Harvest

CHAPTER SEVENTEEN

The medical records file room was in the hospital basement, just down the hall from Pathology and the morgue. It was a department well known to every physician at Bayside. This was where doctors signed off on charts, dictated discharge summaries, and initialled lab reports and verbal orders. The room was furnished with comfortable chairs and tables, and to accommodate the often erratic work hours of its physicians, the department stayed open until 9 p.m. every night.

It was six that evening when Abby walked into medical records. As she'd expected, the room was nearly deserted for the dinner hour. The only other physician was a haggard-looking intern, his desk piled high with delinquent charts.

Heart pounding, Abby approached the clerk's desk and smiled. "I'm compiling statistics for Dr. Wettig. He's doing a study on heart transplant morbidity. Could you pull up a list on your computer? The names and record numbers of all heart transplants done here in the last two years."

"For a records search like that, we need a request form from the department."

"They've all gone home by now. Could I get that form to you some other time? I'd like to have this ready for him by the morning. You know how the General is."

The clerk laughed. Yes, she knew exactly how the General was. She sat down at her keyboard and called up the Search screen. Under Diagnosis, she typed in: Cardiac Transplant, then the years to be searched. She hit the Enter button.

One by one, a list of names and record numbers began to appear. Abby watched, mesmerized by what she saw scrolling down the screen. The clerk hit Print. Seconds later, the list rolled out of the printer. She handed the page to Abby.

There were twenty-nine names on the list. The last one was Nina Voss. "Could I have the first ten charts?" Abby asked. "I might as well start working on this tonight."

The clerk vanished into the file room. A moment later she re-emerged hugging a bulky armful of files. "These are only the first two. I'll get you the rest."

Abby lugged the charts to a desk. They landed with a heavy thud. Every heart transplant patient generated reams and reams of documentation, and these two were no different. She opened the first folder to the patient information sheet.

The name was Gerald Luray, age fifty-four. Source of payment was private insurance. Home address was in Worcester, Massachusetts. She didn't know how relevant any of this information was, so she copied it all down onto a yellow legal pad. She also copied the date and time of transplant and the names of the doctors in attendance. She recognized all the names: Aaron Levi, Bill Archer, Frank Zwick, Rajiv Mohandas. And Mark. As expected, there was no donor information anywhere on the chart. That was always kept separate from recipient records. However, among the nurses' notes, she found written:

'0830 — Harvest reported complete. Donor heart now enroute from Norwalk, Connecticut. Patient wheeled to OR for prep…" Abby wrote: 0830. Harvest in Norwalk, Conn.

The records clerk wheeled a cart to Abby's desk, deposited five more charts, and went back for more.

Abby worked straight through the supper hour. She didn't stop to eat, didn't allow herself even a break, except to call Mark to tell him she'd be home late.

By closing time, she was starving.

She stopped at a McDonald's on the way home and ordered a Big Mac and giant fries and a vanilla milkshake. Cholesterol to feed the brain. She ate it all while sitting in a corner booth, keeping an eye on the dining room. At that hour, the other patrons were mostly the post-movie crowd, teenagers on dates, and here and there a few depressed-looking bachelors. No one even seemed to notice she was there. She finished every last French fry, then left.

Before she started the car, she made a quick survey of the parking lot. No van.

At ten-fifteen, she arrived home to find that Mark was already in bed and the lights were out. She was relieved that she would not have to answer any questions. She undressed in the dark and climbed under the covers, but she didn't touch him. She was almost afraid to touch him.

When he suddenly stirred and reached out to her, she felt her whole body go rigid.

"I missed you tonight," he murmured. He turned her face to his and gave her a long and intimate kiss. His hand slid down to her waist and caressed her hip. Stroked along her thigh. She didn't move; she felt as frozen as a mannequin, unable to respond or resist. She lay with her eyes closed, her pulse roaring in her ears, as he pulled her into his arms. As he slid inside her.

Who am I making love to? she wondered as he thrust again and again, their hips colliding with brutish force.

Then it was over, and he was sliding out of her.

"I love you," he whispered.

It was a long time later, after he'd fallen asleep, that she whispered her answer.

"I love you too."

At 7.40 a.m. she was back in Medical Records. Several of the desks were now occupied by physicians cleaning up paperwork before making their morning rounds. Abby requested five more charts. Quickly she took notes, gave the charts back to the clerk, and left.

She spent the morning in the medical library, looking up more articles for Dr. Wettig. It wasn't until late that afternoon that she returned to Medical Records.

She requested ten more charts.

Vivian finished off the last slice of pizza. It was her fourth slice, and where she put it all was a mystery to Abby. That elfin body consumed calories like a fat-burning furnace. Since they'd sat down in the booth at Ginelli's Abby had eaten only a few bites, and even those were an effort.

Vivian wiped her hands on a napkin. "So Mark still doesn't know?"

"I haven't said a thing to him. I guess I'm afraid to."

"How can you stand it? Living in the same house and not talking?"

"We talk. We just don't talk about this." Abby touched the sheaf of notes on the table — the notes she'd been carrying around all day. She'd been careful to keep them where Mark wouldn't find them. Last night, when she'd returned home after McDonald's, she had hidden the notes under the couch. Lately it seemed she'd been hiding so many things from him, and she didn't know how long she could keep it up.

"Abby, you've got to talk to him about this eventually."

"Not yet. Not until I know."

"You're not afraid of Mark, are you?"

"I'm afraid he'll deny everything. And I'll have no way of knowing if he's telling the truth." She ran her hands through her hair. "God, it's like reality's completely shifted on me. I used to think I was standing on such solid ground. If I wanted something badly enough, I just worked like hell for it. Now I can't decide what to do, which move to make. All the things I counted on aren't there for me any more."

"Meaning Mark."

Wearily, Abby rubbed her face. "Especially Mark."

"You look awful, Abby."

"I haven't been sleeping very well. I've got so many things to think about. Not just Mark. But also that business with Mary Allen. I keep waiting for Detective Katzka to show up on my doorstep with his handcuffs."

"You think he suspects you?"

"I think he's too bright nor to."

"You haven't heard anything from him. Maybe he'll let it slide. Maybe you're giving him too much credit."

Abby thought of Bernard Katzka's calm grey eyes. And she said, "He's a hard man to read. But I think Katzka's not only smart, he's persistent. I'm scared of him. And weirdly enough, fascinated by him too."

Vivian sat back. "Interesting. The prey intrigued by her hunter?" "Sometimes I just want to call Katzka and blurt out everything. Get it all over with." Abby dropped her head in her hands. "I'm so tired. I wish I could run away somewhere. Sleep for a whole week."

"Maybe you should move out of Mark's house. I've got an extra bedroom. And my grandmother's leaving."

"I thought she was a permanent house guest."

"She makes the rounds of all her grandkids. Right now I've got a cousin in Concord who's bracing herself for the visit."

Abby shook her head. "I don't know what to do. The thing is, I love Mark. I don't trust him any more, but I love him. At the same time, I know that what we're doing could ruin him."

"It could also save his life."

Abby looked miserably atVivian. "I save his life. But I destroy his career. He may not thank me much for that."

"Aaron would have thanked you. Kunstler would have. Certainly Hennessy's wife and baby would have thanked you."

Abby said nothing.

"How certain are you that Mark's involved?"

"I'm not certain. That's what makes this so hard. Wanting to believe in him. And not having any evidence to tell me one way or the other." She touched her notes. "I've looked at twenty-five files so far. Some of the transplants go back to two years ago. Mark's name is on every one of them."

"So is Archer's. And Aaron's. That doesn't tell us anything. What else have you learned?"

"All the records look pretty much the same. Nothing to distinguish one from any other."

"OK, what about the donors?"

"That's where things get a little interesting."Abby glanced around the restaurant. Then she leaned towards Vivian. "Not all of the charts mention which city the donor organ comes from. But a number of them do. And there seems to be a cluster. Four of them came from Burlington, Vermont."

"Wilcox Memorial?"

"I don't know. The hospital was never specified in the nurses' notes. But I find it interesting that a relatively small town like Burlington ends up with so many brain-dead people."

Vivian's gaze met hers in a stunned look. "There's something really wrong here. We were hypothesizing nothing more than a shadow referral network. Donors who are simply kept out of the registry system. But that doesn't explain a cluster of donors in one town. Unless…"

"Unless donors are being generated."

They fell silent.

Burlington is a university town, thoughtAbby. Full of young, healthy college students. With young, healthy hearts.

"Can I have the dates on those four Buffington harvests?" said Vivian.

"I have them right here. Why?"

"I'm going to check them against the Burlington obituaries. Find out who died on those dates. Maybe we can identify the names of the four donors. And find out how they ended up brain dead."

"Not all obits list the cause of death."

"Then we may have to go to the death certificates. Which means a trip to Burlington for one of us. A place I've been dying to visit. Not."Vivian's tone of voice was almost breezy. That warrior woman bravado again; she had the act down pat. But this time it wasn't enough to hide the note of apprehension.

"Are you sure you want to do this?" said Abby.

"If we don't, then Victor Voss wins. And the losers are going to be

HARVEST

people like Josh O" Day." She paused. And asked, quietly: "Is this what you want to do, Abby?"

Abby dropped her head in her hands. "I don't think I have a choice any longer."

Mark's car was in the driveway.

Abby pulled up behind it and turned off her engine. For a long time she simply sat there, scraping up the energy to get out of the car, to walk into the house. To face him.

At last she stepped out of the car and walked in the front door.

He was in the living room, watching the late night news. As soon as she came in, he clicked off the TV. "How is Vivian doing these days?" he asked.

"She's fine. Landed right back on her feet. She's buying into a practice in Wakefield." Abby hung up her coat in the closet. "And how was your day?"

"We got a dissecting aorta. He bled out sixteen units just like that. I didn't get out till seven."

"Did he make it?"

"No. We ended up losing him."

"That's too bad. I'm sorry." She shut the closet door. "I'm kind of tired.! think I'll go up and take a bath."

"Abby?"

She paused and looked at him. They were separated by the width of the living room. But the gulf between them seemed miles wider. "What's happened to you?" he asked. "What's wrong?"

"You know what's wrong. I'm worried about my job."

"I'm talking about us. Something's wrong with us." She didn't say anything.

"I hardly see you any more. You're atVivian's more than you are here. When you are home, you act like you're somewhere else."

"I'm preoccupied, that's all. Can't you understand why?"

He sank back, suddenly looking very tired. "I have to know, Abby. Are you seeing someone else?"

She stared at him. Of all the things Mark might say to her, this was the last thing she'd expected. She almost felt like laughing at the trivial nature of his suspicions. If only it were that simple. If only our problems were the same as every other couple's. "There's no one else," she said. "Believe me."

"Then why aren't you talking to me any more?"

"I'm talking to you now."

"This isn't talking! This is me trying to get the old Abby back. Somewhere along the way I've lost her. I've lost you." He shook his head and looked away. "I just want you back again."

She went to the couch and sat down beside him. Not close enough to touch, but close enough to feel connected, if only distantly.

"Talk to me, Abby. Please." He looked at her, and suddenly it was the old Mark she saw. The same face that had smiled at her across the operating table. The face she loved. "Please," he repeated, softly. He took her hand and she didn't pull away. She let him take her into his arms. But even there, where she'd once felt safe, she could not relax. She lay stiff and uneasy against his chest.

"Tell me," he said. "What's wrong between us?"

She closed her eyes against the sting of fresh tears. "Nothing's wrong," she said.

She felt his arms go very still around her. Without even looking at his face, she knew that he could tell she was, once again, lying.

At seven-thirty the next morning, Abby pulled into her parking stall at Bayside Hospital.

She sat in her car for a moment, eyeing the wet pavement, the steady drizzle. Only mid-October, she thought, and already this dreary foretaste of winter. She had not slept well last night. In fact, she could not remember the last good night's sleep she'd had. How long could a person hold up without sleep? How long before fatigue led to psychosis? Glancing in the rearview mirror, she scarcely recognized the haggard stranger staring back at her. In two weeks it seemed she had aged ten years. At this rate she'd be hitting menopause by November.

A flash of maroon in the mirror caught her eye.

She snapped her head around just in time to see a van retreating behind the next aisle of cars. She waited for another glimpse of it. It didn't reappear.

Quickly she stepped outside and began to walk towards the hospital. The weight of her briefcase felt like an anchor weighing her down. Off to her right, a car engine suddenly roared to life. She whirled, expecting to see the van, but it was a station wagon pulling out of a stall.

Her heart was slamming against her chest. It didn't calm down until she was inside the building. She took the stairwell down to the basement and walked into Medical Records. This would be her final visit; she was down to the last four names on the list.

HARVEST

She lay the request slip on the counter and said, "Excuse me, may I have these charts please?"

The clerk turned to face her. Perhaps Abby was only imagining it, but the woman seemed to freeze momentarily. They had dealt with each other before, and the clerk usually seemed friendly enough. Today she wasn't even smiling.

"I need these four charts," said Abby.

The clerk looked at the request slip. "I'm sorry, Dr. DiMatteo. I can't get these files for you."

"Why not?"

"They're not available."

"But you haven't even checked."

"I've been told not to release any more files to you. It's Dr. Wettig's orders. He said if you came in, we're to refer you to his office immediately."

Abby felt the blood drain from her face. She said nothing.

"He said he never authorized any chart search." The clerk's tone of voice was plainly accusatory. You lied to us, Dr. DiMatteo.

Abby had no answer. It seemed to her the room had suddenly fallen silent. She turned and saw that three other doctors were in the room, and they were all watching her.

She walked out of Medical Records.

Her first impulse was to leave the building. To avoid the inevitable confrontation with Wettig and just drive away. To keep driving until this was a thousand miles behind her. She wondered how long it would take to reach Florida and the beach and palm trees. She'd never been to Florida. She'd never done so many things other people had done. She could do them all now if she'd just walk out of this goddamn hospital, climb in her car, and say: Fuck it. You win. You all win.

But she didn't walk out of the building. She stepped into the basement elevator and punched Two.

On that short ride to the Administrative floor, several things became instantly clear to her. The first was that she was too stubborn or too stupid to run. The second was that a beach was not really what she wanted. What she wanted was her dream back.

She got out of the elevator and walked up the carpeted hall. The Residency Office was around the corner, past Jeremiah Parr's suite. As she walked past Parr's secretary, she saw the woman sit up sharply and reach for the phone.

Abby turned the corner and walked into the Residency Office. There were two men standing by the secretary's desk, neither of whom Abby had ever seen before. The secretary looked up at Abby with that same stunned expression that had flashed across the face of Parr's secretary, and blurted: "Oh! Dr. DiMatteo-'

"I need to see Dr. Wettig," said Abby.

The two men turned to look at her. In the next instant, Abby was startled by a flash of light. She flinched away as the light went off again and again. A camera flashbulb.

"What are you doing?" she demanded.

"Doctor, would you care to comment on the death of Mary Allen?"

one of the men said.

"What?"

"She was your patient, wasn't she?"

"Who the hell are you?"

"Gary Starke, Boston Herald. Is it true you're an advocate of euthanasia? We know you've made statements to that effect."

"I never said anything of the-'

"Why were you relieved of your ward duties?"

Abby took a step back. "Get away from me. I'm not talking to yOU."

"Dr. DiMatteo-'

Abby turned to flee the office. She almost collided with Jeremiah Parr, who'd just walked in the door.

"I want you reporters out of my hospital now," Parr snapped. Then he turned to Abby. "Doctor, come with me."

Abby followed Parr out of the room. They walked swiftly down the hall and into his office. He shut the door and turned to look at her.

"The Herald started calling a half-hour ago," he said. "Then the Globe called, followed by about half a dozen other newspapers. It hasn't let up since."

"Did Brenda Hainey tell them?"

"I don't think it was her. They seemed to know about the morphine. And the vial in your locker. Things she didn't know." She shook her head. "How?"

"Somehow it leaked out." Parr sank into the chair behind his desk. "This is going to kill us. A criminal investigation. Police swarming up and down the halls."

The police. Of course. By now it's leaked out to them as well. Abby stared at Parr. Her throat felt too parched to produce a single word. She wondered if he was the source of the leak, then decided it was unlikely. This scandal would hurt him, too.

There was a sharp rap on the door, and Dr. Wettig walked in.

"What the hell do! do about those reporters?" he said.

"You'll have to prepare a statement, General. Susan Casado's on her way over. She'll help you with the wording. Until then, no one talks to anyone."

Wettig gave a curt nod. Then his gaze focused on Abby. "May I see your briefcase, Dr. DiMatteo?"

"Why?"

"You know why. You had no authority to search those patient records. They are private and confidential. I'm ordering you to turn over all the notes you took."

She did nothing. Said nothing.

'! hardly think an additional charge of theft is going to help your case."

"Theft?"

"Any information you gleaned from that illegal chart search was stolen. Give me the briefcase. Give it to me."

Wordlessly she handed it to him. She watched him open it. Watched him shuffle through the papers and remove her notes. She could do nothing except hang her head in defeat. Once again they had beaten her. They had made the preemptive strike, and she hadn't been prepared. She should have known better. She should have stashed the notes before coming up here. But she'd been too focused on what she would say, how she would explain herself to Wettig.

He shut the briefcase and handed it back to her. "Is that everything?" he asked.

She could only nod.

Wettig regarded her for a moment in silence. Then he shook his head. "You would have made a free surgeon, DiMatteo. But I think it's time to recognize the fact you need help. I'm recommending you seek psychiatric evaluation. And I'm releasing you from the Residency Programme, effective today." To her surprise, she heard a note of genuine regret in his voice when he added, quietly: "I'm sorry."