Cell

by Robin Cook

“So this is what made you hire Zee?”

  “Precisely,” George said. He went on to tell Paula that when Zee hacked into Amalgamated’s servers, he found no evidence that a dump command had been issued. Yet Sal’s smartphone itself showed exactly the opposite. Nor did Zee find a dump command in any of the other records from the other patients. “But when Zee looked more carefully he saw it!”

  “Saw what?” Paula asked.

  “What he called the artifacts! Some minuscule evidence of an overwrite on the records. Zee sensed that the record in each case had been overwritten to delete the dump command and the recorded vital signs showing the effects of a dump command. He saw the same artifact at the same critical juncture in all five of the records seventeen minutes prior to death. It was his feeling that there had been a cover-up of the dump command coming from outside the server.”

  Paula was astonished, angered, disbelieving, and intrigued all at the same time. “Okay, what does all this mean?”

  “With what proof I have, which is limited to DeAngelis’s phone data, I believe that the dump command was probably a hack job, which was then covered up by another hack job by someone else.”

  “That’s too complicated,” Paula said, shaking her head. “In medicine, when you have confusing symptoms, the diagnosis is usually a single disease.”

  “I admit, I can’t be certain, but Zee discovered something else. When he tried to trace the hacker it led him to two ‘high-anonymity proxy servers.’ He said on the other end of these proxy servers were very likely the sources of the hacks. One, he thought, was here in Los Angeles, possibly up in the Hollywood Hills, and the other was in Maryland.”

  “Maryland?”

  “The server in Maryland was the one that spooked Zee. He told me the server was part of an obscure government agency called URI, standing for Universal Resource Initiative. The only thing he could learn about the organization was that it was loosely associated with the Independent Payment Advisory Board, which, if you don’t know, was set up by the Affordable Care Act to advise Medicare and Medicaid on cost control.”

  Paula appeared crestfallen. “You think this is all some kind of ill-conceived cost-saving plan engineered by the feds?”

  George shrugged. “I don’t know. But that was one of the things that occurred to me. Either by the feds or Amalgamated.”

  Paula leaned forward, head in hands, quietly saying no over and over again. Then, suddenly, pulling herself together, she sat back up, looking directly at George. Anger had trumped dejection. “If you are right about all this, it is a terrible, terrible subversion of probably the biggest innovation in medicine to date. iDoc is going to save people, not kill them! It’s going to revolutionize medicine, democratize it, taking it from essentially ‘sick’ care to true ‘health’ care, giving everyone their own twenty-four-seven doctor who intimately knows them and has access to the latest diagnostics and treatments available.”

  George didn’t respond. Paula had flushed again with a wild look in her eyes. Enraged at the thought that iDoc might have been subverted, she had launched back into her sales presentation. He did not attempt to interrupt her. He understood that she was as shocked about it as he had been. He let her vent.

  “You know as well as I,” she snapped, “iDoc is going to reduce unnecessary medical procedures and break the stranglehold of medical specialists!” She stared back at George challengingly.

  “I agree,” George said, trying to calm her. “I agree with everything you’ve said. But there is a problem—these five suspicious deaths. It’s a situation that has to be looked into and either confirmed and exposed or proven to be somehow circumstantial, if that is even possible with what is known.”

  “Okay, okay!” Paula said, struggling to get herself under control. “How can we look into it?”

  George trod lightly; this step was crucial. “Your access makes you the only one who can confirm or deny the problem. How many people are there on the iDoc programming team?”

  “I don’t know . . . Two hundred, I guess.”

  “Is there anyone in that two hundred that you trust completely? Someone who would have full access and can definitively determine if the program has been compromised?”

  She shook her head. “I’m not close to any of the programmers. Thanks to Langley, none of them have been made available to me. And to be honest, the only person among the key players I don’t trust completely is Langley.”

  “Why?”

  “Langley has implied on several occasions that I have been getting too much credit for iDoc. I wonder if he could be involved in some twisted scenario to discredit the first iteration, then rescue it.”

  “Your intuition notwithstanding, Langley probably has too much to lose to be involved in discrediting iDoc. It doesn’t comport, at least in my mind. Let me ask you this: Who, if anyone, do you totally trust at Amalgamated?”

  “Thorn. He is the only person I completely trust. And I think you are right about Langley having too much to lose, but I still wouldn’t want to approach him with this. I think we should go to Thorn and tell him about what you’ve learned and what we suspect.”

  George grimaced and shook his head. “I don’t know about that, Paula. And for the similar reasons I would hesitate before going to Langley. The money, power, and celebrity involved with iDoc is so off the charts that it would be difficult for the businessman in Thorn to be able to be objective.”

  “You don’t know Thorn like I do. The man has character.”

  George shook his head again. “When I watch Thorn, I see the quintessential businessman, more interested in the bottom line than anything else,” George said.

  “I’ve known him for almost four years now, and he has been like a father to me. He’s a businessman for sure, but with integrity. I trust him implicitly.”

  “Maybe I should forget my paranoia about the government, and we should go directly to the FBI and have the agency either confirm my fears or lay them to rest?”

  She shook her head. “As you suggested, the government might be involved somehow. Going to Thorn would be far better. He would know how we should proceed. I’m sure that Thorn will be as furious as I am if some group is subverting iDoc.”

  George remained hesitant. He admitted he didn’t know Thorn like Paula did, but something was telling him not to go to Thorn and for the reasons he’d given. “I can’t help but worry that Thorn will be influenced by what iDoc can do for Amalgamated’s bottom line more than anything else.”

  “Look,” Paula said, a little put out, “we all know what iDoc will do for Amalgamated’s bottom line, but that is not the issue. Thorn above all else is a very ethical person.” A thought hit her. “I wonder if the AMA could be the guilty party. Organized medicine is going to see iDoc as competition, no question. Maybe this is all an elaborate way of discrediting it from the get-go.”

  George was astonished at that suggestion. The idea hadn’t occurred to him, but he knew it wasn’t completely improbable. After all, in the late forties, it was organized medicine that thwarted Truman’s attempt to create a national health care system in the United States. Still, the idea seemed like a total shot in the dark.

  “Or it could be any one of a number of other stakeholders feeding from the medical trough,” Paula continued. “Like big pharma or the American Hospital Association, both of which will stand to lose money when iDoc becomes fully operational and takes medicine from sick care to preventative care.”

  George nodded. Having become relaxed and feeling safe made staying awake progressively more difficult; he was on the verge of collapsing from exhaustion.

  “You need to sleep,” Paula said, noticing George was struggling to keep his eyes open. She reached out a hand. “Come on. Time to take a nap! We can talk more later over dinner. If you are okay with it, I’ll make us a meal so we can just stay in.”

  “A nap might be good,” Geor
ge admitted. He took her hand and stood, feeling momentarily dizzy. “Just for an hour or so. But I would like to reach a decision about how to proceed with this iDoc situation. If it is intentional killing, it has to stop. And I have a trial I have to prepare for.”

  “When is your trial scheduled?”

  “Soon. July sometime. I forget the exact date, but it is not that far away.”

  “I think we should approach Thorn. The more I think about it, the more I’m certain that he is the right person.” She was firmly set on the idea. “I’m sure he will at least offer you legal help.”

  George’s eyes fluttered, but he was too tired to reply. He swayed, and Paula reached out to steady him.

  “Come on!” she said. “You’re about to fall over.”

  Paula led him back into the house via the French doors into the great room. George didn’t protest. After the heat outside, the air-conditioning felt heaven sent.

  Once inside the guest bedroom, Paula closed the Bermuda shutters and pulled back the covers on the canopied king-size bed. From behind the bathroom door, she brought in a white Turkish towel robe and draped it over the foot of the bed.

  “I don’t think I’ve ever seen a person need sleep quite as much as you do,” she said. “You’ve pushed yourself to your limit.”

  George opened his mouth, but she put her fingers on his lips.

  “Shhh. Sleep. We’ll talk in a bit.” She backed toward the door.

  George sank down onto the bed. He made one last effort at conversation. “If we confirm my fears about iDoc, we’ll have to go to the media, no matter what Thorn says.”

  “Enough!” Paula called from the door with exaggerated authority. “We’ll talk more after you have slept!” She flashed him a smile, then shut the door quickly to keep George from responding.

  In the room’s cool, dim silence George removed his clothes. It was with extreme pleasure that he slipped in between the clean, ironed sheets. The experience was such an extraordinary difference from what he had experienced the night before that it was as if he had been magically transported to a different planet.

  Just before he fell into a deep sleep, he thought how utterly stupid he had been in medical school when he failed to follow up with Paula. What was he thinking? He was finding himself more and more impressed by Paula, and for the first time since Kasey’s death he felt a kind of closeness with her that he was unsure he would ever feel again. He didn’t know if he was ready just yet for romance, nor did he know if Paula would be receptive, considering their history and his current status. As a potential felon and an unemployed resident, his career prospects were far from rosy, but he didn’t dwell on the thought. Sleep washed over him like a virtual tsunami.

  48

  PAULA’S HOUSE

  SANTA MONICA, CALIFORNIA

  SUNDAY, JULY 6, 2014, 7:51 P.M.

  George woke with a start. At first he didn’t know where he was, as he had slept so soundly. Then he remembered, and the whole nightmare flooded back. My God! he thought. He was facing a trial that might send him to prison for years! After the experience of one night in the holding cell, he questioned if he could live through being incarcerated for an extended period. Then there was the issue of essentially having been fired from his residency. Could it be that his radiology career and maybe even his medical career were over? His only solace was that at least for the moment he was safely hidden away in Paula Stonebrenner’s house.

  Looking at the golden hue of the light coming through the Bermuda shutters, George sensed it was nearing sunset. Surprised, he grabbed his phone to see the time. He was amazed! It was almost eight o’clock in the evening. He imagined he’d been asleep for only an hour, which had been his plan. Certainly not over five hours!

  George got up, wondering where Paula was and why she hadn’t awakened him for the dinner she had talked about. He was eager to find her, but instead took advantage of the beautiful and convenient shower. He had rinsed off in his own apartment, but this experience was far better.

  A few minutes later he was refreshingly clean, reasonably rested, and enveloped in the oversize Turkish towel robe Paula had put out for him. He left the guest suite and found Paula in the great room overlooking the pool, using her iPad. Delicious, savory smells were coming from the kitchen area.

  When Paula spotted him she broke into a wide smile. “Back from the dead, I see. I hope you’re hungry!”

  “Very hungry. I’m sorry I slept so long. Why didn’t you wake me?”

  “You obviously needed to sleep.”

  “I hope I haven’t kept you from your dinner.”

  “I’ve been happy to wait for you. I’m about to throw some steaks on the barbie by the pool! Sound good?”

  “Sounds heavenly.” He noticed that she had opened a bottle of wine. He picked it up and looked at the label. He didn’t recognize it, but it looked expensive. “May I?”

  “Please do. For both of us. I was letting it breathe a little.”

  George poured them both a glass, thinking how strange it was to savor the anticipation of what promised to be a pleasant dinner in the midst of all the tumult of the previous day and a half. There was a remarkable unreality to it all.

  George watched as Paula continued her preparations for dinner, putting dressing on a salad she’d already made. Once that was done, Paula grabbed the platter with the steaks and motioned George to follow her out to the grill. He carried both glasses of wine. While she was checking the temperature of the grill she said, “You do know that Amalgamated has been in direct negotiation with CMS to use iDoc for Medicare and Medicaid?”

  “I do,” George responded.

  “Maybe that’s why Zee found that a federal agency was connected to the Amalgamated servers.”

  “Could be,” George said. “It would be a relief if that were the case.”

  Paula put the steaks on the grill, asking George how he liked his.

  “Medium rare,” George said. “Can I help?”

  “I think I have it under control.” She set a couple of ears of corn on the upper level of the grill, and for a while they watched the steaks sizzle and contentedly sipped their wine. When the meat was done, Paula put it back on the platter with the now-grilled ears of corn. Carrying everything between them, they went back into the house.

  “I’m more and more certain that I should talk with Thorn,” Paula stated as they sat down. “Either with or without you. That’s your call.”

  “With me,” George said. Even though he still had reservations about Thorn, he was happy to have a plan of action.

  She smiled. “Good. Because Thorn will certainly have a lot of questions that I won’t be able to answer.” She then changed the subject. “What’s this about your being placed on administrative leave?”

  “It is exactly what you think. I haven’t been technically fired, but it is as if I have been, at least in the short run.”

  “What will that do to your residency, now that you’re in the last year, if you don’t get reinstated?”

  “It ends it unless some other program would be willing to pick me up. Whether that might happen, I have no idea. But if I can’t finish my residency, I can’t sit for radiology boards. Simple as that.”

  “And that means what for your future?”

  George shrugged. He was at a loss. “Maybe I’ll have to become a vitamin salesman? Truthfully, I have no idea. I’ll have to talk with Clayton. I’m hoping he’d be my savior since he, and not the chief, is actually in charge of the residency program.”

  “Thorn might be able to help as well since he and Clayton are brothers-in-law. Thorn is married to Clayton’s younger sister.”

  “I once asked Clayton how he became so deeply involved with Amalgamated, and he told me. That explains a lot.”

  For a few minutes they ate in silence, then suddenly Paula piped up: “Hey! I have an i
dea! Let’s try to let the whole problem with iDoc, Zee’s untimely death, and your radiology future slide for a few hours and just relax and enjoy ourselves. What do you say? We can’t do anything about all this mess tonight.”

  George shrugged. “I’m willing to give it a try. And the wine might help. Actually, I’m surprised I am eating as well as I am. And, Paula, everything is delicious.”

  “Thank you for saying so. And about the wine, I’m happy to say we have plenty.” She refilled both their glasses. Suddenly her face lit up. “David Spitz and Rachel Simmons! Remember them?”

  George certainly did. They were former friends and classmates at Columbia Medical and had dated off and on. George liked them both a lot, but they were always at each other’s throats. “Of course I remember them: the Bickersons!”

  Paula laughed. “Yes! Well, guess what? They’re married!”

  “No way!”

  “Yes! I went to their wedding in San Mateo two months ago.”

  He whistled. “Will wonders never cease? I never saw that one coming.”

  “I don’t think anyone did. Even they didn’t.”

  They chuckled and continued talking about their common experiences with friends and professors and rotations while attending Columbia Medical School. Mostly in retrospect, they had enjoyed the four years of hard but rewarding work.

  “You know,” George said, “there is something I never told you but thought about a lot, even though I gave you some grief on the subject. I always admired the way you were able to deal with both medical school and B-school at the same time. For me, the demands of medical school were more than enough.”

  “Yeah, well, you worked at the blood bank and all the other jobs you held down. I didn’t have to do that. My parents supported me financially.”

  “It was still impressive,” George said. He didn’t want to discuss his financial struggles, which hadn’t improved as much as he had hoped.

  As the evening progressed, they both surprised themselves by relaxing, something neither expected under the circumstances. It was helped by the second bottle of wine, the food, and the environment. As they continued chatting they both were able to let go of the past and even laugh about it. Paula thought that perhaps she was a bit too forward in pursuing George. He countered that he couldn’t even explain to himself what he had seen in Pia Grazdani!