Implant. Part 29

He and Diana fell into each other's arms and wept.

Even now his eyes clouded at the memory.

After that, as Lisa brightened, so did their lives. Duncan hadn't realized how his daughter's problems had tainted their entire family life. But now that she was getting back to normal, the days seemed brighter, his own step lighter. Laughter again around the dinner table as Lisa began riding her horse and hanging out with some of her old friends. Her grades turned around and she began dating Kenny O"Boyle.

They dated for months, and Kenny became the sole topic of Lisa's conversation. She and Diana would have long mother-daughter talks about him, and Diana told Duncan she was worried that Lisa might be getting too involved. She'd just turned eighteen, true, but she'd missed a lot of growing up in those black years.

Duncan wasn't crazy about Kenny. He seemed a s.h.i.+fty, inarticulate dolt, but then Duncan was naturally leery about any male sniffing around his daughter. Lisa adored him. And Lisa was happy. Happy for the first time in years. So Duncan decided to keep his eyes open and his mouth shut.

And then the McCready committee reared its ugly head.He remembered the morning five years ago when it all began, in the doctors lounge at Fairfax Hospital, somebody showing him the article on the front page of the Post. He'd just come off two scheduled procedures, an abdominal aneurysm graft and a carotid endarterectomy, all after rus.h.i.+ng in at 3:00 A. M. to close a torn femoral artery on a motorcyclist "donorcyclist, " as the E.R staff called them. He was tired. But not too tired to be furious at Senator Vincent's public condemnation of his million-dollar charge to Medicare the year before.

Every time he turned around some baseball player or basketball dribbler was signing a contract for five or six million dollars a year. How many lives did they save in a year? Barbra Streisand can get twenty million for two nights of warbling, but you, Duncan Lathram, you moneygrubbing bloodsucker, you charge too G.o.dd.a.m.n much.

He'd wished he had some legal recourse, but how the h.e.l.l did you sue a congressional committee? And what would he accomplish but call even more unwanted attention to himself?

What did it matter? he remembered thinking. The whole brouhaha would blow over in a couple of days.

But he was wrong.

His auto-da-fe' at the hands of the Guidelines committee continued with unflagging zeal. Apparently the members thought they'd found a particularly tasty bone in Duncan Lathram and wanted to keep gnawing away at him. Then the Alexandria Banner picked up the story, followed by a patient's rights group demanding an investigation, so the State Board of Medical Examiners got involved, and soon Medicare had a team of pettifogging auditors formicating through his office records, pawing through his files, and swarming in the hospital records room, sifting his charts for pecuniary indiscretions. To h.e.l.l with patient confidentiality. Those weasel-faced bureaucrats would know all the secrets of everyone he'd operated on in the past few years. But what did that matter? Spurred by the Guidelines committee, the government had declared jihad on Duncan Lathram.

Duncan was angry and embarra.s.sed, but not too worried. His medical records were impeccable, and he'd match his morbidity and mortality stats against anyone in the country. Let them investigate. He'd come up smelling like a rose.

He just wished they'd hurry and get the whole mess over and done with.

But it dragged on, and in the ensuing months Duncan began to notice a hint of coolness from some of his colleagues at the hospital. He was getting fewer requests for surgical consults. He understood theirpredicament, worrying about guilt by a.s.sociation. They were waiting till things cooled down.

Still, he was in for a nasty shock one day as he began one of the surgical consultation requests he did receive. When he entered the patient's hospital room and introduced himself, the patient bolted upright in bed. Duncan still remembered his words.

"Oh, no. Forget it. No way I'm gonna be operated on by some knife-happy, money-grubbing quack! " Duncan was mortified, angry enough to punch a hole in the wall. And dammit, hurt. He consoled himself that most likely he had just experienced the nadir of the whole affair.

It couldn't get any worse.

The only way he could go from there was up.

Again, he was wrong.

Because all the bad press was having a devastating effect at home.

Duncan Lathram, MD, was the talk of the town . . . including the high school.

And so in retrospect it seemed inevitable that he would come home one night to find Lisa sobbing in her mother's arms. She and Kenny had had a fight and broken up. The cause of the fight? What the kids were saying about Lisa's father, saying to Kenny behind Lisa's back.

Kenny's parting shot? "Forget the prom! Forget everything! I ain't going' anywhere with the daughter of no crook! " Devastating for any teenager, but to Lisa it seemed like the end of the world.

Barely able to speak through her sobs, she wanted to know why her father hadn't said anything, why he hadn't come out and defended himself.

Duncan remembered the scene as if it had occurred only a moment ago.

He knelt before his daughter and gripped her hands. "Honey, these are lies from spotlight-hunting buffoons. The way these things work, the louder I proclaim my innocence, the guiltier I look."

"But you haven't said anything! " "I'm letting my records do the talking. I've got nothing to hide, Lisa.

When the bureaucrats finish their investigation, I'll be vindicated.

And they'll be the fools."

"But meanwhile they're making you look like a crook! And making everybody hate me! And you don't care! " "Of course I care." He realized then that he'd misread the whole situation. He'd treated it as a brief but unpleasant interlude, another in a long series of fleeting Capitol Hill cacophomes that would die down as soon as Congress, in tune with its well-earned reputation for a short attention span, moved on to the next hot topic.

So he'd done nothing to counter the accusations leveled. That had been a mistake.

Another mistake was thinking it would involve only his practice. He should have seen that his professional obloquy would have a ripple effect on his private life as well. He'd always separated the practice and the family, but there was no way of insulating the latter from the ravages upon the former, not with an a.s.sault of this magnitude.

He hurt for Lisa.

"But what could I have done, Lisa? What can I do to make this better?

' "I don't knowsomething. You could plea bargain or whatever they call it. Something, anything to make them shut up and get off our backs."

"Plea bargain? " He was stunned. "You don't plea bargain when you're innocent." Lisa tore her hands from his and ran upstairs, screaming, "Thanks!

Thanks for nothing! My life is over! And all because of you! I might as well have AIDS! " Diana followed her, glaring back at him. "She's right, you know. You could have done something! " This was vintage Lisa, always taking everything too hard, seeing everything in the worst light. With her history, though, that kind of outburst could not be laid off to hyperbole and histrionics.

They increased her therapy sessions and kept an eye on her day and night. But a week later, when it became clearat least to Lisathat she and Kenny were through for good, she dug out a h.o.a.rd of old pills she had squirreled away over the yeatsa potentially lethal combination of antidepressants like Elavil, Parnate, Desyrel, Sinequan, Norpramin, Tofranil, Nardil, and lithiumand took them all.

And then she fell. Over the railing. Down to the hard, cold foyer floor. Where Duncan found her.

And then she died.And Diana blamed him.

And Duncan blamed himself.

He had never realized what grief could mean, never imagined he could mourn the loss of another human being the way he mourned Lisa. And he knew it was all his fault . . . all his fault . . .

Until the audits and investigations were completed. Then he knew who was really to blame.

The rasorial crew of Medicare auditors finished their quest for any improprieties that might grease his path to the gibbet, always in full view of his steadily diminis.h.i.+ng patient flow, and the worst they could come up with were a few errors in the coding of certain procedures.

The quality a.s.surance examiners found no casesnot one! of unnecessary surgery. Every single procedure met or exceeded recommended . . . .

Indications.

No apology, though, from the Guidelines committee and their fugleman, McCready. They'd moved on to other hatchet jobs.

Except for a few loyal patients who wrote letters on Duncan's behalf, no one had come to his defense throughout the entire ordeal. His colleagues had kept their heads down. Even some A.M.A paper-pusher was quoted as saying the amount Duncan billed was "excessive." Duncan learned the meaning of alone.

The long-delayed reports finally got forwarded to the State Board of Medical Examiners. The "coding irregularities" did not result in any net gain on Duncan's partactually he lost moneybut still he was issued a warning to be more careful in the future. Since there was no evidence of fraud or negligence, or of performing even a single unnecessary procedure, -the board exonerated him.

But where was that publicized?

In a small paragraph buried deep in the Banner. But the Was.h.i.+ngton Post, which had broken the original story that started this nightmare, never mentioned it.

The public flogging was over, but it had dragged on too long. Referral patterns had changed. Generalists who used to feed his practice had found new surgeons.

His practice was ruined. He'd been held up to national scorn and then cleared. But his reputation remained tainted.

He could have shrugged it off, all of it, if Lisa still were alive and Diana still behind him.

But Lisa was gone. Dear, dear Lisa, who left without a goodbye, blaming him for all her pain.

Diana, too, blamed him. And soon their marriage went the way of his practice.

But he wasn't to blame. He'd done nothing wrong. Couldn't she see that? It was the committee . . . that d.a.m.ned Guidelines committee.

McCready and his claque of pharisaical louts had plundered his life and then casually '. moved on.

Duncan had actually entertained thoughts of buying an a.s.sault rifle and blowing them all away. But then McCready had died, and the Guidelines committee disbanded, leaving Duncan with no target for the monstrous, smoldering ma.s.s of rage, coiled and writhing within him.

But he got over itgot past it, to use the current phrase. After all, he still had his sonBrad had stuck by him from beginning to end.

And Oliver, of course. Steadfast, sedulous Oliver. Without them .

Well, he just might have shoved a gun barrel in his mouth. So he started anewnew state, new specialty, new persona.

And everything seemed fine until the president revived the Guidelines committee. It was then that Duncan realized that the rage had never gone away. Like a cancer, it had metastasized throughout his system until it now lived in every tissue.

- And still he might have controlled it if so many committee members hadn't begun looking around for someone to enhance their appearance for the heavy TV exposure they expected . . . and come to him, because he had the implants . . .

The irony should have been delicious.

Make me loo/2 good for the tameras . . .

He stopped himself from hurling his gla.s.s across the room. No sense in wasting good scotch.So now five of the original seven were gone. McCready from natural causes, four Duncan's doing, and two left . . . the two youngest who were unlikely to seek out cosmetic surgery.

Almost time to call it quits. The new committee was in complete disarray, The Guidelines act moribund. One more strikethe biggest of alland it would be dead.

Just like Lisa.

And he wouldn't have to worry about Gin interfering with the last target. She'd be too off balance after today. Wouldn't even know about that patient. She'd be home, enjoying a day off.

And then he'd quit. Flush the TPD and wait for his moment to dissolve the last implant.

Which reminded him, he had to move the TPD. He'd left it in his top drawer in case Gin went for another look. Now that the games were over, he'd have to find a new hiding place.

He lifted his gla.s.s.

Par, Regina.

Mind your own business and we'll all live happily ever after.

If not . . .

Gin lay in her bed in the dark, listening to the tick of the old mantle clock from the other room. An awful night alone, grappling with her doubt, her confusion. But she'd pa.s.sed through that fire, emerging with a new perspective.

She hadn't imagined this. For a while there she'd been dazed and unsure, rocked back on her heels by the way everything had gone so wrong today. But she was on her feet again.

It's not over, Duncan, she told the darkness. You're smart . . . no, you're brilliant. Somehow you got way ahead of me on this. You probably think you've won. But I know what I saw, and I know what I know.

This is not over.

THE WEEK OF OCTOBER SUNDAY GINA WAS GOING TO FIND OUT EVERYTHING ABOUT.

Duncan.

She started her engine as Duncan's black Mercedes pulled to a stop at the end of his street. She couldn't park outside his house, or even onhis block. Duncan lived in an ultraexclusive Chevy Chase neighborhood of large, stately, Federal-style homes on half-acre lots in which her little red Sunbird would stick out like a garbage scow at the Potomac Yacht Club. But one of the hallmarks of the neighborhood's exclusivity was limited access. The brick-pillared entrance opened onto a secondary road near a small, upscale strip mall. Gin had camped in the mall's parking lot most of yesterday and all of this morning and no one had bothered her.

Yesterday had yielded nothing of interest. Duncan had gone out only once, stopping at a liquor store, a gourmet coffee shop, a gas station, and an electronics specialty shop. "Caliguire Electronics, " read the sign over the front door. "Audio, Video, SurroundSound, Satellite Dishes, Custom Electronics." Gin remembered Duncan talking about his satellite dish on occasion. This was probably where he'd got it. .

"Boy toys, " she'd muttered.

And then it struck her, custom electronics. Duncan needed some sort of miniature ultrasound transducer to dissolve his implants. Something small enough to hide on his person and aim at his victim when he got within range. Something pocket-sized OhmiG.o.d! His pager. His old-fas.h.i.+oned oversized beeper. She remembered how he'd had it in his hand when she saw him with Allard, and how it had gone off as they were standing with Senator Vincent on the hearing room floor before Senator Marsden gaveled everyone to their places. A few minutes later Senator Vincent was convulsing behind the dais.

What if it was oversized for a reason other than Duncan's stubborn unwillingness to part with a less than state-of-the-art piece of equipment? What if his pager was a mini-transducer?

Could Duncan have used this place or someplace like it to fas.h.i.+on one for him?

The question nagged Gin the entire time he was inside, which stretched out almost to an hour. Finally, he came out and returned home.

Gin had seriously considered the idea of returning to the electronics shop to question the owner about transducers disguised as beepers, but then Gerry's words came back to her.

No more Nancy Drew stzz.

Gerry . . . she missed him. She wished he'd call.

But it was good advice. Not only was she too old to be Nancy Drew, she didn't want to be a detective, being an internist was quite enough.

And besides, questioning the folks at Caliguire might prompt a call toDuncan.

,Better just stick to following him around.

Nice way to spend a weekend.

So now it was Sunday evening, the light fading, and this was the first Gin had seen of Duncan all day. She'd worried that he might have another way out of his neighborhood, but a drive by his house an hour ago had revealed the Mercedes parked at the top of the semicircular drive before the front door of his brick colonial.

Then the radio gave her the most likely reason why he'd - chosen now to be on the move. The Redskins game was over.