Robin Cook - Host

Lynn had gotten to Carl’s house at about a quarter to nine. Pep had been ecstatic to see her and had purred with such ferocity, Lynn had dropped everything and fed her right away. Once the cat had been taken care of, Lynn wandered around the house, going from room to room, thinking about Carl.

In retrospect, such reminiscing was probably not a good idea. Same with her coming back to Carl’s house at all. As Michael had suggested, she should have called Frank to take care of the cat because being there made her sense of bereavement overwhelming. Everything in the house reminded her of her stricken lover and his unique personality, his keen intelligence, his love of life, and even his compulsive neatness, which was a step beyond Michael’s. With a bit of embarrassment she remembered some of the petty quarrels they had had about how she hung up her bath towel and sometimes left her underwear on the bathroom floor.

With these thoughts in mind, the extent of her loss had weighed on her, and Lynn became depressed. It had gotten to the point of wondering who was worse off, she or Carl. What saved the day from such negative self-fulfilling reminiscence was the sudden realization that she couldn’t just wander around feeling sorry for herself. Instead she had to make a concerted effort to occupy her mind as she had done the evening before. To that end she had gone into Carl’s bathroom first and taken a long, hot shower. She’d stayed under the hot torrent long enough to dilute the day’s emotions. Following the shower, she’d donned one of Carl’s oversize bathrobes and gone into his study. At his desk she’d turned on the PC and went online.

What she had done first was find out how many people in the general population had blood serum protein abnormalities or gammopathies. The issue had been gnawing at her ever since she’d read Morrison’s chart and since she found out that Carl was seemingly developing it. Adding to her curiosity was finding out, from the otherwise disappointing visit to the IT Department, how many people discharged from the Mason-Dixon Medical Center had been diagnosed with that condition while they had been an inpatient.

What she had learned surprised her. Although the Mason-Dixon had far fewer episodes of hospital-based infections, as Dean English had pointed out, the hospital was off the charts when it came to the incidence of blood serum abnormalities. When Lynn looked into multiple myeloma, she’d found the same situation. Patients coming from the Mason-Dixon had five times the national rate for both problems. Lynn had no explanation for such discrepancies. Could it have something to do with the hospital or the lab? She had no idea, but she had definitely decided she had to bring up the subject with Michael to get his take.

At that point, to continue to keep herself from falling back to obsessing over Carl and feeling sorry for herself in the process, she’d turned her attention back to the anesthesia records she had brought from her room. Studying the printouts from a new and unique perspective had led to her shocking new discovery.

Lynn tipped forward again, taking her eyes away from staring blankly at the ceiling. The mere thought that Carl’s disastrous condition might not have been an accident made Lynn’s blood run cold. It was such an unnerving idea that she wondered if she was becoming delusional. Was her fragile emotional state turning her into a conspiracy theorist?

Intent on proving herself wrong, she went back to what she had been doing. Spread out in front of her on Carl’s desk were sections of vital-sign tracings from each of the three cases. With a pair of scissors she’d found in Carl’s top desk drawer — after briefly looking again at the engagement ring — she had cut them out of the anesthesia record graphs. The segments she had chosen showed the blood pressure, pulse, oxygen saturation, and ECG of each patient from the moment of the frame offset to the sudden fall in blood oxygen. Her idea was to look for slight alterations in the vital signs in all three cases to see if there were any similarities. What she hadn’t anticipated was that by isolating these portions and just looking at one of them before comparing all three, she was able to see something that apparently everyone else had missed, including herself.

To confirm what she thought she had noticed, Lynn took the cut-out segment of Carl’s record and proceeded to cut it up into smaller pieces, each representing one minute of anesthesia time. Once she was done, she took all the pieces and arranged them in a vertical column so that she could compare one to the other. Once she did this, what she thought she had seen earlier became even more apparent. There was definite periodicity, meaning the tracing repeated itself. Every minute the recording of the vital signs had been looped, meaning the same one-minute segment was playing over and over, from the moment of the frame offset until the oxygen saturation suddenly dropped.

Printing another copy of Carl’s anesthesia record and taking one of the minute segments she’d cut out, Lynn was able to match the repeating segment. It had come from the minute time period just prior to the frame offset.

Lynn was stunned. For a moment she didn’t move or even breathe as her mind churned. What she had discovered was definitely real, and the implications were more than disturbing. One thing she understood: from the moment of the frame offset until the fall in the blood oxygen, the anesthesia machine wasn’t monitoring Carl’s vital signs. Instead it was constantly replaying the same, normal segment and masking what was really happening to her lover while the monitors suggested everything was normal. “My God!” she said out loud. With copies of Scarlett Morrison’s and Ashanti Davis’s records, she quickly determined it was the same.

Grabbing her mobile phone, Lynn speed-dialed Michael’s number. Her pulse was racing as the call took its time going through. She looked at the clock. It was almost eleven-thirty. It was late, but Michael usually stayed up until midnight. The distant phone rang four times. On the fifth Michael picked up.

“Yo!” Michael said with no preamble, knowing it was Lynn. “Vlad here is just about to bag it. Can I catch you in a moment?”

“I need to talk,” Lynn said with unmistakable urgency.

“You all right?”

“I’m not sure.”

“Are you in mortal danger this very second?” There was a touch of sarcasm in his tone, which wasn’t all that unusual.

“Not literally, but I just discovered something that has me totally unglued and will blow your mind.”

“Okay, I got you covered, but I need five. I’ll be right back to you.” He then disconnected.

Feeling moderately panicky after her metaphoric lifeline was summarily terminated, Lynn put her phone down. She did it slowly. Her mind was going a mile a minute. As bad as the implications were about Carl’s, Morrison’s, and Davis’s anesthesia disasters not being accidents or even episodes of malpractice, the added issue of the serum protein abnormality popped back into her head.

Could the gammopathy and the looping of the anesthesia record be related? It didn’t seem possible, but if there was one thing that Lynn had learned about medical diagnostics during her four years of medical school, it was that even when you were faced with a patient with disparate and seemingly unrelated symptoms, more often than not the underlying problem was one disease.

A sudden noise, not necessarily loud but somehow foreign, registered in Lynn’s ears. It came from the floor below, either from the living room or the foyer. It was more like a vibration of the whole structure of the house than just a sound carried in the air. Trying to figure out its origin, Lynn held her breath, listening intently. Her first thought was that it was a book falling and landing flat. Her second thought was perhaps Pep had jumped from a piece of furniture onto the floor. But Lynn quickly ruled out Pep as the culprit when she caught sight of the cat fast asleep in the club chair by the fireplace. Seeing that the animal’s keen senses had not been disturbed gave her a bit of encouragement, but it didn’t last.