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Authors: Robin Cook

Critical (38 page)

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“HOLY SHIT,”
Arthur MacEwan cried. “Did you see that?”

“I never saw anybody move so quickly,” Ted Polowski said. “It was unbelievable. And look at Angelo. He's having trouble getting up.”

“There goes Franco. He's got the gun.”

Arthur and Ted had followed Angelo and Franco into Manhattan, and when the two had pulled up behind the silver Range Rover and parked, Arthur and Ted had gone around the block and pulled over to the curb at a hydrant on 30th Street. From there, they had a good view of the blue van, and they settled in for what they thought might be a long wait. But it turned out not to be the case. Almost immediately, a white van pulled up behind the blue one, and Ted, who knew most of the Lucia people, recognized Richie Herns as the driver. And then it was only a few minutes later that Angelo had bounded out of his vehicle to confront the guy in the Range Rover.

Still shaking his head over what he had just witnessed, Arthur called Carlo, who, along with Brennan, was having lunch with the boss, Louie. “You'll never believe what we just saw,” he said excitedly. He then went on to describe the shellacking Angelo had just suffered from a guy in a Range Rover who Angelo had tried to pick a fight with. “You would not believe how fast this guy was,” Arthur continued excitedly. “Angelo didn't stand a chance. Angelo even pulled a gun, but the guy knocked it out of his hand, then threw it out into the street. I'm telling you, it was unbelievable.”

“Where are you?”

“We're across the street from the city morgue in Manhattan.”

“City morgue?” Carlo questioned “Why the hell the city morgue?

“We don't have the foggiest idea.”

“Why did Angelo pick a fight?”

“No clue about that, either.”

“Is Angelo okay?”

“I think so. He's walking a little strange, but he's getting into the blue van just now.”

“Hang on,” Carlo said. “Let me tell Louie about this.”

Arthur could hear Carlo relate the story, and Louie's bewildered reaction.

Carlo came back on the line. “Louie wants to know if you recognized the guy.”

“No,” Arthur said. “But his Range Rover had the name of a business called Bieder-something Heaven.”

“Any phone number or address?”

“We couldn't see from where we were. The lettering was too small, but there was several more lines of print.”

“Do you know if Franco is there as well?”

“Oh, yeah! He's here. He tried to stop Angelo from bothering the guy, and after the scuffle, he went out and got Angelo's gun from the middle of the street. Oh, one other thing. There's a second van, too, parked just behind Angelo and Franco's. Whoa, Angelo's started the blue van. I'm going to have to sign off here. Nope! False alarm! Angelo just pulled up a car length to be on the corner, and Richie's pulling up behind him. There's someone else in Richie's van, but we don't know who it is. Should one of us walk over there and check it out?”

“No! Absolutely not. They don't expect anyone to be watching, and we don't want them to have any reason to believe so. Hold on again. Let me tell Louie the rest of this weird story.”

Once again, Arthur could hear Carlo relate the details, but he couldn't hear Louie's responses. Carlo came back on the line. “Louie said you're doing a good job. He wants you to stay with them. Later this afternoon, Brennan and I will come over and relieve you.”

“Sounds good,” Arthur said.

 

CARLO PUT HIS
phone back in his jacket pocket and looked across at Louie. Louie stared back. His fleshy face was scrunched together, his brow deeply knitted. It was obvious he was deep in thought. Carlo and Brennan knew enough to stay silent and eat their pasta.

Finally, Louie broke the silence and took the napkin away from his neck where he'd poked it under his collar. “I don't understand any of this, but what I do understand is that it's got to stop. They are acting weird to say the least, knocking people off and brawling in broad daylight on a Manhattan street. And what's this about the city morgue?”

Carlo and Brennan knew Louie well enough not to respond until Louie directly asked them a question. Louie had always had a propensity to think out loud. As Louie heaved his considerable bulk out of the chair and began to pace, Carlo and Brennan exchanged a glance, wondering what was coming.

Louie wandered over to the bar, continuing his dialogue. After mindlessly playing with a shot glass full of toothpicks for several minutes, he came back to the table. “You guys are sure there was no company at the Trump Tower that you recognized when you stopped there this morning?”

Carlo and Brennan both shook their heads.

“Get a phone book!” Louie ordered Brennan. Dutifully, Brennan left his seat to bring a phone book to the table. “Try to look up Bieder-something Heaven!” Louie ordered when Brennan returned.

Louie looked at Carlo. “If they keep up this irresponsible behavior, we're going to have the entire NYPD out here on our backs sooner or later. What do you think?”

Carlo nodded. Since he was asked a specific question, he said, “They are taking big chances, so it must be important business.”

“That's exactly what I was thinking. I mean, that detective came all the way out here to warn us.”

“Nothing in the phone book,” Brennan reported.

“I didn't think there would be,” Louie said. “Not with a guy who could handle Angelo Facciolo so easily. The name's undoubtedly a cover.”

“Do you think they could have been waiting at the city morgue for the same thing?” Brennan asked, risking putting in his own two cents. “I mean, why would Angelo pick a fight with someone in broad daylight unless there was competition or some sort of existing bad feelings?”

“Good thought, “Louie said. “I'm glad we're watching them. I'd like to know what's going on, but if they knock off someone else, I'm going to let that detective know we're not involved.”

 

AFTER THE ADRENALINE
rush evoked by Angelo, it took Adam a while to calm down, but by the time he arrived at the hotel, he was composed enough to think clearly about the unfortunate and totally unexpected incident. Although nothing untoward had happened, it still could if someone had observed the altercation and had called the police with a description of Adam's Range Rover. Consequently, Adam was disappointed in himself for not having driven off immediately. He certainly did not get any secondary gain from the useless confrontation—in fact, quite the contrary.

“Will you be needing your car soon, Mr. Bramford?” the doorman said, opening Adam's driver's-side door.

“No, thank you,” Adam said as he alighted. He specifically wanted the car put into the garage.

Adam went up to his room. He needed to make a call and did not want to use his cell. He wanted a landline. One of the fallouts of his one-sided fight was a reluctance to return to the OCME area for fear of again running into the smartly dressed thug.

Seated at a desk in the changing room of his junior suite, Adam placed his call. The protocol was for him to ask for a fictitious individual by the name of Charles Palmer and then be given another number to call. Once he had the second number, he'd leave his direct-dial number. At that point, he had to wait. The return call usually came within a minute.

There was no small talk when Adam spoke to one of his handlers. “I'm in need of a home address,” he said, without reference even to a name. Adam didn't have to question if the information could or could not be obtained. With his handlers' access to the highest levels of government, it was always available.

“We will have it in a few minutes. You'll have it on your BlackBerry.”

That was it. Adam pressed the disconnect button on the phone and then called room service. He thought he'd have lunch before heading over to his second-favorite attraction in New York City: the natural history museum.

 

“HOW WAS I
to know he'd be a karate expert,” Angelo snapped back.

“That's not the point,” Franco said. “The point is you didn't think, and when you don't think, you make mistakes. Luckily nothing drastic happened.”

“That's easy for you to say. I feel like I got run over by a truck; my chest hurts, and so does the side of my neck.”

“Consider your bruises as a warning to keep your cool. I've never seen you like this, Angelo. You're just too damn eager. As I said to Vinnie, you're juiced up something awful.”

“You'd be juiced up if the broad had burned your face such that you look like a freak.”

“You said that, I didn't.”

“What did you do with my gun?”

“It's here under my seat,” Franco said. He took out the scratched handgun and handed it to Angelo. Angelo looked it over carefully. He removed the clip, made sure there was no bullet in the chamber, then pulled the trigger several times. The mechanism worked smoothly. “It seems okay.”

“It might be a good idea to fire it a couple of times to be sure.”

Angelo nodded as he pushed the clip back into the base of the butt.

“You haven't answered the question I asked you earlier,” Franco said. “Are you going to be able to control yourself? Otherwise, I'm going to send you home for a few days. Mark my word! I'll take care of Montgomery myself.”

“Yeah,” Angelo said irritably. “I'll control myself! Maybe I shouldn't have gotten out of the van, but at least I got rid of the SUV, which was blocking our view.”

“At too great a risk, I might add. I mean, you understand that, don't you?”

“I do now. I suppose.”

“From now on, I want everything done my way until we get her on the boat. Then I don't care what you do. Apparently, Vinnie likes your cement shoes idea. That's fine. I couldn't care less if you and Vinnie want some payback beyond just whacking her. But I don't want any more reckless behavior. Are we on the same page here or what?”

“Yeah, we're on the same page,” Angelo said.

“Look at me!”

Angelo reluctantly glanced over at Franco.

“Say it again.”

“We're on the same fucking page,” Angelo repeated irritably.

“Good,” Franco said. “We got that cleared up. Now let's go get some lunch. Montgomery's not being cooperative. We'll have to come back and try to get her when she leaves tonight.”

21
APRIL 4, 2007
3:05 P.M.

H
ello, excuse me!” a voice called.

Laurie looked up from her work. One of the histology technicians was standing in the doorway, clutching a cardboard tray for microscope slides.

“Maureen asked me to run these down,” the woman said. “She also asked me to apologize for not getting them to you sooner. Two people called in sick today.”

“No problem,” Laurie said. She reached over and took the tray. “Thanks for bringing them, and thank Maureen for getting them to me so quickly.”

“Will do,” the woman said amiably.

Clutching the tray, Laurie looked back at her cluttered desk. Working nonstop, she had filled in only approximately two-thirds of her matrix, although the process, as painstaking as it was, was speeding up, since she had become accustomed to where in the hospital records she'd find the specific information she wanted. She'd also added more categories as she'd gone on, which forced her to go back to cases she thought she'd finished. One thing was certain: With as many categories as she now had, constructing the matrix was significantly more work than she'd originally imagined.

Although Laurie enjoyed a certain compulsive contentment about her progress, it had to contend with a growing disappointment that her efforts were probably not going to provide any insight into the mystery. As she worked, she'd hoped that she'd see some unexpected commonality, but it wasn't happening. If a few cases were in the same OR, the next one would be in a different OR; if several patients were on the same floor, the next one would be on a different floor; and so on and so forth. Yet she had persisted and would continue to do so, since it was all she had.

Relishing a break from what was essentially tedious data entry, Laurie cleared a space on her desk for her microscope. Turning on the lamp, she slipped the first slide of David Jeffries's lung section into the stage clip, rotated the revolving nosepiece to the lowest objective, and lowered the objective close to but not touching the slide. Putting her eyes to the eyepiece, she used the coarse adjustment knobs to pull the objective back up from the slide until she got an image. Reflexively, her hand went to the fine-adjustment knob and brought the image into sharp focus.

Laurie was again awed by the degree of damage wrought by the bacteria, many of which she could see as disclike clusters in the microscope's two-dimensional field. The normal alveolar structure of the lung was being dissolved by the bacteria's flesh-eating toxins such that abscesses of varying sizes were being formed. As she moved around with the help of the mechanical stage, she could see capillary walls in various stages of sepsis, causing hemorrhages into the septic soup that filled the lungs. The amount of destruction of the lungs' normal architecture reminded her of images of a city following a carpet bombing or a trailer park directly ravaged by a category five hurricane.

For more than an hour Laurie went through the tray of slides one by one. Using a higher-power lens, Laurie was even more impressed with the bacteria's pathogenicity. Focusing in on fibrous tissue responsible for maintaining the lung's normal structural architecture, she could see that the tissue was coming apart like the skin of an onion. Covalent bonds were being broken and collagen itself was dissolving into its constituent molecules.

“Hey, sweetie,” Jack said as he quietly breezed in. He was becoming progressively adept on his crutches. “How's your day going?”

Laurie looked up, her face paler than usual.

“What's up?” Jack questioned. His smile waned. “You look terrible.”

Laurie took in a deep breath and let it out. The tissue destruction she had been viewing had had a visceral effect on her. The fact that it had occurred within hours in a previously healthy person couldn't help but underline how fragile human beings ultimately were. The idea of enjoying any sort of health seemed a miracle.

Jack put his hand on her shoulder. “Really, are you okay?”

Laurie nodded and took another breath. She tapped the barrel of her microscope. “I think you ought to take a look at this. Keep in mind it was a normal, healthy person just a few hours earlier.”

Laurie pushed herself back from the desk to give Jack room.

Jack put his crutches aside and leaned down toward the eyepiece, but about halfway he hesitated, then regained full height.

“Wait a second,” he said suspiciously. “Is this a setup? Am I being slyly seduced into looking at a slide of your MRSA case from yesterday?”

“Remind me never to try to slip something by you,” Laurie said with a wan smile. Her blood pressure had quickly risen back to normal, returning color to her face and clearing the accompanying queasiness. She admitted it was a section of lung from David Jeffries.

Jack looked into the microscope, and, moving the mechanical stage, he took a quick tour of the section. “Wow,” he said. “It's totally destroyed. I see hardly any normal architecture.”

“Does it change your mind about elective surgery where you might find yourself dealing with such a pathogen?”

“Laurie!” Jack scolded.

“Okay,” Laurie said, pretending to be nonchalant. “I just thought I'd ask.”

“How were your cases today? You seemed to have been engrossed more than usual.”

“They were fine, particularly from a teaching perspective, such that they took longer than I hoped. I wanted to get up here ASAP and work on my matrix.” She patted the legal pad. “It's the only thing left that I have that has a snowball's chance in hell to convince you that you are specifically at risk for being exposed to MRSA during your scheduled surgery.”

“And?” Jack asked, looking at Laurie askance.

“I haven't found anything yet,” she admitted before looking at her watch. “But I still have about fifteen hours.”

“Ye gods. And you call me bullheaded.”

“You are bullheaded. I'm merely persistent, and, of course, I have the added benefit of being right.”

Jack waved Laurie away and gathered his crutches. “I'm heading to my office to clean things up since I'll be gone for a few days.” He emphasized the
few days.

“How were your cases today?”

“Don't ask. Riva promised some good ones; instead she gave me two natural deaths and an accidental one, none of which were at all challenging. Lou's case was more interesting. The slug's caliber and the indentations from an apparent chain to keep her sunk suggested the same killer. The difference was she was raped.”

“Tragic.”

“Another testament to the inherent wickedness of man.”

“I'm glad you said man. Now get out of here. I only have fifteen hours.”

“What time do you want to leave this evening?”

“Actually, we should take separate cabs, unless you want to stay late. I want to finish this matrix.”

“I'll come back here when I'm done in case you change your mind. I don't want to hang around, because I want to watch my buddies play basketball to remind me why I'm willing to go under the knife.”

On that issue, Laurie had to hold her tongue. Instead, she said, “Is Chet still in your office, or has he left for the day?”

“I wouldn't know. I stopped in here first.”

“Well, if he is, you should try to dampen his enthusiasm for his new lady friend.”

“Oh? How come?”

“By coincidence, she's the CEO of the company that has built the three Angels specialty hospitals.”

“Really?” Jack said, raising his eyebrows. “That is a coincidence. Why dampen his enthusiasm?”

“She's the one who all but ordered me out of the orthopedic hospital yesterday. I don't know about long-term, but right now I question her motivation.”

“Not to worry,” Jack said. “I'm sure Chet will have eyes for someone else tonight. A week from now, he won't even remember her name.”

“I hope so, for his sake.”

With Jack out of her office, Laurie went back to the microscope. Although she had made an effort to appear upbeat with Jack, she was again feeling despondent. She'd joked about the fifteen hours, but in reality, it was far too little time to solve a mystery that had been confounding people with Ph.D.s in epidemiology.

Suddenly, Laurie's hand stopped twirling the horizontal mechanical stage control. She'd seen something unusual zip past the microscope's field. Since she was viewing at high-power, objects moved very quickly in and out of the field with very little rotation of the control. She slowly reversed direction with the control, and the strange object came into view.

Laurie was entranced. It appeared to be in the middle of what had been a bronchiole, probably close to what had been an alveolus, or the terminal sac in the bronchial tree where oxygen entered the blood and carbon dioxide came out. Laurie immediately questioned whether it had been there originally or was an artifact, inadvertently introduced or formed during the slide's preparation. It was about the size of the white cells Laurie had seen, which were the body's defensive cells, but there was no nucleus. It had absorbed almost none of the standard stain used by histology.

Most remarkable, it was a nearly round disk, symmetrical with a scalloped border, giving it a stellate appearance. Why she thought the symmetry was important was that most artifacts she'd seen didn't have such symmetry. Laurie looked at the object itself. The scalloped border comprised about one-fifth the diameter. The center of the object was opaque, with the mere hint of either nodularity or being mottled. One minute she'd see it, the next minute she wouldn't. She wished the object had taken the stain, because if it had, she would have known if what she was seeing was real or something she was conjuring up. Trying to keep her excitement in check, Laurie took out a grease pencil to mark the glass slide so that if the scope's mechanical stage were to accidentally move, she could find the object again. She did this by placing four dots in the cardinal directions. Satisfied, Laurie then shifted to low power. When she looked in again, the object was significantly smaller, and because it lacked staining, it tended to blend in to the chaotic surroundings.

Switching back to high power, she made sure the object, whatever it was, was still in the field. With that ascertained, she quickly went down to get Jack.

When Jack looked at the object, he said, “My gosh, how did one of my grandmother's butter cookies get into David Jeffries's lung?”

“Be serious,” Laurie said. “What do you think it is?”

“I'm not fooling. It looks just like it came from one of my grandmother's cookie cutters. We called it a star, but obviously it has far too many rounded points.”

“Do you think it is an artifact?”

“That would be my first guess, but it is surprisingly symmetrical. I suppose that's due to the dynamic tension between the hydrophilic and hydrophobic forces at the interface of the menisci.”

“What the hell is that?”

“How should I know?” Jack said, still looking at the microscopic object. “I'm just running off at the mouth, speaking pseudo-scientific gibberish.”

Laurie swatted Jack's shoulder playfully. “Here I thought you knew what you were talking about.”

Jack looked up. “Sorry, I have no idea what it is. I don't even know if it is real or artifact.”

“Nor do I,” Laurie admitted.

“Have you found any others, or is this it?”

“So far that's it. Now that I found it, though, I'm eager to see if there are more.”

“Do you have any idea what it could be?”

“I know what I think it looks like, but it can't be.”

“Come on! Run it by me!”

“It looks like a diatom. Do you remember those from biology?”

“I can't say that I do.”

“You must. They're a type of algae or phytoplankton with silicate cell walls.”

“Give me a break,” Jack said. “Now, how do you remember that?”

“They're so beautiful, kinda like snowflakes. I did sketches of them in high-school biology.”

“Well, congratulations on your discovery. But if you're interested in my vote, I'd say I'd lean toward artifact rather than a pelagic diatom unless the university gave him a glass of Antarctic sea water as part of his terminal treatment.”

“Very funny,” Laurie said sarcastically. “Artifact or not, I'm going to look for more.”

“Good luck! Say, I'm about to head out. Do you want to change your mind and come along?”

“Thank you but no thank you. I'm going to look at these slides for a while, then finish my matrix. Don't wait up for me. I know you're going to bed early.”

“Good grief, Laurie. You're beating a dead horse.”

“Maybe so, but I'm not sure I'm going to sleep that much tonight, one way or the other.”

Jack bent down to give Laurie a hug, but she stood up and gave him a real one.

“See you later,” Jack said, affectionately touching the end of Laurie's nose with his index finger.

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