Pandemic

15

TUESDAY, 5:25 P.M.

Invigorated by his short-term success after so much effort, Jack made it back to the OCME in record time. Wondering when Laurie was planning on leaving for home, he headed directly up to the front office.

“Dr. Montgomery and her secretary left about twenty minutes ago,” Carla Rossario said. Carla was Dr. Paul Plodget’s secretary. Paul was the new deputy chief, since Calvin Washington had retired. “Dr. Montgomery wanted to get home early because company was expected. Then, right after she left, Cheryl took off.”

Jack winced. He didn’t like the sound of company. In his mind, it might have been the last thing they needed at the Stapleton-Montgomery household. For a brief moment he thought about calling Laurie to prepare himself for what he was going to be facing when he got home, but he decided against it. If there was a problem, he knew Laurie would have called or at least texted. Instead, Jack hurried up to his office. He wanted to see what he could find out about Carol Weston Stewart from social media. He knew he could have called Bart and have him do it, but he didn’t want the MLI to have all the fun. He also wanted to check out Dover Valley Hospital.

Tossing his bomber jacket into the corner to avoid taking the time to hang it up, Jack sat down at his monitor with the idea of jumping onto the Internet. Instead, he found himself face-to-face with a Post-it Note from his old officemate Dr. Chet McGovern. It was a simple message to call Dr. Aretha Jefferson.

Hoping for more good news, Jack made the call. Aretha picked right up, as if she had been hovering over the phone.

“Hey, Jack!” she said, apparently able to tell it was he who was calling. “I’ve got some significant news for you. I’m ninety percent certain we’re dealing with a seriously pathological virus. Currently the cytopathic effects are much more pronounced with the human kidney cells than they were just this morning. Now I’m just waiting for the titer to increase so I can start the identification process full-speed.”

“Bravo,” Jack said. “That’s terrific news, even if it’s also very scary. I don’t like the idea of a seriously pathological virus being on the subway.”

“You and me both,” Aretha said.

“I’ve been making some progress as well,” Jack said. “I now have a name to attach to the patient. I don’t have any address yet or any other information, but that should come as a matter of course. I had a breakthrough by combining together a heart transplant and a relatively unique tattoo as my inquiry and just cold-calling the city’s heart transplant centers. I hit pay dirt with my fourth call.”

“You’re the man,” Aretha said. “Hey! It’s after five. Are you going to run tonight?”

“Are you?”

“That’s my intention,” Aretha said. “I don’t want my new friends to forget about me.”

“I don’t think you’ll have to worry about that, with the way you played last night,” Jack said. “Anyway, I imagine I’ll see you. I think I’m going to need a run.” Jack couldn’t help but wonder exactly what Laurie had meant by company.

“Try to make it,” Aretha said. “I have a little surprise to tell you.”

“Why not tell me now?”

“I prefer to do it in person.”

“Okay,” Jack said. “See you then.” He disconnected because he could see another call coming in. It was Detective Lou Soldano. As he switched over, he chided himself for not asking Aretha about the time frame for the identification process.

“I was hoping to hear from you sometime today,” Lou said, after they exchanged the usual hellos. “Any info on those three cases we worked on yesterday morning?”

“Nothing yet,” Jack said. “And to be truthful, I’ve kinda dropped the ball. I meant to check with Toxicology about the death-in-custody case, but it slipped my mind. And in respect to the gunshot case, I haven’t even started the reconstruction. To be totally honest, that’s going to be a while. I’ve been busy with that contagious case that I took after you left.”

“Any change in your thinking about the suicide/homicide case?”

“No. I’m not going to change my mind about that one. I’m going to sign it out as a probable homicide. You better advise your friend Walter he needs legal representation.”

“What’s happening on the home front with you? Any change for the better?”

“I wish,” Jack said. “Last night Laurie’s mom was as irritating as ever. She’d found a family friend psychiatrist-cum-businessman who also subscribes to the discredited MMR vaccine theory of autism. Once again I allowed myself to get drawn into an argument of sorts just when Laurie showed up from work. She accused me of baiting her mother. I mean, talk about missing the point.”

“Is the nanny still threatening to leave?”

“Laurie says she spoke with her this morning and claims everything is hunky-dory in that arena. I’ll find out more tonight when I get to talk with Caitlin myself.”

“I feel for you, buddy.”

After hanging up with Lou, instead of going on the Internet as he’d planned, Jack put in yet another call. This time it was to Bart Arnold. He was hoping to catch the man before he left for the day, as it was now almost six. As Jack listened to the electronic sound of the phone ringing, he bemoaned how much he was being forced to be on the phone of late, despite how much he detested it. When all was said and done, Jack was a man of action, which was why he had chosen surgery as a specialty when he finished medical school.

“Hello, Dr. Stapleton,” Bart managed between some heavy breathing, suggesting he had had to run for the phone. “You just caught me. A second later and I would have been in the elevator lobby and wouldn’t have heard my desk phone.”

“I’m glad I got you,” Jack said. “I have some interesting news for you. I now have a name for the subway death. It’s Carol Weston Stewart.”

“Good work! How on earth did you manage? Hank Monroe and I have gotten zilch.”

“A bit of luck was probably the most critical,” Jack admitted. “Out of desperation, I just started calling all the city’s heart transplant programs and described a thirtyish Caucasian female with a distinctive tattoo. I hit pay dirt at MGH, who did her surgery. I got confirmation with a photo.”

“Simple but obviously effective,” Bart said. “Is she from Brooklyn like we thought?”

“I don’t know yet,” Jack said. “All I know is the name. MGH claims they don’t know any of the patient’s details. Can you imagine? They did the surgery for a sister hospital in New Jersey called Dover Valley. Are you familiar with it?”

“I’m not familiar with that particular hospital,” Bart said. “But I know where Dover is. I live in Jersey just across the GW Bridge. Dover’s due west about thirty miles or so. It’s a rural area but within commuting distance of the city.”

“I was told the Dover hospital paid all the bills for the patient’s surgery directly. Does that sound weird to you?”

“I haven’t the faintest idea,” Bart admitted. “With all the consolidation going on in healthcare, nothing surprises me anymore.”

“It surprised me,” Jack said. “It was the president of MGH who told me, and to be honest, I trust him about as far as I can throw him. He’s the shameless-businessman hospital administrator type.”

“Do you want me to follow up with this Dover Valley Hospital in the morning?” Bart asked.

“Thank you, but no,” Jack said. “I just heard back a few minutes ago from the lab that it seems as if an unknown pathogenic virus is involved. Thank goodness we haven’t seen any additional cases, but I’m still worried we will at some point. I’m going to look into the hospital myself. I don’t want you MLI types having all the fun.”

“Oh, yeah, of course,” Bart joked. “Knock yourself out!”

“How long would you estimate it would take to drive out to Dover, New Jersey?”

“You are actually going to go all the way out there yourself?” Bart asked. As a matter of policy, he wasn’t accustomed to the medical examiners doing their own field investigations.

“I don’t think a phone call or two is going to be adequate,” Jack said. “My intuition is telling me there is something about this case that is out of the ordinary. I think it’s worth looking into above and beyond getting Carol Weston Stewart’s details. When I know more, I’ll fill you in.”

“Drive time to Dover will depend on the traffic,” Bart said. “I’d avoid rush hour if I were you. If you’re driving from here, you’d use the Lincoln Tunnel. It’s a pretty straight shot out Route Three. With no traffic, I’d guesstimate forty-five minutes.”

“Thanks, Bart,” Jack said. “I’ll keep you informed.”

“Wait! Hang on,” Bart said. “I’m glad you called. I had tried to call you an hour earlier. I have some information for you. Hank Monroe and I have really put the pressure on the DNA people to get some stat results, which they’ve done. Hank has gone ahead and used it for CODIS and NamUs, which is all pending but now academic since you have a name. But there was something about the results that the DNA people thought you’d like to know, and I promised to tell you ASAP. The CODIS results for the patient and the heart were exactly the same. They matched perfectly in all twenty loci.”

“That can’t be,” Jack blurted out. Once again, the subway death case was playing with him, teasing him, or, more accurately, tormenting him. “Something got screwed up,” he added. “It was a donor heart. I was told it was a good match, but it can’t have the same DNA.”

“That’s what they said. So they went to Histology and got another piece of the heart and ran it again. The results were the same.”

“I don’t believe this,” Jack said.

“Well, they didn’t, either,” Bart said. “In fact, Dr. Raymond Lynch, the head of the DNA lab, asked me if there was any chance you were running some kind of a covert personal test on their work. He felt that it couldn’t have been a heart transplant unless it was from an identical twin.”

“Good grief,” Jack said. “It was definitely a heart transplant. I was told the donor had been in a motorcycle accident. I suppose it could have been an identical twin. No wonder it was a targeted donation.”

“What’s a targeted donation?”

“It’s when a transplant organ is gifted to a specific individual outside the official sharing system.”

“Well, now you know,” Bart said. “I promised Dr. Lynch I’d tell you right away.”

“Thanks, Bart,” Jack said. He felt a bit shell-shocked.

After he’d hung up with Bart, Jack stared ahead for a few minutes with unseeing eyes. It seemed that nothing about this case was conventional. Could the donor truly have been an identical twin? What a bizarre coincidence.

Pulling himself over to his monitor, Jack went on the Dover Valley Hospital website. The first thing that confronted him was a number of photos, and he was impressed from the moment the page opened. He’d expected a small, generic community hospital with a bit of age. Instead, he was looking at pictures of a decidedly modern structure, considerably larger than he would have imagined, with carefully manicured grounds.

Selecting the “About Us” section and then the “Overview,” he read that the hospital was private, nonprofit, and founded in the 1920s as a community hospital, but by the turn of the century had evolved to be more of a nursing facility. Threatened with bankruptcy, it had been bought by GeneRx, the largest local employer, with the goal of renovating it to serve the health needs of its employees. But then GeneRx, being the good neighbor it was, decided to return the hospital back to functioning as a community resource as well, so that all the inhabitants of Dover and the immediate towns would have access to superior healthcare and not be forced to travel to find it. With two hundred beds and ultramodern facilities, the hospital was now fully accredited by the Joint Commission as “a provider of high-quality, comprehensive, and humanistic care.”

Moving on to the “Facts and Figures” section of the website, Jack read that it had been selected as a “Best Regional Hospital” according to a recent U.S. News & World Report with recognition of its 3T MRI machines, its hybrid operating rooms, its IVF, or in vitro fertilization, unit, and its certification as a transplant center that included heart transplants in addition to all the other more usual organs. He then read that the hospital was associated with the prestigious Manhattan General Hospital and many of its departments, although particularly through its own award-winning Zhao Heart Center.

Jack stopped reading and looked back at the mention of the Zhao Heart Center. “My word,” he said aloud. “This Zhao guy gets around.”

Going on to read the rest of the website, Jack found himself progressively more impressed, which considerably surprised him. Although he hadn’t admitted it to himself, he had been prepared to have a negative feeling about the place. Yet the hospital sounded as if it was an island of healthcare excellence out in what he envisioned were the backwoods compared with NYC.

Jack’s positive reaction to the Dover Valley Hospital stimulated a curiosity about the facility’s owner, the company GeneRx. Jack had never heard of it, which wasn’t terribly surprising, as he was not oriented toward business, particularly businesses relating to healthcare. GeneRx sounded as though it was definitely healthcare-oriented, and probably related to gene therapy, according to its name.

Typing “GeneRx” into his browser, Jack was in for yet another surprise. It wasn’t in the same category as the donor heart and the recipient having the same CODIS result, but it was surprising nonetheless. GeneRx on its website was described as an up-and-coming biopharmaceutical company totally owned by a Chinese billionaire by the name of Wei Zhao, the same man Jack had just complimented as “getting around.”

Reading on, Jack learned that although the company had only a few products on the market currently, it had almost a dozen in phase III trials, all of which were expected to be available within a year or two. Looking at photos, Jack could see it was a sprawling, modern facility that had most likely been designed by the same architects who had done the Dover Valley Hospital. Looking further, Jack could see that the complex included a farm, aptly called the Farm Institute, in the same architectural style. Jack knew enough about current bioscience to know that the cutting edge in drug development was proteins such as monoclonal antibodies. Although these proteins were originally made laboriously by cell culture, now they were often made in bulk by farm animals such as goats, sheep, pigs, and chickens. Using the latest methods of genetic manipulation, such as the gene-editing technique CRISPR/CAS9 to add genes or to remove them, these familiar barnyard animals were turned into transgenic, living bioreactors producing the desired drugs in their milk, eggs, or blood.

Fascinated, Jack next focused his search on Wei Zhao. In a fraction of a second there were millions of hits. Jack might not have heard of Wei Zhao, but a lot of other people obviously had. Most of the articles were about biotech and the pharmaceutical industry. A number were in Chinese. Glancing down the links, Jack found a promising Wikipedia article and clicked it open. There was more material than he wanted because he knew he needed to get home, so he skimmed it. Even the highlights were riveting.

Wei Zhao had been born in 1960 in Shanghai, China, to parents who were academics at Fudan University but also landowners. It was being landowners that was their downfall, as the family became targeted by students during the Chinese Cultural Revolution. Although only six years of age at the time, Wei was banished along with his parents to the countryside, where the parents were forced to work the land. All three almost starved. But as a resourceful teenager who was willing to accept the dogma and emulate the Red Guards, Wei ended up back in Shanghai, where he eventually managed to be admitted into the Shanghai Jiao Tong University. There he applied himself and studied biotechnology with a particular emphasis on pharmaceutical manufacturing. Seeing a future in generic drugs on the world stage, he founded his first company at age twenty-five and never looked back. He was a millionaire by thirty and a billionaire by thirty-five as he expanded into all aspects of the pharmaceutical industry. It was at that time that he expanded his operations into the United States and founded GeneRx in Dover, New Jersey.

Jack’s mobile phone pulled his attention away from his reading. A quick glance confirmed the worst: It was Laurie, and he immediately felt guilty. Another glance informed him it was after six. He answered with a manufactured cheerful hello.

“Why aren’t you home?” Laurie demanded. Jack could tell she was stressed, which he could have guessed would be the case. He wondered if it had to do with the “company” but resisted asking.

“Still at the grindstone,” Jack said instead, trying to be cute. “I’ve made some progress on the subway case. I now have a name, even if I don’t have a confirmed diagnosis.”

“I need you here,” Laurie said, not taking the bait.

“I’m on my way,” Jack said. “I’ll be home in twenty minutes or so.”

“Don’t take any unnecessary risks,” Laurie cautioned. “I wish you’d use Uber or Lyft. I hate to think of you on that bike in traffic.”

“It would be twice the time by car,” Jack said, trying to help her see the bright side.

“At least you’d be in one piece.”

After appropriate goodbyes, Jack grabbed his bomber jacket and headed for the back elevator.