Endorphin Conspiracy, The (20 page)

Chapter 35

It had to be Kapinsky. Kapinsky was always the first one there, long before rounds in the morning, the last one to leave at night. He had been there at Jessica’s bedside the night before she coded, had examined Smithers before he was discharged to the seventh floor. Kapinsky was the resident on the service when Jesus Romero was admitted with his head injury; Kapinsky had had contact with the rabbi when he was a patient at the Trauma Center as well. Kapinsky, the fucking fly in the ointment, whose fumbling hands were a hazard in the operating room, who should have been bounced by Pederson from the program,
but never was
.

If Kapinsky had been part of this thing, why was he murdered? Had he had second thoughts, threatened to expose the conspiracy, or did he just screw up somehow? Who else was in on the project?

His mind racing, he got up, walked to the kitchen without turning on any lights. Geoff was ravenously hungry, so he made himself a peanut butter and jelly sandwich on stale white bread and popped the tab on a Budweiser. The head from the beer foamed out of the can and spilled down the sides, forming a large puddle on the countertop. Geoff looked around for a sponge or a paper towel, using the refrigerator light for illumination, but could not find one. “Didn’t Kapinsky ever clean this dump?”

He opened a few drawers and came upon a pile of neatly folded dishtowels. That was more like it. It seemed like Kapinsky to have folded them so neatly. Geoff’s thoughts returned to Kapinsky’s role in all this, his murder, the suicide note. He still couldn’t believe Kapinsky had written the note, nor that he was gay, as asexual as he had known him to be. If Geoff was wrong, if that was all true, there had to be some kind of evidence here of a relationship, something indicating his despair, his depression. Letters, notes,
something
.

Geoff walked back to Kapinsky’s desk, searched the drawers with a penlight. He came across three by five cards on neuroanatomy, class notes, research papers, nothing personal.

Geoff got up, moved to the dresser, examined the photos resting on top. Kapinsky with his sister and mother at med school graduation. His hair was not as thin, no mustache. Geoff smiled. Without the mustache, Kapinsky looked a lot like his mother.

He searched the drawers, top down. Nothing in the top two but a silver dollar collection hidden in a sock, a small switchblade pocket knife. Geoff placed the knife in his sweat pants pocket. It might come in handy. Geoff tried to open the bottom drawer. It was stuck at first, but he managed to jiggle it open. Running shorts, a jock strap, a box of condoms. Not so asexual, after all. Nothing else of note. No hidden envelopes, photos, notes. Nothing. Geoff was disappointed.

He tried to close the drawer, but it jammed on the track. He jiggled it again. Geoff heard something drop to the floor behind the drawer. He pulled the drawer off its track and out, got down on the floor, searched with the penlight.

Geoff was startled when
he saw a small, bound, composition notebook. Geoff held up the book so he could see the writing on the cover in the penlight’s dim light. In Kapinsky’s hand was scrawled the simple word, “Journal.”

Geoff stood up, walked over to Kapinsky’s desk and sat down. He was hesitant to turn on the lamp and instead continued using the penlight, though it was beginning to flicker.

The first entry was dated July 1, 2003. Geoff tried to think back to that period of time and reconstruct his own life. He had been working like a dog as a second-year resident and had been happily married to Sarah for two years.
Happy times.

The penlight flickered and went out, the room now illuminated only by the dim rays of slivered moonlight streaming between the slats of the window blind. Geoff played with the penlight until he got it to work again and returned to the first entry.

For Kapinsky, the rookie, it was the first day of his internship.

“Started my internship in Neurosurgery at the New York Trauma Center today. I can’t believe I’m here! Spent last night wandering the halls of the Center. Came back to my apartment so charged up I finished reviewing my neuroanatomy book again. Everyone else was out partying. I’m sure I got a good head start on them all! Hundreds of young doctors from around the country would die to be here, and here I am. Howard Kapinsky from Queens at the fucking New York Trauma Center. It’s going to be great. I’ll show them all!”

Kapinsky’s boyish excitement brought a smile to Geoff’s face. He scanned down the page. “I’ve been assigned to a team lead by Dr.Geoffrey Davis. He’s a tall, good-looking gentile—G-d, even the name is blue-blooded—athletic, smart, charismatic. Probably a great surgeon. A real lady-killer, at least that’s the scoop here among the staff in the hospital. He’s everything I wish I were. Maybe if I stick with him throughout this residency some of it will rub off.”

The reflection of Kapinsky’s deep-seated insecurity and envy was unsettling. Geoff weeded through the pages one at a time, looking for the slightest inkling of anything to do with endorphins, the project, spies,
anything
relevant.

Geoff found it strange Kapinsky never wrote about relationships with any women in his life, except his mother of course. There was a detailed cataloging of interesting cases, almost verbatim transcripts of his ongoing verbal battles with Geoff at rounds, further signs of Kapinsky’s deep insecurity. It was all very personal, and ultimately it felt to Geoff like a violation to be sorting through another person’s innermost thoughts and feelings, especially when Geoff himself was so much an issue.

Until Geoff came across the entry dated November 25, 2009. “Had another big problem in the O.R. today. It was finally my opportunity to do a case as the first surgeon, a simple burr hole in the skull to relieve a sub-dural hematoma, and I drilled right into the brain tissue. I felt awful, but Dr. Pederson, though he was angry at first, was very understanding. He took me to his office after the operation and let me know it was obvious I didn’t have the manual dexterity to be a surgeon. He said I had two choices: leave the program, something I could never do, or do medical neurosurgery (Is there such a thing?) and get involved part-time in an exciting research project he and Dr. Balassi had been working on jointly. Geoff worked with Balassi for a year, so I think I’ll take Pederson up on it.”

Geoff read on. January 10, 2010. “The project is exciting. It has to do with new endorphin analogs to be used for pain control in head injury patients. It’s all pretty hush-hush, though, and I was warned by Balassi not to talk about it with anyone. His assistant, Walter, keeps an eye on things constantly, and I catch him checking on me now and then. That guy gives me the creeps! It seems there’s a lot of industrial espionage going on in the biotechnology industry, and PETronics Corporation wants to be the first to hit the market with the new drug before anyone is even aware of the possibility. It’s great to be involved with something like this.

“January 19, 2010. Great news! We completed synthesis of an endorphin analog today, and according to Balassi, we were given the okay by the FDA for human trials. And guess what, little Howard Kapinsky from Queens is to be the one to administer this breakthrough drug!”

Geoff nodded his head in dismay, then continued reading. “It has to be given in a special way, since it would be broken down rapidly in the bloodstream, but I dare not mention it, even here. No one’s to know about any of this. PETronics Corporation is still paranoid about someone stealing their idea.”

“How’d you inject it, Kapinsky? How’d you inject it?” Geoff whispered as he bit his bottom lip and flipped forward searching for the answer.

“March 16, 2010. I’ve been very busy on the wards during the day and in the lab at night. Geoff and I have been at odds, and it’s very upsetting, more than he knows. I’ve come to a realization as to why there’s so much friction between us, but it’s difficult for me to write. I’ve told no one...” The entry trailed off at the bottom of the page.

“Come on, Kapinsky, get it out!” Geoff muttered in frustration. He turned the page.

“It’s, and this is difficult for me to admit even to myself in my own journal, that I’m attracted to him, that I’m... I’m...gay.”

No shit! Just like O’Malley said. Geoff read on.

“That’s right—gay. Besides my fantasies about Geoff, I had my first sexual relationship with another man last month. His name is Ricardo, a very hot Puerto Rican lab tech working with Balassi. It was very satisfying, much more so than it has ever been with a woman, though there haven’t been very many. No pressure, no expectations, nothing. It’s the best I’ve ever been treated, by man or woman. I’m worried, though, about people at work finding out. It probably wasn’t smart to get involved with someone at work. But it gave me pleasure. Something I haven’t had much of in my life.

“April 3, 2010. It was one of the worst days of my life. Dr. Balassi called me into his office and showed me photographs of me and Ricardo last night. My G-d, does Pederson know, too? Balassi wants to meet with me tomorrow. I’m scared shitless. My life could be ruined.”

“Son-of-a-bitch,” Geoff muttered. “One of the oldest tricks in the book.”

“April 4, 2010. Shock and surprise! I saw a side of Josef Balassi today I never dreamed existed. He was understanding and sensitive to my situation and promised not to tell Pederson or anyone else. He said my secret was safe with him. In fact, he said I could stay with the lab. Now that he knew something so intimate about me, he felt as though he could trust me more and would let me in on a new aspect of the project.”

“May 12, 2010. No entries for a while. Things have taken a turn. Walter’s peering at me strangely these days. He gives me the creeps. I think Balassi must have told him. I’m being blackmailed to remain with the project and do more than I want to, more than I should do as a physician. I don’t think Balassi would do it, but, G-d, if those photos get out about me, and my family found out, I don’t know what I’d do! Balassi’s not what I thought he was. I’ve totally fucked up my life.”

Geoff continued reading. He noted a definite change in the tone. Despondent was a good description. Kapinsky’s handwriting, normally akin to Chinese, had become total chicken-scratch, barely legible. Fortunately, Geoff was used to deciphering it in patient charts.

“May 25, 2010. I was told to inject a new compound today into a patient named Jesus Romero. Carried it out per instructions, but no effect noted yet. I think the stuff has a delayed reaction. The new analog they’re working on is going to be more immediate. I’ve had it with this! I didn’t spend my whole life training to become a slave! I’m going to do some snooping around on my own and see what’s really going on, what Balassi’s hiding.

“July 03, 2010. Snooped around Balassi’s desk after he left for dinner. The lab was empty. Found a list of what appears to be patient numbers under the heading Sigma Project. Balassi’s getting careless in his arrogance. There’s big time involvement here. Is this a James Bond movie or real life? Sometimes I think it’s all just a bad dream. How did I let myself get involved in all this? I must have been set up from the beginning. Shit, I’m scared!

“The numbers under the Sigma Project match patients I injected already in the NSICU. The other is a little girl who was just admitted a few days ago. I won’t do it even if he threatens to announce my secret on the reader board in Times Square!”

“Kapinsky, you coward, how could you?” Geoff swore under his breath.

“July 05, 2010. I tried to refuse, but Balassi brought Pederson in and showed the photographs to him right in front of me! I’ve never been so humiliated in my life. They forced me to carry it out. They said it was a newer analog and would bring her further out of her coma, that it wouldn’t cause any harm, that it was part of a classified experiment backed by the United States Government,that it would be tantamount to treason to refuse. Well, I could live with that, but I removed myself from the situation in a way they’d never know. I left it there at her bedside in a syringe marked “irrigation.” The nurse did the job for me without realizing it. My G-d, what have I become?”

When you have eliminated the impossible, whatever remains, however improbable, must be the truth.

Of course! The only way to reach the deep brain tissue was to deliver it
directly
, and the only way to do that and evade detection was to deliver it with an entry site that was already there:
the ICP bolt!

Every one of those patients—Romero, the Rabbi, Jessica, DeFranco, Smithers—had ICP bolts drilled through their skulls that communicated directly with the space around the brain to measure the pressure in their heads and monitor their levels of injury. The lines were flushed daily. It was not a difficult chore to substitute the endorphin, or any substance for that matter, with the saline irrigation. The nurse on shift that night delivered the substance without knowing it when she irrigated the line.

Geoff resumed reading. “After she coded, they said it must have been too potent to inject directly into the brain. They would have to refine the analog further. I was instructed by Balassi to start raising the suspicion of a mercy killer on the loose and plant evidence to implicate Geoff. Tie it in with a drug problem. Balassi told me Geoff had had one in the past. I was supposed to accuse him of forging medication logs. At first I refused, then Walter—I hate that man—came to visit me at my apartment that night and...it was awful.”