Chapter 7

New York City

Dr. Leigh finished his teleconference with Lily feeling somewhat distracted. He looked at the black screen on his computer, closed the cover and pulled up the horse racing slip for the day’s picks. He would get to the analysis a little later. New York would have to wait.

* * *

Francis Becker had remembered Lily Robinson quite well. Yes, she was older, but she had that same captivating smile, and although seemingly warm and engaging, had a sense of aloofness about her. He imagined that she was never close with anyone since she appeared to keep herself focused on business and little else. Not unlike Marie Washington, except Marie wasn’t as disciplined or as smart. He made the call.

Becker updated the Chief ME on his findings regarding the autopsies he had conducted. “Hi, Marie, Becker here. Yep, still workin’ on the cases. Looks like some respiratory process goin’ on. I need to do a few more studies. Well the microscopics showed some congestion, but I’d like to do some IHCs. What?” he said with slight laugh, “Yup, I know you medical examiner types don’t do those immunohistochemical stains, in fact you shy away from the microscope and just go by the gross for the most part, but I’m just an ol’ surgical pathologist. We depend on ‘um. Yup, I’ll keep ya posted, okay, will do. Bye.”

He didn’t let her know that there had been similar lesions in the lungs in all his patients and when he compared notes with his colleagues across town, they had seen analogous results. He thought he should probably check in with Jim Cassidy and perhaps even with the ED physician, Stu Greene to see if there had been additional circumstances where the patient may have recovered.

Becker took the stairs up to the ED and looked to see if Greene was on duty and to ask if he had seen Jim Cassidy. Greene was sitting in the center bay checking lab results when Becker interrupted him.

“Dr. Greene, sorry to interrupt,” said the Chief of Pathology. “Have you had any additional cases like the ones I did the autopsies on? I sent out that vial you found to be analyzed, along with some fluid and tissue samples. I imagine we should have the results back in a day or two.”

“I did have one additional case, but she seemed to do alright after several hours in the ED. A kid in her twenties. Gave her supportive care and she came around. Weird, but she also had been down around the Garden the day before she got ill. I asked some of my coworkers around town and they’ve had similar incidences. Oh, and one other doc I talked to found some white powder in a plastic bag stuffed between his patient’s butt cheeks. Who knows what that was since he didn’t hang on to it. Anyway, if we’re talking a viral illness of some kind, then it’s not easily transmitted from one person to another. Or it has a very long incubation period. Let’s hope you and I don’t come down with something in a few weeks. God, I don’t want to relive the Ebola scare and I don’t want to be on your autopsy table.”

They stopped talking when they saw a commotion at the entrance to the emergency department. A group of young girls, in their mid to late teens, were being wheeled in by several EMTs.

“This one’s going down fast. I need some help here,” shouted Jim Cassidy, pushing a stretcher with a lifeless form. She looked about fifteen, had long brown hair, a petite body with two IVs and a breathing tube. The other two girls were ill, but not intubated.

Stu Greene ran over to the group. “What cha got here, Jim? Looks like these kids are having respiratory difficulties, and hmm, red eyes too. Hey, we got one here we need to get on fast,” he said in a loud voice. The triage nurse had already cleared one of the exam rooms.

They hooked up the girl who was intubated to a heart monitor and when her blood pressure dropped, they pushed in the drugs and the defibrillator was readied to deliver the counter shock. It whined as it charged, and then beep, beep, beep.

“Get that epi in the line stat. Shit, we’re losing her.” The EKG went flat. “Stand back. Watch the paddles,” Greene said turning to the nurses. “Ready, one two three.” A loud zap was heard in the room as the instrument discharged. The voltage was dialed up both on the instrument, and within the doctor delivering the jolt. One of the girls who wasn’t very sick began to sob loudly, and the nurse gave her a small dose of a sedative, midazolam, through her IV. She closed her wet eyes for a moment and quieted down with a look of relaxation on her face. They pulled the curtain between the rooms.

Jim Cassidy and Francis Becker watched the scene unfold.

“Are you thinking what I’m thinking?” said Cassidy.

“Yes sir,” was the answer.

“Miss,” said Dr. Becker in his very polite and twangy voice, “where are ya’ll ladies comin’ from?”

The girl with the midazolam peaceful look on her face opened her eyes and stared at the two of them.

“We were just, like, down in Times Square, ya know.” She struggled to get the words past her oxygen mask.

“Take ya time miss. It’s okay. We’re here ta help ya. I’m Dr. Becker and this here is Mr. Cassidy.”

“I don’t know. Like, we were shopping, thinking of going to a concert. Our parents like let us go into the city for the day.” She wheezed, rubbed her eyes and tried to sit up, but fell back into the bed.

“Miss would you mind if we took a look in your handbag?” said Jim Cassidy very gently.

“Um, like, I don’t know. Um, I have some things in there I don’t want my parents to see. Sometimes I have a cigarette. Uh, I guess it’s okay, but please, can you not talk with my parents about this? They’re really going to freak out.”

Jim Cassidy took the handbag and opened the flap to expose the contents. He methodically took things out one by one. A brush, a comb, an iPhone in a pink case, a pack of Camels (which he put off to the side), a key chain with three keys on it, hand cream, a wallet, a flyer with the list of upcoming events at the Garden, a water bottle, and in the front pocket some cellophane wrapped perfume cards. There were no vials of white powder or anything else that he thought could remotely contain poison. He opened the privacy screen, and went to see how the other two patients were doing.

Stu Greene emerged from the next room and pulled the curtain behind him. He looked at Cassidy.

“This one’s for Becker, or the ME, however they want to handle it. Christ, what the hell is going on? I got a teenager in my ED who just died of respiratory failure. Looks like severe pulmonary edema.”

Jim Cassidy went into the cubicle and looked at the dead girl. She had a tube down her throat and lines coming out from both of her arms. She looked restful. Hands lying by her sides with fingertips adorned with ruby red nail polish. He thought she was too young to be at this kind of peace. He quickly searched the room for her handbag. When he saw it, he rummaged through to see if there were any vials or powders. Nothing of note. This handbag too had flyers for restaurants and concerts, a bottle of red nail polish, and the familiar perfume card. He decided this time to keep those items and not return them to the purse.

* * *

Becker went back to his office trying to understand what had just happened. He picked up the phone and called Lily. He hadn’t heard back from her since delivery of the tissue and blood samples to her chemist friend. When he finally reached her on the phone he inquired as to the toxicology results, but she just apologized and said she hadn’t heard back from Dr. Leigh. She wanted to know whether Becker had any additional information. Anything that could tie the cases together.

“Lily, let’s not do this over the phone. Come on in, darlin’,” I have a nice leather chair in my office, been crafted in Texas. You know, it’s for those days that never end.”

Lily took a taxi right over to Becker’s office and when he saw her, he began to collect pieces of the puzzle for her review.