Robin Cook 1990 - Vital Signs

by Vital Signs(lit)

  "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 cream 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."

  "How would you suggest we find him?" Marissa asked.

  "I'd still like to talk to him, especially since I have the condition he described. Of all the data he could have dreamed up, why did he pick something so unusual? What could he have hoped to gain?

  It doesn't make sense."

  "People do strange things for strange motives," Lester said. He got to his feet.

  "I hope this paper wasn't the only reason you've come all the way to Australia."

  "We also thought we'd go out on the Great Barrier Reef," Wendy said.

  "A little work and a little play."

  "I trust your play will be more rewarding than your work," Lester said.

  "Now if you'll excuse me, I've got to get back to my own work."

  A few minutes later Marissa and Wendy found themselves standing by the front information desk again. The receptionist was calling them a taxi.

  "That was rather abrupt," Wendy said.

  "One minute he was telling us he had the time, the next he was shooing us out of his office."

  "I don't know what to make of all this," Marissa agreed.

  "But there is one thing I do know. I'd like to find that Tristan Williams just to wring his neck. Imagine the nerve of making up patients just to publish an article!"

  "That old publish-or-perish mentality," Wendy said.

  "A taxi will be along directly," the receptionist said as she hung up the receiver.

  "I suggest you wait outside. The taxi queue is just up the street."

  The women left the FCA clinic, stepping into the glorious morning sunshine.

  "So what does the tour
director suggest we do now?" Wendy asked.

  "I'm not sure," Marissa said.

  "Maybe we should go out to the University of Queensland and use the medical library."

  IS7

  "Oh, boy!" Wendy said with obvious sarcasm.

  "Now that sounds titillating!"

  Charles Lester had not gone back to his work. Marissa and Wendy's visit had disturbed him. It had been over a year since the last inquiry about that irritating paper by Williams. At the time he'd hoped it would be the last.

  "Damn," he said aloud, smacking a fist on his desk top. He had the uncomfortable premonition that there was trouble ahead. The fact that these meddlesome women had come all the way from Boston was upsetting to say the least. Most distressing of all was the possibility that their search for Williams might persist. That could spell disaster.

  He decided it was time to confer with some of his associates.

  After figuring the time difference, he picked up the phone and called Norman Wingate at home.

  "Charles!" Dr. Wingate exclaimed with delight.

  "Good to hear your voice. How's everything Down Under?"

  "It's been better," Lester said.

  "I have to talk to you about something important."

  "Okay!" Dr. Wingate said.

  "Let me get the extension."

  Lester could hear Dr. Wingate say something to his wife. In a few minutes he heard another phone being picked up.

  "I've got it, luv," Dr. Wingate said. Lester heard the other extension disconnect.

  "What's the problem?" Dr. Wingate said into the phone.

  "Does the name Dr. Marissa Blumenthal mean anything to you?"

  "Good Lord, yes," Wingate said.

  "Why do you ask?"

  "She and a companion named Wendy Wilson just left my office. They came in here with that article about TB salpingitis."

  "My God!" Wingate said.

  "I can't believe they're in Australia.

  And we were so generous to them." He related the details of the pair's attempt to break into the Women's Clinic's computer record system.

  "Did they get anything out of your computer?" Lester asked.

  "We don't believe so," Wingate said.

  "But those women are troublemakers. Something will have to be done."

  "I'm coming to the same conclusion," Lester said.

  "Thanks."

  Hanging up his phone, Lester pressed his intercom.

  "Penny," he said, "ring up Ned Kelly in security. Tell him to get his arse up here on the spot."

  Ned Kelly's name wasn't really Ned Kelly, it was Edmund Stewart. But at a young age Edmund had taken such a liking to the stories of the renowned bushranger Ned Kelly that his friends had started calling him Ned.

  Although most Australian men liked to think of themselves as some reflection of the famous outlaw, Ned took to imitating him, even to the point of sending a pair of bullock testicles to the wife of a man he was feuding with. A life of contempt for authority and petty crime led people to call him Ned Kelly, and the name stuck.

  Lester pushed away from the desk and walked over to the window. It seemed that just when things were running smoothly, some irritating problem had to crop up.

  Lester had come a long way from his humble origins in the cutback of New South Wales. At age nine he'd arrived in Australia from England with his family. His father, a sheet-metal worker, had taken advantage of liberal immigration policies in the immediate post-World War II period. The Australian government had even paid passage for the whole family.

  Early on, Lester had gravitated toward learning. He saw it as his ticket out of the sapping dullness of the vast Australian interior. In contrast to his brothers, he thirsted for knowledge, taking correspondence courses to supplement the meager schooling available in his tiny hometown. His studies had led him to medical school. From then on he'd never looked back. Nor did he tolerate hindrances. When people got in his way, he stepped on them.

  "Watchagot?" Ned asked as he came through the door. Behind him was Willy Tong, a slightly built but muscular Chinese man.

  Ned kicked the door shut with a resounding thump, then sat on the arm of the couch. He was not a big man, but he exuded toughness. Like Carstans, he wore shorts along with a shirt and tie. On his sleeve was sewn the logo of the security department of the clinic. His face was tanned to a lined, leathery texture. He looked as if he'd spent his entire thirty-eight years in the desert sun. Above his left eye was a scar from a knife fight in a pub. The argument had been over a pitcher of beer.

  Lester was chagrined to have to resort to such men. It was a bore to have to deal with the likes of Ned Kelly. Yet occasionally it was necessary, as it was at present. Lester had met Ned purely by accident when he was in his last year of medical school. Ned had come into the university hospital with one of his many gun shot wounds. During the course of his recuperation, they'd become acquaintances. Over the years Lester had used Ned for various projects, culminating in his being hired as head of the clinic's security department.

  "We have a couple of women interested in that article by Williams," Lester said.

  "It was the same article that brought that gynecologist from L.A. here. Do you remember? It was about a year ago."

  "How could I forget," Ned said with a sinister smile curling his lips.

  "He was the poor man who had that awful auto accident.

  Remember him, Willy?"

  Willy's eyes narrowed as he smiled broadly.

  "These women were talking about finding Williams," Lester said.

  "I don't want that to happen."

  "You should have let me take care of Williams way back when," Ned said.

  "It would have saved a lot of trouble."

  "He was too much in the spotlight at the time," Lester said.

  "But let's not worry about that now. Now we have to worry about these women. I want something done, and I want it done before they dredge up any more information on TB salpingitis."

  "You want it to look like some kind of accident?" Ned asked.

  "That would be best," Lester said.

  "Otherwise, there will be an investigation, which I'd prefer to avoid. But can you manage an accident when there are two people involved?"

  "It's more difficult," Ned admitted.

  "But certainly not impossible.

  Be easy if they rent a car. Yanks are lousy left-hand drivers."

  He laughed.

  "Reminds me of that gynecologist. He almost killed himself without our help."

  "The women's names are Marissa Blumenthal and Wendy Wilson," Lester said. He wrote them down and handed the paper to Ned.

  "Where are they stayine." Ned asked.

  "I don't know," Lester said.

  "The only thing I do know is that they are planning to go out on the Reef."

  "Really!" Ned said with interest, "Now that bit of info could come in handy. Do you know when they plan to go?"

  "No," Lester said.

  "But don't wait too long. I want something done soon. Understand?"

  "We'll start calling hotels as soon as we get downstairs," Ned said.

  "This should be fun. Like going out in the bush and shooting 'roos."

  "Excuse me," Marissa whispered.

  "I'm Dr. Blumenthal and this is Dr. Wilson." Wendy nodded hello. They were standing at the main circulation desk of the University of Queensland Medical

  School Library.

  They had driven halfway to St. Lucia, where the university was located, when they'd asked the taxi driver if he knew where the medical school library was. To their surprise, he'd responded by "throwing a u-ey" and heading directly back to Herston. The medical school, they'd learned, was a short distance from the

  FCA.

  "We're from the States," Marissa said to the man behind the medical school library circulation desk.

  "And we were wondering if it might be possible for us to use the library facilities."

  "I don't see why not," th
e man replied.

  "But it would be best if you inquired in the office down the hall. Ask for Mrs. Pierce, the librarian."