Terminal (25 page)

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Authors: Robin Cook

BOOK: Terminal
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Sterling nodded.

Dr. Mason’s intercom crackled on. “Sorry to disturb you, Dr. Mason,” Patty, his secretary, said. “But you told me to warn you about Ms. Richmond. She’s on her way in and she seems upset.”

Dr. Mason swallowed hard. There was only one thing that could set Margaret off. He excused himself from Sterling and left his office to intercept his director of nursing. He caught her near Patty’s desk and drew her aside.

“It’s happened again,” Ms. Richmond snapped. “Another breast cancer patient with a cyanotic respiratory arrest. Randolph, you have to do something!”

“Another death?” Dr. Mason asked.

“Not a death yet,” Ms. Richmond said. “But almost worse, especially if the media gets involved. The patient is in a vegetative state with obvious brain damage.”

“Good Lord,” Dr. Mason exclaimed. “You’re right; it could be worse if the family starts asking questions.”

“Of course they will ask questions,” Ms. Richmond said. “Once again, I must remind you that this could ruin everything we’ve worked for.”

“You don’t have to tell me,” Dr. Mason said.

“Well, what are you going to do?”

“I don’t know what else to do,” Dr. Mason admitted. “Let’s get Harris up here.”

Dr. Mason had Patty call Robert Harris and told her to buzz him the moment Harris arrived. “I have Sterling Rombauer in my office,” he told Ms. Richmond. “Maybe you should hear what he has to say about our medical student extern.”

“That brat!” Ms. Richmond said. “When I caught him over in the hospital sneaking a look at Helen Cabot’s chart I felt like throttling him.”

“Calm down and come in and listen,” Dr. Mason said.

Ms. Richmond reluctantly allowed Dr. Mason to lead her into his office. Sterling got to his feet. Ms. Richmond told him he didn’t have to stand on her account.

Dr. Mason had everybody sit, then asked Sterling to bring Ms. Richmond up to date.

“Sean Murphy is an interesting and complicated individual,” Sterling said as he casually crossed his legs. “He’s lived a rather double life, changing drastically when he got into Harvard undergraduate school, yet still clinging to his blue-collar Irish roots. And he’s been successful. Currently he and a group of friends are about to start a company they intend to call Oncogen. Its goal will be to market diagnostic and therapeutic agents based on oncogene technology.”

“Then it’s clear what we should do,” Ms. Richmond said. “Especially considering his being insufferably brash.”

“Let Sterling finish,” Dr. Mason said.

“He’s extremely bright when it comes to biotechnology,” Sterling said. “In fact I’d have to say he’s gifted. His only real liability, as you’ve already guessed, is in the social realm. He has little respect for authority and manages to irritate a lot of people. That said, he’s already been involved with the founding of a successful company that was bought out by Genentech. And he’s had no significant difficulty finding funding for his second venture.”

“He’s sounding more and more like trouble,” Ms. Richmond said.

“Not in the way you think,” Sterling said. “The problem is that Sushita knows approximately as much as I do. It’s my professional opinion that they will deem Sean Murphy a threat to their investment here at Forbes. Once they do, they’ll be
inspired to act. I’m not convinced a move to Tokyo and, essentially, a buyout, will work with Mr. Murphy. Yet if he stays here, I think they’ll consider reneging on renewing your grant.”

“I still don’t understand why we don’t send him back to Boston,” Ms. Richmond said. “Then it’s over. Why take the risk of jeopardizing our relationship with Sushita?”

Sterling looked at Dr. Mason.

Dr. Mason cleared his throat. “From my perspective,” he said, “I don’t want to be rash. The kid is good at what he does. This morning I went down to where he’s working. He’s got a whole generation of mice accepting the glycoprotein. On top of that, he showed me some promising crystals that he’s been able to grow. He insists he’ll have better in a week. No one else has been able to get this far. My problem is I’m caught between a rock and a hard place. A more dire threat to our Sushita funding is the fact that we have yet to provide them with a single patentable product. They expected something by now.”

“In other words, you think we need this brat even with the risks,” Ms. Richmond said.

“That’s not the way I would phrase it,” Dr. Mason said.

“Then why don’t you call Sushita and explain it to them,” Ms. Richmond said.

“That would not be advisable,” Sterling said. “The Japanese prefer indirect communication so that confrontation can be avoided. They would not understand such a direct approach. Such a ploy would cause more anxiety than it would alleviate.”

“Besides, I already alluded to all this with Hiroshi,” Dr. Mason said. “And they still went ahead to investigate Mr. Murphy on their own.”

“The Japanese businessman has a great problem with uncertainty,” Sterling added.

“So what is your take on this kid?” Ms. Richmond asked. “Is he a spy? Is that why he’s here?”

“No,” Sterling said. “Not in any traditional sense. He’s obviously interested in your success with medulloblastoma,
but it’s from an academic point of view, not a commercial one.”

“He was very open about his interests in the medulloblastoma work,” Dr. Mason said. “The first time I met him he was clearly disappointed when I informed him he would not be permitted to work on the project. If he’d been some kind of spy, I think he’d keep a lower profile. Rocking the boat only draws further scrutiny.”

“I agree,” Sterling said. “As a young man he’s still motivated by idealism and altruism. He has not yet been poisoned by the new commercialism of science in general and medical research in particular.”

“Yet he’s already started his own company,” Ms. Richmond pointed out. “That sounds pretty commercial to me.”

“But he and his partners were essentially selling their products at cost,” Sterling said. “The profit motive did not play a role until the company was bought out.”

“So what’s the solution?” Ms. Richmond asked.

“Sterling will monitor the situation,” Dr. Mason said. “He’ll keep us informed on a daily basis. He’ll protect Mr. Murphy from the Japanese as long as he is a help to us. If Sterling decides he is acting as a spy, he’ll let us know. Then we’ll send him back to Boston.”

“An expensive babysitter,” Ms. Richmond said.

Sterling smiled and nodded in agreement. “Miami in March is very agreeable,” he said. “Particularly at the Grand Bay Hotel.”

A short burst of static from Dr. Mason’s intercom preceded Patty’s voice: “Mr. Harris is here.”

Dr. Mason thanked Sterling, indicating the meeting was over. As he accompanied Sterling out of the office. Dr. Mason couldn’t help but agree with Ms. Richmond’s assessment: Sterling was an expensive babysitter. But Dr. Mason was convinced the money was well spent and, thanks to Howard Pace, readily available.

Harris was standing next to Patty’s desk, and for the sake of propriety, Dr. Mason introduced him to Sterling. As he did, he couldn’t help but feel each man was the other’s antithesis.

After sending Harris into his office. Dr. Mason thanked Sterling for all he’d done and implored him to keep them informed. Sterling assured him he would, and left. Dr. Mason then went back into his office to deal with the current crisis.

Dr. Mason closed the door behind him. He noticed Harris was standing stiffly in the center of the room; his patent leather visored hat with its gold trim was wedged under his left arm.

“Relax,” Dr. Mason said as he went around behind his desk and sat down.

“Yes, sir,” Harris said smartly. He didn’t move.

“For crissake, sit down!” Dr. Mason said when he noticed Harris was still standing.

Harris took a seat, his hat remaining beneath his arm.

“I suppose you’ve heard another breast cancer patient has died,” Dr. Mason said. “At least for all practical purposes.”

“Yes, sir,” Harris said crisply.

Dr. Mason eyed his head of security with mild irritation. On the one hand he appreciated the professionalism of Robert Harris; on the other hand the militaristic playacting bothered him. It wasn’t appropriate for a medical institution. But he’d never complained because until these breast cancer deaths, security had never been a problem.

“As we told you in the past,” Dr. Mason said, “we believe some misguided demented individual is doing this. It’s becoming intolerable. It has to be stopped.

“I’ve asked you to make this your number-one priority. Have you been able to turn anything up?”

“I assure you, this problem has my undivided attention,” Harris said. “Following your advice I’ve done extensive background checks on most all of the professional staff. I’ve checked references by calling hundreds of institutions. No discrepancies have turned up so far. I’ll now be expanding the checks to other personnel who have access to patients. We tried to monitor some of the breast cancer patients, but there are too many to keep tabs on all the time. Perhaps we should consider putting security cameras in all the rooms.” Harris did not mention his suspicion of the possible connection between these cases and the death of a nurse and the attempted assault
of another. After all, it was only a hunch.

“Maybe cameras in every breast cancer patient’s room is what we have to do,” Ms. Richmond said.

“It would be expensive,” Harris warned. “Not only the cost of the cameras and the installation, but also the additional personnel to watch the monitors.”

“Expense might be an academic concern,” Ms. Richmond said. “If this problem continues and the press gets hold of it, we might not have an institution.”

“I’ll look into it,” Harris promised.

“If you need additional manpower, let us know,” Dr. Mason said. “This has to be stopped.”

“I understand, sir,” Harris said. But he didn’t want help. He wanted to do this on his own. At this point it had become a matter of honor. No screwball psychotic was going to get the best of him.

“And what about this attack last night at the residence?” Ms. Richmond asked. “I have a hard enough time recruiting nursing personnel. We can’t have them attacked in the temporary housing we offer them.”

“It is the first time security has been a problem at the residence,” Harris said.

“Maybe we need security people there during the evening hours,” Ms. Richmond suggested.

“I’d be happy to put together a cost analysis,” Harris said.

“I think the patient issue is more important,” Dr. Mason said. “Don’t dilute your efforts at the present time.”

“Yes, sir,” Harris said.

Dr. Mason looked at Ms. Richmond. “Anything else?”

Ms. Richmond shook her head.

Dr. Mason glanced back at Harris. “We’re counting on you,” he said.

“Yes, sir,” Harris said as he got to his feet. By reflex he started to salute, but he caught himself in time.

“V
ERY IMPRESSIVE
!” Sean said aloud. He was sitting by himself in the glass-enclosed office in the middle of his expansive
lab. He was at an empty metal desk, and he had the copies of the thirty-three charts spread out in front of him. He’d chosen the office in case someone suddenly appeared. If they did he’d have enough time to sweep the charts into one of the empty file drawers. Then he’d pull over the ledger featuring the protocol he’d developed to immunize the mice with the Forbes glycoprotein.

What Sean found so impressive were the statistics concerning the medulloblastoma cases. The Forbes Cancer Center had indeed achieved a one hundred percent remission rate over the last two years, which contrasted sharply with the one hundred percent fatality rate over the eight years prior to that. Through follow-up MRI studies, even large tumors were shown to have completely disappeared after successful treatment. As far as Sean was concerned, such consistent results were unheard of in the treatment of cancer except for the situation of cancer
in situ
, meaning extremely small, localized neoplasia that could be completely excised or otherwise eliminated.

For the first time since he’d arrived, Sean had had a reasonable morning. No one had bothered him; he hadn’t seen Hiroshi or any of the other researchers. He’d started the day by injecting more of the mice which had given him a chance to get the copies of the charts up to his office. Then he’d toyed with the crystallization problem, growing a few crystals that he thought would keep Dr. Mason content for a week or so. He’d even had the director come down to see some of the crystals. Sean knew he’d been impressed. At that point, reasonably confident he wouldn’t be disturbed, Sean had retired into the glass office to review the charts.

First he’d read through all the charts to gain an overall impression. Then he’d gone back, checking on epidemiological aspects. He’d noted that the patients represented a wide range of ages and races. They were also of varying sex. But the predominant group consisted of middle-aged white males, not the typical group seen with medulloblastoma. Sean guessed that the statistics were skewed due to economic considerations. The Forbes was not a cheap hospital. People needed adequate medical insurance or sizable savings accounts to be patients
there. He also noted that the cases came from various major cities around the country in a truly national distribution.

But then, as if to show how dangerous generalizations were, he discovered a case from a small southwestern Florida town: Naples, Florida. Sean had seen the town on a map. It was the southernmost town on the west coast of Florida, just north of the Everglades. The patient’s name was Malcolm Betencourt, and he was nearing two years since the commencement of his treatment. Sean noted the man’s address and phone number. He thought he might want to talk with him.

As for the tumors themselves, Sean noted that most were multifocal rather than being a single lesion, which was more common. Since they were multifocal, the attending physicians in most cases had initially believed they were dealing with a metastatic tumor, one that had spread to the brain from some other organ like lung, kidney, or colon. In all these cases, the referring physicians had expressed surprise when the lesions turned out to be primary brain tumors arising from primitive neural elements. Sean also noted that the tumors were particularly aggressive and fast-growing. They would have undoubtedly led to rapid death had not therapy been instituted.

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