Foreign Body

by Robin Cook

“Why did your husband have a cardiologist?”

  “Three years ago he and I took a trip to Africa to see the animals. Both of us had to take a bunch of shots and also an antimalaria medication called mefloquine. Unfortunately, he experienced a side effect where his heart beat irregularly, but it went away by itself.”

  “So your husband had a normal heart for all intents and purposes,” Jennifer said. “Well, it was the same with my granny. She had remembered being told that she had had a heart murmur when she was a child, and had always thought there was something wrong with her. I had her seen at the UCLA Med Center by a top cardiologist, and he figured out that she’d apparently had what they call a patent ductus, which embryos need but are supposed to close. Granny’s stayed open but then mostly closed later. She also had some irregularity like your husband, but that was determined to have been caused by a cold remedy and went away. Her heart was perfectly normal, and for her age quite remarkable. With your husband and my granny having cardiac histories like that, it’s enough to make you paranoid.”

  “Do you think your friend may be willing to take a look at my Herbert?”

  While the waiter took their coffee order and cleared the dishes, the women leaned back and didn’t speak, both rehashing the conversation. When the waiter left, both leaned forward again. Jennifer spoke. “I can certainly ask her if she’d take a look at your husband. She’s a terrific person, and I think a famous medical examiner, both she and her husband. They work together in New York.” She paused. “When did you find out about your husband?”

  “That was the most bizarre thing,” Lucinda said. “I had gotten a call, which had awakened me, from a family friend in New York, who’d wanted to convey his condolences about Herbert. The trouble was, at that point I’d not heard anything. I thought Herbert was just fine, like I’d left him some three hours earlier.” Lucinda stopped talking, and her lips quivered as she fought back tears. Finally, she sighed audibly and dried the corners of her eyes. She looked at Jennifer, tried to smile, and apologized.

  “There’s no need to apologize,” Jennifer assured her. In truth, Jennifer was feeling a tad guilty, pushing Lucinda as much as she was. Yet the similarities between the two cases seemed to grow. “Are you alright?” Jennifer asked. Without really thinking about what she was doing, Jennifer reached out and gripped Lucinda’s wrist as a spontaneous gesture of support. The move surprised even Jennifer; she hardly knew the woman, and here she was touching her. “Maybe we should talk about something else,” Jennifer suggested, withdrawing her contact.

  “No, it’s okay. Actually, I want to talk about it. Up in the room I was just brooding, which wasn’t helping anything. It’s good for me to talk.”

  “So what did you do after you talked with your friend from New York?”

  “Of course, I was taken aback. I asked him where on earth he’d heard such a thing. Well, he’d heard it on CNN as part of a piece on medical tourism. Can you imagine?”

  Jennifer’s lower jaw slowly dropped open; she had seen the same segment as Lucinda’s friend, although possibly not at the same time.

  “Anyway,” Lucinda continued with progressive control over her fragile emotions, “while I was still talking to my friend, insisting that Herbert was just fine, the second phone line began to ring. I asked the friend to hold for a moment while I pressed the other button. It turned out that it was the hospital—specifically, our case manager—informing me that Herbert had indeed died.”

  Lucinda paused again. There were no more tears, just some deep breathing.

  “Take your time,” Jennifer urged.

  Lucinda nodded as the waiter came over to inquire if they wanted more coffee. Both women shook their heads, totally preoccupied with their private conversation.

  “I thought it was horrid that CNN knew about my husband before I did. But I didn’t say anything at the time. I was too overwhelmed by the news. All I did was tell Kashmira Varini I’d come right to the hospital.”

  “Hold up!” Jennifer said, raising her hands for emphasis. “Your case manager’s name is Kashmira Varini?

  “Yes, it is. Do you know her?”

  “I can’t say I know her, but I’ve met her. She was Granny’s case manager, too. This is getting stranger still. This morning I asked her about your husband’s death, and she told me she wasn’t aware of it.”

  “She certainly was aware of it. It was she whom I met last night.”

  “Good grief,” Jennifer voiced. “I had a feeling the woman wasn’t trustworthy, but why would she lie about something I could easily find out about?”

  “It doesn’t make sense.”

  “I can tell you one thing. When I see her this afternoon, I’m going to ask her directly. This is ridiculous. What does she think we are, children, that she can just out-and-out lie to our faces?”

  “Perhaps it has something to do with their need for confidentiality.”

  “Bullshit!” Jennifer said, and then caught herself. “Pardon the language. I’m just getting progressively ticked off.”

  “You don’t have to apologize. I raised two boys.”

  “Maybe so, but most people don’t give women the same latitude. But getting back to CNN. Something very similar happened to me.” Jennifer went on to explain how she, too, had heard about her grandmother’s passing on CNN and had actually called both the healthcare company that had arranged everything and the hospital itself only to be reassured that her grandmother was doing fine. It was only later when she got a call back from the hospital by Mrs. Varini that she learned the truth and that her granny had indeed passed away.

  “How bizarre! It sounds as if the right hand doesn’t talk to the left hand at the Queen Victoria.”

  “I’m wondering if it might be worse than that,” Jennifer replied.

  “Like what?”

  Jennifer smiled, shook her head, and shrugged her shoulders all at the same time. “I haven’t the foggiest idea. Of course, we could just be suffering from grief-driven paranoia. I’m the first one to admit I’m far from my right mind with the shock of losing my best friend, mother, and grandmother—all at once. On top of that, I’m learning that jet lag is not for kids. I’m exhausted, but I can’t sleep. Maybe I’m not thinking so well, either. I mean, it could be that elective surgical deaths are so uncommon for the Queen Victoria that they don’t quite know how to handle it. After all, they didn’t even build mortuary facilities.”

  “What are you going to do?”

  “Pray that my friend Laurie Montgomery comes. If she doesn’t come, I truly don’t know what I’ll do. Meanwhile, this afternoon I’m going back to the hospital. I’m going to ask Mrs. Varini why she lied to me, and I’m going to make it absolutely clear, if I haven’t already, they are not to touch Granny. What about you? Would you like to have dinner tonight?”

  “What a thoughtful invitation. Can I let you know later? I just don’t know where my emotions are going to be.”

  “You can let me know whenever you like. It probably will have to be early. I think what’s going to happen is that I’ll just run out of gas and then sleep for twelve hours. But what are you going to do about the hospital? Are you just going to wait until your sons get here and let them make the decisions?”

  “That is exactly what I am going to do.”

  “Maybe you should give our friend Mrs. Varini a call and make sure she can’t claim a misunderstanding and do something without your expressed approval. When the next of kin are grieving, it’s easy to bully them. Ironically, it’s usually about doing an autopsy, not about not doing one.”

  “I think I’ll take your advice. Last night I wasn’t myself.”

  “Are you done with lunch?” Jennifer asked. “I’m going to head back to the hospital. I was going to go to the embassy, but I think I’ll put that off. I want to pose a few questions to the case manager, like why she lied to me. I’ll let you know if I learn anything startling.”

  Having already signed their respective checks, the women stood, an
d several busboys ran over and pulled out their chairs. The restaurant was now full, forcing them to weave among a crowd of people waiting for tables. Out in the lobby, they said their good-byes with a promise to talk later. Just as they were about to separate, Jennifer thought of something else. “I think I’m going to look into the CNN connection if possible. Would you mind terribly finding out from your New York friend exactly when he saw the segment about your husband, New York time?”

  “I’d be happy to. I’d planned to call him back. I know he felt terrible about having broken the news.”

  They were about to separate again when Lucinda said, “Thank you for encouraging me to come out of my room. I think this was a lot healthier, and I’m afraid I wouldn’t have if left to my own devices.”

  “It was my pleasure,” Jennifer responded. She was holding her phone in preparation for calling her car and driver.

  Chapter 14

  OCTOBER 17, 2007

  WEDNESDAY, 1:42 P.M.

  NEW DELHI, INDIA

  How long will you be, madam?” the driver asked. He was holding the car door as Jennifer climbed out. During the ride from the hotel to the hospital she had managed to fall asleep for some twenty minutes or so, and now felt distinctly worse than she had when she’d started. Still, she wanted to talk with Kashmira Varini.

  “I’m not sure,” Jennifer said, looking up at the hospital. She’d just gotten the idea to go up to the fourth floor where she’d been told her grandmother’s room had been and see if she could find the day nurse who’d been assigned to her case. “But it won’t be long, not the way I feel.”

  “I’ll try to stay here,” the driver said, pointing down at the ground, “but if the doormen chase me, you’ll have to call my mobile.”

  “No problem,” Jennifer said.

  As had been the case on the earlier visit, the two colorful doormen opened the double doors without Jennifer having to say a word. Because it was hotter outside than it had been that morning, it felt colder inside. As far as she was concerned, it was definitely over-air-conditioned.

  At that time there were forty to fifty people in the lobby, all either upper-middle-class Indians or well-to-do foreigners. Near the admitting desk were a handful of prospective patients, some sitting in wheelchairs. A number of hospital staff were in evidence with their charges in varying stages of the admitting process. Glancing into the coffee shop, Jennifer could see it was full, with some people standing and waiting for tables.

  With the aplomb garnered from all the hours she’d spent in a hospital, Jennifer didn’t hesitate in the slightest from making her way over to the elevators. When she boarded, she made certain the button for the fourth floor had been pressed, and then melted into the background.

  For Jennifer, the patient floor was one of the most pleasant she’d seen, and she’d seen her share. The floor itself was covered with attractively colored high-quality sound-absorbing industrial carpet, and combining it with a high-tech acoustic ceiling and walls constructed of sound-dampening material, the ambient noise was muffled down to almost nothing. Even the sound of a large, fully loaded food tray cart was minimal as it passed behind Jennifer while she walked over to the nursing station.

  Several patients had just returned from surgery, so most everyone was busy, including the floor clerk. Jennifer just watched. She was impressed how similar the protocols for running the floor seemed to be to what she’d experienced at UCLA Med Center, despite her being halfway around the world in a developing country.

  In a relatively short time the immediately postoperative patients had been settled in their rooms, stabilized, and returned to the company of their next of kin. As abruptly as it had started, the flurry of activity dissipated. It was then that the floor clerk, whose nametag said merely “Kamna,” happened to notice Jennifer. “Can I help you?” she asked.

  “I believe you can,” Jennifer responded. She wondered if Kamna was a proper name or meant something like clerk. “My name is Jennifer Hernandez, and I am Maria Hernandez’s granddaughter. I believe she was a patient on this floor.”

  “You are correct,” Kamna said. “She was in room four-oh-eight. I’m very sorry.”

  “I am, too. Is this a common problem here?”

  “I’m not sure what you mean.”

  “Are deaths relatively frequent?”

  Kamna jerked almost as if Jennifer had hit her. Even the head of one of the nurses using a computer terminal bobbed up with a shocked expression on her face.

  “No, it is very rare,” Kamna said.

  “But there was another one just last night around the same time. That’s two in a row.”

  “That’s true,” Kamna agreed nervously. She looked down at the nurse for support.

  “I’m Nurse Kumar,” the woman said. “I’m the head nurse on this floor. Can I be of assistance?”

  “I wanted to speak to whoever was taking care of my grandmother.”

  “There were actually two. First there was Ms. Veena Chandra, who is new to our staff, and since she is new, a senior nurse by the name of Shruti Aggrawal was assigned to supervise.”

  “I suppose it would be safe to say that Ms. Chandra would have been the person actually interacting with my grandmother.”

  “That’s correct. Everything had gone entirely normally. There had been no problems whatsoever. Mrs. Hernandez had been doing excellently.”

  “Is Ms. Chandra available?”

  Nurse Kumar paused while giving Jennifer a moment of scrutiny, perhaps worried that Jennifer could possibly have been a deranged woman in the hospital to exact revenge. Everyone was acutely aware of the Hernandez demise. But apparently, Jennifer had passed muster. “I don’t see why not. I’ll see if she can speak with you now.”

  “Perfect,” Jennifer said.

  Nurse Kumar got up, walked down the corridor a way, and after a quick glance back at Jennifer, disappeared into a patient’s room.

  Jennifer glanced back at Kamna, who’d not moved a muscle. She was clearly still unsure of Jennifer’s mind-set and intentions. Jennifer flashed a smile, intending to calm the woman, who appeared like a rabbit ready to flee. The woman flashed a smile back, one even more fake and fleeting than Jennifer’s. Before Jennifer could try to put the woman at ease, she saw Nurse Kumar emerge from the patient room with a young nurse in tow. Jennifer blinked. Even in a nursing uniform, the newly hired nurse looked like a beauty queen or a movie star, or even more irritating, as far as Jennifer was concerned, a lingerie model. She was the kind of female who never failed to make Jennifer feel fat. She had a perfect body and a photographer’s dream face.

  “This is Nurse Veena Chandra,” the head nurse said when the women had reached the station. At the same moment, the elevator arrived and out stepped one of the uniformed guards Jennifer had seen downstairs. Since he just seemed to be lingering in the background, Jennifer sensed that the head nurse had called down when she’d been out of sight.

  Veena greeted Jennifer, palms together. Jennifer tried to imitate the gesture. Veena was even more beautiful up close, with flawless bronze skin and stunning green eyes, which Jennifer found mesmerizing. The problem was the eyes didn’t engage hers except for fleeting moments before looking away, as if Veena was bashful or somehow self-conscious being in Jennifer’s presence.

  “I’m Jennifer. Mrs. Hernandez’s granddaughter.”

  “Yes, Nurse Kumar has told me.”

  “Do you mind if I ask you a few questions?”

  Veena exchanged a quick uncertain glance with her head nurse, who nodded that it was okay.

  “I don’t mind.”

  “Maybe we could step over to those chairs by the window,” Jennifer said, pointing to a small sitting area with a modern couch and two chairs. Jennifer felt crowded by the head nurse and the clerk, who were standing like statues, hanging on every word.

  Veena again looked to Nurse Kumar, which began to confuse Jennifer. The woman was acting as if she were twelve, whereas Jennifer guessed she was in her twen
ties, even if just barely. She was acting as if she would have preferred being anywhere but where she was, facing a conversation with Jennifer.

  Nurse Kumar shrugged and gestured toward the sitting area.

  “I hope I’m not making you uncomfortable,” Jennifer said to Veena as they walked over and sat down. “I didn’t even know my grandmother was in India when I learned she had died. So I’m not very happy about her death, to put it mildly, and I’m looking into it to a degree.”

  “No, you’re not making me uncomfortable,” Veena replied tensely. “I’m fine.” For a brief moment the image of Maria Hernandez’s contorting face flashed in her mind’s eye.

  “You are acting very nervous,” Jennifer commented, trying vainly to make sustained eye contact.

  “Maybe I’m afraid you are angry with me.”

  Jennifer reflexively laughed, not loud but more in surprise. “Why would I be angry with you? You helped by grandmother. My goodness. No, I’m not angry. I’m thankful.”

  Veena nodded but seemed unconvinced, although she did allow herself more eye contact.

  “I just wanted to ask you how she was? Did she seem happy? Did she suffer at all?”

  “She was fine. She wasn’t suffering. She even talked about you. She told me you were becoming a doctor.”

  “That’s true,” Jennifer said. She wasn’t surprised. Her grandmother was extremely proud of what Jennifer had done, and to Jennifer’s chagrin bragged about it to anyone who would listen. Jennifer tried to think of what else to ask. She actually hadn’t given it a lot of prior thought. “Was it you who found Maria after her apparent heart attack?”

  “No!” Veena said comparatively explosively. “No, no,” she repeated. “Mrs. Hernandez died on the evening shift. I work days. I’m off at three-thirty. I was home. This is my first month working here. I work days with supervision.”

  Jennifer regarded the young nurse, who was, in actuality, a contemporary. Jennifer couldn’t help but feel there was something amiss, as if they weren’t quite on the same wavelength. “Can I ask you a couple of personal questions?”