Andrea would say her glands were overactive, again, but this really was different. Trent seemed to care about her, too. He seemed sincerely interested in her welfare. She'd often wondered if she'd ever form a real attachment. Maybe this was it. Maybe not. A long sigh drifted through her lips, ruffling Trent's hair. Oh well, she wouldn't assume anything. She'd enjoy it for what it was worth. If things lasted, great. If not, she'd simply go on.
She always did.
Chapter IX
. . . I WILL FOLLOW THAT METHOD OF TREATMENT WHICH, ACCORDING TO MY ABILITY AND JUDGMENT, I CONSIDER
FOR THE BENEFIT OF MY PATIENTS . . .
"Acquired immunodeficiency syndrome is the end result of infection with the human immunodeficiency virus, or HIV, as it is commonly called. Can anyone tell me what is the biggest problem with this virus?"
Andrea's voice was strong and she was clearly in control. This time, Krastowitcz felt awkward and disadvantaged.
Touché'.
The woman had managed to switch the environment as easily as he channel surfed on his days off.
The small group of medical students eagerly hung on every word.
"Mr. Harrison?"
A nervous young man scratched his head and gazed at the floor. "Since AIDS represents only one aspect in the prolongation of infection, we have to consider the whole spectrum, not just AIDS."
"Very good. Gentlemen and ladies, this is Sergeant Krastowitcz, from the Omaha Police Department. He will be joining us for rounds today and I certainly hope you have your case presentations ready."
Great! He'd have to listen to some mumbo-jumbo he couldn't understand.
"Case presentations?" Surprised voices chimed in unison. "How many case presentations?"
"You present all your patients. First to the intern, then to me. You'll be expected to use the standard, three minute SOAP for-mat."
"Doctor Pearson?"
"In case you've forgotten, that's Subjective: meaning gathering a history; Objective: the physical exam, lab work, x-rays; your Assessment is derived from information gathered during the history and exam; and finally, the Plan will include your recommendations for treating the patient."
She offered no other explanation. Krastowitcz wondered what the students thought. They stared at him with a mixture of awe and discomfort. These people certainly seemed impressed with Andrea. Hell, Krastowitcz himself was impressed. The white coat she'd hastily thrust at him was too tight for his massive arms and put way too much pressure on the tiny white seams. He felt self-conscious. She, on the other hand, seemed so in control of the situation. Of course, they were on her turf now.
During Andrea's lecture, she seemed unaware of his discomfort. Walking down the west wing of Dorlynd Medical Center, Krastowitcz tuned out the drone of voices. How many future serial killers walked these hallowed halls?
Sunlight peeked through one of the many skylights dotting the ceiling, blinding his tired eyes. Seven o'clock was too damned early for him. With only three hours of sleep, he was in no mood for the sick and dying, especially ones with AIDS. In fact, he wasn't exactly in the mood to deal with the living, either.
The faint odor of disinfectant hit Krastowitcz. Lysol mixed with urine, feces, starch, and sickness made his stomach roil.
This was a place of death.
The team approached the first patient's room.
"Be aware that AIDS usually progresses from the initial acute infection stage, which may mimic mononucleosis, through an asymptomatic phase, then to an AIDS related complex characterized by generalized lymphadenopathy and, finally, active AIDS. The last stage, which we will see today, is characterized by fever, weight loss, diarrhea, dementia, neuropathies, and secondary infections. These secondary infections can be centralized in the lungs with an atypical parasitical infection, toxoplasmosis, myocardiosis, or bacteremia.
"In the case of Mr. Randolph, we will observe a secondary cancer in the form of Kaposi's sarcoma which is manifested by purplish lesions covering his extremities. Any questions?" Andrea placed her hand on the knob.
Krastowitcz wanted to ask her if the guy was contagious, but kept it to himself. No one else seemed to be too concerned. He'd been told time and again, he couldn't catch AIDS unless there was an exchange of bodily fluids. But was that really true, or did physicians make it up because they didn't know exactly how it was transmitted? Or maybe the government covered up how easily it was really caught and didn't want a mass panic?
"Everyone gown and glove. For Mr. Randolph's protection, not ours." She pointed to a cart next to the door. On it were a stack of gowns, a box of rubber gloves, and a tray of masks. "Since Mr. Randolph has no immune system left, what would happen if even a slight cold virus were introduced?" She pointed toward a tall female medical student.
"Possibly pneumonia and then, death."
"Thank you, Sharon. That's correct. We gown for Mr. Randolph's protection. We glove for ours."
They proceeded, and a sandy-haired medical student raised his hand. "Doctor Pearson? Does this patient manifest any other secondary infections?"
"Yes, Mr. McDermott. Mr. Randolph has been diagnosed with the parasite
Pneumocystis carinii
. The patient is literally being suffocated by the millions of tiny parasitic animals living in his lungs, causing a rare pneumonia. Other manifestations include intestinal parasites, amebiasis and giardiasis, which flourish in the gay bowel syndrome, rampant yeast infections, shigellosis, and a papovavirus that causes warts. The list is endless and each patient manifests different and more resistant diseases."
"Why is that, doctor?" Krastowitcz asked and glanced around the room for a can of Lysol.
"The AIDS infection wipes out the body's all-important T cells, leaving it virtually defenseless against infection. The infection ultimately kills the patient."
She opened the door.
"Good morning, Mr. Randolph," Andrea cheerfully greeted the emaciated skeleton on the bed. Her manner had shifted, somehow. Krastowitcz watched her with growing interest. She was poised, forceful, and in control.
Calm and confident.
Everything he despised in a woman. Somehow, though, on Andrea, he almost liked it. She was different than she'd been the past few days. But, of course, she wasn't a woman now, she was a doctor.
"Would you mind, Mr. Randolph, if I bring a few colleagues to examine you today?"
"No, ma'am." He wheezed, but a violent coughing fit stopped him. It sounded as though he hacked up pieces of his lungs. Randolph spit into the basin, and Krastowitcz almost gagged. There
were
parts of his lungs in there. Krastowitcz swallowed hard.
"Now, observe Mr. Randolph's lesions." She picked up the skeletal arm and beckoned her students to crowd around the patient.
Krastowitcz hung back. The man was a living skeleton, only will kept him alive. So this was AIDS. He'd seen a few cases. Gay inmates had threatened to spit at him. He'd told them not to touch him or he'd make sure they'd never spit again.
"Mr. Randolph has volunteered to be one of our first vaccine trials. This will be Phase I, doctors, in which the safety of the vaccine and antibody response will be tested. While it appears the vaccine is safe, there is still concern about antibody response, especially since the disease progresses in the face of high anti-body levels. The greatest fear is that the disease will mutate as the different vaccines are injected.
"This mutated version becomes resistant to the vaccine and causes new forms of secondary life-threatening infections. We have to find a vaccine that will kill the virus before it mutates within the cell. Thank you, Mr. Randolph. You've been wonderful today. I'll be back this afternoon to see how you feel."
"Thank you, Doctor Pearson," Randolph said weakly.
The entourage left the room and Andrea shook her head. Angrily stripping off her gloves, she slammed them into the receptacle and led the group down the hallway, then stopped and addressed them.
"As you can see, Mr. Randolph is in the final stages of the course of this disease. Although he hopes to survive until we can administer Dr. Grafton's Phase I Vaccine, it's unlikely he will. Now, he'll succumb to the pneumonia." She jammed her balled fists into her lab coat. "He's battled it for the last four months, but as the parasites increase in his lungs, he must rely more and more on oxygen. Damn it! Only a few scientists care to work on these castaways."
She sucked in a deep breath and stopped in front of the next door and prepared to re-gown. "Michael is a seventeen-year-old IV drug user. He's had active AIDS for six months. It progresses more rapidly in younger patients." She pointed to three medical students. "Go on in and get his history. He's expecting you."
The students filed into the room, and Andrea pulled Krastowitcz aside. "Medicine's most depressing field, wouldn't you agree? And a major researcher and vaccine developer has been slaughtered. For what?"
"Yeah, but this researcher did some slaughtering of his own." She glared at him like he was supposed to have answers. Hell, he didn't even have the questions. She was right about one thing. There had to be a reason why Grafton had killed and been killed in such gruesome ways.
There was always a reason. And Krastowitcz loved being the one to find it.
The morning progressed with the same scene repeated so many times, Krastowitcz lost count. He hadn't realized there were so many AIDS patients in Omaha. The ward seemed as lonely and emaciated as the bodies it contained. Tucked away in the back of the hospital, no one could see these pathetic souls waiting out the final days of their lives.
He'd always believed AIDS was a product of a decadent lifestyle and fags always got what they deserved. But no one deserved to die this way--shunned and alone. Some of these people hadn't seen their families for months. Some were too afraid to see them and Krastowitcz couldn't blame them. They looked horrible, worse than holocaust survivors, if that was possible.
And these people were afraid of their horrible end, too. Krastowitcz could understand their fear of death. A healthy fear made for a cautious cop; a queasy sensation accompanied him during rounds. Andrea was a doctor, and if there was danger she wouldn't expose him to it, no matter how big a sexist she thought he was. At least, he hoped she wouldn't.
Patients probably didn't know anything about Grafton's strange appetites or his lab assistant, but Krastowitcz had a few other sources he intended to check out. He and Trent had a couple of gay snitches. They could at least find out if the suspects were known gays in the community. What suspects? Even that was pretty slim. It was time to call in a few favors.
ROUNDS TOOK four hours. By eleven-thirty, Krastowitcz was back at his desk and still puzzled by the box of pictures from Grafton's apartment. He held the mutilation photos up and matched them to the ones on his bulletin board. Strange. They were identical, except for one thing: Grafton's views were fresh. No decay or dried up remains. Somewhere in there was the key to Grafton's murder. Slowly extracting each picture, he placed it either in the growing pile on his desk or on his bulletin board, next to the unsolved mutilations. Amid the snapshots of Milton Grafton, Krastowitcz placed slips of papers with names becoming all too familiar.
So far in this investigation, he had a bunch of pictures and some names; no real suspects. Not even circumstantial evidence. But if he could find Grafton's murderer, he'd be able to close old cases and clear his board. Dammit, there had to be some answers in the photographs.
But what?
He glanced over his list.
Andrea Pearson's name jumped out at him.
At first, he'd thought her guilty of something. He'd actually disliked her. Now. . . now he wasn't so sure. Probably the only thing she could be guilty of was being vulnerable. Sometimes she was two different people. One, angry and defensive; the other, the woman he'd seen today, compassionate, self-confident, and authoritative. Yep. She'd surprised him this morning. She'd been a different person. One he hadn't expected to find.
One he liked. Oh, yeah. He really liked the woman-doctor.
He picked up a picture of Dwight Hardwyn. The man was much younger, but the eyes still flashed anger and cruelty. He hadn't liked this guy at first, but he was certainly clean, and Andrea seemed to like him a lot. Maybe, there was something between them?
No. She'd said Hardwyn was married. Of course, that didn't mean anything, especially if someone was prone to fooling around. But, this time Krastowitcz hoped he was wrong and, like any other good investigator, he trusted his hunches. Yeah, some-times they were wrong, but more often than not they were right.
There were other pictures to sort through. A whole box filled with a man's life and he planned to check them out one by one. Andrea had identified most people still in Omaha. Peter Mueller, the lab assistant, had been with him for years, since Grafton's Ohio days. From what Andrea said, Mueller hadn't been getting along with Grafton, especially weeks before his death. Seemed they were always arguing about something. Grafton continually used himself as a guinea pig and it angered Peter. Maybe Peter knew something about Grafton's mutilation parties? Had helped him?
What a great bunch of people!
Andrea also said she and Peter were constantly arguing and the assistant seemed overly possessive of Grafton and his research project.
The picture of Father Jamison, however, puzzled Krastowitcz. A priest in the middle of serial mutilations, murder, and death? No. Probably a close friend of Grafton's, the spiritual advisor for the dying at Dorlynd, teacher to Andrea's roommate.
The group photo with Tom McNaughton looked like it had been taken at some sort of dinner or banquet.
What was McNaughton's connection in all this?
Maybe he was closer to Andrea than she let on. She'd said they
were
friends. But, now, no more? There had to be more to it. Just how close was their friendship? He'd forgotten to ask her about McNaughton at dinner.
There was something else--
Grafton had accused McNaughton of cocaine usage and the disgruntled resident had threatened him after being suspended from residency. The punk sounded like a poor-little-rich-boy from California or upscale New York. Andrea said he was a Corvette driving son-of-a-surgeon who wore fancy clothes and some-times a little white powder around his nostrils. She'd seen him snort at parties.