by Robin Cook
He went up to the floor for inpatient rounds. One of the nurses gave him the results of Madaline Krammer’s arteriogram. All the coronary vessels showed significant, diffuse, nonfocal encroachment. When the results were compared with a similar study done six months previously, it showed significant deterioration. Harry Sarnoff, the consulting cardiologist, did not feel she was a candidate for surgery, and with her current low levels of both cholesterol and fatty acids, had little to suggest with regard to her management. To be one hundred percent certain, Jason ordered a cardiac surgery consult, then went in to see her.
As usual, Madaline was in the best of moods, minimizing her symptoms. Jason told her that he’d asked a surgeon to take a look at her, and promised to stop by the next day. He had the awful sense that the woman was not going to be around much longer. When he checked her ankles for edema, Jason noted some excoriations.
“Have you been scratching yourself?” he asked.
“A little,” Madaline admitted, grasping the sheet and pulling it up as if she were embarrassed.
“Are your ankles itchy?”
“I think it’s the heat in here. It’s very dry, you know.”
Jason didn’t know. In fact, the air-conditioning system of the hospital kept the humidity at a constant, normal level.
With a horrible sense of déjà vu, Jason went back to the nurses’ station and ordered a dermatology consult as well as a chemistry screen that included some forty automated tests. There had to be something he was missing.
The rest of rounds was equally depressing. It seemed all his patients were in decline. When he left the hospital he decided to take a run out to Shirley’s. He felt like talking and she’d certainly made it clear she enjoyed seeing him. He also felt he should break the news of Helene’s murder before she heard it from the press. He knew it was going to devastate her.
It took about twenty minutes before he pulled into her cobblestone driveway. He was pleased to see lights on.
“Jason! What a pleasant surprise,” Shirley said, answering the bell. She was dressed in a red leotard with black tights and a white headband. “I was just on my way to aerobics.”
“I should have called.”
“Nonsense,” Shirley said, grabbing his hand and pulling him inside. “I’m always looking for an excuse not to exercise.” She led him into the kitchen, where a mountain of reports and memoranda covered the table. Jason was reminded of what an enormous amount of work went into running an organization like GHP. As always, he was impressed by Shirley’s skills.
After she brought him a drink, Jason asked if she’d heard the news.
“I don’t know,” Shirley said, pulling off her headband and shaking out her thick hair. “News about what?”
“Helene Brennquivist,” Jason said. He let his voice trail off.
“Is this news I’m going to like?” Shirley asked, picking up her drink.
“I hardly think so,” Jason said. “She and her roommate were murdered.”
Shirley dropped her drink on the couch and then mechanically occupied herself cleaning up the mess. “What happened?” she asked after a long silence.
“It was a rape murder. At least ostensibly.” He felt ill as he recalled the scene.
“How awful,” Shirley said, clutching her hand to her chest.
“It was gruesome,” agreed Jason.
“It’s every woman’s worst nightmare. When did it happen?”
“They seem to think it happened last night.”
Shirley stared off into the middle distance. “I’d better phone Bob Walthrow. This is only going to add to our PR woes.”
Shirley heaved herself to her feet and walked shakily to the phone. Jason could hear the emotion in her voice as she explained what had happened.
“I don’t envy you your job,” he said when she hung up. He could see her eyes were bright with unshed tears.
“I feel the same about yours,” she said. “Every time I see you after a patient dies, I’m glad I didn’t go into medicine myself.”
Although neither Shirley nor Jason was particularly hungry, they made a quick spaghetti dinner. Shirley tried to talk Jason into staying the night, but though he had found comfort being with her, helping him to endure the horror of Helene’s death, he knew he couldn’t stay. He had to be home for Carol’s call. Pleading a load of unfinished work, he drove back to his apartment.
After a late jog and a shower, Jason sat down with the printouts of all patients who’d had GHP physicals in the last year. Feet on his desk, he went over the list carefully, noting that the number of physicals had been divided evenly among all the internists. Since the list had been printed in alphabetical order rather than chronologically, it took some time for Jason to realize that the poor predictive results were much more common in the last six months than in the beginning of the year. In fact, without graphing the material, it appeared that there had been a marked increase in unexpected deaths over the last few months.
Taking a pencil, Jason began writing down the unit numbers of the recent deaths. He was shocked by the number. Then he called the main operator at GHP and asked to be connected to Records. When he had one of the night secretaries on the line, he gave the list of unit numbers and asked if the outpatient charts could be pulled and put on his desk. The secretary told him there would be no problem at all.
Putting the computer printout back into his briefcase, Jason took down his Williams’ Textbook of Endocrinology and turned to the chapters on growth hormone. Like so many other subjects, the more he read, the less he knew. Growth hormone and its relation to growth and sexual maturation were enormously complicated. So complicated, in fact, that he fell asleep, the heavy textbook pressing against his abdomen.
The phone shocked him awake — so abruptly that he knocked the book to the floor. He snatched up the receiver, expecting his service. It took another moment before he realized the caller was Carol Donner. Jason looked at the time — eleven minutes to three.
“I hope you weren’t asleep,” Carol said.
“No, no!” Jason lied. His legs were stiff from being propped up on the desk. “I’ve been waiting for your call. Where are you?”
“I’m at home,” Carol said.
“Can I come get that package?”
“It’s not here,” Carol said. “To avoid problems, I gave it to a friend who works with me. Her name is Melody Andrews. She lives at 69 Revere Street on Beacon Hill.” Carol gave him Melody’s phone number. “She’s expecting a call and should just be getting home. Let me know what you think of the material, and if there’s any trouble, here’s my number”—which she recited.
“Thanks,” said Jason, writing everything down. He was surprised how disappointed he felt not to be seeing her.
“Take care,” Carol said, hanging up.
Jason remained at his desk, still trying to fully wake up. As he did so, he realized he hadn’t mentioned Helene’s death to Carol. Well, that might be a good excuse to call Carol back, he reflected as he dialed her friend’s number.
Melody Andrews answered her phone with a strong South Boston accent. She told Jason that she had the package, and he was welcome to come over and get it. She said she’d be up for another half hour or so.
Jason put on a sweater and down vest, left the house, walked down Pinckney Street, along West Cedar, and up Revere. Melody’s building was on the left. He rang her bell, and she appeared at the door in pin curls. Jason didn’t think anyone still used those things. Her face was tired and drawn.
Jason introduced himself. Melody merely nodded and handed over a parcel wrapped in brown paper and tied with string. It weighed about ten pounds. When Jason thanked her she just shrugged and said, “Sure.”
Returning home, Jason pulled off his vest and sweater. Eagerly eyeing the package, he got scissors from the kitchen and cut the string. Then he carried the package into the den and placed it on his desk. Inside he found two ledgers filled with handwritten instructions, diagrams, and experimental d
ata. One of the books had Property of Gene, Inc. printed on the cover; the other merely the word Notebook. In addition there was a large manila envelope filled with correspondence.
The first letters Jason read were from Gene, Inc., demanding that Hayes live up to his contractual agreements and return the Somatomedin protocol and the recombinant E. coli strain of bacteria that he’d illegally removed from their laboratory. As Jason continued reading, it was apparent that Hayes had a significant difference of opinion concerning the ownership of the procedure and the strain, and that he was in the process of patenting the same. Jason also found a number of letters from an attorney by the name of Samuel Schwartz. Half of them involved the application for the patent on the Somatomedin-producing E. coli and the rest dealt with the formation of a corporation. It seemed that Alvin Hayes owned fifty-one percent of the stock, while his children shared the other forty-nine percent along with Samuel Schwartz.
So much for the correspondence, Jason thought. He returned the letters to the manila envelope. Next he took up the ledger books. The one that had “Gene, Inc.” on the cover seemed to be the protocol referred to in the correspondence. As Jason flipped through it, he realized that it detailed the creation of the recombinant strain of bacteria to produce Somatomedin. From his reading, he knew that Somatomedins were growth factors produced by the liver cells in response to the presence of growth hormone.
Putting the first book aside, Jason picked up the second. The experiments outlined were incomplete, but they concerned the production of a monoclonal antibody to a specific protein. The protein was not named, but Jason found a diagram of its amino-acid sequence. Most of the material was beyond his comprehension, but it was clear from the crossing out of large sections and the scribbling in the margins that the work was not progressing well and that at the time of the last entry, Hayes had obviously not created the antibody he’d desired.
Stretching, Jason got up from his desk. He was disappointed. He had hoped the package from Carol would offer a clearer picture of Hayes’s breakthrough, but except for the documentation of the controversy between Hayes and Gene, Inc., Jason knew little more than he had before opening the package. He did have the protocol for producing the Somatomedin E. coli strain, but that hardly seemed a major discovery, and all the other lab book outlined was failure.
Exhausted, Jason turned out the lights and went to bed. It had been a long, terrible day.
CHAPTER 11
Nightmares involving gross permutations of the terrible scene in Helene’s apartment drove Jason out of bed before the sun paled the eastern sky. He put on coffee and as he waited for it to filter through his machine, he picked up his paper and read about the double murder. There was nothing new. As he’d expected, the emphasis was on the rape. Putting the Gene, Inc., ledger in his briefcase, Jason started out for the hospital.
At least there was no traffic at that early hour as he drove to the GHP, and he had his choice of parking places. Even the surgeons who usually arrived at such an uncivilized hour were not there yet.
When he arrived at GHP, he went directly to his office. As he’d requested, his desk was piled with charts. He took off his jacket and began to go through them. Keeping in mind these were patients who had died within a month of getting a fairly clean bill of health from doctors who’d completed the most extensive physicals GHP had to offer, Jason searched for commonalities. Nothing caught his eye. He compared EKGs and the levels of cholesterol, fatty acids, immunoglobulins, and blood counts. No common group of compounds, elements, or enzymes varied from the normal in any predictable pattern. The only shared trait was most of the patients’ deaths occurred within a month of having the physical. More upsetting, Jason noticed, was that in the last three months the number of deaths increased dramatically.
Reading the twenty-sixth chart, one correlation suddenly occurred to Jason. Although the patients did not share physical symptoms, their charts showed a predominance of high-risk social habits. They were overweight, smoked heavily, used drugs, drank too much, and failed to exercise, or combined any and all of these unhealthy practices; they were men and women who were eventually destined to have severe medical problems. The shocking fact was that they deteriorated so quickly. And why the sudden upswing in deaths? People weren’t indulging in vices more than they were a year ago. Maybe it was a kind of statistical equalizing: they’d been lucky and now the numbers were catching up to them. But that didn’t make a whole lot of sense, for there seemed to be too many deaths. Jason was not an experienced statistician, so he decided to ask a better mathematician than he was to look at the numbers.
When he knew he wouldn’t be waking the patients, Jason left his office and made rounds. Nothing had changed. Back in his office and before he saw the first scheduled patient, he called Pathology and inquired about the dead animals from Hayes’s lab, and waited several minutes while the technician looked for the report.
“Here it is,” the woman said. “They all died of strychnine poisoning.”
Jason hung up and called Margaret Danforth at the city morgue. A technician answered, since Margaret was busy doing an autopsy. Jason asked if the toxicology on Gerald Farr revealed anything interesting.
“Toxicology was negative,” the tech said.
“One more question. Would strychnine have shown up?”
“Just a moment,” the technician said.
In the background Jason could hear the woman shouting to the medical examiner. She returned to the phone. “Dr. Danforth said yes, strychnine would have shown up if it had been present.”
“Thank you,” Jason said.
He hung up the phone, then stood up. At the window, he examined the developing day. He could see the traffic snarled on the Riverway from his window. The sky was light but overcast. It was early November. Not a pretty month for Boston. Jason felt restless and anxious and disconsolate. He thought about the parcel from Carol and wondered if he should turn it over to Curran. Yet for what purpose? They weren’t even investigating Hayes except as a drug pusher.
Walking back to the desk Jason took out his phone directory and looked up the phone number of Gene, Inc. He noted the company was located on Pioneer Street in east Cambridge next to the MIT campus. Impulsively, he sat down and dialed the number. The line was answered by a woman receptionist with an English accent. Jason asked for the head of the company.
“You mean Dr. Leonard Dawen, the president?”
“Dr. Dawen will be fine,” Jason said. He heard the extension ring. It was picked up by a secretary.
“Dr. Dawen’s office.”
“I’d like to speak to Dr. Dawen.”
“Who may I say is calling?”
“Dr. Jason Howard.” “May I tell him what this is in reference to?”
“It’s about a lab book I have. Tell Dr. Dawen I’m’ from the Good Health Plan and was a friend of the late Alvin Hayes.”
“Just a moment, please,” the secretary said in a voice that sounded like a recording.
Jason opened the center drawer to his desk and toyed with his collection of pencils. There was a click on the phone, then a powerful voice came over the line, “This is Leonard Dawen!”
Jason explained who he was and then described the lab book.
“May I ask how it came into your possession, sir?”
“I don’t think that’s important. The fact is I have it.” He was not about to implicate Carol.
“That book is our property,” Dr. Dawen said. His voice was calm but with a commanding and threatening undercurrent.
“I’ll be happy to turn the book over in exchange for some information about Dr. Hayes. Do you think we might meet?”
“When?”
“As soon as possible,” Jason said. “I could get over just before lunch.”
“Will you have the book with you?”
“I will indeed.”
For the rest of the morning Jason had trouble concentrating on the steady stream of patients. He was pleased Sally hadn’t scheduled
him through lunch. The minute he finished his last exam, he hurried out to his car.
Reaching Cambridge, Jason threaded his way past MIT and among the new East Cambridge corporate skyscrapers, some with dramatically modem architecture that contrasted sharply with the older and more traditional New England brick structures. Making a final turn on Pioneer Street, Jason found Gene, Inc., housed in a startlingly modern building of polished black granite. Unlike its neighbors, the structure was only six floors high. Its windows were narrow slits alternating with circles of bronze mirrored glass. It had a solid, powerful look, like a castle in a science fiction movie.
Jason got out of his car with his briefcase and gazed up at the striking facade. After reading so much about recombinant DNA and seeing Hayes’s grossly deformed zoo, Jason was afraid he was about to enter a house of horrors. The front entrance was circular, defined by radiating spikes of granite, giving the illusion of a giant eye, the black doors being the pupil. The lobby was also black granite: walls, floor, even ceiling. In the center of the reception area was a dramatically illuminated modem sculpture of the double helix DNA molecule opening like a zipper.
Jason approached an attractive Korean woman sitting behind a glass wall and in front of a control panel that looked like something out of the Starship Enterprise. She wore a tiny earpiece along with a small microphone that snaked around from behind her neck. She greeted Jason by name and told him he was expected in the fourth-floor conference room. Her voice had a metallic sound as she spoke into the microphone.
The minute the receptionist stopped speaking, one of the granite panels opened, revealing an elevator. As he thanked her, Jason suddenly fancied that she was a lifelike robot. Smiling, he boarded the elevator and looked for the floor buttons. The door closed behind him. There was no floor-selector panel, but the elevator started upward.
When the doors reopened, Jason found himself in a doorless black foyer. He assumed the entire building was controlled from a central location, perhaps by the receptionist downstairs. To his left a granite panel slid open. Within the doorway stood a man with coarse features, impeccably dressed in a dark pinstripe suit, white shirt, and red paisley tie.
