by LaGreca, Gen
A screeching alarm pierced the silence. Sudden, erratic readings distorted the monitor. The cat’s blood pressure plummeted. Its heart beat irregularly. The animal was in dire trouble. David threw off the cloths covering it and for a few frantic minutes tried every remedy possible to restart the rapidly failing heart, but to no avail. The animal died on the table.
Chapter 27
The Raise
Bright-colored heads of hair bobbed like new flowers before Randall Lang. His wife, Beth, and their three children, the blondes and redheads of his life, assembled in his home office for a monthly family ritual. A tall stack of checks placed before him on his desk swayed precariously with every breeze. It was the last Sunday of October: time to pay the bills.
Each month Beth prepared the checks, then passed them to her husband to sign, because she could refuse the children nothing. Each month Randy objected to the small mountain of bills, ranting about the family’s spending. But he, too, could subtract nothing from the bulging budget. Although he protested loudly, like a kettle boiling over and losing its steam, he ultimately signed all of the checks.
“I figured we could get this over with early, Dad,” explained thirteen-year-old Stephen Lang, “so I gathered the troops when you didn’t leave to play racquetball with Uncle David this morning.”
As he was bringing the stack of checks closer to him, Randy’s hand stopped at the mention of his brother.
“Are you guys still playing?” asked Stephen. “I can’t remember a Sunday that you ever missed, until this month.”
There was a pause.
“No, we’re not playing,” Randy finally whispered.
He had told no one, not even Beth, about the rift with his brother. The family members glanced curiously at each other. Something was wrong, they sensed.
“Daddy, now try not to get upset when you see my coach’s bill.” Stephen’s twin, Victoria, began the familiar chorus. “The extra ice-skating lessons were absolutely essential to prepare for my next competition.”
Randy looked at his daughter listlessly.
“And, Dad, I know you’re gonna have a fit when you see the concert tickets on my credit card,” said the young pianist, Stephen. “But my teacher wanted me to see those performances in addition to taking lessons. I tried to get matinees, which are cheaper.”
Randy nodded numbly.
“And, honey,” said Beth, “you’ll also see a bill for Michelle’s new computer. I can explain . . .”
Beth stopped talking because her husband was not listening. He was signing the checks without protest or commotion. The family members looked at each other incredulously.
Since Randy had begun campaigning for Governor Burrow, Riverview Hospital had entered a propitious period. After a lengthy battle for government permission to reopen its old Stanton Pavilion, its request had suddenly been granted. After another long struggle, it had received permission from the Bureau of Medicine to obtain a new scanner. The agency also had approved the hospital’s long-standing request to redesign the Emergency Department. And CareFree surprisingly had paid eighty thousand dollars in claims previously denied, which the hospital had been contesting.
The board of directors, elated with this turn of fortune, had voted Randy a hefty raise and bonus. “We always knew you had a brilliant business mind, Randall,” Charles Hodgeman, the chairman of the board, had said, handing Randy a bonus check. “Now you have the proper attitude and focus to lead us in the right direction.” Randy had accepted the check with the enthusiasm of a motorist getting a speeding ticket.
His perplexed family watched him sign the first to last check without a whimper.
“Aren’t you gonna yell at us today, Daddy?” asked seven-year-old Michelle.
“No, honey.”
“But, Daddy, I don’t get it.” Victoria stretched her long neck to see the papers on the desk. “Are you sure my bills are in there?”
“They’re there, Victoria.”
“Hey, Dad, do you have a fever or something?” asked Stephen.
“No, kids, I’m okay. I got a raise and a bonus,” he said quietly. Even Beth looked surprised. In the manner of hiding a guilty secret, Randy had told no one, not even his wife. “So now we have the cash flow to cover all this.”
The group looked dumbfounded. They waited, but Randy volunteered nothing more.
“That’s good, isn’t it?” asked Stephen.
“I suppose,” said Randy.
Slowly the family filed out of the office, their bowed heads appropriate for leaving a sick man’s bedside.
* * * * *
In a windowless lab of the William Mead Research Center, an unshaven David Lang had spent a sleepless night trying to answer the question throwing his life into code blue. Two sighted cats watched him; two blinded cats felt his presence; one dead cat held a secret that tormented him.
Still dressed in surgical scrubs from the operation of the previous night, David sat hunched on a stool on that last Monday morning of October, his elbows propped on the lab counter, his eyes swollen from lack of sleep, his hands holding up his head. He read and reread the medical records of his laboratory cats. He traced and retraced every step in the fatal surgery on his third experimental feline. He asked himself the same questions repeatedly: What was the cat’s physiology? What were the changes in the animal’s blood pressure? Was a blood vessel cut? Could there have been bleeding? Was there swelling in the brain? Could the cat have had a stroke? What could account for the shockingly rare occurrence of a living creature dying on the table under his knife? He found no answer.
He considered the new drug used in his second nerve-repair surgery, the scar inhibitor, which he had introduced to the cat’s brain immediately before its death. Could something have contaminated the drug? Did anyone break into the lab? Did someone tamper with the substance? In a small chemical lab on another floor of the building, he tested the vial of the scar inhibitor used on the third cat. The results compared exactly to previous analyses, with no trace of a contaminant.
Then he tested the blood of the two cats that had survived the second nerve-repair surgery and compared the results with those for the blood of the cat that had died. He found an unusual chromatographic band in the blood of the dead cat that was absent from the blood of the live ones. He collected that band in a sample jar and carried it across campus to Danzer Hall, home of the university’s chemistry department, for analysis by a chemist in a better-equipped lab.
David walked through piles of stiff fallen leaves covering the grassy field between the buildings. He’d neglected to wear a coat, oblivious to the chilly air cutting through his thin surgical scrubs and to the odd stares from passersby in overcoats. He was relieved that he had not scheduled any surgeries or appointments that week, save for Nicole’s case. Knowing CareFree, he was prepared to trace his paperwork personally through a maze of departments to obtain final approval for the dancer’s treatment. While walking, David telephoned Mrs. Trimbell to postpone Nicole’s appointment with him and hospital admission from that Monday until the following day. At Danzer Hall, too impatient to wait for the elevator, he climbed steps three at a time to the office of his friend, chemistry professor John Kendall. David presented the unknown substance in the sample jar and asked Kendall to identify it. Hearing the panic in David’s voice, the stocky chemist with the black-rimmed glasses and the kind face agreed to test the substance immediately and to call with the result.
“The sample you gave me contains benzyl alcohol,” Kendall told him later on the telephone. “David? Are you okay?”
Benzyl alcohol! David was speechless. Benzyl alcohol was highly toxic to brain tissue. A small amount of it could denature the brain’s protein and halt its biological activity. And like an explosion razing a building, the devastation from benzyl alcohol was irreversible.
David drew cerebrospinal fluid from the two sighted cats, whose surgeries were successful, and also from the dead one. He asked Kendall to test the serumlike fluid, whi
ch circulates through the brain and spinal cord. The analyses yielded normal results for the live animals, but the dead cat’s cerebrospinal fluid contained, in a greater concentration than in its blood, the same deadly poison, benzyl alcohol.
By Monday afternoon, David knew the cause of death: a poison in the brain. But how did it get there? Could something at the surgical site have introduced benzyl alcohol to the cat’s brain? He had to find the answer because he would be using the same procedure on Nicole.
David considered the chemicals that he had administered in the fatal operation on the third blinded feline, wondering what reaction could have produced benzyl alcohol. For the second nerve-repair surgery, which he had performed on three cats, David had employed a different general anesthetic on the third cat than on the prior two. The general anesthetic used on the successful two animals was made by Phil Morgan’s company, but it was a drug discontinued by CareFree following Morgan’s defense of David’s experimental surgery. With the supply of Phil Morgan’s anesthetic almost depleted after the surgery on the first two cats, David had switched to a replacement anesthetic for his operation on the third feline. Could the new anesthetic have reacted with the scar inhibitor to produce the benzyl alcohol? After all, it was at the moment that he injected the scar inhibitor into the third cat’s brain that the animal’s heart arrested. Yes!
David phoned John Kendall at Danzer Hall. “I can’t tell you what this is about, only that someone’s life is at stake. And I can’t wait for an analysis from a commercial lab. They’re all closing now.”
Minutes later he gathered a canister of the anesthetic that he had used to replace Phil Morgan’s discontinued drug, along with a vial of his scar inhibitor. He took them across the campus at dusk to Kendall, who had canceled a dinner engagement to run an analysis for him.
Again David wore no coat. Again people stared. Again he felt no sensation of cold through the thin cloth of his scrubs. He felt nothing but the exhilaration of solving a problem that had to be rectified immediately. He would find that the replacement anesthetic used on the third cat reacted with his scar inhibitor to produce benzyl alcohol, which killed the cat. Then he would select a safe anesthetic for Nicole’s surgery. And he would have the luxury of sleeping that night, of feeling refreshed for surgery on his precious human patient.
That evening David sat with John Kendall before an instrument. A tiny pen plotted on a chart the chemical result of mixing the scar inhibitor with the only drug used on the third cat that was not used on the first two, the drug that had to be the cause of the third cat’s death—the replacement anesthetic.
The chemist’s shocking interpretation of the chart reeled David back into a maze with no exit:
“There’s no benzyl alcohol produced by mixing those two drugs, David. Your scar inhibitor and replacement anesthetic don’t react at all with each other.”
* * * * *
On that cheerless Monday night an unfed, unwashed, unshaven David Lang stood before a bright stream of light flooding a laboratory counter. Dozens of shiny metal instruments lay before him. Nicole had already lost her perception of color and motion. She was rapidly losing her ability to detect light. Maybe the third cat’s death was a fluke, he concluded, an inexplicable occurrence whose cause eluded him. Two blinded cats remained to have the second surgery. He lifted cat 4 from its cage. He dripped into its veins the replacement anesthetic, because it was one of the shrinking number of anesthetics still available and because John Kendall’s analysis proved that it did not react with the scar inhibitor. Following all the usual procedures, David began the surgery. He opened the cat’s scalp. He looked into its brain. The optic nerves had grown back! He removed the scar tissue to free the nerves. He injected the scar inhibitor.
The monitor on the cat screeched its alarm, its graphs went awry, its readings plunged into the danger zone. For a few desperate moments, David tried to restart the animal’s heart, but to no avail. The fourth cat was dead.
Chapter 28
Approval Pending
He was standing on the tracks of a railroad when he heard the clanging of a locomotive. The wheels ground against the track, heading straight toward him. The ground vibrated fiercely. Then he saw the distorted image of his face reflecting off the shiny steel engine. He must get out of the way! But his legs would not move. The train’s piercing whistle blasted in his ears—
A startled David Lang awoke to his cell phone’s ringing on the lab bench. His neck ached from the awkward position in which he had fallen asleep.
“Hello,” he mumbled, still shaken from the nightmare.
“Dr. Lang?” His secretary did not recognize his voice.
“It’s me.”
“Nicole Hudson is here for her appointment.”
“Oh!” The windowless lab hid daylight from him. He glanced at the clock. Ten-fifteen. His new enemy, sleep, had robbed two hours from his life—two precious hours!—when he could spare not a minute. “I’ll be right there.”
Notebooks, records, and chemicals covered the lab counter. He had rechecked everything, searching for a clue. He had investigated every drug used on Nicole and on the cats: its composition, preparation date, batch number, purity, potency. Earlier that Tuesday morning chemist John Kendall had confirmed that David’s latest blood and cerebrospinal samples contained benzyl alcohol. Those samples came from cat 4, showing it died from the same poison in the brain as cat 3. David did not know how the toxin got there.
As he splashed water on his face and walked to his nearby office, his thoughts kept returning to the replacement anesthetic that he had given to cats 3 and 4. But he had witnessed John Kendall’s test himself. The replacement anesthetic used on the dead cats did not react with his scar-inhibiting drug. He had to find another cause, and soon—otherwise the train would . . .
“Come in, Nicole,” he said to the lovely vision in brown slacks and soft suede jacket.
She rose to approach him, leaving Mrs. Trimbell to wait in the reception area. David had brought a rush of cold air in with him, Nicole thought, when he entered the office. Or was it his voice that was oddly cool and toneless? He seemed preoccupied as he silently escorted her into the examining room. He closed the door, his manner bearing no hint of their intimacy of two days ago. She sat on the end of the examining table while he lowered the blinds.
When the room was darkened, David held a light before her from a distance of ten feet. He turned the knob of the light slowly, increasing the intensity.
“Tell me when you see the light,” he instructed.
Nicole said nothing.
He continued to turn the switch, until the light was at full force. “Do you see anything now?”
“No.”
She had seen the light from that distance a mere two weeks ago. He moved closer. “Tell me when you see the light,” he said from a distance of eight feet, turning the knob and watching the beam grow to its strongest intensity on her face.
“I don’t see anything yet.”
At five feet he did the same. Nicole had no response.
He moved directly in front of her with the light at its highest intensity.
“I see light,” she said finally.
David stared at her, alarmed. He knew that he must operate by tomorrow at the latest. He had never been successful in his nerve-repair experiments when he had waited until all regained function had vanished.
“I want you to check into the hospital now and wait for my further instructions.”
“What’s wrong, David?” she asked the stoical presence before her.
“I can’t talk to you now. I have to go.”
She reached up to his face. He tried to move away, but her hand caught the stubble of his beard, revealing that he had not shaved since their last meeting.
“David, what’s wrong?”
“Please don’t ask. I’m very busy.”
She cupped his face with her hands. “Something terrible is wrong. I know it. And it involves my case. All the . . .
bad . . . things that happen to you involve my case.”
“Nicole, please! I can’t take this right now.”
He moved away. She felt his body lean against the side of the examining table. She jumped down and reached out to find his hands covering his face.
“David, I must know!” Her voice trembled.
He tried moving away, but she moved with him, tears forming in her eyes, her hands clutching his arms.
“You have to tell me!”
“Don’t ask, please.”
“Something’s terribly wrong and I’m concerned.”
“You must let me handle this.”
“If you don’t tell me, I could get very upset,” she cried, knowing she was using the ultimate weapon against him. “I could run away—”
“All right! All right!” She heard anger mixed with caring in the desperate voice. “But if I tell you, then you must promise you won’t run away, because I couldn’t handle that now. I have other things on my mind.”
“I promise I won’t run away.” The gravity of her tone matched his.
He led her to a chair, and he sat on his doctor’s stool next to her. He took her face gently in his hands, the tenderness of their last evening returning to him.
“You must swear you won’t tell anyone what I’m about to reveal.”
“Of course. I swear.”
“After your accident, I duplicated your injury on five laboratory cats. I cut their optic nerves. Then I performed the first nerve-repair surgery on them, just as I had on you.” His hands fell to her arms, grasping them tightly. “These experiments are illegal, so no one must know!”
“I see.”
“On Saturday night I began doing the second surgeries on the cats.”