Terminal

“The wording,” Sean said. “Listen to this: the patient ‘suffered through’ a prostatectomy three months ago. I use expressions like ‘suffered through’ just to see who reads my workups and who doesn’t. It’s a little game I play with myself. No one else uses that kind of phraseology in a medical workup. You’re supposed to just give facts, not judgments.”

“Imitation is the highest form of flattery, so I guess you should be flattered,” Janet said.

“The only thing of interest here is in the orders,” Sean said. “He’s being given two coded drugs: MB300M and MB305M.”

“That code is comparable to the one I saw in Helen Cabot’s computer file,” Janet said. She handed him the paper on which she’d written the treatment information she’d gotten from the computer.

Sean glanced at the dosage and the administration rate.

“What do you think it is?” Janet asked.

“No idea,” Sean said. “Did you get any of it?”

“Not yet,” Janet admitted. “But I finally located the supply. It’s kept in a special locker, and the shift supervisor has the only key.”

“This is interesting,” Sean said, still studying the chart. “From the date and time of the order they started treatment as soon as he got here.”

“Same with Helen Cabot,” Janet said. She told him what Marjorie had explained to her, namely that they started the humoral aspect of the treatment immediately whereas the cellular aspect didn’t begin until after the biopsy and T-cell harvesting.

“Starting treatment so soon seems odd,” Sean said. “Unless these drugs are merely lymphokines or some other general immunologic stimulant. It can’t be some new drug, like a new type of chemo agent.”

“Why not?” Janet asked.

“Because the FDA would have had to approve it,” Sean said. “It has to be a drug that’s already been approved. How come you only got Louis Martin’s chart? What about Helen Cabot’s?”

“I was lucky to get Martin’s,” Janet said. “Cabot is getting pheresed as we speak, and the other young woman, Kathleen Sharenburg, is being biopsied. Martin was a ‘to follow’ for his biopsy so his chart was available.”

“So these people are on the second floor right now?” Sean asked. “Right above us?”

“I believe so,” Janet said.

“Maybe I’ll skip lunch and take a walk up there,” Sean said. “With all the usual commotion in most diagnostic and treatment areas, the charts are usually just kicking around. I could probably get a look at them.”

“Better you than me,” Janet said. “I’m sure you’re better at this than I.”

“I’m not taking over your job,” Sean said. “I’ll still want copies of the other two charts as well as daily updates. Plus I want a list of all the patients they’ve treated to date who have had medulloblastoma. I’m particularly interested in their outcomes. Plus I want samples of the coded medicine. That should be your priority. I have to have that medicine; the sooner the better.”

“I’ll do my best,” Janet said. Knowing how much trouble it had been merely to copy Martin’s chart, she had misgivings about getting everything Sean wanted with the kind of speed he was implying. Not that she was about to voice those concerns to Sean. She was afraid he’d give up and leave for Boston.

Sean stood up. He gripped Janet’s shoulder. “I know this isn’t easy for you,” he said. “But remember, it was your idea.”

Janet put a hand on Sean’s. “We can do it,” she said.

“I’ll see you at the Cow Palace,” he said. “I suppose you’ll be there around four. I’ll try to get back about the same time.”

“See you then,” Janet said.

Sean left the cafeteria and used the stairs to get to the second floor. He emerged at the south end of the building. The second floor was a center of activity and as bustling as he’d expected. All the radiation therapy as well as diagnostic radiology was done there; so was all the surgery and any treatment that could not be done at the bedside.

With all the confusion Sean had to squeeze between gurneys carrying people to and from their procedures. A number of the gurneys with their human passengers were parked along the walls. Other patients sat on benches dressed in hospital robes.

Sean excused himself and pushed through the tumult, bumping into hospital personnel as well as ambulatory patients. With a modicum of difficulty he proceeded down the central corridor, checking each door as he went. Radiology and chemistry were on the left, treatment rooms, ICU, and the surgical suites were on the right. Knowing that the pheresis was a long procedure and not labor-intensive, Sean decided to try to find Helen Cabot. Besides looking at her chart, he wanted to say hello.

Spotting a hematology technician sporting rubber tourniquets attached to her belt loops, Sean asked her where pheresis was done. The woman guided Sean through a side corridor and pointed toward two rooms. Sean thanked her and checked the first. A male patient was on the gurney. Sean closed the door and opened the other. Even from the threshold he recognized the patient: it was Helen Cabot.