Michael Palmer - Natural Causes

The scene in Annalee's room was much as it had been when Sarah sprinted off, except that hematologist Helen Stoddard was now conferring with Eli and Randall Snyder. Sarah groaned at the sight of her. Since their conflict over Lisa Grayson, they had passed in the halls and sat near each other at conferences, and not one word had been exchanged between them.

Well, Dr. Stoddard, Sarah thought as she approached the three treating physicians, if you thought I was a quack before, you're going to think I'm a positive lunatic now. And a homicidal lunatic at that!

"I need to speak with you all over here," Sarah whispered, motioning toward the only unoccupied corner of the room. "It's very important."

"Not again." Helen Stoddard moaned. "Eli, I thought you promised-"

"Helen, either shut up or leave," Eli snapped with uncharacteristic impatience. "This girl is in big trouble. We've got to do whatever we can to save her."

"What's going on?" Snyder asked. "Are you all going to give her the heparin or not?"

"Yes," Helen Stoddard said, quickly and definitively.

"I think you'd best hear what I have to say first," Sarah countered.

She briefly described what she found at her locker and showed the three physicians the contents of the FedEx package.

"I was concerned about Annalee's high temperature, the speed with which her symptoms were developing, and also the pattern of her twelve acupuncture pulses. Crotalid poisoning would explain all that."

"You're absolutely mad," Helen Stoddard said. "Someone purposely placed this in your locker? How on earth can you possibly expect us to swallow-"

"Dammit, Helen," Eli cut her off. "Would you just listen for once?"

The woman glared at him, then at Sarah. Then she whirled and stormed from the room. A moment later Peter Ettinger stormed in.

"What in the hell is going on here? Why did the hematologist leave that way?" he demanded.

Eli moved to confront him, but Sarah stopped the professor with a raised hand.

"Wait, Dr. Blankenship," she said. "Please. I know how important Annalee is to Peter, and I know how worried he is about what's going on. Let me talk to her for a second." She whispered a few words in Annalee's ear and then returned to the group. "Annalee says it's all right with her if he stays."

"Okay," Blankenship growled. "But one disruptive word, Ettinger, and you're out."

"Peter, Annalee has been poisoned," Sarah said. "Someone has injected crotalid venom either into her IV line or into the IV bag. I don't know enough about crotalid venom to know which or when it was done. But I am absolutely certain of what I'm saying. It is essential that we get this antivenin into her as soon as possible."

"This is insane," Ettinger said.

"How do we know the antivenin is what is in those vials?" Randall Snyder asked.

"Well, for one thing, they're sealed. For another, if this was anything but antivenin, there would be no sense in someone placing it in my possession."

"Assuming someone did," Peter said.

"Dr. Blankenship," Sarah asked, ignoring Ettinger, "do you know if there are any side effects to the antivenin?"

"An allergic reaction to the horse serum it's made in, I would think," Blankenship said. "Nothing else comes to mind."

"We can handle that."

"Here, let me see the package insert."

Randall Snyder glanced once again at the fetal monitor. "Eli, there's been a slight drop in the baby's pulse. You've got to decide."

"Crotalid poisoning," Peter said. "Sarah, you are really crazy."

"Ettinger, this issue has been decided," Eli warned, glaring at the taller man from beneath his massive brow. "Either go stand on the other side of the bed or get the hell out."

Peter hesitated and then rather meekly did as he was ordered. Eli quickly scanned the instructions and drew the contents of ten of the vials into a large syringe. Sarah explained the situation to Annalee. There was complete silence in the room as Eli slid the needle into the rubber port of the IV tubing and slowly discharged the cloudy liquid into her bloodstream.

The response to the antivenin was dramatic.

In less than five minutes, Annalee reported that the intense pain in her extremities had begun to abate. Twenty-six minutes after the injection, the bleeding from her nose and needle stick sites stopped completely. By early afternoon, her fever was gone and nearly all of her clotting studies and other laboratory tests were normal.

Six hours after the administration of the antivenin, Glenn Paris convened an emergency session of the executive committees of the hospital trustees and medical staff. After hearing the accounts of Randall Snyder, Eli Blankenship, Helen Stoddard, and the labor and delivery nurses, the participants voted unanimously to place Sarah Baldwin on immediate, indefinite, paid leave from the hospital and from her residency until the details of her involvement in Annalee's case became known with certainty.

The body had been in the morgue at the state medical examiner's office for three days before a definitive identification was made. Actually, body was not so apt a description of the remains as skeleton. A week before, the crew of a trawler, fishing seventy-five miles off the Massachusetts coast, had hauled it aboard along with several hundred pounds of haddock.

The skeleton had not a shred of clothing or tissue left on it, except for some cartilage on the ribs and in several of its joints. Still, the medical examiner was able to place the time of death within the past six months. He also had no problem classifying the death as a homicide. There were fracture/dislocations of two cervical vertebrae. The nature of the bony fragments strongly suggested blunt force. The ropes and diver's weights, still tied around the skeleton's extremities and what was once its midsection, removed what doubt remained.

Now, the ME inspected the dental X rays obtained from the Boston police. His dental forensics expert had just matched them with certainty to those films taken of the skeleton. He dictated his findings into a hand-held recorder and then called the BPD detective who had sent the X rays over.

"I think you can contact the missing man's family and tell them he is no longer missing," the medical examiner said. "Unfortunately, it would seem that your Dr. Truscott has done his last operation."

It was early afternoon when Mrs. Annie Frumanian knocked on Rosa's door.

"It's that charming Mr. Mulholland calling from Atlanta," she twittered.

Mulholland, who had flown home shortly after the visit to BIO-Vir, had spent his one night in Boston at her bed and breakfast. He was an almost legendary insomniac, and had made inestimable points with Mrs. Frumanian by staying up until well past midnight listening to stories of her life. He later told Rosa that no prescription sleeping pill had ever worked as well on him.

"Ken, have you got anything?" Rosa asked, once she was certain the landlady had hung up the extension.

"An address from three years ago is the best we've been able to do so far," the virologist said. "If you find our Mr. Fezler, maybe you should let him know that, assuming the social security number we used is the right one, we have inadvertently alerted the IRS that he hasn't filed a tax return in four years."

Fezler, the creator of the CRV113 virus, was almost certainly the skittish, stuttering little man who had tried to make contact with Sarah. However, although the old-timers at BIO-Vir remembered him as having been there for at least five years, none of them knew anything about his personal life, and there was no record in personnel that he had ever worked for the lab. From what little their inquiry around BIO-Vir turned up, Rosa and Ken had formed a picture of Fezler as an extremely solitary, very bright, and strikingly overweight man, perhaps in his late forties or early fifties. While in BIO-Vir's employ, he lost an enormous amount of weight. He also lost an enormous number of monkeys. And much to the dismay of animal supervisor Cletus Collins, the record of those primates, like Fezler's personnel file, had vanished.