Miracle Cure

by Michael Palmer

  “Crisis,” he said, racing past them and into the on-call room.

  If he was right, the key to unlocking nearly everything was a single sheet of paper in his briefcase. He pulled the battered case from beneath the bed and dumped its contents out on the white cotton spread. For a moment, he thought his memory had failed him, but then he found what he was searching for, caught between the pages of a journal article. It was the letter Nellie Hennessey had given him requesting support for her latest walk for charity—more specifically, the portion of the solicitation that included a list of the previous walks she had done.

  Nellie, tell me something. Exactly how long after you started your treatment with Vasclear did it take for your symptoms to go away?

  How long? Not very, darlin’. I can tell you that much.

  Brian recalled the conversation with Nellie and her daughter, Megan, almost verbatim.

  I remember exactly, Ma. You had your first treatment on August tenth, and your pain was gone the day of my birthday, the twenty-fourth. It was exactly two weeks to the day.

  August 10, two years ago. The day Nellie started treatment. Brian ran his finger down the list. The walk he remembered noticing had been right around that time.

  JULY 27–25-MILE WALK FOR AIDS. 25 MILES

  COMPLETED. $2,600 RAISED.

  Brian stared at the date. Why hadn’t he thought to question it before? Within two weeks of walking twenty-five miles in July heat, Nellie was on the cath table at Boston Heart, being diagnosed with end-stage arteriosclerotic heart disease.

  Other pieces began drifting into place as well. Nellie’s symptoms, as described in her chart, were classic angina. But her own description of the pain was far from typical. Why hadn’t that registered? Her parents both lived into their late eighties or nineties. When was the last cardiac case he had seen who could boast that? Never, that was when.

  Nellie’s phone number was on the solicitation sheet.

  “Hello, Nellie Hennessey here,” she answered.

  “Nellie, it’s Dr. Holbrook calling from the hospital.”

  “Oh, yes, dear. Is everything all right?”

  “Fine. Everything’s fine. I was just looking at the list of walks you gave me, and I realized that you went on a long one just before your heart trouble was diagnosed.”

  “That’s right,” she replied without a hesitation. “Twenty-five miles for AIDS.”

  “Do you remember if you had any chest pain during the walk?”

  “Not really. Not that I remember. But don’t forget, Dr. Holbrook, I never had any real chest pain to begin with. It was all in my shoulder and sort of up into my neck. In fact, by the time I had that positive treadmill test with Dr. Jessup, it seemed like my problem might actually be getting better.”

  That’s because it was never cardiac pain to begin with! Brian wanted to scream.

  “Nellie, you’ve helped me a great deal,” he said instead. “I hope your next walk is a huge success.”

  “It’s not that one you should be cheering for,” she said. “It’s the one after that.”

  “Oh?”

  “December twenty-first I’m doing the annual Boston Christmas walk. The benefit charity changes every year.”

  “And what is it this year?”

  “I’d have thought you would know, dear,” she replied. “It’s Boston Heart Institute.”

  Brian repacked his briefcase and sat for a time absently polishing the revolver with a washcloth. If he was right—and his theory was the only one that fit the facts—seventy-five percent or so of the Phase Two beta Vasclear group didn’t have cardiac disease to begin with. The seventy-five percent that “improved” so dramatically. The pains that brought them to the attention of Carolyn Jessup were bursitis or esophagitis or gastritis or pleurisy, or any of the other myriad masqueraders of cardiac disease. As a cardiologist in private practice, he had seen at least as many patients whose symptoms turned out to be noncardiac in origin as those with bona fide heart disease.

  It would have been easy enough for an EKG machine to be electronically “adjusted” to print out the pattern of coronary artery disease during a stress test. But what about the arteriograms done in the cath lab? Jessup wasn’t the only one watching the monitor screen. There were, at a minimum, two sharp, well-trained nurses and an experienced cath tech, to say nothing of the students, residents, fellows, and private cardiologists who frequented the lab. Among the entire group, they had observed thousands of caths. They would certainly be able to tell if a study was abnormal or not, and to what degree.

  Could a cardiac cath possibly be faked on the spot? Was there any way to alter a patient’s arteriogram at the moment he was having it?

  No, Brian concluded. There was no way, unless … unless the arteriogram being viewed on the monitor screen during the initial cath wasn’t the patient’s at all.

  Brian took a pad of progress-note paper from the drawer of the small writing desk and began composing a letter to Teri, detailing what he believed was going on with Vasclear. Then, after a couple of sentences, he stopped writing and tried one last call to her at home. She answered on the first ring.

  “Hey, it’s me,” he said.

  His relief at hearing her voice instantly lifted the apprehension that had been stifling him.

  “Oh, Brian, I just came in and got your messages. I was about to have you paged. Are you okay? Has your friend Phil shown up?”

  “Not a sign of him. Teri, there’s big trouble here and I believe Vasclear and Newbury Pharmaceuticals are right in the middle of it. When are you coming up?”

  “Not until Saturday morning.”

  “Can you make it up tomorrow?”

  “Brian, I’d love to, but that would be impossible.”

  “Okay. In that case, can you stay by your phone for a while right now?”

  “Of course. But what’s going on?”

  “I think Art Weber and Carolyn Jessup have been forging the results of the Phase Two Vasclear study. I don’t think most of the patients in the beta group ever had heart disease. And I don’t think they’ve been getting Vasclear, either.”

  “That’s impossible. We’ve reviewed the arteriograms and cardiograms. We’ve even interviewed the patients. Do you have any hard evidence at all?”

  “I’m going down to the video library to try and get some right now. I’ll call you as soon as I do.”

  “Okay. I’ll be right here. Just be careful, Brian. Don’t do anything dangerous.”

  Brian slipped the revolver back into his lab coat pocket, hurried to the desk, and told the ward secretary he would be on-page for the next hour. Less cautious than he had been, he ran the six flights down to the cath-lab film library—the only place where he might find tangible proof of his theory.

  Art Weber seemed smugly confident that Brian had been bought—at least until after the ceremony. It stood to reason, then, that Leon and his friends might have been taken off their search-and-destroy status. With any luck, by the time Weber realized his miscalculation, Brian would be somewhere safe with the documentation he needed to blow the lid off a billion-dollar scam.

  The basement was totally deserted and eerily silent. At the far end of the long hallway, past the machine canteen, the lights in the animal facility were off. Determined not to repeat his earlier mistake, Brian remained in the safety of the stairwell and scanned the ceiling and walls of the corridor for cameras. Convinced there were none, he moved to the cath-lab door. It was strange and frightening to think that Leon, and possibly others from Newbury, might be just a few feet directly below him.

  The video library could be reached either through the lab itself, or directly from the hallway. Brian chose the hallway door. Like most of the secured rooms in BHI, the library had a keypad entry system. Brian tapped in his code and quickly slipped inside the totally dark, windowless space. Before turning on the lights, he used the illumination from his penlight to make a careful scan of the walls and ceiling. There were no surveillance cameras
that he could see, but there was a grate—probably air-conditioning—in the center of the ceiling. He quietly climbed on a chair and tried to peer behind it. If there was a camera there, it was too far back to see. He hesitated, then shrugged and flicked on the overhead light. Having gotten this far, he wasn’t about to wait.

  The room was long—twenty-five feet or so—and narrow. The rear two-thirds was occupied by shelves of catheterization videos in individual cardboard containers, the front third by the two Vangard viewers. Brian flipped both of the viewers on and used a log book to obtain Nellie’s film numbers. In all, she had been catheterized four times: pretreatment, then at six months, one year, and two years after the onset of Vasclear therapy.

  Brian had no difficulty finding all four films. He set the pretreatment video in one Vangard and the two-year film—the one on which he had assisted—in the other. Then, slowly, he advanced each film to the first view, the left anterior oblique shot taken immediately following an injection of dye into Nellie’s right coronary artery. When viewed individually, there was nothing unusual about either film. The pretreatment video showed extensive arteriosclerosis throughout the branches of the right coronary. The two-year film, while not completely free of blockages, showed excellent vessels for a woman Nellie’s age.

  It was only when the films were studied carefully, side by side, that the secret became apparent: The arteriograms were not from the same patient. Brian scanned the initial and latest videos, then briefly ran the other two, which were identical to the most recent one. The pretreatment video—the one that had pointed Nellie Hennessey toward the Vasclear study—was bogus. It was a damn close match, chosen by someone who had access to a large number of abnormal cases and knew cardiovascular anatomy well. But the pattern of each person’s cardiac vessels, if mapped out carefully, was unique. And Nellie Hennessey’s pre- and posttreatment patterns were clearly different from each other. Somehow, during the initial study, a video of the catheterization of a diseased patient was fed into the system and projected onto the monitor screen in the cath lab.

  “Remarkable,” Brian whispered. “Absolutely remarkable.”

  He sat there for a time, nearly consumed by a mix of anger and regret. If he was right, he had deprived his father of potentially curative surgery and had put his own recovery on the line in order to treat Jack with nothing more potent than intravenous water. No wonder Carolyn Jessup kept pushing Jack into Laj Randa’s court. She knew all along that the Vasclear being given to the test subjects was useless. Vasclear’s success stories had never had cardiac disease to begin with.

  Brian rewound the films, slipped them back in their boxes, and replaced the six-month and one-year films in their slots. Then, cradling the other two videos in his left hand, he snapped off the viewers, cut the lights, and carefully opened the door to the hallway an inch.

  While not irrefutable, the Hennessey films would definitely be enough evidence to postpone the Vasclear signing and bring Teri, her boss, and their cardiology experts down to the viewing room to look for other instances of fraud. If Brian was right, they would find another 170 or so cases where the pretreatment and posttreatment films had anatomic discrepancies. Art Weber and the other powers at Newbury Pharmaceuticals didn’t know it, but they were on the ropes.

  All was quiet in the corridor. Brian leaned his shoulder against the door and eased it open a bit more. Nothing. All he had to do now was make it to the clinical unit and hide the two films in the on-call room. In the morning, with the crush of staff and visitors, he would have no problem getting them out of the hospital.

  He pushed the door open all the way and stepped into the corridor. The heavy pistol butt cracked down on his left wrist like a jackhammer. Electric pain exploded through his hand, paralyzing his fingers. The video boxes clattered across the tiled floor.

  Clutching at his wrist, Brian stumbled backward and hit the wall, narrowly keeping himself from falling. Standing just a few feet away, leering at him, was an apparition—the thin gunman who had absorbed bludgeonings first in the New York woods, then in Brian’s living room. A grotesque violet bruise now extended from his hairline to the corner of his mouth, puffing his eye and discoloring his cheek and the side of his nose. A swatch of hair had been shaved away, exposing a nasty gash that had been closed with rows of neatly placed stitches.

  The man called out in Russian to someone who was inside the cath lab, covering Brian’s other route of escape. Brian, still trying to shake some feeling into his hand, knew he had only moments to act. In one motion, he thrust his good hand into his lab coat pocket, pointed the pistol in the direction of the gunman, and fired. The bullet caught the Russian squarely in the center of his chest. His eyes widened in terror, pain, and disbelief as he lurched sideways. There was a sudden gush of blood from between his lips, and he was dropping to his knees when the cath-lab door opened.

  Brian, the gun now out of his coat pocket, fired again and again at the doorway. Then he took two steps backward, fired once more as he was turning, and sped off down the hallway.

  A gunshot echoed down the corridor, then another. Concrete chips sprayed from a spot not far from Brian’s face. His lab coat billowing behind him like a cape, he rounded the corner and headed down a long, straight passage toward the main hospital. There were footsteps pounding after him. In seconds, whoever it was would have a clear shot. Reacting instinctively, Brian cut to his right, down a flight of stairs to the subbasement. The unfinished concrete tunnel was deserted. He bolted past the laundry, which was closed for the night with a steel accordion gate. Footsteps were echoing down the stairs behind him, but now, running in sneakers, he thought he might be opening some ground.

  A tunnel marked Power Plant branched to the right off the main corridor. With no idea where he was, Brian raced down it, searching frantically for someplace to hide. What he saw instead was a tall, narrow, unlit staircase going up. At the top, there looked to be darkness enough to conceal him. He would also have the advantage of shooting down at his pursuer if he had to. He took the concrete stairs two at a time, trying to re-create how many shots he had fired and guess at how many bullets the revolver might hold.

  He reached the top of the flight and crouched in the blackness. The stairs ended at a small landing and beyond that, a heavy steel door. Fighting air hunger and an icy tremor that he didn’t seem able to control, he flattened his body tightly against the door. Could he be seen from down below? He didn’t think so, but there was no way to be sure. Of one thing he was certain—he had just shot a man to death. He searched his feelings for any sense of remorse, but he found none. His father was dead because of the remorseless greed of these people—so were Bill Elovitz and Angus MacLanahan. If he had to kill again, he would.

  He sat in the darkness, still pressed back against the steel door. There was no sound from below. Was someone there, waiting? How in the hell had they known where he was? There had to be a camera behind the ceiling grate. No other explanation made sense. One minute passed. Nothing. Brian slipped out of his lab coat and rolled it into a ball beneath him. Dark green scrubs might be harder to spot through the gloom than the white coat. Then, from the hallway, he heard a radio crackle to life and a brief exchange in Russian. Moments later, Leon passed by below him, pistol at the ready, glancing only briefly up the stairs.

  Brian held his breath, reached above him, and grasped the metal bar that might open the door. Slowly, silently, he pushed it. The door gave just a bit. Fresh, damp air wafted toward him. Was it possible the door opened to the outside? He pushed a bit harder. There was a clank of metal as the door popped free of its casing. The sound echoed down the stairs. In an instant, Leon was below him, gun drawn. Brian fired first. The killer backed away, but then reached around the corner and fired wildly up the stairs. The bullet careened off the wall and slammed into the door. Still in a crouch, Brian pushed the door open and fired twice down the stairs. The first was a shot, the second an impotent click.

  Leon stepped out and fired, but B
rian was already outside. A chilly rain was falling. He was in a shallow stairwell in an alley between buildings at the very fringe of the hospital. To his left, the alley appeared to dead-end. To the right, he could hear traffic noises. He dropped the revolver and ran down the pavement in that direction. Chest burning, he splashed across the deserted, rain-slicked street and past a construction site. There was no way he could keep running like this for much longer.

  A shoulder-high row of dense hedge surrounded an apartment building ahead of him and to his right. He summoned all his remaining strength and hurled himself in an awkward roll, attempting to clear the bushes but missing badly. The dripping branches at the top of the hedge tore at him as he crashed through. Soaked and bleeding from a new set of scratches and gashes on his arms and face, he fell heavily to the ground on the other side, gasping for air.

  CHAPTER THIRTY-SIX

  HIS SCRUBS SOAKED THROUGH, BRIAN LAY IN THE RAIN on the sodden ground for another fifteen minutes, peering through the hedges at the hospital two hundred yards away. There was no sign of Leon, but he knew that meant nothing. The Newbury Pharmaceuticals goons would already be mobilized and searching the area for him. Trying to make it back into White Memorial was out of the question. Weber and the powers at BHI would have the hospital’s own security force looking for him, and maybe the Boston police as well.

  By now, some story about the man shot to death in the basement of BHI would have been concocted, and in all likelihood, Brian would be at the center of that tale.

  He pushed himself to his feet and tried to flex some of the achiness from his arms and back. His knee was throbbing from the pounding run through the concrete tunnels. Rain spattered on the shallow gouges on his arms, keeping them from clotting over. At that moment, his beeper went off. The clinical ward was calling him. In addition, he realized he had the code-call beeper for the entire hospital. Luckily, he also had his wallet in the back pocket of his scrub pants.