"It all happened so fast. The guy was obviously already in there, apparently waiting for Rakoczi. Just when she was about to shoot me, he shot her. God…" Jack's voice trailed off as he thought of how close he had come to one last trip over to the OCME.
"You crazy ass," Lou complained. He gave Jack's shoulder a light smack and then shook his head. "You have this weird penchant for getting into the damnedest situations. You walked right into the middle of an execution-style hit. Are you aware of that?"
"I am now," Jack admitted.
The elevator arrived and they boarded. They moved to the back of the car.
"Okay," Lou said. "The question is why? Do you have any ideas?"
"I do," Jack said. "But let me backtrack. First of all, Laurie was almost killed with a sudden overwhelming dose of potassium, which is a clever way to kill someone. There's no way to document it, thanks to the physiology of potassium in the human body, but don't get hung up on that. The point is that I think all the patients in Laurie's series were killed in this shrewd fashion, but they weren't random targets. All of them, including Laurie, had tested positive for the genetic markers of serious medical illnesses."
The elevator arrived on the first floor, and Lou and Jack got off. The hospital was crowded with people, and they kept their voices down.
"So how does all this add up to a gangland-style hit on the nurse?" Lou questioned.
"I think it is evidence that there is a major conspiracy here," Jack said. "I think if you are lucky you're going to learn the nurse was working for someone in some tangled web which will eventually lead back to an actuarial type within the AmeriCare administration."
"Wait a second!" Lou said, pulling Jack to a stop. "Are you suggesting that a major healthcare provider like AmeriCare might be involved with killing their own patients? That's crazy!"
"Is it?" Jack questioned. "In any geographical area where these healthcare giants actually compete with each other, something they try to avoid by choking off competition or buying out the opposition if they are big enough, they compete with the cost of premiums. How do they determine their premiums? Well, the old-fashioned, actuarial way was to pool risk, figure out how much it is going to cost to take care of a group of people by essentially guessing, then add on profit, divide by the number of people, and bingo, there's the premium. Suddenly, under everybody's noses, the rules have changed. With the decipherment of the human genome, the old concept of health insurance is bound for the trash heap. Using single, easily performed tests, people who are destined to cost them significant money can be recognized. The problem is that the large healthcare companies cannot show discrimination, so they have to take them. At that juncture, from a purely business perspective, they should be eliminated."
"You mean to tell me that you think some AmeriCare administrators are capable of committing murder?"
"Actually, no!" Jack said. "The actual killing has to be done by severely screwed-up individuals, which I'm quite certain you'll be learning about Miss Rakoczi if she is indeed the culprit. What I'm talking about is a horrid variant of white-collar crime with varying levels of complicity. At the top, I'm talking about some person who might have been recruited from the automobile industry or any other business, who sits in an office, far removed from patients, and thinks about the bottom line exclusively. Unfortunately, that's the way business works and why some level of government oversight is necessary as a general rule in a free-market economy. I might sound like a misanthrope, but human beings tend to be basically self-interested and often function as if they are wearing blinders."
Lou shook his head. He was disgusted. "I can't believe you're saying all this. Hospitals for me have always been the place you go to be taken care of."
"Sorry," Jack said. "Times are changing. The deciphering of the human genome has been a monumental event. It has briefly dropped off everyone's radar, but it is coming back big-time. It is going to change everything we know about medicine in the not-too-distant future. Most changes are going to be for the good, but some are going to be for the bad. It's always that way with technological advances. Maybe we shouldn't label them 'advances.' Maybe a less value-laden word like 'changes' would be better."
Lou stared at Jack. Jack stared back. Jack thought the detective's expression hovered somewhere between frustration and irritation.
"Are you pulling my leg about all this?" Lou questioned.
"No," Jack said with a short laugh. "I'm being serious."
Lou meditated for a moment and then said moodily, "I don't know if I want to live in your world. But screw it! Come on! Let's make this ID on Rakoczi."
They entered the ER, which was already overflowing with patients. Several uniformed policemen were in evidence. Lou sought out the ER director, Dr. Robert Springer. Dr. Springer took Lou and Jack back to a trauma room, the door of which was closed. Inside, they found Jasmine Rakoczi. She was lying naked on an ER bed. An endotracheal tube had been inserted and then attached to a respirator. Her chest was intermittently rising and falling. Behind her, on a flat-screen monitor, blips recorded her pulse and blood pressure. The blood pressure was low, but the pulse was normal.
"Well?" Lou asked. "Is this the lady you saw in Laurie's room?"
"It is," Jack said. Then he looked at Dr. Springer. "Why are you respiring her?"
"We want to keep her oxygenated," Dr. Springer said while he adjusted the respirator's rate.
"Don't you suspect her brainstem was destroyed?" Jack questioned. He was surprised that they were making such an effort in such a clearly moribund situation.
"Without doubt," Dr. Springer said, straightening up. "The organ people are trying to locate any next of kin. They want to salvage the internal organs."
Lou looked up at Jack. "Now that is going to be ironic," he said. "She might save a handful of people."
"Ironic isn't a strong enough word," Jack replied. "I'd lean toward mordantly satirical."
To Dr. Springer's surprise, the detective then cuffed the medical examiner on the head, accused him of being a pompous ass, and then the two walked out, laughing.
epilogue
6 WEEKS LATER
DETECTIVE LIEUTENANT Lou Soldano nosed his departmental Chevy over to the curb next to a fire hydrant and tossed onto the dash the plastic-laminated card that spelled out who he was and who owned the vehicle. He then reached over, got out his breath spray from the glove compartment, and gave himself a few good squirts to hide the Marlboros he'd inhaled en route. Tipping his rearview mirror down, he looked as his reflection. He needed a shave, but he always needed a shave, especially at a quarter after eight in the evening. Since he couldn't do anything about his stubble, he used his fingers to get his hair all going in the same direction. Satisfied with his appearance, he opened the door and stepped out onto the street.
The air had the silky feel of a spring night. Thanks to daylight savings, the sky was a light rose color that faded to silvery violet to the east. Lou walked up Second Avenue with a spring to his step. He'd called Jack and Laurie that afternoon in the hope of meeting up with them to bring them up to speed on the AmeriCare case, and they had invited him to join them for dinner at their favorite restaurant, Elios.
Lou had already had a few meals with Jack and Laurie at Elios- some good, some not so good. In the latter category was the evening Laurie announced that she was a marrying the twerp she had dragged along. Lucky for everyone, it was a false alarm and the memory of the evening brought a smile to Lou's face. It was also lucky that he and Jack didn't shoot themselves right there in the restaurant. They both had been devastated.