by Mortal Fear
Table of Contents
Title Page
Copyright Page
Acknowledgements
Dedication
Chapter 1.
Chapter 2.
Chapter 3.
Chapter 4.
Chapter 5.
Chapter 6.
Chapter 7.
Chapter 8.
Chapter 9.
Chapter 10.
Chapter 11.
Chapter 12.
Chapter 13.
Chapter 14.
Chapter 15.
Chapter 16.
Chapter 17.
EPILOGUE
“A chilling odyssey into the origins of life—and death.”
—USA Weekend
MORTAL FEAR
At a large Boston clinic, a world-class biologist stumbles upon a miraculous discovery, a major scientific breakthrough. Soon, healthy. middle-aged patients are dying of old age. And the ultimate experiment in terror begins …
“Page-turning action … reaches out and grabs you!”
—Richmond Times-Dispatch
DR. ROBIN COOK, a graduate of Columbia Medical School, finished his postgraduate medical training at Harvard. He is the author of Shock, Abduction, Vector, Toxin, Chromosome 6, Contagion, and numerous other bestselling novels.
Coast-to-Coast Raves for Robin Cook’s thriller
MORTAL FEAR
“AN EXCELLENT SUSPENSE NOVEL!”
—Copley News Service
“POPULAR FICTION AT ITS BEST … fast-paced, thoroughly grounded in fact and peppered with interesting insights … Robin Cook, a physician, uses the latest medical and scientific data to give the novel an immediacy and power that grabs the reader.”
—Chattanooga Times
“EXCITING … CERTAIN TO PLEASE COOK’S HUGE FOLLOWING.”
—Kirkus
“FASCINATING … Robin Cook, master of such medical thrillers as Coma and Mindbend, weaves his narrative around a fascinating question recently explored by real researchers: Why do humans age and ultimately die?”
—Washington Post
“A REALISTICALLY FRIGHTENING PICTURE OF THE EVIL POTENTIAL OF GENETIC MANIPULATIONS … Robin Cook takes his scalpel to the medical profession once again!”
—Cincinnati Post
“FAST-PACED AND ENERGETIC!”
—The Commercial Appeal
“ENGROSSING … RICH IN POWERFUL IMAGERY … Cook, a doctor himself, clearly knows his subject!”
—Chicago Tribune
“ROBIN COOK IS AT IT AGAIN … a definite skill at creating excitement!”
—Indianapolis News
“NO ONE CAN TOP COOK WHEN HE’S SPINNING HIS MEDICAL MURDER-AND-MYSTERY YARNS!”
—Marlboro Enterprise/Hudson Daily Sun
“HIS BIGGEST WINNER … EVERY BIT AS GOOD AS COMA … Cook spins a believable story of greed, corruption and fear that sweeps the reader into a maelstrom of horror … WELCOME BACK, ROBIN COOK!”
—Panorama
“ENTERTAINING, THOUGHT-PROVOKING, AND INFORMATIVE … An arresting look at the ethical dilemmas inherent in the practice of genetic engineering.”
—Dow Jones News
“A GUARANTEED BESTSELLER!”
—San Jose Mercury News
Titles by Robin Cook
SEIZURE
SHOCK
ABDUCTION
FEVER
VECTOR
TOXIN
INVASION
CHROMOSOME 6
CONTAGION
ACCEPTABLE RISK
FATAL CURE
TERMINAL
BLINDSIGHT
VITAL SIGNS
HARMFUL INTENT
MUTATION
MORTAL FEAR
OUTBREAK
MINDBEND
GODPLAYER
BRAIN
SPHINX
COMA
THE YEAR OF THE INTERN
This is a work of fiction. Names, characters, places, and incidents are either the product of the author’s imagination or ate used fictitiously, and any resemblance to actual persons, living or dead, business establishments. events or locales is entirely coincidental.
MORTAL FEAR
A Berkley Book / published by arrangement with the author
PRINTING HISTORY
G. P. Putnam’s Sons edition / January 1988
Berkley edition / February 1989
All rights reserved.
Copyright © 1988 by Robin Cook.
This book may not be reproduced in whole or in part, by mimeograph or any other means, without permission.
For information address: The Berkley Publishing Group, a division of Penguin Putnam Inc,.
375 Hudson Street, New York, New York 10014.
The Penguin Putnam Inc. World Wide Web site address is http://www.penguinputnam.com
eISBN : 978-1-101-14186-1
BERKLEY®
Berkley Books am published by The Berkley Publishing Group,
a division of Penguin Putnam Inc.,
375 Hudson Street, New York, New York 10014.
BERKLEY and the “B” design
are trademarks belonging to Penguin Putnam Inc.
http://us.penguingroup.com
ACKNOWLEDGMENTS
This book could not have been written without the support and encouragement of all my friends who have helped me in a difficult time. You all know who you are, and you all have my heartfelt thanks.
For my older brother, Lee, and
my younger sister, Laurie.
I’ve never been between two nicer people.
PROLOGUE
OCTOBER 11, WEDNESDAY P.M.
The sudden appearance of the foreign proteins was the molecular equivalent of the Black Plague. It was a death sentence with no chance of reprieve, and Cedric Harring had no idea of the drama about to happen inside him.
In sharp contrast, the individual cells of Cedric Harring’s body knew exactly what disastrous consequences awaited them. The mysterious new proteins that swept into their midst and through their membranes were overwhelming, and the small amounts of enzymes capable of dealing with the newcomers were totally inadequate. Within Cedric’s pituitary gland, the deadly new proteins were able to bind themselves to the repressors that covered the genes for the death hormone. From that moment, with the fatal genes exposed, the outcome was inevitable. The death hormone began to be synthetized in unprecedented amounts. Entering the blood-stream, the hormone coursed out into Cedric’s body. No cell was immune. The end was only a matter of time. Cedric Harring was about to disintegrate into his stellar elements.
1.
The pain was like a white-hot knife starting somewhere in his chest and quickly radiating upward in blinding paroxysms to paralyze his jaw and left arm. Instantly Cedric felt the terror of the mortal fear of death. Cedric Harring had never felt anything like it.
By reflex he gripped the steering wheel of his car more tightly and somehow managed to stay in control of the weaving vehicle as he gasped for breath. He’d just entered Storrow Drive from Berkeley Street in downtown Boston, and had accelerated westward, merging with the maddening Boston traffic. The images of the road swam before him and then receded, as if they existed at the end of a long tunnel.
By sheer strength of will, Cedric resisted the darkness that threatened to engulf him. Gradually, the scene brightened. He was still alive. Instead of pulling over, instinct told him his only chance was to get to a hospital as fast as possible. By lucky coincidence the Good Health Plan Clinic was not too far off. Hold on, he told himself.
Along with the pain came a drenching sweat that started on Cedric’s forehead but soon spread to the rest of his body. Sweat stung his eyes, but he dared not loosen his grip on the steering wheel to
wipe it away. He exited the highway onto the Fenway, a parklike complex in Boston, as the pain returned, squeezing his chest like a cinch of steel wire. Ahead cars were slowing for a traffic light. He couldn’t stop. There was no time. Leaning forward, he depressed the horn and shot through the intersection. Cars went by, missing him by inches. He could see the faces of the startled and enraged drivers. He was now on Park Drive with the Back Bay Fens and the scruffy victory gardens on his left. The pain was constant now, strong and overpowering. He could hardly breathe.
The hospital was ahead on the right, on the previous site of a Sears building. Only a little further. Please…. A large white sign with a red arrow and red letters that said EMERGENCY loomed above.
Cedric managed to drive directly up to the emergency room platform, braking belatedly and crashing into the concrete abutment, He slumped forward, hitting the horn and gasping for breath.
The first person to reach his car was the security guard. He yanked open the door and after a glance at Cedric’s frightening pallor yelled for help. Cedric barely choked out the words, “Chest pain.” The head nurse, Hilary Barton, appeared and called for a gurney. By the time the nurses and the security man had Cedric out of the car, one of the emergency room residents had appeared and helped maneuver him onto the stretcher. His name was Emil Frank and he’d been a resident for only four months. A few years previously he would have been called an intern. He too noticed Cedric’s cream-colored skin and profuse perspiration.
“Diaphoresis,” he said with authority. “Probably a heart attack.”
Hilary rolled her eyes. Of course it was a heart attack. She rushed the patient inside, ignoring Dr. Frank, who’d plugged his stethoscope into his ears and was trying to listen to Cedric’s heart.
As soon as they reached the treatment room, Hilary ordered oxygen, IV fluids and electrocardiographic monitoring, attaching the three main EKG leads herself. As soon as Emil had the IV going, she suggested to him that he order 4 mg. of morphine to be given IV immediately.
As the pain receded a little, Cedric’s mind cleared. Even though no one had told him, he knew he’d had a heart attack. He also knew he’d come very close to dying. Even now, staring at the oxygen mask, the IV, and the EKG machine as it spewed paper out onto the floor, Cedric had never felt so vulnerable in his life.
“We’re going to move you to the coronary care unit,” Hilary said. “Everything is going to be okay.” She patted Cedric’s hand. He tried to smile. “We’ve called your wife. She’s on her way.”
The coronary intensive care unit was similar to the emergency room as far as Cedric was concerned-and just as frightening. It was filled with esoteric, ultramodern electronic technology. He could hear his heartbeat being echoed by a mechanical beep, and when he turned his head he could see a phosphorescent blip trace across a round TV screen.
Although the machines were frightening, it was a source of some reassurance to know all that technology was there. Even more reassuring was the fact that his own doctor, who had been paged shortly after Cedric’s arrival, had just come into the ICU.
Cedric had been a patient of Dr. Jason Howard’s for five years. He had begun going when his employers, the Boston National Bank, insisted that senior executives have yearly physicals. When Dr. Howard suddenly sold his private practice several years previously and joined the staff of the Good Health Plan (GHP), Cedric had dutifully followed. The move required changing his health plan from Blue Cross to the prepaid variety, but it was Dr. Howard that had attracted him, not GHP, and Cedric had let Dr. Howard know it in no uncertain terms.
“How are you doing?” Jason asked, grasping Cedric’s arm but paying more attention to the EKG screen.
“Not … great,” Cedric rasped. It took several breaths to get out the two words.
“I want you to try to relax.”
Cedric closed his eyes. Relax! What a joke.
“Do you have a lot of pain?”
Cedric nodded. Tears were running down his cheeks.
“Another dose of morphine,” Jason ordered.
Within minutes of the second dose, the pain became more tolerable. Dr. Howard was talking with the resident, making sure all the appropriate blood samples had been drawn and asking for some kind of catheter. Cedric watched him, reassured just seeing Howard’s handsome, hawklike profile and sensing the man’s confidence and authority. Best of all, he could feel Dr. Howard’s compassion. Dr. Howard cared.
“We have to do a little procedure,” Jason was saying. “We want to insert a Swan-Ganz catheter so we can see what’s going on inside We’ll use a local anesthesia so it won’t hurt, okay?”
Cedric nodded. As far as he was concerned, Dr. Howard had carte blanche to do whatever he felt was necessary. Cedric appreciated Dr. Howard’s approach. He never talked down to his patients—even when Cedric had had his physical three weeks ago and Howard had lectured him about his high-cholesterol diet, his two-pack-a-day cigarette habit, and his lack of exercise. If only I’d listened, Cedric thought. But despite Dr. Howard’s doomsday approach to Cedric’s lifestyle, the doctor had admitted that the tests were okay. His cholesterol was not too high, and his electrocardiogram had been fine. Reassured, Cedric put off attempts to stop smoking and start exercising.
Then, less than a week after his physical, Cedric felt as if he were coming down with the flu. But that had been only the beginning. His digestive system began acting up, and he suffered terrible arthritis. Even his eyesight seemed to deteriorate. He remembered telling his wife it was as though he had aged thirty years. He had all the symptoms his father had endured during his final months in the nursing home. Sometimes when he caught an unexpected glimpse of his reflection, it was as if he were staring at the old man’s ghost.
Despite the morphine, Cedric felt a sudden stab of white-hot, crushing pain. He felt himself receding into a tunnel as he had in the car. He could still see Dr. Howard, but the doctor was far away, and his voice was fading. Then the tunnel started to fill with water. Cedric choked and tried to swim to the surface. His arms frantically grappled the air.
Later, Cedric regained consciousness for a few moments of agony. As he struggled back to awareness, he felt intermittent pressure on his chest, and something in his throat. Someone was kneeling beside him, crushing his chest with his hands. Cedric started to cry out when there was an explosion in his chest and darkness descended like a lead blanket.
Death had always been Dr. Jason Howard’s enemy. As a resident at Massachusetts General, he’d carried that belief to the extreme, never giving up on a cardiac arrest until a superior ordered him to stop.
Now he refused to believe that the fifty-six-year-old man whom he’d examined only three weeks carlier and had declared generally healthy was about to die. It was a personal affront.
Glancing up at the monitor, which still showed normal EKG activity, Jason touched Cedric’s neck. He could feel no pulse. “Let me have a cardiac needle,” he demanded. “And someone get a blood pressure.” A large cardiac needle was thrust into his hand as he palpated Cedric’s chest to locate the ridge on the sternum.
“No blood pressure,” reported Philip Barnes, an anesthesiologist who had responded to the code call that automatically went out when Cedric arrested. He’d placed an endotracheal tube into Cedric’s trachea and was ventilating him with oxygen by compressing the Ambu bag.
To Jason, the diagnosis was obvious: cardiac rupture. With the EKG still being recorded, yet no pumping action of the heart, a situation of electromechanical dissociation prevailed. It could mean only one thing. The portion of Cedric’s heart that had been deprived of its blood supply had split open like a squashed grape. To prove this horrendous diagnosis, Jason plunged the cardiac needle into Cedric’s chest, piercing the heart’s pericardial covering. When he drew back on the plunger, the syringe filled with blood. There was no doubt. Cedric’s heart had burst open inside his chest.
“Let’s get him to surgery,” Jason shouted, grabbing the end of the bed. Phil
ip rolled his eyes at Judith Reinhart, the coronary care head nurse. They both knew it was futile. At best they might get Cedric on the heart-lung machine, but what then?
Philip stopped ventilating the patient. But instead of helping to push the bed, he walked over to Jason and gently put an arm on his shoulder, restraining him. “It’s got to be cardiac rupture. You know it. I know it. We’ve lost this one, Jason.”
Jason made a motion to protest, but Philip tightened his hold. Jason glanced at Cedric’s ivory-colored face. He knew Philip was right. As much as he hated to admit it, the patient was lost.
“You’re right,” he said, and reluctantly let Philip and-Judith lead him from the unit, leaving the other nurses to prepare the body.
As they walked over to the central desk, Jason admitted that Cedric was the third patient to die just weeks after having a clean physical. The first had been another heart attack, the other a massive stroke. “Maybe I should think about changing professions,” Jason said half seriously. “Even my inpatients have been doing poorly.”
“Just bad luck,” Philip said, giving Jason a playful poke in the shoulder. “We all have our bad times. It’ll get better.”
“Yeah, sure,” Jason said.
Philip left to return to surgery.
Jason found an empty chair and sat down heavily. He knew he’d have to get ready to face Cedric’s wife, who would be arriving at the hospital at any moment. He felt drained. “You’d think by now I’d have gotten a little more accustomed to death,” he said aloud.
