Mortal Fear

CHAPTER 8

It was just after eight that Saturday morning when Jason, bleary-eyed, entered Shirley’s office. It was paneled in dark mahogany, with dark green carpet and brass fixtures, and looked more like it belonged to a banker than to the chief executive of a health care plan. Shirley was on the phone talking to an insurance adjuster, so Jason sat and waited. After she hung up she said, “You were right about the insurance. They have no intention of paying a claim unless the break-in is reported.”

“Then report it.”

“First let’s see how bad the damage is and what’s missing.”

They crossed into the outpatient building and took the elevator up to the sixth floor. A security guard was waiting for them and unlocked the inner door. They dispensed with the booties and white coat.

Like Hayes’s apartment, the lab was a mess. All the drawers and cabinets had been emptied onto the floor, but the high-tech equipment appeared untouched, so it was obvious to both of them that it had been a search and not a destructive visit. Jason glanced into Hayes’s office. It was equally littered, with the contents of the desk and several file cabinets strewn about the floor.

Helene Brennquivist appeared in the doorway to the animal room, her face white and drawn. Her hair was again severely pulled back from her face, but without her usual shapeless lab coat, Jason could see she had an attractive figure.

“Can you tell if anything is missing?” Shirley asked.

“Well, I don’t see my data books,” Helene said. “And some of the E. coli bacterial cultures are gone. But the worst is what’s happened to the animals.”

“What about them?” Jason asked, noting that her usually emotionless face was trembling with fear.

“Maybe you should look. They’ve all been killed!”

Jason stepped around Helene and through the steel door into the animal area. He was immediately confronted with a pungent, zoolike stench. He turned on the light. It was a larger room, some fifty feet long and thirty feet wide. The animal cages were organized in rows and stacked one on top of the other, sometimes as many as six high.

Jason started down the nearest row, glancing into individual cages. Behind him the door closed with a decisive click. Helene had not been exaggerating: all the animals that Jason saw were dead, hideously curled in contorted positions, often with bloodied tongues as if they’d chewed them in their final agony.

Suddenly Jason stopped short. Staring into a group of large cages, he saw something that made his stomach turn: rats the likes of which he had never seen. They were huge, almost the size of pigs, and their bald, whiplike tails were as thick as Jason’s wrists. Their exposed teeth were four inches long. Moving along, Jason came to rabbits the same size, and then white mice the size of small dogs.

This side of genetic engineering horrified Jason. Although he was afraid of what he might see, morbid curiosity drove him on. Slowly, he looked into other cages, seeing distortions of familiar creatures that made him sick. It was science gone mad: rabbits with several heads and mice with supernumerary extremities and extra sets of eyes. For Jason, genetic manipulation of primitive bacteria was one thing; distortion of mammals was quite another.

He retreated back to the central part of the lab, where Shirley and Helene had been checking the scintillation cultures.

“Have you seen the animals?” Jason asked Shirley with disgust.

“Unfortunately. When Curran was here. Don’t remind me.”

“Did the GHP authorize those experiments?” Jason demanded.

“No,” Shirley said. “We never questioned Hayes. We never thought we had to.”

“The power of celebrity,” Jason said cynically.

“The animals were part of Dr. Hayes’s growth hormone work,” Helene said defensively.

“Whatever,” Jason said. He was not interested in any ethical argument with Helene at the moment. “At any rate, they’re all dead.”

“All of them?” Shirley questioned. “How bizarre. What do you think happened?”

“Poison,” Jason said grimly. “Though why anyone searching for drugs would bother to kill lab animals beats me.”

“Do you have any explanation for all of this?” Shirley said angrily, turning to Helene.

The younger woman shook her head, her eyes darting nervously about the room.

Shirley continued to stare at Helene, who was now shifting uncomfortably from foot to foot. Jason watched, intrigued by Shirley’s suddenly aggressive behavior.

“You’d better cooperate,” she was saying, “or you’re going to be in a lot of trouble. Dr. Howard is convinced you’re keeping something from us. If that’s true and we find out, I hope you realize what that can do to your career.”

Helene’s anxiety was finally apparent. “I just followed Dr. Hayes’s orders,” she said, her voice breaking.

“What orders?” Shirley asked, lowering her voice threateningly.

“We did some free-lance work here…”

“What kind?”

“Dr. Hayes moonlighted for a company called Gene, Inc. We developed a recombinant strain of E. coli to produce a hormone for them.”

“Were you aware that moonlighting was specifically forbidden under Dr. Hayes’s contract?”

“That’s what he told me,” Helene admitted.

Shirley glared at Helene for another minute. Finally she said, “I don’t want you to speak of this to anyone. I want you to make a detailed list of every animal and item missing or damaged in this lab and bring it directly to me. Do you understand?”

Helene nodded.

Jason followed Shirley out of the lab. She had obviously succeeded where he had failed, in breaking through Helene’s facade. But she hadn’t asked the right questions.

“Why didn’t you press her about Hayes’s breakthrough?” he said as they arrived at the elevator. Shirley hit the down button repeatedly, obviously furious.

“I didn’t think of it. Every time I think the Hayes problem is under control, something new comes up. I had specifically demanded the no-moonlighting clause in his contract.”

“It doesn’t much matter now,” Jason said, boarding the elevator after Shirley. “The man is dead.”

She sighed. “You’re right. Maybe I’m overreacting. I just wish this whole affair was over.”

“I still think Helene knows more than she’s telling.”

“I’ll talk to her again.”

“And after seeing those animals, you don’t think you should call the police?”

“With the police come the newspapers,” Shirley reminded him. “With the newspapers comes trouble. Aside from the animals, it doesn’t appear that anything terribly valuable is damaged.”

Jason held his tongue. Obviously, reporting the break-in was an administrative decision. He was more concerned about discovering Hayes’s breakthrough, and he knew the police and newspapers wouldn’t help in finding that. He wondered if the breakthrough could have involved the monstrous animals. The thought gave him a shiver.

Jason started rounds with Matthew Cowen. Unfortunately, there’d been a new development. Besides his other problems, Matthew was now acting bizarrely. Only a few minutes earlier the nurses had found him wandering in the halls, mumbling nonsense to himself. When Jason entered the room he was restrained in the bed, regarding Jason as a stranger. The man was acutely disoriented as to time, place, and person. As far as Jason was concerned, that could have meant only one thing. The man had thrown emboli, probably blood clots, from his injured heart valves into his brain. In other words he’d had a stroke or perhaps even multiple strokes.

Without delay, Jason placed a call for a neurology consult. He also called the cardiac surgeon who’d seen the case. Although he debated immediate anticoagulation, he decided to wait for the neurologist’s opinion. In the interim, he started the patient on aspirin and Persantine to reduce platelet adhesiveness. Strokes were a disturbing development and a very bad sign.

Jason did the rest of his rounds quickly and was about to leave for home and for some much-needed sleep when he was paged by the emergency room for one of his patients. Cursing under his breath, he ran downstairs, hoping whatever the problem was, it could be easily solved. Unfortunately, that was not to be the case.

Arriving breathless in the main treatment room, he found a group of residents giving CPR to a comatose patient. A quick look at the monitor screen told him there was no cardiac activity at all.

Jason stepped over to Judith Reinhart, who told him the patient had been found unconscious by her husband when he tried to waken her in the morning.

“Did the EMTs see any cardiac or respiratory activity?”

“None,” Judith said. “In fact, she feels cold to me.”

Jason touched the woman’s leg and agreed. Her face was turned away from him.

“What’s the patient’s name?” Jason asked, intuitively bracing himself for the blow.

“Holly Jennings.”

Jason felt like he’d been hit in the stomach. “My God!” he murmured.

“Are you all right?” Judith asked.

Jason nodded, but he insisted that the ER team maintain the CPR long past any reasonable time. He’d suspected trouble when he’d seen Holly on Thursday, but not this. He just couldn’t accept the fact that, like Cedric Harring, Holly would die less than a month after her fancy GHP physical told her she was okay, and two days after he’d seen her again.

Shaken, Jason picked up the phone and called Margaret Danforth.

“So once again there’s no cardiac history?” Margaret asked him.

“That’s correct.”

“What are you people doing down there?” Margaret demanded.

Jason didn’t answer. He wanted Margaret to release the case so they could do the autopsy at GHP, but Margaret hesitated.

“We’ll do the case today,” Jason said. “You’ll have a report early next week.”

“I’m sorry,” Margaret said, making a decision.

“There are questions in my mind, and I think I’m obligated by law to do the autopsy.”

“I understand. But I suppose you wouldn’t mind supplying us with specimens so we can process them here as well.”

“I suppose,” Margaret said without enthusiasm. “To tell the truth, I don’t even know the legality. But I’ll find out. I’d rather not wait two weeks for the microscopic.”

Jason went home and fell into bed. He slept for four hours, interrupted by a call from the neurologist concerning Matthew. He wanted to anti-coagulate and CAT-scan the patient. Jason implored him to do whatever he thought was best.

Jason tried to go back to sleep, but he couldn’t. He felt shell-shocked and anxious. He got up. It was a gloomy, late fall day with a slight drizzle that made Boston look dreadful. Fighting a depression, he paced his apartment, searching for something to occupy his mind. Realizing he couldn’t stay there, he put on casual clothes and went down to his car. Knowing he was probably asking for trouble, he drove over to Beacon Street and parked in front of Carol’s apartment.

Ten minutes later, as if God had finally decided to give him a break, Carol emerged. Dressed in jeans and a turtleneck, with her thick brown hair gathered in a ponytail, she seemed the young college student the Club Cabaret advertised. Feeling the light drizzle, she opened a flower print umbrella and started up the street, passing within a few feet of Jason, who scrunched down in his car seat, unreasonably afraid she’d recognize him.

Giving her a good lead, Jason got out of his car to follow on foot. He lost sight of her on Dartmouth Street, but picked her up at Commonwealth Avenue. As he continued to follow her, he kept a sharp eye out for the likes of Bruno or Curran. At the comer of Dartmouth and Boylston, Jason stopped at a magazine stand and thumbed through a periodical. Carol passed him, waited for the light, then hurried across Boylston. Jason studied the people and the cars, looking for anything suspicious. But there was no indication that Carol was not alone.

She was now passing the Boston Public Library, and Jason guessed she was heading for the Copley Plaza Shopping Mall. After buying the magazine, which turned out to be The New Yorker, Jason continued after her. When she folded her umbrella and went into the Copley Plaza, Jason quickened his step. It was a large shopping and hotel complex, and he knew he could easily lose her.

For the next three-quarters of an hour, Jason busied himself by pretending to study window displays, reading his New Yorker, and eyeing the crowds. Carol happily hopped from Louis Vuitton to Ralph Lauren to Victoria’s Secret. At one point Jason thought she was being tailed, but it turned out the man in question was simply trying to pick her up. She apparently rebuffed his advance when he finally approached her, because he quickly disappeared.

At a little after three-thirty, Carol took her bags and umbrella and retreated into Au Bon Pain. Jason followed, standing next to her as they waited to order and taking the opportunity to note her lovely oval face, smooth olive complexion, and dark liquid eyes. She was a handsome young woman. Jason guessed she was about twenty-four.

“Good day for coffee,” he said, hoping to start a conversation.

“I prefer tea.”

Jason smiled sheepishly. He wasn’t good at pickups or small talk. “Tea’s good, too,” he said, afraid he was making a fool of himself.

Carol ordered soup, tea, and a plain croissant, then carried her tray to one of the large communal tables.

Jason ordered a cappuccino and then, hesitating as though he could find no place to sit, approached her table.

“Do you mind?” he asked, pulling back a chair.

Several of the people at the table looked up, including Carol. A man moved several of his packages. Jason sat down, giving everyone a limp smile.

“What a coincidence,” Jason said to Carol. “We meet again.”

Carol eyed him over her teacup. She didn’t say anything, but she didn’t have to. Her expression reflected her irritation.

At once Jason recognized that his whole act appeared to be a come-on and that he was about to be sent packing. “Excuse me,” he said. “I don’t mean to be a bother. My name is Dr. Jason Howard. I was a colleague of Dr. Alvin Hayes. You’re Carol Donner, and I’d like very much to talk with you.”

“You’re with GHP?” Carol asked suspiciously.

“I’m the current chief of the medical staff.” It was the first time Jason had ever used the title. At a regular academic hospital it had great significance, but at GHP the job was a bothersome sinecure.

“How can I be sure?” Carol asked.

“I can show you my license.”

“Okay.”

Jason reached behind for his wallet, but Carol grasped his arm.

“Never mind,” she said. “I believe you. Alvin used to speak of you. Said you were the best clinician there.”

“I’m flattered,” Jason said. He was also surprised, considering the little contact he’d had with Hayes.

“Sorry to be so suspicious,” Carol said, “but I get hassled a lot, especially the last few days. What would you like to talk about?”

“Dr. Hayes,” Jason said. “First, I’d like to say that his death was a real loss to us. You have my sympathy.”

Carol shrugged.

Jason wasn’t sure what to make of her response. “I still have trouble believing Dr. Hayes was involved with drugs. Did you know about that?” he asked.

“I did. But the newspapers had it wrong. Alvin was a minimal user, usually marijuana but occasionally cocaine. Certainly not heroin.”

“Not a dealer?”

“Absolutely not. Believe me, I would have known.”

“But a lot of drugs and cash were found in his apartment.”

“The only explanation I can think of is that the police put both the drugs and the money in the apartment. Alvin was always short of both. If he ever had extra cash, he sent it to his family.”

“You mean his ex-wife?”

“Yes. She had custody of his children.”

“Why would the police do such a thing?” Jason asked, thinking her comment echoed Hayes’s paranoia.

“I don’t know, really. But I can’t think of any other way the drugs could have gotten there. I can assure you, he didn’t have them when I left at nine o’clock that evening.”

Jason leaned forward, lowering his voice. “The night Dr. Hayes died he told me he’d made a major discovery. Did he tell you anything about it?”

“He mentioned something. But that was three months ago.”

For a moment Jason allowed himself to feel optimistic. Then Carol explained that she didn’t know what the discovery was.

“He didn’t confide in you?”

“Not lately. We’d kinda drifted apart.”

“But you were living together — or did the newspapers get that wrong too?”

“We were living together,” Carol admitted, “but in the end just as roommates. Our relationship had deteriorated. He really changed. It wasn’t just that he felt physically ill; his whole personality was different. He seemed withdrawn, almost paranoid. He kept talking about seeing you and I tried to get him to do it.”

“You really have no idea what the discovery was?” Jason persisted.

“Sorry,” Carol said, spreading her hands in apology. “The only thing I remember was that he said the breakthrough was ironic. I remembered because it seemed an odd way to describe success.”

“He said the same to me.”

“At least he was consistent. His only other comment was that if all went well, I would appreciate it because I was beautiful. Those were his exact words.”

“He didn’t elaborate?”

“That was all he said.”

Taking a sip of his cappuccino, Jason stared at Carol’s face. How could an ironic discovery help her beauty? His mind tried to reconcile that statement with his guess that Hayes’s discovery had something to do with a cancer cure. It didn’t fit.

Finishing her tea, Carol stood up. “I’m glad to have met you,” she said, thrusting out her hand.

Jason stood up, awkwardly catching his chair to keep it from falling over. He was nonplussed by her sudden departure.

“I don’t mean to be rude,” she said, “but I have an appointment. I hope you solve the mystery. Alvin worked very hard. It would be a tragedy if he’d discovered something important and it was lost.”

“My feelings exactly,” said Jason, frantic not to see her disappear. “Can we meet again? There’s so much more I’d like to discuss.”

“I suppose. But I’m quite busy. When did you have in mind?”

“How about tomorrow?” Jason suggested eagerly. “Sunday brunch.”

“It would have to be late. I work at night and Saturday is the busiest.”

Jason could well imagine. “Please,” he said. “It could be important.”

“All right. Let’s say two P.M. Where?”

“How about the Hampshire House?”

“Okay,” Carol said, gathering up her bags and umbrella. With a final smile she left the café.

Glancing at her watch, Carol quickened her step. The impromptu meeting with Jason hadn’t figured in her tight schedule, and she didn’t want to be late for the meeting with her PhD adviser. She’d spent the late evening and early afternoon polishing the third chapter of her dissertation and she was eager to hear her professor’s response. Carol took the escalator down to the street level, thinking about her conversation with Dr. Howard.

It had been a surprise to meet the man after hearing about him for so long. Alvin had told her that Jason had lost his wife and had reacted to the tragedy by completely changing his environment and submerging himself in his work. Carol had found the story fascinating because her thesis involved the psychology of grief. Dr. Jason Howard sounded like a perfect case study.

The Weston Hotel doorman blew his whistle with a shriek that hurt Carol’s ears, making her wince. As the taxi lumbered toward her, she admitted that her response to Dr. Jason Howard went a bit further than pure professional interest. She’d found the man unusually attractive, and realized that her knowledge of his vulnerabilities contributed to his appeal. Even his social awkwardness had an endearing quality.

“Harvard Square,” Carol said as she got into the cab. She found herself looking forward to brunch the following morning.

Still seated in front of his cooling coffee, Jason admitted to being totally bowled over by Carol’s unexpected intelligence and charm. He’d expected an unsophisticated small-town girl who’d somehow been lured away from high school by money or drugs. Instead she was a lovely, mature woman quite capable of holding her own in any conversation. What a tragedy that a person with her obvious assets had become mixed up in the sordid world she inhabited….

The insistent and jarring sound of his beeper snapped Jason back to reality. He switched it off and looked at the LCD display. The word “urgent” blinked twice, followed by a telephone number Jason did not recognize. After seeing his medical identification, the Au Bon Pain manager allowed Jason to use the phone behind the cash register.

“Thank you for calling, Dr, Howard. This is Mrs. Farr. My husband, Gerald Farr, has developed terrible chest pains and he’s having trouble breathing.”

“Call an ambulance,” Jason said. “Bring him to the GHP emergency. Is Mr. Farr a patient of mine?” Jason thought the name sounded familiar but he couldn’t place it.

“Yes,” Mrs. Farr said. “You did a physical on him two weeks ago. He’s the senior vice president of the Boston Banking Company.”

Oh. no, Jason thought as he hung up the receiver. It’s happening again. Deciding to leave his car on Beacon Street until he’d handled the emergency, he ran from the café, dashed over the pedestrian connection to the hotel side of the Copley Plaza complex, and leaped into a cab.

Jason arrived at the GHP emergency room before the Farrs. He told Judith what he expected and even called anesthesia, pleased to learn Philip Barnes was on call.

When he saw Gerald Farr, Jason knew immediately that his worst fears were realized. The man was in agonizing pain and was pale as skim milk, with crystalline beads of perspiration on his forehead.

The initial EKG showed that a large area of the man’s heart had been damaged. It was not going to be an easy case. Morphine and oxygen helped to calm the patient, and lidocaine was given for prophylaxis against irregular heartbeats. But, despite everything, Farr wasn’t responding. Studying another EKG, Jason had the feeling that the infarcted area of the heart was expanding.

In desperation, he tried everything. But it was all for naught. At five minutes to four, Gerald Farr’s eyes rolled up inside his head and his heart stopped.

Unwilling as usual to give up, Jason commanded the resuscitative efforts. They got the heart to start several more times, but each time it would slip back into a deadly pattern and fail again.

Farr never regained consciousness. At six-fifteen, Jason finally declared the patient dead.

“Shit!” said Jason with disgust at himself and life in general. He was unaccustomed to swearing, and the effect of his doing so was not lost on Judith Reinhart. She leaned her forehead against Jason’s shoulder and put her arm around his neck.

“Jason, you did the best you could,” she said softly. “You did the best anybody could. But our powers are limited.”

“The man’s only. fifty-eight,” said Jason, choking back tears of frustration.

Judith cleared the room of the other nurses and residents. Coming back to Jason, she put her hand on his shoulder, “Look at me, Jason!” she said.

Reluctantly, Jason turned his face toward the nurse. A single tear had run down from the corner of his eye, along the crease of his nose. Softly but firmly she told Jason that he could not take these episodes so personally. “I know that two in one day is an awful burden,” she added. “But it’s not your fault.”

Jason knew intellectually that she was right, but emotionally it was another story. Besides, Judith had no idea how badly his inpatients were doing, especially Matthew Cowen, and Jason was embarrassed to tell her. For the first time, he seriously contemplated giving up medicine. Unfortunately, he had no idea of what else he could do. He wasn’t trained for anything else.

After promising Judith that he was okay, Jason went out to face Mrs. Farr, steeling himself against the expected anger. But Mrs. Farr, in the depths of her grief, had decided to take the burden of guilt on herself. She said her husband had been complaining of feeling ill for a week, but that she’d ignored his complaints because, frankly, he’d always been a bit of a. hypochondriac. Jason tried to comfort the woman as Judith had tried to comfort him. He was about equally successful.

Confident that the medical examiner would take the case, Jason didn’t burden Mrs. Farr with an autopsy request. By law, the ME didn’t need authorization to do a postmortem in cases of questionable death. But to be sure, he called Margaret Danforth. The response was as expected: she indeed wanted the case, and while she had Jason on the phone, she spoke to him about Holly Jennings.

“I take back that snide comment I made this morning,” Margaret said. “You people are just having bad luck. The Jennings woman was as bad off as Cedric Harring. All her vessels looked terrible, not just the heart.”

“That’s not a lot of consolation,” Jason said. “I had just given her a physical showing everything was fine. I did a follow-up EKG on Thursday, but that showed only minimal changes.”

“No kidding? Wait till you see the sections. Grossly the coronary vessels looked ninety percent occluded, and it was disseminated, not focal. Surgery wouldn’t have done a damn thing. Oh, by the way, I checked and it’s okay for us to give you small specimens from Jennings’s case. But I should have a formal request in writing.”

“No problem,” Jason said. “Same with Farr?”

“Sure thing.”

Jason took a cab back to his car and drove home. Despite the fog and rain, when he got home, he went for a jog. Getting mud-spattered and soaked had a mild cathartic effect, and after a shower he felt some relief from his burdensome emotions and depressive feelings. Just when he was starting to think about food, Shirley called and asked him over for dinner. Jason’s first response was to say no. But then he recognized he felt too depressed to be alone, so he accepted. After changing into more reasonable clothes, he went down to his car and headed west toward Brookline.

Eastern’s flight #409, nonstop from Miami to Boston, banked sharply before lining up for the final approach. It touched down at seven thirty-seven as Juan Dfaz closed his magazine and looked out at the fog-shrouded Boston skyline. It was his second trip to Boston and he wasn’t all that pleased. He wondered why anyone would choose to live in such predictably bad weather. It had rained on his previous trip just a few days ago. Looking down on the tarmac, he saw the wind and rain in the puddles and thought nostalgically of Miami, where late fall had finally put an end to the searing summer heat. Getting his bag from under the seat in front of him, Juan wondered how long he’d be in Boston. He remembered that on the previous trip he’d been there only two days, and he hadn’t had to do a thing. He wondered if he’d have the same good fortune. After all, he got his five thousand no matter what.

The plane taxied toward the terminal. Juan looked around the compartment with a sense of pride. He wished his family back in Cuba could see him now. Would they be surprised! There he was, flying first class. After being sentenced to life in prison by the Castro government, he’d been released after only eight months and sent first to Mariel and then, to his astonishment, to the USA. That was to be his punishment for having been convicted of multiple murder and rape — being sent to the USA! It was so much easier to do his type of work in the United States. Juan felt that the one person in the world whose hand he’d most like to shake was a peanut farmer someplace in Georgia.

The plane gave a final lurch, then was still. Juan rose to his feet and stretched. Taking his carry-on bag, he headed for baggage. After retrieving his suitcase, he caught a cab to the Royal Sonesta Hotel, where he registered as Carlos Hernández from Los Angeles. He even had a credit card in that name, with a legitimate number. He knew the number was good, since he’d taken it off a receipt he’d found at the Bal Harbour shopping plaza in Miami.

Once he was comfortably relaxed in his room, with his second silk suit hanging in the closet, Juan sat at the desk and called a number he’d been given in Miami. When the phone was answered, he told the person he needed a gun, preferably a.22 caliber. With that business taken care of, he got out the name and address of the hit and looked up the location on the map supplied by the hotel. It wasn’t far away.

The evening with Shirley was a great success. They dined on roast chicken, artichokes, and wild rice. Afterward they had Grand Marnier in front of the fire in the living room and talked. Jason learned that Shirley’s father had been a doctor and that back in college she’d entertained the idea of following in his footsteps.

“But my father talked me out of it,” Shirley said. “He said that medicine was changing.”

“He was right about that.”

“He told me that it would be taken over by big business and that someone who cared about the profession should go into management. So I switched to business courses, and I believe I made the right choice.”

“I’m sure you did, too,” Jason agreed, thinking about the explosion of paperwork and the malpractice dilemma. Medicine had indeed changed. The fact that he now worked for a salary for a corporation stood as testament to that change. When he’d been in medical school he’d always imagined he’d work for himself. That had been part of the appeal.

At the end of the evening, there was a bit of awkwardness. Jason said he’d best be going, but Shirley encouraged him to stay.

“You think that would be a good idea?” Jason asked.

She nodded.

Jason wasn’t so sure, saying he’d have to get up early for rounds and wouldn’t want to disturb her. Shirley insisted she was up at seven-thirty as a matter of course, Sundays included.

They stared at each other for a time, the firelight making Shirley’s face glow.

“There’s no obligation,” Shirley said softly. “I know we both have to be slow about this. Let’s just be together. We’ve both been under stress.”

“Okay,” Jason said, recognizing he did not have the strength to resist. Besides, he was flattered that Shirley was so insistent. He was becoming more open to the idea that not only could he care about another person but another person could care about him.

But Jason did not get to sleep the whole night through. At three-thirty he felt a hand on his shoulder, and he sat up, momentarily confused as to his whereabouts. In the half light, he could just make out Shirley’s face.

“I’m sorry to have to bother you,” she said gently, “but I’m afraid the phone is for you.” She handed him the receiver from the nightstand.

Jason took the phone and thanked her. He hadn’t even heard the phone ring. Propping himself on one elbow, he put the receiver to his ear. He was certain it would be bad news, and he was right. Matthew Cowen had been found dead in his bed, apparently having suffered a final, massive stroke.

“Has the family been notified?” Jason asked.

“Yes,” said the nurse. “They live in Minneapolis. They said they’d come in the morning.”

“Thanks,” Jason said, absently giving the phone back to Shirley.

“Trouble?” Shirley asked. She set the receiver back in the cradle.

Jason nodded. Trouble had become his middle name. “A young patient died. Thirty-five or so. He had rheumatic heart disease. He was in for evaluation for surgery.”

“How bad was his heart disease?” asked Shirley.

“It was bad,” Jason said, seeing Matthew’s face, remembering him as he’d been when he entered the hospital. “Three of his four valves were affected. They would have had to replace all of them.”

“So there were no guarantees,” Shirley said.

“No guarantees,” Jason agreed. “Three valve replacements can be tricky. He’s had congestive heart failure for a long time, undoubtedly affecting his heart, lungs, kidneys and liver. There would have been problems, but he had age on his side.”

“Maybe it was for the best,” Shirley suggested. “Maybe he’s been spared from a lot of suffering. Sounds like he would have been in and out of the hospital for the rest of his life.”

“Maybe so,” Jason said without conviction. He knew what Shirley was doing: she was trying to make him feel better. Jason appreciated her effort. He patted the thigh through the thin cover of her robe. “Thanks for your support.”

The night seemed awfully cold when Jason ran out to his car. It was still raining, in fact, harder than before. Turning up the heat, he rubbed his thighs to get his circulation going. At least there was no traffic. At four A.M., Sunday morning, the city was deserted. Shirley had tried to get him to stay, arguing that there was nothing for Jason to do if the man had died and the family was not available. As true as this was, Jason felt an obligation to his patient that he could not dismiss. Besides, he knew he’d not be able to get back to sleep. Not with yet another death on his conscience.

The GHP parking lot was mostly empty. Jason was able to park close to the hospital entrance rather than under the outpatient building where he usually parked. As he stepped out of his car, preoccupied with thoughts of Matthew Cowen, he didn’t notice a darkened figure hunched over at the side of the hospital door. Rounding the front of his car, the figure lunged at Jason. Caught completely unaware, Jason screamed. But the figure turned out to be one of the drunken street people who frequented the GHP emergency room, asking for spare change. With a shaking hand, Jason gave him a dollar, hoping he’d at least buy himself a little food.

Shirley had been right. There was nothing for Jason to do but write a final note in Matthew Cowen’s chart. He went in and viewed his body. At least Matthew’s face looked calm, and as Shirley suggested, he was now spared further suffering. Silently. Jason apologized to the dead man.

Paging the resident on call, Jason instructed him to ask the family for an autopsy. Jason explained he might not be immediately available. Then, feeling as ineffectual as ever, after these deaths, he left the hospital and returned to his apartment. He lay for some time, staring at the ceiling, unable to sleep. He wondered what kind of job he could get in the pharmaceutical industry.