Death Benefit

35.

COLUMBIA UNIVERSITY MEDICAL CENTER NEW YORK CITY MARCH 24, 2011, 8:50 P.M.

The wind blew fiercely down Haven Avenue and into the canyon of 168th Street. Pushed from behind, Pia and George made rapid but chilly progress from the dorm toward the medical center. It was raining, and George struggled with a cheap umbrella until it finally turned inside out for the third time. He stuffed it headfirst into a trash can. Pia strode on, head down, the hood of her sweatshirt pulled tightly over her head.

Once inside the hospital, they descended into the labyrinthine bowels of the nearly century-old building to the morgue. It was malodorous and poorly lit and filled with outdated equipment. The morgue served as a way station for the dead: In simple cases, bodies would be picked up by a funeral home. A van from the OCME, the Office of the Chief Medical Examiner, would come if there were complicating factors.

Both Pia and George found it difficult to reconcile this run-down, dirty place with the hospital and medical center as they knew it. Some campus buildings were slightly shabby on the outside but pristine and modern within. The morgue was unkempt inside and out, and at this time of the evening seemed to have been deserted by anyone from the realm of the living. Old-fashioned wooden meat-locker-style doors with metal signs proclaiming that only authorized personnel were to be admitted were the order of the day. The only noise in the godforsaken place was a low-grade electrical hum and the drip of water onto cement floor.

Following their noses, they walked into the tiered amphitheater of the abandoned autopsy room, which looked like the set of a horror movie depicting Victorian times. Some of the seats were broken. The pit area, with its two ancient autopsy tables, was being used as storage for a random collection of pipes, old sinks, and discarded toilets. With the constant fight for space in the medical center, George wondered out loud why the area hadn’t been retrofitted.

Finally Pia and George walked into the morgue itself. Arranged along the walls was a series of walk-in coolers. The fifteen or so corpses in the room were on separate gurneys, some covered by sheets, others fully exposed. Still in place on a few of the bodies were the various tubes and wires used to treat and monitor them while they were still alive. A couple of the bodies were clothed, others naked. Most still wore the hospital johnnies they expired in. Mixed in were a couple of long black body bags.

Pia and George were wondering why they couldn’t find anyone working there when the night diener, or mortuary attendant, startled them.

“What do you want?” the man asked. It was obvious he was unhappy at being disturbed. He was perhaps fifty or sixty, small of stature, wearing a stained lab coat. He had a bulbous head too large for his body with a badly maintained comb-over wedged on top. He wore small oval glasses and squinted through them at his uninvited guests. The casting department for the Victorian horror movie had done a good job.

“And how did you get in?” he added before Pia or George could answer his first question.

“We came in that way,” Pia said, indicating their entrance route.

“That’s the back entrance. Visitors are supposed to come in the front. No one ever comes in the back way.”

“We’re here to ask about a couple of autopsies,” George said. “Autopsies that might have been performed down here today. The patients would have been two staff members who died early this morning, Dr. Rothman and Dr. Yamamoto?”

The attendant laughed cynically, as if this was the funniest thing he had heard in ages.

“There hasn’t been an autopsy done down here in fifty years. I never heard of either of those patients. They’re not here, if that’s what you want to know. And if there was an autopsy, it would be done in the anatomy department of the medical school, where they still do them. On account of the teaching. You need to get in touch with the pathology resident on call. And you can go out the front way.” The man pointed in the direction of the usual exit. He then stood there implacably.

George looked at Pia, who didn’t seem in the mood to argue.

“Okay,” George said. “Thanks.”

As Pia and George waited for the elevator to rumble its way down to them, George snuck a look back toward the chamber of horrors.

“Can you believe that guy?”

“I’ve been in some creepy places, but that’s the creepiest.”

“Do you think he ever leaves?” George said.

“You get the impression that he lives down here.”

“I’ll be happy if I don’t see that face again.”

“I should think so,” said Pia. “If we come back down here, it means we’re dead.”

Back in the land of the living, George called the on-call pathology resident. Dr. Simonov agreed to meet with them and asked that they come up to the clinical path lab. When Pia and George found him, Simonov was taking a break in a small windowless office with a giant mug of strong coffee on the desk in front of him.

“So what can I do for you guys? It’s not often I get called by medical students. What’s up?”

Simonov was Russian but had lived in the West long enough to almost completely lose his accent. Only the occasional dropped article gave him away. He’d gone to both college and medical school in the States.

“We’re wondering if there was an autopsy performed today on either Dr. Rothman or Dr. Yamamoto or both,” George said. He had suggested to Pia that he do the talking this time. She didn’t care. “They died early this morning when-”

“Yes, I know who they were,” Simonov said. “Everybody in the medical center knows about them. Why are you asking?”

“There are questions about how quickly they died,” Pia said before George could speak. “It was a relentless downhill course despite maximum treatment so that we-”

“No autopsies were done on them here,” Simonov said, cutting Pia off. “Not a lot of autopsies are done anymore in general. It’s a pity, but it is reality. There’s no money. But Rothman and Yamamoto, they would not have been done here under any circumstances. Having died like they did of an infectious disease while working meant that they are definitely medical examiner cases, pure and simple. All we did here was put the bodies in body bags, seal them up, and decontaminate the exterior. They were then picked up by the OCME.” He spelled out the acronym, explaining it stood for Office of the Chief Medical Examiner.

“I know what the OCME is. So do you know the results?”

“Results!” Simonov laughed at Pia’s question. “Maybe in three weeks or more,” he said. “They get a lot of bodies down there, and they generally take their time.”

“Down where?” Pia said. “Where exactly is the OCME?”

“You gonna go down there now? I wouldn’t advise it. But, okay, whatever. It’s on East Side, First Avenue and Thirtieth Street, near NYU Medical Center.”

“Thanks. If we call them up, do you think they’ll answer our questions?”

“Now?”

“Tomorrow.”

“How would I know? Maybe they never had medical students asking questions. But then again it is affiliated with NYU Medical Center, which is a teaching hospital. For all I know they may have a medical student elective.”

“Who should we call? Should we ask for someone in particular?”

“I knew one of the MEs, but he’s no longer there. But they have a PR department. I’d call them. Maybe call the medical legal investigator on the case.”

“Do you think they’d tell us the results if we called?” George asked.

“You mean call the ME’s office?” Simonov smiled and let out a quick, knowing laugh. “You think in this great big city bureaucracy you can just call and they jump and tell you results? Not in a million years. This case is important, they were important guys. It’s going to be a media event. There’s probably going to be lawsuits about safety, that kind of thing. Since it’s an infectious case, the autopsies have probably already been done, but they’re not going to release any results for three, four weeks after the toxicology screens are completed. But there’s not going to be general access to the information, and they definitely won’t give the results to a couple of green medical students.”

“You’re probably right,” Pia said. She knew more than most people about city institutions.

“If I were you, find something else to do. But it’s your life. If you insist on looking into the case, I’d go down there. I wouldn’t try calling on the phone. If you’re there in person and meet with someone who more or less takes pity on you or likes you, you might learn something.” Simonov winked at Pia. She got his inference but ignored it.

“So if you’re really committed,” Simonov continued, “go to the OCME. Just don’t count on getting any answers. As for calling, you might as well call three-one-one.” Simonov was referring to the citizens’ help line-people called to report a cat stuck up a tree or a loud movie set on the street. Simonov checked his watch and picked up his coffee.

“If you decide to call three-one-one, tell them there’s still a big pothole on my street. Been there since Thanksgiving.”

Back out in the rainy night, Pia and George slogged along 168th Street, keeping as far away from the curb as they could. Every time a yellow cab zipped by, it splashed water up onto the sidewalk.

“Well, that was almost useless,” Pia managed against the wind.

“I’m not sure I’d write it off as useless. He reminded us about the politics involved. He also emphasized that there’s undoubtedly going to be a thorough investigation as a prelude to any legal action. I think that’s information you should take to heart. It’s time to drop all this, Pia.”

“Dreamer,” Pia said. “I’m in this until I get some answers.”

“You are impossible,” George commented, as a sudden gust of wind came down from Haven Avenue, halting their forward progress for a moment. They had reached Fort Washington Avenue. Looking to the side, Pia realized they had come abreast of the Black research building.

“What time is it?” Pia asked.

George managed to glance at his watch. “It’s after ten. Time for us to be in bed.” For George the idea of bed had immediate appeal. It brought up the fact that they had had sex that day, or at least Pia had had sex. Ever the optimist, he wondered if just maybe, after his accompanying her back over to the hospital to check on the autopsy, she might consider a continuation. George closed his eyes and screwed up the courage to speak.

“Do you want to come to my room? Stay the night? Or we could go to your room, whichever you prefer.”

“What for?” Pia asked, blankly.

“Well, for one thing, we ended things a little quickly this afternoon. Maybe if we had more time . . .”

“That’s a thought,” Pia said in a preoccupied fashion. “Have you noticed where we’re standing?”

George looked up. In truth he hadn’t been particularly aware of the immediate surroundings.

“We’re just outside the Black building,” Pia added. “It’s after ten, as you said. I want to go up to the lab for another quick visit to check out that damn micro storage locker. I’m not going to be satisfied until I do it, and this is the best time. I’ve been in there fifty times at night like this.”

“No, Pia!” George said firmly. “It’s too big a risk.”

“I don’t think there’s any risk whatsoever. You head back to the dorm. It’ll only take me twenty minutes at most.”

George looked ahead at the dorm looming in the misty night. It beckoned as a haven of warmth and security. He looked back at Pia. She was smiling up at him, confident as usual. Most important, she hadn’t said no to his suggestion that they sleep together. “You really think it’ll be safe, that no one will suddenly pop in?”

“Absolutely. Twenty minutes it’ll take me. I’ll call you as soon as I get back to the dorm.”

“And you remember that whatever you find out, it won’t prove anything?”

“I’m aware of that.”

George’s mind went into overdrive. Maybe it was a good idea. Maybe if she got the damn micro storage locker out of her mind, she’d give up on her self-destructive investigation.

“All right,” George said with sudden resolve. “I’m coming with you. Maybe I can help speed things up.” He grabbed her hand and started to pull her toward the Black building entrance.

Pia resisted. “Are you sure?”

“I’m sure,” George said. In his mind’s eye what he could see mostly was them climbing into bed, holding each other tightly.

Pia shrugged. “It might be quicker with two people. All right, let’s do it.”

Without another word, Pia and George ducked into the Black building. The security man knew Pia well and didn’t bat an eye. Pia used her key to open the main door, a key Spaulding had not asked for. The logbook was back where she expected it would be, in Spaulding’s desk. Inside the biosafety unit she used Rothman’s spare key from his office to open the storage locker. They worked quickly and efficiently.

George wouldn’t have wanted a physician to check his blood pressure at any point during the visit, but Pia seemed icy cool and focused.

Pia had George read out to her how many of each sample were recorded in the logbook while she counted the actual samples. As Pia suspected, there were three samples missing from the storage freezer, at least according to the book. There were supposed to be thirty samples of the zero-gravity salmonella typhi, divided evenly between what was called alpha S. typhi and beta S. typhi. One of the missing samples was from the beta salmonella strain and the other two were the alpha strain, which was the strain that had infected Rothman and Yamamoto. Out in the main part of the unit near the hoods, Pia found a small collection of six labeled petri dishes in the incubator. Each was labeled with either an alpha or a beta.

After Pia and George had left the biosafety unit and removed their protective clothing, Pia found two of the same type of stoppered containers used in the storage facility without labels sitting next to Spaulding’s sink.

After replacing the logbook and the spare key, Pia said to George, “Okay, we’re done.”

George’s heart rate calmed down once they had exited the lab without incident.

“What does all this mean, Pia?” George asked as they rode down in the elevator.

“I don’t know,” Pia admitted. “It might not mean anything, but information is information. What I’d like to do is go over the discrepancies with Spaulding if I can figure out how.”

“Good luck with that,” George said.

Pia and George fought their way through the weather back to the dorm. Though he was exhausted, George felt strangely exhilarated. He and Pia had actually worked together. George knew he’d been useful and was acutely sensitive to Pia’s gestures, like the way she had put her hand on the small of his back to encourage him to precede her through the outer dorm door. She was obviously pleased with what they had accomplished. They stopped in the lobby and pushed the elevator button. Both cars were on upper floors.

Pia stared at the elevator’s slow-moving floor indicator. George cleared his throat to speak, but Pia didn’t want to hear what he had to say. She just wanted to get to her bed and try to sleep.

“Pia, you must know how I feel about you. I’ve tried to tell you a hundred times. More than that. Pia, would you look at me?”

Pia reluctantly turned to George. He had that earnest look.

“You know I worry about you because of my feelings for you. I love you, you must know that. I think about you constantly.”

On hearing the words, something in Pia’s brain fizzed into life. A laboratory animal learns to stop engaging in a certain behavior, like touching a red button, if it gets a painful shock every time, even if previously it got a reward, like a piece of food. In Pia’s mind, there was a connection between protestations of affection and pain. She had learned that the people who said those words would cause her pain, and should be avoided, like an electric shock.

Pia pressed the elevator button again, as it appeared that the car was stuck on the eighth floor. She said nothing.

“Our relationship can’t be totally one-sided.”

“What do you mean, ‘relationship’ . . . ? Look, George, this isn’t the time or the place for this.”

“When is the time, Pia? I’ve wanted to tell you I love you for years.”

The elevator finally arrived, the doors opened, and a cluster of students noisily piled out. A party had started in someone’s room and now was moving to a bar up on Broadway.

George pulled Pia aside as the door closed. She rolled her eyes.

“George, come on. Not now.”

“I’m sorry, but I have to say it. I know you don’t want to hear this, but I don’t understand you.”

“That makes two of us.”

“But we need each other, don’t you think? I know I need you.”

“I don’t know what that means-to ‘need’ someone. Someone needing me, I don’t want that responsibility.”

The second elevator arrived with a straggling student who hurried to catch up with his friends. Pia got in the car and held the door for George.

“Get in, George, Jesus.”

Pia punched the eleventh floor for her room and seven for his. Message delivered. George reluctantly got in. Pia’s mind was already full of competing problems-Rothman, the Sisters, Africa, the rest of her life-and now here was another one. She wondered what it was like to think about someone constantly as George said he did of her. It was an alien concept. She glanced at George, who was looking at the floor. She had no idea what he was thinking or feeling. The elevator stopped on seven and Pia reached out and pressed the hold button. George hesitated for a moment, than stepped out.

“Good night, George,” Pia said.

George just nodded as the doors closed. To Pia he looked pathetic.