Marker

"Good! Very good! Or at least it was when I left. Let's walk down and check in with the CCU. I didn't expect to be gone this long. It's just down the hall."

"Fine with me," Lou said, getting to his feet.

The CCU charge nurse came out of the unit and told Jack and Lou that Laurie was doing fine, she was sleeping, and that her doctor had been in to see her. She also said that there were plans afoot to move her to the University Hospital, where her father was on staff.

"Sounds good," Jack said. He looked at Lou.

"Sounds good to me, too," Lou said.

After the CCU, Lou wanted Jack to come with him down to the emergency room. He wanted Jack to identify for the record that the dead woman was the nurse who Jack had seen in Laurie's room. He explained that when he'd left the OR earlier, he'd called police headquarters about setting up the Hummer as a crime scene and bringing the body inside the hospital. He was particularly interested in having the Glock checked by ballistics.

As they walked back toward the elevator, Lou cleared his throat. "I know you're exhausted, and for good reason, but I'm afraid I have to know what happened from the moment you got down to the garage."

"I caught the nurse just as she was about to get into her car," Jack said. "She already had the door open, so I yelled and ran up to her. Obviously, she wasn't cooperative, which is an understatement. When I grabbed her arm to keep her from getting in the vehicle, she kneed me in the balls."

"Ouch!" Lou commiserated.

"That was when she pulled out the gun and ordered me into the car."

"Take this as a lesson," Lou said. "Never get into a car with an armed felon."

"I didn't think I had a lot of choice," Jack said.

They reached the elevator lobby, where there was a smattering of people waiting. They lowered their voices.

"That's when I appeared on the scene," Lou said. "I saw you get into the car. I could even see the woman's gun. Unfortunately, I had to wait for a few cars before I ran over. What went on in the car?"

"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 ca

"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.