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Authors: Mason Lucas M. D.

Error in Diagnosis

BOOK: Error in Diagnosis
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Brickell glanced to the side of the room. Urging her to wrap things up, Julian gave her his most subtle

“I have time for one more question,” she said.

Before she could recognize anybody, an uninvited voice asked, “Is there any possibility GNS is an act of biological terrorism?”

Her eyes found the young woman in the center of the room who had asked the question. She had no clue who she was, but she didn't feel she could use her refusal to follow proper protocol as a way of dismissing the extremely valid question.

“All possibilities will be carefully evaluated,” she was careful to answer. “But at this time, we have no evidence that GNS is the result of a biological weapon.” Brickell took two short steps backward. “I'm sorry. I'm going to have to stop here. I encourage all of you to refer to our website for the exact date and time of our next briefing.”

She turned away from the lectern, and with Julian in tow, she quick-walked out of the briefing room.

“Excellent job,” he told her. “Especially that last question.”

“Excuse me?”

“Your responses were honest and on point. I'm sure they helped to diminish the anxiety of an impending crisis.”

Brickell was well aware that part of Julian's job was to contain prickly situations and curry favor with her regardless of how difficult the situation seemed. But today, his fairy-tale optimism was over the top.

“Julian, we're dealing with a potentially devastating disease that's spreading out of control. To make matters worse, it's selectively attacking pregnant women, one of any society's most vulnerable groups.” She looked at him as if he should know better. “What did you call it—‘an impending crisis'? This crisis is hardly impending. It has a large gray fin, is finished circling, and just about ready to bite us all on the ass.”

An imprint of Penguin Random House LLC

375 Hudson Street, New York, New York 10014


A Berkley Book / published by arrangement with the author

Copyright © 2015 by Gary Birken.

Penguin supports copyright. Copyright fuels creativity, encourages diverse voices,
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BERKLEY® and the “B” design are registered trademarks of Penguin Random House LLC.

For more information, visit

eBook ISBN: 978-0-698-18506-7

Cover design by Jason Gill.

This is a work of fiction. Names, characters, places, and incidents either are the product of the author's imagination or are used fictitiously, and any resemblance to actual persons, living or dead, business establishments, events, or locales is entirely coincidental.


For Jax, Lucas, Charlee, Jacob, Maya, Mason, and Madison, who continue to keep me young and provide me with inspiration.


Title Page



Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

Chapter 14

Chapter 15

Chapter 16

Chapter 17

Chapter 18

Chapter 19

Chapter 20

Chapter 21

Chapter 22

Chapter 23

Chapter 24

Chapter 25

Chapter 26

Chapter 27

Chapter 28

Chapter 29

Chapter 30

Chapter 31

Chapter 32

Chapter 33

Chapter 34

Chapter 35

Chapter 36

Chapter 37

Chapter 38

Chapter 39

Chapter 40

Chapter 41

Chapter 42

Chapter 43

Chapter 44

Chapter 45

Chapter 46

Chapter 47

Chapter 48

Chapter 49

Chapter 50

Chapter 51

Chapter 52

Chapter 53

Chapter 54

Chapter 55

Chapter 56

Chapter 57

Chapter 58

Chapter 59

Chapter 60

Chapter 61

Chapter 62

Chapter 63

Chapter 64

Chapter 65

Chapter 66

Chapter 67

Chapter 68

Chapter 69

Chapter 70

Chapter 71

Chapter 72

Chapter 73

Chapter 74

Chapter 75

Chapter 76

Chapter 77

Chapter 78

Chapter 79

Chapter 80

Chapter 81

Chapter 82

Chapter 83

Chapter 84

Chapter 85

Chapter 86

Chapter 87

Chapter 88

Chapter 89

Chapter 90

Chapter 91

Chapter 92

Chapter 93

Chapter 94

Chapter 95

Chapter 96

Chapter 97

Chapter 98

Chapter 99



West Palm Beach, Florida

Tess Ryan was lost.

Gradually maneuvering her SUV down one indistinct street after another, she bemoaned her spinning instructor, Cal's, decision to build his new gym in a warehouse district that was more confusing than an English hedgerow maze. But in spite of the fact that every building and street appeared identical, she still couldn't explain how she had gotten lost driving to a location she had easily found four times a week for the past eleven months.

Fearing she would miss the beginning of her class, she allowed a frustrated sigh to escape her lips. Had this morning's dilemma been an isolated event, she might not have been so dismayed, but of late, she had been plagued with
repeated mental errors and memory lapses. Earlier, she had had to look up her sister's phone number, a call she had made a hundred times a year for as long as she could remember. A couple of days ago, she was stuck at an ATM machine struggling to remember her PIN number.

Heading west, she shaded her eyes from a sun that was settling above an endless row of flat gravel roofs. After a few more minutes of randomly creeping up and down the grid-like streets, she spotted a line of familiar cars parked in front of the gym. With an appreciative glance overhead to acknowledge the divine intervention, she pulled in behind the last car. Grabbing her gym bag, she pushed open the door. With her first step she was out of the car, and with the next she was standing in front of the gym. Curling her fingers around the knob, she took a cleansing breath, and then with a ginger push, she slipped inside.

Cal's gym was hardly a showroom for the modern workout facility. The collection of basketball jerseys that hung randomly from the rafters did little to divert one's eye from the grit and black smudges that tattooed the cinderblock walls. His artistic masterpiece was the wall outside of his office that he had wallpapered with dozens of collapsed Red Bull cartons. Over the relentless objections of his students, he insisted on keeping the gym oppressively hot. Normally, Tess didn't mind but today, she felt as if she were standing in front of a wood-burning oven. Making matters worse, the pungent smell of ammonia cleaner permeating the air sent her stomach into a series of backflips.

By the sound of Paul Simon's “Diamonds on the Soles of Her Shoes” blaring from Cal's boom box, Tess knew the class was still in its warm-up run. She chanced an apologetic smile his way. From his bike, which sat atop a three-foot wooden platform, the ex–Navy corpsman wagged a reprimanding finger in her direction, but then with a wink and an indulgent grin, he motioned her to join in. Tess mouthed,
Thank you
, made her way between the first two rows, and climbed on her bike.

Long-legged with elevated cheekbones and shadowy blue eyes, she was in excellent physical condition and never had any difficulty keeping up with the class. But today, after only five minutes, she was breathless. Assuming the heat and ammonia fumes were to blame, she decided to press on. To ease her breathing, she stood up and leaned forward over the handlebars. But her performance didn't improve, and she found herself grunting and gulping for air even more feverishly. While she struggled to figure out what was happening to her, she felt the room begin to spin. Setting her ego aside, she slowed her pace and sat back down. She waited a few seconds but the whirling sensation only got worse.

Wondering if Cal hadn't noticed her struggling, she raised her head and looked toward the front of the gym. Instead of seeing his usual determined face pushing the class on, all she could make out was an obscure silhouette. She craned her neck forward and squinted, trying to bring his blurred image into focus, but everything around her became a shapeless convergence of oscillating gray and white shadows.

Consumed with terror, she clutched the handlebars and closed her eyes. To her further dismay, the loss of visual cues only made her vertigo worse. She felt her body rolling and pitching as if she were in a fragile skiff on high seas. She could still hear the music and Cal's shouts of encouragement but they were garbled and soon became distant echoes—echoes that would be the last thing her brain would process.

Tess's head plunged forward and her body wilted. Toppling from the bike like a Raggedy Ann doll, she was moments away from her head hitting the cement floor when the woman next to her screamed. Fortunately, Cal had seen Tess falling several seconds earlier and was already racing toward her. His final stride was followed by a desperate lunge. With his arms fully extended, he snatched her up before she hit the ground. Then, with one powerful jerk, he had her safely cradled in front of him.

“Get me some water and a cold towel,” he announced to the class.

Hurrying toward the other side of the gym, he carried her past his bargain-basement artificial Christmas tree before easing her down on a sprawling canvas mat used for a women's self-defense class. Well trained in CPR, Cal knelt down beside her and studied her breathing pattern. It was rapid but not labored. Her lips were pink—a reliable sign she wasn't suffering from oxygen starvation. Her pulse was strong and regular. Next, he checked her pupils. They were neither pinpoint nor dilated—another good sign.

“Can you hear me, Tess?” he asked, taking note of a small pool of foamy saliva gathering at the corner of her
mouth. When she didn't answer, he repeated his question, “Tess, if you can hear me squeeze my fingers.” Still no response. He looked up at the group and in a voice that now boomed to a fever pitch said, “Somebody call nine-one-one right now.”

Just at that moment, the woman standing next to Cal gasped. With a quivering finger, she pointed at Tess's face. Cal's head snapped back. Seconds earlier Tess's eyes were motionless—now they ricocheted back and forth as if they were two Ping-Pong balls in a wind tunnel. Cal had spent six months of his enlistment at the Great Lakes Naval Hospital assigned to the neurology floor. He was quite familiar with the signs of a seizure. If Tess were having one, it was unlike any he'd ever seen. His eyes remained locked on her like a laser. He felt helpless knowing the only thing he could do until the EMTs arrived was to monitor Tess's pulse and breathing. If either faltered, he'd begin CPR immediately. He swept his clammy hand across his forehead, wiping away a few beads of sweat. And then, in a room overtaken with a deafening silence, he waited.

BOOK: Error in Diagnosis
8.43Mb size Format: txt, pdf, ePub

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