The Last Word

by Lee Goldberg

  Yokley possessed enough weaponry to either overthrow a small country or arm a mid-sized rap music company. It took five large trucks to haul all the weapons downtown to be logged, traced, and examined by ballistics and forensics experts from the LAPD, the ATF, and the FBI.

  At six p.m., Chief Masters and District Attorney Neal Burnside called dueling press conferences. Each man took full credit for the arrest of a “major black-market supplier of weapons” and for keeping scores of guns off the LA streets, thus preventing an untold number of robberies, shootings, and murders, perhaps even an all-out gang war.

  The FBI and the ATF also held their own press conferences, trumpeting the interagency cooperation and the unprecedented number of weapons seized in the raid, which, they intimated, was a monumental victory in the war on terror.

  No one in any of the press conferences, however, saw any reason to mention Steve Sloan. But he didn’t mind. He was used to his work being overshadowed or ignored. What counted to him was that he’d accomplished what he’d set out to do.

  His reward would come later. And when it did, it would not be at all what he expected.

  CHAPTER NINETEEN

  The next two weeks were uneventful compared to most weeks in Dr. Mark Sloan’s life. He was inundated at the hospital with mindnumbingly boring administrative tasks, requiring him to shuffle from one meeting to another and leaving him little time to practice any actual medicine. If Janet Dorcott was planning to drive him out by making his job intolerably dull, she was succeeding.

  But she wasn’t putting any pressure on him to go—because, he assumed, the pressure was off of her. The killer nurses scandal had been pushed off the front page and the nightly newscasts by daily updates on the Gaylord Yokley investigation, heightened fears about the spread of the West Nile virus, the contentious mayoral race, and the discovery that a famous movie star had fathered a child out of wedlock.

  The boring routine at the hospital wouldn’t have been so hard to take if Mark had at least had an interesting homicide investigation to keep him occupied. The murder rate in Los Angeles had not suddenly plunged; rather, the current cases weren’t difficult or puzzling enough to require Mark’s deductive skills. And he hadn’t stumbled on any mysteries to solve on his own, though he supposed he could always jet out to Scotland and see if he could prove the existence of the Loch Ness monster once and for all.

  Steve had been kept busy on the Yokley case, uncovering the gun merchant’s ties to ROAR, the homegrown but loosely organized antigovernment terrorist group. According to e-mails and documents found at Yokley’s home and car dealership, ROAR was plotting to plunge the city into anarchy by supplying gangs with assault weapons and provoking a street war among them that would overwhelm the resources of the police force.

  But the leaders of ROAR had never been known for their stunning intellect, and Steve didn’t think Yokley was smart enough to have concocted the plot on his own.

  Mark and Steve believed that Carter Sweeney was probably behind it, even though there was no evidence of any kind linking him to Yokley. Sweeney didn’t really believe in any of ROAR’s dogma, which was liberally cribbed from the KKK and Aryan Nations, but he would find the group easy to manipulate for his own purposes. Creating havoc in Los Angeles on the eve of the mayoral election was just the kind of thing that would keep Sweeney amused in captivity.

  Even if Steve could find ties to Sweeney, there was nothing more the law could do to him. He was already sentenced to death. He could die only once. In a sense, Sweeney had a free pass to commit any crime he wanted, assuming he could pull it off from inside his cell.

  If throwing Los Angeles into turmoil was Sweeney’s master plan, then Mark could relax, knowing that it had been foiled—though if Teeg hadn’t tried to shoot his estranged girlfriend, the plot might have succeeded.

  Even so, Carter Sweeney was still very much on Mark’s mind that morning as he sat reading the Los Angeles Times over breakfast at his kitchen table. The news of Sweeney’s upcoming habeas corpus hearing had finally come out.

  What surprised Mark was that the news was relegated to a mere paragraph on page 29, squeezed in between a paleobotanist’s theory that figs were mankind’s first cultivated crop and the discovery of a new species of crustacean in an underground lake in Israel.

  The marginalization of Carter Sweeney to near obscurity must have been a great relief to both Neal Burnside and John Masters, but it troubled Mark.

  Why hadn’t Sweeney found a way to make his hearing front-page news? It was very uncharacteristic of him to let an opportunity for attention slip away. So it had to be a calculated move. To what end? Sweeney must have other plans to capitalize on his hearing. But what were they?

  Mark was still pondering those questions over his Grape-Nuts and coffee when Steve came upstairs with Olivia, who’d obviously spent the night. They were both freshly showered and dressed for work.

  It wasn’t an awkward moment, at least not for Mark and Steve. Mark had long since reconciled himself to the fact that his son had a love life and, if they were going to live together, that meant inevitably bumping into some of Steve’s lovers in the house. It was a small discomfort to live with for his son’s company.

  Not many fathers and sons enjoyed the close relationship that Mark and Steve had. But few of Steve’s girlfriends were impressed by it. They wondered about the maturity and independence of a fortysomething man who still lived at home with his sixtysomething father. And many women didn’t appreciate having to face their boyfriend’s dad whenever they spent the night. It was, for most women, a relationship breaker.

  But Mark got the sense that Olivia Morales wasn’t looking for a relationship when she went home with Steve. She and Steve weren’t sharing any furtive, flirtatious looks or stealing touches, strokes, and squeezes whenever they could. They appeared to be friends-with-benefits, which was an expression that perfectly described what Mark considered the fast-food attitude that people had towards relationships these days.

  She got a bowl and a spoon, sat down next to Mark, and poured some cereal.

  “Good morning, Dr. Sloan,” she said. “You’re up awfully early.”

  “Were you hoping I wouldn’t be?” Mark asked.

  “Of course I was,” she said. “Seeing you gives me flashbacks to high school when I’d get caught sneaking out of my boyfriend’s bedroom by his parents.”

  “Enjoy it,” Mark said. “You don’t get many chances in life to feel eighteen again.”

  “Seventeen,” Olivia said.

  “I didn’t need to know that,” Mark said.

  “Sorry,” she said. “I babble when I’m nervous.”

  Steve sat down next to her. “This Yokley case is turning into a full-time job for both of us.”

  It was an abrupt change of subject, almost a non sequitur, but Mark was thankful for it.

  “With so many people and law enforcement agencies taking credit for the arrest, is there any official recognition or appreciation left for the two of you?” Mark asked.

  “Neither one of us has received a promotion or a raise, if that’s what you’re asking, but we haven’t been shoved to the sidelines either,” Steve said. “This isn’t a homicide case, so there’s really no reason for us to be involved anymore. The fact that we still are acknowledges our contribution.”

  Olivia shook her head. “Boy, do they have you snowed. They just like having us around to do all the tedious legwork. Where else would they find detectives with our experience who’d be willing to do it?”

  “Karen Cross knows who brought her into this,” Steve said. “So do the agents at the FBI and the ATF and everybody else. Those are favors I can call in someday.”

  “You’ve already called in a few with me,” she said with a sly smile.

  “Is that what last night was?” Steve said playfully.

  Mark cleared his throat to remind them that he was still there. “So where’s the investigation heading?”

  “Wherever the guns lead
us,” Steve said.

  “And there are a lot of guns,” Olivia added.

  “We’re trying to trace them from two directions,” Steve said. “Where they were bought or stolen from originally and any past crimes in which they might have been used.”

  “That’s going to take an enormous amount of time and manpower,” Mark said. “What about the ROAR angle?”

  “Nobody is taking that very seriously. ROAR went down with Carter Sweeney years ago,” Steve said. “Gaylord Yokley is a one-man band.”

  Olivia nodded in agreement. “All that’s left of ROAR is maybe half a dozen fat white guys with sixth-grade educations and Confederate flags in their garages who can’t understand why they aren’t running the world.”

  “But they managed to get their hands on fourteen hundred assault weapons,” Mark said.

  “Thank God for the Second Amendment,” Steve said. “What would the terrorists and crooks do without it?”

  CHAPTER TWENTY

  As soon as Mark stepped into the hospital, his pager started vibrating on his belt. He glanced at the readout and saw that Jesse was paging him from the ICU. Mark headed straight there.

  He found Jesse examining a set of chest X-rays up on the light box near the nurses’ station. Mark looked over his shoulder.

  “That was fast,” Jesse said. “I didn’t know you were in the hospital.”

  “I was walking in when you paged me,” Mark said, studying the films. Both lungs were covered with diffuse patchy infiltrates—fluffy, white spots indicating inflammation caused by some kind of infection. “Who do these belong to?”

  “Ken Hoffman,” Jesse said.

  Mark was shocked. He’d spoken to Hoffman, the heart-lung transplant patient, the previous night. Hoffman hadn’t exhibited any signs of difficulty. In fact, he was doing so well that it seemed likely he’d be released in another day or two.

  “What happened?”

  “He woke up this morning lethargic, feverish, disoriented, and suffering from shortness of breath,” Jesse said. “His breathing rate has gone from sixteen to forty breaths per minute. I listened to his lungs and they sounded wet. So I got him up here, ordered a chest X-ray and ran his blood gases.”

  “What are his O2 sats?” Mark asked, referring to the amount of oxygen saturation in Hoffman’s blood.

  “They are on the way,” Jesse said.

  Mark went to Hoffman’s bed and found the patient gasping hard, his skin sweaty, pale, and blue.

  A nurse handed Jesse a piece of paper. Jesse glanced at the paper, then held it out to Mark. “I’ve got the blood gases. The O2 sats have dropped from ninety-five percent to eighty-five percent.”

  “Let’s get him on an oxygen mask,” Mark said to one of the ICU nurses hovering nearby. “Fifty percent O2 and run his blood gases again in an hour.”

  The nurse nodded and got to work. Mark stepped away to confer with Jesse out of Hoffman’s earshot.

  There were several explanations for Hoffman’s rapid decline and none of them were good. It could be a bacterial infection, a viral infection, or his body rejecting his new organs.

  If he was fighting a viral infection, the ordinary course of action would be to boost his immune system. But if it wasn’t a viral infection, strengthening his immune system would turn his body against his new heart and lungs.

  If the problem was organ rejection, they would boost his anti-immune drugs to stop the heart and lungs from being attacked by his immune system. But if it wasn’t organ rejection, weakening his immune system would leave his body defenseless against a rampaging virus.

  “I think we should play it safe and assume he’s got it all,” Jesse said, seemingly reading Mark’s thoughts. “Let’s bump up his anti-rejection drugs, the steroids, and cyclosporine, and put him on broad-spectrum antibiotics until we know exactly what we are dealing with.”

  “I was going to suggest the same thing.” Mark glanced at his watch and saw that he was already late for a senior staff meeting on the annual budget. “I’ve got to go. Let me know right away if there’s any change in his condition.”

  “Will do,” Jesse said.

  Mark hurried off to the third-floor conference room, where the tedious meeting had already been going on for ten minutes, though it probably felt like ten hours to the unfortunate department heads who were sitting through it.

  Dr. Kerry Sakmar, the head of pediatrics, was giving a Power-Point presentation on his department’s financial needs, justifying every dollar in his budget to stone-faced Janet Dorcott, as Mark slipped into the room.

  Janet shifted her cold gaze to Mark as he took his seat. He felt like a high school student sneaking in late for homeroom and getting caught by his teacher.

  “Sorry I’m late,” Mark said. “I was checking on a patient.”

  “At least it was a patient and not a homicide victim this time,” Dorcott said. “I suppose that’s a small sign of progress.”

  Mark didn’t bother to comment. Instead, he opened his copy of the proposed budget and tried to concentrate on the pediatric presentation. But his mind kept wandering back to Hoffman’s condition and his sudden, and disturbing, slide.

  A half hour later, Janet was grilling Dr. Sakmar, making him justify every cotton swab and paper clip, line item by line item. It was like water torture, and every department head around the table had broken into a sweat, dreading his or her own presentation.

  Except for Mark. He was calm. The other department heads were younger and more ambitious than he was, and they had more reason to play politics with Janet Dorcott. He wasn’t interested in scoring points, nor was he intimidated by her authority. He had no intention of justifying his budget to a woman with no medical experience whatsoever. Hospitals weren’t the same as discount superstores. He would present his budget as a package and she could take it or leave it. There weren’t any cuts he was willing or able to make.

  But he didn’t get the chance to have that fight that morning. His beeper vibrated. It was a message from Jesse. Ken Hoffman’s condition was deteriorating fast.

  Mark left the meeting and didn’t come back.

  CHAPTER TWENTY-ONE

  Over the next twenty-four hours, Hoffman’s condition went up and down as Mark and Jesse struggled to stop his decline and diagnose the cause of his worsening condition.

  They began by intubating him and putting him on a ventilator. At first the oxygen saturation in his blood increased, giving them cause for hope, but then a few hours later it plunged even lower than before.

  Desperate to stop Hoffman’s oxygen levels from plummeting further, Mark and Jesse increased the amount of oxygen he was receiving to eighty percent. His blood gases improved, but by the next morning, his O2 sats had dropped to just seventy-two percent, their lowest level yet.

  Mark had to see for himself what was going on in Hoffman’s lungs. So he performed a bronchoscopy, sliding a specialized camera and catheter down Hoffman’s throat and into his bronchial tubes.

  He was looking for indications of a bacterial or fungal infection. Patients with repressed immune systems are prone to infections or possibly even the activation of tuberculosis that’s been sitting dormant in their bodies for years.

  Mark saw some nonspecific inflammation, which wasn’t a surprise, considering Hoffman’s breathing problems and cloudy chest X-rays. But he didn’t see any bleeding or signs of infection. The sputum, the fluid in the lungs, appeared to be clear.

  Except for the inflammation, which had to be caused by something , everything looked fine. The bronchoscopy didn’t reveal a thing to Mark and only succeeded in adding to his growing frustration and infuriating sense of impotence.

  He collected samples of the sputum and lung tissue and rushed them down to Amanda in pathology, hoping her tests would give them some answers.

  Amanda called Mark and Jesse down to her lab a few hours later. Mark could tell from the scowl on her face as he walked in that the news wasn’t good.

  “I looked at his blood,
and he’s got an elevated white blood cell count, which is indicative of a virus, infection, or organ rejection,” Amanda said. “I looked at his sputum and his lung tissue and saw no evidence of fungi or bacterial infection.”

  “You make it sound like there’s nothing wrong with the guy,” Jesse said. “He can’t breathe. His last chest X-ray looked like a snowstorm. There’s got to be something causing the inflammation in his lungs.”

  “I know, but whatever it is, it’s not showing up on the slides.”

  “So we’re back where we started,” Mark said.

  “Which is nowhere,” Jesse said gloomily. “It’s either infection or rejection and we’re already treating both. The tests haven’t told us a damn thing.”

  “All we can do is continue with the course we’re on,” Mark said. “Keep him on the ventilator and treat him with steroids and antibiotics.”

  “And hope for a miracle,” Jesse said without much conviction.

  “They’ve been known to happen,” Amanda said.

  But four hours later, it didn’t look likely that there were any miracles in store for Ken Hoffman. His lungs looked like bones in the chest X-rays and his O2 sats continue to drop even though he was breathing pure oxygen on his ventilator. His lungs were barely functioning.

  It was a death sentence.

  Mark had the grim task of informing Hoffman’s wife and two young children that his prognosis didn’t look good.

  By midafternoon, two weeks after his transplant and a little more than a day after his breathing problems began, Ken Hoffman died of respiratory failure.

  CHAPTER TWENTY-TWO

  It became Dr. Amanda Bentley’s job to discover exactly what caused Ken Hoffman’s respiratory failure. She was getting just as frustrated as Mark and Jesse had been.

  Mark tried to stay out of Amanda’s way, but his curiosity kept getting the better of him. He found excuses to stop by her lab several times over the course of the next few days, and each time she had nothing new to tell him and she was awaiting various test results.