Foreign Body

by Robin Cook

  Then, to make matters worse, her driver had been late, something she was going to learn was an Indian tradition, forcing her to cool her heels in the hotel’s lobby. Fearful that sitting down would cause her to fall asleep, she used the time to inquire about Mrs. Benfatti and whether the woman was staying at the same hotel, which it turned out she was. Jennifer hadn’t necessarily decided to call the woman but wanted to know just the same in case she decided to do so.

  Jennifer found the two towering, traditionally costumed, turbaned doormen as imperturbable as the hospital building itself. Each offered a traditional palms-pressed Indian-style greeting before pulling open his respective door, neither spoke nor changed his neutral expression.

  The interior of the hospital was markedly over-air-conditioned, as if trying to proclaim the hospital’s luxuriousness by itself, and as modern and rich-looking as the outside. The floors were marble, the walls a highly finished light-colored hardwood, and the furniture a combination of sleek stainless steel and velvet. To the left was a smart coffee shop that could have been in a five-star Western-style hotel.

  Unsure of what exactly to do, Jennifer approached the information counter, which looked more like the front desk of a Ritz-Carlton or a Four Seasons than a hospital, especially with the attractive young women dressed in impressive saris, not pink volunteer smocks. One of them had noticed Jennifer’s entrance and, as Jennifer approached, graciously asked if she could be of assistance. Knowing how the harried employees and volunteers of American hospitals acted, Jennifer was already impressed with the institution’s consumer orientation.

  The second Jennifer said her name, the receptionist told her that Mrs. Kashmira Varini was expecting her, and that she would let the case manager know that Jennifer had arrived. While the receptionist made the call, Jennifer took in more of the lobby. There was even a cute bookstore and gift shop.

  Within moments, Mrs. Varini appeared at the door leading into one of several offices located behind the information counter. She was dressed in a particularly eye-catching sari of exceptional fabric. Jennifer sized her up as she approached. She was slim and somewhat shorter than Jennifer’s five-six-and-a-half, although not markedly so. Her hair and eyes were all significantly darker than Jennifer’s, and she wore her hair up and clasped tightly at the back of her head with a piece of silver jewelry. Although her facial features were generally pleasant, her lips were narrow and would have appeared hard had she not been sporting a beatific smile that Jennifer would later discover to be false. Reaching Jennifer, Kashmira used the typical Indian greeting. “Namasté,” she said.

  Although Jennifer felt self-conscious, she returned the greeting.

  Kashmira then embarked on the usual socially acceptable questions concerning the trip and how Jennifer liked her room and the hotel, and whether the transportation had been acceptable. Even after such a quick exchange, the smile had essentially disappeared except for a few short, subsequent de rigueur bursts at appropriate junctures.

  At that point Kashmira became extremely serious as she conveyed the sympathies of herself, the doctors, and, indeed, the whole hospital staff for Jennifer’s grandmother’s passing. “It was a totally unexpected tragic event,” she added.

  “That it was,” Jennifer said, eyeing the woman and experiencing a reburst of the anger she’d felt that morning about the whole affair, not only losing the person closest to her in all the world but also having been dragged away from possibly one of the most important rotations in her entire medical-school career. She knew her pain-in-the-ass father was probably as guilty as anyone for the current situation, but at the moment she leveled it all at Queen Victoria Hospital in general and Kashmira Varini in particular, especially since Jennifer’s immediate impression was that she was conveying less-than-sincere sympathy to boot.

  “Tell me,” Kashmira said, totally unaware of Jennifer’s sleep-deprived state of mind, “where should we go to get the unpleasant arrangements business out of the way? We can either go into the coffee shop or into my private office. It’s totally your decision.”

  Taking her time, Jennifer looked beyond the information counter at the open door where Kashmira had emerged and then, turning in the opposite direction, glanced into the glass-fronted coffee shop. What made the choice was concern that if she didn’t have another cup of coffee, she might fall asleep. When Jennifer communicated her verdict to Kashmira, the case manager acted quite pleased, which was the cause of one of her brief smiles, since it suggested Jennifer would prove easy to manipulate.

  Jennifer did get coffee, though it failed to have much of an impact, and she soon decided it was imperative she get back to the hotel for a nap. As a further explanation of how bad she was feeling, a quick computation told her that had she still been in L.A., she would be soon settling in for the night.

  “Mrs. Varini,” Jennifer said, interrupting her host, who was describing the hospital’s lack of mortuary facilities. “I’m very sorry, but I’m finding it hard to concentrate due to lack of sleep, and I’m certainly less capable than normal to make any significant decisions. I’m afraid I’m going to have to return to my room for a few hours of rest.”

  “If it’s anyone’s fault, it is mine,” Kashmira said, not particularly convincingly. “I shouldn’t have scheduled things so tightly. But we can make this short. We really only need a simple decision from you, and we can do the rest. We just need to know if you intend to embalm or cremate. Just tell us! We’ll make it happen.”

  Jennifer rubbed her eyes and audibly sighed. “I could have done that from L.A.”

  “Yes, you could have,” Kashmira agreed.

  Jennifer opened her eyes, blinking enough to get the foreign body sensation to disappear, then regarded the expectant Mrs. Varini. “Okay, I need to see my grandmother. That’s why I came.”

  “Are you certain?”

  “Of course I’m certain!” Jennifer snapped before she could control herself. She hadn’t meant to be quite so demonstrable. “She’s here, isn’t she?”

  “She is here for sure. I just wasn’t certain you’d want to see her. It’s been since Monday evening.”

  “She’s been in a cooler, hasn’t she?”

  “Yes certainly. I just thought maybe a young girl like yourself would not want—”

  “I’m twenty-six and a fourth-year medical student,” Jennifer interjected irritably. “I don’t think you have to worry about my sensibilities.”

  “Very well,” Kashmira said. “As soon as you finish your coffee, we’ll have you see your grandmother.”

  “I’ve had enough coffee. I’m starting to get jittery.” Jennifer pushed her half-filled cup and saucer back from the edge of the table and stood up. While Kashmira did the same, Jennifer paused for a moment to let a touch of dizziness pass.

  Using one of the silent, ultramodern elevators, they descended a floor to the basement level, where there were mechanical rooms, a modern staff cafeteria, a staff locker room, and various and sundry storerooms. Down the central corridor and past the cafeteria was a freight dock. A single elderly guard in an oversized uniform sat in a straight-backed chair tipped against the wall.

  There were two coolers, both sited on the elevator side from the cafeteria. Without comment, Kashmira led Jennifer to the nearer one and struggled to open it. Jennifer lent a hand. It certainly wasn’t a mortuary cooler, as Kashmira had admitted. The interior was filled with shelving that ran from the floor to the ceiling along the cooler’s forty-foot length. A quick glance from Jennifer told her that it contained mostly sealed foodstuff but also some sealed medical supplies that needed refrigeration. In the center was a hospital gurney whose occupant was completely covered with a clean hospital sheet. The cooler’s smell was mildly cloying.

  “There’s not a lot of space,” Kashmira said. “Perhaps you’d like to go in yourself.”

  Without a word, Jennifer stepped inside. The temperature felt adequate at somewhere near freezing. Now that Jennifer was actually in her grandmother’s p
resence, she wasn’t so confident she actually wanted to look at her. Despite the suggestion to the contrary, Jennifer, the medical student, had never gotten accustomed to looking at dead bodies, even after she had the chance to spend a week observing in a morgue in middle school. She glanced back at the case manager, who caught Jennifer’s eyes and wrinkled her brow as if to say, Well? Are you going to look or what?

  Realizing she could not delay any longer, Jennifer grabbed the edge of the sheet and, fighting back tears, pulled the cloth up to expose her grandmother’s face. At first the shock was that she looked so normal. She appeared to be the warm, generous, white-haired grandmother and the always-sympathetic and in-your-corner-no-matter-what stalwart that Jennifer had known. But then when Jennifer looked more closely, it wasn’t fluorescent light that made her skin and lips the color of alabaster except along the side of her neck where there was dark purple lividity. Her color was truly a lifeless, translucent, blotchy, peachlike tan, and she was without a doubt dead.

  In keeping with her fragile emotions, Jennifer’s sadness switched back to anger. She let the sheet drop and looked back at Kashmira Varini, and the woman’s false sympathy irritated her further. Jennifer walked out of the cooler and watched Kashmira struggle to close the heavy door. Jennifer didn’t offer to help.

  “There!” Kashmira said, standing up straight and wiping her hands after the door had clicked shut. “You can see why you need to come to a decision for your loved one. She can’t stay here any longer.”

  “Is there a death certificate?” Jennifer asked, seemingly out of the blue but more because Mr. Benfatti’s fate suddenly reoccurred to her.

  “Most definitely. There would have to be a death certificate if either cremation or embalming were being considered. The death certificate was signed by Mrs. Maria Hernandez’s primary surgeon.”

  “And the cause of death was definitely a heart attack?”

  “It was!”

  “What caused the heart attack?”

  For several seconds, Kashmira stared back at Jennifer. Jennifer couldn’t tell if the woman was shocked, irritated, or simply frustrated by Jennifer’s question or by what might appear to her as Jennifer’s foot-dragging regarding the body deposition.

  “I don’t know what caused your grandmother’s heart attack. I’m not a doctor.”

  “I’m about to become a doctor, and I can’t imagine either what could have caused her to have a heart attack. Her heart was literally and figuratively one of her best features in lots of ways. What about an autopsy? Did anyone think of that? I mean, if the doctors don’t know what happened to their patient, they usually want to know, and that’s a good indication for an autopsy.”

  Kashmira was surprised at such a suggestion, but so was Jennifer. Up until the moment Jennifer had said it, she’d not considered an autopsy, nor did she even know she wanted one. She’d said it more for Kashmira’s sake, and probably because Kashmira and maybe even the hospital were trying to bully her into making a decision. Autopsy, cremation, and even embalming were violent events, and Jennifer hated to think she was somehow responsible, no matter how irrational such a feeling was. But there was also a new thought as well: How similar was Herbert Benfatti’s death to Maria’s, and could both have been prevented?

  “The police or a magistrate are the only people in India that can ask for an autopsy, not the doctor.”

  “You’re joking.”

  “I’m certainly not joking.”

  “That’s like asking for collusion between the police and the magistrates, if you ask me. What about learning something from my grandmother’s passing, something that could keep another, future patient alive? I mean, after all, you had a pretty similar death again last night. If they knew what had caused my grandmother’s heart attack, could Mr. Benfatti’s heart attack possibly have been prevented and the man saved?”

  “I don’t know anything about a Mr. Benfatti,” Kashmira responded, almost too quickly. “What I know is that we have a body in this cooler, which has been in there too long and has to be removed. Our experience is that families claim bodies immediately, so we have to reach a resolution now. As you can plainly see, the body cannot stay in here. It’s simply not meant for bodies, and the body has been in here since Monday night.”

  “That is your problem,” Jennifer said. “I’m shocked your hospital doesn’t have better mortuary facilities. I just got here to India after flying for almost twenty-four hours, and I’m just learning the details. My difficulty is that I’m mentally and physically exhausted. I’m going to go back to my hotel and sleep for a few hours before I make my decision. I’m also going to visit my embassy and talk to them about logistics. I know you feel confident what they are going to say, but I don’t, and I like to hear such things from the horse’s mouth.”

  “The horse’s mouth?” Kashmira questioned.

  “It’s an expression. It means directly from the person or persons involved. I’m going to take a nap, visit the American embassy if I can, and then I’ll come back.”

  “That’s too late. A decision has to be made now.”

  “Listen, Ms. Varini, to be honest, I’m getting a bad feeling here like I’m being pushed too hard. And now with this second death last night, which seems a wee bit too similar to my granny’s, I’m even less likely to make a hasty decision. I mean, you say you don’t know anything about it, which is probably true, but I want to know something about it. It’s too close to my grandmother’s death and sounds too similar.”

  “I’m sorry, but other people’s records are confidential. And in regard to yourself, I was specifically told that I had to obtain your decision this morning. We simply cannot have your grandmother’s body in this cooler another hour.” For emphasis, Kashmira reached out a hand and made renewed contact with the cooler’s door. “If you are not willing to cooperate, I’m afraid you will have to speak with our president directly, because he has the authority to speak to a magistrate and petition the court to make the decision for you.”

  “I’m not speaking with anyone for a few hours,” Jennifer snapped back. Now she was truly angry. Earlier, she had the opinion Queen Victoria Hospital was trying to push her, and now she was sure of it. Although on the one hand such an action was understandable because of their lack of proper storage, on the other hand it seemed provocative, especially their unwillingness to even consider an autopsy if she expressly indicated she wanted one. “I’ll give you a call when I’m able to think a little better, and I’ll come back. Meanwhile, let me warn you people: Don’t defile my grandmother’s body without my permission unless you are willing to deal with one very unhappy camper.”

  “An unhappy camper?” Kashmira questioned, totally confused.

  Jennifer rolled her eyes. “It means someone who’s really pissed.”

  Chapter 11

  OCTOBER 17, 2007

  WEDNESDAY, 9:45 A.M.

  DELHI, INDIA

  Jennifer stared out the Mercedes’s window. She was so embroiled in her own thoughts she didn’t even notice the traffic. The reality was that she had been what she called “pissed” far sooner than she’d admitted. There was no doubt Queen Victoria Hospital was jerking her around, and having been a victim long enough in her relatively short life, she didn’t relish the role. Breaking out of the role had been her major challenge. The seminal event had occurred in middle school, where truancy and fighting had become the rule for her. At loose ends, her grandmother, who had been a particularly proud woman, did something she normally would not have done: She begged for someone’s help. The person she turned to was Dr. Laurie Montgomery, a New York medical examiner whom the grandmother had practically raised from age one to age thirteen as her nanny.

  At the time Jennifer had found it big-time weird to meet a stranger who called her own grandmother “Granny.” But Granny had been Laurie Montgomery’s nanny for twelve years. Not surprisingly, Dr. Montgomery had fallen in love with Granny and considered her family. So when Jennifer’s demons drove her over
the cliff, Granny pleaded with Laurie Montgomery to try to stop Jennifer’s downward spiral.

  With as much love and respect as Laurie held for Maria, she was happy to help. What she did was invite the wayward Jennifer to the Office of the Chief Medical Examiner after school for one week to follow her around and see what her job was all about. The other medical examiners had been skeptical of a twelve-year-old girl having a career week at the morgue, but Laurie had prevailed, and the result beat expectations. The situation had been sufficiently “weird” and “yucky,” in Jennifer’s own terms, to capture her adolescent imagination, especially since it was the first academic career to which she’d been even slightly exposed. Jennifer took it all in stride—until the third day. That day, a girl just her age was brought in with a perfectly clean, round red dot in her forehead. She’d been shot by a rival gang.

  Fortunately, Jennifer’s story went on to have a happy ending. Jennifer and Laurie had clicked more than either would have imagined, prompting Laurie to check with both her philanthropic mother and her own private school as to the possibility of Jennifer’s getting a scholarship. A month later, Jennifer found herself in a demanding academic environment with no gang affiliations, and the rest was history.

  “Of course!” Jennifer said loud enough to startle the driver.

  “Is there a problem, madam?” the driver asked, while looking at Jennifer through the rearview mirror.

  “No, no problem,” Jennifer said, as she reached for her shoulder bag and began rummaging for her phone. She had no idea what it would cost to call New York, but she wasn’t going to worry about it. She was going to call Laurie Montgomery. Laurie didn’t even know Granny had died, and that was reason enough to call. On top of that was the decision issue, and even the autopsy idea. Now that she had thought of calling Laurie, Jennifer had trouble explaining to herself why she hadn’t thought of it earlier.