You OK? she wrote.
“Define okay. I feel as though I’ve been hit by an invisible bus. I’m trying to fight back at whoever nearly killed me, but nobody seems to notice. How about you?”
Grace made a so-so sign.
“She seems a little more worn out than she was earlier this morning,” her husband observed. “Maybe they shouldn’t have taken her down to radiology for those X-rays.”
“We wheel patients down there if we can because they’re better quality than the films done by the portable machine,” Will replied. “Here’s one of the reasons she’s not feeling better, this white stuff right back here. A pneumonia.”
He pointed to the area on himself. At that moment, another finding in the films caught his eye. There was a small density inside the wall of Grace’s right chest, just below her third rib, perfectly round and much whiter even than the bone, which suggested that the object was metallic. The lateral view confirmed the object’s presence and located it toward the front and fairly deep. Almost certainly, it was a BB.
“Look at this,” he said.
Grace smiled.
BB, she wrote. Brother shot me.
“How old were you?”
12.
“On purpose?”
Who knows?
“I never even knew about this,” Mark said. “My wife, shot. What a mysterious, exotic woman you are, Grace. Having met the man, though, I don’t have to stretch my imagination too far to see him doing it and it not be an accident.”
Grace waved him off, but her expression suggested she agreed.
“Did your parents take you to a doctor?” Will asked.
Grace nodded.
“I imagine he said trying to get it out was more trouble than it was worth, and that it would either work itself out or stay there for the rest of your life.”
Another nod.
“Obviously, he was right, because there it is.”
There it is, she wrote.
“And there it will stay.”
Keep your spirits up.
“I appreciate that. Listen, don’t worry about me. Somehow I’ll come out of this okay. And don’t worry about what’s going to happen with your chemo.”
I know.
“There are alternatives. Right now you should just concern yourself with getting better. Well, I think I should leave you to rest.”
Thanx.
“I’m just grateful you made it. What a thing to go through.”
You, too.
Will smiled, kissed her on the cheek, shook Mark’s hand, and turned toward the door.
“Dr. Grant?” Mark said.
Will turned back. Mark had moved closer to the X-ray view boxes and was peering at Grace’s films.
“Yes?”
“If this BB is here on her chest films, then wouldn’t you expect it to be on her mammograms, as well?”
“Some of the views, yes, of course.”
“Well, it wasn’t there.”
“Pardon?”
“It wasn’t there.”
“Are you sure?”
“As you can probably tell, Dr. Grant, I am a very meticulous man-not obnoxious about it, I hope, but I am a stickler for details. There was no BB on Grace’s breast films-not any of them. Did you see it there, hon?”
She shook her head tentatively.
Never thought about it, she wrote.
Will tried to remember the distinctive density in Grace Davis’s mammograms, but he couldn’t. It would only have been on a couple of the views-perhaps two or three out of ten-but from what he could tell, it definitely should have been on some. He did sense that, just as with these films, had there been a BB on the mammograms he would not only have noticed but commented on it. Instantly, a meteor shower of questions flashed across his mind. Could the camera angles of the mammograms possibly have cut out the BB? Possible but not likely. Could he, Grace, and Mark Davis all have missed the BB in the other set of films? Again, possible but not likely. Did he ever read the radiologist’s dictated report? Doubtful. There wasn’t any question about the cancer that was there, so what the radiologist had to say really didn’t matter to him. Could Grace’s mammograms have been accidentally switched with another woman’s? Ugh. The possibility was sickening but not really feasible, because the cancer in the X-ray had been biopsied and confirmed by a pathologist.
Nevertheless, it appeared quite possible that some sort of mix-up had occurred.
Over two decades of working in hospitals, Will had encountered almost every imaginable permutation of error. Working under enormous time pressures, with massive volumes of patients and procedures, handicapped by human frailties, imperfections, miscommunications, and personality disorders, to say nothing of fatigue, mechanical failure, and the vagaries of biology, caregivers made mistakes. Many of those mistakes passed by totally unnoticed or caused no inconvenience of any great magnitude. Some of them altered lives, and some either devastated lives or, sadly, ended them.
Will knew he had enough problems of his own to work out without trying to track down the source of this odd conflict. Still, he also knew there was no way he wouldn’t do it.
“Guys, listen,” he said, “I don’t have a good explanation for this, but I’m sure there is one-at least I think there is one. I’ll check with someone in radiology here, and then I’ll speak to the person at the cancer center who did those mammograms.”
It was only then that he recalled his unpleasant encounter over the phone with radiologist Charles Newcomber. That time he had gone over Newcomber’s head and prevailed, but it would be a pleasure to put the pompous prig on the hot seat once again.
“Please keep us posted,” Mark said.
“Oh, don’t worry,” Will replied, knowing that this time the encounter with Newcomber would occur in person, and that this time he would have the hospital X-rays tucked under his arm. “I will.”
Alone in his office, Augie Micelli sipped on a brandy, stared across the room at a spider plying its trade in the corner, and scratched boxes around words on a yellow legal pad-his way since college of working through problems. From the portable CD player on the floor by his desk, Gene Ammons’s soulful tenor sax was playing “Willow Weep for Me.” A drug addict, Ammons was known as Jug, perhaps for the way he drank, Micelli thought fondly, or maybe for the stretches he did in the jug before, at forty-nine, he died.
Although Micelli had been there at his desk for several hours with a drink close at hand, he was still far more sober than not. There was significant work to do, so he had been treading the delicate line between maintaining a clear head and keeping the shakes in check. It was a case that, when all was said and done, might not even pay the electric bill. But if Will Grant was telling the truth, if he had been framed and was now being purged from medicine much as Micelli, himself, had been, taking the case had been the right thing to do. Now the trick was seeing to it that Grant never made it anywhere near a courtroom, and that meant figuring out how he could have been railroaded so smoothly.
Spread out across the desk and on the floor around him were articles, xeroxed book pages, and printouts from the Internet, all dealing with the narcotic fentanyl. Usual dose; onset of action; route of administration; duration of action; pharmacologic effects; side effects; symptoms of overdose; chemical formula; metabolites. Gene Ammons had moved on to “I Remember You,” Micelli’s favorite on the album, which was to say the one that made him feel most blue.
“Not good,” he muttered as he considered the case, “not good at all.”
The only explanation that fit all the facts was that Will Grant was both an addict and a liar. Micelli bounced the eraser of his pencil on an article dealing with the pharmacokinetics of sufentanil, ten times more powerful than fentanyl, eight hundred times more powerful than morphine, and of carfentanil, which was nearly fifteen times more powerful even than that. He found himself thinking about a statement from one of his law-school professors, and wrote it in block letters at the bottom of the yellow sheet.