The Second Opinion, page 20
She set the knapsack and films on the kitchen table and showered upstairs. Toweling off in front of the bathroom mirror, she couldn’t help but notice the change in her appearance since her departure from Africa. True, she had been up all night, and in difficult circumstances, but she couldn’t begin to count the nights she had stayed up with a sick or dying patient. There was a pallor to her skin and a hollowness surrounding her eyes that were stark departures from what she had grown used to in the healthy, oxygen-rich air and uncomplicated work environment of the jungle.
It was, she knew, nothing more or less than stress or strain, whatever the difference was between the two. She was Valentine Michael Smith in Robert Heinlein’s Stranger in a Strange Land, marooned on Mars, raised by Martians since infancy, and now returning to Earth. The book had been one of her absolute favorites from the first time she read it. If challenged, she could probably recite much of it by heart. Now, in some ways, she was Mike Smith. She could only hope her story had a less violent ending than did his.
She threw her cat burglar clothes into the hamper, and put on khakis, a tank top, and a lightweight, frayed flannel shirt that dated back to high school. Even her body seemed less muscular than it had been, similar to Mike Smith’s initial weakness caused by a reaction to the atmosphere of Earth.
“You can do this,” she said, vowing that, at least, she would begin jogging every day. “You can do this.”
Her bed began beckoning, but she sensed if she lay down now, that would be it for the day, and she had things to do. The shower, fresh clothes, and the resolve to get more exercise had a buoying effect, and the moment she stepped out of her bedroom, she felt energized—ready for the day, and excited to examine the spoils of her raid on Lydia Thibideau’s fortress.
Singing the sweet lullaby out loud, she danced down the back stairs to the kitchen, put a pot of water on for tea, picked up Hayley’s films, and held them up to the window.
Then her heart stopped.
One of the films was the negative MRI that had been taken of Hayley almost a year ago at the Beaumont Executive Health Center. The other one was of a man named Fitzgibbon, with wildly metastatic pancreatic cancer, taken three years ago. In her haste to gather the films and records together, and to replace them in Thibideau’s file cabinet, she had grabbed the wrong MRI.
In an instant, Thea’s upbeat mood was gone, replaced by the exhaustion she had so successfully held at bay, and by a cavernous melancholy.
All that effort.
All that pain.
All that risk.
“Dammit! . . . Dammit! . . . Dammit to hell!”
Making no attempt to stem a flood of tears, Thea slumped forward, her face pressed against her arm, sobbing mercilessly.
“Hey, what gives? Something happen with your squeeze?”
Dimitri, barefoot in jeans and a T-shirt that read save a tree; eat a beaver, sank down on the seat across from her.
“N-no,” she stammered around sobs. “He’s v-very sweet.”
“You need a towel or some Kleenex or something?”
“N-no. I’m allowed to c-cry, you know. It’s not such a b-bad thing.”
“Hey, I know. I did it once myself. But I stopped when Mom finally backed the car off my foot. Go ahead. Let it flow. Then you can tell your old bro who’s gone and done you wrong.”
The teapot began to whistle, and by the time Thea had filled a tea ball with some black chai and let it steep, she had regained a modest amount of composure.
“You want some of this?” she asked.
“Yaargh! Never drink tea before the sun’s above the yardarms, matey. Yaargh!”
Dimitri was clearly tuned in to how upset she was, and as genuinely anxious to help as he was capable of being. Thea liked him like this, although she couldn’t actually remember when she had last seen him so. She set her tea down and took him step by step from her initial meeting with Hayley Long to the negative exam by acupuncturist Julian Fang, to her decision, after being assaulted in the parking lot, to allow Sean Flowers to get her into Lydia Thibideau’s office, and finally to her disastrous error while replacing Thibideau’s patients’ records and X-rays.
Her story was choppy because she had decided to omit her communication with their father, and his giving her the name of Jack Kalishar. If her brother picked up on that, he gave no indication. Instead, probably overwhelmed by the situation, he shifted restlessly in his seat, jiggled his leg constantly, and tore several paper napkins into tiny bits. She asked for any theories he could come up with as to why Thibideau might have padded her caseload of cancers, but he had no interest in speculating. Only when she tried to show him the two MRIs did his interest seem piqued. He immediately took one of the films, the one of Edward Fitzgibbon, and held it up to the window with one hand.
“This his cancer?” he asked, correctly indicating the largest portion of the tumor.
“It is.”
“And this is his liver, and here’s his spleen, right? Destroys old red blood cells, pools new red blood cells, helps build the immunity strength of the body through the reticuloendothelial system. . . .”
Thea sat quietly while Dimitri correctly identified virtually every structure in the MRI, and even provided a tidbit or two about each one.
“Hey, I’m impressed,” she said when he had run out of organs.
“I couldn’t get into med school like the rest of you Sperelakis kids. Hell, I couldn’t get out of community college. So a while back I decided to teach myself medicine. It was like toe-tally bor-ring.” He said the words with a Valley girl accent and gesture.
“Well, I’m impressed just the same, Dimitri. I should have had you take my boards for me.”
“Or better still, Niko. He barely passed his.”
“How do you know?”
“I hacked into the National Medical Board’s computer, just for fun. I could have made him flunk, but I didn’t.”
Thea giggled at the notion.
“Good thing. He’s become a very good surgeon.”
“If you say so.”
“What I say is thanks for cheering me up a little.”
“Glad to be of service. Say, tell me, do you happen to have a cell phone?”
“I’ve been using Petros’s. It’s in that knapsack. Why?”
“Because you’ve got it on vibrate and it’s going off, that’s why.”
Only at that instant did Thea hear the faint buzz from among her burglar implements.
“You’re like a mutant with that hearing of yours,” she said, fishing out the phone and flipping it open. “Hello, this is Thea.”
“Thea, it’s Marlene in your father’s room.”
Thea went cold.
This was it. . . . She just knew it. . . . It was over.
“What happened to him?” she managed.
“Happened? Oh, nothing, really. No change. I’m sorry, Thea. I should have said that right away.”
Thea exhaled.
“That’s okay, Marlene. What’s going on?”
She glanced over at Dimitri, who, completely lost in his own world, had poured half a shaker of salt onto the table and had begun dividing it into piles with a butter knife. She had once been told that no one at the busy neuropsychological evaluation service had ever seen anyone test as high for raw intelligence as he did.
“Well, you asked me to call if anything strange happened with any of Dr. Sperelakis’s visitors,” the nurse was saying.
“Yes.”
“Well, something just did. I don’t know what to make of it, but it involves Dr. Hartnett.”
“Dr. Hartnett?”
Thea flashed on the thank-you note in Jack Kalishar’s record from the director of development.
“He just left here,” the woman said. “He comes in several times a day.”
“I know. He’s one of my father’s closest friends, and he is also his primary care doctor.”
“Well, he said he wanted to do a brief exam on Dr. Sperelakis, and for me to wait outside.”
“Well,” Dimitri said, standing up suddenly, and speaking as if Thea was not involved with a phone call. “It’s time for me to get back to my World of Warcraft encounter. I’m up to level sixty-eight and rising. The baddest man on the planet. See you later, sis.”
“See you . . . Sorry, Marlene. I was interrupted. He asked you to leave.”
“Yes, exactly. Well, I went out of Dr. S.’s room, but I stayed near the door to the step- down unit.”
“Go on.”
“I couldn’t see much because I was shielded by Dr. Hartnett’s back, but I swear I saw him inject something into your father’s central line.”
CHAPTER 34
“What’s the matter, Tony, are those fish chunks too scary for you?”
Hands on her hips, Stacy Sims stood on the Collins Avenue Pier, looking down at her lifelong friend with typical defiance. She was taller than Tony D’Allessio by several inches, and as light in hair, skin, and eyes as he was swarthy. Her hair was pulled back in a single heavy braid, and beneath her T-shirt were the first hints that her eleven-year- old body was beginning to change. Lying beside her on the sun- darkened wood, ready to drop into the water some thirteen feet below, was a baited hook at the business end of an ancient rod and reel that had once belonged to her grandfather.
“I’m doing it,” Tony said, not at all happy with being teased by a girl—especially this one. “This stuff I got for my birthday is all new. It takes some getting used to.”
“You could always use a plug. I have some good ones. They might not be as good as bait, but at least they’re not slimy.”
“I told you, I can do this. I want to catch halibut and they like live bait.”
“What they really like is deep water. You’ll never catch any halibut fishing from here. A striper, maybe, but not any halibut.”
“I meant striper.”
“You sure hate to be wrong, Tony D’Allessio.”
“Who doesn’t?”
They were alone on the old pier, which was a popular spot for talking and for watching the ocean, but not such a great spot for catching fish.
“Stripers beware!” Tony cried out as he dropped the baited hook over the railing and into the water.
Moments later, Stacy had done the same. The sun peered out from behind a pure white cloud that looked like a crocodile, and flooded the pier with warm sunlight. At almost the same moment, Tony snapped his rod toward the clearing sky and let out a yelp.
“Got one! . . . A big one, too.”
The new Penn bent in a rainbow arc. Stacy quickly reeled in her bait and set her rod aside.
“Go, Tony, go!” she cheered.
The youth wasn’t the biggest kid in school, but he was wiry and strong and, in nearly everything he did, determined. He set the end of the rod against his stomach and stepped back from the railing, pulling with all his strength.
“It’s coming!” he shouted, reeling in several turns, then several more. “It’s coming!”
Stacy moved forward to the railing and looked over, expecting to see a giant striper, or even a shark.
What she saw instead was a dead body—a man, faceup, fully clothed, bobbing rhythmically on a slight chop. His arms were stretched to the side like Christ on the cross. There was a length of brown seaweed across his bloated, stone gray face, and beneath the kelp she could just make out a protruding purple tongue. Tony’s hook had gotten him in the center of his jacket. The line, through the eyes of Tony’s new Penn rod to his new Penn reel, was still taut.
“Tony!” Stacy screamed.
“I almost have him!”
“Tony, you can stop!”
CHAPTER 35
Pancuronium.
The closer Thea got to the Beaumont, the more convinced she became that Scott Hartnett, her father’s friend and personal physician, was administering the long- acting paralytic to keep Petros from communicating with her. The irony was painful. The poor man already had, quite possibly, the most horrible medical condition imaginable—locked- in syndrome. And his physician was doing all he could to make that condition worse.
Before leaving for the hospital, she had gone over to the carriage house and managed to intrude enough on Dimitri’s video war to borrow one of his computers and look up the drug. If her brother was the least bit interested in what she was doing, he didn’t show it, interrupting her research only to give a triumphant whoop at the destruction of one of his enemies.
Pancuronium was a powerful curare- like drug used primarily in the operating room to prepare a patient to have their trachea intubated. Onset of action one to two minutes. First cousin to the more rapidly acting, but shorter lasting sux—succinylcholine. Duration of action for pancuronium, two to three hours—quite a bit longer if the drug was administered along with opiates or barbiturates.
If someone wanted to continuously keep Petros Sperelakis from exchanging information with his physician daughter, an injection of Pavulon, the brand name of pancuronium, was the perfect way to do it. The antidote to reverse the effect of the drug, at least partially, was the class of pharmaceuticals known as anticholinesterases—edrophonium and neostigmine being the ones Thea had studied the most, and had even used clinically to reverse the effects of poisoning with certain insecticides and nerve gases.
“Dimitri, do you want to come in to the hospital and visit Dad?”
“Got ’im! Die, sucker, die!”
“Dimitri!”
“Would he know I was there?”
“He might.”
“Well, I’ll wait until I’m sure it’s a worthwhile trip. Watch this. . . . See that guy sneaking up on me over there? The gnome . . . Well, I just take aim at his gnome belly and . . . pow! Splat! Gnomeor gnome.”
“How about the barbecue at Niko’s tonight?”
“What barbecue?”
“Dimitri, I told you about it. More than once. Niko said he did, too.”
“Count me out, little sister. Those twins are double trouble.”
“What do you mean?”
“Greedy they are. Yaargh! Take money from poor Petros, they did. Double yaargh!”
“Why would they do something like that? They’re both surgeons. They must have plenty of money.”
“My dear naïve house mate. You need to begin playing video games. That’s where you’ll find real emotions. True human frailty.”
Thea felt herself getting irritated.
“Dimitri, will you please stop this nonsense talk and say what you mean?”
Dimitri immediately took a monocle from a small box of props on his desk, inserted it over his left eye, and adopted a distinguished British accent.
“I assure you, madame, that both of our siblings are just as adept at losing money as they are at making it. One twin never invests without clearing it with the other twin, and neither twin knows the first thing about investing. Neither, for that matter, does their father. Talked the Lion into investing in some sort of Internet dot-com company they and a friend of theirs started. He went in big- time even though he doesn’t know the first thing about the product they were marketing. Let’s just say he didn’t lose nearly as much as the Twinkies told him he lost.”
He set the monocle back in the box and shot something on the screen in front of him.
“But how do you know that?”
Dimitri stayed focused on the screen as he talked.
“Let’s just say that sometimes, when I’m bored, or even when I’m not, I find myself hacking into their e-mail. I know, I know. The shame of it. Don’t worry. I follow the hackers’ creed and never use my material for anything other than personal amusement. And the twins are nothing if not amusing. Anyhow, count me out of the barbecue. They never come to any of mine.”
Thea left without even bothering to ask if her brother had ever had a barbecue.
Throughout the ride to the hospital, her mind had been in turmoil as to what to do about Scott Hartnett, Lydia Thibideau, and Hayley. The first thing she had decided to do was to draw blood on Petros to confirm her belief that he had been receiving pancuronium and perhaps secondary drugs to enhance its duration of action.
She considered and rejected the possibility of administering one of the antidotes to the paralytic agent. At this stage, even with her newly acquired staff privileges, it might be difficult getting a nurse to inject such an arcane medication, especially given her father’s compromised physical state. Reputations in a hospital were quickly damaged and always difficult to repair.
Was it worth waiting until she had absolute proof before confronting Hartnett? It sounded as if the private-duty nurse was quite confident in what she had witnessed. No, there was no sense in delaying matters. If nothing else, she could put an end to Hartnett’s machinations, what ever the purpose. It made sense to draw the blood, see if Dan could get it analyzed in the state crime lab, and call Hartnett.
As for Thibideau, hers was a hornets’ nest best left undisturbed until the meaning behind her bogus MRIs became clearer. Was she in some way aligned with Hartnett? It certainly seemed that might be the case. Research grant money? Possibly. FDA approval of new, wildly profitable anticancer drugs? Even more likely. The constant, powerful pull of influence, fame, and fortune was difficult to resist, to say nothing of the basic need for continued employment. Thibideau certainly wouldn’t be the first academic to cheat on his or her research. In their recent meeting, she had seemed aloof and even haughty, but there was nothing about her that suggested dishonesty or a lack of respect for medical science.
Thea’s natural, Asperger’s tendency to give people the benefit of the doubt was being stretched toward the breaking point.
She pulled into her father’s spot at the institute wondering how to deal with Hayley. Her new friend was razor sharp and highly intuitive. There was no sense in trying to shield her from the truth. But what, exactly, was the truth? She was receiving an investigational medication doled out by the hospital research pharmacy, but a great deal of evidence pointed to the fact that she did not have cancer in her body, and in all likelihood, she never did. Was it too risky for her to stop her chemo? Was it too risky for her to continue?
