Second Opinion (22 page)

CHAPTER 40

It was after eleven when Thea, using her electronic pass, pulled into the parking lot outside the Petros Sperelakis Institute for Diagnostic Medicine. Seeing her father's name on the facade of such an elegant building and such a renowned center of medicine brought a small jet of energy to what had otherwise been an absolutely discouraging and exhausting evening. Her brother's and sister's angry words, Scott Hartnett's alcohol-driven anxiety, and Amy Musgrave's allegations about a man incapable of defending himself were simply more than she wanted to deal with.

If only she had come away from Lydia Thibideau's office with the two different films with Hayley's name on them. With Dan's help, she might have chanced taking them to the police, and turning the investigation over to them. Maybe now she should consider going to a lawyer—seeing if there could be some sort of charges brought against Thibideau or even trying for a court order allowing a specialist to have access to the MRIs of Samuel Blackman and the late Warren Grigsby. But what would that accomplish? There would always be a logical explanation, and the whole matter could take months or even years to sort out.

Was Thibideau responsible for the hit-and-run accident? Was her cheating on her clinical research the secret Petros had uncovered— the secret that seemed to have cost him so much of his life?

Thea used the pass to open the door to a largely deserted lobby, and headed directly down to the tunnels and across to the building housing the step-down unit. The gleaming passageways were largely deserted, save for laundry trains, a janitor rhythmically swinging his massive buffer from side to side, and some haggard house officers. Thea flashed back to her own residency. It was a period of amazing growth for her, and one that established her ability to look beyond what others thought was best for her to what she herself thought was best.

At the moment, what was best was to put Niko's party behind her and spend some time with their father; and after that, a visit and maybe some tea with Hayley. Someone knew, she kept thinking. Someone knew what had happened to the Lion, and why. She just had to keep the pressure on without putting the poor guy in anyone's crosshairs.

The nurses working in the step-down unit weren't the least bit surprised to see Thea at such an hour. One of them had quipped that she was like a ghost who haunted the hospital at night. The private-duty nurse, a young grad named Tiffany, seemed superfluous given the lack of activity in the unit and the paucity of visitors, probably due to the barbecue. She was working on Petros's legs when Thea arrived.

'Anything?' Thea asked, moving in across from the nurse and massaging her father's quadriceps muscle.

'Not really. A little while ago, I was cleaning the corners of his eyes with a Q-tip and I could swear his lid twitched. But he didn't do it again.'

Thea felt herself react to the nurse's words, but forced a calm response.

'If it's significant, it'll happen again.'

She sent Tiffany on a break, then wiped the lotion from her hands and did a quick exam, talking softly to the man as she did.

'Hang in there… Your skin looks great… The nurses are doing a terrific job… Niko had a barbecue tonight for about a zillion people… They all asked about you… Terrific food… The kids send their love.'

His joints seemed stiffer, especially at the wrists and ankles—not such a good sign.

Gag reflex: none.

Extremity reflexes: all absent.

Belly: soft.

Cardiovascular system: stable.

Lungs: scattered wheezes, pops, and other indicators of alveolar sac fluid. Not such a good finding, but not surprising, either.

Thea made a mental note to have his bronchial tubes suctioned out more frequently. When he was awake, the procedure had to be very unpleasant for him, but it was a vital, lifesaving maneuver, and besides, unless Tiffany's observation was legitimate, he wasn't awake anymore. Anticipating another nonresponse, she removed the paper tape from each of his lids and lubricated the inside of the lower ones.

'Dad, give me a sign. Give me a sign you can hear me. Come on, Dad. I love you. Show me you can hear me.'

With agonizing slowness, Petros's left eye flicked upward, then returned to neutral.

'Yes!' Thea whispered, pumping her fist below the bed. 'You're back!'

Intensely, she tried sorting out what might have happened to cause this improvement, and what Petros might be capable of in terms of communication. Looking upward, even a millimeter, seemed like such a consummate effort for him—quite a bit more difficult, it seemed, than the movement described by locked-in victim Bauby in his memoir.

There had been no arrivals recorded by Tiffany or her predecessor since Sharon Karsten's visit from three to three thirty. The last appearance by Hartnett was for ten minutes at two thirty. If he had been administering regular doses of a tranquillizer and a long-acting muscle relaxant like pancuronium, he might have assumed that with Niko's party, Thea would not be returning to the hospital this night, so he could wait until morning to give the next dose.

His mistake.

'I need to find a way to communicate with you without tiring you out. Look up if you understand me… Excellent!'

The movement was faint, little more than an upward flicker, but it was definite. Thea added a tiny bit of lubricant. She felt determined this night to push to the limit Petros could handle. She needed to know what to do next, and with her father and Dimitri both convinced the accident had really been attempted murder, and with the grisly warning from the man in the parking lot, she needed to know quickly.

'Dad, I know this is difficult for you,' she said to the motionless figure below her, his chest rising and falling eerily in response to the mechanical demands of his ventilator; the overhead monitor validating that within the shell of his body, his heartbeat was strong and regular. 'I'm going to ask you some questions. All you have to do is look upward if the answer to my question is yes. Otherwise, don't move at all and I'll figure things out. Do you understand?… Please, do you understand?'

A flicker of movement.

'Oh, thank God… Okay. You figured out that Jack Kalishar never had cancer of the pancreas. That's why you gave me his name.'

The upward movement of Petros's eye was tenuous but definite.

'Wonderful.'

Through the glass door, Thea saw the nurse, Tiffany, asking silently if she was needed, and waved her away.

'Okay, let's try again. Is Lydia Thibideau behind all this?… Come on, Dad. Is she?… I take that as a no.'

How could she not be involved?
Thea wondered.
How could she not know?

'Have many patients in the Beaumont been cured of illness that they don't actually have?'

Again, a positive response.

'Patients with diseases other than just pancreatic cancer?'

More slight movement.

'That's it. Good. Keep at it, Dad. Keep trying. Scott Hartnett is involved, isn't he?… Yes! I knew he was. He has some way of convincing patients and their physicians that the patients have a serious illness. They get treated and cured, and then they donate large amounts of money to the Beaumont out of gratitude. That's right, isn't it?'

Petros's eye movement this time was barely detectable. He had tried valiantly. Now it seemed as if he was running down.

But how?
Thea's mind was screaming.
How could Hartnett work such deception?

'One more. Just one more question. Do you know who is responsible for hurting you?'

Nothing.

'Dad, does that mean no? Move your eye if you mean no.'

Again, nothing. Whether he was answering her question or not, the Lion was done—at least for the moment.

'You did great, Dad. You did terrific.' Thea kissed him on the forehead.
'S'agapo, Mpampa,'
she said. 'I love you very much.'

CHAPTER 41

One issue clarified, many more to deal with.

Thea left the step-down unit well after midnight, feeling at once saddened and buoyed. There could be no doubt that Scott Hartnett, brilliant internist and a family friend for many years, was at the center of a medical scam that had added hundreds of millions of dollars to the treasure trove that was the massive endowment of the Beaumont Clinic. Nearly every building at the hospital, and most of the floors within those buildings, were named for someone, to say nothing of the individual rooms and pieces of equipment—even some of the individual furnishings.

Brass Plaques Are Us,
she thought, smiling savagely to herself.

Creating, then subsequently curing illness, where none existed.

Remarkable.

Thea headed back into the tunnel on her way to Hayley's room, wondering just how many patients were involved. Certainly, Hayley Long was one of them. She and Jack Kalishar had to be among the wealthiest patients of the hospital. How many others were there? How many different illnesses?

Then, there were the doctors.

Assuming a complex, pervasive medical scam was going on at the Beaumont, how many others besides Hartnett were part of it? Were the primary care docs and oncologists and various specialists aware of what they were dealing with? The answer, for the vast majority of them, had to be no. If the scheme had been going on for as long as it seemed, someone almost certainly would have caved in and spoken up as Petros had apparently done.

As she entered the elevator in the basement of the building named for her father, Thea couldn't help but wonder if he was part of the deception. She found it nearly impossible to believe so principled a man, with more money than he was likely able to spend over the rest of his lifetime, and a worldwide reputation, would risk his legacy—risk everything that mattered—to pile up donations and add brass plaques to the walls of his hospital. Had he been involved and finally decided that enough was enough? Would he ever tell her if he were?

'Your father has been fighting against the fundraising philosophy that has enabled our main hospital and its satellites to win award after award for our nursing service.'

Musgrave's exact words. She had sounded so sure of herself—so passionate. It was time for Thea to sit with Hayley, and later with Dan, and get their opinions. At this point, what she needed more than anything were allies—allies and ideas. One thing seemed certain: At the moment, Petros was as vulnerable to Hartnett and whoever else was involved as he was to the ravages of his injuries.

Hayley was not in her room.

The books were there, and her clothes, and a pile of papers on her bedside table, and a half-empty pitcher of water. Apparently, she had gone off wandering the hospital as she sometimes did. Perhaps she had even gone to see Petros, as she had in the past. Thea's revelations about the MRIs in Thibideau's files had to have been unsettling for the woman. A walk made perfect sense.

Feeling vaguely uneasy, Thea sat down in Hayley's reading chair and flipped through the pages of a dry business magazine without actually digesting the words. Five minutes later, her unease had intensified, and after ten minutes, she was at the nurses' station. There were four women—two aides and two RNs—on the night shift on PS-4, as the floor was known. None of them had seen Hayley leave, and it was their policy to have any patient departing the floor for any reason sign out. Thea checked the book. Nothing.

'Something's happened,' she said, before even trying to reason out where her friend might have gone.

The charge nurse immediately called her supervisor.

'Page her,' Thea insisted. 'Page Hayley throughout the hospital.'

'Can't,' the shift supervisor said. 'It's strictly against regs to broadcast any patient's name.'

She called security.

At this point, although she was concerned, Thea did not believe that anything untoward had happened to Hayley. Instead, she was becoming increasingly convinced that her friend had undergone a change of heart as a result of their conversation about the MRIs, and had used her vast resources to have herself simply removed from the Beaumont.

Thea couldn't help but recall a Sunday morning during her internship at the hardscrabble city hospital across town, when an angry suburban attorney stormed onto one of the busy, understaffed female medical floors. He was on his way in to see his mother, who was hospitalized there with some sort of progressive dementia, along with a myriad of other problems. A mile from the hospital, he had pulled his car over. There, wandering in no particular hurry down the other side of the street, wearing nothing but a Johnny, which was totally open in the back, was his mother. Livid, he bustled her into his car, brought her back to the hospital and to her bed, only to discover that no one on the floor knew she had left.

Instant legend.

It wasn't at all like the Beaumont to lose a patient with no one knowing where she had gone, but the place was gigantic, and those in the many private med/surg rooms had a great deal of freedom and autonomy. It was up to Amy Musgrave's nurses to know which patients could be trusted and which ones couldn't. Certainly there was no reason to anticipate that Hayley would be a problem.

By a quarter after one, the nursing staff and security people had come up empty. They had even bowed to Thea's insistence that they enlist housekeeping and any available nurses and aides to check every public bathroom stall—men's and women's—in case Hayley had experienced some sort of med reaction, and had gone into one of them before passing out.

'She's back home in Georgia,' Thea said to the supervisor, when the last of the negative reports had come in. 'We should call her husband.'

'How would she get a flight at such a late hour?'

'It would be
her
plane. Or
her
limo. Or even
her
helicopter. Any helicopter takeoffs from here since she was last checked?'

'Not that I know of. And why would she leave everything in her room like this?'

'She's a multibillionaire. She's used to doing whatever she wants to. Can you give me her husband's number?' Sorry, it's—

'I know. I know. Against regs. I'm pretty sure this isn't the circumstance the HIPAA people were protecting patients against when they drafted their laws. If I can't call her husband, then you call him.'

The nurse was flustered and anxious.

'I think I'd better call Amy first. She might want the hospital lawyers brought in.'

Thea could only groan. 'Go ahead and get her in here.'

One phone call to Atlanta and the whole matter could possibly be resolved.

But that one phone call, when it was finally made, only added to the confusion, and to Thea's concern. Hayley's husband had spoken to her twice that evening—once when Thea was with her, and once an hour or so later. Initially, Hayley and he had decided that she would continue with her chemotherapy. But after some thought, she had completely reversed her stance and had decided to stop her treatment until a repeat MRI could be obtained. If the film showed no evidence of residual tumor, she intended to get a second opinion from a GI oncologist in Atlanta as to whether to resume her therapy. As to her whereabouts, her husband had nothing to add to the situation except his anxiety.

Musgrave, who had made the call, seemed appropriately alarmed. She spoke to
her
nurses as if they were the ones who had initiated the search, and more or less ignored Thea. She was about to order a second, even more in-depth search of the hospital, along with a policy-violating overhead page, when Thea had had enough.

She motioned Musgrave away from the group now clustered at the nurses' station.

'Call the police, Amy,' she demanded in a harsh whisper, glaring at the fiery nurse. 'Hayley's either gone into hiding someplace where we'll never find her, or she's been kidnapped.'

'Why would she have gone into hiding?' Musgrave asked.

'You seem to be tuned in to most of what's going on around this hospital. I was hoping you might know something about the answer to that question.'

'I don't know what you're talking about.'

But she did.

Thea, who considered herself a weakling when it came to reading people's expressions and their tone of voice, could see fear and uncertainty etched across the nursing supervisor's face. It seemed for an instant as if she were going to blurt out something like
How did you find out?
But instead, Musgrave spun around and returned to the security officer in charge.

'Call in the police,' she said. 'I'll get ahold of Dr. Karsten. And I'll call in Dr. Thibideau as well. Perhaps she knows why Ms. Long decided to stop her treatments when they seemed to be working so well.'

Good move, Amy,
Thea silently cheered, praying that for whatever reason, Hayley had gone into hiding, but knowing in her heart that wasn't the case.