Terminal (18 page)

“Better you than me,” Janet said. “I’m sure you’re better at this than I.”

“I’m not taking over your job,” Sean said. “I’ll still want copies of the other two charts as well as daily updates. Plus I want a list of all the patients they’ve treated to date who have had medulloblastoma. I’m particularly interested in their outcomes. Plus I want samples of the coded medicine. That should be your priority. I have to have that medicine; the sooner the better.”

“I’ll do my best,” Janet said. Knowing how much trouble it had been merely to copy Martin’s chart, she had misgivings about getting everything Sean wanted with the kind of speed he was implying. Not that she was about to voice those concerns to Sean. She was afraid he’d give up and leave for Boston.

Sean stood up. He gripped Janet’s shoulder. “I know this isn’t easy for you,” he said. “But remember, it was your idea.”

Janet put a hand on Sean’s. “We can do it,” she said.

“I’ll see you at the Cow Palace,” he said. “I suppose you’ll be there around four. I’ll try to get back about the same time.”

“See you then,” Janet said.

Sean left the cafeteria and used the stairs to get to the second floor. He emerged at the south end of the building. The second floor was a center of activity and as bustling as he’d expected. All the radiation therapy as well as diagnostic radiology was done there; so was all the surgery and any treatment that could not be done at the bedside.

With all the confusion Sean had to squeeze between gurneys carrying people to and from their procedures. A number of the gurneys with their human passengers were parked along the walls. Other patients sat on benches dressed in hospital robes.

Sean excused himself and pushed through the tumult, bumping into hospital personnel as well as ambulatory patients. With a modicum of difficulty he proceeded down the central corridor, checking each door as he went. Radiology and chemistry were on the left, treatment rooms, ICU, and the surgical suites were on the right. Knowing that the pheresis was a long procedure and not labor-intensive, Sean decided to try to find Helen Cabot. Besides looking at her chart, he wanted to say hello.

Spotting a hematology technician sporting rubber tourniquets attached to her belt loops, Sean asked her where pheresis was done. The woman guided Sean through a side corridor and pointed toward two rooms. Sean thanked her and checked the first. A male patient was on the gurney. Sean closed the door and opened the other. Even from the threshold he recognized the patient: it was Helen Cabot.

She was the only one there. Outflow and inflow lines were attached to her left arm as her blood was being passed through a machine that separated the elements, isolating the lymphocytes and returning the rest of the blood to her body.

Helen turned her bandaged head in Sean’s direction. She recognized him immediately and tried to smile. Instead, tears formed in her large green eyes.

From her color and general appearance Sean could see that
her condition had dramatically worsened. The seizures she’d been suffering had been taking a heavy toll.

“It’s good to see you,” Sean said as he bent down to bring his face close to hers. He resisted an urge to hold and comfort her. “How are you doing?”

“It’s been difficult,” Helen managed to say. “I had another biopsy yesterday. It wasn’t fun. They also warned me I might get worse when they started the treatment, and I have. They told me I was not to lose faith. But it’s been hard. My headaches have been unbearable. It even hurts to talk.”

“You have to hold on,” Sean said. “Keep remembering that they have put every medulloblastoma patient into remission.”

“That’s what I keep reminding myself,” Helen said.

“I’ll try to come to see you every day,” Sean said. “Meanwhile, where’s your chart?”

“I think it’s out in the waiting room,” Helen said, pointing with her free hand toward a second door.

Sean gave her a warm smile. He squeezed her shoulder, then stepped into the small waiting room that connected to the corridor. On a counter was what he was searching for: Helen’s chart.

Sean picked it up and flipped to the order sheets. Drugs similar to those he’d seen in Martin’s chart were duly noted: MB300C and MB303C. He then turned to the beginning of the chart and saw a copy of his own workup which had been sent as part of the referral package.

Flipping the pages quickly, Sean came to the progress note section, and he read the entry for the biopsy that had been taken the day before, indicating they had gone in over the right ear. The note went on to say that the patient had tolerated the procedure well.

Sean had just begun to scan for the laboratory section to see if a frozen section had been done when he was interrupted. The door to the hallway crashed open and slammed against the wall with such force that the doorknob dented the plaster.

The sudden crash startled Sean. He dropped the chart onto the plastic laminate countertop. In front of him and filling the
entire doorway was the formidable figure of Margaret Richmond. Sean recognized her immediately as the nursing director who’d burst into Dr. Mason’s office. Apparently the woman made a habit of such dramatic entries.

“What are you doing in here?” she demanded. “And what are you doing with that chart?” Her broad, round face was distorted with outrage.

Sean toyed with the idea of giving her a flip answer, but he thought better of it.

“I’m looking in on a friend,” Sean said. “Miss Cabot was a patient of mine in Boston.”

“You have no right to her chart,” Ms. Richmond blustered. “Patients’ charts are confidential documents, available only to the patient and his doctors. We view our responsibility in this regard very seriously.”

“I’m confident the patient would be willing to give me access,” Sean said. “Perhaps we should step into the next room and ask her.”

“You are not here as a clinical fellow,” Ms. Richmond shouted, ignoring Sean’s suggestion. “You are here in a research capacity only. Your arrogance in thinking that you have a right to invade this hospital is inexcusable.”

Sean saw a familiar face appear over Ms. Richmond’s intimidating shoulder. It was the puffy, smug countenance of the frustrated Marine, Robert Harris. Sean suddenly guessed what had happened. Undoubtedly he’d been picked up by one of the surveillance cameras, probably one in the second-floor corridor. Harris had called Richmond and then had come over to watch the slaughter.

Knowing that Robert Harris was involved, Sean could no longer resist the urge to lash back, particularly since Ms. Richmond wasn’t responding to his attempts to be reasonable.

“Since you people aren’t in the mood to discuss this like adults,” Sean said, “I think I’ll wander back to the research building.”

“Your impertinence only makes matters worse,” Ms. Richmond sputtered. “You’re trespassing, invading privacy, and showing no remorse. I’m surprised the governors of Harvard
University would let someone like you into their institution.”

“I’ll let you in on a secret,” Sean said. “They weren’t all that impressed with my manners. They liked my facility with a puck. Now, I’d really like to stay and chat with you people, but I’ve got to get back to my murine friends who, by the way, have more pleasant personalities than most of the staff here at Forbes.”

Sean watched as Ms. Richmond’s face empurpled. This was just one more of a series of ridiculous episodes that had him fed up. Consequently he derived perverse pleasure out of goading and angering this woman who could easily have played linebacker for the Miami Dolphins.

“Get out of here before I call the police,” Ms. Richmond yelled.

Sean thought that calling the police would be interesting. He could just imagine some poor uniformed rookie trying to figure out how to categorize Sean’s offense. Sean could see it in the paper: Harvard extern actually looks into his patient’s chart!

Sean stepped forward, literally eye to eye with Ms. Richmond. He smiled, pouring on his old charm. “I know you’ll miss me,” he said, “but I really must go.”

Born Ms. Richmond and Harris followed him all the way to the pedestrian bridge that spanned the gulf between the hospital and the research building. The whole time they maintained a loud dialogue about the degeneracy of current-day youth. Sean had the feeling he was being run out of town.

As Sean walked across the bridge he recognized how much he would have to depend on Janet for clinical material pertaining to the medulloblastoma study, provided, of course, he stayed.

Returning to his fifth-floor lab, Sean tried to lose himself in his work to repress the anger and frustration he felt toward the ridiculous situation he found himself in. Like the empty room upstairs, Helen’s chart didn’t have anything in it to get upset about. But as he cooled down, Sean was able to acknowledge that Ms. Richmond did have a point. As much as he hated to admit it, the Forbes was a private hospital. It wasn’t a teaching
hospital like the Boston Memorial, where teaching and patient care went hand in hand. Here, Helen’s chart was confidential. Yet even if it was, Ms. Richmond’s fury was hardly appropriate for his infraction.

In spite of himself, within an hour Sean became engrossed in his crystal-growing attempts. Then, as he held a flask up against the overhead light, he caught a bit of movement out of the corner of his eye. It was a rerun of the incident on his first day. Once again the movement had come from the direction of the stairwell.

Without so much as looking in the direction of the stairwell, Sean calmly got off his stool and walked into the storeroom as if he needed some supplies. Since the storeroom was connected to the central corridor, Sean was able to dash the length of the building to the stairwell opposite the one where he’d seen the movement.

Racing down a flight, he ran the length of the fourth floor to enter the opposite stairwell. Moving as silently as possible, he climbed the stairs until the fifth-floor landing came into view. As he’d suspected, Hiroshi was there furtively looking through the glass of the door, obviously baffled as to why Sean had not returned from the storeroom.

Sean tiptoed up the remaining stairs until he was standing directly behind Hiroshi. Then he screamed as loud as he was able. Within the confines of the stairwell, Sean was impressed with the amount of noise he was capable of generating.

Having seen a few Chuck Norris martial arts movies, Sean had been a little concerned that Hiroshi might turn into a karate demon by reflex. But instead Hiroshi practically collapsed. Conveniently he’d had one hand on the door handle. It was that support which kept him standing.

When Hiroshi recovered enough to comprehend what had happened, he stepped away from the door and started to mumble an explanation. But he was backing up at the same time, and when his foot hit the riser of the first stair, he turned and fled up, disappearing from view.

Disgusted, Sean followed, not to pursue Hiroshi, but rather to seek out Deborah Levy. Sean had had enough of Hiroshi’s
spying. He thought Dr. Levy would be the best person to discuss the matter with since she ran the lab.

Going directly to the seventh floor, Sean walked down to Dr. Levy’s office. The door was ajar. He looked in. The office was empty.

The pool secretaries did not have any idea of her whereabouts but suggested Sean have her paged. Instead, Sean went down to the sixth floor and sought out Mark Halpern, who was dressed as nattily as ever in his spotless white apron. Sean guessed he washed and ironed the apron every day.

“I’m looking for Dr. Levy,” Sean said irritably.

“She’s not here today,” Mark said. “Is there something I can help you with?”

“Will she be here later?” Sean asked.

“Not today,” Mark said. “She had to go to Atlanta. She travels a lot for work.”

“When will she be back?”

“I’m not sure,” Mark said. “Probably tomorrow late. She said something about going to our Key West facility on her way back.”

“Does she spend much time there?” Sean asked.

“Fair amount,” Mark said. “Several Ph.D.s who’d originally been here at Forbes were supposed to go to Key West, but they left instead. Their absence left Dr. Levy with a burden. She’s had to pick up the slack. I think Forbes is having trouble replacing them.”

“Tell her I’d like to talk to her when she comes back,” Sean said. He wasn’t interested in the Forbes’s recruiting problems.

“Are you sure there’s nothing I can do?” Mark said.

For a second Sean toyed with the idea of talking with Mark about Hiroshi’s behavior, but decided against it. He had to speak to someone in authority. There wasn’t anything Mark would be able to do.

Frustrated that he could get no satisfaction for his anger, Sean started back toward his lab. He was almost to the stairwell door when he thought of another question for Mark.

Returning to his tiny office, Sean asked the tech if the pathologists
over in the hospital cooperated with the research staff.

“On occasion,” Mark said. “Dr. Barton Friedburg has coauthored a number of research papers that require a pathologic interpretation.”

“What kind of guy is he?” Sean asked. “Friendly or unfriendly? Seems to me that people fall into one camp or the other around here.”

“Definitely friendly,” Mark said. “Besides, I think you might be confusing unfriendly with being serious and preoccupied.”

“You think I could call him up and ask him a few questions?” Sean asked. “Is he that friendly?”

“Absolutely,” Mark said.

Sean went down to his lab, and using the phone in the glass-enclosed office so he could sit at a desk, he phoned Dr. Friedburg. He took it as an auspicious sign when the pathologist came on the line directly.

Sean explained who he was and that he was interested in the findings of a biopsy done the day before on Helen Cabot.

“Hold the line,” Dr. Friedburg said. Sean could hear him talking with someone else in the lab. “We didn’t get any biopsy from a Helen Cabot,” he said, coming back.

“But I know she had it done yesterday,” Sean said.

“It went south to Basic Diagnostics,” Dr. Friedburg said. “You’ll have to call there if you want any information on it. That sort of thing doesn’t come through this lab at all.”