Marker

by Robin Cook

  Calvin concluded his conversation, which Laurie could tell dealt with the agenda of the up-and-coming Advisory Board luncheon. The Advisory Board had been set up by the mayor almost twenty years ago, to make the OCME less beholden to both the executive branch and law enforcement.

  Calvin let his heavy legs plop down on the floor. He peered at Laurie through his newly acquired, rimless progressive lenses. Laurie felt herself tense. Thanks to a lingering, mild problem with male authority figures from an early age, Calvin had always intimidated Laurie, even more than the chief. It was a combination of his imposing physical presence; his unwavering cold, black eyes; his legendary stormy temperament; and his occasional chauvinism. At the same time, she knew him to be capable of warmth and gentlemanly behavior. What worried her at any given encounter was which side would be dominant.

  “What can I do for you?” Calvin began. “Unfortunately, we have to make this short.”

  “It won’t take but a moment,” Laurie assured him. She handed over the matrix she had prepared. Then she quickly summarized the history of the four cases as they had unfolded, followed by her ideas concerning the possible mechanism, cause, and manner of death. It took only a few minutes, and when she was done, she fell silent.

  Calvin was still studying the matrix. Finally, he looked up. His eyebrows were arched. Settling back into his seat, which complained with a squeak, he arched his index fingers with his elbows on the desk, and shook his head slowly. His expression was of confusion. “I guess my first question has to be why you are telling all this to me at this early stage? None of these cases has been signed out yet.”

  “Purely because I thought you might want to warn someone over at the Manhattan General what our thinking was, to raise the index of suspicion.”

  “Correction!” Calvin boomed. He took a fleeting glance at his watch, which wasn’t lost on Laurie. “I would be warning them what your thinking was, not mine. Laurie, I’m surprised at you. You’re using grossly inadequate data here to make a premature and ridiculous leap.” He slapped the matrix with the back of his free hand. “You’re suggesting that I communicate pure speculation, which could be extraordinarily detrimental to the Manhattan General Hospital if it got out into the wrong hands, something that happens all too frequently. It could even cause a panic. We deal in facts here at the OCME, not fanciful supposition. Hell, we could lose all credibility!”

  “I have a strong intuition about this,” Laurie countered.

  Calvin slammed his sizable palm down onto the surface of his desk. A few papers went wafting off. “I have zero patience with female intuition, if that’s what this is boiling down to. What do you think this is, a sewing club? We’re a scientific organization; we deal in facts, not hunches and guesswork.”

  “But we’re talking about four essentially unexplained cases within a two-week period,” Laurie said while inwardly groaning. It seemed that she had awakened Calvin’s dormant chauvinism.

  “Yeah, but they do thousands of cases over at the Manhattan General. Thousands! I happen to know they have a low death rate, well below the bellwether three percent. How do I know? I serve on the board. Come back with some facts from toxicology or infallible evidence of low-voltage electrocution and I’ll listen to you, not some cockamamie story of serial killer on the loose with no facts to back it up.”

  “They were not electrocuted,” Laurie said. At one point, she had briefly considered the idea, since standard 110 voltage was capable of causing ventricular fibrillation. But she’d dismissed the idea because patients weren’t routinely subjected to power sources. Maybe one could have been exposed to an aberrant piece of equipment, but surely not four, particularly since none had been monitored.

  “I’m just trying to make a point,” Calvin yelled. He stood up abruptly, causing his desk chair to roll back on its casters and strike the wall. He handed Laurie her paper. “Go back and get some facts if you are so motivated! I don’t have time for this foolery. I’ve got to go to a meeting where we deal with real problems.”

  Embarrassed at being chastised like a schoolgirl, Laurie fled the administration area. Calvin’s office door had been open during the exchange, and the people waiting to see Bingham watched her departure with expressionless faces. She couldn’t imagine what they thought about what they had heard. She was relieved to catch an empty elevator to pull herself together. As she had said to Riva, she knew she was thin-skinned at the moment, and under normal circumstances, she probably could have brushed off Calvin’s crusty response to her concerns. Yet combining Calvin’s reaction with Jack and Riva’s, she felt like a modern-day Cassandra. She couldn’t believe that people whom she respected could not see what was so clear to her.

  Back in her office, she threw herself into her chair and for a moment buried her head in her hands. She was stymied. She needed further information but was paralyzed by having to wait for the charts to come over from the Manhattan General through the usual channels. There was no way she could speed up the system. Other than that, she had to wait for Peter to work his magic with the gas chromatography and mass spectrograph. Short of getting yet another similar case the following day, which she was not wishing for, there was nothing to be done.

  “I have to assume your meeting with Calvin was not as auspicious as you hoped,” Riva said.

  Laurie didn’t respond. She was feeling even more temperamental than earlier. From when she was a little girl, she’d always sought approval from authority figures, and when she didn’t get it, she felt terrible. Calvin’s reaction was a case in point, making her feel that all the disparate segments of her life were unraveling. First was the situation with Jack, next her mother and the BRCA1 problem, and now it seemed that even her job was in disarray. On top of it all, she felt physically exhausted from insufficient sleep two nights in a row.

  Laurie sighed. She had to pull herself together. Thinking about the BRCA1 problem reminded her that she had agreed with Jack to have herself tested for the marker by calling her old college roommate, Sue Passero. At the time, Laurie had not been completely forthright, since she actually hadn’t entirely decided to do it, so her acquiescence was more to assuage his unexpected insistence than a real decision. Yet suddenly, she saw the idea in a new light, since getting away from the OCME, even for just a couple of hours, sounded like a good idea. The thought also occurred to her that she could kill two birds with one stone. Knowing Sue as well as she did, Laurie was confident that while getting tested, she could pass along her concerns about the possibility of a serial killer that would give the hospital a reason to be vigilant without the need to cite herself or the OCME as the source.

  Laurie got out her address book for Sue’s office number and made the call. They had been close in college and in medical school, and having ended up practicing in the same city, they got together every month or so for a dinner. They always vowed to see each other more often, but somehow it never happened.

  Laurie got one of the clinic secretaries where Sue worked and asked for Sue. Laurie’s intention was just to leave a message for Sue to call back at a convenient time, but when the secretary asked who was calling and Laurie said “Dr. Montgomery,” the secretary went off the line before Laurie could explain. The next thing she knew, she was talking with her friend.

  “This is a nice surprise,” Sue said cheerfully. “What’s up?”

  “Do you have a minute to talk?”

  “A minute, what’s on your mind?”

  Laurie said she needed to be tested for BRCA1 for reasons that she would explain later. She also mentioned that she had been switched to AmeriCare but had not yet made arrangements for a primary-care doctor.

  “No problem. Come over anytime. I can set you up with a script and send you down to the lab.”

  “How about today?”

  “Today is fine. Come on over! Have you had lunch?”

  “I haven’t.” Laurie smiled. It was going to be three birds with one stone!

  “Well, get your rear end over here, g
irl! The cafeteria food is not something to write home about, but the company will be good.”

  Laurie hung up and got her coat from behind the door.

  “I think you are doing the right thing about being tested,” Riva said.

  “Thank you,” Laurie responded. She looked at her desk to be sure she wasn’t forgetting something.

  “I hope you’re not cross with me,” Riva said.

  “Of course not,” Laurie responded. She gave Riva’s shoulder a reassuring squeeze. “As I said earlier, I know I’m oversensitive these days, and everything is bothering me more than it should. Be that as it may, and I know you’re not my secretary, but I’d appreciate it if you would once again take messages, especially from Maureen or Peter. I’ll make it up to you.”

  “Don’t be silly. I’ll be happy to answer your phone. Are you going to be back this afternoon?”

  “Absolutely. It’s going to be a quick lunch and a simple blood test, although I might stop and say hello to my mother as well. Anyway, I’ll have my cell if you need to call.”

  Riva waved and went back to her work.

  Laurie walked out the OCME entrance on First Avenue. There was a bite to the air. The temperature had dropped as the day progressed, so it was colder than when she’d walked to work that morning. As she descended the front steps toward the curb, she got her zipper started and pulled it up to her chin. Standing on the curb, she was shivering slightly as she raised her hand to hail a cab.

  The ride to Manhattan General was a little longer than the ride she’d taken the previous day to University Hospital. Both institutions were on the Upper East Side and approximately equal distance to the north from OCME, but the General was farther west, sprawled along Central Park. It took up more than an entire city block, with several pedestrian walkways spanning the surrounding streets to connect with outlying buildings. The complex had been constructed of gray stone in fits and starts during the course of almost a century, so the various wings were of slightly different architectural design. The newest wing with the most modern silhouette and named for the benefactor, Samuel B. Goldblatt, stuck off the back of the main structure at right angles. It was the VIP wing, the equivalent of where Laurie’s mother had been roomed over at the University Hospital.

  Having been to the Manhattan General on a number of occasions, including visiting Sue, Laurie knew where she was going, which was helpful, since the hospital was always mobbed. She headed directly to the Kaufman outpatient building. Once inside, she walked down to the internal medicine section and inquired after her friend at the main check-in desk. When Laurie mentioned her own name, the secretary handed her an envelope. Inside was a completed script for a screen for the BRCA1 marker, as well as a note from Sue. The note told her where the genetics lab was located in the central building on the second floor. There were also instructions for Laurie to go first to admitting. As a new AmeriCare subscriber, she had to get a hospital card. The final line in the note said that Laurie should go directly to the cafeteria when she was finished, and that Sue would meet her there.

  Obtaining the hospital card took more time than the blood test. She had to wait in line to see one of the customer-service representatives. Still, it took only fifteen minutes, and she was soon on her way up to the laboratory on the second floor. Sue’s directions were clear, and Laurie found the genetics diagnostics lab without difficulty. Inside, it was surprisingly serene in comparison to the rest of the hospital. Canned classical music issued from wall speakers. Framed prints of Monet’s “Water Lilies” from the Museum of Modern Art lined the walls. No patients were in the waiting room when Laurie handed over Sue’s script to the receptionist. It was apparent that walk-in genetic testing was in its infancy, but Laurie knew it would soon be changing, and with it, medicine in general.

  Sitting in the waiting area, Laurie was again forced to confront the reality of what might be lurking deep within the core of her being. It was a disturbing revelation to think she was possibly carrying an instrument of her own death in the form of a mutated gene. It was a kind of unconscious suicide or built-in self-destructive device, which was certainly the reason she’d been actively avoiding thinking about it. Would she be positive or negative? She didn’t know, and being in the hospital made her feel like a gambler, something she was never comfortable with. Had Jack not insisted, she most likely would have put off doing the test indefinitely. But now that she was there, she would have the blood drawn, and then she would forget about it, a trait Laurie shared with her mother.

  After the blood was drawn, a deceptively simple procedure, Laurie returned to the first floor and waited in line at the main information desk. She had no idea where the cafeteria was located in the extensive complex. When it was her turn, the pink-smocked volunteer asked Laurie if she wanted the main cafeteria or the staff cafeteria. Momentarily indecisive, Laurie said the staff cafeteria and was given directions.

  The directions were complicated but made easier by the volunteer’s last suggestion—namely, to follow a purple line on the floor. After a five-minute walk, Laurie found herself in the staff cafeteria. Since it was quarter past twelve, the place was bustling. Laurie had no idea the staff of the Manhattan General was as large as it was, especially considering that the crowd represented only a portion of one shift out of three.

  Laurie looked around at the teeming faces both sitting at tables and waiting in the steam-table line. The babble of reverberating conversation reminded her of the noise of a wetland sanctuary on a late summer night. With such a crowd, Laurie couldn’t help but be immediately pessimistic about hooking up with Sue. The plan smacked of trying to meet a friend in Times Square on New Year’s Eve.

  Just when Laurie was about to head over to the cashiers to ask for a house phone to page her friend, a hand tapped her on the shoulder. To Laurie’s delight, it was Sue, who enveloped her in a big hug. Sue was a big-boned, athletic woman of color who had excelled at college soccer and softball. Laurie felt tiny in her embrace. As usual, Sue looked fetching. In contrast to most of her colleagues, she was dressed in a stylish and flattering silk dress overlaid with a highly starched white coat. Similar to Laurie, she liked to indulge her feminine side with her attire.

  “I hope you didn’t bring your appetite,” Sue teased while gesturing toward the steam-table line. “But joking aside, the food’s not that bad.”

  As they descended the steam-table line and chose their food, they maintained a superficial banter about their respective professional roles. While waiting in the cashiers’ line, Laurie asked about Sue’s two children. Sue had gotten married just after medical school and had a boy, fifteen, and a girl, twelve. Laurie couldn’t help but be jealous.

  “Except for the agony of adolescence, everything is hunky-dory,” Sue said. “What about you and Jack? Any light at the end of the tunnel? Seems to me you’ve got to get a move on, girl! I happen to know you are sneaking up to the big forty-three in a few days, since I’m close behind.”

  Laurie felt her face flush, along with a twinge of irritation that she was incapable of hiding anything. She could tell that Sue had caught the reaction, and since she and Sue had been friends for almost twenty-six years, she had confided in her about her desire for children and the situation with Jack, particularly over the last two years. Laurie was not going to be able to get away with platitudes.

  “Jack and I are history,” Laurie said, deciding to be more forthright than she actually felt, “at least intimacy-wise.”

  “Oh, no! What’s wrong with that boy?”

  Laurie wrinkled her forehead and shrugged to say she had no idea. She didn’t want to get into a long, drawn-out emotional conversation in her current state.

  “Well, you know something . . . good riddance. You’ve been more than patient with that indecisive nincompoop. You should get a medal, because he ain’t going to change.”

  Laurie nodded and had to restrain herself from defending Jack, even though what Sue was saying was true.

  Sue wouldn�
��t let Laurie pay for her lunch and insisted on putting the charges on her house account. With their trays in hand, they managed to get a table for two by the window. The view was of an inner courtyard with an empty fountain. In the summer, it was lush with flowers, water gushing from the fountain’s multiple tiers.

  They talked casually for a few more minutes about the situation with Jack, with Sue doing most of the talking. She then insisted that she would find someone more suitable for Laurie, and Laurie teased her by daring her to try. The conversation then switched to why Laurie had to have the BRCA1 screen. Laurie told the story about her mother and the fact that as usual, her mother had hidden the information from her. Sue’s only comment was that she would arrange an appointment for Laurie with a top-notch oncologist if the test came back positive.

  “What about a primary-care physician?” Sue asked after a short pause. “Now that you are officially a subscriber, you’re going to need one.”

  “How about you?” Laurie suggested. “Are you taking new patients?”

  “I’d be honored,” Sue replied. “But are you sure you would be comfortable with me as your doc?”

  “Absolutely,” Laurie said. “I’ll also have to switch my gyno.”

  “I can help you with that as well,” Sue said. “We’ve got some terrific people on staff, including the woman I use my myself. She’s quick, gentle, and knows her stuff.”

  “Sounds like a good recommendation. But there’s no rush; I’m not due for a yearly checkup for another six months.”

  “That might be true, but I think we should get it in the works. The woman I’m thinking of is awfully popular. For all I know, she has a six-month wait for a first appointment. She’s that good.”