Natural Causes

by Michael Palmer

  “I must first stress what Dr. Snyder has already brought up,” Rosa began. “The connection, whether significant or not, between the three DIC cases and the ingestion of Sarah’s prenatal supplement is quite firmly established. I should add, however, that my laboratory work and research does not suggest a direct toxic relationship between DIC and the ingestion of any herb. An allergy of some sort to one of the components, or perhaps contamination with a toxin, would be much better bets. But I have serious doubts about either of those possibilities as well. As has also been mentioned, discovery of a labor patient with DIC who has never taken herbal prenatal vitamins would effectively absolve Dr. Baldwin of any responsibility.”

  “What do you make of this Herbal Weight Loss product?” Paris asked.

  “I was hoping you’d be able to help us there, Mr. Paris,” Rosa said. “This Pramod Singh, what can you tell us about him?”

  “Not very much, really. Six years ago, when I came to MCB, I made the decision to incorporate various aspects of what is called holistic medicine into our hospital. I was looking for an identity for MCB—something that would make the public want to come to us.

  “Pramod Singh was a highly respected Ayurvedic physician who heard about what we were trying to do and contacted me. I put him on salary, and he worked in our outpatient department for almost two years. Then he just quit. No notice. Not even a letter of explanation. Just a one-sentence note. The next time I heard about him was when I saw him on one of these dumb programs.

  “I had originally hoped Singh might be part of a larger holistic department at the hospital. But until our McGrath Foundation grant, we’ve been on such thin financial ice that I couldn’t guarantee anything. By the way, as long as I’m on the subject, I hope you’ll all be my guests at the demolition of the Chilton Building the end of the month. It will kick off the largest construction project in MCB history. We’ll be having a champagne reception just before the big bang. I also hope some of you will buy chances in the raffle we’re running to be the one to actually push the button. A once-in-a-lifetime opportunity, if I do say so myself.”

  “Did any of you know Dr. Singh was using this weight loss powder when he was at MCB?” Rosa asked, pointedly ignoring Paris’s bombast. “Well, you might ask around.”

  “Do you really think this product and the DIC cases are connected?” Snyder asked.

  “Remember, Dr. Snyder,” Rosa said. “My stock in trade is probabilities. The more times a connection happens, the more likely it is to be significant. Now, to the many other commonalities I have uncovered among our three cases, we can most probably add the exposure four or five years ago to Dr. Singh and his product. But remember, as Mr. Paris just explained, he purposely established a unique facility where products like Singh’s powder or Sarah’s prenatal supplement might exist. So in the end, our three women’s choosing to be cared for at the Medical Center of Boston may prove to be the most significant commonality of all.”

  “God, that’s all we need!” Paris exclaimed. “Rosa, you’re not planning to speak to the press about this, are you?”

  Rosa smiled at the notion.

  “It was like pulling teeth for Dr. Baldwin just to get me to speak to you at all,” she said. “I’m not inclined to trust any wider audience with my findings, at least not yet.”

  “Okay, everyone,” Matt said. “If there’s no other business, we’ll call it quits and I’ll finish preparing for our first offensive. Arnold, the Ettinger deposition’s going to be taken at eleven at Mallon’s office. You’re welcome to attend.”

  “I just might,” the lawyer responded.

  “Give ’em hell, Daniels,” Paris said.

  One by one the MCB group filed out, until only Matt, Sarah, and Rosa remained.

  “I thought the session went very well, Matt,” Sarah said.

  “Come on. We got almost no place, and you know it.” He paced to the window, his fists clenched in frustration. “Parts of hospital charts missing; Chinese tongs getting paid to frame you and a helpless old man; some nervous, little, stuttering weirdo following you. Somebody, someplace knows what in the hell is going on around here. And I’m getting sick and tired of it not being me.”

  “I might be able to help a little bit,” Rosa said softly.

  “What are you saying?” Matt stopped pacing.

  “There’s something I know that I haven’t spoken about at all. I’ve decided to share it with you two but, for now at least, with no one else. Please don’t speak of this to anyone.”

  Matt glanced over at Sarah.

  “You have our word,” he said.

  “Okay. Lisa Grayson had some sort of DNA virus in her bloodstream at the time she had her crisis. My lab person doesn’t know exactly what it is, but he does know it’s not usual. He wants some more serum from Lisa.”

  “Even though she has no DIC symptoms?” Sarah asked.

  “He’ll take what he can get. If nothing grows, he’ll look for antibodies and see if he can back his way into an identification. He’s very good at what he does. One of the best. But I’m afraid we can’t get to Lisa without going through this attorney of hers.”

  “In that case, maybe we should ask him before we begin to dissect Ettinger,” Matt said.

  “It’s very important,” Rosa said. “I don’t believe either the herbal weight loss powder or Sarah’s vitamins are solely responsible for what’s happened. They may both be playing a role, but an infection of some sort makes more sense. I have a terrible, terrible feeling that unless we get to the bottom of things soon, more women are going to die.”

  Fifty miles to the west, Annalee Ettinger lay on her canopied bed, nestled in the arms of her fiancé, Taylor.

  “Tay,” she said. “It’s happening again. Here, feel right here. I swear I’m having some contractions.”

  CHAPTER 29

  October 11

  THERE WERE NO POLITE INTRODUCTIONS; NO CIVIL shaking of hands. Once the combatants were present and seated at the massive conference table in Jeremy Mallon’s law firm library, once the stenographer had readied her machine and loosened her fingers, the battle simply began. With no judge present, Sarah wondered just how ugly it might get.

  “State your full name please,” Matt said, after dictating the time, date, location, list of those present, and the purpose of the session.

  “Peter David Ettinger.”

  “Your occupation?”

  “I am an anthropologist and a healer.”

  “Your education?”

  “I have a bachelor’s degree from Reed College and a master’s from the University of Michigan, both in anthropology, and both with honors.”

  “On the television ads for your weight loss product, you are often referred to as ‘Doctor.’ Have you a degree at that level?”

  “I hold an honorary doctorate in herbal sciences from the Holbrook College of Chiropractic, and several other honorary doctorates as well.”

  “Do you have a Ph.D.?”

  “No.”

  “An M.D.?”

  “Certainly not.”

  “And what is your current occupation?”

  “I am the executive director of the Xanadu Holistic Health Community and president of the Xanadu Corporation.”

  “And exactly what does the Xanadu Corporation do?”

  “We formulate and distribute the Ayurvedic Herbal Weight Loss System.”

  The key to a successful deposition, Matt had explained to Sarah, was the same as that for a successful courtroom cross-examination—never ask a question to which you do not already know the answer. Unfortunately, he was quick to add, the only significant questions he would be asking Peter Ettinger today were those to which they had no answer.

  Sarah stared down at her hands, folded tightly on the table in front of her. She hoped Peter could not tell how tightly. When she had first returned to Boston, she had actually entertained notions of reestablishing some sort of professional or platonic relationship with the man. Now she could barely st
and to look at him. She had never done anything more virulent than to move her life along in directions that did not include him. No public condemnations; no nasty letters; no tell-all articles; no demands for palimony. Yet here he was, helping to orchestrate a legal case against her that could well put her in professional purgatory, if not in prison.

  “You mentioned you were a healer, Mr. Ettinger—oh, excuse me, do you prefer to be addressed as Mister or Doctor?”

  “Either way. Mister will be fine.”

  “Don’t badger this man, counselor,” Jeremy Mallon warned matter-of-factly. “Either in your words or your tone. You do, and this deposition may be over a lot sooner than you expect.”

  “Mr. Mallon, please don’t threaten me,” Matt countered. It seemed to Sarah he was purposely exaggerating his Mississippi drawl. “You saddled this mule months ago in the shop of a sick old man. Now you and your stable of experts had better be ready to ride it yourselves.”

  In the corner of the room, the stenographer dispassionately whispered into the hooded microphone of a tape recorder at the same time she was tapping out the exchange on her machine. Arnold Hayden, seated to Matt’s right, nodded that Matt’s response was appropriate and necessary. Across from Hayden, Jeremy Mallon’s associate countered by whispering something in Mallon’s ear. Sarah managed a furtive glance across at Peter, but saw only an emotionless mask. Circles within circles within circles. The whole affair would have been incredibly fascinating to her, had not her livelihood and way of life been at stake.

  The morning had begun contentiously an hour before the actual deposition. Mallon flatly refused to allow his client, Lisa Grayson, to have her blood drawn or, in fact, to be contacted by Matt, Sarah, Rosa Suarez, or anyone else who did not clear such contact with him. Matt had kept his cool and had stopped short of indicting the Ayurvedic Herbal Weight Loss System. But it was clear to Sarah that before this session was through, Peter’s remarkable gold mine would come under attack.

  Arnold Hayden had been with them from the outset of the day. Sarah was pleasantly surprised to realize that her initial impression of the man as being far more legal form than substance was way off base. He had a practical and theoretical acumen that Matt clearly found useful, and a calming manner that helped keep her inside her skin. Now, in combat, his presence and bearing seemed to add credibility and force to Matt’s examination.

  There was also the matter of Hayden’s helping out should Matt’s compromised objectivity become manifest in any way. Unwilling to give up either Sarah or her case, Matt had asked for his assistance with that in mind. And although he had not spelled out to Hayden the extent of his and Sarah’s evolving relationship, she suspected the hospital attorney had some idea.

  “Okay, now, Mr. Ettinger,” Matt said, “getting back to the issue at hand. Would you mind telling us your definition of what a healer is?”

  For almost an hour and a half, Matt asked, rephrased, and asked again questions designed more to fill in blanks and set tone than to get at any major legal point. The strategy he, Sarah, and Hayden had agreed upon was to try to get Peter to acknowledge that Sarah’s method of prescribing and dispensing herbs was, in fact, no different from his own. Once made, the point would essentially transform Peter into an expert witness for them. They would then begin to dissect the connection between Ettinger, the Xanadu Ayurvedic Weight Loss System, and Pramod Singh.

  “When I get to that point,” Matt said, “I’m just going to wing it.” He dangled his Egyptian amulet. “I mean, what chance does he have against two thousand years of black magic?”

  At the ninety-minute mark, they took a break, during which Mallon had one of his secretaries serve coffee.

  “Hey, Matt, maybe you should switch cups with Jeremy,” Sarah whispered. “There’s no telling what he might have put in yours.”

  “Nonsense,” Matt drawled. “He’s about as intimidated by me as a hungry mountain lion would be by the Easter bunny. The last thing he’d want to do at this point is to bump me off. I’m too much fun to play with. But right about now I’m going to start tightening the screws on his expert. The measure of how effective I am will be how loudly and how often Mallon objects to my questions. Arnold, do you have any suggestions?”

  “None, really,” Hayden said. “Except that I think it’s time to pin down some things about this Dr. Singh. So far, I’m impressed by the way you’ve handled matters.”

  “Thanks. That’s kind of you to say—especially considering that I haven’t done any damage whatsoever.”

  “What you’ve been throwing are body blows,” the older lawyer replied. “No one really pays much attention to them, but they set up the head shots. You’re doing just fine.” He patted Matt encouragingly on the shoulder as the session resumed.

  “Okay, Mr. Ettinger,” Matt began, “I’d like to spend some time talking about this Ayurvedic Herbal Weight Loss System of yours.”

  “Why?” Mallon asked.

  “You’re the one who brought this man in as an expert,” Matt said. “I’m just trying to document his qualifications.”

  “Peter, I don’t see where this line of questioning is relevant. If you don’t care to answer the questions, I don’t see any reason why you should.”

  “Offhand I can think of two reasons, Mr. Ettinger,” Matt said with calm force. “First of all, if you refuse, I promise you that I’ll be in front of a judge before this day is done, bringing a motion to compel you to answer. And second”—he looked first at Sarah and then at Mallon, before deliberately leveling his gaze again on Peter—“second, I have good reason to believe—hell no, I have proof—that just as Lisa Grayson took Sarah Baldwin’s herbal preparation before her ill-fated delivery, so did she take your Herbal Weight Loss product as well!”

  “But—”

  “I said proof.”

  “Wait!” Mallon snapped. “Peter, hold it. Don’t respond. Mr. Daniels, I don’t intend to bite at that worm. But since what you are alleging is news to me, I would like to speak with Mr. Ettinger in private before we continue.”

  “Take your time,” Matt said.

  Arnold Hayden turned his face away from Mallon and brought his fist up to the side of his jaw. Matt’s timing and delivery had been perfect. His first head shot had landed squarely.

  Sarah watched as her former lover unfolded his reedy six-and-a-half-foot frame. He glanced over at her, his expression pinched and angry. For a moment, it seemed as if he was about to make an obscene gesture.

  Grow up, she mouthed.

  She was gratefully uncertain of his reply.

  “Okay,” Mallon said upon their return. “Not only do I approve of Mr. Ettinger’s answering this line of questions, I encourage it.” His expression was smug, his manner once again self-assured—too self-assured.

  Sarah strained to understand why.

  “Mr. Ettinger, how did you first meet Pramod Singh?” Matt went on.

  “We had done a series of seminars together some years ago when he was on the staff of the Medical Center of Boston. He told me about a set of ancient Ayurvedic dietary rules and herbs that he had been using on his patients for weight loss with remarkable success.”

  “Was Lisa Summer one of those patients?”

  “I don’t know.”

  “Constanza Hidalgo?”

  “I don’t—”

  “Stop, Peter!” Mallon snapped. “Mr. Daniels, stick to the issue and the patient at hand.”

  “Mr. Ettinger, did Pramod Singh want to market his product to the general public?”

  “He did.”

  “With you as the spokesman—the figurehead?”

  “Among other things.”

  “And so you two Ayurvedic entrepreneurs struck up a deal of some sort?”

  “Object to the antagonistic form of the question,” Mallon cut in. “Don’t answer it, Peter.”

  “Mr. Ettinger, exactly what is in this product of yours?”

  “A number of herbs, plants, and roots. Twelve to be exact. Dr. S
ingh obtains them in India and elsewhere in the Far East, and ships them to me. We have a production facility where the naturally occurring substances are combined with a protein powder to form a combination balanced nutritional replacement and appetite suppressant.”

  “But you have no scientific verification of the product’s composition, do you?”

  Ettinger glanced over at Jeremy Mallon. When he turned back to Matt, he was grinning confidently.

  “As a matter of fact,” he said, “unlike Dr. Baldwin’s preparation, we have absolute scientific verification—FDA analysis and approval of the product. I demanded those before ever allowing the Xanadu name to be used, and we insist upon retesting on an ongoing basis.”

  Another head shot. But this time, from the plaintiff’s side of the table. Matt fussed with his notes. Sarah could feel him struggling to maintain composure as he searched carefully for the next question.

  “This production and packaging facility,” he asked finally, “is it out there on the grounds of the Xanadu Community?”

  “It is.”

  “Shipping, too?”

  “In a separate building, but yes. Shipping is done at Xanadu also.”

  “Mr. Ettinger, just how much money are you two raking in off this powder?”

  “Objection!” Mallon cried out. “Peter, don’t answer. Mr. Daniels, the form and content of that question are amateurish—in the baseball terms you might better understand, strictly bush league. Until now I have made a number of allowances for the fact that, aside from a misplaced molar or whatever, this is your first malpractice case. But I draw the line at questions like this.”

  Crimson rushed to Matt’s cheeks. Beneath the table, Sarah patted him gently on the thigh.

  “Easy does it,” she whispered.

  Matt calmed himself with a slow, deep breath. “Mr. Ettinger, go over briefly what happens at this production plant of yours.”

  “It’s quite simple, really,” Ettinger said, as if he were speaking to a third grader. “The raw plants and roots come in, get thoroughly washed, inspected, and sterilized by heat or U.V. light. Next they’re ground or pulverized, proportioned out according to the ancient Ayurvedic menu we’re using, and combined with the commercially prepared protein base. Finally, the mixture is sterilized again and packaged.”