Implant

by F. Paul Wilson

  Gin used the records-room phone. First she tried the club dining room, but he wasn't there. Then she tried the pro shop. Maybe she could catch him before he started his round.

  "Doc Lathram?" said the chief caddy. "Haven't got a tee time for him."

  "Maybe he's playing with someone else."

  "Maybe, but I ain't seen the Doc round here for months."

  "Are you sure?"

  "Missy, I'm here just hour every day. Doc Larhram's been a member here forever, but it must be six months since I put his bags on the back of a cart. But if he shows up I'll give him a message if you want."

  "No," Gin said. "Never mind." What's that all about? she thought as she hung up. When he hasn't been bitching about the kakistocracy, it's been about his golf, his slice, his bogies, complaining about the condition of the greens.

  So what's he been up to?

  Not golf, obviously. What else had he been lying about?

  Gin was uncomfortable. She didn't like the idea of Duncan Lying, to her or anyone else.

  On impulse she went back upstairs and returned to Duncan's office.

  "I left some papers on his desk," she told Barbara as she breezed by her.

  Great, she thought as she swung the door open. Now I'm lying too.

  Tense and uneasy, feeling like a sneak, she went to the big partners desk and tugged on the top drawer. It wouldn't budge. Locked.

  Damn.

  She dropped into his chair and slouched there, swinging back and forth, wondering what to do.

  What, if anything, was going on here? And what should she, could she, do?

  Most likely it was all just nothing, but she had to ask herself, Did Duncan have anything to do with those four dead or damaged legislators?

  Probably not. Their deaths, accidents, and illnesses weren't really linked . . . just one of those weird coincidences that sometimes occur. . . the kind of coincidence that gets conspiracy theories started.

  Still, why was he lying about where he went when he cut out of here early every afternoon? Did that really matter?

  But she had seen an injection vial of something in Duncan's top drawer, also some sort of trocar. Why were they -- there? What was in that bottle? Why did he keep the drawer locked?

  Damn! She hated doubting Duncan like this. But why wasn't he where he'd said he'd be? Where the hell was he?

  Duncan removed the dressing from Kanesha's face and studied his work.

  He gripped her chin and gently turned her head back and forth.

  Reflexively her hand fluttered up to cover the area of the surgery.

  Duncan gently pulled the hand away and pressed it against her hip.

  "No need to do that anymore, Kanesha." The thick, stiff wad of scar tissue that had held the left side of her mouth prisoner was gone. In its place were a pair of healing hairline incisions and a normal-looking angle of the mouth. Duncan was pleased. But now the most important test.

  '"Smile for me, Kanesha." Again the hand came up and covered that corner of her mouth. She looked at her mother. Her expression said, Get me out of here.

  "C'mon, Neesh, " said her mother. "Smile for Dr. Duncan." Duncan pulled the child's hand down again and stood her on the chair.

  He turned her toward the mirror on the wall.

  '"Look at that girl in there," he said. "What do you think of her?"

  Kanesha stared at herself in silence for a moment, then leaned forward for a closer look. Her left hand came up again, this time not to cover, but to touch, to confirm that what she saw was real.

  Duncan watched her, waiting for a smile. And the smile was important.

  Kanesha's had been a tougher piece of surgery than he'd anticipated. The scarring had gone deeper than usual, not only had he had to free up all the subcutaneous layers, but he'd had to do a partial reconstruction of the perioral musculature. A smile was the only way he'd know how successful he'd been.

  "Well?" he said. "Don't keep me in suspense, little girl. Has Kaneshe Green got something to smile about or not?" He poked a wiggling finger into her flank, tickling her.

  She giggled, and with that giggle came a smile. An enormous smile, bright, even, symmetrical.

  She stopped giggling and stared. The smile faltered for a heartbeat as she leaned forward, her eyes wide, then it returned full force.

  She turned to Duncan, grinning, joy and wonder dancing in her dark eyes. Her mother burst into tears and reached for her daughter, but Kanesha did the unexpected. She leaned - forward, threw her arms around Duncan's neck, and hugged him. An instant later her sobbing mother had her arms . around Duncan as well.

  "Oh, thank you, Dr. Duncan! Thank you so much!" This was getting a mite sticky.

  "Now, now, ladies, ' he said, extricating himself from the tangle of limbs. "We've made a big jump, but we're not finished yet."

  "Not finished?" the mother said, wiping her eyes. "She's beautiful!"

  "Of course she is. But she's not fully grown yet. And some scarring might redevelop in the deeper tissues. In a few years I may want to do one more procedure, to make her perfect."

  "She looks perfect now! Oh, Dr. Duncan, if there's ever anything I can do to repay you, anything at all, just,"

  Duncan put his hand on Cindy Green's shoulder. "Just keep her smiling."

  "No, I'm serious."

  "So am I. Keep her safe, keep her healthy, keep her smiling. Daughters are . . . " His voice caught. He cleared his throat. "Daughters are precious. I don't want to find out I did that surgery for nothing."

  "I will," she said, putting her hand over his. "I promise."

  "Good!" He straightened and lowered Kanesha to the floor. "Stop at the desk on your way out. The nurse will have some ointment and instructions for its use. I want to see Kanesha next week."

  Cindy Green was puddling up again. "Dr. Duncan . . . "

  "Come on, come on," he said, ushering them toward the door. "You're wasting time. Get her home and let her show off that smile." That'll teach you to doubt me, he thought as he watched them go.

  "Okay, Marge," he called out. "Who's next. Let's keep moving." He didn't have all day.

  It began as a whim, which soon evolved into a compulsion, and by midafternoon Gin found herself in the periodicals section of the Alexandria Public Library.

  Lisa Lathram . . . there had to be more on Lisa Lathram. And where better to find it than in the town where she lived and died?

  Disappointingly, the Alexandria Banner's obit was identical to the one in the Host. But a short news blurb about her death made an offhanded mention of her father being under investigation by the Virginia State Board of Medical Examiners.

  Gin went rigid in her seat. Duncan? Investigated? For what?

  She began buzzing backward through the microfilmed issues of the Banner. Fortunately it was a small paper with a low daily page count.

  Whenever she found mention of Duncan she photocopied the page and put it aside. When the Lathram references petered out, she assembled the copies and read through them in chronological order.

  The first story appeared about three months before Lisa's death. Half the Banner's front page was devoted to Duncan, citing him for billing Medicare over a million dollars in vascular surgery fees the preceding year. An editorial in the same issue categorized him as a prime example of "unchecked greed in a profession run amok." Gin shook her head in wonder. A million . . . a lot of money, even for a vascular surgeon. But billing Medicate for a million didn't mean you received a million. It only paid a fraction of what was billed. And even if it paid dollar for . . . dollar, so what? She'd seen how Duncan worked when he was a vascular surgeon. If he billed a million, it was because he'd earned a million.

  The follow-up article described how a patient's rights group was circulating petitions calling for an investigation of Dr. Lathram to determine how much, not if, but how much unnecessary surgery he was performing. The petitions were forwarded to the Virginia State Board of Medical Examiners. Soon the Banner was announcing on its front
page that Duncan Lathram, MD, was under investigation for suspicion of malfeasance and fraud by the state board. Then came an article revealing that Medicare's fraud unit was conducting an audit of Duncan's office and hospital records.

  God, how awful, she thought. How humiliating to have all those investigators pawing through your records, probably while patients sat in the waiting room.

  Then Lisa's death.

  And after that . . . nothing.

  Where was the resolution? What was the outcome? She couldn't find a single mention anywhere. Had Duncan lost his Virginia license? Was that why he was in Chevy Chase now?

  One way to find out. She glanced at her watch. Still time to call the Virginia state board.

  It took four calls, but Gin finally tracked down the executive secretary, a Mrs. Helen Arnovitz. She asked if Duncan Lathram was still licensed in the state, and if so, had any disciplinary action ever been taken against him?

  Helen put her on hold and returned a minute later.

  "Yes, he's still licensed and no action was ever taken. However, I remember the case well. The board did conduct an investigation for the possibility of fraudulent billing and performing unnecessary surgery."

  "And?"

  "The charges were found to be groundless. The board was obligated to investigate due to some adverse publicity Dr. Lathram had been receiving, but found no malfeasance. When the results of the Medicare audit came back clear, we completely exonerated him."

  "So it was all much ado about nothing."

  "For us, but not for poor Dr. Lathram."

  Gin stiffened. "Really? Why not?"

  "His practice dwindled to the point where he had to close his office. I understand he's doing quite well now in Maryland, but it was a shame that Virginia had to lose such a fine vascular surgeon."

  "I'm sure it was. Thank you." Gin hung up, leaned back, and closed her eyes.

  Her heart went out to Duncan.

  Public humiliation, the death of his daughter, the closing of his practice, the breakup of his marriage . . . all in the same year. Why had it happened? What had started it all? It was enough to drive anyone . . .

  . . . crazy.

  No. That wasn't fair. Duncan was anything but crazy. And none of this had any connection to Schulz, Lane, Allard, and Vincent. At least none that she could see.

  So why didn't she feel relieved?

  There was more to this. Had to be. But where to look?

  No time for that now. She was due at Lynnbrook tonight. She'd hoped this mini-research-trip would ease her mind but it hadn't.

  Only one thing to do. And she hated herself for doing it.

  Gerry slouched in the cubicle that served as his Office staring at Martha's drawing of an orange horse, truly a horse of a different color.

  He should have been devising a way to snare Senator Schulz's uncle as an accomplice in laundering hono rana. Instead he was thinking about the loss of three of members from the same committee. What were the odds of that happening by chance? Especially when they'd all had surgery from the same doctor.

  His phone rang. The receptionist down in the visitor area. "There's a Dr. Panzella here to see you." He damn near dropped the phone.

  "What? Dr. Pan, she's there? Now?"

  "Yes. Standing right in front of me."

  "I'll be right down." Gerry grabbed his suit jacket and headed for the elevators. He pressed the down button but none opened immediately so he took the stairs. Only three floors. Nothing to it.

  He burst through the doors and found Gin standing in the center of the lobby. Her features were tight.

  "Gin? Is something wrong?" She handed him a package, something wadded up in a brown paper lunch bag. "Here. This is what you wanted."

  "I wanted?" Baffled, he wormed his hand inside the bag and produced a test tube filled with clear fluid, a sheet of computer printout came with it.

  "I don't get it."

  "It's what Oliver Lathram puts in his brother's implants."

  "Oh, hey, I didn't,"

  "Analyze it, Gerry. Satisfy your curiosity, resolve your suspicions, and then let me know what you find. That's a list of what's supposed to be in the solution. See if the analysis matches it." She was so stiff, her expression so grim.

  '"Gin, what's wrong?"

  "I don't like what I'm doing, Gerry. I'm not proud of myself for sneaking this out of Oliver's lab."

  "But you didn't have to. I was only,"

  "You started me thinking, you got me worried. So now I want to know too."

  "I'm sorry."

  She started to say something, then seemed to change her mind. It looked as if she'd been about to say, You should be, but she said, "It's okay. You're just doing your job."

  He offered the tube to her. "You can have this back."

  She shook her head. "Too late now." The tension was so thick between them Gerry doubted even a Ginsu knife would cut it.

  "Dinner was great the other night," he said. "You're a super chef."

  "I'm glad you liked it." No thaw yet. He'd have to pull out the big guns.

  "Martha loved it. And she loves you." Gin's features softened.

  Finally.

  "And I love her," she said. Then she pointed to the test tube. "But let me know about that stuff’s soon as you hear, Gerry. It's important to me."

  "Don't worry. As soon as I hear, you'll hear. But in the meantime, what are you doing for dinner tonight?" She shook her head.

  "Moonlighting at Lynnbrook." She turned and started walking away. "You will let me know . . . . won't you?"

  Gerry raised three fingers, Boy Scout style. "Promise." Damn right I promise, he thought. Because I can see you're going to be a basket case until I do.

  As he headed upstairs to get a lab requisition form, he didn't know whether he should be elated or depressed. He had a sample of Duncan Lathram's solution, but he'd also made Gin terribly upset. Was the prize worth the cost? If analysis turned up a toxin, how would he tell her?

  But he would. And pull her out of Lathram's place so fast her head would spin.

  Gin ran into Dr. Conway as she checked into the doctors lounge at Lynnbrook. He was on his way out. She nodded absently. Duncan and Oliver's secret sauce was on her mind and Conway was almost gone before she realized she hadn't seen him since Harriet Thompson's death.

  "I heard about Harriet Thompson," Gin said. "Sorry."

  "Yeah," he sighed. He looked depressed. "Me too. But there's some lawyer in town who's real happy about it."

  "Oh, no. You're getting sued?" He nodded. "For gross negligence. The daughter in San Diego who couldn't get free to come look after her mother for a few days managed to find a lawyer as soon as she got to town. Probably called I-800-SUE-DOCS or whatever number the ambulance chasers are using today. Never miss an opportunity to cash in, right?"

  Gin could understand his bitterness. "Why doesn't she sue the PRO?"

  "Don't you know? Physician Review Organizations are immune from malpractice suits. That leaves me."

  Gin felt awkward and angry. Not knowing what else to do, she put a hand on his shoulder. "Don't worry. You'll win."

  "Sure," he said. His smile was humorless. "Bet you just can't wait to get into practice. He walked out."

  18

  ON THE HILL

  "You're GOING TO HAVE TO LEARN TO PLAY THE GAME, Hugh."

  Gin slowed as she passed the closed door to Senator Marsden's office.

  Her mind had been far away, wondering what the analysis of Oliver's secret sauce was showing. She'd die if there was anything incriminating in it.

  The waiting was consuming her. She could barely concentrate on anything else. But the condescension in the voice slipping through the senator's transom pulled her up short.

  She knew Senator Kramer had arrived for a meeting. Their voices weren't raised but even out here she could sense the tension.

  Senator Marsden's voice sounded tight. "When I start thinking of the Senate as a game, I'll know it's past time to quit.
" Kramer chuckled.

  "I was pretty self-righteous too when I was a freshman. But I learned. And if you want to get things done in this town, you'll learn too. You don't, you get left out in the cold."

  "I'm not in favor of loosening up on offshore drilling at the moment. I don't think we need it now."

  "I'm sorry to hear that, Hugh. Because it's important to my people."

  "Do I take it that my position on easing offshore drilling restrictions will affect your vote on the Guidelines bill?"

  "Oh, I wouldn't put it that way. Let's just say I'm reserving my judgment until your bill gets out of committee."

  "I see."

  "It's horse trading, son, " Kramer said, getting folksy all of a sudden.

  "It's what makes the wheels turn. I'm obliged to keep the home folks happy and prosperous. Remember, one person's pork-barrel project is another person's wise investment in the local infrastructure."

  "How about simply casting a vote for something because it's the right thing to do?" Gin heard a chair scrape against the floor.

  "Because what's right for you isn't necessarily right for me. We'll talk again sometime, Hugh." Not wanting to get caught with her ear to the door, Gin hurried off.

  She related the conversation to Alicia on their way to the Senate cafeteria in the basement of the Dirksen Building. The Hart and Dirksen buildings were attached, but the walls down here were brick, the doors a dark oak, in sharp contrast to the antiseptic decor of the newer Hart.

  They passed the Senate Post Office, then turned into the of. "I'm not surprised, " Alicia said. She picked out a tuna salad and a diet Pepsi. "A lot of the people on the Hill don't think he's for real. And the ones that do are leery of him."

  Gin took a turkey on rye and a Mountain Dew. "Care to explain that?"

  Alicia scanned the tables. "Let's see if we can get off by ourselves and I'll give you the true facts."

  "True facts? You mean as opposed to the other kind?"

  "Exactly."

  They found an isolated corner table. Alicia sat with her back to the wall and watched the room as she spoke.

  "First off, you should know that Senator Marsden ruffled a lot of feathers right off by coming to town with a self-imposed term limit. He said depending on how much he accomplished, he might serve only one term, and absolutely positively no more than two. That was a no-no."