The Patient

by Michael Palmer

  “My guess is it’s going to be pretty crazy here tomorrow,” she said, her voice neutral.

  “I think you could say that.”

  His smug expression said he knew he had won. Jessie thought about demanding written proof of the date the HE committee had approved ARTIE. But she knew Gilbride well enough to suspect he could produce such a document even if it belied the truth. And why should she hurt herself, Sara, and her other patients over this, anyhow? she thought. Better to try to do things on her terms—to take the promotion and begin making some discreet inquiries to other neurosurgery departments in the city and around the country.

  “I’ll do what I can to help you out,” she said.

  “Spoken like a true team player,” Gilbride replied.

  CHAPTER 10

  ALEX BISHOP HAD TAKEN A FURNISHED STUDIO IN a clapboard tenement a mile from the hospital. It was midnight, and his shift at the hospital had just ended. On the way back to his room, he stopped at a convenience store for some Diet Pepsi, a dozen Almond Joy candy bars, and several packs of nicotine gum. His last cigarette had closely followed his decision to hunt down Malloche. Until the man was behind bars or dead, no more smokes. That was the deal he had made with himself, and it had been a bear of a promise to keep. Periodic nicotine gum or patches helped keep the craving under reasonable control, but nothing had touched his substitute addiction to Almond Joys, which was now up to five or six bars a day. Each morning he did a hundred push-ups and four times that many sit-ups as penance.

  The tenement was in a fairly tough neighborhood. Bishop headed there half hoping some punks might try to shake him down. He was going through one of those periods when he simply craved action. But he knew this just wasn’t the time. He needed to show whatever restraint was necessary to keep from calling attention to himself.

  Everything was coming together.

  The robot-assisted operation on Marci Sheprow had eliminated what lingering doubt he had regarding Claude Malloche’s choice of a surgeon. The Mist, as some called the elusive, genius killer, was either on his way to Eastern Mass Medical Center, or he was already there. And Carl Gilbride was to be his surgeon. It hadn’t been easy to gather information discreetly on Gilbride, but gradually a picture of the man was beginning to emerge. And thanks to the ignition wire he had loosened on Jessie Copeland’s car, before too much longer, the pieces of the Gilbride puzzle that were missing would be filled in by her.

  What Bishop knew so far was that Carl Gilbride was an empire builder, much like Sylvan Mays had been. He had a humble background, and had begun living above his means as soon as he could. Now, he was an autocrat, forging a department that was already considered among the best in the country. Socially, he and his wife were tight with Boston’s upper crust. Mrs. Gilbride was on the board of the symphony.

  Did Gilbride seem like someone Claude Malloche could buy? Based on the information Bishop had gleaned so far, the answer was unequivocally yes. If the price was right, would he do the surgery even if he knew who Malloche was? That question remained to be answered.

  Getting close to Jessie Copeland was going to help fill in the gaps and also make it easy for him to get a fix on the neurosurgical patients on Surgical Seven and in the outpatient department. Through his offhand inquiries, he had heard nothing but good things about her, and he felt fairly certain from some of what had been said that she was not that tight with Gilbride. In that respect, she was just what the doctor ordered. His initial impression was that she seemed too nice and too feminine to be earning a living cutting into people’s brains. But he had known a number of nice, exceedingly feminine women in the agency who were quite capable of blowing a person’s brains to bits if the job required it.

  It would all have been so much easier if only he had gotten one dependable look at Malloche, just one. But the Mist never did business personally, and when he did come into the open to any extent, he used disguises and very often, substitutes. This time, though, he was nearing the end of the line.

  Bishop’s studio was on the third floor of the rickety four-floor walk-up. He hadn’t slept much since coming to Boston, but still, he was pleased to note, his legs had some spring. He reached his apartment door and had his key in hand when he stopped. The two hairs he had set in place between the door and the jamb were gone. They might have fallen or been blown free, but there was no breeze at this level. His .45 was inside the room, wrapped in a towel beneath a corner of the mattress. There was no way he could have brought it in to work. Running away now would ruin any chance he had to get Malloche. If someone had been in his apartment, or was there now, dealing with the situation immediately was his only option. And the fire escape was his only chance.

  Bishop crept softly up to the fourth floor, then up the narrow flight to the roof. Totally under control, with the arm strength of a gymnast, he swung himself over the roof’s edge, lowered himself onto the wrought-iron fire escape by the fourth floor, and inched down a flight. The curtains to the west window of his apartment were drawn, but he could just make out furniture shapes through a narrow opening between them. The lights were off, but there was some illumination from the south-facing window just over the pullout that was his bed. From what he could see, the place looked empty.

  For five minutes, ten, he remained crouched on the landing, motionless, peering in. Then suddenly he saw movement just to the left of the door. A man, solidly built, arose and went into the john for a minute or so, then returned to his spot. Bishop couldn’t be positive, but it appeared the intruder was carrying a gun loosely in his right hand. He continued observing between the curtains until he felt certain the man was alone. A gun in trained hands versus surprise. Under most circumstances, Bishop knew, he would take his chances with his reflexes and the gun. This time, he had no choice. He might well end up cut to shreds before he reached his target, but the windowpanes were small and the wood framing them was old. Besides, this wouldn’t be the first time he had gone through a window—in either direction.

  He took an Almond Joy from the plastic bag, opened the wrapper, and took a bite, careful as he always was to get the right mix of coconut, chocolate, and almond. What remained of the bar he held on to as he stepped up on the railing of the fire escape. He flipped it against the window lightly enough to produce a sound but preserve some ambiguity. Then he reached up and grasped one of the stairs leading to the fourth floor.

  The intruder warily approached the window. Bishop didn’t wait for him to open the curtains. A feet-first entry would have been safer, but infinitely less effective. Instead, Bishop pulled his uniform jacket over his head and dove straight in. Wood and glass exploded into the room. His head hit the man in the midchest like a medicine ball, while his hand latched onto his wrist. He hyperflexed the joint and the gun clattered free even before the two of them had hit the floor. A sharp elbow to the jaw, followed by a powerful backhand to the opposite cheek, and it was over. Five seconds—maybe six.

  Bishop rolled over the pieces of wood and shards of glass and had the muzzle of the man’s Smith & Wesson .38 jammed up under his chin before his cobwebs had cleared. The intruder was beefy enough—taller than Bishop by a couple of inches, and a good twenty to twenty-five pounds heavier. But he was just a kid.

  “Scoot toward the door!” Bishop snapped. “I don’t want to kill you, but I will if you give me any trouble.”

  When he could reach the switch, he flipped on the overhead light. Kid, indeed! The man looked like a collegiate football player. Twenty-six, tops. He was bleeding from the corner of his mouth and from a fairly decent gash on his forehead that was going to require some stitches. To his credit, or perhaps his discredit, he didn’t seem that frightened. Bishop straightened up and moved several feet away.

  “Stay flat on your back, legs together, arms out,” he said. “Just like a snow angel. Okay, who sent you?”

  “Internal affairs. I wasn’t supposed to hurt you, just talk to you.”

  “Thank goodness for that. And what were you sup
posed to say?”

  “That this is your last chance to come back to the farm.”

  “How did you know where to find me?”

  “They told me you were here at the hospital. I spotted you yesterday and followed you here. Can I get up now?”

  “No. If all you were supposed to do was talk to me, you could have done it there.”

  He took his cell phone and dialed a number in Alexandria, Virginia. Clearly, Mel Craft had been sleeping.

  “Mel, it’s me, Alex. Internal affairs sent someone after me.”

  “Damn. Where is he now? How badly is he hurt?”

  “He’s on the floor of my apartment. Nothing that a few stitches won’t take care of. Christ, Mel, he looks like he’s seventeen.”

  “I’m twenty-eight.”

  “Shut up! Mel, how did they find me?”

  “How do you think? I.A. knows we were partners and what you did for me. Hell, everyone knows. The bastards must have had my phone tapped when I made those calls to Boston for you. I never told them a thing. I didn’t have to. Alex, I told you in D.C. If they want you, sooner or later they’ll get you.”

  “Not with this kind of punk, they won’t. Mel, talk to them. Tell them I let Dennis the Menace here off with nothing more than a scolding. Tell them I need to be left alone for two weeks.”

  “I’ll tell them, Alex, but I can’t make any guarantees. And Karen and I are leaving first thing in the morning for ten days in Brazil. I’ll do what I can before I go.”

  “Right now.”

  “Okay, right now. Alex, the last five years have changed you—hardened you in ways that no one who knows you thinks are good. You’d be much better off if you’d just let the whole thing drop.”

  “Five hundred people, Mel. That’s how many that bastard or his men have killed. Five hundred. Probably more.”

  “Says you, Alex. Let it go.”

  “Tell them to give me my two weeks, or promise them for me that the next twenty-something they send after me will be shipped back to them in a bag.”

  “I’ll do what I can. I’m glad you took it easy on the kid.”

  “I think he is, too. Have a good vacation, Mel.”

  CHAPTER 11

  CHAOS.

  Two days had passed since the successful surgery on Marci Sheprow—two days of reporters and faxes, telegrams and news briefings and CNN broadcasts. For Jessie, all Carl Gilbride’s triumph had meant was more work. Since her return from Chicago, she had, to all intents, been covering her practice and his.

  The bright spot for her was the embryonic connection that had developed with Alex Bishop. Yesterday, a chance meeting in the cafeteria had led to a half-hour “date” for coffee later that evening. As she had sensed during their ride back through the rain from lot E, there was much more to the man than one might have expected. He was two years older than she was and well past a marriage that had produced no children. While in the Marines, he had finished college with a degree in philosophy and had seen action in the Gulf. He liked the same sort of movies she did and seemed to be better read, although since she left for medical school thirteen years ago, most people were. And to top matters off, his looks were even more appealing to her than they had been that first night. As things were left, they would try to meet in the cafeteria again tonight, same time, same seats.

  Although she hadn’t gotten home from the hospital until almost 1 A.M., Jessie had set her alarm for five o’clock and headed back in. With the exception of two new cases—an elective aneurysm resection for tomorrow, and a pre-op to be done on a tenacious glioblastoma—her service was pretty much as it had been. Tamika Bing was still in her near-catatonic state despite the best efforts of psychiatrists and physical, occupational, and speech therapists. Mrs. Kinchley and Mrs. Weiss were complaining in private about each other to the staff, then each denying she had ever said any such thing when the matter was brought up to the pair of them.

  Of all Jessie’s patients, only Dave Scolari seemed changed. His eyes were noticeably brighter, and he smiled warmly as she came into his room.

  “Hey, Doc, how goes it?”

  “It goes. I stopped by last night, but you were asleep. I see you’ve been getting more mail.”

  She motioned at the cards and letters that were open on his tray table—an interest she hadn’t seen from him before.

  “My mom handles them for me. We’ve started answering some, too. I just tell her what to say and she writes it down.”

  Jessie felt her heart leap. She had seen enough medical miracles to know that faith and attitude were prime ingredients.

  “That’s great, Dave. I’m glad you’re doing that,” she said. “So will a lot of people be when they get your reply.”

  “There’s something else I have to show you,” he said, looking like a kid who had just brought home an unexpected A.

  His jaws tightened into the grimace of extreme effort, and his eyes narrowed with strain. Then suddenly, shakily, his right arm came off the bed. At the same time, his fingers moved. It was subtle—reeds in a gentle breeze. But in neurology, movement of any kind meant intact nerve conduction pathways.

  “I can do the other side a little, too,” Dave said.

  Jessie took his hand in hers, then hugged him.

  “Oh, Dave. This is the best,” she said, wondering if he fully appreciated the mammoth implications of his minute movements. “This is just the best.”

  “That friend of yours, Luis, keeps coming by to see me. He’s quite a guy.”

  “Oh, he is that,” Jessie said. Luis was an artist and Boys Club coach who had taken his life in many wonderful directions since the tragic auto accident that had paralyzed him.

  “After he left, I just decided I was going to do this. I tried for hours. Then, last night, all of a sudden, I could. I haven’t told anyone yet. I wanted you to be the first.”

  “It’s a tremendous step forward, Dave. Just wonderful. Now you’ve got a heck of a lot of work to do.”

  “I’m ready,” Scolari said.

  Jessie sailed through the rest of her rounds. When she arrived back at her office, just after eight, a plump, dowdy-looking woman in her fifties was seated outside in one of the waiting area chairs. It took several seconds before Jessie realized it was Alice Twitchell, one of Gilbride’s office staff. “Quiet,” “competent,” “colorless,” “proper” were the words she had always brought to Jessie’s mind.

  “Hi,” Alice said somewhat sheepishly. “I guess I’m on loan to you from Dr. Gilbride.”

  Now what?

  Jessie unlocked her door and motioned the woman inside.

  “You’re on loan to me?”

  “Dr. Gilbride said that for a while, you were going to help him out screening referrals and handling some of the calls.”

  “He told you that?”

  “He did. In fact, here are some messages and memos to get you started.”

  Alice handed over a stack of papers.

  “I don’t believe this,” Jessie couldn’t keep herself from saying. “I just don’t believe this. Exactly where are you supposed to work?”

  Alice shifted uncomfortably, but held her place.

  “Dr. Lacy’s on vacation for two weeks,” she said. “For now, I’m to be across the hall in his office. The phone people will be here in just a few minutes to add a line to your phone and hook me up with you. Dr. Copeland, I can see you’re upset. I’m sorry. This wasn’t my idea.”

  “I know, Alice. I know. It’s just that I was already working twenty-six-hour days. I don’t know what more he expects me to do.”

  But Jessie did know precisely what Gilbride expected her to do—everything that got in the way of his next press conference or television appearance. She could go to him, ask why she was getting the secretary and the extra work, and why not one of the other surgeons, but there was no reason to bother. Gilbride would have some disparaging remark about each of the others’ ability to get organized and get things done, sandwiched around some smarmy
praise for her. No, he would say, Jessie was the logical choice—the only choice to keep the place moving while he was doing what had to be done. He would be sure to mention teamwork a dozen or so times, and dress it up with reminders of her intimate knowledge of ARTIE, as well as of her impending accelerated promotion. Gilbride was a total jerk, but he was also a damn sly one. Jessie glanced at the first memo.

  “Here, Alice,” she said, resigned, “write a letter to these people thanking them for the donation to the department that they dropped off in Marci’s name, and also for their note. Assure them that the money will go directly to neurosurgical research.”

  “Thank you, Doctor,” Alice said.

  CHAOS.

  The referral calls started at nine and continued unabated for the rest of the day. Pennsylvania, Utah, Canada, London. Private doctors, individuals, even other neurosurgeons. Several frantic patients simply showed up at the hospital, begging for Gilbride’s evaluation. Almost all of them had significant disease. Apparently, Gilbride had also given Jessie’s name to the hospital public relations people. Reporters for a number of lesser-light publications and broadcasting stations were being patched up to her for comment.

  Midway through the day, Gilbride called. By that time, Jessie’s clinic appointment book was filled for weeks, and she had actually begun to book some of those patients in to her surgical schedule before seeing them in order to hold the OR time, anticipating that she would agree with their referring physician that surgery was necessary.

  “So, Jessie,” Gilbride said cheerfully, “I’m down here at Channel Four, getting set for their call-in show. How goes it?”

  “How do you think it goes, Carl?”

  “I spoke to Alice. She says you’re doing fine, and that the cases are rolling in.”

  “Oh, they’re rolling in, all right. We’re very busy. But then again, we were busy before all this started. Carl, these people want you, not me.”