Damage Control

ALSO BY ROBERT DUGONI

The Jury Master

The Cyanide Canary

For my mother, Patty Dugoni, one of the thousands of breast cancer victims living today.

And for my cousin, Lynn Dugoni, one who is not.

Every little girl knows about love. It is only her capacity to suffer because of it that increases.

—Françoise Sagan

No man can climb out beyond the limitations of his own character.

—John Morley

1

Redmond, Washington

D
R
. F
RANK
P
ILGRIM
adjusted the flexible lamp clipped to the edge of his cluttered metal desk, but the additional illumination did not keep the typewritten words on the page from blurring. He set his wire-framed glasses above his bushy gray eyebrows and pinched the bridge of his nose. His eyes had reached their limit; they could no longer take the strain of a night reading small print.

Pilgrim glanced across the room, the details a blur. It wasn’t too long ago he could watch the television screen atop the military-green filing cabinets without glasses. Now he could barely make out the cabinets, even with prescription help. His cataracts were getting worse. It didn’t matter. With all the reality-TV crap being broadcast, he had long since relegated the television to background noise. It kept him company at night. He liked to listen to the Mariner baseball games, though the team continued to disappoint him. At seventy-eight, he didn’t have many years left to experience a World Series in Seattle.

The telephone on his desk rang at precisely ten p.m, as it had every night for the past forty-eight years. “I’m just finishing up,” he said, speaking into the old-fashioned handset. He rocked in his chair, bumping against floor-to-ceiling shelving cluttered with a lifetime of books and knickknacks from his and his wife’s trips around the world. Their next stop would be China in the summer. “Just a couple more minutes and I’ll be done, dear.”

His wife told him to be careful walking to his car, reminding him that he was an old man with a cane and an artificial hip and no longer the starting wingback at the U-Dub. “I’m as young as you are, beautiful,” he said. “And as long as I still feel like I’m eighteen, I intend to act that way.”

He told her he loved her and hung up, looking out through the wood-shuttered window of his ground-floor office. His fifteen-year-old BMW sat parked in its customary spot beneath the flood-lights’ tapered orange glow. When he’d opened his practice, the lot had been surrounded by cedar and dogwood trees, but that was a good many years ago, when getting to Redmond required taking a ferry from Seattle across Lake Washington. With the construction of the 520 and I-90 bridges, the population on the east side of the lake had exploded. Office complexes and high-rise condominiums now shadowed his medical building.

Pilgrim rolled back his chair, closed the file, and carried it to the cabinet, pulling open the drawer to the file he’d angled as a marker and sliding it back in place. Then, as was also his routine—rain or shine—he slipped on his raincoat and hat that he used to think made him look like Humphrey Bogart in
Casablanca,
and reached to shut off the television. He hesitated at the lead news story.

“Robert Meyers was at the Washington State Convention and Trade Center in downtown Seattle today to give the keynote address at a conference on global warming.”

Pilgrim turned up the volume and watched the charismatic young senator enter the convention center, shaking hands with some of the attendees.

“Meyers took the opportunity to continue his attacks on the current Republican administration’s record on the environment.”

The broadcast cut to a shot of Meyers standing at a podium behind a throng of microphones. “This is an issue whose time has come,” he told the audience. “The people of the Pacific Northwest know this as well as any in the United States. The current administration’s continued disregard for the environment is a further demonstration that it is out of touch with issues that will affect the future generations of this great country.”

The story ended, and Pilgrim switched off the television. Curious, he raised his glasses back onto the perch above his eyebrows and used his finger to trace the faded letters on the white cards on the front of the file drawers. His daughter remained determined to modernize the practice, which was now hers, but to him the computer screens, hard drives, and printers throughout the rest of the office made it look like the control room of a spaceship. Not so in the sanctity of his four walls. All he needed were cabinets and the twenty-six letters of the alphabet—a filing system that had worked just fine before Bill Gates and computers. His daughter had relented, but only after he agreed to separate his active from his inactive files. In exchange, she promised not to ship any of his files to storage. His cabinets would leave his office with his body.

He stepped to the cabinet containing his closed files and slid open the third drawer down, straining to read the faded ink on the raised tabs. He pulled the file from the crowded drawer and raised the next in sequence to mark its place, then walked to his desk. Sitting, he heard the familiar sound of the bells indicating the front door had opened. At this time of night, he locked the front door, though the janitor had a key, and Emily occasionally came back to do paperwork after putting her two children to bed. She had her father’s gene for long hours.

Pilgrim stood and pulled open his office door. “Emily, is that you?” The well-dressed man in the dark suit and raincoat stood like a giant amid the miniature chairs and tables. More curious than concerned, Pilgrim asked, “Can I help you?”

“Dr. Frank Pilgrim?”

“Yes. How did you get in?”

The man closed the outer door, locking it. “I brought a key.”

“Where did you get a key?”

The man approached. He did not answer.

“What is it you want?” Pilgrim asked. “I have no money here, or anything that would even remotely be considered a narcotic.”

The man reached into the pocket of his raincoat, pulled out a syringe, and removed the stopper at the end of the needle. “That’s okay, Dr. Pilgrim. I’ve brought my own.”

Pilgrim’s eyes narrowed. He balled his fists. “My daughter is here. She’s?… she’s in the office right over there.” He called out. “Emily! Emily, there’s a man here. Call the police.”

The intruder stepped forward, displaying no concern. Pilgrim stumbled into his office and closed the door, but the man caught the edge and pushed it open, knocking Pilgrim backward. He closed the door behind him. Pilgrim scrambled for the telephone, but his momentum abruptly stopped, and he felt himself being pulled back by his collar. Instinctively, he turned. The man grabbed him by the throat and jabbed the hypodermic needle into Pilgrim’s chest, depressing the plunger. A burning sensation spread quickly across Pilgrim’s shoulders and down his arms and legs. Pain gripped him, constricting the flow of air to his lungs. He righted himself, then fell backward into the filing cabinet, shoving closed the drawer. The images blurred, distorted and unrecognizable. He lurched for the telephone and managed to grasp the receiver, but the strength in his legs dissolved and he collapsed across the desk, sliding to the floor, his arms pulling forty-eight years of clutter on top of him.

2

Seattle, Washington

H
ER KNUCKLES FELT
thick and swollen, and her skin was as chilled as if she were working outside in a numbing-cold rain. Dana Hill fumbled with the button of her silk blouse and missed the hole. The button slipped from her grasp. She flexed her fingers and noticed the tremors. She could not steady her hand. She chastised herself, grabbed the stubborn button again, adjusted her blouse, and pushed the bead through the slit. Then she worked her way down the row and tucked the shirttail into her wool skirt. Sweat trickled from beneath her arms—the radiologist had advised that the aluminum in deodorant could interfere with the images.

She sat in one of the chairs and pulled a binder from her briefcase, flipping it open to her presentation. She read three sentences, made a note in the margin, then closed the binder and set it on an adjacent chair, and considered the room. The pastel colors and floral wallpaper contrasted sharply with the vinyl table in the center. The sheet of white paper covering it always made her feel like a slab of meat being weighed at the butcher shop. A colored diagram of the female body hung on the wall, the fallopian tubes a bright red, the ovaries blue, the uterus green. She considered her watch. How long had she been kept waiting? At Strong & Thurmond, she billed her clients in six-minute increments; few would tolerate being kept waiting. Every fifteen minutes was a .25 on Dana’s billing sheet, which translated into $62.50, based on her $250-an-hour billing rate. The numbers caused her to reconsider the statistics she’d read in the articles from the Internet. Who said too much information was a good thing? Did she need to know that one of every seven women in the United States develops breast cancer, that a new case is diagnosed every three minutes, or that a woman dies of the disease every twelve minutes?

One every twelve minutes. A .20 on her time sheet.

Her cell phone beeped, mercifully interrupting her train of thought. She retrieved it from her briefcase and noted that she had missed a call from her brother, James. She was not surprised; she’d read that twins could have an almost innate sense about each other. Her brother always seemed to know when she was troubled. Sadly, she had either not inherited the same gene or had never managed to cultivate it. She returned his call.

He answered on the first ring. “Dana? How come you didn’t answer your phone?”

“I’ve had the ringer off.”

“
You
had the ringer turned off?” His voice rose with incredulity.

“Very funny. I’m at the doctor’s.”

“I know; your secretary told me. Is everything okay?”

“Everything is fine,” she said, trying to sound convincing. “Just annual checkup stuff.”

He didn’t buy it. “You don’t sound fine. You sound anxious.”

She debated what to tell him and decided on the truth. “I found a small lump in my breast in the shower the other morning. I’m just here to have it checked out. I’m sure it’s nothing.”

“What did the doctor say?”

She noted the alarm in his voice. “I don’t know; I’m waiting to talk with the radiologist.” She sat in the chair. “I’m sure I’m fine.” Seeking to change the subject, she asked, “Why did you call?”

He sighed, then asked, “Why don’t you ever listen to your messages?”

“Because it takes too long. Do you know how many messages I get? It’s quicker to just call back. Did you call to gloat again about how much more you love teaching the law than practicing it?”

He didn’t answer her.

“James, that was a joke.”

“I know… Listen, this can wait. I’ll call you later.”

“It’s fine. I’m just sitting here waiting for the doctor. You know how that goes. I could be here until tomorrow. Is anything wrong?”

Again he paused. “I have a problem. I’m not sure how to handle it.”

“What about?”

“It’s complicated. I’d rather not talk to you about it over the phone. Can we have lunch? I could meet you downtown.”

She shut her eyes. It seemed she never had time. She rubbed her forehead, feeling the onset of a headache. “I can’t today. I have to give a presentation this afternoon. What about tonight? Grant is picking up Molly. I could meet you after work.”

“I can’t tonight,” he said. “I have a late class and forty legal briefs on the Erie Doctrine and federal jurisdiction to read.”

“So teaching isn’t all peaches and cream after all?”

“What about tomorrow?” he asked.

“You’re not sick, are you?”

“No, nothing like that.”

“I don’t have my calendar with me. Call Linda and make sure I’m free.”

The door to the room pushed open. A tall woman wearing a white smock over a beige shirt and blue cotton pants stepped in holding two X-rays. “James, I have to go. The doctor just walked in.”

He rushed the next sentence. “Okay, but call and tell me what the doctor says.”

“I’ve got to go.”

“Dana?”

“I’ll call you. I’ll call you.” She disconnected and shoved the phone into her briefcase. “Sorry about that.”

“Not a problem. I’m Dr. Bridgett Neal. I’m sorry to have kept you waiting.” Dr. Neal’s white smock seemed a size too large. It dangled to her knees and hung from her shoulders as if she’d borrowed it from a big sister. “The mammogram went all right?” Neal wore no jewelry or discernible makeup. She had dark hair with a curl and fair skin. Dana guessed Irish, maybe Scandinavian.

“As well as having my breast flattened like a pancake can go.” Dana mustered a smile. Her conversation with James had distracted her. Now anxiety seeped back into her joints, making her restless.

Neal smiled. “I tell my husband every man should have a similar experience with their testicles to appreciate it fully.”

Dana chuckled. “And you haven’t had any volunteers?”

“Imagine that.” Neal flipped on the light box and snapped three X-rays in place. “We’ve located the lump.” She pointed the end of a red-capped pen at a subfusc gray dot the size of a pea. “When was your last exam? I didn’t find any notation in your file.”

“About a year ago. I asked my doctor to have the files sent over.”

Neal sat on a rolling stool and adjusted the height. “I have them. I’d like to talk with you about the incident in high school.” She reviewed notes Dana assumed had been made by the nurse during their earlier conversation. “You indicated there was no mammogram taken?”

“I don’t think so. Dr. Watkins described it as hard tissue that became inflamed when I had my period.”

Neal grimaced. “It’s too bad they didn’t do a mammogram, but they didn’t always do them back then. It would have been a useful baseline to compare with these images.” She pointed back at the mammogram. “How old was your mother when she had her mastectomy?”

“My age—thirty-four.” Dana’s stomach flipped. She brushed strands of hair from her face, pulling it back off her forehead and readjusting the clip, then she wrapped her arms across her chest. She wished she’d brought a sweater. Why did they always keep these rooms so cold?

Neal put down the pen. “Lumps are not uncommon in younger women. They can come and go with your menstrual cycle.”

“I’m on the pill.”

Neal picked the pen back up. “Lumps are still not uncommon. How long have you been on the pill?”

“Since my daughter was born, almost three years… and four years before that. I’ve wanted to stop, but my husband refuses to wear a condom.”

Neal finished making a note, and slipped the pen into the front pocket of her white coat. She stood. “Will you open your blouse for me?”

“Again?” Something was wrong.

Neal looked calm. “I’d like to feel the nodule.”

Dana sat on the edge of the examination table. The buttons were decidedly easier to undo. She unclasped her bra and raised her right arm over her head. Neal probed with her fingers, looking past Dana at the diagram on the wall. “Do you have any pain in that area?”

“No.”

Neal wrote some additional notes in the chart. Dana reclasped her bra. “Hold on.” Neal looked up. “As long as you’re here, I’d like to do a fine-needle aspiration.”

The words hit Dana like a blow to the chest. “What? Why?”

Neal pointed to the X-rays. “The bump you found appears to have an irregular edge, and its hard.”

“Oh, shit,” Dana said.

Neal raised a hand to calm her. “That doesn’t mean it’s cancerous.”

“Then why the aspiration?”

“Without another mammogram to compare it to, I don’t know how long it’s been there or if it’s changed shape. A fine-needle aspiration allows me to have some tissue examined under the microscope.”

Anger began to replace Dana’s fear. Her mother had lost a breast thirty years ago, and it seemed nothing had changed. “How long will it take? I have an important presentation to give today.” She thought it sounded like an excuse.

“Just a few minutes. It will save you the trouble of having to come back. I can give you the results over the telephone. If it’s fluid, we’ll know immediately. If it is a mass, I’ll obtain some cells and send it down to the lab. Depending on how backed up they are, they should have the results in a few days. The alternative is to schedule you for a biopsy in the surgery clinic downstairs.”

Dana sat again. Neal opened and closed drawers, removing a needle and syringe. Dana said, “You know, when I was seventeen, I never thought anything about it. I remember being embarrassed because my mom was freaking out in front of the doctor. Now I know exactly how she felt. I’m most concerned about my daughter.”

Neal snapped on latex gloves. “How old is your daughter?”

“Three. I read that breast cancer can be genetic.”

“Let’s take it one step at a time. We’ll do the aspiration today, and I’ll give you some written information to take home to read. I’ll call you with the results as soon as I get them. In the interim, try to find something else to focus on.”

Dana nodded, though she was unable to think of anything at that moment.