Chromosome 6

by Robin Cook

  “I just came in fifteen minutes ago,” Bart said. “Janice was already gone.”

  “Wasn’t there a message on your desk?” Jack asked.

  Bart started to peek around under the clutter. Bart’s desk looked strikingly similar to Jack’s. Bart pulled out a note which he read aloud: “Important! Call Jack Stapleton immediately.” It was signed “Janice.”

  “Sorry,” Bart said. “I’d have seen it eventually.” He smiled weakly, knowing there was no excuse.

  “I suppose you’ve heard that my floater has been just about conclusively identified as Carlo Franconi,” Jack said.

  “So I’ve heard,” Bart said.

  “That means I want you to go back to UNOS and all the centers that do liver transplantation with the name.”

  “That’s a lot easier than asking them to check if any of their recent transplants is missing,” Bart said. “With all the phone numbers handy I can do that in a flash.”

  “I spent most of the night on the phone with the organizations in Europe responsible for organ allocation,” Jack said. “I came up with zilch.”

  “Did you talk to Euro Transplant in the Netherlands?” Bart asked.

  “I called them first,” Jack said. “They had no record of a Franconi.”

  “Then it’s pretty safe to say that Franconi didn’t have his transplant in Europe,” Bart said. “Euro Transplant keeps tabs on the whole continent.”

  “The next thing I want is for someone to go visit Franconi’s mother and talk her into giving a blood sample. I want Ted Lynch to run a mitochondrial DNA match with the floater. That will clinch the identity, so it will no longer be presumptive. Also have the investigator ask the woman if her son had a liver transplant. It will be interesting to hear what she has to say.”

  Bart wrote Jack’s requests down. “What else?” Bart asked.

  “I think that’s it for now,” Jack said. “Janice told me Franconi’s doctor’s name is Daniel Levitz. Is that anyone you have come in contact with?”

  “If it’s the Levitz on Fifth, then I’ve come in contact with him.”

  “What was your take?” Jack asked.

  “High-profile practice with wealthy clientele. He’s a good internist as far as I could tell. The curious thing is that he takes care of a lot of the crime families, so it’s not surprising he was taking care of Carlo Franconi.”

  “Different families?” Jack questioned. “Even families in competition with each other?”

  “Strange, isn’t it?” Bart said. “It must be one big headache for the poor receptionist who does the scheduling. Can you imagine having two rival crime figures with their bodyguards in the waiting room at the same time?”

  “Life’s stranger than fiction,” Jack said.

  “Do you want me to go to Dr. Levitz and get what I can on Franconi?” Bart asked.

  “I think I’ll do that myself,” Jack said. “I have a sneaking suspicion that when talking with Franconi’s doctor what’s unsaid is going to be more important than what is said. You concentrate on finding out where Franconi got his transplant. I think that’s going to be the key piece of information in this case. Who knows, it might just explain everything.”

  “There you are!” a robust voice boomed. Both Jack and Bart looked up to see the doorway literally filled with the imposing figure of Dr. Calvin Washington, the deputy chief.

  “I’ve been looking all over for you, Stapleton,” Calvin growled. “Come on! The chief wants to see you.”

  Jack gave Bart a wink before getting to his feet. “Probably just another of the many awards he’s given me.”

  “I wouldn’t be so glib if I were you,” Calvin snapped, as he made room for Jack to pass. “Once again, you got the old man all riled up.”

  Jack followed Calvin to the administration area. Just before going into the front office, Jack caught a glimpse of the waiting room. There were more than the usual number of journalists.

  “Something going on?” Jack asked.

  “As if I have to tell you,” Calvin grunted.

  Jack didn’t understand, but he didn’t have a chance to ask more. Calvin was already asking Mrs. Sanford, Bingham’s secretary, if they could go into the chief’s office.

  As it turned out, the timing wasn’t good, and Jack was relegated to sitting on the bench that faced Mrs. Sanford’s desk. Obviously, she was as upset as her boss and treated Jack to several disapproving looks. Jack felt like a naughty schoolboy waiting to see the principal. Calvin used the time by disappearing into his own office to make a few phone calls.

  Having a reasonable idea of what the chief was upset about, Jack tried to come up with an explanation. Unfortunately, none came to mind. After all, he could have waited to get Franconi’s X rays until Bingham’s arrival that morning.

  “You can go in now,” Mrs. Sanford said, without looking up from her typing. She’d noticed the light on her extension phone had gone out, meaning the chief was off the phone.

  Jack entered the chief’s office with a sense of déjà vu. A year ago, during a series of infectious disease cases, Jack had managed to drive the chief to distraction, and there had been several such confrontations.

  “Get in here and sit down,” Bingham said roughly.

  Jack took the seat in front of the man’s desk. Bingham had aged in the last few years. He looked considerably older than sixty-three. He glared at Jack through his wire-rimmed glasses. Despite his jowls and sagging flesh, Jack saw that his eyes were as intense and intelligent as ever.

  “I was just beginning to think you were really fitting in around here, and now this,” Bingham said.

  Jack didn’t respond. He felt it best not to say anything until he was asked a question.

  “Can I at least ask why?” Bingham said obligingly in his deep, husky voice.

  Jack shrugged. “Curiosity,” Jack said. “I was excited and I couldn’t wait.”

  “Curiosity!” Bingham roared. “That was the same lame excuse you used last year when you disregarded my orders and went over to the MGH.”

  “At least I’m consistent,” Jack said.

  Bingham moaned. “And now here comes the impertinence. You really haven’t changed much, have you?”

  “My basketball has improved,” Jack said.

  Jack heard the door open. He turned to see Calvin slip into the room. Calvin folded his massive arms across his chest and stood to the side like an elite harem guard.

  “I’m not getting anywhere with him,” Bingham complained to Calvin, as if Jack were no longer in the room. “I thought you said his behavior had improved.”

  “It had, until this episode,” Calvin said. He then glared down at Jack. “What irks me,” Calvin said, finally addressing Jack, “is that you know damn well that releases from the medical examiner’s office are to come from Dr. Bingham or through public relations, period! You examiner grunts are not to take it upon yourselves to divulge information. The reality is that this job is highly politicized, and in the face of our current problems we certainly don’t need more bad press.”

  “Time out,” Jack said. “Something’s not right here. I’m not sure we’re talking the same language.”

  “You can say that again,” Bingham asserted.

  “What I mean is,” Jack said, “I don’t think we are talking about the same issue. When I came in here, I thought I was being called onto the carpet because I bullied the janitor into giving me keys for this office so I could find Franconi’s films.”

  “Hell, no!” Bingham yelled. He pointed his finger at Jack’s nose. “It’s because you leaked the story about Franconi’s body being discovered here at the morgue after it had been stolen. What did you think? This would somehow advance your career?”

  “Hold up,” Jack said. “First, I’m not all that excited about advancing my career. Second, I was not responsible for this story getting to the media.”

  “You’re not?” Bingham asked.

  “Certainly, you’re not suggesting that Laurie Montg
omery was responsible?” Calvin asked.

  “Not at all,” Jack said. “But it wasn’t me. Look, to tell you the truth, I don’t even think it’s a story.”

  “That’s not how the media feels,” Bingham said. “Nor the mayor for that matter. He’s already called me twice this morning, asking what kind of circus we’re running around here. This Franconi business continues to make us look bad in the eyes of the entire city—particularly when news about our own office takes us by surprise.”

  “The real story about Franconi isn’t about his body going on an overnight out of the morgue,” Jack said. “It’s about the fact that the man seemingly had a liver transplant that no one knows about, that’s hard to detect by DNA analysis, and that somebody wanted to hide it.”

  Bingham looked up at Calvin, who raised his hands defensively. “This is the first I’ve heard about this,” he said.

  Jack gave a rapid summary of his autopsy findings and then told about Ted Lynch’s confusing DNA analysis results.

  “This sounds weird,” Bingham said. He took off his glasses and wiped his rheumy eyes. “It also sounds bad, considering that I want this whole Franconi business to fade away. If there is something truly screwy going on like Franconi getting an unauthorized liver, then that’s not going to happen.”

  “I’ll know more today,” Jack said. “I’ve got Bart Arnold contacting all the transplant centers around the country, John DeVries up in the lab running assays for immuno sup-pressants, Maureen O’Conner in histology pushing through the slides, and Ted doing a six polymarker DNA test, which he contends is foolproof. By this afternoon, we’ll know for sure whether there’d been a transplant, and, if we’re lucky, where it had taken place.”

  Bingham squinted across his desk at Jack. “And you’re sure you didn’t leak today’s newspaper story to the media?”

  “Scout’s honor,” Jack said, holding up two fingers to form a V.

  “All right, I apologize,” Bingham said. “But listen, Stapleton, keep this all under your hat. And don’t go irritating everyone under the sun, so that I start getting calls complaining about your behavior. You have a knack for getting under people’s skin. And finally, promise me that nothing goes to the media unless it goes through me. Understand?”

  “As clear as a crystal,” Jack said.

  Jack could rarely find an excuse to get out on his mountain bike during the day, so that it was with a good deal of pleasure that he pedaled with the traffic up First Avenue on his way to visit Dr. Daniel Levitz. There was no sun, but the temperature was pleasantly in the fifties, heralding the coming spring. For Jack, spring was the best season in New York City.

  With his bike safely secured to a NO PARKING sign, Jack walked up to the sidewalk entrance of Dr. Daniel Levitz’s office. Jack had called ahead to make sure the doctor was in, but he’d specifically avoided making an appointment. It was Jack’s feeling that a surprise visit might be more fruitful. If Franconi had had a transplant, there was definitely something surreptitious about it.

  “Your name please?” the silver-haired matronly receptionist asked.

  Jack flashed open his medical examiner badge. Its shiny surface and official appearance confused most people into thinking it was a police badge. In situations like this, Jack didn’t explain the difference. The badge never failed to cause a reaction.

  “I must see the doctor,” Jack said, slipping his badge back inside his pocket. “The sooner the better.”

  When the receptionist regained her voice, she asked for Jack’s name. When he gave it, he left off the title of doctor so as not to clarify the nature of his employ.

  The receptionist immediately scraped back her chair and disappeared into the depths of the office.

  Jack’s eyes roamed the waiting room. It was generous in size and lavishly decorated. It was a far cry from the utilitarian waiting room he’d had when he’d been a practicing ophthalmologist. That had been before the retraining necessitated by the managed-care invasion. To Jack, it seemed like a previous life, and in many ways it was.

  There were five well-dressed people in the waiting room. All eyed Jack clandestinely as they continued to peruse their respective magazines. As they noisily flipped the pages, Jack sensed an aura of irritation, as if they knew he was about to upset the schedule and relegate them to additional waiting. Jack hoped none of them were notorious crime figures who might consider such an inconvenience a reason for revenge.

  The receptionist reappeared, and with embarrassing subservience, she guided Jack back to the doctor’s private study. Once Jack was inside, she closed the door.

  Dr. Levitz was not in the room. Jack sat in one of the two chairs facing the desk and surveyed the surroundings. There were the usual framed diplomas and licenses, the family pictures, and even the stacks of unread medical journals. It was all familiar to Jack and gave him a shudder. From his current vantage point, he wondered how he’d lasted as long as he had in a similar, confining environment.

  Dr. Daniel Levitz came through a second door. He was dressed in his white coat complete with a pocket full of tongue depressors and assorted pens. A stethoscope hung from his neck. Compared with Jack’s muscular, thick-shouldered, six-foot frame, Dr. Levitz was rather short and almost fragile in appearance.

  Jack immediately noticed the man’s nervous tics, which involved slight twists and nods of his head. Dr. Levitz gave no indication he was aware of these movements. He shook hands stiffly with Jack and then retreated behind the vast expanse of his desk.

  “I’m very busy,” Dr. Levitz said. “But, of course, I always have time for the police.”

  “I’m not the police,” Jack said. “I’m Dr. Jack Stapleton from the Office of the Chief Medical Examiner of New York.”

  Dr. Levitz’s head twitched as did his sparse mustache. He appeared to swallow. “Oh,” he commented.

  “I wanted to talk to you briefly about one of your patients,” Jack said.

  “My patients’ conditions are confidential,” Dr. Levitz said, as if by rote.

  “Of course,” Jack said. He smiled. “That is, of course, until they have died and become a medical examiner’s case. You see, I want to ask you about Mr. Carlo Franconi.”

  Jack watched as Dr. Levitz went through a number of bizarre motions, making Jack glad the man had not gone into brain surgery.

  “I still respect my patients’ confidentiality,” he said.

  “I can understand your position from an ethical point of view,” Jack said. “But I should remind you that we medical examiners in the State of New York have subpoena power in such a circumstance. So, why don’t we just have a conversation? Who knows, we might be able to clear things up.”

  “What do you want to know?” Dr. Levitz asked.

  “I learned from reading Mr. Franconi’s extensive hospital history that he’d had a long bout with liver problems leading to liver failure,” Jack said.

  Dr. Levitz nodded, which caused his right shoulder to jerk several times. Jack waited until these involuntary movements subsided.

  “To come right to the point,” Jack said, “the big question is whether or not Mr. Franconi had a liver transplant.”

  At first Levitz did not speak. He merely twitched. Jack was determined to wait the man out.

  “I don’t know anything about a liver transplant,” Dr. Levitz said finally.

  “When did you see him last?” Jack asked.

  Dr. Levitz picked up his phone and asked one of his assistants to bring in Mr. Carlo Franconi’s record.

  “It will just be a moment,” Dr. Levitz said.

  “In one of Mr. Franconi’s hospital admissions about three years ago, you specifically wrote that it was your opinion that a transplant would be necessary. Do you remember writing that?”

  “Not specifically,” Dr. Levitz said. “But I was aware of a deteriorating condition, as well as Mr. Franconi’s failure to stop drinking.”

  “But you never mentioned it again,” Jack said. “I found that surprising w
hen it was easy to see a gradual but relentless deterioration in his liver function tests over the next couple of years.”

  “A doctor can only do so much to influence his patient’s behavior,” Dr. Levitz said.

  The door opened and the deferential receptionist brought in a fat folder. Wordlessly she placed it on Dr. Levitz’s desk and withdrew.

  Dr. Levitz picked it up and, after a quick glance, said that he’d seen Carlo Franconi a month previously.

  “What did you see him for?”

  “An upper respiratory infection,” Dr. Levitz said. “I prescribed some antibiotic. Apparently, it worked.”

  “Did you examine him?”

  “Of course!” Dr. Levitz said with indignation. “I always examine my patients.”

  “Had he had a liver transplant?”

  “Well, I didn’t do a complete physical,” Dr. Levitz explained. “I examined him appropriately in reference to his complaint and his symptoms.”

  “You didn’t even feel his liver, knowing his history?” Jack asked.

  “I didn’t write it down if I did,” Dr. Levitz said.

  “Did you do any blood work that would reflect liver function?” Jack asked.

  “Only a bilirubin,” Dr. Levitz said.

  “Why only a bilirubin?”

  “He’d been jaundiced in the past,” Dr. Levitz said. “He looked better, but I wanted to document it.”

  “What was the result?” Jack asked.

  “It was within normal limits,” Dr. Levitz said.

  “So, except for his upper respiratory infection, he was doing quite well,” Jack said.

  “Yes, I suppose you could say that,” Dr. Levitz said.

  “Almost like a miracle,” Jack said. “Especially as you’ve already mentioned the man was unwilling to curb his alcohol intake.”

  “Perhaps he finally had stopped,” Dr. Levitz said. “After all, people can change.”

  “Would you mind if I looked at his record?” Jack asked.

  “Yes, I would mind,” Dr. Levitz said. “I’ve already stated my ethical position about confidentiality. If you want these records, you will have to subpoena them. I’m sorry. I don’t mean to be obstructive.”