Stigma

by Philip Hawley Jr.

  Stigma

  Philip Hawley Jr.

  Los Angeles pediatrician turned novelist Philip Hawley Jr.'s debut novel — reminiscent of classic medical thrillers like Michael Crichton's The Andromeda Strain and Robin Cook's Coma — is a subterfuge-laden page-turner that revolves around Luke McKenna, a pediatric E.R. physician and former secret member of a black ops unit of the Navy SEALS who vows to get to the bottom of an unidentifiable illness that killed a young Guatemalan boy. His investigation, however, only succeeds in putting his life and those of his loved ones in mortal danger.

  After the boy — who was flown all the way to Los Angeles from Central America — inexplicably dies, McKenna orders an autopsy, only to find himself stymied by hospital administrators who are obviously trying to cover something up. McKenna realizes that a conspiracy of international proportions is being pulled off: The boy's body is suddenly transported back to Guatemala and a former lover and employee of pharmaceutical giant Zenavax is found murdered just minutes after she called McKenna, desperately wanting to meet with him. Framed for her murder, the E.R. doctor must use all of his former military training to stay alive long enough to identity the true villain

  Philip Hawley Jr

  Stigma

  FOR MOM AND DAD

  ACKNOWLEDGMENTS

  During the writing of this novel there were many who came along at just the right moment, like stepping stones appearing suddenly and unexpectedly just as the literary quagmire threatened to swallow me whole. They include:

  My wife, Janelle, who read the early drafts without giggling (well, most of the time) and offered insights that allowed me to understand more fully the characters in this story. She doggedly sifted through a great many words to help me find those that should remain, encouraged me through the difficult times, and remained ever hopeful, even when I doubted myself.

  My son, Ned, and my daughter, Sara, for their patience and love. I am truly blessed.

  Paul Guyot and his wonderful wife, Kelly, who were to my creative efforts like rainfall on parched soil.

  My teachers, most notably Bill Barnett, who aptly nicknamed me “Neb,” for my nebulous and evasive answers while a high-school student in his English literature class; and Shelley Singer, who taught me the importance of precision in both thought and word.

  The many readers who suffered through early drafts, including: Will and Brenda Langdon, friends in the truest sense; my brother George, who knows more about arcane subjects than I would have ever imagined; my brother Ned, who revealed to me his considerable literary talent; my brother Victor, who has a peculiar affection for really nasty villains; my sister, Erin, who has a keen literary eye and also offers great family discounts for her cleaning services; Bruce Johnson, who can shoot the stem off an apple at three hundred yards; Bob and Maryann Hussey; Edgar Hussey; Tammy Sparks; John and Marilyn Maher; and Gayle Robertson.

  Ed Stackler, the enormously talented editor who taught me the finer points of storytelling and showed me how to turn a rough draft into a finished novel.

  Lyssa Keusch and the entire staff at HarperCollins, who worked so tirelessly supporting this book. Also, Rob McMahon and Erin Brown, who were its earliest champions.

  Mega-talented authors Robert Browne, who designed the cover for this e-book edition, and Brett Battles, who generously shared his knowledge about e-book publishing. Gifted editor and Ninja, Elyse Dinh-McCrillis, who copyedited this e-book edition.

  My agent and friend, Simon Lipskar, who has one of the most challenging jobs in the world and performs it with equal measures of insight, tenacity, patience, and kindness.

  Elmer Crehan, MD, and John Thom, MD, two pediatricians who set a high and noble example for those who follow them.

  1

  Calderon figured that, on this night, he had to be the only chauffeur at Los Angeles International Airport who was picking up a dying boy.

  A TV monitor above one of the airport luggage carousels flashed, announcing the arrival of Flight 888 from Guatemala City. It was 6:18 P.M. The plane was a half hour late, but Calderon was on time and that’s what mattered. He’d never been late for a job.

  He slid a finger down the lapel of his coat and surveyed his black uniform. Not a stray crease, not a single mark or stain — the boy and his mother deserved at least that much. He ignored the stench of spent diesel from a bus passing behind him as he stood outside the glassed-in baggage claim area and watched for his passengers. Inside, a swarm of travelers sluiced down the escalator and streamed around an eager clot of livery drivers who were jouncing like nervous puppies. No skill, no finesse.

  Calderon was a professional. His passengers wouldn’t have to find him. He had their descriptions; he’d find them. When they emerged from the last Customs checkpoint, he would appear nearby — a respectful distance away, unobtrusive, but clearly visible to the persons in his charge. He’d immediately conform to their attitude and manner, gregarious if he needed to be, silent and inconspicuous if they preferred. He was especially good at his work, and he knew it. Recognizing the inescapable patterns that define people, anticipating their next thought — these things came naturally to him. He had a knack for this work.

  And he usually enjoyed it, but not tonight.

  For the young boy and his mother, this was probably their first-ever trip away from home, and almost certainly their first time on a plane. They’d be frightened after being locked away with strangers in a strange metal tube with wings, herded through narrow passageways, hammered with noisy directives, perhaps even stripped of a belonging or two along the way.

  Weary and apprehensive, the mother would nevertheless hide behind a mask of stoicism when he greeted her. She would be surprised and pleased to discover that a Guatemalan driver, someone from her homeland, was waiting to welcome them to America, but she wouldn’t dare show her relief. He understood; it was their way.

  Calderon would befriend her by telling stories about his own journey to America twenty-five years ago. He could still summon the memories of his illegal border crossing: he and his mother crammed into a crowded compartment under the bed of a box truck, the decrepit transmission assaulting his ears until he couldn’t hear anymore, the rancid odors of a dozen unwashed bodies, and his mother choked with fear.

  Once he seated the boy and his mother in the town car, Calderon would smile warmly into the rearview mirror, lift his shoulders, give them a gentle laugh, and point out the similarities of their journeys. However you come to America, you’re certain to be crowded into a tight space with strangers.

  The boy’s mother might not even smile, but she would appreciate the story. Perhaps her shoulders would relax as he distracted her from her worries for one brief moment.

  Calderon imagined the mother’s dread. Her son was a sickly boy, a medical mystery. American doctors would try to unravel the diagnostic puzzle. America’s prodigious wealth and know-how were poised and standing ready, all for a four-year-old boy from a tiny village in the Guatemalan rain forests.

  Only in America.

  Josue Chaca and his mother had no idea that Calderon would be there to greet them. He would explain that it was a small welcoming gesture, another gift from the hospital waiting to receive them, University Children’s Hospital.

  Josue was one of the chosen few, emblematic of American generosity, plucked in a seemingly random way from among millions of children around the globe who endure their deformities and ailments simply because that’s the only life they know.

  A loud horn sounded inside the baggage claim area and a red light flashed atop one of the carousels as the machinery groaned to life.

  When Calderon and his mother had arrived in America, flashing red lights were the enemy. Back then, America’s considerable resources had been a constant threat, fuel that fed his
mother’s never-ending fear of deportation. They were happiest when they received no attention at all, wanting instead to be left alone to eke out their meager existence in rural Oklahoma. A strong and healthy twelve-year-old boy, Calderon had been tossed into an immigrant labor pool that casually discarded those who couldn’t keep up.

  All of that had changed when he became an American citizen on his eighteenth birthday. It was the same day he enlisted in the Army. Life had begun on that day.

  Seven years later his dreams had died when the U.S. military tossed him out like so much garbage. His stomach knotted as he remembered the night he returned home to his mother’s ramshackle apartment. He spent the entire night staring at her bedroom door, which was too rotted to hold in the muted sounds of her weeping. She was probably still thinking about her son’s disgrace when, a few months later, a tornado buried her under a two-story pile of rubble. The government bureaucrats could have saved her, but instead they let her suffocate to death.

  Now, the same America that had for so many years hovered over Calderon and his mother like a storm cloud, the same America that had excreted them as if they were bilious waste, that same America was giving aid and comfort to this woman and her boy. Josue Chaca and his mother were tasting the American dream, if only for a short time.

  Calderon’s assignment was simple: Make sure the boy never reached the hospital. Josue Chaca and his mother would be discovered later, perhaps in some dank alley — newly arrived visitors who fell victim to random gang violence. It was a distasteful assignment, made necessary only because of his client’s lax attitudes about security.

  His cell phone sounded. It was a unique ringtone assigned only to Mr. Kong, his “spotter” at the gate. “They here?” Calderon asked.

  “We got a problem,” Kong said. “Something’s happening up here…”

  2

  “Will she have any scars?” the woman asked.

  “Nothing that anyone will notice,” Dr. McKenna lied. He knew her girl had the worst kind of wounds — hidden from view, out of reach — the kind that fester for a lifetime. “She’ll have a small scar here, just behind her ear, but in a few years you probably won’t even be able to see it.”

  “Her fourth birthday is next week. We were talking about her party when…” The woman’s words gave way to a muffled sob.

  McKenna gently lifted the edge of the wound with forceps. “When what?”

  “When we fell down the stairs.”

  “We?”

  “I was carrying her.” A heavy sigh. “It was dark. I guess I didn’t look where I was going.”

  He gave her a sidelong glance. “What did she hit her head against?”

  “I didn’t notice.” She fidgeted nervously, leaning forward in her chair. “You’re sure she’s going to be okay?”

  “It’s a superficial wound — she was lucky. It could’ve been a lot worse.” And next time, or the time after that, it probably will be. The bruises flashed in his mind, yellowish-brown marks he had found when he removed the girl’s blouse. Fading echoes of violence. They were too old to have happened a few hours ago, and with a little imagination they formed the outline of a hand. A large hand.

  Luke McKenna let the conversation evaporate while waiting for the social worker to arrive. It seemed a complete waste of time to lob lies back and forth. He was growing frustrated with this woman, and annoyed at himself for being irritated with her, so he returned his thoughts to the girl.

  Surgical drapes covered the child’s head. Except for a small exposed area around the wound behind her right ear, the only trace of her was a tendril of curly red hair peeking out from under the edge of a sterile drape. She was breathing heavily, slowly, nearly asleep now, having spent herself during her first hour in the emergency room. Like most children her age, the girl had fought every step of the way. That is, until two nurses wrapped her body, flailing arms and all, in a Velcro papoose designed specifically with combative toddlers in mind.

  An occasional sigh was the woman’s only assurance that her daughter was still breathing under all those bloodstained towels and drapes.

  Luke adjusted the overhead light with his elbow and picked up a clamp. “As soon as I finish with these stitches, we’ll send her over for some X-rays just to make sure that she—”

  “She doesn’t need any X-rays.”

  Of course. You’ve been through this before, you know the routine. No X-rays, no chance that we’ll find old healing fractures. Her voice was thick, but not from alcohol or drugs. It was difficult to speak clearly with her lower lip protruding awkwardly.

  McKenna put his instruments down and shifted his gaze to the woman. She had the face of a boxer — the one who lost the fight. Her cheeks were a latticework of contusions and raw abrasions, her left eye was clamped shut, and her lower lip had swelled to the size of a small walnut. Dried blood matted her short brown hair in spots. Passing her on the street a month from now, he probably wouldn’t recognize her.

  A flashing red light invaded his peripheral vision. The intercom unit on the wall called out, “Dr. McKenna, the Trauma Unit wanted me to let you know — the airport transport is on its way in.”

  Luke worked a jaw muscle. “Tell ’em I’ll be there.”

  He knew that the frustration creeping into his voice wasn’t helping. Looking back at the woman, he said, “For your daughter’s sake, it’s important that we get those X-rays. Without them, I can’t be certain about the extent of her injuries. If this was caused by a fall—”

  “I told you, we fell down the stairs.” Her face was an equal mix of defiance and fear. “That’s how it happened.”

  “Okay,” was all he could think to say. What he wanted to say was, But I don’t believe you.

  “That’s what happened. We fell,” she whispered to no one in particular.

  Tears began running down her bruised cheeks. She looked about his age, thirty-six, but life’s afflictions probably added ten years to her face.

  He reached over and placed a hand on her arm.

  She recoiled with a shudder.

  Luke drew back as if yanked by a rope. “Sorry.”

  He was clumsy at this, he realized. What did he expect — that she’d collapse onto his shoulder and admit that some cretin had beaten the two of them?

  “I just want you to understand that I’m concerned about you,” he said. “I’m concerned about both of you.” The words felt awkward and cumbersome.

  They shared several seconds of uncomfortable silence before McKenna settled on a different approach. He glanced at a side table, rechecking the patient’s chart to see that the woman’s last name was the same as her daughter’s. “Mrs. Erickson, you sustained some fairly significant injuries yourself. I’ll say it again. You should be seen in an emergency room — tonight.”

  The woman exhaled heavily. “Can’t one of the doctors here just take a quick look at me, maybe give me some bandages?”

  He shook his head. “I wish we could, but this is a pediatric hospital. Unless it’s a life-threatening emergency, we have to send you to an adult facility. There’s a hospital just a few blocks away that—”

  “Never mind, then.”

  Adjusting the needle to start another suture, Luke went back to work on the girl’s wound. It was time for plain talk. “I’m sorry if what I’m going to say offends you, but your injuries don’t look like they happened falling down a stairway.”

  “It wasn’t a stairway like in a house. We were outside.” She squirmed in her chair, as though she were sitting on a hot griddle. “The steps outside our back door are concrete. It was dark. I slipped.”

  He looked up just as the woman pulled back a strand of hair hanging over her swollen eye. Her hand was shaking.

  “Then do you mind if I swab a few areas on your daughter’s scalp?” he asked. “We can test it for traces of concrete.” He had no idea whether such a test even existed.

  She didn’t respond.

  As he snipped the ends of the last suture, he h
eard the woman weeping again. He slowly removed the surgical drapes.

  The girl’s head did not move. She was asleep.

  Luke and Mrs. Erickson both turned to a metallic sound — curtain hangers scraping along an overhead track. A tall, thin man, his graying hair pulled back neatly into a ponytail, peered at them from behind the half-open privacy curtain.

  It was Dennis, the social worker. Luke waved him into the room.

  If anyone could connect with this lady, it was Dennis. He had more experience with child abuse than anyone else in the hospital, and his skills were particularly useful when dealing with an abused spouse who was afraid to talk.

  Of course, it was now considered more “correct” to refer to these incidents as non-accidental trauma rather than child abuse, to remove the supposed bias conveyed by the word “abuse.” Luke still preferred the term “child abuse.”

  Seeing the question on Dennis’s face, Luke shrugged his eyebrows. No, he hadn’t made any progress.

  In a relaxed motion, Dennis crouched to meet the woman’s downward gaze. He smiled, introduced himself, and said, “A police officer is on his way to the hospital. He has some questions for you—”

  “No police!” she snapped.

  Her daughter startled with a loud cry.

  The woman reached over and stroked the girl’s forehead with an unsteady hand. “Really, we’ll be fine,” she said in an unconvincing tone. “I don’t need to talk to anyone. I just want to go home.”

  The intercom unit lit up again. “Dr. McKenna, they’re calling again. They say they need you in Trauma One.” The red light blinked off.

  “Mrs. Erickson, we’re here to help you,” Dennis continued. “When we see injuries that aren’t easily explained by an accident, we have to notify the police, as well as the county’s Department of Children and Family Services. It doesn’t mean that we’ve decided anything, only that we believe the injuries could have been caused by another person. Do you understand what I’m saying?”