Page 31 of Life Support

She didn’t turn on the light but simply stood in the semi-darkness, inhaling Ellen’s scent, faintly sweet, like the summer flowers she so lovingly tended. Roses and lavender.

  She opened the closet and randomly touched one of the dresses hanging there. Just by its texture she recognized it: her mother’s linen summer shift, a dress so old that Toby could remember Ellen having worn it to Vickie’s college graduation. And here it was, still hanging in the closet with all the other dresses Ellen had kept through the years. When was the last time I took you shopping? I can’t remember. I can’t remember the last time I bought you a dress. . .

  She closed the closet door and sat down on the bed. She had changed the sheets several days ago, in hopeful anticipation of her mother’s eventual return home. Now she almost wished she hadn’t done so; all traces of her mother had been stripped away with the sheets, and now the bed smelled blandly of laundry soap. She lay down, thinking of the nights Ellen had occupied this same space. Wondering if the air itself had somehow been imprinted with the shadow of her presence.

  She closed her eyes, inhaled deeply. And fell asleep.

  Vickie’s call awakened her at eight the next morning. It took eight rings before Toby managed to stumble to her own bedroom to pick up the phone. Half-drugged by sleep, she could barely focus on what her sister was trying to tell her.

  “A decision has to be made, but I can’t do it myself, Toby. It’s just too much on my shoulders.”

  “What decision?”

  “Mom’s ventilator.” Vickie cleared her throat. “They’re talking about turning it off.”

  “No.” Toby came fully awake. “No.”

  “They did the second EEG and they said it’s just as—”

  “I’m coming in. Don’t let them touch a thing. Do you hear me, Vickie? Don’t let them touch one goddamn thing.”

  Forty-five minutes later, she walked into the ICU at Springer Hospital. Vickie was standing in Ellen’s cubicle; so was Dr. Steinglass. Toby went straight to her mother’s side and, bending down, whispered: “I’m here, Mom. I’m right here.”

  “The second EEG was done this morning,” said Dr. Steinglass. “There’s no activity. The new pontine hemorrhage was devastating. She has no spontaneous respirations, no—”

  “I don’t think we should talk about this in the room,” said Toby.

  “I realize it’s not easy to accept,” said Steinglass. “But your mother can’t comprehend anything we’re saying right now.”

  “I’m not going to discuss this. Not in here,” said Toby, and she walked out of the cubicle.

  In the small ICU conference room, they sat at the table, Toby grim and silent, Vickie on the verge of tears. Dr. Steinglass, whom Toby thought of as competent but detached, looked uncomfortable in his new role of family crisis counselor.

  “I’m sorry to raise this issue,” he said. “But it really does need to be addressed. It’s been four days now, and we’ve seen no improvement. Both, EEG’s show no activity. The hemorrhage was massive, and there’s no brain function left. The ventilator is just . . . prolonging the situation.” He paused. “I do believe it would be the kindest thing to do.”

  Vickie looked at her sister, then back at Steinglass. “If you really think there’s no chance. . .”

  “He doesn’t know,” said Toby. “No one does.”

  “But she’s suffering,” said Vickie. “That tube in her throat—all those needles—”

  “I don’t want the ventilator shut off yet.”

  “I’m only thinking about what Mom would want.”

  “It’s not your decision. You’re not the one who takes care of her.”

  Vickie shrank back in her chair, eyes wide with hurt.

  Toby dropped her head in her hands. “Oh God, I’m sorry. I didn’t mean to say that.”

  “I think you did mean to say it.” Vickie rose from her chair. “All right, you make the decision, then. Since you seem to think you’re the only one who loves her.” Vickie walked out.

  After a moment, so did Dr. Steinglass.

  Toby remained in the room with her head bowed, shaking with self-disgust and anger. At herself. At the woman who’d called herself Jane Nolan. If I could just find you. If I could have just one goddamn moment alone with you.

  By that afternoon, she’d run out of both anger and adrenaline. She didn’t have the energy to try reaching Dvorak again; she didn’t feel like talking to anyone right now. In a chair by Ellen’s bed, she leaned back and closed her eyes, but she could not shut out the image of her mother lying only a few feet away. With every whoosh of the ventilator bellows, she could picture quite clearly her mother’s chest rising and falling. The lungs filling with air. The oxygen-rich blood streaming from the pulmonary alveoli to the heart, and then to the brain, where it would circulate, useless and unneeded.

  She heard someone enter the cubicle, and she opened her eyes to see Dr. Steinglass standing at the foot of Ellen’s bed. “Toby,” he said quietly. “I know it’s hard for you. Nevertheless, we have to make the decision.”

  “I’m not ready.”

  “We’re faced with a difficult situation here. The ICU beds are all full. If an MI comes in, we’re going to need space.” He paused. “We’ll keep her on the ventilator until you make your decision. But you understand the position we’re in.”

  She said nothing. She only gazed at Ellen, thinking: How frail she looks. Every day she seems to shrink even smaller.

  “Toby?”

  She looked at Dr. Steinglass. “I need a little longer. I need to be certain.”

  “I could have the neurologist speak to you.”

  “I don’t need another opinion.”

  “Maybe you do. Maybe—”

  “Please, can’t you just leave me alone?”

  Dr. Steinglass took a step back, surprised by the anger in her voice. Beyond the doorway of the cubicle, several nurses were staring.

  “I’m sorry,” said Toby. “Give me some time. I need time. One more day.” She picked up her purse and walked out of the ICU, acutely aware, with every step she took, that the nurses were watching her.

  Where do I go now? she wondered as she stepped into the elevator. How do I fight back when I’m being attacked from all sides?

  The opposition had grown too many tentacles. Detective Alpren. Jane Nolan. Her old nemesis Doug Carey.

  And Wallenberg. First she had embarrassed him by requesting that autopsy. Then she’d raised troubling questions about his two Creutzfeldt-Jakob patients. She’d made an enemy, certainly, but as far as she could tell, she’d caused him no serious damage.

  So why has Brant Hill worked so hard to discredit me? What are they trying to hide?

  The elevator stopped on the second floor to admit a pair of billing clerks just getting off work. Toby glanced at her watch and saw it was already past five; the weekend had officially begun. She caught a glimpse of the administrative hallway and suddenly had a thought.

  She squeezed out of the elevator and walked up the hall to the medical library. The door was still unlocked, but the library was deserted for the day. She went to the reference computer and turned on the power.

  The Medline search screen came on.

  Under “author’s name” she typed in: Wallenberg, Carl.

  The titles of five articles appeared, listed in reverse chronological order. The most recent one was three years old, and it had appeared in Cell Transplant: “Vascularization after Cell-Suspension Neural Grafts in Rats.” There were two co-authors also credited, Gideon Yarborough, M.D., and Monica Trammell, Ph.D.

  She was about to scroll down to the next article listing when her gaze paused on that name, Gideon Yarborough. She remembered the bald man at Robbie’s funeral, tall and elegantly dressed, who had tried to intercede when she and Wallenberg were arguing. Wallenberg had called the man Gideon.

  She went to the reference desk and pulled the Directory of Medical Specialists from the shelf. She found the name listed under the section for surgical s
pecialists:

  Yarborough, Gideon. Neurosurgery.

  B.A. Biology, Dartmouth. M.D. Yale University.

  Residency: Hartford Hospital, General Surgery; Peter Bent Brigham, Neurosurgery. Board Certified: 1988.

  Postgraduate Fellowship: Rosslyn Institute for Research in Aging, Greenwich, Connecticut.

  Currently practicing: Wellesley, Massachusetts, Howarth Surgical Associates.

  The Rosslyn Institute. It was the same research facility where Wallenberg had once worked. Robbie Brace had said Wallenberg left Rosslyn after a falling-out with one of his fellow researchers over a woman. A romantic triangle.

  Had Yarborough been the other man?

  She carried the Directory of Medical Specialists back to the Medline computer, and this time she typed in Yarborough under “author’s name.”

  Several articles appeared, among them the one she’d already noted from Cell Transplant. She scrolled down to the first article published, dated six years ago, and read the abstract. It described experiments using rat fetal brain tissue fragments, broken up into individual cells by the enzyme trypsin, and then injected into the brains of adult rats. The transplanted cells had thrived and formed functioning colonies, complete with newly grown blood vessels.

  A chill had begun to creep up her spine.

  She clicked on the next article, from Journal of Experimental Neurobiology. Yarborough’s co-authors were names she didn’t recognize. The title was: “Morpho-functional Integration of Transplanted Embryonic Brain Tissue in Rats.” There was no abstract attached.

  She scrolled up to the next article titles:

  “Mechanisms of Fetal Graft Communication with Host Brain in Rats.”

  “Optional Gestational Stage for Harvest of Fetal Rat Brain Cells.”

  “Cryopreservation of Fetal Rat Brain Grafts.” An abstract was attached to this one. “After cryopreservation in liquid nitrogen for ninety days, fetal mesencephalic brain cells showed significantly decreased survival as compared to fresh cells. For optimal graft survival, immediate transplant of freshly harvested fetal brain tissue is mandatory.”

  She stared at that last phrase: Freshly harvested fetal brain tissue.

  By now the chill had spread all the way up to the nape of her neck.

  She clicked on the most recent article, dated three years ago: “Transplantation of Fetal Pituitary Grafts in Elderly Monkeys: Implications for Prolongation of Natural Life Spans.” The authors were Yarborough, Wallenberg, and Monica Trammell, Ph.D.

  It was the last article they’d published; soon after, Wallenberg and his research partners had left Rosslyn. Was it their controversial research that had forced them out?

  She rose and went to the library telephone. Her heart was racing as she dialed Dvorak’s home phone number. The phone kept ringing, unanswered. She glanced up at the wall clock and saw it was five-forty-five. The answering machine clicked on, and then came a recording: This is Dan. Please leave your name and number. . .

  “Dan, pick up,” said Toby. “Please pick up.” She paused, hoping to hear a live voice, but no one came on. “Dan, I’m in the Springer medical library, extension two five seven. There’s something here on Medline you have to see. Please, please call me back right—”

  The library door opened.

  Toby turned to see the evening security guard poking his head into the room. He looked just as startled to see her as she was to see him.

  “Ma’am, I have to lock up for the night.”

  “I’m making a phone call.”

  “You can finish the call. I’ll wait.”

  In frustration she simply hung up and walked out of the library. Only as she pushed into the stairwell did she remember she’d left the computer on.

  Sitting in the parking lot, she used her car phone to call Dvorak’s direct line in the medical examiner’s office. Again, a recording came on. She hung up without leaving another message.

  With a violent twist of the ignition she started the car and pulled out of the parking lot. Driving purely by habit, she headed toward home, her mind focused on what she’d just read on the Medline computer. Neural grafts. Fetal brain cells. Prolongation of the natural life span.

  So this was the research Wallenberg had been working on at Rosslyn. His associate had been Gideon Yarborough, a neurosurgeon who now practiced in nearby Wellesley. . . .

  She turned into a gas station, ran inside, and asked the cashier for the Wellesley telephone directory.

  In the Yellow Pages, under Physicians, she found what she was looking for:

  Howarth Surgical Associates

  A multispecialty group

  1388 Eisley Street

  Howarth. It was a name she’d remembered seeing in Harry Slotkin’s medical record. When Robbie had brought her to Brant Hill to look at Harry’s chart, they’d seen the name in the M.D. order sheet:

  Preop Valium and six A.M. van transport to Howarth Surgical Associates.

  She got back in her car and drove toward Wellesley.

  By the time she reached the Howarth building, she was starting to put it all together, in a way that made horrifying sense.

  She parked across the street from the building and gazed through the gloom at the nondescript two-story structure. It was heavily cloaked by shrubbery, with a small parking lot in front that was currently empty of cars. The upstairs windows were dark; downstairs, the entryway and reception area were lit but no movement could be seen inside.

  Toby got out of the car and crossed the street to the front entrance. The doors were locked. On the window were stenciled the doctors’ names:

  Merle Lamm, M.D., Obstetrics and Gynecology

  Lawrence Remington, M.D., General Surgery

  Gideon Yarborough, M.D., Neurosurgery

  Interesting, she thought. Harry Slotkin had been sent here from Brant Hill, supposedly for a deviated nasal septum. Yet none of these doctors was an ear, nose, and throat specialist.

  From somewhere in the building came the faint whine of machinery. A furnace? A generator? She couldn’t identify the sound.

  She circled around to the side of the building, but dense shrubbery hid any view through the windows. The low whine suddenly shut off, leaving absolute silence. She rounded the corner and found a small paved lot at the rear of the building. Three cars were parked there.

  One of them was a dark blue Saab. Jane Nolan’s.

  The building’s rear entrance was locked.

  Toby returned to her car and picked up the phone. Again she tried calling Dvorak on his direct office line. She didn’t really expect him to answer and was startled when his voice came on with a brisk: “Hello?”

  Her words came out in a rush. “Dan, I know what Wallenberg’s been doing. I know how his patients are getting infected—”

  “Toby, listen to me. You have to call your attorney at once.”

  “They’re not injecting hormones. They’re transplanting pituitary cells from fetal brains! But something’s gone wrong. Somehow they transmitted CJD. Now they’re trying to cover it up—trying to hide the disaster before it becomes public—”

  “Listen to me! You’re in trouble.”

  “What?”

  “I just spoke to Alpren.” He paused. Quietly he said, “They’ve issued a warrant for your arrest.”

  For a moment she said nothing but simply stared at the building across the street. One step ahead, she thought. They’re always one step ahead of me.

  “This is what I think you should do,” he said. “Call your attorney. Ask him to accompany you to the police station, Berkley Street headquarters. The case has been transferred there.”

  “Why?”

  “Because of your mother’s . . . condition.”

  Homicide was what he meant. It would soon be considered a homicide.

  “Don’t make Alpren arrest you at home,” said Dvorak. “It’ll just turn into a shark-feeding for the media. Come in voluntarily, as soon as you can.”

  “Why did they issue the warran
t? Why now?”

  “They have new evidence.”

  “What evidence?”

  “Toby, just come in. I can meet you first, and we’ll come in together.”

  “I’m not going anywhere until I know what his evidence is.”

  Dvorak hesitated. “A pharmacist near your home says he filled a prescription for your mother. Sixty tablets of Coumadin. He says you called in the prescription by telephone.”

  “That’s a lie.”

  “I’m only telling you what the pharmacist said.”

  “How does he know I made the call? It could have been another woman, claiming to be me. It could have been Jane. He wouldn’t know.”

  “Toby, we’ll straighten it out, I promise. Right now your best move is to come in. Voluntarily, and without delay.”

  “And then what? I spend the night in jail?”

  “If you don’t come in, it could be months in jail.”

  “I didn’t hurt my mother.”

  “Then come in and tell it to Alpren. The longer you wait, the guiltier you’ll seem. I’m here for you. Please, just come in.”

  She felt too defeated to say a word, and too tired to consider all the tasks that now had to be done. Call an attorney. Talk to Vickie. Arrange for bills to be paid, the house to be watched over, the car to be picked up. And money—she would have to transfer money from her retirement savings. Attorneys were expensive . . .

  “Toby, do you understand what you need to do?”

  “Yes,” she whispered.

  “I’m going to leave my office now. Where would you like to meet me?”

  “The police station. Tell Alpren I’m coming in. Tell him not to send anyone to my house.”

  “Whatever you wish. I’ll be waiting for you.”

  She hung up, her fingers numb from clutching the receiver. So now the storm finally breaks, she thought. She sat preparing herself for the ordeal to follow. Fingerprints. Mug shots. Reporters. If only she could slink away somewhere and gather up her strength. But there was no time now; the police were expecting her.

  She reached for the ignition and was about to turn the key when she glimpsed the flicker of headlights. Looking sideways, she saw Jane’s Saab pull out of the Howarth driveway.