Error in Diagnosis

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Error in Diagnosis Page 17

by Mason Lucas M. D.


  After filling his lungs with the moist salt air, he stuck his hands deep into the pockets of his coat. He took another look around and then got into his rental.

  After a short drive that took him through the center of the city he pulled up in front of a Queen Anne house with a wide porch and gable that were crying out for a couple coats of fresh paint. The driveway was empty. He stepped out of the car. The heavy clouds had faded and were now nothing more than a delicate haze. Barbier walked up the front path of the house and then climbed the three steps to the front door. Shading his eyes with his hand, he attempted to peer through a small glass pane. Even squinting, he couldn’t see a thing. Unable to locate a doorbell, he knocked several times on the arched door.

  “Nobody lives there,” came a gravelly voice from behind him.

  Barbier turned around. A stocky man with a sparse gray beard dressed in stained overalls and a baseball cap was standing on the sidewalk. He walked back down the steps and approached him. He was a stone-faced man of short stature. His unsteady hand reached for the cigarette that drooped from the corner of his mouth. Barbier guessed he was at least eighty years old.

  “Do you live around here?” he asked, showing the man his RCMP identification.

  “As a matter of fact I do. My name’s Martin Daigle.”

  “I’m looking for a man by the name of Eli Steinhoff. Do you know him?”

  “Yeah. He rents the guest house in the back,” Daigle said, pointing down the driveway.

  “How well do you know him?”

  “I speak to him from time to time.”

  “Would you mind answering a few questions about him?”

  Daigle took a second look at Barbier’s identification. The corners of his mouth curled into a slight grin.

  “Do I have a choice?”

  “Let’s just say your country would appreciate your help.” The old man smiled proudly. “Did Mr. Steinhoff ever mention anything about his prior jobs, political views, family . . . anything of that nature?”

  Daigle shook his head slowly. “The few conversations we had were pretty short and boring.”

  “Did he have any regular visitors?”

  “None that I’ve ever seen. He was kind of a loner. He told me once all of his friends and relatives lived in Europe somewhere.”

  “When was the last time you spoke with him?”

  “A couple of days ago. He said he had urgent business outside the country. He told me he wouldn’t be back for a week or so.” Daigle shrugged and then pawed at his stubbly gray whiskers.

  “Are you the . . . the caretaker of the property?”

  “No. I’m the landlord.”

  “You didn’t mention that.”

  “You didn’t ask.”

  “What kind of tenant is he?”

  “He pays his rent in cash and always on time. I got the feeling he had plenty of money.”

  “Really? What made you think that?”

  “His clothes were pretty nice and he drove an expensive car. My father always taught me never to count another man’s money, so I guess I could be wrong . . . but I don’t think so. I’ll tell you one thing, though. He’s a pretty strange fellow.”

  “What makes you say that?”

  “Sometimes, he’d barricade himself in that house for days. And for the last week or so the lights have been on all night. He has about ten different newspapers from the U.S. delivered every day.”

  Barbier again glanced down the driveway. “I’d really like to have a look inside,” he said, slipping his hand into the pocket of his coat and handing Daigle a search warrant.

  “This is official business, right?”

  “Absolutely,” he answered the old man’s irrelevant question.

  “I guess it’ll be okay then,” he said.

  “After you,” Barbier said, gesturing toward the house.

  With a slight limp, the man escorted him down the dirt driveway. When they reached the entrance to the single-story house, he pulled out a key ring. After a few seconds of fumbling, he located the correct key.

  Daigle unlocked the door and pulled it toward him. He reached in and flipped on the lights. They both stood in the doorway, staring into the living room.

  The room was small and had been painted a drab shade of gray. A light but even layer of porous dust covered a set of shabby green drapes. In the center of the room there was a long table. Three desktop computers each with its own monitor occupied the majority of the space. Barbier stopped briefly at the table and quickly examined the computers. They were all shut down and he decided against trying to boot any of them up. He crossed the teak floor. He felt it give just a little with each step.

  The door to the first bedroom was closed, but it was poorly hung and a crescent of light streamed from beneath it. He reached for the handle, pushed open the door and turned on the light. Taking a few steps forward, he stopped in the middle of the room. If Barbier were exploring a gallery of a modern art, he would have called it one of the most intriguing exhibits he’d ever seen.

  Vosky had left without dismantling his scientific workshop. There were still countless papers affixed to bulletin boards and piles of books and scientific journals were festooned across the floor. In disbelief, Barbier walked over to the far wall and began scrutinizing the documents. He had never excelled in foreign languages but he knew enough from his training to recognize Russian when he saw it. Vosky’s handwriting was impeccable, but each line of writing had a slight upward bend to it. Some of the pages were filled with mathematical formulas and equations. Others contained complex graphs, algorithms and long narrative paragraphs.

  After spending time in front of each of the four walls, Barbier walked over to the kidney-shaped desk. It, too, was piled high with scientific books and journals with dozens of bookmarks sticking out from between the pages. He opened each of the five drawers in turn. They were all empty except the middle drawer, which contained a single manila folder. Opening it, he found a couple dozen newspaper clippings that had been cut out with meticulous precision. The articles were from various newspapers across the United States and Canada, but all of them dealt with the same topic—the GNS crisis. At the back of the stack, there was a separate group of articles fastened together by a large paper clip. Barbier removed the paper clip and slowly began thumbing through the articles. To his surprise, they were all from newspapers published in various cities in the U.S. In many of the margins, Vosky had made notes and each time a doctor’s name appeared in the text, he had underlined it in green ink.

  54

  Barbier walked out of Vosky’s bedroom and headed for the front door. He suspected it would take the forensic division of the RCMP days to analyze all the material. He stopped when he saw Martin Daigle standing in the middle of the living room looking past him into Vosky’s room.

  “There’ll be some other agents arriving in the next few hours. I’d appreciate it if you would assist them.”

  “Of course. What is all that stuff in there?”

  “I don’t know but it’s way beyond anything I’d understand,” he answered, escorting Daigle out of the house and back to his car. Barbier did take the time to remind Mr. Daigle that he had assisted him in a highly confidential matter that involved the national security of Canada. He handed him one of his cards.

  “Please call me if Mr. Steinhoff should return unexpectedly.”

  Daigle glanced at the card. “I’m a patriotic man, sir. You can count on me.”

  With his inward grin, Barbier climbed back into his car and reached for his cell phone. He tapped in the number to the director’s office so that he could make the arrangements to get a team out to Vosky’s house to gather up the contents and get them back to RCMP headquarters.

  “It’s Barbier. Would you please see if the director is available to speak with me?”

  “Please hold.”
The director was a compulsive and highly organized man but was rarely available when Barbier called. He was, however, generally good about returning his phone calls in a reasonable amount of time. Barbier knew he couldn’t leave the island until he had heard from him. He figured his best bet was to go into town and get something to eat. Barbier started the engine and pulled away from the curb expecting to hear from his assistant that the director would call him back as soon as possible. He had just pulled away from the curb when she came back on the line.

  “The director will speak with you now. Please hold.”

  55

  DECEMBER SIXTEENTH

  Centers for Disease Control and Prevention

  NUMBER OF CASES: 6,123

  NUMBER OF DEATHS: 24

  Dr. Renatta Brickell had always been a stickler for punctuality. At precisely nine A.M. she called the third meeting of the Presidential Task Force on GNS to order. There were a few new faces at the table but the remainder of the group was the same. At the invitation of the surgeon general, one of the new physicians in attendance was Hollis Sinclair.

  To begin the meeting, Dr. Mary Grandeson from Birmingham brought the group up to date on her investigation into the possibility that GNS was being caused by a toxic skin product. Wright was still in Germany. She had received more than one phone call from him informing her that he was duly impressed with the German group’s cutting-edge research. He couldn’t give her a definite answer, but felt the possibility GNS was being caused by a nanotoxin found in a cosmetic product was real. Knowing how desperate everybody in the group was for encouraging information, Grandeson shared the conversation with them. She finished her comments by assuring the task force her group would diligently continue their work on nanotoxins.

  When Grandeson concluded, Brickell made a special point to thank her before continuing with the meeting’s agenda.

  “I’m sure we all know Hollis Sinclair, who is presently serving as the acting chief of neurology at Southeastern State. As you are aware, he strongly questions the CDC’s feeling that GNS is not a viral illness. I thought it was important to invite him to join us today so that we all might hear his theories firsthand.” She smiled at him and took her seat.

  “Thank you, Dr. Brickell. To expand on what the surgeon general just mentioned, I’m far more suspicious GNS is being caused by a virus than Dr. Cox and his colleagues at the CDC.” He then turned to Mary Grandeson. “And, as compelling and as extraordinary as your work is, Mary, I don’t believe you’ll be able to show that this illness is the result of a toxic nanoparticle or an e-waste product. As many of you already know, I’m convinced GNS is being caused by a new strain of parvovirus. With your indulgence, I’ve prepared a short presentation that will explain how I arrived at that conclusion.”

  Sinclair spent the next fifteen minutes presenting what Jack would call a well-organized argument for his theory. Because the president had lifted the gag order on Isabella Rosas the night before, Sinclair wasted no time informing the group that she was no better and expecting her to recover was a pipe dream at best.

  After he concluded, Renatta Brickell was the first to ask a question.

  “Hollis, I think I speak for many of us in the room when I express my concern that you’ve not been able to identify or grow this new parvovirus in the laboratory from any specimen taken from a GNS patient.”

  “I understand your concern, but we believe in time we will able to grow the virus in the laboratory. The problem is it will probably take weeks, maybe months, which naturally begs the question: Do we have the luxury of waiting that long? From where I sit, the answer’s no. I believe we have enough solid medical evidence to prove GNS is a parvovirus infection.” He looked over at Jack as if he expected him to make a comment on the assertion, but Jack was not so inclined to do so. Sinclair continued, “I’m quite comfortable recommending that a national program of Vitracide therapy be initiated immediately. I would remind everyone that not only are we diagnosing hundreds of new cases every day, but the women we’re presently treating are getting sicker and sicker by the hour.” He shook his head slowly and then in a grave voice added, “Treating these women and their babies with Vitracide is the only hope we have of saving them. To wait any longer would be a medical error of catastrophic consequences.”

  Douglas Fraiser, an epidemiologist from New York, raised his hand. “I completely agree with Dr. Sinclair. I would like to make a motion that this committee inform President Kellar we strongly endorse the use of Vitracide.”

  “Dr. Fraiser, I can assure you the president is keenly interested in any recommendation this committee might make, but please remember we serve in an advisory capacity only. We don’t make policy.”

  “I would be interested in hearing Dr. Sinclair’s thoughts on treating the mother and fetus together,” Madison said.

  All eyes in the room fell on Sinclair.

  “From a medical standpoint, I believe both mother and fetus are infected and need to be treated. On the other hand, I’m not naïve to the complex moral and religious issues involved. I believe we should educate the families and make it clear to them that they have options. Those options should be handled on an individual basis by the families in consultation with their physicians and spiritual advisors.”

  “I’d like to say something,” came a voice from the far end of the table.

  Dr. Carol Quinton from Stanford University raised her hand. Quinton was highly respected and had achieved a praiseworthy list of academic accomplishments during her thirty-year career. She was a woman of short stature who generally spoke in a hushed tone.

  Before addressing the group, she stood up. “It’s well known the majority of errors we make as physicians are those of commission, not omission. In other words, when we screw up, it’s usually because we did something ill-advised as opposed to failing to act. Dr. Sinclair makes a convincing argument that GNS should be treated with Vitracide, but before we agree to a wholesale endorsement of this plan, I urge you to strongly consider the price our patients will pay if we’re wrong. For all we know, a week from now, most of these women could fully recover without any intervention on our part and go on to give birth to perfectly healthy babies.” She shook her head slowly. “Let’s not shoot from the hip because we’re all frustrated. I’m quite familiar with Vitracide. It’s an effective drug but it’s also nasty as hell. It can destroy normal heart tissue after only a few doses.” A guarded look came to her face before she continued. “We shouldn’t kid ourselves: If we do decide to use it, there are going to be some bad results—including deaths to both mother and baby.”

  After the buzzing in the room subsided, Brickell thanked Dr. Quinton for her insightful comments. For the next half an hour, there was considerable debate on both sides. Almost everyone in attendance offered an opinion on the use of Vitracide. Jack didn’t tabulate the votes exactly, but his impression was there were more in favor of recommending the drug’s use than those who were opposed.

  “The president’s well aware that at this time of the year everybody would prefer to be at home with their families and not traveling. He’s asked me to convey his profound gratitude to all of you for attending these meetings.”

  Brickell stood by the door to personally thank each of the physicians as they exited. When the last one had left the room, she returned to the table and sat down.

  “That was an interesting meeting,” she told Julian Christakis.

  “Sinclair seems pretty convinced he’s got the answer to GNS.”

  “Maybe,” she responded, reaching for her cell phone. “But I couldn’t tell if that’s gifted medical intellect or unbridled ego doing the talking. I’m going to call the president.”

  “Maybe we should let some time pass so we can get a better feel for—”

  “I think time is something we’re running out of. You may not have noticed, but Hollis Sinclair was quite perturbed with my failure to provide
him with a blanket endorsement of his plan.”

  “Just how important is it that Hollis Sinclair is perturbed?”

  She grinned at Julian’s naïveté.

  “Hollis Sinclair’s a man consumed with an enormous sense of purpose. Before the sun comes up tomorrow, the president’s going to know every detail of what transpired here today. I can’t predict how he’ll react, but if he gets bombarded with calls from Hollis Sinclair’s allies and we haven’t briefed him, well . . . we both might be looking for a job.”

  “It’s hard for me to believe it’s—”

  She raised her finger to her lips to silence him. “This is Dr. Renatta Brickell. I’d like to speak with the president, please.”

  56

  DECEMBER SEVENTEENTH

  NUMBER OF CASES: 6,823

  NUMBER OF DEATHS: 26

  After yawning and then stretching his arms high over his head, Jack closed his laptop and got up from the desk. He was just about to step out on the balcony to watch the last few minutes of the sunrise when his cell phone rang. It was Marc.

  “There’s been an interesting development,” he told Jack. “Every couple of days I check the National GNS Data Record for late entries. If you recall, there was a single case reported in a small town in Indiana. The patient’s name was Maggie Recino. They transferred her up to Chicago. Initially Ms. Recino’s travel history was reported as negative, but later her mother informed Dr. Cole in Indiana that she was staying in Fort Lauderdale when she learned she was pregnant.”

  “For how long?”

  “About a month. I called Cole. He really didn’t have anything to add, but he did mention he’d called Dr. Sinclair and shared the information about Fort Lauderdale with him.”

 

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