Viral

by Robin Cook

  “You are right. As I’ve said, it’s mostly denial. It’s also true that I haven’t had time to really let it sink in.”

  “If it is anything like my experience, it’s going to be tectonic when it hits.”

  “I can imagine. I guess I should be thankful for Juliette.”

  “That’s my point exactly,” Jeanne said. “But beware, it might be paralyzing.”

  In the living room they sat on opposing couches beneath the large, multipaned window looking out onto West 217th Street. Brian related the calls he’d had, first with Roger Dalton at MMH Inwood and then with Ebony Wilson.

  “I can’t believe Peerless,” Jeanne exclaimed when he finished his rant. “They certainly have perfected the art of disclaiming responsibility, but they can’t have just singled us out. They must do it to all their policy holders.”

  “I’m sure they do,” Brian said. “It’s no wonder they have the money to pay their CEO millions. It’s a type of legalized fraud. Like last time, I was told I could request a review, which is guaranteed to be an exercise in futility, or I can sue. Proceeding with a lawsuit is probably equally as pointless as asking for a review. With their in-house attorneys, they have undoubtedly prepared for any and every eventuality. On top of that, suing is expensive, with no guarantees.”

  “Having grown up in France where this type of tolerated robbery involving healthcare would never happen, I have to wonder how has it come to be here in the United States that hospitals and health insurance companies operate with such impunity?”

  “I think it has been a kind of accident of history,” Brian said. “It certainly wasn’t planned that healthcare got associated with employment here in the USA way back during World War II. And from my own experience, having relatively good health insurance from being a member of the NYPD made me indifferent to cost. I never cared or questioned. I guess it’s a kind of moral hazard, and the consequences have been dramatic over the years. Can you ever imagine that a few hours in the emergency room for my wife would cost almost twenty-seven thousand dollars, only for her to end up dead? Beyond the emotional costs, that’s akin to being forced to buy something like a car without knowing the price and being given a nonfunctioning wreck with no recourse.”

  “In France the government has tried to hold down costs, but it’s not easy with what’s going on here in the USA.”

  “France and the entire rest of the industrialized world as far as I know have tried to rein in healthcare costs,” Brian said. “It’s a uniquely American disaster, although what’s happening here is putting pressure on prices elsewhere I’m afraid.”

  “I agree with you. It’s American capitalism run amok with no moral balance in an industry that’s supposed to be altruistic. Private equity shouldn’t be allowed to interfere in healthcare.”

  “You’re so right,” he agreed with a shake of his head. “Talk about irony: It’s a tragedy of personal greed trumping altruism.”

  “Exactly, and the final result is to cause suffering for people like us,” Jeanne said. “It’s infuriating, and Charles Kelley and Heather Williams are poster children for the whole damn situation.”

  “It’s a wonder they can sleep at night.”

  “They must make it a point to avoid thinking about the lives they turn upside down. Unfortunately, I’m a prime example. Not only did I lose my husband, but in the course of my lawsuit and bankruptcy, I lost my business, most of my savings until Patrick and Megan put a stop to it, and then even my house.”

  “Don’t tell me that,” he pleaded. “You lost your house?”

  “I’m afraid so,” Jeanne confirmed. “It was partially my fault. While trying to pay off the hospital, I got behind on the mortgage, which exposed it to Kelley’s pit bull lawyers.”

  “Yikes,” Brian said. “At the moment that’s my biggest worry, especially if it aggravates Juliette’s sense of security. I’m behind on my mortgage payments as well.”

  “From my experience, I’d advise you to change that if you can.”

  “I know. Patrick McCarthy recommended the same thing. The trouble is, I need some income. As I said when we were in the hospital waiting for Juliette to be seen, I’ve been thinking of trying to get my old NYPD job back. I even called my commanding officer a little while ago and made plans to go out to the ESU Headquarters tomorrow after the funeral to talk to him about it.”

  “That sounds like a prudent plan to me, as this pandemic is not going away tomorrow.”

  “I have to do something,” Brian said. “He suggested for me to join in on some of the training opportunities they’ve set up in lieu of having a new class of cadets. I’d like nothing better than to immerse myself in some simulation exercises, whether I end up back on the force or not. The mere physicality of it would be therapeutic. I haven’t gotten any real exercise since I came back from Cape Cod, and I need to find a way to take my mind off of things.”

  “I think it’s a wonderful idea,” Jeanne said. “And to encourage it, I’d be happy to come over tomorrow and help with Juliette, provided you wouldn’t mind.”

  “Mind?” Brian questioned with an exaggerated expression of surprise. “I’d love it. It would be a great relief. Leaving Camila to carry the burden of Juliette, especially if the funeral upsets her as much as the wake, was the only reservation I had. One thing I can say without exaggeration is that my daughter seems to truly adore you.”

  “Likewise,” she said. “It will be a pleasure to spend time with her. But to get back to what we were talking about earlier, I find myself wondering if you and I are outliers, or if there are other people in this community who have suffered like we have at the hands of Charles Kelley and Heather Williams.”

  “That’s a good question. If I had to guess, I’d say we’re not alone by a long shot. Grady Quillen, the retired cop who served me, said he’s been a busy bee for Premier Collections, especially of late. And Megan Doyle seems pretty booked, too.”

  “The more I think about it, the more curious I am,” Jeanne pondered. “If there is a huge number, why hasn’t it been the subject of some kind of exposé in the media so that Kelley and Williams could get the comeuppance they deserve?”

  “That’s maybe even a better question. Personally, I’d hate that kind of notoriety myself with my sad story in the tabloids, but you are right: It seems like perfect fodder for the likes of the Post or Daily News. Tearjerker stories about powerful elite ogres who are being paid millions to exploit the masses have a strong appeal for obvious reasons. Maybe it has something to do with patient–client privilege that makes the media hesitant.”

  “But they wouldn’t have to use real names,” Jeanne said. “I think it’s curious. At least I’m curious. I’d like to find out how many people right here in Inwood have suffered like we have and learn their individual horror stories. The local hospital is supposed to help people and the community, not bankrupt everybody.”

  “It wouldn’t be difficult to get a good idea of the numbers regarding MMH and Charles Kelley in terms of lawsuits,” Brian said. “It would be more difficult to dig up much of anything about Peerless Health and Heather Williams.”

  “How so?”

  “That kind of general information about lawsuits is available on the New York Civil Court’s and the New York Supreme Court’s websites. All you’d have to do is run a search using Premier Collections as the plaintiff.”

  “I didn’t know such information was available. How about giving it a try?”

  “Come on into the office! We’ll use my computer.”

  A few minutes later, with Jeanne looking over his shoulder, he brought up the New York City Supreme Court website and typed in his search parameters. A millisecond later they were taken aback. Just since 2014 there had been many hundreds if not thousands of cases in Manhattan involving MMH Inwood and the significantly larger MMH Midtown. Scrolling forward, they also could see that there had
been a significant uptick in activity since the beginning of the Covid-19 pandemic.

  “My God!” Brian murmured. “Who would have guessed? And these are only cases involving more than twenty-five thousand dollars. If we look at the Civil Court for under twenty-five thousand there will probably be a lot more. It seems as if MMH and Premier Collections have sued a sizable portion of the entire metropolitan New York population.”

  “Let’s look at the Civil Court website,” Jeanne said.

  A number of clicks later, they were again shocked by the numbers. “This is certainly eye-opening,” Brian said. “The trouble is we can’t use this resource to tease out the cases here in Inwood like you wanted. At least I can’t do it. Maybe Patrick McCarthy might be able to. As a litigator, he has more options available to him for online data on these websites. What would also be interesting to know is how many of the cases are pending like mine and how many are closed.”

  “This is a bigger problem than I could have imagined.” As if weighed down by this new information, Jeanne collapsed into one of the side chairs with her legs splayed out in front of her, her arms limp at her sides. “And to think the hospital prevails in most all the cases because the ‘services have been rendered.’ Those are the words Patrick McCarthy used to explain to me why I lost my case. People don’t realize what they are signing when they go into the hospital.”

  “You’ve got that right,” he said. “Especially when it involves an emergency situation. They’re told ‘sign here’ to get their loved one treated, and they sign without reading anything. I did, too.”

  “People also count on their health insurance to take care of things and not only think about their profits.”

  “The whole situation is outrageous. It’s also frustrating during these lawsuits that the court can’t rule on the prices the hospital charge, no matter how ridiculous they are. It’s got to be discouraging to be a judge.”

  “Plus, most hospitals won’t tell you their charge master prices, which they’ve spent the last fifty years raising beyond any reason.”

  “Oh, yeah,” Brian said with renewed disgust. “I forgot about the infamous charge master prices. How do you know about that?”

  “I told you that when I got sued, I spent quite a lot of effort researching USA hospital business practices. What do you know about it?”

  “Only what Megan Doyle happened to tell me during our brief meeting.”

  “It’s a major part of the hospital scam,” Jeanne said. “The only time patients can find out what things cost is after the services have been rendered, and they get the bill, and even then, they have to hire someone like Megan Doyle to figure it all out. It’s absurd.”

  “I know how we could get at least a partial list of Inwood residents that MMH Inwood has sued or is in the process of suing,” he said. “We could ask Grady Quillen, who served me. He wouldn’t be restricted by any patient–client confidentiality issues as far as I know.”

  “Do you think he would give you that information?”

  Brian shrugged. “I don’t see why not. We’ve been acquaintances for years, and my father was his commanding officer. We could assure him we wouldn’t give out our source, so his employer wouldn’t find out. He already gave me one name: Nolan O’Reilly, whose story rivals ours, as he lost his son and his house in the process.”

  “If we could put together even a couple of dozen or so stories combined with the sheer number of court cases, we might be able to get either the Post or the Daily News interested enough to run an exposé.” Abruptly she sat up straighter in her chair, her amber eyes sparkling. “And do you know what else we could do?”

  “No, not really,” he said, raising his eyebrows in curiosity.

  “We could go to our city council member for the 10th District,” Jeanne said excitedly. “I’m sure we could get him interested and involved. The more I think about all of this, the stranger it seems that it has been allowed to go on for so long.”

  “It’s definitely an unconscionable problem,” Brian agreed, but without the enthusiasm she was exhibiting. He was much too emotionally caught up in his own precarious situation, with his wife’s funeral scheduled for the following day and Juliette’s problematic behavior, to think about some kind of social movement, no matter how appropriate.

  “Suddenly I feel a little like an Erin Brockovich,” Jeanne said zealously. “Did you see that film with Julia Roberts?”

  “I think so,” he said, struggling to reboot his brain. “Yes, I saw it.”

  Suddenly Camila appeared in the archway leading out into the front hall. “I’m sorry to interrupt, but Juliette just threw up and now says she’s feeling sick again.”

  “Oh, God! Where is she?” Brian asked nervously, getting to his feet.

  “She’s upstairs in her room,” Camila said. “I think you’d better go and check on her.”

  CHAPTER 28

  September 1

  Disturbingly similar to a few hours earlier, Juliette was lying on her side, immobile, facing the wall with her legs drawn up. The only difference was now she was clutching Jeannot Lapin against her chest in a firm embrace.

  “Camila says you’re feeling bad again, Sweet Pea,” Brian said as he sat down on the edge of the bed and stroked her back as he’d done earlier. Jeanne moved to stand at the foot of the bed. “Can you tell me what’s wrong?”

  Juliette didn’t respond or move and Brian could see she had her eyes closed. He also noticed she wasn’t sucking her thumb, which he thought was mildly encouraging.

  “What about Jeannot Lapin?” he asked, imitating Jeanne’s earlier way of getting Juliette to talk by addressing the rabbit. “She looks like she’s not feeling so good, either.”

  “She is hot,” Juliette said, turning her head and looking up at her father. “She’s cold and then she’s hot.”

  Brian reached out and pretended to feel the rabbit’s forehead and then did the same with Juliette’s. “You are right,” he agreed. “Jeannot feels a little warm to me. Maybe we should take her temperature.”

  “Her name is Jeannot Lapin,” Juliette corrected before rolling over onto her back.

  “You’re right,” Brian said. “I stand corrected.” He turned, looked up at Camila, and asked her if she’d bring the thermometer.

  “Of course,” Camila said and disappeared.

  “Does Jeannot Lapin have a sore throat?” he asked, redirecting his attention to his daughter and continuing with the indirect questioning.

  Juliette shook her head.

  “How about a cough, or does she just feel sick? Does she think she might throw up again?”

  Juliette shook her head for the second time.

  “How about a headache?” Jeanne asked.

  “Yes, she has a headache,” Juliette said.

  Brian and Jeanne exchanged a glance. Each shrugged their shoulders, not knowing what else to ask. Camila returned with the thermometer. Juliette allowed her to put it under her tongue before Camila stepped back out of Brian and Jeanne’s way.

  “How long after eating did Juliette throw up?” Brian asked Camila.

  “It was while she was eating. By the time I had made the bacon and eggs, she didn’t seem very hungry and ate very slowly. Then she threw up sitting at the table. It was all very sudden.”

  He nodded. “Maybe there was something wrong with the eggs.”

  “I don’t think so,” Camila said. “I had some myself and had no problem.”

  After waiting for the usual three minutes, Brian took the thermometer out of Juliette’s mouth and then twirled it in his fingers, looking for the column of mercury. “100.8 again,” he said when it flashed into view. “No wonder Jeannot Lapin feels hot.”

  Standing up, he motioned for Jeanne to step out of the room with him. Once in the hall he said: “It’s certainly not a particularly worrisome fever, but I think it is a feve
r, nonetheless. What should we do? God! I wish that Dr. Bhatt wasn’t on vacation. The last thing I want to do is go back to the MMH Inwood ED, not with the way we were treated earlier.”

  “I’m with you there,” Jeanne said. “I don’t think it will be necessary, but I do wish they had at least done a Covid test.”

  “The doctor was adamant it wasn’t indicated, but who knows. I’m still irritated. I also wish they had done basic blood work just to be sure she wasn’t coming down with something.”

  “I have to use the bathroom fast,” Juliette said urgently to Camila from inside the room yet loud enough for Brian and Jeanne to hear. As they ducked back inside, they saw Juliette and Camila disappear into the bathroom and the door slam behind them.

  “Uh-oh,” Brian said. “Sounds like more stomach issues.”

  While they waited, he picked up Jeannot Lapin as a nervous gesture and gave it a close inspection. “This little rabbit has been a godsend. I’ve never been into stuffed animals, but this one is damn cute. Did you really have it since you were Juliette’s age?”

  “Just about,” Jeanne said. “Maybe a year older.”

  “How did it stay so pristine?” Brian asked. “In comparison, Bunny looks like she’d been through a war.”

  “I don’t know, to be truthful. I guess I’ve always been on the meticulous side.”

  Five minutes later Juliette and Camila emerged from the bathroom. Juliette made a beeline for Brian and rescued Jeannot Lapin. Then she climbed back up on the bed and rolled over on her side, assuming the same position she’d been in when Brian and Jeanne had arrived.

  “A bit of diarrhea,” Camila reported. “And some cramps, but I think she feels better now.”

  “Thank goodness,” he said. He placed his palm on her forehead. “She seems to be about the same temperature as before.” Juliette pushed his hand away.

  “She said she wanted to sleep,” Camila said.