Judging from his passion, Barnard Medical had the right guy in its research department.
“Of course, the drag company can’t advertise the new uses unless those uses pass FDA scrutiny much like that given a new drag. Often clinicians—practicing physicians, the ones actually working with patients—are the ones who discover these secondary uses. There’s no rale against a physician using a drag for unapproved uses, just rales against the drag company advertising it for that use. Maybe even more important, we also find new ways to help old drags work better.”
“Like what?”
“Like delivering heart medication sublingually—under the tongue—to get it into the bloodstream more directly. Or using skin patches for everything from smoking to seasickness. In fact, we’re working on something now that—”
A knock at the door interrupted. “Dr. Demarcos,” a woman in a hospital-issue smock stuck her head in. “You asked me to remind you of your lecture. You and Dr. Hilliard start in five minutes.”
He upped the wattage on his smile. “Thanks, Greta.” He waved her away and turned back to me, not making a move to stand up or usher me out.
“You work with Langley Hilliard?” I tried to keep my tone even.
He studied my face. “That’s right. He’s testified for you before, hasn’t he?”
That was a mild way of describing it. I need to remember that the details of my life aren’t as fascinating to other people as I think they are. I changed the subject. “You ever testify as an expert witness?”
He shook his head. “I don’t have the temperament for that. Or maybe Langley’s just such a master at it that I could never hope to compete.”
Demarcos took my silence as agreement or encouragement. “Langley is one of those old-liners who came through when God still attended medical school graduations and granted physicians immunity from all mistakes. He’s so convincing because he truly believes doctors are infallible. You see that in some older docs. Maybe, back when they were making house calls, all they had to offer was faith.”
He chuckled. “Me personally? I’d rather be perfecting some more miracle cures. They work better—and pay better.”
I didn’t respond, but he didn’t notice.
“I’ve enjoyed it, Avery.” He stepped around his desk, putting his arm in the small of my back in a courtly gesture as we both turned to the door. “Please let me know if I can be of assistance in the future.”
“Thanks again. This has been most interesting. I hope I haven’t made you late for your lecture.”
“Not at all. You’re welcome to join us. We’re reviewing some new hip replacement options.” He grinned, his teeth startlingly white under the bright fluorescent hallway fights.
“I’ll take a raincheck.” I absentmindedly watched him stride down the hall as if he owned the place. Guess he didn’t need notes for his lecture.
He’d painted, in a few words, a portrait of Langley Hilliard I’d never seen before, but one I could recognize. Hilliard was what, sixty-five years old? Times had changed dramatically over his professional life. Insurance companies now second-guessed every move, and doctors were no longer revered. Demarcos was probably right; Hilliard’s lies were believable when he defended a doctor because Hilliard really believed what he said—doctors can do no wrong. He didn’t have grace enough to get down off his crumbling pedestal and join the rest of us, fallible as we are. A new perspective on Hilliard, but still not one I liked or admired.
I checked my watch. Eleven o’clock. It had been a long day already. I took the nearest exit, which landed me on the sidewalk on the far end from where I’d entered the medical maze—and farthest away from the marina and my car. At midday, just enough sun had appeared to leave a cool tingle in the air. I could walk and check voice mail at the same time.
Mom had left a message.
“Avery? Give me a call, hon. Remember Miranda Cole? That mountain goober boyfriend has gotten seriously scary. You remember Constable Raymond? Got that constable’s commission so he can carry a gun and know everybody’s business? Well, he told your father—he ran into him at the post office—that someone stole explosives from the highway construction site. You know they’re widening Main Street north of town? And one of Constable Raymond’s so-called informants, likely somebody he shoots pool with at Tap’s, told him this goober is bragging how he was the one who stole it.
“Miranda’s mama’s real upset. Your machine just beeped. Maybe you can’t hear the rest of this. Call me.”
The next message was from Jake, louder and not nearly so breezy. “Gahdammit! You won’t believe what this asshole judge did this morning! Where the hell do these guys get off? Bifurcated my effin’ trial. Can you believe it? Bifur-effin-cated it. I’m so freakin’ thrilled, I just had to share the news.”
I had to hold the phone away from my ear. Good thing I’d gotten outside before I picked up that message. That one would’ve echoed down the hospital halls. Bifurcated—broken the trial into two parts. As a defense attorney, I’d always fought rabidly for that, especially in cases where the plaintiffs’ injuries were gruesome but their case was weak. I hadn’t wanted a jury to feel so sympathetic it ignored all the holes in the case and decided to give away some of my client’s money. Judges seldom granted my most fervent wish, though. Not unless the injuries were really bad and the plaintiffs’ case had enough holes to drive a track through.
Now I felt schizophrenic. I knew the logic of what the judge had done and, sitting on the defense side of the courtroom, I would’ve felt it amply justified. But now that I stood on the other side of the courtroom, well, dang it, we wanted them to hear about those ghastly injuries. We wanted them to know how real the pain and injury and loss were. The judge’s decision meant we’d have to convince the jury Perforce was liable before the jury could hear any testimony about the plaintiffs’ injuries. The jurors would deliberate twice: first to decide who won and, if and only if we won, then they would hear about the injuries and talk about awarding money.
Jake Baker really didn’t want me to leave him a message about my morning’s activities. He really didn’t want to know.
I walked slowly, enjoying the crisp air. Demarcos was clearly one of the research insiders. Maybe someone with a more objective perspective could tell me something that didn’t paint Perforce Pharmaceuticals and Uplift in such a glowing light.
Dr. Lazarus Ellin. Mark’s journal said Ellin made at least one referral to a research study. If Ellin could give me another perspective on drag research, then stopping by to see him about Tunisia Johnson wouldn’t be a frivolity after all.
As I crossed Calhoun Street, was it my imagination or did the breeze carry a whiff of smoke? I was only blocks from what was left of Mark’s apartment. Sanda’s exhausted face came to mind. Dear Lord.
As I approached the marina, I tried calling Mom but got no answer. I’d have to catch up later on the continuing drama, “As Dacus Turns.”
10
MIDDAY FRIDAY
At 11:15 I turned left from the Variety Store’s parking lot. A new concrete bridge carries traffic across the Ashley and its bordering marshes to the islands far more efficiently than the old drawbridge does at this time of day, so I’d make my 11:30 appointment.
What had been a modest brick ranch now housed Dr. Lazarus Ellin’s office. Over time, road-widening projects, convenience stores, strip shopping centers, and traffic had swallowed up the houses along a once-pleasant neighborhood street. The houses now huddled too close to the road in weedy yards converted into parking spots. Signs advertising video rentals, MADAME OLLIE’S PALM READING, and DR. LAZARUS ELLIN, GENERAL MEDICINE vied for attention.
My tires bounced over the bumpy break in the curb and crunched to a stop in the graveled yard between a red Ford Escort with a baby seat in the back and a mini track with faded paint and a bumper sticker that read TITHE—ANY FOOL CAN HONK. A gleaming Cadillac, old but well-tended, stood beside the building.
What I took to be a single fam
ily crowded the waiting room on the converted front porch. It was hard to tell whether the woman reading a dog-eared magazine actually had a lot of clildren or whether the children were moving so quickly they only appeared innumerable.
Dr. Ellin’s nurse—her tag said GLADYS—led me straight into his office, which had once been a small back bedroom. Never leave a lawyer lurking about in your waiting room when such can be avoided.
I’d worked with Dr. Ellin, putting together seminars for medical conferences on small-practice liability. Even though we’d known each other, with that passing familiarity of occasional colleagues, I’d never been to his office.
Somehow, seeing him at the annual meetings, I’d always assumed he was one of the prosperous, successful black physicians folks trotted out, just like they trotted me out as a prosperous, successful lady lawyer. Part of the “ones to watch” crowd. His office sent a different message.
The furnishings were cheap, badly battered discards. The linoleum was a violent brown, checked with cracks, ominously discolored in spots, and curling dangerously. Index-coded file folders filled his desk and stood knee-high against the wall. An insurance peer-review board would have a hissy fit, seeing how far behind he was with his chart dictation. Or maybe this was his filing system.
The shelves behind his desk held a few books, with framed photographs scattered among them. Most looked like family shots. Out of habit, I studied his books, mostly early editions of medical texts, now outdated. Even the Webster’s dictionary was faded and tattered.
Heavy footsteps approached and the flimsy door swung open, creating a flutter of paper on his desk.
“Avery! How good to see you!” He enveloped my hand with a strong, dry grip and settled down in the wooden chair beside me, on the visitor’s side of the desk. “It’s too early for you to be on the program committee and I doubt you’re selling anything. So to what do I owe the pleasure?”
Lazarus Ellin was a tall man, beefy but not overweight. His hair had grayed over the years I’d known him into a gentle silver, and his life had arranged the wrinkles over his dark face in a pleasant way.
I chuckled. “No, not selling anything. Asking. For free information. What can you tell me about the wonderful world of pharmaceutical research? And can you tell me how to find Tunisia Johnson?”
From his expression, neither of those questions even faintly resembled what he’d expected. “A little more background, Avery? One topic is very broad. The other may be too personal.” He settled back, filling the sturdy wooden chair, his expression reserved.
“Do you know a medical resident named Mark Tilman?”
He pursed his lips, studying a minute. “I don’t b’lieve so.”
“Did know, I should say. He died in a car accident Wednesday night.” I kept talking, bypassing his sympathetic expression. “His research notes indicated you referred Tunisia Johnson to a study. The study prompted my other question, because I’m taking a crash course in new drug development and testing for a case I’m working on. Thought you could help me kill two birds.”
“I don’t know that I can help you much. I’m at the low end of the research totem pole.”
“But you refer patients to studies. How do you know about the studies?”
“Oh, the medical school and the centers here make sure we know. Every now and then, patients come to me, asking questions because they’ve seen something on TV. But most times, the researchers contact me direct, knowing I have patients they might can help.”
“What do you mean, they know?”
“To be blunt, they need black folks. And poor folks. To make sure their study takes into account all kinds. And I got plenty of people comin’ here who aren’t rich or white.” He shrugged. “Because I do general practice, I got all kinds of ailments coming in, and I get plenty of folks who can use some free medical treatment.”
“You learn they’re enrolling patients in a particular study, and you have someone with that problem who would qualify. Then what?”
“If I think it’s somebody who’ll take it seriously and if it looks like it might be some help to them, then I’ll refer them. Sometimes I do the follow-up with the patient here, fill out the questionnaires and such. Other times, I don’t even know whether they have been enrolled unless they come to see me about something else.”
From out in the hall, a penetrating wail cut through his response. The cry rose and fell but never stopped for breath. His nurse pecked at the door and opened it without waiting for a reply.
“Doctor, we’ve got an emergency just come in.”
Her voice was calm but compelling. When she announced an emergency, no one could doubt it was real, even without the wail in the background.
Dr. Ellin didn’t waste time excusing himself. I should have stayed put, but the pained cry and the nurse’s air of quiet urgency created a vacuum that sucked me along in its path.
Gladys glanced at me as I stood in the hallway across from the examining room door, but she was busy keeping the adults who had crowded into the small room against the wall and out of the way. As Dr. Ellin bent to examine his patient, I could see a small girl, the source of the wailing.
She looked to be six or seven, her wiry hair gathered into several large ponytails, her eyes wide with fright and filled with tears, her mouth a big round O.
Her family members shifted restlessly, unnerved by her plaintive insistent wailing, but none of them spoke.
With gentle words I couldn’t quite make out, Dr. Ellin quieted the shriek to a sob. He stepped away from the end of the examining table to flip open some cabinet drawers, reaching between two family members—a young man in a Harley T-shirt who might have been her dad and a young woman in her teens.
When Dr. Ellin stepped aside, I saw the girl’s hand resting on her knee and almost started wailing myself. Buried deep in the fleshy part of her hand, a fishhook glinted against the blood crusted in her pink palm. A string of fishing line dangled from the hook, curling along her thin leg.
I hoped nothing tugged that line.
Dr. Ellin distracted her with his calm, hypnotic words while he expertly snipped the line, letting it fall to the floor. She barely flinched as he gave her a shot.
He talked to her as he waited for the local anesthetic to take effect, then he bent to work. Within seconds, he was cleaning the wound with disinfectant and the nurse was handing him a bandage she’d prepared. He took the little girl’s face in his hands and kissed her forehead.
A grandmotherly woman, her flowered dress belted where her waist should have been, looked as though she wanted to kiss Dr. Ellin’s feet. Dr. Ellin spoke to each family member in turn, his hand on the little girl’s head the whole time and his voice so gentle I couldn’t make out more than a word here and there. He gave the mother and grandmother some final instructions before the nurse shepherded the family down the hall to the payment desk. A quiet discussion ended with a dismissing wave of Dr. Ellin’s hand and grateful looks from the three adults. A stem but discreet look from the nurse flowed, for Dr. Ellin’s benefit.
The family left with a large kid in a Panthers T-shirt carrying the little girl, her head on his shoulder. Any patients in the waiting room had likely resented me breaking in line, but nobody could have begrudged the little fishhook girl.
“Dr. Ellin, you’re not the one to set charges for patients,” the nurse scolded after she closed the reception room door. Respectful but stem, her voice carried down the hall to where I stood.
“Gladys, you know the Pitkins full well. What good would it do to charge them? They’ll pay something when they can.” Clearly an oft-rehearsed argument.
“At least charge them enough to pay for the anesthetic you used,” Gladys said. “The medical supply won’t take chickens and yam bushels and hoodoos in payment the way some folks do.”
Dr. Ellin smiled and nodded. I’m sure Gladys was used to him, but it didn’t stop her from trying to keep him and his office and her livelihood on an even keel.
&nbs
p; I wandered back down the hall to wait in his office. I should let them discuss their business in private.
When he returned, he had two cups of coffee in his hand, one for me.
“Sorry,” he said. “Where were we?”
I couldn’t compliment the strong, bitter coffee, and he would’ve been embarrassed if I complimented his bedside manner with the little girl, so I went back to business. “I was going to ask you about Perforce Pharmaceuticals. Have you ever had a patient participate in one of their studies?”
“Once. One of the best-run studies I’ve seen. Everything was first class.”
Great. “What drag was it?”
“For tele reflux. Still not on the market, as far as I know. Worked well for the two patients I referred, though. They’re complaining they can’t get it anymore.”
Great Even better.
“Are you doing the follow-up for Tunisia Johnson?”
He hesitated, as if weighing options. “For that study, they needed patients who could come to Barnard Medical for follow-up.”
“How can I get in touch with Tunisia?”
His eyes narrowed and his mouth tightened. “I can’t tell you.” Something in his face shut down.
As usual, an obstacle in my path just made me more determined. The only problem was, I couldn’t really explain, even to myself, why I needed to find her. It just felt like something I could fix, unlike Jake’s trial, where I felt like we were sinking. “You said Barnard Medical? Would Blaine Demarcos know her?”
He shrugged, his face oddly impassive. “With Tunisia, there’s no telling.”
To be polite, I swallowed another gulp of coffee and slipped my bag onto my shoulder. No point pushing it any further. “Thanks for letting me interrupt your morning. I know you’ve got patients who need to see you.”
“My pleasure, Avery.”
We shook hands matter-of-factly. I couldn’t get over the sudden change in his demeanor.
Gladys stepped out of the reception area as I came down the hall, holding out a large Styrofoam cup and plastic spoon. I started to wave it away, thinking it was more of that horrid coffee.
DONE GONE WRONG Page 8
