Error in Diagnosis

by Mason Lucas M. D.

  “We’re not telling other hospitals what to do. They’re free to go ahead with antiviral therapy.”

  “Without my lead and the support of Southeastern State? That’s never going to happen.” He threw his hands up in the air and leaned forward over the edge of Helen’s desk. “And, to make matters worse, we’re subjecting these patients to a dangerous form of never-before-tried therapy that makes Vitracide look like a mild laxative. I’m going to speak to every board member, and when I do, my official position will be that changing Southeastern State’s recommended treatment plan without even discussing it with them was unconscionable and a flagrant breach of medical ethics.”

  Helen held up a calming hand. “I’ve spoken to every board member and given them my opinion. Because of the new circumstances, they have instructed me to proceed as I see fit.”

  “Even if that means—”

  “I’m the dean of this medical school, Hollis, and I believe there’s sufficient scientific merit in Jack Wyatt’s theory to justify waiting a little longer before initiating Vitracide therapy.”

  “I advocate the use of an FDA-approved drug and I’m called a medical heretic. Wyatt and his girlfriend propose an experimental operation with no scientific basis and you tell me it makes sense to you. Pardon me for being a little grumpy regarding your sense of fairness and request for my support.”

  “I’m sorry you feel that way, but my decision’s final. We’re going to give Tess Ryan a reasonable amount of time to show signs of recovery before beginning your program of Vitracide.”

  “What’s a reasonable amount of time?”

  “A few days. And, as I’m sure you know, Mike Ryan has given his complete consent and favors waiting as well.”

  “If Mr. Ryan wants to consent to a misguided private medical experiment and turn his wife into a guinea pig, that’s his choice. But in my opinion this is a page right out of Dr. Josef Mengele’s diary.”

  “Your concern for the safety of Tess Ryan is duly noted.”

  Sinclair’s face tightened with rage. “Every day brings more deaths from this disease. Supposing, while we’re waiting to see if this ridiculous treatment plan works, other patients deteriorate and we lose the one opportunity to cure them and their babies. How will you be judged then?”

  “I’m not saying we should be inflexible. If there’s good reason to proceed with Vitracide sooner, that’s exactly what we’ll do. In the meantime, let’s hope Tess Ryan improves.”

  With a defiant snicker, he said, “You’re wasting your time. That’s never going to happen. She’s a dead woman.”

  “Hollis, as your dean, I’m again asking for your support on this.”

  “That’s not going to happen. I’m not going to dismiss the oath I took just so that I can be politically correct. Any further delay in beginning Vitracide puts our patients in grave peril.” He pushed back in his chair. “I’m sure you’re aware there’s a strong feeling amongst many of the medical staff that Dr. Wyatt’s presence at Southeastern State has been extremely disruptive. Just because his best pal’s an important donor doesn’t mean inviting him here was a wise or appropriate thing to do. He should have been thanked politely for his services and then asked to leave days ago.”

  “It was my decision to invite Jack Wyatt to Southeastern State. If you or anybody else on this faculty has a problem with that, then I recommend you submit a formal complaint to the board and we can handle it as prescribed by due process.”

  Making no effort to conceal his smirk, Sinclair started for the door. “I don’t care what the board members told you informally. I’m going to insist on an emergency meeting. Let them look me in the eye and tell me they’re willing to let thousands of women die needlessly.” Without waiting for a response, he marched out of her office.

  Feeling a tight lump forming at the top of her stomach, Helen pressed her palms to her eyes. She opened her desk drawer, pulled out one of her chewable antacid pills and popped it in her mouth. After a minute or so, she reached for the phone. Anticipating Sinclair’s next move, she dialed the president of the university.

  83

  The hospital coffee shop was only about half-filled. When Jack walked in, he was a few minutes early for his meeting with Special Agent Westenson. He spotted a table toward the rear of the shop and sat down. A minute or so later, he saw Westenson and Barbier walk through the door.

  “We apprehended the suspect this morning,” Westenson said. “I wanted to come over and thank you in person for your help.”

  “I appreciate that, Mr. Westenson, but other than to inform you about the call, I really didn’t do very much.”

  “It was your call that led us to him,” Barbier said. “We knew he was in South Florida, but we didn’t know exactly where. He had acquired a significant number of forged documents, which would have made locating him a nightmare. We knew why he was here so we figured he’d attempt to draw you or Dr. Sinclair out.”

  “No offense intended, but what was your plan if he decided just to wait outside the hospital and shoot me?”

  “That probably wouldn’t have worked. You see, Dr. Wyatt, you’ve been under pretty tight surveillance for the past several days.”

  “He was very convincing on the phone. If you hadn’t warned me, I probably would have met him at his hotel. If you can share the information with me, I’d be interested in knowing who he turned out to be.”

  “I can’t tell you very much. Suffice it to say he’s a highly trained scientist. Unfortunately, he’s also criminally psychotic. For reasons yet to be determined he became wildly delusional about GNS to a point that he believed he had masterminded every detail of the outbreak. From what we can decipher from his notes and computer files, he believed he was working for Russia as a bioterrorist.”

  “The first time we spoke, you didn’t give me too many details. Why do you think he was after me?”

  “We didn’t at first, but we did have strong reason to believe he intended to kill Dr. Sinclair. I met with Dr. Sinclair the same day you and I spoke. I made the same request of him that I made of you.”

  “And?”

  “He told me the entire FBI was out of their collective minds for pursuing a bioterrorism possibility. A few days ago, we discovered Vosky had managed to penetrate hospital security and get into the crisis center. He was in the room when your team met to discuss the state of your research on the flu vaccine. It wasn’t too hard to figure out why he became focused on you as the person who would destroy his plans to continue to spread GNS.”

  After Barbier and Westenson left, Jack returned to the ICU. In all honesty, he had never given much thought to his conversation with Westenson at the restaurant. As soon as he reported the call to Westenson, he dismissed the entire matter from his mind. Jack was pleased the man was in custody, but unfortunately, his incarceration would do nothing to stem the rising death toll from GNS.

  84

  DECEMBER TWENTY-FIRST

  NUMBER OF CASES: 8,004

  NUMBER OF DEATHS: 41

  Helen Morales’s first order of business after returning from lunch was to place a call to the surgeon general. For the better part of an hour, she briefed Brickell on the medical and political state of things at Southeastern State and their probable impact on the rest of the country.

  When she was finished, she called Jack and Madison and asked them to join her in Tess’s room.

  “How’s she doing?” Helen asked

  “About the same,” Madison answered. “No signs at all of improvement as yet, I’m afraid. But’s it’s only been twenty-four hours.”

  She turned to Jack. “How’s Mike holding up?”

  “Poorly.”

  Helen pressed her palms together. “Needless to say, Hollis Sinclair is still pretty angry.”

  “What a surprise,” Madison said.

  “He’s made sure all the hospital board membe
rs know that he will be the one directing the national program of Vitracide treatment and that Southeastern State University School of Medicine would be recognized as the key player in the cure of GNS. He’s certainly intimated that he will be closely involved in deciding where and when the drug will be distributed.”

  “Is there a specific reason that Jack and I haven’t been asked to attend any of these meetings that seem to be taking place every two hours?”

  “There are several,” Helen answered flatly without further explanation. As far as Jack was concerned, none was needed. “Let me fill you in on where we are now. At least through Christmas, we’ll be making no changes in the treatment plan. If Tess fails to show any signs of recovery, we will officially endorse a program of Vitracide therapy under the direction of Dr. Sinclair.”

  “I’m not sure another few days is enough time to start seeing improvement,” Jack said.

  “Unfortunately, that’s all the time we’ve got,” Helen stated again. “A little while ago, I called the surgeon general. She’s on board with the plan. She’s going to speak with the president later, but she thinks he’ll be comfortable waiting as well.”

  “Did she have a sense of what the rest of the medical community in the country is thinking?” Jack asked.

  “There’s still controversy, but there’s no question that most hospitals and physicians are feeling the pressure to start Vitracide. As much as I hate to say it, Hollis has done a yeoman’s job of rallying support for his parvovirus theory.” She looked down at her watch. “I’ve got to get going. Please call me immediately if there are any changes in Tess’s condition.”

  Jack shuffled his feet and then rubbed his temple. He still believed the key to curing GNS was removing the thyroid. But he had dealt with enough neurologic diseases in his career to realize the recovery time for many of them took weeks and sometimes even months. Originally, he’d hoped for at least a week following surgery to see if Tess would show signs of recovery. At the moment, it didn’t seem like Helen thought that was going to happen.

  Jack reminded himself to cling to a positive outlook, but he couldn’t deny the obvious—the clock was ticking, and before long Dr. Hollis Sinclair would get his way.

  85

  DECEMBER TWENTY-SECOND

  NUMBER OF CASES: 7,456

  NUMBER OF DEATHS: 52

  The first thing Jack did when he got out of bed was to call the ICU. The nurse caring for Tess reported to him that there had been no change in her condition through the night. He thanked her and told her he’d be in later.

  “No change in her condition,” he whispered. It was a term that most experienced physicians had heard countless times. Sometimes it was reassuring and portended improvement. But, in the case of Tess Ryan, Jack suspected that wasn’t the case. It had only been forty-eight hours since her surgery. Jack knew that wasn’t enough time to declare either victory or defeat.

  After a long shower, he got dressed. He brewed a cup of coffee, walked over to the desk and sat down. Before going to the hospital, he decided to review some of the latest articles he had already read on autoimmune diseases. While they were all of interest, there was nothing specific he could identify that would further help him in speeding Tess’s recovery. He closed the top of his laptop, gathered his things and left for the hospital.

  When he was crossing the lobby, he saw Mike standing at the elevator. He caught up to him before the doors opened.

  “I called before coming over to the hospital,” Mike said. “Her nurse told me she had an uneventful night . . . whatever that means. Do you think she’s any better?”

  “I haven’t seen her yet but it sounds like she’s the same.”

  “I was kind of hoping we’d see some signs of improvement.”

  “It still may be a little early to make any judgments.”

  The doors opened and they stepped inside the elevator. They rode up in silence but as soon as they got off, Mike said, “I’m willing to give this two more days, Jack. If we don’t see . . . at least some signs that Tess is getting better, I’m going to reschedule the C-section.”

  Jack didn’t say anything. He simply nodded. It was obvious both he and Mike knew his statement was definitive and didn’t call for a response.

  86

  Helen Morales sat behind her desk reviewing the agenda for the emergency meeting of the hospital board that was scheduled to take place in a few hours. When Hollis Sinclair had told her he would make sure such a meeting took place, she hadn’t doubted it for a second. She was still looking over the agenda when the beep of her intercom startled her.

  “Dr. Morales. President Carmichael would like to speak with you.”

  “Put her through, and please hold any other calls.”

  “She’s not on the phone . . . she’s here in the office,” Ali said in a voice just loud enough for Helen to hear.

  “I’ll be right out.”

  Donna Anne Carmichael had been the president of Southeastern State University for the past sixteen years. Formally educated and having earned her doctorate in ancient languages, she was a consummate academician, masterful at defining crucial initiatives and rallying people to the cause. Her fund-raising efforts and accomplishments were a model for all university presidents to aspire to.

  Helen greeted Carmichael warmly and escorted her to the couch.

  “I hope you don’t mind me dropping in without calling first, but I thought it might be a good idea if we spoke before today’s meeting. To begin, I want you to know I have supreme confidence in your judgment.”

  “Thank you.”

  “As president, the only higher-ups whom I’m constantly massaging are the university trustees. I’m not generally bombarded with phone calls from the hospital board members,” she explained. “But it’s understandable that this whole GNS thing has left them . . . well, in a prickly mood. Some of them have been persuaded by Hollis Sinclair that Dr. Wyatt’s presence here at Southeastern State has been quite counterproductive.”

  “Jack Wyatt is an outstanding physician with a laudable national reputation. I feel fortunate he agreed to serve as a guest professor. His input has been very helpful. Hollis Sinclair’s a talented physician but he’s been behaving badly for the past week or so. The bottom line is I have no regrets about inviting Jack Wyatt here.”

  “I’m sure you’re aware that there are a number of highly respected doctors on Southeastern State’s medical staff who believe his chimerism–flu vaccine theory is a Hail Mary at best.”

  “I guess that remains to be seen.”

  “Has Tess shown any signs of improvement?”

  “It’s only been a little more than two days since we removed Tess’s thyroid, Madame President.”

  “I’ll take that as a no. What’s your long-term plan?”

  “I’m not sure I have a long-term plan. For now, we’re going to continue to wait for signs of recovery.”

  “Any idea how long?” Carmichael asked.

  “I think that’s up to her husband. As far as the other families are concerned, we can offer them other treatment options.”

  “Dr. Sinclair strongly opposes that idea, and I believe both the trustees of the University and the hospital board members agree with him. And to be honest with you, I’m not sure I don’t as well. We don’t want to come across as desperate and experimenting with people’s lives. Dr. Sinclair insists as long as we’re observing Tess Ryan, it would be a grave error in judgment to proceed with Vitracide.”

  “Are you asking me for a specific date when we should abandon Jack Wyatt’s treatment plan?” Helen asked.

  “Yes, I am. On a national level, Dr. Sinclair’s been by far the most verbal proponent of Vitracide. I think our colleagues across the country are watching us here at Southeastern State waiting to follow our lead.” By her tone and demeanor, Donna struck Helen as a woman who was sensing she was running ou
t of room to maneuver.

  “If we don’t see any improvement in Tess’s condition in the next three days, I’ll support abandoning Dr. Wyatt’s treatment plan and recommend moving ahead immediately with Vitracide.”

  “Shall we say the morning of the twenty-sixth?”

  “Of course.”

  “One final thought: If and when we do begin Vitracide therapy, perhaps that would be an appropriate time for Dr. Wyatt to . . . to resume his responsibilities at Ohio State.” Helen shook her head and splayed her fingers out on the armrests of her chair.

  Carmichael started to get up and Helen followed. “I’ll ask you again. This time just between us girls: Any regrets about inviting Jack Wyatt here?”

  Helen sighed. “I’m not sure. Ask me again in forty-eight hours.”

  87

  DECEMBER TWENTY-THIRD

  NUMBER OF CASES: 9,123

  NUMBER OF DEATHS: 52

  Lying wide-awake in bed, Jack stared overhead at an antique-style ceiling fan. It was six A.M. To say the least, it had been a restless night’s sleep. He had been at Tess’s bedside until midnight before he finally left the hospital and returned to his hotel.

  Tess had shown no real signs of improvement. Watching the fan making the slowest revolutions it was programmed for, Jack tried to convince himself to the contrary. But in his heart he knew her coma was just as deep as the day Dr. Willwade had removed her thyroid gland.

  He threw back the covers and sat on the side of his bed for a minute or two staring aimlessly across the room. Finally, he picked up his phone from the nightstand and dialed the ICU.

  “How’s she doing?” he asked the nurse caring for Tess.