A Brain (16 page)

Sitting down amidst the chaos, Philips dialed Admitting. He felt his mood deteriorating further as the phone rang interminably on the other end of the line.

“Have a moment?” called William Michaels. He'd leaned in through Philips' open door, his cheerful grin in direct contrast to Martin's scowl. Then his eyes swept around the room in total disbelief.

“Don't ask,” said Philips, anticipating some smart comment.

“My God,” said Michaels. “When you work, you don't mess around.”

At that point someone finally answered the phone in Admitting, but it was a temporary receptionist who transferred Martin to someone else. That person only handled admissions, not discharges or transfers, so Philips was switched again. Only then did he learn that the person he had to speak to was on a coffee
break, so he hung up, frustrated with bureaucracy, saying, “Why didn't I become a plumber?”

Michaels laughed, then asked how Philips was doing with their project. Philips told him that he'd had most of the X rays pulled, indicating the pile with his hand. He told Michaels that he thought he could run them all in a month and a half.

“Perfect,” said Michaels. “The sooner the better, because the new memory storage and association system we've been working on is proving better than we'd dreamed. By the time you finish we'll have a new central processor to handle the debugged program. You have no idea how good it's going to be.”

“Quite the contrary,” said Philips, getting up from the desk. “I have a pretty good idea. Let me show you what the program picked up.”

Martin cleared a viewing screen and put up Marino's, Lucas', Collins', and McCarthy's X rays. With his index finger, then the piece of paper with the hole in it, Philips tried to show the abnormal densities on each.

“They look all the same to me,” admitted Michaels.

“That's just the point,” said Philips. “That's how good this system is.” Just talking with Michaels rekindled Martin's excitement.

Just then the phone rang and Philips picked it up. It was Dr. Donald Travis from New York Medical Center. Martin explained his problem about Lynn Anne Lucas but purposefully left out the radiologic abnormality. Then he asked Travis if he would arrange to have a CAT scan and some special X rays done on the patient. Travis agreed and hung up. Immediately the phone buzzed and Helen told Philips that Denise was ready for the next angiogram.

“I got to be going anyway,” said Michaels. “Good
luck with the films. Remember, it's up to you now. We need this information as soon as you can give it to us.”

Philips lifted his apron off its hook and followed Michaels out of the office.

One of the large fluorescent light fixtures directly over Kristin Lindquist was malfunctioning so that it flickered at a rapid frequency and emitted a constant buzzing sound. She tried to ignore it, but it was difficult. She hadn't felt right ever since she'd awakened that morning with a slight headache and the quivering light intensified her discomfort. It was a steady dull pain and Kristin noticed that physical exertion did not make it worse as was the case with her usual headaches.

She looked at the naked male model on the platform in the center of the room, then down at her work. Her drawing looked flat, two-dimensional and without feeling. Normally she liked her life drawing class. But this morning she was not enjoying herself and her work reflected it.

If only the light would stop flickering. It was driving her crazy. With her left hand she shielded her eyes. That made it better. Using a fresh piece of charcoal, she began to draw a base for her figure to rest
on. She started with a perpendicular line, pulling the fresh charcoal straight down the paper. When she lifted the marker she was surprised no line had resulted. Looking at the end of the charcoal she could see a flattened area where it had rubbed against the paper. Thinking it was a defective piece, Kristin turned her head slightly to make a mark with the charcoal in the corner of the paper. As she did so she noticed that the perpendicular line she had just drawn appeared in the periphery of her vision. She looked back and the line disappeared. Rotating her head slightly caused the line to appear. Kristin did it several times to make sure she wasn't hallucinating. Her eye couldn't perceive the perpendicular line when her head was perfectly aligned with it. If she rotated her head in either direction the line appeared. Weird!

Kristin had heard of migraine headaches, and although she'd never had a migraine, she guessed she was experiencing one. After putting down her charcoal and stacking her materials in her locker, Kristin explained to the instructor that she was not feeling well and left for her apartment.

Walking across the campus, Kristin experienced the same dizziness that she'd noticed on her way to class. It seemed that the world would abruptly rotate just a fraction of a degree to make Kristin's step feel slightly off-balance. It was accompanied by an unpleasant although vaguely familiar odor and a slight ringing in her ears.

One block from campus, Kristin's apartment was a third-floor walk-up, which she shared with her roommate, Carol Danforth. As Kristin climbed the stairs she felt a heaviness in her legs which made her wonder if she were getting the flu.

The apartment was empty. Carol was undoubtedly at class. In one way that was good because Kristin guessed she needed some undisturbed rest, but she would have appreciated Carol's sympathy. She took two aspirins, slipped out of her clothes, climbed into bed, and put a cold cloth over her head. Almost immediately she felt better. It was such a sudden reversal that she just lay there, concerned that if she moved the strange symptoms would recur.

When the phone by her bed rang she was pleased because she wanted to talk to someone. But it wasn't one of her friends. It was the GYN clinic calling to tell her that her Pap smear was abnormal.

Kristin listened, trying to keep herself calm. They told her not to be concerned because abnormal Pap smears were not that uncommon, especially when associated with the slight erosion she had on her cervix, but to be on the safe side they wanted her to return to the clinic that afternoon to repeat it.

Kristin tried to protest, mentioning her migraine headache. But GYN was insistent, saying the sooner the better. They had an opening that afternoon and Kristin could be in and out in no time.

Reluctantly Kristin agreed to come. Maybe something really was wrong with her and if that were the case she had to be responsible. But she dreaded going alone. She tried calling her boyfriend, Thomas, but of course he wasn't in. Kristin knew it was irrational, but she couldn't help feeling there was something evil about the Med Center.

 

Martin took a deep breath before entering Pathology. When Philips had been a medical student, that service had been his
bête noire.
His first autopsy had been an ordeal that he had not been prepared for. He
had assumed it was going to be like first-year anatomy, where the cadaver bore as little resemblance to a human being as a wooden statue. The odor had been unpleasant but at least it had been chemical. Besides, anatomy lab had been characterized by pranks and jokes, relieving any tension. Not so with pathology. The autopsy had been on a ten-year-old boy who had died from leukemia. His body was pale, but supple and all too life-like. When the corpse had been rudely opened, then gutted like a fish, Martin's legs had turned to rubber and his lunch came up in his mouth. He'd avoided vomiting by turning his head, but his esophagus burned from the acid of his own digestive juices. The professor had droned on, but Philips had heard nothing. He had stayed but he had suffered, and his heart had gone out to that lifeless boy.

Now Philips pushed open the doors to Pathology. The environment was a far cry from what he'd experienced as a medical student. The department had been moved to the new medical-school building and housed in an ultramodern setting. Instead of small and somber spaces with high ceilings and marble floors where footsteps echoed unnaturally, the new pathology area was open and clean. The predominant materials were white Formica and stainless steel. Individual rooms had been replaced by areas demarcated by shoulder-height dividers. The walls were covered with colorful prints of Impressionist paintings, particularly Monet.

The receptionist directed Martin to the autopsy theater where Dr. Jeffrey Reynolds was helping the residents. Martin had hoped to catch Reynolds in his office, but the receptionist insisted that Philips could go into the theater because Dr. Reynolds did not
mind interruptions. Philips wasn't worrying about Reynolds, he was concerned about himself. Nonetheless, he followed the receptionist's pointing finger.

He should have known better. In front of him on a stainless steel table, like a side of beef, was a corpse. The autopsy had just begun with a Y-shaped incision across the chest and down to the pubis. The skin and underlying tissues had been flopped back revealing the rib cage and the abdominal organs. At the moment of Philips' entry, one of the residents was loudly clipping through the ribs.

Reynolds saw Philips and walked over. In his hand he held a large autopsy knife like a butcher knife. Martin glanced around the room to keep from looking at the procedure in front of him. The area resembled an operating room. It was new and modern and completely tiled so that it could be easily cleaned. There were five stainless steel tables. On the rear wall were a series of square refrigerator doors.

“Greetings, Martin,” said Reynolds, wiping his hands on his apron. “I'm sorry about that Marino case. I would have liked to have helped you.”

“I understand. Thanks for trying. Since there wasn't going to be a post, I tried to run a CAT scan on the corpse. It was surprising. Do you know what I found?”

Reynolds shook his head.

“There was no brain,” said Philips. “Somebody removed the brain and sewed her back up so you practically couldn't tell.”

“No!”

“Yeah,” said Philips.

“God. Can you imagine what kind of blowup that could cause if the press got a hold of it, much less the family? They were definite about no autopsy.”

“That's why I wanted to talk to you,” said Philips.

There was a pause.

“Wait a minute,” said Reynolds. “You don't think Pathology was involved.”

“I don't know,” admitted Philips.

Reynolds' face reddened, and veins appeared on his forehead. “Well I can assure you. The body never came up here. It went directly to the morgue.”

“What about Neurosurgery?” asked Philips.

“Well, Mannerheim's boys are crazy, but I don't think that crazy.”

Martin shrugged, then told Reynolds the real reason he'd stopped by was to inquire about a patient by the name of Ellen McCarthy who'd arrived dead at the ER about two months previously. Philips wanted to know if she'd been autopsied.

Reynolds snapped off his gloves and pushed his way through the doors into the main portion of the department. Using Pathology's terminal for the main computer, he typed in Ellen McCarthy's name and unit number. Immediately her name appeared on the computer screen followed by the date and number of the autopsy as well as cause of death: head injury resulting in massive intracerebral hemorrhage and brain-stem herniation. Reynolds quickly located a copy of the autopsy report and handed it to Philips.

“Did you do the brain?” asked Philips.

“Of course we did the brain!” said Reynolds. He grabbed back the report. “You think we wouldn't do the brain on a head-injury case?” His eyes rapidly scanned the paper.

Philips watched him. Reynolds had gained nearly fifty pounds since they'd been lab partners in med school and a fold of skin on the back of his neck concealed the top of his collar. His cheeks bulged out
and just beneath the skin there was a fine network of tiny red capillaries.

“She might have had a seizure before the auto accident,” said Reynolds, still reading.

“How could that be determined?”

“Her tongue had been bitten multiple times. It's not certain, just presumptive . . .”

Philips was impressed. He knew that such fine points were usually only picked up by forensic pathologists.

“Here's the brain section,” said Reynolds. “Massive hemorrhage. There is something interesting though. A section of the cortex of the temporal lobe showed isolated nerve-cell death. Very little glial reaction. No diagnosis was advanced.”

“How about the occipital area?” asked Philips. “I saw some subtle X-ray abnormalities there.”

“One slide taken,” said Reynolds, “and that was normal.”

“Just one. Damn, I wish there had been more.”

“You might be in luck. It indicates here the brain was fixed. Just a minute.”

Reynolds walked over to a card catalogue and pulled out the
M
drawer. Philips felt some mild encouragement.

“Well, it was fixed and saved but we don't have it. Neurosurgery wanted it so I guess it's up in the neurosurgical lab.”

After stopping to watch Denise flawlessly and efficiently perform a single-vessel angiogram, Philips headed over to surgery. Dodging patient traffic in the holding area, he walked up to the OR desk.

“I'm looking for Mannerheim,” said Philips to the blond nurse. “Any idea when he'll be out of surgery?”

“We know exactly.”

“And what time will that be?”

“Twenty minutes ago.” The other two nurses laughed. Apparently things were going smoothly in the OR for them to be in such good moods. “His residents are closing. Mannerheim's in the lounge.”

Philips found Mannerheim holding court. The two visiting Japanese doctors were standing on either side of him smiling and bowing at irregular intervals. There were five other surgeons in the group, all drinking coffee. Mannerheim was holding a cigarette in the same hand as his cup. He'd given up smoking a year ago, which meant he didn't buy any cigarettes, but borrowed them from everybody else.

“So you know what I told this smart-ass lawyer?” said Mannerheim, gesturing dramatically with his free hand. “Of course I play God. Who do you think my patients want screwing around inside their brains, a garbage man?”

The group roared with approval, and then began to disperse. Martin approached Mannerheim and looked down on him.

“Well, well, our helpful radiologist.”

“We try to please,” said Philips pleasantly.

“Well, I can tell you I did not appreciate your little joke on the phone yesterday.”

“It wasn't meant to be a joke,” said Philips, “I'm sorry that my comment seemed out of place. I didn't know Marino was dead and I'd noticed some very subtle abnormalities on her film.”

“You're supposed to look at the X rays before the patient dies,” said Mannerheim nastily.

“Look, what I'm interested in discussing is that Marino's brain was removed from her corpse.”

Mannerheim's eyes bulged and his full face turned
a dull red. Taking Philips by the arm he led him away from the two Japanese doctors.

“Let me tell you something,” he snarled, “I happen to know that you moved and X-rayed Marino's body last night without authorization. And I can tell you this, I don't like anybody fucking around with my patients. Especially my complications.”

“Listen,” said Martin, shaking his arm free from Mannerheim's grasp. “My only interest is some strange X-ray abnormalities that could result in a major research breakthrough. I have no interest in your complications.”

“You'd better not. If there was something irregular done to Lisa Marino's body, it would be on your head. You're the only one known to have taken the body from the morgue. Keep that in mind.” Mannerheim waved a threatening finger in Philips' face.

A sudden fear of professional vulnerability made Martin hesitate. As much as he hated to admit it, Mannerheim had a point. If it became known that Marino's brain had been removed, the burden would be on him to prove that he didn't do it. Denise, with whom he was having an affair, was his only witness.