“Here, honey. You take some of this with you. Mizriz Brown brought in a whole mess of bog. We can’t possibly eat all this and I just bet you hadn’t had lunch.”
The thick gray-white stew Szeged better than it looked—or sounded. Chicken bog, made with chicken, rice, sausage, and whatever else was handy, cooked into a spicy unrecognizable mush, was a Lowcountry specialty.
“Thanks.” I meant it.
I strolled out, scooping spoonfuls of the warm stew, and finished the whole cup before I got to my car. The shiny Cadillac had gone, leaving the battered track and the Escort huddled in the parking lot next to my Mustang.
11
MIDDAY FRIDAY
I sat in the parking lot outside Dr. Ellin’s brick house, toying with my cell phone, mulling over my options. So far, I’d gathered glowing reviews on Perforce Pharmaceuticals and Uplift. Without evidence Perforce knew of a problem and failed to protect patients from it, without some flaw in its FDA approval, Jake’s case would be all uphill.
Puzzled by the way Dr. Ellin had shut down on me, I dialed directory assistance. No listing for Tunisia Johnson, according to the operator’s smooth voice.
“Does that cover the entire Charleston area? Or just—”
“That’s the entire region, yes, ma’am. Could I help you with another number?”
“No. Thanks—no, wait. How about the office of Dr. Harold Redfearn in Dacus, South Carolina?”
She transferred me to another operator.
Trying to gain perspective through others’ eyes wasn’t particularly helpful if you didn’t know how they saw things, what peculiar color their vision had. You can only judge that if you’ve known the person for a while. I’d known Dr. Redfearn since he’d begun treating my childhood ills and scrapes, so he could give me some perspective.
“Doc, quick question. You ever participate in any drag research studies? Or is that just for guys near teaching hospitals?”
“Hey, Avery. Good to hear from you,” he said, subtly chiding me for my abruptness. “And yes, a time or two. Usually too much hassle for me and the patient, for too little benefit.”
Over the phone, his froggy voice conjured up a full picture of his stand-up shock of prematurely white hair and his craggy Frankenstein face.
“When you refer patients, are they treated at a research center?”
“Sometimes. Not always. If the protocol is simple and the follow-up straightforward, we may do it here without them having to go to Greenville or Atlanta. Depends on what protocol the FDA approved. Drag companies want their studies standardized across all test sites, so the protocols are regimented.”
“But you don’t participate in very many studies?”
“Naw. Too much hassle, if you do it right. I know a couple of guys who’ve decided it looks like a good revenue stream. What with insurance companies continually cutting what they’re willing to pay us for services, some guys look for anything that pays.”
“What do they pay you?”
“Usually just enough to cover administrative costs, but some guys remind me of a welfare mother who thinks having more babies means having more money. They can count the income but aren’t as good at figuring what it costs them. Bottom line, I think payments to doctors and patients skew the results sometimes. Say you get a few hundred dollars to sign up patients for a well-funded study and you feel you need the money more than you need your integrity, you might recommend patients who aren’t well-suited or for whom something else might be a better alternative.”
He murmured instructions to someone in his office before he continued. “Maybe I’m old-fashioned, but I think it’s all become too commercial, opened the door too wide for those who like to check their scruples at the door. Too much conflict of interest. At the very least, doctors should tell patients they’re getting paid to sign them up, but most don’t bother sharing that. They just tell how much the patients will get paid for acting as guinea pigs. It just doesn’t feel right to me.”
“How much do the patients get paid?”
“Varies. For some, getting their regular doctor visits paid for is a plus. Any travel expenses or payment for their time is a bonus. Some do it for good-hearted reasons, so they can help find a cure. The problem is, for those living on the margin, money is money. They see only one part of the equation.”
“What do you know about the drag Uplift?”
He switched subjects without missing a beat. “Great drag. Effective for those deeply depressed, but also good for mild depression, those who don’t want to loll themselves but who might get irritated enough to kill a mother-in-law.” He chuckled, probably remembering a particular family. Maybe more than one.
“Kidding aside,” he said, “chronic, lifelong depression is a truly horrid disorder. But milder depression can also hit short term, like before menopause or when a spouse dies. Uplift is very effective at getting folks over those rough spots, maybe for a couple, three years. Then they’ll be fine.”
“How does it stack up against other antidepressants?”
“By far and away, my personal favorite to prescribe. If someone needs something stronger, I recommend intensive counseling along with one of the stronger drags. Pills don’t make all your problems go away. Sometimes folks need help working through their emotions, not just a signed prescription blank.”
Which made him one of the golden few among physicians.
“What do you know about Perforce Pharmaceuticals? As a company.”
“Can’t say I’ve ever really thought about it. For years, they led the development of new antibiotics. Most of those are generic now, but that’s where they made their reputation. Guess what we know about any of these companies comes from the drag reps they send around. Perforce reps know their stuff, and they offer some of the best drags in several lines.”
More good news. “Thanks for your time, Doc. I know you’re busy.”
“Saw your dad yesterday. He said you were out of town. See you when you get back? Maybe then you can fill me in on what you’re working on.”
“Yeah. It should be over by then.” The way it was shaping up, it probably wouldn’t be a story I wanted to tell over lunch at Maylene’s. “Thanks again.”
Maylene’s came to mind because my stomach rambled faintly. Lunchtime was ticking past, and, with no breakfast, that spicy chicken bog was starting to chum. If I didn’t catch Blaine Demarcos now, during lunch, no telling when I could track him down. I drove back over the Ashley River and found a space in a parking deck at the backside of Barnard Medical, near the door where I’d exited earlier. Now that I knew about that secret entrance and could avoid the winding halls, maybe I could get in and out quickly and still catch Jake before court reconvened after lunch.
A doctor, complete with lab coat and ubiquitous stethoscope—why do they carry those things? Don’t they have them in the examining rooms?—was coming out the door as I approached. The discreet sign said STAFF ENTRANCE ONLY. He kindly held the door for me, rather than force me to use the swipe card I didn’t have.
Please, please be there. I needed this to be quick. My wish wasn’t immediately granted. Demarcos wasn’t in his office, but the duty nurse at the station paged him for me. If I could get all this help wearing a black suit and carrying a notebook, I wondered, what I could get with a stethoscope strung around my neck?
“Avery. I wasn’t expecting to see you again so soon.” Demarcos strode toward me.
He didn’t say, “What a pleasant surprise,” but he smiled as if he meant it.
“I would’ve asked you this when we met, but I didn’t realize you would know. Dr. Lazarus Ellin, out on James Island? He said you might have a current address for Tunisia Johnson.”
I hoped mentioning Dr. Ellin would lend credibility to my request.
“Tunisia Johnson?” He said it slowly, as if trying to put a face with the name.
“Dr. Ellin referred her to a study you’re conducting. You might have a more current address.” Not exactly a lie.<
br />
He shook his head. “Sony. Can’t help. She dropped out of the study.” He shrugged. “That’s a problem we have sometimes, you know.”
My expression prompted him to explain.
“For whatever reason—drags, alcohol, a new boyfriend or abusive husband—sometimes it’s hard to keep them involved and compliant with the study guidelines.”
I didn’t know Tunisia Johnson, but I suddenly felt protective.
My stare must have gone on a bit too long because his gaze shifted. “Sorry I couldn’t be of any help.” His New Jersey accent became sharp and dismissive.
“Sorry to bother you. Thanks anyway.” I managed a quick smile and watched him stride off down the hall.
I hadn’t mentioned Mark’s research journal at either meeting with Demarcos. I told myself it didn’t look like an official medical center document, and I wasn’t sure whether it belonged to Mark or the research project. Mark had sent that journal for a reason. No cash-strapped medical resident goes to the expense of sending a notebook by courier to his girlfriend—a girlfriend he expects to see later that day. Last night’s fire added to the distant drumbeat I could hear in my head. Until I put some of the puzzle pieces together, the fewer of Mark’s colleagues who knew about the journal and its whereabouts, the better.
I knew my next step was a wrong one—but I knew I’d take it anyway. Another question-and-answer session at the nurse’s station got me directions to the research department, where the paperwork was managed for the center’s pharmaceutical and federal grants.
Demarcos had headed in the opposite direction. Good. Less chance for an awkward encounter. The nurse’s directions led me to a tiny cubicle barely big enough for a desk and the large girl who sat behind it. She looked fresh out of high school.
“How may I help you?” She was either new at her job, the product of some new patient-friendly training seminar, or the aftereffect of an experimental tranquilizer.
“I’m Avery Andrews.” I offered my hand and she shook it, put off her stride momentarily by this unpatient-like initiative.
“I’m an attorney and have worked with several of the doctors here over die years.” Not a lie. Technically.
She nodded and beamed. “Yes, ma’am, I recognize your name.”
“I understand you handle the research intake interviews for Dr. Demarcos and the other physicians.”
Her beaming brightened at my mention of Demarcos. She nodded vigorously, which set her chins quivering slightly. She looked like a chubby puppy, painfully eager to please.
“I need to contact a patient of Dr. Demarcos’s who has left a study.”
While I talked, I pulled out my notebook, ready to take down the information. Act like you know what you’re doing, Aunt Letha always says, and everyone will think you do. I couldn’t cite which exact sections of the Code of Professional Conduct I’d just violated, but I preferred to focus on justifiable ends at the moment rather than questionable means.
Her eagerness to help and her obvious respect for Demarcos made my rationalization pinch a bit, but it also moved things along and reduced my chances of getting caught.
She punched up four or five screens on her computer. I could see the screens change but couldn’t make out the information as it flashed past.
“Here she is. Tunisia Johnson. She’s in Mt. Pleasant.” The privacy laws have cost a lot of paper, but haven’t changed either helpful or malicious human nature. She gave me a street and house number.
“What they’re working on is really exciting—a nasal spray contraceptive. Is that phenomenal or what? Easy to use, not messy, and without the pill’s side effects.” She sounded like an infomercial.
I tried to look appreciatively awed by the concept. “How does it work?”
“Well, I’m no doctor, but a friend of mine—Sarah Jay—works with the study, instructing women how to use the spray. It’s supposed to block the pituitary gland from sending messages to the ovaries. It works sort of like the pill but, since the pituitary is close to the sinus passages, the medication doesn’t have to float around all over your body before it finds its way to where it’s supposed to go.”
“That is interesting.” A simplistic but, I’m sure, effective description of a complicated process that even the researchers themselves didn’t fully understand. With an aging but still fertile female population who’d been on the pill for too long, this could be a significant breakthrough. Even if only a few of the side effects could be avoided, it would open the market to some of the millions of women who had never been able to use the pill.
Demarcos had quite a little pet project here. No wonder he was so close-mouthed and defensive.
“Thank you so much—Deb.” I spotted her nametag on her desk. A ceramic dragon held her business cards. Gatekeeper Deb ? Friend of the horn-of-plenty hat man at the garbage Dumpster?
“Oh, you’re certainly welcome.” She stood to escort me from her cubicle, the perfect hostess.
“What you do must be very interesting, Miz Andrews,” she said as she backed me into the hallway. “Being a lawyer, that must be something special. Despite all those awful lawyer jokes.” She looked sincerely pained.
How sweet. Nobody had ever worried if bad jokes hurt my feelings. I smiled and thanked her as she squeezed back into her cubicle.
Blaine Demarcos picked that moment to turn the corner at the far end of the hall. I didn’t waste any more time saying good-bye.
I scooted into the cross hall, hoping he hadn’t recognized me. Did I dare attempt it? I was here. What did I have to lose? A lot, actually. I followed the signs to Medical Records.
Dian, a comfortably padded woman my mother’s age, sat behind a counter that ran the length of the records office. I was in luck. Dian’s supervisor Jonette, who was immune to my friendly charm and a stickler for detail, was out to lunch.
“Whoops. The lawyer’s here. Somebody’s lost another patient. How fresh is it? Will I have the record here, or do I have to track down the bits and pieces from the different departments?” Dian had pushed back from her desk as I walked in and stood with her hands on her hips, smiling. “Haven’t seen you in a while, sweetie.”
“Nobody’s lost one.” I smiled back. “Least, not that I know of. But I do need a record. Tunisia Johnson. Here’s her Mt. Pleasant address, but I don’t have her date of birth with me. You need that?”
Volunteering my lack of information would look less suspicious than if she asked and I couldn’t produce it. Apparently, word that I was no longer defending doctors—and no longer had a reason to be requesting records—hadn’t reached here yet.
I’d once been a regular, though, and I’d learned long ago that too many folks make the mistake of forgetting records clerks are people—often very ignored people who appreciate those who are nice to them.
Dian reappeared from the stacks with a manila folder. “Here she is. Tunisia Johnson. Oops. This one’s stuck inside it. Wait a sec.”
I froze with my hand out for the file.
“Well, it’s another T. Johnson. Tabitha. Ah, same address. Must be her daughter. Yep. Here it is.” She plopped both files on the countertop and pulled the patient history sheets.
“Sometimes they accidentally get filed together if they’ve been in together to see the clinic doctor.”
“While I’m at it, maybe I’d better check both.” I closed the folders quickly, smiled warmly, and scuttled toward an empty cubicle just as the early lunch crowd, including Jonette, filed in the door. In Jonette’s operation, I bet you could set your clock on the lunch returns.
My guilty conscience should have troubled me more, but getting patients’ records and maintaining their confidentiality had once been a routine part of my job. So what if it hadn’t been a routine part of my job to do that without proper authorization? I wasn’t going to share anything with anybody. This Tunisia thing had turned into a puzzle I simply had to solve, just a small detour from Jake’s case while I waited for the trial to crank up.
I thumbed quickly through Tunisia’s records. She’d apparently used the hospital’s clinic for her primary medical care. Before that, she’d had no regular physician. Her last recorded visit had been six months ago when she’d seen Mark Tilman for a chronic bronchitis. He’d noted her blood pressure as 138/88 and her temp at 99, both slightly elevated. Nothing else seemed remarkable.
Since both records were slim, I zipped Tunisia’s and her daughter’s through the collating copier in the back room, dropped the originals in the to-be-filed basket, and waved casually to Dian on my way out. Avoiding the Dragon Lady of the Records Room had probably used up my quotient of good luck for the whole day.
At least I had Tunisia’s address. What that got me, I didn’t know. But something about Demarcos’s casual dismissal and Lazarus Ellin’s odd transformation had made me determined to find Tunisia Johnson.
My stomach burned ominously. Midafternoon, and I still hadn’t eaten. With the photocopies tucked safely in my satchel, I headed toward the exit. Contemplating where to grab a late lunch and not paying particular attention to where I was going, I bumped—literally—into Blaine Demarcos.
12
LATE FRIDAY AFTERNOON
“Three times in one day.” Demarcos grabbed my shoulders to steady us both. “The stars must be aligned.” His dark eyes focused on my face.
The first thing I registered was not embarrassment at causing the collision, but guilt. I squelched that. No way he knew what I had in my briefcase.
DONE GONE WRONG Page 9
