up some of the herbs.”

  “And?”

  “It’s going to take someone with more time than I have, and access to a better library. The various names—scientific, western, Asian—make the whole thing pretty complicated.”

  “The more complicated the better,” Mallon said. “There are potential problems of miscommunication all over the place. Language problems, fouled-up shipping orders …”

  “Lack of consistent dosage control,” Andrew added. “Contamination with other herbs or pesticides.”

  “Scary stuff—especially if any of these herbs has potential effects on blood clotting.” Mallon spent half a minute absently tapping his eraser on the table. “Well, the whole thing would pack more punch if we knew more of the biology,” he said finally. “But until we do, I suspect Devlin will be able to get a few miles out of what we have here. This material has potential, Andy. Big potential.”

  “I agree.”

  “Tell me. What’s your relationship with this Sarah Baldwin?”

  Truscott thought a bit, then said simply, “I don’t have one.”

  “Well, then, do what you can to dig up anything else on her, Andy. Anything at all.” Mallon took two envelopes from his desk. “A reward for your loyalty and for this information,” he said, passing one of them over. “And here’s the letter you requested from the medical director at Everwell. The position it promises assumes that Everwell will be taking over MCB. No takeover, no position. Clear?”

  “Clear.”

  “Good. I like clear. You’re doing fine, Andy. Just fine.” Mallon slipped the material into his briefcase and snapped it shut. “Rather than try to fax all this to Devlin, I’m going to drop it off myself. Sorry to seem as though I’m rushing you out, but my wife is waiting for me.”

  “No problem,” Truscott said as they headed out. “I’m about a week behind in sleep, and I ought to try to get at least a little caught up—especially seeing as how I’m scheduled to meet with Willis Grayson tomorrow morning.”

  “The Willis Grayson?”

  “Yes. Didn’t I mention that? God, that was dumb of me. I meant to tell you about that when I got here, and I got so involved with—”

  “Tell me about what?” Mallon had stopped walking.

  “The girl who survived the DIC, the one who’s still in the hospital—”

  “Yes?”

  “She turns out to be Grayson’s daughter.”

  “What?”

  “I don’t know the whole story, but apparently she’s been living this hippie existence for years as Lisa Summer. Grayson showed up by helicopter this morning. He’s made appointments with every doc who had anything to do with her case.”

  “Why?”

  “I don’t really know. I guess he wants to find out exactly what happened. I’m scheduled to meet with him at eleven.”

  Mallon rubbed at his chin.

  “Do you know where he’s staying?” he asked.

  “Grayson? Nope. No idea.”

  “It doesn’t matter. I can find that out. What kind of shape is his daughter in?”

  “She’s depressed as hell. But medically she’s doing pretty well. Her arm—what’s left of it—is healing nicely.”

  “And she lost her baby?”

  “That’s right.”

  “Willis Grayson’s grandchild.…”

  “Pardon?”

  “Nothing. Nothing.” Suddenly oblivious to Andrew, Mallon snatched up the phone from a nearby desk, called Axel Devlin, and alerted him that a messenger would be by shortly with a special package for him. Then he dialed another number. “Who’s this, Brigitte?… Oh, Luanne, how’re you doing? This is Jeremy Mallon speaking.… Fine, I’m just fine, thank you. Listen, you know the reception?… Yes, well, Mrs. Mallon is there right now, and she’s expecting me. Would you find her please and tell her I’m going to be late. In fact, tell her that if I’m not there by ten I won’t be there at all. Do you have that?… Thank you, Luanne. Thanks very much. I’ll catch up with you later in the week.” He set the receiver down. “I don’t think Mary Ellen would trash seventeen years of marriage over one missed reception,” he said as much to himself as to Truscott. “Listen, Andy, I’m going to stay here and make some calls. You know the way out, yes?”

  “Sure. Are you going to try to contact Grayson?”

  “The man’s got a ton of lawyers, I’m sure. But I doubt any of them are M.D.’s. Men like Grayson want the best. I’ve just got to find a way of educating him as to who, in this type of legal business, the best is. You take care now.”

  Without waiting for Truscott to leave, he hurried back into his office.

  TAKE IT OR LEAVE IT

  by Axel Devlin

  July 6

  Dateline: Crunchy Granola General, a.k.a. the Medical Center of Boston (MCB). At a news conference attended by just about everybody in the city with a microphone, Glenn Paris, a.k.a. California Dreamin’, let the public in on the latest tribulation to befall his once-august institution of healing. It seems MCB obstetrics patients, THREE OF THEM that we know of, have developed a horrible bleeding disorder called DIC. One of those poor souls lost her arm. The other two lost their lives. And all three of their unborn children died before they could be birthed. FIVE DEAD; ONE MAIMED. This is serious stuff, my friends. Serious and terrifying as hell.

  Always image conscious, Paris yesterday staged a smooth and appealing show, the purpose of which was to assuage public concern over this sudden lethal epidemic. M.D.’s gave medical explanations. Paris promised an immediate investigation by the epidemiology section of the Centers for Disease Control in Atlanta. And last but far from least, herbalist, acupuncturist, and obstetrician Sarah Baldwin, M.D., explained how she had leapt into the breech with her trusty acupuncture needles to save the life of the latest DIC victim.

  Well, it turns out that there was one fact that neither Dr.
Baldwin nor Mr. Paris chose to share with the public—one potentially crucial thing that all three afflicted women had in common. They had all taken a special HERBAL PRENATAL SUPPLEMENT concocted by Dr. Baldwin herself. It’s made up of nine different herbs and roots with names like elephant sleeper and moondragon. The good doctor recommends it to all her clinic patients in place of tried and true (and FDA controlled) prenatal vitamins. Now two of those HERBAL PRENATAL SUPPLEMENT patients are dead and a third is maimed. Coincidence???

  Well, I ran all this past a pharmacist friend of mine. We are still trying to wipe the astonished look off his face. He now has the list of the roots and herbs in Dr. Baldwin’s potion and has promised to do some research for us all. Meanwhile, even he will not be able to answer such questions as: Where do these herbs and roots come from? Who checks them for contamination? Who checks them for composition?

  Incredible, isn’t it, what can happen when a health institution is allowed to slip farther and farther out of the mainstream of accepted medical care. Well, stay tuned.… And don’t say the old Axeman didn’t warn you.

  CHAPTER 13

  July 6

  SARAH STOOD IN THE OPERATING ROOM BENEATH AN icy, blue-white light. She was delivering an infant by cesarean section before a gallery of observers that included, it seemed, every person with whom she had had any contact over the eventful week just past.

  “Too bad, your baby’s dead,” she said to the patient, whose face was covered with a sheet. She turned to the gallery and bowed. “Too bad, everyone, her baby’s dead. Too bad.”

  Glenn Paris smiled down at her approvingly, as did Randall Snyder and Annalee Ettinger. Alma Young, in uniform, applauded and blew her kisses. Several reporters from the press conference gave her A-okay signs. Others photographed her. Then, with a flourish, she whisked the sheet aside only to see herself. Her eyes were bloody hollows; her mouth was agape in a silent scream of death.

  Sarah awoke shrieking, bathed in a chilling sweat. It was four-thirty in the morning.

  Trembling, she pushed herself out of bed and pulled on her robe. Then she put on some tea and drew a hot bath. She was terrified, she knew, not only by the disturbing content of her dream, but by the fact that she had experienced it at all. For much of her early life, she had been a slave to all manner of nightmares. The most consistent scenario, often recurring as many as two or three times a week, revolved around her being bound, gagged, and totally helpless. From there, on any given night, she would be stabbed repeatedly, beaten, smothered, thrown from a great height, or hurled into the sea. Never in the horrible dreams did she actually see the face of her assailant. On rare occasions, the man—she never doubted it was a man—would burn her with cigarettes. At times the vivid nightmares so haunted her, so dominated her life, that she would simply refuse to go to sleep.

  In her mid-teens, at the suggestion of a concerned teacher, she began seeing a psychologist. It seemed obvious to the woman that some event in Sarah’s past—isolated or recurrent—was at the core of her terror. The therapist did what she could to get at that source. But Sarah’s mother, already drifting deeper and deeper into her dementia, could supply little useful information.

  The psychologist then sent Sarah for a number of sessions of hypnosis, and once even took a day off to drive her to Syracuse for a consultation at the university medical center. Nothing helped. Sarah simply could not connect with any event in her childhood that could have sparked such bizarre and debilitating fantasies.

  During college, the disturbing dreams seemed to come less frequently, but they were no less terrifying. She tried another course of psychotherapy and hypnosis, and even consented to take some sort of pill designed, her physician said, to alter the neurologic pattern of her sleep. What the drug altered instead was her grade point average, which dropped that semester from a 3.8 to a 2.9.

  Eventually peace did come for her. The answer lay in the simple mountain people whom she had traveled halfway around the world to help. In a village in the foothills of Luang Chiang Dao, just a few miles from the Burmese border, Dr. Louis Han, placed her in the hands of a healer—a wizened, stoop-shouldered man, who was, Han said, over 110 years old.

  The healer, speaking a dialect of Mandarin that Sarah could not understand, communicated with her through Han. Whether her nightmares were grounded in a past event, or perhaps even a future event, was of no consequence, he said. What mattered was that at the time of sleep, she was not at ease. The spirit that guided her throughout each day remained locked within her. The devastating dreams were nothing more than that day spirit, expressing anger at being detained and demanding a clean separation from her so that it, too, might rest and renew.

  All Sarah need do to end the nightmares, the old man promised, was to spend some quiet, contemplative time at the end of each day, first embracing her guiding spirit and then releasing it.

  Not even Louis Han knew the exact nature of the tea the healer brewed for her that night. But Sarah drank it willingly and soon drifted off to sleep. When she awoke, two days later, she knew the day spirit within her, an elegant, pure white swan.

  Each night from then on, she meditated before going to bed, often actually seeing her swan take flight. Her days, even the most trying ones, began ending peacefully. And the vivid nightmares that had defied her and so many physicians had never recurred—not until tonight.

  The hot water supply in Sarah’s building, which later in the morning would be inadequate even for a decent shower, was plentiful at such an early hour. Sarah kept the tub filled with a slow, hot stream until she trusted her shivering was gone for good. Things happen for a reason, she reminded herself. The belief was one of the pillars on which she had built her life. Things happen to teach us or to send us off in other, more important directions. By the time she toweled off and slipped into her robe, the message in her nightmare—two of them, actually—seemed quite clear.

  Understandably, but quite unacceptably, she had begun allowing the demands of work to override her life. Her periods of meditation and reflection had grown brief and generally ineffectual. The connection with her spiritual self was all but gone. She was paying less and less attention to Sarah, trusting more and more that her work on behalf of others was enough to provide her with the strength to deal with each day. The nightmare was telling her otherwise.

  It was telling her something else as well: She had made more than enough appearances on center stage. Lecturing to educate medical students and other residents was one thing; providing news footage was quite another. From this morning on, she resolved, it would be back to basics and back to business. No more cameras, no more interviews.

  She padded over to the window. The first streaks of dawn glowed against a dull, slate sky and shimmered off a misty rain. One other positive thing her nightmare had given her was some extra time before work. Time to get centered, to regain perspective. Beginning tomorrow, she resolved, when she wasn’t at the hospital, she would set her alarm to awaken her twenty minutes earlier. She put on a tape of ocean sounds, set a large pillow on the floor, and eased down into a lotus position.

  Please let me do the right thing today, she thought, settling herself with a few deep breaths. For my patients and myself, let me do the right thing.

  Her breathing slowed and grew shallow. The tightness in her muscles began to disappear. Her thoughts grew more diffuse and less distracting.

  Then the telephone rang.

  The fifth ring told her that her answering machine was not turned on; the tenth, that the caller was determined—or in trouble. Betting a hundred to one that it would be a wrong number, or worse, a crank, Sarah crawled over to the phone by her couch.

  “Hello,” she said, clearing some residual sleep from her throat.

  “Dr. Baldwin?”

  “Yes?”

  “Dr. Baldwin, this is Rick Hochkiss. I’m a stringer with the Associated Press, and I was at the news conference you gave yesterday.”

  “You are extremely thoughtless and rude to
be calling at this hour.” She debated simply hanging up. “What do you want?” she asked finally.

  “Well, for starters, I’d like your comments on the accusations made about you in Axel Devlin’s column this morning.…”

  • • •

  Lisa Grayson sat before the pop-up mirror in her tray table, trying as best she could to do something with her hair. In minutes her father would be making his third visit to the hospital. This time she was ready to see him. She had made the decision the night before. But not an hour ago, a messenger had delivered a gold necklace bearing her name in elegant script, with a diamond chip dotting the “i.”

  Had that been all—had her father continued to show no insight into who she was or what was important to her—she might well have decided to send him away once again. But with the gift was a note. It was written on stationery her mother had commissioned years before, featuring an etching of Stony Hill, their home. Lisa set her brush aside and studied the picture, wondering if her room had been changed at all. Then she reread her father’s words.

  DEAR LISA,

  I know that you are angry with me for things I did that hurt you. I’m sorry, very sorry that I did not take the time to understand you better. I need you. Please forgive me, and come back into my life. I promise this time it will be on your terms.

  I love you,

  DADDY

  I’m sorry. Five years. Five years gone from their lives together. If only he had understood that those were the only words she needed to hear. I’m sorry.… I need you. Lisa touched the bandage covering what remained of her arm. Now she needed him as well. Perhaps she always had.

  The telephone interrupted her thoughts.

  “Hello?”

  “Lisa, it’s Janine at the nurses’ station. Your father’s here again.”

  “Good. It’s time. Could you please send him back?”

  When Willis Grayson knocked and entered her room, Lisa was on her feet, facing him. He held a rose in one hand and a newspaper in the other. He stood in the doorway for a time, getting a sense of her; then he tossed the paper and flower on the bed and rushed to embrace her.