The Second Opinion, page 11
Most striking in one of the articles was the fact that most long- term survivors with locked-in syndrome chose to return home in hopes that the interaction with loved ones would enhance their desire to live. Improved communications technology such as infrared eye movement sensors and computer voice prosthetics, coupled with a plain old alphabet board, had actually made it possible for a lawyer with LIS to return to his profession.
With time, Thea vowed, she would begin to educate her father in what she was learning about his condition. Only then, only when they knew everything there was to know about LIS, along with the amount of neurological function the Lion was going to regain, would it be fair to sign any health proxies.
The afternoon light had begun to thin by the time Thea set aside her notes on LIS and turned her attention to the next item on her list—billionaire businessman Jack Kalishar.
First the basics, she wrote on her yellow legal pad. John (Jack) Joseph Kalishar, age 57 . . . Occupation: businessman. President and CEO of K-Group, corporate raider. Born: Indianapolis, IN. Current residence: Boca Raton, FL. Married, two children—24 (m-Mark), 22 ( f-Marcy). Estimated worth: 1.7 billion . . . Pilot, speedboat ocean racer . . . art collector.
His photos—there were dozens on Google Image—were of a lean, tanned man with an aquiline nose and narrow, dark eyes. His looks weren’t that appealing to Thea, although she suspected that many women would find him attractive. Why would he be so important that of all the words, of all the names her father could have chosen, he had picked Kalishar?
Why????
Thea scribbled down the word and ornamented it with flowers, then continued clawing through item after item on the Internet searching for a clue—any clue.
Why?
When the clue finally appeared, it almost passed her by. It was in a Wall Street Journal article on philanthropic giving in which Jack Kalishar’s name was mentioned exactly once.
Reginald Pickard’s World Vaccine program is just one of a number of health- related philanthropies established by this group of businessmen. Following his close call with cancer, Jack Kalishar of Kalishar Investments has formed the Breath of Life Foundation to fill needs in the areas of medical research, medical student education, and the upgrading of health care facilities.
Cancer, Thea wrote after copying down the segment verbatim.
What kind of cancer?
Was K treated here?
Connection to Dad?
Another hour added little except for the address and a phone number for the Breath of Life Foundation. The information about Kalishar’s cancer she could get from his medical record. She was gathering her notes together with plans to visit Hayley Long, when her father’s cell phone began to vibrate. Thea hurried to an empty glassed-in carrel to one side of the main floor, built along with two others for cell phone use or for answering pages.
“Hello, this is Thea Sperelakis,” she said, precisely as she had done until it came naturally in role-playing pragmatics improv class.
“Thea, it’s Sharon Karsten here.”
Perfect timing, Thea thought.
“Yes, how are you?”
“A little perturbed, and I guess a little embarrassed, too. Thea, there are some members of the credentialing committee who resent my efforts to circumvent what has been established as standard procedure. Out of respect for your father they are willing to cut some corners, but they are steadfast against giving you unrestricted privileges without the usual check of your references and employment history. The application forms will be in your new mailbox in the mail room outside the library. The best I’ve been able to do is to get you provisional staff privileges that will require Dr. Hartnett to sign off on all your patient notes.”
“Including admission notes?”
“We have hospitalists who will do that for you if you decide to write any admission notes in addition to theirs. I’m talking about office patients and notes you write as a consultant.”
“That doesn’t make a lot of sense. Neither does just accepting the hospitalist’s admission note when it’s my patient. I’ll write my own admission history and physical if that’s okay, but I’ll be happy to have one of the hospitalists or Scott sign off on anything, even though it seems like I’ll just be making more work for them.”
“He’s grateful to have you. He has been handling referrals to your father from around the country, and indeed around the world. We have a force of physicians out there recruiting patients to be sent to our most renowned specialists, including the great Petros Sperelakis.”
Thea remembered Hayley speaking about the doctor, sort of a salesman, who had convinced her physician in Atlanta to begin sending her to the executive health program at the Beaumont, and subsequently to Petros and to Lydia Thibideau.
“Well, I’ll do whatever I have to,” she said.
“Excellent. Scott will be so relieved to turn Petros’s appointment book over to you. Most of the referrals in there are quite ill, but there are many chronic problems as well.”
Thea felt edgy. Just a few days ago they were begging her to step in and take over her father’s practice. Now that she had agreed to do so, they weren’t ready to give her unrestricted staff privileges.
“What about medical records?” she asked. “Will I have access to them?”
“Actually, Scott will retrieve them electronically and forward them to you. The credentials committee has been adamant about protecting our system and our patients’ records from anyone without full staff privileges.”
“So, there’s no way I can just read through any of my father’s patients’ records—see how he did things?”
“Why would you be wanting to do that?” the CEO asked.
Danger!
Suddenly Thea felt out of her element. Karsten’s query had been made in an off handed way, but there were layers beneath it, Thea could tell that much. This was the sort of complex business that had driven her away from hospital politics and intrigues in the first place.
“I . . . I’ve been reading some patient notes Dad has on file in his office, and I just wanted to learn about them in more detail. That’s all.”
The lie took just a few seconds to materialize, and it probably could have come out smoother, Thea supposed. But considering that she couldn’t remember the last time she had told one, she had conjured it up quickly and told it quite well. Still, lying bothered her. No guile. That was how Dr. Goldman had described Aspies to her—people incapable of telling a decent lie. Now, after just a short time back in civilization, one had simply rolled out.
Welcome home.
There was little left to the conversation with Karsten. Thea rang off and sat on the edge of the small desk, trying to make sense of why they had begged her to come on board the medical staff, and then were suddenly making it difficult for her to do so. Scott Hartnett, from all she could tell, was a fine doctor and a good person. Still, the last thing she wanted was for anyone to be looking over her shoulder. If Dimitri’s and Daniel’s suspicions were right, someone had twice tried to kill her father. If restricted staff privileges were the best she could get from the credentials committee, she would find a way to work around them.
The strength of her intellect was in logic and concreteness. This situation was, to this point at least, neither logical nor concrete. Bewildered, she returned to the computer station and was packing her notes when the tall reference librarian, Rachel, approached.
“Dr. Sperelakis,” the woman said, “I haven’t got very much for you on John or Jack Kalishar, but I did find this article in the Beaumont Bugle. That’s our bi monthly newsletter here at the clinic. The article’s on microfiche and it’s almost exactly three years old. Here, I printed it out for you.”
Thea took the single sheet and settled into the high- tech computer chair. Basically, the short article, with a photo of Kalishar posing with six or seven hospital dignitaries, was about the businessman/ philanthropist’s attendance at a black-tie dinner honoring the hospital’s researcher of the year, Dr. Lydia Thibideau. The name registered instantly—Hayley Long’s oncologist, the world-renowned specialist on cancer of the pancreas. Thea focused back on the photo. Thibideau, shorter by half a foot than Kalishar, stood directly to his right. She was a stocky, jowly woman with a determined, bulldog look. Directly to Kalishar’s left, looking positively dashing in his tuxedo, was the Lion himself.
Why would Kalishar be attending such a dinner?
Thea read the caption beneath the photograph, which identified each dignitary by degree or academic title.
Petros Sperelakis, Davis and Edwina Hart Professor of Medicine, Director, Sperelakis Institute for Diagnostic Medicine . . . Jack Kalishar, benefactor, the Lydia Thibideau Gastroenterology Research Center . . .
Thea checked her notes once more, and next to where she had questioned what kind of cancer Jack Kalishar might have survived, she wrote pancreatic. It wasn’t that surprising that Kalishar had the same cancer as Hayley Long, or that he had been treated by the same oncologist. Lydia Thibideau was famous and undoubtedly had patient referrals from all over the world. What was surprising and interesting was that Kalishar was still alive.
Cancer of the pancreas was one of the most common of cancers, and one of the most lethal. The primary reason for such a high mortality was the lack of alerting symptoms until it was too late—until spread to distant organs had occurred.
Thea used the Internet to refresh her memory about the disease, although there really was no need. Her vast mental library held both primary journal articles, and secondary articles from textbooks:
• Major known associated cause: advancing age (majority of cases over sixty years old)
• Five-year survival: 4 percent
• Most effective treatment for disease localized to a limited segment of the pancreas: surgery, radiation, and chemotherapy in combination
• Average survival in this aggressively treated group: seventeen months
Was Jack Kalishar’s pancreatic cancer an adenocarcinoma, the most common type, or was it one of the more obscure types such as an insulinoma, arising from any one of a number of different kinds of pancreatic hormonal cells? Kalishar was, against long odds, a five-year survivor of an extremely deadly disease. Had he been operated on? Was he part of an experimental drug protocol, like Hayley?
Suddenly, there were so many questions, each one of them easily answerable if she could somehow gain access to his medical record, locked electronically in a cybersafe named Thor, which was, at least for the time being, inaccessible to her without disclosing her interest to Hartnett.
Thea flipped through her notes and slid them into her briefcase.
With some thought, she would find a way. And that way, almost certainly, would involve some lying—a skill at which she had never been even the least bit adept. She flashed back on an exchange with her mother when she was a young girl—one the two of them would laugh about over the years as Thea’s lack of guile became apparent.
“Thea, did you brush your teeth?” Eleni had asked one evening before bed.
“Yes,” came her firm response.
“Thea, I asked if you had brushed your teeth.”
“No.”
CHAPTER 19
No matter how hard he tried, Dan couldn’t keep his tongue away from the stitches inside his mouth. He thought about just giving in and tearing them apart to create the permanent hole Thea had warned him about. He felt angry and embarrassed, frustrated and impotent. He had taken martial arts at the police academy and been among the most capable in his class, yet his reaction time outside the ICU had been as slow as syrup.
Since his decision to leave the force, he knew he had been living through a smoldering depression. It wasn’t hard to understand. He had shot and killed a fourteen- year- old. Now, just as it felt as if his self-esteem might finally be on the rise, he had allowed himself to be beaten to the floor in the hallway of the hospital, kicked in the groin and then in the face, and his only response to the attack had been to throw up on himself.
He sat there on the bench in the locker room, staring down at the plastic bag that contained his rancid uniform. They had told him to go home, but that was the furthest thing from his mind. He needed to find the man who had done this to him. It was a matter of pride, but he knew it was something else as well. He needed Thea’s respect. There was something about her, a gentleness and innocence, that appealed to him greatly. She had thanked him for saving her father’s life, if in fact that is what he had done, and even held his hand as he was waiting to be evaluated in the ER. But when she asked him what the assailant looked like, and all he could say was that the man had a tan, a mustache, and black- rimmed glasses, her disappointment was nearly palpable.
Why hadn’t he paid better attention? Why hadn’t he been sharper? This job wasn’t much, but it was a stepping- stone back toward life—back toward at least a modicum of self-respect, maybe even back to the force. Josh was a great kid and had been totally understanding about his taking the security guard job. What would he think when another disparaging story about his dad hit the papers?
Dan knew he was probably projecting too much—he had a tendency to do that. Still, he had been badly humiliated by a man and he wanted payback. That the man might have been after Thea’s father just made the matter that much more acute. He had already lost several hours, but there were still things he could do. Failing at those, there was Thea’s brother and his theories. If the bogus orderly was after Petros, it stood to reason he might be connected with the hit-and-run as well.
The security office was in the basement of the Sherwood Building. Dan dropped his uniform off at the laundry and then followed the yellow line through the broad main tunnel. The officer manning the twelve central video consoles, an ample, cheerful woman named Jessica, was an acquaintance if not a friend. Her concern for his injuries was genuine.
“Police gone?” Dan asked after assuring her that his pride had taken a far bigger hit than his body.
“A while ago.”
“They take any tapes?”
“We made a copy of the one from video eight that included the ICU, but we have the original.”
“Can I see it?”
“You sure you want to?”
“I can handle it.”
“It’s bundled with video from every other camera on every floor in the building. A minute per site.”
“I know. What about the rest of the tapes? The guy had to get in and out of the hospital somehow.”
“At that hour, do you know how much foot traffic there is, and how many entrances? We made copies of them, too, but it may take weeks for anyone to do a decent job of reviewing them.”
Jessica motioned him to the small supervisor’s office, pushed some buttons on her panel, and electronically sent the video to the screen where Dan was sitting.
He found the attack and began watching it over and over again. Unfortunately, the position of the camera made him the star and included an Oscar- worthy full-face shot as he took one for the team and sank to his knees. There was very little of the assailant besides his back, except for two shots. Dan froze them each half a dozen times. By the sixth pass, he was convinced of several things. The man was a pro—a martial arts expert with incredibly quick feet and textbook balance. He had placed a thin towel over the bar on the cart to keep from leaving fingerprints. He had enough of a contact within the hospital to be able to obtain a false ID badge, although it was not one that would have stood up to close scrutiny. The instant it was clear he wasn’t going to make it into the ICU, he acted definitively, put his adversary down, and walked rapidly but calmly away, exiting the way he had come, toward the Sperelakis Institute.
A pro.
Another conclusion was that both the glasses and the mustache were fake. Dan felt almost sure of it now. They were just too obvious—a diversion, like an eye patch or a cast. A hundred out of a hundred witnesses would have remembered the mustache, but none the shape of the man’s face or the color of his eyes.
Finally, there was the bundle on top of the steel cart. A weapon of some sort? A change of clothes? Something medical? What ever it was, the killer—Dan had no doubt that the murder of a patient or nurse was the man’s intent—took pains to carry it away with him. If the police had thought things through as he had, they would be checking the hospital-wide videos for the man and the bundle.
Unable to watch himself get pummeled one more time, Dan tilted back in the supervisor’s chair and looked away. He had majored in criminology at Northeastern, and always knew he would someday be a police detective. His high grades in every related course reflected that goal. One of those subjects was forensic logic—a trip inside the mind of a criminal. For a time, Dan focused on the man as he had been programmed to do by the crusty, but brilliant, criminologist who taught the course.
It may seem at times as if there are an infinite number of scenarios by which a criminal could have committed his crime and escaped, but in truth there is only one—the real one.
On one wall of the office was a large whiteboard map of the entire Beaumont Clinic campus, with the tunnels shown as lightly dotted lines. First Dan chose the entrance that might follow the most logical movements of his assailant: through the Sperelakis Institute, then up to the third floor and across the walkway to the ICU. It was certainly the shortest route from the outside to the unit, but there was a security desk in the lobby, which was manned until the hospital entrances were shut down at the end of visitors’ hours. That meant the killer would have had to enter, sign in, and then find a place to change, most likely in a restroom stall. Possible, but risky—and riskier still heading out, especially if there was trouble. No, Dan thought. The man had probably taken the crowded main entrance on Collins Avenue, changed in a restroom, then made his way someplace to where a steel cart was . . . was what? Waiting for him?
