Робин Кук - Mortal Fear

“It’ll cost ya,” Roger teased. “Whatcha got?”

Jason followed the man into his disheveled office.

“Unfortunately, some pretty embarrassing evidence.” Jason opened the charts of his three late patients to the EKG sections and placed them in front of Roger. “I’m ashamed to even discuss this, but I’ve had three middle-aged men die right after their fancy executive physicals showed them in pretty good health. One was today. Cardiac rupture after a massive MI. I did the physical exam three weeks ago. This is the one. Even knowing what I do now, I can’t find even a bit of trouble or any of the tracings. What do you think?”

There was a moment of silence while Roger studied the EKGs. “Welcome to the club,” he finally said.

“Club?”

“These EKGs are fine,” Roger said. “All of us have had the same experience. I’ve had four such cases over the last few months. Just about everybody who’s willing to bring it up has had at least one or two.”

“How come it’s not come up?”

“You tell me,” Roger said, with a wry smile. “You haven’t exactly been advertising your experience, have you? It’s dirty laundry. We’d all rather not call attention to it. But you’re acting chief of service. Why don’t you call a meeting?”

Jason nodded glumly. Under the aegis of the GHP administration, which made all of the major organizational decisions, chief of service was not a desirable position. It was rotated on a yearly basis among all the internists, and had fallen onto Jason’s shoulders two months previously.

“I guess I should,” Jason said, collecting his charts from Roger’s desk. “If nothing else, the other doctors should know they’re not alone if they’ve had the same experience.”

“Sounds good,” Roger agreed. He heaved his considerable bulk to his feet. “But don’t expect everybody to be quite as open as you are.”

Jason headed back to the central desk, motioning to Sally to ready the next patient. Sally took off like a sprinter. He then turned to Claudia.

“Claudia, I need a favor. I want you to make a list of all the annual physicals I’ve done over the last year, pull their charts, and check on their state of health. I want to be sure none of the others have had serious medical problems. Apparently some of the other doctors have been having similar episodes. I think it’s something we should look into.”

“It’s going to be a big list,” Claudia warned.

Jason was aware of that. In its desire to promote what it called preventive medicine, GHP had been strongly advocating such physicals and had streamlined the process to take care of the maximum number of people. Jason knew that he did, on the average, between five and ten a week.

For the next several hours, Jason devoted himself to his patients, who treated him to an endless stream of problems and complaints. Sally was relentless, filling examining rooms the moment the previous patient vacated. By skipping lunch, Jason was actually able to catch up.

In the middle of the afternoon, as Jason was returning from one of the treatment rooms where he had done a sigmoidoscopy on a patient with recurrent ulcerative colitis, Claudia caught his attention and motioned for him to come over to the central desk. She was sporting a cocky smile as Jason approached. He knew something was brewing.

“You have an honored visitor,” Claudia said with pursed lips, imitating a Lily Tomlin character.

“Who?” Jason asked, reflexly scanning the adjacent waiting room area.

“He’s in your office,” Claudia said.

Jason shifted his eyes toward his office. The door was closed. It wasn’t like Claudia to put someone in there. He looked back at his secretary. “Claudia?” he questioned, extending her name out as if it were more than three syllables. “How come you allowed someone in my office?”

“He insisted,” said Claudia, “and who am I to refuse?”

Obviously whoever it was had offended her. Jason knew her that well. And whoever it was certainly had some kind of stature at GHP. But Jason was tiring of the game. “Are you going to tell me who it is or am I supposed to be surprised?”

“Dr. Alvin Hayes,” Claudia said. She batted her eyes and made a sneer. Agnes, the secretary who worked for Roger, snickered.

Jason waved at them in disgust and headed for his office. A visit by Dr. Alvin Hayes was a unique occurrence. He was the GHP token and star researcher, hired by the Plan to promote its image. It had been a move reminiscent of the Humana Corporation’s hiring Dr. William DeVries, the surgeon of artificial-heart fame. GHP, as a health-maintenance organization (HMO), did not support research’ per se, yet it had hired Hayes at a prodigious salary in order to expand and augment its image, especially in the Boston academic community. After all, Dr. Alvin Hayes was a world-class molecular biologist who had been on the cover of Time magazine after having developed a method of making human growth hormone from recombinant DNA technology. The growth hormone he had made was exactly like the human variety. Earlier attempts had resulted in a hormone that was similar but not exactly the same. It had been considered an important breakthrough.

Jason reached his office and opened the door. He could not fathom why Hayes would be paying him a visit. Hayes had all but ignored Jason from the day he had been hired over a year previously, despite the fact they’d been in the same Harvard Medical School class. After graduation they had gone their separate ways, but when Alvin Hayes had been hired by GHP, Jason had sought the man out and personally welcomed him. Hayes had been distant, obviously impressed by his own celebrity status and openly contemptuous of Jason’s decision to stay in clinical medicine. Except for a few chance meetings, they ignored each other. In fact, Hayes ignored everyone at the GHP, becoming more and more what people referred to as the mad scientist. He’d even gone to the extreme of letting his personal appearance suffer by wearing baggy, unpressed clothes and allowing his unkempt hair to grow long like a throwback to the turbulent sixties. Although people gossiped, and he had few friends, everyone respected him. Hayes worked long hours and produced an unbelievable number of papers and scientific articles.

Alvin Hayes was sprawled in one of the chairs facing Jason’s antique desk. About Jason’s height, with pudgy, boyish features, Hayes’s unkempt hair hung about his face, which appeared more sallow than ever. He’d always had that peculiar academic pallor that characterizes scientists who spend all their time in their laboratories. But Jason’s clinical eye noted an increased yellowishness as well as a laxness that made Hayes look ill and overly exhausted. Jason wondered if this was a professional visit.

“Sorry to bother you,” Hayes said, struggling to his feet. “I know you must be busy.”

“Not at all,” Jason lied, skirting his desk and sitting down. He removed the stethoscope draped around his neck. “What can we do for you?” Hayes appeared nervous and fatigued, as if he hadn’t slept for several days.

“I have to talk to you,” he said, lowering his voice and leaning forward in a conspiratorial fashion.

Jason flinched back. Hayes’s breath was fetid and his eyes had a glassy, unfocused look that gave him a slightly crazed appearance. His white laboratory coat was wrinkled and stained. Both sleeves were pushed up above his elbows. His watch fitted so loosely that Jason wondered how he kept from losing it.

“What’s on your mind?”

Hayes leaned farther forward, knuckles resting on Jason’s blotter. He whispered, “Not here. I want to talk with you tonight. Outside of GHP.”

There was a moment of strained silence. Hayes’s behavior was obviously abnormal, and Jason wondered if he should try to get the man to talk to his friend Patrick Quillan, thinking a psychiatrist might have more to offer him. If Hayes wanted to talk away from the hospital, it couldn’t be about his health.