Foreign Body

by Robin Cook

  “Are you a doctor?”

  “Not yet. I’m in my last year of medical school. I’ll graduate in June of ’08.”

  “Why didn’t you tell me?” she demanded, although with considerably less acrimony.

  “I didn’t think it mattered,” Jennifer said, although when she thought about it, she had experienced episodes where people seemed inappropriately to give her opinion more credence, even about issues unrelated to medicine, when they found out she was a medical student.

  “I’m not going to promise anything,” Rita said. “But I’m on my way to the hospital now, and I’ll think about what you said. I will call you in the morning.”

  “Fair enough,” Jennifer said.

  The fact that Rita went on to say good-bye gave Jennifer reason to be optimistic. The woman would not only get back in touch with her but would also cooperate. But as Jennifer thought about this third death in so many nights and its implications, it reminded her of a famous Shakespearean quote: “Something is rotten in the State of Denmark.” At the same time, it did cross her mind that she could be using this conspiracy idea as another way of blocking the real impact of her grandmother’s passing.

  Chapter 22

  OCTOBER 17, 2007

  WEDNESDAY, 10:11 P.M.

  NEW DELHI, INDIA

  Ramesh Srivastava did all he could to keep his composure. Here it was after ten at night and he was getting yet another call. To him it has seemed like he’d been on the phone all evening. First it had been his deputy of the department of medical tourism calling to say that his immediate subordinate deputy had called him only minutes earlier with the disappointing news that there’d been a report on CNN of yet another American patient death in a private Indian hospital. It was the third in three days, this time at the Aesculapian Medical Center. What made it particularly newsworthy was that the patient, David Lucas, was only in his forties. No sooner had Ramesh finished that unsettling call than he got a call from Khajan Chawdhry, the CEO of the involved hospital, with all the details as he knew them. Now here was the phone ringing yet again.

  “What is it?” Ramesh demanded, with no attempt at sociability. As a high-ranking Indian civil servant, he didn’t expect to be working this hard.

  “It is Khajan Chawdhry again, sir,” the CEO said. “I’m sorry to bother you, but a slight problem has developed in relation to one of your specific orders—namely, your insistence there should be no autopsy.”

  “How can there be a problem?” Ramesh demanded. “It’s a very simple order.”

  Earlier, Khajan had explained the bizarre sequence of events involving David Lucas’s demise, starting with the incipient cyanosis with no airway obstruction, followed by the changes in the heart’s conduction system and a sudden rise in the patient’s temperature and potassium level. As a nonphysician, Ramesh had asked for a translation of the irritating doctor gobbledygook and had been told the man had died of some sort of heart attack/stroke combination as a best-guess hypothesis. Ramesh’s response had been for the attending surgeon to sign the death certificate as exactly that, and under no circumstances ask for an autopsy to be authorized.

  “The problem is the wife,” Khajan said sheepishly. “She said she may want an autopsy.”

  “People generally do not want autopsies,” Ramesh said irritably. “Did the surgeon talk her into requesting one after I specifically ordered him not to do so?”

  “No, the surgeon is well aware of the general negative feeling about autopsies in the private sector, and specifically aware of your feelings in this case. It wasn’t he who has spoken to the wife about an autopsy, but rather another American, by the name of Jennifer Hernandez, who had called her prior to the wife’s even hearing about her husband’s death. It was this Hernandez woman who raised the issue of a possible autopsy by saying several American forensic pathologists were on their way to look at her grandmother, and could look at her husband as well, provided the husband’s body was not cremated or embalmed.”

  “Not her again!” Ramesh groaned out loud. “This Hernandez woman is becoming intolerable.”

  “What should I do if Mrs. Lucas insists on the autopsy?”

  “Like I told Rajish Bhurgava over at the Queen Victoria, make sure the autopsy request gets picked up by one of the magistrates we’re accustomed to working with, and inform him there’s to be no autopsy. Meanwhile, try your best to get Mrs. Lucas to agree to cremate or embalm. Lean on her! Is she still at the hospital?”

  “She is, sir.”

  “Do your best.”

  “Yes, sir.”

  Ramesh disconnected and immediately called Inspector Naresh Prasad.

  “Good evening, sir,” Naresh said. “I don’t hear from you for months, then twice in one day. What can I do for you?”

  “What have you learned?”

  “What have I learned about what?”

  “About the mole in the Queen Victoria Hospital and the thorn in my side, Jennifer Hernandez.”

  “You’re joking. We just spoke today. I haven’t started looking into either issue yet. I’m just putting a team together for tomorrow.”

  “Well, both problems are getting worse, and I want some action.”

  “How are they getting worse?”

  “There was another death, and again CNN had it on the air almost immediately. I heard about it from a deputy whose assistant happened to catch it on TV not much later than the CEO of the hospital heard it directly from his staff doctor who’d tried to resuscitate the patient.”

  “Am I to assume it was the same hospital, the Queen Victoria?”

  “No, this time it was the Aesculapian Med Center.”

  “Interesting! Changing hospitals might help if the culprit is a staff physician. He or she would have to have privileges at both hospitals. That could narrow the list down quite nicely.”

  “Good thought. That hadn’t occurred to me.”

  “Maybe that’s why you’re a bureaucrat and I’m a police investigator. What about the woman? What’s she done to irritate you further?”

  Ramesh told Naresh what Khajan had told him about Jennifer talking the wife into requesting an autopsy even before the hospital had informed the woman her husband had died.

  “How did the Hernandez woman know the man had died?”

  “I don’t know for certain, but I’d have to guess she saw it on CNN International.”

  “Maybe she knows someone at CNN who is informing her. What do you think of that idea?”

  For a moment Ramesh did not respond. He found himself getting vexed at wasting his time with such mental gymnastics. That was Naresh’s job, not his. What he wanted was results. He wanted to be rid of the whole mess so that the public-relations damage could be fully accessed and then, he hoped, repaired.

  “Listen!” Ramesh said suddenly, ignoring Naresh’s question. “What it all comes down to is this. Jennifer Hernandez is making a supreme nuisance of herself, and in the process putting the future of Indian medical tourism in jeopardy, particularly from the perspective of the United States, which promises to be our biggest potential market because of its idiotic healthcare system and the out-of-control medical inflation it fosters. I want you to take care of this woman, either yourself or some agent you trust. Tail her for a couple of days and keep me informed in real time who she sees, who she talks with, and where she goes. I want a full report, and most of all I want a reason to deport her without causing a scene or publicity of any sort. If she’s not doing anything wrong, conjure it up. But for heaven’s sake don’t make a martyr of her, meaning no strong-arm tactics. Understood?”

  “Quite so,” Naresh said. “I will start in the morning with the Hernandez woman, and I will see to it myself. I will also put a trusted agent on the issue of who is tipping off CNN.”

  “Perfect,” Ramesh said. “And as I said, keep me informed.”

  As he hung up the phone, Ramesh noisily exhaled in exasperation. Although he felt good about having built a little fire under Naresh and took
the man at his word, meaning he expected him to follow Jennifer Hernandez around starting in the morning, the question of whether it would be enough and soon enough dogged him. In his mind he considered Naresh dependable and reasonably competent but certainly not the sharpest knife in the cutlery drawer. At the same time, Ramesh worried what the effect of yet another death reported by CNN was going to have on the higher-ups who’d called him that very afternoon to complain about the other two. It was clear it wasn’t going to be positive, and it cast more doubt on the efficacy of Naresh’s methodical but slow style. Such thinking reminded Ramesh of his call that afternoon to Shashank Malhotra, who was anything but slow and methodical. Believing it couldn’t hurt to rile the rash businessman a little more, Ramesh picked the phone back up and made what he hoped would be the last call of the day.

  “Are you calling me with some good news this time?” Shashank demanded as soon as he knew who was calling.

  “I wish that were the case,” Ramesh responded. “Unfortunately, there was another medical tourist death tonight that has already been reported on CNN International.”

  “Was it again at Queen Victoria?” Shashank demanded. It was clear he was in no mood for small talk.

  “That’s the single aspect of the event on the positive side,” Ramesh said. “It was at the Aesculapian Med Center on this occasion.” In a way, Ramesh was provoking Shashank with this comment, knowing the Aesculapian Med Centers were just as much a part of Shashank’s holdings as the Queen Victoria Hospital. “The bad aspect is that the patient was young and leaves behind a wife and two children. Such a story frequently garners more media attention because of the sympathy angle.”

  “You don’t have to tell me what I already know.”

  “The other problem is this Jennifer Hernandez. Somehow she’s got herself involved in this case as well as the last one, even though it was at a different hospital.”

  “What has she done?”

  “You understand that on sensitive cases like this we want to avoid autopsies, because autopsies are like feeding wood to a fire. The less attention the better, so we avoid the media and specifically avoid giving them anything newsworthy, which frequently autopsies are.”

  “I understand. It makes sense. Don’t make me ask again!” Shashank growled. “What has she done?”

  “She’s somehow convinced both widows to demand autopsies.”

  “Shit!” Shashank snapped.

  “I’m curious,” Ramesh said, trying to sound nonchalant. “I asked you this afternoon if you could find someone who could talk with her and convince her that what she is doing is not in her best interests and that maybe, just maybe, it would be far better for her to take her grandmother’s remains back to America before she severely impacts Indian medical tourism. Later this afternoon, I was informed of quite a number of patients making last-minute cancellations of their scheduled surgeries, not only from America but also Europe.”

  “Cancellations, you say.”

  “Yes, cancellations,” Ramesh repeated, knowing that Shashank’s business mind closely associated cancellations with lost revenue.

  “I must confess that this afternoon I put off taking your suggestion,” Shashank growled, “but I’ll look into it right now.”

  “I think you’d be doing Indian medical tourism a big favor. And in case you’ve forgotten, she’s staying at the Amal Palace Hotel.”

  Chapter 23

  OCTOBER 17, 2007

  WEDNESDAY, 10:58 P.M.

  DELHI, INDIA

  Excuse me, sir,” the cabin attendant said as she gently shook Neil McCulgan’s shoulder. “Could you raise the back of your seat? We’re in the final approach, and we’ll be landing at the Indira Gandhi International Airport in just a few minutes.”

  “Thank you,” Neil said, and did as he was told. He yawned, then pushed back in his seat and wiggled around to get comfortable. Despite having left Singapore almost an hour and a half late, they were arriving only an hour late. Somehow they’d managed to pick up a half-hour, even though they’d been flying into the jet stream.

  “I’m impressed with how well you sleep on a plane,” Neil’s immediate seat neighbor said.

  “I’m lucky, I guess,” Neil responded. He had spoken with the gentleman for the first hour, learning that the man sold Viking kitchen appliances in northwestern India. Neil had found the man interesting, since their conversation made him realize, as an emergency-room doctor, how little he knew about the world in general.

  “Where are you staying in Delhi?” the stranger asked.

  “Amal Palace Hotel,” Neil said.

  “Would you like to share a cab? I live in the neighborhood.”

  “I have a hotel car picking me up. You’re welcome to join, provided you don’t have to wait for luggage. I just have carry-on.”

  “Same with me.” He stuck out his hand. “The name’s Stuart. I should have introduced myself earlier.”

  “Neil. Nice to meet you,” Neil said, giving the man’s hand a quick shake.

  Neil leaned forward and tried to look out the window.

  “Nothing yet to see,” said Stuart, who was sitting at the window.

  “No lights or anything?”

  “Not this time of year, not with the haze. You’ll see what I mean on our drive into town. It’s like a dense fog but is mostly pollution.”

  “That sounds nice,” Neil said sarcastically.

  Neil leaned back against the headrest and closed his eyes. Now that he was nearing his journey’s destination, he started to think about how he should meet up with Jennifer. During the two stops he’d had to make en route, he’d debated calling her. What he couldn’t decide was whether it was best to surprise her in person or by phone. The benefit of the phone call would be to give her some time to adapt to the idea. The problem with it was that there was a good chance that she might simply tell him to turn around and go home. Ultimately, it was such a fear that made him opt not to call.

  The huge plane’s wheels touched down with a thump that caused Neil’s eyes to pop open in surprise. He gripped the armrests to keep himself back in the seat as the plane braked.

  “How long are you staying in Delhi?” Stuart questioned.

  “Not long,” Neil said evasively. He wondered briefly if he should disinvite the gentleman from sharing his ride. He was in no mood to get into any kind of personal conversation.

  Apparently taking the hint, Stuart didn’t ask any more questions until they’d passed through both passport control and customs. “Are you here on business?” Stuart asked, as they waited for the hotel car to be brought around.

  “A little bit of both,” Neil lied while being less than receptive. “And yourself?”

  “The same,” the man said. “I’m here often and keep an apartment. It’s quite a city, but for my purposes, I prefer Bangkok.”

  “Really,” Neil said with little interest, although he vaguely wondered what the man’s “purposes” were.

  “If you have any questions about Delhi, give me a call,” the man said, handing Neil a Viking kitchen appliance card.

  “I’ll do that,” Neil said insincerely, pocketing the card after a quick glance.

  Both weary travelers settled into the hotel SUV’s backseat. Neil closed his eyes and returned to musing about how he was going to hook up with Jennifer. Now that he was in the same city as she, he found himself even more excited than he’d expected. He was truly looking forward to seeing her and to apologizing for not coming the moment she’d asked him.

  Neil opened his eyes long enough to check the time. It was five after midnight, and he realized that as excited as he was to see Jennifer, it would have to wait until morning. But then he began to wonder how he would surprise her then, an issue complicated by his acknowledging he had no idea of her schedule. He suddenly had an uncomfortable fear. Although it seemed unlikely enough for him not to have thought of it before, she might have concluded the business about her grandmother during the course of Wednesday, her fi
rst full day in Delhi, and could be flying out at that very moment: maybe even on the same plane he’d just flown in on.

  Opening his eyes, Neil shook the thought from his mind. He laughed at himself and looked out the window at the haze his fellow traveler had described earlier. It was enough to make health-conscious Neil feel congested.

  Shortly thereafter, the hotel car pulled up the ramp to the hotel’s main entrance. Several porters and doormen surrounded the vehicle, opening the doors.

  “Give me a call if I can help in any way,” Stuart said, shaking hands with Neil. “And thanks for the ride.”

  “Will do,” Neil responded. He got his carry-on bag from a porter with some effort, insisting he’d prefer to bring it into the hotel himself—not only was it not heavy, it had wheels.

  Check-in was accomplished sitting down at a desk, and as Neil handed over his passport, he asked the formally dressed clerk who’d introduced himself as Arvind Sinha if they had a Jennifer Hernandez registered. Unseen by the clerk, he actually crossed his fingers.

  “I can check for you, sahib,” Arvind said. He used a keyboard that he pulled out from beneath the desk’s surface. “Yes, we do, indeed.”

  Yes! Neil said to himself. Ever since he thought about the possibility of Jennifer’s having already left, he’d been torturing himself. “Can you tell me her room number?”

  “I’m sorry, I cannot,” Arvind apologized. “For security purposes, we cannot give out guest room numbers. However, the operator can connect you, provided Ms. Hernandez hasn’t a block on her phone and provided you think it is appropriate to call. It is past midnight.”

  “I understand,” Neil said. As excited as he was now that he knew she was there, he couldn’t help but be mildly disappointed. At the very least, he’d planned on going to her door and putting his ear against it. He’d decided that if he heard the TV, he was going to knock. “Can you tell me if she’s scheduled to check out in the next day or so?” Neil asked.