Pandemic

by Robin Cook

  Jack parked next to Stephen’s car. Stephen and Han were waiting at the base of a walkway, which had a series of steps that led up to the house.

  “It’s a little different than Manhattan,” Stephen said with a chuckle as the group filed upward. “As bucolic as it is, it’s hard to believe it is only about thirty-eight miles as the crow flies to Times Square. Maybe you should think about moving out here. It’s a wonderful lifestyle.”

  Jack didn’t respond, but internally he smiled and joked to himself that these two doctors were sounding like they were members of the chamber of commerce, promoting the area.

  When they arrived at the door there was no need to ring a bell or knock. It was opened by a slight Asian fellow a bit long in the tooth who obviously had been observing their progress as they approached. Stephen gestured for Jack to precede, and the others filed in after him.

  The slender Asian shut the door behind the guests and then informed them that the boss was in the gym and that they should all follow him. As they did so, Jack had an opportunity to gaze around the home. The interior decor was pleasant but of an indeterminate style that, if pressed, Jack would have called nondescript American. Although everything was extraordinarily neat and of apparent high quality, there would have been no way for Jack to guess it was occupied by a billionaire Chinese businessman. The only exception was a large vitrine in the entrance hall filled with an extensive collection of jade objects. Somewhere in the back of his mind, Jack remembered Chinese people valued jade.

  As they walked, Ted whispered to Jack, “The servant’s name is Kang-Dae Ryang. He’s been the boss’s personal assistant for almost forty years. Interestingly enough, he’s a defector from North Korea who swam across the Yalu River in the winter when he was young.”

  “I noticed all three of you have called Dr. Zhao ‘the boss,’” Jack said. “Is that just a figure of speech or something more?”

  Ted laughed. “It’s something more. Bruce Springsteen is Dr. Zhao’s favorite singer. Dr. Zhao loves American culture.”

  It was a rather long walk, as it was a big house. When they arrived, Jack was moderately surprised. He’d heard that they were going to the gym but didn’t take it so literally. But it was a real gym, with every conceivable piece of workout machinery, and was nearly the size of the gym in Jack’s old high school. And any preconceived notions Jack might have entertained before seeing Wei Zhao, he had to trash. With someone who was a reputed academic type, he’d expected a slight individual like pencil-thin Kang-Dae, probably nearsighted with glasses. The moment he saw Wei Zhao, he knew he’d been entertaining a foolish delusion. As the man stood from a weight machine he had been using, he seemed to keep rising. At six-two, Jack was usually as tall as or a bit taller than most people he encountered. Not so with Wei. Jack guessed Wei must have been six-four or even a bit taller. Even more surprising was the man’s build. He had a narrow waist, with broad shoulders and bulging biceps.

  While wiping perspiration off his face with a towel, Wei approached the group. His slight smile made his expression both welcoming and amused. He was wearing a tight-fitting black synthetic fiber V-neck top along with black sweats. He wasn’t as muscular as Warren, but it looked as if he had been at some point in his life. He had straight black hair neatly trimmed and totally devoid of gray. His face was round, with wide cheekbones and small features. His eyes were as black as night and shined with penetrating intensity.

  Stephen did the formal introductions, and Wei bowed during them. Jack bowed back, feeling mildly intimidated. Jack thought of himself as being in reasonably good shape, but here was a man obviously more than ten years his senior who appeared in peak physical condition. On top of that, he was superbly educated, with Ph.D.s in two subjects, not to mention that he’d amassed a literal fortune through his business ventures. In a competitive world it was a hard act to follow. Jack was thankful his self-esteem was reasonably secure despite what was going on at the home front.

  “We owe you a good deal of thanks for your excellent and hard work,” Wei said, echoing what Jack had already been told. “I heard you were remarkably persistent. Way to go!” His voice was almost accent-free and his syntax was unmistakably American.

  “It is the role of the medical examiner to speak for the dead,” Jack said. “For that to have meaning, the dead have to be identified.”

  “My sense is that there was more to your motivation than your job description,” Wei said. “It was difficult for us to bear hearing the news, but necessary. We have to figure out what went wrong so it doesn’t happen again. We are now a certified heart transplant center with plans to become one of the most active in the country. We cannot have mysterious and unexpected deaths. We appreciate your efforts.”

  “As I told the others, it is my job,” Jack said.

  “Humble as well as talented,” Wei said. “You are the type of person we are constantly searching for to become part of the team. Would you be interested?”

  “Thank you, but I’m very happy where I am, careerwise,” Jack said.

  “Who knows?” Wei questioned with a conspiratorial smile. “Maybe we can change your mind. To that end, I would like to invite you to have a bite of an early lunch with me, unless it’s too early for you.”

  “That’s very gracious,” Jack said. “It’s not too early for me and would be my pleasure.” Once again, Jack was taken aback. He’d anticipated a short visit with the billionaire and had been wrestling with what to ask in the limited time he’d have. Now it seemed he’d have more than enough time over lunch.

  “Well, in that case I think we should head on back to the hospital,” Stephen said.

  “I agree,” Ted said.

  Han merely smiled broadly in apparent enthusiastic agreement.

  “If you have any more questions, don’t hesitate to call or stop in,” Ted said, handing one of his business cards over to Jack. Then the three doctors shook hands with Jack in turn, said goodbye, and trooped out of the gym behind Kang-Dae.

  “Here’s my suggestion as your host,” Wei said. “I will send you up to the great room with Kang-Dae as soon as he returns, and he will provide whatever refreshment you would like. Or if you prefer, he could give you a tour of our grounds. It’s up to you. Meanwhile, I will take a quick shower. Does that sound like an acceptable plan?”

  “Sounds like a perfect plan,” Jack said.

  20

  WEDNESDAY, 11:30 A.M.

  Jack’s experience with luncheons was limited. He usually had no time, neither in his current life or in his past life, nor did he particularly like to sit around motionless in the middle of the day. Yet despite his lack of experience, he still thought this present lunch was strikingly unique. He was sitting with a Chinese billionaire catty-corner at a mahogany Chippendale table that sat sixteen, which was positioned in the center of a formal dining room with a huge chandelier. Large windows afforded a pleasant view out over the pond. Only Wei and himself were at the table. Earlier Jack had been introduced to Wei’s wife, Pakpao, but she did not join them. Kang-Dae was in the room but not at the table. He was sitting motionlessly on a side chair near the door.

  Wei had been true to his word when he said he would be taking a quick shower. Jack had no sooner gotten a glass of ice water from Kang-Dae and briefly looked at the framed photographs adorning the wall above the fieldstone fireplace in the great room when Wei reappeared. In contrast to his workout clothes, he was dressed in a dark, well-fitting suit, a white shirt, and a dark tie and looked like the businessman he was reputed to be.

  As soon as Wei had appeared, Jack had to ask about the photos, as they were all of the same individual, Arnold Schwarzenegger. All of them showed Arnold posing with his over-the-top musculature in the many bodybuilding competitions he had won back in the 1970s.

  “He was my idol back when I was a teenager,” Wei had explained. “He’s the one who got me interested in bodybuilding and pr
obably saved my life. It gave me something to live for during a dark time in the midst of the Communist Cultural Revolution, when my parents and I were forced out into the countryside to work the land.”

  Although Jack hadn’t had much time while Wei was showering, it had been enough time for him to again change his modus operandi. Earlier, when he’d thought his interview with Ted and Stephen was about to abruptly end, he’d decided to throw caution to the wind and put all his cards on the table. But now he had decided to reverse course, convinced that the confrontational style of going for broke would rather quickly put him out on the street and thereby end his sanity-saving diversion of investigating the conundrum of Carol Stewart’s death. The fortuitous opportunity to meet the boss and establish a relationship put him in a good position to figure out what was going on from the top down, and his intuition was continuing to tell him loud and clear that something was definitely afoot beyond the possibility of a new pandemic. In Jack’s mind, GeneRx and Dover Valley Hospital were in cahoots about something, and he meant to find out what it was.

  “This is one of my favorite dishes,” Wei said, as a young woman dressed in a traditional Chinese costume held a platter so Jack could help himself. “It’s called Kung Pao chicken. It is a little spicy, but not as spicy as the Sichuan version. We Shanghainese cannot take the heat.” He smiled at his own joke.

  After both men had been served and the young woman departed, Jack was eager to start a conversation, but he held back, uncharacteristically unassertive. He was still a bit intimidated being in Wei Zhao’s presence. Wei had no such hesitation: “Dr. Friedlander and Dr. Markham both mentioned that you were surprised to learn that we had ruled out virus contributing to Carol Stewart’s death.”

  “That’s true,” Jack said. “A virologist at the Public Health Laboratory saw what she thought were virus-induced cytopathic effects on cultured human kidney cells.”

  “It had to have been artifact,” Wei said. “It was one of our worries, too, until we saw there was no virus present with electron microscopy. What we are confident we’ll be finding are some abnormal proteins released by the heart that apparently turned on an immune-inflammatory cascade, ultimately resulting in a cytokine storm. That’s why we wanted a second autopsy, mostly to get samples of the donor heart and of the anastomoses with the large vessels. Something went terribly wrong, and we need to find out what it was. We’ve only been a certified heart transplant center for three months, and we will need to report this fatality, as we were responsible for the patient’s post-operative care.”

  Jack nodded. There was no doubt Wei was clinically knowledgeable even though not trained as a medical doctor. The idea had entered Jack’s mind that Stephen and Ted could be doing something behind the boss’s back that the boss didn’t know about. But that seemed far-fetched with the medical understanding Wei was revealing. Jack was certain that whatever was going on between Dover Valley Hospital and GeneRx, Wei knew about it and was intimately involved.

  “I have ordered an entire team of molecular biologists to look into this case twenty-four/seven until it is solved,” Wei continued. “It’s a challenge. Carol’s sudden death underlines our general ignorance about the complement system and the inflammasome.”

  “It is an area of physiology that needs a lot of study,” Jack said, feeling pressure to respond.

  “After your autopsy, what exactly did you think killed Carol Stewart?” Wei asked.

  “I thought the mechanism of death was a cytokine storm,” Jack said. “We agree on that. But the cause, I’m not sure. Maybe an antigenic protein was involved, but there was no sign of inflammation in the heart. What worries me is the possible involvement of a new, lethal virus, whether associated with the transplant or not. The story of her getting on the subway in Brooklyn asymptomatic and then dying on reaching Manhattan is too much like a repeat nightmare of 1918.”

  “A virus worried us, too,” Wei admitted. “We were relieved when we looked at the electron micrographs and saw no viruses whatsoever.”

  For a few minutes the two men ate in silence while Jack’s mind was in a turmoil. He couldn’t decide what to ask next. He wanted to bring up the matching DNA CODIS profiles but was contemplating how to do it diplomatically. Almost as if reading his mind, Wei did it for him.

  “Dr. Friedlander and Dr. Markham also said that your DNA lab reported that the patient and the donor heart matched. We have extensive DNA sequencing ability. Our preliminary results show them to be close but nowhere near to being identical, so we wouldn’t know what to make of your lab’s results besides recommending they be repeated. But even that is unnecessary. We can send you full genome sequences in the near future for your records, because we are doing both.”

  Jack was about to argue that the tests had already been repeated when he decided to let the matter drop for the time being. He thought it best to talk to Dr. Lynch, head of the DNA laboratory, about the issue when he got back to the OCME. Jack was more interested in building bridges with Wei than in destroying them. He couldn’t help but believe the closeness of the match between the donor heart and the recipient was critical to whatever weird thing was in progress, but pushing the issue could potentially be explosive.

  “How is it you ended up here in New Jersey?” Jack asked, to keep the conversation away from testy subjects. “It is a long way from Shanghai.”

  “You mean here in New Jersey in particular or in the United States?”

  “Both, I guess,” Jack said. He really didn’t care.

  “I am fond of New York for business,” Wei said. “But I needed space. New Jersey gives me access to both, as you can tell from this view from my dining room.”

  “Why the United States?” Jack asked. “My understanding is that you have done very well in China.”

  “I have done well in China, and it continues businesswise,” Wei said. “I have been able to take good advantage of the Chinese economic miracle. But there are limits. Although pharma is expanding in China by replacing local remedies, prices are being controlled. Here in the United States that’s not the case, because your politicians are dependent on pharma campaign donations. There is much more money to be made here in all aspects of healthcare, even if there are more problems with labor.”

  “The unreasonable price of healthcare is a rather sad state of affairs for us Americans,” Jack said, although he didn’t need to be reminded by Wei.

  “And for me there is an even greater motivation,” Wei said. “I’m fearful when I am in China today.”

  With a bit of surprise, Jack sat back and looked at his host, half expecting to see him smile to suggest he was being humorous. But Wei didn’t smile. Instead he stared out the window at the pond, obviously in deep thought.

  “What are you fearful about?” Jack asked. As a known billionaire, Jack would have imagined a life of extraordinary ease for him in China, with as much security and servants as he could possibly need.

  “The government,” Wei said nostalgically. “Things have changed over the last number of years, particularly with Xi Jinping’s love for centralized power, both his own and the Communist Party’s. Everything has become arbitrary for us successful businessmen. One day we are considered the darlings of the Politburo, the next an enemy. Xi has made it possible for businessmen to be snatched out of their offices or homes and declared corrupt at whim with no due process. It’s a terrible way to live. Several of my acquaintances have been arbitrarily jailed without access to lawyers, and no court dates.”

  “That’s no way to live,” Jack agreed.

  Wei went on to tell several of the stories of his friends and the frustration he’d felt about not being able to help them.

  “That is awful,” Jack said, and meant it.

  “I go back to my home in Shanghai as little as possible,” Wei admitted. “Several years ago, I decided to completely pull out of the People’s Republic of China, but the government h
as made moving capital progressively more difficult, particularly of late, with new restrictions by the PBOC, or People’s Bank of China, and the State Administration of Foreign Exchange.”

  “You seem to be doing all right here in New Jersey,” Jack said. “I was very impressed with my tour of GeneRx, the Farm Institute, and what I saw of the hospital. Also, I’d have to add the Zhao Heart Center at MGH in Manhattan. Very impressive and very generous of you.”

  “Thank you,” Wei said. “We are proud of what we have been able to do. But it is not without effort and anxiety. Unfortunately, GeneRx has only two drugs on the market at present, although there are a slew in phase three trials. We need a breakout product or medical activity, of which we have a number in the wings. Presently I am dependent on the PBOC to allow adequate funds to keep everything afloat. But enough about me. What about Dr. Jack Stapleton? How is life for him?”

  Jack straightened up by reflex. Wei’s question took him aback. Although Wei had been talking in surprisingly personal terms, Jack had no inkling he’d ask for a response in kind.

  “I know what your government salary is,” Wei said, before Jack could respond. “You deserve more, a lot more. I’d suggest at least double, and we would be prepared to offer that. We need another pathologist of your stature.”

  “I like my job,” Jack said, amazed that Wei was back to offering him a job, especially after just talking about financial insecurity.

  “You have not had an easy life,” Wei said. “Being forced out of clinical medicine must have been disappointing. And then to have your family killed after coming to visit you while you were retraining in pathology had to have been a life-shattering event. And now with your second child in your second family possibly having autism, I would think significantly raising your income might be a source of comfort. Autism treatment can be very expensive. Private industry pays significantly more than government jobs. It is something for you to consider.”