Authors: Robin Cook
“Well! How's it going?” said Michaels, appearing at the doorway. He could tell from the litter that little had changed since the morning visit.
“Depends on what you're referring to,” said Philips. “If you mean the program, the answer is fine. I've only run a few films, but so far it is performing with an accuracy of about a hundred-ten percent.”
“Wonderful,” said Michaels, clapping his hands.
“It's more than wonderful,” said Philips. “It's fantastic! It's the only thing around here that has been going right. I'm just sorry I haven't had more time to work on it. Unfortunately, I'm behind on my regular work. But I'm going to stay here for a while tonight and run as many films as I can.” Philips saw Denise turn and look at him. He tried to read her expression but the noisy clatter of the typewriter rapidly spewing out the report captured his attention. Michaels saw what was happening and he came up behind Philips to look over his shoulder. From Denise's perspective, the two of them looked like proud parents.
“It's reading a skull film I just took on a young woman,” Martin said. “Her name is Kristin Lindquist. I thought maybe she'd have the same abnormality as those other patients I described to you. But she doesn't.”
“Why are you so committed to this one abnormality?” asked Michaels. “Personally, I'd rather see you
spending your time on the program itself. There will be time for this kind of investigative fun later.”
“You don't know doctors,” said Martin. “When we release this little computer on the unsuspecting medical community it's going to be like confronting the Medieval Catholic Church with Copernican astronomy. If we could present a new radiological sign that the program had discovered, it would make acceptance much easier.”
When the print-out typewriter paused, Philips tore off the report. His eyes scanned the sheet rapidly, then riveted on one central paragraph. “I don't believe it.” Martin grabbed the film and put it back up on his viewer.
With his hands blocking out most of the X ray, Philips isolated a small area at the back of the skull. “There it is! My God! I knew the patient had the same symptoms. The program remembered the other cases and was able to find this very small example of the same abnormality.”
“And we thought it was subtle on the other films,” said Denise looking over Philips' shoulder. “This just involves the tip of the occipital pole, not the parietal or temporal region.”
“Maybe it's just earlier in the progress of the disease,” suggested Philips.
“What disease?” asked Michaels.
“We don't know for certain,” said Martin, “but several of the patients who showed this same density abnormality were suspected of multiple sclerosis. It's a shot in the dark.”
“I don't see a thing,” admitted Michaels. He put his face very close to the X ray, but it was no use.
“It's a textural quality,” said Martin. “You have to be aware of what the normal texture is before you
can appreciate the difference. Believe me, it's there. The program is not making it up. Tomorrow I'll get the patient back and cone down right over the area. Maybe with some better films you'll be able to see it.”
Michaels admitted that his appreciation of the abnormality was not critical. After turning down an offer of dinner in the hospital cafeteria, Michaels excused himself. At the door he again begged Martin to spend more time running old films through the computer, saying there was a good chance the program would pick up all sorts of new radiologic signs, and if Philips took time to follow up each one, the program would never get debugged. With a final wave, Michaels departed.
“He's eager, isn't he,” said Denise.
“With good reason,” said Martin. “He told me today that to handle the program they have designed a newer processor that has a more efficient memory. Apparently it's going to be ready shortly. When it is, I'll be the only one holding them up.”
“So you're planning to work tonight?” asked Denise.
“Of course.” Martin looked at her and for the first time noticed how tired she was. She'd gotten almost no sleep the night before and had worked all day.
“I was hoping you'd be interested in coming over to my apartment for a little dinner and perhaps finish what we had started last night.”
She was being deliberately erotic and Martin was an easy target. Sexual expression would be a wonderful way to deal with the frustrations and exasperations of the day. But he knew he had to do some work and Denise was too important to just be used as he had the nurses when he was an intern needing to diffuse his tension.
“I've got to catch up a little,” he said at last. “Why
don't you go home early. I'll call and perhaps come over later.”
But Denise insisted on waiting while he went over all the angiograms and the day's CAT scans, which had been dictated by the neuroradiology fellows. Even if his name did not appear on the reports, Philips checked everything done in the department.
It was a quarter to seven when they scraped back their chairs and stood up to stretch. Martin turned to look at Denise, but she hid her face.
“What's the matter?”
“I just don't like you to see me when I look so awful.”
Shaking his head in disbelief, he reached out and tried to lift her chin, but she shook off his hand. It was amazing how within seconds of switching off the viewer she had changed from an engrossed academician to a sensitive woman. As far as Martin was concerned she appeared tired but as appealing as ever. He tried to tell her, but she wouldn't believe it. She kissed him quickly, then said she was going home for a long bath, and that she hoped to see him later. Like a bird in flight, she left.
It took Martin a few moments to collect himself. Denise had the power to short-circuit his brain. He was in love and he knew it. Getting out Kristin's telephone number he dialed, but there was no answer. He decided to take a file of correspondence to proofread while he ate dinner in the cafeteria.
It was nine-fifteen when Martin cleared up the last of the dictation and correspondence. During the same time he had been able to run twenty-five more old films through the flawlessly functioning computer. Meanwhile Randy Jacobs was making frequent trips back and forth from the file room. He'd been
returning the completed envelopes, but since he'd pulled several hundred additional ones, Philips' office was even more jumbled and disorganized than before.
Using the phone at his desk, Philips again tried Kristin's number. She answered on the second ring.
“I'm a little embarrassed,” he said, “but looking at your X ray more closely, I think there is a very small area that needs closer examination. I was hoping you'd be willing to come back, like tomorrow morning?”
“Not in the morning,” said Kristin. “I've missed classes two days in a row. I'd rather not miss more.”
They agreed on three-thirty. Martin assured her that she would not have to wait. When she arrived she was supposed to come directly to Philips' office.
Hanging up, Martin leaned back in his chair and let the day's problems wash over him. The conversations with Mannerheim and Drake were exasperating, but at least they were consistent with the personalities of the two men. The conversation with Goldblatt was different. Philips had not expected such an attack from someone who had been his mentor. Martin was quite sure that Goldblatt had been responsible for his being named Assistant Chief of Neuroradiology four years ago. So it didn't make sense. If hostility to the computer work was behind Goldblatt's conduct, they were in for more trouble than either Philips or Michaels had anticipated. The thought made Martin sit up and search for the list he'd made of the patients with the potentially new radiologic sign. Corroboration of the new diagnostic technique had assumed greater importance. He found the list and added Kristin Lindquist's name.
Even allowing for Goldblatt's dislike of the new computer unit, his behavior still did not make sense.
It suggested collusion with Mannerheim and Drake, and for Goldblatt to be siding with Mannerheim, if that were the case, something out of the ordinary had to be going on. Something very bizarre.
Philips sat up and snatched his list: Marino, Lucas, Collins, McCarthy and Lindquist. After McCarthy he had written “Neurosurgical lab.” If Mannerheim could be devious, so could he. Philips walked out of his dim office into the brightness of the corridor. Toward the fluoroscopy rooms he saw what he was looking for: the cleaning carts of the janitorial staff.
Having accustomed himself to working long hours, Martin had had numerous opportunities to become acquainted with the cleaning crew. On several occasions they had cleaned his office with him in it, joking that he secretly lived under his desk. It was an interesting group composed of two men in their middle twenties, one white and one black, and two older women, one Puerto Rican, the other Irish. Philips wanted to speak to the Irish woman. She'd worked for the center for fourteen years and was their nominal supervisor.
Philips found the crew inside one of the fluoroscopy rooms having their coffee break. “Listen, Dearie,” said Martin to the woman. Dearie was her nickname, because it was how she addressed everyone else. “Can you get into the Neurosurgical Research lab?”
“I can get into everything in this hospital except the narcotics cabinets,” said Dearie proudly.
“Wonderful,” said Martin. “I'm going to make you an offer you can't refuse.” He went on to say that he wanted to borrow her passkey for fifteen minutes to get a specimen from the Neurosurgical lab which he wanted to X-ray. In return she could have a free CAT scan!
It dook Dearie a full minute to stop laughing. “I'm not supposed to give this out, but considering who you are . . . . Just have it back before we leave Radiology. That gives you twenty minutes.”
Philips used the tunnel to get to the Watson Research Building. The elevator was waiting in the deserted lobby and he got right in and pressed his floor. Although Martin was in the middle of a busy medical center within a populous and sprawling city, he felt isolated and alone. Research was done between eight and five, and the building was vacant. The only sound was the wind hissing in the elevator shaft as the car sped upward.
The doors opened and he stepped out into a poorly illuminated foyer. Passing through a fire door he found himself in a long hallway that ran the length of the building. To conserve energy nearly all the lights were out. Dearie hadn't given him a key, she'd given him her whole brass ring of keys and it jangled in the silence of the empty building.
The Neurosurgical lab was the third door on the left, close to the other end of the corridor, and as Martin got closer, he felt himself tense. The door to the lab was metal with a central frosted pane of glass. After glancing over his shoulder, he slipped the passkey into the lock. The door swung open. Philips quickly stepped in and closed the door. He tried to laugh at his own sense of suspense, but it didn't do any good. His nervousness had increased out of proportion to what he was doing. He decided he'd make a lousy burglar.
The light switch made an inordinately loud snap when he turned it on. Banks of fluorescent light bathed the huge lab. Two central counter tops ran down half of the room, complete with sinks, gas jets,
and overlying shelves of laboratory glassware. At the far end was an animal surgical area, which looked like a modern operating room in three-quarter size. It had operating lights, a small operating table, and even an anesthesia machine. There was no separation between the operating area and the lab except that the operating area was tiled. All in all it was an impressive setup and stood as tribute to Mannerheim's ability to obtain research grants.
Philips had no idea where a brain specimen would be stored, but he thought there might be a collection, so he only looked in the larger cabinets. He drew a blank but noticed there was another door down near the surgical area. It had a clear glass panel with embedded wire mesh and he leaned against the window, peering into a dark room beyond. Just beyond the door he could see a series of bookshelves containing glass jars; a whole group of which held brains immersed in preserving fluid.
With every second that passed Martin's anxiety continued to increase. The moment he saw the brains, he wanted to find McCarthy's and leave. He pushed open the door and began quickly scanning the labels. A strong animal smell assaulted his nose and in the darkness to the left he caught a glimpse of cages. But the jars held his interest; each was labeled with a name, a unit number and a date. Guessing that the date was the death of the patient, Philips walked quickly down the long row of jars. Since the only light was that which came through the glass panel in the door, he had to lean closer to the jars with each step. McCarthy's was at the very far end of the room near an exit door.
Reaching up to grasp the specimen, Philips was devastated by a bloodcurdling scream that
reverberated around the small room. It was immediately followed by a crash of metal against metal. Philips' legs buckled as he spun around to defend himself, his shoulder hitting the wall. Another scream shattered the air, but an attack did not materialize. Instead Martin found himself staring into the face of a caged monkey. The animal was in an absolute rage. His eyes were burning black coals. His lips were drawn back exposing his teeth, two of which had broken when he had tried to bite through the steel bars of his prison. From the top of the monkey's head protruded a group of electrodes like multicolored spaghetti.