“Will do.” Geoff stood and walked to the door.
“And, Geoff,” added Balassi. “Thanks.”
Chapter 16
“Please tell me about your head injury protocols, Dr. Davis,” Dr. Yuri Zelenkov said. “The home office has been most gratified by the work here at the Trauma Center. I’m sure we will be just as generous with funding next year if your success continues.”
Geoff and Zelenkov stood by the doorway of the PET scan control room, had just finished the tour of the area. Zelenkov was short, but his broad shoulders filled out his dark blue suit, bulging at the seams. Bald, with a grey fringe of hair impeccably trimmed above his ears, his small mouth neatly framed by a salt and pepper goatee. His eyes were dark, almost charcoal gray, his stare severe, made more so by an intermittent twitch of his left eyelid. His accent was unusual, a mix of Russian and Scandinavian, peppered with a hint of British. Odd. Zelenkov was a Russian name. Must have been his schooling.
Balassi’s admonition to tell Zelenkov only what he needed to know echoed inside Geoff’s head. “All closed head injury patients get a head bolt placed to monitor the intracranial pressure. They have a PET scan on admission, they’re scanned again if there is any change in the mental status, and one last time at discharge.”
“And your conclusion from these studies?”
Geoff paused, considered his words carefully. “We’re currently analyzing the data. It’s to be submitted for publication later this fall.”
Zelenkov stroked his goatee, peered at Geoff, seemed to force a grin. “I admire a man who guards his words, Dr. Davis. It shows you can be trusted with things of importance. But I must remind you it is PETronics that funds this research, so you need not fear revealing your preliminary data to us.”
Geoff realized Zelenkov was correct. Besides, it was the cyclotron isotopes Balassi seemed concerned about, not the head injury data. “So far it appears there is an excellent correlation with the head injury patients’ endorphin levels as demonstrated by PET scan, and the level of consciousness. It’s not perfect, but there is a greater correlation than we thought there would be.”
Zelenkov nodded approval. “Impressive, Dr. Davis.” He paused. “May I call you Geoffrey?”
“Geoff would be fine.”
“Very well then, Geoffrey. I don’t know if it’s been mentioned to you at all, but the home office in Copenhagen has a special educational grant program for chief residents at the institutions we joint venture with. An all expense paid four week trip to Copenhagen. You’d be our special guest, lecture at our medical school, test new isotopes on patients using PETronics’ fourth generation PET scanner.
“I can see how much you’ve learned here, but you can accelerate your training in Europe, where there’s no FDA to delay new technology or get in the way of highly experimental research. Unfortunately, the scientific bureaucracy in the United States hampers advancement. It takes an average of seven years in your country to approve a new technology for patient use. In Europe, new medical devices are approved for general use after only one year of testing. Clinical research centers in Europe are once again taking the lead, this time by default.”
“The FDA can be a real pain and hinder progress, there’s no question about it, but someone has to safeguard the public from potential harm. It’s a balancing act, imperfect at times, but necessary.”
The spasm of Zelenkov’s left eye accelerated, spread to the corner of his mouth. “Don’t be so sure, Geoffrey. The history of scientific discovery is replete with risk, researchers and patients risking their health, sacrificing their lives for the public good.
“Louis Pasteur injected himself with his own small pox vaccine, Jonas Salk injected himself with the polio vaccine he developed. New medicines, therapies of all sorts have been tested on AIDS patients, prisoners and the military before being used on the general public. As you can see, there are alternative ways of safeguarding the public other than bureaucratic nuisances like the FDA.”
Geoff tensed his jaw. He had no fondness for government bureaucracy either, but the life of another human being was too great a cost for scientific advancement. There was no point in debating Zelenkov further. It would just get Geoff in deeper trouble with Balassi. “I suppose there are alternatives, Dr. Zelenkov.”
Zelenkov managed a thin smile, his twitch diminished. He leaned toward Geoff, extended his hand. “I’m glad you can see things from our perspective, Geoffrey. Please consider my offer to visit PETronics. I think you will find it a very rewarding experience.”
Chapter 17
The team of doctors and nurses rounding on the neurosurgical patients recently discharged from the NSICU paused by the door to room 725. Mark Jackson, the first-year neurosurgery resident, lead the discussion.
“How’d Smithers do last night?” he asked Leslie Rogers, the night nurse coming off shift.
“Considering the extent of his injuries, he’s recovering well from a medical point of view. His vitals have been stable, though he hasn’t eaten much since yesterday and didn’t sleep well at all. The thing I’m more worried about is how much residual brain damage he might have. His psychological status seems a bit strange.”
“Strange? What do you mean?” asked Mark, as he looked over the neuro record from the night shift.
“He took a nap after the ICP bolt was flushed and removed yesterday afternoon, but when he woke up around dinner time he started acting a little paranoid.”
“Paranoid? All of these head trauma patients act a little weird. You and I would, too, if we had our brains scrambled like he did. He probably has some residual brain swelling, that’s all.”
Leslie Rogers was annoyed at the young resident’s flippant attitude. “I’ve been a neurosurgical nurse since long before you started medical school, Dr. Jackson. I’ve seen thousands of post-head trauma patients, and I’m telling you the patient has more than the usual post-head trauma depression or lack of inhibition. He was downright paranoid during the night.”
“I wasn’t questioning your experience, Leslie, but he seemed to be coming along fine yesterday when we discharged him from the NSICU,” said Mark Jackson. “Why don’t you tell me more about this?”
“During the night he kept saying I was trying to drug him and refused to eat or take any medication by mouth. It almost seemed like he was hearing voices, he seemed so agitated and distracted. He had a very fitful night’s sleep. We’ve had to sedate him and give all of his medications and fluids intravenously.”
Leslie Rogers checked her watch. “In fact, he’s due for another dose of his sedative now.”
“What did you give him?” Mark asked.
“Just some Seconal and—”
The startling sound of glass breaking inside room 725 resonated along the hospital corridor. Mark Jackson and Leslie Rogers dropped their charts and rushed into Smithers’ room.
“Oh, my God!” screamed Leslie. She put her hand to her mouth.
Standing by the far side of the bed, still holding the chair he had used to break the window, was Smithers. His chest heaved, and his bloodshot eyes danced wildly as the wind rushed in through the gaping window. A fresh cut across his forehead dripped blood on the floor below.
“Stay away from me!” he screamed, saliva spraying from the corners of his mouth. “You’re trying to poison me, I know you are!”
Mark Jackson approached cautiously, his shoes crunching on the shards of glass that covered the floor.
“Mr. Smithers, no one here is trying to poison you. The doctors and nurses here—all of us—are trying to help you. You’ve been in a bad accident. You’re recovering, and everything is going to be all right. I think you’re just overtired and feeling stressed from the whole ordeal.”
Mark continued advancing towards Smithers. “Why don’t you get back in bed, and we’ll give you a little somet
hing to—”
“I won’t let you give me any more of your poisons! You’re fucking up my head, man!” Smithers threw the chair at them.
Mark and Leslie ducked, and the chair crashed into the wall. Several more people crowded the doorway to the room. Leslie Rogers tried to shoo them away.
“Mr. Smithers, we won’t give you anything, I promise,” Mark said. He halted in his tracks.
Smithers climbed up on the window ledge. “That’s what he told me, too, but he fucking lied to me! Look what’s happened,” Smithers said, pointing to his head. “But it’s not going to happen again. I won’t let it!”
“Who told you, Mr. Smithers? Maybe I can talk to him,” asked Mark, feebly trying to reason with him by playing into his paranoid delusion.
Mark extended his hand in as non-threatening a way he could. “Why don’t you just step back in the room. I promise to tell him never to do it again. Deal?”
Smithers remained on the window sill. His legs were wobbly, barely able to hold up the rest of him. His bloated face was drenched with sweat. He looked down at the street below, then back toward Mark and Leslie.
Ever-so-slowly, Mark Jackson approached, his hand extended, to barely a foot away.
Smithers reached out his trembling hand, then quickly pulled back. He began to laugh like a madman. “I’m free!” he screamed as he fell backwards out of the seventh story window.
Mark Jackson lunged forward, but it all happened much too quickly. All he came up with was Smithers’ slipper.
“Holy shit!” he yelled, looking out the window. “He’s landed on the third floor overhang! Call a code!”
Geoffrey Davis was on his way to the ER when he was paged stat to the third floor roof. He arrived on the scene just after the code team had started the resuscitation attempt. Unfortunately, they were delayed by the fact the fire exit to the roof had been left locked. They’d had to remove a patient from a third floor room and smash a window to get to Smithers.
Officer Smithers lay on his back, unconscious, bloody fluid oozing from his mouth and nose. Medic Enrique Santos straddled his chest, performing CPR. Mark Jackson breathed him with an ambu bag, and an intern monitored his vitals.
“What the hell happened here, Mark?” asked Geoff.
“We were making rounds on the seventh floor, and Leslie Rogers was just telling me the patient had been acting strangely during the night, when all of a sudden we heard this loud crash, and there he was by the broken window, a chair in his hand, raving like a lunatic.” Jackson continued breathing Smithers with the ambu bag.
“Jesus Christ. What the hell is going on with the neurosurgery service?” asked Geoff in frustration. He knelt at the patient’s side opposite Santos, placed his stethoscope on Smithers’ belly, turned to the intern on his right. “What’s his blood pressure?”
“70/40. Pulse barely palpable.”
“Doesn’t look good, Geoff,” Santos said.
“No, it doesn’t, my friend. How’d you get involved in this code?”
“I was coming off shift, leaving the trauma center. I heard the crash and saw him fall. I ran right up here.”
“You’ve tried to save him twice, only I don’t think he’ll be as fortunate this time.” Geoff removed the stethoscope, felt Smithers’ belly, which was rapidly expanding. “Keep the compressions going,” he ordered, knowing it was a lost cause.
“Don’t you think he’s hemorrhaging too quickly for us to keep up with it?” Santos asked.
“I’m sure you’re right. In fact, he probably transected his abdominal aorta. His femoral pulses are absent,” Geoff said in a hushed tone.
“Should we call it off?” Mark asked.
Geoff panned the surreal scene taking place on the third floor roof around him, then his patient, who just yesterday had been on the miraculous road to recovery from severe head injuries. He thought they had saved him, just like Jessica and DeFranco. The last patient on the NSICU service. Damn. Something or someone was working against him.
Geoff thought of the most recent e-mail message he’d received, the words now holding greater meaning. There are no accidents in life.
He looked down at Smithers’ corpse, then at Santos, at the intern fruitlessly pumping Smithers’ chest.
Geoff turned to Mark Jackson. “Call it off. He’s gone.”
Chapter 18
Geoff and Stefan sat in a booth in the back corner of a smokey coffee house on Houston Street. Geoff wasn’t thrilled with the idea of taking the train down to SoHo after his last subway trip, but he had thought it was only fair to meet in Stefan’s neck of the woods, since Geoff had called him for help. So Geoff had taken a cab. The irony of the present situation wasn’t lost on the two brothers, trying now to communicate above the tavern’s din.
“I’m trying to remember the last time you asked me for help,” Stefan said. “It’s usually the other way around.” He sipped his Molson’s, placed it back down on the table. “I think it was 1998. You were having problems installing a program on your hard drive. I had to do some re-programming for you. Fixed it pretty well, best I can recall.”
Geoff shifted in his seat, took a swig of Stoli. The iced vodka slid down the back of his throat, burning a track in its wake. “Stefan, you make it sound like I don’t need you for anything. You know that’s not true. I really appreciated being able to stay at your place the other night.”
“Don’t take it to heart, big brother. I’m just giving you a hard time. Making up for all those times you beat me up in the backyard.” Stefan smiled. “Any more news on the rabbi?”
“Nothing I’ve heard about. The ME’s office should be finishing his post pretty soon. I haven’t heard any more about his background, any history of mental illness.”
Stefan examined the printouts of the e-mails Geoff had brought. He enjoyed being needed by Geoff. “Hmm. Very smart sender you’ve got here. Each e-mail message passed through at least five different Internet gateways before arriving in your box. Impressive. Has to be a hacker. Or a spy. Almost impossible to trace.”
“Can you narrow down the location at all by looking at these gates on the printout?”
“Not really. Could be from the next room, could be from China. Here. Look at this path of origin,” said Stephan. “On the surface, the message seems like it came from ‘USDA.gov,’ an Internet address at the U.S. Department of Agriculture. This may be the case, but I’d bet he’s using someone else’s address or simply routing the electronic message through the gate to disguise the real origin. That’s what makes it so tough to pin down. It’s kind of like trying to trace a phone call routed through many different satellite networks. Only tougher.” Stefan paused, thought for a moment. “Have you responded to any of the messages?”
“I thought about responding to the last one, but I wasn’t sure it would be wise.”
“There are two advantages to getting a conversation going. One, just like a phone call, it may make it easier to trace. Maybe the sender will slip up and give us a clue. I doubt it, but you never know. Second, you may get some clues about who this person is just by striking up a conversation. Sex, background, interests. Discerning gender alone narrows it down by fifty percent. You may find out a lot that way.
“I guess it’s worth a try.”
Stefan studied the text of the message further. “Any significance to the codename Proteus that comes to mind?” He looked up at Geoff, adjusted his glasses. “You were the classics major.”
“None I can think of, other than the obvious. Proteus, Greek sea god able to change shapes at will, or in this case, e-mail addresses.”
“That’s it?” Stefan asked.
Geoff paused, rubbed his brow, thought further. “For what it’s worth, the myth is that if Proteus was caught and held onto through his many disguises he’d resume his own shap
e and be compelled to answer questions.”
Geoff sank back in his seat. “Whoever this Proteus is, he or she is behind what’s going on at the Trauma Center or is onto it. I’ve got to find out who it is, Stefan.”
“I hear ya, brother. I do. I didn’t say it was impossible, just almost impossible. I think I can trace it down if you give me a few days. In the meantime, write back. Give it a try.”
Geoff leaned forward, looked around, spoke in hushed tones.
“I don’t have a few days, Stefan. Patients are dying for reasons I don’t understand.”
“Sounds like some pretty heavy shit coming down. I’ll do what I can.” Stefan smiled, reached into his shirt pocket. He handed Geoff a small black metal object, slightly larger than a computer flash drive. “Happy birthday, big brother.”
Geoff held up the device and examined it. He was puzzled. “My birthday’s not until November, but I’ve got a drawer full of flash drives I bought at Costco last week. Any files in particular you want me to download?”
“A little something I put together for you. I think it will come in handy.” Stefan grinned, adjusted his wire-frame specs. He leaned across the table, motioned for Geoff to do the same. “When you told me about the problems you were having getting data out of the Traumanet system, I did some analysis of the situation. A system like Traumanet has multiple layers of security. It has to, given the confidential information that’s out there and the large number of users, each person with different information needs and roles. Physicians tend to have a pretty high level of access in healthcare information networks, but I think you’ve been shut out of the high level information loop, Geoff. The data’s out there in cyberspace. You just can’t retrieve it.”
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