Stigma

by Philip Hawley Jr.

  She turned him down.

  One by one people started filing out of the room.

  She was still standing next to Josue’s body when, a few minutes later, she realized everyone had left. The boy had taken on an eerily pale cast and one of his arms hung awkwardly. She took his hand in hers and held it for a long moment before placing it alongside the body.

  Then she covered him with a sheet.

  The moisture in her eyes turned to tears. She began to shake and grabbed the edge of the table to steady herself. The tears grew to a stream, and she wept inconsolably.

  Megan realized she was crying as much for herself as for Josue, and pitying herself only made her feel all the more deficient and miserable. Whatever made her think she could save lives?

  “Megan?”

  She whirled around and ran a sleeve under her moist nose.

  It was Luke.

  “You okay?” he asked.

  She wiped her eyes with both hands and tried to raise a smile. “Oh yeah, don’t I look great?” she said in a wet, hoarse voice. She could see that he was studying her.

  “Someone needs to talk to the family,” he said. “Are you up to it?”

  “Family?”

  “The boy’s mother. She flew up with him. She’s waiting in the conference room.”

  Megan grabbed her lower lip with her teeth and clamped down until it hurt. Still, tears welled in her eyes.

  “Why don’t I do it?” Luke offered.

  “No, I will.”

  “Are you—”

  “I’ll do it,” she snapped, then immediately raised a hand in apology. “I’m sorry.”

  “Nothing to be sorry about,” he said while glancing over her shoulder at Josue’s body. “Take your time.”

  Luke turned to leave, but stopped abruptly when his eyes passed by the boy’s chest X-ray. He stepped closer to the screen.

  She watched him study it. After almost a half minute, a feeling of unease swept over her. “What do you see?”

  His eyes stayed on the X-ray. “I forgot to mention — let the mother know that we’ll be doing an autopsy. We don’t have a cause of death, so it automatically goes to the coroner.”

  A wave of nausea hit her. “What are you looking at?”

  “Not enough to explain what happened,” he said finally. Luke drew back a step, still looking at the X-ray. “There’s obviously something going on in the airways. See, here, the entire bronchial tree is involved. That’s what struck me when I saw this before, during the code. But now that I’m seeing this up close, what’s striking is the lung tissue.”

  “I must be missing it. What do you see?”

  “That’s my point. Not much. The lungs themselves don’t look bad enough to explain what happened.” He paused, then said, “I’m going to run this by Ben Wilson. Tell the front desk that I’ll be downstairs for a few minutes.”

  Luke was almost out the door before she could acknowledge him. “Sure.”

  Megan brought herself back to the task in front of her. She gathered herself, wiping her cheeks again and combing her hair back with her fingers. As she crouched to retie her running shoes, she muttered to herself, “Megan Callahan. Grim Reaper.”

  * * *

  “It can’t be done that quickly,” Calderon said into the cell phone headset while driving east on the Santa Monica Freeway in his black town car.

  “Find a way. It has to be tonight,” his client said. “She’s been leaving messages at the hospital. She’s trying to arrange a meeting with the boy’s doctor. For tonight.”

  Calderon glanced to his right while working a cheek muscle, thinking. Mr. Kong was in the adjacent lane, driving the rented green van with their equipment. The Asian was expressionless, as usual, eyeing cars on the freeway as if he were some kind of weapons targeting system.

  “I know where she’s going to be at ten o’clock,” the client added. “That gives you a little over two hours to work out the details. I don’t care how it gets done.”

  His client made it all sound so easy. Obviously, he had no military training.

  “What about the boy?” Calderon asked.

  “That’s being handled.”

  Calderon tapped the steering wheel a few times with his thumb. “And who’s this doctor that Tartaglia’s supposed to meet with?”

  “One of the E.R. docs. The one that took care of the boy.”

  “What’s his name?”

  “Don’t worry about him. He’s not connected to—”

  “If I’m going to do this, I need to know everything that you know. Everything.”

  “Okay,” his client said after a moment. “The doctor’s name is McKenna. Luke McKenna.”

  Calderon’s eyes suddenly fell out of focus. His face flushed with heat.

  7

  Light spilled from an open door at the end of the basement corridor, painting the opposite wall with a yellow rectangle. The distinctive sound of Johnny Cash’s baritone voice grew louder as Luke approached the door. When the music reached the final line of the chorus, another voice, loud and off-key, joined in and sang, “Because you’re mine, I walk the line.”

  Ben was still in his office.

  Dr. Ben Wilson, Chief of Pathology, hadn’t given back so much as a sliver of his thick drawl since coming to Los Angeles twenty years ago. Luke sometimes wondered whether Ben accentuated it just to make a statement. Jewish by heritage and Texan by birth, he had opinions on almost every subject and was quite willing to share them.

  Luke tapped on the doorjamb as he entered the pathologist’s office. The place carried a vague scent of formaldehyde. Two walls were lined floor to ceiling with unfinished bookshelves that held an equal mix of textbooks and cowboy memorabilia. On top of Ben’s desk sat a fifteen-gallon dry fish tank, home to Charlotte, his pet tarantula.

  Ben was sitting over a microscope when he looked up and waved Luke into the room. “What brings you down here?”

  “Just lost a patient upstairs, a four-year-old boy from Guatemala. Respiratory failure — at least that’s what it looked like. I want to ask you about an autopsy.”

  The pathologist ran a hand through his bushy, gray temples. “Anything else you can tell me?”

  “The boy was first seen in our clinic down there about a month ago. His white count was fifty thousand, mostly lymphocytes.”

  Ben reached over and turned off the music. “No doubt you’ve already thought about leukemia. Any blasts?”

  “None.”

  “Well, I know I’m old-fashioned, but did anyone actually look at a blood smear under a microscope? Most of those automated cell counters are dumber than dirt. They’re notoriously inaccurate, especially when you’re looking for abnormal cells. Wouldn’t surprise me if this turns out to be lab error.”

  Luke came around and helped himself to the computer sitting at one end of the desk. He pulled up the boy’s chest X-ray. “Maybe, but look at this.”

  Ben reached for his glasses and peered at the screen. He grabbed one of his eyebrows and began twirling it into a cone-like shape. “And you say this boy came in with respiratory failure?” he asked.

  “That’s right.”

  The twirling gained speed. “Well, I’ll be damned. A focal bronchial pattern, and not overly impressive at that. You’d think the lungs would be all shot to hell.” Ben looked over the rim of his glasses at Luke. “What did his chest sound like?”

  “When he first arrived, his lungs were completely clear. At the end, just before he coded, I heard a few crackles and rales but he was still moving air in and out.”

  Ben looked back at the X-ray. “I’ll be damned.” His eyebrow was spinning at a furious rate.

  “I was hoping I could get you to do the autopsy.” Luke slid into the chair next to the tarantula tank. Charlotte was nowhere in sight.

  “If I understand what you’re telling me — this boy lands on our doorstep, dies in our E.R., and we don’t know why — then this is a coroner’s case. You know that.”


  “Would the coroner let you do this case? That is, if you asked?”

  Ben snapped his fingers. “In a New York minute. They got the same problem I do. Too much work and too little staff.”

  “I want to know why this boy died, Ben. If you do the case, I know I’ll get an answer.”

  Ben cleaned his ear with a finger. “Are you planning on taking a bite out of me after you finish butterin’ me up?”

  “Thanks.”

  “Whoa, partner, I didn’t agree to anything.”

  “But you’re going to.”

  Ben massaged his chin. “Ah, hell. Have someone bring the body down here. I’ll call one of the M.E.’s and tell ’em what we’re doing.”

  “You doing it tonight?”

  “Hell no. I got a life, you know, and last time I checked, I was busy enjoying it. But there’re a few things I wanna do before the body cools.”

  “Like?”

  “Like grabbing some bone marrow,” Ben said. “Those cells are sensitive little critters, and the marrow might look a lot different by Sunday.”

  “Sunday?”

  “We’re having friends over tomorrow, and next week’s gonna be busy, so I guess that leaves Sunday for the autopsy. If you wanna stop by, I’ll be here bright and early.”

  “See you then.”

  As Luke turned for the door, Ben asked, “You see the article in yesterday’s paper, the one about Zenavax issuing stock on the New York Stock Exchange?”

  Luke showed him a disinterested look.

  The pathologist didn’t seem to notice and went on: “They’re doing an IPO, selling shares to the public. Burns my butt, the way those people are getting rich off your daddy’s work.”

  In a very real sense, Luke’s father had given birth to Zenavax Corporation. Its products, vaccines based on an entirely new concept of immunity, were derived from breakthrough work by a research team at University Children’s — a team led by his father, Elmer McKenna. The elder McKenna’s creation, a radically different type of influenza vaccine, represented a quantum leap forward.

  Unlike other flu vaccines, the one his father had developed protected against almost every strain of the virus that killed hundreds of thousands of people around the globe each year. And due to the vaccine’s unique properties, a single immunization provided recipients with lifetime immunity against the pervasive disease.

  “Did you know that Zenavax has a market value of nearly three billion dollars?” Ben said. “Get a copy of the article. You may find it interesting.”

  Luke tapped the tarantula’s tank. “I doubt it.”

  “It lists the company’s officers and shows what each of them’ll be worth when their stock options vest in a few weeks.” Ben slapped the desk with both hands. “Guess how much that woman’s gonna be worth?” He didn’t wait for an answer. “Two million bucks.”

  That woman was Kate Tartaglia, the same woman whose phone calls Luke had yet to return. She was also the microbiologist who had abandoned his father four years ago, taking what she had learned from the elder McKenna and trading it in for the lofty salary and stock options that Zenavax had offered her. At the time, she was a little known contract employee on Elmer’s research staff. Few had taken notice when she resigned her position.

  But that soon changed. Unknown to anyone at University Children’s, Zenavax was working at the time on a new vaccine technology nearly identical to his father’s. Over the next several months, while the hospital prepared its patent applications at the glacial speed common to most academic institutions, Zenavax paid several visits to the U.S. patent office, submitting applications that incorporated lessons the company had learned from its new employee, Kate Tartaglia. In doing so, Zenavax effectively preempted University Children’s and captured for itself complete ownership rights to the new vaccine technology — all because Luke’s father had never gotten around to having Tartaglia sign one of the hospital’s standard employment contracts, which included nondisclosure provisions and would have given University Children’s exclusive ownership rights to her work.

  Ben shook his head. “How do I say this? Your daddy’s an awfully bright fella, and like you, I’m fond of the man. But he needs — what’s the word? — a handler. Someone’s got to keep an eye on him, keep him from stepping in manure while he’s busy thinking those big thoughts.”

  His father’s administrative lapse had cost University Children’s a financial windfall that would have funded all of the hospital’s financial needs for the next several decades.

  Luke had also paid a price. Kate Tartaglia had been his girlfriend — that is, until she betrayed his father.

  Ben seemed unaware of Luke’s connection to Kate. In fact, few at the hospital had ever known about his relationship with her. University Children’s research activities had long ago outgrown their facilities, and Kate had worked in a laboratory at the university campus on the other side of town. Occasionally, her work brought her to the hospital, and it was during one of those visits that his father had introduced them.

  Luke figured he’d been lucky to learn where Kate’s priorities lay before their relationship had gone any further. Apparently, loyalty and fair play were not part of her ethos.

  He wasn’t sure his father had learned anything from the fiasco. Things like contracts, intellectual property, and patents were more distant from his father’s mind than the moons of Jupiter, and always would be. That his father had managed to retain his position as head of Infectious Diseases at University Children’s was a testament to the sovereignty and dominion of academic tenure.

  Luke could almost hear an audible click in his mind, as though tumblers had suddenly fallen into place. The reason for Kate’s earlier calls to the E.R. now seemed clear. She probably wanted to “clarify” the newspaper article for him, assuaging her guilt with some tortured logic.

  He silently cheered the fact that he’d changed cell phone carriers and his number about a year ago. Otherwise, she doubtless would have already gotten through to him. He decided to let her conscience continue to simmer in its own bitter juices. He’d return her calls in a few days, if ever.

  Ben pursed his lips, as if another thought was forming.

  Luke preempted him. “I have to get back to the E.R.”

  “Go on, then, git.” Ben flapped his hands in the air and turned back to his microscope. “And make sure you get that body down here. Soon.”

  * * *

  Another boy played in Luke’s memory as he walked back to the E.R., a teenage boy who would be a man today, had he not died on Luke’s watch. The boy occasionally released his grip on Luke’s mind, sometimes for days at a time, but he always came back. Luke had a lifetime to replay the events of that night, which, no matter how much time passed, refused to fade to a distant memory. All the things he could have done differently, all the things he could have done more quickly, all those things that — had he simply been better — would have spared the boy’s life.

  When the Pentagon recruited him for Proteus fifteen years ago, he was just six months out of the Naval Academy and one of only three Navy SEALs drafted for the program. It was all about proving he was good enough. It was all about the achievement. It was all about being one of the twenty-four most elite warriors in the world. It was the kind of thing that restless and adventuresome young men leap into without thinking about where the journey would take them, and how it might forever strip the calm from their souls.

  Luke entered the stairwell leading back to the first floor. The pain was coming now, as it often did when he thought about the boy. It was barely a twinge, a faint throb just above his right eye, but it would build swiftly.

  He had entered Annapolis as a fresh-faced seventeen-year-old, filled with the dreams and ideals of a youthful imagination. But somewhere along the way, honor and service morphed into an irrational zeal and he crossed over to a darker reality. He became an unholy weapon — a Proteus warrior. When he came out the back end of that journey seven years later, they took back hi
s uniform and weapons but they couldn’t reclaim the killing skills or psychic residue that clung to him like a caustic resin.

  Luke slowed his pace, counting the steps to distract himself. The metallic echo of each footfall on the steel-grate treads pounded at his skull. He climbed another step, gripped his forehead and squeezed with all the strength he could summon. Suddenly, a sharp stabbing pain pierced his skull. He grabbed the handrail to balance himself.

  Just a few more seconds…

  His right eye exploded, shattering his senses, emptying his mind. His back arched, the muscles in his face convulsed. Then, just as suddenly as it began, the pain was gone.

  He leaned heavily over the handrail, his grip slipping as cold sweat seeped from his palms.

  “Dr. McKenna, are you okay?” a woman’s voice asked.

  Luke strained to focus his vision. “Yeah. I’m fine.” He pointed to his stomach. “Must have been something I ate.”

  When he finally looked up, he recognized the woman. She was a stair climber, like him, part of that small subculture of hospital workers who eschewed elevators.

  She looked doubtful, but after he straightened, she stepped past him.

  He followed her with his eyes as she walked down the stairs. When she turned back toward him, he said, “If you’re going to the cafeteria, don’t order the lasagna.”

  8

  “She blames us for her boy’s death,” Caleb Fagan said. “Josue Chaca’s mother is a quiet sort, but I can see it in her face.”

  Luke lifted his gaze to the immunologist, whose dyed-brown hair was too dark for his vein-streaked alabaster skin.

  They were sitting in the E.R. doctors’ room. Luke had been filling out a Suspected Nonaccidental Trauma report for the Erickson case while listening to Caleb describe his brief visit with the Guatemalan boy’s mother.

  “She tell you anything? Anything that might point us to a cause of death?” Luke asked.

  The immunologist shook his head. “I assume there’s going to be an autopsy.”

  “Sunday.”

  “Call me when you get the results back.” Caleb slapped his thighs as if to signal his legs that it was time to leave. “Our folks in Guatemala are going to want to know what you find.”