Miracle Cure (28 page)

“Isn’t it wonderful?” she said.

“It is that.”

“My only big concern is how long the clinic is going to remain open,” Lucy said.

“I never thought of that.”

It made sense that once the drug was in general use, the care of most Vasclear patients could be turned back over to their own doctors. Any physician with access to a pharmacy or a UPS truck would have access to Vasclear.
Time, Newsweek
, CNN, evening news programs, now Oprah.… How desperate everyone had been for a drug like this one. And how many hundreds of millions watched those shows and read those magazines? It would be a medical gold rush.

Brian flashed on what Laj Randa had told him about the cost of a course of treatment with the drug. One hundred dollars a dose, fifty or so doses in a full course. And what’s more, the managed-care people and insurance companies, the real controllers of cost in the country, would gladly pay. One quintuple bypass was the equivalent of how many doses of Vasclear? And, Brian reflected sourly, if the patient happened to be a nonresponder like Jack, and that patient was one of those who happened to die before he got into the OR, so much the better.

“Well, the drug still has to be given IV,” Brian said. “For all we know, Vasclear-administration clinics will become all the rage over the next few years, like surgicenters. And even if that doesn’t happen, you’re an
excellent nurse, and I’m certain you won’t have any trouble landing something new.”

“Thank you for saying that. Are you okay, Brian?”

“What do you mean?”

“You just seem distracted. Distracted and sad.”

“I have a lot on my mind.”

“Your dad?”

“Yeah, him. Some other stuff.”

“Anything I can do?”

The question was punctuated with a less-than-subtle mammary nudge. Brian considered asking if she knew the names of the eighteen patients treated during the Phase One evaluation, but thought better of it. Just a word from her to Art Weber, and the fuse would be lit beneath one B. Holbrook.

“Thanks, Lucy,” he said, “but it’s stuff I’ve got to work through for myself.”

On the overhead TV, a barber named Al Morgenfeld from Moline, Illinois, was telling a hundred million people what it had been like to live with severe angina, knowing that each twinge in his chest or shoulder or jaw could be the start of what he called the Big One.

“Dr. Norman,” Oprah then asked, “tell me something. Why haven’t you sent Al for coronary artery bypass surgery like so many thousands of others have had?”

“Well, for one thing,” the doctor replied, “he already had bypass surgery once, seven years ago. Repeat surgery would be riskier. I got wind of Vasclear over a year ago and have been in constant touch with the people at Newbury Pharmaceuticals. We’ve been holding out for a nonsurgical cure of Al’s disease.”

“What you mean to say is that you’ve been holding out for a miracle.”

“Exactly. And I think we’ve got one.”

Brian turned and headed off toward the physician’s office.

“Hey, I almost forgot,” Lucy called after him. “Your girlfriend is in room two.”

“Girlfriend?”

“Nellie—the woman who was willing to turn her daughter over to you”—she ran up and whispered the rest of the sentence in his ear—“as your sex slave.”

“Oh,” Brian said with far less enthusiasm in his voice or expression than he had intended, “thanks.”

He went back to the office, purposely avoiding room 2. It wasn’t Nellie who had him upset. She was a delight. It was what she represented—a Vasclear cure—that upset him.

Why not Jack?
he asked himself for the millionth time.
Why not my father?

Finally, after a few minutes of shuffling papers, he headed in to see her. Nellie seemed, if anything, even more full of life than when he had last seen her at the cake cutting. But she was also very upset.

“Dr. Holbrook, the nurse just told me about your father’s death,” she said. “I’m so sad for you.”

“Thank you.”

“Was it his heart?”

“It was, yes.”

“That must have been very frustrating for you as a cardiologist. I’m so sorry.”

Impressed as before with her intuitiveness, Brian thanked her again, then conducted a fairly brief physical exam, which showed a normal heart and excellent arteries.

“How old were your parents when they died?” he asked.

“Parent,” she said. “My mother is ninety-three and still bright as a penny and living by herself, thank you
very
much.”
It was clearly a question she enjoyed answering. “My father died three years ago at eighty-nine. Believe it or not, he fell off a ladder and broke his hip. The operation did him in. A blood clot in the lungs, they said.”

A pulmonary embolus
, Brian translated to himself—an avoidable complication of not mobilizing the man early and often enough, and inadequately thinning his blood post-op. To all intents, Nellie’s father hadn’t even died of natural causes. Her parents had essentially both lived into their nineties! Usually the most common predictor of cardiovascular disease—positive and negative—was family history. What had happened to Nellie?

“Well, Nellie, the nurse will be in to hook you up,” he said. “Afterward, you can see the secretary about next month’s appointment.”

“Wait, I almost forgot.” She fumbled in her purse and handed him an unsealed envelope with
Dr. Holbrook
printed on the front.

It was a neatly typed letter announcing a twenty-mile charity walk for the homeless and requesting sponsorship for each mile. An attached page summarized a number of similar events in which she’d participated.

“This is wonderful,” Brian said, scanning the list, wondering what his father would have been like with a clean set of arteries. “I’ll be happy to sponsor you.”

He wrote in a pledge, tore off that portion of the letter and gave it to her, then dropped the rest of the announcement into his briefcase. For a decade or more, the battered case had served as his combination medical bag, library, portable desk, and even closet. He would next see Nellie’s papers when he cleaned the thing out, as he was forced to do every week or two.

“Will I see you before I leave?” Nellie asked.

“Only if the secretary has a problem making your appointment.
Otherwise, she has all the schedules, and you can just pick a date.”

She has all the schedules
. The image sent Brian suddenly hurrying to the front desk, where the receptionist, Mary Leander, was filling out an appointment slip for a patient.

“Can I help you, Dr. Holbrook?” she asked.

“Ah … yes. Yes, you can.” Brian realized that he should have taken a minute or two to prepare for this performance. “I was asking Mrs. Hennessey when it was that she shifted from receiving treatments every two weeks to every four and she couldn’t remember. I was thinking the answer might be in the clinic appointment book, but I didn’t know how far back they go.”

Brian hoped his explanation made sense to Mrs. Leander, because it made absolutely none to him.

“Well, I don’t know,” she said. “I think we get a fresh book each year. I have no idea where the old ones are kept, or even if they’re kept at all. Maybe somewhere in the office here.”

She gestured behind her at the ceiling-to-floor shelves of forms, ledgers, procedure manuals, papers, and the like—far more than Brian had time to sift through at the moment. But if there was an appointment ledger from the first year of the clinic’s existence, then maybe he could find the names of the other sixteen patients from the Phase One trials.

“Thank you, Mrs. Leander,” he said. “I’ll check some other time when I have the chance.”

That evening, Brian’s first night duty since before Jack’s death, was blessedly quiet. He had decided to wait until eleven before searching for the first Vasclear-clinic appointment book. At exactly five of, he checked on the
two sickest patients on the ward, reassuring himself that they were reasonably stable. Then he told the charge nurse he’d be on-beeper, left the floor, and slipped into the clinic through the same door Jessup and Weber had used to bring in Walter Louderman.

The place, as before, was eerily dark. Brian decided to keep it that way. He used his penlight to negotiate the long corridor to the receptionist’s office, wondering if, perhaps, the glass-fronted room might be locked.

Despite being alone, Brian moved cautiously. If the door was locked, the game was over and he would return to the ward. But he could see immediately that it wasn’t even completely closed. He slipped inside, hesitated, then flicked on the overhead lights. In the nearly total darkness, the sudden fluorescence was blinding. He allowed his eyes to adjust, then explored the drawers of the metal desk behind the receptionist’s station. Nothing. Next he turned to the bank of shelves.

It took just a few minutes to find them—two thin volumes, leather-bound, obviously purchased from the same stationer, identical to the one lying closed on the receptionist’s desk. Each had a year embossed in gold on the cover. Brian pulled the first one out and settled down on the receptionist’s chair. The appointments were widely scattered at first, but then rapidly filled in. Brian reasoned that what he was seeing was the transition between Phase One patients, who may have been seen initially in their cardiologists’ offices, and the larger double-blind study, Phase Two, which soon grew to over six hundred cases. The clinic, itself, seemed to have been opened two and a half years ago, about halfway through Phase One.

He found early appointments for both Bill Elovitz and Kenneth Ford. Using them as a marker, he began to scratch down names and follow them through the ledger, searching for those who did not have the two weeks of
almost-daily treatments demanded by Phase Two. After twenty minutes the list, counting Elovitz and Ford, had grown to ten. Brian felt reasonably certain that most, if not all, of the ten were Phase One patients. Then, he heard the tones of a keypad being punched, followed moments later by a door opening. A faint shaft of light pierced the darkness in the hall.

On a sudden adrenaline rush, Brian cut the lights in the office, thrust the list of names into his pocket, dropped to his knees, and crawled as quickly as he could out through the darkness to the waiting room. The lights in the hallway flared on. Brian inched toward the patients’ entrance, then ducked behind a sofa as he sensed the intruder approaching the reception area.

Only now did Brian curse himself for overreacting. He had dived for cover like a prowler about to be caught in the act. He was on the faculty of the institute and on duty that night. He also possessed the keypad access code to the clinic and a perfectly legitimate reason for being there—a reason he had established earlier in the day during a conversation with the receptionist, Mrs. Leander. Now, however, it was too late.

The piece of furniture he had flattened himself behind—wooden arms and frame with loose cushions on top—offered some, but not total, cover. Brian lay on the floor looking under the furniture and wondering if all of his seventy-five inches was hidden. He reached down slowly and shut off his pager. But he decided against disabling the code-call beeper. If there was a cardiac arrest somewhere in the hospital, however, his own might follow close behind.

The door to the waiting room was maybe six feet away, but there was no way he could chance going for it. The noise of opening it would probably get him caught, and there was also the possibility it was locked. He
pressed the side of his face onto the heavy-duty carpet and breathed silently.

Suddenly the fluorescents flickered on in the waiting room. Beneath the furniture, Brian could make out the pants legs and sneakers of a man standing across the room. Sneakers? He wondered whether hospital security allowed such dress. The sneakers turned one way then another as the man scanned the room. Then, after an unending two or three minutes, the overheads went off.

Brian sensed more than heard the man retrace his steps. The hallway lights were turned off, and once again the clinic was thrown into pitch darkness. A door opened and shut. It sounded as if it was at the end of the hallway.

Brian waited. Five minutes.… Ten.

Finally, he inched his way to the door and gently tested the knob. No problem. He was about to open it when he remembered the appointment book. He had left it on the receptionist’s desk. He had no stomach for resuming his search for the remaining Phase One patients tonight, but assuming the clinic was empty, there was no sense in leaving the book there to invite questions. Still on his hands and knees, his senses alert for any hint that the intruder hadn’t really left, he inched his way across to the office door and stopped. The silence and darkness were total.

For several minutes, he lay there, listening. Finally, he pushed himself up, opened the door, and turned on the light.

The appointment ledger was gone.

He rushed to the shelves, but only the year 2 book was there. He checked the floor and the desk drawers. Nothing. Once again, his pulse was hammering. Why had the security guard, or whatever he was, thought to take the book? The situation made no sense, but was terrifying nonetheless.

He could not think of a thing to do except return to the ward and worry. Then, just as he was about to cut the light, he glanced up at one side of the office and groaned out loud. A black nozzle protruded from a corner where the bookcase wall, another wall, and the ceiling met—a security camera focused on the glass and the counter of the receptionist’s area, not exactly concealed, but not that easily noticeable, either.

Brian stared at it for a few seconds, wondering who was watching him, and from where. Then, feeling absolutely helpless, he snapped on his beeper, turned off the lights, and left the clinic.

If anyone confronted him about the late-night foray, he still had an excuse, albeit a bit feeble, that Mrs. Leander would support. But no matter what, he couldn’t shake the dreadful feeling that the fuse beneath him had just been lit, and that he had struck the match.

B
Y THREE-THIRTY IN THE MORNING
, B
RIAN WAS PHYSICALLY
and mentally spent. Action on the ward had picked up around midnight, with one patient dropping her blood pressure, and another going into a series of difficult-to-manage cardiac arrhythmias. Neither patient was part of the Vasclear study. It took several hours to stabilize the two women, and Brian was forced to slip a temporary pacemaker into one of them. Finally, all was calm, although by now the muscles in the back of his neck were like braided ropes, and those in his legs ached unremittingly.