“Name the time,” Lloyd said.
At eight-thirty the next morning Lloyd was in the pathology department again. He walked past the reception area quickly, hoping not to run into Todd English again. He stopped outside the door near the end of a hallway. Next to it, a brushed-metal name plate was inscribed, “Stanley Kowalski, M.D., Ph.D.” in gaudy Gothic font. Lloyd knocked on the wood-paneled door and stepped back. Almost immediately, the door swung open and Kowalski’s round face poked out. He wore a wide grin, his pale eyes beaming. He reached out and pumped Lloyd’s hand, pulled him in his office and shut the door. “I’ve been waiting for you,” he said with a chortle. “Oh, it’s so good to see you, Lloyd. We can drop the formalities and use our Christian names, right?”
Lloyd had only exchanged a few phone conversations with the pathologist over the last couple of years. Only saw him in person once or twice, so Kowalski’s sudden friendliness puzzled him. Or maybe it had been there all along and he just failed to notice it.
“Sure, Stanley,” Lloyd said.
“Stan, please. Only my mother calls me Stanley.” He shimmied his head in an apparent parody of Mrs. Kowalski and howled with laughter, slapped Lloyd on the back. “Oh, Lloyd, have a seat.” Kowalski skipped around his desk and sunk in his plush leather chair.
Lloyd smiled. “Thanks for doing this.”
Kowalski held up his hand in a don’t-mention-it way, reached for a plastic platter. He removed its foil cover and held it over his desk. “Cookie?”
“Thanks, I’m fine.”
The smile dissipated from Kowalski’s face. “They’re homemade.”
Lloyd thought he could hear the faraway echo of Uncle Roy’s voice. Now eat a cookie so we don’t offend the nice man. “Well, just one then, thanks.” Lloyd plucked a dysmorphically shaped affair smothered in brown sugar and bit into it.
“Good, huh?”
“Mmph! Dewicious!” Lloyd said with his mouth full.
Lloyd looked up at the wall at Kowalski’s back. An oversized photograph in a gilded frame with baroque curls hung on the wall. Staring back at him was a frumpy woman in a red blouse with a frilled collar flanked by two pudgy boys in matching sleeveless argyle sweaters – juvenile Kowalski clones sans the bottle-brush mustache. The portrait was strategically positioned, not for Kowalski’s viewing, but for the delight of the odd castaway who might maroon on the pathologist’s desolate island of an office.
Lloyd decided to indulge his host. “Beautiful family.”
“The apple of my eye.” Kowalski leaned forward. “So, what’s keeping you from tying the old knot?”
“Just haven’t met the right girl, I guess,” Lloyd said with a wry smile which he immediately regretted.
“I hear you, brother.” Kowalski jerked his head. “What do you think of the cookies?”
“Scrumptious,” Lloyd said. He dug his tongue between his teeth to pry out the doughy shrapnel that remained wedged there.
“Cyndi baked them just for you. That’s my better half, of course.”
“About the autopsy…”
“Yes, yes, business before pleasure. You’re going to love this,” Kowalski said with a wink. “He slid open a desk drawer, extracted a couple of cardboard slide holders and got to his feet. “Come, brother. We’re using the multi-headed scope.” Kowalski beamed a devilish grin as if he were inviting Lloyd for a joyride in his father’s Lamborghini.
They walked down a dank corridor of glazed cinder block walls the color of pea soup. “You know, I didn’t always want to be a pathologist.”
“Really?” Lloyd said, hoping he didn’t sound too facetious.
“Wanted to be a detective, like Inspector Columbo, piecing together bits of evidence, pestering criminals with just one more question… Even went so far as adopting a Bassett hound.”
“So what happened?”
“Medical school happened. But I sure loved that dog. I like to think I became a medical detective. After all, looking at slides is a lot like studying a crime scene.”
“Right,” Lloyd said.
“When I look down the barrel of that microscope, I’m always asking myself, whodunit? Then one day the Brookfield zoo calls me to look at a brain tumor on a West Highland Silverback gorilla. So I decided to learn some veterinary pathology on the side, you know, kind of as a hobby. Pretty soon I was hooked, and before you know it I got pretty darn good at it.” Kowalski swaggered. He looked like a guy who was still trying to gain approval from the cool kids at his twenty-year high school reunion.
“But with this case,” Kowalski said, lowering his voice. “I was a real detective.”
He pushed open a door and invited Lloyd to a sit at a table holding a microscope with six sets of binocular eye pieces, all connected by metal tubing.
“I should have known something wasn’t right the first time you gave me the autopsy number. But I was so swamped with work that I plain didn’t catch it. And then there was the whole thing with Todd English... I’m still kicking myself for missing it.”
“What wasn’t right?” Lloyd asked.
“Do you still have that autopsy number?” Kowalski asked.
Once again, Lloyd found the autopsy report in his lab coat pocket and read the number that was printed near the document’s header. “A231556.”
“See, it can’t possibly be that number,” Kowalski said with a smile.
“But it is,” Lloyd said.
“Oh, I know. If you look up that number on the computer you get the same report you have in your hands. But that can’t possibly be your report.”
“Why’s that?” Lloyd asked.
“You see, the letters in front of the number indicate what kind of report it is. So A is for autopsy, FNA for fine needle aspiration, SB is surgical biopsy and so on. So right off the bat I should have known that number was wrong,” Kowalski said.
“I don’t follow,” Lloyd said. “Isn’t this an autopsy report, hence the A?”
Kowalski leaned forward. “Ah, but your report is a veterinary autopsy, so it should read VA. No wonder I couldn’t find any slides under that number.”
“So you found my mouse by adding a V in the front,” Lloyd said.
“No I didn’t.” Kowalski sat back in his chair and chuckled.
“Okay, you just lost me.”
“There are no samples with that number whether you look under A or VA. Nothing, nada, zip,” Kowalski said.
“So where did this report come from?” Lloyd asked.
“I have no idea,” Kowalski said. “But I did find your mouse.” Lloyd straightened in his chair. “I used the drop-off date you gave me. It took a little digging around but I found him… in a little tub of formalin in a storage cabinet of our gross room.”
“Wait a minute. What are you saying?” Lloyd asked.
“That’s right. No autopsy was ever done on your mouse. Well, until last night, when I did it myself. I mean, Carbajal performing an autopsy? Who are we kidding?”
“Inspector Kowalski,” Lloyd said, “I could kiss you right about now.”
“Don’t you want to see the slides first? I had them processed overnight and took a quick peek this morning. I think this is going to really knock your socks off.”
Kowalski flipped a switch at the base of the microscope and placed the first slide on its stage.
“I haven’t spent much time looking through a microscope since medical school,” Lloyd said.
“I’ll walk you through,” Kowalski said. “Take a look. Why don’t you start by telling me what organ this is?”
Lloyd adjusted the eyepieces and peered at the magnified section. He saw a pink and white blob.
“It all looks the same to me,” Lloyd said.
“Take your time. Think about what you’re looking at.”
It looked like tiny white worms squirming out from a central nest. And small pink marbles scattered around the periphery.
“This is kidney,” Lloyd said.
“Good. At least you’re
on the right planet.” Kowalski rotated the turret holding the objective lenses and adjusted the focus. “Now that we’re at higher magnification, can you tell me if this is normal kidney tissue?”
“I have no idea.”
“Fair enough. Look at the epithelium of the glomeruli. What do you see?”
“I don’t know. It looks a little puffy,” Lloyd said.
“Puffy! Good word. And do you see the intertubular capillaries?”
“No. But I wouldn’t know where to start looking.”
“You’re doing good,” Kowalski said. “Much better than you think. Puffy is dead on, though the way I would phrase it on a report is, ‘cloudy swelling and hydropic degeneration of the glomerular epithelium’. And the reason you can’t see the intertubular capillaries is because most of them are collapsed or at least contracted, with little or no blood left inside of them.”
“What does that mean?”
“Let’s look at the next slide,” Kowalski said.
The next scene looked like speckled pink floor tiles of slightly irregular shape and size plastered together with dirty gray grout. “That’s liver,” Lloyd said with slightly more confidence.
“See? Just like riding a bike. We’ll make a pathologist out of you yet.”
“Thanks but I think I’ll stick with Neurology.”
“Is this normal liver?”
“I don’t have a clue,” Lloyd said.
“Liver’s tough,” Kowalski said. “This is your regular H and E stain, but let me show you something really interesting.” Kowalski pulled the slide off the microscope stage and replaced it with a new one. “This is a Sudan stain. Now what do you see?”
“I don’t know. Black spots.”
“Right. And where are the black spots? Are they in the liver cells?”
Lloyd scanned the slide. “No. They’re outside of the hepatocytes. What the hell are they?”
“Granules. Black granules in the lumen of the portal veins and scattered near the walls of the veins. And notice the marked degeneration of the parenchyma of the hepatocytes.”
“I’ll take your word for it,” Lloyd said.
“Let’s get down to the nitty-gritty,” Kowalski said. He loaded a fresh slide on the microscope stage.”
“Brain,” Lloyd said. “At last.”
“What did Woody Allen say? My second favorite organ.” Kowalski chortled. “So the million dollar question is, ‘Can mice get Mad Cow Disease’?”
“Sure they can,” Lloyd said.
“Correct. You know, I spent a month in the English countryside back in ninety-three. Saw more cases of BSE than pretty much anyone this side of the pond. So the next question is, ‘Does this mouse have prion-induced spongiform encephalopathy?’”
“You tell me, inspector.”
“Does the brain look like sponge?”
“No, not really,” Lloyd said.
“No sponge, no BSE. But look carefully. There are low-grade, non-specific destructive changes. So here you have dead brain cells, ravaged kidneys, black granules in the liver…
“What is this? What are you getting at?”
Kowalski removed the final slide from the microscope stage, leaned back in his chair and pulled in a deep breath. “Lloyd, what I’m getting at is… your mouse was poisoned.”
Chapter 30
“Poisoned?” Lloyd said. “With what?”
Kowalski shrugged. “I can try to send some tissue samples to toxicology. The little guy’s been marinating in formalin for a while but we should be alright.”
“What do you suspect, Stan?”
“It could be some sort of toxin…”
“Or…” Lloyd tried to coax him.
“My gut tells me it’s a heavy metal.”
“Like mercury?” Lloyd said.
“Is there thimerosal in your preparation?” Kowalski asked.
“Oh, come on,” Lloyd said. “Thimerosal doesn’t do this.”
“Yeah, you’re right. Of course it doesn’t.” Kowalski said.
The two men looked at each other silently for half a minute.
“When will we get the toxicology report?” Lloyd asked.
“I’d say a day or two.”
Lloyd rapped his fingers on the table. “I need to test some other samples. I’ll have my lab assistant get them to you.”
“What did you have in mind?”
“Just trying to cover all bases.” Lloyd got to his feet and shook Kowalski’s hand. “Thanks Stan. You did good. You did real good.”
“My pleasure,” Kowalski said. Lloyd headed for the door. “Hey Lloyd, maybe we can get a beer sometime. You know, if you have time.”
“I’d like that,” Lloyd said. He didn’t really mean it, but the guy might have just saved his ass. “Thank Cynthia for the cookies.”
“Cyndi. Maybe we could have you over for dinner.” Kowalski was beaming.
Lloyd nodded. “Yeah, sure. Maybe after things get less hectic.”
For a moment, as he walked back towards the reception area of the pathology department, the thought of finding Todd English and kicking his ass crossed Lloyd’s mind. But that would be a bad move, especially being on probation. And he was practicing being polite now.
Academic probation. He needed to put a stop to this nonsense right away. After all, everything started because of a bogus autopsy report: the block on his research, the investigation by the Institutional Animal Care and Use Committee, even the scuffle with the pathology fellow.
He stepped on the elevator. He had to speak to Lasko immediately. He had to tell him that it had all been a big misunderstanding. As the elevator climbed with a steady hum Lloyd’s head started swimming. Where did that bogus autopsy report come from? How was his mouse poisoned? The elevator jolted to a stop and a moment passed before the aluminum doors parted. As he stepped off the elevator, he realized he couldn’t very well march into Lasko’s office and tell him what he had learned. At least not yet. He decided to head back to the lab to talk to Kaz.
Lloyd stepped in his lab and froze. Kaz was sitting in front of his laptop looking sheepish. Next to him was Nick De Luca, half-sitting on a tall stool while George Lasko stood with his arms folded, a stern expression on his face.
“What’s going on?” Lloyd asked.
“Indeed, Dr. Copeland,” Lasko said. “That’s what I’m here to see for myself.”
Lloyd glanced at Kaz, who just raised his eyebrows. De Luca said nothing and looked at the floor.
“I had an interesting conversation with Dr. Norbert this morning,” Lasko said. “I think you know what I’m getting at.”
Lloyd said nothing. If Lasko wanted to hang him, Lloyd wasn’t about to hand him the rope.
“You can’t say I didn’t warn you,” Lasko said raising a gnarled finger to the air.
“If there’s something you want to discuss, please get to the point. I have patients to see,” Lloyd said.
“Patients to see? Well we’ll see about that,” Lasko said with a thin grin.
“What do you want?” Lloyd said.
“I want the remaining vials of the prion,” Lasko said.
“What for?”
“You seem indignant when I’m the one who should be indignant here. As the new Chief of Staff I gave you a very clear and simple directive: cease your research activities. And do you show a modicum of respect? Not towards me, mind you, but for the office that I hold, for our institution. Not at all. You turn your back and inject more mice haphazardly, following no apparent research protocol. Well, I won’t have it. I won’t stand for insubordination in my hospital. You will inject no more mice with your lethal concoction.”
“I’m done injecting mice,” Lloyd said.
“Good,” Lasko said with a supercilious tone.
“I’m going to start human trials,” Lloyd said.
Lasko laughed. “You are deluding yourself, young man. Your research is over, don’t you understand? Done. Now if you’re smart you’ll fall in line and try
to salvage what’s left of your pitiable career.”
“You can’t stop me,” Lloyd said.
“Watch me,” Lasko said. “Mr. De Luca, can you kindly have Dr. Copeland relinquish the remaining vials of prion?”
De Luca took a step towards Lloyd and quietly said, “Dr. Copeland? Would you mind unlocking the refrigerator?”
“Relax, De Luca. There’s no more prion vials here.”
“He’s lying,” Lasko said. “There should be five more vials.”
Lloyd shrugged and said, “Suit yourself.” He walked to the refrigerator and unlocked it. Lasko peered into the empty compartment.
“What have you done with them?” Lasko asked.
“None of your business,” Lloyd said.
“They don’t belong to you,” Lasko shouted.
“They don’t belong to you either.”
“That’s it,” Lasko said. “Effective immediately your clinical privileges at this institution are suspended.”
“You can’t do that.”
“Can’t I?”
“You have no authority. That’s up to the Credentials Committee,” Lloyd said.
“You really need to take a better look at our hospital’s bylaws manual,” Lasko said. “I have the authority to place a temporary suspension on the privileges of any physician who I believe presents an imminent danger to patient care. Credentials Committee is entrusted to make such a suspension permanent. I’ll have my secretary set up the hearing.” He marched to the door of the lab, turned and said, “You better polish up your resume, Dr. Copeland. You’ll be looking for a job real soon.” He jerked his head. “Are you coming, Mr. De Luca?”
De Luca squeezed his lips together, put his hands in his pockets and shuffled towards the door. The two men left. The only sound in the lab was the humming of the refrigerator motors. Lloyd glanced at Kaz. The technician was staring at him.
“What do you want me to say?” Lloyd said.
Kaz shook his head. “How did this all happen?”
“Wolfgang was poisoned,” Lloyd said.
“What?” Kaz said.
“I just spoke to Kowalski. The autopsy report was wrong.”
“Poisoned? How?”
“I don’t know yet. I need you to get blood samples on all the subjects,” Lloyd said.
The Art of Forgetting Page 21