Robin Cook - Critical

Angela turned to Cynthia. "What was your take on that medical examiner? Did she strike you as an independent sort?"

"Absolutely. Why else would she come out and visit our hospital when there was no mystery about the cause of death. I didn't like her there while we're trying to keep a lid on this affair. That's why I came down to get you. I thought it was something you should handle."

"I'm glad you did. I considered her a threat the moment I laid eyes on her. I don't know exactly why, but she struck me as very focused and driven, and, to compound it, very intelligent. Did you see how she made eye contact? Most people caught in a similar circumstance would have been cowed to some degree."

"She did the same to me," Cynthia said. "I definitely challenged her the moment I heard she was a medical examiner."

"She worries me," Angela admitted. "If she manages to get any of this MRSA problem into the press, it will certainly come to the attention of institutional investors as part of their due diligence. If that happens, more than likely the IPO will have to be postponed, or if it's not, it certainly won't be successful."

"I think you did a terrific job talking to her."

"You think so? Really?"

"I do. First, you mixed just enough condemnation and commendation, threat and praise, to put her off balance. Second, your warning about calling her boss definitely affected her negatively; I don't think she will be making any more visits, whether announced or not. And finally you made her understand that there are a number of people working on solving the problem who have much more epidemiological training than she has. I'm sure she feels she'd fulfilled her responsibility."

"I hope you are right," Angela said, not fully convinced.

"I'm sure I am. I was impressed. You were brilliant. You really played her like a violin."

Angela shrugged. She wasn't so sure. Her intuition was telling her the opposite, and that Dr. Laurie Montgomery was going to be a problem. Angela wondered if she should talk to Michael about her. But then, after another short session staring out the taxi's window, Angela suddenly pulled her cell phone from her Louis Vuitton bag, slipped it open, and speed-dialed her secretary.

"Loren? Get me Dr. Harold Bingham's number."

To Cynthia, she said, "I want to be totally certain Dr. Laurie Montgomery behaves."

DR. WALTER OSGOOD was nervous. The whole time he'd been talking with his supervisor of the Angels Orthopedic Hospital's clinical laboratory, Simon Friedlander, he kept thinking about the surprise visit from the woman medical examiner. He'd explained to her why he'd advised not to bother testing the MRSA to determine their explicit subtype. The woman had nodded repeatedly as if she'd understood, yet he sensed she hadn't agreed. It was subtle but definite, and it worried him.

When he'd finished the meeting with Simon, which had been stressful because of his nervous preoccupation with Dr. Laurie Montgomery's visit, Walter asked if he could use Simon's office to make a private phone call. Sitting at the man's desk, he noticed a family photo. One of Simon's sons was the same age as Walter's only child. Before making his call, Walter picked up the framed photo so he could see the boy's image more clearly. He was an obviously healthy child, with a shock of unruly blond hair and a purposefully silly but happy expression. Walter fought off a sudden surge of sadness, anger, and envy. He put the photo back down, closed his eyes, and took a deep breath to rein in his emotions involving the unfairness of life. At the moment, his son was far from healthy, having been diagnosed with a rare, severe form of Hodgkin's disease requiring what his health insurer deemed "experimental" treatment. At the moment, Walter's son had no hair and had lost a quarter of his former weight.

Opening his eyes, Walter took out his wallet and extracted a small piece of paper with a single phone number with a Washington, D.C., area code. It was supposed to be for emergencies only, and he debated if this qualified. Making a sudden decision, he picked up the receiver and dialed.

On the other end, the phone rang a number of times, and Walter wondered what he'd say if he got voice mail. Just when he thought the phone wouldn't be answered, it was. A deep, wary voice said, "What is it?" There was no hello.

"This is Walter Osgood," Walter began, but he was immediately cut off.

"Are you on a landline?"

"I am."

"Hang up and call this number," the voice said. He rattled off a phone number and hung up.

Walter rapidly wrote the number on the edge of an envelope addressed to Simon. He then dialed the number. The same voice immediately answered. "You were not supposed to call me unless there is an emergency. Is that the case?"

"How do I know what constitutes an emergency?" Walter snapped. "As far as I'm concerned, if it isn't now, it will be."

"What is it?"

"A New York City medical examiner by the name of Laurie Montgomery came to the Angels Orthopedic Hospital asking questions."

"Why is that an emergency?"

"She'd autopsied a patient who'd died yesterday from MRSA. She wanted to go into the OR, and had even been up in the engineering spaces."

"So what?"

"That's easy for you to say. I don't like it. The next thing, it could be in the papers."

"What's her name again?"

"Dr. Laurie Montgomery from the Office of the Chief Medical Examiner. What are you going to do?"

"I don't know. But I'll keep you informed, and you do the same."

The line disconnected. Walter glanced at the receiver as if it could answer his question. Then he lowered it into its cradle. The strangest part was that he didn't even know the man's name.

Walter carefully erased the phone number he'd written on the envelope on Simon's desk before walking out into the lab.

LAURIE'S TAXI WAS now speeding south on Second Avenue toward the OCME and running the lights. But instead of concern about her safety, other than being certain her seat belt was secure, Laurie was obsessed with her surprising visit to Angels Orthopedic Hospital. Nothing had been as she'd expected.

The edifice was far more luxurious than she'd imagined. And the cast of characters had run the gamut from congenial to rude, and the CEO of Angels Healthcare, whom she never expected to meet, was definitely in the latter category. Laurie wondered if the woman would act on her thinly disguised threat to call Bingham. Under New York City law, a medical examiner definitely has the right, while investigating a case, to do what is needed to protect the public, and visiting an OR where there had been eleven infectious deaths over three months would certainly fall into that category.

If anything, the visit had only intensified her urge to talk Jack out of his surgery, at least until the MRSA mystery had been solved. Although Angela Dawson had expressed a remorse for the toll the outbreak had taken on their patients, she seemed just as concerned about the institution itself. It was as if the two were equivalent, which shocked Laurie. She could not believe that under the circumstances, the hospital was continuing to do surgery, that the reduced revenues were on a par with lost lives. The CEO had been introduced to Laurie as a doctor, which Laurie had assumed to be medical doctor, but now she thought it must be Ph.D., not M.D. It just didn't seem possible for her to be otherwise.

She tried to focus on the outbreak, but the contradictions were confusing. Although she knew the airborne spread of staphylococcus was possible, it wasn't common, mainly because staph cannot be aerosolized like anthrax or other airborne bacterial threats. Staphylococcus remains viable for a very short time outside a warm, moist, nutrient-rich environment, and when a few errant molecules did land within someone's nose or mouth, it behaved itself admirably and almost never caused problems. Yet in her series of mostly primary pneumonia, it had to have been airborne, and it had to have been a large dose. But that meant the patients had to have been exposed in the operating room to a relatively large amount of the pathogen. The trouble with that scenario was that the HVAC system was outfitted with HEPA filters that caught viruses a hundred times smaller than bacteria, and even if a few got through, the air in the OR changed every six minutes. On top of that, the patients undergoing general anesthesia never breathed the ambient air. In short, Laurie told herself it was impossible. Her series could not happen either naturally or purposefully.