Robin Cook - Host

“Really?” Michael asked. “There’s a drug that costs five hundred thousand dollars a year?”

“It’s a monoclonal antibody, or biologic, like the drozitumab you saw on the front of Ashanti’s record. My father lost his job in the 2008 subprime catastrophe and ultimately his health insurance. He died because we couldn’t afford to pay for the drug.”

“That sucks,” Michael said. “Big-time!”

“Tell me about it! Anyway, I’m thinking Sidereal is doing something damning, maybe using people in the Shapiro for clinical trials, like we said. Yet somehow it seems overkill to me for us to get death threats for that unless they are somehow behind these anesthesia disasters.”

“You mean to create more subjects?” Michael asked, aghast at the idea.

“I know, it sounds too dastardly to even think about, but who’s to know? The only way I can think of possibly finding out is going into the Shapiro. If nothing else, once we are in there, I can use one of the terminals in the network operations center where you visited and look at their data. Of course that brings up the question of how you did tonight with your buddy Vladimir.”

Michael chuckled. “It was a slammin’ good time. Really, the guy’s got a good vibe and a good heart. He even brought me a souvenir, like he promised. I got to show it to you. It’s called a matryoshka doll. There’s one inside the other for about fifteen dolls, the last being a tiny thing.”

“Did you get the Shapiro scrubs?” Lynn asked, totally uninterested in the doll.

“No problem. We have two, just like you wanted, including hats and masks.”

“One set will be enough,” Lynn said. “I’m thinking I should go in by myself. This whole affair is getting more and more serious and risky. I think it is my battle, because of Carl.”

“We’ve been over this,” Michael said. “Case closed! We both go or neither of us goes.”

“We’ll see,” Lynn said. “How about the thumbprint?”

“I’m sure I got that, too. He had a couple of beers, and I was careful with the bottles. There should be plenty of prints.”

“Excellent,” Lynn said. They passed the ramp that led up to the Ravenel Bridge to Mount Pleasant. It was marked by a large overhead traffic sign. The name of the town reminded her of the horrific home invasion that they had learned about from the TV in the surgical lounge. The mother had been a patient at the Mason-Dixon Medical Center and had been diagnosed with a blood protein abnormality. All at once, the confusing gammopathy issue came back into her overstressed mind.

“There’s another aspect of all this that troubles me,” Lynn said, trying to organize her thoughts. She still felt shaky and discombobulated from what she had been through with the Russian goon. “It’s this gammopathy stuff. It keeps popping up. Before that bastard broke in, I learned something curious that I can’t explain. Remember those stats I got down in the IT office about the discharge diagnosis of gammopathy and multiple myeloma from the Mason-Dixon Med Center?”

“I remember,” Michael said. “But not the actual numbers.”

“The actual numbers don’t matter,” Lynn said. “The significant issue is that the number of people on discharge with these two diagnoses is five times the national average. Five times!”

Michael nodded as he considered what Lynn had just told him, but he didn’t say anything.

“Doesn’t that surprise you?” Lynn asked. She couldn’t believe he was seemingly taking it in stride.

“It surprises me,” Michael said. “Let me get this straight. You’re saying that the number of people coming into our hospital with an unrelated illness and leaving with a diagnosis of a blood serum abnormality is five times the national average?”

“That’s exactly what I am saying. And to make it more confusing, most of these patients are relatively young, in their thirties and forties, whereas gammopathy usually appears in an older population, like people in their sixties.”

“And patients with a discharge diagnosis of multiple myeloma is five times more common in our hospital.”

“That’s what I’m telling you.”

“Okay, how do you explain it?”

“I don’t,” Lynn snapped. “That’s why I’m bringing it up, for Chrissake.”

“Okay, keep it cool, girl,” Michael said calmly. “We’re on the same team here.”

“Sorry,” Lynn said. She took a deep breath to calm down.

“Is discovering this gammopathy and multiple myeloma info what had you ‘totally unglued’ and upset when you called me earlier?”

“Oh my gosh, no!” Lynn blurted. She swung back around to face Michael, thumping her forehead with her knuckles in mock punishment. “I can’t believe I forgot to tell you my most important discovery. The anesthesia records show that in all three cases the tracing had been looped.”

Michael shot a quick glance at Lynn to make sure she wasn’t jerking him around. “Looped, as in being played over and over?”

“Exactly,” Lynn said, with her voice reflecting her sudden excitement. “From the moment of the frame offset in each record, the records were looped with the minute prior to that point, when everything was normal. It means that from the frame offset until the low-oxygen alarm sounded, the anesthesia machine wasn’t recording the patient’s real-time vital signs. Those signals were interrupted, and the looping was giving the false impression that everything was normal.”

“That’s serious shit,” Michael said.

“The question is, could it be a software glitch?”

“I can’t imagine,” Michael said. “It has to be a hack job, and if it is, who’s doing it and why? Holy shit!”

“It has to be all tied together,” Lynn said.

“What do you mean?” Michael asked. He turned into the hospital grounds and headed for the multilevel garage.

“What’s going on in Anesthesia has to be connected somehow with the protein abnormalities.”

“That seems far-fetched,” Michael said.

“I thought so at first. But remember what we learned last year in diagnostics: even when symptoms seem entirely unrelated, they are almost invariably part of the same underlying disease. My intuition tells me we are going to find the same here with the abnormal proteins and the anesthesia disasters.”

“If they are associated, I can’t think how,” Michael said.

“Nor can I,” Lynn admitted. “I might be delusional, but I can’t stop thinking that I have to get into the Shapiro, even if just to get access to their records.”

“We, white man,” Michael said, again making reference to Ron Metzner’s Lone Ranger joke. “We’re a team, girl. There’s no way I’m going to let you go into Shapiro by yourself. If this is some major conspiracy, the risks go up.”

“It will be your decision if we get to that point,” Lynn said. “There’s still that thumbprint access that has to be overcome.”

They left Carl’s Cherokee in a visitor parking spot and walked across the hospital campus toward the medical dorm, a bit overwhelmed by what they had experienced and what they had been talking about. Neither one spoke, particularly as they passed the dark, nearly windowless Shapiro Institute. Both were now thinking about Carl being locked away in its bowels. It made it personal.

Such thinking was the hardest for Lynn, as it immediately evoked a combination of guilt, benumbing anger, and crushing loss, threatening her life on so many levels. She had to look away from the massive, sinister-looking building and force herself to think of something else. “I guess I’m going to have to make an effort to look like I’m back to being a medical student.”

“Hallelujah, woman!” Michael exclaimed. “If we are dealing with a major conspiracy that’s uptight about us asking questions about Carl, then we gotta believe somebody is going to be keeping tabs on us.”