DECEMBER NINETEENTH
NUMBER OF NEW CASES: 7,850
NUMBER OF DEATHS: 31
It was twenty minutes to ten when Madison and Jack pulled into the visitors’ parking lot of Orlando Memorial Hospital. They went directly to the patient welcome center, where an elderly woman wearing a pin recognizing her two thousand hours of volunteer service to the hospital directed them to the third-floor office of Dr. Lucien Androise, the chief of pathology. Before accepting the position, Androise had spent fifteen years at Case Western Reserve University. Over the years, Jack had worked with him on at least a dozen cases. They had an excellent professional relationship and there wasn’t a pathologist alive he respected more than Lucien.
Jack and Madison followed the main corridor to its end outside Lucien’s office. The door was ajar, and Jack saw his old colleague, a squat man with fatty ears and stubby fingers hunched over a microscope. Jack rapped on the door of couple of times. Lucien looked up, smiled broadly and waved them in.
After exchanging a warm greeting, Jack introduced Madison.
“My pleasure to meet you,” he said, shaking her hand. He redirected his attention back to Jack. “Let’s see what you two have.”
Jack handed him the leather case containing the slides. Lucien invited them to have a seat at the Formica-topped counter. Spaced equally apart were four state-of-the-art microscopes. They were of the teaching variety, manufactured with two eyepieces; one for the pathologist and one for the student.
“I can’t thank you enough for agreeing to review the case,” Jack said.
“It’s my pleasure. We’re taking care of a lot of women with GNS, but we haven’t performed any biopsies as yet.”
“To my knowledge, Southeastern State’s the only hospital that has,” Jack said.
Lucien ran his finger down the slides until he reached the one he wanted to look at first.
“So, did you pluck anybody’s tail feathers at Southeastern State by sneaking away with these slides and coming up here?”
“We may have ruffled a few,” Jack answered. “Officially, the request for your opinion comes from Arnold Kazminski, the father of the young lady whose brain tissue you’re about to look at. So, from a medical ethics standpoint, we’re on solid ground. I can’t say the same is true regarding the wisdom of the decision from a political standpoint. But, even if we come under fire when we get back, it shouldn’t amount to much more than a flesh wound.”
“You’ve always been the consummate diplomat, Jack.”
After arranging the two dozen slides in his preferred order, Lucien slid the first one on the viewing platform. He removed his five-dollar flea market reading glasses and looked in the eyepiece of the microscope.
“As I mentioned on the phone, I’m interested to know if you see anything at all that’s definitely diagnostic of a viral infection,” Jack said.
Lucien took several minutes studying a large sampling of the slides before he invited Jack and Madison to have a look.
“There’s a component of inflammation here that could possibly be the result of a viral infection,” he said.
Jack lifted his eyes from the microscope. “You’re saying possibly. The pathologists at Southeastern State were more on the definitely side.”
Androise interlaced his fingers behind his neck. “In my opinion, the findings on these slides are not specific. I can’t exclude a viral infection but it’s by no means the only possibility.” He raised his hands and turned his palms toward the ceiling. ‘You asked for another opinion. All I can say is I don’t feel nearly as strongly as the Southeastern State pathologists do that this young lady’s brain tissue is infected with a virus.” With an easy shrug of his shoulders, he reached for one of the few slides he hadn’t as yet looked at and positioned it on the microscope.
Jack glanced over at Madison. Her face was painted with a stony expression.
“I certainly appreciate you coming in on Sunday to have a look at—”
“Wait a sec,” Lucien said abruptly. He rotated the lenses to a higher magnification. “This is interesting. On this slide, there are some very subtle features of…” Lucien said nothing for the next minute or so, but then glanced up from the microscope with a puzzled look on his face. “Let me have a closer look at these and I’ll give you a call.”
“What are you…”
“I’d rather not say anything right now.”
With narrowed eyes Jack asked, “I don’t mean to sound pushy but we’re on a pretty tight schedule, Lucien—do you have any idea when we might hear from you?”
“I understand. I’m only talking about a day or two. I don’t suppose you brought any of the original biopsy material. I might want to do some different stains on them.”
“I thought you might ask for that,” Jack said, removing a small container of formaldehyde and handing it to Lucien.
“Great,” he said, sliding his glasses back in place and coming to his feet.
With a knowing smile, Jack extended his hand. “Thanks again for having a look at the slides.”
“I’m happy to help…but I’m not sure I’ve done anything more than further muddy the waters.”
“I doubt that’s the case,” Jack assured him. “I look forward to your call. One last favor: Would you mind keeping our little visit here today confidential?”
“What visit?” he asked Jack before turning to Madison and extending his hand. “It was such a pleasure meeting you.”
Jack followed Madison out of Lucien’s office and down the main corridor. He was more than familiar with Lucien’s coy and cautious manner. Jack had a feeling his old friend was onto something.
“Do you feel like making a stop on the way back?” Jack asked Madison as they waited for the elevator.
“What kind of a stop?”
“My mother lives on Hutchinson Island. I owe her a visit.”
“Jack, I hate to sound like a jerk but do you really think with the time constraints we’re under this is the best time for a family—”
“You might find her interesting to talk to. She recently retired from the University of Georgia as the chief of pediatric cardiology. She spent her entire career doing research. Her department became pretty renowned for their work on congenital heart disease.”
“Really? Do you know if she worked with Charlotte Duffy?”
“I would say they were inseparable. She is Charlotte Duffy.”
“I beg your pardon?”
“You’ve obviously heard of her.”
“Are you kidding? I’m a perinatologist. Of course I’ve heard of her.”
“Does that mean you wouldn’t mind stopping by?”
“I’d love to meet her.”
Jack removed his cell phone and tapped in a text message. A minute later his phone chimed twice. He looked down at the message.
“Okay, she’s expecting us.”