Patient (14 page)

Chapter 17

THERE WAS A PALL OVER SURGICAL SEVEN WHEN Jessie arrived at work. Terry Gilligan, something of a mascot on the neurosurgical service because of his dense brogue and infectious wit, was dead. His cardiac arrest had occurred during the early-morning hours and was intractable to the heroic efforts first of the nurses, then of the entire code team. He had been on assisted ventilation because of a seizure and borderline pulmonary reserve, and his tumor was a bad one. But no one had come close to giving up on him.

On a morning that had begun so badly, Jessie was relieved that at last Carl had opted to stay around and see patients. With only her own work to attend to, her day gradually smoothed out. But nothing prepared her for what she found waiting when her afternoon clinic was over—waiting in room 6 of the neurosurgical ICU. When she arrived, the ubiquitous candy striper, Lisa Brandon, was rubbing lotion into Sara Devereau’s feet. “Well, hi,” Jessie said. “Here you are again.”

“Here I am,” Lisa said cheerily.

“You know, everyone on the service is pulling for you not to figure out what you want to do with your life, Lisa. You’re far too valuable as a volunteer here.”

Lisa brushed aside some slips of dark hair.

“That’s very kind of you to say, even if it isn’t true.”

“Ah, but it is. You’re doing a great job with the patients—this one in particular.”

“Thank you. Well, I think we have a surprise for you here.”

We?
Jessie looked quickly at Sara. Reasonably peaceful, but deeply comatose. Still, something about Lisa’s proud expression made her pulse jump a notch.

“Luckily, I’m one of the few neurosurgeons in the world who likes surprises,” she said.

“Okay, then,” Lisa replied, “here goes.” She raised her voice. “Sara, it’s Lisa. Dr. Copeland’s here. Can you open your eyes?”

For two fearfully empty seconds there was nothing. Then, suddenly, Sara’s eyelids fluttered and opened.

“Oh, God!” Jessie exclaimed, grasping her friend’s hand. “Oh, God. Sara, it’s me, Jessie. Can you hear me?”

Sara’s nod, though slight, was unequivocal.

“She started responding to me about an hour ago,” Lisa said. “I almost called you, but then I asked the nurses when you were expected, and they said you’d be up soon.”

Jessie barely heard the woman. Tears welling, she was stroking Sara’s forehead and looking into eyes that were clearly looking back at her.

Conjugate gaze intact ... pupils midposition, reactive
, her surgeon’s mind automatically recorded. She reached over and grasped Sara’s other hand as she had at least once every day since the surgery.

“Sara, can you squeeze my hands?” she asked.

The pressure, faint but definite, and equal on both sides, broke the dam. Jessie made no effort to wipe aside her tears.

“Oh, Devereau,” she said, “where in the hell have you been?”

Sara’s lips struggled to form a word. Over and over again they opened and closed. Finally, there was the faintest wisp of a sound.

“J ... Jessie,” she said.

Jessie turned to Lisa.

“Did you tell the nurses?” she asked.

“No. I thought you might want to.”

“Well, you’re right. I do want to.” She crossed to the door. “Hey, everyone, room six. On the double. Our patient has something she wants to say!”

BECAUSE OF TERRY Gilligan’s death, the entire MRIOR schedule was moved up. Tomorrow’s morning case would now be Gilbride’s operation with the team of Chinese neurosurgeons. In the afternoon, Jessie would operate on Ben Rasheed, a fifty-year-old black laborer and father of four, who presented with severe weakness in his left arm and leg, and was found by Jessie to have a rather large tumor on the right side of his brain—almost certainly an astrocytoma. The sooner the tumor could be removed and graded for malignancy, the sooner appropriate post-op therapy could be instituted—most likely radiation.

With a potentially difficult case tomorrow, followed in the evening by her first real date with Alex, Jessie decided to head home at eight—for her a quite reasonable hour. After reviewing Rasheed’s films again, and making some notes regarding the surgical approach she would use, she took the shuttle to lot E and drove to the Back Bay.

She straightened up her apartment, defrosted some lasagna she had made a month or so ago, and ate it between shots in one of her higher-scoring games of Pin Bot. It had been two years since she scraped together every bit of cash she had and bought the one-bedroom condo. Generally, she felt the apartment served her needs quite well, although her feelings about it often mirrored what was transpiring in the rest of her life. Tonight, with Sara awake, Alex looking like he might be the start of something good, and an exciting OR case in the afternoon, the place felt perfect.

At ten o’clock, when her beeper went off, she had just brewed a cup of Earl Grey, run a steaming tub, lit several scented candles, and set out her favorite huge bath sheet. The callback message on the LED was from the evening shift nursing supervisor on Surgical Seven. Being paged by the extremely capable nurse when she wasn’t on call was unusual, Jessie thought—unusual enough not to ignore.

“Dr. Copeland, I’m really sorry to call you like this,” the woman said, “but Dr. Sanjay is up here from anesthesia. Apparently there’s some problem with Ben Rasheed.”

“What kind of problem? I just went over him this morning.

“Oh, it’s nothing medical. Dr. Sanjay says Ben told him he wasn’t having surgery tomorrow. Wait a minute—here he is.”

Jessie steeled herself for what she knew was going to be a struggle—understanding Sanjay, who spoke perfectly good English, but so rapidly and with such a dense Indian accent that he was always hard to follow.

“Your patient, Mr. Rasheed, tells me he is not going to have his operation tomorrow afternoon. Instead, he is going to have it in two days’ time. According to your patient, someone named Hermann will be taking his place.”

Jessie covered her eyes with her hand. What in the hell had the Countess done now? Borne by her years of making decisions as a surgeon, she ticked off her possible courses of action in seconds, discarding each as impractical, given the circumstances, the hour, and the personalities involved. Finally, only one option remained.

“I’ll be there in twenty minutes,” she said. “Go ahead about your business. I’ll page you after I’ve had the chance to speak with Mr. Rasheed.”

AT TEN-THIRTY In the evening, the ride to EMMC took just fifteen minutes. The best part about coming to the hospital at such an hour was that there would be parking spaces in the central underground lot. Throughout the ride, Jessie tried to find some explanation for Ben Rasheed’s sudden refusal to be operated on tomorrow other than that he had sold his OR time to Count Hermann. But no other rationale made sense.

As she turned in to Longwell Street, which ran along the back of the hospital, she peered up at the Surgical Tower. From this side, her office was visible seven stories up. Suddenly, she pulled the Saab over and stopped. There was a light on in her office. Moments later, the silhouette of a figure passed behind the sheer white curtain.
Housekeeping?
Hard to believe at this hour, she decided.

She hurried into a parking spot and raced through the basement to the Surgical Tower elevator. She stepped from the car on seven, hesitated, and then used a nearby house phone to call security, hoping that Alex was around. Instead, her call was answered in two minutes by the guard whom she had seen in the cafeteria with him, a bear of a man named Eldon Ellroy.

The corridor outside the offices was on evening-light status, with every other fixture dark. There was no light coming from beneath any of the doors, including hers. Gently, silently, Ellroy tried the knob. Locked. Then Jessie inserted the key, turned it, pushed the door open, and stepped back into the corridor. Nothing. Ellroy reached around the jamb and switched on the light. The tiny office was empty. He motioned her inside, and she confirmed that there was nothing out of place. Ellroy reassured her kindly that ever since the hospital started cutting back on electricity, security had been getting many more calls such as hers. Then he left.

Jessie stood in the silence, still tensed. The papers on her desk and in her drawers seemed in order, but she couldn’t shake the feeling that someone had been there. Finally, she marginally convinced herself that the light and silhouette she had seen were in one of the orthopedists’ offices on Surgical Six. Turning off the light and carefully locking the door behind her, she headed to the ward and Ben Rasheed’s room.

Rasheed’s ebony face, set off by a clean-shaven scalp, was thick-featured, deeply lined, and, to Jessie, handsome. His outsized, heavily callused hands could easily have palmed a basketball. He had a spirit that made him one of Jessie’s favorites, and loved to tell stories about his life as a bodyguard, chauffeur, and construction worker, and to drop the names of the famous people with whom he had, at one time or another, crossed paths.

Rasheed’s half of the double room was adorned with photos of his wife and children. As soon as he saw Jessie at the doorway, he playfully ducked beneath the sheets. She pulled up a chair and waited. Rasheed stayed where he was.

“I ain’t comin’ out until you say you’re not mad at me,” he announced.

“Ben, I
am
mad at you. You can’t do this.”

Slowly, tortoise-like, Rasheed emerged. His expression was deadly serious.

“Doc, I
got
to,” he said.

Jessie took a calming breath.

“Okay, okay. Start from the beginning.”

“A few hours ago, this woman come to see me. She spoke like, I don’t know, like a Nazi in a war movie.”

“I know who she is.”

“Okay. Well, she says that her husband’s very sick and needs an operation bad, but that he can’t get no time in the operatin’ room for two days. She says that if I change places with him, an’ let him have my time, I could have his.”

“How much money did she offer you?”

“I ... I promised I wouldn’t say.”

Jessie was about to demand to know, but then realized there was no need. Ben Rasheed was anything but dumb. He knew what was at stake for himself. If he was making this decision, the money had to be enough for him.

“Ben, this is potentially a very dangerous thing for you to do,” she said. “You’ve already had some major symptoms. With this type of tumor, things can come apart very quickly. That’s one of the reasons we’ve put you in the hospital to wait for your operation.”

“I know that. But I also know you won’t let nothin’ bad happen to me.”

“Ben, that’s a little naive. The longer we wait, the more chance something bad
will
happen. And if it does, I can’t make any guarantees.”

“But you said that about the operation, too, Doc. No guarantees. I know this tumor in my head might kill me whether I wait an extra day or I don’t. I got four kids, a wife, an’ a mortgage, an’ I got nothin’ in the bank an’ no life insurance. For what this lady’s gonna pay me, I’m willin’ to roll the dice. Christ, for that kind of money, if she wanted my kidney, I’d hand it over. I know you’re angry with me, Doc. I’m sorry ’bout that. But a man’s gotta do what a man’s gotta do.”

Jessie knew that were their roles reversed, she would have made the same choice.

“Okay, I’m not angry with you, Ben,” she said. “One thing, though. You don’t have to tell me the amount, just tell me the terms.”

“Some now, more after the guy’s operation.”

“I want you to get it all up front. Mrs. Hermann has cash. I’m certain of it.”

“You gonna talk to her about that?”

“You bet I am,” Jessie said.

THE EXCHANGE WITH Orlis Hermann was brief and to the point.

“I don’t know how much you offered Ben Rasheed, Mrs. Hermann,” Jessie said, “but I want it paid in full before the Count’s operation tomorrow.”

“Or what?” Orlis asked.

The two women faced off across the dimly lit hospital room, with Rolf Hermann and one of his sons looking on. Jessie refused to blink.

“Or I’ll do whatever is necessary to get your husband taken off the MRI-OR schedule and pushed back to his original slot.”

“I have already spoken with Dr. Gilbride about the change in schedule. He wants to do this operation as quickly as possible.”

“I don’t care,” Jessie replied. “I believe he also wants to keep me on his staff.”

Orlis studied her resolve, then said simply, “Mr. Rasheed will have his money tomorrow morning.”

“One more thing. If I hear of you interacting with any of my patients again without my permission, I’ll move heaven and earth to have you and your family shipped to another hospital. Is that clear?”

“Get out,” Orlis Hermann said. “Get out of here this instant.”

Jessie stormed from the room, left word with Sanjay, the anesthesiologist, that his afternoon case had changed, and hurried down to her car. She was determined that Orlis Hermann wasn’t going to ruin what had been a wonderful day. With any luck, the water in the tub would just take a little heating up. She was at the parking attendant’s booth when she realized that her purse was still on the chair in her office.

“Sorry, but you can’t leave your car there,” the sleepy attendant told her when she tried to park it off to one side.

Weary of conflicts, Jessie turned around and eventually pulled into the slot she had just left. She took the elevator back to Surgical Seven, inserted the key in her office lock, and opened the door. As she was reaching for the light switch, a strong hand snatched her wrist and jerked her inside. At the same instant, the man’s other hand clamped tightly across her mouth.

Chapter 18

EVEN BEFORE SHE HEARD HIS VOICE, JESSIE KNEW it WAS Alex.

“Jessie, it’s me,” he whispered. “I’m going to let go. Just promise me you won’t scream. ... Do you promise?”

She nodded. His grip lessened and finally released altogether. Jessie turned, rubbing her mouth, and glared at him through what light the filmy curtains permitted. She felt as if she had been gored.

“I knew you were too good,” she said.

“I’m sorry.”

“Can I turn the light on?”

“How about the one on your desk?”

Jessie switched it on and moved quickly to her own chair before he could stop her or object.

“That was you in here a while ago, too, wasn’t it?” she said.

“By sheer chance I looked out the window just as you pulled over to the side of the street. I wasn’t sure, but I thought it was you.”

Jessie forced her lips tightly together until she was certain she could speak without crying or screaming. Absurdly, she flashed on the tub in her apartment, and the tea, and the candles. Alex just sat there, arms folded, waiting. At least there was nothing smug in his expression, she thought. At least there was no half-assed, knee-jerk attempt at fabricating some lame explanation for why he had twice broken in to her office.

“Well,” she managed finally, “you haven’t killed me, so I assume I’m going to get some sort of tale to convince me you’re not just a low-life snoop or thief or pervert—something like that you’re an undercover cop working on a case?”

His smile was uncomfortable.

“Actually, I’m CIA.”

“Uh-huh.”

“Well, sort of CIA.”

“Sort of.”

“We get paid by the CIA, but we function pretty independently. I should say functioned. We’ve been broken up and those of us who are still alive have been sort of decommissioned.”

“We?”

“An antiterrorist group, I guess you’d call us.”

“Does your ‘group’ have a name like SPECTRE or SMERSH?”

“No. No name.”

“ID?”

“No.”

“A phone number?”

“Not really. There’s a guy in Langley who’d probably vouch for me, but he’s on vacation.”

“On vacation. ... Alex, what were you doing in my office?”

“I’ll tell you, but I need you to promise you’ll give me the benefit of the doubt.”

“Benefit of the doubt? Until I hear a reasonable explanation for what you just did, I’m not promising to give you the benefit of anything.”

He studied her for a time, then sighed.

“I was getting ready to go through your patient records,” he said.

“Of course. You broke into my office to go through my patient records. What else? I should have guessed that right away. How foolish of me.” Jessie felt herself coming unraveled.

“I wish you wouldn’t do this,” he said.

“What I’m going to
do
in about ten seconds is call the police.”

“If that’s what you think you have to do, I won’t stop you.”

“Is this some sort of bluff? You think if you tell me it’s okay to call the police, I won’t?”

“No. No bluff. Listen, if I go out to get something from my locker, will you wait here for me?”

“Are you going to bolt?”

“No.”

“Look at me! Are you going to take off?”

“Jessie, that’s the last thing I’m going to do. Will you wait here? There are lives at stake.”

“My, my, such high drama. Go ahead. I’ll wait. But before you go, I want to tell you that I’m feeling a little used by you, for whatever silly reason. And I hate that feeling. So whatever it is you’re going to go and get from your locker had better be good, or else don’t bother.”

Bishop stood slowly and, never taking his eyes from her, backed out of the office. Jessie sat there, staring unseeingly at the elegant paperweight Emily had given her last Christmas, feeling too stunned and disappointed to move. She knew there was nothing Alex could tell her that would erase the hurt. She thought about just leaving—going home to bed. If she stayed and Alex didn’t come back, she’d be relieved. If he did return, she’d probably not believe anything he told her anyway. So why not just go?

Shit!

Employee lockers were in the subbasement. Jessie timed out five minutes, and was about to head home when Bishop returned carrying a large manila envelope. He looked relieved to see her still there.

He sat down, cradling the envelope in his lap. “What I told you before is the truth. For years I’ve worked undercover for a branch of the CIA. Mostly I’ve been in Europe.”

“Go on,” she said, interested in his story, but disinclined to believe it.

“Have you ever heard of Claude Malloche?”

“No.”

“That’s not surprising. Not many people have. In fact, in some places he’s called the Mist or some equivalent, suggesting that he really doesn’t exist. But he does. He kills for a living. A prime minister or a plane full of tourists, Malloche really doesn’t care as long as the price is right. He’s French by birth, but he comes and goes—Germany, the Balkans, Russia. He has places all over. I have reason to believe that he or those who work for him have killed more than five hundred people, if you count the jetliner explosion over Athens five years ago, and the one over the Canary Islands two years ago.”

“I thought Arab terrorists were blamed for that Athens one,” Jessie said, upset with herself for participating in his tall tale.

“The money was Arab, and one of their splinter groups claimed responsibility, just like the Algerian separatists took credit for the Canary Islands disaster. But Malloche blew up both planes for those groups. I’m certain of it.”

“And why are you so certain?”

“Because, for five years now, tracking down Claude Malloche is all I’ve done.”

“Pardon me for stating the obvious,” Jessie said, “but it would appear you’re not very good at your job.”

Bishop sighed.

“Unfortunately, there are a few important people in Washington who agree with that assessment,” he said. “In fact, they’re the same ones who aren’t even convinced there is a Claude Malloche. They think he’s a figment of the CIA’s imagination, used to explain every assassination or bombing we’re unable to solve.”

“Like Santa Claus gets credit for Christmas presents.”

“Jessie, you have every right to be furious with me. But please, just hear me out.”

“Go ahead.”

“Malloche is like the bull’s-eye at the center of a target. Surrounding him is a small organization I have heard called the Dark—maybe ten or twelve men and women who are suicidally loyal to him. They are the only ones who ever have contact with him—and live. And around that group is another ring of supporters, much more diffuse and less informed, and then another ring. So far the network has proven impossible to penetrate very deeply. We’ve lost several people trying. Those at the center have no political agenda other than money. Malloche himself is ruthless, brilliant, incredibly careful, and absolutely without regard for human life—
other
humans’ lives, that is.”

“And you’ve been chasing him.”

“At the moment, I’m all that’s left of a unit that once was six. Four of the others have disappeared, and are presumed dead. One is teaching recruits. I can’t get more men or more money to keep after Malloche.”

“Because people in Washington don’t think he exists.”

Bishop looked as if he were about to speak, then nodded instead.

“Do they know
you
exist?” Jessie asked.

“They’ve demanded that I stop what I’ve been doing and return to Virginia to join my former partner and become an instructor for new recruits to the agency. I’m overdue to report by almost a month now. They’ve already sent a man here to bring me back or kill me.”

“And did you kill him?”

“I could have, but I didn’t. Next time they send someone, I will probably have to.”

“That’s great to hear. There really isn’t a phone number I could call to verify all this?”

“Not really.”

“How do you get paid?”

“I don’t think I do anymore. But when I did, it was a rather complicated, convoluted process.”

“Of course. Forget I asked. You have a photo of this Malloche?”

“Maybe. Maybe dozens. He doesn’t look the same in any two of them.”

“Fingerprints?”

Bishop shook his head. “Maybe,” he said again.

“Okay, no definite photos, no definite fingerprints, no definite proof he exists. No pay stubs to prove
you
exist. What has all this got to do with me and my patients?”

Bishop extracted some eight-by-ten-inch photographs from the envelope, hesitated, then handed several of them over.

“These are pretty gruesome,” he said, “but after watching you in the OR with that child, I know you can handle it.”

The photos were of corpses—one man and two women in white coats, another woman, quite young, in street clothes—taken in a medical clinic of some sort. Each of them had been shot in the center of the forehead, right above the bridge of the nose.

“Explain.”

“These photos were taken about three months ago by the police in an MRI clinic in Strasbourg, France, right on the border with Germany. The shot placement is a trademark of Malloche’s. It’s the only thing I’ve ever found him to do with any consistency. Look.”

He passed over several more photos of various victims. Each had been-shot in virtually the same place.

“Two months ago,” Bishop went on, “I was able to question a man in one of those outer rings I spoke about, but one not that far from the center. It’s a break I’ve worked years for. The guy had been picked up by the police in Madrid in connection with a political killing there. They had him on video from a surveillance camera. He offered to cut a deal in exchange for being allowed to disappear. One of the arresting officers had known me for years, and when he found out what the killer was bringing to the table, he contacted me immediately. Basically, what the guy said was that Malloche has a brain tumor and that he’s looking for a doctor to operate.

“I began sending out alerts to the FBI in this country, and the equivalent agencies throughout Europe, although I always knew he’d surface in the U.S. or, a remote possibility, in Italy or the U.K.”

“Why those places?”

“You tell me.”

“The finest neurosurgeons, the best equipment.”

“With the U.S. head and shoulders above the others.” He extracted another set of photographs from the envelope and continued. “Three and a half weeks ago, a prominent neurosurgeon in Iowa was shot to death in his office, along with his secretary.”

“Sylvan Mays. He was involved in the same sort of robotics research we are.”

“Exactly. Did you know him?”

“I’ve heard him speak at some conferences, but we’d never really met. I think Carl Gilbride knew him pretty well.”

“From what you do know of this Dr. Mays, do you think he’s the sort who might have come to Claude Malloche’s attention?”

“Perhaps. If Malloche really exists.”

“Do these help convince you? I got them from the Iowa City police. The one sprawled out on the floor is Sylvan Mays. The one at her desk is his receptionist.”

“Same bullet holes.”

“Malloche has a thing about witnesses. Mays’ wife says he had been talking about coming into a lot of money, but he wouldn’t say how, and there’s no extra money in any of his bank accounts. I have a feeling Mays had already agreed to do Malloche’s surgery, and then something went wrong. Malloche decided he didn’t trust him, or Mays tried to back out for some reason.”

“Bad idea, it would seem. Okay, Alex, I’ve seen enough.”

“You believe me?”

“Hell no. And if this Claude Malloche really does exist, I have no reason to believe you’re not him.”

“Jesus. Jessie, I’m telling you the truth. I’m certain Malloche has learned all he can about robotic surgery and Marci Sheprow’s operation, and has decided to have Carl Gilbride perform his surgery.”

“Then why not go to Carl?”

“I’ve checked around. I get the sense that Gilbride would be willing to cut almost any corner—or any deal—depending on what was in it for him. I don’t know if I can trust him. I don’t have time to check on whether or not he has made any major deposits over the last couple of weeks either, so I’ve just got to go with my gut. And my gut says Malloche is here or he’s gonna be here real soon. Five years, Jessie. Five years and this is the best shot I’ve had at the bastard—maybe the last shot.”

“Well, good luck, and good night.”

Jessie stood to go.

“Please, wait, Jessie. I told you that our unit had lost four men.”

“Yes.”

“Well, two of them were killed when an informant we trusted sold us out and we were ambushed by Malloche’s people. One of those men who was killed was my older brother, Andy. I was wounded. He was dragging me to cover when he was shot by a long-range sniper right here.” Bishop pointed to the spot just above the bridge of his nose. “His killer fired from nearly half a mile away. Malloche is one of the very few people on earth who could have made that shot.”

“If that’s really true,” Jessie said, “I’m sorry. I honestly am. Now, I’m going home.”

“Wait! Dammit, Jessie, please. I need your help. This is my last chance. I’m not going to give up and go teach at their secret agent school, and the agency is going to keep after me. If I kill one of their men, they’ll just send someone better.”

“I think you should give up.”

“With Mays dead, this seems like the obvious place for Malloche to go—especially after Gilbride got all that publicity for operating on that gymnast. So far, though, I haven’t been able to figure out whether or not Malloche is here. Since I arrived, I’ve been lifting prints off glasses and other things from every new male patient who’s come onto the neurosurgical service. I’ve sent them to Interpol, and today I brought them to D.C. in hopes of matching them to any of the two or three dozen maybes I’ve gotten on Malloche over the years.”

“And?”

“Nothing. I’ve got to know more about each of the patients. And when we determine which one Malloche is, I may need help capturing him. There are just too many doubters. I need him alive. But even dead, I have a chance to identify him.”