“I agree.”
Christy’s Google Internet search on fibromyalgia and chronic fatigue syndrome brought tens of thousands of hits. She found useful general descriptions of these illnesses and current thinking regarding cause and treatment. Others reported on hundreds of clinical studies, but the approaches were so divergent, that she concluded that physicians, not knowing what to do, would try anything. The support sites ranged from informative and helpful to extraterrestrial, blaming the air we drink, the water we ingest, as well as Republicans, and aliens. The most disturbing sites were those that questioned the legitimacy of these diagnoses, labeling patients as lazy, neurotic, depressed, or worst of all, as drug seekers.
Friends, family, and especially Paul, were supportive at the beginning. Soon, the novelty of the illness, whatever it was, wore off, and she remained alone with its reality.
Paul rose from the sofa. “Let’s go out for pizza tonight.”
“I’m too tired, sweetheart, and I’m not hungry.”
“You can’t stay cooped up in your apartment. We haven’t been out in months. Can’t you try?”
“I can’t. I’m beat.”
Paul reddened with anger.
Christy knew he’d been understanding since she became ill, but she could tell he was running out of patience.
“You’ve given up, Christy. You sit around like a slug.” He paled as the words came out. “Even Dr. McDonald said that for the sake of your body and your psyche, you needed to get out, to do things.”
Why am I not surprised? she thought.
“You think I like being this way, Paul? I remember what our lives were like. Look at me, now. I don’t blame you for being upset, but don’t attack me for an illness that’s not my fault.”
He hugged her. “I’m sorry. I know it’s been difficult. I should be more understanding, more supportive, and yes, less selfish. Your illness had posed a character question for me, and I don’t like the answer. It’s not rational, but I keep thinking that if you’d only get off your ass and do something…”
I’ll never be happy, Christy Cooper thought, as she strolled into the first aisle of Berkeley’s Andronico’s Market on Telegraph Avenue. She watched couples and families shopping together, enjoying each other’s company, and acting as if they didn’t have a care in the world. While Christy suspected this was pure illusion (hell everyone thought that she and Paul were happy) she couldn’t resist the fantasy.
She and Paul had been separated for three months, and the promised adjustment to her single status had yet to occur.
Paul called last night as she watched the evening news. After the perfunctory questions about work, he struck home with the loaded question. “And how are you feeling, Christy?”
“Don’t ask me that question unless you really want to know.”
The phone remained silent, but for his breathing. “I love you, Christy, and I’m worried.”
“Look, Paul, I love you too, but it’s not enough. This thing, whatever it is, is killing me, and it’s destroyed what we had together.”
Aisle one at Andronico’s was a walk through a virtual jungle of fruits and vegetables. The left side of the aisle had every variety of vegetable, while the right was reminiscent of the Farmer’s Market in Los Angeles, where every fruit looked as if it were on steroids. Juicing machines squeezed oranges and grapefruits and the air was ripe with their scents. Christy bought a quart of orange juice, and opted for two dozen beautiful ruby-red grapefruits for eating and squeezing later.
When she returned home, she stored the groceries before bringing out her Sunkist commercial juicer. She squeezed eighteen grapefruits into a ceramic pitcher. She covered the top of the pitcher with plastic wrap and replaced it in her refrigerator. Later that night, before going to bed, she poured a large glass of cold grapefruit juice, enjoying its rich flavor and the tang of the fresh squeezed citrus.
Two days later, she was so weak that she couldn’t get out of bed.
She dialed Paul’s number.
“It’s Christy. Something’s terribly wrong with me,” she said in a whisper. “You must help me…I’m so frightened.”
“I’ll be right over. I’m calling Dr. McDonald to let him know I’m bringing you to Brier Hospital.”
Jim McDonald met them in the ER just before noon.
Christy looked pale, and although she was slow to respond, her answers showed that her mind was intact. She had scaly lesions on her arms and hands, her scalp showed patches of hair loss, and her neurological exam revealed areas of loss of sensitivity to touch and diminution of reflexes.
Jim ordered a blood count, a screening laboratory panel, drug screen of blood and urine, and a brain CT scan. All were normal. Jim asked Jack Byrnes to consult, and afterwards they sat together.
“I don’t know what’s going on,” Jack said. “None of this fits with fibromyalgia or chronic fatigue syndrome and whatever it is, it’s progressive. I’m worried…I hate to worry.”
“Me too,” said Jim. “What do you suggest?”
“If we can’t find something soon, maybe we should consider sending her to UC medical center or Stanford. Maybe they’ve seen this, whatever it is.” Jack paused for a moment. “I do have one suggestion. It’s going to sound odd to you, but we’ve got nothing to lose.”
“What is it?”
“Let’s ask Arnie Roth to come by to see her.”
“Arnie Roth. He’s merely a family practitioner. What can he offer?”
“Arnie’s helped me before with unusual or odd medical problems. Maybe he can help her.”
That afternoon, Jack placed the call. “Arnie, it’s Jack. I’d like you to see a patient for me.”
An internist, and particularly a subspecialist like Jack Byrnes asking for help from a family practitioner was a stop-the-presses moment.
“Come on, Jack. What’s the joke?”
“This is an odd case, Arnie, and you’re an odd fellow. Maybe you can pick up the scent of something.”
“Very funny. When I finish here, I’ll come over.”
Jack held Christy’s chart. “Thanks for coming, Arnie.”
I walked into the ER. The place was a madhouse. The usual disharmonious confusion of scents inundated me at once. I slowed for a moment as I entered as if forcing my way through a heavy aroma curtain. I knew Jim McDonald well and considered him a friend and a colleague, yet he stared at me strangely.
Jack reviewed Christy’s history, the progression of her illness, and the extensive and negative diagnostic testing.
I looked at Jack. He smiled back at me, and I knew why he called.
“I’ll do the best I can,” I said.
When I entered Christy’s room, the strong smell of garlic hit me at once. I turned to Jack. “Have you tested her for arsenic or pesticides?”
Jim stared at me. “What are you talking about?”
“Arsenic’s on the toxicology screen and it’s negative,” said Jack. “Nothing here suggests pesticides.”
I walked to Christy’s bedside. “My name is Arnie Roth. Your doctors asked me to see if I can help.”
“Nice to meet you, Dr. Roth,” she said slowly.
“I understand that you were recently in China. Did you bring back any souvenirs?”
“I bought clothes, several paintings, and some statuary.”
“Anything else?”
“A ceramic pitcher.”
“Tell me about the pitcher.”
“It’s a beautiful piece with an intense floral motif and Chinese characters. I bought it in Guizhou Province in China. I use it to hold my freshly squeezed grapefruit.”
I felt suddenly warm all over and a little dizzy. I turned to Jack and Jim. I tried, but couldn’t control the smile bursting from within. “It’s chronic selenium toxicity.”
Jim stood upright. “Selenium toxicity! Where in the world does that come from?”
I looked at Jack. He smiled and nodded.
“Let’s put it together,” I said. �
�A healthy woman returns from China with an illness that defies our best diagnostic testing and it gets worse before our eyes. You may not detect it, but my nose, which is extraordinarily sensitive these days, recognizes the strong aroma of garlic exuding from her lungs. In the absence of arsenic or pesticides, it must be selenium. It’s leaching out of that ceramic pitcher because the grapefruit juice is so acidic.”
Jack took a deep breath. “I’ll send someone over for the pitcher and we’ll analyze it and the juice.”
Jim turned to me. “What’s this all about? That was amazing.”
“I don’t want to talk about it, Jim. Let’s leave it at this, I’m real sensitive to aromas, and it allows me to help my patients. Please don’t let this get around, Jim. Please.”
“What next, Jack?” Jim asked.
“Let’s confirm the diagnosis, and then I’ll call the poison control center. I don’t think that they have any specific form of treatment except to avoid selenium. I think she’s going to do well when her body rids itself of this toxin.”
Christy felt better within a week. By the sixth week, she was overjoyed to be virtually back to normal.
Christy felt vindicated. She wasn’t neurotic, depressed, or a malingerer, but she was having a difficult time dealing with those who thought she was, or couldn’t stick by her. Was she asking too much—expecting too much of those who professed to care for her? She understood, but could she forgive? Could she forget?
Chapter Fifty-Two
The police ambulance screeched to a halt at Brier Emergency. The EMTs whisked Henry Fischer through the sliding glass doors into the treatment room’s intense fluorescent lights.
“When we got there,” the EMT said, “the detective described Fischer grabbing his chest seconds before he collapsed. His monitor tracings in the ambulance looked like a heart attack to us.”
The EMTs removed the handcuffs as they transferred Henry to the hospital gurney. Afterward, the uniformed officer who’d accompanied them, reached for Henry’s wrists to reapply the cuffs and heard, “Leave them off.”
“And who the hell are you?” the policeman said, turning toward the bulldog-faced Sharon Brickman, the chief of cardiology.
“I’m Dr. Brickman. And I won’t have this man in handcuffs while we’re trying to treat him.”
“I’m sorry, Doctor, but he’s in custody. Policy requires me to keep him cuffed.”
“What’s your name, officer?” Sharon barked.
“Patrolman Kelly.”
“Well, Kelly, first, the man’s unconscious, second, if you get in my way and anything bad happens to my patient, I’m holding you and the Berkeley P.D. legally responsible. Get on the radio and see how well that sits with your bosses.”
Within thirty minutes, Sharon read the EKGs, studied the blood tests, and performed an emergency echocardiogram. Her conclusion: Henry was in the midst of a massive myocardial infarction, a severe heart attack.
Sharon put his chart down. “Does he have any relatives here?”
“His wife just arrived, I’ll bring her in,” said the ER nurse.
Ruth trembled as she entered the room. “How is he, Doctor?”
“He’s having a major heart attack. We need your permission to get him to the cath. lab immediately for an angioplasty.”
“We’re in the middle of a bitter divorce, am I the right person for this?”
“Right or wrong, I don’t give a damn. If we don’t get to him, and soon, the discussion will become academic.”
In spite of all that had happened, Henry was still the father of her children and her bitterness didn’t encompass his death. “Where do I sign?”
The procedure went well. Once inside the blocked coronary artery, Sharon extracted the clot. Then she passed a thin flexible wire through the narrowed segment and opened it up with a balloon catheter. In moments, the signs of heart muscle injury disappeared.
When Henry Fischer awakened in the CCU, he tried to scratch his nose, but found his right wrist handcuffed to the bed rail.
Panicked, he screamed, “Where am I? What am I doing here?”
Henry pulled on the handcuffs, rattling the bed as the nurse entered. “Calm down Mr. Fischer. You’re in Brier Hospital’s coronary care unit.”
“What am I doing here? Why am I handcuffed?”
“My name is Sherrie Blake, and I’m your nurse. You had a heart attack, but you’re doing well. The doctors had to do an emergency angioplasty to open a major vessel to your heart.”
Henry’s head swam. He vaguely remembered the police, the pain in his chest, but nothing more.
He pulled on his right wrist against the cuff. “Take this thing off me.”
“No can do, Mr. Fischer. You’re under arrest and the police insist on the cuffs.”
“Under arrest?”
Sherrie handed Henry the San Francisco Chronicle, folded open to page two, and he read:
Berkeley,
Berkeley Police yesterday raided Horizon Pharmacy suspected of misbranding and adulteration of a cancer treatment drug. Henry Fischer, the president of Horizon, and Brian Shands, his assistant, were charged with a felony for diluting prescriptions for Taxol, an anticancer drug.
District Attorney Kevin Walters said that these men will face additional charges stemming from the alleged dilution of several other medications, including the Pneumovax vaccination for pneumonia.
Henry Fischer has been hospitalized at Brier coronary care unit with a heart attack. Brian Shands remains in custody awaiting arraignment.
“This is crazy,” Henry said. “I want these cuffs off now.”
Sherrie walked to the door and stepped into the hall. She turned to the officer. “The bastard wants the cuffs off.”
The patrolman smiled. “Is that the way you talk about your patients?”
“You know what he did.”
“Alleged, Sherrie. Alleged.” He entered Henry’s room. “I’m Officer Blair. Can I help you, sir?”
“Take these cuffs off.”
“I’m sorry, sir, but I’m not authorized to remove them. The DA has instructed me to give you your Miranda warning, sir. You have the right to remain silent…”
“I want to see my attorney,” Henry said.
Lilly Shands spoke into the intercom’s hand piece as she sat in the booth looking at Brian through the Plexiglas window. He wore an orange jail jumpsuit and hadn’t shaved since they arrested him. “I don’t understand what’s happening, Brian.”
“It’s all a mistake, Lilly. I’ll be out on bail tomorrow.”
“The newspapers and the television have been saying terrible things about what you and Henry did. People stare at me on the street. Tell me what you did.”
“We did what all pharmacists do, what all business people do, we tried to maximize our profits, but only in a completely ethical way.”
“They’re saying that you and Henry were responsible for people dying. That can’t be true.”
“That’s the DA enjoying his fifteen minutes of fame and boosting his prospects for reelection.”
“What’s going to happen to us if you go to jail?”
“I’m not going to jail, and anyway, I’ve provided for your needs.”
“I’m frightened.”
“Bring me my gray pin-striped suit. I’ll need it in the next few days when they release me.”
She paused a moment and looked into Brian’s eyes. “When you get out, I want us to go to a marriage counselor. Things haven’t been right between us for at least a year. I can feel it. I know you’re drifting away.” She held her face and cried.
Oh Christ! Brian thought. On top of everything, I have her too. She’s such a pain in the ass.
“Whatever you want,” Brian said with a thin smile limited to his lips.
Henry Fischer remained in the hospital for nine days then they transferred him to jail.
Two days later, Henry Fischer and Brian Shands stood before Judge Horace Miller for arraignment. Sylvia Collins, Horizo
n’s business attorney, asked for their release on their own recognizance.
Kevin Walters, the DA, stood. “These are men of means, your honor, and they face serious charges and long sentences if convicted. I request five million dollars each for bail, and that they surrender their passports.”
“That’s ridiculous, your honor,” Collins said. “These men are pillars of the community. They have deep roots in Berkeley, and pose no flight risk.”
Judge Miller looked sideways at the defendants. “Three million each, and the defendants are to surrender their passports.”
“You’re not looking well, Henry,” Brian said as they left the courthouse and walked into the nearby park. In a remote area, away from the crowds, they stopped and sat on a stone bench.
“You wouldn’t look so great either, if you’d just had a heart attack, not that you give a shit.”
“Give me a break, Henry. We were never friends. This was a business arrangement. We used each other, nothing more.”
“You really fucked up both of our lives. I told you we should stop. I begged you after Ruth threw me out, but you were too greedy, too sure of yourself. You wouldn’t listen.”
Brian smiled. “With your heart, Henry, I wouldn’t get too excited. You’re a fool. When I finish ratting you out, they’ll be more than happy to make a deal with me.”
“I’m a fool? You’re living in a dream world. Deals, ratting me out…that ain’t gonna happen. They have us cold, I know it, and if you’d take a minute to think about it, you’d know it, too. You did everything, diluting the drugs, substituting the medication, and falsifying the labels. Your hands are all over this thing.”
“I won’t walk, but when I tell them that you were the mastermind, that you threatened and coerced me, and they look at the bucks that you made, they’ll believe me and will make a deal to get at you.”
Henry stood and studied Brian, and with a sardonic smile. “Too many people knew what you were doing, Brian. I knew, Tino Ruiz knew about the long hours in the clean room and the labels, and your own meticulous records of drug purchases and drug billings. The discrepancies are damning. I don’t think Monica can help us.”
The Sixth Sense (Brier Hospital Series Book 3) Page 23
