Informed Consent (10 page)

W
ynn watched
his son stride away.

That went as well as it could have,
he told himself. Not only had he made his request, he’d managed to get the dead kid’s car off his property. If the authorities found the car in the ferry parking lot, he’d have what the lawyers called plausible deniability. He smiled at his own cleverness. The cancer might be eating away his strength but his mind remained strong and clear.

Only Leonard could tie the vehicle to him, and Wynn didn’t intend to invite him back to the island again. If all went as planned, the next—and last—time he’d see Leonard would be in the hospital for their transplant surgery.

Suddenly, Leonard stopped, three-quarters down the path to the shed, but well short of the door. His head swiveled to the copse of trees to the left of the path and he craned his neck forward, staring hard at something.

Wynn’s heart rate ticked up a notch.
Had he noticed the disturbed earth? It wouldn’t do for Leonard to discover the grave and the body it held. He’d have to kill him, and any hopes of recovery would die with him. Unless he could find a corrupt surgeon willing to do an off-the-books cadaver liver transplant,
he mused. He instantly rejected that idea as impractical.
Too bad; it would have resolved the issue of whether Leonard would agree to the organ donation.

He followed Leonard’s line of sight and realized he was staring at one of the well-hidden traps he’d dug just after moving into The Blue House. He’d been stronger and younger then, and had dug the pits without breaking a sweat. A far cry from his current state.

How could his son have spotted the trap, and what would happen if Leonard fell into it—would his liver be unusable if it were punctured by dozens of sharpened sticks? He’d researched Leonard’s background after Tran had coughed up his name, and he knew his son had some experience as an air marshal. But he hardly expected a flying policeman who’d apparently quit under a cloud to have such a keen eye. He held his breath as he watched Leonard stare at the patch of earth near the stand of dense trees.

After a moment that seemed to stretch into eternity, Leonard continued along the path. Wynn exhaled.

As Leonard proceeded to the shed, Wynn felt an unfamiliar pang of regret. Perhaps if he’d had a different life, he’d be a different man. More like his son.

Eh,
he brushed the thought away, as if it were a gnat.
Things hadn’t been different. They were the way they were. No regrets
, he reminded himself.
No fear, not of death not of anything
.
B.T.K
.

He waited at the window until he saw Leonard ease the dirty Honda out of the shed and along the driveway to the right of the path. Once the car was out of sight, he let the curtain fall over the glass.

S
asha stared
at the side of her husband’s head and willed him to look at her. He didn’t take his eyes off the road ahead. She pondered her next move. He’d been nearly mute since he’d shown up at the dock driving a dusty Civic loaned to him by Wynn. The closest he’d come to answering any of her questions had been monosyllabic grunts and cautioning looks, which she assumed meant he didn’t want to talk about his meeting in front of Captain Nicholas.

And that was fine. Understandable, even. So she’d spent the boat ride asking Eli Nicholas inane touristy questions and learning interesting facts like lobster traps, once thought to be inescapable, were in fact the equivalent of lobster revolving doors.

But once they were back on the mainland, situated in the rental car, with two sleeping babies in the backseat, she
had
expected some conversation. Instead, he was doing an excellent impersonation of a taciturn Mainer.

She hit the button to turn on the radio.

“What are you doing?” he asked without turning his head.

“Looking for a public radio station. Staring at the patch of gray hair over your ear isn’t as scintillating as you might think it is.”

A shadow of a smile flitted over his lips then evaporated instantly. “That’s silver, not gray, thank you very much.”

“He speaks!” she said in mock surprise.

He sighed, letting out a great
whoosh
of breath. “I don’t what to talk about it, yet. Later.” He flicked his eyes in her direction. “Okay?”

“Of course it’s okay. But I can tell that whatever you and Doug Wynn talked about is bothering you. I’m here whenever you’re ready to tell me.” She squeezed his hand to let him know she meant it.

He lifted her hand to his mouth and kissed it. “I don’t deserve you.”

“You really don’t,” she agreed. He gave her another sidelong glance, and she laughed so hard her sides ached. “Just kidding, silver fox.”

After a few moments, she spoke again. “I meant to ask you about the car Doug Wynn lent you to drive back to the ferry.”

“What about it?”

“I’m sure it’s just a coincidence, but somebody reported a black Honda missing. There was a flyer up in the café. Actually, two. Stolen—or as the flyer said—misplaced black Honda Civic. And a Chinese kid—well, a young guy—who’s gone missing. He was last seen in Mt. Desert.”

Connelly’s cheek twitched. “Was there a picture of the guy?”

“Yeah. Tall, skinny Asian kid. Last seen wearing a leather jacket and jeans.” She gave a wry laugh. “Not much to go on.”

“Oh, it’s plenty.”

She turned and gave him a puzzled look, but he didn’t elaborate.

They drove in silence for several miles before he blurted, “His name’s Duc Nguyen.”

She startled. “Who? The kid? I don’t think that’s what the poster said.”

“Doug Wynn. His real name is Duc Nguyen.”

She considered this piece of information. “Nguyen? Is that Vietnamese?”

“Yeah. He Americanized it when he came here.”

“So, does he actually know your dad?” she asked, her excitement mounting.

“Something like that.”

His dry tone didn’t match the import of that face. “Something like that? What does that mean.”

He negotiated a hairpin turn in the road before answering her. “He
is
my dad.”

For a moment, she thought she misheard him. “Doug Wynn is your father?”

“Yes.”

She waited for something more. A display of emotion, an explanation of how his long-lost father was going to fit into their lives going forward. Something. But Connelly had lapsed back into silence.

“I don’t understand,” she finally said. “Why didn’t you bring him with you to meet us? Or why aren’t we staying with him? What
happened
up there?”

“Well, one thing that happened is I found a
punji
pit in his backyard.”

“A what?”

“
Punji
pit. The Viet Cong used them to ambush soldiers. They’d dig a pit and fill it with sharpened sticks, sometimes the points would be smeared with poison or excrement from wild animals. Then they’d cover the pit with leaves and grass and wait for some poor soul to stumble into the trap.”

“Wait. What? His backyard was booby trapped? If you’d have fallen into it, you’d have been impaled.” she asked, her stomach turning at the thought.

“Probably,” he agreed.

After a moment’s silence, she asked, “Your dad was with the Viet Cong?” She couldn’t imagine how a United States Army nurse and a Viet Cong soldier would have struck up a romance.

He shook his head. “I don’t think so. I think he really was just some farm kid. But, he would have known how to make a trap. Everyone living in the war zone would have been aware of them.”

“Okay. So why’s he have one in his freaking yard?”

“Security, I’m guessing.”

“Security? What’s wrong with an alarm system?”

“I don’t know his story, Sasha. But I’m guessing he has the kind of enemies that aren’t going to be put off by a Guardian Protection sign in the flowerbed.”

“Good Lord.”

“And unless I’m mistaken, your missing Asian guy is the messenger he sent to Pittsburgh.”

She caught the tremor in his voice and knew that he was thinking the same thing she was: the kid was missing, and Connelly had just driven a stolen car to the dock, conveniently removing evidence of a possible crime from his father’s property.

“What have we done by inviting this man into our lives?” She glanced back at the two car seats and realized she was shaking.

“Oh, don’t worry. He doesn’t want to be in our lives.” He barked out a mirthless laugh.

“Now, I’m completely confused. What do you mean? He obviously wants a relationship with you. He went through the trouble of tracking you down.”

“He was very clear about the fact that he doesn’t want anything to do with us.” He hit the turn signal and headed up the gravel driveway that led to the rental house.

“We’ll if he doesn’t want to be a part of your life, what does he want?”

Connelly pulled up to the charming front porch and brought the car to a stop. He twisted in his seat and looked into her eyes. “My liver.”

T
roy assumed
he’d be the first one into the laboratory, considering that the sun hadn’t yet even begun to poke its face over the Downtown skyscrapers when he raised his identification badge to the card reader and waited for the click.

But when he eased open the door to the lab, Mikki looked up at him from a thick binder.

“Oh, hi,” he said in surprise.

“Morning. What are you doing here so early?” she asked with a smile.

“I was just about to ask you the same thing.”

She turned to face him full on, and he could see the excitement shining in her eyes. “Dr. Allstrom texted me. She said we’re going to have a brain sample later today.”

“She texted you?” he echoed. Confusion and disappointment warred with anger but he wouldn’t take it out on Mikki. That wouldn’t be fair.

Mikki cocked her head. “Yeah. Did she text you, too? I can handle it on my own. In fact, someone must have come in and prepped everything last night. All I need now is the brain slices.”

His shoulders slumped forward. “That was me. I was at Golden Village when Mrs. Chevitz took a turn. Dr. Allstrom told me to come prep. I just assumed …”

“I would have assumed it was my brain, too, under the circumstances,” Mikki was quick to reassure him. “It’s not like Dr. A to play favorites. I’m sure it was an oversight.”

“I guess,” he said, unable to keep the dismay out of his voice.

“Listen. You did all the grunt work. And you’re here now. Let’s just do the work up together.”

He blinked and studied her closely. “Do you mean it?” Dr. Allstrom might not typically play favorites, but the research team was less a team working together and more a pit of competitors jostling each other for primacy. “That’s awfully solid of you.”

Mikki shrugged. “Karma. I’d want someone to do it for me. So, come on,” she waved him toward the metal table and smiled.

They bent their heads over the binder and silently reviewed the procedure for isolating the cortical gray matter that they would need for comparison to the demyelinated gray matter already fixed on the slides from the recently deceased patients with dementia.

After Troy was confident he had a handle on their task, he looked sidelong at Mikki. “It’s amazing, isn’t it?”

“This is the missing piece. This is
it,
Troy.” Her voice shook with enthusiasm.

“I’m so glad Dr. Allstrom was able to convince the family and treating physician. I was concerned they wouldn’t consent given their religious beliefs.” Troy gave voice to the worry that had niggled at him all night long.

“What do you mean? Mrs. Chevitz was already enrolled.” She wrinkled her forehead and gave him a questioning look.

“Right, but she’s an observant Jew. The Jewish religion has a prohibition against autopsy. Dr. Allstrom said she was going to talk to the clinician and explain how important Mrs. Chevitz’s sample is to our work.”

Her curious expression morphed into one of concern. “Are you sure? About the autopsy prohibition, I mean.”

“Yeah. I dated a girl whose family was super religious. Her dad was a rabbi.” He laughed at the memory. “Boy, did he hate my Episcopal butt.”

“If that’s the case, then why are the Chevitzes allowing the autopsy?” Mikki pressed.

He answered slowly. “I’m not an expert, but I know there are exceptions to the ban on desecrating the body. I guess Dr. Kayser explained how many productive lives could potentially be extended if the medicine makes it to the market. It’s a close question, because I always thought
halakhah
would usually only make an exception if the autopsy could save a specific, known person. Or … something like that. Also, I guess it would depend on if she’s Orthodox, Reform, or Conservative. They have different beliefs—it’s almost like the differences between the various Protestant denominations.”

“What’s
halakhah
?”

“Jewish law. But, anyway, it’s awesome that they signed the consent.”

She gnawed at her lower lip for a second and then wheeled her stool around to grab a folder off the desk behind her. She flipped through it twice before she looked up at him with a pained expression. “There’s no consent in here, Troy.”

They stared at each other in mutual dismay for a moment.

“I’m sure she got one,” he finally said.

“What if she didn’t?”

He shook his head, rejecting the very idea. “She must have. I’m sure she would have. She was going to talk to Dr. Kayser when I left to come over here last night.”

“I guess she did,” she agreed halfheartedly.

Troy’s thrill of anticipation turned into a blanket of anxiety. He ignored the cold clench in the pit of his stomach and turned back to the binder, pretending he was reading the protocol again and pretending not to feel Mikki’s worried eyes boring into the back of his head. After a few moments of silence, she slipped off her stool and left the room. He kept his eyes on the page in front of him.

A
l Kayser woke
from his four-hour nap and checked the time on the bedside clock. Six o’clock on the dot. He picked up the phone and pressed the zero button.

“Good morning, Golden Village,” the calm voice of the weekend receptionist said, smooth as silk.

“Good Morning, Ella. This is Dr. Kayser. How’s my patient doing?”

“Mrs. Chevitz? The attendant just checked on her. She’s sleeping peacefully. Her kids … not so much,” her voice dropped a notch and took on a mournful note.

“I’d imagine. These next days will be hard for them, there’s no doubt about that. I’ll get cleaned up and head over. Will you let them know I’m on my way?”

“Will do. Do you have everything you need? I can send an aide over with towels or toiletries.”

“I always keep an overnight kit in the car,” he assured her, “so I’m all set. But I appreciate the offer. I’m just thankful you folks are kind enough to let me use a vacant cottage in situations like this.”

“Oh, Dr. Kayser,
we’re
so grateful to
you
for taking such good care of our guests.”

He hung up and headed to the bathroom, his spirits buoyed by the genuine appreciation in Ella’s voice. He washed his face, shaved, and brushed his teeth with the series of economical movements he’d used every day since his long-ago residency. He locked up the room and returned his Dopp kit to his trunk, then crossed the lawn to the main building. Once inside, he greeted Ella and checked his watch.
6:10 a.m.

As he started toward the hallway to Adina’s room, the main lobby doors opened with a pneumatic whine, and the sound of running feet hitting the tile floor echoed through the space. Ella’s welcoming smile turned frosty at the disturbance, and Al glanced over his shoulder to see his a young Japanese woman sprinting toward him. Her white lab coat billowed out, and her long, loose dark hair trailed behind her like kite tails.

“Dr. Kayser? Are you Dr. Kayser?” she called.

Ella sprang out of her chair. “Young lady, please lower your voice,” she scolded with as much disapproval as Al had ever heard her muster.

“I’m sorry,” the woman stage whispered as a crimson stain worked its way up her neck to her cheeks. She closed the gap between herself and him, “Are you Dr. Kayser?” she repeated softly.

“I am.”

A ripple of relief rolled across her face. “Oh, thank goodness. Mikki Yotamora,” she said, sticking out her hand.

“Ms. Yotamora,” he said then corrected himself after glancing at her embroidered coat pocket, “I beg your pardon, Dr. Yotamora. What can I do for you?”

She caught her breath and seemed to screw up her courage before answering. “I’m doing graduate work for Dr. Greta Allstrom. I’m on her research team.”

Al didn’t know what she’d say next, but instinct told him it wouldn’t be good. “I see,” he said to prompt her.

“Dr. Allstrom had me come into the lab very early this morning to prep for some important brain tissue slices she expects to receive today.”

His stomach dropped. “Not from Adina Chevitz?”

She nodded. Her eyes were wide and sad. “Another researcher and I were chatting while we worked, and he mentioned that it was lucky that the Chevitz family had agreed to the donation because their religion prohibits autopsy. Is he correct?”

“I think you know he is. That’s why you’re here, isn’t it? To warn me?” he asked gently.

“I … I’m here because I’m concerned. I wanted to double check. The only consent form in our file is several years old. It permits blood draws. I thought, maybe, there was an oversight and the consent to harvest brain tissue was left in her room or something.” She said the words haltingly, as if she were searching for some reasonable explanation for her boss’s behavior.

“I assure you they were not. Adina Chevitz is a very religious woman, and her Jewish faith is important to her. She did not consent to a post-mortem autopsy of her brain, as your lead researcher well knows.”

Mikki Yotamora’s lower lip quivered. “She’s critical to our study. It’s so important that we compare our results to her gray matter to see—”

His anger flared. “Did Dr. Allstrom send you over here to wheedle me?”

“What? No. No, she doesn’t know I’m here. Please, you can’t tell her.” The color drained from the woman’s face.

“I promise not to mention it,” he assured her as his rage at Dr. Allstrom subsided in the face of her student’s obvious fear. “Would you like to speak to Mrs. Chevitz’s son and confirm for yourself that she doesn’t wish to participate?”

“No, I can’t do that.” She had the expression of a trapped animal, unable to flee but aware that she was stuck.

“Okay, let’s do this. You wait here, and I’ll double check. I give you my word that if the family is willing to allow the brain study, I’ll get you a signed informed consent form.”

She nodded. “Thank you. Please explain that she’s the missing piece. If we can see her gray matter and compare it to the gray matter of the patients who took the supplement, we’ll be leaps and bounds closer to getting our drug to market. It’s
so
crucial.”

“I’ll tell the family.”

He left the graduate student standing in the hall and gave soft tap on Adina’s door.

“Come in,” she called in a shaky voice.

Her sons and daughters were arranged in a semi-circle around her bed, with red-rimmed, puffy eyes. He nodded to the children and then crossed the room to clasp Adina’s hand.

“How are you this morning, dear?”

“I’m ready, Dr. Kayser. Whenever He is, I am.” She smiled, then her gaze shifted to her family. “They’ll take good care of each other, I know.”

“We will, Mother,” Ruth sobbed.

Al puffed out his cheeks and exhaled. “I have to ask you a question, Adina.”

She nodded, looking up at him with clear brown eyes, still smiling.

“The researchers who come in and take blood samples every now and again, you know who I mean?”

“Yes, sure.”

“They’re very interested in your brain.”

“It’s a good brain,” she agreed solemnly.

“It is a good brain. It’s served you well. And they’re trying to understand how to help folks whose brains aren’t as long-lasting and healthy as yours is in the later years. They think your brain might hold the key.”

“Alzheimer’s. Dementia. I’ve lost lots of friends to the fog of their memories. More than I can count.”

He was sure she had. “I told the researchers that your Jewish faith prohibits any post-mortem study of your brain because I believe that to be true. But I’m certainly not a rabbinical scholar, and they’re very eager. So I told them I would confirm with you. Are you willing to let them have a part of your brain?” He continued to hold her soft, warm wrinkled hands in his as he spoke, and she neither stiffened nor reacted visibly to the question.

Her son made a guttural, wordless shout of surprise, and Ruth’s sisters joined her in a long wail. But Adina shushed them all. “I can’t think over that noise. Quiet yourselves.” She tilted her head and blinked at him from behind her oversized, once-fashionable glasses. “It’s not
just
my brain, is it? I mean, they could look at a gentile’s brain to answer this, yes?”

“Yes,” he agreed. “As I understand their work, they need brain tissue from a mentally competent member of the study who didn’t take their supplement. That’s the control group. There surely aren’t many of you, but you aren’t the only control.”

She thought for a long moment. “Then, no, I’m afraid I can’t help them. It would be a
mitzvah,
perhaps. But, no, it’s not natural. I’ve lived a good, faithful life. I want a good, faithful death. Don’t leave my body alone. Call the burial society right away. Get me in the ground as soon as you can. Sit the
shiva
.” She had turned toward her children and was speaking directly to Ralph.

“I will, Mother,” he promised.

“I hope I haven’t upset you,” Al said.

“No, I’m not upset.” Adina released his hand, shrugged her narrow shoulders, and raised her palms to the ceiling. “You don’t ask, you don’t get.”

He laughed and patted her arm, “I’ll let them know. I’ll be back in a bit.”

As the door closed behind them, she called, “Tell them I said
mazel tov!
”

Mikki Yotamora pitched forward expectantly when she saw him. “Did she agree?”

“No. She’s adamant about her wishes. No autopsy. She wishes you good luck with your work, but she can’t help you.”

The young woman lowered her head and seemed to collapse in on herself, scooping her spine and shoulders into a C. “Thank you for asking.” Then she looked up with a spark of fear. “What do I do about the standing order? I can’t cancel it. Only Dr. Allstrom has authority.”

“What order?”

“With the on-call morgue. She already put in the papers. That’s why Troy’s sitting in the lab waiting. Everything’s in place.”

“You go back to the lab. Don’t tell anyone you talked to me. I’ll take care of the rest,” he muttered darkly.

She nodded.

As she turned to go, he stopped her. “You were right to come find me. That inner voice that told you to do it—don’t let it fade. You’ll need it again in your career, trust me. As long as you keep listening to it, it’ll be there.”