Natural Causes

CHAPTER 9

July 5

SARAH HAD NEVER MUCH LIKED GETTING DRESSED UP. As far as she could tell, that displeasure dated back to Sunday mornings in Ryerton, the rural New York town where she was raised. Her mother, perhaps responding to the stigma of having had a daughter out of wedlock, spent at least an hour each Sunday getting her ready for church. Sarah's dresses were pressed and perfect, her shoes spotless. Her hair was often braided half a dozen times before every strand was deemed in place. And always-at least until the early symptoms of her mother's Alzheimer's disease began to appear-the outfit was topped with a large, white bow.

Now Sarah twisted and turned before her bedroom mirror, trying to assess the third-or fourth-in the series of outfits she had tried on. It was eight o'clock in the morning. In fifteen minutes her cab to the hospital was due. Two days before, instigated no doubt by Glenn Paris and his PR department, the story had broken in both Boston papers about how eastern and western medicine had joined forces at the Medical Center of Boston to save the life of a young woman. However, the positive publicity for MCB was short-lived.

A day later, a small article, under no byline, had appeared in the Herald. Unnamed but reliable sources had reported that the unusual and cataclysmic obstetrical bleeding complication was not the first but the third such to occur in an MCB patient within the past eight months. And unlike Lisa Summer, the source further related, both of the previous cases had died.

Glenn Paris's rapid response to the story had been to schedule a press conference for nine o'clock on the morning of July 5. With Independence Day being relatively slow for news, his carefully prepared statement was carried by every Boston radio and television station. Presenting at the session, he announced, would be Drs. Randall Snyder and Eli Blankenship, chiefs of the departments of obstetrics and internal medicine at MCB, and Dr. Sarah Baldwin, the resident who had contributed so uniquely to saving the life of Lisa Summer.

At eight-fifteen, when the doorbell rang, Sarah was wearing leather flats, a gathered madras skirt, a beige cotton blouse, and a hand-embroidered Burmese belt, topped by a loose-fitting turquoise blazer. Her major concession to the formality of the occasion was wearing panty hose-not comfortable in any month, but even less so in July.

"Coming," she shouted into the intercom.

She snatched up the ornate brass earrings fashioned for her by an Akha craftsman and slipped them in place as she hurried down the stairs. Though she admired Glenn Paris, being a performer in one of his extravaganzas was not Sarah's style. But the report of a third DIC case in an MCB patient did demand a quick, reassuring-but-informative response from the hospital. And Paris felt she could help accomplish that. What had been a curiosity with the first patient, then a serious concern with the second, had suddenly become a terrifying priority.

The cabbie let her off on the street side of the Thayer Building. Glenn Paris met her in his outer office and greeted her warmly. As always, he was noticeably well dressed. Today, his tan suit, sky-blue shirt, and red power tie seemed tailor-made for television. He appeared somewhat tense, but there was a confident, dedicated energy about him that Sarah found disarming and attractive. It was the same sort of aura that had initially drawn her to Peter Ettinger.

"Sarah, do you have any idea who might have leaked this information to the Herald?" Paris asked.

"No, sir."

"Neither does anyone else I've talked to. A letter about the Hidalgo case comes in from the New York City Medical Examiner to our chief of surgery. He sends copies to pathology, obstetrics, hematology, internal medicine, the morbidity and mortality committee, and then, almost as an afterthought, to me. No sooner do I read about the case in my copy of the letter, than I read it in the damn paper. Now, isn't that just something! Each of the people I have spoken with gave a Xerox of the letter to one or more others. At last count, any of twenty-five or thirty people could have leaked it. They all say they had no idea it was that important. Not important! Well, I'm going to get him, Sarah. This time whoever it is has gone too far. Mark my words, I'm going to get him."

"I'm sure you will," Sarah said softly.

Although she understood his anger, she was not comfortable with it. She came close to reminding him that, regardless of the source of the news leak, regardless of the negative publicity, something very serious and frightening was going on. And the Medical Center of Boston did seem to be right in the middle of it.

When they left the building on the campus side, they saw a fairly large number of people-hospital staff, reporters, and one television camera crew-streaming across toward the auditorium.

"Looks like we're going to have quite a turnout," Paris said. "That's good. We've got to let the public know we're on top of this thing. Our foundation grant is looking very good, but it's not a lock. Negative publicity can still hurt us."

"Have you met with any members of the medical staff yet?" she asked, hoping to bring him back to the real issue at hand.

"Dr. Blankenship and I have been huddled almost continually since this article broke. I have an old friend who's an administrator at the Centers for Disease Control in Atlanta. I put Eli in touch with him, and he tells me they're trying to get someone up here in time for-"

Paris stopped short, his hand raised to keep her silent. He motioned her into the shadow of the outpatient building. Ahead of them, just at the corner of the building, a well-dressed man with a briefcase in one hand was engrossed in intimate conversation with one of the hospital's maintenance workers. Two days before, the maintenance staff's wildcat job action had crumbled before Paris's threat to fire everyone involved. Fliers damning his action were subsequently posted throughout the hospital. And although they were all back at work, none of the maintenance staff had moved to take them down.

"You know that guy in the suit?" Paris whispered.

Sarah shook her head. The man, perhaps in his early forties, had a slight build, blow-dried hair, and a distinctively aquiline profile. The diamond in the ring on the small finger of his left hand was easily noticeable from where they were standing, some fifty feet away.

"I would say he's either a car salesman or a lawyer," Sarah said.

"What he is, is scum," Paris responded. "But he is a lawyer. And as a matter of fact, he's also an M.D."

"I'm impressed."

"Don't be. His name's Mallon. Jeremy Mallon. Ever heard of him?… No? Good. He's a bigtime ambulance chaser who is also on retainer for Everwell. I think he even owns a piece of their action. For months now, I've suspected he's been behind some, if not all, of the trouble we've been having. This little tete-a-tete we're watching goes a long way toward proving me right."

Suddenly Mallon caught sight of them. A word from him sent the maintenance worker scurrying off in the other direction. Paris moved in quickly, with Sarah a few feet behind.

"You son of a bitch," Paris snapped. "I knew it was you."

"I have no idea what you're talking about," Mallon said unctuously. "And I would caution you to watch what you call anyone in public."

Even if Paris had not prejudiced her, Sarah knew she would have instantly disliked the man.

"That power failure was no damn accident," Paris raged. "Neither was that bogus strike. I thought it, now I know it. I hope you paid that worm well, shyster, because as of now, he's out of a job."

Paris had raised his voice enough so that several of those headed toward the auditorium stopped to watch. Two MCB administrators, one of whom Sarah recognized as Colin Smith, the hospital's chief financial officer, hurried toward them.

"Paris, you're way out of line," Mallon said. "I don't need to make any trouble for you. You do a perfectly good job of that all by yourself."

"Get out of here right now."

"Nonsense. There's a publicly announced press conference that I want to attend. It will be fascinating to see how you plan to tiptoe around the fact that this place is becoming a death house."

"Why, you filthy-"

The two administrators stepped in front of Paris before he could lunge at the man.

"Easy, Glenn," Colin Smith said. "He's not worth it."

"I want you away from my hospital!" Paris shouted.

"You're looking and sounding more and more like a drowning man, Paris," said Mallon, who suddenly appeared to Sarah as some sort of serpent. "And as for its being your hospital, enjoy it while you can, because I don't believe that will be the case for much longer."

"Get out of here!"

This time Colin Smith had to physically restrain his boss.

"I do actually have more important things to do than to watch you gun yourself in the foot again, Paris. I can catch the highlights of that on the evening news." Mallon turned without waiting for a response and left through the outpatient building.

"Scum," Paris muttered.

"Easy does it," Smith urged.

"They're not going to get us, Colin. The day Everwell and that creep take over MCB will be the day they have to bury me."

"It'll never happen, Glenn," Smith said. "We've got the ace up our sleeve. You know that, and I know that."

His words had a remarkably calming effect on Paris. Sarah could see the muscles in his face relax. His fists unclenched. And finally he smiled.

"Right you are, Colin," he said. "Right you are. You're a good man."

He apologized to Sarah for his loss of composure, and introduced her to Smith and the other man, whose title had something to do with overseeing the hospital's physical plant. Then he sent them on ahead.

"Sarah, in case you hadn't guessed," he said, "the ace Colin was talking about is our grant. It's coming from the McGrath Foundation, and we've been courting them for almost three years now. But please, not a word to anyone. As I said before, this is not yet signed, sealed, and delivered. And I have no doubt that if he knew the magnitude of the grant and who it was coming from, that sleaze Mallon would do whatever he could to keep it from happening."

"It'll happen," Sarah said.

"Well, it's down to the wire now. We get the money, we win; we don't, Mallon and Everwell win. It's about as simple as that."

As they reached the building that housed the auditorium, they heard, then spotted a sleek helicopter, which swooped over the campus and then made a neat landing on the helipad Paris had insisted be built atop the surgical building.

"The person from the CDC?" Sarah asked.

"Doubtful. I don't even know if they're sending anyone yet. More likely it's some network VIP coming to the press conference."

"Or else one of our patients has some well-off family or friends."

"Doubtful again. I have every admission checked over by our PR staff. If somebody worth knowing about was a patient here, I promise you I'd be aware of it. Now, then, let's go in and give them a show."

"I'll do what I can," Sarah said.

• • •

Belted in the copilot's seat of his Sikorsky S76 jet helicopter, Willis Grayson watched the Medical Center of Boston expand below. What excitement he felt at the prospect of seeing his only child for the first time in five years was virtually consumed by his rage at those who had led her to such a place and such a condition.

Upon his return from restructuring a Silicon Valley company, he had found a detective named Pulasky camped outside the gate to his Long Island estate. The detective had the first new photos Grayson had seen of his daughter since well before she disappeared. The man also had with him copies of both Boston papers. And although the stories in them contained no pictures of Lisa Summer, Pulasky assured him the patient in the Medical Center of Boston and his daughter were one and the same person.

A visit by some of Grayson's Boston people to Lisa's Jamaica Plains address confirmed Pulasky's claim. After paying the man off, Grayson had made two calls. The first was to summon his pilot; the second was to order Ben Harris, his personal physician, to cancel his office patients and clear his schedule for an immediate flight. Within two hours they had touched down on the rooftop heliport of the Medical Center of Boston.

"Keep her warm, Tim," Grayson said, stepping out onto the tarmac. "If Lisa's in any condition to travel, we're getting her the hell out of here and down to our hospital." He helped his internist out onto the roof. "Now don't hold anything back from me, Ben," he ordered. "Remember, your allegiance is to me, not to that inbred medical fraternity I keep reading about. If someone's fucked up with Lisa's care, I want to know."

For nearly all of his fifty-four years, the driving force in Willis Grayson's life had been anger. As a child, he had drawn strength from the helpless rage of being strapped down on hospital beds while doctors wrestled with his life-threatening attacks of asthma. In his teens, fury at the prolonged absences of his industrialist father and the emotional unavailability of his socialite mother became manifest in repeated aggressive acts, leading to his expulsion from several private schools.

And years later, when he was finally admitted to the inner sanctum of his father's company, it was his desperate, unbridled need for retribution that drove him to maneuver the man out of power and to rechart the course of the business from manufacturing to corporate raiding. In just over two decades, his personal worth had grown to nearly half a billion dollars. But within him, little had changed.

Lisa's room was on the fifth floor of the building on which the chopper had landed. While the helipad was state of the art, the fifth floor was in need of refurbishing. In less than a minute, Grayson had made mental notes of an unemptied wastebasket, walls in need of paint, an unattended elderly patient strapped to his chair in the hall, and a pervasive smell that he suspected was a mix of grime, sweat, and excrement.

"This place is a pit, Ben," he said. "I just don't understand it. She could buy her own goddamn hospital, and she ends up in a place like this."

Grayson's people had reported Lisa's room as 515. With his physician several paces behind, Grayson hurried past the nurses' station, oblivious to the woman who was seated there, writing notes.

The stocky young nurse, whose name tag identified her as Janine Curtis, R.N., M.Sc.N., called out to them. "Excuse me. May I help you?"

"No," Grayson growled over his shoulder. "We're going to room five fifteen."

"Please stop," she demanded.

Grayson stiffened. Then, his fists slowly opening and closing at his sides, he did as she requested. Behind him, Dr. Ben Harris breathed an audible sigh of relief.

"Lisa Summer's real name is Lisa Grayson," Grayson said with exaggerated patience. "I'm her father, Willis Grayson, and this is her private physician, Dr. Benjamin Harris. Now may we proceed?"

Confusion darkened the nurse's face and then just as quickly vanished.

"Our visitors' hours don't begin until two," she said. "But if Lisa approves, I'll make an exception just this once."

Grayson's fists again clenched. But this time they remained so.

"Do you know who I am?" he asked.

"I know who you say you are. Look, Mr. Grayson, I don't want to be-"

"Ben, I just don't have time for this," Grayson snapped. "You stay here and explain to this woman who I am and why we're here. If she gives you any problem, call the goddamn director of this excuse for a hospital and get him up here. I'm going to see Lisa."

He stalked off without waiting for a reply.

One of the slide-in labels on the door of room 515 read "L. Summer." The other was blank. Willis Grayson hesitated. Had he done the right thing by not sending flowers or calling first? If, as he suspected, others had poisoned her against him, there was no telling what she was thinking. No, he decided, it was better to make this visit unannounced.

After she had been coerced into leaving home by Charlie or Chuck, or whatever the hell his name was, Grayson had spent tens of thousands of dollars trying to find her. The trail went cold in Miami. Then suddenly the boy showed up at home without her and with no idea where she had gone. For months afterward Grayson had him followed and his mail screened. But nothing came of it. Eventually the boy had just drifted away, with no clue as to how close he had come to having both his legs broken-or worse.

No, Grayson thought angrily, it will take more than a few flowers.

He tapped lightly on the door, waited, and then tapped again. Finally he eased it open. The olio of powder and lotion, starch and antiseptic was familiar and unpleasant. He had not been in a hospital room since the evening nearly eight years ago when he and Lisa sat together, holding his wife's hand as she surrendered to the malignancy she had battled for over a year.

Now his daughter sat motionless in a padded, high-backed chair, staring out the window. The sight of the bandages covering what remained of her right arm brought bile to Grayson's throat. He stepped around and sat down on the marble sill. Lisa glanced at him momentarily, then closed her eyes and looked away.

"Hi, honey," he said. "I'm so glad I found you. I've missed you so much."

He waited for a response, but knew from her expression and the set of her shoulders that there would be none.

Damn them, he thought, lumping her friends, roommates, lovers, and doctors-real and imagined-into an ill-defined object of molten hate. Damn them all to hell for bringing you to this.

"I'm sorry for what you've been through." He tried again. "Please, Lisa. Please talk to me… I want to get you out of here. Dr. Harris flew up with me. You remember him. He's right outside. His staff is waiting for you at the medical center back home. He'll check you over, and if he says it's safe, we'll have you there in ninety minutes. Tim's on the roof with the helicopter. He's missed you, too, hon. Everybody's missed you. Lisa?"

Lisa continued looking away. Grayson stood and paced about the room, searching for the words that would begin to open her heart to him.

If only you had listened to me in the first place, he wanted to scream. If only you had listened to me, none of this would have happened.

"I know you're angry with me," he said instead, "but everything can be all right now. You're all I have, and I'll do anything to have you with me again… Please, Lisa. I know you're hurting. I want to help you fight back. I want to help you find out why this horrible thing happened to you and… and to my grandson. And if anyone is responsible, I want more than anything to be the hammer that helps you strike them down… All right, all right." He took a calming breath and moved back to the window. "I understand that it might not be easy for you after all this time. Listen, I'll be staying at the Bostonian. The number will be right by your phone. I'm going to arrange for a private nurse to take care of you, and I'm going to have Ben Harris get in touch with your doctors. Please, baby. I-I love you. Please let me back in your life."

He hesitated, and then turned and headed for the door.

"Come back later, Daddy," she said suddenly.

Grayson stopped. Were the words only in his mind?

"This afternoon," she said. "Three o'clock. I promise to talk with you then."

Her soft monotone held neither anger nor forgiveness.

Willis Grayson turned back and stared at her. Lisa was again sitting motionless, gazing out the window.

"Okay," he said finally. "Three o'clock."

He gently kissed his daughter on the top of her head. She reacted not at all.

"I'll be here at three," he whispered. "Thank you, baby. Thank you."

He paused by the door and looked back once again at the stump that had been her hand and arm.

Someone was going to pay.