Mutation

4 Later Monday Morning

The small alarm on Marsha’s desk went off, signaling the end of the fifty-minute session with Jasper Lewis, an angry fifteen-year-old boy with a smudge of whiskers along his chin line. He was slouched in the chair opposite Marsha’s, acting bored. The fact of the matter was that the kid was heading for real trouble.

“What we haven’t discussed yet is your hospitalization,” Marsha said. She had the boy’s file open on her lap.

Jasper hooked a thumb over his shoulder toward Marsha’s desk. “I thought that bell means the session is over.”

“It means it is almost over,” Marsha said. “How do you feel about your three months in the hospital now that you are back home?” Marsha’s impression was that the boy had benefited from the hospital’s structured environment, but she wanted to learn his opinion.

“It was okay,” Jasper said.

“Just okay?” asked Marsha encouragingly. It was so tough to draw this boy out.

“It was like fine,” Jasper said, shrugging. “You know, no big deal.”

Obviously it was going to take a bit more effort to extract the boy’s opinion, and Marsha made a note of reminder to herself in the margin of the boy’s file. She’d start the next session with that issue. Marsha closed the file and made eye contact with Jasper. “It’s been good to see you,” Marsha said. “See you next week.”

“Sure,” Jasper said, avoiding Marsha’s eyes as he got up and awkwardly left the room.

Marsha went back to her desk to dictate her notes. Flipping open the chart, she looked at her preadmission summary. Jasper had had a conduct disorder since early childhood. Once he hit age eighteen, the diagnosis would change to an antisocial personality disorder. On top of that, he also had what appeared to Marsha as a schizoid personality disorder.

Reviewing the salient features of the boy’s history, Marsha noted the frequent lying, the fights at school, the record of truancy, the vindictive behavior and fantasies. Her eye stopped at the statement: cannot experience affection or show emotion. She suddenly pictured VJ pulling away from her embrace, looking at her coldly, his blue eyes frigid as mountain lakes. She forced her eyes back down on the chart. Chooses solitary activities, does not desire close relationships, has no close friends.

Marsha’s pulse quickened. Was she reading a summary of her own son? With trepidation, she reread the review of Jasper’s personality. There were a number of uncomfortable correlations. She was happy when her train of thought was interrupted by her nurse and secretary, Jean Colbert, a prim and proper New Englander with auburn hair. As she looked up, her eye caught a sentence that she had underlined in red: Jasper was essentially reared by an aunt, since his mother worked two jobs to support the family.

“You ready for your next patient?” Jean asked.

Marsha took a deep breath. “Remember those articles I saved on day care and its psychological effects?” she asked.

“Sure do,” Jean said. “I filed them in the storage room.”

“How about pulling them for me,” Marsha said, trying to mask her concern.

“Sure,” Jean said. She paused, then asked: “Are you okay?”

“I’m fine,” Marsha said, picking up the next chart. As she scanned her recent notes, twelve-year-old Nancy Traverse slunk into the room and tried to disappear into one of the chairs. She pulled her head low into her shoulders like a turtle.

Marsha moved over to the therapy area, taking the seat opposite Nancy. She tried to remember where the girl had left off at the previous visit, describing her forays into sex.

The session began and dragged on. Marsha tried to concentrate, but fears for VJ floated at the back of her mind along with guilt for having worked when he had been little. Not that he’d ever minded when she’d left. But as Marsha well knew, that in itself could be a symptom of psychopathology.

After Hobbs left, Victor tried to busy himself with correspondence, partly to avoid the lab, partly to take his mind off the terrible news that Hobbs had told him. But his thoughts soon drifted back to the circumstances of the boy’s death. Edema of the brain, meaning acute brain swelling, had been the immediate cause. But what could have been the cause of the edema? He wished Hobbs had been able to give him more details. It was the lack of a specific diagnosis that fed Victor’s fears.

“Damn!” Victor yelled as he slammed his open palm on the top of his desk. He stood up abruptly and stared out the window. He had a good view of the clock tower from his office. The hands had been frozen in the distant past at quarter past two.

“I should have known better!” Victor said to himself, pounding his right fist into his left palm with enough strength to make them both tingle. The Hobbs child’s death brought back all the concern Victor had had for VJ — concern he had finally put to rest. While Marsha fretted over the boy’s psychological state, Victor’s worries had more to do with the boy’s physical being. When VJ’s IQ dropped, then stabilized at what was still an exceptional level, Victor had felt terror. It had taken years for him to overcome his fear and relax. But the Hobbs boy’s sudden death raised his fears again. Victor was particularly concerned since the parallels between VJ and the Hobbs boy did not stop with their conception. Victor understood that, like VJ, the Hobbs boy was something of a child prodigy. Victor had been keeping surreptitious tabs on the child’s progress. He was curious to see if the boy would suffer as precipitous a drop in IQ as VJ had. But now, Victor only wanted to learn the circumstances of the child’s tragic death.

Victor went to his computer terminal and cleared the screen. He called up his personal file on Baby Hobbs. He wasn’t looking for anything in particular, he just thought that if he scanned the data, some explanation for the child’s death might occur to him. The screen stayed dark past the usual access time. Confused, Victor hit the Execute button again. Answering him, the word SEARCHING blinked in the screen’s lower-right-hand corner. Then, to Victor’s surprise, the computer told him there was no such file.

“What the devil?” Victor said. Thinking he might have made an entry error, Victor tried again, typing BABY-HOBBS very deliberately. He pressed Execute and after a pause during which the computer searched all its storage banks, he got the exact same response: NO FILE FOUND.

Victor turned off the computer, wondering what could have happened to the information. It was true that he hadn’t accessed it for some time, but that shouldn’t have made a difference. Drumming his fingers on the desk in front of the keyboard, Victor thought for a moment, then accessed the computer again. This time he typed in the words BABY- MURRAY.

There was the same pause as with the Hobbs file and ultimately the same response appeared: NO FILE FOUND.

The door to the office opened and Victor twisted around. Colleen was standing in the doorway. “This is not a day for fathers,” she said, gripping the edge of the door. “You have a phone call from a Mr. Murray from accounting. Apparently his baby isn’t doing well either and he’s crying too.”

“I don’t believe it,” Victor blurted. The timing was so coincidental.

“Trust me,” Colleen said. “Line two.”

Dazed, Victor turned to his phone. The light was blinking insistently, each flash causing a ringing sensation in Victor’s head. This couldn’t be happening, not after everything had gone so well for so long. He had to force himself to pick up the receiver.

“I’m sorry to bother you,” Murray managed, “but you’ve been so understanding when we were trying to get a baby. I thought you’d want to know. We brought Mark to the Children’s Hospital and he is dying. The doctors tell me there is nothing they can do.”

“What happened?” Victor asked, barely able to speak.

“Nobody seems to know,” Horace said. “It started with a headache.”

“He didn’t hit his head or anything?” Victor questioned.

“Not that we know of,” Horace said.

“Would you mind if I came over?” Victor asked.

A half hour later, Victor was parking his car in the garage opposite the hospital. He went inside and stopped at the information desk. The receptionist told him Mark Murray was in the surgical intensive-care unit, and gave him directions to the waiting room. Victor found Horace and Colette distraught with worry and lack of sleep. Horace got to his feet when he saw Victor.

“Any change?” Victor asked hopefully.

Horace shook his head. “He’s on a respirator now.”

Victor conveyed his condolences as best he could. The Murrays seemed touched that Victor had taken the time to come to the hospital, especially since they never socialized.

“He was such a special child,” Horace said. “So exceptional, so intelligent...” He shook his head. Colette hid her face in her hands. Her shoulders began to quiver. Horace sat back down and put an arm around his wife.

“What’s the name of the doctor taking care of Mark?” Victor asked.

“Nakano,” Horace answered. “Dr. Nakano.”

Victor excused himself, left his coat with the Murrays, and departed the waiting room with its anxious parents. He walked toward Pediatric Surgical Intensive Care, which was at the end of the corridor, behind a pair of electronic doors. As Victor stepped on the rubberized area in front of the doors, they automatically opened.

The room inside was familiar to Victor from his days as a resident. There was the usual profusion of electronic gear and scurrying nurses. The constant hiss of the respirators and bleeps of the cardiac monitors gave the room an aura of tension. Life here was in the balance.

Since Victor acted at ease in the environment, no one questioned his presence, despite the fact that he was not wearing an ID. Victor went to the desk and asked if Dr. Nakano was available.

“He was just here,” a pert young woman replied. She half stood and leaned over the counter to see if she could spot him. Then she sat down and picked up the phone. A moment later the page system added Dr. Nakano’s name to the incessant list that issued from speakers in the ceiling.

Walking about the room, Victor tried to locate Mark, but too many of the kids were on respirators that distorted their faces. He returned to the desk just as the ward clerk was hanging up the phone. Seeing Victor, she told him that Dr. Nakano was on his way back to the unit.

Five minutes later, Victor was introduced to the handsome, deeply tanned Japanese-American. Victor explained that he was a physician and friend of the Murray family, and that he hoped to get some idea of what was happening to Mark.

“It’s not good,” Dr. Nakano said candidly. “The child is dying. It’s not often we can say that, but in this case the problem is unresponsive to any treatment.”

“Do you have any idea of what’s going on?” Victor asked.

“We know what’s happening,” Dr. Nakano said, “what we don’t know is what’s causing it. Come on, I’ll show you.”

With the hurried step of a busy doctor, Dr. Nakano took off toward the rear of the ICU. He stopped outside a cubicle separated from the main portion of the ICU.

“The child’s on precautions,” Dr. Nakano explained. “There’s been no evidence of infection, but we thought just in case...” He handed Victor a gown, hat, and mask. Both men donned the protective gear and entered the small room.

Mark Murray was in the center of a large crib with high side rails. His head was swathed in a gauze bandage. Dr. Nakano explained that they’d tried a decompression and a shunt, hoping that might help, but it hadn’t.

“Take a look,” Dr. Nakano said, handing Victor an ophthalmoscope. Leaning over the stricken two-year-old, Victor lifted Mark’s eyelid and peered through the dilated, fixed pupil. Despite his inexperience with the instrument, he saw the pathology immediately. The optic nerve was bulging forward as if being pushed from behind.

Victor straightened up.

“Pretty impressive, no?” Dr. Nakano said. He took the scope from Victor and peered himself. He was quiet for a moment, then straightened up. “The disappointing thing is that it is getting progressively worse. The kid’s brain is still swelling. I’m surprised it’s not coming out his ears. Nothing has helped; not the decompression, not the shunt, not massive steroids, not mannitol. I’m afraid we’ve just about given up.”

Victor had noticed there was no nurse in attendance. “Any hemorrhage or signs of trauma?” he asked.

“Nope,” Dr. Nakano said simply. “Other than the swelling, the kid’s clean. No meningitis as I said earlier. We just don’t understand. The man upstairs is in control.” He pointed skyward.

As if responding to Dr. Nakano’s morbid prediction, the cardiac monitor let out a brief alarm, indicating that Mark’s heart had paused. Mark’s heart rate was becoming irregular. The alarm sounded briefly again. Dr. Nakano didn’t move. “This happened earlier,” he said. “But at this point it’s a ‘no-code’ status.” Then, as an explanation, he added: “The parents see no sense in keeping him alive if his brain is gone.”

Victor nodded, and as he did so, the cardiac monitor alarm came on and stayed on. Mark’s heart went into fibrillation. Victor looked over his shoulder toward the unit desk. No one responded.

Within a short time the erratic tracing on the CRT screen flattened out to a straight line. “That’s the ball game,” Dr. Nakano said. It seemed like such a heartless comment, but Victor knew that it was born more of frustration than callousness. Victor remembered being a resident too well.

Dr. Nakano and Victor returned to the desk where Dr. Nakano informed the secretary that the Murray baby had died. Matter-of-factly the secretary lifted the phone and initiated the required paperwork. Victor understood you couldn’t work here if you let yourself become upset by the frequent deaths.

“There was a similar case last night,” Victor said. “The name was Hobbs. The child was about the same age, maybe a little older. Are you familiar with it?”

“I heard about it,” Dr. Nakano said vaguely. “But it wasn’t my case. I understand many of the symptoms were the same.”

“Seems so,” Victor said. Then he asked: “You’ll get an autopsy?”

“Absolutely,” Dr. Nakano said. “It will be a medical examiner’s case, but they turn most over to us. They’re too busy downtown, especially for this kind of esoteric stuff. Will you tell the parents or do you want me to do it?”

Dr. Nakano’s rapid change of direction in his conversation jarred Victor. “I’ll tell them,” he said after a pause.

“And thanks for your time.”

“No problem,” Dr. Nakano said, but he didn’t look at Victor. He was already involved with another crisis.

Stunned, Victor walked out of the ICU, appreciating the quiet as the electronic doors closed behind him. He returned to the waiting room where the Murrays guessed the bad news before he could tell them. Gripping each other, they again thanked Victor for coming. Victor murmured a few words of condolence. But even as he spoke a frightful image gripped his heart. He saw VJ white and hooked up to a respirator in the bed where Mark had lain.

Cold with terror, Victor went to Pathology and introduced himself to the chief of the department, Dr. Warren Burghofen. The man assured Victor that they would do everything in their power to get the two autopsies, and get them as soon as possible.

“We certainly want to know what’s going on here,” Burghofen said. “We don’t want any epidemic of idiopathic cerebral edema ravaging this city.”

Victor slowly returned to his car. He knew there was little likelihood of an epidemic. He was only too conscious of the number of children at risk. It was three.

As soon as Victor got back to his office he asked Colleen to contact Louis Kaspwicz, the head of Chimera’s data processing, and have him come up immediately.

Louis was a short, stocky man with a shiny bald head, who had a habit of sudden unpredictable movements. He was extremely shy and rarely looked anyone in the eye, but despite his quirky personality, he was superb at what he did. Chimera depended upon his computer expertise for almost every area, from research to production to billing.

“I have a problem,” Victor said, leaning back against his desk, his arms folded across his chest. “I can’t find two of my personal files. Any idea how that could be?”

“Can be a number of reasons,” Louis said. “Usually it’s because the user forgets the assigned name.”

“I checked my directory,” Victor said. “They weren’t there.”

“Maybe they got in someone else’s directory,” Louis said.

“I never thought of that,” Victor admitted. “But I can remember using them, and I never had to designate another path to call them up.”

“Well, I can’t say unless I look into it,” Louis said. “What were the names you gave the files?”

“I want this to remain confidential,” Victor emphasized.

“Of course.”

Victor gave Louis the names and Louis sat down at the terminal himself.

“No luck?” asked Victor after a few minutes when the screen remained blank.

“Doesn’t seem so. But back in my office I can look into it by using the computer to search through the logs. Are you sure these were the designated file names?”

“Quite sure,” Victor said.

“I’ll get right on it if it’s important,” Louis said.

“It’s important.”

After Louis left, Victor stayed by the computer terminal. He had an idea. Carefully he typed onto the screen the name of another file: BABY-FRANK. For a moment he hesitated, afraid of what might turn up — or what might not. Finally he pushed Execute and held his breath. Unfortunately his fears were answered: VJ’s file was gone!

Sitting back in his chair, Victor began to sweat. Three related but uncrossreferenced files could not disappear by coincidence. Suddenly Victor saw Hurst’s engorged face and remembered his threat: “You’re not the white knight you want us to believe... You’re not immune.”

Victor got up from the terminal and went to the window. Clouds were blowing in from the east. It was either going to rain or snow. He stood there for a few moments, wondering if Hurst had anything to do with the missing files. Could he possibly suspect? If he did, that might have been the basis for his vague threat. Victor shook his head. There was no way Hurst could have known about the files. No one knew about them. No one!