Critical Judgment (1996) (13 page)

Abby’s alarm went off at seven
P.M
. Her next shift at work wasn’t for two days, but after an all-nighter, her body needed to be eased back into normal-world time. Sleeping some during the day, then getting up and staying awake until midnight, usually did the trick. Her shades were up—another trick of the trade—so that the early-evening light could help her get oriented. She rolled out of bed, aware that the house was very quiet. Josh was either passed out in his room, or he had pulled himself together and gone into work.

For a few minutes she sat on the small chair by her window, gazing at the mountains as she sorted out her emotions. She was uncomfortable with the coldness that had worked its way into her heart. But, in truth, there was nothing she could do about it. The look in Josh’s eyes as he grabbed her shoulders would never be erased from her memory, regardless of what became of their relationship.

Stretching, she walked to the living room. Even before she saw the note on the dining-room table, she knew that he was gone. The computer and printer that were his lifeline were missing as well.

Abby sank down onto the sofa and reread the note. After so many recent arguments and so much verbal abuse, she knew that her overriding feeling at that moment was relief—relief that there would be some space between them; relief that Josh had agreed to get help; and, finally, relief that her conflict about attending the Alliance meeting had been resolved.

I
t was seven-thirty in the evening when Abby smoothed out Lew’s map on the passenger seat of the Mazda and headed across the valley. Dense clouds made headlights helpful, and a drop in the temperature suggested rain might be on the way. Just over twenty-four hours had passed since she had read Josh’s note. There had been no word from him since. Nor had she tried to find out where he had gone. As isolated as she was feeling, as apprehensive as she was about the future, she knew that separating was the best thing they could have done. There might not be healing yet, but at least the bleeding had stopped. She
had
called Garrett Owen, the neurologist, and learned that Josh had scheduled an appointment several weeks away for an evaluation of headaches.

“If he had told my nurse that it was an emergency,” Owen told her, “she would have spoken to me, and I would have found a spot to squeeze him in.”

Abby was about to ask Owen to do just that but stopped herself. It was Josh’s game now, and he could call the shots.

The route on Lew’s map took her past the cutoff to Ives’s trail, then along the base of the northern hills.
Finally, about a mile west of town, she found the dirt road labeled on the map “my driveway.” At the base of the road was a crudely cut and painted arrow that read, The Meadows—Alvarez.

The stony dirt drive sloped steeply upward for half a mile. It was hard to imagine Lew getting home at all when it snowed. At the crest of the hill was his farm, an unpretentious patchwork of wooden-fenced meadows, stretching out around a rambling whitewashed two-story house, a large old barn, and two garage-sized outbuildings. The spectacular vista, south and east, spanned the entire town and included a long-distance view of the Colstar cliff and the mountains beyond. There were several cows grazing nearby. Farther out, in a field of wildflowers, a pair of horses moved slowly toward one another.

She had no idea how many members of the Alliance would be there and was somewhat dismayed to see just two cars, one of which she assumed to be Lew’s. Alvarez greeted her warmly at the door. He was wearing worn jeans, a plaid denim work shirt, and scuffed cowboy boots. The outfit looked as natural on him as did blue scrubs and a clinic coat.

“This place is lovely,” she said as he led her through a fireplaced kitchen that looked as if it had been designed by someone who had a passion for cooking.

“I knew you’d like it.”

They passed through a short paneled hallway to a spacious den. The walls of both were covered with framed photographs. Most of them seemed to be taken in a foreign country, and a number of them featured a woman—a slender, dark-haired beauty with a luminous smile. Abby asked where the pictures had been taken.

“Paraguay. That’s where I was born, and where I chose to practice after I finished my training here. The woman in the pictures is … was … my wife. She’s dead.”

“I’m sorry.”

His sadness was palpable.

“Thank you. So am I,” he said.

The den was set up with a wet bar, some dishes of pretzels and chips, and a slide projector and screen. The only other person there was a stout, middle-aged woman named Barbara Torres, the associate director of the Patience Valley Region Visiting Nurse Association.

“I’m very pleased you’ve come,” she said. “We’ve been hearing so many good things about you.”

Abby thanked the woman and accepted a Perrier and lime from Lew.

“Are you expecting many people tonight?” she asked.

Lew and Torres exchanged brief glances.

“Gil Brant, who owns the pharmacy in town, should be here shortly,” Lew said. He paused, searching for the right words. “The Alliance used to number several dozen, but for now, at least, I’m afraid we’re it.”

 … Very few. They’re harmless because no one takes them very seriously
.

Lyle Quinn certainly seemed to have his facts in order.

Lew motioned her to an easy chair positioned to get a good view of the screen.

“Perhaps while we’re waiting for Gil,” Lew went on, “Barbara and I could fill you in on our group’s history and goals.”

“Please.”

“I was the last ER physician to come here before you. By the time I arrived, David Brooks, who’d been here for a couple of years, had been noticing a disturbing number of the sort of cases you refer to as NIWWs.”

“NIWWs?” Torres asked.

“Abby’s abbreviation for ‘no idea what’s wrong,’ ” Lew said. Barbara’s smile suggested that, like him, she appreciated the irony in the label. “Well,” Lew continued, “over the months after I started here, David and I began talking about these cases—the strange rashes, chronic fatigue, adult asthma, headaches, and the like.
We became convinced that some sort of environmental exposure had to be at the root of them all. And, of course, the most likely source was up there on the cliff.”

The doorbell rang. Lew left and returned with Gil Brant, a tall man with a cheerful, ruddy face.

“Let me congratulate you on your handwriting and the accuracy of your prescriptions,” Brant said after their introduction. “And let me also thank you for your commitment to see this cause of ours through.”

Abby felt her cheeks redden. Lew spoke up quickly.

“Gil, Abby has made it clear that she’s not committed to any cause. She’s come to hear what we have to say and to see if there’s a unifying explanation for the strange cases she’s been seeing in the ER. That’s all.”

“Yes, yes, I see. Well, then, why don’t we have at it?”

“Barbara, why don’t you show Abby what we have?” Lew said.

Torres took a computer printout from her briefcase and handed it over.

“This is a list of one hundred seventy-five patients who have been seen in the emergency ward by Dr. Alvarez, Dr. Brooks, bless his soul, and by some of us at the VNA. The ages and diagnoses are beside each name. Some of them may have had definite diagnoses made by their private doctors by now, but we have no way of knowing.”

Abby scanned the printout. The patients she had seen during her own brief experience at PRH were a microcosm of this group.

“I could probably add an additional twenty or so patients myself,” she said. “What about enlisting some of the other doctors in town?”

“When David first confirmed my sense that there was a pattern,” Lew said, “just as I did when you told me about your strange cases, we decided to do just that. Without even suggesting that Colstar was at fault, we sent out flyers announcing an organizational meeting of a group we named Alliance for a Healthy Patience and
describing the symptoms we’d seen. About fifty people attended that meeting, including at least fifteen doctors from the hospital staff.”

“Well, what happened?”

Lew turned to the pharmacist.

“Gil?”

“Well, the people at Colstar got wind of what we were doing and started a campaign to discredit us almost immediately. Attendance at our meetings dropped each time. Then, when we tried and failed to prove our theory about what was going on, we began to be looked on as … as—”

“Go ahead, Gil, say it. As quacks.”

“Well, what
was
your theory?” Abby asked.

Brant looked to Lew, who nodded that it was fine for him to go on.

“Cadmium,” he said. “This Colstar plant, in addition to being the company headquarters and research center, manufactures all of their rechargeable batteries. Cadmium is one of the main components. Colstar has it shipped in by the ton. Our theory right from the beginning has been that all of the varied symptoms we’ve been seeing have been caused by cadmium poisoning either through the air or the water.”

Abby strained to remember what little she knew of the adverse effects of the heavy metal.

“Toxicity somewhat like mercury, yes?”

“Exactly,” Brant said. “It’s in the same column as mercury in the periodic table of elements. You know your chemistry.”

Lew lowered the lights with a dimmer and flicked on the slide projector. The first slide, expertly prepared, was headed, “Symptoms and Signs of Cadmium Toxicity.” The list was extensive.

“These slides were put together for presentations to both OSHA and EPA,” he explained. “Obviously, they didn’t make much of an impression, or we wouldn’t be here tonight.”

The list included all of the symptoms and findings Abby and the others had been seeing, plus a number of additional ones. Kidney failure, which Abby had not encountered in the ER, was the most serious common manifestation, along with severe respiratory disease. But everything from headaches to skin eruptions to gingivitis and even sterility was listed as well.

“So,” Abby said, “don’t keep me in suspense. What were the blood levels?”

Again, the three Alliance members exchanged glances.

“We managed to get fourteen or fifteen samples sent off on various patients,” Lew responded. “They were all negative.”

“Done at the hospital or sent out?”

“Mostly here. The hospital lab has a contract with employee health at Colstar to monitor nickel, cadmium, lithium, and the other potential toxins used at the plant. So they have all the equipment and expertise.”

“We think the hospital lab is under instructions to keep any positive test under the tightest wraps,” Torres added.

“Another possibility is that someone in the lab replaces all blood sent in for cadmium levels with blood they know will be negative,” Brant chimed in.

“But why?”

“The usual reason,” Lew said. “Money. It would cost millions for Colstar to close for any length of time, locate the source of contamination, and do whatever is necessary to correct it. In addition, Colstar competes with a number of other companies for very lucrative government contracts. Anything that forces them to retool would also make them ineligible or unable to stay in the game. Did you know that Senator Corman is from Patience?”

“Most definitely. It was always the first thing I was told whenever I asked anyone about the town.”

“Corman’s tight with Ezra Black. Colstar’s one of the
companies in Black’s empire,” Lew went on. “Plus, Corman has as much support around here as he does clout in Washington. He’s responsible for ensuring that huge government contracts keep coming this way. But if there’s an environmental disaster involving the company, it’s doubtful even he could protect it. Let’s show you some more of these.”

The first ten shots were different views of the plant itself, perched atop its massive butte.

“These were taken by Dave Brooks about eight years ago. Note the smoke coming from those stacks. The company—and their story’s backed up by the EPA—tells us that’s just steam. We have doubts. Now they only emit whatever it is at night. You hardly ever see smoke during the day.”

“And what are those?”

Abby pointed to three identical dark, ill-defined areas in one of the shots, each one tall and narrow. They were situated one directly above the other and spaced vertically down the sheer cliff face beneath the plant. The angle of the other shots was such that the rectangles were not apparent in any of them.

“I’ve never even noticed those before,” Lew said. “Have you two?”

“I would have thought they were just shadows,” Barbara said, “or else some sort of optical illusion. But now that you call my attention to them, I can see them clearly.”

“They look like slits in the rock,” Brant added. “Windows of some sort? I don’t know if they’re even there now.”

“Curious,” Lew said. “Well, we’ll have to check. Thanks for noticing them. I knew we brought you up here for a reason. Next, take a look right here in the corner.”