by Lee Goldberg
Spoken like a true lawyer, Mark thought.
“When I want your opinion, Clarke, I will ask for it,” Janet said, then turned back to Amanda. “I’m waiting, Dr. Bentley, to hear your explanation.”
Clarke blinked hard but otherwise maintained his composure.
The stranger in the back of the room cracked a thin smile. It seemed to amuse the guy to see the lawyer slapped down. Whoever this man was, Mark decided, he must not be all bad.
“Donors are screened for a range of infectious diseases in a manner consistent with established national organ-procurement standards,” Amanda said in a matter-of-fact way. “We followed those standards and didn’t find West Nile virus antibodies in any of our tests.”
“Why not?” Janet said.
“It takes weeks for the body to manufacture antibodies against an invader,” Sharpe said. “If Corinne Adams was infected within fifteen or twenty days of her accident, there might not have been any antibodies present in her system to see.”
“Even if there were,” Mark said, “it wouldn’t mean she was fighting an infection at the time.”
“I don’t understand,” Janet said, her tone implying that her confusion was due not to any lack of knowledge on her part but rather to someone else’s ineptitude.
“Antibodies in the blood simply indicate that the virus was once in the body. It doesn’t mean that the virus is still there,” Mark explained, trying not to sound patronizing. “If you had mumps as a child, you will have antibodies against the virus in your body for the rest of your life to defend you if it ever comes back.”
Janet turned to Sharpe. “Then how did you find the West Nile virus in the samples when Dr. Bentley couldn’t?”
“We used PRC testing to reveal the presence of the viral RNA in the donor rather than the antibodies created by the body to combat it.”
“Why didn’t you do that?” Janet asked Amanda.
“It’s not a required or routine test according to national organ-procurement protocols,” Amanda said. “And it takes time, much more than we have in a typical organ-donation situation.”
Mark had told Janet that, too, though not in so much detail. Either Janet hadn’t listened to what he said or she didn’t accept his explanation.
“If Corinne Adams was infected,” Clarke said, “why wasn’t she showing any obvious symptoms?”
“The incubation period for West Nile virus varies,” Sharpe said, “but it’s about fourteen days. If she was infected less than two weeks ago, she wouldn’t have been showing any symptoms.”
“If she had been, we wouldn’t have done the transplant,” Jesse said. “Though not everyone who is infected with the virus gets sick. So without symptoms to see or West Nile antibodies in her tests, we had no way of knowing she was infected.”
“If she wasn’t sick yet, why did the symptoms show up so fast, and to such an extreme degree, in the patients who received her organs?” Trotter asked.
“Because their immune systems were compromised by the anti-rejection drugs,” Sharpe replied. “They were extraordinarily vulnerable.”
Trotter sighed, visibly relieved. He almost smiled.
“So, if I understand you,” the lawyer said, “the CDC has determined that Corinne Adams was infected with West Nile virus and, through no fault of ours, she passed the virus along to the recipients of her organs.”
Mark had shared the same conclusion with Janet Dorcott yesterday. But the official CDC determination meant that the hospital would be free of any legal liability in the deaths, even if the media and the public might not immediately grasp the distinction.
However, neither the hospital’s liability nor the possible negative publicity was on Mark’s mind at the moment. He was thinking about fate, which was having a lot of sick fun messing with him lately.
Enough already, Mark thought. I get the point. There’s no escaping you. Is it really necessary to keep reminding me?
“I advise you to start testing every prospective organ donor for West Nile virus,” Trotter said to Janet.
“Then you might as well shut down our transplant unit altogether,” Jesse said. “The odds of someone getting infected with West Nile virus from an organ transplant are right up there with getting hit by a meteor. There are only two recorded cases of West Nile being transmitted by organ transplant.”
“I agree with our legal counsel on this,” Janet said. “Better safe than sorry.”
Mark spoke up. Her ignorance was getting harder and harder for him to take.
“It’s already impossible to get donor organs for everyone who needs them. If you raise the standards for organ donation too high, you’re going to reject a lot of viable organs, and people will die because of it,” he said. “Any organ transplant carries a risk of fatal complications. But the benefits far outweigh the risks. Organ recipients, and those waiting for donor organs, will be the first ones to tell you that.”
“We’ll take this up at a later date, Dr. Sloan,” Janet said, her face tight with anger. “I’m sure Dr. Sharpe and the CDC have far more important things to do than listen to us debate hospital policy.”
But Sharpe and his team didn’t seem ready to go anywhere. And neither did the unidentified man leaning against the wall.
“I agree with you, Dr. Travis,” Sharpe said. “It’s extremely rare for someone with an undetected case of West Nile virus to die of unrelated causes and then infect others with his donated organs.”
“Great. Case closed. I’m glad that’s over,” Jesse said, getting up from his seat. “Now I can get back to work.”
“So what do you think the odds would be of it happening twice in one month at the same hospital with the same surgeon?” Sharpe asked.
Mark had a terrible feeling that Sharpe wasn’t posing a hypothetical question.
“It’s never happened here before,” Jesse said, standing at the table.
“Yes,” Sharpe said. “It has.”
CHAPTER THIRTY
Jesse sat down and glanced first at Mark and then at Amanda. They were every bit as startled by Sharpe’s statement as he was. So were Janet Dorcott and her two assistants, who were rendered even more deeply speechless than they already were. Clarke Trotter began smoothing his tie, which apparently wrinkled at the slightest hint of liability.
“As part of our investigation, we reviewed the last half dozen organ-harvesting operations performed at this hospital and followed up with the recipients,” Sharpe said, referring to the file in front of him.
He went on to explain that a week before Corinne Adams’s operation, Jesse had removed two kidneys and a liver from Bruce Wethersby, a thirty-one-year-old bike rider who was hit by a car and left brain-dead. His organs went to three recipients, one in San Bernardino and two others out of state.
The recipient of the liver tested positive for West Nile RNA but hadn’t shown any symptoms yet.
“Unfortunately, the kidney recipients weren’t so lucky,” Sharpe said. “One has developed acute flaccid paralysis consistent with West Nile-related encephalitis and is in a coma. The other kidney recipient died two days ago from brain-stem herniation. Both victims have tested positive for West Nile RNA and antibodies.”
Mark noted that they weren’t being called patients anymore; they had become victims. The distinction was significant and ominous.
“We tested the donor’s tissue and fluid samples for West Nile,” Sharpe said, “and they came back positive for the virus.”
The man leaning against the wall stepped forward and began to stroll casually around the table. “It could be a big, tragic coincidence that these two organ donors were both bitten by virus-carrying mosquitoes before they showed up in this hospital and had their organs harvested by Dr. Travis. But we don’t think so.”
“Who are ‘we’?” Mark asked pointedly.
“The FBI, Dr. Sloan. I’m Special Agent William Ort. I’m also an M.D. Some people in the bureau call me Special Agent Ort. Others call me Dr. Special Agent Ort. But the
y all call me when there’s a federal crime of a medical nature.”
“A doctor who likes to solve crimes,” Amanda said, glancing at Mark. “Imagine that.”
“You think somebody intentionally infected these donors with West Nile virus before or after they were admitted to this hospital,” Mark said.
“I do,” Ort said.
“You think it’s me,” Jesse said.
Ort shrugged. “You’re certainly a person of interest.”
“I’d have to be one dumb killer,” Jesse said.
“I’ve seen dumber,” Ort said.
Mark was sure that Jesse wasn’t the only suspect. Amanda’s pathology lab did all the testing of the donors’ blood, tissue, and organs. There were also several interns, nurses, and orderlies who had worked with both donors in the ER, the ICU, and during the transplant surgery.
If someone outside the hospital was infecting donors, the question was whether he was doing so before or after the victims had their accidents.
Corinne Adams fell down a flight of stairs. But what if she was pushed?
Bruce Wethersby was hit by a car. But what if it was intentional ?
That meant someone chose the victims, somehow injected them with the virus, and then engineered their accidents. It seemed like a massively complex undertaking. But it was doable.
If they were infected with the virus after their accidents but before they arrived at Community General, then the possible suspects would include the paramedics, the firefighters, and the police officers who arrived at the scene to treat the victims.
Whoever it was would have had to obtain a sample of West Nile virus from somewhere, and that wouldn’t have been easy. But once he had the virus, keeping it viable would take only a freezer.
Whoever was doing it had come up with a chilling and ingenious way to kill. He was letting the organs, bones, and tissues do the killing for him. There was no telling how many people he could murder from a distance, all over the United States, just by infecting one person.
It was serial killing by proxy.
Mark was still mulling over the implications when he noticed Ort studying him. Ort didn’t look pleased with whatever he’d read in Mark’s expression.
“This is now a federal serial killer investigation,” Ort said. “The CDC is lending us their resources and expertise. Representatives from the National Institutes of Health and the Food and Drug Administration will also be involved.”
“You’re talking about a lot of people descending on this hospital from outside agencies,” Janet said. “Things are going to get out of hand very quickly.”
“By that, I presume you mean that the media will find out about our investigation,” Ort said. “That’s inevitable.”
“There’s no evidence that anyone at Community General Hospital is involved in this,” Janet said, “but if word gets out before you have a suspect, the implication will be that we are responsible for these deaths.”
“Murders,” Ort said.
“The reputation of this hospital could be ruined,” Janet said. “That’s a crime, too.”
“I can’t be concerned about that,” Ort said.
“You’d better be,” Trotter said. “Need I remind you of past cases in which the FBI falsely implicated people in crimes and later paid out millions in legal judgments as a result?”
“That’s not my problem,” Ort said. “I expect nothing less than the full cooperation of everyone in this hospital. You will be receiving warrants within the hour compelling you to open specific patient records for our review.”
“We need to shut down the transplant unit immediately,” Mark said.
“I think that’s a good idea,” Sharpe said.
“It’s a horrible idea,” Janet said. “We do that and it’s practically an admission of guilt—and a public relations nightmare for this hospital.”
“If we don’t,” Mark said, “we run the risk that someone else will be infected and more viable organs will be ruined.”
“Keeping the transplant program running will help the investigation conclude more swiftly,” Janet said. “The FBI can catch whoever it is in the act.”
“Unless it’s me,” Jesse said.
“Or me,” Amanda said.
“Or me,” Mark said. “Besides, I don’t think you want the liability of using a donor as a guinea pig. If you’re right, and someone outside Community General is responsible, by keeping the program open you are encouraging the killer to go ahead and infect, and perhaps murder, another victim.”
“Dr. Sloan has a good point,” Trotter said.
“Shut up, Clarke,” Janet said.
“I agree with Dr. Sloan and Dr. Sharpe,” Ort said. “If you don’t close the transplant program down voluntarily, I’ll see to it that the appropriate agency compels you to do it anyway. You won’t like that publicity any better. We’re done for now.”
Everyone rose. Janet Dorcott pointed at Jesse.
“You’re suspended until further notice. I don’t want to see you in this hospital.” She turned to Mark. “We have to talk. Now.”
Ort stepped between them. “Me first.”
The agent led Mark to the back of the room, where they could talk privately.
“Thanks for saving me,” Mark said.
“When I said I wanted everyone’s full cooperation, I wasn’t talking about you,” Ort said. “I’d like you to cooperate less.”
“Meaning what?” Mark asked, genuinely confused.
“I saw the look on your face. You were already thinking about what investigative angles you and Scooby-Doo were going to pursue. Don’t.”
“I do have some experience at this sort of thing,” Mark said. “I could be an asset.”
“You’re a suspect,” Ort said.
Mark looked at him incredulously. “I’ve been a consultant to the LAPD for over forty years. My son is a homicide detective. I’ve worked closely with the FBI many times, and so have Dr. Travis and Dr. Bentley.”
“I’m aware of all that,” Ort said.
“Then how could you possibly believe that any of us would purposely infect an organ donor with West Nile virus?”
“I know cops and FBI agents who’ve turned out to be rapists, embezzlers, blackmailers, and killers,” Ort said. “So do you, Dr. Sloan. We both know their badges and past achievements in law enforcement didn’t make any difference. They still committed heinous crimes. I believe whatever the evidence tells me. And right now, it tells me that you are a possible suspect. Stay out of this investigation.”
Ort held Mark’s gaze for a moment to emphasize his point and then walked away.
Someone was using patients at Community General Hospital as guns, and their organs as bullets, to kill people. There was no doubt that these killings would go public, and when they did, the scandal would smear the hospital where Mark had spent his entire career and destroy the reputations of two doctors who were like his own children.
If Dr. Special Agent William Ort thought Dr. Mark Sloan was going to sit by and let that happen, then Ort wasn’t much of a detective—and he needed all the help that Mark could give him.
Whether he wanted it or not.
CHAPTER THIRTY-ONE
Steve and Tanis showed up outside of Tony Sisk’s house in the hills above Malibu shortly after the attorney left for work. They were driving a Pacific Bell truck and were wearing telephone technician uniforms.
It took them only a few minutes to attach the bugs to the phone lines at the junction box. They didn’t need to break into Sisk’s house and plant listening devices in order to eavesdrop on conversations in the rooms. They had devices that could do the job from outside.
The phone line bugs did double duty. Not only did they record incoming and outgoing calls, but when the phones weren’t in use, they became voice-activated listening devices, capturing any conversations that were going on in the room.
Another device, hidden under the windows, picked up the sound waves in the room and transmitt
ed them back to the secret Web site using the home’s own satellite dish.
Steve and Tanis managed to thoroughly and efficiently violate Tony Sisk’s civil rights in under half an hour.
From there, they moved on to Sisk’s office building on Wilshire Boulevard in Beverly Hills. Still posing as telephone technicians, they were able to do all their work without leaving the garage.
While Tanis compromised the office’s phone lines and surveillance system, Steve slipped underneath Sisk’s Mercedes S-class and planted devices that would turn the car into a luxurious mobile recording studio.
An hour later, Steve and Tanis were at Starbucks having coffee and cake, their earphones plugged into their laptops, listening to Sisk discuss all the weaknesses in the DA’s case against a famous basketball player accused of rape.
“Now this is what I call police work,” Tanis said, smiling happily.
Steve wished he could share her pleasure, but uneasiness gnawed at him deep inside. He couldn’t shake the feeling that something was very wrong.
Mark sat on his deck facing the beach, a notepad in his lap. It was a sunny, cloudless day, the sky a brilliant blue, the sea an emerald green. He watched the waves break and thought about murder.
As soon as he got home, he had set up his laptop on the kitchen table and searched the Internet for information about the car accident that left Bruce Wethersby, the first organ donor, brain-dead. He found a small news item in the Los Angeles Times and learned that it wasn’t a hit-and-run accident. The distraught driver, forty-four-year-old Charlotte Unger, called 911 and stayed at the scene, comforting the victim until the paramedics arrived.
Unger told police that Wethersby crossed in front of her car as she was making a right turn. It was possible that Unger also pushed Corinne Adams down the staircase at UCLA, and the FBI was certainly going to look into it, but Mark was going to assume for now that the killer wasn’t responsible for the initial accidents.
