After Michaels left, Philips went back to work. He'd developed a system of feeding the old X rays into the machine that speeded up the process. But as he worked he began to feel progressively more uncomfortable about Kristin Lindquist's absence. A growing sense of responsibility overtook his initial irritation at her apparent unreliability. It would be too much of a coincidence if something happened to this woman that precluded him from getting more X rays.
Around nine Martin dialed Kristin's number again. Her roommate answered it on the first ring.
"I'm sorry, Dr. Philips. I should have called you. But I cannot find Kristin anyplace. No one has seen her all day. I've even called the police."
Philips hung up, trying to deny reality by telling himself it couldn't happen. It was impossible… Marino, Lucas, McCarthy, Collins and now Lindquist! No. It couldn't be. It was preposterous. Suddenly he remembered he hadn't heard from Admitting. Lifting the phone, he was surprised when it was answered after four rings. But the woman who was looking into the case had left at five and wouldn't be back until eight the next morning, and there was no one else who could help him. Philips slammed the receiver down.
"Damn!" he shouted, getting up from his stool and beginning to pace. Suddenly he remembered the section of McCarthy's brain he'd put in the cabinet.
At the darkroom, he had to wait for a technician to finish processing some ER films. As soon as he could, Martin opened the cabinet and retrieved the film and the now dried-up slice of brain. Not knowing what to do with the specimen, he ended up dumping it into the wastebasket. The unexposed film went into the developer.
Standing out in the hallway next to the slot where his film would emerge, Martin wondered if Kristin's disappearance could possibly be just another coincidence. And if it were not, what would it mean? More important, what could he do?
At that moment the X ray dropped into the holding bin.
Martin expected the film to be totally dark, so that when he snapped it up on the viewer, he was shocked. "Holy Christ!" His mouth opened in disbelief. There was a lucent area the exact shape of the brain slice. Philips knew that there was only one possible cause. Radiation! The density abnormality on the X rays was from a significant amount of radiation.
Philips ran all the way down to Nuclear Medicine. In the lab next to the betatron he found what he needed: a radiation detector and a generous-sized, lead-shielded storage box. He could lift the box but it wasn't something he was interested in carrying so he put it on a gurney.
His first stop was his office. The jar with the brain was definitely hot so he donned some rubber gloves and put it into the lead box. He also found the newspaper he'd put the brain on and put that in the box. He even, went out and found the knife he'd used to cut the brain and put that in the box as well. Then with the radiation detector he went around his room. It was clean.
Down in the darkroom, Philips got the wastebasket and dumped its contents into the box. Testing the wastebasket afterward, he was satisfied. Back in his office he took off the rubber gloves, threw them into the box, and sealed it. He checked the room again with the radiation detector and was pleased to find only an insignificant amount of radiation. His next step was to take the film out of the dosimeter he wore on his belt and prepare it for processing. He wanted to know exactly how much radiation he'd received from the brain specimen.
During all this feverish physical activity, Martin tried unsuccessfully to relate all the disparate facts: five young women, presumably all with significantly high levels of radiation in their heads and maybe other parts of their bodies… neurological symptoms suggestive of a condition like multiple sclerosis… all with gynecological visits and atypical Pap smears.
Philips had no explanation for these facts, but it seemed to him that the radiation must have been the central issue. He reasoned that high levels of general radiation could cause alterations in cervical cells and therefore an atypical Pap smear. But it was peculiar that all of the cases had had atypical smears. Once again it seemed difficult to explain a specific phenomenon by coincidence. Yet what else could be the explanation?
When the cleanup was completed, Philips wrote down Collins' and McCarthy's unit numbers and the dates of their GYN visits on his list. Then he hurried down the central corridor of Radiology and cut through the main X-ray reading room. At the elevators, he pushed the down button with a rising sense of urgency. He realized that Kristin Lindquist was a walking time bomb. For the radiation in her head to show up on a regular X ray, there had to be a very large amount involved. And to find her, Martin believed he would have to solve all the puzzling events of the last week. To his surprise he found Benjamin Barnes draped over his work stool. The pathology resident might not have a pleasant personality but Martin had to respect the man's dedication.
"What brings you up here two nights in a row?" asked the resident.
"Pap smears," said Philips with no preamble.
"I suppose you have an emergency slide for me to read," said Barnes sarcastically.
"No. I just want some information. I want to know if radiation can cause an atypical Pap smear."
Barnes thought for a moment before answering. "I've never heard of it from diagnostic radiology but certainly radiotherapy will affect the cervical cells and hence the Pap smear."
"If you looked at an atypical smear, could you tell if it was caused by radiation?"
"Maybe," said Barnes.
"Remember those slides you looked at for me last night?" continued Philips. "The brain sections. Could those nerve-cell lesions be caused by radiation?"
"I kinda doubt it," said Barnes. "The radiation would have to have been aimed with a telescopic sight. The nerve cells right next to the damaged ones looked fine."
Philips face went blank while he tried to put together the inconsistent facts. The patients had absorbed enough radiation to show up on a X ray, yet, on a cellular level, one cell was totally knocked out while a neighbor was all right.
"Are Pap smear specimens saved?" he asked finally.
"I think so. At least for a while, but not here. They're over in the Cytology lab, which operates on bankers' hours. They'll be in in the morning after nine."
"Thanks," said Philips, sighing. He wondered if he should try to get into the lab right away. Perhaps if he called Reynolds. He was about to leave when he thought of something else. "When they read Pap smears, is the result in the chart just the classification, or do they describe the pathology?"
"I think so," said Barnes. "The results are stored on tape. All you need is the patient's unit number and you can read the report."
"Thanks a lot," said Philips. "I know you're busy so I appreciate your time."
Barnes gave a slight nod of acknowledgment, then put his eyes back to his microscope.
The Pathology computer terminal was separated from the lab by a series of room dividers. Pulling up a chair, Martin sat down in front of the unit. It was similar to the terminal in Radiology with a large TV-like screen directly behind the keyboard. Taking out the list of five patients, Philips keyed in the name Katherine Collins, followed by her unit number and the code for Papanicolaou Smear. There was a pause, then letters appeared on the screen as if someone were typing. First it spelled out Katherine Collins very rapidly, followed by a slight pause. Then the date of the first Pap smear followed by:
Adequate smear, good fixation, and proper staining. Cells show normal maturation and differentiation. Estrogen effect normaclass="underline" 0/20/80. A few Candida organisms seen. Result: negative. Philips checked the date of the first smear while the machine spelled out the next report. The date corresponded to the first date Philips had written on the list. Looking back up at the computer screen, Philips' disbelieving eyes read that the second Pap smear on Collins was also negative!