Robin Cook 1990 - Vital Signs

by Vital Signs(lit)

  Tristan sighed.

  "This all brings back bad memories," he said with a shake of his head. He tilted his hat back and scratched his forehead.

  "But maybe I'd better tell you my story so that you have some idea what you are up against. Maybe then you'll go home and live your life. But the telling will take a while. And it's for your ears only. Agreed?"

  "Agreed," Marissa said.

  "All right," Tristan said.

  "Let's go inside and get a couple of stubbies."

  Tristan went into the canteen and walked directly into the kitchen. The crew were busy cleaning up from the noonday meal, From the fridge he got two ice cold beers and carried them into the empty dining room. Motioning toward one of the picnic like tables, he popped the tops of the beers and handed one to Marissa.

  She sat down facing him.

  "I was employed by FCA directly from my specialty training in pathology," he said after a long pull on his beer.

  "I was impressed by the organization. It was expanding. Right after I was hired, the chief of the department, that's what he called himself, came down with hepatitis and had to take an extended leave. Since there were only two of us in the department back then, I found myself the chief." Tristan chuckled.

  "Almost immediately," he continued, "I started seeing these cases of granulomatous salpingitis, one after another. I knew it was unique, and having just come from training, the possibility of making some kind of academic discovery held great appeal. I have to admit I also liked the idea of getting a paper in one of the journals. So entirely on my own, I decided to write the cases up.

  "My first suspicion was tuberculosis, despite TB being rare here in Australia. But since we'd been having a recent increase in immigration from Southeast Asia, where TB is still endemic, I thought it was possible.

  "But I had to be sure it was TB. I ruled out fungi through elaborate stains. It definitely wasn't fungi. I looked exhaustively for organisms, but could never find any. But still I was sure it was

  TB."

  "What about sarcoid?" Marissa questioned.

  Tristan shook his head.

  "It wasn't sarcoid," he said.

  "The chest X-rays were all normal and none of the patients had swollen glands or eye problems.

  "So I was confident that it was TB although I had no idea how it was spread. But then I made an association with something else that was going on at the clinic. About a year before I began seeing these cases, the clinic had started having Chinese technicians and security people rotate through some sort of fellowship program.

  I thought that the clinic was training the technicians in in vitro fertilization to go back to Hong Kong where they'd come from.

  But I wasn't sure. They always came in pairs and didn't stay long.

  Only for a few months. Many didn't even speak English. But the fact that they were coming from Hong Kong, where there had been a significant influx of Southeast Asian boat people, made me think they might have had something to do with the rash of TB salpingitis."

  "Where did they go after their fellowships?" Marissa asked, recalling the pair of Chinese at the Women's Clinic.

  "I had no idea," Tristan admitted.

  "I assumed back to Hong Kong. I had never been interested, at least not until I started looking into the TB cases. Then I became curious. So I scheduled a meeting with Charles Lester, the director of the clinic, and I asked him about the Chinese. But he told me it was classified information. All he would say was that it had something to do with the government!"

  Tristan shrugged.

  "What could I do? I asked a few other people, but no one seemed to want to talk about it. But then a pair of Chinese got in a bad car accident. Bad enough to kill one and hospitalize the other. They hospitalized him in the FCA facility. He was the only male patient they'd ever had.

  "I made it a point to visit the bloke, just about every day. He was tight-lipped but could speak English. Not a lot, but enough.

  His name was Chan Ho. I tested him for TB without anyone else knowing, but was disappointed when he tested negative because it blew holes in my theory. Still in the process of stopping by every day I got to know the fellow a bit. I learned he was some kind of Buddhist monk. He'd learned Chinese martial arts as part of his studies. Now, that caught my attention; martial arts have been my sport since I've been knee-high to a wallaby. When the bloke got out of the hospital, I invited him to come to my gym.

  He turned out to be unbelievable at kung fu."

  Marissa remembered how the Chinese man in the gray suit had disarmed Paul Abrums with a deft kick.

  "Then I learned something else: Chan loved beer. He'd never had any until he'd come to Australia, or so he said. I discovered that after a few good Australian beers he loosened up. That's when he really surprised me. I found out he wasn't from Hong Kong at all, he came from a town near Guangzhou in the People's

  Republic of China."

  "He was from Communist China?" Marissa asked.

  "That's what he told me," Tristan said.

  "I was surprised too.

  Apparently he'd just passed through Hong Kong-illegally, I might add. One night I managed to get him really pissed-" "You got him angry?" Marissa was confused.

  "No! Drunk," Tristan said.

  "Then he really opened up. He told me that in the PRC he'd been a member of a secret society, a martial arts organization called the White Lotus. He said that it was because of his martial arts ability that he'd been brought out of China by one of the Hong Kong triads called the Wing Sin.

  Apparently the FCA footed the bill. He led me to believe that they paid big bucks for him and his companion to be smuggled here to Australia."

  "But why?" Marissa asked. Tristan's story was going in directions she'd never anticipated. They seemed far afield from the issue of

  TB.

  "I had no idea," Tristan admitted.

  "But it all intrigued me.

  Seemed like a weird kind of program, especially since it was supposed to involve the government. I started thinking all sorts of things, like maybe it had something to do with Hong Kong being turned over to the PRC in 1997."

  "The last thing Communist China needs is in-vitro fertilization,"

  Marissa said.

  "Don't I know it," Tristan said.

  "Nothing made sense to me.

  So I tried quietly asking around the clinic again, but still I couldn't find anyone who would say anything about these visitors, especially anyone in administration. I talked to the director again, but he warned me to leave it alone. I should have taken his advice."

  Tristan tipped his head back and finished his beer. Standing, he asked Marissa if she was ready for another. She shook her head.

  She hadn't finished the one she had. While Tristan went back into the kitchen, she reviewed in her mind what he'd told her. it was certainly curious, but hardly what she'd come thousands of miles to hear.

  Tristan came back with a new beer and reclaimed his seat.

  "I know this all sounds weird," he admitted.

  "But I was convinced that if I could figure out why the Chinese were there, then I'd be able to explain the salpingitis cases. That might sound strange, but they were happening at the same time, and I was convinced it couldn't have been by chance. And whether the PRC needed it or not, I thought that these Chinese technicians were being trained in in-vitro techniques. When they were at the clinic, they were always in the in-vitro lab."

  "Do you think it could have been the other way around?"

  Marissa asked.

  "Maybe the Chinese were providing information rather than getting it."

  "I doubt that," Tristan said.

  "Modern technical medicine is not one of China's strong suits."

  "Yet around the time you're talking about," Marissa said, "the FCA did start to show a rather sudden increase in overall efficiency with their in-vitro. I read about it in the medical school library."

  "From having talked with Chan Ho
for many hours, there's no way he'd be able to add to our technical knowledge."

  What about his companion?" Marissa asked.

  "The one who died."

  ""Chan refused to talk about him," Tristan said.

  "I asked him on many occasions. All I learned was that he was not a martial arts expert like Chan."

  "Maybe he was an acupuncturist," Marissa suggested.

  "Or an herbalist."

  "Possibly," Tristan said.

  "But I can assure you that FCA did not start doing acupuncture as part of the in-vitro protocol. But Chan did lead me to believe that he had felt responsible for his companion since he was afraid he would be sent back to the PRC after the bloke died."

  "Sounds like the companion was the more important of the two," Marissa said.

  "Maybe he did provide some knowledge or skill."

  "It would be tough to get me to believe that," Tristan said.

  "They were all quite primitive fellows. What I started to think about was drugs."

  "How so?" Marissa asked.

  "Heroin smuggling," Tristan said.

  "I know that Hong Kong has become the heroin capital for moving heroin from the Golden Triangle to the rest of the world. I came to think that the explanation for all this weird activity was the movement of heroin, especially since TB is endemic in the Golden Triangle."

  "So these Chinese duos were couriers?" Marissa asked.

  "That's what I was thinking," Tristan said.

  "Maybe the one who didn't know martial arts. But I wasn't sure. Yet it was the only thing that seemed to justify the money that had to be involved.

  " "That means the FCA has to be in the drug business," Marissa said. In her mind's eye she remembered the surprising opulence of the clinic. That lent a certain credence to what Tristan was saying. But if that were the case, how did TB salpingitis fit in?

  "I was planning on investigating it," Tristan said.

  "I intended to use my next vacation to go to Hong Kong and trace the trail back to Guangzhou if necessary."

  "What made you change your mind?" Marissa asked.

  "Two things happened," Tristan said.

  "First, the chief of pathology came back, and second, my paper came out in the Australian

  Journal of Infectious Diseases. I thought I was about to become professionally famous for describing a new clinical syndrome.

  Instead it turned out to be a king hit on me. As I said, I'd never cleared the paper with the administration. well, they went crazy. They wanted me to recant the paper, but I wouldn't. I got on my academic high horse and bucked the system."

  "The cases in your paper were real patients?" Marissa finally asked.

  "You didn't make them up?"

  "Of course I didn't make them up," Tristan said indignantly.

  "I'm not a complete alf. That's the story they put out. But it wasn't true."

  "Charles Lester told us you'd made them up."

  "That lying bastard!" Tristan hissed.

  "All twenty-three cases in that paper were real patients. I guarantee it. But I'm not surprised he told you differently. They tried to force me to say the same. But I refused. There were even threats. Unfortunately, I ignored the threats, even when they were extended to my wife and my two-year-old son "Then Chan Ho disappeared and things got ugly. My pathology chief wrote to the journal and said I'd manufactured the data, so the paper was officially discredited. Then someone planted heroin in my car which the police found following an anonymous tip. My life became a living hell. I was indicted on drug charges. My family was intimidated and tormented. But like an idiot, I stood up to it all, challenging the clinic to deny the existence of the patients whose names I had saved. Drunk on idealism, I wasn't going to give up. At least not until my wife died."

  Marissa's face went ashen.

  "What happened?" she asked, afraid to hear the rest.

  Tristan looked down at his beer for a moment, then took a swig. When he looked back at Marissa his eyes were filled with tears.

  "It was supposedly a mugging," he said in a halting voice.

  -Something that doesn't happen too often here in Australia. She was knocked down and her purse was taken. In the process, she broke her neck."

  "Oh, no!" cried Marissa.

  "Officially she broke her neck hitting the pavement," Tristan said.

  "But I thought the fracture resulted from a kung fu kick although I couldn't prove it. But it made me terrified for my son's safety. Since I had a trial to face, I stayed, but I sent Chauncey to live with my in-laws in California. I knew I couldn't protect him."

  "Your wife was American?" Marissa asked.

  Tristan nodded.

  "We met when I was doing a fellowship in San Francisco."

  What happened at the trial?" Marissa asked. was acquitted of most of the criminal charges," Tristan said.

  But not all. I served a short time in jail and had to do some community service. I got fired from FCA, obviously. I lost my specialty certification but managed to hold on to my medical license. And I fled out here to the outback."

  "Your son is still in the States?" Marissa asked.

  Tristan nodded.

  "I wasn't about to bring him here until I was certain it was over."

  "What an ordeal."

  "I hope you will take it to heart," Tristan said.

  "You are probably right about your friend's death not being accidental.

  You're probably also right about your own life being in danger.

  I think you'd better leave Australia."

  "I don't know if I can at this point," Marissa said.

  "Please don't be as foolish as I was," Tristan said.

  "You've already lost a friend. Don't persist. Forget your idealism. All this represents something very big and very sinister. It probably involves organized Chinese crime and heroin, a deadly combination.

  People always think of the Mafia when they think of organized crime, but the Mafia is a Girl-Scout operation compared to the Chinese syndicate. Whatever is at the bottom of it all, I realized I couldn't investigate it on my own. Nor should

  YOU."

  "How could organized Chinese crime be associated with TB salpingitis?" Marissa asked.

  "I haven't the slightest idea," Tristan said.

  "I doubt there is a direct causal link. It has to be some unexpected side effect."

  "Did you know that FCA is controlled by a holding company that also controls all the Women's Clinics in the States?"

  "I do," Tristan said.

  "That was part of the reason I went to work for FCA. I knew that they were planning to expand around the globe primarily because of their in-vitro fertilization technology.

  Marissa touched Tristan's arm. Even though her loss was different, she felt the kinship of shared tragedy.

  "Thank you for talking with me," she said softly.

  "Thank you for being so open and trusting."

  "I hope it has the desired effect of sending you home at once," Tristan said.

  "You must give up this crusade you are on."

  "I don't think I can," Marissa said.

  "Not after Wendy's death, and not after all the suffering that the TB salpingitis has caused me and so many others. I've come this far and risked this much.

  I have to find out what's going on."

  "All I can tell you is that a similar compulsion ruined my life and killed my wife," Tristan said. He sounded almost angry. He wanted to talk her out of her foolishness, but seeing the glint of determination in her eyes, he knew it would be in vain. He sighed.

  "I'm getting the idea that you are a hopeless cause.

  "If you have to proceed, then I suggest that you contact the Wing Sin Triad in Hong Kong. Maybe they will be willing to help--for a price. That was what I was planning to do. But I have to warn you that it will be dangerous since the Hong Kong triads are notorious for violence, especially when heroin is involved; the amounts of money are astronomical. The heroin alone coming from t
he Golden Triangle is worth over a hundred billion dollars a year."

  "Why don't you come with me?" Marissa said.

  "Your son is safe in America. Why not follow up on what you had planned to do years ago? We can do it together."

  Tristan laughed aloud.