Robin Cook - Foreign Body

Jennifer opened her eyes. Such thinking raised the issue of smothering. Someone could have smothered her grandmother and produced generalized cyanosis, but as soon as the idea occurred to her, Jennifer actively swept it from her mind. She couldn’t believe how paranoid she was becoming. She felt embarrassed. She knew, just as she knew where her next breath was coming from, that no one had smothered Granny.

The elevator landed at the lobby and most everyone got out, including Jennifer, who made it a point to lock eyes for a moment with the guard, who was holding the doors ajar. “Why, thank you,” Jennifer said brightly. The guard acted surprised to be addressed but didn’t return the nicety.

Wasting no time, Jennifer headed to the marble front desk, rounded it, and walked to Kashmira Varini’s open door. Jennifer rapped on the jamb. Kashmira was at her desk, filling in a form. “Come in, please,” she said when she looked up in response to Jennifer’s knock. She stood and went through her usual greeting, which Jennifer merely acknowledged with a slight bowing of her head. Kashmira then motioned to a seat and Jennifer dutifully sat. Jennifer looked at Kashmira.

“Thank you for coming back,” Kashmira said. “I hope you had a refreshing nap.”

“I didn’t sleep a wink.”

“Oh!” Kashmira voiced, apparently expecting a more positive reaction to what she meant more as a rhetorical question. She was definitely hoping to begin the discussion on a more favorable note then it had ended that morning in the basement. “Did you get something to eat? I could order you a small sandwich or a salad.”

“I had my lunch, thank you.”

“Did you see your consular officer at your embassy?”

“Nope,” Jennifer said and then added, “Mrs. Varini—”

“Please call me Kashmira.”

“Okay, Kashmira. I think we should clear the air. This morning I specifically asked you about Mr. Benfatti. You lied to me. You said you didn’t know anything about a Mr. Benfatti, and then I learn you are his case manager. What gives?”

For a moment, Kashmira pondered her words. She cleared her throat before speaking. “I apologize for that. It came out of a sense of frustration. I was trying to convince you to stay on the subject of your grandmother and the dire need to make a decision, which should not be so difficult. I’m sure you know we do not talk about other patients. That’s what I should have said. I must confess I was exasperated with you, and still am to a degree. I just got a call from Lucinda Benfatti, and she has informed me that you specifically advised her to wait with her decision as well. Now, I know she’d thought about waiting until her sons got here, but I was hoping that after the shock wore off, I could ask her to ask them their preference before they started their trip so the body could be dealt with appropriately. That’s how it has always worked in the past. This kind of problem has never come up before.”

“Are you saying that dealing with patient death is a common problem here?”

“Quite the contrary,” Kashmira said forcefully. “Don’t read something into my words which is not there.”

“Okay, okay,” Jennifer said, afraid she might have pushed the woman a little too far. “Thank you for your apology, and I accept. Actually, I’m impressed how you explained it. I was very curious how you were going to, because I didn’t think you could.”

“This issue about your grandmother has me entirely flummoxed.”

“It’s nice to know we at least see eye-to-eye about something,” Jennifer mumbled.

“Excuse me?”

“Forget it,” Jennifer added. “I was making a bad joke. But there is something I would like to see. I’d like to see my grandmother’s death certificate.”

“What on earth for?”

“I just want to see what it has on it as the cause of death.”

“It has heart attack, just like I said.”

“I’d still like to see it. Do you have it, or at least a copy?”

“I do. It’s in the master folder.”

“May I see? I assume I’ll be getting a copy at some point anyway. It’s not a state secret.”

Kashmira thought for a moment, shrugged, and pushed herself in her chair over to a bank of file cabinets. Pulling out one of the drawers, she scanned the tabs and eventually pulled out an individual file. Opening it, she found a very Indian-looking government document. She returned to the desk, handing the document across to Jennifer.

Jennifer took it, and seeing her grandmother’s name gave her a stab of emotion. The languages were Hindi and English, so she had no trouble going over it. She scanned the hand-lettered entries to alight on the cause of death, heart attack, and the time of death, ten-thirty-five p.m., October 15, 2007. Jennifer committed it to memory and handed the paper back to Kashmira. Kashmira returned it to the file and the file to its rightful place in the cabinet.

Scooting her chair once again back to the desk, Kashmira glanced over at Jennifer. “Now! After all is said and done, are you ready to tell me what we are to do, cremate or embalm?”

Jennifer shook her head. “I’m at my wit’s end as well. But there’s hope on the horizon. My grandmother was nanny to a woman who has conveniently become a forensic pathologist. I spoke with her, and she’s on her way here, which will, I believe, have her arriving tomorrow night. I’m going to defer to her and her husband, who is a medical examiner as well.”

“I remind you, forensic pathologists or not, it will make no difference. There’s to be no autopsy, period. It has not and will not be authorized.”

“Maybe, maybe not. At least I’ll feel like I’ve got someone on my side. I know I’m not thinking too well. I’m utterly exhausted, but I can’t sleep.”

“Perhaps I could get you some sleeping medication.”

“No, thanks,” Jennifer said. “What I would like is a copy of my grandmother’s hospital records.”

“That can be arranged, but it might take twenty-four hours.”

“Whatever! And I’d like to talk to the chief surgeon.”

“He’s very busy. If you have some specific questions, write them down, and I’ll try to get some answers.”

“What if there was malpractice involved?”

“There is no such thing as malpractice in an international setting. Sorry.”

“I have to say you’re not being very helpful.”

“Listen, Miss Hernandez. You would undoubtedly find us more helpful if you would be cooperative with us.”

Jennifer stood up.

“Really,” Kashmira said. “I could get you something for sleep. Perhaps after a good night’s rest you’d come to your senses and realize you must make a decision. Your grandmother cannot stay in our cooler.”

“I already realize that,” Jennifer said. “Why not transfer the body to a regular city mortuary?”

“That would be impossible. Public mortuaries in our country are in frightful condition thanks to our byzantine bureaucracy. Mortuaries are administered by the home ministry, not the ministry of health, as they should be, and the home ministry cares little about them and grossly underfunds them. Some have no refrigeration, others only intermittently, and bodies routinely rot. To be brutally honest, we cannot allow that to happen even to your grandmother because of the potential negative media consequences. We’re trying to help you. Please help us!”

All at once, Jennifer felt off-balance. She got to her feet. Although still being less than tactful, Queen Victoria Hospital seemed to be going from trying to bully her to pleading with her. “I’m going back to the hotel,” Jennifer managed. “I need to rest.”

“Yes, you go have a long sleep,” Kashmira said. She stood as well and bowed over her pressed-together hands.