Foreign Body (7 page)

Jennifer rolled her eyes. Such a trick to avoid responsibility was so typical of Juan. He was shameless.

"Considering this awful circumstance, we had expected Mr. Hernandez to come here to India forthwith at our expense, but he said he was unable to travel because of a back injury."

Yeah, sure, Jennifer silently mocked. She was well aware that every November he could drive all the hell up to the Adirondacks to hunt and climb over mountains with his other worthless buddies with no trouble at all.

"We will surely extend the same invitation to you as the new next of kin. The contract your grandmother signed included airfare and lodging for a relative to accompany her, but she had said it was not needed. Anyway, funds are still available."

Jennifer felt herself getting choked up, imaging her grandmother dying in far-off India, and her body alone on some cold slab in a mortuary cooler. With travel, room, and board available, she knew instinctively she could not let her granny down, never mind the inconvenience of her personal responsibilities-namely, medical school and her new surgical rotation. She'd never forgive herself, despite the fact that her grandmother had not conveyed to Jennifer that she was going in the first place.

"Arrangements could be made through the American embassy and documents signed from afar, but your presence is definitely preferable. It is safer under such circumstances when a family member is present to avoid any mistakes or misunderstanding."

"Alright, I'll come," Jennifer said abruptly, "but I want to come immediately. That means today if possible."

"That should not be a problem if there are seats on the late-afternoon Singapore flight through Tokyo. We've had American patients from the L.A. area before, so I'm familiar with the schedule. The bigger problem will be the visa, but I should be able to arrange that through the Indian health ministry for a special emergency M visa. We can let the airline know from this end. I will need your passport number just as soon as possible."

"I'll head to my apartment and call you with it," Jennifer promised. She was glad she had one, and the only reason she did was because of her grandmother. Maria had taken her and her two brothers to Colombia to meet relatives when she was nine. She was also glad she'd made the effort to renew it.

"Perhaps I'll have most of the arrangements done by the time you call back. Despite the hour here in India, I will do it right now. But before I let you go, I want to ask again whether you want your grandmother's body cremated, which we recommend, or embalmed."

"Don't do either until I get there," Jennifer said. "Meanwhile, I'll ask my two brothers what they think." Jennifer knew that was a lie. She and her brothers had gone in opposite directions in life, and they rarely talked. She didn't even know how to get a hold of them, and for all she knew they were still in prison for dealing drugs.

"But we need an answer. The death certificate is already signed. You must decide."

Jennifer hesitated answering. As a matter of habit whenever someone pushed her, she pushed back. "I assume the body is in a cooler."

"It is, but our policy is to take care of it immediately. We don't have the proper facilities, as Indian families claim their deceased kin immediately to cremate or bury, but mostly cremate."

"A good part of the reason I'm coming is to see the body."

"Then we can have it embalmed for you. It will be far more presentable."

"Look, Ms. Varini," Jennifer said. "I'm coming halfway around the world to see my grandmother. I don't want her disturbed until I arrive. I certainly don't want her sliced and diced by an embalmer. I'll probably have her cremated, but I don't want to decide until I see her one last time, okay?"

"As you wish," Kashmira said, but with a tone that suggested she strenuously disagreed with the decision. She then gave Jennifer her direct-dial number with the insistence that Jennifer get her passport details back to her just as soon as possible.

Jennifer flipped her phone closed. Her perplexity and annoyance at the case manager's inappropriate and continued insistence that she make a decision about what to do with her grandmother's body, when she clearly indicated she didn't yet know, at least had the effect of taking the edge off her grief. But then Jennifer shrugged her shoulders. The situation was probably just another example of how some people lacked common sense in regard to social skills.. Kashmira Varini was probably one of those midlevel administrators who had a box next to "dispose of body" that needed to be checked off.

Leaving the locker room at a fast walk, she planned her next few hours, which she sensed would also help take her mind off her grandmother's passing. First she would need to go back into the OR suite to seek out Dr. Peyton and explain the situation. She would then rush to her apartment, get her passport, and call in the number. Then she would head over to the medical school and explain everything to the dean of students.

After passing through the main OR doors, Jennifer stopped at the main desk. While she waited to ask one of the busy head nurses if Dr. Peyton and his students were still in the anesthesia room where she'd left them, she found herself pondering a perplexing issue: How was it that she learned of her grandmother's death from CNN, of all places, some hour and a half before she heard it from the hospital? Since she couldn't think of a single possible explanation, she decided that once she got to India, she was going to try to ask the hospital authorities. It was her general understanding that next of kin were supposed to be notified before names were given out to the media, although it occurred to her that this might be the case only in the United States and not in India. But that thought led to another: Why was CNN even interested in putting her grandmother's name on the air? It wasn't as if she were a celebrity. Was it just as a lead into the issue of medical tourism?

And who was this known, reliable source who claimed that her grandmother's death was merely the tip of the iceberg?

Chapter 4

OCTOBER 15, 2007

MONDAY, 11:40 P.M.

DELHI, INDIA

(SIMULTANEOUS WITH JENNIFER'S QUESTIONING HER

GRANDMOTHER'S

DEATH BEING ANNOUNCED ON CNN)

Kashmira Varini was a slim, sallow, no-nonsense woman who rarely smiled and whose skin tone was always in sharp contrast to the saris that she inevitably wore. Even late in the evening, having been called back to the hospital on an emergency basis to deal with the death of Mrs. Hernandez, she'd made the effort to dress in a freshly pressed, richly colored red-and-gold outfit. Although almost lifeless in appearance and not particularly sympathetic, she was good at what she did by conveying to patients a strong, reassuring proficiency, efficiency, and commitment, especially with the help of her superb command of English English. Although patients coming from afar for surgery were invariably scared and therefore nervous, she put them at ease the moment they got to the hospital.

"Could you hear enough from my side of the conversation to guess what Ms. Hernandez said?" Kashmira questioned. She was sitting in the hospital CEO's office at a library table. He was seated across from her. In contrast to her elegant ethnic costume, Rajish Bhurgava, the rounded, mildly overweight CEO, was attired cowboy-style with ill-fitting jeans and a plaid flannel shirt that snapped rather than buttoned. He had his legs crossed and his cowboy boots precariously balanced on the corner of the table.

"I could tell you were not able to get permission to embalm or cremate, which was the major goal of the call. That's unfortunate."

"I tried my best," Kashmira said, in her defense. "But the granddaughter is distinctively pertinacious in comparison with the son. Maybe we should have just gone ahead and cremated without asking her."

"I don't think we could have taken that risk. Ramesh Srivastava was very clear when he called me that he wanted this case to disappear. He specifically said he did not want any possible continued cause for media attention, and if the granddaughter is bullheaded, as you suspect, cremating the body without permission could have caused a blowup."

"You mentioned Ramesh Srivastava earlier when you called me about Hernandez's death and told me we had to deal with it tonight. Who is he? I've never heard the name."

"I'm sorry. I thought you knew. He's a top-level administrator who's been placed in charge of the department of medical tourism in the health ministry."

"Is he the one who called you about the death?"

"He is, which was shocking. I've never met the man, but he's an important individual.

His appointment shows how vital the government thinks medical tourism is becoming."

"How did he hear about the death before we did?"

"That is a good question. One of his subordinates saw it on CNN International and felt it serious enough, considering its possible effect on the PR campaign the Ministry of Tourism and the Indian Healthcare Federation have been co-sponsoring, to inform Srivastava immediately despite the hour. What impressed me was that Srivastava then called me directly instead of delegating it to one of his underlings. It shows how serious he thinks it is, which is why he wants the case to disappear, which, of course, is why he wants rapid disposition of the body. To help, he said he'd call to have the death certificate signed without delay, which he did. He also ordered that no one from the hospital staff on any pretext should talk to the media. He said that on the air there was a hint of some kind of investigation. He does not want an investigation of any sort."

"I got that message loud and clear, as did everyone else."

"So," Rajish said, letting his legs fall to the floor and slapping the table for emphasis,

"let's get the body cleared for cremation or embalming and out of here."

Kashmira pushed back her chair, the legs of which screeched against the floor in protest.

"I will get the process started immediately by making the travel arrangements for Ms.

Hernandez. Are you planning on talking to Mr. Srivastava again tonight?"

"He asked me to call his home with an update. So, yes, I will be calling."

"Mention to him we might need his support to get an emergency M visa for Ms.

Hernandez."

"Will do," Rajish said, jotting down a quick note to himself. He watched Kashmira walk out the door. Returning his attention to the phone Kashmira had used to call Jennifer and taking out Joint Secretary Srivastava's phone number, which Rajish had written on a piece of scratch paper, he made the call. It made him feel proud to be calling someone so high in the health bureaucracy, especially at such an unorthodox hour.

After answering on the first ring, suggesting he was waiting by the phone, Ramesh Srivastava wasted no time with small talk. He asked if the body had been taken care of as he'd requested. "Not quite," Rajish had to admit. He went on to describe how they'd asked the son but that the son had designated the granddaughter but the granddaughter had demurred. "The good part," Rajish explained, "is that the granddaughter will be on her way to Delhi within a few hours and that as soon as she arrives they will press her for a decision."

"What about the media?" Ramesh questioned. "Has there been any media patrolling around the hospital?"

"None whatsoever."

"I'm surprised and encouraged. It also brings me to the issue of how the media got news of the death in the first place. In the context the piece was presented on the air, it seems to us that it had to have been a left-wing student who is against the rapid increase in private hospitals in India. Are you aware of any such person or persons at Queen Victoria Hospital?"

"Absolutely not. I'm certain we in the administration would be aware of such a person."

"Keep it in mind. With public hospital budgets stagnant, particularly for infectious disease control, there are people who feel quite emotional about the issue."

"I will certainly keep it in mind," Rajish said. The idea that one of their medical staff could be a traitor was troubling, and the first thing he was going to do in the morning was raise the issue with the chief of the medical staff.

Chapter 5

OCTOBER 15, 2007

MONDAY, 10:45 A.M.

LOS ANGELES, USA

(SIMULTANEOUS WITH RAJISH BHURGAVA'S LEAVING

THE QUEEN VICTORIA HOSPITAL)

Jennifer was in the process of making her way from the medical school back to the main building of the UCLA Medical Center and felt amazed at what she'd been able to accomplish despite her emotional fog. From the moment she terminated the conversation with the Queen Victoria Hospital case manager a little over an hour ago, she'd dealt with her new preceptor, dashed home, called back to India to give her passport number, made her way to the med school, got the blessing of the dean for a week off, arranged a replacement for her gainful-employment blood-bank job, and was now hoping to solve her emotional fears, economic concerns, and the problem of malaria prophylaxis.

Although she'd taken out the almost four hundred dollars she had in savings, she was worried it might not be enough even with her credit card and Foreign Medical Solutions of Chicago paying her major expenses. Jennifer had certainly never been to India, much less on a mission dealing with a dead body. The possibility she would need a significant amount of cash was hardly far-fetched, especially if cremation or embalming was not something that could be charged.

Being as busy as she'd been over the hour-plus had had the secondary benefit of keeping her from obsessing about the reality of her grandmother's passing. Even the weather helped, since it was as glorious as the dawn had predicted. She could still see the mountains in the distance, although not with quite the same startling clarity. But now that she was almost finished with her errands, reality began to reassert itself.

Jennifer was going to miss Maria terribly. She was the person with whom Jennifer was the closest, and had been since Jennifer was three years old. Besides her two brothers, neither of whom she spoke with for months on end, her only relatives that she knew were in Colombia, and she'd met them only once back when her grandmother had taken her there for that expressed purpose. Relatives on her mother's side were a complete mystery. As far as Jennifer was concerned, her father, Juan, didn't count.