Robin Cook - Critical

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Critical: краткое содержание, описание и аннотация

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Angela Dawson, M.D., appears to have it all: at the age of thirty-seven, she owns a fabulous New York City apartment, a stunning seaside house on Nantucket, and enjoys the perks of her prosperous lifestyle. But her climb to the top was rough, marked by a troubled childhood, a failed marriage, and the devastating blow of bankruptcy as a primary-care internist. Painfully aware of the role of economics in modern life, particularly in the health-care field, Angela returned to school to earn an MBA. Armed with a shiny new degree and blessed with determination, intelligence, and impeccable timing, Angela founded a start-up company, Angels Healthcare, then took it public. With her controlling interest in three busy specialty hospitals in New York City and plans for others in Miami and Los Angeles, Angela's future looked very bright.
Then a surge of drug-resistant staph infections in all three hospitals devastates Angela's carefully constructed world. Not only do the infections result in patient deaths, but the fatalities also cause stock prices to tumble, leaving market analysts wondering if Angela will be able to hold her empire together.
New York City medical examiners Laurie Montgomery and Jack Stapleton are naturally intrigued by the uptick in staph-related post-procedure deaths. Aside from their own professional curiosity, there's a personal stake as well: Laurie and Jack are newly married, and Jack is facing surgery to repair a torn ligament at Angels Orthopedic Hospital. Despite Jack's protests, Laurie can't help investigating-opening a Pandora's box of corporate intrigue that threatens not just her livelihood, but her life with Jack as well.

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Mildly chagrined at being so impersonally rejected when she thought she was about to do the man a favor, Laurie turned on her heels and walked out of the windowless office.

NOW IT WAS definitely an emergency, Walter Osgood reasoned. The first time it had been vague intuition, based mostly on Dr. Laurie Montgomery's resistance to accepting his rationale for failing to have the MRSA completely characterized. But now it was different. She was back in the Angels Orthopedic Hospital, despite the company's CEO all but telling her directly not to return, and on this occasion requesting to speak with him of all people.

Getting out the emergency number again, Walter called Washington. This time the phone rang even more times than it had the previous day, yet it was eventually answered. The deep, wary voice on this occasion sounded sleep-addled. "What is it this time?"

"The same problem."

"Are you on a landline?"

"Yes."

"Call me back at this number." The man gave Walter another number, then disconnected.

Walter waited for several minutes before dialing. The same man answered, although the slight hoarseness was gone. "Are you talking about the medical examiner?"

"Yes, she came back this morning, apparently investigating even though she was all but told not to. She worries me. I'm not sure I want to continue if something is not done about her."

"Something is surely being done. You have to be patient."

"Like what is being done?" Walter demanded. He hated all the secrecy, especially since he was the one out in the cold.

"We have an individual in the city at this moment whose specialty is to take care of this kind of problem."

"You are going to have to be more specific."

"I think the less you know, the better."

"Are you saying someone is here in New York right now?"

"That's exactly what I am saying."

"How about his or her name and a number."

"Sorry, I can't do that."

"I'm not sure I want to continue with all this."

"I'm afraid you don't have any choice at this point. It was your option to begin, but it is not your option to stop. The pressure must be maintained at least for a few more days."

Walter felt a mixture of anger and fear, but the fear won out. He didn't respond.

"I hope your silence means you understand the reality of your situation."

"If she shows up again in the next few days, can I call you to let you know whomever you sent here hasn't convinced her to stop her meddling?"

"Yes, you do that, but rest assured, we have sent our best negotiator."

"One other question. I don't know your name."

"There's no need for you to know my name."

Similar to the call the day before, the line was cut off precipitously and Walter found himself listening to a dead line. Slowly, he hung up the receiver. Despite the reassurances the man had given, Walter panicked and wondered how bad a decision to become involved it would turn out to be when all was said and done. His only consolation was that his son had seemingly stabilized, and the doctors who were administering the supposed experimental treatment were moderately optimistic.

BY THE TIME Laurie had had the time to read only a few of the day's op-ed pieces in the Times, Jack had appeared accompanied by a youthful doctor dressed in scrubs but covered by a long, white coat as crisp and clean as Dr. Friedlander's. Apparently, such smartness was hospital policy. Laurie had to admit that it appeared far superior to some of the residents at the University Hospital who seemed to revel in having the most soiled white coats, as if it were testament to how hard they were working.

Jack introduced the man as Dr. Jeff Albright. To Laurie, he had the bluest eyes she'd ever seen.

"I'm lucky," Jack continued. "Dr. Albright has agreed to pass gas for me in the morning. I told him you were concerned about MRSA and me having surgery, so he graciously offered to come out and have a word with you and hopefully put your mind at ease."

Laurie shook hands with the anesthesiologist, and noting how young he appeared made her feel old by comparison. She also felt abashed from Jack's introduction, as if she were an oversolicitous mother. Jeff gave the usual stereotypical assurance and said that Jack was as healthy as an ox, making Laurie wonder just how healthy oxen were, since she thought the expression was "strong as an ox." When Jeff finished his prepared speech, Laurie asked him how many cases he'd done after which the patient came down with an MRSA infection.

Somewhat nervously, his eyes flicked back and forth between Laurie and Jack. Apparently, Jack had not asked such a specific question. "One," he finally admitted. "It was several months ago, after a shoulder rotator cuff repair. Like the others, it was totally unexpected and unfortunately fatal."

"What was the name?" Laurie asked.

"I'm not sure I'm at liberty to divulge that," Jeff said.

Laurie knew she had the right to ask, as it was undoubtedly a medical examiner case, but she didn't push the issue. The name didn't matter, other than to reassure herself she'd not missed a case. She was more interested in Jack's upcoming surgery.

"Was there anything you can remember about the case that was unusual?"

Jeff shook his head. "It went entirely smoothly. Well, there was one thing. We staff have been regularly tested for MRSA ourselves on a weekly basis. During the week that the death occurred, I did turn positive. Whether it happened from that patient, I don't know. But I can safely say I'm free now. I was screened just yesterday."

"I'm happy to report I'm also free of those buggers," Jack said.

"Were you the anesthesiologist for David Jeffries on Monday?" Laurie asked.

"No, I wasn't. That was Dolores Suarez."

"Thank you for talking with me," Laurie said. She smiled weakly. Jeff's efforts didn't make her any more confident.

"We'll take good care of your husband," Jeff promised. He said good-bye and disappeared back into the examining area.

"So," Jack said. "You have to admit this is a nice operation, so to speak. Just the fact there's no waiting makes it unique."

"It's neat, it's clean, it's pleasant," Laurie admitted. "But there is obviously a problem here, despite its apparent cleanliness."

"Don't tell me you are not reassured."

"MRSA is surely not respecting the luxurious venue."

"You are impossible," Jack said with a sigh. "Every hospital is seeing MRSA."

"But every hospital is not seeing multiple cases of MRSA necrotizing pneumonia that's killing people as if it were a raging hemorrhagic fever like Ebola."

"Come on!" Jack said with some frustration. "Let's get to work."

"THIS IS A fucking mess," Franco complained. "This is what you got me out of bed for?" He gestured ahead through the van's windshield. In front of the medical examiner's office was an unruly crowd of fifty or sixty people staging an unauthorized protest over the medical examiner's initial report regarding Concepcion Lopez, whom Bingham had posted the day before. Most of the protestors were Hispanic. And most were carrying amateurish placards taped or stapled to broom handles attesting to a supposed cover-up and complaining of police brutality to the Hispanic community.

"What I can't figure is what they're doing here so goddamn early," Angelo said.

"I'd guess to get on the morning news," Franco said. "Besides, they get more bang for the buck if they block rush-hour traffic, which they are obviously doing."

Many of the protestors were wandering out into First Avenue. Police in riot gear were waiting to be called out of their bus parked on 30th Street. For the time being, the regular police were trying to keep the crowd out of the streets and confined to an area directly in front of the OCME but with minimal success.

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