Terminal (A Medical Thriller)

February 26

Friday, 4:45 P.M.

“Just a second, Corissa,” Kathleen Sharenburg said as she stopped and leaned against one of the cosmetic counters of Neiman Marcus. They’d come to the mall just west of Houston to shop for dresses for a school dance. Now that they had made their purchases, Corissa was eager to get home.

Kathleen had had a sudden sensation of dizziness giving her the sickening sensation that the room was spinning. Luckily, as soon as she touched the countertop, the spinning stopped. She then shuddered through a wave of nausea. But it too passed.

“You all right?” Corissa asked. They were both juniors in high school.

“I don’t know,” Kathleen said. The headache she’d had off and on for the last few days was back. It had been awakening her from sleep, but she hadn’t said anything to her parents, afraid that it might be related to the pot she’d smoked the weekend before.

“You look white as a ghost,” Corissa said. “Maybe we shouldn’t have eaten that fudge.”

“Oh my God!” Kathleen whispered. “That man over there is listening to us. He’s planning on kidnapping us in the parking garage.”

Corissa spun about, half expecting some fearful man to be towering over them. But all she saw was a handful of peaceful women shoppers, mostly at the cosmetic counters. She didn’t see any man.

“What man are you talking about?” she asked.

Kathleen’s eyes stared ahead, unblinking. “That man over there near the coats.” She pointed with her left hand.

Corissa followed the direction of Kathleen’s finger and finally saw a man almost fifty yards away. He was standing behind a woman who was shuffling through a rack of merchandise. He wasn’t even facing toward them.

Confused, Corissa turned back to her best friend.

“He’s saying we cannot leave the store,” Kathleen said.

“What are you talking about?” Corissa questioned. “I mean, you’re starting to scare me.”

“We have to get out of here,” Kathleen warned. Abruptly she turned and headed in the opposite direction. Corissa had to run to catch up with her. She grabbed Kathleen’s arm and yanked her around.

“What is wrong with you?” Corissa demanded.

Kathleen’s face was a mask of terror. “There are more men now,” she said urgently. “They are coming down the escalator. They’re talking about getting us as well.”

Corissa turned. Several men were indeed coming down the escalator. But at such a distance Corissa couldn’t even see their faces much less hear what they said.

Kathleen’s scream jolted Corissa like an electric charge. Corissa spun around and saw Kathleen begin to collapse. Reaching out, Corissa tried to keep Kathleen from falling. But they were off balance, and they both fell to the floor in a tangle of arms and legs.

Before Corissa could extract herself, Kathleen began to convulse. Her body heaved wildly against the marble floor.

Helping hands got Corissa to her feet. Two women who’d been at a neighboring cosmetic counter attended to Kathleen. They restrained her from hitting her head on the floor and managed to get something between her teeth. A trickle of blood oozed from Kathleen’s lips. She had bitten her tongue.

“Oh my God, oh my God!” Corissa kept repeating.

“What’s her name?” one of tine women attending Kathleen asked.

“Kathleen Sharenburg,” Corissa said. “Her father is Ted Sharenburg, head of Shell Oil,” she added, as if that fact would somehow help her friend now.

“Somebody better call an ambulance,” the woman said. “This girl’s seizure has to be stopped.”

IT WAS already dark as Janet tried to see out the window of the Ritz Café. People were scurrying past in both directions on Newbury Street, their hands clasped to either coat lapels or hat.

“I don’t know what you see in him anyway,” Evelyn Reardon was saying. “I told you the day you brought him home he was inappropriate.”

“He’s earning both his Ph.D. and an M.D. from Harvard,” Janet reminded her mother.

“That doesn’t excuse his manners, or lack thereof,” Evelyn said.

Janet eyed her mother. She was a tall, slender woman with straight, even features. Few people had trouble recognizing that Evelyn and Janet were mother and daughter.

“Sean is proud of his heritage,” Janet said. “He likes the fact that he’s from working stock.”

“There’s nothing wrong in that,” Evelyn said. “The problem is being mired in it. The boy has no manners. And that long hair of his…”

“He feels convention is stifling,” Janet said. As usual she found herself in the unenviable position of defending Sean. It was particularly galling at the moment since she was cross with him. What she’d hoped for from her mother was advice, not the same old criticism.

“How trite,” Evelyn said. “If he was planning on practicing like a regular doctor, there might be hope. But this molecular biology, or whatever it is, I don’t understand. What is he studying again?”

“Oncogenes,” Janet said. She should have known better than to turn to her mother.

“Explain what they are once more,” Evelyn said.

Janet poured herself more tea. Her mother could be trying, and attempting to describe Sean’s research to her was like the blind leading the blind. But she tried nonetheless.

“Oncogenes are genes that are capable of changing normal cells into cancer cells,” Janet said. “They come from normal cellular genes present in every living cell called proto-oncogenes. Sean feels that a true understanding of cancer will come only when all the proto-oncogenes and oncogenes are discovered and defined. And that’s what he’s doing: searching for oncogenes in specialized viruses.”

“It may be very worthwhile,” Evelyn said. “But it’s all very arcane and hardly the type of career to support a family on.”

“Don’t be so sure,” Janet said. “Sean and a couple of his fellow students at MIT started a company to make monoclonal antibodies while he was getting his master’s degree. They called it Immunotherapy, Inc. Over a year ago it was bought out by Genentech.”

“That’s encouraging,” Evelyn said. “Did Sean make a good profit?”

“They all did,” Janet said. “But they agreed to reinvest it in a new company. That’s all I can say at the moment. He’s sworn me to secrecy.”

“A secret from your mother?” Evelyn questioned. “Sounds a bit melodramatic. But you know your father wouldn’t approve. He’s always said that people should avoid using their own capital in starting new enterprises.”

Janet sighed in frustration. “All this is beside the point,” she said. “What I wanted to hear is what you think about my going to Florida. Sean’s going to be there for two months. All he’ll be doing is research. Here in Boston he’s doing research plus schoolwork. I thought maybe we’d have a better chance to talk and work things out.”

“What about your job at Memorial?” Evelyn asked.

“I can take a leave,” Janet said. “And I can certainly work down there. One of the benefits of being a nurse is that I can find employment just about anywhere.”

“Well, I don’t think it is a good idea,” Evelyn said.

“Why?”

“It’s not right to go running after this boy,” Evelyn said. “Particularly since you know how your father and I feel about him. He’s never going to fit into our family. And after what he said to Uncle Albert I wouldn’t even know where to seat him at a dinner party.”

“Uncle Albert was teasing him about his hair,” Janet said. “He wouldn’t stop.”

“That’s no excuse for saying what he did to one’s elder.”

“We all know that Uncle Albert wears a toupee,” Janet said.

“We may know but we don’t mention it,” Evelyn said. “And calling it a rug in front of everyone was inexcusable.”

Janet took a sip of her tea and stared out the window. It was true the whole family knew Uncle Albert wore a toupee. It was also true that no one ever commented on it. Janet had grown up in a family where there were many unspoken rules. Individual expression, especially in children, was not encouraged. Manners were considered of paramount importance.

“Why don’t you date that lovely young man who brought you to the Myopia Hunt Club polo match last year,” Evelyn suggested.

“He was a jerk,” Janet said.

“Janet!” her mother warned.

They drank their tea in silence for a few moments. “If you want to talk to him so much,” Evelyn finally said, “why not do it before he leaves? Go see him tonight?”

“I can’t,” Janet said. “Friday night is his night with the boys. They all hang out at some bar near where he went to high school.”

“As your father would say, I rest my case,” Evelyn said with uncamouflaged satisfaction.

A HOODED sweatshirt under a wool jacket insulated Sean from the freezing mist. The cinch for the hood had been drawn tight and tied beneath his chin. As he jogged along High Street toward Monument Square in Charlestown, he passed a basketball from one hand to the other. He’d just finished playing a pickup game at the Charlestown Boys Club with a group called “The Alumni.” This was a motley assortment of friends and acquaintances from age eighteen to sixty. It had been a good workout, and he was still sweating.

Skirting Monument Square with its enormous phallic monument commemorating the Battle of Bunker Hill, Sean approached his boyhood home. As a plumber his father, Brian Murphy, Sr., had had a decent income, and back before it became fashionable to live in the city, he had purchased a large Victorian town house. At first the Murphys had lived in the ground-floor duplex, but after his father had died at age forty-six from liver cancer the rental from the duplex had been sorely needed. When Sean’s older brother, Brian, Jr., had gone away to school, Sean, his younger brother Charles, and his mother Anne had moved into one of the single-floor apartments. Now she lived there alone.

As he reached the door, Sean noticed a familiar Mercedes parked just behind his Isuzu 4×4, indicating older brother Brian had made one of his surprise visits. Intuitively, Sean knew he was in for grief about his planned trip to Miami.

Taking the stairs two at a time, Sean unlocked his mother’s door and stepped inside. Brian’s black leather briefcase rested on a ladder-back chair. A rich smell of pot roast filled the air.

“Is that you, Sean?” Anne called from the kitchen. She appeared in the doorway just as Sean was hanging up his coat. Dressed in a simple housedress covered by a worn apron, Anne looked considerably older than her fifty-four years. After her long, repressing marriage to the hard-drinking Brian Murphy, her face had become permanently drawn, her eyes generally tired and forlorn. Her hair, which she wore in an old-fashioned bun, was naturally curly and although it had been an attractive dark brown, it was now streaked with gray.

“Brian’s here,” Anne said.

“I guessed as much.”

Sean went into the kitchen to say hello to his brother. Brian was at the kitchen table, nursing a drink. He’d removed his jacket and draped it over a chair; paisley suspenders looped over his shoulders. Like Sean, he had darkly handsome features, black hair, and brilliant blue eyes. But the similarities ended there. Where Sean was brash and casual, Brian was circumspect and precise. Unlike Sean’s shaggy locks, Brian’s hair was neatly trimmed and precisely parted. He sported a carefully trimmed mustache. His clothing was decidedly lawyer-like and leaned toward dark blue pinstripes.

“Am I responsible for this honor?” Sean asked. Brian did not visit often even though he lived nearby in Back Bay.

“Mother called me,” Brian admitted.

It didn’t take Sean long to shower, shave, and dress in jeans and a rugby shirt. He was back in the kitchen before Brian finished carving the pot roast. Sean helped set the table. While he did so, he eyed his older brother. There had been a time when Sean resented him. For years his mother had introduced her boys as my wonderful Brian, my good Charles, and Sean. Charles was currently off in a seminary in New Jersey studying to become a priest.

Like Sean, Brian had always been an athlete, although not as successful. He’d been a studious child and usually at home. He’d gone to the University of Massachusetts, then on to law school at B.U. Everybody had always liked Brian. Everyone had always known that he would be successful and that he would surely escape the Irish curse of alcohol, guilt, depression, and tragedy. Sean, on the other hand, had always been the wild one, preferring the company of the neighborhood ne’er-do-wells and frequently in trouble with the authorities involving brawls, minor burglary, and stolen-car joy rides. If it hadn’t been for Sean’s extraordinary intelligence and his facility with a hockey stick, he might have ended up in Bridgewater Prison instead of Harvard. Within the ghettos of the city the dividing line between success and failure was a narrow band of chance that the kids teetered on all through their turbulent adolescent years.

There was little conversation during the final dinner preparations. But once they sat down, Brian cleared his throat after taking a sip of his milk. They’d always drunk milk with dinner throughout their boyhoods.

“Mother is upset about this Miami idea,” Brian said.

Anne looked down at her plate. She’d always been self-effacing, especially when Brian Sr. was alive. He’d had a terrible temper made worse by alcohol, and alcohol had been a daily indulgence. Every afternoon after unplugging drains, fixing aged boilers, and installing toilets, Brian Sr. would stop at the Blue Tower bar beneath the Tobin Bridge. Nearly every night he’d come home drunk, sour, and vicious. Anne was the usual target, although Sean had come in for his share of blows when he tried to protect her. By morning Brian Sr. would be sober, and consumed by guilt; he’d swear he would change. But he never did. Even when he’d lost seventy-five pounds and was dying from liver cancer, his behavior was the same.

“I’m going down there to do research,” Sean said. “It’s no big deal.”

“There’s drugs in Miami,” Anne said. She didn’t look up.

Sean rolled his eyes. He reached over and grasped his mother’s arm. “Mom, my problem with drugs was in high school. I’m in medical school now.”

“What about that incident your first year of college?” Brian added.

“That was only a little coke at a party,” Sean said. “It was just unlucky the police decided to raid the place.”

“The lucky thing was my getting your juvenile record sealed. Otherwise you would have been in a hell of a fix.”

“Miami is a violent city,” Anne said. “I read about it in the newspapers all the time.”

“Jesus Christ!” Sean exclaimed.

“Don’t use the Lord’s name in vain,” Anne said.

“Mom, you’ve been watching too much television. Miami is like any city, with both good and bad elements. But it doesn’t matter. I’ll be doing research. I won’t have time to get into trouble even if I wanted to.”

“You’ll meet the wrong kind of people,” Anne said.

“Mom, I’m an adult,” Sean said in frustration.

“You are still hanging out with the wrong people here in Charlestown,” Brian said. “Mom’s fears are not unreasonable. The whole neighborhood knows Jimmy O’Connor and Brady Flanagan are still breaking and entering.”

“And sending the money to the IRA,” Sean said.

“They are not political activists,” Brian said. “They are hoodlums. And you choose to remain friends.”

“I have a few beers with them on Friday nights,” Sean said.

“Precisely,” Brian said. “Like our father, the pub is your home away from home. And apart from Mom’s concerns, this isn’t a good time for you to be away. The Franklin Bank will be coming up with the rest of the financing for Oncogen. I’ve got the papers almost ready. Things could move quickly.”

“In case you’ve forgotten, there are fax machines and overnight delivery,” Sean said, scraping his chair back from the table. He stood up and carried his plate over to the sink. “I’m going to Miami no matter what anybody says. I believe the Forbes Cancer Center has hit on something extraordinarily important. And now if you two co-conspirators will allow me, I’m going out to drink with my delinquent friends.”

Feeling irritable, Sean struggled into the old pea coat that his father had gotten back when the Charlestown Navy Yard was still functioning. Pulling a wool watch cap over his ears, he ran downstairs to the street and set out into the freezing rain. The wind had shifted to the east and he could smell the salt sea air. As he neared Old Scully’s Bar on Bunker Hill Street, the warm incandescent glow from the misted windows emanated a familiar sense of comfort and security.

Pushing open the door he allowed himself to be enveloped by the dimly lit, noisy environment. It was not a classy place. The pine wood paneling was almost black with cigarette smoke. The furniture was scraped and scarred. The only bright spot was the brass footrail kept polished by innumerable shoes rubbing across its surface. In the far corner a TV was bolted to the ceiling and tuned to a Bruins hockey game.

The only woman in the crowded room was Molly, who shared bartending duties with Pete. Before Sean could even say anything a brimming mug of ale slid along the bar toward him. A hand grasped his shoulder as a cheer spread through the crowd. The Bruins had scored a goal.

Sean sighed contentedly. It was as if he were at home. He had the same comfortable feeling he’d get whenever he was particularly exhausted and settled into a soft bed.

As usual, Jimmy and Brady drifted over and began to brag about a little job they’d done in Marblehead the previous weekend. That led to humorous recollections of when Sean had been “one of the guys.”

“We always knew you were smart the way you could figure out alarms,” Brady said. “But we never guessed you’d go to Harvard. How could you stand all those jerks.”

It was a statement, not a question, and Sean let it pass, but the comment made him realize how much he’d changed. He still enjoyed Old Scully’s Bar, but more as an observer. It was an uncomfortable acknowledgment because he didn’t truly feel part of the Harvard medical world either. He felt rather like a social orphan.

A few hours later when Sean had had a few drafts, and he was feeling more mellow and less an outcast, he joined in the raucous decisionmaking involving a trip up to Revere to one of the strip joints near the waterfront. Just at the moment the debate was reaching a frenzied climax, the entire bar went dead silent. One by one heads turned toward the front door. Something extraordinary had happened, and everyone was shocked. A woman had breached their all-male bastion. And it wasn’t an ordinary woman, like some overweight, gum-chewing girl in the laundromat. It was a slim, gorgeous woman who obviously wasn’t from Charlestown.

Her long blond hair glistened with diamonds of moisture, and it contrasted dramatically with the rich deep mahogany of her mink jacket. Her eyes were almond shaped and pert as they audaciously scanned the room, leaping from one stunned face to another. Her mouth was set in determination. Her high cheekbones glowed with color. She appeared like a collective hallucination of some fantasy female.

A few of the guys shifted nervously, guessing that she was someone’s girlfriend. She was too beautiful to be anyone’s wife.

Sean was one of the last faces to turn. And when he did, his mouth dropped open. It was Janet!

Janet spotted him about the same time he saw her. She walked directly up to him and pushed in beside him at the bar. Brady moved away, making an exaggerated gesture of terror as if Janet were a fearful creature.

“I’d like a beer, please,” she said.

Without answering, Molly filled a chilled mug and placed it in front of Janet.

The room remained silent except for the television.

Janet took a sip and turned to look at Sean. Since she was wearing pumps she was just about eye level. “I want to talk with you,” she said.

Sean hadn’t felt this embarrassed since he’d been caught with his pants off at age sixteen with Kelly Parnell in the back of her family’s car.

Putting his beer down, Sean grasped Janet by her upper arm, just above the elbow, and marched her out the door. When they got out on the sidewalk Sean had recovered enough to be angry. He was also a little tipsy.

“What are you doing here?” he demanded.

Sean allowed his eyes to sweep around the neighborhood. “I don’t believe this. You know you weren’t supposed to come here.”

“I knew nothing of the kind,” Janet said. “I knew I wasn’t invited, if that’s what you mean. But I didn’t think my coming constituted a capital offense. It’s important I talk with you, and with you leaving on Sunday, I think it’s more important than drinking with these so-called friends of yours.”

“And who is making that value judgment?” Sean demanded. “I’m the one who decides what is important to me, not you, and I resent this intrusion.”

“I need to talk to you about Miami,” Janet said. “It’s your fault you’ve waited until the last minute to tell me.”

“There’s nothing to talk about,” Sean said. “I’m going and that’s final. Not you, not my mother, and not my brother are going to stop me. Now if you’ll excuse me, I have to go back in and see what I can salvage of my self-respect.”

“But this can impact the rest of our lives,” Janet said. Tears began to mix with the rain running down her cheeks. She’d taken an emotional risk coming to Charlestown, and the idea of rejection was devastating.

“I’ll talk with you tomorrow,” Sean said. “Good night, Janet.”

TED SHARENBURG was nervous, waiting for the doctors to tell him what was wrong with his daughter. His wife had gotten in touch with him in New Orleans where he’d been on business, and he had gotten the company Gulfstream jet to fly him directly back to Houston. As the CEO of an oil company that had made major contributions to the Houston hospitals, Ted Sharenburg was afforded special treatment. At that moment his daughter was inside the huge, multimillion-dollar MRI machine having an emergency brain scan.

“We don’t know much yet,” Dr. Judy Buckley said. “These initial images are very superficial cuts.” Judy Buckley was the chief of neuroradiology and had been happy to come into the hospital at the director’s request. Also in attendance were Dr. Vance Martinez, the Sharenburgs’ internist, and Dr. Stanton Rainey, chief of neurology. It was a prominent group of experts to be assembled at any hour, much less at one o’clock in the morning.

Ted paced the tiny control room. He couldn’t sit still. The story he’d been told about his daughter had been devastating.

“She experienced an acute paranoid psychosis,” Dr. Martinez had explained. “Symptoms like that can occur, especially with some sort of involvement of the temporal lobe.”

Ted reached the end of the room for the fiftieth time and turned. He looked through the glass at the giant MRI machine. He could just barely see his daughter. It was as if she were being swallowed by a technological whale. He hated being so helpless. All he could do was watch, and hope. He’d felt almost as vulnerable when she’d had her tonsils out a few months earlier.

“We’ve got something,” Dr. Buckley said.

Ted hurried over to the CRT screen.

“There’s a hyperintense circumscribed area in the right temporal lobe,” she said.

“What does it mean?” Ted demanded.

The doctors exchanged glances. It was not customary for the relative of a patient to be in the room during such a study.

“It’s probably a mass lesion,” Dr. Buckley said.

“Can you put that in lay terms?” Ted asked, trying to keep his voice even.

“She means a brain tumor,” Dr. Martinez said. “But we know very little at this point, and we should not jump to conclusions. The lesion might have been there for years.”

Ted swayed. His worst fears were materializing. Why couldn’t he be in that machine and not his daughter?

“Uh oh!” Dr. Buckley said, forgetting the effect such an exclamation would have on Ted. “Here’s another lesion.”

The doctors clustered around the screen, transfixed by the vertically unfolding images. For a few moments they forgot about Ted.

“You know it reminds me of the case I told you about in Boston,” said Dr. Rainey. “A young woman in her twenties with multiple intracranial tumors and negative metastatic workup. She was proved to have medulloblastoma.”

“I thought medulloblastoma occurs in the posterior fossa,” Dr. Martinez said.

“It usually does,” Dr. Rainey said. “It also usually occurs in younger kids. But twenty percent or so of the incidents are in patients over twenty, and it’s occasionally found in regions of the brain besides the cerebellum. Actually, it would be wonderful if it turns out to be medulloblastoma in this case.”

“Why?” Dr. Buckley asked. She was aware of the high mortality of the cancer.

“Because a group down in Miami has had remarkable success in getting remissions with that particular rumor.”

“What’s their name?” Ted demanded, clutching onto the first hopeful news he’d heard.

“The Forbes Cancer Center,” Dr. Rainey said. “They haven’t published yet but word of that kind of a result gets around.”