Flawless

by Joshua Spanogle

I realize that I am not the most politic when it comes to dealing with people, that my savoir faire leaves a lot to be desired. But I’m an angel when compared to Ravinder Singh. While my evaluations at CDC always suggested the need for improvement in professional relations, Ravi’s, I believe, implored him to learn the definition of the phrase. The man was insane.

  “Bull. Bull, man,” Ravi said in a harsh whisper. “What was your wife doing?” Two nurses down the hall stared.

  “I don’t know anything. I am not a doctor.”

  Let’s fill in that bright line between Dr. Singh and myself. I can be pretty compelling when I need to be; I’m a pain in people’s asses, I can twist an arm or two when needed. But in an investigation, Ravi is a cluster bomb. When he was in Benin doing his meningitis work, rumor had it he’d come across a corrupt headmaster at a boys’ school there. The man denied any outbreaks at the school, unless, of course, a donation was made to the school’s “scholarship fund”—in which case he might be able to give the ballistic CDC investigator access to the boys. Ravi, who’d contracted malaria a few days earlier, was in no mood to haggle. He grabbed the guy by the shirt, dragged him over his desk, slapped him two or three times across the face, broke his glasses, then asked the questions again. This time, the headmaster seemed able to produce information, and Ravi ended up making a small donation to the Headmaster Spectacles Replacement Fund.

  Thank God, I thought, we’re not in Benin.

  “Hey. Don’t say that to me again, because I know it’s not true,” Ravi said. Just so you know, this—this browbeating—is not the approach you would take with ninety-nine percent of people you interview on an investigation. But for some reason we didn’t know, the Lums were lying low. They would not complain to Ravi’s superiors and we all knew it. “Let’s go through it all again,” he insisted. “Does she use any cosmetic products? Creams, soaps, astringents—”

  “I already told you, no.”

  “Bull. All women use that stuff. Has she had any exposure to chemicals? Arsenic? Polyvinyl chloride? Something called TCDD?” These were some of the chemicals known to cause soft tissue tumors.

  “No.”

  “Did she get any procedures done in Hong Kong?”

  “Procedures? No.”

  “Bull. Did she do anything out of the ordinary in the last year?”

  “No.”

  “Bullshit. Bullshit. Bullshit.”

  “Ravi—” I said.

  “What?”

  “—Lay off.” I could tell this was going nowhere. Ravi, in the thick of battle, could not. “Mr. Lum doesn’t want to talk, it’s his right.”

  “It’s not his right, Doctor.” Ravi shot a look at me like he wanted to kill. For his part, Lum looked relieved that someone was getting this lunatic off his back.

  “As long as this is a side project for you, it is. Mr. Lum would tell us if he knew anything that would help his wife.”

  A look of total misery crumpled Lum’s face. “I want to help my wife,” he insisted, then he turned away from us, toward her room. I made space for him to pass. He did, shuffling as if he’d been beaten, sliding his hand along the wall for support.

  After Lum was gone, I turned back to Ravi. “We going to be able to work together, Dr. Singh?”

  “If you let me do my job.”

  “Which is not this. Your boss know you’re here today?”

  He didn’t answer.

  “This is my deal, bud,” I said. “Not because I want it to be, but as you said, nobody will officially touch this with what we have now. San Francisco doesn’t see anything here. The state won’t give a damn about this until another half-dozen cases pop up.”

  “I run my own show.”

  “Of course you don’t. You got some wiggle room, but you don’t run your own show. I’m the only one who runs his own show.”

  “And you have no cred. Not now. Not a shred of it.”

  “I didn’t say it was perfect.” I thought for a moment, trying to see all the angles—me, Ravi, California and San Francisco public health departments. “You be careful with Monica. Don’t let her get sucked into this any more than she already is. It could get very dicey.”

  “Monica’s a big girl. She wants to be involved.” He paused. “And she likes skin. Fuck it—I got a meeting.” He stalked down the hall past me, then stopped. He turned. “They said you didn’t play too well with others.”

  “Funny. They said the same thing about you.”

  He grinned. “This is going to be a blast, McCormick.”

  Weird thing is, I think he meant it.

  50

  ON THE WAY OUT OF the hospital, I turned the conversation with Mrs. Lum over in my head. One thing kept bubbling to the surface. A gestalt. A feeling. It was the same vibe I got down in Milpitas from Mr. Yang, with his dead wife, his knife, and his huddling kids. These people were terrified.

  So your wife is bleeding out and you go to the hospital. You didn’t go sooner, because you were scared of something. But if you’re so scared, why hang around for the consultations with plastics, derm, oncology? Why not bolt as soon as your wife is stabilized? Despite the new laws protecting admitted patients from prying eyes, it wouldn’t have been difficult for a motivated party to find out where the Lums were camping out. There were better places to get lost than at the General.

  So why didn’t they leave? Why did they think the General would be safe?

  Because they wanted to have their cake and eat it, too.

  I stopped abruptly, and a man on crutches stumbled into me. I threw an apology over my shoulder as I ran.

  “Where’s the billing department?” I asked at the information desk.

  The elderly lady there dutifully pulled out a map, searched on it for what seemed like two weeks. “Don’t get that question much,” she explained, before reaching for the phone.

  Information received, she directed me to the fourth floor of a building located in front of the main hospital.

  A hospital’s billing department has got to be one of the most depressing places on the planet. First off, there’s the environment—all drab cubicles and computers and buzzing fluorescent lights. More depressing is that the billing department is ground zero for many of the problems facing health care at the moment. Listen carefully, and you can almost hear the foundations of the system groan.

  I stopped at the desk, hit a tiny bell, and looked out over the stockyard of billing personnel. I imagined the conversations with Medicare or Medi-Cal or some private insurer, the battles just to get thirty cents on the dollar. I played out the calls to collection agencies who were set loose on some poor soul who got way in over his financial head with his chemo treatment. This office doled out misery, it received misery. Underneath it all is the vague feeling—screw “vague,” the acute feeling—that this just cannot go on any longer. And yet it goes on.

  An overweight woman with a pretty face answered the bell. I gave her the spiel, and she called a Mr. Diggs to assist me. Diggs was a skinny black man with a big smile and bigger glasses. Surprisingly, neither Diggs nor the receptionist looked miserable. I made a mental note to test the water here after I was finished with this mess.

  Diggs asked how he could help.

  Here goes, I thought. “I need access to the billing records of a patient.” Then I gave him the whole CDC line, flashed the old ID. I prayed he wouldn’t see the need to double-check with my nonexistent superiors.

  Diggs really was in a good mood that day—perhaps Medicare had just increased reimbursement—and didn’t hassle me. Instead, he led me through the warren of cubicles to his desk. “We don’t see CDC much,” he confided.

  Neither do I, I thought.

  “In fact, I don’t think we ever see them. Something going on?”

  “Unfortunately, I can’t discuss.”

  “Sure, I know. Just asking. Patient name?”

  “Beatrice Lum.”

  He batted a few keys on his computer. “Asian, huh? Avian flu stuff?”

/>   “No, thank God.”

  “Good. You guys know what’s happening with it?”

  “I don’t. Different division.”

  “Should I be stockpiling Tamiflu?”

  “Is this the record?” I asked, avoiding his question. I mean, this guy didn’t listen. Different division, Mr. Diggs. As in a division that’s not affiliated with flu, CDC, or any organ of government, federal, state, or local. Still, I had sympathy for the man. There’s a lot to be worried about these days and not a lot of answers.

  “This is it,” he announced.

  I scanned the screen. Surgical fees, payment for the anesthesiologist, hospital fees, other sundries. This bill came to over forty thousand dollars.

  “That’s weird,” Diggs said.

  “What?”

  He pointed to the bottom of the screen: the word “Paid” was there, with today’s date. “Hold on a second.” He tapped more keys. “Looks like this woman is paying for services just as soon as they’re done. Cashier’s check. I mean, I like to see this. But…”—he rubbed at his face, baffled—“no one does that.”

  “Check the patient’s address.”

  Diggs went to the patient record, found the address.

  “Can you get on the Internet here?”

  “Sure.”

  “Let’s double-check the address online.”

  Diggs cut and pasted the address into Google. “Weird,” he repeated. “That address doesn’t exist.”

  “Weird,” I agreed, already backing away from Diggs and his computer. Because now I knew that the patient didn’t exist either.

  51

  I RAN—DOWN THREE FLIGHTS in Building 20, across to the main hospital, up another four flights. By the time I arrived on the fifth floor, I was out of breath and disoriented by the hospital’s layout. I collared a group of physicians and asked for 4D, the surgical ward. They told me. I ran.

  I burst into Beatrice Lum’s room. The curtain was drawn around Beatrice Lum, and I ripped it back.

  The bed was empty. Two IVs dangled and dripped onto the floor.

  I slid the curtain to the wall, for the first time looking at the patient in the window-side bed. She was elderly, dark-skinned, and shocked by my sudden appearance. “Did you see these people leave?” I asked her. “Did you hear them say anything?”

  No trace of comprehension on her face. The name on the whiteboard near the entrance to the room read “Martinez.”

  “Estas personas están saliendo? Estas…es la…” I might as well have been speaking Farsi. Damn my laziness in Spanish class.

  I ducked back into the hall, grabbed a nurse. “You have 15-2?”

  She nodded.

  “Where’s the patient?”

  “She’s in the room.”

  “She’s not.”

  The nurse walked quickly to the room, stuck in her head. “Maybe they went for a walk. She’s ambulatory and we’ve been trying to get her out of bed.”

  “Her belongings are gone. Call Security.”

  “I’m sure they just went for a—”

  “Without her IVs? Call Security!”

  The nurse glowered at me, set down the pitcher of water she was carrying, and headed for the ward clerk. A minute later, I heard a broadcast over the PA system. “Patient Beatrice Lum, please contact Security. Patient Beatrice Lum…”

  52

  SO, THE LUMS WERE SO tweaked they did not want anyone to know they were at the hospital. They paid in cashier’s checks to preserve anonymity. That worked—until Ravi’s scorched-earth tactics and my probing of Mrs. Lum pushed them too far.

  They were gone.

  And what was scaring them was scaring me.

  As I raced to my car, I kept checking over my shoulder to see if anyone was following me. The tall man in the oversized T-shirt? No. The burly guy in construction clothes? No. The delivery man? The gardener? The short one, the fat one? No, no, no.

  The Asian guy with the tweed vest? Maybe. The Asian guy strolling along, talking on a cell phone? Maybe.

  My guts were twisted by the hangover, the smoothie, a mounting paranoia, and the suspicion that I was becoming a racist fuck.

  I tried to peer into the dark black water that seemed to be engulfing me and those I came in contact with. Daniel Zhang, the Lums, the Yangs, the Murphys…

  Murph.

  A few hours, I thought. A few hours more of Paul Murphy living and breathing on this planet and telling me what had disfigured these people. A few more hours in which I could have told him to bundle up his kids, flee to a place far from here. But I’d screwed up and come too late. Murph was dead and his wife and kids were dead. Now other people were dead and dying.

  I got into the car, pulled out my phone, and dialed Ravi. “The Lums bolted,” I told him.

  “What are you talking about? They checked out?”

  “No. They left AMA—” Against Medical Advice. “Yanked out the IVs and split.”

  “We’ll track them down at home,” he said.

  “We won’t. They gave a false name and address.”

  “Check Billing.”

  “Already did. They paid with a cashier’s check.”

  “Un-be-freaking-lievable. Damn it. Damn it.” There was a pause. “Don’t say it, McCormick.”

  “What?”

  “Don’t say ‘I told you so.’”

  “Much as I’d like to blame you for everything, Ravi, I think you only accelerated things. It was only a matter of time before they left.”

  “Why?”

  “Because they’re scared stiff about being found by someone, and it’s not us. And they’re more terrified of them than they are of a bunch of tumors.”

  53

  SO WE DIDN’T KNOW WHO and we didn’t know the details of where, but we did know what—aggressive, weird fibrosarcoma. But a few cases had not and would not get public health into an uproar. For the time being, any queries had to be on the underneath. Which meant I had to call in more favors.

  I dialed a number in Atlanta.

  “Millicent Bao.”

  “Millie, it’s Nathaniel McCormick.”

  “Oh, my goodness. Nate. Where are you?”

  “California.”

  “Wow. Still there. So you’re actually making it work with Brooke?” She sounded skeptical.

  “Working at making it, more like. How’s the brood?”

  “More chaotic than the Middle East. Clive just turned one, and our eldest, the potty mouth, is trying to make sure his first word isn’t ‘mommy.’ Ellen’s started to become materialistic already, and…”

  Millicent Bao was researcher in the National Center for HIV, STD, and TB Prevention at CDC. She’d spent her early years doing fieldwork in China, where the blond-haired, blue-eyed girl from West Texas met a dark-haired, dark-eyed Chinese grad student named Li-ming Bao. Love, marriage, five kids. I met Millie through Li-ming, who did epidemiology work in Africa, which was part of my CDC beat. In that last year, when I wasn’t on a plane to visit Brooke, they took me in. You got five kids, what’s one more, right?

  Most important today, though, were Millicent Bao’s very deep contacts in China.

  “I need a favor,” I said.

  “How big?”

  “Moderate.”

  “A one or two nights’ babysitting favor?”

  “I’m on the West Coast, Millie.”

  “But you’ll be back.”

  “You hear what I’m asking, then you decide.”

  “Watch out,” she warned. “I’m sensing no matter what it is, we’ll want a week.”

  “I need you to check with Hong Kong public health, find out whether they’ve had a spike in cases of dermatofibrosarcoma protuberans.”

  “Uh, say again.”

  “Dermatofibrosarcoma protuberans. Soft tissue tumor. Rare.”

  “You doing cancer now?”

  “Not really.”

  “Can I ask what this is for?”

  “You can ask, but…Well, let’s just say I do
n’t think CDC is going to be interested in this yet. And don’t let anyone know the request came from me. Definitely don’t say anything to the ex-boss.”

  “All right. And what do I tell Hong Kong?”

  “I don’t know. Act like you don’t speak the language that well.”

  “They speak English in Hong Kong, Nate.”

  “Tell them you only speak Laotian. Just tell them we have a low suspicion there’s a cluster there, but we want to make sure. We can bump it to the next level if need be. Right now, though, we don’t want anyone to think we’re crying wolf.”

  She laughed. “‘We.’ No ‘we’ about it, pumpkin. You don’t work here anymore, remember?” Her tone became serious. “Nate—is this something we should be worried about?”

  “Not yet. Let me do the worrying for now.”

  “Two nights,” she bartered. “Consecutive. On a weekend.”

  “You trust me that much?”

  “No. But I haven’t seen a movie in the theater for a year.”

  I gave Millie my cell number and disconnected.

  So, the what was answered, progress was being made on the where. It was time to do something about the who.

  54

  “GANG TASK FORCE,” THE FEMALE voice said.

  I’d spent a few seconds deciding whether to call the number for General Works or the Gang Task Force. But it wasn’t really a decision: Asian victim, Asian thugs. The scale tipped toward the GTF.

  I read the receptionist the case number from the follow-up report the officer had given me after Daniel Zhang’s assault.

  “Just a moment,” the receptionist said, and began to hum. “That case is assigned to Inspector Tang. I’ll connect you.”

  Click, click. Ring, ring.

  “Jack Tang,” a voice said.

  I introduced myself, mentioned that I was calling about the assault of Daniel Zhang the night before. Tang asked me to hold on. I could hear shuffling around the telephone, then the voice in my ear. “Who are you again?”

  I told him.

  “Right,” he said. “The witness. Your friend never returned my follow-up calls.”

  “I’m not surprised.”

  “He didn’t want EMS. Or to go to the hospital.”