Sara entered the hospital room and her heart leaped when she saw Chelsea sitting in a chair smiling back at her. Gone were the IV's. The hiss of oxygen was wonderfully absent. The only reminders of Chelsea's stay in the ICU were several potted plants that hadn't yet been loaded in the Fergusons' car.
"Ready to go home, Chelsea?" Sara had a hard time believing this was the same teenager who'd seemed at death's door not so long ago.
"Doctor, we can't thank you enough," Mrs. Ferguson said. "Dr. Pearson was by earlier this morning. He said because Chelsea was in the study for that new drug—Jana somethingor-other—he'd need to see her in a couple of weeks to draw some blood for follow-up studies. Frankly, if that Dr. Ingersoll had said that, I'd tell him to forget it. But Chelsea says she has no problem coming back if you or Dr. Pearson say she should."
"Is that right, Chelsea?" Sara said. "Will you come back?" Chelsea nodded. Even after she was out of the ICU and well on her way to recovery, Sara couldn't recall hearing the girl speak more than a dozen words.
"I think it would be a good idea to do that," Sara said. "If you'll call my nurse, she can set up an appointment to see me in the clinic. Either Dr. Pearson or I can draw the blood samples while you're there, so you don't have to spend a lot of time waiting in the lab."
Sara did one last exam of her patient and pronounced her fit to go. "I'll just sign the order, and a nurse's aide will put you in a wheelchair and take you downstairs. Chelsea, are you okay here by yourself while your mom brings the car around?"
"Sure." When she finally spoke, Chelsea's voice was soft, her speech hesitant. Well, a near-death experience would probably do that to you.
Sara was halfway to the nurses' station when Mrs. Ferguson hurried up behind her. "Doctor, I want to thank you again. I'm sure you and Dr. Pearson saved Chelsea's life. If there's ever anything I can do—"
"No need to thank me. The fact that Chelsea is able to go home will be reward enough."
"And when we come back, I want to find out how to lodge a complaint against that terrible Dr. Ingersoll."
Sara hesitated. "We'll talk about that later. After all, it was the medication that Dr. Ingersoll helped develop that saved Chelsea's life. And maybe he was having a bad day when he first saw her."
As she pulled the chart from the rack and began to write discharge orders, Sara wondered why she'd defended a man she'd hated for so long.
Dr. Lillian Goodman passed a steaming paper cup to Verna Wells. "Have you seen Dr. Ramsey this morning?"
Verna took a sip and nodded approvingly. "You always get it right. Thanks, Dr. Goodman." She moved aside a stack of files and set the cup carefully on the desk at the nurses' station.
"Dr. Ramsey won't be here today. The schedule Gloria gave me shows him working three days a week."
"Oh. Well, I just wanted to see how he was doing. I know it can be intimidating, getting used to a new practice location."
Verna eased herself out of her chair and followed Lillian down the hall. "I know he'll appreciate your help. He seems to be getting the hang of things just fine, but I'm really glad to see you two becoming friends."
Lillian drained her own cup and tossed it in a wastebasket. "We're just colleagues, Verna. I'd do the same for any new doctor, male or female."
"Dr. Goodman, it's time you thought of getting a life outside these four walls. Dr. Ramsey's a nice man. There's nothing wrong with noticing that . . . or even doing something about it."
Lillian was shaking her head before Verna finished talking. "John Ramsey is trying to recover from the death of his wife. He's vulnerable."
"But you two seem—"
Lillian held up her hand. "I know what John feels right now. I've been down that road. He needs someone to talk with. He needs someone to care about what he's going through. He needs an occasional hug, a human touch. He needs . . . Well, what he needs is a good friend, and that's what I intend to be. But I'm not going to let it get more serious." I can't. Not right now.
No one knew he was in New York. He'd used a false ID at airport security, paid cash for his ticket. He traveled from Kennedy Airport via public transportation, spent the night in a cheap hotel under yet another name, walked to this building today carrying his toiletries and dirty linen in an anonymous briefcase. Tonight he'd be back home. And he hoped he'd be much richer for the trip.
The only light in the room where he now waited was the faint flicker from a small black-and-white TV on the table in front of him. A secure feed led to that TV from the fish-eye lens of a camera concealed in the crown molding of the confer ence room one floor below. The camera let him see all twelve men gathered around the mahogany table, while a microphone transmitted sound from the room. The men fidgeted and whispered to each other, most of them ignoring coffee that grew cold in their cups. He could hear an occasional comment. "What's going on?" "Why all the secrecy?"
He reviewed the security measures on which he'd insisted. The room in which he sat was a vacant office well removed from where the board members of Darlington Pharmaceuticals were gathered. Both rooms had been swept for bugs only ninety minutes ago and pronounced clean. He'd been in place for an hour before the first man arrived. He wouldn't leave until an hour after the last one departed, but first he'd wipe down every surface he could have touched. He didn't think they'd try to identify him by fingerprints, but he wanted nothing left to chance. Tonight he'd leave New York, having never really been there.
There was no camera in his room, but even if there were, his face was shrouded in darkness. He fiddled with the small gadget attached to the microphone on the table in front of him. It would distort his voice, making it completely unidentifi able, even if someone chose to record it and try to match it to a voiceprint later. Ridiculous? He thought not. Just leaving nothing to chance.
One floor below him, the man at the head of the table, the CEO of Darlington Pharmaceuticals, stood and cleared his throat. Conversations died in midsentence. "Gentlemen, I'll get right to it. You all know that we have tried to acquire Jandra Pharmaceuticals. Even in their weakened cash position, they've turned down our offers. I believe we now have an opportunity to snatch up the company for even less money."
"Ridiculous. We have inside information that they're about to launch a new product that will revive the company." The speaker's hands were in constant motion, fiddling with the pencil in front of him, adjusting his tie, centering and recentering a legal pad. He looked around the room before returning his gaze to the CEO. "What's changed?"
"The man whose voice you're about to hear can put a stop to the success of that new product. Matter of fact, he guarantees it." The CEO took a sip of water. "Of course, there's a price. But I can assure you, it's worth it."
In the darkened room, the man leaned toward the microphone and spoke slowly and distinctly: "Gentlemen, Jandra is about to launch a new antibiotic, Jandramycin. It offers the only cure for the deadly epidemic of Staph luciferus that is sweeping the world, taking over two thousand lives so far. Jandramycin is, and will be touted as, a 'wonder drug.' However, it has shortcomings and faults. These have been purposefully hidden during the various phases of drug testing. I'm in a position to bring them to light. The result will sink Jandramycin and send Jandra stock plummeting."
He let the buzz around the room die down. Someone would ask the question, and it turned out to be the oldest man on the board, who asked three. "How can you do it, why are you doing it, and how much will it cost us?"
He smiled. "I won't answer the first two questions, but I assure you I have my methods and my reasons. As for the price, it's ten million dollars, wired into a bank account in the Cayman Islands. Four million up front. Another three million when Jandra accepts your offer to buy them. The final three million when your acquisition is complete. These terms are nonnegotiable. You have fifteen minutes to decide."
Everyone wanted to talk at once. Questions flew, and the CEO fought to keep order.
The first question, of course, was "Can we afford this
?"
The answer there was simple. The four million was manageable. Everything else was dependent on a successful acquisition, and if that happened, the price was right.
Gradually, the buzz died down. The CEO rapped his water glass on the table. "Gentlemen, it's decision time. Price is not the crux of our debate. At issue is whether we support and underwrite this piece of industrial espionage. If we vote to accept this proposal, nothing that took place in this room can ever be revealed. Not to a spouse, a business partner, even in the confessional. Hands for 'yes.'"
Some hands shot up decisively. Others eased up gingerly. But in a moment, every hand was raised.
7
HOW MANY PATIENTS IN THE STUDY NOW?" INGERSOLL THREW THE QUEStion over his shoulder as he strode through the tunnel that linked the medical school with University Hospital.
Rip didn't break stride, nor did he reach for the note cards in the pocket of his white coat. He knew the number of patients who'd received Jandramycin, their names and diagnoses, and how they'd been at their last follow-up appointments. "Thirtynine counting the patient we put on Jandramycin yesterday."
"Oh, that was the woman—"
"It's a man. Mr. Rankin is a fifty-one-year-old school principal with sepsis from Staph luciferus, acquired when a cut on his foot from a camping trip became infected. He—"
"No need for all that. Thirty-nine. That's what I want to know."
The two men walked along in silence, Rip carefully keeping a pace behind his chief. Most doctors in postgraduate programs became good friends with the men and women under whom they trained. By the time a fellowship was over, they had formed a collegial bond. That wasn't the case here, though. From day one, Rip had received the unspoken message: You're here to learn from watching me, but I'm in charge, and don't you forget it.
"How many cases do we need before Jandra can submit their new drug app?" Rip said.
Ingersoll mumbled something.
"Sorry. I didn't hear that."
Ingersoll didn't slow or even turn his head. "I said the application for approval of a new drug was filed with the FDA two weeks ago."
At the doors of the ICU, both men found their way blocked by a cluster of people. The women cried, the men tried vainly to comfort them, and there was about the group an aura of defeat and despair. Rip had seen that scene too many times, but it never failed to move him. Someone didn't make it. For the doctor, the aftermath meant an hour's worth of paperwork. For the family, it was the beginning of a lifetime of "what if 's" and "if only's."
Slowly the group moved into the waiting room, opening a path for the doctors. Ingersoll was about to push through the swinging doors when Rip said, "How could they apply two weeks ago? I recall being told they needed at least forty patients from us before they could file the app. Two weeks ago we had thirty-seven."
"Let me worry about that. Your job is to keep the study running smoothly." Ingersoll strode to the nurse's desk, where he stopped and cleared his throat loudly. "I need the chart for my patient—" He looked pointedly at Rip.
"Cletus Rankin. Room eighteen."
"For my patient, Cletus Rankin, in room eighteen," Ingersoll repeated, as though the nurse hadn't heard Rip.
Ingersoll took the proffered chart, scanned it, and nodded with satisfaction. "Defervescing already. Good, good."
Just like Ingersoll. Use a five-dollar word instead of saying, "His fever's coming down." "Yes, he seems to be responding well. I looked in on him earlier this morning, and—"
"I'll just pop in to see him myself."
It only took Ingersoll a minute to make what Rip termed his usual cameo appearance: nod to the family, put a hand on the patient (didn't seem to matter where, it was the touching that counted), assure everyone that things were going well, and exit.
"You have the lab results from yesterday?"
"Aren't they on the chart?" Rip said.
"If they were, I would have seen them. Did you deliver the blood samples?"
"Yes, sir. To both the hospital lab and Resnick."
"Then get the results, and see that they get onto the ICU chart."
"Will do."
Ingersoll pushed back his sleeve and consulted a watch that appeared to have every function except the position of the International Space Station. "I'm leaving this afternoon to attend a meeting in Bermuda, where I'll be speaking on Jandramycin. Take care of things while I'm gone. See you Monday."
Rip ducked back into Mr. Rankin's room to answer questions the family had apparently been hesitant to ask his chief. He checked the chart, wrote a couple of orders, and decided he'd treat himself to a mocha latte before tracking down the errant lab reports.
The Starbucks in the medical center's basement was crowded. Rip had almost decided to sit outside in the courtyard when he saw Carter Resnick at a table for two in the corner. His first inclination was to ignore the research associate, but at the last minute he veered offtoward Resnick. "Mind if I join you?"
"Help yourself." Resnick moved his briefcase from the second chair and gestured toward it. "The great one turn you loose long enough to get a cup of coffee?"
Rip eased into the vacant chair. "He's leaving for Bermuda. But there's still plenty of work for both of us to do. What are you doing here?"
"I had to get out of the lab for a bit. You can't believe how boring it is, running lab tests on our patients, collating data. I wish Ingersoll would let me have some patient contact." Resnick sipped his drink—he'd also opted for a latte—then swiped at the foam moustache on his upper lip.
Rip tasted his coffee, found it too hot to drink, and set it aside, spilling a few drops in the process. "What do you know about the new drug application for Jandramycin?"
"Not much. I know Jandra said they wanted a hundred patients before they submit."
Rip toyed with his cup, making wet circles on the table. "And how many patients have we collected?"
"You know that as well as I do. Thirty-nine."
"Ingersoll told me this morning that the NDA has already gone in. Where did all the patients come from?"
"There are a couple of investigators in Germany, but they didn't start collecting patients until after we did."
"So how did Jandra come up with the volume of data needed for a new drug application?"
Resnick finished his drink, this time ignoring the foam moustache. It made his Cheshire cat grin more pronounced. "It's magic, isn't it?"
John Ramsey had been in the medical center's Faculty Club before, but never as a faculty member. The club wasn't what the name implied—no dark wood, overstuffed furniture, and faculty members sitting around sipping drinks and smoking cigars. It was bright and airy and highly functional. Windows on three sides showed views of Dallas or the buildings of the Southwestern campus. Tables were set for groups of diners from two to ten. Steam tables held several entrees. There was a well-stocked salad bar. But for John, the best thing on the menu, and his lunch of choice, was a Reuben sandwich on pretzel bread, and that was what he now held.
"Thanks for meeting me for lunch, Mark." John took a bite of his sandwich, chewed, and washed it down with iced tea.
"Glad to do it," Dr. Mark Wilcox said. "Besides, I don't get invited to the Faculty Club at the medical center very often."
"You can thank my chairman," John said. "He let me charge this to his account. Part-time faculty members don't get this kind of perk."
Mark put down his BLT. "How are you doing? Be honest with me. How long as it been since you lost Beth? Three months?"
"Closer to four. And not a day goes by that I don't miss her. But I'm trying to get my life back together. That's why I begged Don Schaeffer for this job. Unfortunately, I may have gotten myself into trouble before I saw my first patient." John took another swallow of iced tea, then cleared his throat. "That's why I invited you here today. I need some advice."
"Ask away, although I doubt there's anything in medicine I know that you don't. I'm a lowly GP who's fresh out of medical school, and y
ou're a wise old internal medicine specialist."
"Don't sell yourself short, Mark. When I first met you on ward rounds during your third year of medical school, it didn't take me long to realize that tall, redheaded fellow who asked so many questions was pretty sharp. Then one of your classmates told me you were a practicing lawyer before you applied to medical school. That explained your maturity, I guess, but the fact that you chose to leave a good career to start over in medicine was what really impressed me."
"Nothing to it. I just decided I could help people a lot more by trying to cure their ills than by suing doctors who hadn't been able to." Mark frowned at the man who'd become his mentor. "Are you in legal trouble?"
"I may be." John related his story in short, unemotional sentences, much as he'd present a case to a consultant. He finished with, "The family says they're going to sue the medical center and everyone involved. So what do you think my exposure will be?"
Mark tented his fingers and pursed his lips.
Thinking before he talks. No wonder I thought he'd be a good doctor.
"I could give you the standard lawyer's disclaimer. I need more facts. I need to read your malpractice insurance policy, including the tail coverage. I need— Never mind. You just want my opinion. My opinion is that you assisted the physician in charge of the activity in trying to save the life of a patient. You may have done more than the average citizen, but you never went beyond your capabilities and training, never breached the standard of care. The medical center's policy aside, you're probably protected under the Good Samaritan Law of the state."
John let out a breath he didn't know he was holding. "So you think I don't have to worry?"
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