Miracle Cure

by Michael Palmer

  Brian sensed more than heard the man retrace his steps. The hallway lights were turned off, and once again the clinic was thrown into pitch darkness. A door opened and shut. It sounded as if it was at the end of the hallway.

  Brian waited. Five minutes.… Ten.

  Finally, he inched his way to the door and gently tested the knob. No problem. He was about to open it when he remembered the appointment book. He had left it on the receptionist’s desk. He had no stomach for resuming his search for the remaining Phase One patients tonight, but assuming the clinic was empty, there was no sense in leaving the book there to invite questions. Still on his hands and knees, his senses alert for any hint that the intruder hadn’t really left, he inched his way across to the office door and stopped. The silence and darkness were total.

  For several minutes, he lay there, listening. Finally, he pushed himself up, opened the door, and turned on the light.

  The appointment ledger was gone.

  He rushed to the shelves, but only the year 2 book was there. He checked the floor and the desk drawers. Nothing. Once again, his pulse was hammering. Why had the security guard, or whatever he was, thought to take the book? The situation made no sense, but was terrifying nonetheless.

  He could not think of a thing to do except return to the ward and worry. Then, just as he was about to cut the light, he glanced up at one side of the office and groaned out loud. A black nozzle protruded from a corner where the bookcase wall, another wall, and the ceiling met—a security camera focused on the glass and the counter of the receptionist’s area, not exactly concealed, but not that easily noticeable, either.

  Brian stared at it for a few seconds, wondering who was watching him, and from where. Then, feeling absolutely helpless, he snapped on his beeper, turned off the lights, and left the clinic.

  If anyone confronted him about the late-night foray, he still had an excuse, albeit a bit feeble, that Mrs. Leander would support. But no matter what, he couldn’t shake the dreadful feeling that the fuse beneath him had just been lit, and that he had struck the match.

  CHAPTER TWENTY-FOUR

  BY THREE-THIRTY IN THE MORNING, BRIAN WAS PHYSICALLY and mentally spent. Action on the ward had picked up around midnight, with one patient dropping her blood pressure, and another going into a series of difficult-to-manage cardiac arrhythmias. Neither patient was part of the Vasclear study. It took several hours to stabilize the two women, and Brian was forced to slip a temporary pacemaker into one of them. Finally, all was calm, although by now the muscles in the back of his neck were like braided ropes, and those in his legs ached unremittingly.

  The emergencies did have the beneficial side effect of keeping Brian’s mind off the debacle in the Vasclear clinic. There wasn’t much more he could have done wrong there. Worst of all was losing control of the clinic appointment book. But getting himself videoed on someone’s security system was certainly a close second.

  What to do? As he made a final check of each patient on the ward, the question began reverberating in his head.

  He splashed some water on his face, signed off the ward and on to his beeper, and headed down to the security office in the basement of the Pinkham Building. The guard on duty there was a crew-cut bull of a man whose name tag read JIM UNDERHILL. He wore the standard blue wool uniform of his department, and was sitting behind a waist-high counter reading a Stephen King paperback.

  On the wall to his right was a bank of eight monitor screens, with the scene on each of them changing every ten seconds or so. Brian tried to pick out the Vasclear reception area, then remembered that he had left the clinic completely dark.

  Brian held up his photo-ID card, while at the same time angling to get a look at the man’s shoes.

  “Yes, Dr. Holbrook,” Underhill said, “I’ve heard of you. What can I do for you?”

  I heard you was comin. Hadn’t those been animal-keeper Earl’s exact words?

  Unlike his exchange with Mary Leander, this time Brian was prepared.

  “I’m sorry I couldn’t get down sooner,” he began, “but we had a couple of emergencies on my floor at Boston Heart. I was one of the last ones to leave the Vasclear clinic tonight around eight-fifteen. Before I left, I went into the reception area to check on some appointments. Then I got an emergency page to the CCU and had to run out. About an hour later I realized I had left my little black medical bag on the receptionist’s desk. But when I went back for it, it was gone.”

  “Couldn’t someone have just found it and put it away for you?”

  “Maybe. But Lucy Kendall, the charge nurse, and I were the last ones there, I think. I called her at her home when I realized what had happened, and she didn’t know anything about my bag.”

  Wearily, the guard pulled a clipboard out from under his desk. As he did, Brian moved to the end of the counter, feigning watching the screens, and got a clear glimpse at his shoes. Black leather, polished to a high gloss. Almost certainly, the intruder at the clinic wasn’t one of the hospital’s regular security force.

  “Okay, Doc,” Underhill said wearily, “fill out this incident report.”

  “Actually, Jim, I’ve never had much faith in filling out forms. But while I was in the receptionist’s office looking for my bag, I noticed a surveillance camera sort of hidden away beside the bookshelf. I wondered if maybe you picked up something here—a video of whoever took my bag.”

  Underhill squinted as he probed his memory. Then he gave up and took a laminated sheet from a clipboard hanging beneath the screens.

  “Just as I thought,” he said after a minute’s perusal of the paper. “There’s no screen listed that includes the Vasclear clinic.”

  Brian felt a sudden chill.

  “Well, what do you think that surveillance camera is for?” he asked.

  The guard shrugged.

  “No idea. Maybe it ain’t hooked up.”

  “Maybe,” Brian said, though he didn’t believe that for a moment. “Are there any other security cameras around the hospital that aren’t projected here?”

  “No idea, although I don’t see why there would be. The head of my department, Tom Dubanowski, probably knows. You might ask him. He’ll be here around seven.”

  “Thanks,” Brian said.

  He left the security office weighted down by a feeling of impending disaster. Someone had seen him via the office surveillance camera. That same someone had sent the guy in the sneakers up to investigate. And now, whoever it was had the appointment ledger and with it at least a few concerns about what Brian had been looking for. He spent some badly needed mental energy trying to work out who that might be. Newbury Pharmaceuticals could have installed the cameras, but the plant was several miles from the hospital. How could they have gotten someone up to the clinic so quickly? Or maybe Jim Underhill had lied. Maybe he kept a pair of sneakers under his desk for dashing about. The guard certainly wouldn’t have been the first one in the hospital to withhold the truth from him.

  The hour—it was after four A.M., now—didn’t contribute to clear thinking. Ward rounds would be starting up in less than three hours. Brian knew he was nearing what he thought of as the point of no return, the point where he would be worse off trying to get his mind and body functioning after a couple hours of sleep than he would be by simply pouring down some residents’ coffee, summoning up the adrenaline of utter fatigue, and attempting to go the distance—twenty-four hours plus the following workday. It would certainly make for an adventurous ride home.

  Heads you go to bed, tails it’s the machine canteen, he decided, reaching into his pocket for a coin. What his hand landed on instead was the list—ten names hastily printed on a small, crumpled piece of paper.

  Before he was fully aware he had made a decision, Brian was at the door of the record room in the basement of the building adjacent to Pinkham. Every computer logon to the record room was recorded somewhere. It seemed logical that from now on, the guy in sneakers or his boss would be keeping close tabs on charts relea
sed to Brian. Sooner or later, he would probably have to resort to an electronic review. But before that happened, he might be able to get a look at one or two charts in their original form.

  The door was closed, but there was a phone on the wall beside it with instructions. Brian explained who he was to the Hispanic woman who answered, and that he wanted to review the hard copy of a chart he couldn’t seem to call up on his laptop. Moments later, the door opened the length of a chain and a young woman peered out. Brian showed her his ID badge and said he’d be happy to get security to accompany him if she would feel more comfortable.

  “That won’t be necessary,” the woman said. “The security guard is already here.”

  The door was eased shut to release the chain, then opened fully. The woman, in her early twenties, was slender, raven-haired, and lovely. Her clothes and hair seemed just a bit askew, and her lipstick a bit smeared. A man and a woman behind a locked door in a hospital in the early-morning hours. Brian groaned inwardly. And to make matters worse, the man was another security guard. He and Jim Underhill would be comparing notes before long. Brian stood outside the door, considering just mumbling some excuse and leaving. But the woman had already seen his ID. At this point, not entering might actually arouse more suspicion in the guard.

  It took just a minute for the young attendant to return with the chart of the first name on Brian’s list, a woman in her mid-seventies named Sylvia Vitorelli. Brian set the record in a small dictation carrel. Aware that the young woman and the guard were watching and waiting, he flipped through the chart as quickly as possible. Because Vitorelli had been a longtime WMH patient, with a hysterectomy, gall-bladder removal, surgically repaired ankle fracture, and cardiac problems, the chart was a weighty one, perhaps an inch and a half thick. Finally, though, he was able to piece together her story.

  A resident of the North End, not far from the hospital, Vitorelli was a married mother of four and a grandmother, who at one time had smoked more than a pack of cigarettes a day. She began having chest pains and was referred to Carolyn Jessup, who treated her with traditional medical therapy for over a year until making her part of the Vasclear Phase One trials nearly three years ago. Brian reviewed Vitorelli’s stress test, cardiac ultrasound, and other EKGs. Her cardiovascular disease was fairly extensive, though not as extensive as Brian’s father’s.

  It sounded from Jessup’s notes as if Vitorelli had had an excellent early response to her Vasclear therapy. Then, suddenly, the chart simply ended. No more notes, no laboratory reports, nothing. Brian skimmed through the pages searching for a section that might have been out of order.

  “You going to be much longer, Doc?” the security man called to him. “Elana wants to go for her break, and we can’t leave you in here alone.”

  “One more minute,” Brian said.

  He turned to the lab-report section. There were none after the first three months of Vitorelli’s Vasclear therapy. Absolutely none.

  He made a photocopy of the front sheet of the chart, thanked the eager Elana, and headed back to the ward. Unless he was way off-base, the final pages of Sylvia Vitorelli’s chart had suffered the same fate as Kenneth Ford’s. Did the woman represent a third case of Vasclear failure followed by signs and symptoms that might have been pulmonary hypertension? Was it worth trying to prove his suspicion?

  If he was right about Sylvia Vitorelli, Phase One testing seemed to have an inordinate number of problems, yet Phase Two was nearly perfect. Had the modifications in the chemical synthesis of the drug made that great a difference?

  The questions seemed endless.

  But there was another question of even more immediate concern to him. How long did Brian Holbrook have left at Boston Heart?

  CHAPTER TWENTY-FIVE

  THE BOSTON GLOBE

  Vasclear Orders Flooding In

  Boston-based Newbury Pharmaceuticals confirmed that orders for its new, as-yet-unapproved drug Vasclear have been pouring in not only from all over the country, but from all over the world as well. The medication, which comes in 10-cc vials and must be diluted and administered intravenously, has been reported to eliminate the plaques that cause heart attacks in as many as seventy-five percent of patients.

  Dr. Art Weber, Vasclear project director for Newbury, says that the overwhelming demand for the drug is almost certain to create initial shortages and drive up the price.

  AT SEVEN-FIFTEEN, WHEN PHIL CALLED PATIENT rounds to order, Brian was just stepping out of the on-call-room shower. He had done his best to stay awake until the morning crew arrived, but with no specific emergencies to pump him up, he hadn’t stood a chance. When the nurse’s call woke him at six-thirty, he had been flat on his back in a deathlike sleep for two hours. Within seconds of her call, he was out again. By agreement, fifteen minutes later, she called a second time, not letting him leave the phone until he could recite the Pledge of Allegiance and the names of all the chambers, valves, and arteries of the heart.

  Brian toweled off and dressed, furious with himself for having placed his job, his future, and the immediate security of his daughters in jeopardy. But in truth, what had he done? An elderly survivor of the Holocaust had come to see him with a serious medical problem. In investigating the problem, he had stumbled onto a similar case. It was only natural for Brian or any decent doc to want to get to the bottom of the situation.

  He hurried out to the ward and caught up with the gang that surrounded the bed of the patient in 514.

  “Sorry I’m late, Phil,” he said.

  “No problem. Looks like you had a busy night.”

  You have no idea.

  “Busy enough for these old bones. I didn’t schedule Mrs. Cameron for a permanent pacer, but she’s going to need one.”

  “I’ll take care of it.”

  Rounds were scheduled to last until nine-thirty—ten at the latest. Technically, as the teaching visit for the month, Phil was not only charged with educating the nurses, students, residents, and fellows, but he was legally responsible for signing off on all the patients on the service as well. Brian watched his friend function in the role, working on the staff with just the right combination of questions, cajoling, inoffensive humor, and medical wisdom. In Brian’s opinion, Phil’s assessment of himself was far from the mark. He was a hell of a doc. But Brian knew that what might have been respected, even revered, in a faculty member at many hospitals, was the norm at Boston Heart.

  Midway through rounds, as they were approaching a string of student cases on whom Brian had nothing to report, he cut away, went to a secluded phone across from the nurses’ workstation, and dialed Sylvia Vitorelli’s number. A woman answered.

  “Hello?”

  “Hello, Mrs. Vitorelli?”

  “Who?”

  “I’m calling Mrs. Sylvia Vitorelli.”

  “There’s no one here by that name. You must have the wrong number.”

  “Wait, please don’t hang up.”

  Brian read off the number he had dialed.

  “I’m sorry,” the woman said. “That’s my number, but there’s no one here by the name you said.”

  “Please,” Brian said. “I’m a doctor calling from White Memorial Hospital and I’m trying to find this woman. The number I dialed is the one that’s listed in the hospital record for her. How long have you had it?”

  “More than six months.”

  “Thank you,” Brian murmured, setting the phone down.

  He made it back to rounds for another twenty minutes, then escaped again to the phone. This time the call was long-distance, to the man listed as Sylvia’s next of kin, Richard Vitorelli in Fulbrook, New York. Brian, now more careful than he ever would have been before the near disaster in the Vasclear clinic, used the outside operator and a credit card rather than going through the hospital operator. A woman answered.

  “Who did you say you were again?” she asked.

  “Dr. Holbrook from White Memorial Hospital in Boston.”

  “Did you take care of
my mother-in-law?”

  “I … no … not exactly.”

  “I think you should speak to my husband. He’ll be home late tonight. You’ll have to call tomorrow.”

  “Well, could you just tell me how Mrs. Vitorelli is?”

  There was a prolonged pause before the woman answered.

  “She died,” she said finally. “She collapsed here in this house and died at the hospital about two years ago.”

  Brian felt his pulse respond to the news. Sylvia’s chart ended not too many months before that.

  “I’m sorry,” he said. “Could you tell me any of the details of her death—any at all?”

  “I … think you’d better call back when my husband’s here.”

  “Okay, but please, just tell me, do you know the cause of death?”

  “It was her heart. Now please, call back tomorrow.”

  Sylvia’s daughter-in-law had hung up before Brian could ask her another question. But he was asking himself plenty. Was Sylvia hospitalized anywhere before her death? Did she have a cardiological evaluation at any point? A blood count? An autopsy? And perhaps the two biggest questions of all: Was it too late for him just to let the Vasclear matter drop altogether? Was he even capable of doing that?

  “Well, another riveting set of rounds, eh?”

  Brian hadn’t even noticed Phil approaching.

  “Sorry I kept leaving the group. I had a couple of calls to make.”

  “Hey, no problem. You just keep putting in the pacemakers and saving the lives. I’ll take care of the theoretical stuff.”

  “You really are a very good teacher, Phil.”

  “Aw, pshaw.”

  “Seriously. I can tell you really love doing it, too. Not everyone does, you know.”

  “Well, the truth is I do love it. I love everything about what I’m being paid to do here. That’s why I’m willing to put up with some of the bullshit and the unwritten rules. It goes with the territory. It’s also why I can’t be of any more help to you with this Vasclear thing, and why I’m begging you to be careful.”