by L Jan Eira
CMC1224 was a new drug being tested in humans in the hopes of curtailing the frequency of an arrhythmia termed atrial fibrillation. Jack explained that this rhythm disorder was the most common of all; in the United States, one out of ten Americans in their seventies and eighties are burdened by this problem. The atria, the top two chambers of the heart, quiver rapidly making the ventricles beat fast and irregularly. As such, atrial fibrillation places individuals at risk for developing clots, which can cause strokes and disability.
Research efforts also included a new mode of delivering drugs into the body. Jack took a long time reviewing this folder. The concept was new to him. As he did so, Claire left to go make coffee. By the time she returned with two large mugs of Mr. Coffee-dripped medium boldness House Blend Starbucks, Jack had completed his review of the contents in the folder.
“Wow, Claire, this is really cool. They have come up with a way to insert medications into tiny bubbles. This one experiment in pigs with liver cancer is delivering chemotherapy right to the site of the malignancy. Nuclear-tagged molecules in the bubbles that allow tracking throughout the body. When the bubbles reach the site of the cancer in the liver, they use ultrasonic waves, at a pre-specified frequency, to burst the bubbles allowing release of high concentration of the chemotherapeutic drug right where they want it. They dial in the correct frequency and bang. This is expected to cut down significantly on systemic side effects. They are putting the medication right where it is needed, so it doesn’t affect other organs. Very neat, huh?” Jack had a look of excitement and enthusiasm.
“That is pretty cool. Is it working? Are they getting results?” she asked.
“I think so. They are comparing medication delivery by bubbles to the site of the malignancy versus giving the medication intravenously. The response rates are much higher with significantly less side effects.”
“Are they using this technology with other medications? Targeting other organs?”
“Not yet, but there are plans to use this technology in the heart, brain and—”
“Yes, I can see how it would deliver medications to the brain for seizures, brain cancer, Parkinson’s, et cetera,” interrupted Claire.
“Exactly. This is exciting stuff. This is also the bubble study John was trying to show us when we visited him in the research lab with the medical students. Using these bubbles filled with air, ultrasound visualization of the heart structures is enhanced marvelously. I was very impressed with the images when Rupert kicked us all out, that son of a bitch.”
“Now, now, Jack. Let it go with Rupert, already. So what else is there?”
Jack moved on to the last couple of folders and read their contents. After a moment, he announced to Claire this was a study of congestive heart failure fluid-overloaded patients resistant to medications. The research involved an apparatus resembling a kidney dialysis machine that ultra-filtrates blood and removes excess water. Jack gave testament to the utility and importance of this tool. He had seen it work wonders in some of his sicker heart patients in whom nothing else had made a difference.
The last folder was the most interesting yet. Jack studied it intensely, each moment more enthusiastically than before. After a long period of silence, Jack looked at Claire.
“Wow. No, double wow!” exclaimed Jack.
“What, what?” Claire could feel the fervor and exhilaration in Jack’s voice. She craned her neck to see the papers in the folder.
“Biological pacemakers. Wow! They are using mesenchymal pacing cells—”
“What kind of cells?” interrupted Claire.
“Mesenchymal cells are early cells in differentiation taken from bone marrow, capable of developing into any type of tissue. The researchers have found the gene that codes the cells into becoming cardiac pacing tissue. If this work is successful, in the future, instead of surgically inserting pacemaker devices in the hearts of patients with slow heartbeat disorders, I will be implanting these types of cells. The early research in dogs seems promising. They are using the canine model to induce sinus node dysfunction. The sinus node is the area that produces the heartbeat. The dog undergoes a procedure to destroy the node and develops a slow heart rate. Before implanting the biologic pacemaker cells, they document that the heart beats at twenty to thirty beats per minute, even when they make the dog exercise on a treadmill. The mesenchymal cells with rearranged genes geared to make them like sinus nodes are deployed and they take over the heartbeat. Voila! As good as new. Treadmill testing than confirms the dog’s heart responds appropriately to exercise. The pulse goes up appropriately. This is so neat.”
“That is neat. I suppose inserting these cells into the heart would be much easier on the patient than undergoing a pacemaker implantation?” asked Claire.
“I imagine,” Jack said, taking a few seconds to ponder the realm of possibilities, a smile on his face.
“So where does all this take us?” asked Claire, breaking the silence and jerking Jack into the reality of the moment. “Are we any closer to understanding why or how the murders took place?” she continued.
“No, not really. Let’s look at Rupert’s calendar entries. I saw some unusual entries.” While speaking, Jack looked through several pages of the copies he had made of the calendar. Then he continued, “Rupert wrote down two names on the edge of the calendar. One is a Major Wayne Rooner. Who could he be? A cop? A soldier? Boy scout troop leader?”
Claire smiled. “Maybe he’s an airline pilot? Why don’t you ask the cops?” she said.
“I will. The other name written on the side is Muhammad Akrim.”
“Did they have meetings? And when, and why?”
“Couldn’t tell you.” Jack walked to his computer, hit the Esc button to wake it up and Googled the names Major Wayne Rooner and Muhammad Akrim. Claire followed him and watched in anticipation. They were not rewarded with any returns from the information highway.
“I will have the cops investigate these names,” said Jack with a tired tone in his voice. He pulled out his Treo from his left pocket and found the phone number for Detective Herb Fuller in his Contact database.
*****
Seven days ago
September 24
8:10 AM
“I reviewed the medical records in detail. I also looked into the ongoing research projects at Newton Memorial over the last year. The whole thing starts with different trials whereby the number of rats being purchased for experimentation skyrockets for about three months. As this starts to taper off, the money required to purchase rats decreases to its usual baseline. Soon afterwards, we start to see a spike in the number of in-patients dying of unusual causes at Newton Memorial. After the in-patients start dying, we see the out-of-hospital casualties of equally bizarre circumstances. It is noteworthy that these were all men of similar age group and previously in good health. Deaths were premature, freakish, unexplained and marked by confusion, paranoia and bizarre behavior. The causes of death have been acute heart attack, intra-cranial bleeding, acute aortic dissection and cardiac arrest occurring in patients who had just been studied in the hospital and discharged with markers of a good prognosis. The tests are not one hundred percent foolproof, but for so many patients to have tested normal and go on to die so soon afterwards is implausible. These circumstances have all the ingredients of a research study. It is methodical and systematic.” After speaking these words, Jack sat down and waited for comments from the agents, detectives and other police officers in the meeting room.
“Good work, Jack. This does seem to provide some pretty convincing evidence that the hospital is the source of the crimes. It seems to be related to the research laboratory,” said Herb agreeingly.
“I don’t think we have proof that the research lab is involved. It could be that an employee anywhere in the hospital is scoping out the patients,” interjected Mike.
“True, but I think that’s where we must concentrate our efforts first. We have to start somewhere. Thanks for such a thorough and insight
ful analysis, Jack,” added Herb appreciatively.
“What about motive?” asked Susan.
“Until proved otherwise, motive is almost always money. Who would gain financially?” asked Herb.
“The head of the department, Dr. Ian Rupert. Have you interrogated him yet?” asked Jack.
“No, but I think we need to,” answered Herb.
“We don’t have enough to compel him to talk. We should wait and get more information,” said Mike.
“I think we have enough to ask him to come in for a brief discussion,” disagreed Herb.
“You will be tipping him off to our strategy and investigative direction. I would wait,” rebutted Mike.
“Okay, I will bow to your learned opinion, Mike. You have more experience than we do here in Evansville.” Herb looked at Susan, as if to get confirmation.
“What did we get from the re-interviewing of all the people at the crime scene?” asked Mike after a short moment.
“I spoke with a nurse who recalled seeing Dr. Rupert the morning of the murders,” answered Susan. She paused for a beat to look through her notes.
“What did you find out?” inquired Herb.
“Joan Wally was one of the nurses on duty the shift of the murders. She recalls seeing Dr. Rupert and thinking about how strange it was to see him there at that hour. It was a little before six o’clock in the morning. He had a small bag with him. He looked through the charts and heart monitors for several minutes. He paged Dr. Connor and asked him to come up to the unit. She recalls hearing him say that he wanted Dr. Connor to see Butterworth. She remembers seeing Dr. Rupert leave the unit with a small device in his hand. A few minutes later, Ms. Wally had to go to the blood bank to get two units of blood for her patient, Christine Rickman. The nurse recalls it was odd to see Dr. Rupert in the waiting room, hiding behind a large column. As she walked by, she noticed he was concentrating and working on a small handheld device. Why stand behind a column? There was no one in the waiting room. There was no one to hide from. She proceeded to the blood bank. When she was on her way back, she heard gunshots coming from the CCU. She ran away and called the police from a phone downstairs. Afraid of what was happening, she did not return to the crime scene. This is why we didn’t interview her the first time. She was reported as missing at the time. I finally tracked her down and spoke with her.”
“Good work, Susan,” praised Herb.
“Any fingerprints on the gun or shell casings, other than the perp’s?” asked Susan of the group, unsure who was handling that aspect of the investigation.
“No, none at all. I have also been checking our ballistic database, but the weapon continues to be a no show,” answered Mike.
“Okay, let’s keep up the investigation and search for the source of the gun. It does look like Rupert had the opportunity to have given Butterworth the gun,” said Herb.
“Yes, but again, this is not conclusive. We need more.” Mike was cocksure as he spoke.
“What should our next step be?” asked Susan.
“We’ll re-interview the lab personnel. I would like to interview the nurse Susan talked about and see if I can get anymore from her,” said Mike with confidence. After all, he was an agent of the FBI. All others were local small-town cops.
“Okay, Mike, go over and talk to nurse Wally again. Then work on the gun aspect of things. We’ll go to the research lab and see what we find there,” said Herb authoritatively.
*****
10:30 AM
The doors to the research lab were locked. The police, pending a search, had secured the department. Yellow tape crisscrossed the door, declaring it off limits to all but the authorities and their designees. Herb removed the yellow tape and unlocked the door. The animal cages were still there.
“I figured you guys took all the animals somewhere else,” stated Jack.
“We don’t have the facilities. We have the SPCA come here daily and take care of the animals. It’s working out all right,” answered Susan.
“What is the SPCA?” inquired Jack.
“The Society for the Prevention of Cruelty to Animals,” she explained.
They started to snoop around in different directions as soon as the lights to the large room came on showering brightness everywhere. Herb and Susan searched the offices. The first of the offices was that of the Laboratory Chief James Miller. This was the second go around. The CSI people had been through taking pictures, drawing schematics of each room and taking inventory.
The invoices and requisition forms for the purchase of the animals necessary to run the lab were found here. This re-established that the number of rats sacrificed in experimentation had spiked up tremendously earlier in the year, occurring right before the murders began. This lent confirmation to the notion that the murders were merely the continuation of a bleak killer experiment transferred from the animal lab to the male humans at large. Not actually at large, since the chosen ones had been selected from people that had required services at the hospital. The cardiac examination of these men had actually served to certify that they were indeed good specimens for research. Good enough to be killed.
While the detectives nosed around the offices looking for paperwork, Jack searched for the lab equipment, looking for something that might give him a clue about the macabre poisonous research efforts. The equipment in the lab was much like that of a surgical suite with which he was very familiar. Jack continued to browse.
Meanwhile in Miller’s office, Herb came across a large folder of invoices from a company called MultiTech, Inc. Susan made note of this name. Looking through the invoices, it was clear that this company manufactured research drugs. She made a call to the station requesting that these folders and all others be taken to the police station for further detailed analysis.
“Herb and Susan look at this,” requested Jack from the entryway into the office.
Intrigued, the detectives followed Jack, who appeared to be like the ten-year-old that finally discovered the location of his hidden Christmas present. Jack guided the cops to an area where a large ultrasound machine was the focus in the room. In a cabinet nearby, there were two devices. The larger of the two, labeled Bubble Maker, was used to compose tiny bubbles, which could be filled with any material or drug. Another small hand-held device was labeled Radiofrequency Sonicator. This small gadget comprised a small round dial demonstrating a series of frequencies. The exact niche for this device was unclear. Both these units proudly displayed their maker was MultiTech, Inc. There were several vials of medications, some known to Jack, others not. The unknowns were research drugs.
“These vials of drugs with letters and numbers, like JMJ81661, LFJ659, and JAC21072, and so on, are investigational agents that don’t have a real name yet. I have the paperwork for the experiments involving these,” said Jack presenting the vials as he spoke.
“Can any of these make a man go crazy and start killing?” asked Herb, as Susan gazed at the drug vials pensively.
“That’s the million dollar question,” said Jack. “I don’t know yet.”
“I found purchase orders, delivery records, and invoices from MultiTech, Inc. about these contraptions. Here they are. They manufactured two of each of these units. I only see one pair here. Where’s the other pair?” asked Susan looking through papers inside one of the folders then at the gaping eyes staring back at her. Silence ensued as the men shrugged their shoulders.
“Not sure what all this means, if anything,” said Herb breaking the moment’s silence.
“We’ll look into MultiTech, Inc.,” said Susan.
*****
12:58 PM
The three musketeers Herb, Susan and Jack, walked to the cafeteria. Jack had a lunch date with his beautiful wife.
“Hi, Claire. Sorry I’m late.” Jack took off his jacket and hung it over a chair next to Claire, who was drinking a glass of water.
“That’s okay. I’m used to it by now.” She smiled as she realized Jack had an entourage.
&nb
sp; “These are the detectives I am working with. This is Detective Herb Fuller and this is Detective Susan Quentin.” They shook hands and exchanged pleasantries.
The four walked through the cafeteria-style line and gathered their food. They sat down eating and talking about the weather, life in Evansville, Newton Memorial Hospital and what the institution has done for the community and county. Herb reminisced about the time before the hospital was built. He discussed how the land where the hospital stands used to be a huge farm, although he was too young to have any concrete recollections. After a few heartbeats of slightly uncomfortable silence, the conversation turned to the business at hand.
“What about Major Rooner and the other man, Muhammad Akrim?” asked Jack.
“We’re still waiting on the full information. We might have something by tomorrow. So far, I know the major is a military career man who has been in several wars. He more or less fell off the end of the earth about three years ago. Apparently, he has been on some secret mission or assignment. The military is being hush-hush about the whole thing, but hopefully we can persuade them to give us more information. Our FBI connection, detective Mike Ganz, is pursuing that issue.” Susan paused to take a bite of her burrito, then a sip of her iced tea.