Side Effects

by Michael Palmer

  "By design, Dr. Bennett, quite by design. You see, where there is grant money involved, there are bound to be, how should I say it, omewhat less than fully qualified applicants contacting us. We prefer o do our own preliminary research and then to encourage only appropriate institutions and agencies to apply. Our offices are at 238 K street, Northwest, on the seventh floor. Please feel free to visit any time you are in Washington. Perhaps your pathology department would be interested in applying for a capital equipment grant."

  "Perhaps," Kate said distractedly. William Zimmermann had heard enough.

  "Dr. Thompson, " he said, "I want to thank you for helping to clear up the confusion here, and also for the wonderful support your agency has given my Omnicenter."

  "Our pleasure, sir, " Dr. James Thompson said. "Well? " Zimmermann asked after he had hung up. "Something's not right, " she said. "What?"

  "He mentioned my pathology department. How did he know I was a pathologist?"

  "I told him you were at the very start of the call."

  "I'm not trying to be difficult, Bill-really, I'm not-but you referred to me as a physician, not a pathologist. You remember, Tom, don't you?"

  A look at the uncertainty in Tom's eyes, and she began having doubts herself. "Well?"

  "I… I'm not sure, " was all the resident could say. Kate stood to go.

  "Bill, I may seem pigheaded to you, or even confused, but I tell you, something still doesn't feel right to me. I just have a sense that Dr.

  Thompson knew exactly who I was and what I wanted before you ever called."

  "You must admit, Kate, " Zimmermann said clinically, "that when one looks first at the business with the baseball player, then at the conflict over whether or not a chemist actually performed tests he swears he never ran, and now at what seem to be groundless concerns on your part regarding the Ashburton Foundation and my long-standing computer engineer, it becomes somewhat difficult to get overly enthusiastic about your hunches and senses and theories. Now, if you've nothing further, I must get back to work."

  "No, " Kate said, smarting from the outburst by the usually cordial man.

  "Nothing, really, except the promise that no matter how long it takes, I will find out who, or what, is responsible for Ellen's bleeding disorder. Thanks for coming, Tom. I'm sorry it worked out this way."

  With a nod to both men, she left, fingers of self-doubt tightening their grip in her gut. She bundled her clinic coat against the wind and snow and pushed head down out of the Omnicenter and onto the street. What if she were wrong, totally wrong about Redding and Horner, about the Omnicenter and Ellen's bleeding, about Reese? Perhaps, despite the critical situation in Berenson 421, despite the nagging fears about her own body, she should back off and let things simmer down. Perhaps she should listen to the advice of her father-in-law and reorder her priorities away from Metropolitan Hospital. They were waiting for her in her office, Stan Willoughby, Liu Huang, and Rod Green, the flamboyant, black general surgeon who was, it was rumored, being groomed for a Harvard professorstlp. I "Kate, " Willoughby said. "I was just writing you a note." He held the paper up for her to see. Kate greeted the other two men and then turned back to Wiljj› loughby. He was tight. His stance and the strain in his smile said so. "Well? " she asked.

  "Pardon?"

  "The note, Stan. What would it have said?"

  "Oh, I'm sorry. My mind is racing." He cleared his throat. "Kate, we need to talk with you."

  "Well, sit down then, please." She felt her heart respond to her sudden apprehension. "A problem?"

  Willoughby was totally ill at ease. "I… um… Kate, yesterday you did a frozen section of a needle biopsy on one of Dr. Green's patients."

  "Yes, a breast. It was an intraductal adenocarcinoma. I reported the results to Dr. Green myself." Her pulse quickened another notch. "Was there, um… any question in your mind of the-"

  "What Dr. Willoughby is trying to say, " Rod Green cut in, "is that I did a masectomy on a woman who, it appears, has benign breast disease."

  The man's dark eyes flashed. "That's impossible." Kate looked first to Willoughby and then to Liu Huang for support, but saw only the tightlipped confirmation of the surgeon's allegation. "Liu?"

  "I have examined specimen in great detail, " the little man said carefully. "Track of biopsy needle enters benign adenoma. No cancer there or in any part of breast."

  "Are… are you sure? " She could barely speak. "Kate, " Willoughby said, "I reviewed the slides myself. There's no cancer."

  "But, there was. I swear there was."

  "There was no cancer in my patient, " Green said. "None." His fury at her was clearly under the most marginal control. "You have made a mistake. A terrible, terrible mistake."

  Kate stared wide-eyed at the three men. It was a dream, a grotesque nightmare from which she would awake at any moment. Their stone faces blurred in and out of focus as her mind struggled to remember the cells.

  There were three breast biopsies, no, two, there were two. Green's patient was the first. The pathology was a bit tricky, but it was nothing she would ever miss in even one case out of a thousand, unless..

  .. She remembered the fatigue and the strain of the previous morning, the stress of Jared's being away, the crank phone calls, and the disappearance of Ian Toole. No, her thoughts screamed, she couldn't have made such a mistake. It wasn't as if they were saying she had missed something, although even that kind of error would have been hard to believe, they were claiming she had read a condition that wasn't there.

  It was… impossible. There was just no other word. "Did you check the slides from yesterday? " she managed. "The frozens?"

  Willoughby nodded grimly. "Benign adenoma. The exact same pathology as in the main specimen." He handed her a plastic box of slides. Green stood up, fists clenched. "I have heard enough. Dr. Bennett, thanks to you, a woman who came to me in trust has had her breast removed unnecessarily. When she sues, even though I will in all likelihood be one of the defendants, I shall also be her best witness."

  He started to leave and then turned back to her. "You know, " he said,

  "that letter you sent to the papers about Bobby Geary was a pretty rotten thing to do." He slammed the door hard enough to shake the vase of roses on the corner of her desk. Kate could barely hold the slide as she set it on the stage of her microscope. This time, the yellow-white light held no excitement, no adventure for her. She knew, even before she had completed focusing down, that the specimen was benign. It was that clear-cut. Her mistaking the pattern for a cancer would have been as likely as an Olympic diver springing off the wrong end of the board.

  "Something's wrong, " she said, her eye still fixed on the cells. The words reverberated in her mind. Something's wrong. She had said that to Bill Zimmermann not half an hour ago. "Kate, " Willoughby said gently,

  "I'm sorry."

  Only after she looked up from the microscope did she realize she was crying. "Stan, I swear this is not the slide I read yesterday. It can't be." But even as she said the words, she admitted to herself that, as in the situation with Bobby Geary, her only defense was a protestation of innocence. "You've been under a great deal of stress lately, Kate. Do you suppose that-"

  "No! " She forced herself to lower her voice. "I remember the biopsy I saw yesterday. It was cancer. I didn't make a mistake."

  "Look, " Willoughby said, "I want you to take a few days off. Rest.

  After this coming weekend we can talk."

  "But-"

  "Kate, I'm taking you off the schedule for a while. Now I don't want you coming back into work until after we've had a chance to discuss things next week. Okay? " There was uncharacteristic firmness in the man's voice. Meekly, she nodded. "Okay, but-"

  "No buts. Kate, it's for your own good. I'll call you at home and check on how you're doing. Now off you go."

  Kate watched her colleagues leave, Stan Willoughby, head down, shuffling a few feet ahead of Liu Huang, who turned for a moment and gave her a timid, but hop
eful, thumbs-up sign. Then they were gone. For a time she sat, uncertainly, isolation and self-doubt constricting every muscle in her body, making it difficult to move or even to breathe. With great effort, she pulled the telephone over and lifted the receiver. "I want to place a long-distance call, please, " she heard her voice say. "It's personal, so charge it to my home phone… I'm calling San Diego."

  Thursday 20 December

  It had taken narcotic painkillers and amphetamines along with his usual pharmacopoeia, but in the end, Becker had prevailed. Now he ached for sleep. He could not remember his last meal.

  Catnaps at his desk, cool showers every six or seven hours, bars of chocolate, cups of thick coffee for four days, or was it five?

  These had been his only succor. Still, he had endured. In the morning, a messenger would hand deliver his manuscript and box of slides to the editor in chief of The New England Journal of Medicine. The letter accompanying the manuscript would give the man ten days to agree to publish the Estronate studies in their entirety within four months and to oversee the appointment of an international commission to assume responsibility for the initiation of Beckerian population control. The study was in a shambles, with reference books, scrap paper, coffee cups, discarded drafts, candy-bar wrappers, and dirty glasses covering the furniture and much of the floor. Like a prizefighter at the moment of triumph, Willi Becker, more skeleton than man, stood in the midst of the debris and pumped his fists in the air. After forty years and through hardship almost unimaginable, he had finished. Now there was only the matter of gaining acceptance. It was ironic, he acknowledged, that decades of the most meticulous research had come down to a few frenetic days, but that was the way it had to be. With the pathologist Bennett snooping about the Omnicenter and Cyrus Redding's antennae up, time had become a luxury he could no longer afford. Studies in Estronate 250.

  Becker cleared off his easy chair, settled down, and indulged in thoughts of the accolades, honors, and other tributes to his genius and dedication certain to result from the publication and implementation of his work. He was nearing receipt of a Nobel Prize when the phone began ringing. It took half a dozen rings to break through his reverie and another four to locate the phone beneath a pile of journals. "Hello?"

  "John? Redding here."

  The voice brought a painful emptiness to Becker's chest. For several seconds, he could not speak. "John?"

  Becker cleared his throat. "Yes, yes, Cyrus. I'm here."

  "Good. Fine. Well, I hope I'm not disturbing anything important for you."

  "Not at all. I was just… doing a little reading before bed."

  Did his voice sound as strained, as strangled, as it felt? "What can I do for you? " Please, he thought, let it be some problem related to their myasthenia. Let it be anything but… "Well, John, I wanted to speak with you a bit about that business at the Omnicenter." Becker's heart sank. "You know, " Redding continued, "the situation with these women having severe scarring of their ovaries and then bleeding to death."

  "Yes, what about it?"

  "Have you learned anything new about the situation since we spoke last?"

  "No. Not really." Becker sensed that he was being toyed with. "Well, John, you know that the whole matter has piqued my curiosity, as well as my concern for the safety of our testing programs. Too many coincidences. Too much smoke for there not to be a fire someplace."

  "Perhaps, " Becker said, hanging onto the thread of hope that the man, a master at such maneuvers, was shooting in the dark. For a time, there was silence from Redding's end. Becker shifted nervously in his chair.

  "Cyrus? " he asked finally. "I'm here."

  "Was there… anything else?"

  "John, I won't bandy words with you. We've been through too much together, accomplished too many remarkable things for me to try and humiliate you by letting you trip over one after another of your own lies."

  "I… I don't understand."

  "Of course you understand, John." He paused. "I know who you are. That is the gist of what I am calling to say. I know about Wilhelm Becker, and even more importantly, I know about Estronate Two-fifty."

  Becker glanced over at his manuscript, stacked neatly atop the printer of his word processor, and forced himself to calm down. There was little he could think of that Redding could do to hurt him at this stage of the game. Still, Cyrus Redding was Cyrus Redding, and no amount of caution was too much. Stay calm but don't underestimate.

  "Your resourcefulness is quite impressive, " he said. "John, tell me truly, it was Estronate Two-fifty that caused the problems at the Omnicenter, wasn't it?"

  "It was."

  "The hemorrhaging is an undesirable side effect?"

  Becker was about to explain that the problem had been overcome and that his hormone was, to all intents, perfected. He stopped himself at the last moment. "Yes, " he said. "A most unfortunate bug that I have not been able to get out of the system."

  "You should have told me, John, " Redding said. "You should have trusted me."

  "What do you want?"

  "John, come now. It is bad enough you didn't respect me enough to take me into your confidence. It is bad enough your uncondoned experiments have put my entire company in jeopardy. Do not try to demean my intelligence. I want to extend our partnership to include that remarkable hormone of yours. After all, it was tested at a facility that I fund."

  "Work is not complete. There are problems. Serious problems."

  "Then we shall overcome them. You know the potential of this Estronate of yours as well as I do. I am prepared to make you an onthe-spot offer of, say, half a million dollars now and a similar amount when your work is completed to the satisfaction of my biochemists. And of course, there would be a percentage of all sales."

  Sales. Becker realized that his worst possible scenario was being enacted. Redding understood not only the chemical nature of Estronate, but also its limitless value to certain governments. How?

  How in hell's name had the man learned so much so quickly? "I… I was planning eventually on submitting my work for publication, " he offered.

  Redding laughed. "That would be bad business, John. Very bad business.

  The value of our product would surely plummet if its existence and unique properties became general knowledge. Suppose you oversee the scientific end and let me deal with the proprietary."

  "If I refuse, " Becker said, "will you kill me?"

  Again Redding laughed. "Perhaps. Perhaps I will. However, there are those, I am sure, who would pay dearly for information on the physician whom the Ravensbruck prisoners called the Serpent."

  For a time there was silence. "How did you learn of all this?" Becker asked finally.

  "Why don't we save explanations, Dr. Becker, for a time after our w business arrangement has been consummated."

  "I need time to think."

  "Take it. Take as much as you need up to, say, twenty-four hours."

  "The intrinsic problems of the hormone may be insurmountable."

  "A chance I will take. You owe me this. For the troubles you have the caused at our testing facility, you owe me. In fact, there is something else you owe me as well."

  "Oh?"

  "I wish to know the individual at the Omnicenter who has been helping you with your work."

  Becker started to protest that there was no such person, but decided against testing the man's patience. In less than twelve hours a messenger would deliver the Estronate paper and slides to The New England Journal of Medicine, making the hormone, in essence, public domain. He had already decided that exposure of his true identity and the risk of spending what little was left of his life in prison was a small price to pay for immortality. "Forty-eight hours, " he said.

  Redding hesitated. "Very well, then, " he said finally. "Forty-eight hours it will be. You have the number. I shall expect to hear from you within two days. The Estronate work and the name of your associate.

  Good-bye." He hung up. "Good-bye, " Becker said to the dial tone. As
he drew the receiver from his ear, he heard a faint but definite click. The sound sent fear stabbing beneath his breastbone. Someone, almost certainly William, was on the downstairs extension. How long? How long had he been there?

  In the cluttered semidarkness of his study, Willi Becker strained his compromised hearing. For a time, there was only silence. Perhaps, he thought, there hadn't been a click at all. Then he heard the unmistakable tread of footsteps on the stairs. "William? " Again there was silence. "William?"

  "Yes, Father, it is." Zimmermann appeared suddenly in the doorway and stood, arms folded, looking placidly across at him. "You… ah… you surprised me. How long have you been in the house?"

  "Long enough." Zimmermann strode to the bookcase and poured himself a drink. He was, as usual, immaculately dressed. Light from the gooseneck reading lamp sparked off the heavy diamond ring on the small finger of his left hand and highlighted the sheen on his black Italian-cut loafers. "You were listening in on my conversation, weren't you?"

  "Oh, perhaps." Zimmermann snapped a wooden swizzle stick in two and used one edge to clean beneath his nails. "Listening was a rude thing to do."

  "Me, rude? Why, Father…"

  "Well, if you heard, you heard. It really makes no difference."

  "Oh?"

  "Just how long were you listening in?"

  Zimmermann didn't answer. Instead, he walked to the printer, picked up the Estronate manuscript, and turned it from one side to the other, appraisingly. "A half million dollars and then some. It would seem there is some truth about good things coming in small packages."

  "Give me that." Becker was too weak, too depleted by the drugs, even to rise. Zimmermann ignored him. "Wilhelm W. Becker, MD, Phd, " he read.

  "So that's who my father is."

  "Please, William."

  "How good it is to learn that the man John Ferguson, who so ignored and abused my mother all those years, was not my father. The Serpent of Ravensbruck. That's my real father."

  "I never abused her. I did what I had to do."

  "Father, please. She knew that you could have come home much more often and didn't. She knew about your women, your countless women. She knew that neither of us would ever mean anything to you compared to your precious research."