Devil's Waltz (9 page)

“Trailers,” I said. “Melendez-Lynch must be over-joyed.”

“Melendez-Lynch went
adios
, last year.”

“You’re kidding. Raoul
lived
here.”

“Not anymore. Miami. Some hospital offered him chief of staff, and he took it. I hear he’s getting triple the salary and half the headaches.”

“It
has
been a long time,” I said. “Raoul had all those research grants. How’d they let him get away?”

“Research doesn’t matter to these people, Alex. They don’t want to pay the overhead. It’s a whole new game.” She let her arm fall from my waist. We began walking.

“Who’s the other guy?” I said. “Mr. Gray Suit.”

“Oh, him.” She looked unnerved. “That’s Huenengarth —
Presley
Huenengarth. Head of security.”

“He looks like an enforcer,” I said. “Muscle for those who don’t pay their bills?”

She laughed. “That wouldn’t be so terrible. The hospital’s bad debt is over eighty percent. No, he doesn’t seem to do much of anything, except follow Plumb around and
lurk
. Some of the staff think he’s spooky.”

“In what way?”

She didn’t answer for a moment. “His manner, I guess.”

“You have any bad experiences with him?”

“Me? No. Why?”

“You look a little antsy talking about him.”

“No,” she said. “It’s nothing personal — just the way he acts to everyone. Showing up when you’re not expecting him. Materializing around corners. You’ll come out of a patient’s room and he’ll just
be
there.”

“Sounds charming.”

“
Très
. But what’s a
girl
to do? Call Security?”

I rode down to the ground floor alone, found Security open, endured a uniformed guard’s five-minute interrogation, and finally earned the right to have a full-color badge made.

The picture came out looking like a mug shot. I snapped the badge onto my lapel and took the stairs down to the sub-basement level, heading for the hospital library, ready to check out Stephanie’s references.

The door was locked. An undated memorandum taped to the door said new library hours were three to five
P
.
M
., Monday through Wednesday.

I checked the adjoining reading room. Open but unoccupied. I stepped into another world: oiled paneling, tufted leather chesterfields and wing chairs, worn but good Persian rugs over a shoe-buffed herringbone oak floor.

Hollywood seemed planets away.

Once the study of a Cotswolds manor house, the entire room had been donated years ago — before I’d arrived as an intern — transported across the Atlantic and reconstructed under the financial guidance of an Anglophile patron who felt doctors need to relax in high style. A patron who’d never spent time with a Western Peds doctor.

I strode across the room and tried the connecting door to the library. Open.

The windowless room was pitch-dark and I turned on the lights. Most of the shelves were empty; a few bore thin stacks of mismatched journals. Careless piles of books sat on the floor. The rear wall was bare.

The computer I’d used to run Medline searches was nowhere in sight. Neither was the golden-oak card catalogue with its hand-lettered parchment labels. The only furniture was a gray metal table. Taped to the top was a piece of paper. An inter-hospital memo, dated three months ago.

TO:
Professional Staff
FROM:
G. H. Plumb, MBA, DBA, Chief Executive Officer
SUBJECT:
Library Restructure
In accordance with repeated requests by the Professional Staff and a subsequent confirmatory decision by the Research Committee, the Board of Directors in General Assembly, and the Finance Subcommittee of the Executive Board, the Medical Library reference index will be converted to a fully computerized system utilizing Orion and Melvyl-type standard library data search programs. The contract for this conversion has been put out to competitive bid and, after careful deliberation and cost/benefit computation, has been awarded to BIO-DAT, Inc., of Pittsburgh, Pennsylvania, a concern specializing in medical and scientific research probe systems and health-care workstation integration. BIO-DAT officials have informed us that the entire process should take approximately three weeks, once they are in full receipt of all relevant data. Accordingly, the library’s current card files will be shipped to BIO-DAT headquarters in Pittsburgh for the duration of the conversion process, and returned to Los Angeles for purposes of storage and archival activity, once the conversion has been terminated. Your cooperation and forbearance during the conversion period is solicited.

Three weeks had stretched to three months.

I ran my finger along the metal table and ended up with a dust-blackened tip.

Turning off the light, I left the room.

Sunset Boulevard was a bouillabaisse of rage and squalor mixed with immigrant hope and livened by the spice of easy felony.

I drove past the flesh clubs, the new-music caverns, titanic show-biz billboards, and the anorexically oriented boutiques of the Strip, crossed Doheny and slipped into the dollar-shrines of Beverly Hills. Passing my turnoff at Beverly Glen, I headed for a place where serious research could always be done. The place where Chip Jones had done his.

The Biomed library was filled with the inquisitive and the obligated. Sitting at one of the monitors was someone I recognized.

Gamine face, intense eyes, dangling earrings, and a double pierce on the right ear. The tawny bob had grown out to a shoulder-length wedge. A line of white collar showed over a navy-blue crewneck.

When had I last seen her? Three years or so. Making her twenty.

I wondered if she’d gotten her Ph.D. yet.

She was tapping the keys rapidly, bringing data to the screen. As I neared I saw that the text was in German. The word
neuropeptide
kept popping out.

“Hi, Jennifer.”

She spun around. “Alex!” Big smile. She gave me a kiss on the cheek and got off her stool.

“Is it Dr. Leavitt yet?” I said.

“This June,” she said. “Wrapping up my dissertation.”

“Congratulations. Neuroanatomy?”

“Neurochemistry — much more practical, right?”

“Still planning on going to med school?”

“Next fall. Stanford.”

“Psychiatry?”

“I don’t know,” she said. “Maybe something a bit more… concrete. No offense. I’m going to take my time and see what appeals to me.”

“Well, there’s certainly no hurry — what are you, twelve years old?”

“Twenty! I’ll be twenty-one next month.”

“A veritable crone.”

“Weren’t you young, too, when you finished?”

“Not that young. I was shaving.”

She laughed again. “It’s great to see you. Hear from Jamey at all?”

“I got a postcard at Christmas. From New Hampshire. He’s renting a farm there. Writing poetry.”

“Is he… all right?”

“He’s better. There was no return address on the card and he wasn’t listed. So I called the psychiatrist who treated him up in Carmel and she said he’d been maintaining pretty well on medication. Apparently he’s got someone to take care of him. One of the nurses who worked with him up there.”

“Well, that’s good,” she said. “Poor guy. He had so much going for and against him.”

“Good way to put it. Have you had any contact with the other people in the group?”

The group.
Project 160
. As in IQ. Accelerated academics for kids with genius intellects. A grand experiment; one of its members ended up accused of serial murder. I’d gotten involved, taken a joyride into hatred and corruption…

“…is at Harvard Law and working for a judge, Felicia’s studying math at Columbia, and David dropped out of U. of Chicago med school after one semester and became a commodities trader. In the pits. He always was kind of an eighties guy. Anyway, the project’s defunct — Dr. Flowers didn’t renew the grant.”

“Health problems?”

“That was part of it. And of course the publicity about Jamey didn’t help. She moved to Hawaii. I think she wanted to minimize her stress — because of the M.S.”

Catching up with the past for the second time today, I realized how many loose ends I’d let dangle.

“So,” she said, “what brings you here?”

“Looking up some case material.”

“Anything interesting?”

“Munchausen syndrome by proxy. Familiar with it?”

“I’ve heard of Munchausen — people abusing their bodies to fake disease, right? But what’s the proxy part?”

“People faking disease in their children.”

“Well,
that’s
certainly hideous. What kinds of illnesses?”

“Almost anything. The most common symptoms are breathing problems, bleeding disorders, fevers, infections, pseudoseizures.”

“By
proxy
,” she said. “The
word
is unnerving — so calculated, like some sort of business deal. Are you actually working with a family like that?”

“I’m evaluating a family to see if that’s what’s going on. It’s still in the differential diagnosis stage. I have some preliminary references, thought I’d review the literature.”

She smiled. Card-file, or have you become computer-friendly?”

“Computer. If the screen talks English.”

“Do you have a faculty account for SAP?”

“No. What’s that?”

“‘Search and Print.’ New system. Journals on file — complete texts scanned and entered. You can actually call up entire articles and have them printed. Faculty only, if you’re willing to pay. My chairman got me a temporary lectureship and an account of my own. He expects me to publish my results and put his name on it. Unfortunately, foreign journals haven’t been entered into the system yet, so I’ve got to locate those the old-fashioned way.”

She pointed to the screen. “The master tongue. Don’t you just love these sixty-letter words and umlauts? The grammar’s nuts, but my mother helps me with the tough passages.”

I remembered her mother. Heavyset and pleasant, fragrant of dough and sugar. Blue numbers on a soft white arm.

“Get an SAP card,” she said. “It’s a kick.”

“Don’t know if I’d qualify. My appointment’s across town.”

“I think you would. Just show them your faculty card and pay a fee. It takes about a week to process.”

“I’ll do it later, then. Can’t wait that long.”

“No, of course not. Listen, I’ve got plenty of time left on my account. My chairman wants me to use all of it up so he can ask for a bigger computer budget next year. If you want me to run you a search, just let me finish up with this, and we’ll find all there is to know about people who
proxy
their kids.”

We rode up to the SAP room at the top of the stacks. The search system looked no different from the terminals we’d just left: computers arranged in rows of partitioned cubicles. We found a free station and Jennifer searched for Munchausen-by-proxy references. The screen filled quickly. The list included all the articles Stephanie had given me, and more.

“Looks like the earliest one that comes up is 1977,” she said. “
Lancet.
Meadow, R. ‘Munchausen syndrome by proxy: The hinterland of child abuse.’ ”

“That’s the seminal article,” I said. “Meadow’s the British pediatrician who recognized the syndrome and named it.”

“The hinterland… that’s ominous too. And here’s a list of related topics: Munchausen syndrome, child abuse, incest, dissociative reactions.”

“Try dissociative reactions first.”

For the next hour we sifted through hundreds of references, distilling a dozen more articles that seemed to be relevant. When we were through, Jennifer saved the file and typed in a code.

“That’ll link us to the printing system,” she said.

The printers were housed behind blue panels that lined two walls of the adjoining room. Each contained a small screen, a card slot, a keyboard, and a mesh catch-bin under a foot-wide horizontal slit that reminded me of George Plumb’s mouth. Two of the terminals weren’t in use. One was marked
OUT OF ORDER
.

Jennifer activated the operative screen by inserting a plastic card in the slot, then typing in a letter-number code, followed by the call letters of the first and last articles we’d retrieved. Seconds later the bin began to fill with paper.

Jennifer said, “Automatically collated. Pretty nifty, huh?”

I said, “Melvyl and Orion — those are basic programs, right?”

“
Neanderthal
. One step above cards.”

“If a hospital wanted to convert to computerized search and had a limited budget, could it go beyond that?”

“Sure. Way beyond. There are tons of new software programs. Even an office practitioner could go beyond that.”

“Ever hear of a company called BIO-DAT?”

“No, can’t say that I have, but that doesn’t mean anything — I’m no computer person. For me it’s just a tool. Why? What do they do?”

“They’re computerizing the library at Western Pediatric Hospital. Converting reference cards to Melvyl and Orion. Supposed to be a three-week job but they’ve been at it for three months.”

“Is it a huge library?”

“No, quite a small one, actually.”

“If all they’re doing is probe and search, with a print-scanner it could be done in a couple of days.”

“What if they don’t have a scanner?”

“Then they’re Stone Age. That would mean hand-transfer. Actually typing in each reference. But why would you hire a company with such a primitive setup when — Ah, it’s finished.”

A thick sheaf of papers filled the bin.

“Presto-gizmo, all the gain, none of the pain,” she said. “One day they’ll probably be able to program the stapling.”

I thanked her, wished her well, and drove home with the fat bundle of documents on the passenger seat. After checking in with my service, going through the mail, and feeding the fish — the koi who’d survived infancy were thriving — I gulped down half a roast beef sandwich left over from last night’s supper, swigged a beer, and started in on my homework.