“Dr. Caldwell,” Mariel continued, “please have the man’s discharge papers prepared. He has already told his colleague he would like to leave. Mr. Wang, confirm again that the patient wants to leave the hospital, please!”
The Chinese man Mariel had addressed spoke with the runner, and the runner nodded his head in reply and seemed to acquiesce verbally at the same time.
“Wait a second!” Paul said, not about to be so easily duped. “How do I know that’s what this gentleman asked? He could have asked the patient anything. Let me get someone from hospital administration down here.”
Paul exited from the room out into the hall but was immediately confronted by two more sizable, uniformed Nano security men. They blocked his way, arms crossed, determined expressions on their faces.
“Step aside!” Paul ordered, but the men held their ground. “Hey!” Paul shouted down the hall toward the ER desk. “Where the hell is our security? Get someone down here from administration stat!”
Pia again tried to speak to Mariel, but Mariel continued to ignore her. Instead Mariel snapped her fingers for the patient to get to his feet. When he did so, he faltered, requiring the two Chinese men in suits to step forward to help support him.
“Mariel!” Pia yelled. “This is outrageous. What the hell is going on?”
Mariel treated Pia to one of her signature disdainful expressions. “What is going on is we’re signing him out of the hospital and over to our jurisdiction and our responsibility. I told you on the phone we were going to take care of this situation.” The last sentence was hissed quietly, through clenched teeth.
“I know what you told me,” said Pia with disbelief. “But I’m telling you he needs to be monitored and completely examined.”
“The patient can be better monitored at the Nano infirmary, which is better equipped to handle this kind of emergency, and he will be looked after by Nano’s physicians, who are intimately aware of the totality of the man’s health status. I thank you for helping the man, but I told you not to let them treat him, and they took his blood.”
Now Pia was openmouthed. Not the least of the surprises was the suggestion that Nano had a fully staffed infirmary. Dr. Caldwell was still protesting out in the hall, saying that the man should be kept in the hospital, that his patient was being essentially kidnapped, that he and the staff were being held hostage in their own hospital.
Pia watched as the strange group prepared to leave. The two Chinese men were supporting the patient, followed by the two security guards and then Mariel. Before the patient left the room he treated Pia to a weak smile and a wave as if to say thank you.
“Come on!” Mariel ordered Pia before exiting. “You can ride in the vehicle with me.”
Dutifully, Pia followed. Out in the hallway the group joined the other two security guards, who then let Paul run down the hall toward the ER desk. With two security guards in front and two bringing up the rear, the group headed for the main ER exit.
When Paul reached the ER desk his timing was opportune. Arriving at that very second was a gaggle of suited hospital administration functionaries that included the hospital president, Carl Noakes. Along with this group were several uniformed hospital security people. Adding to the confusion were several uniformed Boulder policemen who also arrived at the same time, including the officer who’d gone out with the EMTs to get the stricken runner.
“Ah, Dr. Caldwell,” said Mr. Noakes, slightly out of breath. “Perhaps you can explain what is going on here.”
Paul groaned inwardly—Mr. Noakes, the hospital president, was a figurehead as far as Caldwell was concerned, and not the man you wanted to see in a situation like this. He was a bottom-line bureaucrat.
“We have a problem here where a non-English-speaking patient who presumably had had a cardiac arrest is being signed out against my orders.”
At that critical point the two disparate groups met head-on. Noakes held up his hand for everyone to stop. Then he cleared his throat. “I think we have a misunderstanding here. What is the patient’s name, Dr. Caldwell?”
“We don’t have his name,” said Paul.
“Yao Hong-Xiau,” the runner shouted out, and a Chinese suit yelled at him.
“We should clear this area and move into one of the unoccupied exam rooms,” Noakes suggested. He gestured with his hand after being shown where to go by the ER charge nurse. Everyone complied. Many of the ER patients waiting to be seen watched with utter fascination. It looked to them like some sort of a movie involving international intrigue was being filmed with police and armed security people eyeing each other.
“There is no misunderstanding,” Mariel said calmly once everyone had regrouped in relative privacy. “This man is a representative of the Chinese government and a guest of the United States government, and he has expressed his wish to come back to our facility forthwith. These two gentlemen with me are Chinese nationals with diplomatic status who are visiting Nano.” Mariel pointed out the two men in suits, and they both nodded in acknowledgment.
“How about we wait for our translator who will be here very soon?” Paul suggested.
Mariel regarded Paul with a supercilious expression. “We’re not waiting. We would like to get this man into our infirmary.”
As if to underline her point, the patient apparently asked to sit down, and the two men supporting him pulled over a chair from a desk.
“What about hospital charges for the visit?” questioned Noakes.
Paul groaned inwardly. It was typical of Noakes to be consumed by economics at a time like this. ER charges were certainly secondary to the ethics of prematurely removing a potentially vulnerable patient from an ER under armed guard.
“I’m glad you reminded me,” said Mariel, forcing a smile. “I am fully authorized to take care of any charges.”
She pulled a stack of bills out of a bag she was carrying, and Pia could see they were hundred-dollar bills. Mariel made sure Noakes could see, too, and reeled off a stack. There had to be several thousand dollars in her outstretched hand, and more where they came from.
“This should take care of it,” she said.
“This is very unorthodox, we don’t usually accept cash without an invoice . . .” Noakes said, eyeing the money.
“For your inconvenience,” said Mariel, and separated a few more bills from her stash and added them to her offer. When Noakes seemed paralyzed, she reached out and forcibly placed the money in his hand. “That should more than cover it, And we are truly sorry for any inconvenience.”
“Mr. Noakes . . .” began Paul, unhappy with the proffered resolution, but Noakes had stepped aside and the runner’s group quickly made their way out of the room and then out of the ER.
Pia followed, hoping to talk to Mariel. She had a hundred questions, so she trotted alongside Mariel, who was striding quickly toward the second of two black vans idling in the parking lot. The uniformed drivers with dark glasses had the vans conveniently positioned to make a fast exit. The patient was helped into the lead vehicle with the Chinese suits.
“Mariel, what’s going on?”
“Pia.” Mariel stopped and fixed her with a cold stare. “There’s a lot more to Nano than just our little area. The world is full of people who’d love to get their hands on what we’re doing throughout the company. Nanotechnology is one of the most important fields of research, which we are leading, but we’re vulnerable. We have to protect ourselves.”
“With men with guns? And what does that have to do with this man? He was out for a jog, for God’s sake. He collapsed. And you come with armed guards? And then you say he’s a representative from the Chinese government? And Nano has an infirmary? And . . .”
“Pia, I thank you for calling me. But now you have to trust me, and stop asking questions! We have to leave. Are you coming? We need to get this man back to the facility a
-sap.”
Pia was still dressed in the borrowed lab coat, and, more important, she realized she’d set down her phone somewhere in the ER. “My phone . . .” she said, looking over her shoulder, momentarily torn about what she should do.
“We can’t wait for you. If you want to stay, you’ll have to make your own way back. But come back immediately, Pia, we have a lot of work to do.”
Pia nodded and turned to walk back to the ER. Mariel spoke up once more. “And, Pia,” she called out. Pia faced Mariel and squinted against the low sun behind her.
“Just forget about all this, okay?”
Without waiting for an answer, Mariel hauled herself up into the front seat of the black van and slammed the door behind her. Pia stood there and watched the two trucks drive away.
14.
BOULDER MEMORIAL HOSPITAL, AURORA, COLORADO
TUESDAY, APRIL 23, 2013, 2:05 P.M.
Pia walked back to the ER, her head full of questions. Most of them centered on Mariel Spallek. Mariel wasn’t an overly friendly person, which was something that Pia usually appreciated, as she thought it was more honest. She was authoritarian, to be sure, but was knowledgeable and a good supervisor, both constructive and demanding. She could also be passive-aggressive, which she’d been that morning, but Pia didn’t care, she wasn’t looking for a social interaction. Pia had gotten to the point of knowing what to expect from Mariel, at least up until having called her for help in regard to the downed Chinese runner.
But Pia could never have imagined that Mariel would show up with four armed guards and proceed to sign out a patient without a diagnosis or even a hint of an explanation for the man’s apparent cardiac arrest!
Pia reentered the ER in somewhat of a daze. She saw the place was getting back to normal. There were still a few clusters of people standing around, talking about what had happened. The cop who had shown up with the ambulance to pick up the runner was still there, but he was deep in conversation with several of the hospital security people. Pia couldn’t help but wonder where he’d been when the Nano contingent had first shown up and stormed into the ER. A few of the administrator types were still there, but not the hospital president. Apparently, with the acceptance of Mariel’s money, he felt the situation had been resolved; the patient had been seen and the bill paid.
On a side table in the room where the runner had been taken, Pia found her cell phone. She figured she’d take a cab back to Nano—in her cell phone case she kept a twenty-dollar bill for emergencies.
As she retreated toward the ER’s front desk where she intended to inquire about getting a taxi, Pia recognized she was more shaken up than she initially had admitted to herself. The sight of guns disturbed her. It was a common enough occurrence to see armed guards with weapons, even assault rifles these days, especially at an airport, but the memory of seeing Will McKinley getting shot in the head at point-blank range was still fresh, and she herself was kidnapped by men with guns. She’d seen firsthand what a bullet could do to flesh and bone.
As Pia approached the desk, she heard her name being called. It was Paul Caldwell.
“You’re still here. I thought you had abandoned us with the rest of the Nano contingent.”
“My phone,” said Pia, showing it to Paul. “I left it behind.”
“Are you okay? That was a weird experience.”
“Sure, I’m fine. But it was weird, as you say.”
“Hey, how about we get a coffee in the hospital coffee shop,” Paul suggested. “Now that things are back to the usual emergency room stuff, the team here can handle it. I want to hear more about this Nano place. It must be very exciting if things like this are going on every day.”
“Hardly,” Pia said seriously. “At least not in the section I work in. It’s a research facility, and nothing exciting has happened since I’ve been there for almost two years.” As Pia spoke she realized that a lot of things could be going on at Nano that she would have no idea of, given the size of the facility and the staff.
“I’m teasing,” Paul laughed. “But I’m not teasing about the coffee idea. What do you say? I’d like to hear how you happened to come out here to Boulder rather than start your residency.”
A red flag went up in Pia’s brain. Although she was ravenously hungry, having missed a meal following her attenuated run, she couldn’t but help wonder about Paul’s motives. He was a man, a good-looking man, but she had had quite enough of men since she’d been a young girl in foster care. Perhaps more important than her need for food, she was really curious about the Chinese runner’s situation. She wanted to find out what Paul might be thinking as to his diagnosis. And she wasn’t excited about getting back to Nano quite so quickly and having to face Mariel. With such thoughts in mind, she decided to ignore the red flag, at least for the time being.
“What do you say?” Paul repeated. He could tell that Pia was miles away.
“Okay, sure,” Pia said. “Would they have something to eat as well as coffee?”
“Absolutely,” Paul stated. “But for food I’d recommend the cafeteria. A much bigger selection.” He motioned for Pia to follow, and together they went to the hospital cafeteria, still bustling with its lunchtime crowd.
Paul guided a tray past the food selections, and Pia absentmindedly placed a prewrapped egg salad sandwich and a bottle of water on it. She was not a finicky eater. She tried to pay, but Paul would have none of it, saying her money wasn’t good at his hospital. They took a table in the back of the room.
“So where do we start?” he said, taking a sip of his coffee. It was the only thing he had selected.
“What do you mean?” Pia asked, unwrapping her sandwich and opening the water bottle.
“I mean, that was pretty intense, right. You obviously know that woman who showed up. And what exactly is this Nano place? I don’t know anything about it.”
So Pia told Paul Caldwell about her work and about Nano. Paul had cycled on that same mountain route that she used for jogging, but he had no idea what went on inside the sprawling complex. As Pia talked, he began to think she didn’t, either.
“Your specialty is salmonella?”
“I did a lot of work on salmonella,” Pia said. “It’s what got me the invite to come out here to try to solve a problem that salmonella and other flagellated bacteria cause with a new way to fight sepsis through nanotechnology.” Pia stopped herself, remembering what Mariel had told her about secrecy. But Paul was an ER doctor—what interest could he have in nanotechnology, other than a professional curiosity?
“Go on,” said Paul. As he listened to Pia, Paul reconfirmed that she was undeniably gorgeous, with exotic features and lovely skin. He knew she had an athletic runner’s body, having caught a glimpse of her in her spandex when she’d first come into the ER and before she’d been given the white coat she was still wearing. And she was a medical researcher, operating on some technological frontier he knew almost nothing about. He was enthralled with her. But he sensed she was aloof and not completely comfortable talking with him. He wondered why. There were lots of things he wanted to talk to her about, but he restrained his usually ebullient and talkative side and concentrated on the medicine. He didn’t have to pretend. That, too, fascinated him.
“Tell me,” Paul said when there was a pause in the conversation. “Have you been taking advantage of the great Colorado outdoors? That’s what lured me here.”
“I have,” Pia said. “Mostly running, but I have been biking a bit, too.”
“No skiing?”
“Some. I at least tried it. It’s more of a commitment than I’m willing to make. How about you?”
“Skiing, mountain biking, running, even mountain climbing. I can’t get enough. It’s a major reason I’m in emergency medicine. When I’m off, I’m really off, and I’m out there doing something. Maybe we can hook up sometime and go for
a run or something. I have to say, I like you.”
“That’s nice,” Pia said noncommittally. She wondered if coming to the cafeteria had been a good idea, remembering the red flag issue.
Pia’s reaction to his innocent offer to get together was hardly encouraging, so Paul quickly turned the conversation to their recent shared experience.
“So this runner you came in with. You said when you found him he was unresponsive. How long would you say it was that he wasn’t breathing?”
“I have no way of knowing,” said Pia. “All I know is that he wasn’t breathing when I examined him. And I couldn’t feel a heartbeat, not until I had done CPR.”
“And yet the neuro seemed fine, and the EKG was absolutely normal,” said Paul. “Very curious, to say the least.”
“He recovered as if he had been sleeping. I know no Chinese at all, but it didn’t sound as though he were slurring his words when he woke up. And he had full motor function. Immediately he tried to get up.”
“If you had to guess how long he’d not been breathing, what would you say?”
“I saw him on the ground from quite a distance, and noticed he hadn’t moved. I mean, it had to be fifteen, twenty minutes at least. I know that sounds impossible.”
“It would be very interesting to get some follow-up. Since he’s somehow associated with Nano, do you think you could ask about him? Do you think he works there?”
“I haven’t the slightest idea,” Pia said. “He didn’t strike me as a scientist, for some reason. But my boss said he was a representative of the Chinese government, whatever that meant.”
“That woman is your boss?”
“I’m afraid so,” Pia admitted. “Actually my direct boss. I have to work with her every day.”
“My sympathies,” Paul said.
“Actually, she’s not that bad. Professionally, she’s very good at what she does. She’s trained as a molecular biologist and oversees most of Nano’s bio-research. She’s very helpful with my research.”