Vital Signs

by Robin Cook

  “I don’t know what to make of all this,” Marissa agreed. “But there is one thing I do know. I’d like to find that Tristan Williams just to wring his neck. Imagine the nerve of making up patients just to publish an article!”

  “That old publish-or-perish mentality,” Wendy said.

  “A taxi will be along directly,” the receptionist said as she hung up the receiver. “I suggest you wait outside. The taxi queue is just up the street.”

  The women left the FCA clinic, stepping into the glorious morning sunshine. “So what does the tour director suggest we do now?” Wendy asked.

  “I’m not sure,” Marissa said. “Maybe we should go out to the University of Queensland and use the medical library.”

  “Oh, boy!” Wendy said with obvious sarcasm. “Now that sounds titillating!”

  Charles Lester had not gone back to his work. Marissa and Wendy’s visit had disturbed him. It had been over a year since the last inquiry about that irritating paper by Williams. At the time he’d hoped it would be the last.

  “Damn,” he said aloud, smacking a fist on his desk top. He had the uncomfortable premonition that there was trouble ahead. The fact that these meddlesome women had come all the way from Boston was upsetting to say the least. Most distressing of all was the possibility that their search for Williams might persist. That could spell disaster.

  He decided it was time to confer with some of his associates. After figuring the time difference, he picked up the phone and called Norman Wingate at home.

  “Charles!” Dr. Wingate exclaimed with delight. “Good to hear your voice. How’s everything Down Under?”

  “It’s been better,” Lester said. “I have to talk to you about something important.”

  “Okay!” Dr. Wingate said. “Let me get the extension.”

  Lester could hear Dr. Wingate say something to his wife. In a few minutes he heard another phone being picked up. “I’ve got it, luv,” Dr. Wingate said. Lester heard the other extension disconnect.

  “What’s the problem?” Dr. Wingate said into the phone.

  “Does the name Dr. Marissa Blumenthal mean anything to you?”

  “Good Lord, yes,” Wingate said. “Why do you ask?”

  “She and a companion named Wendy Wilson just left my office. They came in here with that article about TB salpingitis.”

  “My God!” Wingate said. “I can’t believe they’re in Australia. And we were so generous to them.” He related the details of the pair’s attempt to break into the Women’s Clinic’s computer record system.

  “Did they get anything out of your computer?” Lester asked.

  “We don’t believe so,” Wingate said. “But those women are troublemakers. Something will have to be done.”

  “I’m coming to the same conclusion,” Lester said. “Thanks.”

  Hanging up his phone, Lester pressed his intercom. “Penny,” he said, “ring up Ned Kelly in security. Tell him to get his arse up here on the spot.”

  Ned Kelly’s name wasn’t really Ned Kelly, it was Edmund Stewart. But at a young age Edmund had taken such a liking to the stories of the renowned bushranger Ned Kelly that his friends had started calling him Ned.

  Although most Australian men liked to think of themselves as some reflection of the famous outlaw, Ned took to imitating him, even to the point of sending a pair of bullock testicles to the wife of a man he was feuding with. A life of contempt for authority and petty crime led people to call him Ned Kelly, and the name stuck.

  Lester pushed away from the desk and walked over to the window. It seemed that just when things were running smoothly, some irritating problem had to crop up.

  Lester had come a long way from his humble origins in the outback of New South Wales. At age nine he’d arrived in Australia from England with his family. His father, a sheet-metal worker, had taken advantage of liberal immigration policies in the immediate post-World War II period. The Australian government had even paid passage for the whole family.

  Early on, Lester had gravitated toward learning. He saw it as his ticket out of the sapping dullness of the vast Australian interior. In contrast to his brothers, he thirsted for knowledge, taking correspondence courses to supplement the meager schooling available in his tiny hometown. His studies had led him to medical school. From then on he’d never looked back. Nor did he tolerate hindrances. When people got in his way, he stepped on them.

  “Watchagot?” Ned asked as he came through the door. Behind him was Willy Tong, a slightly built but muscular Chinese man. Ned kicked the door shut with a resounding thump, then sat on the arm of the couch. He was not a big man, but he exuded toughness. Like Carstans, he wore shorts along with a shirt and tie. On his sleeve was sewn the logo of the security department of the clinic. His face was tanned to a lined, leathery texture. He looked as if he’d spent his entire thirty-eight years in the desert sun. Above his left eye was a scar from a knife fight in a pub. The argument had been over a pitcher of beer.

  Lester was chagrined to have to resort to such men. It was a bore to have to deal with the likes of Ned Kelly. Yet occasionally it was necessary, as it was at present. Lester had met Ned purely by accident when he was in his last year of medical school. Ned had come into the university hospital with one of his many gunshot wounds. During the course of his recuperation, they’d become acquaintances. Over the years Lester had used Ned for various projects, culminating in his being hired as head of the clinic’s security department.

  “We have a couple of women interested in that article by Williams,” Lester said. “It was the same article that brought that gynecologist from L.A. here. Do you remember? It was about a year ago.”

  “How could I forget,” Ned said with a sinister smile curling his lips. “He was the poor man who had that awful auto accident. Remember him, Willy?”

  Willy’s eyes narrowed as he smiled broadly.

  “These women were talking about finding Williams,” Lester said. “I don’t want that to happen.”

  “You should have let me take care of Williams way back when,” Ned said. “It would have saved a lot of trouble.”

  “He was too much in the spotlight at the time,” Lester said. “But let’s not worry about that now. Now we have to worry about these women. I want something done, and I want it done before they dredge up any more information on TB salpingitis.”

  “You want it to look like some kind of accident?” Ned asked.

  “That would be best,” Lester said. “Otherwise, there will be an investigation, which I’d prefer to avoid. But can you manage an accident when there are two people involved?”

  “It’s more difficult,” Ned admitted. “But certainly not impossible. Be easy if they rent a car. Yanks are lousy left-hand drivers.” He laughed. “Reminds me of that gynecologist. He almost killed himself without our help.”

  “The women’s names are Marissa Blumenthal and Wendy Wilson,” Lester said. He wrote them down and handed the paper to Ned.

  “Where are they staying?” Ned asked.

  “I don’t know,” Lester said. “The only thing I do know is that they are planning to go out on the Reef.”

  “Really!” Ned said with interest. “Now that bit of info could come in handy. Do you know when they plan to go?”

  “No,” Lester said. “But don’t wait too long. I want something done soon. Understand?”

  “We’ll start calling hotels as soon as we get downstairs,” Ned said. “This should be fun. Like going out in the bush and shooting ’roos.”

  • • •

  “Excuse me,” Marissa whispered. “I’m Dr. Blumenthal and this is Dr. Wilson.” Wendy nodded hello. They were standing at the main circulation desk of the University of Queensland Medical School Library.

  They had driven halfway to St. Lucia, where the university was located, when they’d asked the taxi driver if he knew where the medical school library was. To their surprise, he’d responded by “throwing a u-ey” and heading directly back to Herston.
The medical school, they’d learned, was a short distance from the FCA.

  “We’re from the States,” Marissa said to the man behind the medical school library circulation desk. “And we were wondering if it might be possible for us to use the library facilities.”

  “I don’t see why not,” the man replied. “But it would be best if you inquired in the office down the hall. Ask for Mrs. Pierce, the librarian.”

  Marissa and Wendy walked down the corridor and into the administration office.

  “Absolutely,” Mrs. Pierce answered in reply to their request. “You’re more than welcome to use material here at the library. Of course, we will not be able to allow any of it to circulate.”

  “I understand,” Marissa said.

  “Is there anything I could help you with?” Mrs. Pierce offered. “It’s not every day we have visitors from Boston.”

  “Perhaps there is,” Marissa said. “We were lucky enough to have been given a tour of the FCA clinic building this morning. I must say, we were truly impressed.”

  “We’re quite proud of the clinic here in Brisbane,” Mrs. Pierce said.

  “For good reason,” Marissa said. “What we’d like to do is to read some of their current papers. I imagine they publish quite a bit of material there.”

  “Indeed they do,” Mrs. Pierce said. “They have been our leaders in reproductive technologies here in Australia. They are also generous contributors to the medical school; we have a lot of their material.”

  “We’re also interested in a certain Australian pathologist,” Wendy said. “His name is Tristan Williams. We have a reprint of one of his papers that appeared in an Australian journal. We’d like to see if he’s done any subsequent articles.”

  “We’d especially like to locate him,” Marissa interjected. “ Perhaps you may have some suggestions as to how we might do that.”

  “It didn’t mention where he practiced in the article?” Mrs. Pierce asked.

  “He’d been at the FCA when he published the paper,” Wendy said, “but that was two years ago and he’s since left the FCA staff. We asked over there at the clinic, but no one seemed to have a forwarding address.”

  “We have an annual publication by the Royal College of Pathology,” Mrs. Pierce said. “It contains the hospital and university affiliations of all Australian pathologists. I think that would be the most fruitful place to start. Why don’t you come with me? I’ll acquaint you with our reference and periodical rooms.”

  Marissa and Wendy followed Mrs. Pierce. The woman was quite striking: she had flaming red hair and was quite tall, particularly in contrast to Marissa and Wendy. Together the three women descended a curved stairway leading to the lower floor. Mrs. Pierce’s pace was brisk. Marissa and Wendy had to hurry to keep up with her.

  Mrs. Pierce stopped at a group of computer monitors. She put her hand on the top of the first screen. “Here are the terminals for literature searches. This would be the easiest way to search for Dr. Williams’ latest articles.”

  Leaving the computer area, Mrs. Pierce walked to a series of low bookshelves. She pulled a dark-covered volume from the shelf and handed it to Wendy. “Here’s the Royal College of Pathology’s publication. That’s the best way to locate a pathologist, at least in terms of his professional associations.”

  Leaving the shelves, Mrs. Pierce strode off at a determined pace. Marissa and Wendy hurried after her.

  “She must do triathlons on the weekends,” Wendy muttered under her breath to Marissa.

  Mrs. Pierce led them to another corner of the periodical room. “This section here,” she said, making a sweeping gesture with her hand, “is devoted to FCA-related articles. So that should keep you busy for a while. If you have any further questions, please feel free to come see me back in the office.”

  After Marissa and Wendy thanked Mrs. Pierce, she left them on their own.

  “Okay, what first?” Wendy asked.

  “Look Williams up in the book you’re holding,” Wendy said. “If it says he’s gone to Perth I’ll scream. Did you know that’s about three thousand miles away from here?”

  Wendy set the book on top of one of the periodical shelves and turned to the Ws. There was no Tristan Williams.

  “At least he’s not in Perth,” Wendy said.

  “I guess Mr. Charles Lester was telling us the truth,” Marissa said.

  “Did you doubt him?” Wendy asked.

  “Not really,” Marissa answered. “It would have been too easy for us to check.” She scanned the surrounding shelves. “Let’s take a look at some of this FCA material.”

  For the next hour Marissa and Wendy pored over articles on a wide range of topics related to reproductive technology. The scope and breadth of FCA research was as impressive as the clinic itself. It soon became clear that FCA had played a pioneering role in fetal/fertility research, especially in regard to the use of fetal tissue for treatment of metabolic and degenerative diseases.

  Most of the articles they merely skimmed. Those dealing with in-vitro fertilization they put aside. Once they had finished a cursory look at all the material, they turned back to the articles on in-vitro fertilization.

  “I’m impressed but confused,” Wendy said after half an hour. “I must be missing something.”

  “I have the same feeling,” Marissa said. “When you read these articles in sequence, it shows that their percent success per cycle in terms of achieving pregnancy was going up every year. Like for five cycles the success rate went from twenty percent in 1983 to almost sixty percent in 1987.”

  “Exactly,” Wendy said. “But what happened in 1988? Maybe it’s a misprint.”

  “Can’t be a misprint,” Marissa said. “Look at the data for 1989.” She tossed a paper onto Wendy’s lap. Wendy studied the figures. “Curious that they didn’t even calculate the per-cycle pregnancy rate after they’d made such a big deal out of doing it in every other year.”

  “It’s a simple calculation,” Marissa said. “Do it yourself for five cycles.”

  Wendy pulled a piece of paper from her purse and did the division. “You’re right,” she said when she’d finished. “It’s the same as 1988, and when compared to 1987, it’s much worse. Less than ten percent. Something was going wrong.”

  “Yet look at the pregnancy rate per patient,” Marissa said. “They changed the basis of their reporting. They didn’t talk about achieving pregnancy per cycle anymore, they switched to pregnancy per patient. And that still went up in both 1988 and 1989.”

  “Wait a second,” Wendy said. “I don’t think that’s possible. I want to graph this stuff. Let me see if I can find some paper.” Wendy walked over to the reference desk.

  Meanwhile, Marissa went back to the figures. As Wendy suggested, it didn’t seem possible for rates per cycle to go down while rates per patient went up. And not only that, the pregnancy rate per patient in 1988 approached eighty percent!

  “Ta da!” Wendy said as she came back, triumphantly waving several sheets of graph paper. She set to work, swiftly sketching two graphs.

  After briefly studying her efforts, she pushed the paper across the table to Marissa. “There has to be something we’re missing,” she said. “This still doesn’t make sense to me.”

  Marissa examined the graphs Wendy had drawn. It didn’t make sense to her either. Seeing the supposedly related curves going in different directions seemed contradictory.

  “The crazy part is that they can’t be bogus statistics,” Wendy said. “If they were making them up, they certainly wouldn’t have had the per-cycle success rate go down. They wouldn’t be that stupid.”

  “I don’t know what to make of it,” Marissa said. She handed the graphs back to Wendy, who folded them and put them in her purse.

  “Let’s sleep on it,” Wendy suggested.

  “Maybe we should go back to FCA and ask Mr. Lester,” Marissa said. “But first let’s check to see if our Tristan Williams has been writing any more papers.”

  Afte
r returning all the FCA journal articles to their proper shelves, Marissa and Wendy returned to the computer terminals that Mrs. Pierce had pointed out to them. Wendy sat down while Marissa leaned over her shoulder. Without much difficulty, Wendy set the computer to run a search for all articles written by Tristan Williams. After she pushed the Execute button, it took the computer only a few seconds to flash the result. Tristan Williams had written only one published article, and that was the one they already had.

  “Not what I’d call a prolific bloke,” Wendy said.

  “That’s an understatement,” Marissa said. “I’m starting to get a bit discouraged. You have any suggestions now?”

  “Sure do,” Wendy said. “Let’s have lunch.”

  After inquiring at the circulation desk, Marissa and Wendy walked over to a cafeteria-style lunchroom and bought sandwiches. Taking them outside, they sat on a bench beneath a beautiful flowering tree of a species neither one recognized.

  “Do you think it’s really worth the effort to try to find this Williams character?” Wendy asked between bites. “After all, he might not even appreciate our seeking him out. Sounds like this episode with his one and only paper was his undoing.”

  “I suppose my interest is mere curiosity at this point,” Marissa admitted. “Maybe we should try one more thing. Let’s try calling the Royal College of Pathology and ask them about him. If they don’t know anything or if they tell us he’s in some distant place like Perth, we’ll give up. This already is beginning to feel like a wild-goose chase.”

  “And then we’ll let ourselves have some fun!” Wendy said.

  “Right,” Marissa said.

  Once they finished eating, they returned to the library and consulted the Royal College of Pathology’s publication for the society’s address and phone number. Using a public phone in the library, Marissa made her call. The phone was answered by a cheerful operator who connected Marissa to an administrator named Shirley McGovern once Marissa told her why she was calling.

  “I’m terribly sorry,” Mrs. McGovern said after Marissa repeated her question. “It is the College’s rule not to give out information on its members.”