“You look pretty washed out. Stop if you need to.”
“I’m okay.”
“Here. Here’s some water.”
She took a sip and then moistened her cracked, bleeding lips; then she returned her attention to the notebook. Another ten minutes passed before she looked up. Despite the pain and the drugs, her eyes were sparkling.
“Jared,” she said, “I think I understand. I think I know what Estronate Two-fifty is.”
“Well?”
“This is amazing. Assuming he’s the one who conducted this research—or at least completed it—the late Dr. Paquette was worth his weight in gold to Redding Pharmaceuticals. Estronate Two-fifty is an oral antifertility drug that causes irreversible sterilization. It can be given to a woman by pill or even secretly in a glass of milk.”
“Irreversible?”
Kate nodded vigorously, wincing at the jab of pain from her side. “Exactly. Think of it. No more tubal ligations, fewer vasectomies, help for third-world countries battling overpopulation.”
“Then the scarred ovaries weren’t a mistake?”
“Hardly. If I’m right, the microsclerosis was the desired result, not a side effect.”
“But what about the bleeding? What about Ellen?”
Kate motioned him to wait. She was scanning a column marked Nebenwirkung.
“Look, Jared,” she said excitedly. “See this word? It means side effects. All these women were apparently given this Estronate and monitored for side effects. Jesus, they’re crazy. Paquette, Zimmermann, Horner—all of them. Absolutely insane. They used hundreds of people as guinea Pigs.”
“E. Sandler,” Jared said.
“What?”
“E. Sandler. There it is right at the bottom of the page.”
Kate groaned. “I may be even worse off than I think I am. Twice over the page and I missed it completely. Bless you, Jared.”
Ellen’s name was next to last in a column of perhaps three dozen. Halfway down a similar list on the following page, Kate found the names B. Vitale and G. Rittenhouse. She pointed them out to Jared and then continued a careful line-by-line check of the rest of the column and yet another page of subjects.
“I thought those were all the bleeding problems you know about,” he said.
“They are.”
“Well, whose name are you looking for?”
She looked up and for a moment held his eyes with hers. “Mine,” she said.
She checked the pages once and then again before she felt certain. “I’m not here, Jared. I may be in some notebook marked anthranilic acid, but I’m not here.”
“Thank God,” he whispered. “At least volume three’s given us that much.”
Kate did not respond. She was again immersed in the columns of data, turning from one page to another, and then back. From where he sat, Jared studied her face: the intensity in her eyes, the determination that had taken her through twelve years of the most demanding education and training. At that moment, more so than at any other time in their marriage, he felt pride in her—as a physician, as a person, as his wife.
“Jared,” she said breathlessly, her attention still focused on the notebook, “I think you did it. I think it’s here.”
“Show me.”
“See these two words: Thrombocytopenie and Hypofibrinogenamie? Well, they mean low platelets and low fibrinogen. Just what Ellen is bleeding from. There’s a notation here referring to Omnicenter Study Four B. Modification of Thrombocytopenie and Hypofibrinogenamie Using a Combination of Nicotinic Acid and Delta Amino Caproic Acid.”
“I’ve heard of nicotinic acid. Isn’t that a vitamin?”
“Exactly—another name for niacin. The other is a variant of a drug called epsilon amino caproic acid, which is used to reverse certain bleeding disorders. See, look here. All together, seven women on these three pages developed problems with their blood. They were picked up early, on routine blood tests in the Omnicenter.”
“But Ellen and the other two aren’t listed as having problems with their blood. There’s nothing written next to their names in the side effects column.”
She nodded excitedly. “That’s the point, Jared. That’s the key. Ellen and the two women who died were never diagnosed. Maybe they just didn’t have Omnicenter appointments at the right time.”
“The others were treated?”
Kate nodded. “That’s what this Study Four B is all about. They got high doses of nicotinic acid and the other drug, and all of them apparently recovered. Their follow-up blood counts are listed right here. I think you did it. I think this is the answer. I just hope it’s not too late and that somebody at Metro can get hold of the delta form of this medication. If not, maybe they can try the epsilon.”
Jared handed her the receiver of the bedside telephone. “Just tell me what to dial,” he said.
Kate’s hand was shaking visibly as she set the receiver down. “Ellen’s still in the operating room. Nearly three hours now.”
“Who was that you were talking to?”
“Tom Engleson. He’s a resident on the Ashburton Service. In fact, he’s the one who called—Never mind. That’s not important. Anyhow, he’s been up to the operating room several times to check how it’s going. The gastroscopist has found a bleeding ulcer. They’ve tried a number of different tricks to get it to stop, but so far no dice. They’ve had to call in a surgical team.”
“They’re going to operate?”
Kate shook her head. “Not if they can’t do something with her clotting disorder.”
“And?”
“Tom’s gone to round up the hematologist on call and the hospital pharmacist. I’m sure they can come up with the nicotinic acid. It’s that delta version of the EACA I’m not sure of. Goddamn Redding Pharmaceuticals. I’m going to nail them, Jared. If it’s the last thing I do, I’m going to nail them for what they’ve done.”
“I know a pretty sharp lawyer who’s anxious to help,” he said.
“I’m afraid even you may not be that sharp, honey.”
“What do you mean?”
“Well, we’ve got this notebook and your word that it belongs to Paquette, but beyond that all we have is me, and I’m afraid my word isn’t worth too much right now.”
“It will be when they see this.”
“Maybe.”
“Either way, we’re going to try. I mean somebody’s going to have to come up with a logical explanation for all this that doesn’t involve Redding Pharmaceuticals, and I really don’t think that’s possible. Do you?”
“I hope not.”
“How long do you think it will take before we hear from this resident—what’s his name?”
Kate suddenly recalled a gentle, snowy evening high above Boston Harbor and felt herself blush. “Tom. Tom Engleson.” Did her voice break as she said his name? “I don’t know. It shouldn’t be long.” It had better not be, she thought.
They waited in silence. Finally, Jared adjusted his cervical collar and rubbed at his open eye with the back of his hand. “Kate, there’s something else, something I have to tell you,” he said. “It has a good deal to do with what you were saying before about your word not being worth too much.”
She looked at him queerly.
He held her hand tightly in his. “Kate, yesterday morning I spoke to Lisa.”
Kate sat in the still light of dawn, stroking Jared’s forehead and feeling little joy in the realization that, in his eyes at least, she had been vindicated. Nearly fourteen years that he might have shared in some way with his daughter had been stolen. Fourteen years. His hatred of Win Samuels was almost palpable. To her, the man was pitiful—not worth hating.
She had tried her best to make Jared see that and to convince him that whatever the circumstances, no matter how much time had gone by, he had a right to be a father to his daughter. He had listened, but it was clear to her that his pain and anger were too acute for any rational planning. There would be time, she had said, as much to herself as
to him. If nothing else, there would be time.
The telephone rang, startling Jared from a near sleep.
Kate had the receiver in her hand well before the first ring was complete. For several minutes, she listened, nodding understanding and speaking only as needed to encourage the caller to continue.
Jared searched her expression for a clue to Ellen’s status, but saw only intense concentration.
Finally, she hung up and turned to him. “That was the hematologist,” she said. “They’ve started her on the drugs.”
“Both of them?”
Kate nodded. “Reluctantly. They wanted more of a biologic rationale than Tom was able to give them, but in the end, her condition had deteriorated so much that they abandoned the mental gymnastics. They have her on high doses of both.”
“And?”
She shrugged. “And they’ll let us know as soon as there’s any change … one way or the other. She’s still in the OR.”
“She’s going to make it,” Jared murmured, his head sinking again to the spot beside her hand.
Less than ten minutes later, the phone rang again.
“Yes?” Kate answered anxiously. Then, “Jared, it’s for you. Someone named Dunleavy. Do you know who that is?”
Bewildered, Jared nodded and took the receiver. “Dunleavy? It’s Jared Samuels.”
“Mr. Samuels. I’m glad you made it all right.”
“Are you in trouble for letting me go?”
“Nothing I can’t handle. That’s not why I’m calling.”
Jared glanced at his watch. Seven-fifty. Dunleavy’s sixteen-hour double shift had ended almost an hour before. “Go on.”
“I’m at the nurses’ station in the OR, Mr. Samuels. They’ve just started operating on Mrs. Sandler. I think they’re going to try and oversew her bleeding ulcer.”
Jared put his hand over the mouthpiece. “Kate, this is the nurse who took care of me at Metro. They’re operating on Ellen.” He released the mouthpiece. “Thank you, Cary. Thank you for staying and calling to tell me that.”
“That’s only one of the reasons I called. There are two others.”
“Oh?”
“I wanted you and Dr. Bennett to know I’m going to stay on and special Mrs. Sandler after she gets out of surgery.”
“But you’ve been up for—”
“Please. I was a corpsman in Nam. I know my limitations. I feel part of all this and … well, I just want to stay part of it for a while longer. I’ll sign off if it gets too much for me.”
“Thank you,” Jared said, aware that the words were not adequate.
But Dunleavy had something more to say. “I … I also wanted to apologize for that last crack I made about your wife.” He went on, “It was uncalled for, especially since I only know what I know second or third hand. I’m sorry.”
“Apology accepted,” Jared said. “For what it’s worth, she didn’t do any of the things people are saying she did, and no matter how long it takes, we’re going to prove it.”
“I hope you do,” Cary Dunleavy said.
“That was a curious little exchange,” Kate said after Jared had replaced the phone on the bedside table. “At least the half I got to hear.”
Jared recounted his conversation with the nurse for her.
“They’ve gone ahead with the surgery. That’s great,” she said, deliberately ignoring the reference to her situation. “Ellen’s bleeding must have slowed enough to chance it.…”
Her words trailed off and Jared knew that she was thinking about her own situation. “Katey,” he said. “Listen to me. Zimmermann is dead and Ellen isn’t and you’re not, and I’m not. And as far as I’m concerned that’s cause for celebration. And I meant what I said to Dunleavy. You are innocent—of everything. And we’re going to prove it. Together.” He leaned over and kissed her gently. Then he straightened and said, “Rest. I’ll wait with you until we hear from Metro.” Kate settled back on the pillow.
A moment later, as if on cue, the day supervisor and another nurse strode into the room.
“Dr. Bennett,” the supervisor said, “Dr. Jordan is in the hospital. She’ll be furious if she finds out we haven’t even done morning signs on her prize patient, let alone any other nursing care.”
“Don’t mind me,” Jared said. “Nurse away.”
The supervisor eyed him sternly. “There are vending machines with coffee and danish just down the hall. Miss Austin will come and get you as soon as we’re through.”
Jared looked over at Kate, who nodded. “I’ll send for you if they call,” she said.
“Very well, coffee it is.” He rose and swung his parka over his shoulder with a flourish. As he did, something fell from one of its pockets and clattered to the floor by the supervisor’s feet.
The woman knelt and came up holding a miniature tape cassette.
“Did that fall from my parka?” Jared asked, examining the cassette, which had no label.
“Absolutely,” the supervisor said. “Isn’t it yours?”
Jared looked over at Kate, the muscles in his face suddenly drawn and tense. “I’ve never seen that tape before.” His mind was picturing smoke and flames and blood … and a hand desperately clawing at the pocket of his parka. “Kate, we’ve got to play this tape. Now.” He turned to the nurses. “I’m sorry. Go do whatever else you need to do. Right now we’ve got to find a machine and play this.”
The supervisor started to protest, but was stopped by the look in Jared’s eyes. “I have a machine in my office that will hold that, if it’s that important,” she said.
Again, Jared saw the hand pulling at him, holding him back. For Christ’s sake, Paquette, let go of me. I’m trying to get you out of here. Let go! “It just might be,” he said. “It just might be.”
“So, Norton, first that brilliant letter to the newspapers about the ballplayer and now this biopsy thing. We asked you for something creative to stop Bennett, and you certainly delivered.”
The entire tape, a conversation between Arlen Paquette and Norton Reese, lasted less than fifteen minutes. Still, for the battered audience of two in room 201 of Henderson Hospital, it was more than enough.
“It was my pleasure, Doctor. Really. The woman’s been a thorn in my side from the day she first got here. She’s as impudent as they come. A do-gooder, always on some goddamn crusade or other. Know what I mean?”
For Kate and Jared, the excitement of Reese’s disclosures was tempered by an eerie melancholy. Paquette’s conscience had surfaced, but too late for him. The man whose smooth, easy voice was playing the Metro administrator like a master angler was dead—beaten, burned, and then most violently murdered.
“You know what amazes me, Norton? What amazes me is how quickly and completely you were able to eliminate her as a factor. We asked, you did. Simple as that. It was as if you were on top of her case all the time.”
“In a manner of speaking I was. Actually, I was on top of her chief technician—in every sense of the word, if ya know what I mean.”
“Sheila.” Kate hissed the word. “You know, I tried to believe she was the one who had set me up, but I just couldn’t.”
“Easy, boots. If you squeeze my hand any tighter, it’s going to fall off.”
“Jared, a woman lost her breast. Her breast!”
“You must be some lover, sir, to command that kind of loyalty. Maybe you can give me a few pointers some time.”
Maybe I can, Arlen. Actually, it wasn’t that tough to get Sheila to switch biopsy specimens. She had a bone of her own to pick with our dear, lamented, soon-to-be-ex pathologist. I just sweetened the pot by letting her pick on my bone for a while beforehand.
Norton Reese’s laughter reverberated through the silent hospital room, while Kate pantomimed her visceral reaction to the man.
“I wonder,” Jared mused, “how the lovely Ms. Pierce is going to respond when a prosecutor from the DA’s office plays this for her and asks for a statement. I bet she’ll try to save herself
by turning State’s evidence.”
“She can try anything she wants, but she’s still going to lose her license. She’ll never work in a hospital again.”
“Well, you really stuck it to her, Norton. With that chemist from the state lab in our pocket, Bennett’s father-in-law doing what he can to discredit her even more, and now this biopsy coup, I doubt she’ll ever be in a position to cause us trouble at the Omnicenter again. Our friend is going to be very impressed.”
“And very grateful, I would hope.”
“You can’t even begin to imagine the things in store for you because of what you’ve done, Nort. Good show. That’s all I can say. Damn good show.”
“We aim to please.”
The tape ran through a few parting formalities before going dead.
Jared snapped off the machine and sat, looking at his wife in absolute wonder. “I would have broken,” he said.
“Pardon?”
“If those things had come down on me like they did on you, I would have cracked—killed someone, maybe killed myself. I don’t know what, but I know I would have gone under. It makes me sick just to think of how isolated you were, how totally alone.”
“That’s where you’re wrong. You see, you may have had doubts about me, and justifiably so, but I never had doubts about you; so I wasn’t really as alone as you might think.”
“Never?”
Kate took her husband’s hand and smiled. “What’s a doubt or two between friends, anyway?” she asked.
EPILOGUE
Friday 9 August
Though it was barely eight-thirty in the morning, the humidity was close to saturation and the temperature was in the mideighties. August in DC. It might have been central Africa.
Silently, Kate and Jared crossed the mall toward the Hubert H. Humphrey building and what was likely to be the final session regarding her petition to the FDA for action against Redding Pharmaceuticals.
The hearings had been emotional, draining for all concerned. Terry Moreland, a law-school classmate whom Jared had recruited to represent them, had been doing superb work, overcoming one setback after another against a phalanx of opposition lawyers and a surprisingly unsympathetic three-man panel. One moment their charges against the pharmaceutical giant would seem as irrefutable as they were terrifying, and the next, the same allegations were made to sound vindictive, capricious, and unsubstantiated. Now the end of the hearings was at hand—all that remained were brief closing statements by each side, a recess, and finally a decision.
Side Effects (1984) Page 32
