Foreign Body

by Robin Cook

  Tense from the movie, Cal jumped when he felt the nudge, took one look at who’d caught his attention, and then paused the movie. “Raj! We’re glad to see you back. How did it go?”

  “I’m afraid it did not go well at all,” Raj admitted, and dropped his eyes from Cal’s to the floor. “It was a disaster.”

  There was a moment of silence as all eyes regarded Raj.

  “I thought we shouldn’t have gone ahead with another so soon,” Veena blurted out. “You should have listened to me!”

  Cal raised his hand to quiet her. “I think we should hear from Raj before we jump to any conclusions. Tell us what happened, Raj. Don’t spare the details.”

  Without much embellishment, Raj told the whole story, from colliding with the doctor to being thanked by the doctor in the hospital corridor after the failed resuscitation attempt. When he was finished he fell silent, still looking down at the floor and avoiding eye contact with anyone.

  “That was it?” Cal asked, after a brief silence. Cal was relieved. He and everyone else had expected something a lot worse, like Raj being accused of doing what he in reality did do. “And let me review. The working diagnosis was heart attack and stroke of some sort. That’s what will be on the death certificate?”

  Raj nodded. “That’s my understanding.”

  “And you heard nothing about an inquest, an autopsy, or any investigation?”

  “No. Nothing like that. What I did overhear from the surgeon was that an e-mail had come out that obligated him to call the hospital CEO and report the death immediately. Apparently there’s concern because of the two deaths at the Queen Victoria Hospital causing international attention. They are going to want to suppress any attention toward tonight’s death.”

  “That sounds almost too good to me,” Cal said. “Under the circumstances I can’t imagine that this kind of potential disaster could have any better outcome. Raj, it seems as if you did a terrific job.”

  Raj began to perk up. He even made eye contact with several people. Led by Cal, there was even spontaneous applause. “Let’s get a bunch of Kingfisher from the fridge and make a toast to Raj,” Cal said.

  “What about stopping any more episodes?” Veena questioned. “I think we should decide now to stop them, at least for a few days. Let’s not push our luck.”

  “That seems reasonable,” Cal said, “but let’s get full advantage of this one. Did you get the patient’s hospital record?” Cal asked Raj. Raj went into one of his pockets and pulled out his USB storage device and the succinylcholine syringe. Cal took the storage device and handed it to Santana. “Let’s get this death episode right to CNN. With the failed resuscitation attempt, it should make good copy and have even more impact. Encourage them to get it on the air ASAP.”

  Santana took the storage device. “It will only take me a few minutes, then I’ll be back for that beer. How about waiting.”

  Chapter 21

  OCTOBER 17, 2007

  WEDNESDAY, 9:05 P.M.

  NEW DELHI, INDIA

  Jennifer’s sleep pattern had never been so out of whack. When she’d returned to her room from having dinner with Lucinda Benfatti, she was so tired she’d almost fallen asleep brushing her teeth. But once she’d gotten into bed and turned out the lights, her mind started waking up. Before she knew it, she was anticipating Laurie and Jack’s arrival with great excitement and wondering whether she should have already reserved one of the hotel cars to pick them up. It seemed that ten p.m. to two a.m. was when most of the international flights arrived, so the demand for the hotel’s vehicles was the highest then.

  Worried that she might already be out of luck, Jennifer sat up, turned on the light, and called down to the concierge’s desk. Talking with the concierge, she learned something she didn’t know. An airport pickup for Amal Palace guests was complimentary, and a vehicle was already scheduled to pick up Laurie and Jack. Asking if she could join the pickup, the concierge assured her she could, told her when it would be leaving, and promised to let transportation know that she would be going along.

  With that job out of the way, Jennifer turned the light off again and wriggled down under the covers. At first she started out on her back with her hands comfortably folded on her chest. But with her mind activated from making the car reservation, she found herself puzzling over whether Laurie and Jack would have more luck dealing with the case manager than she did, and what that would mean in regard to a possible autopsy.

  A few minutes later, Jennifer turned on her side while she thought about cyanosis and wondered if Herbert Benfatti had been cyanotic, and how she might find out.

  Five minutes later, she was on her stomach thinking about what she should do the following day. She certainly had no intention of hanging around the Queen Victoria Hospital and being badgered all day. She thought she might try to do a bit of sightseeing, even though, as preoccupied as she was, she thought she might find it tedious. She knew herself well enough to know that even in the best of circumstances, she wasn’t much of the sightseeing type as far as old buildings and tombs were concerned. What she did find interesting was people.

  At that point she started thinking about how little she knew about India, Indians, and Indian culture.

  “Damn!” Jennifer suddenly said to the darkness. Despite her body’s insistence that it was exhausted, her mind was buzzing like a beehive. With frustration Jennifer sat up, turned the bedside lamp on, and got out of bed. In the walk-in closet she located the several Indian guidebooks she’d gotten at LAX, brought them back into the room, and tossed them onto the bed. She then went over to the TV and angled it from pointing at the couch to point at the bed. Leaping back into the bed, she used the remote to tune in CNN International. She then cursed again, realizing she’d forgotten water. Climbing back out of bed and going to the minibar refrigerator, she got herself a bottle of cold mineral water and popped the top. Back in the bed, she puffed the pillows and eased herself against the headboard. Finally comfortable, she cracked one of the guidebooks and turned to the section on Old Delhi.

  As the CNN anchors droned on about clever French entrepreneurs dreaming up Disney-themed hotels for Dubai, Jennifer read about the Red Fort built by Mughal emperors. There were lots of facts and figures and names and dates. On the next page there was the description of the largest mosque in India, with equally boring statistics, such as how many people it could hold for Friday services. But then she came upon something that did really interest her: a lengthy description of the renowned bazaar of Old Delhi.

  Jennifer was trying to locate the world-famous spice bazaar on the guidebook’s cutaway map when the TV caught her attention. The woman anchor announced, “Following up on the news of two deaths in the heretofore vaunted Indian medical tourism hospitals, there has now been a third only an hour or so ago. Although the first two deaths occurred at the Queen Victoria Hospital in New Delhi, tonight’s tragic death occurred at the Aesculapian Medical Center, also in New Delhi, and involved a healthy, although obese, forty-eight-year-old from Jacksonville, Florida, named David Lucas. He’d undergone stomach-stapling surgery this morning. He is survived by a wife and two children, aged ten and twelve.”

  Mesmerized, Jennifer sat up straight.

  “Such a tragedy,” the male anchor agreed, “especially with the children involved. Did they say what the cause of death was?”

  “They did. It seems that it was some sort of heart attack/stroke combination.”

  “It’s awful. People going to India to save a few bucks, and wham, they come home in a box. If I were facing surgery and had to choose between it costing a little less and dying versus spending a bit more and living, there’s no doubt what I’d chose.”

  “No question. And apparently a number of other clients are reacting the same way. CNN has been getting a rising blizzard of reports and e-mails of people canceling surgery scheduled to be done in India.”

  “I’m not at all surprised,” the male anchor said. “As I said, if it were me, I certainly
would.”

  When the anchors switched to another subject dealing with Halloween coming up in a mere two weeks, Jennifer lowered the TV’s volume. She was again stumped. Another cardiac death in a private Indian hospital involving a healthy American occurring about the same time postsurgery.

  Jennifer looked at the clock and tried to figure out what time it was in Atlanta. She came up with about eleven-thirty in the morning. Impulsively, she grabbed her phone, and by using AT&T directory assistance got herself connected to CNN. After explaining what she was interested in and being switched around from several different departments, she finally got a woman on the line who seemed to know what she was talking about. The woman introduced herself at Jamielynn.

  “I just saw a segment on CNN International about a medical tourism death,” Jennifer said. “What I’d like to know is, who—”

  “I’m sorry, we don’t divulge anything about our sources,” Jamielynn said, interrupting Jennifer.

  “I was afraid of that,” Jennifer said. “But what about the time the story came in. That wouldn’t compromise your source in any way.”

  “I suppose not,” Jamielynn agreed. “Let me ask! Hold the line!” Jamielynn was gone for a few minutes before coming back. “I can tell you when it came in but that’s all. It came in at ten-forty-one a.m. EST and was broadcast the first time at eleven-oh-two.”

  “Thank you,” Jennifer said. She wrote it down on the pad by the phone. She then called down to the concierge and asked for the phone number of the Aesculapian Medical Center. Once she had it, she dialed it. She had to wait for a number of rings. When it was answered, she asked to be connected to David Lucas’s room.

  “I’m sorry, we are not allowed to ring patient rooms after eight.”

  “How do family members call after eight?” Jennifer thought she knew but wanted to ask anyway.

  “They have the direct-dial number.”

  Jennifer hung up without saying good-bye. She felt she was on a roll, and called down to the front desk. She asked if there was a guest in the hotel by the name of Mrs. David Lucas. As she waited, she wondered if she’d be able to muster the courage to call the woman so soon after the event.

  “I’m sorry, but we have no Mrs. Lucas registered at the hotel,” the front desk clerk said.

  “Are you certain?” Jennifer questioned. She felt an immediate letdown.

  The clerk spelled the name and asked if Jennifer had an alternate spelling. Jennifer said no and discouragingly was about to hang up when she thought of something. “I’m here at the Amal Palace Hotel because of the Queen Victoria Hospital. Do other private hospitals put their international patients’ next of kin at other hotels?”

  “Yes, they do,” the clerk said. “Even the Queen Victoria does as well if we are fully booked.”

  “Can you tell me what hotels I might try?”

  “Yes, of course. Any of the other five-star hotels. The Taj Mahal, the Oberoi, the Imperial, the Ashok, and the Grand are the most popular, but the Park and the Hyatt Regency are used as well. It depends on availability. If you’d like to be connected to any of these hotels, the operator will be happy to do it.”

  Taking the clerk’s advice, Jennifer called the other hotels in the order in which they had been given. It didn’t take long. Jennifer scored on the third hotel, the Imperial.

  “Can I connect you?” the Imperial operator asked.

  Jennifer hesitated. She would be seriously disturbing and upsetting the woman, no matter whether the woman was aware of her husband’s status or not. Yet with the similarities between her grandmother’s case, Mr. Benfatti’s, and this current one, she felt she had little choice. “Yes,” Jennifer said finally.

  Jennifer grimaced as she heard it ring. When it was answered she rapidly jumped and initially stumbled over her words as she explained who she was and apologized effusively for being a disturbance.

  “You are not disturbing me,” Mrs. Lucas said. “And please call me Rita.”

  You won’t be asking me to call you Rita as soon as I tell you why I’m calling, Jennifer thought to herself as she struggled to find the courage to begin. It was already clear to her that like herself and Mrs. Benfatti, Rita had not yet been informed of her husband’s fate, even though CNN already had it on the air. To soften the blow, Jennifer went ahead and explained to the woman what had happened to her and Lucinda vis-à-vis CNN.

  “That’s awful learning like that,” Rita said sympathetically, but her voice trailed off as if she reluctantly sensed why Jennifer was calling her after nine at night.

  “Yes,” Jennifer agreed, “especially since in the U.S. the media go to great lengths to avoid it because they want the family informed first. But Mrs. Lucas, just a few moments ago I had CNN International on, and the anchors discussed the tragedy of your husband’s passing.”

  After finally getting herself to say it, Jennifer fell silent. As the seconds ticked by, Jennifer didn’t know if she should express sympathy or wait for Mrs. Lucas to respond. As the time passed, Jennifer could no longer stay silent. “I am so sorry to have had to be the one to tell you this awful news, but there is a reason.”

  “Is this some cruel prank?” Rita demanded angrily.

  “I assure you it is not,” Jennifer said, feeling the woman’s anger and pain.

  “But I just left David only a little more than an hour ago, and he was perfectly fine,” she yelled.

  “I understand how you feel, Mrs. Lucas, with a stranger calling you up out of the blue. But I assure you it was broadcast around the world that a David Lucas of Jacksonville, Florida, passed away at the Aesculapian Medical Center an hour or so ago, and he is survived by a wife and two children.”

  “My God!” Rita voiced in desperation.

  “Mrs. Lucas, please call the hospital and make sure of this. If it is true, which I hope it isn’t, please call me back. I’m only trying to help. And if it is true, and they try to pressure you into agreeing to cremation or embalming immediately, please do not do it. Because of my experience with the hospital where my granny and Mr. Benfatti had had their surgery, I’m thinking there is something wrong, something very wrong, with Indian medical tourism.”

  “I don’t know what to say!” snapped Rita, angry but confused that Jennifer sounded so sincere.

  “Don’t say anything. Just call the hospital, and then call me right back. I actually already called the hospital, but they wouldn’t give me any information, which is silly, since it has already been on international television. I’m staying at the Amal Palace Hotel and will stay here by the phone. Once again, I’m sorry to be the one to have had to call you when it was the hospital’s responsibility.”

  The next thing Jennifer knew, she was listening to a dial tone. Rita had hung up on her. Thinking she might have done the same had the situation been reversed, Jennifer slowly hung up the receiver. It gave her a terrible feeling to have been the messenger with such bad news, and she found she hated the role. At the same time, as a physician in training she knew that she might have to do it a number of times over the course of her career.

  Knowing that sleep was now completely out of the question, Jennifer wondered what she should do. She thought about reading more in the guidebook but then gave up. She couldn’t concentrate. She began to worry that even if the CNN report had been correct, Rita might leave her in the dark and not call her back in a kind of passive-aggressive reaction, blaming the messenger.

  Without coming up with a better idea, Jennifer turned up the volume on the TV and blankly began watching a CNN segment on Darfur. But no sooner had she gotten herself comfortable when her phone rang. She snatched it up practically before the first ring terminated. As she hoped, it was Rita, but Rita’s voice had changed. She was now choked up to the point that it was difficult for her to speak.

  “I don’t know who you are or what kind of human being you are, but my husband is dead.”

  “I’m terribly sorry, and I certainly didn’t get any pleasure from having had to be the
one to tell you. The only reason I was willing to do so is to warn you about the hospital possibly trying to bully you into giving them permission to cremate or embalm.”

  “What difference does that make?” Rita snapped.

  “Only that if either is done, an autopsy can’t be done. It seems already that there are similarities between your husband’s unexpected passing and my grandmother’s and Mr. Benfatti’s. I would assume your husband’s death was unexpected?”

  “Absolutely! We had him cleared by his cardiologist only a month before.”

  “It was the same with my grandmother and Mr. Benfatti. To be honest, I’m concerned these deaths are not natural. That’s what I meant when I said something was wrong.”

  “What do you mean exactly?”

  “I’m concerned these deaths might be intentional.”

  “You mean someone killed my husband.”

  “Somehow, yes,” Jennifer said, realizing just how paranoid such a statement sounded.

  “Why? No one knows us here. There’s no way for someone to benefit.”

  “I’ve no clue, I’m afraid. But tomorrow night two forensic pathologists who are friends of mine are arriving. They are going to help me with my grandmother. I could ask them to check your husband’s case, too.” Jennifer knew she was going out on a limb offering Laurie and Jack’s services without consulting them, but she thought they’d be willing to help. Jennifer also knew that in trying to solve a conspiracy, the more cases there were, the more chances of success.

  Jennifer could hear Rita blow her nose before coming back on the line. There were catches in her breathing as she tried to control her grief.

  “Please, Mrs. Lucas. Don’t let them destroy any potential evidence. We owe it to our loved ones. Also, you could ask whoever found your husband if he was blue. Both my granny and Mr. Benfatti were blue.”

  “How would that help?” she demanded, fighting tears.

  “I don’t know. In this kind of situation, if what I fear is true, there’s no predicting what facts might solve the mystery. I’ve learned that studying medicine and trying to make a diagnosis. You just don’t know what’s going to be important.”