Isolation Ward

by Joshua Spanogle

  I looked for any sign of life in Alaine’s eyes, but those black irises kept staring. The moonlight cast razor-sharp shadows across her face.

  “Falk can’t let the experiment go. I mean, at this point he has investment capital, he has his reputation tied up in this, and he thinks he’s going to save the world. Risk everything because of a little rape? No way. Besides, the rapist is his own flesh and blood. Still, they can’t keep a loose cannon like KC around, so Falk thinks a little and he remembers his buddy Randall Jefferson in Baltimore. The guy has a bunch of group homes for the retarded. Falk makes a discreet call. Jefferson is only too happy to oblige, since it won’t be any skin off his nose to cloister a fugitive for a friend. He’s been bilking the state out of funds for God knows how many people who’ve already died. Jefferson figures KC could just slip into the role of one of the deceased—Douglas Buchanan. He tells Falk to send him along, and KC is shipped to Baltimore.

  “Around about now, something else happens: they find out Janet Margulies is pregnant.”

  I looked at Alaine for some positive feedback, but she just stared.

  “Okay, Janet. Janet is with child. Now, this really would not have been good PR, so Falk has a little staph dropped into an IV. Janet dies. No one asks any questions. How many times did it happen, Alaine? The rapes?”

  She finally broke, just a little. A tiny breath. “Five times, at least. We went back through the tapes. Thank God it was only with Janet. She was his . . . She was his favorite.”

  “Lucky girl. Anyway, they’re worried that Douglas might have picked something up from sex with the woman. And they have to be worried that, given his proclivities, he’s spreading it around. How am I doing so far?”

  “Very well, Nathaniel.”

  “That’s when the whole thing comes apart. About two weeks ago, there’s an outbreak in the mentally handicapped community in Baltimore. The esteemed Dr. Jefferson tries to stymie the authorities back east—that’s me and my colleagues—to give the folks here time to figure out what to do. They’re not sure whether this has anything to do with Kincaid or not, but they’re worried. When we—the authorities—begin to zero in on Kincaid, they freak out. Somebody kills Falk’s son, strips the organs, and sends them back here for analysis.”

  I stopped for a moment. “Who killed KC Falk? Who stripped the organs?”

  “A doctor back in Baltimore, I think.”

  “Randall Jefferson?”

  “That would be a good guess. He’d been taking biopsies and doing routine physicals for months.”

  “Who received the biopsies?”

  She didn’t answer.

  “Come on. This is important. It establishes who’s involved.” She looked away from me. And at that moment, I knew. “Oh, no, Alaine. Goddamn it. Why?”

  “I didn’t know what they were. I got some tissue and they told me to analyze it. I didn’t know, Nate.”

  “You didn’t know,” I repeated. I also didn’t know what to do now that Alaine Chen was intimately involved with this imbroglio. It was ugly.

  I continued with my story. “Anyway, I get kicked out of Baltimore for ruffling too many feathers—mostly Randall Jefferson’s—and am sent out here to follow up on a flimsy lead: Gladys Thomas. I talk to her, and she tells me she knows Kincaid. They were involved, in fact, though not sexually. People here get wind of it, they know that Gladys Thomas talked to me, and she dies. The lead, it seems, wasn’t so flimsy after all.”

  Alaine was stony.

  “And the rest, you probably know. The guy hired to do the heavy lifting—killing retarded folks, killing dogs—comes after me. But now, most likely, he’s in a police station, unable to see his own nose, telling the police he was attacked by a mad Nathaniel McCormick.”

  We were quiet for a while, staring deeply into each other’s eyes. If it had been a decade earlier, Alaine and I might well have been in this exact spot, our faces pressed together. I wished she hadn’t taken me here.

  “Are you in love with her?” Alaine asked, I guess picking up on the vibe.

  “Who?”

  She didn’t answer, but said only, “She’s very pretty.”

  And she has a bullet in her ass, Alaine.

  “They killed Dr. Tobel,” I said.

  She smiled, a crooked, unhappy smile. “I thought you were never going to mention her. And the answer to your question is yes. They murdered Harriet.”

  “Why?”

  “Because she was going to tell you just what you told me.”

  “So, it is the truth, isn’t it?”

  “It’s what everyone else believes. Well, almost everyone.”

  “How did they do it?”

  “I’m not sure. I think they gave her a shot of digoxin. I feel . . . They asked me about her health and I told them. They knew about her heart.”

  Digoxin—a drug used to flog a failing heart into beating stronger—is a great drug for folks suffering from congestive heart failure. Dr. Tobel had it in her medicine cabinet. But if you get too much, the heart beats too hard, it requires too much oxygen. Basically, that glorious pump burns through its fuel supply and you die of a heart attack.

  I said, “I’ll make sure the ME runs assays for digoxin.”

  “Yes,” Alaine said.

  At that point, I thought she was going to tell me what the truth was, what the kernel was that everyone else did not believe, or did not know. I mean, if there was ever an opportunity, this was it. Instead, she sighed and stood up. “I don’t like this place anymore. I used to love it so much. I used to find it so peaceful, but now . . .”

  She began to walk, and I followed. I didn’t want to lose the thread of the conversation. So, to keep it going, I said, “Why did you help me?”

  “Oh, Nathaniel. A thousand reasons.” She gave me the sad smile again. “They killed Dr. Tobel. And . . . well, they were going to kill you. And Dr. Michaels, if you didn’t stop.”

  “Really? Couldn’t tell.” She flinched. I asked, “How do you know about Harriet Tobel? I wouldn’t think they’d say anything to you.”

  “I am getting married to Ian, remember?”

  Right. Loose lips and such. “And you’re willing to go to jail for this?”

  She laughed, a real, warm laugh, the kind of laugh that used to make me melt. “Certainly not. I am leaving the country. With Ian.” She smiled. “We’re lucky he was rich before he got involved with this.”

  If I had felt any fondness or tenderness toward Alaine Chen—and I admit I had in the past few days and hours—it started to evaporate at that moment. Was she really as I’d come to see her over the past years—hardened at the core, wanting to do good, actually doing some good, but hard, hard, hard?

  “But he was involved in all of this, with the deaths. . . .” I shook my head, frustrated. “What will he do when he finds out you—”

  “Ian doesn’t know, and at this point I don’t know if he cares. He loves me, despite everything.”

  Like me, I thought. God, this woman was toxic. “Do you love him?”

  “Do you really want to know?”

  Yes, I goddamned do, I thought. But I said, “I couldn’t care less, Alaine.”

  “Good for you. You’re finally growing up.”

  Fuck you, I thought.

  “So, what really happened? What’s this thing that I got wrong and everybody else seemed to get wrong?”

  We had broken from the darkness of the woods. Alaine paused under a streetlamp. “You know what it is. You stole it from Dr. Tobel’s office.”

  I stopped walking for a moment, to think better. Maybe my coordination isn’t as good as I thought it was. “The sequence. The Junin-HIV hybrid.”

  “Yes.”

  “I see. And it didn’t come from the pig.”

  “That’s correct.”

  “Well, you’ll be happy to know we’re confirming that now in Atlanta.”

  Alaine didn’t flinch, nor did she make any move to fill me in. I’d had it with the game. “All
right, sweetie, enough of this bullshit. Tell me what is going on.”

  “You sure you really want to know?”

  “Don’t fucking patronize me. Of course I want to know. Dr. Tobel knew, she found it, and that’s why she was killed.”

  “She did more than find it, Nathaniel. She made it.”

  CHAPTER 96

  Alaine took a large file from her handbag and handed it to me. She began to walk again and said, “Back in ’96, Harriet was working on a vaccine for HIV—”

  “She was working on it before then. I was in her lab for a while, remember?”

  “In ’96 she started making real progress in primate models,” Alaine continued. “But she ran into obstacles. Consistently. It seemed she couldn’t get a robust immune response from the hosts, who continued to develop a simian HIV infection despite the vaccinations.

  “Harriet had this idea to combine some of the surface proteins from other viruses with certain elements of HIV to elicit a robust response. She experimented with a whole host of candidates, but she found the best response—”

  “Oh, no,” I said. Viruses were my life; I could see where this was going.

  “The best responses were from some of the arenaviruses. Harriet settled on Junin, which we know from previous vaccine work elicits an effective immune response. She spliced the envelope gene for Junin into HIV, so that the new . . . organism . . . had both envelope proteins expressed.

  “Well, the primate experiments went very well, but Harriet was having no luck getting any interest in a human vaccine trial, even though everyone was very excited about the prospect of an HIV vaccine.”

  “They still are, Alaine.”

  “Thanks for the public health angle. Anyway, people were nervous about introducing anything that caused a viral hemorrhagic fever into HIV.”

  “I wonder why.”

  “Are you going to let me finish?” she snapped. “Harriet abandons the project for a while; I come into her lab. Then we meet Otto Falk—or, more exactly, I meet Otto, since Harriet already knew him from Baltimore. Falk does his thing with the pigs, gets the organs in order, coauthors a paper in Science with some of his preliminary work. Then he approaches Harriet with his brilliant plan about the vegetative patients.”

  “You’re lying, Alaine.”

  “It’s in the file. Well, not all of it. But you can piece it together.”

  “I can’t believe this.” The file in my hand grew heavier and heavier.

  “Harriet thought Falk’s idea was a good one. She also saw the opportunities for her vaccine work. Otto really wanted her on board—they’d worked together before; she would bring enormous credibility to the project. She knew this, of course, so she told him the price for her involvement.”

  I waited for the other shoe to drop. But in this game we were playing in which Alaine would offer information, then not deliver, she said nothing.

  In any case, I knew what Dr. Tobel’s price was, and some part of me knew my old mentor was capable of something like this. Her argument would have been the same as Otto Falk’s: one life to save a thousand, a million. With something like HIV, one could see how seductive the statistics were.

  I said, “Janet Margulies. The woman KC raped. She was the price of involvement.”

  “Yes,” Alaine said.

  “What happened? Why the virulence?”

  “I don’t know. I was never part of Harriet’s work on the vaccine. As far as I know, she did it all herself. I only found out about this because I found the files. Then I confronted Dr. Falk.”

  “What did he say?”

  “Otto was, well, surprised.”

  “But he knew. From the beginning.”

  “Yes. He had to. He was the one who performed the sham surgery on Ms. Margulies. He cut her open, but left her liver intact. Falk told the team in the room that day that Janet Margulies was a negative control. No one but Falk knew the real name of the patient. Her face was obscured. All the records were sealed to ensure that no one would know who was the control and who wasn’t. This way, no one would know Margulies didn’t get the pig organs; they’d think she was part of the transplant experiment, just like everyone else.”

  “But she wasn’t—”

  “No.”

  “She wasn’t a negative control—”

  “Certainly not.”

  “She was part of a vaccine trial.”

  Alaine nodded.

  “Why didn’t they just come clean about the vaccine work? Separate it from the transplant experiment?”

  Alaine laughed. “Can you imagine, Nate? This would have been much worse than something happening with the xenotransplants. We were prepared for something to happen with the transplants. We had mapped out the risks, gotten approval for every step of the protocol. But Harriet’s study, if you can call it that, was never sanctioned by anybody. It wasn’t well designed or controlled. She was doing it to test the most basic elements of her hypothesis, that’s all. The results would never be published. She’d use them to confirm what she thought; then, later, she’d make a push for real trials. It was kept very quiet, as you can imagine. Even Ian doesn’t know all of it. If any of this had gotten out . . .”

  I filled in. “Then everything would have gone badly. But everything did go badly.”

  “True. Still, nobody saw how bad it was going to get.”

  “That’s how these things go, isn’t it?”

  “I suppose so. I’m sorry, Nate. I know it’s hard about Harriet. It was very hard for me, too.”

  “I’m having trouble taking this all in.”

  “I know.”

  “I’m having trouble believing this.”

  Alaine was quiet; so was I. But I was, as I said, having a good bit of difficulty. Gutted might be a good word to describe how I felt. Stunned, clobbered, eviscerated. Harriet Tobel, who’d been my staunch defender all those years, who I thought was holier than Jesus, had been no better than Otto Falk. No wonder, I guess, the two of them found their way into an unholy embrace.

  I said, “I cannot believe Dr. Tobel would let Kincaid run wild.”

  “She didn’t. She thought that when KC disappeared, he was truly gone; she thought the experiment had simply run aground. She never knew Janet Margulies had been killed on purpose. It was Falk who scuttled it. He, I assume, introduced the staph infection into Janet. He arranged for his son to disappear. He didn’t trust Harriet.”

  “Which is why you, and not Dr. Tobel, were asked to monitor KC, to look at the biopsies.”

  “Yes.”

  “I’m sorry for that.”

  “So am I.”

  “You could have said no.”

  “Yes, I could have, Nathaniel. And I didn’t. So, I’m paying for it.”

  And I guess she was, though whether a lifetime in exile was a fair price, that’s for the Big Guy upstairs to determine.

  I did my best to quiet my brain about Dr. Tobel, to focus on the information presented by the woman beside me. Things still didn’t add up. “What I saw in Baltimore was not AIDS, Alaine. So unless the Junin-HIV virus mutated—”

  “That’s what I think. Or it picked up some replication machinery from another virus in Kincaid, something benign. And then it went to work.”

  “How?”

  “Who knows, Nathaniel? Maybe the HIV part of the virus weakened the immune system and let the Junin part run wild. Who knows?”

  I sat quietly for a moment, trying to make sense of all of this. “Kincaid was immune. But the women he infected weren’t.”

  “Yes. I don’t really know why. We looked at his tissue and found the virus, but it seemed benign in him. I don’t know. . . . I must tell you that at the beginning, Harriet seemed very excited by this. Her guinea pigs—Janet Margulies and, unexpectedly, Kincaid Falk—were immune to the chimera virus. Even though they were out of the picture after a relatively short time, she felt the preliminary results were good. But when you came with the information about the outbreak in Baltimore, she must ha
ve known something went terribly wrong.”

  Alaine sighed and glanced up at the looming lab buildings. I looked at her looking at the buildings. She seemed very sad at that moment, and, again, I was confused about her, about who the hell she was. Was she an ice queen, or just a flawed, ambitious idiot like the rest of us? God, I thought, I really don’t understand people. Scratch that. I really don’t understand women. Men are simple ambitious idiots, present company included. Women—Alaine Chen, Harriet Tobel, even Brooke Michaels— are more nuanced. Infuriating for a guy who wants easy answers.

  Alaine said, “It’s horrible, utterly horrible, Nate. All of this.”

  I had another question, one that had been eating me alive for a few days. “What do you think Dr. Tobel wanted to tell me the night she died?”

  “Maybe she wanted to come clean. Or maybe she wanted to pin everything on Otto Falk and the xenotransplants. We’ll never know, will we?”

  “I guess not.”

  “And now Otto will try to pin everything on Harriet. Ironic, isn’t it?”

  “What?” This was news. Silly me, thinking this whole mess was over.

  “Don’t be naïve about him. Otto has too much at stake; you can see that. His whole life is wrapped up in this work.”

  “How is he going to do it?”

  “I don’t know.”

  I thought about that, about how Otto would move the chess pieces to corner Harriet Tobel. Then I thought how I’d be able to checkmate the eminent transplant surgeon. I thought about what I had—basically some lab reports, little else. The only thing I had linking Otto Falk to the shenanigans of the past months was Janet Margulies’s termination notice: “Discontinue antibiotic as per protocol.” This wasn’t really the stuff of ironclad prosecutions.

  We were back at the parking lot, next to the Mustang and the silver BMW. The lights flashed on the BMW; the alarm chirped. Alaine walked to it. In the backseat I saw luggage, two overstuffed pieces that looked like they might be bound for points south or east or wherever they didn’t have extradition treaties with the U.S.

  “Wait. If you’re so sure Falk is going to get away with this, why are you leaving the country? Why not let Harriet take the fall?”