Robin Cook (27 page)

Dr. Nachman looked at Glover and Mitchell, who smiled and shrugged. “I suppose we could show you some of the facilities tonight,” said Dr. Nachman. “Are you sure you are not too tired?”

“Not in the slightest,” said Adam.

Dr. Nachman stood up, followed by Dr. Glover and Dr. Mitchell. The others excused themselves,
preferring to remain at the table for more coffee and after-dinner drinks.

Dr. Nachman led Adam back to the main building, where guests signed in. Then the four went through another set of double doors to the research center. This part of the building was floored in white tile, the walls painted in bright primary colors.

“These are the administration offices,” explained Dr. Nachman. A moment later Adam found himself crossing a glass-walled bridge. He could see palm trees waving on either side and realized that there were two concentric buildings, one nestled inside of the other, much like the Pentagon in Washington.

Turning down another hallway, Adam smelled the unmistakable odor of caged animals. Dr. Glover opened the first door and for the next half hour led Adam from room to room, explaining the complicated machinery and examining an endless number of rats and monkeys. This was where Arolen was doing its basic fetology research.

To Adam's surprise, white-gowned technicians were working in some of the labs, despite the late hour. Dr. Glover explained that ever since they'd begun to get positive results with fetal implants, they'd been working around the clock.

“Where do you get your material?” asked Adam, pausing by a cage of pink mice.

“Most of the research is done with animal systems,” explained Dr. Glover, “and we breed our animals right here at the center.”

“But surely you're doing some human implants. Where do you get your tissue?” persisted Adam.

“Very good question,” said Dr. Glover. “We did run into a bit of a problem after restrictive laws
were passed, but we've managed one way or another. Most of our material comes from the Julian Clinic.”

Adam wanted to pound the glass cases in frustration. Why couldn't he get anyone to listen to him? Obviously, doctors like Vandermer were increasing the supply of fetal tissue by merely increasing the number of therapeutic abortions.

“Tomorrow,” continued Dr. Glover, pleased that Adam was demonstrating such interest, “we will take you into our hospital wing. We've had some amazing results, particularly in treating diabetics with fetal pancreatic extracts.”

“I know how interesting this is, but I think Dr. Mitchell would like to describe some of his work,” said Nachman, smiling at Glover.

“Indeed,” echoed Dr. Mitchell. “A year from now, when the sales figures are in, we'll see whose department accounts for the biggest increases.”

Mitchell devoted the next thirty minutes to a nonstop monologue on psychotropic drugs, particularly a new brand of phenothiazine. “It's effective for every type of psychotic condition. It's essentially nontoxic, and it changes the most disturbed individual into an exemplary citizen. Of course, some spontaneity is sacrificed.”

Adam started to protest, but thought better of it. He was certain that “some spontaneity is sacrificed” was the company's way of downplaying the drug's side effects. Certainly the stewards on the
Fjord
and the orderlies at the Julian had lacked “spontaneity.”

“What's the name of this new drug?” Adam asked instead.

“Scientific, generic, or trade name?” asked Dr. Mitchell, out of breath from his monologue.

“Trade name.”

“Conformin,” said Dr. Mitchell.

“Would it be possible for me to get a sample?”

“You'll be able to get all the samples you want when the drug is released,” said Dr. Mitchell. “We're waiting for FDA clearance.”

“Just a small amount?” asked Adam. “I'd like to see how it's packaged. As a sales rep, I've learned how important that is.”

Dr. Mitchell looked at Adam strangely. “Perhaps a small amount,” he murmured.

Adam didn't push the issue, saying, “If the drug is close to being released, then you've started human testing.”

“My word, yes,” said Dr. Mitchell, brightening. “We've been using the drug on humans for several years, on patients with intractable psychiatric problems brought in from all over the world, in fact. The drug has proved one hundred percent effective.”

“I'd like to visit the ward,” said Adam.

“Tomorrow,” said Dr. Mitchell. “Right now, I'd like to show you our main chemistry laboratory. It's one of the most advanced in the world.”

There was no doubt in Adam's mind that Arolen's research facilities were superb, especially when compared with those at University Hospital, where money was so tight that every No. 2 Mongol pencil had to be included in grant requests. But after seeing so many labs, Adam became bored. He tried to look interested, but the longer the tour went on, the more difficult that became.

“I think that will be enough for tonight,” said Dr. Nachman finally. “We don't want to exhaust Mr. Schonberg on his first evening with us.”

“I'll second that,” said Dr. Glover. “We only spent half an hour in my department.”

“That's because there is more to see here,” said Dr. Mitchell.

“Gentlemen!” interjected Dr. Nachman, lifting his hands.

“I've enjoyed all of it,” protested Adam, careful to use the past tense so as not to encourage an encore from Dr. Mitchell.

They walked down the main corridor and crossed the connecting bridge to the outer building. Adam stopped to look behind him. He could see that the bridge continued beyond the corridor to a third interior building, which was blocked off by heavy steel doors.

“What's back there?” asked Adam.

“The clinical wards,” said Dr. Nachman. “You'll see them tomorrow.”

That must be where the psychiatric ward is located, thought Adam. He hesitated a minute, then followed Nachman out to the main lobby where they all said good night.

It was quarter to twelve, and even though Adam had had a busy day, he was not sleepy. A dull headache was beginning behind his eyes, and he could not forget he had only two more days to come up with convincing, concrete evidence. Even if he got a sample of Conformin, it would take time to have it analyzed, and then even more time to try to convince someone like Vandermer to have himself checked to see if he'd received it. Knowing sleep was out of the question, Adam opened his door and walked the length of the corridor to the far elevator. A small Formica sign said “Bathers' Elevator.”

Descending to the ground floor, Adam found himself outside in a dense garden of palms, bamboo,
and ferns. A curving pathway led through the lush vegetation. Following it, Adam arrived at the beach.

Taking off his shoes, he stepped onto the cool sand. The full moon made the night almost as bright as day. The sand was smooth and soft as powder. A slight wind rattled the rigging of the Hobie Cats so that they sounded like Japanese wind chimes. Adam could understand why people like Bill Shelly were so enchanted with the place.

Passing the club, Adam could see into the dining room. A few of the busboys were still laying the tables for the next meal.

About a hundred yards beyond the club Adam saw the condominiums. They were designed in a pseudo-Spanish style with stuccoed walls and red tile roofs. Lights were burning in some of the residences, and Adam caught glimpses of men and women watching television or reading. The whole scene was so peaceful it was hard to believe it could be the center of some gigantic conspiracy. Yet apparently it was. All drug firms spent millions of dollars attempting to influence the purchasing behavior of doctors, but MTIC wanted more. It wanted to control the doctors. It was no wonder that Arolen was planning to reduce its sales force.

Adam turned and retreated along the beach to where he'd left his shoes, then made his way back to the main building. Halfway down the hallway, he noticed an exit sign. He tried the door, which opened onto a staircase that wound up toward the roof. After making sure that he could get back in, Adam followed the steps to a door, which was also unlocked. Turning the knob, he found himself gazing out across the top of the main building. The wind was whipping in off the sea. Adam walked over to the four-foot-high wall that marked the
edge of the roof. From this vantage point, he had a clear view of the compound. The residential structures ended at a small rocky hill, beyond which was dense forest. As large as the center was, Adam realized that there could well be more buildings hidden from sight.

Turning, he looked back at the first interior building. In the bright moonlight he could clearly see its outline, and he realized that it was an excellent architectural solution for eliminating windowless offices. Looking down, Adam could see that the space between the buildings had been carefully landscaped with pools, greenery, and palm trees. Both buildings were of equal height, and there was a bridge from one to the other on each floor.

The core building, which Dr. Nachman had said housed the hospital, was not visible. Adam crossed the bridge to the second building, walked to the inner edge, and looked down. Below him was the hospital. It was only three stories, which was why Adam had been unable to see it before. Directly below him was the connecting bridge that led to the steel doors he'd seen on his way out of the lab.

The roof bristled with antennae, wires, and satellite discs, which Adam guessed were related to some complicated communications center. There were a number of bubble skylights, the largest being in the exact center of the building. The roof also contained a cooling tower for air-conditioning and a shedlike access door similar to the one Adam had used to get to the roof of the outer building. Light from the central skylight gave the whole complex an alien, futuristic appearance.

For a few minutes Adam stood with his palms resting on the concrete wall, which was still warm from the day's sun. The night breeze tousled his
hair. With a sigh he wondered what insane impulse had taken him to Puerto Rico. There was no way MTIC would let him leave with its secrets. Frustrated and depressed, he decided he might as well go to bed.

The next day, despite Adam's impatience to see the hospital, he found it wasn't on his schedule until the afternoon. Most of the morning was spent with Mr. Burkett, who showed Adam not only the condo where he and Jennifer would live, but also all the facilities MTIC offered employees' spouses and children. He wondered what Burkett's response would be if he suddenly confronted the man with the knowledge that MTIC was doing its best to see that Adam's child was never born. It took all of his willpower to smile admiringly as they walked about the compound. Adam was relieved when Burkett finally released him just outside of Linda Aronson's office.

Linda greeted Adam with enthusiasm and showed him the computer terminals that distributed Arolen's information all over the world in a matter of minutes. She also introduced Adam to Mr. Crawford, who organized the Arolen cruises. Adam thought the man a dead ringer for the con artist who'd provided Smyth's fake passport.

Crawford showed Adam a graph analyzing where
the doctors who took the cruises practiced. Most came from the New York City area, though in recent months there had been a number of doctors from Chicago and Los Angeles as well. Adam noted that a good ten percent of the doctors who'd been on more than one cruise now worked at the Julian Clinic.

“The cruises have certainly become popular,” said Adam, concealing his dismay.

“Popular isn't the word,” said Crawford proudly. “With our present facilities, there is no way that we can keep up with the demand. MTIC has already purchased a second cruise ship on the west coast. We estimate it will be in service within the year. The eventual plan is to have five ships in operation, which will mean we will be able to accommodate the entire medical profession.”

Mr. Crawford folded his arms across his chest and gave Adam a what-do-you-think-of-that look, a proud parent describing his child's accomplishments. Adam felt sick. An entire generation of doctors programmed to be unknowing representatives of a pharmaceutical house.

Dr. Nachman met Adam for lunch and afterward led him down to Dr. Glover's office, where Glover and Mitchell were arguing over who should show Adam around first.

“It's getting so I can't leave the two of you in the same room,” said Nachman irritably.

Adam wondered if the center's isolation was responsible for their bickering. The competition between the two doctors had a neurotic quality. But Adam was pleased that he would at last be seeing the hospital. He didn't relish another hour of Mitchell's commentary, though, and hoped to escape it.

When they reached the double doors to the innermost building, Dr. Nachman opened them by gently pressing his thumb against a small electronic scanner. Beyond the doors, the covered bridge was glassed on both sides, and Adam saw the attractive landscaping he'd appreciated from the roof the night before.

There was a second set of double doors at the end of the walkway, which Dr. Nachman again opened with his thumb. The minute the men went through, Adam recognized the familiar smell of a hospital. After passing through a three-story foyer illuminated by some of the bubble skylights Adam had seen the night before, they walked past a series of small operating rooms to a nurses' station that boasted all the latest telemetry equipment. One of the nurses showed them into the locked ward beyond. Dr. Glover introduced Adam to several of the patients.

The doctor presented each case, impressing Adam with the amount of information he had committed to memory. The few details he couldn't remember, he was able to call up on one of the computer terminals that were in each room.

There were several diabetics who had received fetal islet-cell infusions and who were now completely off insulin. Adam was impressed in spite of himself, though he knew the ends could never justify the means.

On the far side of the ward were the patients with central nervous system implants. Adam met a young woman whose spinal cord had been severed in an automobile accident. After having been a paraplegic for over a year, she now was able to move her legs, thanks to infusions of fetal central nervous system tissue. Her movement was
uncoordinated as yet, but the results were astounding when compared with the hopelessness of traditional treatment.

She greeted Dr. Glover with a hug. “Thank you for giving me hope,” she said.

“You're welcome,” said Glover, beaming with pride, while Dr. Mitchell glanced through the chart.

“Bacteria count is going up in the urine,” Mitchell criticized.

“We are quite aware of that,” said Dr. Glover.

“Let's move on,” said Dr. Nachman.

They saw another ten or fifteen patients before Dr. Nachman led them back to the foyer, where they took the elevator to the next level. This was the psychiatric floor, and the minute they walked down the hall Dr. Mitchell seemed to come alive. Stroking his beard, running his hand over the smooth crown of his head, he described his patients with the enthusiasm of a born teacher.

“Our main treatment modality is psychopharmacology,” he stated. “Once therapeutic psychotropic drug levels are achieved, we then use a type of behavior modification.”

They came to a set of double doors similar to those that blocked access to the hospital proper. Dr. Mitchell pressed his thumb against the scanner.

“This, of course, is the nurses' station,” said Dr. Mitchell as he waved to two middle-aged women dressed in white blouses and blue jumpers. They just nodded, but two orderlies in blue blazers jumped to their feet. Adam immediately noticed their stiff smiles and unblinking stares.

“Some spontaneity is sacrificed,” thought Adam wryly.

As they continued down the hall, Mitchell described all the technical devices, until Dr. Glover
interrupted, saying, “Adam understands all this, for God's sake. He's been to medical school.”

But Dr. Mitchell didn't even pause in his narrative. Using his thumb, he opened the double doors leading to the ward, and Adam and the others filed in.

For such a modern hospital facility, Adam was surprised to find the ward laid out identically to the one at University Hospital. But aside from the floor plan, everything else was different. At University Hospital the beds, the nightstands, and even the ceilings were about to collapse from lack of maintenance. In sharp contrast, the ward at MTIC was so spotlessly clean that it looked as if it had just opened. Even the patients were lying well cared for in their beds, their covers uniformly pulled up to their chests. They were awake but immobile. Only their eyes moved as they followed the visitors' progress down the ward. Adam had never seen such a peaceful ward and certainly not such a peaceful psychiatric one.

Adam's eyes roved over the blank faces. Dr. Mitchell had begun another of his interminable lectures. Adam was wondering how long he'd have to listen when his eyes fell on the patient in the second bed to the right. It was Alan Jackson! Adam's heart began to pound. He was horrified that Alan might recognize him. He turned quickly to hide his face, but when he glanced back, Alan's expression had not changed. He was obviously heavily sedated. Adam permitted himself a closer look. Alan's head was swathed in bandages, and there was an IV dripping clear fluid into his right arm. Adam realized that the
Fjord
must have stopped in Puerto Rico the day before. No wonder they had kept Alan so heavily sedated. They had scheduled him for involuntary surgery all along.

When Mitchell paused in his patient survey, Adam pointed to Alan and asked, “What was this man's problem?”

Dr. Mitchell looked at Dr. Nachman, who nodded. Mitchell picked up the chart at the foot of Alan's bed and read the summary out loud. “ ‘ Robert Iseman of Sandusky, Ohio; admitted for intractable temporal lobe epilepsy with criminally violent episodes; unresponsive to traditional treatment.' Iseman had been committed to a psychiatric prison without hope of parole. He volunteered to participate in the Arolen treatment series.” Dr. Mitchell placed the chart back in its rack.

“Has he been here long?” asked Adam.

“A few days,” said Dr. Mitchell vaguely. “Why don't we . . .”

“Excuse me,” said Adam, interrupting, “but sometimes it's easier to learn from a specific case than from generalities. What kind of treatment has this man had? It would seem from his bandages that he's had some form of brain surgery.”

“He has indeed,” said Mitchell after another quick glance at Dr. Nachman. “We know from his history that he was a particularly intractable case, and after a course of Conformin we implanted microelectrodes into the limbic system of his brain. That was his only hope for a lasting cure. You remember the classic experiments in which electrodes were imbedded in a bull's head and used to stop it from charging? Well, we've perfected the technique. We can do a lot more than merely stop a bull from charging.”

Adam nodded slowly, as if trying to understand, but his mind recoiled in horror.

“Keep in mind that Mr. Iseman's treatment has just begun,” Dr. Nachman said. “After he's more
fully recovered from the operation, he will undergo conditioning.”

“Absolutely,” echoed Dr. Mitchell. “In fact, treatment will begin tomorrow, and he can anticipate discharge in about four days. Why don't we go down to the conditioning rooms so you can see exactly what we do.”

Adam took a final glance at Alan's expressionless face and followed the doctors through the ward.

“Mr. Iseman will be given a combination of reinforced operant conditioning and adversive conditioning,” Dr. Mitchell was saying. “A computer-guided program will be able to detect undesirable mental processes and reverse them before they manifest themselves in outward behavior.”

Adam's mind whirled. He wondered what Mitchell meant by “undesirable mental processes.” It probably ranged from refusing to prescribe Arolen products to belief in fee-for-service medicine.

“Here is one of our conditioning rooms,” said Mitchell, swinging open a door and allowing Adam to look inside. It was a miniature of the theater on the
Fjord.
There was a large projection screen on the far wall facing two chairs that were fully equipped with electrodes and straps. Adam turned away in horror, allowing the door to swing shut.

“Is there much effect on the personality?” he asked.

“Of course,” said Dr. Mitchell. “That is part of the program. We select only the most desirable personality traits.”

“What about intellect?” asked Adam.

“Very little adverse effect,” said Dr. Mitchell, leading the way back through the ward. “We've been able to document some minor decrease in creativity, but memory retention is normal. In fact, in
some regards memory is enhanced, particularly for technical information.”

Adam looked at Alan as they passed. The man's expression still hadn't changed. He had been reduced to some kind of zombie.

“The research is progressing well,” said Dr. Nachman as he let them through the steel doors. “Of course, application is limited.”

“The fetology work certainly can be put to more general use,” said Dr. Glover.

“That's a matter of opinion,” said Dr. Mitchell. “With the behavior-modification techniques we are perfecting, there will eventually be no locked wards either in hospitals or in prisons. In fact, both the National Institute of Mental Health and the Prisons Administration Board are funding our experiments.”

They emerged into the three-story lobby with the bubble skylights. Dr. Glover was not about to let Mitchell get in the last word. He began to enumerate the various government agencies that were funding fetology.

Adam was in a state of shock. MTIC planned the ultimate destruction of an independent medical profession. Doctors would no longer be free-thinking professionals. They would be employees of the MTIC-Arolen medical empire.

“Adam,” said Dr. Nachman, trying to get Adam's attention. “Are you still with us?”

“Yes, of course,” said Adam quickly. “I'm just overwhelmed.”

“Quite understandable,” said Dr. Nachman. “And I think that we should give you some time to enjoy our recreational facilities. A few hours at the beach will do you a world of good. Shall we meet for dinner at eight?”

“What about visiting the operating rooms for psychosurgery? If possible, I'd like to see them.”

“I'm afraid that is out of the question,” said Dr. Nachman. “They're getting ready for a case this evening.”

“Could I watch?” asked Adam.

Dr. Nachman shook his head. “We appreciate your interest, but unfortunately there is no viewing gallery. If you decide to take the job down here, though, I'm certain we can get you into the OR.”

As Adam went back to his room to change, he realized that he'd better figure out some way of smuggling tangible evidence out of the center. But what evidence? What could he bring back to New York that not only would convince Jennifer not to have an abortion, but would cause the medical profession to put MTIC out of business?

After several hours of lying in the sun, Adam thought he had an idea. It was wild, and probably impossible to execute, but if successful, Adam knew he would have no trouble convincing anyone to take his warnings seriously.