Marker

"I've heard about that," Jack said.

"Me, too," Laurie said. "It's mostly OB and anesthesia cases. It's the modern equivalent of the ambulance chasers of old."

"Well, I don't know about those details," Lou said. "But here comes the most interesting part. Over the last few years, there has been movement to make managed-care companies liable for malpractice, which, as an aside, seems reasonable to me."

"What's reasonable and what isn't has little to do with decisions about healthcare in this country," Jack interjected. "Everything is decided according to vested interests."

"By a strange twist of fate," Lou continued, "managed-care companies and malpractice plaintiff attorneys suddenly found themselves in the same bed in their desire to keep any malpractice-reform legislation from happening. I mean, the goals were slightly different in that the managed-care companies didn't want things changed so they could be sued, and the malpractice attorneys didn't want changes that would cap pain-and-suffering awards or eliminate contingency fees, among other things. Both groups employed lobbyists to make sure malpractice law did not change, which brought them together. So, essentially, their waking up in the same bed spawned a weird marriage between the two groups. How it happened is anybody's guess, but someone in AmeriCare must have realized they could use the shady services of Robert Hawthorne, since at least some of his contacts were… what should we say? Psychopaths or sociopaths capable of murder without pangs of conscience."

"The newest term is 'antisocial disorder,' " Laurie chimed in.

"Okay, whatever," Lou said. "Anyway, some AmeriCare bureaucrat-or bureaucrats, as the case may be-became interested in tapping into the law firm's cast of unsavory medical insiders, which the law firm had formed to drum up business, in order to set up an elimination scheme for high-risk subscribers. These were the subscribers who they knew would be costing them millions of dollars in specialized care and thereby put upward pressure on premium rates. I mean, it makes some sort of sick sense."

"Good grief!" Jack reiterated. "This is close to what I feared, but on a larger scale."

"Let me finish!" Lou said after making sure no one was overhearing. "Whether there was any further cooperation in the works, such that the malpractice lawyers would then take advantage of the deaths by appealing to the next of kin to sue the doctors involved, we don't know. So far, we are only aware of one suit involving a doctor at Saint Francis Hospital."

"But that suit will surely be dropped now that homicide is suspected," Jack said.

"Maybe so," Lou said, "But I wouldn't count on it, since the perpetrator was in the hospital's employ."

"So, what's the state of the investigation at this point?" Laurie asked.

"There's a very active hunt for the Jasmine Rakoczis at these other institutions where a similar pattern of deaths has occurred.

The hope is to nab one and have that individual turn state's evidence. If that happens, maybe the whole house of cards will tumble down."

"Have there been any indictments so far from the hit man's testimony?" Laurie asked.

"Only Robert Hawthorne, who isn't talking and is in fact out on sizable bail," Lou said. "Unfortunately, the hit man was not really apprised of the whole operation. All he knew was that his boss, Robert, was a frequent visitor to the law firm. He didn't know whom he saw or what was ever talked about."

"Nobody in the AmeriCare hierarchy has been indicted?" Jack asked plaintively.

"Not yet," Lou admitted. "But we have our fingers crossed."

"What a nightmare," Laurie said with a shudder, remembering something of her ordeal in the hospital.

"Hey!" Lou said, eyeing the bubbles rising in the flute next to his water glass as if it were the first time he'd seen them. "This is champagne." He reached out and lifted the bottle from the ice bucket. "I don't know why I'm looking at this. I wouldn't know one brand from the next." He nestled the bottle back into the ice. "What is this, some kind of celebration?"

"Sort of," Laurie said with a smile. She looked at Jack, who raised his eyebrows as if there was a secret.

"Okay, out with it!" Lou commanded. He looked from one to the other.

"Well, it's not that big a deal," Laurie said. "I had a medical test today, which wasn't very pleasant I must say, but the result was reassuring. Apparently, the reason I had an ectopic pregnancy was because I had an abnormal or damaged oviduct. The test I had today showed my remaining oviduct is perfectly normal."

"That's great!" Lou said. He nodded a few times. He again looked back and forth between his two friends, both of whom were avoiding eye contact by looking down and swirling their drinks. "Well," Lou added. "Does this favorable result mean you two are pla

Laurie looked up at Jack and said, "Unfortunately, at the moment, it just means it could be put to the real test."

"Too bad," Lou commented. "Well, if you need any volunteers to test that duct, I'm available."

Jack laughed and looked up at Lou and then Laurie. "Why do I have the feeling you two are ganging up on me?"

"Hey, I'm just trying to be a good friend," Lou said while raising both hands to profess his i

"Well, good friend," Jack said, putting his arm around Laurie. "In the oviduct-testing business, I think Laurie and I can manage just fine."

"I'll drink to that," Lou said, raising his glass.

"Me, too," Laurie said.

author's note

The a

The public's disregard for this landmark achievement has continued, even though the involved science and technology have been charging ahead, and reporting startling discoveries, such as the surprising fact that we humans have only about twenty-five thousand or so genes-a far cry from the hundred thousand experts had predicted not too long ago-and not that many more than an organism as comparatively simple as a roundworm! (This discovery is a blow to humanity's hubris equivalent to the Copernican revelation that the earth revolved around the sun, instead of vice versa.) In short, the decipherment of the human genome and the avalanche of research cascading from it has disappeared from most everyone's radar except for those working in the two new and related endeavors of Genomics and Bioinformatics. Genomics, in simple terms, is the study of the flow of information in a cell, while Bioinformatics is the application of computers to make sense of the enormous amount of data coming from Genomics.

In my mind, this lack of interest or apathy or whatever it might be called is startling; I believe the decipherment of the human genome might be the most important milestone in the history of medical science to date. After all, it gives us all the letters of the "book of life" in the right order, despite our having, as of yet, imperfect understanding of the language or the punctuation. In other words, in a cryptic form that is now being decoded with gathering speed, we have access to all the information nature has amassed to make and run a human being! As a consequence, the knowledge of the human genome will change just about everything we know about medicine, and some of the changes are going to happen sooner rather than later.