Royal Pains

by D P Lyle

  “This is so cool,” Evan said while running his hand over one of the chambers. “I want to try it.”

  What’d I tell you?

  “Sure,” Julian said. “Cindy will help you.”

  She lifted the lid and Evan crawled in, settling onto the pad inside. Cindy closed the lid and spun a couple of knobs. I looked through the window. Evan gave me the thumbs-up.

  While Evan soaked up oxygen, we settled in a conference room, where Divya peppered Julian with questions about what other programs he offered, how many employees he had, marketing, and whether he made house calls. She would’ve made a great lawyer.

  Julian’s answers were:

  They had programs to help diabetics control their blood sugar, cardiac patients lower their cholesterol, and hypertensives reduce their salt intake.

  They did orthopedic and stroke rehab.

  They helped with hospice care and with grief counseling.

  He did indeed see many of his clients in their homes. Discreetly, of course.

  A total of eighteen people worked for StellarCare, including two PAs.

  His marketing was far-reaching and he’d love to sit and go over it with her sometime.

  Evan came in, Cindy in tow.

  “That was great,” he said. “A total buzz. We need one of those.”

  “I’ll remember that for your next birthday,” I said.

  We went to Julian’s office. It was the office equivalent of an infinity pool. Corner location. Two totally glass walls that met in an invisible seam. It looked as if you could fly right out over the beach.

  “Not much privacy,” Evan said.

  Julian sat down behind his impressively large, chromelegged, glass-topped desk and pressed a button on one corner. The windows progressively fogged until they were opaque.

  “Whoa,” Evan said. He moved to one glass wall and ran his hand over it as if he expected it to be wet or something. “Do that again.”

  Julian pressed the button and the window cleared.

  “Can I?” Evan said as he walked over to the desk.

  Julian waved a hand. “Of course.” He stood and moved around the desk, propping one hip on the edge. “Please, sit.”

  Divya and I took the two chairs that faced him. Evan played with the button, the walls now fading to opaque again.

  “So, tell me,” Julian said, “what do you think of our little operation?”

  “There’s nothing little about it,” I said. “You’ve put together an impressive clinic here.”

  It was, particularly in comparison with what Divya and I had to work with—the trunk of my Saab and the back of her SUV.

  “I’ve heard good things about you, Hank. That you’re a good doc and your clients really like you.”

  “We call them patients, but that’s always good to hear.”

  “Maybe we can help each other.”

  “In what way?”

  “I see many clients who need a good doctor. I’m sure you see those who need nutritional counseling, weight loss, and an overall wellness and prevention program. That’s what we do here.”

  The windows cleared.

  When I didn’t respond, Julian continued. “Since we aren’t really competitors, we could help each other. Complement each other’s practices.”

  I wanted to say not a chance. I wanted to scream charlatan in his face. I wanted to tell him that I suspected that he was poisoning people with his herbs and spices. Instead I said, “We can explore that.”

  He clapped his hands together and then rubbed them back and forth. “That would be great. I think we could have a bright future together.”

  The windows became opaque again. About as opaque as any future Julian and I could have.

  At least Evan was entertained.

  Julian rubbed his chin as if in deep thought and then said, “How would you like to have an office here?”

  “What do you mean?”

  “I know you see your clients in their homes. I understand that. But aren’t there times you wished you had an office? Where you could do more testing?”

  He did have a point. There are times when an actual office would be nice. Expensive, but nice.

  “HankMed could be a part of the StellarCare family,” Julian said.

  Family? Did Charlie Manson start this way?

  The windows brightened again, the diffused sunlight settling over the left side of Julian’s face, highlighting his features. As if he were a model prepped for a cover shoot.

  “I’m not sure that fits with our practice, but I’m flattered that you would ask.”

  “Give it some thought,” Julian said. “I believe that when you do, you’ll see the wisdom of such a partnership.”

  Partnership? I didn’t see that happening.

  The windows fogged again. I wondered when Evan would get bored with his new toy. If past experience was any indication, it could be hours. Evan could focus on the most inane things sometimes.

  “If we have an office here,” Evan said, “I want one with windows like these.

  My cell buzzed. I checked the screen. Jill. Text message. It said: Need to talk. Labs back. Meet out front.

  Chapter 30

  Evan, Divya, and I met Jill near the front entry and walked across the parking lot to Jill’s Prius, passing half a dozen beautiful people on their way into Julian Morelli’s palace.

  “The lab results on Rose Maher and Amanda Brody are back,” Jill said. “The tech said they weren’t normal.”

  I felt a knot in my gut. I hate when that happens.

  “He e-mailed the results,” Jill continued.

  She unlocked her car, lifted her shoulder bag from the front seat, and placed it on the hood. She slid her laptop out, rested it next to the bag, and began the booting process.

  “Any idea what the results are?” I asked.

  “He said they’re similar to Valerie Gilroy’s.”

  Jill opened the e-mail and then its attached file. I used one hand to shield the sun from my eyes while she scrolled through the pages of lab results.

  Rose Maher had a potassium of 3.2, a magnesium of 1.1, a digitalis level of 2.2, elevated thyroid studies, and a low level of amphetamines in her blood. Amanda Brody’s labs were similar except that her digitalis level was slightly higher at 2.8.

  “They aren’t quite as high as Valerie’s were.” I turned my gaze back toward the StellarCare clinic. “They haven’t been taking Julian’s little poison packets quite as long.”

  “You don’t know that all this came from those pills,” Jill said.

  I gave her my best “get real” look. “Let’s just say my index of suspicion is extremely high. All three are seeing this clown. All three have the same lab profile. The difference is that Valerie almost died. Rose and Amanda are headed that way.”

  “Does this mean I don’t get an office with cool windows?” Evan asked.

  “Sorry you’re not getting a new toy,” Divya said. “This is a serious problem. If Julian is handing out toxic drugs, we have to do something.”

  “Like what?” Jill asked. “We don’t have any proof.”

  “When will the testing of the pills be completed?” I asked.

  Jill adjusted her sunglasses. “I’m not sure. Could be as early as tomorrow.”

  “Let’s hope. Then maybe we’ll have the proof we need.”

  “What now?” Jill asked.

  “Go have a talk with Rose and Amanda.”

  “I’ll go with you,” Divya said. “We can take my SUV.”

  I tossed my car keys to Evan. “Looks like you’re on your own.”

  “I’ll head over to my office,” Jill said, “and call the chemistry lab to get an update on where they stand.”

  As I climbed into Divya’s SUV, I heard Evan ask Jill, “Want to swing by and see a cool van first?” Not waiting for a reply, he went on. “It’s not far. Just follow me.”

  Relentless. Focused. Annoying. My brother.

  Rose Maher listened with mounting anxiet
y as I went over the results of her lab tests. Divya and I sat on her living room sofa, Rose in a deep wingback chair.

  “I can’t believe this,” Rose said. “Why would Julian give me something like that?”

  “The short answer?” I said. “Money.”

  Shaken, Rose stood and left the room for a couple minutes before returning with a paper bag. She handed it to me. “These are all the pills I have left. I want them out of my house.”

  I took the bag and gave it to Divya.

  “Should I sue him?” Rose asked. “Couldn’t what happened to that young girl you told me about have happened to me?”

  “Possible. But now that you’re no longer taking the pills, everything should return to normal. I’ll recheck your blood in a few days to make sure.”

  “Is that enough time?”

  “Probably. At least everything should be moving in the right direction.”

  “I’m so angry. With me for being so stupid. With him for . . .” She sat again, sighing heavily. “Unbelievable.”

  “Relax. Everything will be okay.”

  She looked at me for a beat and then shook her head. “I’m going to sue his ass off.”

  “That’s up to you. We’re testing some of the pills. If they’re the source, we’ll know soon.”

  “They are and you know it.”

  I nodded. “That’s the one thing you, Amanda, and the young girl have in common.”

  “That would surely bolster my case,” Rose said.

  “Most definitely,” Divya said.

  Rose absently squared a stack of magazines on her coffee table and then stood. “I need to call Amanda and tell her about this.”

  “We’re heading over there to talk to her right now,” I said.

  “I feel like such a fool.” Tears collected in Rose’s eyes. “I know better than this. I know there’s no quick fix.”

  “Don’t beat yourself up,” Divya said. “You’re like everyone else. Intellectually you know that something doesn’t make sense, but at the same time you hope it works.”

  “That’s the problem,” Rose said. “It did work.”

  “Poisoning yourself isn’t the safest of weight-loss programs,” Divya said.

  Rose sniffed back tears. “Thank you both for being so persistent. For taking care of me when I wasn’t taking care of myself.”

  “That’s what we’re here for,” I said.

  First, do no harm.

  One of the oldest rules in medicine. Dates back to Hippocrates, even Aristotle. The rule has been passed down through the centuries by the giants of medicine. Names such as Galen and Paracelsus, and on to the twentiethcentury icons Sir William Osler, Proctor Harvey, and Tinsley Harrison. Like every medical student in the country, I had devoured Harrison’s Principles of Internal Medicine while in school. Still crack it open on a regular basis.

  First, do no harm.

  The rule smacks of common sense and sounds like a very simple thing to do. Do not harm the patient while trying to heal him. It’s unfortunately not as easy at it might sound. Doesn’t surgery harm before it helps? Don’t many medications have the potential to harm and even kill? Didn’t physicians once do things that now seem silly and dangerous? Bloodletting, treating syphilis with arsenic, and using leeches to suck out vile humors each made sense at one time. Will our current use of coronary-bypass surgery seem insane and barbaric a hundred years from now?

  First, do no harm.

  Another modern dilemma is what we in medicine call “consuming the patient, making the diagnosis.” Sounds sinister, doesn’t it? It is, and it isn’t. Sometimes making the proper diagnosis requires days and weeks of testing and the patient can die during this pretreatment testing phase. Also some of these tests possess inherent dangers. Angiograms, colonoscopies, exploratory laparotomies, and many other tests and treatments have significant, even deadly complications. It’s the nature of modern medicine. Even well-intentioned and very competent physicians have traveled this road.

  First, do no harm.

  Then there are those who do things outside good medicine and common sense. Usually profit is the motive.

  Rose got it. She understood that Julian was in the game for the money. She understood that he didn’t grasp the “do no harm” principle but had a firm grasp on the bottom line.

  Amanda was the exact opposite.

  After Divya and I told her the results of her blood tests, she became defensive. She refused to believe that Julian Morelli would do anything to harm her.

  “Look at me,” she said. “I feel and look better than I have in twenty years. Do I look like I’ve been poisoned?”

  “There are very few toxins that have any outward effects,” I said. “They don’t give you a skin rash or grow hair on your chest or anything like that. They work inside. They alter the body’s biochemistry. Often they do a great deal of harm before the first symptom appears.”

  “But I feel great. I don’t have any symptoms at all.”

  “Really?” Divya asked. “Hasn’t your appetite dramatically decreased?” Amanda nodded. “Haven’t you lost weight?” Another nod. “Didn’t you say you are having trouble sleeping?”

  “Those are minor aggravations. I have more energy. I’m getting more work done. My exercise capacity has increased dramatically. Aren’t those all good things?”

  “They would be if you were doing it solely with a better diet and a more aggressive exercise program,” I said. “But not this way. Not with a handful of miracle pills.”

  “Hank, I like you and I trust you, but I just can’t believe what you are telling me is the truth.”

  I looked at her with a raised eyebrow.

  “I don’t mean you’re lying. Not that. What I mean is that you said yourself you haven’t had these pills analyzed. So how do you know what is in them?”

  “I know what the lab tests on you, Rose, and a very lucky young lady showed. There’s little doubt in my mind that these abnormalities came from Julian Morelli’s pills. All I’m asking is that while we’re completing our testing, you stop taking them. Doesn’t that make sense?”

  She looked at me but said nothing, skepticism etched all over her face. I knew I wasn’t getting anywhere.

  “Humor me,” I said.

  Once we got back in the car, Divya said, “She’s not going to stop, is she?”

  “Doesn’t sound that way to me. Let’s hope she’s lucky enough not to have any problems until we have the proof to convince her otherwise.”

  Divya cranked up her SUV and pulled from the curb. “So we are relying on luck?”

  “Never underestimate the power of luck.” I grabbed the dashboard as she tore through a turn. “Like you and your driving.”

  “What does my driving have to do with luck?”

  “You’re lucky you’re still alive.”

  “You do know that you sound more like Evan every day?”

  Chapter 31

  As Divya and I headed back toward Shadow Pond to work on patient files, Divya got a call. From her mother. She dropped into her native language, but it was easy to tell this was an argument, not a polite conversation. Divya maneuvered the SUV through a series of breathtaking turns with one hand while holding her cell to her ear with the other. I started to ask if she wanted to pull over and let me drive, but I was afraid to distract her. The trees along the roadside looked unforgiving.

  Maybe Evan was rubbing off on me. A scary thought.

  Maybe fear is universal.

  The human startle response is genetically ingrained. So is the fear of falling. Probably from when our ancestors slept in trees to avoid predators. Seemed to me that fear of crashing would be similarly ingrained.

  Divya finally disconnected the call, tossed her cell phone into the center console, and white-knuckled the steering wheel. Her jaw set, eyes narrowed. I could almost see steam coming from her ears.

  “What’s that?” I asked.

  “Nothing.”

  “Yeah, that’s what it sou
nded like.”

  She laughed. Sort of. More a short exhalation. “My mother.”

  “Want to talk about it?”

  “No.”

  I shut up and held on.

  Here is what I know about Boris Kuester von Jurgens-Ratenicz.

  It’s easier to call him simply Boris.

  He owns Shadow Pond and is our gracious host, letting us live in and work from his guesthouse.

  He is crazy rich, shadowy, and I have no idea what he really does for a living. Something international and murky.

  He is extremely private.

  He has connections. To what, I don’t know, but his web of influence seems to be wide and complex.

  It was his connections that pushed me to knock on the door to Shadow Pond’s main house. Boris’s assistant Dieter answered. I told him I’d like to talk with Boris, only needed a minute or two. He led me to the library, where Boris sat, half-glasses on his nose, shuffling through a mess of papers on his desk. Dieter left, closing the door behind him.

  “What can I do for you, Hank?” Boris asked as he stacked the pages and turned them facedown.

  “I need to ask a favor.”

  He removed and folded his glasses, laying them on the desktop. “What is it?”

  “Have you ever heard of StellarCare?”

  “Julian Morelli’s new clinic, no?”

  I’m constantly amazed at what he knows. “That’s right. It seems his outfit is connected to StellarCare in Zurich and Paris.”

  “Yes?”

  “Do you know anything about the two European clinics?”

  “I didn’t even know they existed.”

  Guess he didn’t know everything after all. “I’m concerned about what Julian might be doing at his clinic and hoped I could find out something about the parent company.”

  He folded one hand over the other on his desktop. “What things?”

  “I’m not sure.”

  “Of course you are, or you wouldn’t be asking for my help. No?”

  “He might be giving his patients some dangerous drugs as part of his weight-loss program.”