Miracle Drug

by Richard L. Mabry M. D.

  Derek Johnson, fresh from a shower and dressed in clothes he’d pulled from his duffel bag, yawned. “No problem. Thanks for letting me crash at your place.” He took a healthy swallow from the coffee cup that sat before him.

  Although it was almost nine at night, the hospital cafeteria was as busy as ever. Around the two men, an auditory backdrop of a dozen conversations, a clattering of dishes, the occasional ring of a cell phone, all provided them with privacy for their conversation.

  “Some things have changed since you left here a few hours ago, and I thought you’d want to stay involved.” Josh went on to bring Derek up to date on what they’d found in Lambert’s office, the disappearance of the RP-78, Barbara Carper’s death, and the arrest of Dr. Chavez. “I think things are heating up.”

  “You realize, of course, that you’re out of this,” Derek said. “Madison has discharged you as his physician. Therefore, hunting for a clue about why Lambert chose you for the job in the first place is sort of moot. As for everything else you’ve described, it sounds to me like it’s a police matter.”

  “You may be right,” Josh said, “But I guess I’m enough of an idealist that I want to see this through to the end. Dropping out right now seems wrong to me. Besides . . .”

  Derek drained his coffee cup and set it down carefully on the saucer. “Besides what?”

  “I think I know why Ben Lambert chose me to care for David Madison. It’s not what I thought. And I’m sort of angry about it.”

  ***

  Dr. Josh Pearson tapped on the door of Karen Marks’s office, then opened it and walked in. She stood and held out her hand. “Doctor, thank you for coming.”

  “Sorry for the late hour, and I apologize for missing your calls earlier,” he said. “I’d turned off the ringer on my phone because we didn’t want anyone to . . . that is, I was involved in something.”

  “Well, you finally called back. The reason I asked you to come here is that this is something you need to hear in person . . . and not from me.”

  The side door of her office opened and David Madison entered. He moved immediately to where Josh sat, reached down to shake the doctor’s hand, and said, “Dr. Pearson, I’m sorry. I made a terrible decision, and I’m already regretting it. Will you take me back as your patient?”

  Multiple emotions, from indignation to vindication, ran through Josh’s mind. He looked at David Madison, still standing, an expression of pure apology on his face. Without turning his head, he saw Karen Marks leaning forward over her desk, her features frozen in a mask Josh couldn’t interpret.

  Josh took a deep breath before speaking. “This isn’t just a matter of hurt feelings or fractured pride. Ordinarily when a patient discharges me, I consider the mutual trust between doctor and patient, trust I consider absolutely necessary, to be gone. And in that case it’s best for all concerned that we not try to resume the relationship.”

  “I’m—”

  Josh held up his hand. “Why don’t you start by explaining your sudden change of heart?”

  Madison, taking the initiation of a conversation as permission, pulled a side chair up next to Josh. “A couple of things, I guess. I’d been in that hospital room for what seemed like a month. True, you literally rescued me from death’s door, but once it was evident I was going to recover, that somehow didn’t seem so important.” He looked down at his scuffed athletic shoes. “And then I got a call from Dr. Dietz. You know the man’s credentials—recognized the world over as an expert in his subspecialty, he’s visited with royalty, lectured to thousands, written or edited a number of textbooks. He expressed mild puzzlement that I’d chosen you as my personal physician instead of someone with his credentials, and I honestly didn’t have an answer for him.”

  “For that matter, why did you choose Ben Lambert in the first place?” Josh asked. “He had more experience than me, but he’s not on a par with Dietz.”

  “Ben was a good, average doctor. He didn’t have all the answers, but he knew enough to get help if he needed it. The main reason I chose him was because I’d known him since we were boys together, and I trusted him.”

  “Yet he handpicked me to succeed him, but you didn’t give me that same trust.” Josh turned his head. He wasn’t sure he wanted to look at this man who’d treated him . . . well, shabbily.

  “I’ll level with you.”

  Josh had learned years ago that when anyone, a politician or a plumber, prefaced remarks with that phrase, what followed was unlikely to be true. But he nodded as though he were ready to hear Madison’s explanation.

  “Dietz wanted the honor of being the ex-president’s personal physician. But when he was faced with making some decisions about treating a potentially lethal disease, even after the worst appeared to have passed, he began to have second thoughts. And when he did, I did as well.” Madison spread his hands. “That’s the truth. So, will you take me back?”

  Josh nodded slowly. “I’ll care for you until you’ve had your last dose of RP-78. I’ll follow you for a month afterward, to watch for late effects like changes in liver and kidney function. That will give you time to choose your new personal physician. I’ll work with him to make the transition smooth. Okay?”

  “If that’s the best I can do . . .”

  “That’s it. And there are two things we need to do.” Josh checked his watch. “I guess you can do this in the morning, but I want you back in the hospital, at least for another day or so—we can decide then whether you’re ready for outpatient follow-up.”

  Madison started to speak, but Karen Marks overrode him with, “Done.”

  “The second thing is getting you the next dose of RP-78.” Josh looked at his watch. “You’re a couple of hours overdue for it. Do you have the medication?”

  “That’s another problem,” Karen Marks said.

  21

  Although she had been gone from the hospital at the normal time for dinner, the nurses had put aside a plate and warmed it in the microwave for Rachel. Admittedly, it was much later than her normal evening meal—more of a midnight snack than dinner—but she was grateful for the gesture. She hadn’t recognized the nurse who brought it to her, and because of this, she stifled her impulse to express sympathy for Barbara Carper’s death. For all she knew, that news hadn’t yet become common knowledge. Still, she shivered at the thought of the murder of a nurse who’d helped care for her during what could have been her terminal illness. She pulled the tray table closer and looked at what the hospital kitchen had sent up for her evening meal.

  Rachel was toying with the food on her plate, the main feature of which was a dish that she thought might represent roast beef, when the room to her door opened and Josh Pearson entered. Before Rachel could say anything, Allison came in right behind him.

  Josh said, “I know it’s late, but I need to ask you something.”

  “Didn’t we just spend a couple of hours together?” Rachel said, laying aside her knife and fork.

  “Yes, and I’d hoped to let you rest,” Josh said, “But something has come up . . . something that involves you.”

  She listened as Josh explained how he’d come to accept Madison as a patient once more and the limitations he’d placed on that offer. “My primary responsibility will be to finish treating him for the infection and do enough follow-up to assure the RP-78 hasn’t caused any complications.”

  “But there’s a problem with finishing the course of the drug,” Allison said. “Chavez apparently had a small cooler in the trunk of his car with what he said was the balance of Madison’s RP-78. But Josh here isn’t sure that’s what it really is. What’s to say it isn’t a dummy vial Chavez put together in order to get the money?”

  “I called, and Dr. Gaschen, chief operating officer of Argosy, found another five hundred milligrams of the drug. Karen Marks arranged for it to be flown here via Air Force jet fighter, but there’s a ground hold in Atlanta that will keep the plane from taking off for another couple of hours.”

  Rachel
pushed her tray table aside and swung her feet off the bed. “And you want me to give permission to take a dose out of the RP-78 being used to treat me and give it to Madison. Right?”

  “You’re my patient, not Josh’s,” Allison said. “And at this point the decision to use what amounts to your medicine for him is up to me. But I want your permission, too.” She looked at Josh, who nodded fractionally.

  “I’ve said it before when there was a lot more at stake than there is now,” Rachel said. “Whatever it takes to make sure David Madison is completely cured, even if it were to endanger my own health—I’m fine with it.”

  ***

  It was after eleven in the evening, but Detective Stan Warren was still at work. He yawned and reached for the Styrofoam cup of coffee sitting on his desk. He brought it to his lips, only to find it was empty. He, like many of his colleagues on the police force, believed coffee was the liquid that kept the wheels of justice turning. Warren heaved himself to his feet and headed for the pot in the corner of the squad room.

  The detective took his coffee back to his desk and called across to a man in shirt sleeves, his tie loosened, who sat at a nearby desk tapping the keys of his computer. “Robinson, what did the officers find when they searched Dr. Lambert’s office?”

  “Just putting it all together,” the other detective said. “Let me show you.”

  Warren moved to look over the man’s shoulder at the computer screen.

  “The combination to the safe was on the bottom of the middle file cabinet drawer—the same place a lot of people ‘hide’ theirs,” Robinson said. “In the safe, there was a vial labeled diphtheria toxoid. There are several fingerprints on it, and we figure some of them belong to Lambert. The lab’s going to do an analysis tomorrow, but we think it may be some sort of inert material, maybe even saline.”

  “And that would be the vial used to immunize Madison, so he really wasn’t protected against diphtheria.”

  “And if you go back through the statements of some of the others involved, Miss Moore was immunized out of the same vial.”

  “On purpose?” Warren asked.

  “No, probably that was luck of the draw. She came in for her immunization right after the nurse had given Madison his. The vial was there, so that’s where her shot came from.”

  “What else?” Warren asked.

  “Here’s where it gets interesting. There’s paperwork for a bank account in the Cayman Islands with a recent deposit of five hundred thousand dollars.”

  Warren nodded.

  “The safe also held two Cayman Islands passports—one in a false name with Lambert’s picture, one for a good-looking redhead.”

  “So Lambert was paid off for his role in all this. But if he and this redhead were going to ride off into the sunset, I’d imagine he’d want something like a million dollars. After all, he’d be leaving his retirement funds and bank account behind.”

  “I’m guessing the other half million was supposed to come after Madison died. But whoever was putting this together decided to get rid of Lambert instead.”

  Warren nodded. “And if he used some kind of injection that mimicked a heart attack, then got rid of the body so there’d be no autopsy, that would tie Lambert’s part of it up with a neat little bow.”

  “Oh, and one more thing.” Robinson turned so he was looking up at Warren. “Remember you asked me to try to backtrack the guy who took a shot at Madison? This was the same guy who dodged in ahead of the real funeral director, snatched Lambert’s body, and delivered the cremated remains back the next day.”

  “Yeah. Leonid somebody,” Warren said.

  “Malnyk. Leonid Malnyk,” Robinson said. “He entered the U.S. using a forged passport a couple of days before he pulled the body-snatching. We think we’ve found the room he was renting, but there wasn’t anything in it that helped us. But we also found his car near the hospital.”

  “Were his keys in his pocket?”

  “No, nothing that simple. We chased down the owners of all the cars in the hospital visitors’ lot and found one rented with an alias that Malnyk sometimes used. The keys were in a magnetized box concealed in the left front wheel well. When the crime lab took the car apart, under the spare tire they found two things that might be of interest to you.” He paused like a conjurer about to pull a rabbit out of a hat. “There was a Canadian passport with our guy’s picture using the name Larry Miller and a bankbook showing a recent deposit of two hundred

  fifty thousand dollars in an account at the same Cayman Islands bank where our friend Dr. Lambert had his.”

  ***

  “Did you sleep well?”

  Rachel opened one eye and saw Josh standing at her bedside. As she came more awake, she heard the sound of voices in the hospital corridor outside. After determining that Madison was to be readmitted after his brief absence from the hospital, Josh and Lang convinced the hospital administration to keep this wing unoccupied except for its two special patients. It made security much easier, but Rachel felt a certain amount of guilt at tying up nurses and aides who could be ministering to dozens of patients instead of two lone charges.

  Josh drew a chair to her bedside. “How was your night?” he asked again.

  “Surprisingly, I was able to sleep pretty well. As I told you earlier, once the crisis from the infection passed, I felt almost rejuvenated. And getting away from the hospital yesterday afternoon, even for only a couple of hours, was wonderful. I can hardly wait to leave here for good.”

  “What’s the noise in the hall?” Rachel asked.

  “Madison is back in the hospital.”

  “Complications?” she asked.

  “No, conscience,” Josh said. “The remaining RP-78 arrived during the night, and it appears to be in order, so we should have plenty of the drug for you and Madison to complete your ten-day courses.” Josh crossed and uncrossed his legs. He rolled his head and flexed his shoulders, and Rachel heard bones cracking.

  “Did you sleep at home last night?” she asked.

  “No, I spent another night in one of the call rooms.” He gestured to the scrub suit he wore beneath his white coat. “But I plan to make it home sometime today to shower and change, maybe even catch a nap. And it won’t be long until you’ll be out of here permanently.” Josh leaned forward. “And that brings me to the reason I’m here.”

  “That could mean a lot of things—some professional, some personal,” Rachel said.

  “Let’s get the professional out of the way first,” Josh replied. “Today is Friday. This evening you and Madison get the eighth of your ten doses of RP-78. As I’ve said before, it’s possible you’ll be fine without the additional drug, but we have no data to support that, and none of us see any need to take that risk.”

  Rachel felt her heart drop, because she still harbored hope that she’d get out of the hospital early—maybe even today.

  “However . . . ,” Josh said, and Rachel felt the ember of hope begin to smolder once more. “However, I’ve talked with Allison and Derek, and they agree with me that so long as you monitor your temperature, your other vital signs, and your general status—so long as you agree to report any changes immediately—then we can probably let you go home tomorrow. That’s Saturday. What do you say to that?”

  “Wonderful,” Rachel said. “I presume Madison’s wife will help watch him.” She was silent for a moment. “Of course, I live alone. Do you still think it will be okay for me to be at home?”

  “I’ve got that covered,” Josh said.

  Warning bells went off in Rachel’s head. “Josh, I love you. We have a lot to decide about our future. But I don’t think it would be a good idea for you to stay at my apartment, even for a good reason like this.”

  Josh smiled. “Not that I wouldn’t like that situation, but I agree it’s not the way we want to start this new phase of our relationship. No, I’ve talked with Allison Neeves about this. She’s agreed to stay with you for a few days until we’re completely certain there’
s no danger of a relapse.”

  “That’s really nice of her,” Rachel said. “Thank you for arranging it.” She grinned. “Of course, I suspect I’ll still see you every once in a while, even after I leave the hospital.”

  Josh nodded. “You can count on it.”

  ***

  “So, I think we can let you go home tomorrow if things are still going well,” Josh Pearson said.

  David Madison sat in a chair in the corner of his hospital room. Rather than a hospital-issue gown, he wore maroon pajamas and a blue robe of some sort of light material. He fought down his initial response, which was to ask Dr. Pearson why he had to be dragged back to Prestonwood Hospital in the first place. Instead, he took a deep breath, counted to five, and said, “You’re the doctor.”

  Pearson pulled his chair closer, so the two men were almost knee-to-knee. “I know. You’re wondering why this sudden change of heart. The truth of the matter is that I’ve been taking this thing about being physician to an ex-president so seriously that I was afraid to trust my judgment. I didn’t want to give some Monday morning quarterback a reason to criticize my decisions. After we got you back here last night and I gave you the seventh dose of RP-78, I sat down with Dr. Neeves and Dr. Johnson and discussed the case. None of us have definitive answers to our questions, but it seems reasonable that if we give the drug for a full ten days, then watch for signs of recurrent disease, you and Rachel—er, Miss Moore—will be fine.”

  “And how would you watch for those signs?”

  Pearson went over his plan. He ended with, “And if this is okay with Mrs. Madison, I think we can let you go home tomorrow—to stay, this time. I’ll still want to see you in the office a few times, probably get some lab work until we’re sure you don’t have any lasting organ damage. That will give you time to arrange with someone to be your personal physician for future care.”

  “I want to talk with you about that,” Madison said. “But let me think about it first.”

  Pearson rose, then sat down again. “When we first met, you told me someone was trying to kill you. Obviously, I’ve seen evidence of that, but you didn’t tell me why. I think you’ve seen I can be discreet. Are you ready to share that with me now?”