Four Scarpetta Novels (16 page)

T
he next morning, eight o'clock, Pacific Daylight Time. Lucy eases to a stop in front of the Stanford Cancer Center.

Whenever she flies her Citation X jet to San Francisco and rents a Ferrari for the hour's drive to see her neuroendocrinologist, she feels powerful, the way she feels at home. Her tight jeans and tight T-shirt show off her athletic body and make her feel vital, the way she feels at home. Her black crocodile boots and titanium Breitling Emergency watch with its bright orange dial make her feel she's still Lucy, fearless and accomplished, the way she feels when she's not thinking about what's wrong with her.

She rolls down the window of the red F430 Spider. “Can you park this thing?” she asks the valet in gray who tentatively approaches her at the entrance of the modern brick-and-glass complex. She doesn't recognize him. He must be new. “It's Formula One shift, these paddles on the steering wheel. Right for shifting up, left for down, both at the same time for neutral, this button for reverse.” She notes the anxiety in his eyes. “Well, okay, I admit it's kind of complicated,” she says, because she doesn't want to belittle him.

He's an older man, probably retired and bored, so he's parking cars at the hospital. Or maybe someone in his family has cancer or did. But it's obvious he's never driven a Ferrari and may never have seen one up close. He eyes it as if it just landed from outer space. He wants no part of it, and that's a good thing when one doesn't know how to drive a car that costs more than some houses.

“I don't think so,” the valet says, transfixed by the saddle leather interior and red “start” button on the carbon-fiber steering wheel. He steps around the back of the car and looks at the engine under glass and shakes his head. “Now, that's something. A convertible, I guess. Must blow you around a lot when you got the top down, as fast as it must go, I guess,” he says. “I got to admit that's something. Why don't you just pull it right over there.” He shows her. “Best spot in the house. That really is something.” Shaking his head.

Lucy parks, grabs her briefcase and two large envelopes containing magnetic resonance films that reveal the most devastating secret of her life. She pockets the Ferrari key, slips the valet a hundred-dollar bill, says very seriously but winks at him, “Guard it with your life.”

The cancer center is the most beautiful medical complex, with expansive windows and miles of polished wooden floors, everything open and full of light. The people who work here, many of them volunteers, are unfailingly polite. Last time she had an appointment, a harpist was perched in the corridor gracefully plucking and strumming “Time After Time.” This afternoon the same lady is playing “What a Wonderful World.” What a joke, and as Lucy walks fast, looking at no one, a baseball cap pulled low over her eyes, she realizes there's no music anyone could play that wouldn't make her feel cynical or depressed right now.

The clinics are open areas, perfectly appointed in earth tones, no art on the walls, just flat-screen TVs that show soothing nature scenes: meadows and mountains, leaves in the fall, snowy woods, giant redwood trees, the red rocks of Sedona, accompanied by the gentle sounds of flowing streams and pattering rain and birds and breezes. Live potted orchids are on tables, the lighting soft, the waiting areas never crowded. The only patient in Clinic D when Lucy reaches the check-in desk is a woman wearing a wig and reading
Glamour
magazine.

Lucy quietly tells the man behind the counter she's here to see Dr. Nathan Day, or Nate, as she calls him.

“Your name?” With a smile.

Lucy quietly tells him the alias she uses. He types something on his computer, smiles again and reaches for the phone. In less than a minute, Nate opens the door and motions for Lucy to come inside. He hugs her, always does. “It's great to see you. Looking fantastic.” He talks as they walk to his office.

It's small, not at all what one might expect of a Harvard-trained neuroendocrinologist considered one of the most outstanding in his field. He has a cluttered desk, a computer with a large video screen, an overflowing bookcase, multiple light boxes mounted on walls where in most offices there might be windows. There's a couch and one chair. Lucy hands over the records she brought with her.

“Lab work,” she says. “And the scan you looked at last time, and the most recent one.”

He settles behind his desk, and she sits on the couch. “When?” As he opens the envelopes, then reads her chart, not a word of it stored electronically, the paper file kept in his personal safe, identified by code, her name not listed anywhere.

“Blood work was two weeks ago. Most recent scan a month ago. My aunt's looked, says I look good, but then considering what she looks at most of the time,” Lucy says.

“She's saying you don't look dead. That's a relief. And how's Kay?”

“She likes Charleston, but I'm not sure it likes her. I like it okay…. Well, I'm always motivated by places that are a bad fit.”

“Which is most places.”

“I know. Lucy the freako. I trust we're still undercover. Seems like it, since I gave my alias to that same what's-his-name at the desk and he didn't question it. Democratic majority notwithstanding, privacy's a joke.”

“Don't get me started.” He peruses her lab report. “You know how many patients I have who would self-pay if they could afford it just to keep their information out of databases?”

“Good thing. If I wanted to hack into your database, I could probably do it in five minutes. The Feds might take an hour, but they've probably already been in your database. And I haven't. Because I don't believe in violating a person's civil rights unless it's for a good cause.”

“That's what
they
say.”

“They lie and are stupid. Especially the FBI.”

“Still topping your Most Wanted List, I see.”

“They fired me for no good cause.”

“And to think you could be abusing the Patriot Act and getting paid for it. Well, not much. What computer stuff are you selling for multimillions these days?”

“Data modeling. Neural networks that take input data and basically perform intelligent tasks the way our brains do. And I'm fooling around with a DNA project that could prove interesting.”

“TSH excellent,” he says. “Free T-four fine, so your metabolism's working. I can tell that without a lab report. You've lost a little weight since I saw you last.”

“Maybe five pounds.”

“Looks like you've gained muscle mass. So you've probably lost a good ten pounds of fat and water weight from bloating.”

“Eloquently put.”

“How much are you working out?”

“The same.”

“I'll note that as obligatory, although it's probably obsessive. Liver panel's fine. And your prolactin level's great, down to two-point-four. What about your periods?”

“Normal.”

“No white, clear, or milky discharge from your nipples? Not that I expect lactation with a prolactin level this low.”

“Nope. And don't get your hopes up. I'm not letting you check.”

He smiles, makes more notes in her record.

“Sad part is, my breasts aren't as big.”

“There are women who'd pay a lot of money for what you've got. And do,” he says matter-of-factly.

“They're not for sale. In fact, I can't even give them away these days.”

“That I know isn't true.”

Lucy is no longer embarrassed, can talk about anything with him. In the beginning, it was a different story, a horror and humiliation that a benign pituitary macroadenoma—a brain tumor—was causing an overproduction of the hormone prolactin that fooled her body into thinking she was pregnant. Her periods stopped. She gained weight. She didn't have galactorrhea, or begin to produce milk, but had she not discovered what was wrong when she did, that would have been next.

“Sounds like you're not seeing anyone.” He slides her MR films out of their envelopes, reaches up, and attaches them to light boxes.

“Nope.”

“How's your libido?” He dims the lights in the office and flips on the light boxes, illuminating films of Lucy's brain. “Dostinex is sometimes called the sex drug, you know. Well, if you can get it.”

She moves close to him and looks at her films. “I'm not having surgery, Nate.”

She stares dismally at the somewhat rectangular-shaped region of hypointensity at the base of the hypothalamus. Every time she looks at one of her scans, she feels there must be a mistake. That can't be her brain. A young brain, as Nate calls it. Anatomically, a great brain, he says, except for one little glitch, a tumor about half the size of a penny.

“I don't care what the journal articles say. No one's cutting on me. How do I look? Please tell me okay,” she says.

Nate compares the earlier film to the new one, studies them side by side. “Not dramatically different. Still seven to eight millimeters. Nothing in the suprasellar cistern. A little shift left to right from the infundibulum of the pituitary stalk.” He points with a pen. “Optic chiasm is clear.” Points again. “Which is great.” He puts down the pen and holds up two fingers, starts with them together, then moves them apart to check her peripheral vision. “Great,” he says again. “So almost identical. The lesion isn't growing.”

“It isn't shrinking.”

“Have a seat.”

She sits on the edge of the couch. “Bottom line,” she says, “it's not gone. It hasn't burned out from the drug and become necrotic, and it never will, right?”

“But it's not growing,” he repeats himself. “The medication did shrink it some and is containing it. All right. Options. But what do you want to do? Let me say that just because Dostinex and its generic have been linked to heart valve damage, I'm not sure you need to worry. The studies are dealing with people who take it for Parkinson's. At your low dose? You'll probably be fine. The bigger problem? I can write you a dozen prescriptions, but I don't think you'll find a single pill in this country.”

“It's manufactured in Italy. I can get it over there. Dr. Maroni said he will.”

“Fine. But I want you to get an echocardiogram every six months.”

The phone rings. Nate punches in a button, listens briefly, and says to whoever it is, “Thanks. Call security if it seems to get out of hand. Make sure nobody touches it.” He hangs up and says to Lucy, “Apparently, someone drove up in a red Ferrari that's attracting quite a lot of attention.”

“Kind of ironic.” She gets up from the couch. “It's all a matter of perspective, isn't it.”

“I'll drive it if you don't want it.”

“It's not that I don't want it. It's just nothing feels the same anymore. And that's not entirely bad. Just different.”

“That's the thing about what you've got. It's something you don't want. But it's something more than what you had, because maybe it's changed the way you look at things.” He walks her out. “I see it every day around here.”

“Sure.”

“You're doing well.” He stops by the door that leads out to the waiting area and there's no one to hear them, just the man behind the desk, who smiles a lot and is on the phone again. “I'd put you in the top ten percent of my patients in terms of how well you're doing.”

“Top ten percent. I believe that's a B-plus. I think I started out with an A.”

“No, you didn't. You've probably had this thing forever and just didn't know it until it became symptomatic. Are you talking to Rose?”

“She won't face it. I'm trying not to resent her for it, but it's hard. Really, really hard. It's not fair. Especially to my aunt.”

“Don't let Rose run you off, because that's probably what she's trying to do for the very reason you just said. She can't face it.” He slips his hands into his lab coat pockets. “She needs you. She's certainly not going to talk about it with anyone else.”

 

Outside the Cancer Center, a thin woman with a scarf wrapped around her bald head and two little boys are walking around the Ferrari. The valet rushes over to Lucy.

“They haven't got too close. I've been watching. Nobody has,” he says in a low, urgent voice.

She looks at the two little boys and their sick mother, and walks over to the car, remotely unlocking it. The boys and their mother step back, and fear shows on their faces. The mother looks old but probably isn't more than thirty-five.

“I'm sorry,” she says to Lucy. “But they're smitten. They haven't touched it.”

“How fast can it go?” the older boy asks, a redhead, maybe twelve.

“Let's see, four-ninety horsepower, six speed, a four-point-three-liter V-eight, eighty-five hundred rpm and carbon-fiber rear diffuser panel.

Zero to sixty in less than four seconds. Around two hundred miles an hour.”

“No way!”

“You ever driven one of these things?” Lucy says to the older boy.

“I've never seen one in person.”

“What about you?” Lucy asks his redheaded brother, who is maybe eight or nine.

“No, ma'am.” Shyly.

Lucy opens the driver's door and the two redheads crane to get a peek and suck in their breath at the same time.

“What's your name?” she asks the older boy.

“Fred.”

“Sit in the driver's seat, Fred, and I'm going to show you how to start this thing.”

“You don't have to do that,” Mom says to her, and she looks as if she's about to cry. “Honey, don't you hurt anything.”

“I'm Johnny,” the other boy says.

“You're next,” Lucy says. “Get over here next to me and pay attention.”

Lucy turns on the battery, makes sure the Ferrari's in neutral. She takes Fred's finger and places it on the steering wheel's red start button. She lets go of his hand. “Hold it in for a few seconds and fire her up.” The Ferrari roars awake.