Robin Cook - Foreign Body

Cal ran in place for a couple of seconds. His shoes were new, and he wanted to make sure they were comfortable. Everything seemed fine. He grabbed his water bottle and headed for the door. He didn’t quite make it. His phone’s insistent jangle brought him to a halt and initiated a rapid debate: Do I get it or do I let voicemail get it?

With so much happening all at the same time, he thought he’d better answer it, but it irritated him. “Yeah!” he said gruffly.

“It’s Sachin,” an equally gruff voice responded.

“Ah, yes, Mr. Gupta,” Cal said with a more businesslike tone.

“You called last night.”

“I did. We have another job. Are you available?”

“It depends on the job and on the compensation.”

“The compensation will be more than the last time.”

“Give me an idea of the scope of the job.”

“It’s an American. A young woman. We’d like to entertain her here for perhaps twenty-four hours, and then we would like her to leave.”

“For good?”

“Yes, for good.”

“Do you know where she is, or is that part of the job?”

“We know where she is.”

“It will be double last time’s charge.”

“How about one and a half times?” Cal suggested. Even though he didn’t care about the cost, he had an irrepressible urge to bargain.

“Double,” Sachin said.

“Alright, double,” Cal responded. He wanted to get out for his run. “But I want it to happen today, if possible.”

“I’ll be by for half the compensation now and for the rest tonight.”

“I’m going out for a run. Give me a half-hour.”

“What is the name, and where do I find her?”

“Her name is Jennifer Hernandez, and she’s staying at the Amal Palace Hotel. Is that a problem?”

“No. It shouldn’t be. We have friends who work in maintenance. We’ll let you know. I’ll give you a call before we bring your guest over for her visit.”

“It’s nice doing business with you.”

“Likewise,” Sachin said before disconnecting.

“That was easy,” Cal said to himself, hanging up the receiver.

“Of course I can see them,” Jack said. He was bending over Laurie, who was semi-recumbent on the examination table. Dr. Arun Ram was standing between her legs, which were draped with an examination sheet, directing the ultrasound probe with one hand and pointing at the screen with the other. He was a short man with honey-colored skin and remarkably dark, thick, medium-length, carefully groomed hair. He was also young: Jack guessed early thirties. What Jack noticed most was the singular gentleness and serenity he projected.

“I’m amazed I can see them so well,” Jack added with excitement. “Laurie, can you see them?”

“If you stop hogging the screen I can.”

“Oh, sorry,” Jack said. He backed up a foot or so. Using his index finger, he counted four in the left ovary alone.

“It’s a wonderful crop,” Arun agreed. His voice matched his composure.

“How much longer with the injections?” Jack asked.

“Let’s measure,” Arun said. Then, to Jack, he added, “Could you hold the probe while I get a ruler?”

“I guess,” Jack said, not sure he wanted to play doctor with his own wife. But he took the handoff of the probe from Arun, and he took it blindly. The image rapidly distorted.

“Careful!” Laurie complained.

“Sorry,” Jack said contritely. Watching the screen, he managed to reposition the probe where it had been. He felt nervous.

Arun opened the exam-table drawer and pulled out a ruler. Placing it directly on the screen, he read out the diameters of the follicles: “Seventeen millimeters, eighteen millimeters, sixteen millimeters, and seventeen millimeters. That’s terrific!” He put the ruler away. “I think we can substitute the gonadotropin trigger injection for your injection shot today.” He took the probe from Jack and removed it. He gave Laurie a reassuring pat on the top of her knee. “We’re done. You can get up, and we’ll meet in my office.” He waved for Jack to follow.

“The trigger will be today?” Laurie asked. “I’m thrilled.”

“We don’t need for them to be much bigger than they are,” Arun said from the doorway, gesturing for Jack to precede him. Inside his office, he moved a couple of chairs over to his desk. Jack took one. Arun sat down and recorded his finds in the chart he’d started for Laurie. “This looks like a very auspicious cycle, with four such healthy-looking follicles poised over the functioning oviduct. Dr. Schoener will be pleased. If the trigger shot is done today, which I’m going to recommend, then the fertilization should be tomorrow. Are we going to utilize intrauterine insemination, or what is your preference?”

“I think we should wait for Laurie,” Jack said.

“Fine,” Arun commented, finishing up and tossing the chart aside. “Did your wife happen to mention that there was a time I aspired to be a forensic pathologist here in India?”

“I don’t believe she did.”

“It’s not important. The reason I didn’t is because the facilities for forensic pathology have been traditionally very bad, for bureaucratic reasons.”

“I notice even a hospital like this one lacks any mortuary facility.”

“That’s true,” Arun said. “There’s little need. Hindu and Muslim families claim their departed immediately for religious reasons.”

“Here I am,” Laurie said brightly, coming into the room. “I’m so excited about reaching the trigger injection. I can’t tell you how much I hate taking hormones.”

“I asked your husband about IUI,” Arun said to Laurie. “He wanted to wait for you.”

Laurie glanced at Jack. “Why did you want to wait for me?”

Jack shrugged. “He asked what our preference was.”

“Well, natural is much nicer. There’s no doubt. But intrauterine gets all those little guys where they need to be. With this much effort, we cannot take any chances. I’m afraid we have to do IUI.”

“Fine,” Jack said, waving his hands in the air.

“Then let’s make an appointment for tomorrow. How about around noon?”

Laurie and Jack looked at each other and nodded. “That’s fine,” Laurie said.

“Noon it is,” Arun said. “We’ll do all we can to see that your little one is conceived here in India. Now that that is out of the way, what is your business here at Queen Victoria Hospital? Is it something I can help you with? I am free. Today is my research day.”

“Do you have any friends who are forensic pathologists?” Laurie asked.

“I do. A very good friend, in fact: Dr. Vijay Singh. He and I have been friends since childhood. We both wanted to go into forensics. He actually did. He teaches at one of the private medical colleges here in New Delhi.”

“Do they have pathology facilities at this medical school?” Jack asked. He was encouraged.

“Absolutely. It’s a medical school and a small hospital.”

“How about autopsy facilities?” Laurie asked.

“Of course. As I said, it is a medical school. They do quite a few academic autopsies.”

Jack and Laurie regarded each other, then both nodded. They knew each other well enough that a significant amount of nonverbal communication occurred between them.

“Arun — do you mind if we call you Arun?” Jack asked.

“I prefer it,” Arun said.

“Do you think your friend Vijay might be willing to allow us to use his facilities? We’d like to do an autopsy.”

“You have to have permission to do an autopsy here in India.”

“This is a special case,” Jack said. “It is not an Indian but rather an American, and the immediate next of kin is here and gives her consent.”

“That is a unique request,” Arun said. “To be honest, I don’t know the legal situation.”