Second Opinion (19 page)

CHAPTER 34

'What's the matter, Tony, are those fish chunks too scary for you?'

Hands on her hips, Stacy Sims stood on the Collins Avenue Pier, looking down at her lifelong friend with typical defiance. She was taller than Tony D'Allessio by several inches, and as light in hair, skin, and eyes as he was swarthy. Her hair was pulled back in a single heavy braid, and beneath her T-shirt were the first hints that her eleven-year-old body was beginning to change. Lying beside her on the sun-darkened wood, ready to drop into the water some thirteen feet below, was a baited hook at the business end of an ancient rod and reel that had once belonged to her grandfather.

'I'm doing it,' Tony said, not at all happy with being teased by a girl—especially this one. 'This stuff I got for my birthday is all new. It takes some getting used to.'

'You could always use a plug. I have some good ones. They might not be as good as bait, but at least they're not slimy.'

'I told you, I can do this. I want to catch halibut and they like live bait.'

'What they really like is deep water. You'll never catch any halibut fishing from here. A striper, maybe, but not any halibut.'

'I meant striper.'

'You sure hate to be wrong, Tony D'Allessio.'

'Who doesn't?'

They were alone on the old pier, which was a popular spot for talking and lor watching the ocean, but not such a great spot for catching fish.

'Stripers beware!' Tony cried out as he dropped the baited hook over the railing and into the water.

Moments later, Stacy had done the same. The sun peered out from behind a pure white cloud that looked like a crocodile, and Hooded the pier with warm sunlight. At almost the same moment, Tony snapped his rod toward the clearing sky and let out a yelp.

'Got one!… A big one, too.'

The new Penn bent in a rainbow arc. Stacy quickly reeled in her bait and set her rod aside.

'Go, Tony, go!' she cheered.

The youth wasn't the biggest kid in school, but he was wiry and strong and, in nearly everything he did, determined. He set the end of the rod against his stomach and stepped back from the railing, pulling with all his strength.

'It's coming!' he shouted, reeling in several turns, then several more. 'It's coming!'

Stacy moved forward to the railing and looked over, expecting to see a giant striper, or even a shark.

What she saw instead was a dead body—a man, faceup, fully clothed, bobbing rhythmically on a slight chop. His arms were stretched to the side like Christ on the cross. There was a length of brown seaweed across his bloated, stone gray face, and beneath the kelp she could just make out a protruding purple tongue. Tony's hook had gotten him in the center of his jacket. The line, through the eyes of Tony's new Penn rod to his new Penn reel, was still taut.

'Tony!' Stacy screamed.

'I almost have him!'

'Tony, you can stop!'

CHAPTER 35

Pancuronium.

The closer Thea got to the Beaumont, the more convinced she became that Scott Hartnett, her father's friend and personal physician, was administering the long-acting paralytic to keep Petros from communicating with her. The irony was painful. The poor man already had, quite possibly, the most horrible medical condition imaginable—locked-in syndrome. And his physician was doing all he could to make that condition worse.

Before leaving for the hospital, she had gone over to the carriage house and managed to intrude enough on Dimitri's video war to borrow one of his computers and look up the drug. If her brother was the least bit interested in what she was doing, he didn't show it, interrupting her research only to give a triumphant whoop at the destruction of one of his enemies.

Pancuronium was a powerful curare-like drug used primarily in the operating room to prepare a patient to have their trachea intubated. Onset of action one to two minutes. First cousin to the more rapidly acting, but shorter lasting sux—succinylcholine. Duration of action for pancuronium, two to three hours—quite a bit longer if the drug was administered along with opiates or barbiturates.

If someone wanted to continuously keep Petros Sperelakis from exchanging information with his physician daughter, an injection of

Pavulon, the brand name of pancuronium, was the perfect way to do it. The antidote to reverse the effect of the drug, at least partially, was the class of pharmaceuticals known as anticholinesterases— edrophonium and neostigmine being the ones Thea had studied the most, and had even used clinically to reverse the effects of poisoning with certain insecticides and nerve gases.

'Dimitri, do you want to come in to the hospital and visit Dad?'

'Got 'im! Die, sucker, die!'

'Dimitri!'

'Would he know I was there?'

'He might.'

'Well, I'll wait until I'm sure it's a worthwhile trip. Watch this… See that guy sneaking up on me over there? The gnome… Well, I just take aim at his gnome belly and… pow! Splat!
Gnomeor
gnome.'

'How about the barbecue at Niko's tonight?'

'What barbecue?'

'Dimitri, I told you about it. More than once. Niko said he did, too.'

'Count me out, little sister. Those twins are double trouble.'

'What do you mean?'

'Greedy they are. Yaargh! Take money from poor Petros, they did. Double yaargh!'

'Why would they do something like that? They're both surgeons. They must have plenty of money.'

'My dear naive housemate. You need to begin playing video games. That's where you'll find real emotions. True human frailty.'

Thea felt herself getting irritated.

'Dimitri, will you please stop this nonsense talk and say what you mean?'

Dimitri immediately took a monocle from a small box of props on his desk, inserted it over his left eye, and adopted a distinguished British accent.

'I assure you, madame, that both of our siblings are just as adept at losing money as they are at making it. One twin never invests without clearing it with the other twin, and neither twin knows the first thing about investing. Neither, for that matter, does their father. Talked the Lion into investing in some sort of Internet dot-com company they and a friend of theirs started. He went in big-time even though he doesn't know the first thing about the product they were marketing. Let's just say he didn't lose nearly as much as the Twinkies told him he lost.'

He set the monocle back in the box and shot something on the screen in front of him.

'But how do you know that?'

Dimitri stayed focused on the screen as he talked.

'Let's just say that sometimes, when I'm bored, or even when I'm not, I find myself hacking into their e-mail. I know, I know. The shame of it. Don't worry. I follow the hackers' creed and never use my material for anything other than personal amusement. And the twins are nothing if not amusing. Anyhow, count me out of the barbecue. They never come to any of mine.'

Thea left without even bothering to ask if her brother had ever had a barbecue.

Throughout the ride to the hospital, her mind had been in turmoil as to what to do about Scott Hartnett, Lydia Thibideau, and Hayley. The first thing she had decided to do was to draw blood on Petros to confirm her belief that he had been receiving pancuronium and perhaps secondary drugs to enhance its duration of action.

She considered and rejected the possibility of administering one of the antidotes to the paralytic agent. At this stage, even with her newly acquired staff privileges, it might be difficult getting a nurse to inject such an arcane medication, especially given her father's compromised physical state. Reputations in a hospital were quickly damaged and always difficult to repair.

Was it worth waiting until she had absolute proof before confronting Hartnett? It sounded as if the private-duty nurse was quite confident in what she had witnessed. No, there was no sense in delaying matters. If nothing else, she could put an end to Hartnett's machinations, whatever the purpose. It made sense to draw the blood, see if Dan could get it analyzed in the state crime lab, and call Hartnett.

As for Thibideau, hers was a hornets' nest best left undisturbed until the meaning behind her bogus MRIs became clearer. Was she in some way aligned with Hartnett? It certainly seemed that might be the case. Research grant money? Possibly. FDA approval of new, wildly profitable anticancer drugs? Even more likely. The constant, powerful pull of influence, fame, and fortune was difficult to resist, to say nothing of the basic need for continued employment. Thibideau certainly wouldn't be the first academic to cheat on his or her research. In their recent meeting, she had seemed aloof and even haughty, but there was nothing about her that suggested dishonesty or a lack of respect for medical science.

Thea's natural, Asperger's tendency to give people the benefit of the doubt was being stretched toward the breaking point.

She pulled into her father's spot at the institute wondering how to deal with Hayley. Her new friend was razor sharp and highly intuitive. There was no sense in trying to shield her from the truth. But what, exactly, was the truth? She was receiving an investigational medication doled out by the hospital research pharmacy, but a great deal of evidence pointed to the fact that she did not have cancer in her body, and in all likelihood, she never did. Was it too risky for her to stop her chemo? Was it too risky for her to continue?

Feeling increasing fatigue, Thea took the tunnels through the underbelly of the hospital to the step-down unit, wondering where Dan was and also when the last time was that she had eaten anything except for a few sips of tea.

Marlene was massaging lotion into Petros's foot, and adjusting the splints that were keeping his contractures at bay. Still, Thea knew, every muscle group was atrophying from disuse. It was inevitable, despite the splints and the lotion and the physical therapy, that the more powerful flexor muscles in his wrists, fingers, and ankles would begin permanently overcoming the weaker extensors. The image of what her father's body would look like before too much more time had passed was disheartening.

'How're things going, Marlene?' Thea asked, immediately pitching in and rubbing lotion into Petros's other foot. 'Any more visitors?'

'Amy was here for a while,' she said, referring to the nursing director. 'She seemed a little upset that you would be hiring nurses to special your father. It's always her position that her nurses, whether it's in one of the units or on any of the med/surg floors, are perfectly capable of caring for their patients.'

'I'll speak to her.'

'Actually, she asked if you would do just that. She said something about having spoken to your sister, and that your sister didn't know anything about special-duty nurses being brought in.'

That's because I never told her.

Thea stopped herself at the last instant from sharing her belief that Petros was in constant danger, and also her newest belief that Scott Hartnett was using paralytic agents to keep him from communicating. It had been a mistake for her to share the discovery of Petros's locked-in syndrome in the first place. She was learning to be less trustful and more careful, but her natural tendencies had already proved costly.

'Anyone else been here?'

'That hunk of a security guard, Daniel Cotton, was here for a little while about an hour ago. It's his second visit that I've recorded. What a nice guy. I have a little bit of a back problem, and he lifted your father for me and moved him as if he was a rag doll. I've actually heard a few tidbits off the hospital grapevine that Daniel Cotton might be involved with a doctor on the staff—a new doctor recently arrived from South Africa.'

'That's absolute nonsense,' Thea said. 'I'm recently arrived from
central
Africa, not South Africa. But I will agree that he's a hunk.'

'Oh, your brother and sister were here right after him, too, but they only stayed for a couple of minutes.'

'I guess they don't believe that the energy of their presence is enough to make a difference,' Thea said.

'I've seen a number of miracles over the years,' the seasoned nurse replied. 'Maybe they haven't.'

Maybe they have, but didn't realize what they were experiencing,
Thea thought, with uncharacteristic cynicism. Dimitri's disclosure about the twins bilking their father out of money disturbed her greatly— even more than the notion that he was eavesdropping on their e-mail. She completed the last of the physical care on Petros, wishing that she could be snuggling in Dan's arms, with her face buried in his chest.

This is no f
un, she thought, wondering if she might have actually said the words aloud.

'Could I please have a few minutes alone with my dad?' she asked.

The nurse smiled as if she approved, gathered some of her things, and left the room.

'Dad, it's me, Thea,' she said in full voice from close to his ear. She removed the paper tape from his lids. 'Can you move at all? Can you give me a sign that you hear me?'

There was no response. Thea peered at his pupils and tried to convince herself that they were slightly more constricted than they had been—a known effect of narcotics. If there were a change, it was minuscule.

'Dad, try. Try hard to move your eye. Just look up and I'll see it. Look up and I'll know.'

'Know what?'

Thea shot upright and whirled to the voice. Scott Hartnett stood just three feet away, smiling at her benignly, looking urbane and confident. Behind him, through the open doorway, she could see Mar-lene shrugging impotently by way of apology for allowing him past her.

'Know if my father can hear me,' she replied, quickly regaining her composure.

Hartnett moved to the bedside and peered down at his longtime friend.

'You still believe he's alert?'

There was something about the man—a smugness, perhaps—that may have been there over the many years Thea had known him, but that now was intensely irritating to her.

'And
able to communicate,' she said, with an unmistakable edge. 'At least he was.'

'What do you mean?'

Thea's internal debate lasted only a few seconds. It was time for some answers. Beyond Hartnett's shoulder, she could see Marlene trying not to look as if she were paying close attention to them. Thea crossed to the door and closed it.

'I mean,' she said flatly, 'that I believe someone is administering a narcotic plus a paralyzing agent like pancuronium to my father, to stop him from using the one set of muscles he has available.'

'But why?'

Again, the smugness.

Thea felt herself beginning to simmer. It seemed as if she had lost her temper more in the brief time she had been home than in all her years in the DRC.

'Why
is not nearly as important as
who,'
she declared. 'I believe that person is you.'

'I see,' Hartnett said, surprising her by not vehemently denying the accusation. 'You know, I wondered about what Marlene might be thinking when she saw me administering my mixture to Petros.'

'Your mixture?'

Hartnett reached into his clinic coat pocket, withdrew a loaded five cc syringe, and passed it over to her.

'It's a combination of vitamins mixed with a small amount of a variety of anticoagulants.'

'Vitamins? Anticoagulants?'

'I learned about the mixture during a three-week seminar I took from Dr. Boris Adamov and his staff in the Moscow Institute of Coagulation last year. Plavix, persantine, fondaparinux, that's—'

'I know, I know, a pentasaccharide bound to heparin.'

'Very good, Thea. That's not an everyday drug. Well, the dose of each component is minuscule, but Adamov has had remarkable results in preventing clots in bedridden older patients. I didn't want to burden our pharmacists by making them formulate this, so I have it sent directly to me by Dr. Adamov, and I administer it myself. I am really sorry that you would be suspicious of me, Thea. Your father and I have been so close for so long. But I know how much strain you have been under since coming home to this.'

He gestured toward the inert figure of his onetime mentor.

Thea felt utterly deflated.

'Could I have that?' was all she could think of to say.

'Of course, but why?'

'I want to have it analyzed.'

'Suit yourself, Doctor,' Hartnett said without rancor.

'You know, I think I will,' Thea replied.