Crisis

by Robin Cook

  “I didn’t have any eureka moment, either,” Latasha admitted. “I might have laughed at some of your ideas, but I have to give you credit for creativity. I can’t come up with nothing, you know what I’m saying?”

  Jack smiled. “Maybe if you combined what I’ve told you with some of this material, you would,” Jack said. He gestured at the case-file material on the table. “There’s quite a cast of characters. There’s depositions here of four times the number of witnesses actually called.”

  “I’d be happy to read some if you could tell me which you think would be potentially the most helpful.”

  “If you were to read any, read Craig Bowman’s and Jordan Stanhope’s. As defendant and plaintiff, they occupy center stage. Actually, I want to reread both their recollections of Patience’s symptoms. For sake of argument, if she had been poisoned as we’re considering, subtle symptoms would be crucial. You know, as well as I, that some poisons are nigh impossible to find in the complicated soup of chemicals that make up a human being. More than likely, we’ll have to tell Allan what to look for in order for him to find it.”

  “Where are Dr. Bowman’s and Mr. Stanhope’s depositions?”

  Jack picked them up. He had placed them in their own stack. Both were thick. He reached across and gave them to Latasha.

  “Holy shit!” she exclaimed, feeling their weight. “What is this, War and Peace? How many pages do we have here?”

  “Craig Bowman’s deposition went on for days. The court reporter has to take down every word.”

  “I’m not sure I’m up to this at nearly two a.m.,” Latasha said. She let the volumes thump down on the table in front of her.

  “It’s all dialogue with lots of spacing. It’s actually easy to breeze through them for the most part.”

  “What are these scientific reprints doing here?” Latasha said, picking up the small stack of scientific publications.

  “Dr. Bowman is the lead author in most of them and a contributing author in the rest. Craig’s lawyer had considered introducing them as supporting evidence of Craig’s commitment to medicine, as a way of blunting the plaintiff’s stratagem of character assassination.”

  “I remember this one when it came out in the Journal,” Latasha said, holding up Craig’s seminal article in The New England Journal of Medicine.

  Once again, Jack was duly impressed. “You find time to read such esoterica?”

  “This isn’t esoteric stuff,” Latasha said with a disapproving chuckle. “Membrane physiology is key in just about every field of medicine these days, particularly pharmacology and immunology, even infectious disease and cancer.”

  “Okay, okay!” Jack said, holding up his hands as if to protect himself. “I take back what I said. My problem is that I went to medical school in the last century.”

  “That’s a lame excuse,” Latasha said. She flipped through the pages of Craig’s paper. “Sodium channel function is the basis of muscle and nerve function. If they don’t work, nothing works.”

  “All right already,” Jack said. “You made your point. I’ll bone up on it.”

  Latasha’s cell phone suddenly sprang to life. In the silence, it made both of them jump.

  Latasha snatched it up, glanced at the LCD screen, and then flipped it open. “What’s happening?” she said without preamble, pressing the phone to her ear.

  Jack tried to hear the voice on the other end but couldn’t. He assumed and hoped it was Allan.

  The conversation was pointedly short. Latasha merely said, “You got it,” and flipped her phone shut. She stood up.

  “Who was it?” Jack asked.

  “Allan,” Latasha said. “He wants us to pay him a visit in his lab, which is just around the corner. I believe it’s worth the effort if we’re thinking of keeping him busy with our stuff. Are you game?”

  “Are you kidding?” Jack questioned rhetorically. He pushed his chair back and got to his feet.

  Jack hadn’t realized that the Boston medical examiner’s office was on the periphery of the vast Boston City Hospital Medical Center complex. Despite the hour, they passed a number of medical-center employees, including several medical students, walking between various buildings. No one seemed in a hurry, despite the hour. Everyone was enjoying the warmth and silky texture of the air. Although technically still spring, it felt like a summer night.

  The toxicology lab was a mere two short blocks’ walk in a new, eight-story glass-and-steel structure.

  In the elevator on the way up to the sixth floor, Jack looked over at Latasha. Her dark eyes were riveted on the floor indicator display, and her face was reflecting her rightful fatigue.

  “I apologize in advance if I say anything inappropriate,” Jack said, “but I have the sense that this special effort Allan Smitham is willing to devote to this case is because of unrequited feelings he has for you.”

  “Maybe,” Latasha said equivocally.

  “I hope that accepting his aid doesn’t put you in an uncomfortable position.”

  “I think I can handle it,” Latasha said in a tone that proclaimed: End of discussion.

  The lab was state-of-the-art and almost deserted. In addition to Allan, there were only two other people there, both lab technicians who were busily engaged at the far side of the generous-sized room. There were three aisles of benches groaning under the weight of gleaming new equipment.

  Allan was a striking-looking African-American with a closely trimmed mustache and goatee that gave him an intimidatingly Mephistophelean air. Adding to his imposing appearance was a heavily muscular frame barely concealed by a white lab coat with rolled-up sleeves over a form-fitting black T-shirt. His skin was a burnished mahogany, a shade or two darker than Latasha’s. His eyes were bright and fixated on his old college friend.

  Latasha introduced Jack, who rated only a quick but firm handshake and a rapid, appraising glance. Allan was unabashedly interested in Latasha, whom he lavished with a broad smile filled with startlingly white teeth.

  “You shouldn’t make yourself such a stranger, girl,” Allan said as he gestured toward his tiny, utilitarian office. He ended up sitting at his desk while Latasha and Jack took two straight chairs in his line of sight.

  “You have an impressive lab,” Jack said, hooking a thumb over his shoulder. “Seems lean on staff, though.”

  “Just for this shift,” Allan said. He was still smiling at Latasha. “In terms of the number of employees, the difference between us and the day shift is like night and day.” He laughed at his own joke. Jack had the feeling he wasn’t lacking self-esteem or humor.

  “What did you find with our samples?” Latasha asked, cutting to the chase.

  “Ah, yes,” Allan said, steepling his fingers while his elbows rested on the desk. “You gave me a little background in your note, which I’d like to go over to make sure I understand. The patient died of a heart attack approximately eight months ago. She was embalmed, interred, and recently exhumed. What you want to do is rule out drug involvement.”

  “Let’s put it more succinctly,” Latasha said. “Her manner of death was assumed to be natural. We want to be sure it wasn’t homicide.”

  “Okay,” Allan intoned as if mulling over what he wanted to say next.

  “What was the result of the screen?” Latasha asked impatiently. “Why are you dragging this out?”

  Jack inwardly cringed at Latasha’s tone. It made him uncomfortable that she was being less than gracious with Allan, who was doing them an enormous favor. For Jack, it was becoming progressively clear there was something between them that he didn’t know and didn’t want to know.

  “I want to be sure you interpret the findings correctly,” Allan said defensively.

  “We’re both medical examiners,” Latasha shot back. “I think we are relatively informed about the limitations of a toxicology screen.”

  “Informed enough to know the predictive value of a negative test is only about forty percent?” Allan questioned, eyebrows raised. “A
nd that is with a recently deceased, not embalmed, corpse.”

  “So you are saying the toxicology screen was negative.”

  “I am,” Allan said. “It was definitely negative.”

  “My God, it’s like pulling teeth,” Latasha complained. She rolled her eyes and flapped her arms impetuously.

  “What drugs constitute your screen?” Jack asked. “Is digitalis included?”

  “Digitalis is included,” Allan said as he half-stood to hand Jack the lab’s toxicology screen drug list.

  Jack scanned the sheet. He was impressed with the number of drugs included. “What methods do you use?”

  “We use a combination of chromatography and enzyme immunoassay for our screens.”

  “Do you have gas chromatography–mass spectrometry?” Jack asked.

  “Bet your ass we got mass-spec,” Allan said proudly. “But if you want me to use the artillery, you’re going to have to give me an idea of what I’m looking for.”

  “We can give you only a general idea at the moment,” Jack said. “According to the symptoms the patient was reported to have had, if drugs or poisons were involved, we would be looking for something capable of producing a markedly slow heart rate, unresponsive to all attempts at pacing, and a respiratory depressant, since she was also described as being cyanotic.”

  “You’re still talking about a shitload of potential drugs and poisons,” Allan said. “Without more specifics, you’re asking me for a miracle!”

  “I know,” Jack admitted. “But Latasha and I are going to go back and brainstorm to see if we can come up with some likely candidates.”

  “You’d better,” Allan said. “Otherwise, this is probably going to be a fruitless exercise. First, I have to figure out what to ignore with all the embalming fluid on board.”

  “I know,” Jack repeated.

  “Why are you even considering homicide?” Allan asked. “If you don’t mind my asking.”

  Jack and Latasha exchanged a glance, unsure of how much to say.

  “We just did the post a few hours ago!” Latasha said. “We didn’t find diddly-squat. There was no cardiac pathology, which doesn’t make sense, considering the history.”

  “Interesting,” Allan said pensively. He locked eyes with Latasha. “Let me get this straight. You want me to do all this work, take up my whole night, and do it on the sly to boot. Is that what you are saying?”

  “Of course we want you to do it!” Latasha snapped. “What’s the matter with you? Why else would we be sitting here?”

  “I don’t mean you and the doc here,” Allan said, gesturing toward Jack. He then pointed at Latasha. “I mean you personally.”

  “Yeah, I want you to do it, okay,” Latasha said. She stood up.

  “Okay,” Allan said. There was a trace of a satisfied smile on his face.

  Latasha walked out of the office.

  Surprised at the sudden ending of the meeting, Jack got up and fumbled for one of his cards. “Just in case you want to ask me something,” he said as he put it on Allan’s desk. He helped himself to one of Allan’s from a small Plexiglas holder. “I appreciate your help. Thank you.”

  “No problem,” Allan said. The lingering smirk was still apparent.

  Jack caught up to Latasha at the elevator. He didn’t say anything until they were on their way down.

  “That was a rather precipitous ending,” Jack said. He pretended not to look at Latasha by watching the floor indicator.

  “Yeah, well, he was getting on my nerves. He’s such a cocky bastard.”

  “I sensed he didn’t have a self-esteem problem.”

  Latasha laughed and perceptibly relaxed a degree.

  They walked out into the night. It was going on three, but there were still people on the street. As they neared the medical examiner’s office, Latasha spoke up: “I suppose you wondered why I appeared somewhat rude.”

  “It crossed my mind,” Jack admitted.

  “Allan and I were tight the last year of college, but then something happened that gave me insight into his personality that I didn’t like.” She keyed open the front door and waved to the security person. As they started up the single flight of stairs, she continued: “I got a scare that I was pregnant. When I told him, his response was to ditch me. I couldn’t even get a call back, so I wrote him off. The irony is that I wasn’t pregnant. During the last year or so, when he found out I was here at the ME office, he’s tried to get us to connect up, but I’m not interested. I’m sorry if it was uncomfortable back there in his office.”

  “No need to apologize,” Jack said. “As I said on the way over, I hope accepting his help won’t cause a problem.”

  “With as many years as there have been, I’d thought I’d handle myself better than I did. But just seeing him made me pissed about the episode all over again. You’d think I would have gotten over it.”

  They walked into the library. The clutter was exactly as they’d left it.

  “How about we take a look at the slides we stained?” Latasha suggested.

  “Maybe you should go home and get some shut-eye,” Jack said. “There’s no reason for you to pull an all-nighter. I mean I love the help and the company, but this is asking way too much.”

  “You’re not getting rid of me that easy,” Latasha said with a coy smile. “I learned back in medical school that for me, when it’s this late, it’s better to just stay up. Plus, I’d love to solve this case.”

  “Well, I think I’m going to take a drive out to Newton.”

  “Back to the hospital?”

  “Nope. Back to the Bowmans’ house. I told my sister I’d look in on her husband to make sure he’s not in a coma. Thanks to his depression, he’s been mixing alcohol in the form of a single-malt scotch with some sort of sleeping pill.”

  “Yikes!” Latasha said. “I’ve had to post several people like that.”

  “Truthfully, with him I don’t think it’s much of a worry,” Jack said. “He thinks far too much of himself. I doubt I’d even go if checking on him was the only reason. What I’m also going to do is check the biomarker assay kit he used with Patience to see if there is any reasonable reason to suspect he got a false positive. If it were a false positive, the possibility goes way up that the manner of death was not natural.”

  “What about suicide?” Latasha questioned. “You’ve never mentioned suicide even as a wildly remote possibility. How come?”

  Jack absently scratched the back of his head. It was true that he’d not thought about suicide, and he wondered why. He let out a small chuckle, remembering how many cases he’d been involved with over the years where the apparent manner of death was ultimately not the correct manner. The last such case had involved the wife of the Iranian diplomat that was supposed to be suicide but had been homicide.

  “I don’t know why I haven’t given even a passing thought about suicide,” Jack said, “especially considering some of my other equally unlikely ideas.”

  “The little you’ve told me about the woman suggests she wasn’t terribly happy.”

  “That’s probably true,” Jack admitted, “but that’s the only thing the idea of suicide has going for it. We’ll keep it in mind along with my hospital conspiracy idea. But now I’m going to head out to Newton. Of course, you’re welcome to come, but I can’t imagine why you’d want to.”

  “I’ll stay,” Latasha said. She pulled over Craig’s and Jordan’s deposition transcripts to a position in front of one of the chairs and sat down. “I’ll do some background reading while you’re gone. Where are the medical records?”

  Jack reached for the correct pile and pushed it over against Craig’s and Jordan’s depositions.

  Latasha picked up a short run of ECG that was sticking out of the stack. “What’s this?”

  “It’s a recording Dr. Bowman made when he first got to Patience’s house. Unfortunately, it’s almost useless. He couldn’t even remember the lead. He had to give up doing the ECG because she was in such
dire straits and rapidly worsening.”

  “Has anyone looked at it?”

  “All the experts looked at it, but without knowing the lead and not being able to figure it out, they couldn’t say much. They all agreed the marked bradycardia suggested an AV block. With that and other suggestive conduction abnormalities, they all felt it was at least consistent with a heart attack someplace in the heart.”

  “Too bad there’s not more,” Latasha said.

  “I’m out of here so I can get back,” Jack said. “My cell phone is on if you have a eureka moment or if Allan is able to pull off a miracle.”

  “See you when you get back,” Latasha said. She was already speed-reading Craig’s deposition.

  At three o’clock in the morning, it was finally easy for Jack to drive in Boston. At some of the traffic lights on Massachusetts Avenue, Jack’s Accent was the only vehicle waiting. On several occasions he debated ignoring the light when there also wasn’t any cross-traffic, but he never did. Jack didn’t have a problem breaking rules he judged ridiculous, but traffic lights didn’t fall into that category.

  The Massachusetts Turnpike was another story. It wasn’t crowded, but there was more traffic than he expected, and it wasn’t all trucks. It made him wonder with amazement what so many people were doing out and about at such an hour.

  The short drive to Newton gave Jack a chance to calm down from the near mania Latasha had unleashed when she said she had access to a toxicologist just at the point Jack was ready to throw in the towel. In a more relaxed state of mind, he was able to think about the whole situation considerably more rationally, and when he did so, it was clear what the most probable outcome was going to be. First, he was going to decide from lack of proof to the contrary that Patience Stanhope most likely died of a massive heart attack despite there being no obvious pathology; and second, that Fasano et al. were most likely behind the despicable assault on Craig and Alexis’s children for trite economic reasons. Fasano had been unambiguously clear about the rationale when he directly threatened Jack.

  Jack’s mild mania had devolved into a tepid despondency by the time he arrived at the Bowmans’ house. He found himself again wondering if the reason he was still in Boston and imagining out-of-the-box conspiracies had more to do with half-conscious fears of getting married in ten hours than trying to help his sister and brother-in-law.