Michael Palmer - The fifth vial

Ben's imagined rhetoric was cut off abruptly. He was standing behind Shirley as she was extolling the virtues of a new machine, whose name and function he had missed completely. Over her shoulder, he could see a young technician, slightly built, with a strawberry blond ponytail. She was removing a large number of tubes of blood from a freezer and gingerly placing them into racks in several Styrofoam shipping coolers filled with dry ice.

"That's a wonderful machine, Shirley," he said, hoping she wouldn't ask even the most elementary question about it. "Tell me, what percent of the tests that are ordered do you actually do here, and how much do you end up sending out?"

"Good question. Actually, the equipment has gotten so sophisticated, accurate, and efficient that just a couple of techs can run virtually all the chemistries and hematology we get. We still send the more obscure and difficult to run tests out to the larger, more regional Whitestone labs, and also to specialty labs like yours. But on the whole, what we get in, we run here."

"Excellent. Those tubes that are being handled over there. Are they being sent out for a specific test?"

Murphy laughed.

"When I told you we send some things out, I wasn't talking about that sort of volume."

She took him gently by the arm and guided him over to the tech.

"Sissy, this is Mr. Ben Callahan from Chicago. He owns a lab that does tissue-typing for transplants."

"Hazardous duty," Sissy said, motioning to the bruises still enveloping his eyes.

"Hey," Ben replied with candor he hadn't planned, "you should see the other guy."

"Sissy," Shirley went on, "Mr. Callahan is interested in these vials you're packing up."

"These? They're backups."

"Backups?"

"In case a sample gets contaminated or the results get questioned. Or in case we need to do a retest for any legal reason."

"As far as we know," Murphy added proudly, "Whitestone is the only lab that takes such precautions. Perhaps that's why we're number one by such a wide margin. I'm sure it adds some to the expense of the tests, but from what I've been told, Whitestone covers that and doesn't pass it on to the consumer or their insurance company."

Ben's mind was whirling.

"So every patient you draw has extra tubes of blood frozen and put in storage?"

"Just a green top," Murphy said. "We've been told that thanks to new technology, that's all they need. We draw an average of four vials of blood on each of our clients — red tops, gray tops, purple tops, black tops. The colors of the rubber stoppers refer to the chemicals that are inside the vials. We refer to the green top as the fifth vial, even if we only draw two on a given patient."

"But you have to ship those green tops out?"

"Oh, yes," Sissy said. "We'd run out of room in no time if we didn't. They're flown to a storage facility in Texas."

"And kept there for a year," Shirley added.

"Amazing," Ben muttered, wondering if it was even legal to draw such a tube without the patient's knowledge, and deciding in the same moment that it probably was — so long as the blood was only used for quality control.

Casually, he glanced down at the FedEx shipping label. Whitestone Laboratory, John Hamman Highway, Fadiman, Texas 79249. It was so simple, yet it fit the facts of the case so powerfully. At a lab, possibly in a place called Fadiman, Texas, Lonnie Durkin's tissue type had been run and undoubtedly recorded. Ben wondered if a tube containing his own blood had also made the trip to Fadiman. If so, it seemed quite possible that his and Lonnie Durkin's tissue types were two items in the same database — a very massive database at that.

It took a while, and the promise of dinner on his next visit, for Ben to extricate himself from Shirley Murphy, but when he finally had, he hurried to a phone and called Alice Gustafson with a summary of the news from Soda Springs, and a single question.

"What kind of vial is drawn to do a tissue typing on someone?"

Her reply, though made in a second, seemed to him to take an hour. "That would be a green top," she said.

Unbelievable!"

The physical therapist and pulmonary therapist stood back from the treadmill and watched in absolute amazement as Natalie passed thirty minutes of brisk uphill walking — 4.5 miles per hour with an elevation of four.

Gradually, Natalie had felt her breathing becoming more strained, and a burning beneath her sternum, but she was determined to hang on for another few minutes. It was little more than two weeks since her medevac return from Brazil, and little more than three since her right lung had been removed at Santa Teresa Hospital in Rio. She had spent the first three days out of the hospital at her mother's, and might have stayed longer were it not for the pervasive odor of cigarettes — present even though, out of respect for her daughter, Hermina was limiting her smoking to the porch and bathroom.

Jenny delighted in having her aunt around, and especially in having the chance to be the caregiver for a change. The two of them spent hours talking about life and standing tall against adversity, as well as about books (Jenny had reluctantly tried the first Harry Potter, and was now devouring the series), movie stars, opportunities in medicine, and even boys.

"Aren't you a little young to be interested in boys?"

"Don't worry, Auntie Nat, the boys are young, too."

Natalie's progress and her attitude had astounded her physicians and rehab specialists. The scimitar scar on her right side was still sensitive, but there were no other outward signs of the massive operation she had undergone. And with each passing day — each passing hour — her left lung was accepting more and more of the responsibilities for gas exchange that once two lungs had shared.

"Hey, Millwood," she said, "I think tomorrow we should hit the track."

The surgeon, trotting briskly on the adjacent treadmill, looked over at her incredulously.

"Just don't hurt yourself," he said. "You know, time is nature's way of keeping everything from happening at once. You don't have to totally rehabilitate in a single session."

"Before this is all over, I'm going to run a triathlon. That's going to be my new sport."

"I think you should stop now, Nat," the physical therapist said. "I promise we'll add something tomorrow."

As Natalie started a cool-down, Millwood turned off his treadmill and hopped off.

"Thank you, ladies, for allowing me to take up your machine like this, but I had to see for myself if the rumors about superwoman, here, were true."

"Are you a believer?" Natalie asked.

"Believer, hell, I'm a disciple."

"In that case you can disciple me over to Friendly's for a hot fudge sundae. If you can stand my grubbiness, I'll wait and shower after I get home. I have to do a little grocery shopping for my mom anyhow, and Friendly's is sort of on the way. We can meet there."

Natalie finished the short cool-down and performed a set of pulmonary function studies under the guidance of her pulmonary therapist.

"The numbers are okay," the woman said, "but your actual performance is much, much better. I honestly have never heard of anyone making this sort of progress after a total pneumonectomy."

"You just watch. If it can be done, I'm going to do it."

Natalie toweled off and changed into a floppy sweatshirt. Macabre and disastrous as losing an entire lung sounded, the recovery, at least to this point, had been nothing like the agonizing ordeal of rehabilitating her surgically repaired Achilles. She had bounced back from that ordeal, and she was determined to make it through this one.