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Authors: Mason Lucas M. D.

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BOOK: Error in Diagnosis
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23

They both remained silent on the drive back to Jack's hotel. By the time Madison dropped him off, he was exhausted. Unfortunately, with his divorce had come a nagging case of insomnia. Even though he was half-dead on his feet, he suspected a restful night's sleep was not in his future.

He was making his way across the lobby when he noticed a squat man with his shirttail draped across his lumpy paunch coming directly toward him. Instinctively he averted his eyes, but it was to no avail. Without breaking stride, the man walked up to him.

“Excuse me, Dr. Wyatt. I know it's kind of late, and I really hate to bother you like this, but I was hoping for a minute of your time to talk with you.”

Jack slowed down, taking note of the man's mismatched, shaggy eyebrows and sagging jowls.

“I'm sorry. Have we met?”

“We've never been formally introduced. My name's Kazminski,” he said with the corners of his mouth creasing into a cordial smile.

“I'm sorry, but it's kind of late and I—”

“Somebody told me you grew up down here. Maybe you remember me. I've been a reporter with the
West Palm Beach News
for nearly thirty years.”

Jack didn't recall the name, and having attended more than one hospital-sponsored seminar regarding the media and medical privacy, he was instantly leery. It didn't take a Rhodes scholar to figure out why Kazminski had ambushed him.

“I'm not trying to be rude, Mr. Kazminski, but if you don't mind I'd really—”

“Most people call me Kaz, but my real first name's Arnold. I guess my mother was in a bad mood the day she named me,” he explained, hiking up his pants with a quick tug on his cracked black leather belt. “Thank God my father had the brains to nickname me Bud two days before I started kindergarten.”

“As I said, Mr. Kazminski, it's been a long day and . . .”

“To tell you the truth, Doc, I've had the same kind of rotten day myself. I'll tell you what. If you don't mind, I'll just walk you to the elevators.” Jack looked toward the far side of the lobby. It seemed hopeless trying to dissuade the pushy reporter, so he decided a controlled dash was his best hope of escape. Jack nodded and started for the elevators. “I was told by a pretty reliable source that you're here to consult on the GNS cases.”

Not having been the victim of a fool's mate since the
first day of his junior high's chess club, he said, “No comment, Mr. Kazminski.”

“I checked you out, Doc. You're an expert in diagnosing tricky neurologic cases. You run the neurology department at Ohio State and you travel all over the place lecturing on the topic.” Jack looked at him askance. Kazminski held up his hand and smiled. “I know what you're thinking. How do I know who you are? Well, I guess after nearly three decades in the newspaper business, you make a lot of friends in all kinds of places—including hospitals.” They stopped in front of the elevators. Jack wasted no time giving the Up button three quick taps. “Do you have any idea what's causing GNS?”

“Look, I'm the last person who'd want to disappoint your readers but I don't think this is the right time or place to—”

Kazminski stepped between the elevator door and Jack. His face suddenly filled with grief. He looked past Jack with a distant stare. “I'm not asking for my readers, Dr. Wyatt,” he began in a cracked voice. “I'm asking for my daughter. She was admitted to Southeastern State a few days ago with GNS.” He cupped his mouth with his hand. “Five minutes of your time, Doc. That's all I'm asking.”

24

The elevator door rumbled open. Instead of moving forward, Jack glanced overhead. A few seconds passed and the doors closed. He looked at Kazminski and pointed to an empty couch a few feet away.

“Sherry's six months pregnant,” Kazminski began. “My son-in-law, David, works for the State Department. He's on his way back from the Far East right now—a little frantic to say the least.” Kazminski waited while a woman in environmental services picked up an empty coffee cup from a nearby end table. “He told me the news of the epidemic has already reached every major city in Asia.”

“Apart from this illness, has she always been healthy?” Jack asked.

“She's never had anything more serious than a cold. She's a social worker assigned to young teenagers in trouble
with the law. She's never missed a day of work because of illness.”

“How familiar are you with the symptoms that led up to her hospitalization?”

“I'm a reporter, Dr. Wyatt. I'm a walking sponge when it comes to accumulating facts. I'll answer anything I can.”

For the next twenty minutes, Jack gathered every drop of information Kazminski could recall regarding his daughter's illness. Her symptoms were identical to all the other women with GNS. Kazminski's claim that he was a fountain of information wasn't an exaggeration.

With his eyebrows gathered in, Jack said, “I'm sorry. I wish there was something I could say to reassure you but I'm afraid, at least from right now, there just isn't a lot of information. We're just starting into this thing. The best minds in the country are all working together trying to find a cure.”

Staring down at his hands, he said, “Two years ago, my wife noticed a little mole on her arm. We saw our family doctor who arranged for a dermatologist to remove it. He told us it was a melanoma but he was certain she was cured. Eight months later she was gone.” He raised his eyes. And then with a blank gaze, he added in just above a whisper, “I'm not sure I can go through losing another . . .” He pulled a business card from the inside pocket of his sports coat and wrote his cell phone number on the back. “My daughter's one of those rare people who everybody loves. She's never done a self-serving thing in her life.” He rolled
his lips back and forth a couple of times. “Until a few days ago, I never questioned the absence of justice. I just thought it was the way things were.”

Lost for words, Jack said, “I'll have a look at her tomorrow.”

“I'd appreciate that, and thanks for listening.” Kazminski handed him the card and shook his hand. “I'd wish you a merry Christmas, Doc, but I don't think too many people are feeling that way.”

Jack waited a few seconds for Kazminski to walk away. He then looked down at his watch. It was close to midnight. He rode the elevator up to the ninth floor and went to his room. Needing a few minutes to gather his thoughts, he walked out on the balcony and looked south along the Intracoastal Waterway.

Beneath the splash of the hotel's floodlights, he followed a sleek catamaran slip under a towered drawbridge. He thought about Tess Ryan and Sherry Kazminski. Then he thought about all the women who were lying in intensive care units across the country. None of them was really just a case of GNS: Each was a victim, a victim whose desperate family members were consumed with terror about what the future held for their loved one.

25

DECEMBER ELEVENTH

NUMBER OF CASES: 2,287
NUMBER OF DEATHS: 7

Jack opened his eyes and shook the sleep from his head. He was just about to throw back the covers and climb out of bed when his phone rang.

“Dr. Wyatt, it's Marc. I'm sorry to call you so early but I'm in the ICU with Dr. Fuller.” From the foreboding tone of Marc's voice, Jack was certain he wasn't calling to tell him Tess and the other patients were showing signs of recovery.

“What's going on?”

“Tess had a major seizure. She's been completely unresponsive to any form of stimuli ever since. Dr. Fuller called
the neurologist on call for a stat consult. She agreed that Tess meets coma criteria.” Marc paused for a moment before adding, “I think things may be going south faster than we anticipated.”

Thumbing his eyebrow, Jack said nothing at first. He wasn't stunned by the news. He suspected things would get worse before they got better, but he was hoping it wouldn't be this soon. It was obvious the slower GNS progressed, the better the chances were of finding a cure. “How is the baby doing?”

“I'm just about to begin a complete evaluation. Madison's on her way in.”

“Has anybody spoken to Mike yet?”

“No. Dr. Fuller thought you might want to be the one to make the call.”

“Do you know if he's in the hospital?” Jack asked, looking down at his watch.

“I haven't seen him as yet. He usually comes in at around eight.”

“I'll call him after I've had a chance to look at Tess. I should be there within the hour.”

Jack showered and got dressed as quickly as he was able. Forty minutes after receiving the phone call from Marc, he was at Tess's bedside. She still had the splotchy red rash, but it was now weeping a thick orange-black colored fluid from the edges. All spontaneous movement was gone. Her face was absent any animation and a gray crescent arc of puffy tissue had developed beneath her eyes.

Jack barely noticed when one of the nurses approached.

“Dr. Wyatt, Mr. Ryan just called. He said he'd meet you in the lobby in ten minutes.”

“Thank you.”

Dreading his impending conversation with Mike, Jack sat down on the far side of the room to gather his thoughts. There was no question in his mind that Dr. Fuller was right: Tess was in a profound coma. With the death toll rising every day, Jack had no idea how long Tess could hold on. He had too much respect for Mike to try to conceal the truth from him. Feeling his options melting faster than a baby's birthday candle, Jack started for the exit.

26

“It's a nice morning,” Mike said, motioning in the direction of the exit. “How about taking a walk? There's a park on the other side of the hospital. It seems like I'm spending more and more time there.”

“Sure,” Jack answered.

They left the hospital and followed a brick-paved path that took them around to the west side of the campus. Similar to Mike, many other family members had discovered the small green space, using it as a respite from the stress and fatigue of the hospital. They sat down on one of a dozen steel benches.

Their conversation began with Jack providing Mike with a detailed update on Tess's condition.

“So, you'd agree with the other doctors that she's worse,” Mike stated flatly.

“Yes.”

“I'm getting the feeling you're struggling to find some way to tell me Tess isn't going to make it.”

“I know I keep saying the same thing, but I need more time.”

“And you still have absolutely no idea what might be causing the illness.”

“Not yet.”

Mike's manner and tone reflected a growing sense of both doom and contrition.

“I got a call from Dr. Sinclair. He told me he thinks he's within a few days of proving what's causing GNS and how to cure it. He wants to set up a meeting with me as soon as possible to discuss his treatment plan.”

“What else did he say?”

“That he believed GNS was a viral disease that was very treatable. He also mentioned that most of the doctors in the country had their heads up their collective asses regarding GNS, and unless they opened their eyes, they had no hope of finding a cure.” Mike waited for a young couple to walk past before going on. “He didn't say it in so many words, but I got the feeling he was counting you amongst those unenlightened physicians.”

Considering the source, Jack wasn't bothered by the comment.

“Over the years I've been called everything from uninspired to intellectually reckless. I guess I've developed a pretty thick skin.”

“Do you think he's right about GNS being a viral disease?” Mike asked.

“My gut feeling is no, but I can't prove he's wrong.”

“So you're saying you don't know?”

“That's right,” Jack answered in a quiet voice. “I'm saying I don't know.”

“On the phone you said you had something to tell me.”

“It wasn't anything specific. I have some understanding of what you're going through and I just wanted to make sure you didn't make any rash decisions. I don't foresee any choices that have to be made on an urgent basis. We should have time to calmly discuss any treatment plans that . . . that are proposed.”

“Since Sinclair's the only one proposing any, I assume you're referring to him.”

“His plan would be included in what I'm talking about.”

“Don't worry. That's why you're here. If you think putting Sinclair off for a few days is the way to go, that's what we'll do.” Mike lifted his eyes, staring off at nothing for a few seconds. “I'd rather not talk about this anymore,” he said, coming to his feet. “Do you mind if we head back to the hospital?”

As they started back toward the hospital, Mike's silence spoke volumes. Jack knew he was doing everything he could to disguise his dismay and fear. Going all the way back to their childhood, one of the first things Jack had learned about Mike was that timing was everything. Now was not the time to try and allay his concerns or look for a silver lining. Jack knew if he tried, it would only make matters worse.

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