by Robin Cook
As soon as they started north, Lynn filled him in on what had happened. “The goon threatened to kill me,” she said to begin, trying to keep herself calm. Merely thinking about the episode got her heart racing all over again. She twisted in her seat to be able to look directly at Michael. The headlights of the oncoming traffic shining through the windshield played across his face. “Actually, he threatened to kill us both.”
Michael shot her a surprised look. “He said my name?”
“He didn’t say your name. To be exact he said, ‘You and your friend have pissed off a lot of people in high places.’”
“He actually said ‘people in high places’?”
“Those were his exact words. He said we, ‘will kill you and your friend if you don’t leave the investigation of Carl’s case to the hospital authorities and go back to being full-time medical students.’ Well, maybe those weren’t his exact words, but pretty damn close.”
“And he said ‘we,’ not ‘I,’ when he was talking about killing us?”
“Absolutely.”
“Terms like ‘people in high places’ and the pronoun ‘we’ make this sound more and more like a fucking major conspiracy.”
“I couldn’t agree more,” Lynn said. “We’ve stumbled onto a hornets’ nest. And my tête-à-tête with the goon got worse. He threatened killing my mother and my sisters if we went to the police. He even knew their names and where they were. That takes resources and connections.”
“Did he include me at that point?”
“Yes! Your family, too!” Lynn shook her head in disbelief that this was all happening. She turned around and faced forward in her seat. They were nearing the commercial center of historic Charleston. Lynn looked at the revelers, surprised at how many there were despite the hour. She wished her life were so simple.
“So that’s why you didn’t want to call the police?”
“Partially. The other reason is that uncovering whatever this conspiracy is all about certainly is a hell of a lot more important than nabbing this single shit-ass psychopath. The idea of ‘people in high places’ being involved blows me away. Something major is in the works, and I think it concerns Sidereal Pharmaceuticals with its Russian connection, and you know how I feel about pharmaceutical companies.”
“I know you are not a fan,” Michael said.
“That’s putting it mildly, whereas I actually hate them,” Lynn said with enough venom to cause Michael to glance over at her.
“Brang it on, woman! Wow! You’re big-time wound up about the drug business. What’s the beef?”
“Where to start?” Lynn said. She sighed and looked back at Michael. “I know we agree on the basics from conversations we’ve had in the past, like the pharmaceutical industry’s hypocrisy. They want people to think their motivation is for the public good when they are, in fact, poster boys for capitalism run amok.”
“You mean how they justify their out-of-the-ballpark prices supposedly because of how much money they have to spend on research.”
“You got it!” Lynn said with disgust. “The reality is that they spend more money on advertising prescription drugs directly to the public than they spend on research. And that doesn’t even include the money they spend on lobbyists and politicians.”
“We agree on all that,” Michael said. “But I’m sensing a lot more emotion here on your part.”
“Did I ever tell you that my father died because he couldn’t afford the medication that would have kept him alive?”
“No, you haven’t,” Michael said, taken aback. Michael knew that Lynn, like him, was never completely open about her childhood, but, considering all their discussions about medical care, he was surprised she had never shared this information about her father’s death.
“That’s right!” Lynn snapped, staring out through the windshield. “To stay alive he had to take the drug for the rest of his life, and it costs almost a half million dollars a year. It’s obscene.”
“Really?” Michael asked. “There’s a drug that costs five hundred thousand dollars a year?”
“It’s a monoclonal antibody, or biologic, like the drozitumab you saw on the front of Ashanti’s record. My father lost his job in the 2008 subprime catastrophe and ultimately his health insurance. He died because we couldn’t afford to pay for the drug.”
“That sucks,” Michael said. “Big-time!”
“Tell me about it! Anyway, I’m thinking Sidereal is doing something damning, maybe using people in the Shapiro for clinical trials, like we said. Yet somehow it seems overkill to me for us to get death threats for that unless they are somehow behind these anesthesia disasters.”
“You mean to create more subjects?” Michael asked, aghast at the idea.
“I know, it sounds too dastardly to even think about, but who’s to know? The only way I can think of possibly finding out is going into the Shapiro. If nothing else, once we are in there, I can use one of the terminals in the network operations center where you visited and look at their data. Of course that brings up the question of how you did tonight with your buddy Vladimir.”
Michael chuckled. “It was a slammin’ good time. Really, the guy’s got a good vibe and a good heart. He even brought me a souvenir, like he promised. I got to show it to you. It’s called a matryoshka doll. There’s one inside the other for about fifteen dolls, the last being a tiny thing.”
“Did you get the Shapiro scrubs?” Lynn asked, totally uninterested in the doll.
“No problem. We have two, just like you wanted, including hats and masks.”
“One set will be enough,” Lynn said. “I’m thinking I should go in by myself. This whole affair is getting more and more serious and risky. I think it is my battle, because of Carl.”
“We’ve been over this,” Michael said. “Case closed! We both go or neither of us goes.”
“We’ll see,” Lynn said. “How about the thumbprint?”
“I’m sure I got that, too. He had a couple of beers, and I was careful with the bottles. There should be plenty of prints.”
“Excellent,” Lynn said. They passed the ramp that led up to the Ravenel Bridge to Mount Pleasant. It was marked by a large overhead traffic sign. The name of the town reminded her of the horrific home invasion that they had learned about from the TV in the surgical lounge. The mother had been a patient at the Mason-Dixon Medical Center and had been diagnosed with a blood protein abnormality. All at once, the confusing gammopathy issue came back into her overstressed mind.
“There’s another aspect of all this that troubles me,” Lynn said, trying to organize her thoughts. She still felt shaky and discombobulated from what she had been through with the Russian goon. “It’s this gammopathy stuff. It keeps popping up. Before that bastard broke in, I learned something curious that I can’t explain. Remember those stats I got down in the IT office about the discharge diagnosis of gammopathy and multiple myeloma from the Mason-Dixon Med Center?”
“I remember,” Michael said. “But not the actual numbers.”
“The actual numbers don’t matter,” Lynn said. “The significant issue is that the number of people on discharge with these two diagnoses is five times the national average. Five times!”
Michael nodded as he considered what Lynn had just told him, but he didn’t say anything.
“Doesn’t that surprise you?” Lynn asked. She couldn’t believe he was seemingly taking it in stride.
“It surprises me,” Michael said. “Let me get this straight. You’re saying that the number of people coming into our hospital with an unrelated illness and leaving with a diagnosis of a blood serum abnormality is five times the national average?”
“That’s exactly what I am saying. And to make it more confusing, most of these patients are relatively young, in their thirties and forties, whereas gammopathy usually appears in an older population, like people i
n their sixties.”
“And patients with a discharge diagnosis of multiple myeloma is five times more common in our hospital.”
“That’s what I’m telling you.”
“Okay, how do you explain it?”
“I don’t,” Lynn snapped. “That’s why I’m bringing it up, for Chrissake.”
“Okay, keep it cool, girl,” Michael said calmly. “We’re on the same team here.”
“Sorry,” Lynn said. She took a deep breath to calm down.
“Is discovering this gammopathy and multiple myeloma info what had you ‘totally unglued’ and upset when you called me earlier?”
“Oh my gosh, no!” Lynn blurted. She swung back around to face Michael, thumping her forehead with her knuckles in mock punishment. “I can’t believe I forgot to tell you my most important discovery. The anesthesia records show that in all three cases the tracing had been looped.”
Michael shot a quick glance at Lynn to make sure she wasn’t jerking him around. “Looped, as in being played over and over?”
“Exactly,” Lynn said, with her voice reflecting her sudden excitement. “From the moment of the frame offset in each record, the records were looped with the minute prior to that point, when everything was normal. It means that from the frame offset until the low-oxygen alarm sounded, the anesthesia machine wasn’t recording the patient’s real-time vital signs. Those signals were interrupted, and the looping was giving the false impression that everything was normal.”
“That’s serious shit,” Michael said.
“The question is, could it be a software glitch?”
“I can’t imagine,” Michael said. “It has to be a hack job, and if it is, who’s doing it and why? Holy shit!”
“It has to be all tied together,” Lynn said.
“What do you mean?” Michael asked. He turned into the hospital grounds and headed for the multilevel garage.
“What’s going on in Anesthesia has to be connected somehow with the protein abnormalities.”
“That seems far-fetched,” Michael said.
“I thought so at first. But remember what we learned last year in diagnostics: even when symptoms seem entirely unrelated, they are almost invariably part of the same underlying disease. My intuition tells me we are going to find the same here with the abnormal proteins and the anesthesia disasters.”
“If they are associated, I can’t think how,” Michael said.
“Nor can I,” Lynn admitted. “I might be delusional, but I can’t stop thinking that I have to get into the Shapiro, even if just to get access to their records.”
“We, white man,” Michael said, again making reference to Ron Metzner’s Lone Ranger joke. “We’re a team, girl. There’s no way I’m going to let you go into Shapiro by yourself. If this is some major conspiracy, the risks go up.”
“It will be your decision if we get to that point,” Lynn said. “There’s still that thumbprint access that has to be overcome.”
They left Carl’s Cherokee in a visitor parking spot and walked across the hospital campus toward the medical dorm, a bit overwhelmed by what they had experienced and what they had been talking about. Neither one spoke, particularly as they passed the dark, nearly windowless Shapiro Institute. Both were now thinking about Carl being locked away in its bowels. It made it personal.
Such thinking was the hardest for Lynn, as it immediately evoked a combination of guilt, benumbing anger, and crushing loss, threatening her life on so many levels. She had to look away from the massive, sinister-looking building and force herself to think of something else. “I guess I’m going to have to make an effort to look like I’m back to being a medical student.”
“Hallelujah, woman!” Michael exclaimed. “If we are dealing with a major conspiracy that’s uptight about us asking questions about Carl, then we gotta believe somebody is going to be keeping tabs on us.”
“Sounds so Orwellian,” Lynn said.
“I hope this means you’re planning on coming to the ophthalmology lecture in the morning?”
“I guess I have no choice.”
As they rode up in the elevator they leaned against opposite sides, regarding each other.
“Are you okay?” Michael asked.
“I’m a basket case,” Lynn admitted. “I’m wasted and I’m still shaky. I don’t think I’ve ever been so tired and drained. I feel like I’ve been run over by a truck.”
“Will you be able to sleep?”
“I hope so.”
“I might be able to find an errant sleeping pill if you’d like.”
“I’d like,” Lynn said. “And I do have yet another request.”
“Hit me!”
“Would you mind if I dragged my mattress down to your room? I don’t want to be alone tonight.”
“Not a problem, as long as you don’t take advantage of me.”
“Under the circumstances, I don’t find that at all funny.”
“Sorry!”
38.
Wednesday, April 8, 9:22 A.M.
Lynn put her pen down on top of her spiral notebook. She had been trying to take lecture notes but wasn’t able to concentrate. She was distracted by the previous night’s horrific experience and what she had learned from the anesthesia records. To make matters worse, the lecturer spoke in an all too typical medical-school monotone. On top of that, the subject matter seemed to her to be truly stultifying. As beautiful as the eye was in its overall structure, this minutiae of the retinal circulation was overkill in relation to what she would need to know once she was a practicing orthopedic surgeon. Even if eye surgery had the benefit of being short and bloodless, she couldn’t understand why her friend Karen Washington wanted to study ophthalmology as a specialty. After spending four years learning about the whole body, it seemed much too narrow in scope from her perspective.
Adding to her inability to focus, Lynn felt groggy, despite having slept for more than six hours. Six hours was about normal for her, but what she had experienced last night had not been entirely normal sleep. She had taken the Ambien tablet Michael had found for her. As she rarely took sleep meds, she was sensitive to them, and when she did use one, she invariably felt a residual hangover.
When she had awakened that morning just before eight on her mattress on the floor of Michael’s room, Michael was already in the shower. It had been the sound of the shower turning on that had aroused her from her drugged slumber. She didn’t get up immediately as it had taken her a few minutes to unscramble her brain and try to put in perspective what had happened the previous evening.
There had been a few times during her first year in college when she’d found herself in mildly problematic situations involving the potential of sexual assault, thanks mostly to alcohol, but she’d never suffered an actual episode. Actually, it had never even come close until last night. The mere thought of how close made her feel almost nauseous. Never had she felt quite so thankful and appreciative of Michael’s friendship, size, and strength. If he hadn’t thrown caution to the wind the night before when he couldn’t get ahold of her on her mobile and when he attacked the intruder, she knew she’d be feeling very differently at that moment.
After sticking her head into Michael’s steamy bathroom to yell at him that she’d be ready to head over to the hospital in a half hour, she carefully collected the beer bottles Vladimir had handled and went back to her own room. Making sure not to touch the bottles, to avoid messing up any of the Russian’s fingerprints, she put them on her desk before getting into the shower herself.
On the way from the dorm to the hospital, Lynn and Michael talked about the paranoia that came with the worry that they were possibly being watched. To both of them, everyone who eyed them looked suspicious, even a couple of the gardeners working in the flower beds who happened to glance up as they passed.
For the first twenty minutes o
f the ophthalmology lecture, Lynn had tried her best to pay attention, but it wasn’t working. When the lecturer turned off the lights once again to go through another series of slides, this time showing fluorescence angiography studies of the back of the eye, she leaned over to Michael, who was sitting next to her as both had taken seats near the door: “I’m outta here,” she whispered.
“I thought the deal was that you were going to make it look like you were back to being a full-time medical student.”
“My mind’s going a mile a minute. I can’t sit still and can’t concentrate worth a damn. I’ve got a couple of errands to run.”
“What I’m worried about is what you might do. Don’t try to get yourself into the Shapiro without me or you and I will be having one hell of a beef!”
“I wouldn’t think of it. Take good notes for me!”
“Screw you! You gotta stay and take your own goddamn notes. It’s not like I’m enjoying myself. This guy is trying to put us to sleep.”
Lynn had to smile. After a quick glance at the lecturer, who had his back to the audience while using a laser pointer to indicate a subtle detail, she stood up and headed for the nearest exit. To make it look like she would be returning, she left her spiral notebook on the arm of her chair. She knew Michael would bring it back without having to be told.
Once outside the lecture room, Lynn went directly to the restroom. Her thinking was that if anybody was watching her, going to the bathroom wouldn’t raise any suspicions. As she walked, she tried to see if anyone in particular took note. No one did.
As long as she was in the restroom, Lynn decided to use the toilet. Afterward she looked at herself in the mirror, thinking she looked like death warmed over. There were dark circles under her eyes and her split lip was crusted with a small scab. There were also a few broken capillaries over her cheekbone that she had tried to cover up with a bit of makeup. She used a damp paper towel to get rid of the crust on her lip.