Fatal

by Michael Palmer

  They sat across from each other in a booth, watching the traffic inch past, and saying little, but each aware of the bonds that would forever exist between them. Three months after she had helped to save his life, Ellen had returned to Belinda for the burial of Colin Morrissey, who rapidly became incapacitated from his neurologic disease and simply wasted away. Soon, sadly, Sara Jane Tinsley would share a similar fate.

  For nearly six months now, the owners of BC&C had been besieged by attorneys, mine agencies, and government investigations. Armand Stevenson had been sent packing and was facing criminal charges. Blaine LeBlanc was gone as well, and latest estimates placed the fines and settlements in the tens of millions. Still, under new management, the operation had remained open, and recently, had even been hiring.

  “So,” Ellen asked finally, “what do you think about your uncle making some sort of plea bargain?”

  Matt shrugged. He was thinking about his mother and her brother’s many kindnesses to her. Since Hal’s imprisonment, Matt had spent even more time with her than before. But she was inching closer and closer to custodial care, and now as often as not called him Hal.

  “He hurt a lot of people,” he said finally. “One minute I want to see him put away forever, and the next I think that he simply went crazy with all the money that was at stake. It’s really out of my hands. All I can do now is keep telling the prosecutors what I know.”

  “Well, I saw him in action,” Ellen said. “I hope he gets twenty consecutive life sentences and they let him plea-bargain down to one. When are you headed back?”

  “Probably tomorrow night.”

  “You miss her.” It was a statement, not a question.

  “I miss her,” Matt said.

  Nikki had been in D.C. for one day and one night, but her responsibilities as a pathologist at Montgomery County Regional Hospital, and as the new medical examiner for Montgomery County, precluded taking much time off. After having her ankle fixed, she had taken a leave of absence from her Boston position, and had simply never gone back. Six weeks later, with the job offer from MCRH in her pocket, she had sent in her resignation, and a week after that, had flown up to Boston with Matt to pack her things.

  “You want to know what she said to me when she was here?” Ellen asked. “She said that men like you don’t come along and resuscitate a girl every day, so she had decided to pay attention to that.”

  “I’m paying attention, too,” he said. “She’s really been great to be around. I just have to get accustomed to . . . to having someone in my life.”

  “It’s just a day at a time.”

  At that moment, Matt’s cell phone began vibrating. Actually, it was Nikki’s. He had never owned one himself, but she insisted they keep in close touch when he was in the big city.

  “I’ll be back in a minute,” Ellen said as he pulled the phone from his pocket. “Say hello for me.”

  “Hey, good afternoon, Doc,” he said. “Didn’t I just talk to you a little while ago?”

  “That was then,” Nikki said. “How’s it going?”

  “Hal’s performing even as we speak. There’re rumblings he’s going to cut some sort of a deal with the prosecutors.”

  “Well, he can’t have his jobs back. I like them.”

  “That won’t be a problem. I have mixed emotions about any plea-bargaining. One moment I think there should be some lenience because he was just crazy, and the next I don’t want him getting away with anything less than the guillotine.”

  “It’ll work out the way it works out,” Nikki said.

  “I suppose.”

  “I know you’re in a tough spot, Matt. For what it’s worth, I think you’re handling things terrifically.”

  “I think I needed to hear that.”

  “I mean it. You’re a great doc and a wonderful man, and I’ll tell you that as often as you want to hear it.”

  “Thanks. You’re pretty terrific yourself.”

  “Say, I almost forgot the reason I called. Yes, Virginia, there is a reason. The neatest thing just happened. I was getting ready to go into the office, but I had a little time, so I took my coffee and Kathy’s mandolin out to the porch and played a few licks out toward the mountains. I have a ways to go on the thing to even be listenable, but I’m getting better.”

  “That’s a gross understatement. Remember, I’ve heard you.”

  “But wait, that’s not the point. While I was playing, this incredibly beautiful little bird flew down and settled on the railing right in front of me. I’ve never seen anything like it. I kept playing and playing and it didn’t move. It just sat there like it was actually listening to my music. It was small, but so red and . . . and so perfect. What do you think it was?”

  Matt swallowed back a fullness in his throat and gazed across the street toward the Hart Building.

  “I think,” he said, “it was a tanager. A scarlet tanager.”

  AUTHOR’S NOTE

  Often readers of my novels will write and ask me questions about how to get more information on medical topics discussed in my books. Fatal deals with several controversial medical issues: environmental toxins and how they can affect our health, as well as the known and unknown side effects of vaccines. As a medical fiction author, it is often difficult for me to fully discuss complex medical issues in the course of a novel. Fatal is no exception. For those readers who would like to do their own investigation into these subjects, the following sources of information may be helpful:

  GOVERNMENT AGENCIES

  Environmental Protection Agency (EPA)

  1200 Pennsylvania Avenue NW

  Washington, D.C. 20460

  www.epa.gov

  This federal agency is responsible for monitoring and controlling the levels of environmental toxins that can affect health.

  Centers for Disease Control (CDC)

  1600 Clifton Road

  Atlanta, GA 30333

  Hotline: 800-232-2522

  Tel: 404-639-3311

  www.cdc.gov

  This federal agency is responsible for monitoring and protecting the public from disease and disability, and sets national health policies.

  Food and Drug Administration (FDA)

  5600 Fishers Lane, HFI-40

  Rockville, MD 20857

  Tel: 888-463-6332

  www.fda.gov

  This federal agency is responsible for licensing and regulating drugs, vaccines, and other medical products.

  National Institutes of Health (NIH)

  9000 Rockville Pike

  Bethesda, MD 20892

  Tel: 301-496-4000

  www.nih.gov

  This federal agency is responsible for scientific research into medical issues that affect human health.

  National Vaccine Injury Compensation Program (VICP)

  Parklawn Building, Room 8A-46

  5600 Fishers Lane

  Rockville, MD 20857

  Tel: 800-338-2382

  www.hrsa.gov/osp/vicp

  This federal office provides information about the National Vaccine Injury Compensation Program, and how to file a claim for a vaccine-related injury or death.

  Vaccine Adverse Events Reporting System (VAERS)

  Tel: 800-822-7967

  www.fda.gov/cber/vaers/vaers.htm

  This federal office provides information on how to report a vaccine reaction, injury, or death to the government vaccine reaction reporting system.

  PRIVATE ORGANIZATIONS

  American Academy of Environmental Medicine

  7701 East Kellogg, Suite 625

  Wichita, KS 67207

  www.aaem.com

  This organization supports physicians and educates the public about the interaction between humans and their environment. It also promotes health through prevention and treatment of environmentally triggered illnesses.

  Developmental Delay Resources (DDR)

  4401 East West Highway, Suite 207

  Bethesda, MD 20814

  www.devdelay.org

/>   This international nonprofit organization, founded in 1994, disseminates information about the causes and prevention of developmental delays in children.

  Immunization Action Coalition

  1573 Selby Avenue, Suite 234

  St. Paul, MN 55104

  Tel: 651-647-9009

  www.immunize.org

  This organization promotes mass vaccination to boost immunization rates and prevent infectious diseases.

  National Network for Immunization Information (NNII)

  66 Canal Center Plaza, Suite 600

  Alexandria, VA 22314

  Tel: 877-341-6644

  www.immunizationinfo.org

  This organization, founded in 2000, is supported by the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, the American Academy of Pediatrics, and the American Nurses Association. It provides the public with information about immunizations.

  National Vaccine Information Center (NVIC)

  421-E Church Street

  Vienna, VA 22180

  Tel: 1-800-909-SHOT

  www.909shot.com

  This nonprofit educational organization was founded in 1982 by parents of vaccine-injured children, and is dedicated to preventing vaccine injuries and deaths through public education and defending the right to informed consent to vaccination. Operates a vaccine reaction registry.

  Parents Requesting Open Vaccine Education (PROVE)

  P.O. Box 91566

  Austin, TX 78709-1566

  www.vaccineinfo.net

  This parent-operated organization, founded in 1997, provides information on vaccines and vaccine policies in Texas.

  ABOUT THE AUTHOR

  MICHAEL PALMER M.D. practices addiction medicine in Massachusetts, where he is currently at work on his eleventh novel.

  Michael Palmer can be contacted at

  michaelpalmerbooks.com

  ALSO BY MICHAEL PALMER

  FROM BANTAM BOOKS

  The Sisterhood

  Side Effects

  Flashback

  Extreme Measures

  Natural Causes

  Silent Treatment

  Critical Judgment

  Miracle Cure

  The Patient

  Here’s a sneak preview of

  MICHAEL PALMER’S

  next pulse-pounding novel of medical suspense

  THE SOCIETY

  Coming from Bantam Books

  in summer 2004

  THE SOCIETY

  by Michael Palmer

  On sale summer 2004

  PROLOGUE

  4,013,864

  Marcia rising tilted back just enough so that neither her chief financial officer, Leonard Smith, seated to her right, nor Executive VP Dan Elder to her left could see what she was writing. She was expected to take some notes at these meetings, anyhow. After all, she was the boss. Smiling inwardly, she added an ornate dollar sign in front of the 4. At the far end of the broad mahogany table, Vice President Joe Levinson droned on. Levinson was the cost containment officer for Eastern Quality Health, and as such was responsible more than anyone except Marcia herself for the managed care company’s strong financial picture. But as a speaker, he was as animated and vibrant as drying paint.

  “. . . We took last quarter’s slumping numbers as a strident warning—a shot across our financial bow if you will—that we had to renew incentives among our employees and physicians in the area of cost containment. The in-house contest we ran was most successful in this regard. Almost immediately there was a twenty-one-percent increase in claims rejected outright, and a thirteen-percent increase in those surgical claims that were bundled for payment together with at least one other claim. There were some complaints from physicians, but nothing Bill’s physician relations people couldn’t handle . . .”

  Four million . . . thirteen thousand . . . eight hundred . . . sixty-four.

  Marcia wrote the numbers out longhand, then she added touches of calligraphy to the figure, which was her salary for the preceding twelve months. Factor in her eight million in unexercised stock options, and she was well into the top ten of female executives in the country. The words had a delightful rhythm to them, she mused, perhaps a samba. She imagined a kick-line of her nineteen hundred employees snaking its way through the building.

  Four mill-ion thir-teen kick! . . .

  Marcia was more than pleased with the way her officers had responded to the recent dip in corporate profits. Her philosophy of one set of premiums and coverages for companies with younger, healthier employees, and another for those who might have a more risky, older crew was infallible.

  “If they don’t get sick, they can’t cost us,” she had preached over and over again to her minions.

  Let some other company cover those who are running out of time or won’t take care of themselves. Every dollar spent researching the demographic makeup of a company (blacks get more hypertension, diabetes, and kidney failure; Asians are ridiculous hypochondriacs; Hispanics have too much alcoholism, drug addiction, and mental illness; thirty-somethings are okay, forty-somethings are not) would return hundreds in the form of payouts that Eastern Quality Health wouldn’t have to make.

  Eight hun-dred sixty-four kick! . . .

  “. . . And so, as I see it, our company has weathered a major financial squall,” Levinson was saying, “but there are major storm clouds on the horizon for the entire industry. Still, our ship will remain seaworthy so long as we never lose sight of the fact that our business is all about health—that is, the health of Eastern Quality.”

  To laughter at his rare humor, and a smattering of applause, Levinson bowed slightly and took his seat. The meeting was, to all intents, over. Standing up, Marcia encouraged her officers to maintain their vigilance, to bring problems and ideas to her attention sooner rather than later, and never to lose sight of the goals of Eastern Quality Health—not to be the biggest HMO, but rather to be the most efficient. Then she stood by the door of her suite and shook the hand of each of them as they left. Finally she settled in behind her desk and gazed out at the reflecting basin and double fountain that graced EQH’s fifteen-acre campus on route 128, eighteen miles north and west of Boston. The setting sun had already dipped below the tree line, yielding to a cloudless evening. Arranged neatly in labeled wire bins on her desk was two or three hours of work she expected to complete before going home. Seldom was she not the last EQH employee out of the building.

  Marcia brushed a minuscule crumb from her Armani jacket and started with a review of reports from the team of attorneys handling one of several suits pending against the company—this one centered on confusion over whether or not a particular policy holder had the coverage for a bone marrow transplant. EQH’s position was, of course, that she did not, although, as of the woman’s death six months ago, the question had become moot. Still, her annoying husband’s unwillingness to accept the truth was prolonging a resolution. Marcia dictated a carefully worded letter demanding that the lawyers stand firm at a settlement of $100,000. It was to be that, or nothing.

  Outside her third-floor window night settled in as she reached for the next set of reports. Finally, at nine, she gathered her things in the Moschino briefcase her husband had given her, straightened her desk, then her skirt, and headed out to the elevator. Floor two of the garage, the so-called officers’ parking lot, was accessed only via the elevator, and only with the aid of a pass card. Marcia pulled her overcoat tightly about her and stepped out into the raw March night. She knew what vehicle each of her upper management officers drove, and took pains to encourage them to choose automobiles reflecting their personal success, and, through that, the success of EQH. Besides her Mercedes SL500 Silver Arrow convertible, there were still two cars in the lot—utilization management director Sarah Brett’s Infiniti, and chief of physician relations Bill Donoho’s Lexus. Marcia made a mental note to reward them both for their diligence.

  She was nearing her car when she felt more than heard the prese
nce of someone else in the lot. She whirled at the sound of footsteps. A man, fedora brim pulled down to the bridge of his nose, hands in his trench coat pockets, had left the shadows and was approaching her.

  How in the hell had he gotten out here? she wondered angrily. This was absolutely the last screwup for Joe O’Donnell. If you couldn’t trust your security chief, who in the hell could you trust? First thing in the morning, O’Donnell was history. And none of his whining about five children was going to save him this time.

  Marcia’s pulse shot up at the sight of the man, then slowed as she took in the situation with the quick, analytical thinking that had become her trademark. There was a security camera sweeping the lot from just above the doors to the elevator foyer, so maybe one of the two guards on duty would spot the stranger. Managed care was at times a controversial and emotional business. Her executive officers were encouraged to have a legally registered handgun. Hers was locked in the glove compartment of the Silver Arrow, but if this was trouble, there was no way she could reach the car in time. She peered through the gloom, trying to get a fix on the man’s eyes.

  Dammit, O’Donnell!

  Less than ten feet away the intruder stopped. By now Marcia was certain that this was no one associated with EQH.

  “Who are you?” she demanded. “How did you get out here?”

  “Mrs. Rising, I have something for you.”

  A woman! Marcia felt her pulse surge once more.

  “Who are you?” she said again, her voice breaking.