by Robin Cook
Wendy hadn't budged. Getting unsteadily to her feet, Marissa. gently shook her friend's shoulder.
"Wendy!" Marissa called softly. Then louder: "Wendy, time to wake up."
"Already?" Wendy asked groggily. She pushed herself up to a sitting position. Then she groaned.
"Oh, my word! I feel awful."
Marissa nodded.
"I know it's hard; I'm still exhausted. It feels like midnight but it's only noon. We'd better get used to it."
Wendy threw herself back on the bed.
"Tell the tour director I died," she said.
An hour later, Marissa and Wendy descended in the elevator to the lobby, feeling much improved. A second shower and room service "tucker," as the bellboy had called the food, had revived them more than they'd expected.
Once they were in the lobby, Wendy went to a nearby travel agency to make inquiries about the Great Barrier Reef while Marissa waited in line to speak with the concierge concerning Brisbane sightseeing. The two rendezvoused half an hour later.
"I got it all figured out," Wendy reported.
"Take a look at this." She smoothed out a map of the entire Queensland coastline including all the offshore islands.
"Holy Toledo," Marissa. exclaimed.
"How long is this reef? It looks like it goes all the way to New Guinea."
"Practically," Wendy said.
"It's well over a thousand miles long and in area it's larger than Britain. But we're going here, to Hamilton Island." Wendy poked her finger halfway up the peninsula.
"It's part of the Whitsunday Island group."
"Are you sure I'm going to like this?" Marissa said. She wasn't big on diving as her friend.
"You're going to love it!" Wendy said.
"Hamilton Island is a good choice because it's got an airport that takes regular jets. We can fly directly from Brisbane with Ansett Airlines. Usually they're pretty well booked, but it turns out that April is offseason."
"Even that doesn't sound so good to me," Marissa said.
"If it's off-season, there's usually a good reason, like it's not a good time to go."
"I was told that we may have a thunderstorm or two, but that's the only negative," Wendy said.
"Is diving on this reef dangerous?" Marissa asked.
"Don't worry! We'll have a dive master with us," Wendy assured her.
"We'll charter a boat and head out to the outer reef.
That's where there are the most fish and the clearest water."
"What about sharks?" Marissa asked.
"They didn't say anything about sharks," Wendy said.
"But sharks stay out in deep water. We'll be diving on the reef itself.
I'm telling you, you'll love it. Trust me."
"Well, I have some tamer information," Marissa said.
"The concierge recommended we take a city bus tour. At first she said to walk around, but when I told her we'd just flown in, she told me about the buses. She said we should be sure to visit the Lone Pine Koala Sanctuary."
"Wonderful!" Wendy said with glee.
"I love koalas."
The bus tour was their first order of business. They were driven around in air-conditioned comfort and viewed such sights as the French Renaissance-style Parliament House and the Italian Renaissance-style
Treasury building. The streets were loaded with sidewalk cafes. Marissa couldn't get over how relaxed and casual everyone looked.
Fatigue eventually took over again. During the second hour both Marissa and Wendy nodded off as the bus slowed for a viewing of the new Queensland Cultural Center. They roused a bit for the visit to the Lone Pine Koala Sanctuary. Not only were there more koala bears than they could have imagined, there were dingos, kookaburras, kangaroos, and evena platypus. They were able to walk among the kangaroos and feed them by hand.
The strength of the animals' curled front paws came as a surprise.
The most appealing creatures by far were the koala bears.
Wendy was ecstatic when she learned she could hold one, but when she did, her enthusiasm waned. They had a peculiar odor that she found unpleasant.
"It's because of their eucalyptus diet," one of the keepers explained.
After they'd watched a koala bear show and learned all sorts of koala bear trivia, they'd had enough. Boarding a city bus, they returned to the hotel.
"No, you don't!" Marissa said as she restrained Wendy from collapsing on the bed.
"Please!" Wendy begged.
"Tell the tour director I have a touch of the bubonic plague."
After their third shower of the day, they followed a suggestion from the concierge and took a short walk across the Victoria Bridge to the Queensland Cultural Center. In a rather modern restaurant called the Fountain Room, they relaxed for their first dinner in Australia. The view of the city across the muddy river was superb.
"I want to try something Australian," Wendy said, hiding behind a huge menu. They ended up ordering barra mundi a type of Australian perch. To complement the food, they selected a chilled Australian Chablis. Once it came and was opened for them, the two women toasted their Australian adventure.
After tasting the wine, Marissa smiled contentedly. Its crisp finish was a delight to her palate. For the moment she was blithely confident the trip would mean just the right combination of relaxation and research.
"Ahhhh," Wendy murmured, peering into her long-stemmed glass.
"Just what the doctor ordered."
"Amen," Marissa agreed.
The next morning, after a hearty English breakfast, Marissa and Wendy hailed a cab.
"Do you know this address?" Marissa asked. She'd given the driver the piece of paper with the FCA clinic's address on it.
"Sure, luv!" he said.
"That's the women's clinic, it is. Buckle up and I can have you there straightaway."
The ride to Herston was pleasant. As they entered the green and hilly suburbs, they noticed a number of quaint, wide perched tin-roofed homes built on stilts.
"Those are called Queenslanders," the driver explained.
"Built in the air to keep 'em away from water. The verandas are to keep em cool. Gets mighty hot here in the summertime."
In minutes, the cab pulled up to a strikingly modern four-story building surfaced entirely with bronzed mirrored glass. The
ISI grounds were landscaped with gorgeous flowering trees and bushes.
Getting out of the cab, Marissa and Wendy were struck by the sounds of the birds. They seemed to be everywhere: brightly colored and chirping and squawking. On the sidewalk leading to the entrance of the clinic they ran into a flock of mynah birds quarreling over a piece of bread.
As soon as the entrance doors closed behind them, the women stopped, awed by the building's interior. The FCA wasn't like any clinic they'd ever visited. The floors were gleaming onyx. The walls were a dark tropical wood polished to a high gloss.
"This place looks like a law firm," Wendy said uneasily.
"You sure you got the right address?"
There was a lush garden area in the center of the building featuring the same mix of flowering trees as outside. There was evena small pond with a waterfall constructed of red granite blocks.
At one end of the spacious lobby was an information area that looked more like the front desk of a luxury hotel.
"Can we be of assistance?" asked one of the two perky receptionists.
Instead of the white that was standard in American clinics, these women were dressed in brightly colored floral prints.
"We're doctors from the United States," Marissa said.
"We are interested in your facility. We were wondering if-" "From America!" the woman said with delight.
"I've just returned from California. How nice of you to visit. I'll ring up Mr.
Carstans. One moment, please."
The receptionist dialed a phone in front of her and spoke briefly. Hanging up, she said, "Mr. Carstans will be out directly.
P
erhaps you would care to sit in our waiting area beyond those planters." She pointed with her pen.
"Who's Mr. Carstans?" Wendy asked.
"He's our public relations man," the receptionist explained.
Marissa and Wendy walked over to the sitting area.
"Public relations man?" Wendy questioned.
"How many clinics do you know that have public relations men?"
"My thought exactly," Marissa said.
"This clinic must do a healthy amount of business to justify that kind of expense."
After a few minutes' wait, a man approached them.
"G'day, ladies," he said.
Carstans was a tall, corpulent fellow with ruddy cheeks. He was wearing shorts along with a jacket and tie.
"Welcome to FCA. My name is Bruce Carstans. What can we do for you?"
"I'm Dr. Blumenthal and this is Dr. Wilson," Marissa said.
"Gynecologists?" Mr. Carstans asked.
"I'm a pediatrician," Marissa said.
"I'm an ophthalmologist," Wendy said.
"Our fame must be spreading far and wide," Mr. Carstans said with a smile.
"Usually we only have overseas gynecologists for visitors. Are you ladies game for a tour of our establishment?"
The women exchanged glances, then shrugged.
"Why not?"
Wendy said.
"It would be interesting," Marissa agreed.
For the next hour Marissa and Wendy were treated to a look at the most up-to-date medical facility either had ever seen. The clinic offered a full battery of women's medical services. There were X-ray rooms, a CAT scanner, and eve nan NMR machine.
There were examination rooms, waiting rooms, minor surgery rooms, as well as delivery and birthing rooms. There was also an overnight ward.
By far the most impressive part of the clinic was the infertility section, boasting its own surgical wing capable of major surgical procedures. There were also six fully computerized ultrasound rooms. Filled with the absolute latest equipment, they had a Star Wars appearance. The clinical infertility lab was a huge room with large incubators, centrifuges, and modern cryogenic units.
Marissa and Wendy thought they'd seen it all when Mr. Carstans opened a heavy door and stepped aside for them to enter.
The women found themselves in a glass enclosure that served as the dust-free entry to a fairyland of high-tech instrumentation.
On the other side of the glass, a number of hooded technicians were at work. The laboratory looked like a space station in the twenty-first century.
"This is the heart of FCA," Mr. Carstans explained.
"This is the basic research section. It is from here that many of the breakthroughs in in-vitro fertilization techniques have come. Right now we are concentrating on cryopreservation techniques for both embryos and gametes. But we are also working on fetal tissue research, particularly for Parkinson's Disease, diabetes, and even immunodeficiency problems."
"I've never seen such a research setup," Wendy said.
"It's a tribute to capitalism," Mr. Carstans said with a smile.
"Private initiative and private investment. It's the only way to get things done in the modern world. The public benefits both in the availability of new techniques as well as superior clinical care."
"What are the FCA success rates with in-vitro fertilization?"
Marissa asked.
"We are approaching a pregnancy rate of eighty percent," Mr. Carstans said with obvious pride.
"No other program can match it."
Mr. Carstans walked the women back to the front entrance.
He could tell they were impressed.
"We are pleased you came to visit," he said, stopping near the waiting area where they'd begun the tour.
"I think you've seen most everything-Hope you enjoyed it. Are there any questions you'd like to ask?"
"I do have a question," Marissa said. Opening her shoulder bag, she pulled out the journal article that Cyrill had given her.
She handed it to Mr. Carstans.
"I assume you're familiar with this article. It's about a series of cases here at FCA."
Mr. Carstans hesitated, then took the paper. He glanced at it, then handed it back.
"No, I've never seen it," he said.
"How long have you been associated with FCAT' Wendy asked.
"Just shy of five years," Mr. Carstans said.
"This paper is only two years old," Wendy said.
"How could the public relations department have been unaware of it? I would have thought that such a paper would have been a significant issue for you. It's about relatively young women coming down with TB in their fallopian tubes."
"As a rule, I don't read technical journals," Mr. Carstans said.
"What journal was it published in?"
"The Australian Journal of Infectious Diseases, " Marissa said.
"What about the author, Dr. Tristan Williams? Apparently he was on the staff here in pathology. Were you acquainted with him?"
"Afraid not," Mr. Carstans said.
"But then again, I don't know all the staff. For questions like these, I'll have to refer you to Charles Lester, the director of the clinic."
"Do you think he'd be willing to speak with us?" Marissa asked.
"Under the circumstances," Mr. Carstans said, "I believe he would be happy to speak to you. In fact, if you'll be patient for a moment, I'll trot upstairs and see if he's free this very moment."
Marissa and Wendy watched Mr. Carstans disappear through a stairwell door. Then they looked at each other.
"What do you think?" Wendy asked.
"Beats me," Marissa said.
"I couldn't tell if he was on the level or not."
"I'm beginning to get a weird feeling," Wendy said.
"This place seems too good to be true. Have you ever seen such opulence at a clinic?"
"I'm amazed that there is a chance we can meet the director," Marissa said.
"I wouldn't have thought that possible without some formal introduction."
Just then Mr. Carstans reappeared.
"You're in luck," he said.
"The director says he'll be delighted to say hello to some esteemed colleagues from Boston, provided you have the time to spare."
"Absolutely," Marissa said.
They followed Mr. Carstans up a flight of stairs. The furnishing in the director's suite of offices was even more lavish than what they had already seen. It was as if they were visiting the office of the CEO of a major Fortune 500 company.
"Do come in!" the director said as he stood up from his desk to greet Marissa and Wendy. He shook hands with both, then indicated seats for them to make themselves comfortable. He then dismissed Mr. Carstans who discreetly left, closing the door behind him. Coming back to the women, the director said, "What about a fresh cup of coffee? I know you Yanks drink lots of coffee."
Charles Lester was a large, heavyset man, but not as beefy as Carstans. He looked like a gracefully aging athlete still up to a good game of tennis. His face was tanned like everyone else's in the city, and his eyes were set deep. He sported a thick mustache.
"Coffee would be fine with me," Wendy said. Marissa nodded, indicating that she'd like the same.
Lester buzzed his secretary and asked her to bring coffee for three. While they waited, he engaged the two women in small talk, asking them what hospitals they were associated with and where they'd done their specialty training. Lester admitted that he'd done some fellowship work in Boston.
"You're a physician?" Wendy asked.
"Very much so," Lester said.
"Some of us prefer the English system of address. As a gynecological surgeon during my training in London, I became accustomed to the title 'mister." But as a doctor I haven't been doing much clinical work of late. Unfortu Iss nately, I've been caught at this desk doing more administrative work than I would like."
A steward brought in the coffee and served it. Lester added a touch of crea
m to his and sat back. He studied the women over the top of his cup, "Mr. Carstans mentioned to me that you were inquiring about an old journal article," Lester said.
"Can I ask what the article was about?"
Marissa pulled the reprint from her shoulder bag and handed it to Mr. Lester. Like Mr. Carstans, he only glanced at it before handing it back.
"What is your interest in this?" he asked.
"It's kind of a long story," Marissa said.
"I have the time," Lester answered.
"Well," Marissa began, "both Dr. Wilson and I have the same infertility problem as the women described in the article: blocked fallopian tubes from tuberculosis." She then went on to explain her background with the CDC and her training in epidemiology.
"When we found out the problem was occurring on an international scale, we decided to investigate. The article was sent to me by the CDC. We called the clinic here but were unable to reach the author."
"What would you have asked him if you'd been successful in reaching him?" Lester asked.
"Two things in particular," Marissa said.
"We wanted to know if he'd done any epiderniologic follow-up on the cases that were reported. We also wanted to know if he'd seen any new cases. Back in Boston we know of three other cases besides ourselves."
"You do know that infertility in general is on the rise?" Lester said.
"Infertility from all causes, not just from blocked tubes."
"We're aware of that," Marissa said.
"But even the increase in blocked tubes is usually a nonspecific inflammatory process or endometriosis, it's not a specific infection, especially not something as relatively rare as TB. These cases raise a lot of epidemiological questions that should be answered. They might even represent some new, serious clinical entity."
"I'm sorry that you've come such a long way to learn more about that article. I'm afraid the author had entirely contrived his data. It was an utter fabrication. Not a whit of truth to it. Those were not real patients. Well, maybe one or two were real cases.
The rest were fictitious. If you had reached me by phone I could have told you as much."
"Oh, no," Marissa groaned. The thought that the article could have been a hoax had never occurred to her.
"Where is the author now?" Wendy asked.
"I couldn't tell you," Lester said.
"Obviously we dropped him from the staff immediately. Since then I understand he's been indicted on drug charges. What eventually happened, I don't know. I also don't know where he currently is, but I do know one thing: he is not practicing pathology."
