Charlatans

by Robin Cook

  The question for Noah was how to go about doing it. Since Dr. Mason was the only other person who questioned Ava’s competence, Noah thought for a fleeting moment about approaching him to ask if his opinion was based on anything other than using Ava as an easy mark for the Vincent case. The idea of attempting to have such a conversation brought a smile to Noah’s face as he considered the absurdity of it. He doubted if the vain blowhard would even talk to him other than to gloat that he’d succeeded in getting Noah dismissed, and Noah couldn’t imagine the conversation staying civil. Noah knew that he’d be unable to resist demanding to know who had alerted him to the Ph.D. issue.

  And how the hell did his bound Ph.D. thesis end up on Dr. Mason’s desk? The main MIT library where the bound theses were stored did not allow them to circulate now that all Ph.D. theses were available online. If people wanted to see the originals, they had to go to the library.

  Noah checked the time. It was quarter past seven. He couldn’t remember the summer hours of the main MIT library on Memorial Drive, but he assumed it would be open until at least 8:00 and possibly as late as midnight. Impulsively, he decided to visit as a way of getting out of his apartment. He knew the place well from having spent considerable time there when he was writing his thesis. What he had in mind was to find out who had borrowed his thesis and how it had been arranged.

  Since it was a hot, muggy summer evening, a T-shirt, jeans, and tennis sneakers without socks sufficed. A few minutes later he was heading down Revere Street. His goal was the MBTA station at Charles Street. There were a lot of people out and about, particularly on Charles Street. When Noah restricted his life to the hospital and his apartment, it was always a minor shock to be reminded he was in the middle of a world-class city.

  The subway station at Charles Street was elevated above the street at the Boston side of the Longfellow Bridge. Noah used the stairs instead of the escalator for a bit of exercise. Except for the trip to the lawyer’s office and several excursions to Whole Foods, Noah had been vegetating in his apartment since Tuesday afternoon.

  The platform was crowded, particularly at the head of the stairs but less so at the far end. Still, Noah held back, knowing it was best for him to be toward the rear of the train. He was only going one stop to Kendall Square. It was for that reason that he had a view back down the stairs he’d just come up. With a minor start, he once again caught a view of the African American fellow who was on his way up on the escalator. When Noah had first emerged from his building, he’d looked for his followers but didn’t see them. He didn’t care one way or the other, as he’d become inured to their presence. If they had meant him harm, it would have already happened.

  Noah studied the man as he approached. For a brief moment their eyes met. There was no sign of recognition on the part of the African American. Whoever he was, it was becoming clear to Noah that he was a professional, even if not as subtle in his technique as his colleague. When the man reached the platform, Noah toyed with the idea of approaching him and asking him if he was working for the hospital but then discarded the notion. Intuitively, he knew the man would deny trailing Noah just as he had the last time Noah spoke with him. Instead, Noah merely watched the man as he disappeared into the waiting crowd farther along the platform.

  After detraining at the Kendall Square stop, Noah searched for his tail but didn’t see him, at least not immediately. It wasn’t until he was a few blocks away from the MIT Library that he saw him again when he looked over his shoulder. The man was at some distance but coming in Noah’s direction. He was clearly not in a hurry but rather moving at Noah’s moderate pace, seemingly content to keep Noah in sight. Noah shrugged, finding it mildly curious that the man’s presence no longer caused him any concern, although he was still puzzled about the situation. The hospital would only care if he was on the hospital grounds, not what he was doing elsewhere.

  As Noah reached the front door of the library, he noted it was open until 11:00 P.M. so there was no need to rush. He used his hospital ID to be admitted, which worked, since there was general sharing of research facilities among several of the academic institutions in the Boston area. Once inside he went directly to the library office to talk with one of the librarians on duty. The sole person available was named Gertrude Hessen.

  “You are correct,” Gertrude said in response to Noah’s question. “Bound Ph.D. theses do not circulate. It has been a policy in place since all of them have been digitized.”

  Noah explained that he was a surgical resident at BMH and had been surprised to see a copy of his MIT thesis on a professor’s desk. “Is there an exception to the rule for professors?” he asked.

  “Not to my knowledge,” Gertrude said. “Are you quite sure it was an original copy of your thesis?”

  “There was no doubt,” Noah said. “Would you mind if I checked the thesis room?”

  “Not at all,” Gertrude said. “Let me get you the key.”

  A few minutes later Noah was in the subterranean stacks of the library, standing at the locked wire cage that contained all the MIT theses going back to the nineteenth century. The key was attached to a wooden paddle by a short chain. Once he was inside, the heavy steel-and-wire door swung closed on its own. The click of the lock seemed loud in the total, mausoleumlike stillness. Noah noticed that the key was needed even to get out, giving him a creepy feeling. With so much material available online, few people ventured into library stacks anymore. Noah wondered how long it would take for him to be rescued if something went wrong and he couldn’t get out of the cage, especially if Gertrude forgot she’d given out the key.

  With some mild unease about his being isolated and locked in, Noah searched quickly for the section where his thesis would be located. The works were filed alphabetically by author rather than by subject matter. It didn’t take him long to find the R’s, and when he did, he was soon looking at the spines of two copies of his bound thesis. There was space for a third copy, but it was empty. Someone had managed to get the volume out of the library against the rules.

  Happy to be back in the library office, Noah told Gertrude one of his bound volumes was definitely missing.

  “I don’t know what to say,” Gertrude admitted with a flutter of her eyelids. “But what I will do is leave a note for the day people to investigate the matter. If you want to leave your mobile number, I can have someone get back to you.”

  When Noah emerged from the library, the sun had set but it was still light. The view of Boston reflected in the Charles River was stunning from the library steps. Noah hesitated for a moment to appreciate it and then scanned the area for his tail, but he was nowhere to be seen. Somewhat surprising himself, he again felt oddly ignored, similar to how he’d felt on leaving the lawyer’s office. As lamentable as it sounded, his followers had been Noah’s main connection with the outside world since Tuesday afternoon.

  Several times on his way back to the subway stop at Kendall Square, he glanced over his shoulder, but there was no one there. Once he’d gotten to the underground station, Noah was happy his tail had disappeared. On his way to the library when he’d been followed, it had crossed his mind that he’d feel vulnerable on the way home, thinking that if anyone meant him harm, a deserted inbound platform would have been a perfect location. Now, as he waited for the subway, there was only one other person, and he was way down at the other end.

  Noah felt a certain relief when the train thundered into the otherwise silent station, and he was able to board the front car with its complement of people. Ten minutes later he was on busy Charles Street, feeling comfortable being back in his neighborhood. As he passed the Thai restaurant that had supplied many of the take-out dinners he’d enjoyed with Ava, he hesitated. For the first time since the meeting in Dr. Hernandez’s office, he felt hungry. After a moment of indecision, he went into the crowded restaurant and ordered what he’d eaten with Ava on so many occasions.

  As the only
solo diner in the entire restaurant, Noah felt out of place and wished he’d ordered take-out. He ate quickly and was soon back out on the street. It was now dark, with the iconic Beacon Hill gaslights providing the bulk of the ambient light. Hiking up Revere Street, he paused several times to look back, strangely hoping he’d see the African American. There were plenty of people. A neighbor whom he recognized from having seen over the years said hello to him as he passed in the opposite direction even though they had never spoken.

  As he neared his building and dreaded being alone, he thought about returning to Ava’s to see if she might relent and be willing to iron out their problems. But remembering her attitude, he thought the chances were slim and just showing up again might make things worse.

  Climbing the stairs, he fished out his key so that by the time he was standing at his door he had it ready. Unfortunately, he didn’t need it. Once again the door had been forced, and on this occasion, it hadn’t just been forced. This time it was apparent a crowbar or something similar had been used, as there was a split between the doorknob and the jamb, with a portion of the jamb missing.

  A wave of anger spread through Noah. Busting his door seemed unnecessarily aggressive, adding insult to injury. Using just his index finger, he pushed it open slowly. He reached within and flipped on the light. From where he was standing, everything seemed entirely normal. He listened intently for fear whoever had broken in might still be there, but the apartment was silent. All he could hear was some music with a heavy bass coming from the unit above.

  32

  MONDAY, AUGUST 14, 9:37 P.M.

  Noah stepped over the threshold and went immediately to the folding table. He was relieved to see that on this occasion his laptop had not been moved. It was still positioned exactly as he had left it, aligned perfectly with the sides of the folding table. Quickly, he flipped open the computer and booted it up. A moment later he was able to check his browser’s history. He wanted to see if it had been cleared as it had been on the recent break-in. It hadn’t. He could see all the websites he’d visited that day. At least no one had been using his computer as had happened on the previous occasion.

  After checking the kitchen for his few appliances, since a toaster had disappeared in the past, he was relieved to see that none were missing. Moving into the bedroom he immediately noticed that a small stack of spare change and a few single-dollar bills were gone. Otherwise, the room seemed the same as he had left it, including his rumpled bed that hadn’t been made in more than a week.

  Moving on into the bathroom, he noticed the mirrored medicine cabinet door was slightly ajar. He opened it and looked inside. Immediately, it was apparent that something else was missing. On the second shelf there had been an unopened prescription for Percocet that he’d been given after breaking his nose during the hospital softball game that spring. Now it was gone.

  Believing his life was unraveling in all sectors, it took Noah some time and a hot shower to calm down from the trauma of yet another violation of his personal space. What bothered him the most on this occasion was the unnecessary physical damage to the door and the jamb. In the grand scheme of things, losing some spare change and an unwanted vial of Percocet was small potatoes in comparison to having to take the time and effort to convince the landlord to do a decent repair and do it immediately since the door couldn’t be secured in its present state. And while he was in contact with the landlord, he was going to demand that the woman tenant above be strongly advised to limit her open-door policy with her many boyfriends. On the positive side, Noah was thankful the intruder didn’t trash the apartment in frustration of finding so little of value.

  When he was able to relax enough to think, Noah returned to his computer to learn more about Brazos University, its medical center, and its medical school. Comfortably clad only in his skivvies, he rebooted his machine.

  Captivated by the extent of the material available, he learned that the university had grown at an impressive rate during the nineties, thanks to the beneficence of a large group of wealthy West Texas oilmen. Sam Weston, honored by the eponymous simulation center, was one of them. The medical school had opened in the mid-nineties upon completion of the nine-hundred-bed hospital, whereas the dental school had to wait until the early aughts. The medical school initially started with only thirty-five students, drawn mostly from West Texas high schools, although they did actively recruit American students who had been forced to attend medical schools in the Caribbean and Europe.

  Noah went on to read that the Brazos University School of Medicine quickly had reached its present class size of 145 students. Graduate residency programs were started the same year the hospital opened its doors but initially limited to family practice, surgery, anesthesia, and internal medicine. Within just a few years a full complement of graduate education programs were added in all the specialties associated with a major tertiary care academic medical center with the openly stated goal to supply a wide range of medical talent for West Texas.

  Next Noah turned specifically to the Brazos University Department of Anesthesiology, learning that it had recruited professors from a good number of the topflight medical centers around the country. The chief of Anesthesia had been brought in from Johns Hopkins, one of the USA’s top academic medical centers, which impressed Noah considerably. He ascertained that all aspects of anesthesia were quickly integrated into the residency program, including sophisticated cardiac surgery, neurosurgery, and transplantation medicine. He also learned that twenty residents were admitted each year, and all residents were required to have performed at least twenty thousand cases during their training.

  Noah rocked back from leaning over his laptop. As he stretched, he stared up at the ceiling. He no longer had any doubt that Ava had trained at a fully accredited institution with probably more than adequate supervision, especially considering that the Brazos University Medical Center handled more than twenty thousand major surgeries per year, which was about the same as the BMH. Brazos University might not be Ivy League, but from Noah’s perspective, he thought it sounded perfectly adequate.

  Noah wasn’t completely satisfied, however, thinking it wasn’t enough to learn she had been in an okay program. He craved more personal information, like exactly how many cases she had handled personally, what was the breakdown of the types of anesthesia, and if there had been any problems. After all, wanting to find out her residency case load had been his misguided motivation for going on her computer. Of course, he did recognize that her being hired by the BMH suggested she had done extraordinarily well, and Dr. Kumar had bragged that she had passed her anesthesia boards with flying colors. Yet Noah found himself motivated to find out more for three reasons. First, he was bored silly from being locked out of the hospital; second, he was infatuated with her and maybe even in love and eager to find out anything he could; and third, he was lonely, frustrated, and, most important, seriously pissed off at her for the way she was treating him despite his effusive and sincere apologies and his willingness to throw pride to the wind by ringing her doorbell. Whether she had anything to do with the thesis issue he tried not to even think about.

  Rocking forward again, Noah suddenly had in mind to check what kind of firewall Brazos University had, if they had one, and if they did, whether it had ever been upgraded. It had been Noah’s experience that young, rapidly growing institutions like Brazos U often lagged in cyber-security, often relegating it to a low level of priority with a constant demand for funds elsewhere. Although Noah guessed that the hospital most likely had up-to-date digital security to satisfy HIPAA regulations, he thought the rest of the institution might be a relative pushover.

  With his natural computer aptitude, Noah had engaged in some innocent hacking in his teenage years, purely for fun. Now he had the opportunity to apply these skills. What he was hoping to find were details of Ava’s medical school and residency records, which he imagined were going to be stellar. Having just finished the re
sident evaluations for the BMH crew, he knew what kind of information was potentially available.

  Going back to the websites of Brazos University School of Medicine and the Department of Anesthesia, he had it in mind to request application forms be emailed to him from both. Once that was done he planned to use the email headers to see if he could get into their systems. But as he waited for the first website to come up on his screen, alarm bells went off in his brain, reminding him that what he was about to attempt was illegal and certainly not ethical. If there was good security, there was a slight chance he could be discovered. With his upcoming Surgical Residency Advisory Board meeting, being caught committing a cyber-felony was hardly advisable. In fact, it was downright stupid.

  Suddenly, Noah had an idea. He knew he could not risk hacking into the Brazos University computer system, but that didn’t mean someone else couldn’t possibly get the same information in another, legal fashion. Noah had never thought of hiring a private detective. He’d never even met one and only knew of their existence from watching crime movies, where they seemed to play an oversized role. But here was a situation where a local private investigator would probably be able to get a significant amount of information and do it entirely aboveboard. The idea was, under the circumstances, decidedly appealing on a multitude of levels.

  Having no idea what to expect, Noah googled Private Investigators in Lubbock, Texas. An instant later he was astounded at the selection of both PI firms and PI individuals. He looked at a few websites of the firms and decided they were too imposing and probably not sufficiently private for his comfort zone. If Noah was going to employ someone, which he hadn’t completely decided, he wanted just an individual, not an entire organization, and one who worked out of the home and didn’t even have a secretary. Although Noah knew what he was proposing was legal, he didn’t want it to get back to Ava. As mad as she had been about his talking with Dr. Kumar, he certainly didn’t want her finding out he’d hired a private investigator to look into her training. Yet he was progressively warming to the idea. He didn’t see any other way to get answers without putting himself in jeopardy.