Side Effects (12 page)

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"The twenty-eight past directors of nursing?"

"Uh-uh. I'm sorry, Marco."

"All this data, and nobody wants any of it." The man was genuinely crestfallen. "I keep telling our beloved administrator that we are being underused, but I don't think he has the imagination to know what questions to ask. Periodically, I send him tables showing that the cafeteria is overspending on pasta or that ten percent of our patients have ninety percent of our serious diseases, just to pique his interest, remind him that we're still here."

"My name?"

"Oh, yes. I'm sorry. It's been a little slow here. I guess you can tell that."

"It's Rittenhouse, Ginger Rittenhouse. Here's her address, birthplace, and birth date. That's all I have. I need to know if she's ever been a patient of this hospital, in or out."

"Keep your eyes on the screen," Sebastian said dramatically. Thirty seconds later, he shook his head.

"Nada. A Shirley Rittenhouse in nineteen fifty-six, but no others."

"Are you sure?"

Sebastian gave her a look that might have been anticipated from a judge who had been asked, "Do you really think your decision is fair?" "Sorry," she said.

"Of course, she still could have been a patient of the Omnicenter." Kate stiffened. "What do you mean?"

"Well, the Omnicenter is sort of a separate entity from the rest of Metro. This system here handles records and billing for the Ashburton inpatient service, but the Omnicenter is totally self-contained. Has been since the day they put the units in--what is it?--nine, ten years ago."

"Isn't that strange?"

"Strange is normal around this place," Sebastian said.

"Can't you even plug this system into the one over there?"

"Nope. Don't know the access codes. Carl Horner, the engineer who runs the electronics there, plays things pretty close to the vest. You know Horner?"

"No, I don't think so." Kate tried to remember if, during any of her visits to the Omnicenter as a patient, she had even seen the man. "Why do you suppose they're so secretive?"

"Not secretive so much as careful. I play around with numbers here; Horner and the Omnicenter people live and die by them. Every bit of that place is computerized: records, appointments, billing, even the prescriptions."

"I know. I go there for my own care."

"Then you can imagine what would happen if even a small fly got dropped into their ointment. Horner is a genius, let me tell you, but he is a bit eccentric. He was writing advanced programs when the rest of us were still trying to spell IBM. From what I've heard, complete independence from the rest of the system is one of the conditions he insisted upon before taking the Omnicenter job in the first place."

"So how do I find out if Ginger Ritteuhouse has ever been a patient there? It's important, Marco. Maybe very important."

"Well, Paleolithic as it may sound, we call and ask."

"The phone?"

Marco Sebastian shrugged sheepishly and nodded.

DEAD END. Alone in her office, Kate doodled the words on a yellow legal pad, first in block print, then in script, and finally in a variety of calligraphies, learned through one of several "self-enrichment" courses she had taken during her two years with Art. According to Carl Horner, Marco Sebastian's counterpart at the Omnicenter, Ginger Rittenhouse had never been a patient there. Tom Engleson had succeeded in contacting the woman's roommate, but her acquaintance and living arrangement with Ginger were recent ones. Aside from a prior address, Engleson had gleaned no new information. Connections thus far between the woman and Beverly Vitale: zero.

Outside, the daylong dusting of snow had given way to thick, wet flakes that were beginning to cover. The homeward commute was going to be a bear. Kate tried to ignore the prospect and reflect instead on what her next move might be in evaluating the microsclerosis cases--perhaps an attempt to find a friend
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or family member who knew Ginger Rittenhouse better than her new roommate. She might present the two women's pathologies at a regional conference of some sort, hoping to luck into yet a third case. She looked at the uncompleted work on her desk. Face it, she realized, with the amount of spare time she had to run around playing epidemiologist, the mystery of the ovarian microsclerosis seemed destined to remain just that.

For a time, her dread of the drive home did battle with the need to get there in order to grocery shop and set out some sort of dinner for the two of them. Originally, they had tried to eschew traditional roles in setting up and maintaining their household, but both rapidly realized that their traditional upbringings made that arrangement impractical if not impossible. The shopping and food preparation had reverted to her, the maintenance of their physical plant to Jared. Day-to-day finances, they agreed, were beyond either of their abilities and therefore to be shared.

Again she checked out the window. Then after a final hesitation, a final thought about calling home and leaving a message on their machine that she was going to work late, she pushed herself away from the desk.

As she stood up, she decided: if it was going to be dinner, then dammit, it was going to be a special dinner.

In medical school and residency, she had always been able to find an extra gear, a reserve jet of energy, when she needed it. Perhaps tonight her marriage could use a romantic, gourmet dinner more than it could her moaning about the exhausting day she had endured. Spinach salad, shrimp curry, candles, Grgich Hills Chardonnay, maybe even a chocolate souffle. She ticked off a mental shopping list as she slipped a few scientific reprints into her briefcase, bundled herself against the rush-hour snow, and hurried from her office, pleased to sense the beginnings of a surge.

It was good to know she still had one.

In the quiet of his windowless office, Carl Horner spoke through his fingertips to the information storage and retrieval system in th e next room. He had implicit faith in his machines, in their perfection. If there was a problem, as it now seemed there was, the source, he felt certain, was human--either himself or someone at the company.

Again and again his fingers asked. Again and again the answers were the same. Finally, he turned from his console to one of two black phones on his desk. A series of seven numbers opened a connection in Buffalo, New York; four numbers more activated the line to a "dead box" in Atlanta; and a final three completed an untraceable connection to Darlington, Kentucky.

Cyrus Redding answered on the first ring.

"Carl?"

"Orange red, Cyrus." Had the colors been reversed, Redding would have been warned either that someone was monitoring Horner's call or that the possibility of a tap existed.

"I can talk," Redding said.

"Cyrus, a woman named Kate Bennett, a pathologist at Metro, just called asking for information on two women who died from the same unusual bleeding disorder."

"Patients of ours?"

"That is affirmative, although Dr. Bennett is only aware that one of them is. Both women had autopsies that showed, in addition to the blood problems, a rare condition of their ovaries."

"Have you asked the Monkeys about them?"

"Affirmative. The Monkeys say there is no connection here."

"Does that make sense to you, Carl?"

"Negative."

"Keep looking into matters. I want a sheet about this Doctor Bennett."

"I'll learn what I can and teletype it tomorrow."

"Tonight."

"Tonight, then."

"Be well, old friend."

"And you, Cyrus. You'll hear from me later."

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Wednesday 12 December

"Coronary Strikes Out Bobby." Kate cringed at the Boston Herald headline on her office desk. The story was one of the rare events that managed to make the front page in both that paper and the Boston Globe. Though the Globe's treatment was more detailed, the lead and side articles said essentially the same thing in the two papers. Bobby Geary, beloved son of Albert and Maureen Geary, son of the city itself, had been taken without warning by a clot as thin as the stitching on a baseball. The stories, many of them by sportswriters, were the heart-rending stuff of which Pulitzers are made, the only problem being that they weren't true.

The storm, which had begun the evening before, had dumped a quick eight inches of snow on the city before skulking off over the North Atlantic. However, neither the columns of journalistic half-truths nor the painful drive into the city could dampen the warmth left by the talking and the sharing that had followed the candlelight meal Kate had prepared for her husband. For the first time in years, Jared had talked about his disastrous first marriage and the daughter he would, in all likelihood, never see again.

"Gone to find something better" was all the note from his wife had said. The trail of the woman and her daughter had grown cold in New York and finally

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vanished in a morass of evanescent religious cults throughout southern and central California. "Gone to find something better."

Jared had cried as he spoke of the Vermont years, of his need then to break clear of his father's expectations and build a life for himself. Kate had dried his tears with her lips and listened to the confusion and pain of a marriage that was far more an act of rebellion than one of love. Kate was finishing the last of the Globe stories when, with a soft knock, a ponderous woman entered carrying a paper bag. The woman's overcoat was unbuttoned, exposing a nurse's uniform, pin, and name tag. Kate read the name as the woman spoke it.

"Dr. Bennett, I'm Sandra Tucker. Ginger Rittenhouse was my roommate."

"Of course. Please sit down. Coffee?"

"No, thank you. I'm doing private-duty work, and I'm expected at my patient's house in Weston in half an hour.

Dr. Engleson said that if I remembered anything or found anything that might help you understand Ginger's death I could bring it to you."

"Yes, that's true. I'm sorry about Ginger."

"Did you know her?"

"No. No, I didn't."

"We had shared the house only for a few months."

"I know."

"A week after she moved in, Ginger baked a cake and cooked up a lasagna for my birthday."

"That was very nice," Kate said, wishing she had thought twice about engaging the woman in small talk. There was a sad aura about her--a loneliness that made Kate suspect she would talk on indefinitely if given the chance, patient or no patient.

"We went to the movies together twice, and to the Pops, but we were only just getting to be friends and

..."

"It's good of you to come all the way down here in the snow," Kate said in as gentle an interruption as she could manage.

"Oh, well, it's the least I could do. Ginger was a very nice person. Very quiet and very nice. She was thinking about trying for the marathon next spring."

"What do you have in the bag? Is that something of hers?" A frontal assault seemed the only way.

"Bag? Oh, yes. I'm sorry. Dr. Engleson, what a nice man he is, asked me to go through her things looking for medicines or letters or doctors' appointments or anything that might give you a clue about why she ... why she ..."

"I know it was a hard thing for you to do, Miss. Tucker, and I'm grateful for any help."
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"It's Mrs. Tucker. I'm divorced."

Kate nodded. "The bag?"

"My God, I apologize again." She passed her parcel across the desk. "Sometimes I talk too much, I'm afraid."

"Sometimes I do, too." Kate's voice trailed away as she stared at the contents of the bag.

"I found them in the top of Ginger's bureau. It's the strangest way to package pills I've ever seen. On that one sheet are nearly two months worth of them, packaged individually and labeled by day and date when to take each one. Looks sort of like it was put together by a computer." "It was," Kate said, her thoughts swirling.

"Pardon?" "I said it was put together by a computer." Her eyes came up slowly and turned toward the window. Across the street, its glass and steel facade jewellike, was the pride of Metropolitan Hospital of Boston. "The pharmacy-dispensing computer of the Omnicenter. The Omnicenter where Ginger Rittenhouse never went."

"I don't understand."

Kate rose. "Mrs. Tucker, you've been a tremendous help. I'll call if we need any further information or if we learn something that might help explain your friend's death.

If you'll excuse me, there are some phone calls I must make."

The woman took Kate's hand. "Think nothing of it," she said. "Oh, I felt uncomfortable at first, rifling through her drawers, but then I said to myself, 'If you're not going to do it, then ..

"Mrs. Tucker, thank you very much." One hand still locked in Sandra Tucker's, Kate used her other to take the woman by the elbow and guide her out the door.

The tablets were a medium-strength estrogen-progesterone combination, a generic birth control pill. Kate wondered if Ginger Rittenhouse had been too shy to mention to her roommate that she took them. Computer printed along the top margin of the sheet were Ginger's name, the date six weeks before when the prescription had been filled, and instructions to take one tablet daily. Also printed was advice on what to do if one dose was missed, as well as if two doses were missed. Common side effects were listed, with an asterisk beside those that should be reported immediately to Ginger's Omnicenter physician. Perforations, vertical and horizontal, enabled the patient to tear off as many pills as might be needed for time away.

The setup, like everything at the Omnicenter, was slick--thoughtfully designed, considerate, and practical--further showing why there was a long list of women from every economic level waiting to become patients of the facility.