Royal Pains

by D P Lyle

  What won the day, or the night, was Nicole finally admitting that she was tired and needed to sleep. We convinced her she had a bed waiting at Westwood Manor.

  Nicole sat in the backseat, right side, next to Ashley, and lolled her head against the window as we rode. Divya drove, Evan snagged shotgun, and I sat in the back, Jill in my lap. I watched Nicole closely. She seemed to be staring out the window but not really focusing on anything. Little was said during the entire trip.

  Divya parked near the steps that led from Westwood Manor’s circular parking area to the front entrance. We all piled out. Nicole took a few steps, hesitated, and seemed to study the mansion. I could see her eyes were wide with confusion, her hands and lips trembling, and an erratic tic worked the right side of her mouth. The entry lights reflected off moist eyes.

  “Nicole?” I said. “You okay?”

  “How did I get here?” She looked around the front garden and then back toward the mansion. “I don’t remember. . . .”

  I gently grabbed her by the shoulders. “You had another one of your spells.”

  She sniffed back tears. “I don’t know what you’re talking about.”

  “Nicole, you’ve got to quit ignoring this,” Ashley said. “There’s something wrong and you’ve got to figure out what it is.”

  Nicole shrugged herself from my grasp and shook her head. “There’s nothing wrong with me.”

  Ashley stepped forward and grabbed Nicole’s arm. “Listen to me. There . . . is . . . something . . . wrong . . . with . . . you.” She emphasized each word. “I love you. I can’t stand to see you like this.”

  “I’m fine. I just want to go to bed.”

  Now Ashley was crying. “You’re not fine. There’s something wrong. You have to let Hank find out what the problem is.”

  “I will not be poked on.” She started up the stairs toward the front door. Over her shoulder she said, “I wish you people would just leave me alone.”

  Chapter 34

  The next morning, I woke early. Not that I had slept all that well. Nicole kept marching through my head. In my dreams, I saw her as a frightened child, a wicked Salem witch, and even an amazingly beautiful psychotic zombie. Not sure where that last one came from.

  Around six, I rolled out of bed and decided to hit the beach for a run. Evan was still holed up in his room. I didn’t wake him to see if he wanted to go. He would’ve probably said no, but maybe not, and that was the problem. Evan had so many early-morning rituals it would’ve been at least half an hour before we got out the door. Better to let sleeping dogs lie.

  I parked at the lot where Ocean Avenue met East Hampton Main Beach, retied my shoelaces, worked my way down to the water’s edge where the sand was firm, and headed west.

  I felt sluggish for the first mile, but then things loosened up and I fell into a rhythm. Like most runners, I find the monotonous pat, pat, pat of my footsteps soothing. Meditative. It doesn’t take long for your mind to wander. Mine went back to Nicole.

  I knew there was more going on in her head than simply drugs. Sure, Morelli’s herbs and spices and the recreational chemicals she might be using could exacerbate her symptoms, but there was something else stirring inside. Whether it was physical, chemical, or psychiatric was the question. Her differential diagnosis included several not so pleasant possibilities: brain tumors, schizophrenia, seizure disorders, and various infections. The list went on.

  I reached the halfway point and turned around, now facing the rising sun. In my sleep-deprived brain, it seemed harsher than usual.

  The question I couldn’t shake was what role Morelli’s concoctions played in all this. Were they simply a red herring? If she was on the same stuff that Valerie Gilroy and Rose and Amanda had been given, it was entirely possible they could be the problem. Not the sole problem, since Nicole’s odd behavior began long ago, but they could be unmasking or complicating some existing condition. Of course, I didn’t yet know what Julian’s pills contained, but I knew some of it. Thyroid, digitalis, and amphetamines for sure. Excess thyroid and almost any amount of amphetamine can uncover previously occult schizophrenia, can increase seizures, and can definitely make sane people seem squirrelly.

  In Nicole’s case, I just didn’t know. Her refusal to allow even simple blood tests, much less a complete neuropsychiatric workup, left me with my hands tied. Frustrating, but that’s the way it was.

  I finished my run and swung by Main Street Bagels. I picked up fresh-from-the-oven bagels, cream cheese, lox, sliced tomatoes, and two cups of coffee before returning home. Evan was just rolling out of bed when I arrived.

  “Cool,” he said. “Breakfast.” He then looked at me, seeing my sweat-stained shirt, and asked, “Where have you been?”

  “Running on the beach.”

  He cracked the lid on one of the cups of coffee and took a sip. “Why didn’t you wake me up?”

  “Somehow I didn’t think you wanted to go for a run this morning. Or any other morning, for that matter.”

  “That’s true. Besides, I have to save myself for tennis later today.”

  I put the bagels in the toaster and arranged the tomatoes and lox on a plate. “Who are you playing with?”

  “Ashley and a couple of her friends.”

  “Here?”

  “Of course. Where else would I play?”

  “I’m sure Boris won’t mind you using his property to entertain your friends.”

  “I asked Dieter and he said it was fine.”

  The bagels popped up from the toaster. I placed them each on small plates, handing one to Evan. He slathered on the cream cheese.

  “I’m surprised you asked,” I said.

  “What? You think I’m a Neanderthal?”

  “Something like that.”

  “I’m classy.” He took a bite of bagel. “I can give you some lessons in classy if you want.”

  “I’ll pass.”

  “Suit yourself. Just trying to help your image.”

  I frowned at him while I built a bagel sandwich: cream cheese, a slab of lox, and several slices of tomato. I took a bite. Excellent.

  “So what do you have planned today while I’m being classy?” Evan asked.

  “Divya and I have a few follow-up appointments.” I took another bite of bagel and spoke around it. “But first I’m going to run by the hospital and see if the lab results on Julian Morelli’s wonder pills are back.”

  “You really think that’s the problem?”

  “Sure smells that way.”

  “He has a good reputation. His clients seem to love him.”

  “That doesn’t mean he knows what he’s doing.”

  Evan swiped a bit of cream cheese from his left cheek and licked it off his finger. “How can that many people be wrong?”

  “How can so many people watch Dancing with the Stars?”

  “Good point.”

  That has always been one of the dichotomies of medicine. Often the doctors that are most loved by their patients are the ones that are the most incompetent. Maybe they’re better salesmen than they are scientists. Maybe they cover their lack of competence with personality. Maybe they’re simply following the tradition of snake oil salesmen, a breed that has been around for many years.

  It was possible that I was wrong about Julian Morelli. That he was driven more by compassion than compensation. That his little pills had nothing to do with Valerie Gilroy’s brush with death. I didn’t believe it. Not for a minute. Finding the same out-of-whack chemistries in three different people, all of whom were taking drugs supplied by Julian, put him directly in the crosshairs. What were the odds that these three people could have ingested these toxins any other way? The answer to that was fairly simple. Virtually zero.

  After we finished breakfast, Evan cleaned up while I showered. I put on a pair of jeans, tennis shoes, a black T-shirt, and an open light gray dress shirt, sleeves rolled up. Since it was now after eight, I called Ashley to check on Nicole.

  “She’s still a
sleep,” Ashley said. “Probably won’t be up for a while.”

  “What about last night? Anything unusual happen after we left?”

  “She was like major angry with me for calling you guys. Said it wasn’t anybody’s business what she did.”

  “Sorry.”

  “Honestly, I think she was more scared than angry. Last night like really shook her up.”

  “Tell me.”

  “She doesn’t remember leaving the bar, doesn’t remember us bringing her home, nothing. Just she was like in the bar and then she was home. Nothing in between.”

  “Is that how it usually is when she has one of these?”

  “More or less. This one might have been worse. I think she’s more freaked than she’s letting on.”

  “What about Bobby Richter? Does she remember him?”

  “No. When I asked her about him, told her she had like picked him up at the Seafoam, she said she didn’t know what I was talking about. Said she never picked up any guy.”

  “I’m not surprised she doesn’t remember him.”

  I could hear her sigh on the other end of the phone. “I finally convinced her that I was telling the truth. Sort of. She still isn’t sure. But the fact that she might have gone home with some random dude really like tweaked her. She’s never done that before.”

  “Are you guys going anywhere today or just hanging around Ellie’s?”

  “I’m playing tennis with Evan later today, but other than that, I don’t think there’s anything planned until tonight. Unless Nicole wants to like go shopping or something, we’ll probably be here. Why?”

  “I’m going to swing by. I want to talk with her.”

  “She may not want to.”

  “I’m counting on you talking her into it.”

  “Me? Thanks a lot.”

  “Ashley, I’m worried about her. You’re her best friend. I know you’re worried, too. Do your best.”

  I parked near the emergency department at Hamptons Heritage Hospital, walked through the ER and down the hall to Jill’s office. She wasn’t there. Her secretary said she was in a budget meeting but should be back in half an hour. I decided to go see a couple of my patients.

  Jesus Morales was still in the ICU. Most of his IV lines had been removed and he was sitting in a chair next to his bed. His nurse said he would be transferred to the surgical ward later in the day.

  “Will I be okay without that thing they took out?” Jesus asked.

  “Your spleen? You won’t even know it’s missing.”

  “Really?”

  “Only reason it’s there is so surgeons will have something to do.”

  He laughed. “When can I work?”

  “Probably a few weeks, but you should ask your surgeon that one.”

  “Cerveza? Okay to have beer with my friends?”

  “After you heal up? Absolutely.”

  Jesus was happy.

  I found Valerie on the third-floor medical ward. Her father, Tony, dozed in the chair next to her bed, a newspaper crumpled in his lap. She smiled when I came in.

  “Dr. Lawson, how are you doing today?” Valerie asked.

  “The real question is, how are you doing?”

  Tony stirred, his eyes blinking open and then focusing on me. He sat up, placing the newspaper on the bedside table.

  “Couldn’t be better,” she said. “I’ll probably get to go home today.”

  “Depending on this morning’s lab results,” Tony said.

  I rested my hands on the bed rail and looked down at Valerie. “I want you to take it easy when you get home. Sort of get your legs beneath you again. No running for a few days.”

  “Why not? I feel great.”

  “You went through a very traumatic event,” I said. “It might take another week for all those drugs to get completely out of your system. Don’t rush it. A week away from running is not going to hurt you.”

  Tony stood. “Do you hear what he’s saying?” He reached out and closed his fingers over his daughter’s hand. “Listen to him.”

  “Okay, okay. If you guys are going to gang up on me, I don’t really have a choice, do I?” She smiled.

  I said good-bye and headed out the door. Tony followed, stopping me in the hallway.

  “What can I do about this?” he asked. “About that Morelli guy? He gave her this stuff.”

  “I’m looking into it.” A nurse walked by. I waited until she had passed. “Valerie might not be the only person harmed by this.”

  “Then we must do something. Tell someone.”

  I reached out and touched his arm. “Like I said, I’m looking into it. Give me a day or two and I’ll let you know what I turn up.”

  He nodded. “Okay.” He glanced toward his daughter’s room. “You saved Valerie’s life. I can’t tell you what that means to me.”

  “I did what any other doctor would’ve done under the circumstances. I’m just glad I was there.”

  “You and I both know that’s not true. Not every doctor would’ve reacted as quickly as you did.” I started to say something, but he raised a hand to stop me. “I know and you know that’s the truth.” His gaze locked with mine. “She’s so much like her mother. I see Verna—that was her name—in Valerie every day.” His face screwed down tight as he fought to control his tears. He swiped the back of one hand across his eyes. “I’m sorry.”

  “No reason to be sorry. I think you’ve held up remarkably well considering the circumstances.”

  He sniffed and wiped his eyes again. “Would you be our doctor? Valerie and me? After she gets out of here?”

  “I would love to. You have a very special daughter, and between the two of us, we’ll take good care of her.”

  Tears welled in his eyes as we shook hands. He clasped my hand in both of his and nodded. I told him I’d call and arrange to see Valerie again in a few days. He promised he’d keep her out of her running shoes.

  “I’ll hide them if I have to,” he said.

  “You might have to. I get the impression she’s stubborn when it comes to that.”

  Tony nodded. “Like her mother.”

  Nathan Zimmer had been transferred from the CCU and was just down the hall from Valerie’s room. When I walked in, he was sitting in bed, his laptop open on his lap. Todd sat in a chair near the window, talking on his cell phone. Papers were scattered over the bed as well as the bedside table.

  “Can I come into your office?” I asked.

  “Wall Street never sleeps,” Nathan said. “Got to stay ahead of the curve.” He nodded toward Todd. “At least they’ll let us use cell phones now.”

  “What you have to do is stay aboveground. I’m not sure jumping into all this right after a heart attack is the best way to make that happen.”

  He cocked his head to one side and looked at me. “You honestly think that I could sit here and do nothing without climbing the walls? Or going postal on the nurses?”

  He had a point.

  Todd pressed his cell phone against his chest and said, “What’s the decision? Are we going to pull the trigger on this deal?”

  “We have to decide right now?” Nathan asked.

  “He said the project was almost fully funded and he has half a dozen people waiting to get in the door. So yes, you have to decide right now.”

  Nathan rubbed his chin, his fingers rasping over stubble. “Okay. Tell him we’ll take a million shares at ten and a quarter.”

  Todd nodded and raised the cell phone to his ear again.

  “I’m glad to see you’ve got the world under control,” I said to Nathan.

  His fingers worked the keyboard. “Always.”

  I told him I’d drop by again in a couple of days. He didn’t say anything, didn’t look up, but tossed a quick wave as I left the room.

  Free enterprise. Nothing quite like it.

  Chapter 35

  Before going back to Jill’s office, I swung by the cafeteria and picked up two coffees. She probably already had some, but
Jill never turned down a fresh cup. Most women might prefer flowers or chocolate, but with Jill it was coffee. Gourmet better than cafeteria, but so long as it was strong and hot, she was fine.

  When I walked in, she was thumbing through some papers on her desk, a cup of coffee in her hand. She looked up, first at me and then at the coffee I held.

  “I was just getting ready to head down for a refill.”

  What’d I tell you?

  “How did your budget meeting go?” I handed her the coffee and sat down.

  “The usual. They expect everything while paying nothing.”

  “Seems to be the way of the world.”

  She handed me the pages she had been looking through. “The lab results on those pills.”

  I shuffled through the reports. It’s not easy to be both surprised and not surprised. I knew what the pills contained, just not exactly. Now that I saw, it was very disturbing: ephedrine, furosemide, desiccated thyroid, and digitalis leaf.

  Who would manufacture something like this?

  “Want to tell me what this all means?” Jill asked.

  I handed the reports back to her. “It’s easy to see what happened to Valerie Gilroy now.”

  “That bad?”

  I massaged the kink that was settling in my neck. “It contains ephedrine. An amphetamine. It’s found in one form or another in several over-the-counter cold remedies. It’s also used to make crystal meth.”

  “You’re kidding.”

  “I wish. This explains the energetic feeling and loss of appetite. Furosemide is a powerful diuretic that not only causes dehydration and water-weight loss but also washes potassium and magnesium out of the system.”

  “Explaining the low potassium and magnesium levels we found in all the blood tests?”

  I nodded. “Then there’s a little desiccated thyroid to rev up the metabolism and help with weight loss. Even more sinister is the digitalis leaf. Basically the foxglove plant ground up and stuck into the pill. Very hard to calculate an accurate dose this way.”