Robin Cook - Foreign Body

Monday, 11:40 p.m.

Delhi, India

(Simultaneous with Jennifer’s Questioning Her Grandmother’s Death Being Announced on CNN)

Kashmira Varini was a slim, sallow, no-nonsense woman who rarely smiled and whose skin tone was always in sharp contrast to the saris that she inevitably wore. Even late in the evening, having been called back to the hospital on an emergency basis to deal with the death of Mrs. Hernandez, she’d made the effort to dress in a freshly pressed, richly colored red-and-gold outfit. Although almost lifeless in appearance and not particularly sympathetic, she was good at what she did by conveying to patients a strong, reassuring proficiency, efficiency, and commitment, especially with the help of her superb command of English English. Although patients coming from afar for surgery were invariably scared and therefore nervous, she put them at ease the moment they got to the hospital.

“Could you hear enough from my side of the conversation to guess what Ms. Hernandez said?” Kashmira questioned. She was sitting in the hospital CEO’s office at a library table. He was seated across from her. In contrast to her elegant ethnic costume, Rajish Bhurgava, the rounded, mildly overweight CEO, was attired cowboy-style with ill-fitting jeans and a plaid flannel shirt that snapped rather than buttoned. He had his legs crossed and his cowboy boots precariously balanced on the corner of the table.

“I could tell you were not able to get permission to embalm or cremate, which was the major goal of the call. That’s unfortunate.”

“I tried my best,” Kashmira said, in her defense. “But the granddaughter is distinctively pertinacious in comparison with the son. Maybe we should have just gone ahead and cremated without asking her.”

“I don’t think we could have taken that risk. Ramesh Srivastava was very clear when he called me that he wanted this case to disappear. He specifically said he did not want any possible continued cause for media attention, and if the granddaughter is bullheaded, as you suspect, cremating the body without permission could have caused a blowup.”

“You mentioned Ramesh Srivastava earlier when you called me about Hernandez’s death and told me we had to deal with it tonight. Who is he? I’ve never heard the name.”

“I’m sorry. I thought you knew. He’s a top-level administrator who’s been placed in charge of the department of medical tourism in the health ministry.”

“Is he the one who called you about the death?”

“He is, which was shocking. I’ve never met the man, but he’s an important individual. His appointment shows how vital the government thinks medical tourism is becoming.”

“How did he hear about the death before we did?”

“That is a good question. One of his subordinates saw it on CNN International and felt it serious enough, considering its possible effect on the PR campaign the Ministry of Tourism and the Indian Healthcare Federation have been co-sponsoring, to inform Srivastava immediately despite the hour. What impressed me was that Srivastava then called me directly instead of delegating it to one of his underlings. It shows how serious he thinks it is, which is why he wants the case to disappear, which, of course, is why he wants rapid disposition of the body. To help, he said he’d call to have the death certificate signed without delay, which he did. He also ordered that no one from the hospital staff on any pretext should talk to the media. He said that on the air there was a hint of some kind of investigation. He does not want an investigation of any sort.”

“I got that message loud and clear, as did everyone else.”

“So,” Rajish said, letting his legs fall to the floor and slapping the table for emphasis, “let’s get the body cleared for cremation or embalming and out of here.”

Kashmira pushed back her chair, the legs of which screeched against the floor in protest. “I will get the process started immediately by making the travel arrangements for Ms. Hernandez. Are you planning on talking to Mr. Srivastava again tonight?”

“He asked me to call his home with an update. So, yes, I will be calling.”

“Mention to him we might need his support to get an emergency M visa for Ms. Hernandez.”

“Will do,” Rajish said, jotting down a quick note to himself. He watched Kashmira walk out the door. Returning his attention to the phone Kashmira had used to call Jennifer and taking out Joint Secretary Srivastava’s phone number, which Rajish had written on a piece of scratch paper, he made the call. It made him feel proud to be calling someone so high in the health bureaucracy, especially at such an unorthodox hour.

After answering on the first ring, suggesting he was waiting by the phone, Ramesh Srivastava wasted no time with small talk. He asked if the body had been taken care of as he’d requested. “Not quite,” Rajish had to admit. He went on to describe how they’d asked the son but that the son had designated the granddaughter but the granddaughter had demurred. “The good part,” Rajish explained, “is that the granddaughter will be on her way to Delhi within a few hours and that as soon as she arrives they will press her for a decision.”

“What about the media?” Ramesh questioned. “Has there been any media patrolling around the hospital?”

“None whatsoever.”

“I’m surprised and encouraged. It also brings me to the issue of how the media got news of the death in the first place. In the context the piece was presented on the air, it seems to us that it had to have been a left-wing student who is against the rapid increase in private hospitals in India. Are you aware of any such person or persons at Queen Victoria Hospital?”

“Absolutely not. I’m certain we in the administration would be aware of such a person.”

“Keep it in mind. With public hospital budgets stagnant, particularly for infectious disease control, there are people who feel quite emotional about the issue.”

“I will certainly keep it in mind,” Rajish said. The idea that one of their medical staff could be a traitor was troubling, and the first thing he was going to do in the morning was raise the issue with the chief of the medical staff.

October 15, 2007

Mondey, 10:45 a.m.

Los Angeles, USA

(Simultaneous with Rajish Bhurgava’s Leaving the Queen Victoria Hospital)

Jennifer was in the process of making her way from the medical school back to the main building of the UCLA Medical Center and felt amazed at what she’d been able to accomplish despite her emotional fog. From the moment she terminated the conversation with the Queen Victoria Hospital case manager a little over an hour ago, she’d dealt with her new preceptor, dashed home, called back to India to give her passport number, made her way to the med school, got the blessing of the dean for a week off, arranged a replacement for her gainful-employment blood-bank job, and was now hoping to solve her emotional fears, economic concerns, and the problem of malaria prophylaxis. Although she’d taken out the almost four hundred dollars she had in savings, she was worried it might not be enough even with her credit card and Foreign Medical Solutions of Chicago paying her major expenses. Jennifer had certainly never been to India, much less on a mission dealing with a dead body. The possibility she would need a significant amount of cash was hardly far-fetched, especially if cremation or embalming was not something that could be charged.

Being as busy as she’d been over the hour-plus had had the secondary benefit of keeping her from obsessing about the reality of her grandmother’s passing. Even the weather helped, since it was as glorious as the dawn had predicted. She could still see the mountains in the distance, although not with quite the same startling clarity. But now that she was almost finished with her errands, reality began to reassert itself.