by G. H. Ephron
“So?” MacRae growled when I called him from my office the next morning. “Every man I know carries a wallet in his pants pocket.”
“And credit cards in his wallet? Were there any in Dr. Philbrick’s wallet?”
MacRae grunted that there were.
“He wouldn’t have gone near that MRI system with those in his pocket. The magnets would have wiped them clean.”
There was silence as MacRae chewed on that.
“Dr. Philbrick was a fastidiously careful technician,” I said.
“We’re waiting for the results of a tox screen,” MacRae said.
Sounded as if he was a step ahead of me. If Philbrick had been drugged or drunk, that could explain why he’d forgotten to remove his wallet before he went into the scan room.
“Lab’s got a perfect safety record. You think they’re reporting every incident?” He dangled the question like a piece of bait. From his tone, seemed as if he already knew the answer.
“I witnessed an incident. A near miss. Someone brought a good-sized test magnet into the scan room. Dr. Philbrick went ballistic.”
“Him and the magnet,” MacRae said.
A comedian. Now he was waiting for the punch line. Reluctantly I gave it to him.
“It was Dr. Ryan who brought in the test magnet.”
“Uh-huh,” MacRae said. “You’ll call me if you think of anything else I should know,” he added with more than a touch of irony. “By the way, when we checked the exit doors in the garage, none of them were taped open.”
“But that’s how I got up. I’m sure—”
“Oh, we’re not doubting your story. We found residual evidence that one of the locks had been taped open. If you hadn’t gotten in that way, we never would have known.”
It was the closest I was ever going to get to “thank you” from MacRae. And the implications were enormous. It meant that someone, anyone, could have been there before Emily, come and gone without passing through the lobby security.
I’d barely put down the phone when it rang. “Dr. Zak?” I didn’t recognize the woman’s voice. “I’m just calling to remind you. You have an MRI scheduled tomorrow at two? We’ve sent you a packet of information”—I gazed at the pile of unopened mail on my desk; I’d probably assumed it was junk—“with directions for getting here and instructions about what to expect.”
I flipped open my date book. There it was, at 2:00 tomorrow, “MRI.” I’d completely forgotten. Seemed like years, not weeks ago that Emily had scheduled the appointment for me. Now I was a whole lot less enthusiastic about getting up on that table and sliding into the narrow tube where Leonard Philbrick had died. Would I lie there wondering if someone was about to walk in the scan room with a tire iron? Was I going to pick up a smallpox or dengue fever? Annie’s paranoia about the place was catching.
“Dr. Zak? We’ll expect to see you?”
I thought about canceling. Then I began to rationalize. How could I pass up the opportunity? There wasn’t another other system in the country as powerful as theirs. After the accident, surely the staff would be even more vigilant than usual. Worst case, I’d pick up a cold. Seemed unlikely, but even if it happened, hey, I was young, in good shape. I’d survive.
“So did you see this?” my mother asked. I was in her kitchen that evening having a piece of pound cake, some coffee, and a long-overdue chat. She pushed a newspaper across the table to me. It was folded back, and in red marker on the inside front page she’d circled “RESEARCHER KILLED IN FREAK MRI ACCIDENT.”
I nearly choked on my mouthful of cake. I’d read the article that morning and knew it didn’t mention me.
“More?” she asked, standing and moving to the counter.
“No, really, I’ve had enough.”
“Enough” is not in my mother’s vocabulary. She was eyeing me like maybe I was sick. “You sure?”
I held up my hands.
“I want Minnie to see that,” she said poking a bony finger at the paper and sniffing.
Minnie Sadowsky was my mother’s longtime friend. Minnie was okay, though still a cheek pincher. It was Dr. Geoffrey—her paragon of a son, an MD, married with three kids—who was the bane of my existence.
I pretended to read the article.
“Why do you want her to see this?”
“Geoffrey gave her a body scan for her birthday.” From my mother’s expression I could see that she didn’t think much of this gift. “Completely safe, he tells her. If there’s cancer, we’ll know, he tells her.” My mother shook her head. “At our age, better not to know.”
“This accident was at an MRI lab,” I said. “He probably gave her a CT scan.”
I’d been noticing ads cropping up all over the place enticing people to “give your loved one a full-body scan.” It was entirely predictable. Every hospital had gotten itself a CT scanner when computerized tomography was the hot new technology. Along comes magnetic resonance imaging, and yesterday’s latest invention becomes today’s white elephant. All that excess equipment lying around still needed to be paid off so voilà, enter the physician/entrepreneur.
“CT, schmee-T. That’s like an X ray?” she asked. I nodded. “I could go to Chernobyl if I wanted radiation. And you know I love Minnie, but this is not such a good gift for her. Already every bunion she’s got is skin cancer; she’s tired, it’s fibromyalgia or Epstein-Whozits syndrome.”
“Maybe he thinks she’ll stop worrying when they don’t find anything.”
My mother looked at me like I had the IQ of a frog. “To find, there’s always something.”
This wasn’t so farfetched. Body scans could easily pick up false positives or harmless anomalies, sending patients off for more unnecessary tests, surgery even.
“It’s some racket,” my mother continued. “You don’t think these guys are hooked up with the surgeons?”
As usual, my mother’s conspiracy theory was entirely plausible. She’d never bought margarine, either.
A while later when I was leaving she asked, “Busy day tomorrow?”
“Every day is busy,” I said. She didn’t need to know that I was as nutty as her friend Minnie.
14
IT WAS a little before two and the chairs in the reception area at University Medical Imaging were empty. Apparently business had taken a dive. Probably only temporary. They were still the only show in town—even Mass General didn’t have a machine as powerful as theirs.
I checked in. The young woman at the reception desk was short and chubby with dark hair and tinted glasses. She gave me a clipboard with forms to fill out.
I sat down and began. I scribbled in my name, address. Checked male. Height and weight. Was I pregnant? I scanned the rest of the questions. Right-or left-handed? On any medications? Any metal implants? Neurological disorders? Not, not, not.
There were several more pages of questions. I sighed and started to fill in the blanks. This was going to take a while, but it was par for the course for any research study.
The final two pages were a consent form. I scrawled my signature at the bottom.
I brought the forms back to the receptionist. She looked them over, then hesitated for a moment as if unsure what to do next. I wondered if tall, blond Amanda had jumped ship and Dr. Pullaski had hired this replacement.
I’d barely sat down with a magazine when the door opened.
“Dr. Zak?” It was Emily. She was smiling, but she had dark circles under her eyes and her skin was almost as pale as her lab coat.
She ushered me into the now-familiar central area with its warning signs and introduced me to the man in a lab coat who was working at the counter. I knew the drill. I shed my wallet and keys. I followed her to an examining room.
Emily shut the door behind her and leaned against it.
“I don’t know how long I can keep this up,” she said. “They’re all looking at me like it was my fault. Dr. Pullaski told the police that I used the lab without her authority. She says she never found my beeper o
r asked Lenny to call me. I’m sure she would have fired me if it weren’t for Dr. Shands. He’s been the only one sticking up for me. And the police—”
“They questioned you again?”
“They showed up here yesterday afternoon, asking about safety procedures, and why we didn’t report the accident with the test magnet. I told them no one was hurt. There was no accident.”
Interesting rationalization. I wondered if she’d really convinced herself of that.
Emily sank down onto a stool. “Honest to God, I’ve told them everything I know.” She started to cry. “Now they’re questioning my neighbors.” She hiccupped, the tears flowing freely. I put my hand on her shoulder. “Wanted to know when I left the apartment that morning. How many times”—she took a ragged breath—“do I have to explain, he was dead when I got here?” She looked miserable, like a wounded animal.
I raised her off the stool and put my arms around her. “I’m sure the police are casting a wide net.”
“Now they want to talk to Kyle. I’m not even seeing him anymore,” she said, snuffling into my shoulder.
Her hair smelled gingery and I could feel her breasts pressing against me, reminding me that this was a woman I held in my arms. The air in the confined space around us seemed charged like a magnetic field.
“The police are probably questioning them because you were here,” I said, trying to move Emily to arm’s length and ward off my own increasing feeling of discomfort. I reached for a tissue and handed it to her.
“They’ll probably check your background,” I went on. “See if there’s anything in your past.”
“Oh, God. You think so?”
Emily held the crumpled tissue over her mouth. Her pupils had dilated. She’d panicked at the mere thought of exposing whatever skeleton was in her closet. I realized how little I knew about her.
“Is there something you’re afraid they’ll find out?”
Red streaks had appeared on Emily’s throat. She fiddled with the top button of her lab coat, buttoning and unbuttoning it.
“In college I did something really stupid. I needed money. I didn’t realize what was going to happen. Kyle helped me through it. He protected me.”
“You mentioned another stalking.” She’d said it had been a stranger who’d since died in a car accident.
She nodded. “That was part of it. I hope the police don’t drag that out again. I thought I’d finally left it behind me.”
Before I could ask what, there was a tap at the door. Emily leaped away as it pushed open.
“Oh, I’m sorry,” Shands said when he saw me, then Emily. Emily tucked the tissue into her pocket. “I see you’re not ready yet.” His gaze lingered for a moment too long on Emily. Then Shands gave me a speculative look. “I’ll be back in a few minutes,” he said and left.
“I’d better go,” Emily said, handing me a hospital gown. She backed out of the room.
As I changed into the hospital gown, I wondered what had happened to Emily that was so shameful she could barely speak of it. Was that the reason she hadn’t wanted the police to investigate her vandalized car?
I put my feet into paper slippers, and tried not to think about how ridiculous I looked. Health care could be humiliating.
“Peter!” Shands said when he returned, giving me his 150-watt smile. “You’re going to enjoy this.” Said the spider to the fly.
Lighten up, I told myself. They’ve got to be on their best behavior.
Shands looked over my medical history for at least ten seconds. He did the standard touchstones—pulse, blood pressure, reflexes—and then he jotted some notes in a file. As if out of thin air, he brandished a hypodermic syringe and came at me with it.
The vehemence with which I jerked away my arm surprised even me. Hadn’t realized I was so jumpy. Still, he should have known better—something you learn early on, don’t come at a patient unexpectedly unless you’re prepared to get kicked in the groin.
“Take it easy,” Shands said. “I was just going to inject a contrast agent. Gives us a clearer picture—”
“I know what a contrast agent does. It’s just that I wasn’t expecting it.”
I wondered if it ever occurred to him to say, “This will only take a moment,” or “This might sting,” or…No, he was a researcher. Annie had been right. He did treat patients like crash-test dummies.
I offered up my arm. He wiped a spot with alcohol. I watched the needle slide in. It burned a little as he depressed the plunger. I was glad Annie didn’t know I was doing this.
“That’s good. Keep your head very still.” I heard Emily’s voice coming through the headphones as I lay in the MRI tube.
Uncle Jack had been right. It felt exactly like being slid into a coffin. I needn’t have worried about feeling spooked by Philbrick’s ghost—the deafening buzzing and thumping pretty much overwhelmed anything that might have gone on in my head. Might as well be inside an engine block. At least they’d given me a pair of prism glasses so that when I looked up, I saw the reflection of my feet hanging out the end of the tube. It was better than staring at the inside of the scanner, inches beyond my nose. Still, I found it easier to take with my eyes closed.
I hoped the contrast agent was making my brain light up in Technicolor. The spot where Shands had injected the contrast agent felt cold.
“Excellent,” Emily said. “We’ve got a good baseline. Now, take your time with this. I’d like you to slowly blink your eyes twenty times.”
The test took about a half hour. Not too bad, and I survived it unscathed. Afterward I sat in the control room with Emily looking at my own brain scan. My “baseline” didn’t seem particularly restful. Like a percussion section, there were pulses on either side in the temporo-parietal region, probably synchronized with the machine’s thumping. Only the visual cortex was quiet. Taking into account that I’d been listening to the Anvil Chorus with my eyes shut, it was about what I’d have expected.
As I watched, I realized that my mouth tasted funny. I mentioned it to Emily.
“Metallic?”
That was it. Emily said it was one of the side effects of the contrast agent and would go away in a few hours.
“Here’s where you were blinking your eyes,” she said. Now the visual cortex at the back and the motor strip were lighting up.
Shands came in and watched over Emily’s shoulder, his arms crossed.
“Here’s where you said your name.”
Shands leaned forward, his chest grazing Emily’s head, staring intently and touching his finger to his mouth.
“Your mother’s maiden name,” Emily said.
He gave me a surreptitious look and straightened. He’d seen something in the scan that he hadn’t been expecting. It reminded me of the evasive look the evaluator gave my mother when we’d had my dad worked up. He’d just shown Dad a pen and asked him what it was. “Ink spreader,” said my father, the same man who’d once read four newspapers a day, every day, including the Daily Forward in Yiddish. I leaned forward, examining the image, wondering what Shands had seen and not wanting to ask.
I heard the door to the room open. When I turned around, Shands had left and the new receptionist was handing a slip of pink paper to Emily. Emily read it. She swallowed.
“Something wrong?” I asked.
“Oh, no,” she said, the smile forced. She picked up the test protocol and consent form from the table. “Just a call I need to return. Won’t be a minute. You mind?”
“Of course not.”
“You can run this some more while I’m gone. Do you need me to show you—”
“It’s okay. I remember from last time.”
When she turned to go, she dropped the papers she was holding.
“Damn.” She started to bend over.
“Go ahead,” I said, and began to pick up the papers. Emily left.
I sorted the pages. Each task I’d done was listed on the test protocol. The beginning and ending times were noted. I set the forms
aside.
As I sat there staring at the frozen image, trying to assume the perspective of an unbiased investigator, I felt anxiety gnawing at the pit of my stomach. This was my brain, not some stranger’s, and something in it had caught Shands’s attention.
I checked the test protocol. According to the time stamp, I was in the middle of tapping my fingers. I backed up the animation to the part where I’d been blinking my eyes. There was activity on either side near the temples and more activity in the limbic system—perhaps evidence that I was hearing sounds and feeling some degree of anxiety. There were pulses near the center as I processed information. But beyond that I saw nothing. It was like reading words written in another language—I could sound them out, but I couldn’t extract meaning, never mind nuance. I watched my brain being put through its paces, not knowing what the hell I was looking for.
Frustrated, I sat back. I folded and unfolded the corner of the consent form. I felt a little queasy. Perhaps nausea was another side effect of the dye Shands injected.
Maybe if I looked at other people’s scans, other “normals,” I’d be able to see what was different about mine. I knew Emily’s and Philbrick’s had been taken. Shands’s, too. I was just about to try to find other scans in the system when Emily returned.
She sat down beside me. “You were able to run it?”
“Pretty mind-blowing.”
“Literally.”
I clicked the mouse and my brain started to animate again, pulses of green, a flash of yellow. “How do you analyze it? I mean, if something were anomalous, how would you know?”
“It’s not something most people can see. It’s all in the statistics. Basically that baby in there”—she pointed to the computer in the adjacent glassed-in room—“separates signal from background noise. That’s why we take a baseline, so we can ignore what your brain does just to cope with being in the scanner. Then the program compares your data to all the data we have on file. It’s a sort of massive regression analysis. If there are anomalies, they get picked up and isolated. Lenny could look at a scan and tell you if it was going to come back with something. I can’t.”