Michael Palmer - Natural Causes

Truscott opened the Herald. He did not know how much Mallon would be paying him for the Changeover Day story, but the equivalent of two weeks' salary was a decent guess. The money was certainly welcome. But more important was the matter of a letter from Everwell guaranteeing Andrew a surgical staff position should the HMO acquire the Medical Center of Boston. Mallon had been generous enough with his payments, but he had yet to deliver on that promise. Perhaps this DIC business was just the lever Andrew needed to pry that letter loose.

Truscott slid a Gaulois from the sterling cigarette case a former lover had given him, lit up, and then dialed Jeremy Mallon's private line.

"Greetings, Mallon, Truscott here," he said. "I'm glad to see you made such quick use of the Changeover Day tape. Listen though. I have something more for you. Something quite good, actually… No, I don't want to discuss it over the phone… That will be fine. Just fine. Oh, one more thing. A letter that was promised me… Yes, precisely that letter. Have it with you when we meet, will you?… That's splendid. Just splendid."

Truscott hung up, gathered the Xeroxed records together, and locked them in his briefcase. Of all the payoffs from Mallon, this promised to be the sweetest. That his disclosures might cause problems for Sarah Baldwin troubled him very little. As a surgeon, she was as capable and self-assured as any woman he had known in medicine. But she also represented everything he found distasteful about the Medical Center of Boston. And now, with this Lisa Summer thing, there would be no living with her or the rest of the oddball element at the hospital. She and her cronies were basking in the sunlight of her success like a herd of overfed sheep. The timing was perfect to seed the clouds for a little rain.

Besides, Sarah's ego had survived the other tidbits about her he had fed to Mallon. It would survive this batch as well. The real prizes at stake were Glenn Paris and his hospital sideshow. Already wounded and weakened, their survival was not nearly so certain.

As he headed out to check on his service, Andrew Truscott was singing softly to himself "Oh, MCB is falling down, my fair lady…"

July 5

Sarah had never much liked getting dressed up. As far as she could tell, that displeasure dated back to Sunday mornings in Ryerton, the rural New York town where she was raised. Her mother, perhaps responding to the stigma of having had a daughter out of wedlock, spent at least an hour each Sunday getting her ready for church. Sarah's dresses were pressed and perfect, her shoes spotless. Her hair was often braided half a dozen times before every strand was deemed in place. And always-at least until the early symptoms of her mother's Alzheimer's disease began to appear-the outfit was topped with a large, white bow.

Now Sarah twisted and turned before her bedroom mirror, trying to assess the third-or fourth-in the series of outfits she had tried on. It was eight o'clock in the morning. In fifteen minutes her cab to the hospital was due. Two days before, instigated no doubt by Glenn Paris and his PR department, the story had broken in both Boston papers about how eastern and western medicine had joined forces at the Medical Center of Boston to save the life of a young woman. However, the positive publicity for MCB was short-lived.

A day later, a small article, under no byline, had appeared in the Herald. Unnamed but reliable sources had reported that the unusual and cataclysmic obstetrical bleeding complication was not the first but the third such to occur in an MCB patient within the past eight months. And unlike Lisa Summer, the source further related, both of the previous cases had died.

Glenn Paris's rapid response to the story had been to schedule a press conference for nine o'clock on the morning of July 5. With Independence Day being relatively slow for news, his carefully prepared statement was carried by every Boston radio and television station. Presenting at the session, he announced, would be Drs. Randall Snyder and Eli Blankenship, chiefs of the departments of obstetrics and internal medicine at MCB, and Dr. Sarah Baldwin, the resident who had contributed so uniquely to saving the life of Lisa Summer.

At eight-fifteen, when the doorbell rang, Sarah was wearing leather flats, a gathered madras skirt, a beige cotton blouse, and a hand-embroidered Burmese belt, topped by a loose-fitting turquoise blazer. Her major concession to the formality of the occasion was wearing panty hose-not comfortable in any month, but even less so in July.

"Coming," she shouted into the intercom.

She snatched up the ornate brass earrings fashioned for her by an Akha craftsman and slipped them in place as she hurried down the stairs. Though she admired Glenn Paris, being a performer in one of his extravaganzas was not Sarah's style. But the report of a third DIC case in an MCB patient did demand a quick, reassuring-but-informative response from the hospital. And Paris felt she could help accomplish that. What had been a curiosity with the first patient, then a serious concern with the second, had suddenly become a terrifying priority.

The cabbie let her off on the street side of the Thayer Building. Glenn Paris met her in his outer office and greeted her warmly. As always, he was noticeably well dressed. Today, his tan suit, sky-blue shirt, and red power tie seemed tailor-made for television. He appeared somewhat tense, but there was a confident, dedicated energy about him that Sarah found disarming and attractive. It was the same sort of aura that had initially drawn her to Peter Ettinger.

"Sarah, do you have any idea who might have leaked this information to the Herald?" Paris asked.

"No, sir."

"Neither does anyone else I've talked to. A letter about the Hidalgo case comes in from the New York City Medical Examiner to our chief of surgery. He sends copies to pathology, obstetrics, hematology, internal medicine, the morbidity and mortality committee, and then, almost as an afterthought, to me. No sooner do I read about the case in my copy of the letter, than I read it in the damn paper. Now, isn't that just something! Each of the people I have spoken with gave a Xerox of the letter to one or more others. At last count, any of twenty-five or thirty people could have leaked it. They all say they had no idea it was that important. Not important! Well, I'm going to get him, Sarah. This time whoever it is has gone too far. Mark my words, I'm going to get him."

"I'm sure you will," Sarah said softly.

Although she understood his anger, she was not comfortable with it. She came close to reminding him that, regardless of the source of the news leak, regardless of the negative publicity, something very serious and frightening was going on. And the Medical Center of Boston did seem to be right in the middle of it.

When they left the building on the campus side, they saw a fairly large number of people-hospital staff, reporters, and one television camera crew-streaming across toward the auditorium.

"Looks like we're going to have quite a turnout," Paris said. "That's good. We've got to let the public know we're on top of this thing. Our foundation grant is looking very good, but it's not a lock. Negative publicity can still hurt us."

"Have you met with any members of the medical staff yet?" she asked, hoping to bring him back to the real issue at hand.

"Dr. Blankenship and I have been huddled almost continually since this article broke. I have an old friend who's an administrator at the Centers for Disease Control in Atlanta. I put Eli in touch with him, and he tells me they're trying to get someone up here in time for-"

Paris stopped short, his hand raised to keep her silent. He motioned her into the shadow of the outpatient building. Ahead of them, just at the corner of the building, a well-dressed man with a briefcase in one hand was engrossed in intimate conversation with one of the hospital's maintenance workers. Two days before, the maintenance staff's wildcat job action had crumbled before Paris's threat to fire everyone involved. Fliers damning his action were subsequently posted throughout the hospital. And although they were all back at work, none of the maintenance staff had moved to take them down.