Error in Diagnosis (27 page)

It was ten thirty when Jack walked into the hospital coffee shop. He had been awake for the past four hours, but he had stayed in his hotel room finishing up his reading on autoimmune diseases and chimerism. His mind was so consumed with other things, he hadn't even given any thought to the information he had shared with the FBI about the phone call he'd received from Vosky posing as a physician and the meeting he was supposed to attend.

There was only one person in line in front of him who seemed to take forever deciding what she wanted. Finally, Jack was able to order two cappuccinos. He picked them up at the end of the counter and carried them out to the lobby. When he saw Mike approaching, he did everything in his power to push an encouraging smile to his face.

“How are you feeling?” he asked him, handing him one of the containers.

“Scared,” he answered directly. “If anybody had asked me a few weeks ago if I would ever be in a position to second-guess my—”

“What happened to Tess is nobody's fault and—”

“That's not what I meant. I was the one who encouraged Helen Morales to invite you here.” Mike's face flushed. “I've made a decision that could result in the death of my wife and unborn baby. That's hardly an easy thing to do. Going with Sinclair's advice over yours was the toughest choice I've ever made in my life. But whatever happens, don't ever think, even for a second, that I don't know you did everything possible to help Tess.”

Jack took a couple of sips of his cappuccino before responding, “I can't begin to imagine what you've been going through. There's an awful lot I don't know, but what I do know is that you're got a lot more important things to concern yourself with than my feelings.” Mike opened his mouth to speak but Jack raised his hand. “We're both way past owing each other explanations or apologies for anything.” He pointed toward the elevators. “C'mon, let's go upstairs.”

Crossing the lobby, Jack spotted Bud Kazminski coming toward him. He looked exhausted and even more disheveled than usual. With no improvement in his limp, he hobbled up and greeted Jack with a fatigued expression and a hangdog shake of the hand.

“Go up without me. I'll meet you up there. We have plenty of time before the operating room calls for Tess,” he told Mike, who continued toward the elevators.

Kaz said, “I don't know if you heard: Mia Kleinfield died a few hours ago. She was admitted the day before Sherry. They managed to save the baby. She was a nurse on the dialysis unit. Everybody's taking it pretty hard.” Kaz looked away for a few seconds and then added, “Sinclair already called my son-in-law this morning. He's pushing David pretty hard to start treatment tomorrow.
To build his case, he's telling everybody Mike Ryan had already agreed, which kind of makes your best friend the poster boy for Vitracide. Anyway, David called me and we had a long talk about it. I think we're going to give Sinclair the go-ahead.”

“A lot of physicians across the country agree with Dr. Sinclair that antiviral medication's the way to go.”

“I'm sure they do—but, obviously, you're not one of them,” Kaz said, with a dubious half smile. “Is it Sinclair you don't trust or are you just opposed to using Vitracide because you don't think it will work and it's nasty as hell?” He held up his hand and after a protracted sigh, added, “You don't have to answer that. You know, Doc, I've spent the better part of my adult life interviewing all kinds of people. The hard part isn't dragging information out of them—it's trying to figure out how much of it's the truth.” Jack didn't comment on Kaz's observation. He got the feeling he was fishing, trying to find out what Jack thought of Sinclair. “I'd love to know what you really think about our decision to treat Sherry with Vitracide.”

“I think I told you.”

“The other thing I've learned as a reporter is to recognize hedging when I hear it.” With a mixture of gloom and hopelessness on his face, Kaz sluggishly raised his eyes. “I've loved three women in my life, Dr. Wyatt: my wife and my two daughters. Sherry and I have always been close but Lisa hasn't spoken to me in years. I guess in her eyes, I made some mistakes she can't
forgive me for. She and Sherry have stayed close. Lisa visits almost every day, but only after her husband makes sure I'm not around. Do you know what it's like to have twin daughters and only one of them cares to speak with you?”

Jack felt his breath catch. “I don't recall you mentioning Sherry was a twin. Are they identical?”

“Yeah.”

“Are you sure?” Jack asked in a voice rising in intensity.

“Of course I'm sure. Why? What difference does it make?”

“Does Lisa have any children?”

“Two, and one on the way.”

“How far along is she?”

“About seven months,” Kaz answered.

“But she doesn't have GNS.”

“Of course not. I think I would have told you that.”

“Has Lisa been healthy her whole life?”

“Neither of the girls has ever been seriously ill.”

Jack renewed his question. “No major illnesses or surgeries?”

“One of them had their tonsils out as a kid,” Kaz answered as he let out a slow breath. “I'm pretty sure it was Lisa. She was about six at the time. I remember her eating ice cream nonstop for three days.”

“I should get going,” he said. “I'll stop in and see Sherry in a couple of hours.”

Jack shoved his hands in the front pockets of his
chinos and walked slowly toward the elevators. Before meeting Mike, he decided to stop in the medical library.

Being a twin: At least now he knew why Sherry was a chimera. He assumed Lisa was as well. But what had him reeling was a simple question. Why had Sherry contracted GNS and Lisa hadn't?

Dr. Lyman Douglas had cared for Tess Ryan through two miscarriages and her present pregnancy. She and Mike had the resources that would have allowed her to be cared for anywhere in the country, but it was Lyman Douglas she insisted upon. She knew he wasn't the busiest doctor in town but she revered him for his calm, caring manner and meticulous approach to her care.

Tess Ryan's C-section was scheduled for noon but since the entire operating team was present and ready to begin, Douglas instructed the nurse manager to have Tess brought to the operating room early.

Fifteen minutes later, accompanied by Mike, Tess was wheeled into the preoperative holding unit. Douglas was there to meet them.

“Are you ready?” he asked Mike.

“I was kind of hoping Jack would be here. I've been
calling him but he's not picking up. I'm a little surprised.”

Douglas glanced down at his watch. “We're only about thirty minutes early. We can wait if you want.”

Mike shuffled his feet for a few seconds. “We might as well go now. I'm sure he's on his way.”

“Okay,” Douglas said. He then motioned at the patient care assistant who moved forward, kicked the break release and slowly began to bring Tess out into the main corridor.

Before they started down the hallway into the operating room, Mike raised his hand. “Can you hold it a sec?” he asked.

Leaning over the railing, Mike eased the sheet a little higher up on Tess's chest. He then leaned over and kissed her twice on the forehead. A couple of his tears dropped on her cheek. He gingerly dried them aside with his finger. He then interlocked his pinky with hers for a few seconds—a habit born from their high school days. Lowering his head, he whispered, “I love you, Tess.” He then took a step back, looked at Douglas and nodded.

“Just have a seat in the waiting room,” Douglas said. “I'll be out to talk with you as soon as we're done. You can still come into the operating room and watch if you'd like. It's not too late.”

“I don't think so. I'll be in the waiting room.”

He then watched as the stretcher carrying the woman he cherished disappeared through the doors that led to operating room number two.

The moment the ICU doors swung open and Jack walked in, he spotted Marc at the nursing station with his head glued to one of the computer monitors. His conversation with Kaz was still on his mind. For some reason, the words of advice his mother had offered him popped into his head. He envisioned her knowing eyes as she suggested that sometimes studying patients without a disease can provide important information in finding its cure.

Instead of walking over to talk with Marc, he reached for his phone. He leaned against the desk and scrolled through his phone book until he found Kaz's number. He checked the time. He still had plenty of time before Tess was scheduled for her C-Section.

“Kaz, it's Dr. Wyatt. I'd like to speak with your daughter. Do you have her phone number?”

“It's not necessary to call her.”

“It's quite necessary. I'm not sure you understand,” he explained in a voice, thinning with patience. “What I want to speak with her about directly relates to helping Sherry.”

“I'm not sure you understand. What I'm saying is you don't need to call her because she's upstairs in the ICU visiting Sherry. That's why I'm still down here in the lobby waiting for her to leave.”

“Thanks. I'll speak with you later.” Jack replaced his phone, turned and started toward the other wing of the ICU.

“Where are you going?” Marc asked.

“I'll be back in a few minutes.”

Jack walked past the nursing station and then down the corridor that led to Sherry's room. Between lengthy strides, he couldn't help but wonder if stumbling upon the fact that Sherry had an identical twin might turn out to be the twist of fate he'd been praying for. He was a few feet from Sherry's room when he saw David step out in the hall followed by a woman.

“Excuse me,” Jack said to David. “I'm Dr. Wyatt, I'm one of the doctors looking after Sherry.”

“David Rosenfelt,” he answered, extending his hand to Jack. “I'm Sherry's husband. This is Lisa, her sister. My father-in-law has told me a lot about you. We're both very appreciative of everything you've done for Sherry.”

“Thank you,” Jack said. He turned to Lisa. “A few minutes ago, I spoke with your father. He mentioned to me you were here. Would you mind if I asked you a few questions about your health?”

“Not at all.”

“Have you had any difficulties with your pregnancy?”

“No. Everything's gone very well,” she answered without hesitation.

“How far along are you?”

“I'm just finishing my sixth month.”

“I assume you've had obstetrical care the entire time.”

“Yes, of course.”

“Did you take the flu shot?”

“About two months ago. Sherry and I use the same OB. As a matter of fact, we both had the shot the same day. It was in his office.”

“Would you say your overall health is good?”

“I'd say it's excellent.”

“Besides having your tonsils out, have you ever had any other surgery?”

She frowned. “As usual, my father's a tad confused about the facts. It was Sherry who had her tonsils out, not me.”

“Are you presently taking any medications?” Jack inquired.

“I take a thyroid pill once a day.”

“When were you diagnosed with low thyroid?”

“Actually, I take it because I don't have a thyroid gland,” she answered.

Jack looked at her neck with a quizzical expression. There was no scar indicating her thyroid gland had been removed.

“Were you born without a thyroid gland?”

“No. I had a very overactive thyroid as a teenager. I
remember my mother taking me to see all kinds of doctors. My father was too busy. They tried a bunch of medications but none of them worked. Finally, one of the doctors gave me some kind of radioactive pills to destroy all of my thyroid gland. It worked. I've been fine ever since . . . except for having to take a thyroid pill once a day.”

“You probably had Graves' disease,” Jack said, feeling the muscles and tendons in his neck tighten like a hangman's noose.

“Yeah. I think that's what they called it. I guess I should have mentioned it when you asked me about my prior health, but it was so many years ago . . . well, I've kind of forgotten about it.”

“Is there anything else at all about your general health that you haven't mentioned?”

“No. I don't think so.”

Jack extended his hand to Lisa, “I appreciate you taking the time to talk with me.”

Starting back toward Tess's room, Jack practically broke into a sprint. He grabbed his cell phone and tapped in Madison's number. His stomach was in a flutter. She answered on the first ring. Trying not to rush his words, he said, “I need you to do something for me right now.”