by Robin Cook
“Just as well,” Michael yelled back.
“Do you want to see if Ashanti is here?”
“I don’t see any point,” Michael said without hesitation. “For the tenth time, let’s get a move on.”
“All right,” Lynn said, but still she hesitated. She had suggested seeking out Ashanti as a way to stall. Her irrational side wanted to wait for Carl to be returned as part of the continuous stream of patients coming and going on the conveyor system. At the same time, Lynn’s rational side agreed with Michael that they needed to leave. For a moment she struggled with her indecision, and as she did so her eyes caught the various color-coded and labeled lines that would be robotically connected to Carl when he was brought back to monitor him and keep him alive. There was the intravenous line in blue, an arterial line in red, a gastrostomy line for nutrition in green, and an intraperitoneal line in yellow.
Michael grasped Lynn’s upper arm. “I know it’s tough for you to leave, but it isn’t going to be any easier if you see him. We have to go!”
“I know,” Lynn shouted with a degree of resignation. “But look! Carl already has an intraperitoneal line!” She pointed to the yellow connector. “Why? He certainly doesn’t have ascites. Not yet, anyway.”
“We can debrief when we get out of this freaking place. We’ve got a lot to process.”
“You know what I think?” Lynn said with sudden urgency and a renewed degree of horror.
“I don’t, but I can tell you are about to tell me. But tell me out in the hallway, where I can hear you. This racket in here is driving me crazy.”
“All right!” Lynn yelled. The noise in the room was beginning to get to her as well. She let Michael pull her toward the walkway. It was just in time, because the conveyor system suddenly lurched in their direction again. When they reached the walkway, Lynn turned back to make sure the patient that was being brought in was not Carl, as the machine positioned itself in front of Carl’s stack. But the patient went into cylinder 62, not 64.
Quickly, they retreated to the door they had used to enter the room. When it closed behind them, their ears were ringing in the comparative silence. Immediately Lynn blurted out, “I think I know what the hell Sidereal is doing. They’re not experimenting on these patients, like we thought. They are fucking using them in a much more perverse way!”
“Okay, okay,” Michael soothed. “What do you mean?”
“You remember how monoclonal antibody drugs like ranibizumab are made.”
“Sure!” Michael said. He was taken aback by Lynn’s sudden passion. He could hear it in her voice and see it in her eyes. “They are made by mice tumors called hybridomas.”
“Which are?”
“What is this, a freaking test? Tell me what you are thinking.”
“Answer my question! What are hybridomas?”
“A kind of cancer made by fusing mouse lymphocytes with mouse multiple myeloma cells and injected back into mice.”
“And where are they injected?”
“Into the abdomen.”
“And why are pharmaceutical companies required to jump through so many hoops to humanize the mouse-generated drugs?”
“To lower the chance of allergic reactions when they are taken by humans.”
Lynn stared at Michael without blinking, waiting for him to connect the dots. It was all there, hanging in the air.
“Mothafuckas!” Michael snapped after a moment when all the pieces of the puzzle fell into place in his mind. He shook his head with repugnance.
“It all fits,” Lynn said with equivalent disgust. “All of it. Sidereal Pharmaceuticals and Middleton Healthcare are in bed together. It’s why so many people going into Middleton Healthcare hospitals are getting gammopathies. It’s why their patients have such a sky-high incidence of multiple myeloma. And here in the Shapiro it’s one hundred percent. They must be using all thousand patients to make truly human monoclonal antibody drugs, which don’t have to be humanized. They are already human!”
“And, worse yet, they must be behind these anesthesia-induced comas,” Michael said. “It must be a new method of recruiting healthy bodies they can tap twenty-four/seven. I’m sorry I have to say this, because of Carl.”
“I’m afraid you’re right,” Lynn said. Her voice reflected both anger and loss. She took a deep breath to stay in control. “Carl’s vegetative state wasn’t an accident. I was afraid as much when I found the looping. Now I know for sure. What I can’t understand is why we didn’t see all this earlier. When I think about it, it’s been staring us in the face.”
“The question now becomes what to do,” Michael said. “Who do we turn to?”
“This is a major conspiracy,” Lynn said. “We can’t go to anybody here in the medical center. There is no way to know who is involved and who isn’t. We’ve got to go to Carl’s father, Markus Vandermeer, and we have to do it tonight. In fact . . .” Lynn pulled out her cell phone. When she turned it on, she immediately saw there was no service. “Damn! I’ll have to call him as soon as we get outside.”
“Let’s go!”
“Wait! As long as we’re in here, I want to at least glance into the so-called recreation space. That’s sick humor if I ever heard it. There can’t be anything recreational about this place, but my thought is that maybe Carl is there.” Lynn pulled out the floor plans and quickly studied them. “Okay! I see where we have to go. It’s really close, and will only take a minute.”
46.
Thursday, April 9, 1:04 A.M.
Misha had to knock to get the pocket door into the SCC, or Shapiro Central Control, to open. For security reasons, the only way it could be operated was from inside. He gestured for Fyodor and Benton Rhodes to precede him into the highly air-conditioned room. He followed. Five armed security men in hospital security uniforms brought up the rear. All were Russian expatriates and took orders from Fyodor. Fyodor had personally recruited them from Saint Petersburg when he’d taken over the hospital security department. He considered them his shock troops.
The technician manning central control was called Viktor Garin. He was dressed in Shapiro coveralls, in contrast to the newcomers. He remained standing as the others crowded around the bank of forty monitors that were alternately displaying security feeds from all of the hallways and a number of the rooms from all six floors of the Shapiro Institute.
Although part of Viktor’s job was to keep his eye on the security monitors, the vast majority of his time was spent on the other side of the room, in front of the feeds coming from the Shapiro automation equipment. It was with the machinery that most problems occurred. In the eight years he’d worked in the Shapiro, there had never been a security breach. The only infractions had been when several of the Shapiro staff members were caught sleeping.
Despite his being in the company of Benton, Fyodor spoke to Viktor in Russian, asking where the intruders were and what they had been doing.
“At the moment they are on floor four, heading for the recreation room,” Viktor answered in Russian. “So far they have only visited the NOC, where they used a terminal to access the data bank, and then went on to Cluster 4-B, where they spent most of their time. As I said, at the moment they are heading for the recreation room.” He pointed to the monitor that was tracking them in the fourth-floor hallway.
“What kind of data were they looking at in the NOC?” Fyodor asked.
“Mortality and discharge statistics and the file for the new patient.”
Switching to English, Fyodor related to Benton what he had learned, including where Lynn and Michael were headed at the moment.
“They certainly are nosy fucks,” Benton said irritably. “It’s going to be a relief to get rid of them.”
“You have to give them credit for being resourceful,” Fyodor said.
“I’m not inclined to give them credit for anything,” Benton said. “And
I certainly don’t like them going in the recreation room. Who knows what potentially infectious agents they could be carrying?”
“As you can see, they’re wearing Shapiro scrubs, hats, and masks,” Fyodor said, pointing to the proper monitor for Benton’s benefit.
“Where did they get them, and how clean are they?” Benton questioned. “It’s going to be a major disaster if these two jerks cause an outbreak in our patient population. As medical students, they are exposed to all sorts of illness. It’s going to be an enormous setback if we lose even one patient producing a truly lucrative drug.”
“We’ll stop them as soon as we can,” Fyodor said. “I think there is a good chance they won’t try to go out onto the floor.”
“We can hope,” Benton said. “The only thing for sure is that they are going to be shocked, and who’s to know what they might do?”
“They’re not going to do anything,” Fyodor said. “They can’t. The whole institute is in full lockdown. They’re not going anywhere and can’t communicate out with their phones.”
“Regardless, let’s take care of them ASAP,” Benton said. “The sooner the better.”
“Agreed,” Fyodor said cheerfully. “Frankly, we have been waiting for you. Did you bring the tranquilizers?”
Benton produced two syringes preloaded with large doses of midazolam.
Fyodor took the syringes. “Can we be sure this will completely tranquilize them?”
“Without doubt,” Benton said with a laugh. “They will be completely zonked out for way longer than what we need to get them over to the OR. For your information, the diagnosis is going to be subdural hematomas. The official cause is going to be head trauma suffered during their unauthorized break-in. Norman Phillips, a neurosurgeon who is friendly to the program, will be surgeon. I’ll be doing the anesthesia to make sure they don’t wake up.”
“Is the surgeon already in the hospital?”
“He’s on his way,” Benton said.
Fyodor turned to his enforcement team and handed the leader the syringes. Speaking in Russian, he told them to get it over with quickly and haul the tranquilized students up to the patient viewing room A. From there they would be helping to transport them one at a time over to the OR when the OR was ready.
47.
Thursday, April 9, 1:11 A.M.
It took Lynn and Michael longer than they had expected to get into the recreation room. The entrance door had been different from all the others. It was as heavy as the door into Cluster 4-B, but instead of operating with a generic touch pad, it had another thumbprint security system like the one on the external door. Similar to their experience with the exterior door, it took several tries. Once again, Lynn had to warm the fake fingerprint by using her breath.
A small green light finally flashed above the touch pad, indicating success, and the door started to slide open. As with the cluster room, the first thing they were aware of was noise issuing forth. It was mechanical again, but not nearly as loud as in the cluster room. As the door opened farther, giving them a view of the interior, both students sucked in a breath and stepped back in shocked surprise.
The room was much larger than the cluster room in all respects, with a ceiling about fifty feet high. The level of illumination from a mixture of LED and ultraviolet recessed ceiling fixtures was intense. Also built into the ceiling was a maze of tracks supporting a number of large grappling hooks, each with long, curved tines. The grappling hooks resembled the claw cranes found in old-fashioned gaming arcades that, for a quarter, allowed players to try to pick up a prize. But here in the Shapiro the claws weren’t picking up prizes but rather ambulating people and dropping others off.
Massed on the floor were hundreds of naked patients, in either a vegetative state or a coma, each wearing his or her helmet and, incredibly enough, walking aimlessly about in a jerky, slightly hesitant, stiff manner, often bumping into each other as well as the walls. Their hands and arms hung limp at their sides.
“My good God!” Lynn cried. “I’m not prepared for this. This is worse than the cluster room. The helmets are not just for sensors.”
“You are so right,” Michael said, completely transfixed at the spectacle. “The helmets have to be stimulating the motor centers in coordinated ways to cause them to walk.”
Lynn shuddered. “They are like zombies, only not dead.”
Just inside the open doorway was a metal wire cage, six feet on a side, to keep the patients from approaching the door to the hallway. Some bumped into the cage just as others were bumping into the walls. The students could see that most of the people had their eyes closed, although a few had them open. Those who had them open had a distant, non-focused look, suggesting that whatever their eyes were seeing was not being registered in their brains. Their mouths were generally closed, although a few were open and drooling. Their expressions were totally blank. The patients made no sounds, even when they collided with one another. The noise in the room came from the grapplers as they brought patients in and deposited them into the crowd and snapped up others and took them off to the side.
Lynn stepped forward into the cage, propelled by her morbid curiosity. It was a sight like none she had ever seen or imagined in her wildest dreams. Michael joined her. Neither of them spoke. Suddenly a torrent of scented disinfectant liquid rained down from an elaborate high-pressure sprinkler system far up on the ceiling. Although it was short-lived, it was enough to drive both Lynn and Michael back into the hallway for a moment to keep from getting soaked. The patients ignored the sudden gush and kept up their endless, mindless wandering.
Stepping back into the cage area again, the students continued their marveling at the drama playing out in front of them. Informed by their neurology training, they knew how complex an activity such as walking was from a physiological perspective. It wasn’t enough to stimulate a specific muscle. There had to be a host of muscles stimulated to varying degrees as well as simultaneous, partial inhibition of the opposing muscles for a human to stand upright much less walk, and it all had to be coordinated through the part of the brain called the cerebellum. It was complicated enough to challenge a supercomputer.
“This is how they manage to keep these people alive,” Michael said, unable to take his eyes off the shuffling assemblage of brain-damaged patients. “This is why they don’t have trouble with pneumonias or the cardiovascular systems. People have to be mobilized or they degenerate. And the UV light provides vitamin D and antisepsis.”
“Oh, no!” Lynn cried suddenly with great anguish.
Michael’s eyes shot in her direction. “What’s wrong?”
“It’s Carl,” Lynn cried, pointing off to the left.
Michael tried to follow her line of sight. It was difficult in the sea of people, jerkily staggering about in chaotic, unpredictable directions, reminding him of the Brownian movement of molecules. To make matters worse, it was hard to fixate on any given face, as they all looked remarkably the same with their blankness.
“Where, exactly?” Michael asked. He went up on his tiptoes, his eyes jumping from face to face, searching for a familiar one.
“I lost him,” Lynn said. She, too, was straining to see better.
“Are you sure you saw him?” Michael asked. “Or might it have been your imagination?”
“I saw him!” Lynn snapped angrily.
“Okay, keep it cool, girl.”
“I’m going out there,” Lynn announced with determination. The cage had a door made of the same wire mesh as the rest of the structure. It was secured with a normal throw bolt. Lynn gave it a twist. The door opened a crack.
Michael grabbed the door to keep it from opening more than a few inches. Several of the patients bumped into it. “I don’t think that’s a good idea,” he said, trying to be calm yet sound forceful.
“I don’t care what you think,” Lynn said. “I’m going out there and
find him.”
“And do what?” Michael demanded. “Seeing him in here is going to be worse than seeing him in one of those damn cylinders, which would have been bad enough. Don’t do this to yourself! Be smart!”
Lynn pushed on the door. Michael kept ahold of it. It was a bit of a tug-of-war. Another patient bumped into it and then veered off like the others but not before hitting up against Michael’s fingers. By reflex of having been unexpectedly touched by one of the ghoulish ambulating inmates, Michael let go of the door. Before he could reach out and grab it again, Lynn had it open enough to squeeze out onto the main floor of the room.
“Shit, Lynn!” Michael yelled after her. “Get your ass back here! You’re acting crazy, girl! Fucking A,” he fumed under his breath. He pulled the door back into its jamb as another patient careened into it. It clicked shut. Michael went back up on his tiptoes. He had already lost sight of Lynn in the jerkily roiling mob. For a brief moment he debated what to do, wondering if he should just wait her out or go after her. It wasn’t as if he thought she could get hurt except emotionally. What he really wanted to do was get the hell out of the Shapiro.
Michael’s momentary torment was suddenly interrupted by the sounds of footfalls and voices in the hallway. He leaned back out through the open door into the corridor and shot a quick glance back up the way they had come. Approaching at a jog was a bevy of uniformed and armed hospital security people.
By reflex, Michael leaned back into the cage and hit the electronic door closer. On the outside was a thumbprint-activated touch pad, but on the inside there was a normal one. The door activated and slid closed, but before it could close completely, a hand shot in and halted it. Michael lifted a foot and gave the intruding fingers a significant kick. With an audible cry of pain, the fingers disappeared and the door sealed shut with a thud.
Faced with this new situation, Michael quickly ended his debate about what to do. He assumed the door to the hallway would not be a significant impediment to those out in the hall. Without further hesitation he opened the wire door and started in the general direction Lynn had gone. Within seconds he was completely surrounded by ambulating patients in various states of coma.