Mercy

CHAPTER 53

Michelle Stevenson poured a little more wine into Julie’s glass. They were back in Michelle’s nicely appointed living room where a framed beetle hung on the wall near a picture of Michelle’s son, Andrew. Julie had gone to the home of Keith and Michelle to talk arachnids-specifically, the lone star tick. Julie’s theory was that somehow the tick saliva had been synthesized and then injected into the patients to turn them alpha-gal allergic.

Julie looked at the picture of Andrew with a renewed feeling of gratitude for her own life, for her many blessings, for Trevor, and a sense of peace she felt now that Lincoln Cole and Roman Janowski were no longer threats.

“Will they charge Roman with murder?” Michelle asked.

“The police are working on it,” Julie said. “That’s why I need your help. Roman certainly had access to the patients, and giving an injection of cetuximab isn’t so hard to do. What I can’t figure out is how he made them positive for the alpha-gal allergy.”

Keith, dressed comfortably in jeans and a navy polo, made a sound suggesting that he was at a loss as well.

“For such a small critter, the tick’s salivary glands are incredibly complex,” Keith said. “I mean, it’s really quite remarkable. It’s certainly a key to their evolutionary success. The bioactive component exhibits a range of pharmacological properties. I’m not sure how it would be synthesized, but I suppose it’s possible, or elements of it at least.”

Michelle said, “What was Romey’s motive in all this?”

“Well, he didn’t come right out and say it, but profit, I’m sure,” Julie said.

“How so?” Keith asked.

“Moving from fee-for-service to the accountable care model changed the profitability equation. The extra money an ACO can earn from Medicare kicks in only if the patient’s cost for care is lower than expected. What better way to control costs than get rid of the expensive patients? Hospitals’ revenues are up, but margins are down because of climbing expenses. A patient like Sam could cost up to a half million dollars, maybe more. Get rid of enough patients like him, put a stop to unnecessary tests and treatments, and it combines to make a big difference to the bottom line. We don’t know how many people Roman murdered, but to make it worth his while it had to be a lot.”

“Judging by the ones we know about, they had a lot of tests and treatments coming their way,” Michelle said, sipping her wine. “Though Very Much Alive would argue those were hardly unnecessary.”

“I agree,” Julie said. “But it was a point Roman made before the FBI came barging in to arrest him.”

“Oh, I would have loved to see the look on his face when that went down,” Keith said.

“You should have seen the looks on the faces of the Boston detectives,” Julie said. “They were none too pleased, and the FBI was gloating a bit, but they got Lucy and Becca out of trouble, thank goodness. I guess intra-agency competition is a normal thing. I’m just glad I was able to put Roman where he belongs.”

“And poor Dr. Coffey,” Michelle said. “What a scare. I’m surprised he didn’t have a coronary.”

“He’s a pompous ass with a heart of stone, so I’m not surprised at all,” Julie said. “He had nothing to do with this, but he earned his place in the operation.”

Keith stood, shaking his head in disbelief. “Crazy. Just crazy. Let’s break for dinner, and then afterward we’ll dive into the nuances of tick saliva,” he said. “I’ve got braised chicken with artichokes in the oven. I’d hate for a lengthy discussion about tiny blood-sucking arachnids to ruin our appetites.”

“I’ll help you get it ready,” Michelle said, rising from her chair.

Julie stood as well. “May I use the bathroom?”

“Of course, you know where it is. Down the hall next to the study.”

When Julie got out of the bathroom, she could hear Keith and Michelle having what sounded like a heated conversation. Marriage was hard, Julie knew, and she wandered into the study to give the couple some space to finish their disagreement. She scanned the bookshelves, noting many medical ethics texts, some novels, a few classics mixed with mysteries and thrillers. Keith had his own section for medical texts, but some remnants from his past life as a bug enthusiast lingered, including a large volume specifically on arachnids.

Julie took the book off the shelf and turned to the index, where she found an entry for the lone star tick. She opened to that page and a shiver tore through her body.

The page was marked up, highlighted, words scribbled in the margin. Several loose pages from a notebook were folded up inside. Julie flipped through other pages in the book, but only the entry for the lone star tick had any markings on it.

Taking care to be quiet, Julie unfolded the loose pages tucked inside. It took her a moment to understand what she was looking at. Gripped with a sudden terror, Julie put her hand to her mouth to silence her gasp.

The pages contained diagrams of what appeared to be a complex incubation system. There were instructions for light and food sources, specific details on moisture and temperature, along with diagrams of the life cycle of the lone star tick from egg to larva to nymph to adult. There was also an illustration of a very large cage and a crude rendering in pencil of rats in the cage.

Julie felt sick. She poked her head out of the study and could hear the tense conversation between Keith and Michelle continuing.

Keith… my God… it’s Keith.

Julie’s heart went to her throat, her thoughts racing.

They hadn’t synthesized the saliva at all. He was using real live ticks to make the patients alpha-gal allergic. But how would he harvest them? From the rat cage he kept in the basement, that’s how.

She recalled snippets of what Michelle had said. “He has rats… a cage he keeps downstairs.” Didn’t she say something about Keith spending hours down there?

Julie walked silently down the hall. She could hear the discussion between Keith and Michelle a bit more clearly. She closed the bathroom door and left the light on inside, hoping it would look like she was still occupied if anyone came looking for her.

“Spare me how in touch with my feelings you are, Keith. You don’t get it and you don’t get me, and let’s stop pretending you do.”

The fight sounded familiar to Julie. It could have been a squabble she once had with Paul. It distracted Keith, though, and allowed Julie to descend the front stairs down to the lower level.

Just like the time she made her way through Sherri’s darkened home, Julie used her phone as a flashlight to go exploring. The basement was a multiroom design, with a bathroom to her right, and a room directly across from the bathroom that functioned as a wine cellar. One end of the hall had a door that probably opened to the garage. At the other end was a second closed door. It was this door Julie opened. She stepped into a utility room covered in drywall with linoleum for flooring.

The flashlight from Julie’s phone cut through the darkness. She scanned one side of the room, bouncing her light over stainless steel tables and shelves with various pieces of lab equipment-all very modern looking, like something Lucy would have in her lab at White. Behind her, Julie heard a sound of scurrying feet.

She whirled and saw a cage on a wooden stand. The cage was far bigger than anything sold at a pet store. Custom built, Julie speculated. Inside were eight rats, crawling over a floor made of moss and grasses. They were playful creatures, all in good health, it seemed. Julie’s nervousness spiked as she opened the top of the cage.

The rats sensed her presence and the scurrying intensified. With her heart thundering, terror percolating in her throat, Julie reached a hand into the cage and felt around for one of the rats. She had experience in handling Winston, so this was doable.

The rats lunged at the intruder. One nipped at Julie’s fingers, another brushed the skin of her hand with its taut tail. Julie pulled her hand away in a panic, but reached in again, this time seizing one of the rats by its plump midsection. The rodent’s legs kicked furiously, scraping against Julie’s hand with sharp-clawed feet.

Julie held the squirming animal with one hand and used the flashlight in her other to check its fur. At first she saw nothing, but a closer examination revealed various protrusions coming up off its body.

Julie held the light closer and saw a tick embedded in the animal’s skin. But not just one tick, at least a dozen on this rat alone. Julie did not need a field guide to know these were lone star ticks.

Julie had just dropped the rat back into the cage when her world went dark. A pain exploded on the side of her head and her knees buckled as she toppled to the floor, sprawled on her back at an odd angle. The throbbing in her temple became an intense, searing pain. She felt a gush of warmth as blood poured from the wound to her scalp. A light came on. Her vision returned, but was blurred.

Julie moaned and tried to stand, but a figure loomed over her and pressed a foot against her sternum to hold her down. Now she could see him clearly. Keith wielded a frying pan in his right hand. He glared at Julie with a look of scorn.

“Quiet. I don’t want our neighbors to hear you.” He knelt on Julie’s chest, and with his hands to her throat, he began to squeeze.

Julie’s throat closed. An urgent need for air overcame her. It was like being underwater, swimming for the surface, while the surface moved farther and farther away. She writhed and wiggled to get free, but Keith had her pinned with his knees. He increased the pressure against her throat.

“I’m sorry, but it will take some time to end you.”

“Michelle…” Julie managed. “Help…”

“I’m afraid Michelle can’t help you now,” Keith said.

Can’t help me because he hurt her, Julie thought. Can’t help me because she’s got a knife in her chest and she’s dead on the kitchen floor.

Julie tried to scream, but all that came out was a hiss of air followed by a pitiful wheeze. Julie’s life began to race through her mind in flashes, not vignettes, but images coming to her thoughts and leaving in flickers. One thought dominated all others.

I want to live. Live! Live!

Julie thrashed and pawed at Keith. She whipped her head from side to side, trying to break free of his hold. Blackness was coming. It was moving toward her like storm clouds swallowing the landscape, like a coming tornado.

With time, Julie’s struggles abated. She became still, no longer feeling the pressure on her throat. No longer feeling anything but lightness. Peace settled over her like a warming light. A light. The bright light replaced the darkness.

A sound came, a loud clanging that reverberated from somewhere not far away. A sudden rush of air filled Julie’s lungs, as if powerful bellows had pushed it there. The sound came again. Julie lolled her head to one side, and through dim vision saw Michelle bring the frying pan Keith attacked her with down on top of his head.

Michelle lifted the weapon and brought it down again, and again, until Julie heard a crack, followed by another. Keith’s skull had collapsed in on itself. His body went into violent spasm before it went completely still. Blood covered the linoleum floor in a wash of red.

Michelle crawled over to Julie, blood splatter dotting her face in a gruesome design.

“Oh my God, Julie, Julie, can you hear me? Are you all right?” Michelle caressed Julie’s face, her hair.

Julie could see her friend’s eyes swimming with worry and fear. She tried to speak, her voice coming out in a rasp.

“I’m alive.”

“Yes, thank God,” Michelle said. “You’re alive.”

“It was Keith,” Julie said, still on her back, chest heaving, spitting out each word. “Keith-he was killing the patients. He killed Sam.”

“No, Julie. No.”

“Yes-it’s true. I found proof. On the rats-the tick is on the rats.”

“No, Julie. What I mean is, Keith didn’t kill Sam. I did.”